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0134 PINE STREET
r I I� r 1 ���Epp 11 �1 N0. 152 1/3 ORA ESSELTE 1 o°i° A a_ , rx NIN c I 0 K , � � � � � v � � � AWE Town of Reg ulatol • a�vsrnBt.E. : Richard V. 5 Building Paul Roma,Buildili 200 Main Street, H: www.town.bai Office: 508-862-4038 SIGN PERNIIT I 1 A photograph showing the existing fk sign location. The photograph is to incl For a proposed building or new facade, lieu of a photograph.• 2. A scale drawing of the proposed sign. A 1) The type of proposed sign (wall, han 2) Dimensions of the proposed sign anc 3) A cross-section with dimensions sho Minimum scale V= P. Minimum sY i G � � � _. I ;�..�,� �':, 4 • } � � N � � � j � � � � .� . � � � � � . . � \ � � o � `. W N `h" t a,, � � } } � m � i, r Office 508.398.5670 Fax 508.398.7170 Christopher S. FISET `1 Attorney at Law i 9 Old Main Street West Dennis,MA 02670 chris@christopherfiset.com ' t. 3 53 _ U `, 1l0 v N M L OGgT/O.V SCA?A.C-: / ••=Go a,4::P7-,a6: .Ju t-Y 23.i97ej .eEFE.e&A CE: d G.C.P. 36076 S i,/BL�EBY CE,�T/FY TNi77 THE 6CJ/L!7/.V!r SAV40 A.l O.t/ TN/S .ol.,.oi.V AS L Off'FiTE a ON THE y.EOu.VD AS SNOW.V NEeEoia./ <i.vD TNFiT /T D o 6 S CO.t/FOC.N TO 7 f,/� ao.c/it/G BY=L.gtMs o.= Ts�E TOW.v o� 9P�l�TRC3G.E ��L�N OF y�/s/E.v cons relic T'E MO. I ARNE g H. FI "oln cal en9ineerir�9 o OJALA y M1 \:�. #26348 C/\I/L L<i.va SueV�YoaS R L TOWN OF BARNSTABLE Permit No. -----__------------- Building Inspector Lasa�n . Cash ------------------- - ,619 IP 1 pY � OCCUPANCY PERMIT Bond -------------------, l Issued to Address ` Waring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Beard of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ..................................................... 19 ....- - .................................................................................................................. Building Inspector 7 Assissor's map and lot numb LOT ........ ................-q�p.......... ter, THE t Swage Permit number ............................1..........................j . .. VMMMU S 33ARESTABLE, ✓ House number ... ... ........ 9. E"RONMENTAL C0011 efb U I't TOWN OF . BAANSTXfffE "of, BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..........F.11...0.........)..X' L...... .............................. TYPE OF CONSTRUCTION ....L: t: ts". .I P�.......................... ..................................................... ............ ............197..[. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......13.9...... .................4,�............. ....................... ii ProposedUse, ..... .......................................................................................................................................... Zoning District ......f..............................................................Fire District ...W,P—S. ................. Name of Owner ..A-.k'n4-.u.rL... ..........Address ...P-9... ..... Name, of Builder ....... P 0.1q. ............Address F0s].—.6—'Jt..... ...... id, Nameof-Architect ..................................................................Address .................................................................................... Number of Rooms ........?......................................................Foundation ........ -C—ina-4�......1.1p Exterior ... ......... ..................................Roofing ..........eg. -=.4....C.e-A. ....................................... Floors .......... ...................................................................Interior ....... &s.f.cz,a..................................................... Heating ....&A... ........ k ......................Plumbing ........P �................................................... Fireplace ............ ......................................................................Approximate Cost ....................... ........ Definitive Plan Approved by Planning Board -----------------—----------- Area ...... ... ....... Diagram of Lot and Building with Dimensions Fee .............. .... ................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 1111 -71-7� I 4-0 . c I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ................... Sullivan, Arthur No, ...... Permit for ....I!.-'-3tor-y..dwalling ............................................................................... Lot #8- Location .....1.34..Pine..,St-..We�st.-Bar-ris-table ............................................................................... � Owner ......Artb=..Sullivan.......................... Type of Construction .........Wood-.Frame........... ...............;...................... ......................................... Plot ............................ Lot ................................ 1, .Permit Granted .......................ahi�..3919 79 Inspection F-24�1 . 19 Date of 16 ........................ ....... Date rn. pleted 19 PERMIT REFUSED 4— ...... ..... ................ '19 < ...... . ...... ....... 7 ....k'A T > no ..... ...... . .. .... Q.................................................. Apr .......................................q*d 19 M ............................................................................... ......................................................................... 6 0 O VOEES. cv� l 0 wxtw�,-, 7oz affYouz�iztnKn9 nEsc�s V® ' 508.428.8700 fax 508.428.8524 �Mra www.lujeanprinting.com 4507 Route 28 •Cotuit, MA 02635 ►4 E se r _ Iy TOWN OF BARNS TABLE BUILDING PERMIT APPLICATION l , Map TOWN.. Parcel �i`BARNSTABEaL Application # c)o Q a Health,Division Date Issued 3' G1 . .