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0071 ARROWHEAD DRIVE
V171 i 3 Town of BarnstableBui,lding . Permit .Post<'<Thls.Ca. rd So That it;�s Visible from�the Street A roved.Plans Must be;Retained on Job and,�th�s�Card�Must beKept , PP � HASfQS['ABLE. •. d �.�. � -�,.�`: ,� ,.�, �. r� "; � �r Y l' � �.;.: � ,gs s x �.� " a'.k, � •� .� v % � ,:� � Roste#,Until:`Final'is ect�on Has.=Been IVlade' a !ems r x �w ea Where a�Certificate of Occu ancisRe wired,such;Buildm' shall Not"be Occupled�unti#a"Final lnspectio,n'has been made p �. ..,r`%.. .. 't.�.::b. ,,' ?,p �.,.. b�.e.,by•_o e...k.,..aa4,a-, z.. ;x. .g ,... ::.. ,:.F to „us, t:, .c .u, ':..#u K r. ..� 5. 3, ..,. a.,..,. ; Permit NO. B-17-4383 Applicant Name: VINCENT D. MALONE Approvals :Date Issued: 12/21/2017 Current Use: Structure Permit Type: .Building Siding/Windows/Roof/Doors Expiration Date: 06/21/2018 Foundation: Location: 71 ARROWHEAD DRIVE,HYANNIS Map/Lot 271-059 Zoning District: RB Sheathing: �, _ Owner on Record: "JACKSON;`NINAT ContractorName k .VINCENTDMALONE framing: 1 Address: 251 ARROWHEAD DR k Contractor t icenseCS=067860 2 HYANNIS, MA 02601, Est Project Cost: $6,000.00 Chimney: Description: re-roof abc disposal new bedford Permit Fee: $35.00 >; Insulation: Project.Review Req: Fee Paid ` $35.00 Date Final:. 12/21/201 7. {h - ng/G um i as � PI b r Rough Plumbing: Building Official t, Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents4cii which this permit has been granted. f x. Final Gas: All construction,alterations and changes of use of any building and structuresks-hall be in compliance with the local zomngby laws anted codes. This permit shall be displayed in a location clearly visible from access treet or road and shall be maintained open for public rasp ction for the entire duration of the work until the completion of the same. ` Electrical < 4 a Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Bwldmgand;Fre Officials are providedonthis permit. Minimum of Five Call Inspections Required for All Construction Work:i 3 ` Rough: 1.Foundation or Footingtt ,••,,, „•_ w..., _ T 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable .]Building .Post�This Card So That rt is Visible From'the Streets A 'roued,Pfans Must be�Retamed on J.ob and:this Card Must be Kept7, .. UA&WrANI.C. a' ".� s"° "'. '„ a };-'b } r, PP a ;fir:, :�'.' 4 '""�fia `.` -s °' s Y x r" • Permit R WFiere:a.Cert�ficate�of�Occu anc. Sis Re. wired,=suchrBuildm shall Not�be Occup�ed�wntil,ak=Final�inspect�onshas,been�made ��,.. ' .. .,.,,�..3 ...r-:lw,«'�.,.::s r..�a' �,.s,�.pia&�r•T��.:,�� ..�„<p ,..r..,,w�,«.'.;..,..�.. �.'�-�g�&;.�:...:.�-,<; .vas�;.««,...,�a 'r�r�.: ,.�_" a �. :3� a.. ., .. :.�' ,f; K.=:....>_ - �i�=m.u�,a.,�.u��>. Permit No. B-17-4383 Applicant Name: VINCENT D. MALONE Approvals Date Issued: 12/21/2017 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration'Date: 06/21/2018 Foundation: Location`.' 71 ARROWHEAD DRIVE, HYANNIS � Map/Lot 271 059 Zoning District: RB Sheathing: � f ` Owner on Record: JACKSON,.NINA T0 z Contractor;Name VINCENT D MALONE Framing: 1 - Address:. 