Loading...
HomeMy WebLinkAbout0064 CEDAR STREET 1-r �ti Town of Barnstable Building Department •:ay �:' �pFTHE 1p� o Brian Florence;CBO Building Commissioner 'MUST COMPLY WITH HOME OCCUPATION BARNSPABLE. * 200 Main street,Hyannis;MA 0260°11lQLES'AND REGULATIONS. FAILURE TO 9 MASS. -00l PI Y MAY RESUL"TIN-FINES �es9• �� www.town.barnstable.ma.us�pTED MAi A , Office: 508-862-4038 Fax:, 508 790-6230 _ Approved: R( a A ., Fee:-" 3 S Permit# HOME OCCUPATION:REGISTRATION::: Date:0� ®] aJ a Name Sn 1�I USf�V.0 �J5_JV1 '-1 Phone# ._. _T _ 1 - - Address 11 bRFZ S�'- Y��11�1//ylf1 (Z loD4vilfage:. Name of Business: �1 �� �A 1.n1'tlllT Type of Business 'PA d�`r�/0C Map/Lot: //\\ V INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a.home:occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no'increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customaryhome occupation shall bepermitted as of right subject to the following conditions:. • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. - • Such use occupies no more than 400 square feet of space. " :There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. No traffic will be generated in excess:of normal residential"volumes. • The use does not involve the production of offensive noise;vibration,smoke;dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. There is no storage or use of toxic or hazardous materials,,or flammable or explosive materials,in excess of normal household quantities. Any need for parking:generated,by such use shall be met on the same lot containing the Customary Home Occupation,.and not within the required front yard. • There is no exterior storage or display of materials or equipment:. " • There are'no.commercial vehicles related to the Customary.Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,.and one trailer not to.exceed 20 feet,in length and not to . exceed 4-tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business;the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: 19A JA',-- Date:00.1 Homeoc.doc Rev. 10/17 Town of Barnstable Building Department' MUST COMPLY WITH HOME OCCUPATIONBrian Florence, CBO RULES AND REGULATIONS, FAILURE TO Building Commissioner ^r}�,API.Y MAY RESULT IN FINES 200 Main Street,_Hyannis, MA 02601 vwyw.town.barnstable.ma.us Pre-application for Business Certificate Date dQjg Map Parcel V Applicant Information Applicants Name a j v!tw VQ LQ'j 1 h- Applicants Address G `i CF-Di9 R 5 N N Email Address G A-ro5E CO 2 a2 CQ) i C L(-)V n. GOrn Telephone Number — v2 Listed ❑ Unlisted Business Information New Business? es No Business is a registered corporation? ________________________. Yes ONIf yes Name of Corporation Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occupation? ________, Yes No If yes then a Home Occupation Registration is required—See Building Division Staff Name of BusinessfllC�V "PAIN.t(i\➢ Business Address 4 C 2 Sfi - -N Y11 rU PV 15 jIn A - 3 M(DJ Type of Business jy'�'►(�� Building Commissioner O e Us Only nditi C Building Commis one Date - — Clerk Office Use Only S SN i own of i5arnstame Building Department Services FTF1E Tp� •', Bri.an Florence, CBO o� Building Commissioner BARNSTA=. ` 200 Main Street,Hyannis,MA 02601 Muss. 9 1639• ��� www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION I�ate:� Name: 'fin R 2A YU . G W L YL-R 1'►')E L U tpo a H phone O Address: G� GEL2jM Sr -- N YNJrJ 1'5 -f A- O.?Gc)1 loge: Name of Business: `:YQ R Diq YU '5 PP, YU-T I YJ C, • 19]W 1-1 NC�. Map/Lot- __01 Type of Business: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,'subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the.dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is canted on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • ' Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing-the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included • No person shall bg employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: Homeoc.doc Rev.06/20/16 _ __-......... ..........