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0011 JOBY'S LANE
i, i � ,®;;.� Town of Barnstable Building Post This Card So That it is Visible from the.Street-Approved Plans Must be Retained on Job'and this Card Must be Kept HAMSMASM `t" $ Posted Until Final Inspection Has Been Made. y� Where a Certificate of Occupancy.is Required„such Building shall Not be Occupied until a Final Inspection has been made. Permit Permit NO. B-20-1837 Applicant Name: Keith Gilmore Approvals Date issued: 08/06/2020 Current Use: Structure Permit Type: Building-Addition/Alteration- Residential Expiration Date: 02/06/2021 Foundation: Location: 11 JOBY'S LANE,OSTERVILLE Map/Lot: 120-081 Zoning District: RC Sheathing: Owner on Record: MAGUIRE, MICHAEL S&CAROLE B Contractor Name: KEITH C GILMORE Framing: 1 Address: 11 JOBY'S LANE Contractor License: CS-098047 2 OSTERVILLE, MA 02655 T Est. Project Cost: $60,655.00 E Chimney: Description: Demo and Remodel two existing bathrooms. Non-load bearing wall Permit Fee: $359.34 locations to be moved. Frame in one skylight unit and frame attic i Insulation: skylight shaft. Fee Paid:" $359.34 Date: 8/6/2020 Final: Project Review Req: �'A � Plumbing/Gas Rough Plumbing: '%Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: 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. Minimum of Five Call Inspections Required for All Construction Work: Service:. 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: C As ssor's map and lot numb /'�.a.... �... .._ �'� P6 %THE T Sew;a Permit number Housenumber .... ��....................................................:... Com NUIM TITLE 6 °moo aY aye TOWN OF BARNS fi�Tt"` � BUILDING ' INSPECTOR .�... 1� 1�:.!g1w..411 �................................. APPLICATION FOR PERMIT TO .......... %4 Y� "� . ...... ......... TYPE OF CONSTRUCTION ........ 1�....................................................................................................... ....../..� �1:........3................19`2 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location�,.a./.. .... ....Gr ..........Q.STEI2�/!� ..................... .......................... . r Proposed Use ...11.f,:f'44....../F64107a te) .................................................I......................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner .J-,p#W.1�...0%�N�.. .��.!!!z4/.1!2/.y�.......Address ...... ....... Y,�.. zvY:,f.��r Name of Builder ..... ' %Y 15-101... gG�/.. . 4: /T��rf✓�/��/..:!.'� �... ...... ...........r�.1..Of.VS.�/�(/.�:.�.......Address ..... S/......../......... Name of Architect ....../..[t,L2�7� .....................Address ./z-1,n,/q'4,0.S........ .tea....... ./l✓.1�!ls�i'0. 1.�. i%'� Number of Rooms ..........4...................................................Foundation ...... ...0fItLIZ/P....... ....... Exterior �Li lit.A( WS........V-.. ...Roofing .....�S.�f?/`7'��.�.................................................... A / Floors ....d.61t ..T.1....F-/.1.�loF. . t!n.......................Interior ......SI1z�Z.(......11C /1......................................... g ..................Plumbing Heating .............................................. /..flay't............. 5�..�..Q....../........fL�. Fireplace ....... .......................................................Approximate Cost ...:....3.. .j...4D.r:........ ................ Definitive Plan Approved by Planning Board ---------------_—-----------19_______. Area 11.W.......93.4..............�0 Diagram of Lot and Building with Dimensions Fee a.... .tip ... ....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH U � I hereby agree to conform to all the Rules. and Regulations of the Town of Barnstable regarding the above construction. Name ..... .. . ' .............. �P Merlesena, John &%Paul tt S + 2�{717:- one story N ......S....... :j;-,Permit for .................................... %ingle family dwelling ............................................................................... Location 11 Joby's Lane ............................................................... O.sterville. . . . .. . ...... . . ...................................... Owner ........John. ... ... & Pa...ul..Merles. . ...ena ............ ...... . .. . .... .. ........ . .... ; frame j Type of Construction ............... name................ #12 Plot ............................ tot ................................ October 5 79 Permit Granted .....................................: :19 i r .1..l ..f........... 19Date of Inspection .......... ..........:... . ......19Date Completed a PERMIT REFUSED ........... .. .............................. 19 .......... .. ......................... .................. . /................. ..... ..... ........... . . ............................................ � frria �. Approve$I...... ... .......... 19 �. .�....... ................................................ ..................... ................................................... C� a "' o•'"" TOWN OF BARNSTABLE Permit No. _21717 i sin , Building.,Inspector Cash1639. ,����J •moo~Y��6' OCCUPANCY PERMIT Bond _ X'1'1$D "No building nor structure shall be erected, and no.land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained'from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector. Issued to John & Paul Merlesena Address 603 Ocean St. Ayannis lot #12 )U Jobvts Lane; Osterville Wiring Inspector /� Inspection date �G`�� ` Plumbing �F inspector o Inspection date V Gas Inspector f r� .