HomeMy WebLinkAbout0012 CAMMETT LANE 67071
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PERMIT PAYMENT RECEIPT
-
TOWN OF BARNSTAK E
BUILDING DEPARTMENT
200 MAIN STREET
HYANNIS, -MA 02601
DATE: 09/19/06
TIME: T1:3a,
PERtiIT $ PAID 7t 00
AMT TENDERED: 45.00'
AM"',APPLIED: 25.-O.D
CHANCE: .00
APPU CATION NUMBER,. Oi1613 't
PAY',ME-NT Mf~Ia,. CHfCP,
PAYMEITI Rif240?
s
i
\ . q
,oFVE Town of Barnstable *Permit#a,60( 3331
ti
Expires 6 months from issue date
41. MSTABM Regulatory Services Fee o?S.unss.
�A iGs9. .10� Thomas F.Geiler,Director 'r
IEDMA�p •�1/� 11/
Building D1viS10n
Torn Perry; Building Commissioner X-PRESS PERMIT
200 Main street, Hyannis;MA 02601
Office: 508-862-4038 SEP 19.2006
'
Fax: 508-790-6230 TOWN OF BARNSTABLE
:EXPRESS PERMIT APPLICATION .= RESIDENTIAL ONLY
Not Valid without lied X-Press imprint
vlap/parcel Number Q 991 Q 03
'roperty Address__ a m m'P-,-4 CA n-z- I'Yl at?
tesidential . Value of Work Minimum fee of$25.00 for work unSU
der$6000.00
)wner's Name&Address M C 1)v.O LU2—
1 z LA �n.9
;ontractor's Name 7 �. q�
TelephoneNumberZQj V.
lome Improvement Contractor License.#(if applicable)_ , I D 0 7 "l
:onstruction Supervisor's License#(if applicable)
]Vvrorkman's Compensation Insurance
Check one:
❑ I am a sole proprietor
"I am the homeowner
I have Worker's Compensation Insurance
isurance Company NameaA-i&d. cauAcLA- c
lorkman's Comp.Policy#_ Q-,AW an CPS
'opy of Insurance Compliance Certificate must be on file.
ermit Request(check box)
bQVe-roof(stripping old shingles) All construction debris will be taken to l SQ.. r
0 Re-ioof(not stripping. Going over existing layers of'oof)
:Re-side, .
❑ -Replacement Windows. U-Value (maximum.44)
*Where required: Issuance of this permit does not exenipt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
Home Improvement Contractors License is required.
1ature
Forms:expmtrg
vise063004
i
Page 7 of 7
CAPIZZI HOME IMPROVEMENT INC.
SPECIFICATIONS AND ESTIMATES
STATE OF MASSACHUSETTS
LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT
OWN THE PROPERTY LOCATED AT I a CA m rn L
IN I _l . M It , MASSACHUSETTS.
I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR
A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING
CODE. j
I GIVE MY PERMISSION TO LESSEE
TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS
STATE BUILDING CODE. ] /
SIGNATURE OF OWNER: '��`�'/G�//� T• i�G~ �c�, . ,
OWNER'S ADDRESS:
OWNER'S TELEPHONE:
LESSEE'S SIGNATURE:
LESSEE'S ADDRESS:
LESSEE'S TELEPHONE:
APLLICANT'S SIGNATURE: Owl
APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit,MA 02635
APPLICANT'S TELEPHONE: 508-428-9518
RESPONSIBLE OFFICER:•
RESPONSIBLE OFFICER ADDRESS:
RESPONSIBLE OFFICER TELEPHONE:
I
Lace: 6/13/2aub 'Dime: u:4u AM To: (9 9,1,S064281S47 R&G Ins. Agoy. Page: 001
-' Client#:47298 CAPIHOM
AC-RRD,. CERTIFICATE OF LIABILITY INSURANCE o613/06 �''
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Rogers&Gray Ins.Agency,Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
P.0.Box 1601 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
South Dennis,MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: National Grange Mutual Ins.Co.
