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HomeMy WebLinkAbout0061 SUNDELIN WAY t uu � � •r�asnaa�.®� .. ..�.. .aa.rn..... -,,:_. -s.::a......:w•nov.;:..�-�-- =`:::�.au.LeL'�:aF!}yYrtic:St��-��uv4��..�i67 JM..,�:.,�•.;*.17�P�.du+��.,..._. .:...ui....,.�ruNi-- - -- 'Town of Barnstable ermit: � Regulatory Services ate: oF'MET "`� Richard V. Scali, Director f Fee: OF SAIRNSTA BLE Building Division 9BA"STABMg` Tom Perry, Building Commissioner ,er fog a 2: 7 200 Main Street, Hyannis,MA 02601 '; www.town.barnstable.ma.us b .� U) • 9 � Office: 50;8 862=:4'031__1-ft_ ._-__ Fax: 508= 90-62 0 -'• Ii:JIl.1�'. � TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT M � hone: '� � � 1 Owne��� � � -C � -� Install at: S I I yll • o A Village: swj-e-1 Map/Parcel: �-- Date: L 5-� S Ne /Used B. Type: adi Circulating C. Manufac lr I C Lab. No. Iv fz D. Model No.: C.o!_,�e Chimney A. New/ xistin (If existing,please note date of last cleaning) F1�e P� B. Flue Size C. Are other appliances attached to Flue? D. Pre-fab Type and Manufacturer VhC-,L Ct wt ve p1 W"-e AA W_-' E. Masonry: -* Line&Unlined Hearth . A. Materials: SLS B. Sub Floor Construction: Installer Name: Rs AePA _Address:'7b--)$ % 'I Phone: Location of Installation: T_°l iH:I:C-Registr-at ion#a26r-79 fp-� (Construction Supervisor# CSC OR check_Homeowner Installing,no license-required LICENSED INSTALLERS SIGN T tAPPLICANTS-SIGNATURE:<< � - APPROVED BY: Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove Rev 11/4/13 �.f f w4 fJ�.�ii'VeSOlrS . 000 J% mhingtow Street Boston,MA 02M wn'w.r�ass:go�dirt - Wurkersa Campensatian Insurance Affidavit:$mffders/CAm"ctors/Eiectri.cianMumbers ir�ralu-apt Infarmation /t,, Please egi Print L y Flame(Budaeess/Organizafian/Individnal)_ Q AWL"j 1 address_ -W-S STD City/StatPJZip_ (OV- `(Mom Phone 621171 Y 7 Are you an employer?Checkthe appropriate bGx: Type of project(rcquirecl): L[3 i am a employer with_ 4. ❑ I am a general contractor and I 6_ ❑New constaction employees{fnllandlorpait-time}-* havehire462 2.❑ I am a sore praptietor orpartner- listed on the attached sheet: 7_ ❑Remodeling ship and have no employees These sob contractors have g_ ❑Demolition. woddng for the in,any capacity_ employees and have workers' ❑Bnildmg addition [No work=' comp_insurance camp_insurarxe.1 regniret3] 5_ We ate a corporation and its 10_0 Electrical repairs or additions 3_❑ I am a homeorimer doing all work officers have exercised their I1_0 Plumbing repairs or additions my-elf [No workers'comp- right of exemption per MGL 12❑Roof repairs insurance required.].T c- 152,§1(4),and weha-.mna �, il employees-[No wodcers' 13_[ -der comp_insurance required-1 *Any applic=1 cut checks box*1 toast also fill out the:section below showing fheir wo3res�compensation policy infarm9G(m- *Homeowners who submit tlris s_­id.-=in&cstin-g dzy use damg=IIrr mid'hiTS ink sarh Mors that check this bar mast attached sa additional sheer showing the name of the smo-coazadnrt and state whether ornot thnse m6fies have mcPmyees- If the sdb-coat act=have employees,they must pmvide tirair warkers'camp.policy mmmber_ am an employer ihatis prmddiag tvorkem'congmnsdio.n irrsuraace for rny employees. Peiow is the paLicy and job site informaliam Insurance Company Nam: ' hA V�e✓S Pol cy 4 or Sself--ims_Lit.;: G k v b 0-2gtI 791 Ir Fxpiiation.Date. Z lob wife Address ` �V�dl9L Lt 1J��'% UtyfState ZiP: [✓y�S Attach a copy of the workers'compensatitm policy declaration page(showing the policy number and expiration date). Failure to secure,coverage as regaimcl under Sectiom 25A of MGL c. 152 can lead to the imposition of criminal pen$1Eies of a fine up to$1;500.Od and/or one pear imprisonme�as well as civil penalties in the farm of a STOP WORK ORDIIZ and a fine of up to$250.00 a day against the violator_ Be advised that:a cagy of this statement maybe fnrwarded to the Office of � Investigations of the DIA Ex insurance:coverage verification- I do hereby certify, c tk es at psn11W s ujf' titatfhe irz f onrra#ian pralrzdcFd abos�e is hua and correct - Date: Phone i# �I OOL4 3� Qf E al ass only. Da Trot write in this area,to be campieted by city or town ofJ`iciat City or Town: PermitUcense# Fssuing Anthority(circle cue)-: 1.Board of Health 2.Building Department 3.dt.3irown Cleric 4.Electrical inspector S.Pfutnrbmg:Inspector 6.Other Contact Person. Phone 9-- 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant'to this statute,an e»rployee is defined as"_..every person in the service of another under any contract of hire, express or implied, oral or written_" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also stains that"every state or Iocal licensing agency shall°withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es) and phone number(s)along with their certi ficafe.(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees;a policy is required_ Be advised that this affidavit may be submitted to the Department of Indust-ial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to-the city or-town that the application for the permit or license is being requested,not the Department of Iadustrial•Accideuts. .Should you,have.any,questions regarding.the law or.if you are_requimd to obtain.a:workers' compensation policy,please call the'Department at the number listed below. Self-insured companies'shbuld enter their self-;n ci�•license number on the appropriate l ne City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/lieense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e,a dog license or permit to burn leaves etc.)said person is NOT required to complete:this.aindavit The Office of Investigations would lice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts; Depattme�nt Qf Tndustdal Accidents Qffbee of kve. t gatiGm 6W washzngton, t Bastm,MA 02111 Tel.#6 1 7-727-49-GO at 4-06 Qr I477 MASSAFE . Fax# 617-727-7749 Revised 4-24-07 wvzw.mAssgov1dia oFTME. Town of Barnstable Regulatory Services Thomas F.Geiler,Director i639. �0 Building Division Tom Perry,Building Commissioner 200 Main Street Hyannis,MA-02601 www.town.barnsfable.ma.us Office: 508-862-4038 Fax 508-790-6230 • Pro e Owner_Must: p_ rty _ Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize Y 1 'k Yto act on my behalf, - in all matters relative to work authorized by this building penrlt (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 AhI Print Name . Print Name Date Q:FORMS:OWNERPERML4SIONPOOIS 62012 'THE of Barnstable i Regulatory Services = Thomas F.Geiler,Director � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 . Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name 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. _ DEFIN TION 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-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'Offcial,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 minirn„m 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 perfomring 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 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 Bbard4-caiaiot 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 far use in your community. Q:forms:hom' =empt Offi,ce of Consumer Affairs &.Business Regulation- Mass.Gov Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) : Consumer Affairs and Business Regulation P Home Consumer Rights'and Resources Home Improvement Contracting HIC Registration Complaints s` Registration# 125796 Home Improvement Contractor Registrant ASHAWAY HEARTH & CHIMNEY INC. Registration Home Page Name ROBERT CABRAL Address 703 STATE RD. City, State Zip DARTMOUTH, MA 02747 Expiration Date 03/04/2016 Complaints Details No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Back To Search ©2012 Commonwealth of Massachusetts. Mass.Gov®is a registered service mark of the Commonwealth of Massachusetts. https:Hservices.oca.state.ma.us/hic/licdetails.aspx?txtSearchLN=25759 10/27/2015 1J Massachusetts.