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0352 CASTLEWOOD CIRCLE
ti The Conunoinyealth of Massachusetts Town of Fahnotitli-hispectional Services State Board of Building Regulations and Standards 59 Town Hall Square Massachusetts State BUdiag Code Falmouth.MA 02540 For One and Tivo Family Dwellings (508)495—7470 Fax (508)548-4290 Building / Sheet Metal Permit Date- pKed1Date: 5 Estimated Job Cost: $ I''tt 6 201tern it Fee: $ Plans Submitted: YES NO TOWN OF'Bh TA E-YES No Business License# Applicant License# Business Information: Property Owner/Job Location-Information: Name:�`���112 Qth1 ,,i PDJ N - Name: O A v-'nS Street: '6q vIII&S U Street: (:�' &LaOA City/Town: City/Town: � 6` �%n Telephone: �'il `�i' `�� ���� � Telephon � �• � � .�. Photo I.D. required/Copy of Photo I.D. attached: YES NO Starrinital J-1 I v A unrestricted license r J-2 I M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq..ft./2-1stories or less + Residential: 1-2 family Multi-family Condo/Townhouses Other Commercial: T Office Retail Industrial Educational Institutional) Other Square Footage: under 10,000 sq.ft. y over 10,000 sq.ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation: HVAC V rk Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: i INSURANCE COVERAGE: 1 have a current liabili insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes m o❑ If you have checked Yes.indicate t type of coverage by checking the appropriate box below: A liability Insurance policy [> Other type of indemnity ❑ Bond Q OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ 1 Signature of Owner or Owner's Agent i By checking this boxes,l hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the test of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. i Duct inspection required prior to insulation installation:YES NO Progress Inspections Date Comments Final Inspection Date Comments Typ of License: BY Zmaster Title ❑Master-Restricted CitylTown ❑Joumeyperson Signature of Licensee Permit# K./o ❑Joumeyperson-Restricted License Number. Fee$ ❑ Check at www.mass.govld6i Inspector Signature of Permit Approval i i COMMONWEALTH OF MA$$=HUSETTS o o I M I o 10 • I SHEET`METAC WORKER$ � �- ISSUES THE FALLOWING LICENSE AS A.. � BUSINESS ,`}��s''��p►. JASON D DEFOREST' jl ''{ :t- y SOUTH SHORE HEATING COOLIN "�-INC �y �. 57 VMTES'pATH M• f,f i r� °l� au g YARMO.UTH,MA 02664 ..•F, ,, 7 226 02/04l2018 r :; _. 14437 Fold Then Detach Along All Perforations s �y COMMONWEAL=TH O.FUIMJMACHUSET�S `� � rSHEET NL 7AVM ER r ; ISSUES T1HE ,F,rOLLOWII�G �t�10ENSE •... ERhUNR:ESTR to r AS q MASTL;GTED,�� x Sl?UTH`ttSHOREf+THYG 'ANDCLG ,#1150N#'E1'DEFt}FtEST q.pZ.'. . u W .SUUTH�SHO}R�E;HYG-#H 57 WH#TES PATH r s YARMouTH ` MA oz664 #z34 v The Commonwealth of Massachusetts _ Department of IndustrialAccidents 1 Congress Street,Suite.100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information I C Please Print Legibly Name(Business/Organization/Tndividual);`' �,�,'II'k J��{1}� uh (, Address: 17 n �, lfl t�5 pot�- City/State/Zip: L • %knVA N��� 0-aU41 Phone#: ab• Viol Are you a ployer?Check ktthe ^�appropriate box: Type of project(required): I. I am a employer with ,- employees(full and/or part-time). ]. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] El Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. " 10 E]Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet These sub-contractors have employees and have workers'comp.insurance.t 13.Q RRoof repairs 6.0 We area corporation and its officers have exercised their right of exemption per MGL a L7 vt 14. hei C'( 152,§1(4),and we have no employees.[No workers'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 suck tContractors 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 must provide their workers'comp.policy number. p am an employer that isproviding workers'compensation insurance for nay employees. Below is thepolicy and job site information. n Insurance Company Name: Nlyay o- 4'huVo'tiVy --- tl Policy#or Self-ins.Lic. ti q30-1 cJ Expiration Date: `l #: I Job Site Address:,�� l.Cl��'�.(�Q(�� ���(�`� City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy nu 'b r and expiration date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by 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$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenaldes ofperjury that the information provided above is true and correct Si ature: L l� Date: Phone#:/ Yt% ll 3C - liVl q Official use only. Do not write in this area,to be completed by city or town offtciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: To: Page 2 of 19 2015-08-27 15:55:57 EDT 18666769319 From: Eagle Insurance Group, LLC '4CC)R V CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODIYYYY) 8/27/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)'must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - - CONTACT Denise Defeo - NAME: Eagle Insurance Group, LLC 0ONNo_ o Exit), 659-5250 IA 1 No (866)676-9319 Ten Commerce Way E-MAIL denisedeleo@ea le assurance net ADDRESS; g g rou p Suite 3 INSURER(S)AFFORDING COVERAGE NAIC# Raynham MA 02767 INSURERABDI Gerling America Insurance 41343 INSURED - INSURERB:Crvm & Forster Insurance Company South Shore Heating & Cooling, Inc. INSURERC: /MacFarlane Energy, Inc. INSURER D 95 Bridge Street INSURER E: Dedham MA 02026 INSURERF: COVERAGES CERTIFICATE NUMBER:$.shore Fuel-15/16 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR I POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDD LIMITS X COMMERCIAL GENERAL LIABILITY 2,000,000 EACH OCCURRENCE S A CLAIMS4MADE �OCCUR DAMAGE TU RENTED $ i00,000 PREMISES Ea occurrence EGGCD000093015 7/1/2015 7/l/2016 VIED EXP(Anyone person). 5 excl PERSONAL&ADV INJURY S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: _ GENERAL AGGREGATE S 2,000,000 X POLICY❑jE7 ❑LOG PRODUCTS•COMP!OP AGG_ S 2,000,000 OTHER: Employee Benefits S 2,000,000 AUTOMOBILE LIABILITY **MCS90 included** COMBINED SINGLE LIMIT - S - 2,000,000 Ea accident A Ix ANY AUTO - BODILY INJURY(Per person) S AUTOS SCHEDULED EAGCDOOD093015 7/1/2015 7/.1/2016 BODILY INJURY(Peraccident),S AUTOS AUTOS HIRED AUTOS E NON-OWNED a*tIDS9955 Broad iozm PROPERTY DAMAGE S AUTOS - Peraccidenl Pollution Endt included** Medical payments S X UMBRELLA LIAB OCCUR - EACH OCCURRENCE S 9 000 000 B EXCESS LIAB CLAIMS-MADE _ AGGREGATE S 9,000,000 DELI I X I RETENTION$ D 1 Isal-1056307 7/l/2015 7/l/2016 S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN N X STATUTE ER ANY PROPRIETOR;PARTNER'EXECUTIVE - E.L.EACH ACCIDENT S 1,000,000 OFFICER!A4EMBER EXCLUDED? NI NIA A (Mandatory in NH) EKGCDD00093025 7/l/2015 7/l/2016 E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under -- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY UMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Note that Rung-Po Tang is covered as an insured on the above-captioned policies inhis capacity as an electrician employed