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0922 OAK STREET (CENT./W.BARN)
�IIII J�AECYCIFp� UPC 12543 No.�3LOR �r cans°� HASTINGS, MN Mmil- -.;. "..Atnh._. �-• ,...yh y -�.a -�'�ir:�.a �N'�11 ACTIVE �I�p �53. 6 Sp , Application number.. ::1 o� ...............�..... ........ ° Date Issued..........�. F sasxsTnB ........................................... o. �snss. .......... i639• e� Building Inspectors Initials.......... S -JUL 0 5 2018 Map/Parcel........:<P... ...QP-9......................... i f &d#WkkNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATIMRIZATION PROPERTY M®RMATION Address of Project: q Z Z 02 K St. NUUBER STREET VILLAGE Owner's Name: Ste✓e Phone Number 5 _ _ 70 Email Address: Cell Phone Number Project cost$�� ( ( � — Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: le" Ards cha 00--c.4 Date: TYPE OF woRK ❑ Siding LJ Windows (no header change)# /� _ Insulation/Weathe 'nzatton ❑ Doors (no header change)# Commercial Doors require on inspector's review ED Roof(not applying more than 1 layer of shingles) Construction Debris will be going to Gr1�S�e�/�']ciJa P,y�P� _ �,Y,co/r► /� L CONTRACTOR'S INFORMATION Contractor's name fZ u„ `7e nm,sc,n - .2,,,- -e cr, Ale-i F[, ICV4 kfl'n G`ow S . Home Improvement Contractors Registration(if applicable)# 17 3 Z.q (attach copy) Construction Supervisor's License S 7 07 (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF TIME SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE PERMIT CAN BE ISSUED. 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 • BARMARM Posted Until Firial Inspection Has Been Made. i63 P 6 Permit �d W� here a Certificate of Occupancy is Required,such Building shall Not be Occupied-until a Final Inspection has been made. Permit NO. B-18-2158 Applicant Name: BRIAN D DENNISON Approvals Date issued: 07/30/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 01/30/2019 Foundation: Location: 922 OAK STREET(CENT./W.BARN),WEST Map/Lot: 216-009 Zoning District: RF Sheathing: Owner on Record: MANNI,CATHERINE H&STEVEN J TRS 1 Contractor Name:` ,BRIAN D DENNISON Framing: 1 Address: 922 OAK STREET Contractor License: CS-095707 2 WEST BARNSTABLE, MA 02668 T. . Est. Project Cost: $30,118.00 Chimney: Description: replace 14 windows Permit Fee: $ 153.60 Insulation: Fee Paid: $153.60 Project Review Req: , Final: Date: 7/30/2018 U_er Z 9 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. Rough 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. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for.public inspection for the entire duration of the work until the completion of the same. i __._ Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work:' 1.Foundation or Footing Rough: 2.Sheathing Inspection - 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 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 Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT I I i APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tens total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s)of each tent j I food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pnL Commercial events may require Fire Department approval Y V V®®Dl COAL /PELLET STOVES x Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE9'iXEM IO Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities sander the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the'gown of Barnstable. Signature Date PLICANT'S SIGNATURE Signature Date 7 - 5� t All permit applkations are subject to a building official's approval prior to issuance. i kenewal Agreement Document and Payment Terms byAndersen. dba:Renewal B Andersen of Southern New England Y 8 Steve Manni =RMA.....l Legal Name:Southern New England Windows,LLC 922 Oak Street RI#36079,MA#173245,CT#0634555, Lead Firm#1237 West Barnstable,MA 02688 10 Reservoir Rd I Smithfield,RI 02917 H:5083623703 Phone:866-563-2235 1 Fax:401-633-6602 1 sales@renewalsne.com Buyer(s)Name: Steve Manni Contract Date: 06/22/18 Buyer(s)Street Address: 922 Oak Street,West Barnstable, MA 02688 Primary Telephone Number: 5083623703 Secondary Telephone Number: Primary Email: s_manni@Comcast.net Secondary Email: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively, this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $30,118 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $10,000 Balance Due: $20,118 Estimated Start: Estimated Completion: Amount Financed: $20,118 8 to 10 weeks 8 to 10 weeks Method of Payment: Financing We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date.Rain and extreme weather are the most common causes for delay. Notes: Plan 1181 6.99% at 7 yrs Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s) and Contractor.Buyer(s)hereby acknowledges that Buyer(s) 1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 06/26/2018 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC dba:Re7n rsen of Southern New England Buyer(s) Signature of Sales Person Signature Signature Paul Conboy Steve Manni Print Name of Sales Person Print Name Print Name UPDATED: 06/22/18 Page 2 / 15 ce of Consumer emirs and Business Reglslation 10 Park Plaza - Suite 5170 Boston, Massachusetts.02116 Horne Improvement Contractor Registration Registration: 173245 Type: Supplement Card SOUTHERN NEW ENGLANDI WINDOWS 'LL Expiration: 9/19/2018 BRIAN DENNISON 26 ALBION RD - - LINCOLN, RI 02865 Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card -:Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the -: HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration: 173245 Type: 10 park Plaza-Suite 5170 Expiration: 9i19i201 8 Supplement Card Boston,NIA 01-116 ;OLITHERN NEW ENGLAND WINDOWS LLC. iENEWAL BY ANDERSON IRIAN DENNISON / --- 16 ALBION RD .INCOLN, RI 02865dersecreiary Not valid without signature chUsettS Dei.Jait ':ti^..ti 'Oi �" !j !iC SO'rd of BSjddi ig' Rea--LAla ons a;.d Standards CS-095707 BRIAN D DENNISON 7 LAMBS POND CIRCLE 'CHARLTON MA 01507 09/48r`208 The Commonwealth of Massachusetts ' Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensatibn Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH TBE PERMIT-MG AUTHORITY. Applicant Information Please Print Leiribly Name (Business/Organization/Individual): 1e gq Address: .2 City/State/Zip: p Phone Are you sin employer?Check the appropriate box: Type of project(required): 1,KI am a employer with Zo temployees(Ul and/or part-time).