� Inspection date vEngineering Department -�� �� f�{��f, Inspection date ��• Q THIS PERMIT WILL NOT BE VALID, SAND .THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. �............�...r. ._..... ........._, 19_ _. IN, _ Building Inspector Y� '3 2s o to C)o o 0 98 � 9� O CERTIFIED PLOT PLAN L. O C A T I O N �STE'e ,2 /lfrgSS - F O R S C A L E 30� D A T E: wG z7, /9Z9 R E F E R E N C /Z 'qS I-SAyOw_ 8 Z 8 7 p ...i ,o.Z.09 A--, .e o2o E::<,--> .Q7-- B oploCZA-1S?`AQGE AS T/--y,- 1 HEREBY CERTIFY THAT THE BUILDING REG, LAND SURVEY SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. 14 1J:EPH M '7G04 / J . M . MONAHAN. JR . & ASSOCIATES 4 mat REGISTERED LAND SURVEYORS & ENGINEERS sly 651 MAIN STREET DENNISPORTJ MASS. 02639 _ THE erm'if number WITH TITLE 5 ENVIRONMENTAL CODE Hc�use number ....770......Ai-.11......................................... 1P NAB& TOWN REGULATIONS 1639. Uri TOWN. PF BARNSTABLE tt TO R TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Heating --.—_.-----------_------'_�--�P1umbing ---''--------.--------------- Fireplace im�h� Coo -�� �7�� ---------------------------�*pprox �om -- , .���.r—.^..................... ____.^_ ' ^J� � r� Definitive Plan by Planning Board� lQ---_. Ansx '—!�.'���-------' ' . 'Diagram of Lot and Building vvhh [Dimensions Fee --.—���i'----`----. . SUBJECT TO APPROVAL OF BOARD OF HEALTH ICU ry ` ^ ` ----�---_� . uCCur*mCr rEmxx//S xEuu/uEu FOR NEW uvvELL/muu ' ` | hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above . construction. Noma —.. ..^�1�L^�. `—.. . 7 �~ ` �� �x7 Construction Supervisors License —.���'...... �'��. �� ^ � | [ EAGER, THOMAS 2817,4 . Peninit for . .„Swimming. Pool No ................ . ........ ...................... Accessory To Dwelling ............................................................................... No EAG ER, E R Accessory Location ...J.1...jqby��. Lane ......................................... 0 t 'lle ................ ............................................ Owner ......T'h*o'ma*s Eap:r................................. Type of Construction ..Frame............................. ................................................................................ Plot ............................ Lot ................................ Permit Granted .........ju4-v..9.,.................1.9 85 Date of Inspection ....................................19 Date Completed //.71*J................. 9 kv > Cr I-- — F 0 z M M J- M C) r4 V ,�qq Assessor's map and lot number .... ....... .............................. 0f o THE o f t 'Sewage Permit number ............................................... // Z DA"STADLE, i rNAB House number ram. .` ..........•. ..................................................... 900 039 e0� YAY a' TOWN OF BARNSTABLE BUILDING INSPECTOR :r APPLICATION FOR PERMIT TO 6.01 A......... .... �o v TYPE OF CONSTRUCTION ... T (., wa �� - �1.k�'x..�........... .?. of. ............................. � , ...... .Y.............L.......19 8.s5� c TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............... . .:........../ -'...................... .... ProposedUse ..... -!..►..!-'...)............................................................................r.................................................... ZoningDistrict ................f-..C................................................Fire District ...................`t...�..........:.........`.............................. Name of Owner ...1.�1.4�MA... ......... `f' .............Address ...��...... C�.v.r..:S... }.!v ......................... Name of Builder ).u21,r !.... /-/,y . ......./ 640) Nameof Architect ..............................................Address .:......:........................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exterior Roofing ' Floors .........................:.............................................................Interior .................................................................................... Fieafing .."`-� � 00 .............................Fireplace .......:: :'......::...:.'•...........................Approximate. Cost :......v.. .a Q. ........................................ ._ v�02 Definitive Plan Approved 'by Planning Board -----------_______-----------19________. Area ...�.................................. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH j #Ouse r� 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. V Name ...C✓ ,1..................... .,. _. .......... Construction Supervisor's License .... 3...F3 EAGER, THO.MAS A=120-081 No ...2 Permit for ..Swimming...Pool ....................... Accessory to Dwelling ............................................................................... 1 Joby's Lane Location ............................................................ Osterville ........................................................ Owner .. Thomas Eager ... ........................................................... Type of Construction ....Frame............................ ................. ......................................................... Plot ............................ Lot ................................ July 9, 85 Permit Granted .......................................19 Date of Inspection ............. ....................19 Date Completeq! .......................................19 Town of Barnstable -Permit# I ILI 'bp Expires 6 mondis from issue date Regulatory Semices Fee Richard Y.Scab,Interim Director Building Div Act Tom Perry,CBO,Building Commissioner 2Q0 Main Street,Hyannis,MA 02601 r®�/ Novo 1 z011 - www.town.bamstable.ma.us Office: 508-862-4038 ExpREss PERmT APPLIcATIoN RESIDENTIAL ONLY Not Valid witit out Red X-Press Imprint. Map/parcel Number /ZO d 9' Address �JY is ,Cane- Property ` AResidential ValueofWorkS /, D sic — Minimum fee of$35.00 for work under$6000.00 , Owner's Name&Address C,,-rn v l N a a j l rP_ Lyl ' n. O Piv%If6 Contractor's Name? .� OT S GI l Telephone Number l -71A `d3? Home Improvement Contractor License#(if applicable) //Z 7 ES Email: Construction Supervisor's License#(if applicable) �0�3�T ( WorkIIi n's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's/C�o�mnpensation insurance J � Insurance Company Name / rTT P&AL— (1 /D N 9� /t , � /N S Workman's Comp.Policy# !D S�7 Jr Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑R -roof(hurricane nailed)(not stripping. Going over existing layers of roof) e-side Z Replacement Windows/doors/sliders.U Value . 3 y (maximum 35)#of windows #of doors: - ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire.Permits required. 'Where required Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: ope wner must sign Property Owner Letter of Permission. o y the Home Improvement.Contractors License&Construction Supervisors License is it SIGNATURE: Q:IWPFILESWORMSWuddingp fo 1EXPRESS.d c p _ Revised 061313 .�! 7/q"1p,3 T 9 f Home Depot Contractor License Numbers: MA: 107774, 112785 Salesperson Name and Registration Number: Janice Campbell : R-1-073-13-00016 Home Improvement Agreement Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/or service the equipment listed below at the price, terms and conditions as outlined on this form. Customer Information: Caroyl Maguire New England South 10447341 —� First Name Last Name Branch Name Lead 11 Jobys lane PSTERVILLE MA F2655 Customer Address City State Zip (617) 962-4567 IF 1 F(508) 353-2992 Home Phone# Work Phone# Cell Phone maguirecb175@gmail.com Customer E-mail Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 908 Boston Turnpike Unit 1 Shrewsbury MA 01545 Address City State Zip or Email CustomerCancellationNorthEast@homedepot.com BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A different CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR.PROFESSIONAL, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE. OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE CONTRACTOR GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL. Acknowl22�n� XA10/12/2017 Customs s Signature Date 1 IqLLH M Massachusetts l�epartmen't a .13u: .1'i`c`Saiey . Board of Building .Reg.ulations a.n.cl, St a.n.d:ards y, L:i .; censerCS404327 l rVisor t • SE•RCa1Y'SUPFtNCHUK �'`' v '✓ � ' .[lam A� ���� .. -636 .EIAST MAIN:ST .,�� 4r' ("� P. MA Camrmission.er pi:r.aio.'n. 'L'l/2912037 a•, r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.muss gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Anolicant Information Please Print Leeibly Name (Business/oTanizationlindividual): (�R u Address: � 3 `f' s City/State/Zip: WZ,2,e QUOPhone#: �6_4 S-- 962- 6q�{2 Are you an employer?Check the appropriate box: l.❑ I 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. ❑Remodeling 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.t 9. ❑Building addition required:] S. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their . 11. Plumbing r self ❑ g repairs or additions my [No workers' comp, right of exemption per MGL insurance required.]t c. 152, §1(4),and we have no 12.[]Roof repairs 3a.❑ I am a homeownet acting as a employees.[No workers' 13.❑Other general contractor(refer to#4) comp.insurance requiredJ Any applicant that checks box#1 mast also fill out the section below showing their woriters'Homeowners who submit this affidavit indicating they are doing all work and then compeasatioa`poliry information.of the sub-con hire outside contractors mast submit a new affidavit indicating such tContractors that check this box must attached an additionsl sheet showing the name sub-contractors and state whether or not those entities have employees. If the sub-connectors have employees,the y 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: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address:- City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the in.formation provided above is true and correct Si pa ' Date: Phone Q(j`rcial use only. Do not write in this-area, to be completed by city or town official City or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: The Commonwealth of Massachusetts Department of Industrial Accidents l Office of Investigations I Congress Street, Suite 100 �'Sr'zl Boston,MA 02114-2017 www mass.gov/dia ct Workers' Compensation Insurance Affi Builders/Contractors/ElePlease Prinit Legibly ARRlicant Information The Home Depot At-Home Services Name (Business/Organization/lndividual): Address: 908 BOSTON TPK City/State/Zip: SHREWSBURY, MA 01545 Phone #: (508) 942-6942 F6. of project (required): Are f�ou an employer? Check the appropriate box: Type P J � q 4. 