-Department of Public Safety Board of.Building Regulations'and Standard ' Construction Supervisor Specialty License: CSSL-099647 ROBERT CABR - 703 STATE RD North Dartmouth7ViA ' Expiration Commissioner .12/26f2015 From:Felicia Amaral FaxID!508-673-0322 Pape 3 of 5 Date:10/21/2015 09:47 AM Page:3 of 5 DATE(MMIDD/YY TV) A`�" CERTIFICATE OF LIABILITY INSURANCE 1012112015 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 endorsements . PRODUCER CONTACT NAME Felicia Amaral INSURIT AGENCY INC. PH WC N E�; (508)672-0820 1C No): E-MAIL famaral@hadleyinsurit.com 246 DURFEE ST. INSURER(S)AFFORDING COVERAGE NAIC0 FALL RIVER MA 02720 NSURERA: TRAVELERS INDEMNITY CO OF AMERICA 25666 INSURED INSURER B: ASH AWAY HEARTH &CHIMNEY INC NSURERC: INSURER D: 703 STATE ROAD NSURERE: NORTH DARTMOUTH MA 02474 INSURER F: COVERAGES CERTIFICATE NUMBER: 6856 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. LPTR TYPE OF INSURANCE POLICY NUMBER MMMDIYYYY MMMD/YCY YYY LIMITS COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ GE T CLAIMS-MADE OCCUR PREM DAMA ISES Ea aaunence b MED EXP(Any one person) $ N/A PERSONALS ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECTO. LOC PRODUCTS-COMPIOP AGO b OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea.. and ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ NON-OWNED Par accident HIREDa%.l1TOS AUTOS $ UMBRELLALIAIS OCCUR EACHOCCURRENCE $ EXCESS I" CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION $ WORNERSCOMPENSATION X/ PER TH' AND EMPLOYERS'LIABILITY X sTo:7UTE ER ANYPROPRIE'rOR/PARTNERIEXECUTIVE Y/N E.L.EACH ACCIDENT $ 100,000 A OFF ICER/MEMBEREXCLUDED? NIA WA WA 6HUBOG28179915 08/27/2015 08/27/2016 (Mandatory it NH) E.L.DISEASE-EA EMPLOYEE $ 100.000 M yyes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more apace is required) Workers'Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool atwww.mass.gov/lwdtworkem-componsgrtion/'investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Donna Fontes ACCORDANCE WITH THE POLICY PROVISIONS. 61 Sundelin Way AUTHORIZED REPRESENTATIVE West Barnstable MA 02668 Daniel M.C4y,CPCU,Vice President—Residual Market—WCRIBMA 01988. 04 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD C +4 Y� + ,` fw; l f 1`,.1f..ai A f�".;' ''_�� ,•T'�"r �.+�.� •, � t`*.•fix � ` .� �:..:1."sm�...-t� r. s .... , L- a p f „ co CD o Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 2-13-13 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, This affidavit is to certify that all work completed for 61 Sundelin Way,West Barnstable has been inspected by a certified Building Performance Institute(BPI) Inspector. Ceiling: R-19 cellulose main attic Knee walls: R-7.4 Thermax All work performed meets or exceeds Federal and State Requirements. Sincerely, I William McCluskey I �-, CO 0, 2 �U Ln -i' O "� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 6 Parcel 0 Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address b 1 's K n d- .0 i Village West" c1%SA:aW Owner D a A R o\. io a I&S Address m e.. Telephone Permit Request R— 1 4 c6 tk t w e to 4e a4 l c► +Ve A r, CA V,g_cnai W'4 aakalpq -�b km . Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1 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 1 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.4 ry Number of Baths: Full: existing new Half: existing new cn— cn C-1 Number of Bedrooms: existing —new a Total Room Count (not including baths): existing new First Floor Room jount Heat Type and Fuel: ❑ Gas Oil ❑ Electric ❑ Other - Central Air: ❑Yes Od No Fireplaces: Existing New Existing wood/coal stove: J%YesF;a No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑ Yes 11111 No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name.W111l0.th Mcclmf Lc,, ,, &.e .