�_ ..... \^ YOU WISH TO OPEN A BUSINESS?F�l rnation, F.3usiness cert-ificetas 1,cost$440.00 for 4 years). A business certific.ate ONLY REGISTERS YOUR NAME in town (which you -)ust do by M r i ust first obtain the necessar signatures an this form at 20.0,Main St.,-Hyannifsi n , 31.-it does riot give you permission to operate.) You rn � y siness Certificate that is � � MA 02 601 (Town Hall) and get the B u . � - | � u*/ | _ ' BUSINESS YOUR HOME ADDRESS-.-G-Li---CEO-op, 5:5E r TELEPHONE Hom,e Telephone Number EIN N'AME OF CORPORATION: TYPE OF BUSINES IS THIS A HOME OCCUPATION? —YES _NO- �rj L,)j BER QaQ (Assessing) startingWhen a n&w business there are several things you must do in orde!r to be in compliance~ w�h��aru�o and ��d ofoh,oT"o�n of �= `="��e '^ ^fonn is intended assist obtaining yournaynoeo� You vuS/ GO uPuu Main St. - (corner of Yarmouth'business t�stuxn *o & MamSne:^) m, "=^==''" � 1. F3UILDING COAAMISSI ER' OF qE MUST COMPLY WITH HOME OGGLWAI i ^'~ ------hCOMPLY MAY RESULT IN FINESV �_ COM ENZ: &k74e:5a a ac/ IQ ,. ) 4aal Ora - - 8O�ADOFHEALTH _ -- This individual has been informed of the permit requirements that peftain to this type ofbusiness. ' Authorized EUgnatuha°^ -----'' -- ' 3' CONSUMER AFFAIRS (iJCE0S|NGAUTHORITY)This CO0S| DQ-' !-ndiv;duo|hesbeeninformedoftheiicenoingrequirementothmtpertointothistypeofbuoineen Authorized Signature* ^ . COMMENTS: ' ^ . ' - -- - -- MOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ' Map V0 Parcel Application # Cd/ S`n S 6 Health Division Date Issued �" p Conservation Division Application Fe =,. Planning-Dept. Permit Fee 0`�'� Date Definitive Plan Approved byPlanning Board Historic - OKH Preservation /Hyannis Project Street Address Ca C e( y U Ace, Village N\0 R,1A Ud` - --- -- -. Owner 3J Al n y- M(LL, , L C Address_Li N(l rt ho(A' Telephone Permit Request Ic.��.OV �jLi �I,��OVI`J " i. crror«' ( LAID D ns r -- — Square feet: 1 st floor: existing proposed _2nd floor: existing __proposed Total new Zoning District Flood Plain -Groundwater Overlay Project Valuation IS, Construction Type Lot Size _ Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure 5ki KA Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes VNo Basement Type: Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) . Basement Unfinished Area (sq.ft) Number of Baths: Full: existingJ___ new __ Half: existing new Number of Bedrooms: _ 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 dNo Fireplaces: Existing_ New _ Existing wood/A oal stove:;❑Yes ❑ No Detached garage: ❑ existing ❑new size_Pool: ❑existing ❑ new size — Barn: C; fisting Q-nev4size— Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other- Zoning Board of Appeals Authorization ❑ Appeal # Recorded LX Commercial ❑Yes No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name fl)CL,V[r , J R-C, Telephone Number e3„2 Address y+k WA i"k,; c��.r�Ct License # e�(7'Uf "e, Y0,Y, G Home Improvement Contractor# JI coo I G4 GD V I C� Worker's Compensation #(JC ' (X O f�j q 6 o A AL CONSTRUCTION,DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO. U ' XCO E -. SIGNATURE DATE } . FOR OFFICIAL USE ONLY } APPLICATION# / DATE IS-SUED } . ) MAP/P RCELNO. . } ADDRESS VILLAGE . \ } OWNER \ \ ƒ DATE OF INSPECTION: / FOUNDATION } FRAME \ INSULATION ^ } FIREPLACE } ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH} FINAL- GAS: ROUGH FINAL FINAL BUIL DING ) . } DATE CLOSED OUT \ ƒ ASSOCIATION PLAN NO. } • � .. . . Z oFI"E rain. 1' : 1m� Town of Barnstable ArFD MA'S A Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder - I,c ez 'J' .,as Owner of the subject property hereby authorize G © I to act on my behalf, in all matters relative to work authorized by this building permit application for: CcJa,r S (Address of Job 01 Signature of Owner Date Print Name If Property Owner is applying for permit, please complete the Homeowners License Exemption Form on the reverse side. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOlDHR\EXPRESS.doc Revised 040215 eooremoncueull�o�C �iW�a�ccseCt Office of Consumer Affairs&Business Regulation License or registration valid for individul use only U7,ME IMPROVEMENT CONTRACTORbefore the expiration date. If found return to: gistration: 160164 Type: Office of Consumer Affairs and Business Regulation piration: .7/2/20%. Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 GEORGE DAVIS, INC.-' GEORGE DAVIS 33 NORTH MAIN STREET. SOUTH YARMOUTH, MA 02664 Undersecretary Not valid without signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards -- -- c-----�---- I.0 IIJlI III LIUll JUl/CI V/JVI - - License: CS-056130 . w:r IS GEORGE F DAVIs4 33 N MAIN ST S YARMOUTH I%A Q 64 ` Expiration Commissioner 03/01/2017 The Commonwealth of Massachusetts . Department of Industrial Accidents Office of Investigations _ 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): G ryl ro r- @ 0—V 0- _ 1, Address:L1�? ` i,� M Cc.I�L(_� VeE� City/State/Zip: t vQ, u ( :v Phone #: Are you an employer? Check the appropriate box: Type of project(required): LTZI am a employer with 13 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. ED/Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for mein,any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.1 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.❑ 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#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: A s'syO Lai{,cl !f j ugjkt r( L( Policy#or Self-ins. Lie.#: ( y CC OOI�O l� O .O��hu� Expiration Date: Job Site Address: C 4 C cd(),.ir Ar C et 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 unde t e pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: �h d� Q_ �1� 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#: GEORDAV-01 BDUQUET ACORO� CERTIFICATE OF LIABILITY INSURANCE DATDIYYIY) 3/23/223/2015 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(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 lieu of such endorsement(s). PRODUCER CONTACT NAME: Mason&Mason Insurance Agency,Inc. PHONE 781 447-5531 FAX (781)447 -7230 458 South Ave. A/C No. o Ell:( ) A/C,No Whitman,MA 02382 A DRESS:info@masonandmasoninsurance.com INSURERS)AFFORDING COVERAGE NAIC p INSURERA:The Travelers Indemnity Compan 25658 INSURED INSURERB:NGM Insurance Company 14788 r George Davis Inc. INSURERC:Associated Industries Insuranc 33 North Main St. INSURER D: South Yarmouth,MA 02664-3145 INSURERE: 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 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER ADDLISUBR MM/DDmFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR 16807900M2261542 01/12/2015 01/12/2016 PREMISES Eaoccurrence $ 300,000 MED EXP(Any one person) $ 50,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident) $ 1000,000 , + B ANY AUTO M9M28491 10/26/2014 10/26/2015 BODILY INJURY(Per person) $ 20,000 ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ 40 Q00 AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIREDAUTOS X AUTOS Per accident $ 1,000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER T - AND EMPLOYERS'LIABILITY STATUTE ER C ANY PROPRIETOR/PARTNER/EXECUTIVE YIN CC50060143902015A 0 310 5/2 0 1 6, 03/05/2016 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,descr be under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN George Davis Inc.North Main Street ACCORDANCE WITH THE POLICY