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0015 CAMROSE COURT
---�-- f i j i� I I i i i i' i J i I� I'' Town of Barnstable *Permit# Regulatory ��, Expires 6 morsths from issue date g ry ' _ Fee ` UsivsrABr , MASS. Richard V.Scali,Interim Director MAY 29 Building "MoLs"R 2015 Tom Perry,CBO,Bgildin '200 Main Street,Hyannis,MA 02601 'U��A�LE www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY + Not Valid without Red X-Press Imprint Map/parcel Numb 73 08-6 aI a Property Address gResidential Value of Work$ 3 I Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address O Contractor's Name S o uFWlN IV Ei. VV(IU 01f)S A r--,VK)/,S O JLJ Telephone Number 16 -2 L FS.-` 900 Home Improvement Contractor License#(if applicable) 173 Y S- Email: Construction Supervisor's License#(if applicable) 0 1g6-7, Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 9 1 have Worker's Compensation Insurance Insurance Company Name II '' nIV b //us Workman's Comp.Policy# WC^^- 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 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders..U-Value C3 d (maximum.35)#of windoz nz #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: ' Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement.Contractors License&Construction Supervisors License is required. s SIGNATURE: TAKEVIN D1Building Changes\EXPRESS PERNUTIEXPRESS.doc Revised 061313 r Renewal RI Ua�#hra7:t byAndemm RENEWAL BY ANllERSEN �,kmm# I3sz45 - Cr .kilt #1w34555 WiNDDM Rnueertar mA,rQenrnGe�,n, 26 Albion Road • Lincoln,Rl 02065 Lead n_#1237 Pu " GILD S/a7 Plione 866.563.2235•Fix 401.633.6602 FaKruilaz lt)#4r-d566iW Southern New England Windows,LI.0 d/b/a ni /I: d Renewal by Andersen of Southern New England R ? CUSTOM WINDOW AND DOOR REMODELING AGREEMENT ° BOwer(s) Buyer(s)soeetnddma C)tr 5uie.and zip Cade 7P.0_Box _ _�0 IW t�(;:L1.7(>:�l>MITGrt(.pM ce eRVR.Sw2 l_w0• K Tfth.eNmber aMk�Td-6p.3.�N m ber:.Sts-776- �E-4aBAddnac 3OUE,t�f'M,3A� M �fr . 8a (.CtAi G lVV Buyer(s)hereby jointly and severally agrees to purchase the,prcidueis and/or services of Southern New England Windows,I:=d/b/a Renewal by elundt:rsen of Southern New England("Contractor"),in aecordant:e with the terms and conditions'described on the front and the reverse of this agreement and on the attached specification sheeq.5)(collectively,this"Agreement'. d Historic 0 Condo ❑HOAT Total Job Amount Sgs� Estimated Starting Dai�, Method of Payment O Check Cash tnanced CC, - Deposit Received t ed aBS►— _Or r? W._ Credit Cards are accepted for deposit only-maximum 113 of the Ba Start of Job(IllOA`_ � project_cost(Fk4se.see Or&Card PaMie t Form)By signing this tit ma Comptetton Date Ai&ree ray, ;Y�acknowledge thatthe Balance it Start of job and the ce on Substantial /Q W Balance on Substantal;CompWon of job cannot be made by credit �. plri on'of job(i.". 3aav card and must be made by personal check bank check;or cash. Buyers)agrees and understands that this Agreement cons-titutes the entire ander-t_andtng:between the parties,at d,ihat the .AM no verbal understandings changing any"of the terms of this Agseemeot.Buyers)acknowledges'that Buyer's)' (1)has.read this Agreement,understands the terms of this Agreement,amid has received a completed,signed,and dated' copy of this Agrecat int,-including the two attached Notices of Cancellation,oa the date first written above and(2)was orally informed of Buyer's:Aghtto cancel this Agreement.DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. (Rhode talarrd Sales t)nty)Notice to Brayer.(1)Do not this Agreement if any of the.spaces intended[or the agreed terms; to the extent of then available information are leti blank:(2)You are entitled to a copy of this Agreement at the time,you sign it (3)Yon tray at any time pay off the full unpaid balance tine aader this Agreemeai and in'so doing you may be entitled to receive a partial rebate of'the finance aired insaraace ehaiges:(4)The seller'has no right to unlawfully eater your premises or commit any breath of the peace to repossess goods purchased nndeir this Agreement.m Yon may cancel this Agreement If it has not been signed at the main ollice os a branch oliice'of the seller,provided you notify the sells;at his or her main ootce or branch office shown in the:Agreement byregtste'ed or certified Mail,W'hicz i sbaB be po4ted not later than msdnight of ihi'ehied calendar day aRer the day oa_which tits buyer signs the Agreement,a cl,"iag Sunday and any holiday on wlsich .gal.mail deliveries are not made.See the accompaayiag notice o!'canceBationform for as explanation of buyer's rights. Buyers)received the consumer education to aerials lirrnaded by the Rl ude Leland Contractors R sinupii Bennet._Y (Btgrrc Initinli) Renewal deki of S-_iithern New England. yer(s) Igriait,. of'Pnxhic�M:tnitget � Sigriul�ue' Stgrtatiir:` 669A -n4wrls yl �Tu NAitINE -OVE t t, 9' Print Name of E odtict-Xhu>ager Print Nante 'Print Native. YOU, THE BUYER(S),.MAY CANCEL THIS TRANSACTION AT ANY•TIME PRIOR TO_MIDNIGHT OF:THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORMS' FOR AN.EXPIANATION OF THIS RIGHT: NOTICE OF CANCELLATION 7C. NOTICE OF CANCELLATION Date of Transaction S fit/-!i :You may cancel I Date of Transaction You may cancel this transaction,whthout'any penalty or o6hgatigri,within this txar►saction,Without achy penatty_or obligation,within three.liusiness days from the above.date.If you cancel,.any I three business days from the:above'date:If you cancel;any property traded irt,any payments n:ide by you under the I property traded in,any payments.madei by you under"tie'. Contract or Sate,and any negotiable instrument-"executed I Contract or Sale,and'any negotiable instrument executed by you will be ieturned wtthinae i business days following I by you will be`returned within ten business days,following receipt by the Seller of yourcancellatioi notice,and any I receipt by the Seller of you r cancellation notice,and any security, interest arising- out of the transaction will be= security interest arising out:of the-transaction ,will be' canceled If you tancel, a must make available to the Seller I .canceled.1f you cancel,rou must make available to tits Seller at your residence,fn substantially asgoo l condition as when. I atyour.residence,in substantially as good condition as when received,any goods delivered to.you under this Contract or.. I received,any goods dekvered•to you under.this Contract or Sale;or you may,if you wish,comply with the instructions of I Sale;or you may,if you wish,comply-with the'instructions of the Seller regarding the return shipment of the goods at the , the Seller regarding the return shipment of the goods at the Sellers expense and risk:If you do make the goods.available X Seller's expense and risk:If you do make the goods available to the es Seller and the Seller do not pick them up within l 'to'the:Selle►and the Seller does not pick there up within twenty dayo:of the date of cancellation,you may retain or 1 twenty days of the date of cai cellation,you may retain or: dh*e,of the,goods without.any further'obligation.If you I 'dispose of the goods.without.any further obligation.If you fail to make the goods available.to the Seller or if you agree,,j fail to:make the goods available.to the Seller,or if.you_agree to return the goods to the Seller:and fail to do so lien you I to return the,goods to the Seller and fail to do so,then you iemain liable for performance ofall obligations under the: remain liable for performance`of all obligations-under the, Contract7ii Cancel this transaction,mail or.deliver a signed I ContractTo cancel this transaction;mail or deliver a- signed and dated copy of this cancellation notice Or'any other, I and dated copy of this,cancellation notice or any other, written notice,or send a telegram to Renewal byAndersen of I written notice,or send a teleggrWi to Renewal byAnderien of Southern New Enigd1anandd at 26 Albion Road;Lh1coln,R)02865,. 1 Southern New.England at 26 Albion.Road,Lincoln,RI 02865, NOT LATER T14AN MIDNIGHT OF �/B' /S I NOT LATER THAN MIDNIGHT OF (Date) _ l (Dace). I.HEREBY CANCELTHISTRANSACTION. 1 HEREBY CANCELTHIS TRANSACTION. ,Buysr*t sl)-t— PAk Nome Dan - Buyws siv alum Print Nurse- Dicta RbA Copy:White Buyer Copy:Yellow Buyer Copy-ink Southern New England Windows d.b.a Renewal by Andersen of SNE ,r Massachusetts-Department of Public Safety j Board of Building Regulations and Standards Construction Supervisor k 4 License: CS4)95707 Rt BRIAN D DENNISbN t 7 LAMBS POND>>` Charlton MA MOTO. r t Pia .- ))"I,,,, Expiration Commissioner 09/06/2016 ���!?fiGvY�t't22 GyG � C�CP./S Office of Consumer Affairs BusinessG�GQ Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 173245 Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS LL Expiration: 9/19/2016 DENNISON BRIAN 26 ALBION RD LINCOLN,RI 02865 _— Update Address and return card.Mark reason for change. SCA1 O 20M.W1I Address L Renewal -LI Employment Lost Card C7�in TLrrw�roun.r�l/�r.�C-�iG:anc�iu:ellf '. 01", c oTRain&Rusioess RegutatiooLicense or registration valid for individul use only MMIPRO"MENT CONTRACTOR before the expiration date. lrfoundreturnto:gisvatlon: 173245 Type Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Expiration: 9/1912016 Supplement,--and Boston,MA 02116 SOUTHERN NEW ENGLAND WINDOWS LLC. - -"'� RENEWAL BY ANDERSON' - DENNISON BRIAN 26 ALBION RD r LINCOLN,RI02865 Undersecretary Not valid without signature —_— The Commonwealth ofMassachusetts Departinent oflndustrtalAccidents Office oflnva gartions 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians)Plumbers Applicant Information Please Print Legibly Name (B.ismess/0rgm&sfion/Individual)• I Address: o2,� �ienl 1 ,4-1} City/State/Zip: W—C.o n - 0:1L-q6,s phone#: y O l - a P F- 9 92�0 Are you an employer?Check the appropriate box: Type of project(required): 1.( I am a employer with -� 4• ❑ I am a general contractor and I employees(full and/or part-time)-* 6. New construction have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. Remodeling shipand have no employees - These sub-contractors have �P Y 8. El Demolition working for mein any capacity. employees and have workers' [No workers'comp.ft rrance comp.tnanra�r,1 9. []Building addition required.] 5. ® We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11. Phunbiag repairs or additions myself.