Capizzi Home Improvement, Inc. INsuRERe: GUARD Insurance Group
Capizzi Enterprises, Inc.1645 Newtown Road INSURER C:
Cotuit,MA 02635 INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
fNbK AD
LTR INSU TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
DATE MMIDD DATE(MWDDrr0 LIMITS
A GENERAL LIABILITY MP010707 06/08/06 06/08/07 EACH OCCURRENCE $1000000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENPREMISE _(Ea TED $SOO OOO
CLAIMS MADE a OCCUR MED EXP(Any one person) $1 O 000
PERSONAL&ADV INJURY $1 000 000
GENERAL AGGREGATE s2,000,000
GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000
POLICY PER LOC
A AUTOMOBILE LIABILITY M1010707 06/08/06 06/08/07 COMBINED SINGLE LIMIT $500,000
ANY AUTO (Ea accident)
ALL OWNED AUTOS
BODILY INJURY $
X SCHEDULED AUTOS (Per person)
X HIRED AUTOS
BODILY INJURY $
X NON-OWNED AUTOS (Per accident)
X Drive Other Car
PROPERTY DAMAGE S
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $HAUTO ONLY: AGG $
A EXCESSIUMBRELLALIABILITY CU010707 06/08/06 06/08107 EACH OCCURRENCE $5 000 000
X OCCUR CLAIMS MADE AGGREGATE s5,000,000
DEDUCTIBLE
X RETENTION $10000 $
B WORKERS COMPENSATION AND CAWC702365 12/25/05 12/25/06 x wcSTATu• oTI-L-
Fp
EMPLOYERS'LIABILITY'
ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $500,000
OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000
If yes describe under
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAL l_ DAYS WRITTEN
I.
NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25(2001108)1 of 2 #M22681 MEE 0 ACORD CORPORATION 1988
l'I�fic r t►j �lit'CArl�rlilfll]C
'// X3os10r1, AM 02.11)
N"Yorhers, compe salluM IX)SM-:aY)OC.Affidnvii: 3uiltjea;s/C;c�7�i1-arir�1 till��Gr.�.riciaYas/ '�uxx�l.►cz ti
;>�3kc•.a>I�� 3nii�rn�aiif�z� 7'l��asr �'�-ini 1e�il►l�? .
3717C; (3:3u5 3asS/Ur aniLati.o»/J�3t3i�idual): CBpIzzi Me Improvement In3c.
� rn F?n,)d
3dress_ Cotutt, MA 02635
' Tel A2&9a18 1 1 800 262-5J6D "'
ty/.Sia:t-el�zP: P�ooe�: •
, 011 an mployer7 Checl;tbe•appropriat.e box:
Type of project.{req'<xireslj: .
1 am a euloyeriRv �_ 9_ 1 am a general contradorand 1 • G.• El Nei?ions Do6om
employees(fuD andlor pa3t-ime).=,: have hied be sub-contndors
' 1 am'a solciiropxietororpartner- listed'on-Le atlacbed sleet . 7-
ship-and 3iaj?e no'employees Tb6se sub-cont bvr; 8. El �Demoliiion
worming £or me Sao any capacity. workers' comp.insnxance. � 0 $rcilding add3tioxi' .
FNo ,�vorlsers'eon'ice 5_ ElWe�e a coiporation and it
re�rtir � Officers have exercised ib i 10.[]33l�eal xepai�s or acldiiioi�
I am a homeomer doing all Work- Wil of exempiim per MGL 11_ED Plumbiag repairs m additions
To elf [[ o vorl ers'comp.. C. 152,§1(4),and vvreIzveno 12.0 Roofrepairs
I33.S�zx ante required ' empiO3rees_ [No rcTorliers' �
!comp.imsim ee 3requimLJ
�n3icsn=Yhat cliecss boa-T w si?o flier vroers' -
ovancas v vbo snb Yids sffidsrsi mdic i�e��s� ��g �°Iboxi PD14 adozmaiifln
curs�na1 r iee7 $xis�ox,n„d �g:0 wo&-end Then lire oaisderonI=j4Drs must subn3h s=-efdavii idc5csf3 snch c
�an sddd?'�ionsl s7�eei sl�oriing�e name oiflze sul>-arr�iTaoiors and Y�e�n.oi�.eis'aoz�o �o7ncy afor..aeiion...