* 7..Q New construction 2.�I am a sole proprietor or partnership and have no employees working for me in any rapacity.[No workers'comp—insurance required.] 8• Remodeling 3.O I am a homeowner doing all work myself[No workers'comp.insurance required_) 9• ❑'Demolition 4.O I am a homeowner and will be hiring contractors to conduct all work on my property. I will 1 0 ❑Building addition entire that all contractors either have workers'compensation insurance or are sole I LF]Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet These sub-contractors have employees and have worker comp.insurance? 13.DRoof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other_W 1 ok 152,§1(4),and we have no employees.[No workers'comp.i stuance required.] rAo cc-,g--,- 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contactors must submit a new affidavit indicating such (Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their worker comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy ad job site information Insurance Company Name: `lrf file 1) Policy#or Self-ins.Lic.#: {,(�C - 3/Se-7 Z,q — Z. Expiration Date: /h 1 Job Site Address:_ _I 1 Z (9cL(<� r-,,+. City/State/Zip: W, r,.7 c�, Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration te). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation ptirushable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification_ I do hereby certify under th ains andpenaldes ofpei jury that the information provided above is true and correct Sienafore: D2te: 7 — Phone#: CIO t-2Z e`i'9e Official use only. Do not write in this area,to be completed by c4 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: Pbone#: i A��R�® CERTIFICATE OF LIABILITY INSURANCE FDATE DIYYYY) 12/2912912017 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 CoBiz Insurance, Inc.-CO NAME: PHONE 1401 Lawrence St, Ste. 1200 303-988-0446 a c No):303-988-0804 Denver CO 80202 E-MAIL : COMailtacobWnsuranGexom INSURE S AFFORDING COVERAGE NAIL @ INSURER A:Acadia Insurance Company 31325 INSURED ESLFRCo-01 Southern New England Windows, LLC. INSURER B:Firemens Insurance Company of WA,D.C. 21784 dba Renewal by Andersen of Southern New England INsuRER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: INSURER F COVERAGES • CERTIFICATE NUMBER:1252851165 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 ADDL SUBR POLICY EFF POLICY EXP LA POLICY NUMBER MM/DD U LIMITS A X COMMERCIAL GENERAL UABiLrrY CPA3158728 1/1/2018 111=19 EACH OCCURRENCE $1.000.000 dLAIMS-MADE OCCUR DAMAGE PREMISES Er occurrence) $30D,000 MED EXP one person $10.000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2.000,OOD PRO- X POLICY 0JECTT LOC _ r PRODUCTS-COMP/OP AGG $2,000,000 , OTHER $ A AUTOMOBILE LIABILITY N CPA3158728 1/12018 1112019 COMBINED SINGLE LIMIT $1,01M.000 X ANY AUTO Ea accidentBODILY INJURY(Per person) $ AUTOS AUTOS ALL OWNED U� I BODILY INJURY(Per accident) $ X HIRED AUTO X NON-OWNED PROPERTY DAMAGE AUTOS I Per acdderd $ $ A X UMBRELLA LIAR X OCCUR CPA3158726 1/12016 1112019 EACH OCCURRENCE $10.000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $1o.DD0.000 DED I X RETENTION$ $ B WORKERS COMPENSATION WCA3158729-20 1/12018 1n2019 AND EMPLOYERS'LIABILITY Y/N X STATUTE ERµ ANY PROPRIETOWPARTNER/EJMCUTIVE OFFICER/MEMBER EXCLUDED? ❑N/A EL EACH ACCIDENT -$I.ODO.000 (Mandatory in NH) EL DISEASE-EA EMPLO $1.000,000 N yyeess describe under DESCRIPnON OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1.000.000 C Pollution Liabi 7930073340000 1/12018 1/12019 Each Oecunence $1.000.000 Claims•Made Pdicy =egale $1,0D0.DD0 Retroactive Date 06202013 Detluctible $10,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more spare Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes . AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25.(2014/01) The ACORD name and logo are registered marks of ACORD i Town of Barnstable *Permit# o obi 3 S— ° Expires 6 months from issue date Regulatory Services Fee — R � y�. 1MAS& Thomas F.Geiler,Director ArED�,i A Building Division p Tom Perry,CBO, Building Commissioner a 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office! 508-862-4038 Fax: 508-790:6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 0/to 0 1 _ CFP_roperty:Address�_ 9vZ 0Ai K S/ (--M,Residential Value of Work • Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address- 5/L`�l/�/U C�_9�2 Or9=K S i GcJ /3R�2hS%�31�" / i4. Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) X-PRESS PERMIT ❑Workman's Compensation Insurance FEB — 6 2013 Check one: ❑, I am a sole proprietor CN-I-am the Homeowner TOWN OF BARNSTABLE ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) �® Reside, g (maximum.35 #of doors c®_Replacement Windows/doors/sliders.U O-Value--- �/ )#-'of windows—� ❑ 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 r�iredd. (SIGNATURE: QAWPFMM\FORMS\building permit forms\E)2FMS.doc I . The Commonwealth ofMassadruselts Deparriment o.f Industrial Acciden& Office oInvestigations 600 Washington Street Boston, 4 92111 wrvw_mas&govldiu N%rorke"' Compensation Insurance Affidavit- BifdiderslContractors/EIectiricians/Phumbers Applicant Information Pease Print Leabl rNana tion/lndividual): S%�-✓L`� �'✓y� Adr�ress 9aZoZ Os97�.S i tiCity/Statel p Are you an employer?Check the appropriate box: Type of project(required): . ❑ I am a general contractor and I 1_❑ I am a employer with 6_ ❑New construction employees(full and/or paxttime).* have:hired the sub-contractors 2_❑ I am a sole praprietoi orgartuer- listed on the attached sheet, 7. ❑Remodeling ship and hat*e no employees These sub-contractors have g- ❑Demolition. wor dngg for me in any capacity. employees and have Viers' 9_- ❑Building addition [No workers'comp.insurance comp-insurance-I repaired] 5. ❑ We area corporation.and its 10.❑Electrical repairs or additions I oxl�cers have exercised ❑1 f_ Plumbing repairs or additions aiu a.homeowner doing all work � ht myself [No workers'comp c 13 of exemption per iwle no 17❑Rflof repairs insurance repaired.]T empc. 2,§1{4),and we have g to [No workers' 13.0Other comp.insurance required.] *Any applicant that checis box#1 must also fiRout be section below shoeing their wuike s'compensation policy information. I Honmowners who submit this a€tidsvit indicating they are doing all wcd and then bite outside contractors mast submit anew affidavit indicating such FContractors that check this bra must attached an additional sheer showing the nmme of the s6-contactm and state whether or not(hose entities hale employees. Ifthe sub-contmaors have®plcyees,they nmsLptavide their workers'comp.policy number- I trin an employer that is prrn Nog workers'compensagm.insarartce for my eatployms� Bdoty is the puNc3'and job site informat6m. Insurance Company Name: Policy#cr.self-ins.Lie.# Expiration Date: Job Site Addles: City/StatelZig: Attach s copy of the workers'compensation policy declarationpage(showing the policy mrmber 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 sta#ement may be forwarded to the Office of Investigations of the DIA for insurance coverage verifuticn. I dv kareby ceili y inter€hepains and patnaWas ofperjury that the informidian print'ded above is hits and correct Phone -=G�-3G� OjTu*l use only: Do not avrite in this area,la be campleted by ditr or talwi officiaC City or Town: PermitUcense# r=d g Authority(circle one): 1.Board of Health 2.Binding Department 3.City/Town Clerk 4.13ectrical Inspector S.Pt.n.mbing Inspector 6.Othez ontact Person: Phone#: OtIKE,°wti Town of Barnstable Regulatory Services IARNSrABLE, ' Thomas F. Geiler, Director rsnss. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office:. 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print tDATE: -^"o?_—_l JOB LOCATION: i~ number street village "HOMEOWNER':: / V /%fIr�it� Sy13 3�aZ 3�03 --naine -- - home_phone-#------ work phone CURRENT MAILING ADDRESS: city/town ._ �^^state ""zip code-• - The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER I Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home'in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such'work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and.requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exetrrption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. • � _mvnn rnn a__ i of IKEr * MUMSTABLE, ; "S. � Town of Barnstable prfl)►M't A . Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street,' Hyannis,MA 02601 www.town.barnstable.ma.us ' Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder h ; as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit;please complete the Homeowners License Exemption Form on-the reverse side. ' QAWPFILESTORWbuilding permit forms\EXPRESS.doc .. --•; a,.� .. � - 9-'^ •...» i ti�.w-.-w.�s-.s.....-.ti,,,;r.,,.r.-yrs.+.y�'„•�"•t• �•A•�-'� ..�-� -. _ r. _.r`,..n-•�°^r.^•...t�.C.:.-`�h�*��.i�'•.-...:.v�•...'...k.-.. -•ti,,, • 4`pp1HE►p��� Town of Barnstable y7 BARNSTABLE. Regulatory Services 9 MASS. � , 039. a. Building Division rF0 MA'S 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection kJo'A-ic ZV1 Tf-f o uT /t—w M c-r Location l 2 2 A I& Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. I The following items need correcting: AJORk P&c-' EE-(J>L. o AJ-E 0ti c2 C4 Pcvc—n-r(f GcJrfS t QNC tt/-7'NOU �- �l-F �� �JI.�/R �E'fc'/Gr /?- (�A9 1970A ov�GS. hT` 'a lJ 3 3 /d/t o H M,# 77-AJ Please call: 508-862-4 .for r-e=inspectioa. Ins ected b r P Y Date �5 S Application to (91Y Rinq,o pigbbiap Regional pisstoric miotritt Committee In the Town of Barnstable _ CERTIFICATE OF APPROPRIATENESS 8 0 i )placation is hereby made,with four complete sets, for the issuance of a Certificate of Appropriateness underzgectio ; of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described.below and on plane n awings, or photographs accompanying this application for. n -1ECK CATEGORIES THAT APPLY: w Exterior building construction: ❑ New El L9 Alteration Indicate type of building: House ❑ Garage ❑ Commercial Other Exterior Painting: ❑ Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other YPE OR PRINT LEGIBLY: DATE DDRESS OF PROPOSED WORK ASSESSOR'S MAP NO. ' I LP WNER ASSESSOR'S LOT NO. -1�1�m OME ADDRESS 0012 S% 4). /S/2,V-2�34e f'7i¢ TELEPH0NEINO.,-Ok.3la S 70_3 ULL NAMES AND ADDRESSES OF ABUTTING'OWNERS, including tliose'of adjacent property owners across any -iblic street orway. (Attach additional sheet if necessary.) 