-1nC, Telephone Number 508- 398` 6 �J'Ig �Address 7- D -niioc,+m Ave, License # _�Z_c 10 i I- MM t �+ �,-rhar��-h 1'l D u o Home Improvement Contractor# Worker's Compensation # 7WC 4 0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO #L(`1'(ti(9UA SIGNATURE DATE << 1 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. s ADDRESS VILLAGE'-° i OWNER DATE OF INSPECTION: FOUNDATION if FRAME 1 INSULATION t FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 1 GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT s w c ASSOCIATION PLAN NO. The Commonwealth of.41assachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 0-7111 1Uivtv.ntass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le--ibly Name(Business/Organization/Individual): C nn e G�,YP_ �'n G Address: D ('milftq ,dn venu�G City/State/Zip-,50 ,41 YOX( %t, ('�(� pa664 Phone : 50$.- 3 q $ - O 3 4 8 Are you an employer?Check the appropriate box: Type of project(required): 1.f R I am a employer with 1-4 4• ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in.any capacity. employees and have workers' 9. ❑Buildin insurance. g addition comp.[No workers'comp. insurance P• required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing 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' 11 M Other comp,insurance required.] *Any applicant that checks box Rl 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: T ep�n o t 0,3 S V.,,0.n oC Gem n Policy 1 or Self-ins.Lic. C 3 31 QV-4 Expiration Date: L4 l / 3 M Job Site Address: FI` sU•n�P (() �/J ..y City/State/Zip. . 8+r^s}-able 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 S 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 Investisations of the DIA for insurance covers-e verification. 1 do hereby certi,under the pains and penalties of perjury that the information provided above is true and correct Sienature: e p Date: 0 « Phone.u: 7 O p ' 3 9 Official use only. Do not write in.this area,to be contpleted by city or town official City or Town: Permit/License Issuing Authority(circle one): 1. Board of Health ?.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone j: Aco CERTIFICATE OF LIABILITY INSURANCE Silo/2�'2 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 NAMEA�RlSk Strategies Company Risk Strategies Company PHONE (]g])986-4400 0..(781)963-4a20 15 Pacella Park Drive ADD RE : Suite 240 INSURERS AFFORDING COVERAGE NAIC 0 Randolph MAL 02368 INSURER A* :Selective Insurance INSURED INSURERB:Safe Insurance Co an 3618 Cape Save, Inc INSURER C:Technolo Insurance Cc an 7 D Huntington Ave INSURER D: INSURER E: South Yarmouth MA 02644 1 INSURERF: COVERAGES CERTIFICATE NUMBER:CL125948081 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 I DDLSUBRPOLICY EFF POLICY EXP UMITS LTR TYPE OF INSURANCE POLICY NUMBER (MWDDNyyn JMMIDD GENERAL LIABILITY EACH OCCURRENCEAIMGE TO RENTED S 1,000,000 ?Jf MERCIAL GENERAL LIABILITY PREMISE Ea occurrenceb 100,000 A CLAWS-MADE FZOCCUR CPPS1994480 0/16/2011 0/16/2012 MEDEXP(Any one person) S 10,000 PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY B�IN�RISING LIMIT S 1 000 000 BODILY INJURY(Per person) S B ANY AUTO ALL OWNED SCHEDULED 6208200 1/6/2011 1/6/2012 en BODILYINJURY(peraccidt) S AUTOS AUTOS PROPERTY DAMAGE NON-OWNED S S Peracddern X HIRED AUTO X AUTOS X Underinsured motorist 81 s $ 100,000 $ UMBRELLA UAS OCCUR EACH OCCURRENCE S 2,000,000 A EXCESS UAS CLAIMS MADE AGGREGATE $ 2,000,000 DED RETENTIONS PPS1994480 0/16/2011 O/16/2012 S C WORKERS COMPENSATION R WC STATRY IMI OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE a N/A E.L.EACH ACCIDENT S 500 000 OFFICERIMEMSER EXCLUDED? C3318007 /9/2012 /9/2013 E.L.DISEASE-EA EMPLOYE S 500,000 (Mandatory In NH) If yes,describe under E.L DISEASE-POLICY LIMIT 5 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101.Additional Remarks Schedule.If more space Is required) Issued as evidence of insurance. Issued as evidence of insurance. Thielsch Engineering, Inc. is listed as additional insured as respects General Liability as required by written contract. CERTIFICATE HOLDER. CANCELLATION msong@capelightcompact.