251 ARROWHEAD DR + Y`= Contractor;License' CS067860 2 HYANNIS, MA 02601 R r Est Protect Cost: $6,000.00 Chimney: Description: re-roof abc disposal new Bedford Permit Fee: $35.00 Insulation: w= Fee Paid $35.00 Project Review Req: N 4* Date 12/21/2017 Final: Plumbing/Gas Rough Plumbing: p Building Official ,. E. Final:Plumbing: This permit shall be deemed abandoned and invalid unless the work aiithonzed�bythis permit is.commenced within siz months after issuance. Rough Gas All work authorized by this permit shall conform to the approved application and the'approved construction documents;for wN'KAhis permit has been granted : Final 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 toad and shall be maintained open for public insp�ectio'n for the entire duration of the work until the completion of the same. �, ` Electrical xt 'S f The Certificate of Occupancy will not be issued until all applicable signatures by the Building andlFire Officials are provided on,this permit., Service: Minimum of Five Call Inspections Required for All Construction Work. , F� Rough: 1.Foundation or Footing - 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: ,'Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable *Permit# -f Building Department Services Expires6mofe from issue e snxrvsTesM : Brian Florence,CBO ® * � Building Commissioner ATFD MA't 1. 200 Main Street,Hyannis,MA 02601 DEC 21 2017 www.town.barnstable.ma.us Office: 508-862-4038 OF ARMS ax: 508-790-6230 LE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 2z D S� Not Valid without Red X-Press Imprint Map/parcel Number Property Address G� � ( Residential Value of Work$ UfJ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Ah'tl a ack'sc)YI 0 t 6--r-nOLAJ h d 0 V-. W o� dl Contractor's Name V 1/-\C ecn A— V /A ON-� �---,,V,\Cjelephone Number - 31 T.c�Y6-� Home Improvement Contractor License#(if applicable) I a3 I0i Email: d w `0 �,•`�� C,�7►�i ca -C .R� Construction Supervisor's License#(if applicable) �-5 Q�a q y ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name _`0 sa v; c2 e v\-C :c i A\-)�-J `A- Workman's Comp.Policy# CN C\ 0 0 S � 5 n Ll Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) n X Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken toT �! �l u ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) �"tA--1- ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is J required SIGNATURE: /�./��'�✓(_//� Q:IWPFILESTORMS\building permit formsNEXPRESS.doc 08/16/17 s Massachusetts De s partment of Public Safety Board of Building Regulations and Standards License: CS-067860 Construction Supervisor w VINCENT D MALONE 62 LONGHILL ROAD ; POCASSET MA 0266 L--�C20 � missioner 08/01/2019 ' i t��ie�paynin�rnunea�a��aaa¢c�ucae� +' Office of-Consumer Affairs>£:Businm Regulaiion _ HOME.IMPROVEMENT CONTRACTOR . i TYPE Individual eg�stration Expiration i23101 U3/30/2019 CENT D.MA ONt.i,i �.. t` f VINCENT D.MALOJ�iE R Cl� -- 62 LQNGHILL POCASSET,MA 02559-- lJndersecr ... A r etary s , _ a Registration valid for individual use only before;the expiration date ff found return to: Office-of Consumer Affairs and-Business Reggi ton m i 10 Bark pigiza-Suite 51:70 n,MA 021.16 `a L ;,. .. Notvalid wl#toutslgnatare e of " - - A � _ �• + i . . I ` Town of Barnstable Regulatory Services iKAM s Richard V.Scali,Director 39. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must ' Complete and Sign This Section If Using A Builder I ,as Owner of the subject property hereby authorize zz,e to act on my behalf, in all matters relative to work authorized by this building permit application for: lil7 (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. os,ighature o r Signature of Applicant MoSon L-. Print Name Print Name Date , A � CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD"YYY) 12/18117 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 have ADDITIONAL INSURED provisions or 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 NAME: United Insurance Agency,Inc. PHONE No.Ext: 508-759-6595 aC No: 508-759-3822 199 Main Street I:-MAIL P.O.Box 1013 ADDRESS: Buzzards Bay,MA 02532 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Providence Mutual