[No workers'comp. right of exemption per MGL 12[]Roof repairs f insurance required]t c. 152, §1(4),and we have no II- employees.[No workers' 13 AOther W,1140 comp.insurance required] 7Pi `Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy' on. t Homeowners who submit this affidavit indicating they are doing all work:and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-confractors have employees,they must provide their walla n'comp.policy mtmber. I am an employer that is providing workers'compensation insurance for my employees Below is the polity and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#. W ' C M 35 � 3 ` gxp on Date: a j5 Job Site Address: zo r Cm,/Sffiteaip r 01 10 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 "depains and penalties of perjury that the informationprovided abo a is and correct Si afore: Date: Phone Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building(Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6:-,.Other CERTIFICATE OF LIABILITY INSURANCE oa/ss/=aa4 THIS CERTIFICATE IS ISSUE®AS A PATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT.AFFIRMATIVELY OR NEG,flYNMY MEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ' BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING I NSH{tEl 4 A9111OPHEO _ REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE NOLDEIL IMPMTANT: if the ceAfficats holder is an ADDM0NAL INSUR€D,the pollcypes)must be endorsed. If SUBROGATION IS WAIVED,subjM to the terms and amndlhions of the pioft cerutin¢oIItzes mey reQuIre an andwwMeaL A stMmwd on this wNcatte does ant ewfty rights to the cartRictIte fielder In by of such a�sidatTae►twngs). PRODUCER Willis of New Jersey, Zac. ttA84E: C/O 26 Oaatusy Blvd PHOTO 1-877- 5-7378 FAX KOM (AM -8HS-4 -2318 P.O., Box 3Q5191 Nashville, w 372305191 USA !aD eertif icat@8 {991n.g� RISITREWS)AFFORDMCOVERACE. RMS IMSURERA:Boloctive Iaouzmnca camany of SS 39926 WDREDSouthasa Sec,England Vindova kLC INSURERB:ihe Beacon s'0oteal,laeusance c=wmv 24017 D/B/n Renewal by 13adar�ya ON3URr�e• may ® 19801 26 Albion Road Lincoln, BS 02865 INSURERC- It INSURER E 94SURSR F v COVERAGES CERTIFICATE NUMBER ws2916o REVISION NUMBEI§: 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, EY.CLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY}LAVE BEEN REDUCED BY PAID CLAIMS. t%SR TYPE OF INSURANCE POLICY kuw2ERt own& POLICY EXP Lam X COMMOLALGEN131ALLIMLITY EACH OCCURREICE 3- 11000,000 CIA MSAME OCCUR 114M O n PROMES comments S 100,000 MEDEW(Anywepws*4 S 10,000 S 2029459 OB/10/2014 08/10/2015 PERSONAL&ADV INJURY S 21000,000 CEML AGGREGATE LIMIT APPLISPER: GEHERALAGGREGATE IS 3,000,000 POLICY®M ®LOC FRObUCfis-CDAII'lOPAt� $ 3,000,000 OrssER: g AUTOMOBILELIABILITY NEDS➢NGI.ELMIT $ 1,000.000 X AMYAUTO BODILY URY(Per paa) S — n AUTOS MS 2029459 08/20/2024 08/10/2025 SODILYOdiURY(PO aft) $ .�. H RFDAuros H AUUTONdSWN� Nd1 PROPERTY DAMAGE S 8 n X UiNBRELLALIAB. X OCCUR EACHOCCiJRREt10E S 5,060,660 EXCESSLke CLA16�-BLADE S 2029459 08/10/2024 08/10/2015 AGGREGATE $ S,000r000 OW RETENTIONS S WDR109ISCAT[OEN PER. $ AFtDEBPLOYERSL[AB3LIYY YIN c. ANYPROPRIEfORMARTNERJE(FCUTIVE EL }t $ 1,000,000 OFRCMIEMBEREXCLUOED? MIA 0000068028 09/21/2014 08/22/2015 powdemy em�ss,, In NH) E-DISEASE-EAEMPLOY S 2,000,000 r} rYtaPRONGFOPERATIONSbdow I I t;.LV-%wE-pOLCyL50T Is 5,000,D00 C 4ork Ccap/6L Covgs wc927938352394 08/21/2014 08/21/2-R-5119.L Ed. Accident a 01,000,000 Statutory Limitc - RC _L. Diaemee Policy rot - $1,000,000 ` _L Disease Ba. employ" - $2,000,000 DE8CdIPTtD�1 Og OPERATEOldS I LOCATt0D35 t UBBCLES(ACORD 101.AddOtonW Romaft Sda0M".nsybe m=dW Nmom spawls'r } I CERTIFICATE MOLDER CANCELLATION SHOULD ANY OP WE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUrHORaED REPRESENTATIVE SotathasII an LLC 26 Albion Read fdneo2ift, rtx 02865-0000 4 O 19a8-2aw ACORD CORPORATION. All rtghta reserved. � ACORD 26(2014401) The ACCIRD name and logo are registered narks of ACORD SR ID:6629625 swcaaBateh 0: 79627 Town of Barnstable *Permit#•y ` l ` Expires mo fro date ' I Regulatory Services Fee .eadsrasr$ r 1639. 2010 Thomas F.Geiler,Director aARNSTA13LE Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma u s Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION `- RESIDENTIAL ONLY L Not Valid without Red X-Press Imprint U Map/parcel.Number ` 3 61 D Property Address t S [V]'Residential Value of Work a).0,0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �S 0 e Camyse, tloalJ Contractor's Name A4.7,CNC6 L"0nJ7T�Ion Telephone NumberjD •36a•SW6 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner Q'I have Worker's Compensation Insurance Insurance Company Name 1✓�u/�l � Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) [�rRe-roof(stripping old.shingles) All construction debris will be taken to &CO ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.44)#of windows 'Where required: Issuance of this permit does not exempt compliance with other town deparhnent regulations,i.e.Historic,Conservation,etc. ***Note: Prope wner m sign Property Owner Letter of Permission. Ppy of the Ho Improvement Contractors License&Construction Supervisors License is" required. SIGNATURE: C:\Uscrs\dewllik\App ta\L oft\Windows\Temporary Internet Filcs\ContentOutlook\4STGU5QO\E)PRESS.doc Revised 090809 i I - Office of Consumer Affairs and eusiiess Regulation 10 Park Plaza- Suite 517a Boston,Massachsetts 02116 Home Improvement r Regis ion ----t Rom 165W i Type: Private Corporation EVfra6on: 4WO12 Tr# 295484 TL HITCHCOCK CONSTRUCTIOU-S ; THEODORE HITCHCOCK 55 LISA LANE WEST BARSTABLE MA 02668 "` �!"" ft"! UpdateAddrm and. card.