�b Conservation Division Application Fee Planning Dept. Permit Fee ,' Date Definitive Plan Approved by Planning gRarVON W" Historic - OKH Preservation/ Hyannis Project Street Address 14 P I In C . V+12 :Lt Village Owner Address 13� n,( 4 1,k) Telephone Permit Request �-CSp IA4L Ca V 7e2�Al,,S i Pc W At l 9-5f6 7M JG - V§2p� FL b� Square feet: 1 st floor: existing Wxroposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valua on Construction Type Vbo t�;, Lot Size I I Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family � � Two Family ❑ Multi-Family (# ::nits) n - Age of Existing Structure Historic House: ❑Yes o On Old King's Highway: ❑Yes ,C V0 Basement Type: ull ❑ 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: 57 existing -.new Total Room Count (not including bathe): existing new First Floor Room Count i Heat Type and Fuel: ❑ Gas Xil ❑ Electric ❑ Other Central Air: ❑Yes 74No Fireplaces: Existing]—New Existing wood/coal stove: ❑Yes Flo Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size \\_ Attached garage:*eexisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use - --- — APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address icense � Home Improvement Contractor# 3 70 t'YIC Q C(�4 �K:1. Worker's Compensation # ALL CONSTRUCTION DE IS RESULTING FRO THIS PROJECT ILL BE TAKEN TO r SIGNATUR DATE k / hr� i FOR OFFICIAL USE ONLY APPLICATION# OATE ISSUED ' MAP/`PARCEL NO. ADDRESS VILLAGE F OWNER DATE OF INSPECTION: ' FOUNDATION ( ' FRAME' •dfie/Zc ®3/z 1 �3 itt-plc . INSULATION -4 FIREPLACE 1 ' ELECTRICAL: ROUGH FINAL' y PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING I r DATE CLOSED OUT ASSOCIATION PLAN NO. a' Depwtnent Of Illli=trial Ac w& D,1 ice-of ' 600 Washington Street Boston,*MA 02111 " wmmass gov qa Workers' Compensation Insurance Affitdavi:t: Builders/Contractors/Electrniciaiis/Plumberg ficant Information PIe e Print L&pjbjV -Name Ukxffi ss/DWmization/tnxividn4: Address: lao- Ci /StatelZi A-re vou an employer? daeck th appropriate bog: Type of project(required), 1 I am a employer wi _ . 4. 0 I am ti general contractor and I employees(fimIl and/or part�ne). * have hired the sub-contwtors' 6 Q New construction A 2.❑ I am a sole proprietor or;partwr- listed on the attached sheet 7. ❑Remodeling ship and have no eploy h o have 8, Demolition working forme in Q Budding addition any-capacity. employees and have woidcErs' [No workers'.corrp.'IDcirrR„ce . . comp.instn-ence.X 9. - ' wed'] 5. We area corporation and its 10.[]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself- [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. .152,§1(4),and we have no employees. No workers' 13.0 Other comp.insurance required] *Any applicant that chw1a;box#1 must also M out the section below showing their workers'compensation policy information. t Homeownan who submit this affidavit indicating they are doing aH wolic and then hire outside contractors must submit a new affidavit indicating such. t—C ntM rS that ebeck.this box mast attached.M additional sheet showing the name of the sub-conhactnrs,,d Sbft whether or not those entities have eMPloycu. If the sub-contactors have employees,they nmstprovide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for eery employees' Below is the poric y and job site information. Iustuance Company Name: Policy#or Self-ins.Lid.# 4i� Expiration Dater Job Site Address: City/State/ ' IR Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date)l:/o� Failure to secure coverage as required under Section 25A of MGL e. 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 7nsurance'coverage verification I do hereby c odor tFie aiirs aid p of perjury that the information provided ab ve is trua and correct Si -776 I?afe: Phone Official use-only. Do not write in this area,to be completed by city or town ofzcial City or Town' Permitllat:ense# Issuing Authority(circle ono: 1.Board of Health 2.BuiIdiz gDepartment 3. City/Town Clerk 4.Electrical Inspector. S.Tlumbiag Inspector 6. Other Cc m#ct Person: Phone# • +b• `•+'+�� • � - �. i. c.vi.0 v zv v. n•i cn�L c.. vvc. 1 an LJOI vV.L •�``""'4 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) TM1,SC&RTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CInK[it CAT OLD HIS 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 WANED,subject to he terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to he certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: DOWL'iNG&ON:IL ENS AGC Y PHONE TFAX 973 EYANNOUG t ROAD (AIC,No,Ext): C,No): H 1 ANTNTI S,NtA 02-601 EMAIL ADDRESS: rGR.RJ INSURER(S)AFFORDING COVERAGE NAIC 4 INSURED INSURER A: A:y(ElUCAN ZUEIC-,i(NSLJicANVCE EMERGENCY CONTRACTORS LLG INSURER B: INSURER'C: INSURER D: 73_1YA\TOUGH RD.ROUTE 28 INSURER E: .i M\'`7S,\1 4A 02601 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIESOF C TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD DIDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT MTN 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 ADO SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MM OMYYYY) (MM MYYYY) LIMITS GENERAL LIABILITY -ACH OCCURRENCE COM'v ERCIAL GENERAL.LIABILITY CLAIMS MADE OCCUR. DAMAGE TO RENTED 5 EMISES(Ea occurrence) i "EC EXP(Arty one person) is RSONAL&ACV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER ,ENERAL AGGREGATE S POLICYED PROJECT❑LOC ODUC?S-COMP.10P AGG 'S AUTOMOBILE LIABILITY ARTY AU O COMBINED SINGLE 9 LIMIT'(Ea accident) ALL OVAED AUTOS BODILY INJURY g SCHEDULE AUTOS ;Per person) HIRED AUTOS BODILY INJURY g NON-OWNED AUTOS ,Per accident) PROPERTY DAMAGE 3 ;Per accident) 71 I RUMBRELLA LIABF'�OCCUR EACHOCCURRENCE i5 EXCESSLI, CLAIMS-MACE AGGREGATE is :DEDUCTIBLETENTION a g WORKER'S COMPENSATION AND Aj LIM S+A�JTORY OTt,_R( EMPLOYER'S LIABILITY YM UB•4568P038•13 03�A20?3 03t03f201C hRITS .?^G?�girop1Pnv?rivERF=XECUrNc N NIA — ERIVIEM3ER EXC_UD_D? E.L.EACH.ACCIDENT S 1,000,OOC (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 z'yes.rmsar:be under DESCRL.':10N.OFOPERAT IONS below E.L.DISEASE-POLICYLIMIT 1,000,000 DESCRIPTION OF OPERATIONSILOCATIONSJVEHICLESIRESTRICTIONSISPECIAL ITEMS HU 5 2fi?LACES ANY PRFOR T :PT:EiC ATE ISSUED TJ TY:E C'ER71"71CATZ:"sv:i`EE.Ati?1_7T(j Wop.KERS "s. (�!�2 CO VI-:2ACtH. CERTIFICATE HOLDER CANCELLATION TO\N-',\r OF BARNSTA3E.^ SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED 200 MAIN S TRE ET BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED i IN ACCORDANCE WITH THE POLICY PROVISIONS. E r AUTHORIZED REPR TAVE l'. .....t7:_...— HYA:\IiS,MA 0_601 i�J'I'"' t....,c: •1~a.�•• ACORD 25(2010/D5) The ACORD name and logo are registered marks of ACORD. 190-2010 ACORD CORPORATION. All rights reserved, I Massachusetts-Department of public Safety Board of Building Regulations and Standards Cu,%to•ujtiun Suhen i,ur License: CS-086385 RANDALLJ> RENCE 5 ANDREA WAY : K, FORESTDW MAC J,�..� -� t4►`� Expiration commissioner 12119/2013 } r p ✓2. Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration: •164370 Type' 10 Park Plaza-Suite 5170 Expirafron: 2tU1/2613 Supplement Gerd Boston,MA 02116 EMERGENCY CONTRACTORS LLC RANDY FLORENCE, . 73 IYANNOUGH RD HYANNIS,MA 02601 Undersecretary No ith ut signature r Inc ny_ t l{rY tt Vl LL•LL 21t7 L.Li Rliv . Regalatory_S&-vices NAM - ---- —.r . .. _ . _ • ��, '; saw Thomas F.Geiler;Director . 