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HomeMy WebLinkAbout0044 LOCUST AVENUE , 0 �ECYCIfp o � 2 l/ll UPC 12543 No. '�°OSi CONSJ� HASTINGS, MN 0 Town of Barnstable - � Building uIJUsi Post This Card So That it is Visible From the Street-.Approved Plans Must be Retained on Job and this Card Must be Kept 1 JAWW& Posted Until Final Inspection Has Been Made. Permit rug Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. :4 Permit No. B-19-1905 Applicant Name: Emily Hutchinson Approvals Date Issued: 06/10/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 12/10/2019 Foundation: Location: 44 LOCUST AVENUE,WEST BARNSTABLE Map/Lot: 197-031 Zoning District: RF Sheathing: Owner on Record: NORTHCROSS,WALTER V&WENDY K Contractor Name''--CAPE ASSOCIATES INC. Framing: 1 Address: PO BOX 865 Contractor License: 160110 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $7,256.00 Chimney: Description: Roof Replacement Permit Fee: $37.01 Insulation: Project Review Req: Fee Paid:` $37.01 Date: ,f 6/10/2019 Final 1 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. 4 f ---------�•''� f Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this,permit. Minimum of Five Call Inspections Required for All Construction Work: i' Service: 1.Foundation or Footing 2.Sheathing Inspection ._ _ Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. 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 All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: r' TOWN OF BARNSTABLE BUILDING POIT APPLICATION Map Parcel v 1O� °�-9� 1�� Application # Health Division pJ 2 '4,xDate Issued �S Conservation Division 9,y Application Fee `� Planning Dept. JAN 14 2016 �'�� Permit Fee Date Definitive Plan Approved by Planning f N OF BARNSTABI. Historic OKH _ Preservation/ Hyannis ®�� I�VAS �O . Project Street Address Aq Village '� 6,4 M, Owner 1 �� Address 9�l� Telephone 3b Z- �� 3 Permit Request I V Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ' Project Valuation 4(' 6 D Construction Type Y'- 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 ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ 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 Caurit � . Heat Type and Fuel: ❑ Gas 0 Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review# Current Use - Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address -Uu I��� License # Lv 6 go -IRA. Home Improvement Contractor# �✓ ��� Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT YVILL BE TAKEN TO SIGNATURE DATE 7/ !° FOR OFFICIAL USE ONLY APPLICATION # r DATE ISSUED t MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: _ f , FOUNDATION ' FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO &� 4'' i Massachusetts Department of Public Safety tsTl Board of Building Regulations and Standards License: CS-100988 Construction Supervisor HENRY E CASSIDY 8 SHED ROW I WEST YARMOUJHA 5• 5 Expiration: Commissioner 11/11/2017 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO, YARMOUTH, MA 02664 'Update Address and return card.Mark reason for change. $CA1 45 20M-05/11 ❑ Address Renewal Employment Lost Card �e (pQ47"1101nWeClGCx,o�C�/t/lru»ac�cweCla _C\ -Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 1:53567 Type: Office of Consumer Affairs and Business Regulation xpiration: ;;;12115h201.6 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATI'ONANC::..? HENRY CASSIDY 18 REARDON CIRCLE '..'' S0.YARMOUTH, MA 02664 Undersecretar Y WNyvalid sign e The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street ....... y,' Boston, MA 02111 ''``r:,•. ::'''. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/lndividual): TO Address: V � r - - — -- City/State/Zip:-_AAA , WYMIUMP a i �`+ Phone #: Are you an employer? Check th appropriate box: Type of project (required): • l. j am a employer with �;j5 4. ❑ I am a general contractor and 1 employees(full and/or part-time).* have hired the sub-contractors 6, ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp, insurance.t 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions q ) 3,El officers have exercised their I am a homeowner doing all work 11,[] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.7 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.� Other h go comp. insurance required.] ��!! *Any applicant that checks box 91 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 hive 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; '�1� /i L t ZY ��1�1,kV Policy 4 or Self-ins, Lic. #: W (ieloj � Expiration Date: Job Site Address: 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 insuraw coverage verification. I do hereby certify d the pai an penalties of perjury that the information provided above is true and correct. Si riature: Date: ( �Z I 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#: CAPECOD-27 BDELAWRENCE AFRO CERTIFICATE OF LIABILITY INSURANCE DATE 1 6/30/23012015 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 pblicy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Mile 134 Alc o EXt: A/C No):(877)816-2156 South