solely by South Shore Heating & Cooling. Insurance coverage is limited to the terms, conditions, exclusions, other limitations and endorsements. Nothing contained-in the certificate of insurance shall be deemed to have altered, waived, or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 .AUTHORIZED REPRESENTATIVE Michael Cox%DENISE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 nnlanrl 9 Load Short Form Job: 15556 Date: Dec 01,2015 South Entire House By: Jason DeForest Shore South Shore Heating & Cooling, Inc. 57 Whites Path,S.Yarmouth,MA 02664 Phone:508-398-6901 Fax:508-760-2681 Email:jason@southshoreheatingcooling.com Web:southshoreheatingcooling:com -Rr• ect Information For: Ryan Calkins 352 Castlewood Circle,'Hyannis, Ma ® • • orma ion, Htg Clg Infiltration Outside db('F) 4 90 Method Simplified Inside db('F) 70 75 Construction quality Average Design TD ('F) 66 15 Fireplaces. ' 0 Daily range - L Inside humidity (%) 50 50 Moisture difference(gr/lb) 50 51 HEATING EQUIPMENT COOLING EQUIPMENT Make Lennox Make Lennox. Trade DAVE LENNOX SIGNATURE Trade ELITE Model SLP98UH070XV36B-* Cond XC20-036-230A** AHRI ref 4792115 Coil CX34-36+SLP98UH070XV36B*+TDR AHRI ref 8086465 Efficiency 97.4AFUE Efficiency 12.8 EER, 20 SEER Heating input 66000 Btuh Sensible cooling 23520 Btuh Heating output 64000 Btuh Latent cooling 10080 Btuh Temperature rise 52 OF Total cooling 33600 'Btuh Actual air flow 1120 cfm Actual air flow 1120 cfm Air flow factor 0.035 cfm/Btuh Air flow factor 0.046 cfm/Btuh Static pressure 0 in H2O Static pressure 0. in H2O Space thermostat Load sensible heat ratio 0.83 ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) Family 288 10386 6296 364 289 Kitchen/Living 466 9854 9400 346 432 Bath 63 1740 1855 61 85 Lin 9 0 0 0 0 Bedroom 150 .4549 3416 160 157 CIS 15 0 0 0 0 Master Bedroom 21.9 4750 3168 167 146 MCLS 16 0 0 . 0 0 Mastr Bath 44 639 242 22 11 Stairs 40 0 0 0 0 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. ;L + - wrightsoft' Right-Suite®Universal 2015 15.0.22 RSU12524 2016-Feb-13 12:11:31 Page 1 C:\Users\Jason\Documents\York\Demo\Ryan.rup Calc=MJ8 Front Door faces: E Entire House 1309 31917 24378 1120 1120 Other equip loads 0 0 Equip. @ 0.95 RSM 23061 Latent cooling 4898 TOTALS 1309 31917 27959 1120 1120 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. 2016-Feb-13 12:11:31 wrightSOW Right-Suitee Universal 2015 15.0.22 RSU12524 Page 2 C:\Users\Jason\Documents\York\Demo\Ryan.rup Calc=MJ8 Front Door faces: E TOWN OF BARNSTABLE•BUILDING PERMIT APPLICATION Map !o !4`I l Parcel ©36 C,F FA'p�4t tlonn "� ��� �D Health Division E Datelss�ued,� �. , .' �l Conservation Division Application Feed Planning Dept. Permit�Fees� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street�Address Village r-( �hv�S Owner /�Y ��✓ G,�fl�'us Address Telephone �' ?i3 7 —3olf 2-- Permit Request beoy d o Vt-i ►6 �S ue�4, DT-- `4ee(0Yz or- �No,.xse- -Do e�7j `ill (4 UP-e_. vA V 5—CQ ii'✓ LtC A-D o i4)1z-- L61AV1) e-s 4 TS- eTIL - �2�+^� �2 A,-tS A-t-r> P sl -fiv ` i'(.l - -ems Sr s" _ �(oD ,UvowS - poo z<S Square feet: 1 st floor: existing � proposed 2nd floor: existing—proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �5��0 Construction Type WOO'P a2 441J Lot Size (9 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure ° 6 5- Historic House: ❑Yes JdNO On Old King's Highway: ❑Yes ❑ No Basement Type: aFull ❑ Crawl ❑/Walkout ❑Other q Basement Finished Area (sq.ft.) �� " Basement Unfinished Area (sq.ft) f��d Number of Baths: Full: existing '2- new 2 Half: existing new Number of Bedrooms: existing ?-new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: *as ❑ Oil ❑ Electric ❑ Other Central Air: kes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION � 1 (BUILDER OR HOMEOWNER) —0 Name l Uld� ���" PS4Da k IJS 1°� � Telephone Number Address 2. �` � W License # Ci 07 Z ntil S , IBC ` r� 2 G b O Home Improvement Contractor# Z Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ' SIGNATURE DATE f FOR OFFICIAL USE ONLY i APPLICATION# � . DATE ISSUED ` MAP/PARCEL NO. ADDRESS VILLAGE t - OWNER DATE OF INSPECTION: FOUNDATION x FRAME INSULATION FIREPLACE r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING - t DATE CLOSED OUT 3 ASSOCIATION PLAN NO. r E ` C f i +� cJire`tro��rnxn�nocKr�f�of e%lla.uac/%uJelfl? Massachusetts-Department of Public Safety flice of Consumer Affairs&Business Regulation Board of Building Regulations and Standards ME IMPROVEMENT CONTRACTOR Construction Supervisor T P gistration 129244 yPe' License: CS-074928 piration 7/3072015 Private Corporalio, WII,I,IAM WHAL}N �> Whalen Restoration Services Inc 122 POND STREBT ' BREWSTER MA?0263 ' } William Whalen 22 American Way. �• w�` Expiration South Dennis,MA 02660 Undersecretary Commissioner 08/10/2016 License or registration valid for individul use on1Y Unrestricted-Buildings of any use group which contain less than 35,000 Cubic feet(991m3)of before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation enclosed space. 10 Park Plaza-Suite 5170 Boston,MA 02116 Failure to possess a current edition of the Massachusetts f�,t ,Q "l/�•-� State Building Code is cause for revocation of this license. Not valid without signature For DPS ucensing Information visit: www.Mass.Gov/DPS �, The Commonwealth of Massachusetts Department of Industrial Accidents i Office of.Investigations 1. Congress Street,Suite.100 1 Boston,MA 02114-2017 www..mass.govldia. Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/OrganizatioWIndividual): Whalen Restoration Services Address: 22 American Way City/State/Zip: South Dennis, MA 02660 Phone#: 508 760 1911 Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 25 4. F1 I am a general contractor and I have hired the sub-contractors 6. ❑New construction employees(full and/or part-time): . ' 2.11 I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition workingfor me in_an.;ca aci employees and have workers' y capacity. 9. n Building addition [No workers'comp.insurance comp.insurance.+ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.0 L am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box k 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 anew 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-contractors have employees,they must provide their workers'comp.policy number. I am an employer that.is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Ace American Insurance Company _- -_ Policy#or Self-ins.Lic.#_UB-5B89454245 Expiration Date: 16 Job Site Address: City/State/Zip: Attach a copy of the.workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under.Section 25A of MGL c. 1.52 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 cerdfy under the pains and enalties o er Lury that the information provided above is true and correct. Si nature:. - --- - �1 Date. Phone Official use only. Do not write in this area,to be completed by c or-town official City or Town; Permit/License# Issuing Authority;(circle.one) 1.Zodar'di 2.