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HomeMy WebLinkAbout0180 BISHOPS TERRACE �Ijh4o3 i t ' K oFt"Erg Town of Barnstable *Permit b ) �YFyk:) O « Regulatory Services �es 6 mon dis rpm issue dale i639' .� Thomas F.Geiler Director G ` 6 2007 Building Division f. Tom Perry, Building Commissioner L 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without lied X Press linpru�t Map/parcel Number Q / - Property Address lub ❑Residential Value of Wor6f) Minimum fee of$25.00 for work under 600$ 0.00. Owner's Name&Address C /A' 0 �e Contractor's Name M Telephone Number Home Improvement Contractor License#(if applicable) 100 7 9 D Construction Supervisor's License#(if applicable) -QCP ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's mpensation Insurance nsurance Company Name evs, Vorkman's Comp.Policy# / =opy of Insurance Compliance Ce ficate must be on file. eimit Request(check box) ❑ Re-roof(stripping old shingles) All co' nstxuciion debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side �.1 �Replacemeint Windows. U-Value P (ni l. 4) 11//�).wZ3 . "`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. Home Improvement Contractors License is required. ,%aiure 'ns:expmtrg '63004 R Cliar,"_: -293 J4�rVl�D;� CA�I�Cnft CERTIFICATE OF LIABILITY INSURANCE . � GATE(:ri"3:TM'/YYY"; i Ro ars.&Gray Ins. I A ency,jnt_ TNIS CcR-1FIC-^T=IS. (SSU .AS 1.MA�E_R yr F 3'-A 1O=: N 7JZB 13-4 CYAANCCONFERS 90 f S! ^N!HECERTIFICATE^L _,t.iHfSCT=1C;- JOES NCT AhttiC,�=Ni C TH COS=R P, O. Box 1601 A�T= BY THE:P^'J:iESLC` . I SCL':n GS^rlis,NO,.A,, OGOOQ-1 Out i ! I INSURED INS!'ZEES A-FORDING COVERAGE NAiC� CapIZZ! Home imoroysment,Inc. iINaURER?: N :1onaI Gtcnsa M'i tu a FRS, G;. i Caoizz! Et,t9 a9S Inc. 'lKSURER 3: Amarfcanin`_emdOR2i i ! i 1645 Newtown Road :JRR CotLii, Y�fA 02635 �t`suP,,E ! —I !NSURE.'1 CC�/ERAGES - ET =PCLICcS INSURANCE LS i=;D BE;OW HA'.G 3==N ISSUSD TO i�qE INSURED NA&I JD pSGJ==G?i E?GUC(?_c10Q!AI'�lC T VO i i TAaJ NG AY !<cOUIR' .dc i,it4FA On CONDf ION GS ANY CGN 'sACT OR OT =�DOCJ1'^ctT YVI 4:R=SPEC I TO Y:4iCN THIS C=;' (=iCA T t M.4Y=E IScLEO O4 MAY PES.AGGREGATE INSURANCENIFi-SA,,rjyN, p'SY TH"OL.IC!ES DESCRIBED H_4E6V IS SUe ECi TOA Tx=_TSRMS,'�C LUSIONS ANO CC dOnC(jS OFSUC:! P OLICES.ACv^tiGA L�„!IT5 SHOh I MAY H!VE SEEP;cJUCED BY PAID CLAIMS. c, 7 PSOFINSURANCE POLICYNU;d3 ER POLICY=.=ECTPIE POLICY EX?fP.ATION' ATc(MbllD 'YYI AT=6YIMID fYY, 'LIHRS GEHc2AL LIASILFfY i!11P010707 06(08i06 i 06108/07 Ear_y�,CGURRERCE ,si OOQ,000 I wMMEicC!AL GENERAL LIA3tL17`f DAM;.GE TO Fi=P:TcD ! i Xj CC- MR' RchY!SFS•_=c^ r;= 5 �JrQ0,00Q' - I I CL;I}AS jnaCE r� (X.tED,:D<;-(Amy=4ae:sznl $10,000 !PERSOtNALaAOVNJURY is1,000000 GENERACAGGREGAT s2,00Q 0t)0 . rarlt AGGRFGA E WAIT APF ES F-E?; PRO•- PRODUCTS_^^ 0'AGO...,niw., �2,000,000 PGLiCY IECF LG? i II AUTOMOEILc LIR8RRY "Y AUTO SINED SINGLE LIMIT 3 I jEa ccc!deri} .aLL O"11FD ALTOS ! - SCHEDULED AUTOS 30D L!INJURY i—�i1RED rtUT S --- --a- -- —"-..—� -"•. u! NON-OWNED AUTOS i 3 GILT IN LR) PROPERTY ROP �t}Ab!aGE ; ! i I ^ARA c!U.31LRY I I I ' :WY;:UTC i Ai�TO C\L'I.= CCIDc?JT 3 - i V lU ?.' tJ vNL'I: !i I I EXC:SS V 3�-!1.•t LI4.31UT7 AGG I I I . Lj Li iI aCGREG:1i- 3 0FDLCT18LE Y 8 wc4fG-ts comPE,,aATION ANo uPLOYs a aafrr J t 12/25t176 112`2of07 rcR s enir GTH e� X ?40P21ESE -74 ='- - C'FFiC'!FKfEt{gER EYCLI:OFl• "` '`^i4 .-ft,,. L ES 4A !CEAfT j QQ,000•-.-- .- �Ify�a -e under � -_ _ i,•, _- _• =L.DIScA„E _4_.APL�cE SJrn0,000 .,. OT4ER I_.L!'fS�aSE. =OUCYLLWIT i 3500,000 _ T I - GtSCRI�;ICN O_ - _ ' _—• _, cr.!n41 I SP_:1AL F,ROVIS:ONS CERTIFICATE hOLDE; carlc_L LAT,O.N S1iCULD.ANY CFf;i;h3CVE.