2A c �osSz-�C '700 ate. 93 ,3GG c ?FYI e. ow v PY& q3 J9-� TR ,:._B`�9:' s� G So ,U .e lg�v i 09-9 Sid ,GENT OR CONTRACTOR NO. ADDRESS )ESCRIPTION OF PROPOSED,WORK: Give particulars of work to be.don,e, Including materials to be used. Please iclude locations of proposed signs. 5��Z� �Zc�,c q,�,� 1Z�S/f��/GG�, SIi263 Ce;:A,*i2�'hhNGL�s g,.4 Soar& S/ S.7 of=h�o�/S��9�v� -,�5�//�VGG� !�l/Thy X/97-7£- A40 iT�Ce&t.2 5111 vC-�':5 Signed Owner ontractor-Agent - For Committee Use Only , This Certificate is hereby Date pro dCommittee Members' Signature�Ap Town of Barnstable ` Old King's Highway Historic District Committee SPEC SHEET ?OUNDATION �/2DN/ S7,52 - /3)210e s-211 Z,!;�ya7l/"yyl/ z >0 3 Si�S SIDING TYPE �i�/�C [���2 ,S/�IN�Ce!� COLOR =IMNEY TYPE COLOR r ROOF MATERIAL/�}jZCI��/EG/G1/Z/�'L COLOR FjZOS% PITCH WINDOWS COLOR SIZE TRIM COLOR DOORS COLORS f _r SHUTTERS COLORS GUTTERS COLORS DECKS MATERIALS GARAGE DOORS COLORS SKYLIGHTS SIZE COLORS SIGNS COLORS FENCE COLOR NOTES Fill out completely, including measurements and materials/colors to be used. Your copies of thin form are raYaired for suL•_:_. of an apg..._atioa, along with Four copies of the plot plan, landscape plea and elevation plans, when applicable. Now 74- If All,;-----�-- 410 Al ea ff J ,AD t+GV/e#'e J I Lem-s. e e/evvd�`p4 -17 le Faso } i - r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 0 ToE(e1d OF Permit# Health Division 7 R�R��STAg�E Date Issued Conservation Division 4 Pm �: S8 Application Fee Tax Collector f N1 Permit Fee Treasurer UrT nl'd1S10P1 Planning Dept. AppWd of bd only$ Date Definitive Plan Approved by Planning Board NofW swvke authorized. Historic-OKH Preservation/Hyannis Project Street Address 15�ZZ i 'Village k)• 13d9 v_si'�3Z, . /167A Owner <S/Cy� C' h<y /�%i9"�/�� Address 9oZo2 0101Z 15 41 dWo A/f} Telephone 10k- 34, 2- 3703 -Wermit Request %��`% 12-0 �/37,3a r2�91`7G 7 q-ate io Square feet: 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. 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 Count 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 Attached garage:❑existing Cl 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 BUILDER INFORMATION Telephone Number ,S�O,5�;--3e�2-3703 Address 92.?- License# 1-/3q2 s%3b, e_//e!�8 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 2 Y GQ/u4,Z,& DATE 6'`1�- 0� ! FOR OFFICIAL USE ONLY PERMIT NO. y . > DATE ISSUED ' MAP/PARCEL NO. t ' ADDRESS VILLAGE / OWNER 1 ''•'f DATE OF INSPECTION: r , FOUNDATION 'P FRAME , INSULATION 'r FIREPLACE �< ELECTRICAL: ROUGH FINAL 4 r PLUMBING: ROUGH FINAL , r GAS: ROUGH FINAL - FINAL BUILDING DATE CLOSED OUT x x ASSOCIATION PLAN NO. k f • , r The Co► nw'nwealth of Massachusetts Department of Industrial Accidents Wee ofh*Vsbwm 600 Washington Street Boston,Mass. 02111 . Workers' Co ensatioR Insurance Affidavit-General Businesses m •- sine / /�! t r. c•r address /02-� 0i9'l� Si (�(/• (3/�I�Ju�i�9'13L� state: /6�//4 zip:05ZZZ:5�Phone#' 3 R-.3z .2 K? work site locatiari(full address): ❑ I am.a sole proprietor and have no one Business Type: ❑Retail❑RestaurantBazBatYng Establishment working in any capacity. ❑Office❑ Sales(mcluding.Real Estate,Autos etc.)' ❑I am an em toyer with etn to es full& art time: ❑ Other %///%%%%///��c i..,,/% % %%/%%//�% �I an employer providing workers' comneusation for my employees worlang on this job.. 2. coda-an••g - • ame ;.:e�A.. - ';.. .. :t'' :.�+:i� '• � •{•: s ;. t. cili phone • .j't !i.'2.: is ':>.:• ..r.,• j insurarice.co . !�_ •j...�. :y '; u.:k:;. ohc. .# I am a sole proprietor and have hired the independent contractors listed below who have rife following workers' .compensation polices: '.+i:.e-:' a.^•'' ° t :-• l;: i>' :L':• �.�: :.�..v.!y'a ..vita: ':a�.`.:,i:: coin'• 'sn- 'n'ame. address:. �' :z:+'� :::.•�• _ ':,'•:': :i: :,•::,. city .:1: .,, ��., , .,v --erg- •.•s.,, - .t r,,.,:,. •:�.••• . :1•d•;'�\':: •.a Ica insuranceco. :t :�'. :'i .e,. Folic :.#.' zr.'•: ~t!;.:; •as e:• •'�' ".': +tip' •:i _ .:>'.`! .c•. COIIi�BII• D 8adre$SS Y 1• -. .. -. .i r. .r. : •• ... , - . . :phone#i FaUure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of eriminalpenalties of a fine up to$1,500.00 and/or one years'imprisonment as well as c1vU penalries in the form of a STOP FVORK ORDER and a fine of$100.00 a day against me. I understand that g copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certi u er the pains and penalties of perjury that the information provided above is&uue and correct Signature G',!�%uc�! Date Print name 22�P�W Phone# S--OF,JeeZ- 700 official use only do not write in this area to be completed by city or town official city or town: permittlicense# []Building Department . ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office []Health Department contact person: phone#; ❑Other (revised Sept 2003) Information and Instructions. Massachusetts General Laws chapter�152 section 25.requires all employers to provide workers' compensation for their employees. As q . uoted from the law", an employee is.defined as every person i.n the service-of another under airy contract � . of hire; express or implied; oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in ajoint enterprise, and including the legal representatives of a deceased,employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the.occupant:of the dwelling house of construction or repair work on such dwelling house or on the grounds or another who employs persons to do.maintenance, building appurtenant thereto shall not because of such.employment.be deemed to be an employer. :. MGL chapter 152 section 25 also'staies that every state'or li)cal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the.commonwealth for any applicant who has not produced acceptable evidence of-compliance with