-Building Dep..artment 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person Phone.#: i r Print Page Page 1 of 4 Print this page • Owner Information-Map/Block/Lot: 273/036/-Use Code: 1010 Owner Map/Block/Lot' GIS MAPS 273 /036/ CALKINS,RYAN W Property Address Owner Name as of 352 CASTLEWOOD 1/1/12 CIRCLE 352 CASTLEWOOD CIRCLE HYANNIS, MA. 02601 Co-Owner Name Village: Hyannis Town Sewer At Address: No GIS Zoning Value: RC-1 • Assessed Values 2013-Map/Block/Lot: 273/036/-Use Code: 1010 2013 Appraised Value 2013 Assessed Value Past Comparisons Building $ 65,800 $ 65,800 Year Total Assessed Value: Value Extra $ 19,800 $ 19,800 2012 - $ 185,900 Features: 2011 - $ 185,500 Outbuildings: $ 1,200 $ 1,200 2010 - $225,600 Land Value: $ 99,700 $ 99,700 2009 - $256,100 2008- $282,800 2013 Totals $ 186,500 $ 186,500 2007- $ 300,600 • Tax Information 2013-Map/Block/Lot: 273/036/-Use Code: 1010 Taxes Hyannis FD Tax $373 (Residential) Community Preservation $49.01 Act Tax Town Tax(Residential) $,633.74 Fiscal Year 2013 TAX RATES HERE 2,055.75 • Sales History-Map/Block/Lot: 273/036/-Use Code: 1010 http://www.town.bamstable.ma.us/assessing/printl3.asp?ap=0&searchparcel=273036 6/2/2015 Print Page Page 2 of 4 vl History: Owner: Sale Date Book/Page: Sale Price: CALKINS,RYAN W 2010-03-30 24450/282 $189500 WHALEY, MARILYN J 2010-03-30 24450/280 $1 FLYNN,ELAINE 2010-01-15 24304/149 $1 WHALEY, MARILYN J 2006-06-16 21109/6 $1 WHALEY, MARILYN J 1994-10-24 9416/197 $0 WHALEY, CLIFTON F &MARILYN 1983-12-30 3975/64 $53000 • Photos 273/036/-Use Code: 1010 There are not any photos for this parcel • Sketches -Map/Block/Lot: 273/036/-Use Code: 1010 �K 281 28 s - ' 1° 1` 1� 16 Gt' As Built Cards:Click card#to view: Card #1 Card #2 • Constructions Details-Map/Block/Lot: 273/036/-Use Code: 1010 Building Details Land Building value $ 65,800 Bedrooms 2 Bedrooms USE CODE 1010 Replacement Cost $109,638 Bathrooms 2 Full Lot Size 0.21 (Acres) Model Residential Total Rooms 5 Rooms Appraised $Value 99,700 Style Ranch Heat Fuel Gas http://www.town.bamstable.ma.us/assessing/printl3.asp?ap=0&searchparcel=273036 6/2/2015 Print Page Page 3 of 4 Assessed $ Value 99,700 Grade Average Heat Type Hot Air Minus Year Built 1965 AC Type Central Effective 40 Interior CarpetHardwood depreciation Floors Stories 1 Story Interior Drywall Walls Living Area sq/ft 1,296 Exterior wood Shingle Walls Gross Area sq/ft 2,652 Roof Gable/Hip Structure Roof Cover Asph/F GIs/Crop • Outbuildings & Extra Features-Map/Block/Lot: 273/036/-Use Code: 1010 Code Description Units/SQ ft Appraised Value Assessed Value WDCK wood Decking 324 $ 1,200 $ 1,200 w/railings FPLI Fireplace 1 story 1 $2,500 $2,500 BRR Bsmt Rec Rm-Average 504 $ 2,200 $ 2,200 BMT Basement-Unfinished 1008 $ 14,200 $ 14,200 FOP Open Porch-roof- 24 $ 900 $ 900 ceiling • Sketch Legend Property Sketch Legend 62N Barn-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor,Living Area FTS Third Story Living Area SOL Solarium (Finished) BMT Basement Area FUS Second Story Living Area SPE Pool Enclosure (Unfinished) (Finished) BRN Barn GAR Garage TQS Three Quarters Story (Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UST Utility Area(Unfinished) FCP Carport KEN Kennel UTQ Three Quarters Story (Unfinished) FEP Enclosed Porch MZ1 Mezzanine,Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story (Unfinished) http://www.town.bamstable.ma.us/assessing/printl3.asp?ap=0&searchparcel=273036 6/2/2015 l— Print Pjge Page 4 of 4 FOP Open or Screened in PRT Portico WDK Wood Deck Porch PTO Patio http://www.town.bamstable.ma.us/assessing/printl3.asp?ap=0&searchparcel=273036 6/2/2015 https://www.client-unner.com/crwa/jobfonriprintview.html AesrnratSm�servk¢s Ine , Calkins, Ryan (EMS) - Loss Address: 352 Castlewood Circle Hyannis, MA 02601 Billing Information: Ryan Calkins Attn: Dianne Calkins, 17 Trout Pnd Lane Brewster, MA 02631 Home Phone: 508 237 3692 Cell Phone: 774 263 9922 Office'Phone: Other Phone: E-mail: J Type of Loss: Fire Date of Loss: March 14, 2015 Open Date: March 16, 2015 Referral: Estimator: Michael Raymond Production Manager: Claim Information: C:334658P:1116050-8D: Insurance Carrier:.MASSACHUSETTS PROPERTY INSURANCE UNDERWRITERS ASSOCIATION Independent Adjuster: FRIEDLINE&CARTER-JASON CULLITY Office Phone: (508)771-3232 Cell Phone: (508)364-6450 Fax: (508)790-2344 E-mail: JASON.C@FRIEDLINEANDCARTER.COM Insurance Agent: SAFE HARBOR/CALLAHAN INSURANCE AGENCY-BARBARA RUBEL Office Phone: (508)896-3771 Fax: (508)896-9276 E-mail: b rube l@calla ha ninsuranceagency.com r' Additional Job Information-.-,Ref Employee--John Baylis Fire loss, probably electrical cause Ron Marshall(uncle)508 237 0608 Forward all mail:to Dianne(mother)at Brewster address lock box 9922 • 1 of 1 6/4/2015 7:20 AM k �1 Ij r. 1p 40 .� C ol. r� k y Restoration Services Inc. Fire,Smoke,Soot,Water Damage&Mold Remediation Services Cleaning Deodorization • Reconstruction Specializing in Fire Restoration - All Work Guaranteed Access, Authorization and Direct Payment Request Form I (we) authorize WHALEN RESTORATION SERVICES to perform work at property located at to repair damage caused by on As owner(s) of this property, I (we) understand that I (we) must authorize this work. I (we) hereby authorize WHALEN RESTORATION SERVICES to perform this work and accept responsibility for payment upon completion. I (we) authorize and direct my Insurance-Company Policy No. , to make payments directly to WHALEN RESTORATION SERVICES, Insurance Claim Specialists, for doing this work and to that extent I (we) assign the benefits applicable to this loss to WHALEN RESTORATION SERVICES. I (we) acknowledge receipt of a copy hereof: OWNER DATED �< SIGNED kq6 - � H ' N RESTORATION REP OWNER SIGNED 22 American Way,South Dennis,MA 02660 Phone:.(508)760-1911 Fax: (508)760-9995 • 1-800-244-2598 •E-Mail:restore@whalenrestorations.com Web Page: http://www.whalenrestora.tions..com # OFFICE COPY Fm:Theresa Cahalane-Norkus To:K. Spelaan, Whalen Restor Sery Inc/Calkins Cert (15087609995) 10:48 06/03/15 GMT-04 Pg 3-4 Client#:245206 WHALENREST DATE(MMIDDIYYYY) ACOR, D. CERTIFICATE OF LIABILITY INSURANCE [ — 610312015 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 pollcy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). PRODUCER John Powers HUB International New England ac°No Ex*506-945.7866 ac No: 866-323-4182 255 Orleans Road ADDRESS: North Chatham,MA 02650 INSURERS AFFORDING COVERAGE NAIC d 508 945.0446 INSURER A:Arbella Protection Ins Co. INSURED INSURER 8: Whalen Restoration Services Inc.; INSURER C: Whalen Services Inc. 22 American Way INSURER D: INSURER E South Dennis,MA 02660 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. _ INSR TYPE OF INSURANCE ADDLSUB POLICYEFF POLICYEXP LIMITS LTR S POLICY NUMBER MMA)D MMIDDNYYY _ A GENERAL LIABILITY 1020D16678 04/01/2015 04/01/201 EACH OCCURRENCE $1000000 COMMERCIAL GENERAL LIABILITY FE 11 FE RENTED $100,000 CLAIMS-MADE OCCUR MED EXP(Any oneperson) $5 000 PERSONAL a AOV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO S POLICY n Pno- LOC $J9QTA AUTOMOBILE LIABILITY 1020016678 4/0112015 04101/201( COMBINED SINGLE LIMIT �Ea ac'0'N1' 11,000,000 ANYAUTO BODILY INJURY(Par person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per acddenl) $ AUTOS NON OWNED PROPERTY DAMAGE $ X HIREOAUTOS TOS X AUTOS Peraccldenl $ A UMBRELLA LIAR HOGCUR 4600055369 4/01/2015 04/01/201 EACH OCCURRENCE S11,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE S1,000,000 ! DIED I X RETENTION$10000 1 $ WORKER 3 COMPENSATION WCSTATU- OTH- AND EMPLOYERS'LIABILITY Y N ANY PROPRIFTORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEAIBER F-XCLUDED7 N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yea,dosuibo undor DE SCRIPTIONOFOPERATIONSbelow E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS LOCATIONS IVEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Project Address; 352 Castlewood Circle,Hyannis,MA 02601 CERTIFICATE HOLDER CANCELLATION Ryan Calkins THEULDANYOF EXPIRA IONHDATE VTHEREOF,E NO�CEIEWIBLL CELLED BE CDEL VER DO IN 352 Castlewood Circle ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE 01988.2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 oft The ACORD name and logo aro roglstorod marks of ACORD NS13923501M1380122 TC002 Rightfax C1-2 6/3/2015 7: 06:24 AM PAGE 2/002 Fax Server DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE T. IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFlCATE 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(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the arms and conditions of the policy,certain policies may require and endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME: HUB INTERNATIONAL NEW EN PHONE FAX 265 ORLEANS RD (A/C,No,Ezt): (A/C,Noy: E-MAIL NORTH CHATHAM,MA 02650 ADDRESS: 77GKF INSURER(S)AFFORDING COVERAGE NAIC INSURED INSURER A: ACE AMERICAN INSURANCE COMPANY WHALEN RESTORATION SERVICES,INC. INSURER B: INSURER C: INSURER D: 22 AMERICAN WAY INSURER E: SOUTH DENNIS,MA 02660 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: O CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS. NSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MM\DD\YYYY) (MPKADD\YYYY) LIMBS GENERAL LIABILITY ACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY AMAGE TO RENTED. $ CLAIMS MADE OCCUR. REMISES(Ea occurrence) ED EXP(Anyone person) $ ERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ POLICY PROJECT❑LOC RODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident)PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND X WC STATUTORY OTHER EMPLOYER'S LIABILITY Y/N UB-5B894542-15 04/01/2015 04/01/2016 LIMITS ANY PROPERITOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1.000,000 Ryes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000.000 DESCRIPTION OF OPERATONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION RYAN CALKINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 352 CASTLEWOOD CIRCLE BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL B DELIV D IN ACCORDANCE WITH THE POLICY PROV HYANNIS,MA 02601 AUTHORIZED REPRESENTATIVE ACORD 25(201D/05) The ACORD name and logo are registered marks of ACORD 1988-201D ACORD CORP R r ghts reserved. . i = 3`2 1 � 1 I J First Floor at 352 Castlewood Circle 16'3" F77 15. err -- T `^ �::: It 36' 10" 16'9" 791. �,.. .. 11r 4" . I � Bathroom ;o O Kitchen Area o, Family Room �' 2'3"1 F2'8 Bedroom ~ _li 24' 10" SD $D F-3 r 4 18'6" 18r 2d R�oltn N — 15' 11 rr ~ I� O �* fair 5r 1" rn Lrvmgroom ~ Ili _ 4 9" o Bedroom Bathroo = ~ IL �— T 6' 1 243" � L. 9r7 '.M 'tT1' u' ' 37 2" S KE DE TORS REVIEWED-- BARNSTABLE BOIL ING DEPT. DATE SIRE DEPAPI'MENT DATE BOTH SIGIVATURESARE REQUIRED FOR Pr"RMtTING Scale:1/8" = 1'0" .8,8Z fill „Oi,ii- OT Si i N r M O 1 p 119,Z i .11 'All iv T — �^ r' 00 Ilcn I iY 1 0 00 00 I~ ' - o i n — — -- 00 a� cd U cn `! I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION o) 00 f, Mapa 73 Parcel Application # Health Division Date Issued Conservation Division Application Fe Planning Dept. 1 Permit Fee. Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address � � W-7h'�C� �F Y �. Village loll C 1 Owner nKLA VD Address 1,��� J.,� �fd VIQUVI Telephone -]((�- C-T Permit Re uest 2e-t�-�vv-e 3� C��" lvS« �''l'► �' -.Z Square feet: 1 st floor: existing proposed 2nd floor: existing—proposed, Total newcr :w co Zoning District Flood Plain Groundwater Overlay Project Valuation Valuation Construction Type w Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supp rting do�merhTation. Dwelling Type: Single Family.* Two Family ❑ Multi-Family (# units) Age of Existing Structure 0I S Historic House: ❑Yes '5�.No On Old King's Highway: ❑Yes ❑ No Basement Type: '-Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 1,4= existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ;-Gas ❑Oil ❑ Electric ❑Other Central Air: -Yes ❑ No Fireplaces: Existing C New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) _ Name �.e� �- Telephone Number8 Address 900 License# 7 5-41:`�- Pov CA-W-I Home Improvement Contractor# 1.����� Worker's Compensation # (5[9 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE A4DATE O FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: '- FOUNDATION FRAME ; INSULATION FIREPLACE .. �J ELECTRICAL: ROUGH FINAL " PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Iv I� I i The Commonwealth ofMassachusetfs' Department of Industrial Accidents 1 ' Offzce of Investigations u 600 Washington Street Boston, MA 0211 www,mass.gov/dia Workers' Compensation Insurance Affidavit: :Builders/Contractors/Electricians/Plumber� Applicant Information Please Print Ise ibl Name Business/Organization/Tndividual). Address:��A' 90a City/State/Zip: �, ��s��`r^''1 OZ � Phone #: �� `a37: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a,general contractor and 1 6 ❑ New construction eyxiployees (full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7. ❑ Remodeling 2. am a sole proprietor or partner-' These sub-contractors have ship and have no employees S. ❑ Demolition working for me in any capacity. employees and have workers' 9 0 Building addition [No.workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or addil 3.❑ I am a homeowner doing all work officers have exercised their l l.❑ Plumbing repairs.or addil , right of exemption per MGL 12.❑ Roof repairs myself. [No workers comp. required.] t c. 152, §1(4),and we have no insurance . - employees. [No workers' 13.