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0590 MAIN ST./RTE 6A(W.BARN.)
_ a slur bA9f11(Oto YI! i Vie � Town of Barnstable Building ��,�� ; Post This Card So That it is Visible.From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept_ A M `� Posted Until final Inspection Has Been Made.'+ ' �r r ° Where a Certificate of Occupancy is Required,such Buildingshah Not be Occupied until a Final Inspection ha;;been made. Permit Permit No. B-18-1845 Applicant Name: CAPIZZI HOME IMPROVEMENT, INC. Approvals Date Issued: 06/12/2018 Current Use: Structure . >?.,IG 4 Permit Type: Building-Deck Expiration Date: 12/12/2018 Foundation: Location: 590 MAIN ST./RTE 6A(W.BARN.),WEST BARNSTABLE _Ma p/Lot: 133-012 Zoning District: RF Sheathing: Owner on Record: CAPUTO, LEE J& MARIA L Contractor Name: ,CAPIZZI HOME IMPROVEMENT, Framing: 1 INC. Address: 590 MAIN STREET 2 -- ---.- -Contractor License: 100740 WEST BARNSTABLE, MA 02668 �.� Chimney: Description: replace exisitng back porch/landing 4x4 like for like at rear,of house Est. Project Cost: $5,600.00 with steps Permit Fee: $ 110.00 Insulation: I 'r Fee Paid: $110.00 Final: Project Review Req: I f i Date:.' 6/12/2018 Plumbing/Gas '— Rough Plumbing: i �. .._.....:__ . Final Plumbing: Building Official Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Gas: All work authorized by this permit shall conform to the approved application and the`approved 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. This permit shall be displayed in a location clearly visible from access street or road and shall-bemaintained-open for public inspection for the entire duration of the Electrical work until the completion of the same. i f Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on'this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work: - 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �IM A - . l Q Application N,mmb&..S1..::/ ............................ . 8AS& P=it FC... o.. ./.`. .... ............Od=F=........................ M�h�e Total F=Paid............. ................. .. ...... 3 TOWN OF BARNSTA13LE Permit Approval by.. ... ... ..........oa..... .�..... ../.. ... BUILDING PERMIT APPLI .......�::3. ............... ...............................� ..... CATION M�• •- Section 1- Owners Information and Project Location Project Address �dl� Owners Name `SAX _4 eZ CA40-4 ' Owners Legal Address 5'`/o K-;-Ik f t- ?d 6 0A 3 2 ty,e✓ r l3/-vAAii-r,,f 4!e state �- � _ zip. . 0 Z 4- Owners Cell# SGr �� y' /�7C E-mail 1' . C/ L)7 O 9 Section 2—Structural Use Single/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 352000 cubic feet Section 3—Type of Permit "4)'/VG ❑ New Construction ❑ - Move/Relocate ❑ Accessory Structure Hof use ElDemo/(entire s�xmc e) El Finish Basement ElFamily/Amnesty N 'r BXire,Alann Rebuild EKDeck Apartment ❑ Sprinkler S�stem ❑ addition ❑ Retah m wall ❑ Soler 2/Renovation ❑ Pool ❑ Isulation Other-specify �ke F'ov Gt`ke Section 4—Detail Cost of Proposed Construction Y U0 Square Footage of Project uW j:ykAi4j Age of Structure / 20 Dig Safe Number 21 e7 gr #Of Bedrooms E.xisdug 3 Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Last updated:ll M17 Section 5 -Work Description ' 4;'kl.e, '-ro 1/f r -7a Cop-e- v fIt✓a�ad�g-L Section 6—Project Specifics ❑ yVTring ❑ Oil Tank Storage • ❑ Smoke Detectors []'Plumbing L ,fi ti '� .+ Gas t� sc , ► u ❑ Fire Suppression _ _. .p,....- `�� El-Heating Sy stem ❑ Masonry Chimney� ._.. ' ❑Add/relocate bedroom ------------water.-Supply _ Public---- -- PriYate Sewage Disposal ❑ Municipal R On Site Historic District ❑ Hyannis Historic District R/Old Kings Highway Debris Disposal Facility- I am using a crane C Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a coastal bank'? Yes ❑ No W j wetland, Section 8—Zoning Information Zoning District 7? i� Proposed Use Lot Area Sq.Ft Y 2- C ��e Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes No Last updstm&117 2017 A :s :.