INSURED INSURER B: Atlantic Charter Vincent D Malone INSURER C: 62 Long Hill Rd INSURER D: Pocasset,MA 02559 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. LTR TYPE OF INSURANCE POLICY EFF PO CY EXP INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FXOCCUR DAMAGE TO RENTE PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 A BOP0096196 06/28/17 05/28/18 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: - GENERAL AGGREGATE $ 2,000,000 POLICY❑PRO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABIUTY - COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS - BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ ' EXCESS UAB CLAIMS-MADE ,. AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION %el PER AND EMPLOYERS'UABILITY Y/N. STATUTE ANY FlCER/M PROPRIETOR/PARTNER/EX E OFFICER/MEMBER /E ECUTIVE NIA E.L EACH ACCIDENT $ 100,000 AEXCLUE (Mandatory in NH) � WCV01057504` 01/25/17 01/25/18 If yes,describe under E.L DISEASE-EA EMPLOYEE $ . 100,000 DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 500,000 _F DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES CORD 101 Additional Remarks Schedule, ,maybe attached if more space is required) Carpentry The Workers Compensation policy does not provide coverage for Vincent D Malone CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept-Fax no(508)790-6230 200 Main St AUTHORIZED REPRESENTATIVE Hyannis,Ma 02601 Kris Dexter ©1988-2015 ACORD CORPORATION. All rights reserved.. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Yhe Commoinreaht ofMas sadimdls Depwft &rtaf1ndustrialAcddem Qf c�ofbMsagatiom ' 600 Wadz&.gt=,kreet Bastan,CIA 02 U1 topiu r asmgarldia War•hers' Camp ensaffim Insm-auce AfHavrit B.mldeislCantmch -Mecb ician.sfPhanhers AuPUcant Infarmatian Please hint Le�Y Name(Susitte ut,-T- anlf dnaY �4 (' C Address: kl �ityffatel �C SS �` / `� I�� Are Tau an employer?check pp epriate bon ' T of project r LEA I am a 1 witfi 4- ❑I am a general contractor stud I Type e j ( � �P * luve hired the ie=b—=�acctos 6. ❑New c8ns5�cfiog employees(frill andfor part time). 2.0 I am a sale proprietas orgartuet listed anthe,attached sheet.. 7 ❑ Pmodediag stab-condractors have ship and lia<< son employees These 8.,❑Demolifiaa wading forma is any capacity. employees andhare wo&.ers 9. ❑Building addition [No typ�2[g,' comp,iactfx a comp_M=rartt r respt- ] 5. ❑ We are a cmporaticn and its 10:0 ELectaical repass,or additions officers have exercised their 3.El ama hameovmer doing alb u*orlc 1L❑Phmsbiagrepaiss or additiams• myself[No worlmrs'camp- T:t of egempfian per MGL VORDofrepairs insmancereqaired-]i c.152,§I(4k aadwehaareno employees-[To woAoe& 13-❑Other coop.iWIM'M requim&] •AnyaWB=tdatchec7aboa#1mustaLwiMcatthesecicabelmvsletfiaga3iea•woffzeWcompeassatianpoHcyiafoc w5mL Iffameaamnwhosub=&Thisaffidaeiii gtiw_yRMdGin'RUwalMAt6MbimaatideCDntmcft z— mhmitamwaffididtiadicalin sacb- fCaut RdM*7t daec$tbis bmt must sGar'h asadditimsl shed sbawiagtbename of abe sab-camtrcto-rs xnd swewhegm arnat$lase emitiesbsee emplayees.7ftbemb-caatradflashace empiefees,they gswidethek w MJM,tamp•parmF amnbm lam are eispTar flint isgrm�idira n�nrkets'cotr�perisrdimi irisrirarrce for m}*cmplv3�es: ,S�top9 is fhegt7cy�anri je5 sate hiformatibm r Issmance:CompanyName: V�\J (�eyVo—�� �• \v 'P0&cy 4'or Self-iMs.Zia-� W� S. ® �piratianDade: i D� vv ` Job Site Address cityfStafdlzsp: PT Attach a copy of the workers'compensationpolicydecTaratitm page(showing the policy number and e=phation date). FaL-=e to secure coverage as required.under Se-ckcn.25A of MGL m 1577 can lead to the impasidonn,of c misiai penalties of a fine up to$1,500:OQ andfor one-yearimpdso>iments as well as cif penalties.in the form of a STOP WQRF ORDERand a ffne, of up to$25 GO a day ag-ainst the violatur. Be advised that a copy of this statement nmy be forwarded to the Office of Iwes fig a6ons of°the A A far insurMw coverage,m I iffMfi .yrl'o hereby ce * ard�sr iris prans of tb&dlie iriforma€imt prosicFed abase fs trus acid tarred Phone ik t7fiSdaL use anr}. Do riot write in this 4mxea,fa be campWad by t7 arto n offrrciat City or Town: PermitiMicense4 Lssniag Aufl@rity(tom one): L Board of HeA i Building Depar[m-ent 3.CitylTuwa Clerk 4:Electrical Inspector S.Plum-bmg Inspector G.Other contact Person: Phone#: a d Instructions ' vr�na�an � cans . ...: , ,_��I setts Geheaal Laws ffiVfzr M reamer all=q:10Y=`fo AmVB a wa ix&compensation for f$aeir=PlOY- Ptn saa�to this sfat�,an=Tk3�is drfned am,¢.cV=ypesson.in.ffie service of znotberunder any 000t act ofliae, express or fixrpIfed,,oral or " er is defined as`pan infYidaaI,parfn�,asso�o��P On or other legal eddy,or any two or mine An�� the I = atives of a den sod employer,or fze of the fi�regaing ina Jaint ,and mclnclmg ��s � However the reoei�r or trustee of an hffN daal,p��tiPA associafion or otherIegal entity,e�Yhlg�P y�- artme�t5andwhoresidesthe��ein,urtheoccupantofthe ownerofadVMUjnghousehavingnotmorethanthree - dweIling house of another who employs peasons to do ,crosf rn-f;❑❑n or repay wow an such dwelling house or on the gmtmds or bmldmg a pia lheretn sbaUnotbecanse of such employmeEtbe deemed t o be an employer." MGL chaptrr 152,§25C(6)also states that aevmT S{8t8 or to cal Ticensing a.gencY shRH Withhold•Hie imance or renew-al of a license or permit to operate a business or to consf act bm ffl gs hL the commonwealth for any applira�dt' ho has aofprodncied acceptable evidencl-of cdmpfian�v�ith the i>zsurancetmYeSaggereg� � Additionally,M(M chapter I52,§25C(7)state¢'Neither the cum n nor Ely ofifs poIilical subdivisions shall . enter i�any coafraet�r the p an ce ofpnblio work tmtzl asxeptable egid�nee of camPliancewith$e;,,�T�Ce.. of1his chaptPabavebeenprese edtn-$1e co g.anthorzLy." J...J _ apply to your sitnafion and,if Please f n obf tiie workers'compensation affidavit completely:by chug the boxes that Iy y k necessarp,'sugply snTi-cantrac(oi(s)name(s), s(es)and phone alongw1athea=tJacatr(s)of nin Limited Liabflity Parb=ffiips(LLP)'vn&no �IoYexs other than th e fiance.Limit�dL AMty Compes(LLC)or r. members or pa ine`rs;are not req�ed���y wa&��ensafiaa.i1 Qr mm If an LLC or LLP does have rmployees,a policy is regahed- B e adYised ibat-. �dayit may be sobmi d to the Degaavit of rndnsfr;al Accidents for coo n of bs�=coverages Also be sure to siga and date the afdavit The affidavit should be refnmed to e city or town that the application fat the permit or license is being regoested,not the D epa-bnent of Irda,�al��deniL Sbavidyon have nay gnestions g the law or ifyae are Urbd CO:Dd in obtain a workers' compensationpoHcLpleasecalltheDepartmentat the numbeaUstCdbelow* Self-inscusdcompanies shouldentertheir self-;,,7017snce l=monmabm onfhe av Mypriafa linm city or Town Ofacials f Please be s=that the affdavitis complete andprinfedIegNY- The Depacimenthas provided a space of the bottom of the affidavit for you to f M old in the event to Office oflnvestigatioas has to conact you regarding tb e appIicant Pleasebes=tof7lmthepe-/licensemmbesWhichwi ,be used as a=Bmcen=ben7n addition,anaFPhc that mtxsE submit multiple p®itllicense applications is arty given year,need only sohmrt one affidavit indicti ng eon t policy inforazatiom[if nmMsarY)and tinder" or Tub e a_d ss"the applicant should vie"a]l