16 � Baadi i Division`. - Tom Perry,Building Commissioner 200 Main street,Hyannis,MA b2601 w'w*town.barnstable_ma.us . Office: 508-862-4038 Fax: -508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder / as Owner of the subject ptop hereby authorize' to act on my behalf, in an mattes relative to work authorized by this building permit (Address of Job) Pool fences:and alarms ate the zesponsibilitp of the applicant. -Pools are not to be filled or utilized before fence is installed and all final inspections are perfomae'd'and.accepted. C� JA Signature of Owner ignature o plicant ..' 12© )vFf6-.r-.e , Print Name rint Nam Date QF0RM5:0WNERPERM NSIONPOOLS•6a012 Regulatory Servic_es • Thomas F.Ge1er,Director Building Division Tom Perry,Budding Commissioner. ; . • 200 Main Street; Hyannis,MA 62601 www.tawn:barnst ble.ma.us . office: 508-862-0 03 8 Fax: 508-790-6230 HOMFsOVMm LICENSE FuXEMYTION Please Print DATE: JOB LOCATION: number street village "HOMFAWNER": name home phone# work phone# CURRENT NLkMING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or Iess and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OR HOMEOWNER 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 sha-U 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 co mina 35,000 cubic feet or larger well 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 I D9.1.1-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 exemption 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 carrot proceed against the umlic enscd person as it would with a Iicensed Supervisor. The homeowner•acting as Supervisor is ultimately responsible. • • • . To ensure that the borneowner is fully awareon of his/her responsibilities,many communities requin;as part of the permit application, that the homeowner certify that he/she undcrostands 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 fnrm/=tifira±ionfor use in your community. Q:forms:bomeexm npt : . ^ , Town of Barnstable Building • Post This CardiSo=That�t is Visible"Fro mithe reet ;A roved`PlansMustlbe Retained o IyIob•and'tliis-Card Must be-Ke t lAlNSTAItl. ' - . FN'.K C"'FAIt s��k` st �.PP� � : • P-. 1 Poste�d�Until)Final;InspectionHas,Been`Made. Permit ,. Where a Certrficate off Occupancy;�s.ReIrg ;such Building shallyNotrbe Occupied!until a Finat Inspection has been made. Permit No. B-17-509 Applicant Name: celio dominato Approvals Date Issued: 04/04/2017 Current Use: Structure Permit Type: Building-Restore to Single Family Expiration Date: 10/04/2017 foundation: Location: 134 PINE STREET,WEST BARNSTABLE Map/Low 25 Zoning District: RF Sheathing: Owner on Record: DUBE ROBERTJ �r '�» 'Contractor Name: Framing: 1 i r e�'8.x ♦ err 'Co tra.�,� •r 576 MAIN ST UNIT 11 1, � � Coni actor lJc nse' Address: inx�r' ,�a} , F t�" -�� . » 2 HYANNIS,MA 02601 5ff ' �Est�P-rofect Cost: $15,000.00 Chimney: Description: restore to a single familyhome remove baseme t apartment remove �� t Fee: $126.50 Permi p kitchen resheetrock basement u rade smoketdetecto rs' n Insulation: Pg Fee"Paid: $126.50 �� 2 Final: Project Review Req: restore to a single family home remove basement apartment ti Date 4/4/2017 u remove kitchen resheetrock basement upgrade smoke,I < °Y £+� " .......... ... .... detectors � {f t r�p` rrx«F ... .wt Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzed bythis permit is commenced within six months after issuance. ._, I Rough Gas: All work authorized by this permit shall conform to the approved application and'the,approved construction documents for,whith.this permit has been granted. All construction,alterations and changes of use of any building and strumcturesshall be incompliance with the local zo�nmg by lawsa nd codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this°permit. o- "ta3" s rS.if,� 'ci t c Service: Minimum of Five Call Inspections Required for All Construction Work: { �; ,x < i r; y 1.Foundation or footing Vxk>. rF�. �S wy r > 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 S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Jan Application # Health Division FEB.2 7 2017 Date Issued O Conservation Division TOWNOFBABNSTABLE Application Fee Planning Dept. Permit Fee i Date Definitive Plan Approved by Planning Board Historic - OKH' _ Preservation/ Hyannis E L X Project Street Address 1 q Village owner 6r6411(io fr/`�,41 Address f 9',! i/k/YYZ5 60XIIJA%� T 1lephone 6 40�f 5�=� X Permit Request ��7lfio� A S/VO�;L 1. Ls oG Gfl� Square feet: lst-lee - existing IS$0 propo8ed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0010 Construction Type Lot Size 1' 7 Grandfathered: Ell Yes ❑ No If yes, attach supporting documentation. welling Type: Single Family Two Family ❑ Multi-Family (# units) Mg+e of Existing Structure Historic House: ❑Yes No On Old King's Highway: ❑Yes ❑ No Basement Type: YFull ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 1,5',80 Basement Unfinished Area (sq.ft) N` m ber of Baths: Full: existing I AM new Half: existing Or new N umber 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 N0 Fireplaces: Existing New Existing wood/coal stove: ❑Yes I No Detached garage: ❑existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: 19 existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ C m mercial ❑Yes .I�No If yes, site plan review# E Current Use Proposed Used APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name � ��� �3 )c>'f/® �`��� Telephone Number Address �E� r `/ y /i License# Home Improvement Contractor# Email Workers Compensation # AL'CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TA�EN TO M SIGNATURE �� DATE O Z — 2;7. 17 FOR OFFICIAL USE ONLY s h APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER. DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Ing I^awM=wwh :c f_Va_%gadr=,d& �ee�ar�e�f crf�dust�Acc�d� Office 0 - # 600 Wadrigoon fleet Raswa,MA 02HI •. tvrvrstmar��rvf�ia • AppHcaxd 1id6 =6DM= Please Print F t.T ZZ 1V r 0 . . aa�tad G LI G' 00 �,�al1w ol,6 IV Are you an employer?.Checkthe apprapriate b� F��of_project . (req� _ L❑ lama v # 4 ❑IamageneraeodmaturandI 6- ❑ ea amdmceian employees(fall&=Viorpad-EM5).* 1are17aed9e suir-coaftactom '�_ Remo Z. lam asale ar - �� ❑ ,❑ deEng Amp and have �laVees Thew sab••contractc=have $. ❑Demolifioa fbrme is 'wodriag �y mF Y empfayees asrdhace x�ori�ss 9_ ❑gn't�ad3ifios bN5 nradmm'camp.iasuraace Cep-4 / I 5. ❑ We are a uuporafiam and ifs I ❑Electrical repairs m ad� 3� am.a hr mxmmer doing aIf wmk• ofl cM have exemised th!k IL❑Fdambiugrepaim or add ffcas ' � !Vsd [Na •gip- right:of esempfion per IMIM 1?.