< Page 7 of 7 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT it I/WE, Cxl p/—P , OWN THE PROPERTY LOCATED AT 0e IMiNJ- 17 IN MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. �" SIGNATURE OF OWNER: )c"/v%,9�•x LtL OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 Q�P� APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: . O RESPONSIBLE OFFICER ADDRESS: i RESPONSIBLE OFFICER TELEPHONE: D� Massachusetts Department of Public Safety ' ,£ce of Consumer Affairs&Business Regulatio, • Board-of Building Regulations and Standards t• OMEIMPROVEMENTCONTRACTOR License: CS-064817 � y Registration: 100740 Construction Supervisor Typ ExPlrafion: 6/23/2018 Supplemen s CAPIZZI HOME IMPROVEMENT,INC. JOHN T STRUMSKI 18 ALDEN AVE <�� BUZZARDS BAY MA-02b32.•, JOHN STRUMSKI j 1645 Newton Rd Cotuk MA 02635 l� Undersecretary �zCK Expi ration: Commissioner _ 0611812018:.' - tied-Buiidinp ofany use Broup which a&W 35,000 cubic fid(991m')of gWca. Issess a currem t edition afthe Massachusetts z Code 14 cause for revoc9an of this license. Tng?nforraWon visit: w=.MmAovJDP3 Licease or registration valid for individual use only before the expiration date. }zf found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 ♦j ' + Not Valid without signature v The co of.Maxac It oft Dep . o fbubw&WAccWn& offlw of 1 do= 600 Wadhtagtm fiber BwmA�MA 011 wwmmw&gov/dIa Workers'Compensadfon Imsu met Affidavlr.Bnflders/Contractors/Eledddan&Mh=bers AWARSAInformatin - Nam(g /0rPnLw Oa/ImWduall: Capital Home Improvement i . '1646 Newtown Road C' /3tatelZi . Cotu MA 02836 Phone#: 508.42H618 Are yn sa gmpb9al flame boat: of eet 1. I am a eMloyer wlth 40+ aPT 4. I am a general contractor and I 66 New eonfaacdon employes(bill andlor part•Hme)." have hired die sub vonttactom ?. J 2.4 I am a Bole proprlebor or pates listed on d:e attached dbeet. Remodeling drip and have no employees Thm -conwatorsbave S. Demoliticm wow for me in any capacity►• mplo�`ee have�o�z 9. Building addition [No workmd'comp.insurance comp,inzaance 5. We are a corporadon and ifs 10. Ehafr W repairs or additions 3. I homeowner doingo have exeroked dum 11. Plumbing repahs or adMons (Nomad"comp; of �per btOL �� mysa instuatice requindj t 2.j 1(4�and we have no ' 3' �� � _ employees.[No workers' comp.insurance ►Atgr ct�e�bab�titti�t oflit 8�b f�iaw'Jb"ft2& ' townaesvrlsu�bmttmiea_ �a3' sllwoflcaodthanhinoaftidec shyftsm ' andSM ohm employmLif s lava la9ea p�'d°(@° W0fi °omp'p° I cne an asnployer that is pmvidbig porkers'�mfP biaxromae jor'fir"WIPPM MOW is thepoNep airdlhb� Company Name AMOUARD INSURANCE COMPANY hmumm 't?J2512Q18 policy#or Self-ins.tic.4P. ��?� �D� - dob Site Address•• r� U R'i'/y - .oily/StdW73p: r' s . Attach a espy of the workers'compasedon po6ey dedw a t�pq'^-f Po1fr9 number and {tits g ) Faihme to secure coverage as required under Section 25A of 1V L c:152 can to flee imposition of cfminat p of a fine up to$1,500.00 and/or one-year imprlsonmsnt,as well ad Civll form of a STOP WORK ORDER and a fine to .00 a die violation. Ba advised flat a copy katememt lie forwarded to the Office i� of up f dqy t ° Invesdgadons ofthe DIA for fimmince ooverage verification. I do pabn andpwaUff olp47t 0A 0M4dMPMvW obOw is tnre and eanecL odd/i2o18 508 428-9518 p,�lciate m4y. Do rwt wrue Inareo,to be epldad by ei4v tom Offlciffl Cttyor Toes: Pern"LIMM# Bs of H Bur Authority(elyde are): 1.Hom+d /Town Clerk t Meet"hgm:tor d.Pl MIN2g IMPtetOr edth�2. lldh>S Dew �y &tlshef Coaaet Peron: Phone ® DATE W.,DD/YYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 12/27/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT_ ROgef$and Gray PfOCeSSIng ROGERS & GRAY INSURANCE AGENCY INC PHC NE xt: (508)398-7980 t(�NoJ: ADDRESS: mall0r0 ersgrra_y.Com 434 ROUTE 134 INSURER(SAFFORDING COVERAGE NAICS___ SOUTH DENNIS MA 02660 INSURER A: AMGUARD INSURANCE CO 42390 INSURED INSURER B: _ CAPIZZI HOME IMPROVEMENT INC INSURERC: INSURER D: 1645 NEWTOWN ROAD INSURERE: COTUIT MA 02635 INSURER F: COVERAGES CERTIFICATE NUMBER: 