-Mark ream for change oPs-cn, S ,oMs Cl-A ❑ Renewal El Empioymeat p Lost Card Of r-eeTCoRsam���g�,mm'��aaaaa/uaefta Regatatioa License or re&trafion valid for hawdul use only HOME®NPROVEMENT CONTRACTOR before the eViration date If found return to: Re9istlMow- Types office of Co�erAltays and Busim segulation Expiration. Private Cogxwalion 10 Park Plaza-Suite 5170 —-- Boston,A[A 02116 TL TCHCOCK VgERV►CE ING v THEOMO E HITGk� 55 LISA LANE ` kwl +i it WEST BARSTABLE,° =` Un&nftrda Not Ia,.wcituaettx-Department of Pubiic-Safekv Board of Building Regulation and Standarth Coostrsrt ftp Sup-s-As^r Sge-c apty License License; CS SL Restricted to: W.WS TED MCHOOCK 55 USA LANE r WEST BARNSTABLE,MA 02668 Expiradiorr_ 6 r2M2 Co�mni�si�mrr Tr#' 1 I own of Barnstable ts� Regulatory Services - � Thomas l±-z'+^i.'er,D=sector Buiddine Division Thomas Perry,CB® Building Commissioner. 200 Main Street, Hyannis;MA 02601 tis ww.town.barnstable.ma.us Office: 508-862-4038 F&x: 508-790-6230 .. 8'8"a�,i di C.d 6� `i i1W ESLA 1?28.8�73 A ID Ta.r:sss.zn adac.-66isaa v Qia a"'j vs.c,a.E"via t3 r.�-aasnu g.a as C)WIjej C) suufCci:properi y L-eceby aurtiarvC �T�i����. 00F ( p/f Qrf io act on my behalf, iii all iila"Crs relaiive t6 work audiotizi-u by Midis buildiii]g pefiliii applicaiioil Or: (Address of r:U) t /Z ZU/U A, , Owner Date s ioeoo'orl n6// Print i ame Q:Forms:buitdins�xnii4lexnresv ' Revised M107 12:13 5984204474 - PALUMW Be CO UrT PACE Bi aaaguaa aA HJ�2 PAGE 2/003 Fax Server A4 RPROM[ED. CERTIRC/!TE OF- E ' WMIWCERNFMW ar IMMA ups Gowmr SIVAIED A 7BJ[VjMM=MUgMM Bowmw TLWICRaXK B 55 LTSA LAwg Compmw YAW BAIRMABUXMA 03M C awfimAm 1"Isalooxp � CD �ac�POt1�. Lnt commm uwm CUUMBawn satap MCWPCQUIWPMM i twesny LM i �unnnmo . SCHEDUM 4Vros Etaer S MMAUSIMY S mouaMmmmas trtarY(pbrAe ,q s aNtA B[Wuly PROPGWD Ms6E $ At9�nurrog MMOWY•ElkaCCWW 5 07i�87N+01lAU�OQBtLT: - MWACCOM 4 _ AGROMM 5 vies � s A� S A 110MVMLATMIM !l44-09 tO HOUMR 'ems xwv� ses�m���ev�sslt �� �R16IE rwec�troRroueu w ' The Commonwealth of Massachusetts a Department of Industrial Accidents � 4—Oft Office of Investigations m ^ r 600 Washinglon Street - Boston,MA 02111 umn mass.gor/rlaa Workers' Compensation Insurance Affidavit: Builders/Contractors/Ple�tricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): / Z. 9.-re/.FeQeiz do/�,SJ n/ ,0 Address:y _/�/f6L City/State/Zip: D Phone#: Q00 Are you an employer?Check the appropriate box.: Type of project{rewired): 1.ErI am a employer with 1 4_ ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6• ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' insurance� 9. ❑Building addition [No workers'comp.insurance comp. required] 5_ ❑ We are a corporation and its I0.❑Electrical repairs or additions 3_Q I am a homeowner doing all work officers have exercised their I LF1 Plumbing repairs or additions self o workers'co right of exemption per MGL m3' � comp. I2.g-goof repairs insurance required.] t c. 152,§I(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. iContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they mast provide their workers'comp.policy number. I am an employer that is providing workers'conWersadm insurance for my ettrployees. Below is the policy and job site information. _ // Insurance Company Name: 11r6�v? ers Policy#or Self--ins.tic.#: (�it� 7 9!o(D rnJf� / O 9 Expiration Date: // /S/ I 0 Job Site Address: IS C 4kOS4f C 14W City/State/Zip: w/s 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 S250 day t the violator. Be advised that a copy of this statement may be forwarded to the Office of investi ions of the DI for insurance coverage verification. I hereby certrf,n der the pains qnd penalties of perjury that the informahon provided above is true and correct Si tune: Date: Phone 0 t5 • SQ ®ffacial use only. Imo not tts'ite in this area,to be completed by cl(jr or tm7t of wia! City or Town: Pennit/License# Issuing Authority(circle one): 1.Board of Health L Building Department 3.City/Tourr Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other e Contact Person: Phone#: f t, �oFI,�r� Town of Barnstable *permit# Expires 6 monthsfrom issue date °� Regulatory Services Fee BARN STABLE, ] Thomas F. Geiler,Director ' v MAss $ �p 16yq. a,� Building DivisiOD rEti t�-t Tom Perry,'CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.b arnstab l e.ma,us Office: 508-862-4038 Fax: 5087790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Kalid without Red X-Press Imprint Map/parcel Number Prop /rty Address C� [ Residential Value of Work ' DOU Minimum fee of$25.00 for work under$60 0 0 Owner's Name &Address CCt Contractor's Name '"'U 0/� H SS U G C i Telephone Number�D�- �" e 7 Uv Home Improvement Contractor License# (if applicable) IP ❑Workman's Compensation Insurance li � ��3'! PER!, Iff Check one: � � ,� � e a5n ❑ I am a sole proprietor �I am the Homeowner S F p 1 1 2008 I have Worker's Compensation Insurance '/) V�1 J'�yGt l ;, e TOWN OF 6�t RNSTABLF Insurance Company Name .