❑Roofrepais rr=acereTLEmgY c-M JIM andwebaveao [No VDAMs' L3.❑'47t COmq_lammmars requim&] •dap cgp€oat Banc chedsbox fl E ea t ffsmaeovrnra bra sari iris�idzeg ig �a�<aIF Waac�d BaralBxe antsid�eoazast snhmicYamW z�da�it SMrfi IGa�fwecber-Tr*s box must rftrfuld=zddidemi shear sh=cingthen:meoflbe =dstdP_vhetlecaraocthnseen�shsn� eamla3mm Tftbesnh-caata kce e=PTaFea%Baey t gcvvide dZw tea' •Pau5—h-- I am rue eriip7�ar 9iatis praviduy�mrrkets'coarlrerrsrtfiarc uunrrrm=a jnr a�eurpfa}�ee.� Sdrnv is ri��a prrlccy m:d jeb sus s��armntrnrL � IasacaasecompaayA me_ 'Policy�or�eJf-ism Ii�� E�gieati�aDafe` '� Job Tile AAdres - CifglStafeJ7�p: Ai ach a copy of the workers'compez=z6onpoIicg declara ioa page(shawmg the policy per and extsaiioa dale). Fail=to secure cos=age as requirednudes Sew 25A o€MCE.c.l7 iaa Iwd to the imposifim of cum- prmh ies of a fine up to$UDa.OD andlar one-yearimpFisonmed as'w&as civil peaslties m the foaa of a STOP WORK OMERand a#me of up to SZ50M a clap ag-atast ffie violdar. Be Mdrised td a copy of this zbkment maybe farwmled to The f}ffim of IzvesE 'ga6=ofthe MA E=a=mce ccsvemgece �rlri�&ersb9 of ffiatiJes uatRratiaa prnrtda abatis is Gas and csmFect DgL- 2 , -7 t3,Jidd a w anFy. Do not irritr in ffds 4mreq,€rt be carup&&ff by my urtown City or Tows: Pelotif;ceme g T—i, AuSrarEty(cazIeone): I.BoardeflImIth 1 BuTffiag Dgmtne at I fRyffirsm C3=k 4.Elechical Iuspectnr 5 PkmEng Ihsgecter C.as Comfint Person: Phaaa P 6 .■..1.� i•t■1 I �+■•Ir ■•�R 1• ■, / •- ••/i.7i'•• Y•1•r■■rt Y-t■/It 1•t [• ■ ■■1• •-�w n Y•r_nt n n +. ■■—..a11 -n �•J. ••iIn i• :� i ••?F•t {■ 1■ • J.1 � Ilt■� .1■ r•ltlt or • ■•t - .I •ar■■�• : -n t.■a t.t1: •Y--■ r■�R••.. -1.-•-••xY1■•I. rrt •• .I■•1■ •1 •■■i' •J: �•t■■ • •1 .t•• ••• •1 t■•1 ' i/ ■. _ ■1/1 itlnil •1/A r. J.• ■■ .■/■l■� Ir ..� ■1 � ■Irl■•w • _ •. / �■ i11.■• ••/ ■1 ■■ as so; move a. n n n•r. •-nn.w an• -w�.•.■rn ro n •:/. 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O• • 1 ■• !i- 10 UO.■ r N.tl 1\ • ►is■ .. t n• t ■•1■ . :71 rrt . 1 _ J _� •�■� ■• n •••.r •t r1■ in ••rlIltp: ►.n� n •.:na 1 1• .n�■ n .n •/vn w •7 ►•nun.• .•r- •.,■nu a • is • . -y■-:nm ^•t ■ [.. 1■ n.u. ••1 n .■•.n.. 1■, •... r.•.r J.n• :... .•■ . rt .. ..■ ••:.■.,- ■- •-■■i■■L■ •'=d 11 / �_\v% / ■\CIA -P■.1 Ia1�■ i ■•13i.V1/ R •G:1 A. ZI� ��-w\3111• III ■ i� IN ■ ]i_• 1J Town of Barnstable Regulatory Services dF Richard V.Scab, Director Building Division EAMIMAI= Paul Roma,Building Comini sioner h� `�� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 5081862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Z / Please Print DATE: aZ 7 7 JOB LOCATION: 13 iA6 ". W63 " q� numbervillage IOMFAWNER": 4 DO Afi-n/A1 ._._ name �'"� �l home phone# �/ / work phone# CURRENt MAILING:ADDRESS: J/ 1 A r4 1 �/ 5-r —4e / -1 % P11Y -5 �it� o zb 0 / i /town shale 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. DEFWITION OF HOMEOWNER 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-fly 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 building2ermit. (Section 109.1.1) Thni dersigned"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 inimum inspection procedures and requirements and that he/she will comply with said procedures and re qune nts. Signatu a ofTiamcovMer 1lAp Ilp wal 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 U HOMEOWNER'S F.RElY1PTTON 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 construetion 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 exemption 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 hirei 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 folly 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 to amend and adopt such a form/certification for use in your community. r Town of Barnstable Regulatory Services ` sAINSrwI= ` Richard V.ScaI4 Director BEAM ;,�•`� Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 509-790-6230 Property Owner Must Coinplete and Sign This Section If Using A Builder I ,as Owner of the subject property hereby authorize to act on my behalf in an matters relative to worm authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final . inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FOR AS:OWNERPERMISSIONPOOLS l • , 1 Mckechnie, Robert From: Mckechnie, Robert Sent: Friday, March 17, 2017 9:22 AM To: ' 'cdominatto@gmail.com' Subject: application for 134 Pine Street,WB i Good Morning, I have started the review of your permit application and need one more piece of information. Please supply a floorplan of the basement existing conditions. This can be scanned into an email to me at this email address, dropped off,or faxed attention me at 508-790-6230. Once this is received I will proceed with the application. Thank you, Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 1 Assessor's map and lot number ...... ........,. .... .. ?-�............ �............ �^') THESewage Permit number ...... . ... . ........................ r Z BA"STAXLE i House number ...........:..:........................................... . '..�"r. 90 rb a O' 1 79• p MA,( „f TOWN - OF '.. BARNSTABLE f BUILDING INSPECTOR APPLICATION"FOR,,PERMIT TO ....... < ..?... �1....:!.:1. ...` ....... .......................... .. TYPE.:OF CONSTRUCTION :.. .I,.R; -_7..��..C?.... A A ............................................................................ a�- .......... .19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......@.. .``........ ..................... .............. ..., ...t°...... ProposedUse ..... ,kl =:.�.�. !�t.. ..........:................................................................................................................................... Zoning District .... ..............................:.............:........,..:.....Fire District ....i ..1....•:::C..'�.......Y,l.7....:...a....ti z. �.:n. :..Name of Owner fe-1~1 (�.1Z...... ...... Address ...A 1......... Name of Builder .� ..i.?.�.U..:... .: ` �.�1? 1..;. .:.::.':::Address S T a= `9 ..: '1� (f - g ►�c��C�1 G ( t a.P .. .:n•. Name of Architect ....... ............. 'Address .....................................................:.............................. Number of Rooms .Foundation r. i �`� c� ` ........................` L............................................... R . _ ... ............ Exierior .. .d.r...��......7..t......... Roofing fr•t=..r,.