225451 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 ADDUSU91? POLICY NUMBER ! PO(MMILIICY EFF MPOUCY EXP LIMITS LTR COMMERCIAL GENERAL LIABILITY I { EACH OCCURRENCE BAMAGE t0 RELAYED _"'� CLAIMS-MADE �i OCCUR t f PREMISES(Ea occunenceJ_ S _ I I MED EXP'Anyone person) }S N/A 1 PERSONAL&ADV INJURY_ S GEN'L AGGREGATE LIMIT APPLIES PER: l GENERAL AGGREGATE s POLICY PE0 LOC j i i PRODUCTS-COMP/OP AGG S OTHER: i I S AUTOMOBILE LIABILITY 1 I EO eBIN D1SINGLE LIMIT S ANY AUTO {tI I BODILY INJURY(Per person) i 5 ALL OWNED i SCHEDULED 4 I AUTOS AUTOS N/A BODILY INJURY(Per accident) S } NON-OWNED I PROPERTY DAMAGE s HIRED AUTOS ; AUTOS I I i _(Peraccident)_,__,___._._ �5 - UMBRELLA LIAB _ OCCUR i (} EACH CUR_RENCE_- S - EXCESS LIAR CLAIMS-MADE ! N/A ( AGGREGATE S DED I RETENTIONS { s WORKERS COMPENSATION 1 I X'SE TUTS c ETH- AND EMPLOYERS'LIABILITY Y/N! j ANYPROPRIETOR/PARTNER/EXECUTIVE } ( E.L.EACH ACCIDENT S 1,000,000 A ;OFFICEfVMEMBEREXCLUDED? NIA'NIA NIA} R2WC863728 12/25/2017 12/25/2018 (Mandatory In NH) } I E.L.DISEASE-FA EMPLOYEEI 5 1,000,000 If os,describe under DESCRIPTION OF OPERATIONS below ! t E.L.DISEASE-POLICY LIMIT 5 1,000,000 i. N/A DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES (ACORO 101.Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees In states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy In force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. r 7 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE MILL BE DEUVERED IN Town of Barnstable ACCORDANCE WITH THE POUCY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE 'Hyannis MA 02601-0000 `-1"'� C Daniel M.Cro a ey,CPCU,Vice President-Residual Market-WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD I JUN 0 8 2018 OAt9.9V �� C�N�er✓ -_ P .P Tor A N-.W = _... -` tom` t - , = <: tT T- � Wi t- 1"4 O 0 T" Tym a � ---:-- --- - JUN '0 8 2C.18 Section 9—Construction Supervisor Name O h iJ T• Sf 0#i kt* Telephone Number Address/ 21 r lie wt own City C o-ry l-u- State O-JA zip U 2(¢ License N=ber License Type �� � Expiration Date Contractors Emafl eg M -�- e C*17; 21 1iGal P. e-a* Cell# dd' I understand my responsiibiilities tinder the rules and regulations for Licensed Construction Supervisor in accordance wi$i 780 CMR the usetts State Building Code. I understand the construction inspection procedures,specific inspections and docmmentation by 780 CMR and th Town of Barnstable.Attach a copy of your License. l Signature VDate O 6 / Section 10—Home Improvement Contractor �Ja Tf-lU cis _ Name C l Zt i AIH& . wilee%. Telephone Number V �12- Address �UewB ows� Cd���f statep Q� -2 // Y on Number D F�piration Date / I understand my responsibilities under the rules and regulations for Home Improvement Cofactors in accordance with 780 CMR the Massachusetts State Building Code. I understand 1he construction inspection procedures,speck inspections and documentation by 780 and the Town of Barnstable.Attach a copy of your H_I.C... Signature Date 6 4 ��! Section 11—Home Owners License Exemption Home Owners Name: Telephone Number V Cell or Woik Number I I understand my responsibmti tinder the rules and l'rm regulations for Licensed Construction.Supervisor <accordance-with 780 mmh CMR the Massachusetts State Building Code. I understand the construction inspection procedures,speciEc'mspections�and doc�e�atioa required by 780 CMR and the Town of Barnstable. J(fN 08 2018 Signature Date T 0 wN n�, APPLICANT SIGNATURE Signature Date7d�� Print Name Telephone Number E-mail permit to• �t ✓M f C �/� 7 - 6to/y 2. &O Ay Last updated:L 1I7/2017 Section 12—Department Sign-Offs . Health Department ❑ Zoning Board(if required) © ? i Historic District ❑ Site Plan Review(if=qd=d) ❑. Fire Department ❑ - . Conservation ❑ For commercial work,please take your plans darecdy to the fire depwftent for approval Section 13— Owner's Authorization as Owner of the subject property hereby authorize to.act on my behalf, iri all matters relative to work