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Cape Light Compact Attn: Margaret Song AUTHORIZED REPRESENTATIVE PO Box 427/SCH 3195 Main Street Barnstable, Imo, 02630 Michael Christian/BAM ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INW125nntrmsint The Ar AlOr1 name onel Innn oro roniafarori medic of artARrl �Iassachuactt:- Delmi-intcni of Public �afrt� Buurc) ofBuildin!_ Rc!�I ations and Standards . ;+ �* Construction Super-,isor Specialty License License: CS SL 102776 Restricted to: IC WIL•LIAM MC CLUSKY T1 37 NAUSET ROAD - WEST YARMOUTH, MA 02673 cam_may/` Expiration: 6128/2013 c.,mm;<•�.nc. Try: 102776 �r Office of Consumer Affairs and eusiness Regulation �1 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration 171380 Type: Corporation -- Expiration: 3/14/2014 Tr# 222184 CAPE SAVE INC. - WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE - = SOUTH YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. i? Address Renewal 17 Employment !t Lost Card PS-CAI is 501,1-04104-G701216 ✓1e Consumer &. d�s ness Regulation License or registration valid for individul use only Office of Consumer Affairs&Bdsiuess Regulation � r.•- T —,_HOME IMPROVEMENT CONTRACTOR before the expiration date If found return to: a (, Office of Consumer Affairs and Business Regulation i , Registration: 171380 Type: 10 Park Plaza-Suite 5170 b�Ia- Expiration: 3/14/2014 Corporation Boston,MA 02116 7 C SAVE INC. WILLIAM McCLUSKEY..—.-"; _?_'... 7-D HUNTINGTON AVENUE= SOUTH YARMOUTH.MA102664 Undersecretary _ Not valid wit o signs r . 460 Yaest Main Street -4. HOUSING Hyannis,)MA 02601-3698 ASSISTANCE ENERGY & HOME REPAIR ��'•= "' T (508) 790-7106 F (508) 790- CORPORATION 2425 HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: _ PLEASE SE R1 1 !1t IT AN 9 'k3AI TI 11SF0(']6! 1tom-1-11 AnE THE APPLICANT HOMEOWNER I hereby consent to and agreethat weatherization work may be ; done by the Weatherization Program of Housing Assistance Corporation ( herein after referred as "Agency") on the propert 1 ocated at: ;8 Dick DPW Theweatherization work done will be based on programmatic priorities and availability of funding and it may include all or someof thefollowing measures: Weather-stripping& caulking of windows and doors, insulation of attics, sdewalls& basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows In consideration of theweatherization work to bedone at my home I agreeto thefollowing 1. l give permission to the"Agency" its agents and employeesto travel onto or acrosssaid property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The H ousing Assistance Corporation reserves the right to inspect thefuel or utility bill for the weatherized unit on an ongoing bads for no more than five(5) years after the weatherization work is completed. I have read the provisions of t reernent as listed and f y give my consent. Home Owner: (signature) D ate: Agent: (signature) Date; 1 HAC approved Weatherization Company : C0 e v� All Cape Energy, Caliber Building&Remodeling, Cape Cod Insulatio a Save, reswell.Construction, Frontier Energy Solutions, Lohr&Sons, Peter Smith, Resolution Energy, Rock Solid Construction Assessor's office(1st Floor): Assessor's map and lot numberro`` Board of Health(3rd floor):... e Sewage.Permit number s SEPTIC.SYSTEM MUS . 9rsntE Engineering Department(3rd floorj: `;' INSTALLED IN COMP � rua House number, '-, , WITH TITLE 5 °°�i670•b.�� Definitive Plan'Approved by Planning Boar 19 : M� _ o r�r APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only �Lb ► TOWN OF • BAR ABLE B U ILM G INSPECTOR APPLICATION FOR PERMIT TO + TYPE OF CONSTRUCTION &61a 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit laccording to the following information: Location a SU I.