Dennis,MA 02660 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC q INSURER A:Peerless Insurance Company-see LIBERTY MUTUAL INSURED INSURERB:ATLANTIC CHARTER INSURANCE GROUP Cape Cod Insulation,Inc. INSURER C 18 Reardon Circle INSURER D: South 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. ILTR TYPE OF INSURANCE D R POLICY NUMBER MMIDDY/YYYY EFF POLICY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR CBP8263063 04101/2015 04/01/2016 DAMAGE TO RENTED— PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN WCE00431901 06/30/2016 06/30/2016 E.L.EACHACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? F7 N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If,yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (11CORD 101,Additional Remarks Schedule,may be attached if more space Is required) Workers Compensation includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 18 Reardon Circle South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Town of Barnstable Regulatory Services � g Webard V.ScA Director ' . Building Division Tom Yem,Building commissioner 200 Dana Street IIyana*MA 02601 www.town.barnstablema.ns Office: 508-8624038 Fax: 508-79M230 Property Owner Must Complete and Sign This Section If Using ABuilder 1, we,-N d.0 N o✓o)cro SS ,as Owner of the subject Property -J j hereby authorize hS U �ct 1 IJ to act on my behalf, in all matters relative to ark authorized by this building permit application for: l-N-� �.-OG�.c.St� y4v� . f�• i3 u fir,Sf-�.�e ����� (Address of Job) "-Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature o Owner Signature of Applicant mint Nkiiie Print Name D= i Q TORMS:OwNWERMISSIONMLS TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application 4C201 Health Division Date Issued Conservation Division Application Fee I Planning Dept. Permit Fee `L Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Addr ss Village i Owner Address Telephone 0 2— 2D Per t Request 6, `� 6�br 0& 8bp i�tge�6k A�u Square eet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. i 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: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Fnished Area (sq.ft.) Basement Unfinished Aa (sq.ft) Number of Baths: Full: existing new Half: existing new -n Z 0 Number of Bedrooms: existing _new I-A 9 " Z Total Room Count (not including baths): existing new First oroomount Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other ®' Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ i Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: i Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes "*No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address . t � ��� License # u V Aca4 Home Improvement Contractor# P Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTI G FROM THIS PROJE T WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. r ADDRESS VILLAGE r OWNER i " '4 DATE OF INSPECTION: I� FOUNDATION r FRAME INSULATION FIREPLACE ; ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO.-)' `r i } a Town of Barnstable Regulatory Services lain Rlcbard V.ScA Director Building Division Tom Perry,BaUftg Con missloner 200 Main Street,Hyaoais,MA 02601 wwwAown.barnstable ara na Once: 508-8624038 Fax: 508-79"230 Property Owner Must Complete and Sign This Section If UsingABuilder I, K)en 4M N` V(h Cr0 SS ,as Owner of the subject property hembyattthorize LAS0 lR�'�,�_ to act on my behalf, in all matters ielative to do authorized by this building permit application for: (Address of Job) n"Pool fences and A ms are the responsibility of the applicant Pools are not to be fled or utilized before fence is installed and all final inspections are performed and accepted. Sigpanrre o Owner Signature of Applicant Pant Nk6e Print Name Date QFowr OVINFRPERMISSMNPOOL4 Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-100988 Construction Supervisor HENRY E CASSIDY 8 SHED ROW ' WEST YARMOUJH MA '2' 7=3 Expiration: Commissioner 11/11/2017 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. scA t :3 2OM-05/11 Address Renewal Ej Employment R Lost Card V/ce r0ai�rr��aooa�uecaLC�o�C�/f/lru�auc�ruleC� C\ -Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 453567 Type: Office of Consumer Affairs and Business Regulation xpiration: ;;1.21:15120:1.6 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATIW:JNC":--. HENRY CASSIDY 18 REARDON CIRCLE--.'. g �d � SO. YARMOUTH, MA 02664 Undersecretary N valid wi ut sign e i :..:. The Commonwealth of Massachusetts Department of Industrial Accidents i Office of Investigations ,:•, ', ' _=. . '� 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): 7t � Address: /) � ��� City/State/Zip:::D0kj L a l� � .a Phone #: � Are you an employer? Check th appropriate box: Type of project (required): 1. 1 am a employer with ' ❑4, I am a general contractor and I 6, ❑ New construction _ ,Iemployees(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' [No workers' comp. insurance comp. insurance.