�SC.?.;3'ci)^LIC:cS RE C.�.VCE!L_D S==O.2E i 4_=X?R,�f!CS �. DATE 1 ' R-G t-t !SS UN !\SL ZWrLL ENO VOR tONAiL a -FY �.. t-" '"�-. -s"`xms"'Su' '_•""�.e N�JTIC -Ta.,t_ ".E.3 t!rtCAi L�E2 Y-N D TO ii :.Le.. ..'Sasd, a'.R"`�, ,.-= - .;l'� y�,1 r- .x > ;-.., 7 ,- T 8UT rAILUR TO JO So ..,,,,^. '�+. **'�' §,µsr -gam .,•,.,_ ., _ y. .-+ '` 'y t IND UPON T4EYiV:t�rZ R I Y'-AG'- eA::.' x „r*al :a=z.,�,•,t` �. ' ter : } � R -'4 3mNTx71VE3 $.z;'�'F tM ��"`"�+ �'� .. 'Y ,v�'T� ACORJ 2 �001 E8 ' ey 'j h t nJ ?(C�x z ss+ _ Ai 'd' ;,r �� �r i6+`Io- a�5-�"�u� � -zt � x 3 r � i ne uotnmon,veatrtz o,j lyl2ssactzusez-ts r � Department of.1ndustrird Accidents Office ofInves-iga ions � fJ 600FashLngzon Sweet Bostoln, 11114 029M W.rnass-g ov/dia Workers" Compensation Insurance Affdav t: Builders/Contractors/`EZectriciaus/Plumbiers Applicant Information Please Print Legibly Name (Bns;nesJOrg ;? tion/Indiv�duai): t [ludic OFCVE�u�Nflt... Address: 16445 NewtoVm ,R,aad :CitylSrate/ZI Tel. 4?8-55i 8.I 800-262-SW p i' one 1F: e ou an employer? check the*appropriate box` Type of pro eet(recjuired): I am.a ei giloyer whiz — 4. ❑ I am a genera-contractor and I e : Io. ees fllll and/or art time . liavchirca the sQb=contractors ' 6 [j Neer coiistriiction P y . P 2.Q I a a:sGie. roprietor or paTtaer- I�stecl on the aftaehed slims t.f 7• Q IZerliot2eIing ship and 11a- I?o employzes 7iese sub=rontiactor}lave 8 Demolition. womb forme gi any capacity. . .workers'romp.Ii1SlII2I1Ce. 9 ( Binding addition jNo wo leers' corlip.inslaauce 5: ❑ W.—ai ee a coapozapon aid its regtrae j officers have e�ercis�ilHeir 1 Q EIecfi calzzpairs or additions 3 Q I a-6 a homeown-er doing ail work -o exem t6n per PTlimb�g r�aiis or additions 12 Q nlsuiance regtnzed.J r employees {'Vo:wor3��rs a, .v _r .: ... . , Oinerrepa^ :.. Ro n e recluat�� ?��r aaphq6rit$ t Xi&d:;eon zl mts•slso fr7I our ie section below s'�orrag e wo czis cbrr�e ��on�a1%c. `o��Zon F_o�eaw�ers w10 ssb :�,e t� nt indics+r�g e re.dcin sII and li Y g fit o de azfaccors�ustsr �i anewaEe. 7,« icaLi-a s on racer t cnxk this boa Must Qra� e3 en Adcuaonal snevt snownzd�e _ scli nee o*�e s D-Co ctcr aid pies woe's C7n po�lcy for ;T .. .. - f inn ail erri IDyer r�rrr ispro�idirig workers'compenTarzon.znsura�zee for my srrz�Zo yees PjO)f�is The . �or Self zis_ L � l Y.� � ..•• `-"; ;� , v:/ xp tlon'Date iSrte Addf=ess _ _. ,...`1,.�:�>.`�' �, "• �`� . _-. - �, � � ,_ � � . �f _ 4� ', :atn a copy or the workers' �onipensation policy declaration page(show-in�the policy nurubez and epiraahion date). hire to setare coverage as reglrired ander Section 2 a ofNICL c_ 152 cm lead to the?jposition'of criininal pezialties of.a up to 1,Svo.Q:0 aIla/ar one-yearpnsonment, as 1ti ell as civil:penaities in tie o.rm of a STOP0 flER:and a.. ne r _ a copy of this stateit't may be forwarded to the Office f tigadons of h6-DIA foi insurance bb lt,-gq veril?ce o1; z n.... ere cQ. under the ales rztzdpenalnes of perj riy that The fnforr,.eiion provide above is Erne and correct _ t 1• r h 1 n i il—_j attire / i � Date: r NEW use onlyDo not 3vrzte rn t�Czs area to tie coin Iete b r r P- y OY f0}y7X O ZClr1js. fi - pa "•a.,.; CUNs '^"y`£ air.-s?ii .- wf�3 '•^-"..i"��` ';.�£...r.. .��' '�6 'x` ''� 'T'1�''.4,;, -* NSA —WORM�£I$I ICeIISea V-A fir_ f L °ard of#H'ealth Bu�i�Iding�Depar=tment�3 ;tClty/Totiy-n Clerlti`"3��Blectrlcal Inspecfor�� P•lumbing Inspect�oz- :�- .