-II Proposed Use Zoning District /` Fire District 1'a r iI Name of Owner DOA) V C1 ! P S Address &O-O (-)9 4 S/ e�/,lf9✓'-j Name of Builder �d / /��j9�t/�tJ / Address pde (77-7 4 =Iiz 41 1//Sq Name of Architect <J W A-)e Address 800 Qq 4 S 7 Number of Rooms q Foundation 61=1 /rCo ti C Exterior 0jnC9 ' Roofing CJ 4/r Floors 4)00 v Interior Sh�'pY/OG� Heating y (J Plumbing �� Fireplace ✓'I C G Approximate Cost Area Diagram of Lot and Building with Dimensions Fee I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regar i g t ve construction. `•xt �, Name ' Construction Supervisor's License V Q59120 7 FONTES, DONNA M. No 3633-4 Permit For 1 , Story - [ r i C Single Family Dwelling r I r • Location Lot #4 , 61 Sunde;lin Way.- -• � - _ s, k' W. ' Barnstable 'Donna M:, Fontes Owne/r.f _ Type Of'Constru� c'tiom '- Frame �c Plot Lot ' ' 7. r ' Permit Granted. - rdrwember,; 117, '1 g 93 ' 7 i + i Date pection/ 19 Date Completed, �19 .l r r i r f OLD KING HIGHWAY HISTORIC, DISTRICT Si P E C S H E E T FOUNDATION SIDING TYPE C l\Y1�'i�\�� COLOR CHIMNEY TYPE COLOR �-2C CL'� C94--\ . ROOF MATERIAL �� Sal\Y�1E COLOR PITCH �01 1Z—\Z- �Ct Z- WINDOWS v�l�(ZC ��J�I�\�� C Y SIZE j =s <" TRIM COLOR �0 DOORS COLOR V� Y 1 1"�-P SHUTTERS \- I GUTTERS y l \ 1 1 DECK GARAGE DOORS�j� COLOR Notes : Fill out completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application, along with three copies each of the plot plan, landscape plan and elevation plans . when applicable. *Plot plan need not be "Certified" , but should show all structures on the lot to scale. Application to 3 d Old King's Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, id triplicate, 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 Building ❑ Addition ❑ Alteration Indicate type of building: Jq.House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE\ \ ADDRESS OF PROPOSED WORK \ SSESSORS MAP NO. OWNER ASSESSORS LOT NO. �w HOME ADDRESS ����TEL. NO. 4� FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacentproperty owners across any public street or way. (Attach additional sheet if necessary). s zsK4 r\ G\rc\�. %��� Cogs�o�ta_`Po•���(�� ®>s1n��'� �� �►-`��C�,.�,,.,__ . �..._...•,_r AGENT OR CONTRACTOR TEL. NO.--- ��`�-�� ADDRESS C' n- ��S DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). I i i Signed Owner-Contractor-Agent Space below line for Committee use. Received by H C tificate is h by DateDG�2W i y TOW A OLD KING'S HI HWAY pprove IMPORTANT: If Certificate is approved, approv Is subject to the 10 day appeal period provided in the Act. Disapproved ❑ �' 'rzrtJv � "fFh? 4�Ol.Er•���h� 17, WIT' - tiIT11PFJ•• r Iu.:.N ram_ _ , f..w 12d.TGl G M,-I111r4G4 , _ ( Q� .� \ b\ m•n..+. q1.9 .9L.p c.,o I Mo I o TL �__ { r 3t�v e6*1 cea-1 r,5a c N•r:r-L I n,eu, A.MU41(J7Al.W61YR 5•f /' y� \r,.� I.� t��' �_.,� L• ' ' 1 { 9.PIOe PITcN•1/+'/rT W"LErr onleZI'"'�c. t•ID!cv. 4.0"1641 u+aab 4_9eeusr u.:rtS'of -44. 1 •� q y�••qj nc.o, 1 4� ���'j �b ,� \ �L �` � \\�,. . � i 5.vtc�..folr3rs•Stine.3e r.InDE WaTcancwT V• ,, A ` <" �. '� j � Y.� l�':{ k ('�, -•�,`\ °C° eNCiR'o°uK°rETaai,U�c�i��2vdJcE wrn•I I a f t°r'r--' •�,.� r 1 `, `' •':'',v,� � '1.Yut57ie.l Tr�¢+'rr'S90'�o woPtc.oa�{6ND 6r♦W I.D-107 I �i Cryay':.�.�u-� �^ _•^•� •"1\ 1 �/ �r�'rC (, • ,lu� 'aCU_tD Foe PS'.oPE27y:Irt6 sTdFr^t!r• ' �.5-7?c%`15rJ .Li a"1..ti,-_.lj� �"�v' roc.D� '\\�/ �ti`• \'.,yl t ' r I. , { >?Z.J<z3 :�\ �`` `\r` ��\\,\'`��t�..•-• �\\='�_`••—_>J �' •crvmacwoa'nvj 2'na Asaxo.lE C`i 2 0 2 > \ \ I I INv,.r rr.a.n.t• !•r - �`f%tEal'r rr P�ae 6.fr 4• 1 O \ ` � \\ \� C \ A. II�•b�TFw I f^.ci.hvn�l' `\ \�\ � 1�� �� W �} �a.ruTTca (¢•,._,tom:..,a� to vCLj \ K a \.err .� Z Irrc. G4w. TA. v ' �� Lj '..y_'_ ., �\�.�4, OIOGS•i2tt6 2Ab 2�1.4�. 