$ 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.7 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 91 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 subcontractors 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:`` (} 169 .Job Site Address: - �I P� City/State/Zip: W' IM , 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 insuraW coverage verification. I do hereby certify d the pai an penalties of perjury that the information provided abo a is true and correct. hz,Si nature: Date: 1 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#: CAPECOD-27 BDELAWRENCE ACORO° CERTIFICATE OF LIABILITY INSURANCE DATE F 63012015 5 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 pblicy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements). PRODUCER CONTACT NAME: Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 A/C o EXt: A/c No):(877)816-2156 South Dennis,MA 02660 ADDRESS: INSURERS AFFORDING COVERAGE NAIC p INSURER A:Peerless Insurance Company-see LIBERTY MUTUAL INSURED INSURERB:ATLANTIC CHARTER INSURANCE GROUP Cape Cod Insulation,Inc. INSURER C: 18 Reardon Circle INSURER D: South 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. ILTR TYPE OF INSURANCE A R POLICY NUMBER MM/DDIYEYri MM/DD�YY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR CBP8263063 04/01/2016 04/01/2016 DAMA PREMISES Eaoccurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ECOT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ REXCESS LIAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE I I ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WCE00431901 06/30/2015 06/30/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 Ifies,describe under DSCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES ()%CORD 101,Additlonal Remarks Schedule,may be attached If more space Is required) Workers Compensation includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE WITH THE POLICY PROVISIONS. South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD DEC212015 =Tffi 1 'fP E[BUILDING PERMIT APPLICATION Map Parcel Application # 7rb I Health Division Date Issued ( �� Ito Conservation Division Application Fee Planning Dept. Permit Fee 350 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village Owner A114/�ce ���r����d�s 3 Address Telephone JEZ f.� & 2- Permit Request /2,zz/2 6xl I e- �i�1-�1_0 X. 4��_— 4 �Z / > ;E, AO ��� ,dui f��© /-.r X ed J/fCG y� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1, ,Construction Type�� d� Lot Size Grandfathered: 0 Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes . lAo On Old King's Highway: ❑Yes LINO Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ 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 0 Electric ❑ Other Central Air: 0 Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes 0 No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �/'��� ®� /6���iJ� �6y� Telephone Number Address ���1ii9�1el G/ License # L1-1/74 Home Improvement Contractor# J. g gL3 Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO v SIGNATURE DATE i FOR OFFICIAL USE ONLY m APPLICATION# v DATE-ISSUED j MAP%PARCEL NO. 1 /V f} ,4 ADDRESS, VILLAGE f OWNER 4 y . DATE OF INSPECTION: i FOUNDATION .s . FRAME s INSULATION _ . ! FIREPLACE ELECTRICAL: ROUGH FINAL J ~ PLUMBING: ROUGH FINAL GAS: ROUGH FINAL C1 . FINAL BUILDING S , DATE;CLOSED OUT ASSOCIATION PLAN NO: ' ff 1 14.. The Parties acknoWedge that.this Agreement is under seal. It-is intended.by-the Parties that the Tenant or any successor Tenant.is the intended beneficiary of the Agreement and shall hays a right of enforcement. Pr.pp6 ty.-.Ow a-.s:S 6ha ture.; Af. Date. 4Y, Phone: Address: _ L c> l�i�e /�fZ� f, Tenant:Signat : � � Date CY Agency Approved UVeatherization Company Adam T. In rated./ All.Cape Energy / 'Alternative:Weat-erization 7 Building.Science, Construction I Cape Cod Insulation / Cape Save. / Frontier Energy Solutions 1 Gohr Home Improvernerit nergy / Tupper Construction Agency Signature __ Date 9Lt— I Massachusetts-Department of Public Safety �— ..... Board o'f Building Regulations and Standards License: CS•100988 S Construction ;Lif)ervlS0r HENRY E CASSIDY 8 SHED ROW WEST YARMOU7H t,� y 2 1 Expiration: Commissioner 11/11/2017 Commissloner 11/11I2015 Office of Consumer Affairs and Business Regulation 10 Park Plaza • Suite 5170 Boston, Massachusetts 02116 Home Improvement Cb:lZt.ra+ctor Registration ' Registration; 153567 ^�'�� •' , Type: Private Corporallon > Explrallon: 12116/2016 Trg 259188 CAPE COD INSU'LAT,ION, INC ' ,►' , 'f HENRY CASSIDY 18 REARDON CIRCLE 50, YARMOUTH, MA 02664 Update Address and return card, MRrk reason for change. $CA i di zorn•osni [] Address (D Renewal Employment Lost C'n. _ ........ IB 097COYLP9LLOOf(GC�P�C�G`<kW<GO�Grd6G�l Office of Consumer Affnlrs& Business Rqulatlon Lleense or registration valid for Indiyldul use only OME IMPROVEMENT CONTRAQTOR before the expiration date, If found return to, eglstrall= 1155557 Type: Ofnce of Consumer Affalrs and Business Regulation xplratl•on;:. 