� e _ — tl Page 7 ot 7 CAPIZZI HOMF,IMPROVEMENT INC. SPECIFICATIONS ANC ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT OWN THE PROPERTY LOCATED AT ' MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT N ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT N ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUllLDR- .CODE. SIGNATURE OF OWNER(S): . - C OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S TELEPHONE: 50 28-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS:.ESS _ RESPONSIBLE OFFICER TELEPHONE: i I 077 t r �= Board of Building Regulations and Standa ds One .Ashburton Place- Room 13'01 k { Boston, Massachusetts 02108 , : }iy Home Improvement Contractor Registration Registration: 10074(l 7 Ott f Type: Private Corporation Expiration: 6/23/2008 CAPIZZI HOME IMPROVEMENT, INC. . Thomas Capizzi, jr. 1645 Newton Rd. ; Cotuit, MA 02635 M1 . Update Address and return card.Mark reason for change. DPS-CA1 5CM-04/05-PC8698 EjAddress (� Renewal 0 Employment E] Lost Card - a r ✓ //��?�LUL O�✓/�JdLF`�LCCJP.CZO. - I r .�, sae �an�n�wreeueez . i . � Board of Building Regulations and Standards HOME IMPROVEMENT CO License or registration valid forindividvI use.onlyj i NTRACTOR before the expiration date. If found return.to: ,� .- Registration 100740 Board of But]dIpg,_.egulatioris and Standards �SO Expiration; 6/23/2008 .one Ashburton Rlace Rm 130I Type 'private Corporation B;oston,ll4a 02I 8 CAPIZZI HOME IMPROVEMENT, INC. " J f44aMFiF Thomas'Capizzi;jr, f } ti t 16454Newton Rd. ' t Cotuit,'.•MA 02635 V. ,. u. Ucput, Administ�atoi t Notvandwithoutsignature ' ✓axe Variv�novuuea� a�✓`lcraoacncatetla Board of Building Regulations and Standards Construction Supervisor License License: CS 74640 B i rthdate: 11/29/1975 Expiration: 11/29/2008 Tr# 6430 JLction:Restri 00 GARY GUSTAFSON —J� 8 SHORT WAY SANDWICH,MA 02563 Commissioner f . 1 Ap �jZ G . 21 Home Improvement Inc I, Gary Gustafson; Production manager Of Capizzi Home Improvemeat, Hereby authorize Lisa Haworth, to sign on my behalfrfor;permit applicatio 8liled alirough the town: b x Signed. r Gary G stafso , Date: ..iis h__ �� �� �.. _-T __._�__ . - -.__.._.,Date. -. -- - - - 1645 Newtown Road Cotuit, MA 02635 (508) 428-9518 (800) 262-5060 FAX (508) 428-1547 Ax �OFTHE tOty 1 own of Barnstable *Permit # ti �.n Expirl m ontlos fran issue dale tsnmt�srnst,e. Regulatory Services Fee Fn 1F.g.. 6. Thomas F.Geiler,Director n �,71,11 7 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press lin Tint Map/parcel Number (Jc 1 Property Address �.�� � 1�H c)�S TJE_a2��G-e� ��j--1.1 S Residential Value of Work '�p O 0 C� Minimum fee of$25.00 for work under$6000.00 )wner's Name&Address,?PCT9-1 C1 Ck- 0 'C,O o r `+[.-t 2 0 RDI GHO P S -Pe-�c � n S :ontractor's Name_ Ap1ZZ l l.J�►�l S - L�Zg -C,�S�, T S o� Telephone Number Qj come Improvement Contractor License#(if applicable) , 0 —1 L4 V ,onstruction Supervisor's License#(if applicable) `'7 -` v -lWorkman's Compensation Insurance Check one: X-PRESS PERMIT I am a sole proprietor [� I am the homeowner APR 17 2007 I have Worker's Compensation Insurance asurance Company Name ?oCju2s '� r� TOWN OF BARNSTRi3LE Vorkman's Comp.Policy# U"L G :opy of Insurance Compliance Certificate must be on file. fry, emait Request(check box) Re-roof(stripping old shingles) Ail construction debris will be taken to Re-roof(not stripping. Going over existing layers of roof) Re-side -- Replacement Windows. U-Value ` — (maximum.44) ".