�.... ..r. .,1 . ...................... ..........,.. ....................................... Floors .......... 1.1..................................................................Interior ......;Q I.R c ca.✓1....................... „ r^ ......Plumbin .....:..n�. Heating ..............'.........'..,J...:. ...5 ` . ..:...................................:............ ' g ....ram..!..:. , �, �......:'..................... g �..... Fireplace ........... ......................................................................Approximate Cost ....�r?. :..nC)t.�.:.�%' C� Definitive Plan Approved by Planning Board --------------------------------19--------. Area .......................................... Diagram of Lot and Building with Dimensions Fee .............................................. `SUBJECT TO APPROVAL OF BOARD OF HEALTH 117 I hereby agree to conform to all the Rules•and 'Regulations of the Town of Barnstable regarding the above construction. Name ... A-��:;, �. ... r: • 4' Sullivan, Ar. U� -153-25 r' No .. �.`522.... Permit 'for ..1a...S Qxy.. w�ell.ing ........................................................... ................... LocationlQ.tr..#$...12. ..Pine.. t.... .....Bar=table ............................................................................... Owner ......A>i hk�X_.. 1d�. 7.51a27.......................... Type Hof Constru4i ion ....Woad..Frame................ , J .................. ........................................................ 7plot ............. ............... Lot ......................... Permit Granted July 30 79 ....... ..4. ...................19 Date of Inspection .............. .....................19 Date Completed ..............:... ................... 19 PERMIT REF SED .. 1 d.............. .... 14 .. . ..... .,. f. . .. ......... Approved ................................................ 19 ............................................................................... . C, , oFUwe Town of Barnstable *Permit¥ ® � )V(v ti Regulatory Services �ee s 6 man t rom issue date AB ERM '° t 9�A , : ��� Thomas F. Geiler,Director r 1013 Building Division Tom Perry, CEO, Building Commissioner V TOWN OF 13ARNST 200 Main Street,Hyannis,MA 02601 �� www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY i e ham_ Not Valid without Red X-Press Imprint Map/parcel Number 1 v� 001 J Property Address / 3 ?I ry C I W L S y4,Pcl S-�-q/3,L� LL a El Residential Value of Work J� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 30� `3y t N c s WCST -13ARn T- 3i. Contractor's Name Nt=w a 1)p Telephone Number 400 Jy2-Z Zit• Home Improvement Contractor License#(if applicable) /1YZ Se Construction Supervisor's License#(if applicable) <?4�6 f3 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name&4Clect -�t 2 C Workman's Comp. Policy# wC —20—Z0 -- d0,35G` Copy of Insurance Compliance Certificate must accompany each permit. 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 #of doors replacement Windows/doors/sliders. U-Value 0' 0 (maximum .44)#of windows *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 the Home Im rovement ontractors License& Construction Supervisors License is qu' ed. SIGNATURE: �AWPFILESTORMSIbuilding permit forms\EXPRESS.doc Revised 070110 MA Reg#146589 s �'!g�f' rom omamorrorwn._ CT Reg#0605216 Federal ID#20-2825129 -- RI Reg#26463 — a4Vdam,Siding and Rory Corporate Headquarters,26 Cedar S4 Woburn,MA,(P)800-342.2211(F)781-M99526,www.newpro.com THIS CORA%T MAQE THE_�_day of_ Ile 6 20 ` .3 between �u�c off- / 1)3)�o (Home Owners)O wners) (Nome Phorre) — 2,L /� )� (BusrCeOPhone) of l< 3f Pine -�(A ddress) 9 �26- (CrtY) (stet (LP) the'Owner"and NEWPRO Operating,LLC,"NEWPRO". The%b address is a condoin/nium. NEWPRO hereby agrees that it will for the consideration hereinafter mentioned,Hanish all labor and material necessary to install the following described work at the prdmises located at TOTALAdd2ss E-Mall forProprietaryuse Additional Model TOTAL Windows Purchased NEWPRO Work Number Q CASH WlndowColor fit; Out: Slidtn Glass Door PRICE C`C Capping Color Steel Securlty Door �� oorCo !n: O DEP031T Model Name Model Numbs s Sidelites Double Hun . 7 O New Construction Unit VVI ORDER O Picture Window Storm Door BALANCE Casement Obscure Glass BOTTOM DUE AT _2 Lite 13 Lite Slider Screens HALF FULL INSTALL Ba /Bow Frame Please Initial. Roof: Sofht;❑ Customer understands that NEWPROO does not Garden Window CASH Awning do any painting or staining, (ill:when removing Ewance paid to Installer at(nstan u n or replacing interior slops or trim) H r NEWPRO®is not responsible for conditions or Sher ed Other circumstances beyond its control Including con- densatlon resulti from or due toGRIDS Clil Euro conditions, pre�ws11n9 ` �NANCE rmegne meauon DESCRIBE WORK: Est.Start Date: Z Customer understands this Is an"estimated date' ^731) Est.Comp.Date: Infflas Li Initials Customerunderstands all steel security doors will have a 3/4"aluminum threshold installed over existing threshold. It shall be the obligatbn of NEWPRO to obtain any and all permits necessary under this agreement,as the Owner's Agent.The Owners who secure their own construction-related permits,or deal with unregistered Contractors wig be excluded from the guaranty fund provisions of MGLC,142A A0 Home Improvement Contractors and Subcontractors shag be registered by the Director and any inquiries about a Contractor or Subcontractor relating to a registration should be directed to: Director.Home Improvement Contractor Registration,One Ashburton PI,Room 1301.Boston,MA 02108,(617)727-8598. If the Owner Is obtaining financing by way of a Retail installment sales Agreement such Agreement shall include a time schedule of payments to be made under said contract and the amount of each payment stated in dollars,Including an finance charges.The Retail Installment Sales Agreement shell be incorporated herein by reference. if the Owner is obtaining a revolving credit Tune to pay,In whole of in part,for the contract amount herein,the temps of the revolving line of credit including Interest rate and payment terms.Shen be clearly set out on the craft application.The portion of the credit application referencing a time schedule of payment,to be made under this contract,and the amount of each payment stated In dollars,including all finance charges•shall be incorporated herein by reference. NEWPRO represents that it canies Workmen's Compensation and Public Liability Insurance in the amount of$100,000-$300,000. If