the insurance coverage required. Additionally, neither the commonwealth nor.any.of its political subdivisions shall enter into any contract for the performance of public work until compliance with the insurance requirements.of this chapter have been presented to the contracting . acceptable evidence of authority. Applicants j Please fill in the workers'compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, 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 of Industrial Accidents. Should you have any questions regarding•'the"'law"or if you are requested, not the Department required to obtain a:workers'.compensation policy,please call the Department at the number list A 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 t in the event the Office of Investigations has to contact you regarding the applicant. Please affidavit for you to fill ou be sure to fill.in the perrnit/license number.which wdl be used as a reference number. The.affidavits.may.be'.returned to the Department by mail or FAX.ufiless other•arrangements have been made.' The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a-call. The Department's address,telephone and-fax number: The Commonwealth Of Massachusetts- Department of Industrial Accidents 8fam of Wesngafions 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 exL 406 i i . Q 1 I N .i ❑ 3 . -� I PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling &O' Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Agency, Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 222 West Main St. PO Box 1990 Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Associated Employers Insurance Compa American Tent and Table, Inc. INSURER B: P. O. Box 1348 INSURER C: Marstons Mills, MA 02648 INSURER D: INSURER E: COVERAGES 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!SSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR NSR DATE MM/DDlYY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAEMAIGE TO RSES aENTED occurrence) $ CLAIMS MADE DOCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PR LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY - $ NON-OWNED AUTOS (Per accident) ) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC 4 AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION S $ A WORKERS COMPENSATION AND WCC5004440012004 04/23/04 04/23/05 X WC STATU- OTH- EMPLOYERS'LIABILITY OR LIMITS EEL ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $100,000 - OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEd$100,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1$500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE r ACORD 25(2001/08) 1 of 2 #34228 MA © ACORD CORPORATION 198E i Of lum ANisum C4t/o F REGISTERED ISSUED BY Date treated or ARUCATION manufactured N No. Academy Tent 8� Canvas 05/31/2002 5035 Gifford Ave. Los Angeles, CA 90058 23 277-8368 This is to certify that the materials described below hereof have been flame retardant treated(or are Inherently nonflammable). FOR AMERIICAN TENT&TABLE ADDRESS 381 OLD FALMOUTH ROAD CITY ONS MILLS STATE MA 02695 Certification is hereby made that:(Check "a"or"b') F�(a) The articles described below this certificate have been treated with a flame-retardant chemical approved and reglstered by the State Fire Marshal and that the application of said chemical was done In conformance with the laws of the State of California and the Rules and Regula- tions of the State Fire Marshal. Name of chemical used............................................................. Chem.Reg.No. ........................ Methodof application..................................................................................................................... (b) The articles described below hereof are made from a flame-resistant fabric or material regis- tered and approved by the State Fire Marshal for such use;Fabric has been tested and passes NFPA701-96. VINYL F- 9.01 Trade name of flame-resistant fabric or material used ................................... Reg. o. ............ The Flame Retardant Process Used ...Will.Not...Be Removed by Washing (wilt or will not) David Bradley By Tom Shapiro - President Name of Applicator or Production Superintendent Title THIS FABRIC WAS USED IN THE MANUFACTURING OF THE FOLLOWING 2EA 30X30 U/W 213C CANOPY TOP ONLY 3EA 30X10 U/W MIDDLE CANOPY TOP C0NAWNT U/W 2PC CANOPY TOP ONLY 'O" _' N MIDDLE CANOPY TOP ONLY CUSTOMER ORDER NO. 61988 2EA 15X15 U/W 2PC CANOPY TOP ONLY WI-8%i UX e 0 UNr 2PC CANOPY TOPS ONLY CUSTOMER INVOICE NO. 49966 YARDS OR QUANTITY COLOR STYLE DATE PROCESSED ALL MATERIALS ARE CERTIFIED BY THE CALIFORNIA STATE FIRE MARSHALL AND MEET THE REQUIREMENTS OF THE NFPA 701 AND UL214*** oFIME Town of Barnstable *Permit O,� \ Expires 6 months from issue date MST" = Regulatory Services Fee 90 26639. Thomas F.Geiler,Director ' �iO�ED MA't�• Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA.02601 X-PRESS PERMIT Office: 508-862-4038 Fax: 508-790-6230 JUN 2. 