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. Home Improvement Contractors License is required. gnature Forms:expmtrg vise063004 - AP IZ G H �f Home Improvement Inc. I, Gary Gustafson, Production manager Of Capizzi Home Improvement, hereby authorize Lisa Haworth, to sign on my behalf for permit applications filed through the-town. Signed: o��7 Gary G stafso .. Date: 1645 Newtown Road Cotuit, MA 02635 (508) 428-9518 (800) 262-5060 FAX(508) 42&1547 Clisn* 4�298 CAPIH01ilA ACGRD� CERTIFICATE OF LIABILITY INSURANCE DATE(,m---JiYYYY) PROOQC=-R 0/109/07 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers&Gray Ins. Agency,lnc. ONLY AND CONFERS NO RIGHTS UPON THE CEEUIFICAT E 431 Route 24 HOLDER.THIS CERTIFICATE DOES NOT AMEND EKENO OR P. 0. Box 1601 ALTER THE COV=-RAGE A=FORDED BY THE POLICIES KLOW. South Dennis,MA 02660-1601 I INSURERS AFFORDING COVERAGE I NAIL INSURED Capizzi Home Improvsment,Inc. �NsuRER National Gunge Mutual Ins, Co. INSURER 3: American In_ematlonal Gr ` I Capizzi Enterprises, Inc. 1645 Newtown Road INSURER G: Cotuit, NIA 02635 iNSURER D: RE. COVERAGES i HE PCLICIES CF INSURANCE LIST`C BELOW HA`.rE S==N ISSUED TO THE INSUR=D,4AMP:r)AG VE=0R i iE POLICY PERIOD INDICATE.NOT•,V1THS TAVDMG ANY REQUIREMENT,TERM OR CONDITION Or ANY CONTRACT OR OTHER DOCUVENT'A'TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE APFCRDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AL THE TERPAS.EXCLUSIONS AND CONO(TICNS OF SUCH FOl IC ES.AGGREGATE L NUT S SHOWN IVAY HAVE BEEN REDUCED BY PAID CLAIMS. In LTR Inand TYPE OF INSURANCE POLICY NUMBER POLICY EFFEC7lVE 7OUCY EXPIRATION ATE'IMM/ IYY L CY EX( f11 'LIMITS A I GE&ERAL uaaarrY MP010707 06/08/06 1 061:08107 EACH'XCURRENCE $1 000,000 MA.1ERCIAL GSVE�A!LIABILITY I PA'11, E TO RENTED �; h1 $500 00Q CLAIMS MADE ❑X GccuR� �iED EXr(Anynnepeiscnl $10006 PERSONAL a AOVINJURY 41,000 OQO GENERALACGRECA.TE $2,000000 GFtI'L AGGREGATE Ut.11T APPLIES FEPt I POUCY El PJECRO• I PRODU CTS•CON PlCP AGG $2,QQf}OQO T LGC AUTOMOF;LE LIABILITY "cMSINEO SINGLE LIMIT $ ANY AUTO - {Et accident) .ALL OWNED ALTOS SCHEDULED AUTOS BODILY INJURY $ (Per perscn) HIRED AUTOS NON-OWNED AUTOS BODILY INJURY $ I I (Pe I am ds•�t) PROPERTY DAId4GE $ fYor ec dart} GARAGE LIABILITY AUTO ONLY•EA ACCIDE14T $ ANY AUTO II I - OTHER THAN EA ACC S AUTO ONLY: ACG $ I EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE 3 i DEDUCTIBLE I 3 I ,RET=NTION S I B riowcERs COMPENSATION AND 1764953 12125J'4S 12`25/07 1u STAT U- OTH- EMPLOYERS'LIABILITY - TOR Ifni rr"' R Ally PROPRIE7CR2PA.RTNER/EXECUTtVE E.L.EACH ACCIDENT $500,000 OFFICOUVEMSER EXCLUDED? i Ityes,d—be under E.L.DISEASE•EA EMPLOYEE $500,000 SPECIAL PROVISIONS La tw OTHER E.L.DISEASE.•POUCY UWIIT $500,000 DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT t SPECIAL PROVISIONS I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE OESCRISED POLICIES BE CANCELLED BEFORE THE EXPIRA rioN DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TOMAIL f_ DAYSWRITTEN NOTICE TO THE 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 - REPRESc?ITATIVES. AUTHORIZED REPRESENTATIVE - - ACORD 25(2001r08) 1 of 2 26435 DMl1N' y © ACORD CORPORATION 1988 i ne uommonwewn of%erassacnusetts Department of Industrial Accidents Office ofInvestibations 600 Washington Street Boston, tM 02111 r'.O,~ .5Y*y`~ www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciaas/Pluxxabers Applicant Information Please Print Le--ibly Name (BusmesJOrganization/Individual): � Address: Ib45 Newtown. RZ d Ci IState/��p: Tel. 4?8 9518 s. ,2s2 5ostt one#: Are you an employer? Check the-appropriate bog: Type of project(required): I am a employer with 4. Q I am a general contractor and i 6 'New consttiiction e ployees (hull and/or part tine have hu ed.tiie sub=contractors 2.Q I am"a sole proprietor or partner- listed on the.attached sbee- 1 7. Q Remodeling ship and Have rio,employees These sub=contraetois have 8. [].Demolition working forme in ary cap acity. workers' romp nisivance. 