❑ Other comp. insurance required,] Any applicant that checks box#I 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 anew 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-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is'providing workers'compensation instrance for my employees. Below is the policy and job site information. Insurance Company Name: 1'1 ` ,V 1"') Policy#or Self-ins.Lie.M C19 ,r E� L C 1 609, Exp iration Date: 3S2 CCs t Job Site Address: _ - Ctvlcl .. City/State/Zip: "In 1S Attach a copy of the workers'. compensation policy declaration page (showing the policy number and expiration dat Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties o: 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 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 0 thr DIA for insurance coverage verification. I'do hereby,certi under the pains and penalties of perjury that the information provided above is true and correct S' nature: Date: Phone.#: �� W 231 �Zc� Official use only. Do not.write in this area, to be completed by city or town official City or Town: # Issuing Authority(circle one): 1, Board of Health.2, )3uilding Department 3. City/Town Clerk .4. Electrical Inspector 5. Plumbing Inspector 6. Other Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the.service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the than three apartments and who.resides therein, or the occupant of the owner of a dwelling house having not more p dwelling house of another who employs persons to do maintenance, constriction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed.to be an employer." MGL chapter 152, §25C(6) also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor,any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants apply Please fill out the workers compensation affidavit completely, by checking the boxes that pp y to your situation and, if necessary, supply sub-contractor(s)name(s), address(es) and phone number(s) along with,their certificate(s) of in Limited Liability Companies (LLC)or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit.. The affidavit should be returned to the city or town that the application for the pen-nit or license is being requested,not the Department of Industrial.Accidents. 'Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom has to contact you re ardin the applicant. Of the affidavit for you to fill out in the event the Office of Investigations y regarding Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, Please do not hesitate to.give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617.-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24707 www.mass,gov/die The Commonwealth of Massach usetts Department of Industrial Accidents Office of Investigations 600 Washington Street 1 Boston, MA 02111 s www.mass.gov/dia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly r Name (Business/Organization/Individual): (—Cl 4112(-2 A( 1_ Address: City/State/Zip: 1 Phone #: 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 6. ❑New construction employees(full and/or.part-time)* __. have hired the sub-contractors - - -- 2.E�rI am a sole proprietor.or partner- listed on the attached sheet. 7. ❑ Remodeling — ship and have no employees These sub-contractors have g, 0 Demolition workingfor me in an capacity. employees and have workers' Y P tY• 9. 0 Building addition [No workers' comp. insurance comp.insurance.1 required.] 5. We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152,§1(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. =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-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be. forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided a ove is true and correct. Signature: Date: g Jd Phone#• 2,1' /. !-t q 3 Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority (circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: AP :- Board of Building Regulations and Standards HOME IMPROVEMENT CONTRA.CTOR .,., - Re. gisirahon:\163193 i Expiraton-"-5/18/2011 �s ;� � s Tr/# 28440•l r ,Type Individual BARRY P.SWEENEY - af 6ARRY SWEENEY•; 720 MASSASOIT RD `` ✓, .EASTHAM, MA 02651~w ...;, Administratvi s '- Massachuse B - ' Dcli u-tment crt'ptthji( Safct� oard of Bu tt.�ilding Reuulatiuns and St;tn fards Construction Supervisor Licen e.License: CS 17564. Restricted to: 00 BARRY P MCSWEENEY PO BOX 1021 6 TRURO,. MA 02666 A ('ununlssiunrr Expiration: 7/9/2011 Tr#: 19647 5 tie License or registration valid for individu,l use only . before the expiration date. If found return to: _* Board of Building Regulations and Standards One Ashburton Place Rm 1301 , Boston,Ma.02108 r" Not alid without signature t ' r Del),"Imcnt of Public Boa►'d of Buildirill Re�sulations and Safct} Construction SupervisorSt.tnilu-(Is License: C$ 17564 Restricted to: 00 7. BARRY P MCSWEENEY ,:. ° PO BOX 1021 TRUR . Q,. MA 02666 a • i cam_ _��x Expiration: 7/9/2011 ('ummissiuncr Tr#: 19647 � r Town of B amstahle Regulatory Services Thomas F Geiler, Director Building bivision Tottl Perry, Building Commissioner 200 Main Strcet, Hyannis,1,, A 0260.1 rvwsw.tovvn.barnstable.ma.us Office: S08-862-4038 Paz: 508 Property Owftef must Complete and Sign This Section if `[using A.Builder JAI as Owner�f-u4e subject property-A hereby authorize (,e 5 to act on my behalf, � � f in all matters relative to work prized by building pe t application fox: Address of Job 6L--n v7 ignature o ate - Print Name ZfPro_ye_rty ownerzs-applying forpermitplease Complete the Homeowners License-Exemption F0= on the revem: "side. Town of Barnstable woe crte ray Regulatory Services 4 Thomas F. Geilrr,Director aAuxsnisr.e, � 16yq Building Division prEO Tom Perry,Building Commissioner 200 Maid•Strcet� Hyannis',hfA 026.01 WWW.town.barnstable.ma.us r Office: 508-962-4038 Fax: 508-790-6230 SO1`,MOWNER LICF-NSE EXEMPTION Plcase print DATE: JOB LOCATION: v lla'gc number street worl_-pbonc# name home phone# ;, ' CURRENT MAiLi qG ADDRESS: , t stag by code . ci tyhown , n for"homeowners" was extended to include ow s owner-occupied dwellings of six units or les and The current exemptio to, allow homeowners to engage an individual for hire who does not possess a license, provided that The owner acts as sup erYisor. DEFWI-f70N OF EO)YLEO'SVNER persons) who owns a parcel of land on which he/she,resides or intends to reside, on which there is, or is intended to be a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures, A person who cons'ttvets more than one home in a two-year period shall,not be considered a homeoner. Such allrbc `homr:owner .shall submit to the$tu7ding Official on a form acceptable to the Building Official, that he/she s responsible for all such work performed under the building-permit. (Section 109.1.1) Thp undersigned"homeowner"assu-mcs'responsibility for compliance with the State Building Codc and other applicable codes, bylaws,rules and regulations. The w undcrgigoed"homeowner'certifies that.he/shc understands the Town of Barnstable Building Dcpartrpcnt rajnirnum inspection procedures and requirements and that he/shc will comply with said procedures and spe rcqu ixemcu ts. Signature of HOrncowr`:C Approval of Building OfCtcial Note: Three-famt7y dwellings containing 35,000 cubic feet or larger will be rcquircd to comply with the St$ta Building Code Secti6rl 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Codc stairs that "Any bomeowocr performing work for which a building perrrdt is required shall be cxempl from the provisions of this srcGon.