1'.'1:45p20:16 Private Corporallon IQ Park Plaza -Sulte 5170 g ,. : ,,,•, 02116 CAPE C00 INSULAT.i.'O:N;:.Nc` "1 Boston,MA HENRY CASSIDY ' 18 REARDON CIRCLE;" da •aO.YARMOUTH,MA 0204. ' ' Undersecretnry N valid wl ut sign e Ilie Uommonwea.lth of Massachusetts Department of Industrial Accidents Y...' Office of Investigations .1 00 Washington Street Boston, MA 02111 mass,gov/dia Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Plumbers Applicaut Information Please Print Le ibl Name (Business/Organization/individual); L"1 � Address; City/State/Zip; � �1, /� t Phone #; � .Are you an employer? Check th* appropriate box: y I. 1 am a employer with �I _ 4. ❑ 1 am a general contractor and I Type of project (required): employees(full and/or part-time),* have hired the sub-contractors 6• New construction 2•❑ 1 am a sole proprietor or partner- listed on the attached sheet, 7, [] Remode.ling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' �i.• [No workers' comp, insurance comp, insurance,# 9. ❑ Building-addition required.) 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their myself. [No workers' comp, right of exemption per MGL l l,❑ Plumbing repairs or additions insurance requited.) t C. 152, §1(4), and we have no 12 ❑ Roof repairs employees, (No workers' 13- Otherjah' 06 comp, insurance required.) ''Any applicant that checks box N I must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this aMdavit indicating they are doing all work and then hive outside contractors must submit a new affidavit indicating such. 'Contractors that check this box must aue.phed an additional sheet showing the name of the sub-conh•actors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp,policy number• 1 am an employer that is providing workers' compensation insurance for my employees. Below is the policy and fob site .�'nformation, Insurance Company Name: & , �, f� � Policy # or Self ins, Lic, #; rVCi 0 Expiration Date:L) Job Site Address, City/State/Zip: Attach a copy of the wbi±liers' coriipensalion 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 Oprisonment, as well as civil penalties in the Con-ri 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 ofthe D1A for insura - covera e verification. I do hereby certify de'-pal e pal an penalties of.perfury that the Information provided above is true and correct, �^ Si mature: ` Date: Phone#: Official use only, Do not write In this area, to be completed by city or town officlal, 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 Pet-son: n1, __ L. i--� CAPECOD-27 BDELAWRENCE ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 6/30/2015 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 pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). PRODUCER CONTACT NAME: Rogers&Gray Insurance Agency,Inc. PHONE ac No): (877)816-2156 434 Rte 134 South Dennis,MA 02660 EMAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC P INSURER A:Peerless Insurance Company-see LIBERTY MUTUAL INSURED INSURER 13:ATLANTIC CHARTER INSURANCE GROUP . Cape Cod Insulation,Inc. INSURERC: 18 Reardon Circle INSURER D South 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. INSR TYPE OF INSURANCE POLICY NUMBER MMIDD� MMIDD E P LIMITS LTR A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE M OCCUR CBP8263063 04/0112015 04101/2016 PREMISES(Ea occurrence) $ 100,000 MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 'OTHER: AGGREGATE LIMIT APPLIES RER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO. lOC PRODUCTS•COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY o COMB NED SINGLE IMIT $ Ea ccldent ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PPReOeP CRdT nDAMAGE S HIREDAUTOS AUTOS $ — UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAWS-MADE AGGREGATE $ OED I I RETENTION$ $ WORKERS COMPENSATION STATUTE 5RH AND EMPLOYERS'LIABILITY _ B ANY PROPRIETORIPARTNERIEXECUTIVE Y� NIA WCE00431901 06/30/2015 06130/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE•EA EMPLOYEE $ 1,000,000 It Yes,describe under DESCRIPTION OF OPERATIONS below I I E.L.DISEASE•POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ('ACORD 101,Additional Remarks Schedule,may be attached It more space Is rectulred) Workers Compensation Includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE WITH THE POLICY PROVISIONS, South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Assessor's map and lot 'number .. ................ ....... ..... aJC, t SEPTIC SYSTEM MUST DE Q Sewage Permit numberN- u INSTALLED IN COMPLIANCE WITH ARTICLE 11 STATE ,y yOfTHEj�� 4� _ TOWN OF BAR � R TOWN G' BAUSTADLS; "6 BUfLDIHG INSPECTOR ,= �'c yap a• ' a�a � APPLICATION FOR PERMIT TO ............... .... .......................... ........................:................................................... k . TYPE OF CONSTRUCTION F +�z& ..... ..............19 7. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ ..... .................. �.......... . ProposedUse ..... .....RiM7n................................................................................................................................. Zoning District ..........................................Fire District .................................. Name of Owner ..,i�� ..... .. Address Name of Builder .... . .. .....Address ... .... ..... Nameof Architect ..........M..................... i............................Address .................................................................................... Number of Rooms Foundation .. ..... Exterior ........... . ................................................Roofing ................ ............../.................................................. Floors ................................................Interior .. ... ! -i<!�/`,,t. Heating ..................................................................................Plumbing .................................................................................. Fireplace .................... . ... . . ...................................................Approximate Cost ...... .4 .................................................... Definitive Plan Approved by Planning Board ---------------_--_-----------19--------. Area .. v.. Diagram of Lot and Building with Dimensions Fee �.7,5......... ..................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above ' construction: Name ...... ............ .... .... ...... .. ..................... P 197~31 Sigoe /mu --- . � � 19383 ' No ---.-- Permit for -.��d�'xz'J�«����m-� . ' ^ ` ----' '-^'^^^'------^~' Localio, ' - �- 95:m�s.t..h......................................... ' .........Weot.. l9...................................... Owner .....GXQAe.^Jahomoa................................ iType of Construction .........W,c"od........................ -..--.-.---.-------~-.-~~-.--.. ' ` Plot ..1g7!!.3I---- Lot ................................ . re,nn, G,pn**z ....... -- lg. 77 ' Date of Inspection !�� --..lg D000 Completed ...... ... ......�19 PERMIT REFUSED . lg ' ---..-.---.-.-......--.-.--.. ' ' —''--'--------''----'---'-----'' .' . . . ' -_----..-.-------.---------- . ' ---------.----.---.---.---.---.. ' ` .---.-.---.'.~-.-.-..,~......~'—....... ' Approved � ' ................................................. 19 --------.----..~......---..-.-.- -------------------------... � | � Assessor's map and lot numberIHE ..(../...1...:. � ..l..�) 9 Sewage Permit number X'.di......W.. ..�............:........ (. d s Z BJB34TSIILE, i House number MAO& 90� t639 �0 YFY h` TOWN ' OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO !�!�A...... /1/Yl.4 rn ............................ TYPE OF CONSTRUCTION �! ? !!•!m F , ..... �,. ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies ffo•-r a permit according to the following information: Location ...... �+ .:.9 !,.,....... �-� . ...............................:... ProposedUse :................................................................................................................ ZoningDistrict .........................................................................Fire District .............................................................................. Name of Owner •t c!-��n .!L !J!d' .a.. .,:..................Address .....�?.1�...../3P4? %.�. - . :.•.� .� L&If, .... ` Name of Builder ... oaX.., e✓►!!'E?. Address ..... /,� .. ..................................................r. Y 1 ... .. o' Nameof Architect .....................................................................Address .................................................................................... � f . Number of Rooms ..................................................................Foundation ...... ..................................................... t. Exterior I�.;!in�..-.... �, .....6..........................................Roofing.. ..... ..!.� ? .....���,c•Yt `?„ F , Floors .....corl-o X.l ............................................................Interior ......`...................................................,........................... Heating ..................................................................................Plumbing .................................................................................. Firep .......:.....................................Approximate Cost ....I?...................................................... lace ..:.................................. /J ...... Definitive Plan Approved by Planning Board -----------______—___ /�� ��.......... - -------19-------. Area ................................ Diagram of Lot and Building with Dimensions Fee /n z � SUBJECT TO APPROVAL OF BOARD OF HEALTH v ♦ j,.S d .. >. ..<<��,•„�.=�-,.:.�...��..•��Rom. _....._-'-v....-�� 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... )2�1��......................... . . � -----.�Aem.t. ---------' u . - Owner ..........8igom -Jobaaen--------- . Type of Construction ---- ' .................. ' ' . Plot — ----' ' --' -- ........................ � . Date of Inspection uo,� Completed - � - ' 'u � . . . . � ... ' ____—,_— —.. lV / -- --------' ! / V / � __`^__,_._______.. ________. - ` -----------^~'---^----'----'- . . ----.----.----.--.