7 2003 EXPRESS PERMIT APPLICATION - RESIDEN "QI�II,�',RNSTABLE Not Valid without Red X-Press Imprint Map/parcel Number O61 Property Address @,Residential Value of Work Owner's Name&Address Contractor's Name 12aly Telephone Number.S�O�"c����3ro3 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) (� Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ® Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. Signature 711� Q:Forms:expmtrg Revise053003 Ot'tttF F �i�6�rtondss l om a.Me awe % 0 ` O •! ::! Regulatory SeMeeS Fee ' �a sraetta;i t2 x ' \ 7 3 303 9��eep Thomas F Genet Memr ` Fa .y'' BuiidingDivision Peter F.Di\Iatteo, Bttildtng Commustoner %3s4,z 367 Main Strt:et. Hyannis,MA 02601W NO 9 � Office: 508-862-n�� 7-0 VNOF ?00 Fax: 508•790-62=0 EIPRESS PERMIT APPLICA1110N - RESMENTIAL ONL_ RI1,37.1 Not VaUd wahout Pad X•FrM-1MP1*U Map:parcelNurnber o2-141, GU 9 Property address liZ•Z- 0.4le �� l`'l/9 . �—Z cal Value ofWork d O (Residential / Owner's Name 8:kddress 9�Z a#K S77lv ,3,*zVsI Contractor's Name_, p 771 /��iU� Telephone Number���' K Home Improvement Contractor license 4(if applicable) 'construction Supervisor's License=(if applicable) r ❑Workman's Compensarion Insurance Check one: ❑ I am a sole propriemr I am the Homeonner ❑ I have Workcr's Compensation Insurance - Insurance Company Name Worianan's Comp.Policy Permit Request(check box) [l Re-roof(stripping old shingles) ❑ Re-roof(not stripping. Going over existing layets of roof) �Re-side • ❑ Replacement Windo%s. U-Value (mgximum•44) ❑ Other(specify) Where required: :ssuaice of this permit does not exempt corttpliaaee ether town ftaturient tepiations.i.e.Historic.Conscr+otion. Signature Q:Fomu:e-%prnrr9:rva)'060 t Application to 2 co 2\2 8 J ®Yb Ring'o Aftb lap Regionar 30igtoric Miotritt Committee In the Town of Barnstable CERTIFICATE OF APPROPRIATENESS i= Application is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness*under Section 6 of 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 ❑ Addition ❑ Alteration Indicate type of building: 1.House ❑ Garage ❑ Commercial ® Other _S/A/Ng 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other TYPE OR PRINT LEGIBLY: DATE ADDRESS OF PROPOSED WORK OfYK S�. W. ASSESSOR'S MAP NO. \ OWNER-S/�(/`�� F r!-1�%/�/`�i2/iti/= N. 1`14WIV/ ASSESSOR'S LOT NO. . HOME ADDRESS 9oZ1Z Dille Si GJ /3/9ivV� i`1!4 D��p�� TELEPHONE FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) AGENT OR CONTRACTOR 3015�� 1�> �� UAW TELEPHONE NOJ-0 771• 1tS.?J— ADDRESS 1.D, 13oJC 9124,il DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. si xv/vC� 5MI.,V6 o v .9W8 /2�'r'G9G6- V/NYL S/ /"6 .gvvjS W126,i) %/fc %#2,z. �2DrYi lJ/N�O�Js Signed owner—'on—tractor-Agent fl r---N f----,r-, n n _ ra �r Committee Use Only 'YJ +J 1 This Certificate is hereby A Date O )C�ommittee Approved/ nied T' i Members' Signatures: ' Town of Barnstable ' Old King's Highway Historic District Committee 2 O O 2 SPEC SHEET FOUNDATION SIDING TYPE yfN`IZ— /37' l9'LC0j9 COLOR jd/-/-/j L: CHIMNEY TYPE COLOR ROOF MATERIAL COLOR PITCH WINDOWS COLOR SIZE TRIM COLOR I DOORS COLORS SHUTTERS COLORS GUTTERS COLORS DECKS MATERIALS GARAGE DOORS COLORS SKYLIGHTS SIZE COLORS SIGNS C0LOR1 Sf1) l nq nn j]r-_-7 (), OCT FENCE COLOR -ABLE I NOTES:: Fill*out completely; inc1luding measurements and materials/colors to be used. Four 1VNI copies of this form are required fo"i s timittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SPECSHT Revised 11/98 4/0 Assessor's offioe (Ist floor): �- Assessor's map-,and lot number �11J �..����.. ........, �Q�oFfNFto`o Board of Health (3rd floor): ' C `_7� Sewage Permit number ......... ...........Q ..............`..> .......... .. B6Sd91'oDLL, Engineering Department (3rd floor): 'moo MAO& House number.. ....... .................._........ ......... ... APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00.2:00 P.M. only TOWN .,OF BARN°STABLE BUILING INSPECTOR _ APPLICATION FOR PERMIT TO ..�y.Q. .� /U.C... .....da:!".J..rw' ..r.................................................... TYPEOF CONSTRUCTION .... ! C1. �1..... r ................................................................................ ...............................�0.. .. .19V TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....�� ........ .� .....SYL........... .. a...r..n. ./...r�. 1 �:.............................:..............:.... ........ s. ��yy 1 _ ProposedUse ....�,)..r n. .le.....4am. ..1'Ju.................................................................................................................. Zoning District ....................�.d..F......................................Fire District .....&-/es.�.... Name of Owner vyl!w o....... an..n../...........Add ress 9�� �......QGL/G..... ...................................... i Name of Builder .....\To. ..n.....r...I.L.LS................Address :!��.....C. .I.Q �.Pa.. .!..r..:... �!.1C,� �.r Name of Architect ........na n ee.......................................Address .......................... .............. Numberof Rooms ..................................................................Foundation .........................................:.......................:........... ........... Exterior ...Iwh!. 9:�......Qf.d.0..r.................................Roofing a.lS.�, �. ......... .............. FloorsI� i '..... .... .!.t ...r . '.. .......1•.:.................:...........................Interior ... 4�+. ..p .. ' .. .......................... ....................... Heating ... ......... ........ . .�.. . . ......... ................................. : .Punbing i Fireplace ................................................................Approximate Cost . ......... Definitive Plan Approved by Planning Board ----------------------_---------19 . Area0... Diagram of Lot and Building with Dimensions 'Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH oQ Ic 9 Q � a aao��39� r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 3 I hereby agree to conform to all the Rules and Regulations of the Town of Bdrnstoble regarding the above construction. NI Name ..... ................:.�.....�..:.