PROVISIONS. South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Mass. Corpor4tions, external master page Page 1`of 2 1 x, Corporations Division Business Entity Summary ID Number: 205621757 i Request certificate -Nevv search Summary for: 33 NORTH MAIN STREET LLC The exact name of the Domestic Limited Liability Company (LLC): 33 NORTH MAIN STREET LLC Entity type: Domestic Limited Liability Company (LLC) Identification Number: 205621757 Old ID Number: 000926624 Date of Organization in Massachusetts: 06-14-2006 Last date certain: The location or address where the records are maintained (A PO box is not a valid location or address): Address: 33 NORTH MAIN STREET City or town, State, Zip code, SO YARMOUTH, MA 02664 USA Country: The name and address of the Resident Agent: Name: GEORGE F. DAVIS Address: 33 NORTH MAIN STREET City or town, State, Zip code, SO,YARMOUTH, MA 02664 USA Country: The name and business address of each Manager: Title Individual name Address MANAGER GEORGE F. DAVIS 33 NORTH MAIN STREET SO YARMOUTH, MA 02664 USA In addition to the manager(s), the name and business address of the person(s) authorized to execute documents to be filed with the Corporations Division: Title 'Individual name Address SOC SIGNATORY GEORGE F. DAVIS 33 NORTH MAIN STREET SO YARMOUTH, MA 02664 USA The name and business address of the person(s) authorized to execute, acknowledge, deliver, and record any recordable instrument purporting to affect an interest in real property: http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=205621757&S... 9/1/2015 17 krigineering Dept.(3rd floor) Map, Parcel "�`d Permit# (o 0 LJ House# Date Issued Z Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30) Fee { Conservation Office.(4th floor)(8:30-9:30/1:00-100)- Planning Dept.(1st floor/School Admin. Bldg.) �1HE Definitive Plan Approved by Planning Board 19 • BARNSTABLE. rEO IAAr e`� TOWN OF BARNSTABLE Building Permit Application Project Street Address_- C e(,� Village k Owner &. LjjAddress Telephone — ,3 rn off. ' Permit Request V"1101 IDPA-s c� 1 �"2 First Floor . square feet Second Floor square feet Construction Type Estimated Project Cost $ -- Zoning,District Flood Plain Water Protection Lot Size Grandfathered Q Yes ❑No Dwelling Type: Single Family Q Two Family ❑ Multi-Family(#units) Age of Existing Structure U h k Aoc.,,r\ Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: Q Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New UTotal Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: Q Gas ❑Oil Q Electric Q Other Central Air Q Yes Q No Fireplaces: Existing New Existing wood/coal stove Q Yes ❑No - Garage: Q Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) Q Barn(size) Q None Q Shed(size) Q Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑"' a ` . Commercial Q Yes Q No If yes, site plan review# Current Use Proposed Use wa ? Builder Information rim Name Telephone Number A d h ' Address t/ 1 License# (44, 136 Home Improvement Contractor# 100 61 co Worker's Compensation# l 14 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 SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. 4 ADDRESS VILLAGE OWNER y DATE OF INSPECTION: - FOUNDATION FRAME - .4 INSULATION - FIREPLACE - ELECTRICAL: ROUGH r FINAL w PLUMBING: ROUGH FINAL GAS: ROUGH FINAL . FINAL BUILDING - DATE CLOSED OUT ASSOCIATION PLAN NO. i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston, MA 02111 w1Uw.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: 33 1 Ut�� � � 7 _U0 cz City/State/Zip:�J.yr�� (� � (� (e(o� Phone#: Are ou an employer?Check the appropriate box: . Type of project(required): l. 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.