(Section 1 D9,1.1 -Lic using of etroction Supervisors);provided that if the homeo�w' engages a pason(s)for hire to do such ons work, that such Homcowncx shall iLct as supervisor." Man horncowners who use this exeri on arc unaware that they arc assuming the responn'bilities y of a supervisor(sec Appendix Q, npt Rules&Rcgulaons for Licensing Conshuetion supaYisors,Scct on 2.15) This lack of awareness bfien results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unli censed person as it mould with x licensed Supavisar., 7?re homeowner acting LsSupervisor is ultimately responsrblc. To ensure that the homeowner'is fully aware of hisAgr responnbili6cs,many communities require,as part of the permit application, that the homeowner certify that hdshe understands the rcspannbilitics of a Superrisor. On the last page of this issue is a,form currently used by several towns. *You may care t amend and adopt such a forrr)ccT ification for use in your community. I _ " Jt ( i ) Mhftin 3 - . gam- a i To Date Time 41� W IL YOU WER UT M of Phone %Area Code Number Extension TELEPHONED M LEASE CALL CALLEDAd.SEE,YOu .WILL CALL AGAIN WANTS TO S9E YOLPI URGENT RETURNEE7UCSUR CALL e° 6,6 °c Message Operator AMPAD 23-021-200 SETS �� EFFICIENCY® 23.421-400 SETS CARBONLESS SENT BY: _ ; 4-17-95 9:11AM ; 5087786448-0 1 508 790 5230;# 2 f MASSACHUSETTS FIRE INCIDENT REPORT DEPARTMENT Revised l� 0 18 2 2 Hyannis Fire Department Report Form if Ex Date Alarm riva� n ervi e rnci ent N 4 Fire 004/16196 Day ITuesdavl 3 100 :25 00:32 01 :32 SIT ACTION TAKEN MUTUAL AID R at u Fi 1 1 Extinguishment 1 ERTY USE (OCCUPANCY) M11 IGNITION FACTOR a I Dwellin : Year Construction 0 ficieno i 2j CORK CT ADDRESS ZIP CODE CENSUS TRACT 352.CASTLEWOOD CIRCLE 02601 000010 11 OCCUPANT NAME (LAST, FIRST, MI) TELEPHONE ROOM or APT. CLIFF F WHALEY 608 771.7415 LIYIN 12 OWNER NAME (LAST, FIRST, MI) ADDRESS TELEP1i0NE MARYLIN R WHALEY 352 CASTLEWOOD CIRCLE 508 771.7415 13 METROD OF ALARM CO• DZST. PERSONNEL ENO RESP. AERIALS RESP. 3 T© RESP. 2 0, Z 1 1 5IiIFT HAZ MAT PRESENT? N TANK. RESP. ; ® OTHER RESP. D 4 Telephone (Direct) NO. ALAIIMS SUBSTANCE O 0 1 SPEC. EQUIP, USED? rtPLTkr.TTTR9T 20 eaRV=aa 0 0: arAR 0 O 0 MOBILE PROPERTY TYPE ' 0 8 VAR=CLE STbLt4N4 I ESTIMATED TOTAL INSURANCE CO. Mobil Property NIA DOLLAR LOSS TOTAL INS. CLAIM PD 1E000„� 0 0 YEAR MAKE MODEL COLOR LICENSE NO. YIN# 30 IF MUIP INVOL. YEAR MAKE pQODEI, SERIAL NO. 40 IN IGNITION 0 0 MASONRY FIREPLACE NIA COMP EX AREA OF s EQUIP INVOLVED IN IGN. Dwel n 1 & 2 Farnll 4 1 ORIGIN Chimne ` b 7 Indoor Fire lass rl FORM OF HEAT IGNITION MATERIAL FOAM _r�177TYPE GHot moor, Ash 6 3 IGNITED Structural Member Fram Sawn Wood 8 3 METH D OF LEVEL OF ORIGIN Number of Stories CONSTRUCTION TYPE GEXTI GUISHMENT ; ti - Proc Anew from Grade to 9 feet abc 1 2 stories 2 Protected Wood Frame 7 EXTI OF DAMAGE Flame smoke8 MAN DETECTOR PERFORCE SPRINKLER PERFORMANCE Confi ed to room of orig p 9 B Co fined to structure Not in room didn't o err 4 No a ui ment present Mats ial generating. FORM TYPE most smoke Structural Member Framin 1 7 Sawn Wood 6 AVENUE OF SMOKE TRAVEL WEATHER 2 CLOUDY - O enln In construction COb7ITIONS ED. officer in Charge: Data PAUL D CHISHOLM CHIEF 4110190 Comnients for this Inoldent have been prinled on an additional comments page. 2,8 �6 tg I. SENT BY: 4-17-96 ; 9:12AM 5087786448-+ 1 508 790 6230;# 3 Commo fiii for Incident; 96 000347 Exposure: 00 Date: 4/16196 RECEIVEC THE 911 CAL.REPORTING THE CHIMNEY FIRE 352 CASTLEWOOD CIRCLE.RESPONCE ENGINE 02 WITH FIREFIGH ERS WASIERSKI,GRANDAW,AND SYLVESTER,AND THE TOWER 820 WITH LIEUT.CADAIN AND FIREFIGHTERS LANMAN O COLTON, WHILE EN OUTETHE FIREALARM OFFICE REPORTED THAT THE POLICE WERE ON LOCATION AND REPORTING THE FRE HAD SPRE AD INTO THE HOUSE,I HAD THE FIREALARM OFFICE STRIKE THE BOX. UPON ARF IVAL ENGINE 822 WAS SET UP ON SIDE ONE OF THE SINGLE FAMILY WOOD FRAME,THE ONLY SMOKE VISI ILE WAS FROI I THE CHIMNEY.BARNSTABLE POLICE OFFICER MET ME IN THE FRONT YARD AND REPORTED THAT THERE VAG FIRE IN WALL BEHIND THE MANTLE. FOUND THAT THERE HAD BEEN A FIRE IN THE FIREPLACE AND IT APPEARS TO HAVE STA TED A PARTION FIRE.CHIEF CHISHOLM ARRIVED ON LOCATION AND WAS IN COMMAND, ACTION T EN ENGINE COMPANY ADVANCED 1 150 FT. INCH AND THREE QUARTER HAND LINE INTO THE LIVING ROOM, REMOVED THE MANTLE AND PANELING AND EXTINGUISHED THE FIRE,ALSO THE BOOSTER LINE WAS IN THE YARD TO WET DOWN HOTOBJECTS FROM THE HOUSE. TOWER C PANY, PLACED SALVAGE COVER OVER THE LARGE BIG SCREEN TV,CHECKED THE ATTIC FOR EXTENSION OF THE FIRE D REPORTED BACK NO EXTENSION,THEN USED GROUND LADDERS TO CHECK THE CHIMNEY FROM THE TOP DOWNANI INSPECT CHIMNEY FOR ANY FIRE,TOWER REPORTS BACK ALL CLEAR NO FIRE. HEAVY RE ICUE 821 CREW USED SAWS/ALL AND SKILL SAW TO REMOVE WALL STUDS AND PLYWOOD AWAY FROM THE BRICKWORK TO CHECK FOR EXTENSION,RESULTS ALL CLEAR.THE HEARTH BRICKWORK AND GLASS FIREPLACE D R WAS THEN REMOVED OUTSIDE. ENGINE 82 8 AND RESCUE 827 ONLY STAGED AT THE HYDRANT. BARNSTAE LE POLICE OFFICER ALEXANDER FIRS'TON LOCATION ALSO ASSISTED IN EXTINGUISHMENT USING THE D P Y CHEMICAL FIRE EXTINGUISHER FROM HIS CRUISER. THE CAUS OF THE FIRE APPEARS TO BE FROM A DEFECT IN THE ORIGINAL CONSTRUCTION OF THE BUILDING,THE MASONRY EEMS TO HAVE BROKEN DOWN OVER TIME AND CREBOSOTE WAS SEEPING THROUGH DURING FIRES AND EN THE 1/4 IN H PLYWOOD AND PARTITIONS BEGAN SMOLDERING.THE FIREPLACE WAS IN OPERATION THIS EVENING NTIL APPROX 2 30 TO 2300 HRS.AND THE OCCUPANT OF THE HOME CLIFF RWHALEY STATED, HE LET THE FIRE BURN OUT AND THEN S HE WAS SHUTTING DOWN THE HOUSE FOR THE NIGHT, HE STARTED TO SMELL LIKE A TAR PAPER SM LL WENT IN THE LIVING ROOM HEARD A POP SOUND AND THEN SAW SMOKE COMING FROM BEHIND THE MANTLE,HE ENT AND CALL D 911 AND WAITED FOR HELP TO ARRIVE, I HAVE ESTIMATED DAMAGE AT$15,000, INSURANCE INFORMATION ON THE BUILDING WAS NOT AVAILABLE FRO MR. WHALEY AHO OWNS THE HOME JOINTLY WITH HIS MOTHER MARYLIN R WHALEY. BARNSTAS LE POLICE OFFICER ALEXANDER IS ALSO DOING A REPORT ON THIS FIRE,THE POLICE CASE NUMBER IS 9600977 . THE MAIN LECTRICAL BREAKER WAS SHUTDOWN BECAUSE WATER FROM EXTINGUISHING THE FIRE RAN INTO TH BASEMEN AND WATER WAS RUNNING INTO THE ELECTRICAL PANEL. COMMAND WAS TERMINATED BY CHIEF CHISHOLM ALL COMPANIES MADE UP AND RETURNED TO QUARTERS AT 0125 HRS. ENG114E 822 TURNED THE PROPRTY BACK OVER TO MR,CLIFF WHALEY AND RETURNED TO QTRS.AT 0132 HRS. CAPTAIN JOSEPH P.CABRAL JR. 4/18/00. FIRE PR EV NTION OFFICE:COULD YOU FAX A COPY OF THIS REPORT TO THE BUILDING AND WIRING INSPECTORS,THEY SHOULD IN BPECTTHIS PROPERTY, > . l4o %S ot VIBL f Comrnor-4 pgt3toW1 d o cr�,G��soc�Q . 'T�s� en►�QI;7 h'c.