1 am a genera] contactor and 1 New construction [2. am a employer wit1,1, ave hired the sub-contractorsemployees (full and/or part-time).* listed on the attached sheet. Remodeling ❑ 1 am a sole proprietor or partner- These sub-contractors have 8. Demolition ship and have no employees employees and have workers 9 Building'addition working for me in any capacity. comp. insurance.: [No workers" comp. insurance 5 We are a corporation and its ]0_❑Electrical repairs or additions required.] officers have exercised their 11.❑Plumbing repairs or additions ❑ 1 am a homeowner doing all work right of exemption per MGL 12.[]Yof repairs / mvself. [No workers' comp. c 152, 51(4),and we have no e-W insurance required.] t ]3. Other G✓t employees. [No workers' comp. insurance required.] re heck box ] must also fill out the section below showing their workers'compensation polio information. *Am applicant that c and t Homeowners who ubmit hisbox affidavit attached to additional yare sheet ll work the name ofthe sub-contras ors and state whether ornot t those entitidavit es havene ch. Contractors that check employees. if the sub-contractors have employees.they must provide their workers'comp.polio.-number. I am an emplover that is providing workers'compensation insurance for my emplovees. Below is the policy and job site information. Insurance Company Name:NATIONAL UNION FIRE INSURANCE COMPANY #: XWC 65831 45(QSI) Expiration Date: 03/01/2018 Policy# or Self-ins.Lic. �T�5e Is City/State/Zip: 0S��r✓: Job Site Address: f olicy declaration page(showing the Attach a copy of the workers' compensatioSeption 2aA of MG c. 1 2 can lead to the policy number on of criminal penalties of a Failure to secure coverage as required underTOP fine up to$1,500.00 and/or one-year imprisonment,Bvi ed that a copy of this statementmay be forwarded Oto the fficeof d a fine of up to$250.00 a day aga' a vio well as civil penalties in the form of a S lato Investigations of the D r in ce coverage verification. un he ains d f perjury that the information provided above is true and correct I do hereby certify t st ♦ � Date: � Si ature: Phone#:Official use on:Dn,ot write in this area,to be completed by city or town official. Permit/License# City or Town Issuing Authoe one): s Board u Huilding Department 3.City/1 ovvn Clerk 4.Electrical Inspector 5.Plumbing inspec or1. 6.OtherPhone#: Contact Pers __, 'G'I1Z777G'�m)P. tlt f ;G�C � Cd'Cf2l JCS ,mot-•= Office of Consumer Affairs and Business Regulation -mom - ;" 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Type: Supplement Card Registration: 112785 HOME DEPOT USA INC Expiration: 04/2212019 2455 PACES FERRY RD C-11 HSC ATLANTA,GA 30339 Update Address and return card. Mark reason for change. O Address ❑ Renewal ❑ Employment ❑ Lost Card office of Consumer Affairs&Business Regulation Registration valid for individual use only HOME IMPROVEMENT CONTRACTOR 9 before the expiration date. Iffound return to: TYPE:SuDDlement Card _ Registration Expiration Office of Consumer Affairs and Business Regulation 112765 04/22/2019 10 Park Plaza-Suite 5170 Boston,MA 02116 (TOME DEPOT USA INC ANDREW SWEET 2455 PACES FERRY RD C-11 HSC d ithou signature ATLANTA,GA 3033-Q Undersecretary i r$ ®v CERTIFICATE OF LIABILITY INSURANCE Doi 72,117 YI 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 CERT►FICATE.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 endoTsement(s). CONTACT PRODUCER NAME: MARSH USA,INC. PHONE I FAX Two ALLIANCE CENTER Alc No ac Nc, 3560 LENOX ROAD,SUITE 2400 E-MAIL ADDRESS: ATLAN i A,GP.30326 I NAIL 9 INSURERIS)AFFORDING COVERAGE 100492-HomeD-GAN"-17-18 INSURER A:ad R"ubliC InsurancE Co 124147 IN5URED I INSURER e;Agn CEneral Insurance Company 142757 THE HOME DEPOT,INC. HOIAE DEPOT U.S.A.,INC. INSURER a:New Hampshire Ins Co ' 1 2455 PACES FERRY ROAD INSURER D: BUILDING 10,20 A LANTA,GA 30339 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-003746387-14 REVISION NUMBER2 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. wo SR+ POUCY EFF POLICY EXP LIMRS INSR I TYPE OF INSURANCE I IVTvDI POLICY NUMBER I M17MmDrY1'YY MMA]DIYYYY A X I COMMERCIAL GENERAL LIABILITY IMWZY 310022 I111112017 0302018 I I X A CTU N I S 9-..Gan.,O0D0C,00 NSES Ea Gcaurence I S CLSMS;SAOE OCCUR 00 !LIMITS OF POLICY XS MIED EXF(Amone prison) i S EXCLUDE i I IOF SIR S1M PER OCC 9,ODD,000 — I I I x-RSONAL 8 ADV INJURY 1 5 I L AGGREGATE UM1TT APPLIE— P I I GENERAL AGGREGATE j S S,DOD,000 GEMS cR' I ` P'n0- I PRODUCTS !S i 9.000,CGG li X I POLICY_;EC. L� I OTHER: I - i IMWTB310021 03/0/2017 03/012018 COraSINEOSINGLELIMIT I5 1,000OOD A AUTOMOBILE LIABILITY (Eaamdenl ( BODILY INJURY(Per person) I= X I ANY AUTO 1 ALL Oro eCHcOULD � I SELF INSURED AUi0 PHY D,MG BODILY INJURY(PIS aeedsm)!S Autos Autos I PROPER?Y DAMAGE IS I NON-OWNED (Per acaderdl I HIRED AUTOS AUTOS 1 S UMBRELLA LIAS �I OCCUR EACH OCCURP.ENC AGGREGATE EXCESS LIAR ' I CLAIMS-MADE! I OED I RETENTIONS PER O H• I S E WORKERS COMPENSATION WLR C491123DO{TN) 031Di2D17 03fO12018 I X I STwTIli'= I I EP. AND.EMPLOYERS•LABILITY Y I N! (03f0112017 031012018 I E L EACH ACCIDENT, I S 1,00D,000 1 C TANY'PROPRiETCH1PARTNERrcXECUT1Vc JI WC 02310242E(AK,NH,NJ,VT) I OFFICERIMEMBFI EXCLUDED- i N rA a I031012017 03ID1P1018 !