9. [ Bni7dina addition .wq workers' comp_ insurance 5. Q We are a corporation acid its b required l officers have exercised 3ieir IO.� Electrical repairs or additions 3.❑ I.am a;homeowner daiug.alt work nghtof exe ption.pei MGL _ I I.Q Phitribinge}iaiis or additions myself'[No workers' couxp. c 152,:§1(4},and w�have 110 I2._0 IZoofiepaiis insurance required l' • employees {lVo workers' comp , �rnceregnired 13.� Other *Any applicant thet checks b6x l must also_filM,but hie section below ffi win their workers co g mpen5sh6n policy info=anon_• Homeowners who submzt8ais sihdavit indicating they are damg aII walk and then lure odtst3e coniractors must submit a new affidavit medicating such _. nhactors$gat efieek this boa must attached an addifiodal sheet showing fhe n me c) e suo-coatmctors add then woiicers co lip mfor izatioa • 1 xrin arz employer that is proycding workers';corrzpensat on,Lzsurance f or my employees Beio�s,is the pDlicjrrrnd ja7�site cnfgrmafion 1 Y-Rii, e�QoTT�p a v r��F �-�Q�.;� � ��T l_r 1 ��1.�1 Policy#or Self-ins. Lie. : y Exp lion Bate:1 Tob Site Address:. CitylState/Zip: attach a copy of the workers' compensation policy declaration page(sh owing the;ptilicy number and expiration date). 'ailiire to secure coverage as required under Section ZSA of MGL c_ 152.can lead to the imposition of crirninai penalties of.a :inea up to$1,500 00 and/o.r'one-year imprisonnment, as well as civil:penalties in the form of a STOP WORK ORDER:arid-a.�ne �f i to$250 00 a:day:z,nst#he Violator.' . .B,e:adv seo#hit a copy oftliis sfatementmayrbe.forrvarded to#lie Office of nvestigations ofthe°DiA for in�,�ra:;ce coverage veifcafion do hereby.ce under tlielains andpen,irlties ofpe ry#liatthe information provided above is true and cvrrec � . i atiire: J Date: t hone#: — Official use only. Do no*write in this area,to be completed by city or town official. City or Town: Permit/Licease# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Towu Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other .Contact_Person:__..._.._...-. ._........_..._...... .._ __...---- ------- -_._.._...- --. .. ..._...hone m:......_ .... . . .._. ._ . _.. ...._....._.... .. ...____ _.._.. �\ fie Ur o�r�ea� a�✓l2cr��aacLuiGell6 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: Board of Building Regulations and Standards Registration: 100740 One Ashburton Place Rm 1301 ExPi�ation:``6/23/2008 Boston,Ma.02108 Type:::Supplement Card CAPIZZI HOME IMPROVEMENT, I bARY GUSTAFSON 1645 Newton Rd. �, Cotuit,MA 02635 Administrator INII valid with t Sig Lure 677/ Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor.Registration Registration: 100740 Type: Supplement Card Expi ration: 6/23/2008 CAPIZZI HOME IMPROVEMENT, INC GARY GUSTAFSON 1645 Newton Rd. COtUIt, MA 02635 Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card ✓fie Tiorrurruyruaea�fz a���Lczaaacrauaet�a Board of Building Regulations and Standards Construction Supervisor License License: CS 74640 B i rthdate: 11/29/1975 Expiration: 11/29/2008 Tr# 6430 Restriction: 00 GARY GUSTAFSON 8 SHORT WAY SANDWICH,MA 02563 Commissioner 'r^'�--�--...-.—.,-_.. _„�v.,..,....--...�.-.,-....... -'" '�..,.t......,�,,,..x.t1,...,......f°�^.J'^`l..r�-�-��.�-.-.s�....... .i.. -.... - �,,•�v,,,,,-�,,.,�.SrT,..ti.,r,.......��,,.,..,,,..,.l,..n..,....