•: ,-�%..., -� Q Construction Supervisor's license 7�...................... MANNI, STEVEN A=216-009 No ..3 .259.. Permit for ...PMi1.d..Z)0.rmer.. ....... ... Sincrle Famil .......................................Y...D e,.J.J Lng....... Location ....9.2.2...Oak....S.t.:r . ._ . . Q .................. West Barn$.t- , qblp...... ........................................... ............... Owner .............Steven...��4TIRj ........... ............................ Type of Construction ...F.XaMe.......................... ............. ............................................... Plot ....................... Lot ...................... .......... Permit Granted .....October... .5. ........ .... .. .... .. .. ..19 87 -Date of Inspection ................................. Date Completed ......................................19 Assessor's offioe (1st floor): 1111111. of Assessor's map and lot number ..... ...................... ..0.... ., s ED IN COMPLIANCE TwE `o Board of Health Ord floor): ` d Sewage Permit number ............. ..7.'. ......... W":....... � s Z BAWSTULE, S ..ENVIRONMENTAL BODE AND rasa e Engineering Department (3rd floor): �ZL 6CF �QwyREGULATIONS o°�e�pY' \0� House number ........................: .......... ........................... .. d. APPLICATIONS PROCESSED 8:30 '9:30 A.M. and 1:00 2:00 P.M.' only. TOWN O,F BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....budL.l'......... ...CZ:L�Y.)./..L:V.....coom. . ..........a.C11.{ f,/... .. .. TYPE OF CONSTRUCTION ....I,U. d......... ...t"aY.n..�,............................................................................. ............................... ......1-3...19"' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 9�.v ......(00.1e. ........ J� w,... a.rncSf l:�... . ................. . . .................................................................... ProposedUse ...... a> >7.1.�V...........ro.Q.n )..................................................................................................................... Zoning District ........................................................................Fire District ... 1 .....�a-r..n..cS 7 -�b/� Name of Owner ...- - P ��......1... .../..Q!> I7.�.............Address Y5. !�...�•.C...v, C.I ......................................... Name of Builder Uhn........[-/.�-(. �?......................Address ..`7 .../../...lQ .... .f�,..../. ........ Nameof Architect ..................................................................Address .....................:.T. ................................................. Number of Rooms ..... ...........................................................Foundation ....�.© .Cl........e-o cceJ.�............... Exterior -I L ..UJI�f..1 ..........C.:e..�l.�.?�.................................Roofing ..Q.S.p.n.CC:ll.................................................. Floors ..0 ar.-.pe.. ........................................................Interior ... Heating ..... .... .4 �'.r ....................................Plumbing ........ .0. le�. Fireplace ..... .el..S. ............Approximate Cost 15 ��� ................................................ .............................................. i Definitive Plan Approved by Planning Board ________________________________19________ . Area .............:>............................ Diagram of Lot and .Building with Dimensions Fee .................... ....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 10% #O A ST; \ ts� o DP;, 0 00 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. —:2 Name . .. ........ ... ......... ........................ Construction Supervisor's License ...976. MANNI , STEVEN No AU4.7... Permit for ....IP:qAI.d..Addi.ti-on ...........91 ag-I e F.aml.1-y...Dwel-1-ing...... 922 Location ....................Oa...k...,$.tre e.t...................... . .......................W......Ba.rxis.table...................... Owner ..........Steve............ ......................... Type of Construction .........FraMe.................... ......................................................... .............. Plot ............................... Lot ................................ Permit Gran'Ld ......J4.MAP�Y;Y.....1.4.,...19 $8 Date of jWpection ....................................19 Coib'pWed .....................................:19 M 0 Assessor's dffioe'Ost floor): Assessor's map and lot number ..... ... .1 �' F l ` . . ..................Q....:. THE I - ' Board of Health (3rd floor): 9 _ Sewage Permit number !�............................. Z BASd940DLE, i Engineering Department (3rd floor): �ZL � �Mbso•o-�0�� Housenumber .................................... ................................... o wo APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2i00 P.M. only TOWN OF BARNSTABLE 7- BUILDING INSPECTOR y 'APPLICATION FOR-PERMIT TO .... .V.,�. ........�(11 Y?.1..�.f,�.....r��.C��'?.........Q..�S.�./.:.MC. TYPE OF CONSTRUCTION W.0.01.d........X�oxn..e............................................................................. ............................... ---1d(p TO THE INSPECTOR OF BUILDINGS: r The undersigned hereby applies for a permit according to the following information: �'f- ;( .....n`..:fa.bzc:,...................................................................... Location ..q. ....... GZ 1..........�... ...............�I...... r S ProposedUse ..... /v........... ).................................................................................................................... • Zoning District ....................................:...................................Fire District ... (�t' .....�� .r..n..�.S..!... ..,b.l�...... Name of Owner ...�?.:re en..........f.../.Q. n.�.............Address 9 a �Q /�; U Name of Builder , hn......../-- e...��S ,,.//.^^ �}../......../............ .c.J...: l (.. � ......................Address �J..� e. n . .....�.�.....� . Nameof Architect ..................................................................Address ....................... ....................................... Number of Rooms ..... ...........................................................Foundation ... .1 -.!.1........ ��..�� .�Q.T. . <•......... r: h..(1.11 Exterior ..L.c.1. :/..1. `.......C.P.�J7.Q. .................................Roofing ..Q.•.. ...: .. .......................................'....)....... Floorsr. ..r... '.. T ........................................................Interior ... /0.•.5./..E'..r.............................................. Heating ..... ( -�. :.i'r.......................................:Plumbing ...... e.................................................... Fireplace ........ _�..............................................................Approximate Cost ....... .... , 00P Definitive Plan Approved by Planning Board --------------------------------19-------- , Area .......... k0....... ............ Diagram of Lot and Building with Dimensions Fee � 00 SUBJECT TO APPROVAL OF BOARD OF HEALTH J o a-s C) v� VA 00 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........................ Construction`Supervisor's License ... MANNI, STEVEN A=2 16.-0-0 9 No 3.1.54.7... Permit for ....guild. Addition .. .... .. .... Single Family Dwelling .......................................................................... Location ...9.2.Z......Qak Street ............................................. W. Barnstable ............................................................................... Owner .....S..t.P_.V P..,.4...MAnnA............................. Type of Construction ...Fr.aM.P........................... ............................................................................... Plot ............................ Lot ................................ Permit Granted .....January 14,......19 88 , ......................... Date of Inspection ....................................19 Date Completed ......................................19 1111dY Assessor's offioe (1st floor): / tN Assessor's map and lot number ...r �l(/..�Q ...�............ � a Board of Health (3rd floor): Sewage Permit number .................. lD 3 v `„LI4L ED H�� 1�_,_,. • . �...................... Z 9AUSTODLL, �8TH TRUZ i t� rnea Engineering Department ( rd floor): �-� {� _ o m� House number .......... ............... .........)d .. 7.. .�1j'���•!ZINXEDITAL C - °Aj�o war ale APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M. only `L�'�A %W TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..��.G)n.61ru..c.-t......C..v.r..127.1..r.................................................... TYPE OF CONSTRUCTION .... .C.aie�.................................................................................. /O-- �S 1917 -- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... c ........v. f�-..... ...........lsif... r-l...r.aV.t. .�Ve............................................................... ProposedUse ..... .1.17.q.1.. .... ...C.r..m.. .. ..L................................................................................................................. t , F j ....� .......Fire District .....L,4.,,:ees--f....�.rn.��w�..�le Zoning District ............... �.. ...................................... Name of Owner .....�Vc, e.n.......�.-/--./--C( n.n./-.........Address .l.cr?c2.....5✓.-a&..... ...................................... Name of Builder .....\j.6. .n...../:-.-I--C./.d ................Address � .....M... '�.�'�... ..:...W.e.KJ. �. .. Nameof Architect ........narl.-�.......................................Address .................................................................................... Numberof RoomsJ..................................................................Foundation ................................1..................I......................... Exterior ...Wh-1--T� ......Q..e.d.ar.................................Roofing .......t .��.. �. /,,.......................................... Floors .......o.Cc_►p..e--t.......................................................Interior ..., . Heating -. l ........1.... a. �.. ..h. . ....�.�:T....�.�..T".E�.1.•.... ..................................;Plumbing ..........................................: Firepp ...>,�.. �..�.f�. lace ..................................................................................Approximate Cost ..........................//............ Definitive Plan Approved by Planning Board ------------------------_-------19-------- - Area ..I-V.Ati- #....C�11 !✓5� Diagram of Lot and Building with Dimensions 0 Fee J�............... .................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 19 Q I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........L-4..�,.... ��-y.��......... Construction Supervisor's License .� ....................... MANNI , STEVEN No permit for .Build Dormer ............................. .......S.i.n.q.l.e...F.ami.1v..Dwelling......,. . . .. .. ....... .... .. Location Oak Street .......................................................... ..................W.e.s.t...B.a.rn.q.takle...................... Owner ...........Steven.....Marini . ......................... Type of Construction Frame I.. ............ .................................................................. Plot ............................. Lot ......................... ...... Permit Granted ....O.C.t0her..5.,.:........ ,'19 87 ,-:-'--Date W '19 of Inspection 14 - .. . ....................... Date Completed .......7 ...............19