----.-----. � ` ' ^ � ___---------- ...... � . . . ` . - ^ ...�. -------.---------.,, ----. — ' .................� --........ --------- ................. ^ � ` Application to 3 D _.0�{Yr OENE S�pP fPHPSN' Old Kings Highway Regional Historic District C --L, in the Town of Barnstable for a 81993 r ' CERTIFICATE OF APPROPRIATENESS towN~ LD K NGBS RNSza. F Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Sectionk6aof>_Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY, 1. Exterior Building Construction: ❑ New Building f] Addition ❑ Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY - DATE ADDRESS OF PROPOSED WORK _"7 y /C-4- -7f ASSESSORS MAP NO. OWNER SO in K A- Jo •%-.f G ti ASSESSORS LOT NO. _ HOME ADDRESS SO 5-f �G I�- �c�-. TEL. NO. FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street o//r way. (Attach addiitional she�et if Inecessarry). k'L ( 7 T ✓�„� fVu;��� cn� ss 1��� R + LA L1f �,. �c� h�� ri��4 rs!G 6C I.. * I AGENT OR CONTRACTOR TEL. NO. 3 t-2 ADDRESS 5 oz'� LTr DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8,other side), including materials to be used, if specifications do not accompany plans. In.the case of signs, give locations of existin si and proposed locations of new signs. (Attach additional sheet, if necessary). Appo, Rcsj, ' Pt -A wt -rI- Signed r� 1�, w Owner-Contractor-Agent Space below line for Committee use. Received by H.D.C. Date The Cer ' 'care 's hereby Date , Time By Approved IMPORTANT: If Certificate is approved,approval is subject to the 10 day appeal period provided in the Act. Disapproved I] OLD KINGS HIGHWAY HISTORIC DISTRICT ` Spec Sheet Foundation Type Flu y C-fN,r--f--c Siding Type _ a S � Lf Chimney Type ►L. L- Color Roof Material Color Pitch Ste/ L Windows D,3 L � C Size X 1 I ct. 31' Trim Color II I /I Doors h z-� �-S �. N< � - ( - O k 6 Color C,.) Shutters 1A Gutters Deck kJ A Garage Doors Color 'Notes: Fill out completely . Including measurements and materials/colors c . - Three copies of this forth are requsred for sutmtttal of an applics along with three copies each of the plot plan. landscape plan and plans. when applicable. 'plot plan need not be "Certified" . but should show all structure . to scale . ,l,. a t An ^-mac, ', ' ..• � � _ -gym �' �i=' ■■ � � r .�� Uei•��� "�••�•' '� • 5 a YVu. �� .ae +�W` ••.� •t• 164 fiT��� 2 Jh fY3�,ti\ .`✓, .J• � f.34.� , '..f� t:!M f•2"��'1i_ ..` . , �� ,, � ja`Y } t,�,� 4 } .: �+•� c R,�grYl+ r afF�Y� ^ /'f 4�TZ-�a�'•J , -r. d��, .•v af2^j �, �f�t- �t. wrr-a: - !. v•''N� °- �kY a i �1 y,„ �( '' _ - - ,! ;Y'� y`,� r"!�'y� �'a =1.".!J 2. 5,1?. •• "'•. /`�.tfs � R�' ,� s�ti�,:..� "('ti�ii;r� r'i f t+y�; rf�E 1._.''��../�a y,- `s �: ,ti • T! '1+-���s'. •,.�• .r�e� �; tt�J.�'Y"; "L4>� lY:V+l7 f�tw�.�\ '1�...•i y., L'1 + v'� �_1 w` .. ^�� � •I — '" +- :.� - "`'-^7�" _� _�,'mill�•LI tyYl ��"Y/,]�, •ty. ..r !_ �•��--_.-- J� :� ISS ilz 1,�I,J-�f�v u.�r��\tau tJar ,''. -�_.��� .v � •f liv a..• laa 4.:lo u:..O „� Ilhaq��a�. � •r-, _._---- �..L' ! il. � ru eafln s.;y"Y 41 •�a..C1i y't 4i. [•a •ft at += J t5m d�.a4 iL. >.l ill• i Gil . r � i �'S'��jir � yf+�v-+rat, ��TM ;:rr:.+•jje:m �::� - • \ W•� � i.�, - •••�� Wit •" _ — sf ' ..,..ter ".:1 1 iI `-'fir•°'. T.. +�• ry .. '; :`� "v_a:r„;'�'"C��t f` ,• ._} i 1 1 COMMONWEALTH MassacArrsettsSt�Q° DEPARTMENT OF PUBLIC SAFETY Codsisosas6torrsvooation OF ONE ASHBORTON PLACE of tDisllossse• li MASSACHUSETTS 0a 4 �11. BOSTON,MA 02108 EXPIRATION DATE CAUTION ... . RESTRICTIONS EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST THEFT, PUT RIGHT THUMB o ; ::,::::•':, :.. ... . o PRINT IN APPROPRIATE. 6 BOX ON LICENSE. S,,:I,.F� bt PH m PHOTO(BLASTING ORR ONLY) FEE: '' .. .. .:':::i> t I�•!^•- ••,-<•_ . 'I' "I - < j-' ✓ .NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY (��0 HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER IPYrttepossessaoa t e�lff8AYseffsstaNBsl! R$OB: d8e�4blifseforrevooaN n �: .:::!"':' !thislloell". THIS''DOCUMENT IMUST BEI iL SIGN NAME IN FULL ABOVE SIGNATURE LINE ~ CARRIED ON THE PERSOPI OF SIGNATURE OF LICENSEE THE HOLDER WHEN EN- OTHERS-RIGHT THUMB PRINT GAGEDIN THISOCCUPATION. IONER �.- --- w HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building Regulations and Standards One Ashburton Place -Room 1301 Boston , Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR Registration 102149 Expiration 06/30/94 ti Type - INDIVIDUAL HOME IMPROVEMENT CONTRACTOR t Registration 102149 ' John Johnson Type - INDIVIDUAL John J . Johnson Expiration 06/30/94 . 