the Owner refuses to pertNt NEWPRO to proceed with the work herein,or in the event of any breach of the Owner of this agreement,for any reason whatsoever shall cause the owner to pay NEWPRO a sum of money equal to thirty-three and one-third percent of the price agreed to be paid,as fixed, liquidated and ascertained damages,and not as a penalty,without further proof of loss or damage. NEWPRO shall not be held liable In damages for delays in the performance of this contract due to causes beyond its reasonable cbd Owner warrants that he is the owner of the property,on which the work Is.to be performed or that he is otherwise authorized on beonf Into this agreement hall of o,the owners to enter This contract represents the entire agreement between Owner and NEWPRO and cannot be changed except in writing signed by both the Owner and NEWPRO. YOU are entitled o a copy of the.Contract at the time you sign. Keep it to protect your legal rights. We,the aforesaid owners,certify that immediately after the signing of the aforesaid agreement,a Copy was furnished to us. You may cancel this agreement H it has been signed by a party thereto at a place other than an address of the seller,which may be his main office,or branch thereof,provided you notify seller In writing at his main office or branch by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. (Saturday is a legal business day). See the attached notice of eancellalion form foran explanation of this right DO NOT SIGN THiS CONTRACT IF THERE ARE ANY BLANK SPACES. he owner ties seen"sample`warranties that win be provided by NEWPRO upon Installation. sample warranties provided to Owner. IN�WCMESS H F,the parties have hereunta signed their names this _day of 4—Y 2 zoo lM 6 EIN4 f/Zvi Sid Marketing Representative Printed t4am Accepted:7RO Opera .LLC /�SOwner 1 \f\ By 'fir j Signed �).�`—� CORPORATE OFFICE Owner 26 Cedar St Office of Consumer Affairs and Business Regulation WARWICK BRANCH OFFICE Wobum,MA 01801 Ten Park Plaza,Suite 5170 24 Minnesota Ave (P)800-242.9974(From NE) Boston,MA 02116 Warwick,RI 02888 (F)781.93.3-0717 Phone:(617)973-8700 (P)800-356-3312(From NE) (F)401-732-1371 WHITE:Branch Copy YFt i.nw i CHANGE ORDER di Qurkame to Yovn... Window&Siding and More 26 Cedar St,PO Box 2696,Woburn,MA 01888.1296 Phone: (800)242-9974 Fax: (781)933-0717 Customer Name: 0 Dube, Job#: Job Address: 13 St Date: 3a13 Existing Contract Date: S ar e 0 a 13 Phone: New Estimate Start Date: The undersigned hereby authorizes changes in work to be done as follows,and agrees that this authorization shall become part of the original contract entered into between the parties hereto and shall be subject to all terms,provisions,conditions,restrictions and obligations of the original contract. And,further agrees that all monies paid shall be first applied to the aforementioned1 additional work. e-.t-)10 ro W1 C 4' LJ Usti f� IWIA CWA AVIIQ h1cf-'JWill Note: This revision becomes part of,and in conformance with,the existing contract. WE AOR E hereby to make changes as specified above,at the following prices: Previous Contract Amt Revised Amt Addt'l Deposit palance Due q 449 rL4yq 3 �a Sales Representative Signature Date ACCEPTED: The above prices and specifications of this Change Order are satisfactory and are hereby accepted. All work to be performed under same terms and conditions as specified in original contract unless otherwise stipulated. Date: Signature: Please sign and return top two(2)copies in enclosed envelope. Keep bottom copy for your records. US-05(Rev Y/Y008) ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 01/03/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES-NOT-AFFIRMATIVEf.Y-OR-NEGATIVELY AMEND,EXTEND OR ALTER THE-CONT.RAGE-AFFORDED-BX,TNE—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: Mackintire Insurance Agency, Inc, a/c°NoExt: 508.366.6161 AC No:SOB.366.5202 11 West Main Street E-MAIL ADDRESS: Westborough, MA 01581-1931 PRODUCER 00013793 CLISTOMERID INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Peerless Insurance Co. 24198 Newpro Operating LLC INSURERB: Acadia Insurance Co. 26 Cedar St. INSURER C: Woburn, MA 01801 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 12-13 Master 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:NOTCNITHSTANDlf7G 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 POLICYEXP LIMITS LTR INSR WVD POLICY NUMBER MM/DDNY MM/DD/YYYY GENERAL LIABILITY CBP 858957 12/31/2012 12/31/2013 EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE T PREM SESO R(Fa urr n e $ 100,000 00r000 CLAIMS-MADE Fx_1 OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO JECT El LOC $ AUTOMOBILE LIABILITY BA 858417 12/31/2012 12/31/2013 COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) 1,000,000 BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ A X SCHEDULED AUTOS PROPERTY DAMAGE _ X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS $ $ X UMBRELLA LIAB X OCCUR CU 858257 12/31/2012 12/31/2013 EACH OCCURRENCE $ 5,000,000 A EXCESS LJAB CLAIMS-MADE AGGREGATE $ 5,000,000 DEDUCTIBLE $ X RETENTION $ 10 r 00 $ WORKERS COMPENSATIN ANDEMPLOYERS'LABILOTY Y/N WC-20-20-003506-0 05/01/2012 05/01/2013 X DOY IMITSI ER ANY B OFFICER/PROPREI BER EXCLUD D?ECUTIVEa N/A E.L.EACH ACCIDENT $ 500 QQQ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ S00,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Weston AUTHORIZED REPRESENTATIVE 11 Townhouse Way We ton, MA Timothy Mo na h ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD Massachusetts - Department of Public Safety Board of Building Regulations and Standards C'uns[nlctiun Sui�tr�:isur � License: CS-096093 I YNN R THOMAS E PEACOCK-JR 38 OAKLAN#A SEEKONK Ogg . Expiration Commissioner 04/08/2014 0 ce of Consumer A ff ' and Business Regulation 10 Park Plaza = Suite 5170 Boston, Njpassachusetts 02116 Home Improvez , ontrador Registration _ Registration: 146589 _1;. Type: Supplement Card s'Ise t� Expiration: 5/5/2013 NEWPRO OPERATING, LLC. TOM PEACOCK 26 CEDAR ST. � i , WOBURN, MA 01801 ;'` ,�-. •,�-,;,��r"' fa;;: Update Address and return card.Mark reason for change. —~BPS-CAI OF SOM-0MfW-G707276 Address Renewal Employment Lost Card Unif ce or ConsumerAUairs&Busincss Regulatiou License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: "k Office of Consumer Affairs and Business Regulation Registration �1q•6�89 Type: 10 Park Plaza-Suite 5170 ExpifawS_ Supplement Card Boston,MA 02116 NEWPRO OPERP.