(Mandatory In SEPIN H) I) WC 023i0224(WI) E L DISESE Fes.EEMPLOYEE`- 1'0�ii'GLJ Ili yes.describe undar Conti usd on Addiliaml Pace I E L DISEASE-POLICY LIMIT I S '•.00D,00<' DESCRIPTION OF OPERATIONS 1300- I � I � I DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,AddlUorral Remarks Schedule,may be attached IT more space is requlmd) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL t>=0 BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATLANTA,GA 34339 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Ndarsh USA Inc Manashi Mukheryee 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/011 The ACORD name and logo are registered marks of ACORD i AGENCY CUSTOMER ID: 100492 LOC*: Atlanta Aeo ADDITIONAL REMARKS SCHEDULE Page 2 of 3 NAMED INSURED AGENCY HOME DEPOT U-SA,INC. MARSH USA,INC. DIEIATHE HOME DEPOT 2455 PACES FERRY ROAD POLICY NUMBER BUILDING C-20 ATLANTA.GA 30339 I NAIC CODE CARRIER EFFECTIVE DATE: ADDITIONAL REMARKS zDaW ONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ER: 25 FORM TITLE certificate of Liabili insurance pensation Continued: . mnify Insurance Company of NorM America Policyer.WLR C49112294(AL.ARFLID,IA,KS,KY,LA.MS,MO.NE,Nfd,ND,OK,SC,SD,WV,WY) e:03I0=7 Expiration Date:03012016 (EL)Limit SI A M= Carrier:New Hampshire Insurance Company Poficy Number.WC 023102422(DC.DS.HI,IN.MD MN,MT,NY.RI) Efiecb*Date:03101r 17 Expiration Date:03101201E (EL)Limit 51,000.000 carrier.ACE Amek-ri Insurance Company Policv Number.WCU C491122a2(050(A7 C..•IL NC,OR,VA,WA) I Efteclive Date:00=7 i Expiration Date:031Dt2D16 i (=!)Limit S1,WD,DW SIR:51.000.000 SIR for ME states of A7-Cr IL NC,OR,VA,WA Cartier.Natlona!Union Fire Insurance Company Policy Number.XWC 6563144(OSI)(CO3CT,GA,1AE,MI.NV,0H,PkLT) Effective Date:0310112017 Expiration Date:03MI2DIB (EL)Limit S;.WO,OW S;,0M.001)SIR for the states of CO,ME.NV,MI.OH,PA.Ur it S750.OM SIR for 0e stale of GA S350.000 SIR for ore State of CT Carrier.Nahonaf Union Fire Insurance ComPanY ny� ?oliLy Number.XWc 6563145 IOSq(MA) Y Effective Date:O'J0120 7 I//1 Il A Expiration Date:03012016 (EL)Limit:S i3OM.OW SIR:S500.0W TX Empoyers XS Indemnity. CartierlOmfls Union Insurance Company Poidy Number.TNS C48613202(TX). Effective Date:03I01rI017 Expiation Dale:03/012018 (EL)unfit:g1D.WD,WD SIRS 1,00D,W1) I ©2008 ACORD CORPORATION. All right`reserved. ACORD 101(200B101) The ACORD name and logo are registered marks of ACORD I Commonwealth of Massachusetts Map 12-6—Parcel . Date: ( a ao NOV 012 Permit c `_ �� `. Estimated Job Cost: $ 5 0 1.!i;n% rmit Fee: $ OF SARNSTABL� Plans Submitted: YES NO Plans'Reviewed: YES NO Business License# - `�a-D Applicant License 0 Business Information: Property Owner/Job Location'Information: Name: Name: Street: 3 0 �� SS �r: Streeto� City/Town: W t_%-k Ke� City/Town: D s� v► l 1 e, M A Telephone: S 0`3-3 6 0 - $3`t o Telephone: o I " 3 3 - t 2- Photo I.D. required/Copy of Photo I.D. attached: YES/ NO Staff Initial J-1/M-1-unrestricted license J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Fire Dept. Approval Institutional_ Other Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: V\_C,,D S:) A)c SIYS4(_� C_&L� V\ 0,A-_ s,� Flo or. 6 1D C Zo r-c- F NSURANCE COVERAGE: have a current lia bil' insurance policy or its equivalent which meets the requirements of M.G.L.Ch.' 112 Yes No ❑ f you have checked Yes, indicate the'type of coverage by checking the appropriate box below: k liability insurance-policy ; Other type of indemnity ❑ Bond ❑ )WNER'S INSURANCE WAIVER: I am aware that the licensee sloes not have the insurance coverage required by Chapter 112 of the Oassachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent 3y checking this box[], I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and iccurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be n compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments Final Inspection Date Comments Type of License: y [ Master Me . ❑ Master-Restricted 4/Town El Signature of Licensee ermit# � •' ❑Joumeyperson-Restricted . ee License Number. `�a� $ El Check at wWw.mass.gov/dal ispector Signature of.Permit Approval �COMMONWEq THLTHL �OF MASSACkUSETTS SHEET METAL WORKERS • AS A MASTER-UAIRESTRICTED ISSUES THE ABOVE LICENSE TO: 9 LUKE S CYR 30 MELISSA DR m � YARt1Dl1TH MA 02673-1463. 420 06/28/13 15004 ► � 09856885 : , rc �k _ TS O�-- 14 D11 ,Q6, i 1 LUKEIS, � / W MFLISSq OR n i, COMMON E 1TH OF MASSACht{1gES ' SHEET'METsAL WC�;RKERS= AS q 1�►ASTER'LUNRESTRICTED ISSUES hQE'96OVE LICENSE TO: I LUKE II x .. df 30 MELIS�Ai DR E7 }4 YAR11O�TH MA ,02673 14G3� 420 Ob/2e/1.3 II t Llow MA 1 in TY. � F T v �' k� F 9856885 i��+ � r L .*� The Commonwealth of Massachusetts Department oflndustrial Act cidents Office of Investigations -600 Washington Street. _ Boston,M-4 02111 www.mass.gov/dia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers APPEcant laforffiation Please Print LeZib Name(Business/0rganizatimY7hdivi&4: 1—'A e_ C r • •Address: 3 o i-`�� s S-—� �r�✓�C , City/State/Zi_p: Phone.#: /.a '5 3 4l.o Are you an employer? Check the appropriate boor Type of project(required);: 1.El am a employer with -4. ❑ I am a general contractor and T employees(EM and/or part time), * have hired the sub-contactars 6. ❑New construction . listed on the-attached sheet; 7. Remode I am a'sole proprietor or partner- � � - ship and have no employees These sub-cofactors have S. ❑Demolition working for me in:any capacity, employees.and have workers' 9 ❑Bin addition [No workers' comp.insurance comp.insurance•$' required_] 5• ❑ We area corporation and'its 10.