�ti.,, Asselesor's,map and lot number '� SEPTIC SY TE.,.j P,'fi11,rU BE v INSTALLED IN �L IAINCE WITH A ,11-1 E 11 �,PTE Sewage-•Permit number ... QI ....................................... SANITAM Co wN �THETo�� TOWN OF BARNSTABLE Z H9BBSTAIM i 039. a' BUILDING INSPECTOR �o war . , APPLICATION FOR PERMIT TO ....... .......... `3>'........ . .............. . . ........... ............................ TYPEOF CONSTRUCTION ..................�/I!. ... ................ ... .. . ... .....................................................:............ ***9,A* 7 ......19... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora permit a cording to the following information: . Location ...........�.. f..0........... ..... ......... ......................... ... .. . ..... .. . .. . ........ ... �!? ProposedUse ...... .� ........ .r... .... . .......... .. ............................................................................ ZoningDistrict .........J ................................................Fire District ............................................................. Name of Owner ..0 .. .............. ........ ... . ........Address .. .Q..... ... .. .. . ............. . Name of Builder V ....Address .r. ..................1�......................./�................. ll Nameof Architect ...... ... ...............................Address .................................................................................... ell Numberof Rooms ...................../...........................................Foundation ............ .......................................... .... ......... . Exierior .... .. ..... .............................................Roofing .......... ...... ........ ..................:... .......................... Floors . ... .................................Interior ........I......... .. .... .... ................................................... Heating ........................ .... .........................................Plumbing ................ �I, r:......�:............................................ ... . . . D o Fireplace ................... Z..S .................................Approximate Cost ..............,,!'..., ...--e..��..,e�........................... Definitive Plan Approved by Planning Board ________________________________19________. Area ,"�?..7.6..4-&.................. aa O Diagram of Lot and Building with Dimensions Fee ............/v.�..................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 2 Y' I 130 4� r { / Y I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ....................... Munroe, Donald 17856 add room No ............... Permit for .................................... barage to dwelling Location 180 Bishops Ter.race. ........ . ...... x Hyannis ............................................................................... t Owner Dona .........ld......Munroe........................................ frame Type of Construction ..........:..............................: Plot ............................ Lot ................................ i July 30 75 fPermit Granted ................ .......................19 I � �-� Date of Inspection A..5 .7 .....................19� Date Completed � ..�` .�`rC��y 1 PERMIT REFUSED t .......................................:........................ 19 lip ....................... ................................................. . ............................................................................... 4 ............................................................................... Approved ................................................ 