❑ I am a sole proprietor or partner- listed on the attached sheet. ❑ Remodeling ship and have no employees These sub-contractors have 8. VDemolition working for me in any capacity. workers' comp, insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their ]0.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 1 1.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.]t 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. DD Insurance Company Name: Policy#or Self-ins. Lic.#: 0u)442 q Y 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 above is true and correct. Signature: Date: WU Phone#: Official use only. Do not write in this area,to be completed by city or town officiaC 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# 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 emerprise,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 owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction 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 Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. 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 permit 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 of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. 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 Revised 5-26-05 Fax#617-727-7749' www,mass.gov/dia f October 30, 2009 Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 Re: 64 Cedar Street, Hyannis To Whom It May Concern; Please be advised that there is no electrical service in the barn to be demolished that is located at 64 Cedar Street,Hyannis. Regards, Bruce Alberico Alberico Electric October 30, 2009 Building Department Town of Barnstable ' 200 Main Street Hyannis, MA 02601 Re: 64 Cedar Street, Hyannis To Whom It May Concern; P 1 Please be advised that there is no in the barn to be demolished that is located at 64 Cedar Street, Hyannis. Regards, Peter J. Hassett Hassett Mechanical, Co. To: Building Department Town of Barnstable Barnstable, Ma. From: Dr. &Mrs. William Johnson 4 Church Street Yarmouthport,MA 02675 ► Re: Agent Authorization Project Address: 64 Cedar Street, Hyannis To Whom It May Concern: Please be advised that George Davis, Inc. is authorized to act as agent on my behalf with regard to the project under review in this building department. x� =�•}�✓,-� Date: DESIGN+BUILD+RENOVATE 33 NORTH MAIN STREET,SOUTH YARMOUTH,MASSACHUSETTS 02664 508-394-0832 508-394-5460 FAx GeorgeDavislnc.com Town of Barnstable 200 Main Street � Hyannis, MA 02601 `' J � L' h T.bl y V' Notice of Intent to Demolish or Move an Historic Building/Structure Is Building/Structure located in a Local or Regional Historic District: YES ❑' Nb ❑ If YES, Protection of Historic Properties Bylaw does not apply and it is not necessary to fill out the remainder of this form. PRINT IN INK Date of Application: ' ( �Q Building/Structure Address: _ G4 Ced&r Aveeot Hy0a"utu Number Street L, Town State Zip Assessor's Map Assessor's Lot#: d� Is Building/Structure listed on the National egister of Historic Places or on a pending list with the National Register of Historic Places: YES ❑ NO How old is the Building/Structure: �� x,, oa) I How is the Building/Structure Occupied: Vacant Number of Stories: _ Architectural style of Building/Structure, describe if not known: Material of Building/Structure: (A 0 t� Is t s Building/Structure associated with one or more historic events or persons. Please list event, description or names: may, Type of Building/Structure and proposed work: S - {u I&M,014,0H, Explanation of the proposed use to be made of the site: Left,{, 0,b tu- O VC Zoning District: M 1� Fire District: �l Applicant's Name: U L )'d C' ® Address: `) !� — t l l_ � �L l� �tl� 1 (���.}�4 C7i L U`L. H j� r t' Nu \Stregt Town State Zip Owner's Name: ?� �A J ( L L l 0,w� �/ ��y M /� �+ Address: '7 l.