� L CI (0 Workman's Comp.Policy# — Copy of Insurance Compliance Certificate must be on file. Permit Request(check.box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to__ ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ e-side Replace=oWindows/ oors/sliders. U-Value `�� (maximum..44) *Where required: Irmit 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 Plome Improvement Contractors License is required. SIGNATURE:�//�`�" Q:\WPFILESTORMS\buiIding permit forms EXPRESS.doc Revisc020108 The Commonwealth of MassacAusett5 Department of Industrial Accidents Office of rnvesfigations 600 Washington Street Boston, MA 02111 www.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/C.ontractors/ElectridansiPlumbers A-pplicant Information Please Print Legibly NaInfe(Businc;&dO'ganiza on/individual): Address: 3 7 �a► �' y_. DC ` City/State/Zip: ©Oh S 6G ee `� %S Phone*: qo( ~ �� yU C) Are yoat an employer? Check the appropriate bor: 'Type of project(required): 111 I am a cmploycr.with 4- [] I am a general contractor and 1 6- ❑Ncw construction employees(full andlor part-time).* have hired the sob-contractors 2-❑ I am a"sole proprietor or partner- listsd on the attached sheet 7. ❑Remodeling ship and have no employees Thege sub-contractors have g, n Demolition woding for me in"any capacity. employees and have workers' 9• El Building addition [No workers' Gomp.- suimmr �� lIlStII3nG m ej S. We arc a corporation and its 10.0 Electrical repass or additions required..] officers have.excrcised their 11.❑Plumbing repairs or additions 3.❑ I am a homeowner doing all work myself [No workers' camp. right of exemption per MGL 12 ❑Roof repairs in cmrance required.]t c- 152, §1(4),and we have no Othcr l 21 kt /t1�✓�f" 13. ] employees. [No workers' --r. comp-rmnnra„ce required] *Any applicant that ehmim box#1 must also fill out the section below showing their workers'corop=m-dAion policy inforenahon- t Homrowam who cubmit this affidxvit indicating ffiey arc doing all work and then hire outside contructars must submit anew affidavit indicating such r--=&actDrs that ehml-this box umst attache]an additions]sheet showing the name of the sub-c t actors and statr whether or not thost cntiba have employees. if the sub-conhurtrna have employees,they must pmvidt their work='comp.policy number. lam an employer thaf is providing workers'compensation insurance for my employees. $elmry is the polity and job sife information. Lnnn-& co Company N-Arnc Stec.eon v`� S Policy#or SeLf--ins.Lic.#: C.),� Expiration Tate � : /U - i _ lob Site Addy ess: 1 CC,- � roS`e G-. 4' Cityista-traipMV Attach a copy of t-heworkers' compensation policy declaration page(showing the policy n er and erpirafion date). Failure to se er cure covage as required under Section 25A of MGL c. 152 can lean to the imposition of ni nal penalties of a fine tip to S1,S00,00 and/or one-year imprisonment, as well as civil penaltics 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 statLmcrit may be forwarded to the Office of Investigations of fhc DIA for Tsuranse coverage yu atiom - 1 do hereby certify under the pains andpenalties of perjury that the information provided above is true and correrf. Si c: i� Phone O fchd use only. Do not write in this area, Ib be completed by city or lawn of xfaL City or Tower: PermitlLlrense# IsstringAuthority(circle one): I.Board of Health 2.Building Department 3. City/Towu Clerk 4.Electrical Inspector S.Plnmbiug Inspector 6. Other phone Ser! 0 3 06 C?: '5Ga Michael Bedard 1 -4CI1 -2,:0-28 a �.aL.-4u-u14::�,.tL::xiY'i/✓'1�.r417Yl,fti iI11Y16' .. From.Shmve '13=�u iron.H-3-ter Insurance At:Hunter Insurance,Inc. FaYID: To Denise ,J�,i�)1>G:':3„ C,I '�TIFICA.TE OF LIABFLITY IhISURAN+� THIS CERTIFICATE 1"5 ISSUED AS A ML•7TGiR OP lNF[ .t 0.1 Jt: ONLY AND CONFERS CIO RIGHYS:UPGN'1`dL'CERT(I i:.':T E HOLDER.THIS CEFtrriFICATE DOI-S NoT,M'AEDIO,E;(:EP CI"M Lnte.r i-si+zelreF,. Tnc._ ALTER THECCIVEftAGEAFFORDEDB'f F.E.POUC:! Lhil.. f'- '69 Aid ".i:=^ ga;c, P-G. Sox 1 -- --"- ll.�nvil.le 2T 028:;i 0005_ 4[ E9-S' ']7 F3a.:40:L-''69-9502 INSURERS AFFORDING COVERAGE —_...—___.--_----.—_-- INBL14ERA rr.eiwn.L nrwnpw 1!LURED A�O O�U INSURER /rl 0 g.aa n nu:c•1 inw•ax>n=:.__ 7-�l:n i1.S f.CC.dtA'.:5 hC. - F,'g;, Rr nr rz AFIb ,?endersen of AI INSURER c' INSURER D. 1 "7 a'efSTe: Leas": ?Iri:ue -- R:f_7C}.f^L S-T 021595 INSURER E: ---.._.----- --- -----.._. ;)-F f't):�`:IEC•)=II%CLWJG�l'STED 6(7i.m'FIAVE BEEN ISSUED To THE INSURED NAMED ABOVE FOR TIE POLICY PERIOO INDICATED.NOTWI:1i5T:vlJll:'t.r-_ jII� nrJv 11=:A.IRE t'iN[ TE.It/.OR C:)FDITtON'.IF)WY Ct1fTiACT OR OTHER pOC[.i,IC-C.T VATH RESPECT To'P/HICH THIS CF37TIFICAIE MAY BE 155UE J OR 66: N'AR: ".-[E :Y[a,IRAN�1=AF FOP.UEG a{THE?OLICI-c5 OFSCRIBSO HEREIN IS SUa E('T TO ALL Y:E T>•L 7EI'k15,'cXn USION5 AJJO COh01TIOCS OF S.ICI• _.._...._. -- Pa_IC Pb K 1'•£. 7 LI[LS'HOWN MA"f 114VE.BEEN R=Ct10ED BY PAID CIAINLS i7CP'EF.