❑Electrical repairs or additions officers have exercised their 3.❑ I am a homeowner doing ill-work' 11.❑Phrmb#g repass or additions myself [No wor]mrs' comp. right of exemption per MGL �.❑goof repairs insurance required-]t c. 152, §1(4), and we have no employees. [No workers' �. Other V f C comp.insurance re#md.] *Any applicant that checks box#1 nmst also fill out fc section below showing thcs workers'compensation policy mfmmatim t Homeowners who submit this affidavit indicating$icy arc doing all work and the=hire outside contractors most submit anew of davft indicating such. *Coubactm that check this box mast snarled an additional sheet showing the name of fhb sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,fhey mnstproyidc their workers'comp.policy nmmbcr. I am an employer that is prav_iding workers'compensation insurance for my employees. Below is the policy and job site information J Ins- rance Company Name: Policy#or Self-ins.Lic.41 Expiration Date: Tob Site Address: My/ p: 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 imprisomnent, as well as*civil penaltirs 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 stateraeait may be forwarded to the Office of Investigations of the DIA for hmrrance coverage verification. I do hereby certify under the pains-andpenatties of perjury that the information provided above is true and correct. Si--anaiure: Date: '(N 2-0 :2— ly Phone 4- Official use only. Do not write in this area to be completed by city or.town official City or Town: Permit/License# �Issning Authority(circle one): 1.Board of Health•2.Bolding Department 3,City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector ' .Ot 6her rContact Person: Phone# Print http://us.mg5.mail.yahoo.com/neo/launch?.rand=3clfibbpmd9t6 Subject: Furnace &A/C installation From: Luke Cyr(lukecyr2120@yahoo.com) To: leern3@aol.com; Date: Wednesday, September 26. 2012 11:31 AM Hi, Let me know if you have any questions, thanks. Luke A&L A&L Heating Cooling & Home Improvements. I would supply and install: GAS FIRED WARM AIR HEAT AND AIR CONDITIONING 1- Carrier AFUE 96% gas fired warm air furnace with ECM motor &cased A/C coil Installed. located in the basement serving the first floor on one zone. • 1-Carrier 16 Seer 410A outdoor condenser. Pad drain and line set included. • PVC type venting for high efficiency furnace. • Insulated galvanized duct system designed to maintain 70 degree temperature in zero degree weather with 15 mph winds and to maintain 15 degrees below outside air temperature in summer. • electrical work included. • gas piping included. HEATING AND AIR CONDITIONING COST: $40M0.00 Homeowner will receive $1,300.00 back in rebates. REFERENCES: Dave Healy: HEALY Home Building & Remodeling: 1-413-627-9202 1 of 2 9/26/2012 11:32 AM dr ring Dept. (3rd floor) Map d2G Parcel 0 o�-/ Permit# House# // Date Issued _ITT q XBoard of Hellth(3rd floor)(8:15 -9:30/1:00-4:30) Conservation Office(4th floor)(8:30-9:30/1:00-2:00) (bTJ\ Plann��nor�l�pn}_�1ct floor ool Armin-) r SEpi MUST�E De ' tive PIa proved=b rd 19 INSTA P� �� 5 TOWN OF BARNSTABLE E�V°RON TOWN R LA I Building Permit Application - -F q�-�P Project Street Addres 1 J0L /J U O S ,Z i9^�C, 195'/ 64 u��.�..e� Village Owner 7 D A-tl : R. Address S�9 Telephone yg� im 3 Permit Request (io>v S %>Lt,c`T 4 /02 k /0 �oa�-t, r���9 -'e-, Tl e x/ s -Ae—ao.,,ZZ'oL cl- 7-a Alf w /000�-4 4 Din- j - First Floor , 19Jquare feet Second Floor /1/l square feet Construction Type _ 6D01 rW-A/A -e, Estimated Project Cost $ 0) 04>77 Zoning District Flood Plain Water Protection Lot Size /V o 2-00 5 fC Grandfathered SLIks ❑No Dwelling Type: Single Family V/Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing_� New Half: Existing New No.of Bedrooms: Existing 3 New Total Room Count(not including baths): Existing S� New First Floor Room Count G Heat Type and Fuel: ❑Gas ❑Oil Electric ❑Other Central Air ❑Yes )00 Fireplaces: Existing New Existing wood/coal stove ❑Yes YNo Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) Attached(size) /y k a-'y ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ;W No If yes, site plan review# - Current Use ;E✓ hgc��r Proposed Use n4 r —e-- Builder Information Name Telephone Number Address 5i9 , License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 0 c v.J D v�•!/ SIGNATURE DATE If 7 BUILDING PERMIT DENIED FOR THE FOLLOANG REASON(S) A� r FOR OFFICIAL USE ONLY PERMRzftO. f DATE ISSUED MAP/PARCEL NO: `~~� ADDRESS VILLAGE; • 0, i OWNER DATE OF INSPECTION: FOUNDATION ea .r FRAME { INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING:: 480VGH in FINAL ra GAS: y ( : GH FINAL ►' ; t FINAL BUILDING,R •�- �,�,�Z ,,• �t� �� , �� . i� f r<4�'�g+ sue- € • ', I - - -� i t , DATE CLOSED ! j I ASSOCIATION PM .NO.I? _ rPREPAZ®Y PAGE a N0: ll -71 ON-4 Tel .DATE. , I 6-t—ch�; TESL • atX/�_I . 