>'� L1 (/� J� I Q rU1 - u t�/ 7^ 1 I A + l0 IC Nu er Stre. Town State Zip Contractor: Address: c1' tlt Yara.n NA ar..614 Number Street Town State Zip Program of Lot and Building/Structure with dimensions: Name: ram.: ,3 I MN r �• �i ��'v ,,ppVA W/W f ��fp Sri BROADVP Agow A2, E� F + AMA 7 _ LL;• .a,yaw�rA y?p _4n ,� l > ice` .41! r t -.,q ME o ,}�I�y t �,_�1 1, t*". 1�{•�i' r a"4 'r �,' � �� - '1�fff E '.� "t ! .r RE MIT MEN g'g <s�. 3 k -aa.'.'�- � .� .G �r `",'S 3.�'. -Gr.•yx';�Ae�T .s q't• 1�A �a�^r ,a WINN r •Y �.•r r,...,,1; `•' 'sue'"'`�"' cap �44+ygk , 4��Ai �xt .r tt s } if' *O✓��1!%�;0' '"`r' y.r } .::�._ � .�._ .'�a''cs. fie. ..c �. 1 RFas A. ,..�3,., .,�` q .��i�., �e� AM BM a VQ at ga . �� `.t I'M s• 3 i � g vp7 _ 2 W {, _ _ �"��fir. f•t -ix �.��-�+- ,r'.�cv` T 3 -. •�' ` si-im �Z� , i� � a'i #•a`.�.�� �`y r !y t - � .i ��� �w-;t"''xiaT"."`� -ram .�-v z..�,.z'- l p11 �'4v� ay- d ti ' x _:y, 4, `. � w M PAE ME 9 i 4 - - '` � �•;.p 'yam-ttr14f ra ME IRS ' '�tc��-Fel�''r� , ,7 w ter" a�. � + lt", �a '��� ;E" � � ��'f 5 r4 -� �,�'cC"''�'L.. '����'� -,sue` '3P�g� �..;Kt� �_�,•�•-s �'- '.a,af�+"—�x y '� r c - k-.•s C� taF�'��- .t �3 -r+..,r\'�'' �'}�� � 7 �"F ?: s e3 sue' z � 4 \ � �= 9'�' '✓^���— � � i"3—Z x`2 9 4c2'Y�JA�Hv fi li wi L �'`i :Y\ �} _ e y 'ail # k >. -fix'Sf � V . �.�MOR 'yix"i_ N °k"s r ,� i ckn'.`z_� .p•'-_ -,,.f? ,�-�' r�s �," � rt� �:�- .` "'"�'„✓ .�? -Y-r}4. 1 iyr'i a �-t XT w # P f l u. ... y � - yva t�. "--'�' `�' mac,' - # � ��� C,5"F.. �� -�" '3` hx 1 dr Mpg �, �_� ,��pit".:- ''ae'7 � ��`�," „��� � �'�*��: �� �,S�✓ 'rL ��> s � p Fes` }':,�„�a�Y�' �.''' ;�..r �"s�- ­0.f- t� 'ri 'ru � 'z"s ' a' n-4,�5 +` Si r } ,g"' v�'t "S , S� u� ,� �2"3 bH '., x 5€ �s r, � �-`��.,.� Y.� � 7 5��,t�z-,;.�a- s 3s. -: r*, �i;a. €-L- r f,e T�•�y'„'�"� S�� y� � 'x �' fie F 1 k4 fi C "Y ; .� .,,a- '�' k C yt'(.` S s>k T'?:� ,r* kr� 1 rx " � 1 •`� "�'. rs` '"' �..: ..�- r `ems .+ 3 '-<, _x " _ * k. ..,'" {ate 7:. r a ✓ >i r g� �+'Sv' k r'��_ br.- c i 'ut' ♦ 53 ` s4 -5e� > r I, s r "'; '7 =� �:.,,_ 1��..-, "�•?'� x,a,,- f;3e _ ..� ',�;.�-.'��. .fir_;�. �.�.:� Al.,.. -. gg J. wMM •< �; i '. is S s N .k-.y a "a x;; _ d f MINt saers� r k"p x "�� FM f k ice£ P {a€ 'IF ✓_ '�� F}+ 2C i r.�' n °�s #ts r %z Y =s � s r"."2 x`` Ss j• t.. ,x s� �5 '..�u *'�,RT ' ;'„'�� = ->.� -u�, y ! •§a.4 4 I n 3. 7 4 ¢` �' ChF + y t: O ���x yM'*� i- + .''a' .t qFg1�"r u `v %- -��-rf`y - s ,tPhlr- S.Y' "ter"' 3£y h. t k 2 u _.<,4 �" Pr r r-' S1141 tiA. h $; s$i ` ��'"s jp )t ' i < _<'. {,. tN �-0. ! WONll Z ;mom �v- 5 � �. �'`� w,z: t �""'�-^� �� US rs i t 'tom`.a° aka - OR RA su R. �r ���+r � � �r� �.a '�.,��. � - �,.s�� �•�` ���, � Ra '�-'_gr-a��, Wes. - _ .s }' 3€ SO t•��J`3`rx�,,,e..y _ -- e �Lm Ny � v� KLP wm­7 pp 2-n MA M� M G F k rt � t �� ju trot WM NO xg vm a`��r E �v C a A � i -lumps MO gF /'�pq 17 il IV __ AC R ,. CERTIFICATE ®F LIABILITY INSURANCE 03/17/20' PRODUCER (781)447-5531 FAX (781)447-7230 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Mason & Mason Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 458 South Ave. HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Whitman, MA 02382 Gwen Vosburgh INSURERS AFFORDING COVERAGE NAIC# INSURED George Dav-I s, Inc. INSURER A: Travelers Ins. Company 00034 33 North Main St. INSURERB: National Grange Mutual 14788 South Yarmouth, MA 02664 INSURERC: Star Insurance 000204 INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY I680790OM226IND09 01/12/2009 01/12/2010 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY - DAMAGE O RENTED $ 300,000 CLAIMS MADE ®OCCUR MED EXP(Any one person) $ 50,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO JECT LOC AUTOMOBILE LIABILITY M9M28491 10/26/2008 10/26/2009 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ B X HIRED AUTOS BODILY INJURY TxT $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE. AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC0452478 03/05/2009 03/05/2010 WC STATu- oTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 500,00O C ANY PROP RIETOR/PARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED? OFFICER OF CORP IS E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under - - - SPECIAL PROVISIONS below INCLUDED E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER C CAN ELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, George Davis Inc. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 33 North Main St. OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. South Yarmouth, MA 02664 AUTHORIZED REPRESENTATIVE David H Mason ACORD 25(2001/08) ©ACORD CORPORATION 1988 P®F created with DdfFactory trial version www.adffactoi-v.com Nhissachusetts - Department of PuhIIC Safer Board of Building Regulations anti Stantlartls --� Construction Supervisor License License: CS 56130 Restricted to: 00r' � GEORGE F DAVIS , 33 N MAIN ST S YARMOUTH, MA 02664 f. Expiration: 3/1/2011 Commissioner Tr#: 12220 ,per ✓fie �ans��wauuecz�l�z a�',/l/�czytcccfuaeCta �\ Board of]Building Regulations and Standards i HOME IMPROVEMENT CONTRACTOR Registration: 160164 Expiration: 702010 Tr# 270040 ' Type: Private Corporation GEORGE DAVIS, INC. ! GEORGE DAVIS 33 NORTH MAIN STREET �� j l SOUTH YARMOUTH,MA 02664 Administrator c a a 7i. rid +, IMA AA r 3 AAA z z�� �� ; y 1 It ��fj "Jf/ ' y' rs`L av'€x *.�.^ `_> t * .. b #` a a0 i• '',» +a Y "'"i ''Y+'> ®"RR +. wA in iA , IP aozl MITI jp -. ry �'_ A ) 4 K .. Al r �. 71 'i All at { T r�{ �e r. " v. ! sk � ti us k yi..n.:,'i31 .. ..J Mkt � ✓S�Y.'Yx .. � .. . r R - b.� 1 �Yf 4 r � n h ems.. t �e WL R mks»^A q a^r .mr.:.f5'ra+axyw MM a n n . M-+r•-.L 7 c s � a pp44 s { \ �► e V • Sp IVOW i 44. pill",Y � , law s o 1 - V WRIt � .. t gg fl IV YI s .--�sum. �.,{• f 4 `.v, a "- ,. F �r�•m. ! �Y ,.,:,,f, ' 4y a 5 b�e• pq'f 8� C " � 4T '. Y � ya�' 'x � i �J(.H.G"£�rf�^�i ="f `re.�"ye'.,, � �� � "_• „, E >� F� ;, .fin - ry if t Pitt -140 Piz ez N �� h��'[ �. ��.4 �?'�.M �� �'i�✓-a � �p�Yf'' '� tj � 1 �� „�3�_ �� l ! yt.. =w..Yaa4o'°`^'��'�'�ot.4S•^, f •p"�' _ '. �. 'F {7 f, `yv r iraa � � � P r a t r }��yR' facYJL=z nc.ol, a '"\�t� r'� r ¢ y `�' 'Ki, w+M„« L�•4.. �.�P d �a� ,yy M. '� j �.. - t� s _ s r ..._ �,_ •� :mod ~; --� _, �+ '"� �; , ��t"t/ s��< } � -•'rr �ir� %�`%' +a. � .."'_ �'\ mks • J}Y..��#"d �dd�c�'�.� � � �I;IfS' IK 4... ..,.Y f2^er�^, ar' •. �.. All- -jig 44 �J a...�-"� •,�st F��r`•£_ v ua��il a! — w I " a r� c r "T g fi iig Ri r' '�l�-"^I �yr5(<.}E+`�`�'���`',yE 4f'� s ��'y✓„2,�' ,s F YE f .$.y-.'F' � w F fl Aft 70 Ell el Ir- d sue. .. � � m � •, .' ,. .: .,;, �' � yf q� rrn '� r 1` �Y 1 '. ' ; .g i Ar w. 14 NO €b l" ^x...?„ Jam.• -..T — a u r x r r S a c We, ' ;1 ` & L o V AR ILI a V R `tr I d- t Town of Barnstable *Permit# �-7 S ` ty � Expires nips om issue date > Regulatory Services > BARNSCABM ' 10 M Thomas F.Geiler,Director & K t,45T Building Division -CO\N ® Tom Perry,CBO, Building Commissioner 200 Main Street;Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY jj Not Valid without Red X-Press Imprint Map/parcel Number f-f Property AddressI.p40f 4S esidential Value of Work & s(, . Minimum fee of$25.00 for work under$6000.00 Owner's Name&Addreshy i �i 1.(—L t t ' c h f j s-n Contractor's Name IVY Is , ?c". Telephone Number (m' f'✓V"D"�'7L Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable)_ 0 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I 4m the Homeowner have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# � Copy of Insurance Compliance Certificate must be on tide. Permit Request(check box) [ e-roof(stripping old shingles) All construction debris will be taken to lam ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Pr�� ner must sign ope wn tter of Permission. Home Im rover t Contra ors License is r SIGNATURE: Q:Forms:expmtrg Revise071405 -T I'r ' 1 i p ✓128 l4'P7Yl lYLOYLu/2llC�fZ. p�,-./��fldJlLC�ll6P.