19 { .................................................................... t r � s Asse*'s map and lot number ��. 5� Sewage Permit number .../l/-4.R,.c........................................ yoF?HET��� TOWN OF BARNSTABLE Z BABBSMLE, i "6 9 BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....:.f.........` �� `�....... �?.* `•..:•.••` ••••••••�-6—t - •••••••••••••••••••••• .............. TYPEOF CONSTRUCTION ................ ! ...................... ........................................................... ..............z..��.....19... . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............ .. .........1�.!". ...... ...................................�.. ...e ProposedUse ,. ...... ` '' .................... ..-�.............. ........................................................... Zoning District ...............................................Fire District ../�',.�Y Name of Owner .. f�- ............��1/!.-. . .......Address . ....... ... .�/. *' G� G�=.•••••.. ...................:...Address .. ..................��........................� ................ Name of Builder �r Nameof Architect .........�l. ................................Address .................................................................................... Numberof Rooms .....................!............................................Foundation ........................................................��......... ..... Exierior ....,;,.11,.; K. .............................................Roofing .......... ............................I.......................... Floors .,• ...................................Interior ................. i '. ....................................................... Heatingi/ --s ................................Plumbing ................. ;, !-v.-2............................................. Fireplace � —'..................................Approximate Cost�. ...... ".. ...................................... Definitive Plan Approved by Planning Board ________________________________19________ . Areat�?....h� .................. Fee Diagram of Lot and Building with Dimensions ""'""' ................: -^ri. .................... SUBJECT TO APPROVAL OF BOARD OF HEALTH U 1Y' I — - i O C." I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. t Name .t.. ...............................�.. � Munroe, Donald A=251-174 ' No 17856 permit for ,,, add room & .... f ............. .................. garage to dwelling ............................................................................... 180 Bishops Terrace Location ................................................................ Hyannis ............................................................................... Owner Donald Munroe frame Type of Construction ............................................ 1 ................................................................................ Plot ........................ Lot ................................ Permit Granted .......L4�y.. ...............19 75 Date of Inspection ....................:.............19 Date Completed .......................... .........19 PERMIT REFUSED .............................................../............. 19 ........................................../�.. ... .. ........ .............................. .�*..p. .. .. d Approved ................................................ 19 ............................................................................... ...............................................................................