2�j1� j=�✓vn. �a-rs� • -=�x�o._._l3aX I f•e Sp:A-L �a jo.P� amadkii . - y THE P, The Town of Barnstable � MASS& Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL a 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with /certain exceptions,along with other requirements. .1 Est.Cost 14 Type of Work: �S � � �� Address of Work: 5 Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. wilding not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: >7 Date Registration No. OR Date Owner's Name Thc Cwtunonivealth of.4hissaclimsens, Deptirtmerit of 111dI.TtrialAccideras rA,VW 600 11a -toty Street .vNiz, ' ,'���• � ,.'�• Buctutr. A1u�:�. OZI11 Workers' Compensation Insurance Affidavit ltc int info•rmatinn: P!Wie PRINTIEDN— nirric, Z__ I _46ey, 5 14&e V'a citv 0,S7Ze,,,0-iX1& z6zl®S 1Y h_n, 0 X1 am a homeowner performing all work myself. r7 I am a sole proprietor and have no one working in any capacity r—i I am an employer providing workers' compensation for my employees working on this job. cnomanv name:_ address: phnne#- insur.ince ro, noficy a 1 am a sole proprietor. general contractor, or h omecivnzr(Circle otte) and have hired the contractors listed below who have the following workers' compensation polices* comenni, nnine, n(hirr5q- phone#- insurance ro. rinfiev N rn ni P.1 n n i in iddrcsc- rip nhone#- insurnnee co, policy Of Attach additi 'nal sheet if niccisr 7! 77 Lin. . ---n-LLL-. _,t T' F.iiiurc to secure coverage as required under Section ZSA of NIGL 152 Can lead to the imposition of criminal pCn21[iCS 01'2 fine up to 51.500.00 2ndiur une%-cirs' imprisonment sonmcnf:is wcii as civil penalties in the form of a STOP NVORK ORDER and it fine of 5100.00 a day against me. I understand that a com-of this statement may be forivircictl I,the orricc of investigitions of the DIA for coverage verification. I do herebr cerrifj-under the pains-and penaltics ofperjun•that the information provided above is true and correct Sicnature Date Print narric hone ofticili use unl% do not i%-rite in this area to be cumpictcd by city or town ofrici2i cit% or tn%%-n: permit/license# r113uildin".Department oUccrising Board L (:I check if immediate response is required Epelectmen's Office ► (:311calth Department contact person: phone N: rj0ther Information and Instructions Massaclwtietts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for th employees. As quoted from the "law-. an enrpJuree is defined as every person in the service of another under an. contract of hire. express or implied. oral or written. An cnrph rer is defined ns an individual. partnership;association. corporation or other legal entity. or anv two or mo the foregoingenga�_ed in a joint enterprise, and including the le, I representatives of a deceased employer. or the receiver or trustee of an individual . partnership. association or other legal entity, employing employees. However t± owner of a dwelling house having not more than three apartments and who resides therein. or the occupant of the dwcllin�g, house of another who employs persons to do maintenance , construction or repair work on such dwelling_ ltc or out the `srounds or building appurtenant thereto shall not because of such employment be deemed to be an employ, MGL chapter 152 section 25 also states that even• state or local licensing agency shall withhold the issuance Or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither the commonwealth nor anyof 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 been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law' or if youare require to obtain a workers* compensation policy. please call the Depar'ment at the number listed below. Cite• or ,towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at tite bottom the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. P1: be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questic please do not hesitate to give us a call. 77 The Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents office of Investigations y 600 «'ashington Street Boston,Ma. 02111 fax #: (617) 727-7749 phone ': (617) 727-4900 ext. 406, 409 or 375 TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. . " /DATE ...:. _ JOB LOCATION Z-17. Number Street address Section of town /"HOMEOWNER" QS r` Ge ✓ —f 5' Name Home phone Work phone PRESENT MAILING ADDRESS City town State Zip cod: The current exemption for "homeowners" was extended to include owner-occur. dwellings of six units or less and to allow such homeowners to engage an is dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person (sY who owns a parcel of land on which he/she resides or intends to side, on which there is, or is intended to be, a one or two family dwellinc attached or detached structures accessory to such use and/or farm structure A person who constructs more than one home in a two-year period shall not r considered a homeowner. Such "homeowner" shall submit to the Building Off: on a form acceptable to the Building Official, that he/she shall be resnonE for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes , responsibility for compliance with the Building Code and other applicable codes, by-laws , rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Deparbment minimum inspection procedures and requiremen- and that he/she will com y with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35 , 000 cubic feet, or larger, will be requirec to comply with State Building Code Section 127. 0, Construction Control. I r-n i E2862 SPP2335 , APPRAISAL ASSOCIATES OF MASS. 4 'irt.. s<r15 ' ,- c r ` -•`.' ems' v THOMAS F. EAGAR947 .