lacaiiGns in (�Y town)."A copy of the-affidavitth3thas been officially stamped or made d bythe cry or taws maybe provided to t� " applicant as proofthat a valid affidavit is on file for nre'pemits or Hcezzsm A new affidavit=ist be fMcd ei3t McH year.Where a bane owner or citizen is obtaining a Iiamse or peM.it not related to any business or commercial 4� - (ie_'dog licemse orpeamit in btnnleaQes e#e.)saidpm=is XOTreghta complete this affidavit Ths Office of avesdgaffi=would like t t3�k yonin adyance far yo=cooperation and sbatlId you have nay q m , please do notb=ifaft to gim MS a C- The Deparimeuf's address,telephone and faXrmmber Ca-=1QUWM1thE Of ChnScaS ent c6flii al Aroidant a face a�� �f[o� obi 11 Fax 617 727 7M Kevised424-07 W W W. R SS.gQgldia. �pFIKE tpw� Town of Barnstable *Permit# Expires 6 n=onths from issue date 1ARNSTAaLE, Regulatory Services FeeAa�4D 9 MASS. cb 1639. Thomas F.Geiler,Director p'ED'AP`p Building Division Tom Perry, Building Commissioner X-1-iJESS PER14 200 Main Street, Hyannis,MA 02601e Office: 508-862-4038 MAY 6 2002 Fax: 508-790-6230 TOWN w EXPRESS PERMIT APPLICATION - RESIDENTIAL ONK BARNSTA � Not Valid without Red X-Press Imprint Map/parcel Number 0 7 " O� Property Address Residential Value of Work j -�IloQ . 6b Owner's Name&Address am LAJ Contractor's Name j4n M y n P �_Tele hone Number - r r� p Home Improvement Contractor License#(if applicable) ZOO 7 L/d Construction Supervisor's License#(if applicable)_C S(k5-7O3�- orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# CA C11r,o;2--5-0 o-z00 Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roo fl ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) �ther(specify) a ✓es *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature PI Q:Fomis:expmtrg Revised 121901 -A 7"ET°�°o� TOWN OF BARNSTABLE i 89HB4T1IILS, i M6 9 BUILDING INSPECTOR ''rE'c yav a. APPLICATION FOR PERMIT TO /�4.5.. ....�."!..... :. � !�1� , ,,,,,,,,,,,,,,,,,,,,,,,,,,,, r 1 TYPE OF CONSTRUCTION ............ ............... .....!/ll9v / ...... d ........................... ...........................111 f6.......19 2.Z i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby/applies for a permit according to the following information: Location ............. ......... ........ ............. ..... e. ProposedUse ............... `. '..w..... ....................................... ................................................................................................. ZoningDistrict ........../.....................J................/.{..........................Fire District .............................................................................. �I/ / / P s Name of Owner ............./.'.��%... G/ 4 Address �/ /.. . ........ . .... ................Sr................................ ........................................yam.+ Name of Builder ( .... '..� . i/.....&......Address r .. j `ft �........... j 7 Name of Architect ...........................,............... ...............Address .................. ..... ...... .................... Numberof Rooms ..................................................................Foundation ................................................................................ Exterior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ......Approximate Cost `�` '- Definitive Plan Approved by Planning Board ---------------__-_-----------19---- . IC7-ep e- Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH J v LU j U) w � 0 4 Z N `U > =�Z y 0 m N2 wa7 0 D cnQ Z ��" OOP - _. � LU ~ U) z 1 ry Lr) � k . � W Z Q C] i X" � 1k, I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ......... .................................................................... Sylvia, Robert ' ' No Permit for .......Pwimining pool . ` / .......................