— L1CPE(F7H)C716F L❑[' II SSA'•" [r — POUGY NUMBER DATE IMMUDDrm DATE(RiUDDJYY _ �_TR N u E 'Rl1 LL D LI" T?FFOK m-:R`=T'ET OI ARCIAf.=_N-J7AL LVOLITY 2:4PS26619 09/16/07 09116 pRE:MISES A X — Wrl)EXP A.,:,x pn scnl-,-- D-[CI II 0.) OCLUR _ PEFSanw.&aJ:IV rcUA:Y f k fJ U.10 G i __----. G£IJERAL AG'.1IcC;nTE.`...- :f j:(1•1°.1 C. C^ _ PTOOIKT.- C![:11'aIOP W--t__...�).tl ='7�-_t'..__.... OE'J:AH L""GAP LaIIr M'Lfi$F'P_R; —'^ RY _ -- ALT_i.t jl_ LIAFLT _ f5I 1:NEI'r Sl.ci l.:UM'7- .f [{. itl L' 09/16/07 09/].6/0Q r`-'no7tlen1l ? .I AJTO ev)ILVIrQU1:'r f -tl133QcaL1T0' - DOJILY IDL4.'P'r .lp.ra�danm+ ._ VO.-(nNnED m7S —? P10P[_RT'/ - j - - ---'--__.__� Atlro oNl_v-G,!_NCCICErJT- —_..--. G FAGL'LJIEIL[T', Ali fLnD ,W7TDOlAY £ICH OCCL'':'TIiI10E 0 I,(.C . E c�_][U'FBREI.• UA91LtTY — - AX nC]!r; (_JcVulr5i.440H CtJS26619 09/16/07 09i 7.6/08 A-; r;(;.'.TE T .__....... _..I. ) X' ...0 n[l 510'00fJ jT•il� _2 C:. - S�cd-;I[E2•Cr N?-crJLTA-t('N ACID � •��- .I:', 10/ Erl°'_c E;�'Ta1111.rr 28886 10/01/07 D1/08 EL EACaP,CCCENT 8 .IIYPROPTIF.'DRN:JTTNF{!":XECIIT.VE - E'. DISEASE-EAEUPLOrI f . "a S . E.:_C)ISf:ASE-FOI.IC'I LJI 1 SIdO=6N.'=R0'.•IE;I'JNSbrl.�r - : OESOrt 1:ONC-O[-ERATI O-� hS:LO)�'FIO�IS l VEHICLES I EXcW61ON9 ADDED BY NDO 6EMENT(SPEG'ViL PROVI530N5 _ . i CANCELLATION, ---- — - "- ..MOONAS S SHOULD ANY OF THE ADO POLIC IES 3R G1IJCELIt'9 -Jf 14 i -i-i r.` Mccn Ai=;4Taia':os, Inc DATE THEREOF,THEE iSSUtHG INSURER WILL EIIDE-)I OR TO Wei. NOTICE T1 To THE GERTWO.ATE HOLDER NIMIED TO i,[.EFTS BU7 cU:a Re 21:�W2f�: ]`r �LILL�C r5f T1 IMP066 NO OBLIC+A710N OR LIABILRY'OF ACJY I'cN0 U°JN'niE IIJf.R12R Ics aGE+';:n 5'i_I: P:At3 t: Drive! PEiPRESENTA7SVEe. ._ RIC 02825 ACCTF.o 25 G:O ir�81— /Xi1 i> ' g Regoufations ,Srar�dards r FlOIV1E 1MIPR VEMENT CON]RACTOR 119535 ���1►`�$113►1 I �� ���� �. 7/24/200 Tr# 130185 TY0' Private �. Ce�r Crabo n ` JetME 1 I PARK 1 aST t F . V0515N8800k�g , of 0289 Adtnintistrat,)� ' r i r, v Customer Name P1�YGUS C C 0 jt f j 6 C l Y Year Built: Renewal Andersen of RI&Ca Cod Renewal Address: /s C 14 tJ403R C 7: CustomerID#: Cape Sales Agreement 1137 park East Drive byMCkrsen. City,Sate,Zip: Order Number. Woonsocket,RI 02895 WINDOW REPLACEMENT.-AndevenCbmpany Phone-Home: .Si�f=77S'. 3320 license#RI12259-Iv1A119535>CT - IV.Celt, �. s -work SaF 77 C � z66p Page: of�Datei.: �-Z��� 0562725 Email: UNITS Technical Dame . CAS Ph C LL GRILLES - Room . IS E � �et s Desoiptbn E i8 dr• _ t L =0 @� 8 P8 cF �. .8 nU h� (PRICES gq n �d 3kOt R NS a 8 tc ' t l F to it lU Ir li IIT 11 i 3 2 2 aP ]Fr y ' 1i ► 3 z i 2' it It .il ,/ l/ ,� .Z . 2 Z 2 Z .Proposal A➢of the -hnd—and dooa ro be pm ncied fen the mW a of stand n y,r g ]y( coos Credits or uses - - ' Sub Total ado.n paopaad W&re=6,"1 for 3 and is m'a m aeeepmce by both Ceammer and Reaewd °Andaarn $ 9 p,vdul bel� Mmae=v (ems wr+p.Rot R ptom on.tom) Payment Method (f AS Description/Notes e E S: Skit Tom!agate.ry.p me F. Soler Reptcxnmtive s�amte A._S.4 ���e o t/#;r3 A 2 I eO .� Sub Total au wa r� ❑ Clredt C ustomet .. ce:.You am haby.v d m fomisb aD sviodoma.nd door tegw¢ed m wmplete duo hDse Credits or Et�enses ❑ Credit Card t Cos ehida ondereipfmd agtea ro pay da:amount small is dos agteemrnt sad aaorbng ro d¢terms berwE . Sec Reverse Side for Terms and Conditions of Sale.You,the buyeq may cancel Total �' ® fig this.transaction at any time pprior to midnigbt of the third business day after the date of this n.Yle attached notice of cancellation for an sales Tar oRloe detd aMy explanation of this rig Total`:•.-slancous Cmdits or Fxpenrer Date Cuamme Sigodoae (tartr tact mod m ndc swift I�#oolsum at Work Permit Cott l'v r MAtlaW Old.I.—AtMded . dWWW Aotepmd Da¢ � - - Special Order Note Total Amount of Agreement 3[ Iatlo Deer astatm Door Mane p01C ery/low tetrl'D— A�p�astlts� 1g L L L A 8oQ F /y.e 7'�?/be S AR/f Deposit Requiredr. spedvp,W6sdow dd4s�sg stainagm Reawn?dt ggaA!and�sesm Remwlmdmrt�ldrsaumaaaui '.. Pleas note detsw are sneak bbid an tepabag B ladWed Rdt W wiaea vss we t�okh ins �NiM a td a `uuy a nanm R ral mopidemea8 /ly C 4-C,O'Ca. C'_ /��1> t,�& 17—,C ho y Balance Due on Completion �agm��t owwags aRm new ode die anmme unless and dmBe seu 6orte nyahsY�+PPto,ak I notm ahwM1 se mmum odmwisemted Atme mdordrcpe aommvncm,daWtwu�ne - Not indudes labor,matmals,installation, A moored msd wewN teen row sew whseown and White-Renewal' Custo l/Ie mer n/�� customer��• Me immtatlm asm _ byAndersan Yetlow-ttsallation Pink-Flomeawnes rcmot'al,and disposal of products replaced. 5 4 , giv cw SIX 1,01 VIII S K � r• e x: r l > p tea,; \ I' tat! In �.•'� Ke � amp" �� "�' ^� .•��.. `: .. afl�� .�� i ��� >c r?...3 INTmot Tom > vv 0 A.�,•,o-._.. i. a i. .' � ,`�`� "�' ` ate, # 3 � 1 4 c y r WE Two .. fit oil 171310 Of ITS tit I it,TAT 1 InIgnt CIA ART Mitzi `:i Tw r ro TOWN OF BARNSTABLE 35392 Permit No. . BUILDING DEPARTMENT ($140. 00} TOWN OFFICE BUILDING Cash .............. HYANNIS.MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Jacques Morin Address Lot #25, 15 Carlerose Ct. Hyannis, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, .AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. January 4, 93 �� . .. . . ..... ............ .... . 