160 Church Street J W . Barnstable MA 02668 John Johnson 1 John J. Johnson 160 Church Street ADMINISTRATOR W. Barnstable MA 02668 _ COMMONWEALTH OF M.A.SSACHUSET ' 7 LIZ DF.IAKINf_NT OF ZNDUS R ALACCID.F-NI*S Goo WASHINGTON STRE1✓I' BOSTON, MASSACHUS=S 02111 gamesGaIoDei° �:c,--m:ssione' -woRIERS' COMPENSATION INSURANCE AFFIDAVIT (l icc nscc/perm i ttcc) with a principal place of business/residence at: v C �.vrc C 4 S e f 4 L r H a (City/statc/Zip) O Z G t' f do hereby certify, under the pains and penalties of perjury, that: ( ] I am an employer providing the following workers' compensation coverage for my employees working on this job. Insurance Company Policy Number iQ 1 am a sole proprictor and have no one working for me. (] l am a sole proprietor,general contractor or homeowner (circle one) and have hired the contractors listed bclo%k• t who have the following workers' eompcnsauon insurance politics: . Name of Contractor Insurance Company/Policy Number name of Contractor Insurance Company/Policy Number Name of Contractor Ins=nee Company/Policy Numbcr Q 1 am a homeowner performing all the work myself NOTE Plcasc be aware tbat while homeowners wbo employ persons to do mainteaaace.eoostruaica or"pair work on a c'wdling of not more than three units is wbicb the homeowner also resides or on the grounds appurtenant tbcrcto arc Mot geaeeall)• considered to be employers under the Workers'Compensation Aa(GL C. 152.scot- 1(5)).applieatioa•by a bomeowaer for a lieeasc or permit may evidence the legal surus of a.a crploycr uoder the Workers'Compensation Act. i unocrstano that a copy of this statement wiL be fon••ardcd to 6c Department of Industrial Aeddcnu'Ofiicc of Insurance for.eoveraic vcrifiution and that failure to secure eovcraNc as rquired under Section 25A of MGL 152 can lead to the imposition ofStiminal penalties consisting of a fine of up to$I500.00 and/or imprisonment of up to one year and civil pcnalues'in the form of a Stop Work Order and a fine of S100.00 a day against me. ? Signed this /D day of i License /Pcrmi cc Liccnsor/Pcrmittor r ..._.�..__.._ _ - I Assessor's office(1st Fbor): - Assessors ma and lot number ^°°" " °'p I 0 3 .QitkL— SEPTIC . TF-V1 f.=. 17 BE c�THE>o y Conservation(4th Floor): / Board of Health(3rd floor): s. �FJ '� . ~ - �' • Sewage Permit number A` �" ";" t'' AND i )AUIT�LL S ���' t� ... ttn rua Engineering Department(3rd flo vsa ° '639'� �,�. � House number oasr Definitive Plan Approved by Planning Board 19 t APPLICATIONS PROCESSED 8:30-9:30 A.M.'and 1:00-2:00 P.M.only, �= f TOWN '. OF BARNSTABLE' k BUILDING ' INSPECTOR APPLICATION FOR PERMIT TO 60 i TYPE OF CONSTRUCTION W o 0 0C- 19 3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 7`( o C v S-{ e 7t�4.ele Proposed Use ti�4--q en h c itO g, c1d 04r y Zoning District Fire District Name of Owner Sr h-e J a h- 1 e -,V Address Zt A C-v-S 7 All e- Name of Builder Je 4 4o,-s c w Address /6 y C 4 v K c 4 S t,! c r Name of Architect Address Number of Rooms 2 Foundation �o�yc C� Co--- 1.2-� Exterior �� d t 4 '2:3 I< Roofing 9s4 4 ', /> Floors Interior y"L tz .1--1L l Heating Plumbing A-Af Fireplace /�-�� Approximate Cost Area BYO I Diagram of Lot and Building with Dimensions Fee �© OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. I Name �e ti vd L-r, 4� ev Construction Si ipervisor's License JOHNSON, SIGNE V j No 36251 Permit For ADD TO DWELLING �. Single family dwelling , Location 44 Locust Avenue , West Barnstable Owner Signe Johnson Type of Construction Wood frame Plot ' t �' Lot Permit Granted ' October 21 19 93 ' Date Hof Inspection: / 'r Frame 19 Insulation /,Z�/9.3 19 fireplace 19 Date Completed 1 19 93 t Assessor's map and lot number ................. Sewage Permit number .-..i G y�FTNET��� TOWN OF. BARNSTABLE BARBSTA.BiL i ° M°9 BUILDING INSPECTOR RFD YAy Or APPLICATION FOR PERMIT TO ................�...................�OY............................................................................ TYPE OF CONSTRUCTION � ��' ::: ..................................................................... ........ ��.r , .. .............1972 r TO THE INSPECTOR OF BUILDINGS: _ The undersigned hereby applies for a permit according to the following information: location /J?A�t!*� —%�� A0v Qs 0,-s �...1 Gt Y� ProposedUse 7R�-�;,b..... ...................................................................................................................................... r 41 - �,� Zoning District ................ ..r...........................................Fire District !!�/ _-� ........................................ ............................... Name of Owner �•r!:... ' / 111/�t�................Address .. .�J...JJL .a.r.� ..... ...::..4 Name of Builder .... Address .................................................................................... Nameof Architect ..........!!....................�..`.............................Address .................................................................................... Number of Rooms ..................................................................Foundation ..... � .r ... ................. ...................:.................. Exterior4+1.�?..... �C,�ri ..............................................Roofing ..........`-t ! t: ............................................... Floors t.t �.�,r�................................................Interior � �+i .. ...................... .. ....j:.......::......?................................................. Heating ..................................................................................Plumbing .................................................................................. Fireplace , aan. �..................................................Approximate Cost ...... :. Definitive Plan Approved by Planning Board _______________... ... _ .. ..