^......................................,.......... Location .........7l. _ _____ ~ . -------..�!a ........................................ ` ^� .. . � Owner .............�R����..���[�. ...................... ' . Type of Construction --.. I__.�oo � ----.—..—.—.--.—..---.------'.-- ` � � plot ............................ Lot ................................ � . � ^ ' Pannh Granted ---. .*28............ 72 Date of Inspection ^ ---]9 ' Date Completed lg ^ ^' ~ ~ PERMIT REFUSED '� .—.---------..---.----...--' 19 ~ � ------......----.—..~—....--`..---- _.-_.--.....—.---~~---_--.........—.. � —....._----.--..—.....~—.—.��..-...—.—., . , ..------.....~..--..........-^.:--....— , ' . . ° Approved .. lQ ' � ^ � .--------.-----..~-..—..----..— � ----^-------------^~—^'----- � w. r' A CORINTHIAN POOL WORK SHEET Name � �::�, � �f - Permits-Codes- Regulations-Ordinances Address 7/ 6 �`d� st t - dim t c Phone s Soil Conditions Water Source Excess Dirt JOB LOCATION & DIRECTIONS Additional Back Fill High Water Table Hydrostatic Valve Extra Equip: Pumps, Hoses, Elec. Leads Branch Date Sold Extra Fittings, Clamps, Silicone, Etc. Date Del. Date Started Date of Proposed Installation Date Completed Size Pool: Series Pool: Installer: Filter: Excavator: Accessories: Electrician: Plumber: Mason: Fence Man: Extras Sold Completion Cert. Final Payment PLOT PLAN INSTRUCTIONS: (1) Show Pool Location in Relation to House or Street (2) Show Location of Underground Cables - Pipes - Septic System (3) Show Pitch of Land and/or any Abnormal Conditions such as Trees, Shrubbery, Fences and Existing Patio (4) Show Wind Direction For Skimmer Location (5) Show Hose Connection on House (b) Show Outside Electrical Outlet (7) Show Equipment Entrance. i _t 1414 IL G_ 1 T _.. z _ i A 7 —t i t�— -•—t �—1 j 1 r -��J" - - + t. r.- '1•'{" j } ' a 1.`::::,5 - —t i-: AF - Y r l + r }- It t r .. i t { i i t " .r- t r - r + .Y-, f 'y-L Y-.-.-4.1 �- .i ". 4 � Y T it 14- -7-� . r + t f. TI - 1-._. _._.J_. r tt ~- y � .... e_t .. } _ r } .-H �l _ n �-1t _ .t .L. T i ':�. 1 '�J-•- : � r-'- `r -t 1 r-r 'i � i L J _ .iYT r�-..1 r-.. r 6 j r_•. ~� t !,. 1� .+ �.- �'__ r r t _ �: i TPT ``{', TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map / Parcels Permit# Ieaii-9r�sipn Date Issued emae AaV nLivision Fee Tax Collector �� Treasurer ZZ4Zll)bU , Date Definitive Plan Approved by Planning Board Hjst�- serva ion yan is Project Street Address Village 9 Owner7k�L, �! tz/ Address Telephone 1790 R — M6G Permit Request �,2. �Q- ��i� 1 ,F_►')7 _..AI r V Square feet: 1 st floor: exis ing proposed 2nd floor:existing proposed Total new Estimated Project Cost � Zoning District Flood Plain Groundwater Overlay Construction Type 41 lb Lot Size Grandfathered: ❑Yes UWb5 If yes, attach supporting documentation. Dwelling Type: Single Family Two Family 0 Multi-Family(#units) Age of Existing Structure Historic House: 0 Yes En — On Old King's Highway: ❑Yes Basement Type: ❑Full 0 Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing. new Half: existirg new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: 0 Gas ❑Oil 0 Electric ❑Other Central Air: 0 Yes ❑No Fireplaces: Existing New Existing wood/coal stove: O Yes O No • Detached garage:0 existing, ❑new. size Pool:❑existing ❑new size Barn:O existing ❑new size Attached garage:O existing ❑new size' Shed:❑existing 0 new size Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded❑ Commercial ❑Yes U o. If yes,site plan'review# Current Use