375.5 yi�ITON.'�rf``4• Ilb t /vnt�: ex.'s SITE ego S&W&GF 9L&r.1...��..�,� TDTeL �;m 4Ss•4i oro - 1 Utz - � �_'!ii-_- "• .,..�..4:�s7 4•%.: rr 2r.14.�.f'_tom.':n�ef,___.___ i '\ Lit 4c P•.i - _v__'r�••� r'TP-6Ya2.ED S'Oe { (pe ,.rac„�P�'+ w�.av¢\r,. Rt' iLG P,Atr <'r.q,c T't.•,f':'•c Gown cope Cn�rnevn�,rx a. a:� J1 C IJILE�I w6EZ: • �'• "tt ,�/� �(� a—fl�cc 4lP.a_Ttl 2a� h.rz.�� La.JD SI:NEYo1'i '-tAr��,•�,' w: ,.dj4 9/� �,'a.°.t•:TTrwC t.'A. 'RTC Le 'f4V^tOUT11,Nlo-! AFaG FI, OJAIA .1..LFi.IPC. DA'I>: A?CgAVEO r✓ATC L�.x.� >K•a r n..t t'- •rc` p COMMONWEALTH OF MASSACHUSFgTS e`er DEI AJZTNTNT OF ENDUSTRI-AL.ACCIDFNIS L 600 WASHrNGTON STk T fames Ganooei B0ST0N, MASSACHUSETTS 02111 -NORKERS' COMPENSATION INSURANCE AFFIDAVIT 1, P;Ea- , (l i cc n scc/perm i rtcc) with a principal place of business/residence at: Ano k S1-- (,�J , At (city/Statc/zip) do hereby certify, undcr the pains and penalties of perjury, that: ( J 1 am an employer providing ncc following workcrs' compcnsation coverage for my employees working on this job. Insurance Company Policy Number jV am a sole proprietor and havc no one working for me. (J 1 am a sole proprietor,gcncr2l conuaaor or homeowner (circle one) and have hired the contractors listed below who have the following workcrs'compcnsation insurance politics: Name of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number I am a homeowner performing all the work myself 1','OTE: Plcasc be aware that wbilc boascowncrs who employ perwos to do raaiatcaaacc.construction or repair work on a 1wc1ling of not more tbaa tbrec units in wbicb the borocowner aJso resides or oa the grounds appurteca.nt thereto arc not geac"11), i considered to be cmploycts unecr the Workers'Compensation Act(GL C 152.sect 1(5)),application by a bomcowacr for a license or pernit may cvidcacc the legal sutus of a.n crploycr uadcr the Workcrs'Cornpcasation Act. i L;n0crstan6 tis:t a copy of ties st:tcmcn will ix forwardcd to 6,c Dcpa:rr.cnt of Industrial Acadcnu'Ofiicc of lnsurancc for.covcraYc verification and that failure to sccu rage:s required under Section 25A of MGL 152 an)cad to the imposiuon ofstimNaJ pcnalucs consisting of a fine of up t andlor imprisonment of up to one year and civil penalties in the form of:Stop Wotk Ordcr and a finc of S 100.00 a day t Signcd this day of �/ . 19 Liccnscc/Pcr rtcc Licensor/Pcrminor v; f3�o�` - - � . r .. .... ._.. ...... .......... .. _ . . .._ _. ; . �.� . ,,, .. ... .. ,. . �� . _ � .� i i N ��Evti �nrl � oil �;� �ES���t�C,E ���. +..err.-��.....Mw�����.+�..r��..�w.. +J� _ ��_�wlr:J u„ u0f�� . ..�,u�nl. r^' � : 1 -12 . i I i � �r 4 onwwN er --- - i i -LEO �l F14 ES �6510ENC1l; Mni tJE I�r.�� (�t-Nri of C�f% �'OP I � FFH EN rm t .. i L! rd:I_. �r�{aij�t P1 IF - f I VrGIC .1�"� rl i l-1 ' � I K BEN I j O0 'v eMlw DWI 0.O e � I �sw(d•v I i G —__4 _ _ I — Lib" • �ecf• wl+. ti�uB/ywlc. I 140 ` I LIVItJG RM. S o z`k4° - j J� I - i fz- Fo" I o � - o� q,cip DECK 71 wdiwpoo� YO rQ � •� �EnRaoM"2 nr,, �AKaoM"3. N CL KNF.tvW.i. �'r'",'61 rKN 6tWA1A.. � C � ' I i yyr rr i 6(rGON� f�oo(L FWN arl'(E�?.��51�GtJGE � � � euie,a,tPyQ�"°°"°.aosr.('? ... / ._...,. aurr.r er QMM•� ; �'.Io' Aw�raaYR (41 .7Dt4 I LUa y �*O�asrY.aC, W�v� .yavoL,,,GI awln,. R¢qcp� — W 4 , • a y_ _ L�1•Y �S � e:.� 5�•8��12 d�-t4p I � -l.L: •\ I'/.+ .. f _ 4 .CY.L: .VYPO EO.O, � -• i•A>::V I'Fy,:t.I'tre� p`1j �R�I��4 fr 'T 1 m� RM µ C.7, I Q F:.:�n �, �;<.. a I I � � .- .�... -_. r+•... xw I �1I \ _._ t .o_�..��`. ti I I� 4 �LLi "Il .r f,� 7 �� •X $ W`y-)" Ig�'agY�' 711J� `I '1FJtb-li-S 4• f+G![G2`iF•.Ff� •�VP1f w n��rr �CriOJ l�r � ';o_ FGfJ�.1p: �-�ILM�.J`+ (`i"j a,;\,I I;.14nT 4-L.I!/ f'} -?r11?. �.QP•JCv�"^{JQ. —r..._._.._._�_.._—_...-_ _—^-__- _ - .:.:..,: t � ,..:.:;i .car! .:-, I:. .;r �• I, fir..•/ i I" P� P ' Yh'� sG , / � k ✓ems ti GOP51G Zg��I��,u�' ORO" �- 0 , x LOT 4 44. 