19................. ....................................... Building Inspector I • 1 1 1 • � • 1 I 1 • 1 / i... :a �tF a •u r f 5 b t ! 4 ���� � D,ft SIJ'�i .�,.{�s"t% F4 H� �� F �• S i�� � t 3�� +. I = F •t '{ c} s sr`x t-`".,z�+fy[ `�T-� K�i- t 3 .> zr,' y? t 4 ,Milli i s .-Q PAYABLE TO: Ml� Hill Jacques Morin } t s 1 f 44 rfFE Rif .. lr� t�r a � u, 02601 k" �ia'.°'f rya',,: ,.rw•��.�'�i. ,,,.,,4, 4„a�al�. F 43�Yr � ®� "ht`.44,.if�•F2�S�.v�di'N1�4�`��,.3..,� s�t �5t3w�lti !�� T�,G ,a r+}. � J"' � mat• fps �+o; a�f.y.,cSP �� ��' •J*,L 4 t�����a � �� �� �y�G?"���46'Q��`Qtdt'3..re5� tvt�4'rL�i$�J� ��� r . r���=q��' �,���I�Y�4y�y, if r 5 f .1 7r,•�} � f y ,. { 'v�5�'_•'sa.�-�".��S{.., p'�.� Yl�� �yis „ � r I d's� T ' } ' f �4 IV V QZF x TOWN OF BARNSTABLE, MASSACHUSETTS o BUILD 1 N PE M tioA'k-273-0$6-�''� DATE be ,L mbLr ;5 92 19 3 2 PERMIT NO. APPLICANT Mark WenzelADDRESS_ Whidah Way, Centerville 400905 J ; (NO.) , (STREET) (CONTR'S LICENSE) PERMIT TO Build Dwelling 11$ I STORY Single Family Dwelling NUMBER UNITS, (TYPE Of IMPROVEMENT) NO. (PROPOSED USE) _ AT (LOCATION) Lot #25_-, 15 Cameroase Ct: , Hyannis ZONING -- (NO.) (STREET) DISTRICT- BET.WEEN AND (CROSS STREET) (CROSS,ST'REET) SUBDIVISION L LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL'CONFORM IN CONSTRUCTI TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: +lJW;1 :iL4JE ($1401.00) Jecque .Morin AREA OR VOLUME ESTIMATED COST $ FEEMIT (CUBIC/SQUARE FEET) OWNER JcAC(jUe ; Niorila I r- ADDRESS 300 budl: clo vV%xi1I hyculrus BUILDING DEPT. BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY C ► PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE A PROVED BY THE JURISDICTION. STREET OR ALL GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINE FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIOI OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL INSPECTIONS REQUIRED FOR -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE ALL�CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR 1. ELECTRICAL FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL,INSTALBLIATIONS.D 2. PRIOR-TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE " .. OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 2 3 INGINSPECTION APPROVALS I DEP RT , 2 H OTHER j- SITE PLAN REVIEW APPROVAL 1 WORK SHALL NOT PROCEED UNTIL THE INSPEC_ PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT,STARTED WITHIN SIX MONTHS OF DATE THE INSPECTIONS INDICATED ON THIS CARD CAN i CONSTRUCTION. -t p..ERM1T IS ISSUED AS-NOTED ABOVE. ARRANGED FOR BY TELEPHONE OR WRITTI 111 NOTIFICATION. • /s Cam,,,,.�... �,,,E /V r � LoT�ZS , -4-7 '6 �20 a t ` 0 �p s� n� \ j lT .1 • LoT�'zG � _ 3•S�� , CERTIFIED PLOT /PLAN LOCATION �R!'©!ST! � .:C, ✓"!!�, SCALE . .� -. �.... DATE PLAN REFERENCE T a 2S AS EC." �ii `'c ` �G.. 8¢. . . . . . . . . .. . . . .. . . . . . . . . . . . .. . A 'ELLEY I CERTIFY THAT THE 'qV! IqY . `� vsrvan SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE- SETBACK REQUIREMENTS OF THE TOWN OF WHEN CONSTRUCTED.. PATE -56' /L /ySz / REGISTERED LAND SURVEYOR. OK BMJ(k -2 11-3 V ��., ce(1st Floor): o Asse a? D�� >`J f rs map and lot number ' A ,1 � �< �0j T N E �soard of Health(3rd floor: � �° d�Q `� Sewage Permit numbs , y,• i . ' • Z BAB.d9TADLL i Engineering Department rd floor): OWE,r� � ��� ?� � � rasa House number /.� l'Js. T�,,p °o 1639. \®� 1. 9�" Cd�UJ�i42 ' � P AFC MAY d. Definitive Plan Approved by Planning Board [� 19 S& (� APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only N P CIO \ TOWN . OF BARNSTABLEyy� BUILDING INSPECTOR APPLICATION FOR PERMIT TO BU�-Lo J 1 f ) W FTT 0 I L Y b k) E ! t b ?1 TYPE OF CONSTRUCTION k,100 f , &I u-���T_ 19 - TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for�a permit according to the following/information:, Location! aS ( '!4/!?F-"�20 S e::- 0 he1,, HAJAJis Proposed Use 6 LF PA-u t�-`f Uj E L I M (I Zoning District C ` Fire District Name of Owner 1A d W, IN Address,3 00 Name of Builder - " "l Address - Name of Architect Address� Number of Rooms Foundation �Q R, 0jW Exterior C1 No. Roofing lT 5 P Floors a 14K-1)"lu . CA60 LJNZ) IIhttior 5 �► e��1- Heating � Plumbing Fireplace 0 Approximate Cost ? f d 0 Area / Diagram of Lot and Building with Dimensions Fee )eq 90 - ��lqdi �. IRA OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regard' thW str� i � , Name Construction Supervisor's License i MORIN,n`Y JACQUES `. i "o . 35392 Permit For 112 Story { Single Family Dwelling P Location Lot . #25, 15 Came-rose Ct. Hyannis r Owner Jacques Morinf1 1 Type of Construction Frame Plot Lot A. Permit Granted September 2 S-,-19 92 ' Date of Inspection / p 19 Dater -bt /°Z/� / 'Z 19 i - _ --------------- co 4,t• , N 0 Q �H� N N ^� OMOD M OD p o ® CEDAR CLAP50ARDS ® ® •4'TO WEATICH . IRtVA7fON ONLY prt eL T 11"u�"u"1III LLUI 00 no TA FIF . NRtlTC CEDAR SHNGLES •3' - La -Q a 'ca TO WEATHER TYP° SIX t. . REAR ELEVATIONS a y a he . FRONT ELEVATION W SCALE.1/4° 1'-0° -. - a RIGHT SIDE ELEVATION Z SCALE. 