rz en7Ploy&-YIzoYisprwr>id Zg xorke�s'�rnpazs�iorz raxsxcr�rzce�na rr�r exzlplaoyses $e�or� rs f;�ie�n;ric3 +rnrd�o>?r site
s�3z_
ac;e- {✓Q333pamy,, II,- cm1 IN L�
ozSel s.l ic. 1: CAt`VC-7 Q(a aS Expiration,Dates:
e Address:1 City/StalelZip:
t a copy of the' 'or)j-
exs'cox�rt rensa oxr poXicy decl�ar-atxoxr page(Si Ming 44P-poIXcp aaxuoaber mad exp o)a date)_
to secrize coNrerage as required lind-cr Section 25A of MGL e_ 152 can lead ib ie b3posidou of clbmb a1 penalties,of a ,.
to $1,500_00 and/or tine-year m3o'Prisonmmt as'vdell as ChrRpenaltesiu 9iye forams of a.STOP-WORK ORDER and a fne
o $250_{}0 a day against;the-ViQ atPr. Ee advised that a copy of ibis statemmt:may be fox rded to the Office of '
gaiionns of-&e M�tar zasnzance coVexage)?e33�j,
a- y cexzx=f?rrxzdey} � ns.�rzrdpc It s.dfP&7uy3,3a urd ihLe kyio- nzadan Pr aVi&d above is iLx- a mud ror7 i �. .
are:
: 6-0 9- q 9 75-19
c--w use on.Iy X)o rxat 1vr7,i`e xrj'h's a!"er,'fO rise coarz,Pde;Fed bjr city or Xna?x:offirriaL
?or TovPs u:
bag �'Cr'�l[tlxxCCnBC� '
A'utliox�� (Circle e)ae):
oarwed of Realth 2,laxdld ng Depart�oo exit 3.QtYrro'16%Qex k a.BecU ical Impedox• S-klumbbag Lupedox
tact;re son:
21.31 91te &v����
Board of Building Regulations. and Standards
One Ashburton Place - Room 1301 .
Boston. Massachusetts 02108
Home Improvemen.hdbntractor Registration
MERE. Registration: 100740
_ T' Type: Private Corporation
Expiration: 6/23/2008
CAPIZZI HOME IMPROVEMENT(,"([N;C�
Thomas Capizzi, jr. `��
1645 Newton Rd. '�
Cotuit, MA 02635
Update Address and return card.Mark reason for change.
DPS-CA1 Co 5OM-04/05-PC8698 Address Renewal Employment ❑ Lost Card
"C/J097Y1J201/Zc!/Caaz, 9e�/UGCJ40QGYG�6cC�.6
Board of Building Regulations and Standards License or registration valid for individul use only
_ = HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
= Re,gistr.-ation:_:::100740
Board of Building Regulations and Standards
" ====j One Ashburton Place Rm 1-301
�Ezp�ation:=_6/23/2008 Boston,Ma.02108
f Type-
Private Corporation
CAPIZZI HOME IMPO�VEMENT�INC.
Thomas Capizzi,`j('�,
1645 Newton Rd. �` 5
Cotuit, MA 02635 V Deputy Administrator Not valid without signature
t
AP IZ2
Lorne f
Improvement
Inc.
I, Thomas Capizzi Jr., owner of Capizzi Home Improvement, hereby authorize Lisa
Haworth, to sign on my behalf for permit applications filed through the town.
Signed:
Thomas apizzi, r. Date:
rl�aIaworth Date:
1645 Newtown Road Cotuit, MA 02635 (508) 428-9518 (800) 262-5060 FAX (508) 428-1547
�90
a
Assessor's map and lot number ............. . . SEPTIC SYSTEM MUST BE rwr
.Sewage Permit number .................A�... ........ INSTALLED IN COMPLIAN '`♦,�
.."""' WITH TITLE 5
House number f aNVIRONMENTAL CODE oo�939'ems
...................................................................... q MA86
TOWN REGUI,ATIOMS �o 39 d�
OR
TOWN OF BARNSTABLE
BUILDING INSPECTOR
x�
APPLICATION FOR.PERMIT TO .................� ...... ..../....y!