authorized by this building permit application for: (Address of job),-,, Signature of Owner date Print Name Last updated:l l/7R017 i oFtwE r Town of Barnstable *Permit# Expires 6 nmonths fi•a,n issue date Regulatory Services Fee BARNSTABLE, y� MASS.1639• 0g Richard V.Scali,Director A, Building Division '`w ,7 • � �, Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 DECC 14 www.town.bamstab.le.ma�isivl//t, Office: 508-862-4038 �� 1!4H111t',' Fax- 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL 6NE-Y 1 Not Valid without Iced X-Press Imprint Map/parcel Number /3 3 0!t�— Property Address 5 9D Maw) S t 3 A v-o S4-e- W e— esidential Value of Work$ 3 -1/f S.av Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address L ,L C`A 1 L)rT�,s; Contractor's Name 'P A V L-J. CA ZC A U i' -i- SaN-S Telephone Nuumber 5y `�2 -/ 1_-+ Home Improvement Contractor License#(if applicable) f 0 3'-q-(q Email: Construction Supervisor's License#(if applicable) C,S 108 ( S 4- ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner -D-1-liave Worker's Compensation Insurance Insurance Company Name l--{- (=o fe-P Workman's Comp.Policy# ki G - 'j/ 3 - 3 a to 6 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request heck box) e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to �/A-EMOU97+ �j✓Y�G 11 Ser✓-I-tQ�'1 0� l'�ou.se VI.Qa✓' p(r,vec�� � C2.r�C��fee S�� ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) GAF e",//iaMs6 ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is required. SIGNATURE: + C:\Users\Decollik44ppData\Local\Microsoft\Windows\Temporazy Internet Files\Content.Outlook\2PIOI DHR\EXPRESS.doc Revised 040215 I i The commonwealth ofMassachusetts Department of.tndustrial Accidents Office of Investigations 600 Washington Street Boston, Ili 02111 www.mass.gov/di a Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Leiribly Name (Business/Or ganization/IndividuaI): ?07V - e� ( Z - Address: /Oa) X-tA/N 5'i ever City/State/Zi Os•i15 i(- Phone Are you an employer?Check the appropriate box: l am a employer with_ Ir 4. ❑ I am a general contractor and I Type of project(required): employees (full and/or part-time).* have hired the sub-contractors . 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ® Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have worker' [No workers'comp. insurance comp. insurance.1 9.. ❑Building addition required:] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their . 1 I- Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL in 12-❑Roof repairs insurance required.]t c, 152, §1(4),and we have no n 3a❑ I am a homeowner acting as a employees. [No workers' 13,-Other e-P general contractor(refer to.94) comp.insurance required.]. 'Any applicant that checla box#1 must also fill out the section below showing their workers'compensation`poliry information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors rant submit a new affidavit indicating such. *Contractors;that check this box mu t attached an additional sheet showing the name of the sub-conttactats and state whether or not those entities have employees. If the sub-contractozs have employees,they must provide their workers'comp.Policy olic number. aman employer that isproviding workers'compensation information. insurance for my employees. Below is the policy and jab site � Insurance Company Name: /I M 2 P Policy#or Self-ins.Lic.#: kV 9 66 3 602 g Expiration Date: Job Site Address: J�clb 17.,ti S' City/State/Zip: kV. 