�.�...�,LJ� -----19 ----. Area Diagram of Lot and Building with Dimensions Fee ................�. ...... .. SUBJECT TO APPROVAL OF BOARD OF HEALTH oc I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...................... Q t............................................. d 197-31 Signe^Johnson No 1938.. Permit-o:or Add.'n..I?Flea,l.xng.::.. Locust Location ..........r.............4!Y ................ - - Owner ..S igAA WM.Qn.................................. Type of Construction .......Wraad.......................... Plot ...1.9.7.-3l. ............ot................................. a Permit Granted,-.-... :14l ....11............19 77 Dbte of Inspection . .....19 .............................. Date Completed '......................................19 PERMIT REFUSED ................................... ..................... 19 ......... .................... ......... Approved ................................................ 19 ............................................................................... ............................................................................... Assessor's map and lot number` .... /...l...J f... .... ) !1� THE o �i Q Sewage Permit number ..7.7. ..... tmm SYSTEM MU d pNSTALLED IN COMP TABLE, House number a 39- .......................................................................... V .•`LE 6 pYAYd�9 TOWN OF BARNS '�`"noNs BUILDING INSPECTOR APPLICATION- FOR PERMIT TO ........ .. ...... .. . ...... . .. ........................................................ TYPE OF CONSTRUCTION .... .. .... .. /„1� .. ..................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location.. . ....... .... .......! `............. . .,r� r.......... ... . . ........................................................................... ProposedUse .. ... ...✓.fL�Q���...�:. . .618,�............................................................................................................... ZoningDistrict ........................................................................Fire District .............................................................................. O ,G� Name of Owner .tt7N.................Address ....`�?......... ... 4... . Name of Builder ... .. .. /....................Address ..... p Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation ......b✓ .................................................... Exterior .... `�G'1!`!1........r`�CtrM,. ..........................................Roofing ..... // ...... .'. .. .... .................................. Floors .....&.V. ............................................................Interior ......................................... Heating ..................................................................................Plumbing .................................................................................. p0 Fireplace ..................................................................................Approximate Cost ....13:. ............................................. . ...... Definitive Plan Approved by Planning Board ---------------------------19-------. Area ........�.?D Diagram of Lot and Building with Dimensions Fee ............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH z , ev f I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above . construction. Name . .......... ...... ... . .1! .....'. .................... crohn-son, 8 Lg'r.e A=197-31- No ...21459... Permit for ......gax.aga................ .............. Location ...................................... ................ tables:...........:................... Owner. ...........5.tgne.-j.ohn&on.......................... Type of Construction .........Firame...................... ............................................................................... Plot ............................ Lot ................................ Pdrmii Granted ....... 1X 12.................1979 Date of Inspection ....................................19 Date (.-ompleted ................t ............19 go PERMIT REFUSED .......... ...... ................................... 19 cr .................... CIS ............................................ co ........... . ..... ............................................. ........... . .... ........................................ M M Approv,ej .................................... 19 ..................................... ......................................... ............................................................................... f i r - ; a bt ' SCALE: �t d I 1 APPROVED BY DRAWN BY DATE: t� N a i � � ' iteRc� �• Ne � �r�+S4r3 "1 V DRAWING NUMBER 'WTBJnM POST 18AB-15 i { y 1 WASL r- � i f f3 ri itILI t 4 } t E i i SCALE ' APPROVED BY DRAWN BY DATE*S;121 �� f UvV DRAWING NUMBER 1.. On xTEEDVWPOST IBM-15