� �lKk`( ��:c"C' �Ov�ES , o Ir � � � " Assessor.'s- 1 ;ce 1st floor Ma dn Lot e29 Permit# nservation Office 4th floor) A az '9 y Date Issued card of Health(3rd floor) 26 Engineering Dept. Ord floor) House# Planning Dept. (1st floor/School Admin.Bldg.): �'��*EAL MUST BE MPLIANCE Definitive Plan Approved by Planning Board 19 E S (Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.) - �$ (�®DE AND TOWN REGULATIONS TOWN OF BARNSTABLE . Building Permit Application Protect Street`A/ddress �5 � Z—L 6-Qv D 1 Village H 7 t N(v i 5 Fire District YAn Jry �v l Owner /V) A R 1 �`/JV .`( W � 11 (^ �y Address-r R U A S Telephone � � 5 Permit Request: Zonin District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of ADDeals Authorization /t/ Recorded Current Use Proppsed Use Construction Type Z::�—/*'5 Eaistinp Information Dwelling Type: Single FamilyTwo familyMulti-family Age of structure 2 Basement Historic House Finished �— Old Kin 's Highway Highw4y Unfinished Number of Baths No. of Bedrooms Total Room Count not including baths / �V First Floor �— Heat Type and Fuel D'd �1 A Central Air Fireplaces Garage: Detached Other Detached Structures: Pool ' Attached Barn None Sheds Other Builde Information Name �J,{e�l J Te hone number Address License# Home Improvement Contractor# J � Worker's Com nsation # NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �J Proiect Cost Fee \� SIGNATURE DATE_ / ,d 1,2 q / Vt I BUILDING PERMIT DENIED FOR THE FOLLOWING ASON(S) BPERM T WHALEY, MARILYN J. FOR OFFICE USE ONLY 137 SHED ADDRESS 352 CASTLEWOOD CIRCLE, HYANNIS VILLAGE w OVINER MARILYN J. WHALEY DATE OF I!ISPECTTON: 1 f FOUNDATION r FRAME Y , INSULAT70N , ' 1 ` FIREPLACE s ELECTRICAL: ROUGH FINAL 4 PLUMBING: ROUGH FINAL GAS: ROUGH FINAL . FINAL BUILDING: r F DATE CLOSED OUT:! '� ASSOCIATE PLAN NO } t 4 g 1 s..... • • TOWN OF BARNSTABLE k BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB. LOCATION 3 bvc;Z, Number Street address Section of: town "HOMEOWNER" I a //Z G / Name Home phone Work phone— PRESENT MAILING ADDRESS City town State Zip P co de The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor DEFINITION OF HOMEOWNER: Person(sj who owns a parcel .of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures accessory to such use and/or farm structures A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be res onsible for all such work erformed under the buildingpermit. P (Section 109. 1.1) The undersigned "homeowner" assumes responsibility for compliance with the Stat Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said proc dures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL V Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Controlq • `v HOME OWNER' S EXEMPTION .The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided' that,,.if Home Owner engages a person(s) for hire to do such work, that such Home Ownex shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for .licensing Construction Supervisors, Section 2. 15) . This .lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The.. Home as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/.her: responsibilities,. man communities require, as part of the permit application, that the Home -Owner certify that he/she understands the responsibilities of a supervisor. . On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification. for use in your community. L'j Assessor's otftce';(lst floor) t A;se4sar , rriap:and' lot number TN f t0 Board of Health brd floor): a Sewage Permit: number ... Engineering Department (3rd?floor) r House number,:. oeeabs LL, • 39• e00 Definitive Plan 'Approved by Pipnning Board _______'________ gE0MAI M1\ ---------------19-------- APPLICATIONS JPROCESSED�':8:30'�9:30'A.M, and 1:00 2:00 P.M. only ri TOWN, OF BARNSTABLE BURRING INSPECTOR APPLICATION PERMIT TO ... TYPE OF: CONSTRUCTION 'Ef ................. ! .� .................. ....................................... ................ - :.....................19........ TO THE INSPECTOR OP BClILDINGS: The undersigned hereby applies for a permit according µ'to the following information .......... Location .. a. .ter �: .: ` 1� C�/rQC ......... C t�.�...;a. .....� ............... Proposed Use ...: .............- _ - ' 1 ?I . ............ .................... . ................................... Zoning District ... ` ... .. (4 . ..�.................................................Fire District :��:;d; Name of .Owner .. .......::5%.�-�:, .:'�...................Address .......... '�Y. ....... Name of Builder- .': ...Address ...L.........: f Name of Architect ..^. . I - � /74�.............................:....................Address 'Number of Rooms ........................................Foundation :J ExleC r I r ri :....i. ..........r� L ........ , fing ......... Floors ..,�����:.1�f.-�-�`:.1.........................................................:..Interior ........ k � Fireplace ...... �. �X J .. .. Approximate Cost ...:....1.0 �` ............ ..:............... ..... - y _� rU f Area 'Diagram of Lot and Building with 'Dimensions �+ ' �. Fee;'..,). - � r - t , P. C. OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS Thereby agree to conform to all;the Rules a construction. nd Regu�lations,of the Town of Barnstable regardingl the.above ' 4# Name .....J.C..�#. . .. .......... i, Construction Supervisor's license C 1' 1 a /irob w Aro6 1 4,4 aw � 1 d „ a . - � ` 'N I+ levy. i�•rr�+4 1 u S// - 2 =Y II 11 '4 I II;. do•LI-.07 '. 1 �I 1 ,I Assessor's office (1st floor): C �YS *THE TO Assessors ma and lot number �7" � .�� s �uRT BE ..o �♦ Board of Health (3rd.floor): / p Sewage Permit number ........ .. ... .. �.. _ ' d ri�gg �{ � �. g !"B'C�by� Z IWSTAILL, i Engineering Department (3rd floor): �i--� '` � "t ���" r�9 � g P � �J a2 � o(� .. s'�i� �. y��e{a� moo b eye House number .... ..TOWN REGULATIO �Fp YPT d` ............. Definitive Plan Approved by Plarining 'Board ________________________________19-------- . APPLICATIONS PROCESSED"8:30-9:30 A.M. and 1:00,-2:00 P.M.,only t TOWN OF BARNSTABLE BUILDING INSPECTOR ` APPLICATION FOR PERMIT TO .. w.� ..:....�.�0.�5�: :.D,r1.i�,l�n..:'t'� �t:.�� 11I.�1� TYPE OF CONSTRUCTION ..... Y•`{• r 0........ ......... ... ...................... . .�.....1.-.5..................19... TO THE INSPECTOR OF BUILDINGS: , The undersigned hereby applies for a permit according to the'following information: Location .. :.....::..1— �� �Q. .:...:... r\RC ..... :.........1V..It4` .,...:......... Proposed Use ....... ............ ......... .. ............. Zoning District ....,.f �` / .........Fire District Name of Owner ......... .. .. ..�.t.�......Y� `ice ..Address ...:...... .. .. Name of Builder Q ....Address ............. Z.CGt.. i.lv. ��...... � QV � Name of Architect ..: ./j ,................ .....Address .... ............... . JJJ Number of .Rooms .:.,. .....................................................Foundation .�x.4.....VAI.1Lt..�.....Z.l� (•.lo�� Exterior l.('1 ....... Q.......