TYPE OF CONSTRUCTION .............�sra.4e.............0 ................................................
.../o./�x/........................I9 3
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ...............��.......C ........J.a.T ...... G.........'.....................................................................................
ProposedUse ........... .�'/9. ..f.. G.............................................................................................................................
Zoning District ............... Fire District ..............................................................................
Name of Owner ��� �o�. /�� 9 '�'��
......................................................................Address ...................�.........................................'..............
Nameof Builder C� N. ���............... ........... ........ ............................Address ........ ................................................................}.........
Nameof Architect ..................................................................Address .......................................................................r.........
Number of Rooms Foundation `JQ.L�fG.................
Exlerior ........../.........................................................................Roofing ...�........c4x...................................... .............
Floors ...c� v -............................................Interior
............. .............. ....................................................................................
Heating ..................................................................................Plumbing ..................................................................................
Fireplace ..................................................................................Approximate. Cost �'�
Definitive Plan Approved by Planning Board ---------------____-----------19 . Area ......��r" .....:4�..'...
all
Diagram of Lot and Building with Dimensions Fee. ........................... .................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
' D
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above .
construction.
No .................. ...r!y ..................
Construction Supervisor's License
BOOKER, KIETH
No .... Permit for ..Build...Garage„_....
..........Single... ... .. ..FA.m.- -Y
....................
Location ....12...Camp,.t.t...Lane...........................
................... .............................
Owner ......Ka..P,.th...D.Q.qx.p,.r.................................
Type of Construction .......Frame........................
................................................................................
Plot .............................. Lot ................................
Permit Granted ........October r...2.1..............19 85
Date of Inspection ..:..................................
19
Date Completed ........... ...............19
®
-3 jj
1A
Assessor's map,.and lot number ..............
pf THE t0
Sewage Permit number ................
t
4 Z 33AR33TADLE, i
House'number ......................................................................... - �.._ °oo MAM
q.
3 �0
a NP-4 a'
TOWN OF BARNSTABLE
BUILDING, INSPECTOR
APPLICATION FOR PERMIT TO .................6:__ ......4—Z..�? .........4
TYPE OF CONSTRUCTION .............�44;0 .4�#............... ..............................................
.......................i ge..'
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:.
location'.............../�..........................., ..................G...........:.....................................................................................
Proposed Use ,T%�s .� .. .
i
ZoningDistrict .................�......................................................Fire District ..........................................................:...................
Name of Owner /„� �� �7
...................................... .........................Address. ................... ...........................
Name of Builder ..........
.............................. . ;W.�. ...........Address ....`-«. l Cf
.
Nameof Architect ..................................................................Address ...........................................................
Number of Rooms :.............................................................:...Foundation /�p�✓p L/ j/G.
..............................................................................
Exterior .Roofing
'............................................................... ."... ...................................... ....
Floors ......... .Interior
Heating ..................................................................................Plumbing ....................................................................................
01
Fireplace ...............................Approximate. Cost ..............................................................�'��
Definitive Plan Approved by Planning Board ------------------------------19--------. Area . 1...�.....S�.�...'....
Diagram of Lot and Building with Dimensions Fee ov
�......................
SUBJECT TO APPROVAL OF BOARD OF,HEALTH
IN
r
i
f
u
5
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
NcrfY4 ................... - '...................
Construction Supervisor's License d..
BOOKER, KIETH 99-3
No ...28574... Permit for ....................................Build Garage
..............Single...Fam.i.1.Y..Dwe.11.i.n.g....................... . . ...... .... . .
Location .....12...Camm.e.q..L.a.ne..........................
Marstons Mills
....................... .......................................................
Owner .......K.i.e.th...Booker.................................
Type of Construction ...F.r.ame............................
................................................................................
Plot ............................ Lot ................................
J
Permit Granted .........October 21, 85
..........I............ .
Date of Inspection................................
Date Completed ..................................x19 9i
-ro