- •..t s. r._..r.: ... :- r•;; SAME P1 AN �,.:.. MORTGAGE INSPECTION PLAN £' IN _ — BARNSTABLE k � ;CALE: 1" = 30' �:��p•i // rn lays L%vf LV I i e o' I CERTIFY TO APPRAISAL ASSOCIATES -OF MASS., SENTRY FEDERAL SAVINGS BANK, AND ITS TITLE INSURANCE . COMPANY, THAT THERE ARE NO VISIBLE ENCROACHMENTS OR EASEMENTS EXCEPT.AS SHOWN AND THAT THIS PLAN WAS PREPARED UNDER MY IMMEDIATE SUPERVISION, _ THE LOCATION OF THE DWELLING AS SHOWN i Land Surveyors Civil Engineers HEREON IS IN COMPLIANCE WITH THE LOCAL ZONING BYLAWS WITH RESPECT TO HORIZONTAL Abe�oston�ztna,$urbcq go.,�nc. DIMENSIONAL REQUIREMENTS. R. �— 172 Milliarn'51.� THE DWELLING 'SHOWN HERE DOES NOT FALL NefD 366tata•AV 02140, WITHIN A SPECIAL FLOOD HAZARD ZONE AS : . . DELINEATED ON A MAP. OF COMMUNITY #250001 DATED 8/19/85 BY THE F.I.A. NOTE: . LOT CONFIGURATION TAKEN FROM GENERAL MOTES: (1) The declarations made above are on the basis of ■y knowledge, ASSESORS MAPS .OF RECORD AND IS NOT information, and belief as the result of, &'mortgage plot plan tape survey inspection NECESSARILY ACCURATE. made to the normal standard of care of registered land surveyors practicing in (lass- achusetts. (2) Declarations are made to the above named client only as of this date. �HE EXACT LOCATION OF THE BUILDINGS OWN CANNOT BE DETERMINED WITHOUT AN (3) This plan was not made for recording purposes, for use in preparing deed des- u IloArC iAICTDIIMCAIT ellovcv criptions.(6)Verifications of property line disensions,building offsets,fences; or lot. SKETCH ADDENDUM Borrower/Client Property Address City County State Zip Code Lender P �-riv" 0. ��� ��-7 FIA Wove ;Corti :. .• � � . . • . • ' - . , .. Ili 19 � ' ' 82 sOL /5 -r- 1 t I • i % , t � f FW 439E c _.. Assessor's map and lot numberr / ��.` w e w �FTHETD Sewage Permit number Z B6HB9TIBLE, House number ....... .....................................::........ :o raea F p i639. `00 ,F0 MAY a' TOWN . OF ;.,BARNSTABLE BUILDING 'IN -SPECTOR A` APPLICATION FOR PERMIT TO ...... �. �9/yf„/,l_ 2/G J ;%/il TYPE OF CONSTRUCTION ........ /J'y��7....................................................................................................... .19./ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for.a permit according to the following information: Location`.. !... ....�T ,/� �.....(+. ......... !. TFI2!//L C.. .....&A,................................................... . Proposed Use ... ........ ; 9/�// y....... . ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner `1/r.!f,,�.;. PI Ac�L.. . .� Q,Sii/►l/�.......Address <.)J...... / a, �1 �..... /l %/ 'Address S.d�......� i�t /...S.!........./��i/�i!A14r. Name of Builder ...........:........ ' Name of Architect ,`//f/..V../., ......34:/. .....................Address A /. i/Ii%.%l ..... /iZ........12iiN/T �o/Z%. Number of Rooms �. �D f�l��i�! h/> �. /3� {(',/l if i , ............... ..................................................Foundation .................. ......:..:............ ........... Exteriorrr(rtrr.s..... ...(-,. /T ...Roofing ...... :�� �L..............................`........................ r Floors 1,���/Ij7/t.7.. ..:.Li,�VU ./ir .......................lnterior� ' tl7��z/i.. l C-,/�........................................ Heating 5..............................................................Plumbing '//34� ... ...1...... Fireplace ��,/ !� p ..:..... ........................................................................Approximate Cost ......... ..1-�. ................................. Definitive Definitive Plan Approved by Planning Board ---------------_---------------19_______. Area ff!�6y.........?-34..............0 Diagram of Lot and Building with Dimensions Fee W SUBJECT TO APPROVAL OF BOARD OF HEALTH w I hereby agree to conform to,all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . y.. ?�'. ................ Merlesena, John &. Paul 7A=120-81 21717 one story No .....t............Permit,for .................................... single family dwelling........................... .............................. ...... Location .........11.. Jo...b. I.s..Lalpq.................... ... Osterville ................................................................................. John & Paul Merlesena, Owner ............MIK9 9499.............................. frame Type of Construction .......................................... .......................................................... ....... ............ #12 Plot ........................ ... Lot ................................ October 5 79 .Permit Grante/'.e..... .............................19 Date of Inspection .. .................................19 Date Completed .....................................19 PERMIT REFUSED ................................................................... 19 ........................ .. ............ (......................... ...........0....... & ............... ............................................................................... ............................................................................... Approv' ed ................................................. 19 ........................................................................... ..............................................................................