092 t/- S.f. It 1\ 1� 0 1 65 0 G� 1 i � 2 O -Ak .o I LOT 3 Z O # 90-092 CERTIFIED PLOT PLAN LOCATION : LOT 4 SUNDELIN WAY, W.BARNSTABLE, MASS. SCALE : I " = 50 ' DATE : 1114193 LOT 4 PB 415 PG 88 PREPARED FOR. REFERENCE : ASSESS. MAP 216 PCL 2-3 DONNA M. FONTES I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. ARNE .; ,in cape engineering inc. ,{ CIVIL ENGINEERS II LAND SURVEYORS J9�3 SURVE R RTE 6A - YARMOUTH, MASS. DATE ,� : TOWN OF BARNSTABLE,,MASSACHUSETTS ,BUILDING PERMIT DATE PERMIT NO. N® .1633 APPLICANT ADDRESS ,} %� -'•t_:... _ (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO -1A 1 1�i 1J;•:•_j..;.i.i... _L�, J .,<' .i 1' !.i � .._ NUMBER OF ( ) STORY DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) uUc i74� 61 vu:lui'-i--in' 'v�<+1'� (i. �uY.iiSi..�:1�J_-4 ZONING 1 AT (LOCATION) DISTRICT (N0.) (STREET) BETWEEN AND (CROSS STREET) - (CROSS STREET) LOT. SUBDIVISION LOT BL6CK SIZE 2. BUILDING IS TO BE FT, WIDE BY FT- LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT:WALLS OR FOUNDATION (TYPE) REMARKS: Sew.qe 493-58% i AREA OR VOLUME 136C so . � 70, 000� 00 PERMIT Sp. ( r:; 0(' ESTIMATED COST FEE 7 (CUBIC/SQUARE FEET) ' Donna Pi. OWNER - :,r- BUILDING DEPT. yq�;! a: - ADDRESS 13ut: 'C ac. 1�..-. :i. CL.�L� BY Y i � I THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHAN:CAL INSTALLATIONS. I. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI 70 LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 64 2 2 2 HEATING INSPECTIO APPROVALS E INEERING EP fTMENT 2 F HEALTH OTHER P G 1k , SITE PLAN REVIEW APPROVAL •. WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. PERMIT 15 ISSUED AS NOTED ABOVE. NOTIFICATION. I '.1—ic. ♦Aµ- '^'+.a,,.�::,�^•VYtt 1 k r +4 �,..._.. '.s:^ �. :A, •-^`J4 -� _4 f '-c..,+.' .;,.�t"4,-�''h�'j-..�Rrt.+r�v+`d1""'�.t_.. w �' *M�>o TOWN OF BARNSTABLE permit too. 36334 BUILDING DEPARTMENT 1 ""'� } TOWN OFFICE BUILDING Cash .YL ..... VV ����►+' HYANNIS.MASS.02601 Bond ..............:. CERTIFICATE OF USE AND OCCUPANCY Issued to Donna M. Fontes Address Lot #4, 61 Sundelin Way, N West Barnstable USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT'BE OCCUPIED UNTIL. SIGNED BY T14E BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. June 8 19 9 4 Bui ding Inspector o`�y�••°, TOWN OF BARNSTABLE BUILDING DEPARTMENT aver =rua TOWN OFFICE BUILDING '679• HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit ...................................... _ _ . _.... ...:.... ._. ...__ .. . issued to ..;.,1/ ?/YtcY...!. .L..:....� ! s. � ! ................... .............._................_...._......_._.__. Please release the performance bond. KASLmxlamo Department of Health Safety and Environmental Services Building Division ' 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner TOWN OF BARNSTABLE Pe*,7,7 SOLID FUEL STOVE PERMIT Date:%-9_ct'� Owner: l�'� Phone. � . Address: Village-\' I Map/Parcel: Date: — i New e: Radiant irculatin C. Manufacturer: Lab. No. j D. Model No.: Chimn A. Ne 4 ;/EZ)dstin (If existing,please note date of last cleaning t g+ ( 'a�B. Flueze C. Are other appliances attached to Flue? C� D. Pre-fab Type and Manufacturer E. Masonry:?-_,�jc)�, Lined/Unlined Hearth A Materials: B. Sub Floor Construction: Install Name: 6&ddr s: I Phone: Location of Installatio APPROVED BY: Please make checks payable to the Town of Barnstable I ' *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Stove.doc _ . ., - ... ♦ _ : .. .r-- .. ... -M .. •. �.. ti •ram.,. TOWN OF BARNSTABLE 36334 Permit No. . BUILDING DEPARTMENT t'"'"' I TOWN OFFICE BUILDING Cash ................ ■Y. .ego• Leo+~ HYANNIS.MASS.02601 Bond .... ........:. CERTIFICATE OF USE AND OCCUPANCY Issued to Donna M. Fontes Address Lot #4, 61 Sundelin Wav, 9 West Barnstable USE GROUP FIRE GRADING OCCUPANCY LOAD` 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. . ;tune.. 8 ...... I9..9 4........... Bui ding Inspector