�1-N%IM---- ` TOM PEACOCK- - _=: 26 CEDAR ST. WOBURN,MA 0180t' Undersecretary Y.� Not valid i ' out signature The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations kw 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): / W 7 n L Address: ado ST City/State/Zip: WO 3c,R ►- Apt.A-- Phone #: 1;2 3 L(Z.- Z z t l Are you employer? Check the appropriate box: 1. am a employer with�— 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. [5Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for me in any capacity, employees and have workers' [No workers' comp. insurance comp,insurance.$ 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.[1Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I'am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: /14YJ_jZ,n-[►✓Z -C is( $UK 04 14 c -� Policy#or.Self-ins.Licc.#: L )C —Z G 'Z U --0035'G 6 S 6 b Expiration Date: ^ / 3 Job Site Address:_/3 ( 1 rk 57 City/State/Zip: t Niz5 hO/t 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 f r' urance coverage cation. I do hereby certify er a pains and pe allies f perjury at the information provided above is true and correct Si ature: Phone#: / y Z 2 Z Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# IsLOther ui Athority(circle one): Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector son: Phone#: f MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston,Massachusetts 02108-1904 (617)723-3800 Ma Only(800)392.6108,FAX(800)851-8424 10/16/2012 Form of Notice of Casualty Loss to Building Under Mass. Gen.Laws,Ch.139,Sec.36 BARNSTABLE BUILDING COMMISSIONER 367 MAIN STREET 367 MAIN STREET HYANNIS MA 02601 Re: Insured: ROBERT DUBE Property Address: 134 PINE ST,WEST BARNSTABLE,MA 02668 Policy Number: 1142891 Type Loss: Fire(including Fire caused by Lightning Date of Loss: 10/14/2012 Claim Number: 305164 Claim has been made involving loss,damage or,destruction of the above captioned propert,which may either exceed$1000.00 or cause Massachusetts General Laws,Chapter 143,section 6 to be applicable. If any notice under Massachusetts General Laws,Chapter 139,Section 3B is appropriate,please direct it to the attention of the writer and include a reference to the captioned insured,location,policy number,date of loss and claim or file number. MPIUA Claims Division CMA00021 . a W Jr i Health request,plus, given him a copy of their written report to our office. b) On 5/06/63, site visit completed by Bob Shea, and it was determined that"mechanical ventilation is needed to solve the mold and moisture problem." 2. Cheryl Nickerson of 293 Riverview Lane in Centerville did an Administrative Withdrawal(without prejudice)which was signed/sealed by our Town Clerk on January 4, 2002. We encourage you to move forward with whatever enforcement means necessary at this property. 3. John Hennessy of 116 Camp Opeeche Road in Centerville. a) On 4/02/03,we conducted the site visit. Bob Shea gave the unit an"Inconclusive" grade,but nothing serious to prevent him from moving forward. b) On 4/23/03,Mr. Hennessy said he was in the process of- scheduling an appointment with Tom McKean to get the Title V approval. I left a phone message for him today to follow-up. Because he works off-Cape,we will give him some extra time to meet with Public Health. 4. Dan Hostetter's property at 485 Pine Street in Centerville. You are in receipt of a copy of a rejection letter sent to Hostetter's Office Manager, Judy McNamara, dated April 29 b. Ms. McNamara recently spoke with Kevin Shea,who encouraged their company to apply for a straight Chapter 40B. My understanding is that Ms. McNamara will be following-up by speaking to Art Traczyk. 5., Maurice McEvoy's property at:44 Pleasant Street in Hyannis. I sent him a Program inquiry letter, dated 5/06/03 of which Lois Barry was sent a copy for your Department's files. I have marked this on my calendar to let Lois know if I don't hear back from him within a month. C. There are two other semi-active, outstanding applications that were referred to us last Autumn by Gloria. [Attached is a copy of a memo dated 10/08/02 to Gloria with updated info on these next two cases below]. 1. Ted Hitchcock of 55 Lisa Lane in West Barnstable. We completed the initial site visit on 9/25/02. The initial plan was to prep him for the December 4t'Amnesty ZBA Hearings last year. Mr. Hitchcock has repeatedly broken appointments to come in to complete the next process of his application. His last appointment was scheduled for January 23`d on which date he was again a"no show." 2. Robert-Dube of134.,Pine in West Barnstable., + We completed the initial site visit on 10/02/02. My last conversation with Mr. Dube was on 10/17/02. He was initially interested in being prepped for the ti_i 2 i December 4 h Hearing date. However, when I contacted Mr. Dube,he said he was being laid off from his job and asked me to call back in a month. I called back a couple of times about a month and a half later, and left messages,but have not heard back from Mr. Dube since. And finally, D. I followed up with a written request from Lois Barry on 1/29/03 to send out an inquiry letter to the following individuals regarding their participation in Amnesty. I sent a letter to each on 2/10/03,but I have not heard back from any of the property owners.They were all formerly legal Family Apartments: 1. Harold Russell for Permit 1982-072, Map/Parcel 249 013, - 563 Strawberry Hill Road in Centerville; 2. Richard& Gail Scherbath for Permit 1988-057, M/P 147 007 020 50 Rosary Lane in Centerville; 3. Robert& Samira Schumann for Permit 1989-080,M/P 227 112 , 443 Elliot Road in Centerville; 4. Allen White for Permit 1992-049,M/P 308 098 362 South Street in Hyannis; 5. Linda Kipnes for Permit 1995-03 3, M/P (?) 296 Long Pond Road in Marstons Mills; and 6. Eric Hubler for Permit 19980135 issued to Hanson 20 Lantern Lane in Hyannis. To date, I have not heard from any of these property owners. Thanks. Paulette 3 ABM Town of Barnstable � M"S. $ ACCESSORY AFFORDABLE HOUSING PROGRAM iOiEo ��0 230 South Street,Hyannis,Massachusetts 02601 (508)862-4683 or(508)862-4695 Fax(508)862-4725 . M E M O TO: Tom Perry CC: Lois Barry,Kevin Shea FROM: Paulette Theresa DATE: May 8,2003.. RE: Accessory Affordable Housing Update vb .w t oFiHETpy, Town of Barnstable Vr �4 ,pA,,SrABLE ; Regulatory Services ,"�; �0� Thomas F. Geiler, Director ArFD1"0�A Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health September 5, 2002 Robert J. Dube 134 Pine--Street= West Barnstable,MA NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00 STATE SANITARY CODE II,MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned by you located at 134 Pine Street,West Barnstable was inspected on September 5, 2002 by Sam White, Health Inspector for the Town of Barnstable because of a complaint. The following violations of the State Sanitary Code were observed: 410.190 - Temperature in shower exceeds 130' F. 410.202 - Water heater is not vented to chimney or outdoors. 