1/4' 1'-0° z a y . ' u W W OL Q O W ; ' �+ ; LLULiAl El- El d° O I IF- E UI Q W Q Ll Z Z 0 < LEFT SIDE ELEVATION . REAR ELEVATION SHEET NUMBER. SCALE.L4' V-D' SCALG L4' 1'-0' j. FILE NAME' ,: - 92113A1 ,I w•-a' 14•-4• 13 co 7-2' 14"-11• 13•-10 5-q 7-2 ,_2 WINDOW 5GHEDULE N KEY CITY. DESORFMON ROUCti OPENING MFR./MODEL REMARKS c A 2 DOUBLE CASEMENT 4•-0 1/2•x 5'-0 1/2• AIDERS01C2S WMrtE PCRMASMIELD ¢ y, B 1 CASEMENT 2'-0 5/8•x 3•-O 1/2• Al nUX C13 WMRE FERMASMELD ® C. i TRIPLE CASEMENT G'-O 3/e'x 6•-0 1/2' AN ERS&CW WHITE PCRMASM W a i r DECK m " D 3 cRGLETOP G'-0 S/e'z 3'-2 3/4 ANDERSEN CTC3 wHrrE PERHASMSLD CA cu 32'x 20' OCTAGON 2'-0 1/2'x 2'-0 1/2' BROSCO *181 F 2 CRCLETOP 4'-0 5/8' x 2'-2 3/4• AMDERSEN OT02 WHITE PCRMA5MCLD N N Q G S DOUBLE "G 2'-G'x 4'-9' WESPNE 2424 C3 O fb + a FAMILY l� M 3 PICTURE/D.M. FLMdQRS 6'-5'x 4'-q' WCSpf! p¢q o J 1 CRGLETOP 4•-9• x 2•-7• ANDERSENGTGW2 WHITE PERMASHIELD ROOM r =9 K 4 DOUBLE HUNG MULLION 5•-0'x 4•-9' WCSPN C3 E 2424-2 0- Lo ® ® O S L 2 CASEMENT 2- 5/e•x 5"-0 3/9 ANDERSEN 015 WHITE PERMASMELD M 1 PICTURE G•-O 3/8•x 5-0 3/8 ANDERSEN CP35 WHITE PERMA5HELD I N 2 AWNING 2-0 5/e•x 2"-0 5/5' ANDERSEN A21 Nnlrt[P[R11A5n21.D n (1 n LIVING I DINING P 1 AWNING G'-O 3/e'X 2• 0 5/8 AN)ERSER AGI WHITE PERMASHELD I A O S SKYLIGHTS 31 3/4'x 5G' vBtx VS 2 MASTER i 4 BEDROOM � DOOR SCHEDULE ----------------J + � KEY CITY. DESCRIPTION ROUGH OPENPIG MFR./MODEL REMARKS © - 12'-2 1/2' - -G'-7 3/4' I 1 1 3.0'x G'e' 2LRE - 3'-2 1/4'x G'-10' STAtLLY K2 II II II - STAR Ur TO -STORAGE OVER 2 1 2'8'x G•C•STEEL IRE CODE 2'-10 1/4'"x G•-10' STANLEY III ® - „ }� OGARAGE 7 3 1. 6'O'x 6'e' SLD[R 6- 3/4'.z G'-10 7/e' ANDERSEN P56R . 7 r .y 4 1 q'-0'x 7•-0. OVERHEAD 9'-G'x 7'-0' L CAFE DOOR o e NOTE.PROVIDE 5/5' WALK-H I O 11 LNCN DN. HEATNG 5TSTEM 77 - ATE L COMMON CODE GYP.�. .1 ' 5 G 4 2•G'x 6'G'6PANEL 2'-0 Le'z 6'-9' MORGAN M-IOSI CLOSET I - t— DUCT GHA- LAV. WALLS BETWEEN I 7 4 2'4'x G'G'GPANEL 2'-G 1/8• x G•-9' MORGAN M-1051 D.W. GARAGE AND VWoaIF Prim . a LIVING SPACES }},, }} a 2. 2'0'x G'G'GPAMEL 2'-2 1/8'x G'-9' MORGAN M-1051 00 _-_- _ ( `� T - T 9 1 - 5'0'x G'G'BIFOLD Y-2 1/8 x G•-9• MORGAN M-4FD-1051 a O �• GARAGE N N 10 3 4.0•x G•G' BIFOLD 4r-2 Le,z C-9 MORGAN M-4FD-1051 W j r O q 10 4 - 11 2 1'G'x 6 6 1'6PANEL -e 1/e z G 1o5 9 MORGJW M- 1 Lir � a q a MASTER FOYER KITCHEN I 2 BATH. 2'-0• ti A Y 9 ° o Li �� 'O ® o I o y Z C3 T-2' o_ H N W I C7 7•-O' 2'-3• 4- 3- 4'-G' 4'--0' 4'-G' 3'-10' 3'-10' G.-O. 11•-0' G'-0' 14•-0' 11'-0' 9'-0' 7-8' 23-0' I CCATHEDRAL FIRST FLOOR PLAN 7•-13/4' 1.1•-10 3/4• 1.3'-10 5/8• G'-0 7/a• CEILING OVER FAMILY RM. BELOW) SCALE,1/4'-1'-0' ID LINE OF oweCIXT ® ® MXDOVCR/PRO',= - t- MEMBRANE AS V . BEDROOM a. - I TO MM 14'-1 3/4' CO 15'-10 1/4' 12'-0' \ 1 O. BEDROOM .-4 ©. BALCONY b i Q Q — ® It OF (3)14'LVL 0 \ I 3: 0 RIDGE BEAM ABOVE 1-__ S \ I 10 �clo) -1 � aQo�eLN QWALK-IN ———— — BATH Y aosrT Lo `Q diACCCS iv COPEN TO yT, PANEL BELOW) O 'r I Q 1 // i Z Z l / I OL O Z COPEN TO q BELOW) �y r,_ PANEL 5 / // i 0 0 Y ® L®J coPEN TO BELOW) cSTORAGc) 5TORAGE SHEET NUMBERI s I ` S-4 3-G 3�. S-6 G�. 4-G 4-G 4•"G 7-° ®I® Q�-7 SECOND FLOOR PLAN 11 11'G SCALE- 1/4• - 1'-0' FILE NAME. ,• r 92113A2 m cu J N .. LJ X OwZl CP4 m d in 2AD F 4' 0' 32'-4• 14'-4' 4 �.� NOTE. G:C.t FOUNDATION alQp 4 CONTINUOUS RIDGE VENT CONT.RAGTOR TO VERIFY N n I TYPICAL BLID-OVER DNCNSIONS Or DOCK Q - LOCA 'OF SONATUBCs o 12 "h•'.'' r I - _ - AYPICALc OF CONSTRUCTION,S oe SPMAL CLC -- — �-------- 4 t 4 ��. .. ATTIC 1/2'PLYWOOD 5MEATMNG/2 x B .•� 9' FBERC1A55 NSU.. RAFTERS AT 16.O.C_/PROVIDE 'PROPCRVC'NT•. _'- -•+,t — Y------ - ( II OR EQUAL STYRArOAM N5UATION TO SLOPED DROP WALL 7F q 1' .;r -TYPICAL ° 0 In In n • CONCRETE WALL f L - INSULATED CCLNcs/PRovDEIiFIfIIILgjgLj MAINTAIN VENTING AT EAVES�cONTN000s w = 4 FOR BLCO 'c �I ONA16• x B•CONTINUOUS -0 12 50FFIT VENTNG/PROVIDE RIGID INSULATION W J >t q if BLLIOtCAD # k CpN�G,FRCTC FOOTING - TED GniNGS. 12 i0 REQUIRED ENERGY CODE REQUIREMENTS CR3o) A L) a cY.� °d , �, "� ,k� �.,.tq WALK—IN BEDROOM a W } Z H FULL` w`BASEi NT o C3 2 x 10's • 16. O.C. 2 x 10'� et 16' o.c. 6-O'T. 6'-0' 6'-0' N W TYPICAL EXTERIOR WALL CONSTRUCTION RED CEDAR CLAPBOARDS AT 4' TO w y. WEATMOR CrRONT ELEVATION ONLY)/ A r LAV. DINING RM. WHITE CEDAR SMNGUES AT 5'TO WEATHER T -�—--�• —F•-—i -t---—f- - -+—-- - SIDE AND REAR CLEVATIONS/L2•PLY. Z . L_J L_Jay _J L J �, —J .�,L_J r , 1 q SMEATTING/2 x 4 STUDS AT 16' O GJ 3 1/2'FIBERGLASS INSULATION c3)z x to CRT ctrPo I L J 5/8'PLY. SUBFLOOR GLUED _ •. .,� TYP. 30• x 30'x 10•GONG.COL. PAD , ' AND NAILED TO J015TS GARAGELl - 2 x to'x et 16'o.c. 2 x 10'x at 16' oz. 000000 Eq 2 z 6 TREATED 5LL q <_,. •' (4'CONE. SLAB W/ I Qo 4 6 1/4' FIBERGLASS NtI S .TYP. C3)2.x 10 GIRT OVMEAD DOORS) N BASEMENT CEILING FULL BASEMENT B'CONCRETE WALL l� - b! 3 1/2'GONG.-FLLCD STEELis W LALLY COLUMN r �k4 L t J _ .4'• GONG. SLAB i Ort a 4 16•x B'CONT.CONE. FOOTING O STAIR Y � _—�• I a `�J � L_t t^ 4 Via• � 4 p DRor WALL FOR D 30 x 30• x lo• ,.1_.. _ CONCRETE COL.PAD Q I� ---J f — ------ ------ I V -14'-0' 4'-0' 5'-0' 2'-0' 9'-0' T-B' C2'C T APRON) 1' O ON04 MC,4•CONCRETE '-6 9'-6' 9'-6' � -61 w 40 os AN 8:CONCRETE 23'-O• -F GROSS SECTION COONT•'coNc. FOOTING - SCALE-1/4' 1•-O' J V' p - W Q CO FOUNDATION-0PLANSCALE- V4* O Q °�- 00 = ",o, SHEET NUMBER. `r • FILE NAME, - 9288A3 OT � S � S CA/AzosE Cada.T� FfcrA N Uly BA JlsEr r