Proposed Use BUILDER INFORMATION Name /' Telephone Number Address eC[)77) d License# _ C`s �`� 7 7 9 424 4 5�' Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO .E SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. '� i. _ _• �; r DATE ISSUED : - a r MAP/PARCEL NO. _ r;• _ r - _ _t ADDRESS �a° '• f VILLAGE a r OWNER ti- DATE OF INSPECTIDQN: FOUNDATION n r FRAME 'w INSULATION ` FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL • - , GAS: - ROUGH FINAL # FINAL BUILDING'P DATE CLOSED OUT i -ASSOCIATION PLAN NO. `{ f --- -- The Commonwealth of Massachusetts Department of Industrial Accidents -�� Olfice of/nyestigalions • ;'�' 600 Washington Street Boston,Mass. 02111 ' Workers' Com ensation Insurance Affidavit name: location city ❑ I am a ho wrier performing all work myself. ❑ I am a sole proprietor and have no one workin in any capacity orI am an employer providing workers' compensation for my employees working on this job. comnnnv name: /Lra f 'h'tE tsuP � It - address: �los t*��/(J/l1 city: l 0 Mir d 3 hone#• � DX erg Sl F! ... ��'} oZ t: S n insurance cn. / /'T� E-h4',�TFvRh noiicv# GEC Uat&(P$l . ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the follo«ing workers' compensation polices: comnanv name, :.: ........... .... address: city phone#- ingnrnnce cn. oltcv#.. comnanv name- address: city- ... phone#' :;:;...... ...:.. ._::::. imnrance co. :.:::»:::.. oiicv# Failure to secure coverage as required under'ection 25A of MGL 152 can lead to the imposition of criminal penalties of a tlne up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tlne of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Oince of Investigations of the DIA for coverage veriacation I do hereby certify under the pairs anddppfennalties perjury that the information provided above is true and correct Sitntature�� Gam' — Date ��2 ®� �.—� - Print name r/Q it bEY_i eK Lt. Q A S C H r •72f Phone# ��J g' 9.S 1 g- oillcial use only do not write in this area to be completed by city or town otIIcial city or town: permit/lIcense# Mudding Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact penon: phone#; ❑Other (mvueo 9i95 PJA) I Town of Barnstable • The • aniuvsTnsce. • � Department of Heal th Safe and Environmental Services �'ArEn 5.t°gym P Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date i AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 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. Q Type of Work: �. C� A��,� (// I Estimated Cost Address of Work: 171 A7eiegeJ bed Owner's Name:___/ �� Date of Application: ��� y'—dy I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 ❑Building 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: Date Contractor Name gistration No. OR Date Owner's Name q:f6=:Affidav I �-7/ F , + - � ., ✓fig 10N7yna�et h � 4 HOME IMPROVEMENT CONTRALTO Jlze C�anunomuvea� p� i� uivrlYd + ,. - j . ReglstrAl Ion 'i100140"" R % BOARD OF`BUILDING REGULATIONS �, TYPe " PRIVA.TE CORPORATION License: .CONSTRUCTION SUPERVISOR Expiration ' '� 1 Number. CS 057032 06/23/00 1 HOME CAPIZZI' Fl IMPROVEMENT Expires 09/26/2t)01 Tr.no: 5742 as'Capizzi INC - ��`I ADMINISTRATORS 00Newton Rd Cotuit Mq _ 0.2635 THOMAS X CAPIZZI JR 280 PERCIVAL DR ! W BARNSTABLE, MA 02668 Admiristrator , . 1 i� BOARD OF BUILDIN G REGULATIONS j a License: CONSTRUCTION SUPERVISOR G y DEPARTMENT OF PUBLIC SAFETY Number: CS 007454 CONSTRUCTION SUPERVISOR LICENSE ar;tt; / Number Expires; ' Expires:0 Reg:Cricted T:o 00 j i j I Restricted To: 00 THOMAS CAPIZZI �� � FREOERICA V''RASCH III 1645 NEWTOWN RD -4 CO'y+:-1-11r1060'BOURNE•"RD �- ;� COTUIT, MA 02635 Administrator �; PLYMOUTH, MA 02360 j