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 certi under the pains andpenalties of perjury that the information provided above is true and correct Signature: Phone Official use only. Do not write in this area, to be completed by city or town officiaL .City or Town: PermitlLicense# issuing Authority(circle one): L Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector i 6.Other Contact Person: Phone#: W 4 (7va Office o,f Cons-Lu-ner Affitire/s c2i d"I u" S'Ll '- ineKi ss Regulation j 10 Park'Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 103714 Type: Supplement Card PAUL J. CAZEAULT & SONS, INC. Expiration: 7/9/2018 RUSSELL CAZEAULT 1031 MAIN ST OSTERVILLE, MA 02658 Update Address and return card.Mark reason for change. SCA I Z3 201-A-05111 El Address EJ Renewal Ej Employment Lost Card K f'ce of Consumer Affairs&Busine;s Regulation License or registration valid for individual use only :TbME IMPROVEMENT CONTRACTOR before the expiration dat6. If found return to: Office of Consumer Affairs and Business Regulation Registratiow .1�0'37`14. Type: 10 Park Plaza-Suite 5170 -�'liv Expirati6iii- :" .7/97201 Supplement Card Boston,MIA 02116 PAUL J. CAZEAULT&SONS, RUSSELL CAZEAULT 1031 MAIN ST OSTERVILLE,MA 02658 Undersecretary Not valid with out6i-dnature Massachusetts -Department of Public Safety Board of SuHding Regulations and Standards Construction superl-isor License: CS-108157 RUSSELL CAZEAULT.._, 2071 MAIN STREET 'R Brewster MA 02631 .57 Watlon Ex Commissioner I112312018 I �`r O l�EIf�1T�Ir��bATE OF I'.a11ABUT 11 ���Ic7lJL'VA��CE [__'�ATE(MMIDD/YYYY) 1 08/11/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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: Linda Sullivan DOWLING &O'NEIL INSURANCE AGENCY PHONN Ez , (508)775-1620 AA/C No, E-MAIL Iullivan@doins.com 973 IYANNOUGH RD. INSURERS AFFORDING COVERAGE NAIC$ HYANNIS MA 02601 INSURERA: LM INS CORP 33600 INSURED INSURER B: PAUL J CAZEAULT& SONS INC INSURERC: INSURER D: 1031 MAINST INSURERE: OSTERVILLE MA 02655 INSURER F: COVERAGES CERTIFICATE NUMBER: 76558 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS COMMERCIALGENERALLIABILITY _ EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO \ BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS" AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ I 1 1. $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS`LIABILITY YIN STATUTE ER FX ANYPROPRIETOR/PARTNER/ ECUTIVE E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED7 NIA N/A NIA WC531S386670026 08/10/2016 08/10/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/Workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Paul Cazeault ACCORDANCE WITH THE POLICY PROVISIONS. 1031 Main Street AUTHORIZED REPRESENTATIVE Ap Ostelville MA 02655 v-) C Daniel M.Cro ey,CPCU,Vice President-Residual Market-WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD PAUL J. ` r7SONS boom Property Owner Must Complete & Sign This Form If Using a Roofer / Builder I(print) L-°-� , as Owner / Agent I I of the subject property hereby authorize Paul J Cazeault & Sons, Inc to act on my behalf in all matters relative to work authorized by this building permit application for: Address of Job L�F'?6 M Signature of Owner (_�_ Mailing Address of Owner L)J Telephone # 58S Date /aZJ if �l 6 Please return this form to Paul J Cazeault & Sons, Inc along with your signed contract. It is needed for us to obtain the building permit required by your town to complete your roofing project FAX—508-420-4555 EMAIL—office@cazeault.com I Town of Barnstable of Regulatory Services o Thomas F.Geller,Director sn�tvsrnBi E, Building Division 0$ Tom Perry,Building Commissioner i639. a� iO�ED Mp`l 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us ffice: 508-862-4038 Fax: 508-790-6230 Approved: Fee: -�� Permit#: R)-7 �- HOME OCCUPATION REGISTRATION Date:_ 9l d� Name: ��� Phone#• � � 6� Address:-Se 'D AszO f Village: Blame of Business: /yyV l At Type of Business: Map/Lot: J -- OJ 2 INTENT: It is the intent of this section to allow the residents,of the Town of Barnstable to operate a home occupation. within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity$hall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no i isual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling'which are not customary in residential buildings,and there is no outside evidence of such use. ' • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shill not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit the undersigned,have read and agree with a above restrictions for my home occupation I am registering. applicant 4-174 Date: D iomeoc.doc Rev.5/30/03 YOU WISH TO OPEN A BUSINESS? � For Your Information:. Business certificates(cost $30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do.by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 15` FL.,.367 Main Street, Hyannis, MA 02601 (Town Hall) l 0 �los v A � DATE: lUS Fill in please: a APPLICANT'S YOUR NAME.: �/ QOi� BU INE S YOUR HOME ADDRESS: . ` TELEPHONE # Home Telephone Number� g 3�9Q NAME OF NEW BUSINESS ZooS TYPE OF BUSINESS IS THISA HOME OCCUPATION? YES, N.O < Have you been given approval from the buildin .divisigrt? ti*#t�_44A .r p f _ ADDRESS OF BUSINESS Ct. e_ as: CL -. A& 0 Trams f bA MAP/PARCEL NUMBER . When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St:—(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has b e it rmed of a permit requirements.that pertain to this type of business. Authorized Si ature" COMMENTS: o 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature"" COMMENTS: ' ' i i 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual ha en info d of the n m r irements that pertain to this type of business. Authorized Signature" COMMENTS: I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION . F r Map Parcel olr, -1 Permit# 2�3 Health Division 45L� Date Issued ��� Conservation Division �'1 Ay R.l 2 EPT, SYSTEM INSTALLED IN ®MPLIANCE Tax Collector WITH TITLE 5 Treasurer © �(`, VJ ENVIRONMENTAL CODE ANTOWNRECULeQTI®CIS Planning Dept. ,pate Definitive,Plan Approved by Planning Board - t k u J w��-4t L P ' istoric-_OKH e Preservation/Hyannis ' Project Street Address S 9 !� �/LI� t.✓ 1 h r c,� Village to P .Owner I P 'N ATQ-To Address fq O Ao&--tT Telephone / (k/I Permit Request %Z 3 -- Cd I _g C� wn k- ti O tti IZ �tN iZ Tt (,� ors O 01- PI IZ- A ( 6 h nO J 1Y0 O Square feet: 1 st floor: existing proposed 2nd floor:existing proposed To al new Estimated Project Cost 00 Zoning District Flood Plain Groundwater Overlay Construction Type W oo o T Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 0� Two Family ❑ Multi-Family(#units) Age of Existing Structure �S_ Historic House: O Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: O Full Cl 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 O Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:listing ❑new size-?YX.1 Y Pool:O existing ❑new size Barn:O existing ❑new size Attached garage:❑existing ❑new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION 1 _ Name M t e k9,! J. 11 :e Telephone Number 9 4 Address 3 �l w�v�y l i'�a-��t License# d S Z L OwTf h✓i Home Improvement Contractor# ///J 5- Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO J e(r.✓ A_A_01 y l SIGNATURE )LAA44 h DATE O FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION , FRAME INSULATION ` FIREPLACE ELECTRICAL: ROUGH, FINAL ; PLUMBING: ROUGH '"` FINAL - GAS: ROUGH ' r (�q FINAL _ r FINAL BUILDING DATE CLOSED OUT ~ ASSOCIATION PLAN NO. •f• : . . : The Town of Barnstable 6 �0� Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 •- Ralph Crossen Fax: 508-790-6230 Building Commissioner 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: e l k wq l-c o o T- )%O r IJ h 1 k Estimated Cost 1/6 0 Address of Work: �f j} . 0,4 i•v �7 rr (•✓. &A 7.4 .6 /f Owner's Name: /Y,4 64 Lfd? Date of Application:T I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law pJob 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 IN PROVEMENT 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: �Z(A q A%% C kAel T -L'I D e Contractor Name Registration No. OR Date Owner's Name gIbmis:Affidav i The Commonwealth of Massachusetts ,. ._ -_� Department of Industrial Accidents ::::: ::. 'T " == Office nf/nyestigations Lam _ :- -"1'� 600 Washington Street i Boston Mass. 02111 Workers n Insurance Affidavit name: M t t± IZ.,p.