`�.. Roofin g ...:..Z..... F "T.................... Floors ......:.....:.......:................:......... Interior .,........ . VSj :...................... ,.......:.......... Heating .16.... ..................Plumbing . -.._ .................... ... ... .......... Fireplace ......{ ./. ...:...:............................... .................Approximate'Cost .,���. :....... : Area •S `f' '.... i 'with Dimensions Diagram of Lot and Building Fee i Nj r 97,44 AH005315 OCCUPANCY PERMITS REQUIRED.FOR NEW DWELLINGS. I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. i Name z. w ...... .o......0 coup P.H.......... Construction Supervisor's License ...o-249(4PS ..... WHALEY, C. F. 'r No :.3.2.Q..7..$:.. Permit for .........Buil. d Addition .. ........................ 1 Dwellin ' } Location :..3.5�....G 1S.t),:QwQ.Qa... irc l.e...... ' P ^..'...: ..ayaahia ....................................... '.� � �:�'+ ........... _ •,� -a , �. , . Owner .. .... ... ..Whale y .................. Type of Construction .... t...k'.];.aMQ.......::.......... jT • ............................................................................... Plot l. . t........J........... Lot ........"................... s' - FT Permits Grantee! 'July 15.�. ...19 88 ^3 Date_of In_s'pection ... .................19 x D"` e Completed ...... .............. ..19 ! { r �. � . {. IM �y „:+.+,f.:: ., :�'*u..S.i� y.- r 1•- .:.f.!.o ., 'c _.����f ....::raki,+ '� � :. w y:.�ox:v �w�C/�Wo d7s:�'s-r�' .a .< ..-.�- *'Y'i. t.+' .i:w. �jr��7�.i.=..:.+:A Assessor's office (1st floor): � � OF t N E TO Assessor's map and lot number .... .j�,."...... .��...... .. Board of Health (3rd floor): \ �Q o ,Sewage Permit number ........./':........... %V............ i BA"STAnLL, Engineering Department (3rd floor): �� i co M 9 �+ House number ............................n.....Y35 A �}r1 a`,J.�.... � '°� d`0 a MA-1 Definitive Plan Approved by Planning Board ________'_______________________19________ , APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...r5; 1C,,..,T ,,,,,,,,�,�n,)C� �,,•_,l.�i.1;�.I��, TYPE OF CONSTRUCTION ... i7...... .............7- I.�� ..... ----........19.E TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .: . ........... ..........�`�� , ► .............. Proposed Use ... .(. .I .........-ati' t"� ........— `���� `,`::?.{.�I�l,►. ........... ........................................................... ZoningDistrict �.. ' / Fire District ........,7.�;�. ..... -� .✓.7....................................... ......,.................................... Nameof Owner ...... .. ..................Address .........'..,..,,..::.... ,. ...................................................... __. k� lr� �c.�..Fes_... i�1F(,..iQlr?.`-A dress-�~ ��%� +�` ► 1.... ► ,� Name of Builder :... . -T�h,.... ... ...... .....:f..__.............�d... .. ......` Mr•:i F :41 Nameof Architect ..... :.... .................................................Address .......................:_................................ .. ...................... om- , 'Number of Rooms ............ .....................................................Foundation S.`a.. .4.....'ii� -,.... .:�<.�.�n...—-3 !.1.►.. ' f E x-1 e r i o r ....... •:'>Q......... 1 � Roofng ....... � . : ... ..... . ,. ................... Floors ... sf•kG .........................................................Interior .........1 �� Heatingr} . ,.,..........................................................Plumbing ......... ../ ........................................................... l / .. Fireplace ...... .t!..............................................................Approximate Cost .........to►,.�- .............. .......................... Area V . ............. .:...lF' <.... Dia ram of Lot and Building with Dimensions (� -0 9 9 Fee ......................................... S4 i m 1I(J, yo ' OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. — Name ....,.?. .�A....... .......... „• C Construction Supervisor's License WHALEY, C. F. A=273-036 No .. .2.0.78„ Permit for ..Build Addition ......................... ......9-in le_„Family..Dwelling„ . ... Location ..........3.5,2... astlewood Circle Hy..anni s..................................... Owner .........Q.,.... .?...Wha.leY.......................... Type of Construction ...Fr.ame.......................... ............................................................................... Plot ............................ Lot ................................ Permit Granted ........July..,1................19 88 Date of Inspection ....................................19 Date Completed ......................................19 40�0 Assessor's office(1st Floor): % - SEPTIC Sys fEM MUSS' BE Assessor's map and lot nu r o -� D3 INSTALLED IN COMPLIANC Conservation [} ,�"/3 ,ujZ Wf mpo P�O�THE rO`e Board of Health(3rd floor): �1�0NMENTPA►L.�+O® . . Sewage Permit number aeaisr�nt TOWN REGULA`®N Engineering Department(3rd floor): t � ra o• • House number 1' " 5 2 Ito HAI Definitive PlamApproved by Planning Iloard 19' APPLICATIONS PROCESSED 8:30-9:30 A.M.and•1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION T 'W�11 J7 19 l Q ].- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location -_F�S�-� Proposed Use Zoning District Fire District kA-11 ra qu Name of Owner Address Name of Builder ��1 P���i S Address _ 10 1. ekc-,— g2AA— Name of Architect Address Number of Rooms 1 Foundation / Exterior �� Roofing l Floors -.���`-qL- Interior L Heating Plumbing Fireplace P � Approximate Cost � Area 41 Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Constructio Supervisor's License _ D Se'1 � 7 #1e.9 /61yffL WHALEY, M. f` 35451 ADD BATHROOM t No Permit For Single Family Dwelling Location 352 -Castlewood Circle -� Hyannis Owner_ -M.. Whaley V. Type of Construction Frame Plot Lot ` `] Permit Granted . October 16 , - 19-i 92 0 Date of Inspection q - 19j Date Completed «° /�/` 19 ' 1 t , S a i yr�- x 1 • r rcf � f .t S � F t Jack. Gillis Construction QUALITY BUILDING&REMODELING Fully Licensed&Insured 10 Leda Rose Lane 508 420-1391 Marstons Mills,MA 02648 - _ � ' ✓fie �oviniro�e�aeall�.n�..,llii::xrc�il,7e/li rU?"t i��C•Ui'`_.:C11 i{Lvi(i tAC i Uri l I i? ✓;G':1S Lla.iVli L•ihv ii I �• =,fir iU!I .!i .ti 1 Y I 1 �ti,i� I" , ara S,'DEa _37 ADMINISTRATOR uai SLV I ._. r COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF 1010 COMMONWEALTH AVE. r MASSACHUSETTS BOSTON, MA 02215 _ LICE NSc EXPIRATION DATE C',')4STR. :;UPERVISOR O 6/3 0/1 9 9`* EFFECTIVE DATE LIC-NO. RESTRICTIONS `DUNE �U6430/1992 051471 ,JOHN F GILLIS 1J LEDA—ROSE LANE SS ti 024-36-1773 sf"I q TG^4S MILL:; 101.4 0264 n PHOTO(BLASTING OPR ONLY) FE(�E(- (� I' 1 0`•�. 0 0 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY `. HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER 1 1 DOB: 9 11 /13/ 1947 THIS DOCUMENT MUST BE �✓ '-^ - CARRIED ONT4E PERSON OF �/ SI 14ATrUYREOFLICENSEE THE HOLDER WHEN EN- COMMISSIONER-\C OTHERS-RIGHT THUMB PRINT OAGED!N T)1ISOCCLIa.ATION. �. / n i l