410.280 - Excessive amounts of condensation observed in bathroom. Bathroom mechanical ventilation system does not appear to be operational when turned on. 410.351(a) - Hot water heater and shower leaking. Toilet runs even without use. 410.500 - Ceiling tiles in hallway and laundry room missing, and water damaged. 410.501(c) - During rainy periods, storage closet in bedroom floods. 410.550(c) - Mole and mouse feces observed in apartment. This indicates a possible infestation of rodents. You are directed to correct the above listed violations within fourteen (14) days of receipt of this notice. r You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, this violation must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. You are also subject to non criminal citations of'$40.00 for the first violation and $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF THE BOARD OF HEALTH omas A. McK an Director of Public Health cc: Gloria Urenas, Building Dept. Patricia Giza, tenant Anthony Alva Attorney at Law 3291 Main Street, P.O. Box 730 Barnstable, MA 02630 Phone (508) 362-8342, Fax (508) 362-7770 September 5, 2002 Barnstable County Deputy Sheriff ' s Office ATTN: Civil Process Division Box 729 Barnstable, MA 02630 Re: IMWDIATE SERVICE OF NOTICE TO QUIT - To: Patricia Giza (011ari) and all other occupants �1.34=PiriiE�,.:Street-(Basement rental) "West Barnstable, MA 02668 , Dear Deputy Sheriff: Kindly serve the attached notice both IN HAND and by leaving it at the rental unit. Ms. Giza is usually present from 4 : 15 p.m. to 6 p.m. Thank you for your assistance. If you have any further questions or comments, feel free to con ,at any time. Sincerely, , on lva Attachment; cc. B. Dube i 14-DAY NOTICE TO QUIT FOR NONPAYMENT OF RENT DATE: September 5, 2002 TO: Patricia Giza (011ari) and all other occupants (-1-34 Pine Street _(Basement rental) West Barnstable, MA 02668 Dear Ms. Giza (011ari) and all other occupants: Your rent being in arrears, you are hereby notified to quit and deliver up in fourteen ( 14 ) days from receipt of this notice the premises now being held by you as my tenant, Namely: +134 -Pine Street (Basement rental) West Barnstable, MA 0.2668 If you fail to so vacate, I shall take due course of law to eject you. PLEASE NOTE ANY MONIES TENDERED BY THE TENANT AND ACCEPTED BY THE LANDLORD OR ITS AGENTS AFTER RECEIPT OF THIS NOTICE ARE ACCEPTED FOR USE AND OCCUPANCY ONLY AND NOT AS RENT AND WITHOUT IN ANY WAY WAIVING ANY AND ALL RIGHTS UNDER THIS NOTICE TO QUIT FOR NONPAYMENT OF RENT OR UNDER SUBSEQUENT SUMMARY PROCESS PROCEEDINGS. THE LANDLORD HEREBY RESERVES THE RIGHT TO ACCEPT MONIES HEREUNDER WITHOUT REESTABLISHING ANY NEW TENANCY. IF YOU ARE A TENANT WITHOUT A LEASE AND, IF YOU HAVE NOT RECEIVED A NOTICE TO QUIT FOR NONPAYMENT OF RENT WITHIN THE LAST TWELVE MONTHS, YOU HAVE A RIGHT TO PREVENT TERMINATION OF YOUR TENANCY BY PAYING OR TENDERING TO YOUR LANDLORD, YOUR LANDLORD' S ATTORNEY OR THE PERSON TO WHOM YOU CUSTOMARILY PAY YOUR RENT, THE FULL AMOUNT OF RENT DUE WITHIN TEN DAYS AFTER RECEIPT OF THIS NOTICE. YOU ARE NOTIFIED TO PRODUCE THE ORIGINAL OF THIS NOTICE AT ANY SUBSEQUENT HEARING OR ANY CONTINUANCE THEREOF'. RENT DUE: $8 50.00. __---- BOB-ffUBE BY HIS ATTORNEYr�/�� .. -An _Alva, Esquire 3291 Main--St. , Box 730 Barnstable, MA 02630 (508) 362-8342 I °FIB►ati Town of Barnstable P Regulatory Services y mUsn& � Thomas F. Geiler,Director MASS q �p 163q. �0 'Fo►q.° Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 September 4, 2002 Robert Dube 134 Pine Street W.Barnstable, MA 02668, RE: Illegal Apartment Map/Parcel: 153-025 Dear Property Owner: A review of our records, including the permitting history of 134 Pine Street, as well as Zoning Board of Appeals records indicate that the use of that address as anything other than that of a single-family home is illegal. You are hereby ordered to discontinue the use of the above-referenced property as it is now being used and restore it to a single-family home. You are to accomplish this work and notify this office to inspect within fourteen (14) days of receipt of this letter. A building permit must be applied for to redesign the layout to accommodate the conversion. You must do this before you make any changes. You have the right to appeal this decision. If you so choose, we will be more than happy to help you. If we do not hear from you within the 14 days, we will be forced to seek criminal action against you. Very truly yours, Gloria M. Urenas Zoning Enforcement Officer GMUAb Q020904b i Town of Barnstable Regulatory Services t Thomas F.Geiler,Director IARNSTABM • MASS. Building Division s639. �0 Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 COMPLAINTlINOUIRY REPORT Date: - —Oo2 Rec'd by: o --- Complaint Name: ��G Map/Parcel A5 Location. --g::D Address: c,�L Originator Name: Street: Village: State: Zip: Telephone: Complaint Description: FOR OFFICE USE ONLY Inspector's Action/Comments Date: Inspector: Additional Info.Attached Q:forms:complaint � i Cl B la-t nt V D ❑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) ❑Re-roof(not stripping. Going over existing layer ❑ Re-side ❑ Replacement Windows. U-Value (maxir i � (specify)ElOther *Where required: Issuance of this permit does not exempt compliance witl Signature i Q:Forms:expmtrg Revised 121901 SMOKE DETECTORS REVIEWED BARNSTABLE BUILDING DEPT. DAT FIRE DEPARTMENT DATE BOTH SIGNATURES APE REQUIRED FOR PERMITTING I 7a SP P_ VfmW Deck 2- j [, 54 SQ ft I N' Ise it IV I r Master V• N I£ y r � Baal Laufdry R b a A A7S7k.T t4�f � tt j_ �• 4r �.� a n I 0.nn9 to n Bath N 1:' 2a _, -_a 2 < \ 3 I � Beam, edfoorr ?. rls ul 1 Car Uer LL [238 SQ ft] rr i Den 2� 6 " t Second Floor d c — Uing i [a83.3S Sq R) u 9tis First taco. [t580 S4 a CorKrete P060 `.2030 5o(tt 24' 1312 Sa ft] 3S' .I l� y ZI r - f n F I (' Cl j , 6j _ o .r E it L ; . 1� �- i '4 ,.. ;� `, �c y ��,. ...� O.� °Y � _ ���� 7 ®� � � �, '1Y 'Ea i2 ��