►� •r location: D /tit j (,v city phone# 1 ❑ I am a homeowner performing all work myself. Tam a sole proprietor and have no one working in any ca acity ❑ I am an employer providing workers' compensation for my employees working on this job. compnnv name: address: ...... ... city: phone#- insurance cn. Pn11cV# �am sole proprietor general contractor, or homeowner(circle one) and have hired the contractors listed below who ha�•e the following workers' compensation polices: companv name• address city: phone :..;: ... insurnnce cn. oiiry#.. company name. .. ;...,;., ... ..:. ..:.. :... :.. address: ......... ............ insurance co. . :>...:........ olicv# ME Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one yeah'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of S100.00 a day against me. I understand that o copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Sienature Date Print name ,n& 'Q ( J . I l-[,V L \ Phone# otllcial use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Buildin Department t; P ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone d; ❑Other (muea 9,95 P1A1 ..;,...... ...;. . Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any comr- 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 cf, the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver trustee of an individual, partnership, association or other legal eirtity,-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 or another who`employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds c. building appurtenant thereto shall not because of such employment be deemed to be an employer. _ MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renew of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: a .,The Commonwealth Of Massachtiseits Department of Industrial Accidents Me of Invesugatlons 600 Washington Street Boston,,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 l ✓/ze iJanvnaa�z�uealr�i o�.,�aoaaC�iea;elta I -: =t DEPARTMENT OF PUBLIC-SAFETY , . CONSTRUCTION. SUPERVISOR :ICENSE Expires: a , - Resttgd 30 16 NICHAEK-1 RENZI 361 PHINNEYS LN a CENTERVILLE, NA 02632 , 'l . JLrN'y.w' r s, r HOMErIMPROVEMENTyCONTRACTOR� Reais ration 111859 BA Ezxration MICHAEL RENZI CONSTRUCTION ` aMICHAEL J RENZI • '�'�;c PHINNEY'S LN`_ . r MINIS7gATpR roCENTERVILLE MA 02632 , i RE-ROOFING V" ocated in OKH or Hyannis Historic District- Certificate of Appropriateness required unless same color/same materials specified on application Map/parcel number Sign-offs from: ❑ Tax Collector Treasurer of uares of shingles or square footage of roof to be shingled peci stripping o d shingles or going over old roof. If going over ❑how many roof layers existing now ❑what size are rafters? What is span? Complete dwelling information for the Assessor's Dept. - if known Signature Workman's Comp. form Home Improvement Contractor Affidavit(RESIDENTIAL ONLY E3/ Home Improvement Contractor's License OR ❑ Homeowner's License Exemption(RESIDENTIAL ONLY) Check expiration date on license COMMERCIAL WORK -No License is required. lad' Fee q-forms-PERMITS 1 Rev3/5/99 I t r o d, I � � `. E � N e N 4 replace existing 4' v �.. landing and stairs ON C to grade DECK st it to gr d Y � ` g (D m M �m�ti in CM � tv to 0 existing landing and stairs to be replaced 1 st Floor I 36"rail L r tT•� U) D -o x C confirm rail Q) M details U � (13 � CL C confirm (2)2 x 8 Cont Flashing�decking \ x double ledgedok 2 X 8 P.T.Joists AG6 or BG6 post caps y 8//`` •L ts"ao ts"o.c. all posts DING Joist Hanger ✓(DIN � o� 11 P.T.Ledger Board o Or 040 N 6 x 6 pt posts to 48"x 12" Oconc.sonotubes embedded post k./ o o laC Q p ABu w/ see section 5/8"x 9"+ ca anchor bolt details v - � tlate printed Barnstable Bldg. De 6/ii/zo>s DECK SECTION 1/2�t _ 1� Approved by: SCALE: Elevation 1 Builder to confirm all dimensions Permit #;_.,,..� `V and conditions on site. These plans are for the sole purpose and use of SHEET: Capizzi Home Improvement and are not to be distributed or used for construction other than by Pg—1 Capizzi Home Improvement.