�6 Board of Building Regulations and Standards. HOME IMPROVEMENT CONTRACTOR Registration: 107333 Expiration: 7/31/2008 Type: Private Corporation GEORGE DAVIS BUILDERS, INC. George Davis 9 NEW VENTURE DR. UNIT 7 So.Dennis, MA 02660 Deputy Administrator ° � ✓fie T�o7ro7nbreurea�fi d���aclfiudel�6 1 I Board of Building Regulations and Standards Construction Supervisor License I t+ + yr License CS 56130 i Expiration 3/1/2009 Tr# 9698 i f Restriction 00 GEORGE F DAVIS-: 9 NEW VENTURE DR`#7 II S DENNIS,MA 02660 Commissioner The Commonwealth of Massachusetts Department of Industrial Accidents 9 Office of Investigations 600 Washington Street W Boston,MA 02111 wwwmass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): - _J Address: , Y City/Rate/Zip's� . ��n 1.sinn. ap u n `Phone#• � � `�OR2 AFy an employer? Check the'appropriate box: Type of project(required): ,-. 1. m a employer with . f ` 4. ❑ I am a.general contractor and I 6 ❑ New construction employees (full and/or part-time).* have hired'the sub-contractors 2.El am a sole proprietor or partner- listed on"die attached sheet 1 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition woiking for mein any,capacity; workers' comp. insurance. 9, ❑ Building addition [No workers';comp. insurance 5• ❑ We are a corporation and its required.] officers have exercised their .10:❑ Electrical repairs or additions 3.❑ I am a homeowner doing,all work ,right of exemption per MGL . 11.❑ PI u1g repairs or additions' myself. [No workers' comp. -4, c. 152,§1(4), and we have no 12. oof repairs insurance required.] t; employees.,[No.workers' 13.0 Other �. . {.. <. comp.-insurance required.] , *Any applicant that checks box#/1 must also fill but 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 ' tContractors that check this box must attached an additional sheet,showing the name of the sub-contractors and their workers'comp.policy inf6nration' ` I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: '�� � Expiration Date: Job Site Address: V ,c City/State/Zip: T"` kavl Attach a copy of the workers' compensation policy declaration page(showing the policy numi er 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 i } Investigations of the DIA for insurance coverage verification. I do hereby certify under he pain d pe alties of perjury t he information provided above is true and correct: , Signature: Dater f� �✓ f y Phone#: 5`\ 0 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 M AUG-21-2007 12 :33 PM P. 02 ••••••••••�••• vrrry � hy416. r.16/ClL 1e Town of Barnstable Regulatory Services Thomas F.GMler,Director ,Building I Melon Tom Perry,CXO Building Comenbrsinnar 200 Main Str* t-IYAWS,A/IA 02601 arvrw tewn.baraaEtwbla��ue Office: 508.862-40311 Page: 508-790.6230 Property Owner Must Complete and Up This Section If Usi bg A"Budder I /� ,>as Owner of the subject property hereby auth,olile �u r � � � � to pet on my behalf, in aa11 matters reladive to wade authadzed by this buil&g perWt applkAdon for- (Addtm of Job) natuft of(Nmer Date Print Nsume Revi,407140LI From:Steve Tallent At:NorthStar Insurance Services.,Inc FaxID:NorthStar Insurance To:Town of Barnstable. Date:8/22/2007 12:57 PM Page:2 of 2 AC ORD CERTIFICATE OF LIABILITY INSURANCE OP ID S DATE(MM/DD/YYYY) GEORG-6 08/22/07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE NorthStar Ins. Services, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 65 Walnut Street Ste. 380 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wellesley MA 02481 Phone: 781-431-2500 Fax:781-431-6134 INSURERS AFFORDING COVERAGE NAIC9 INSURED - INSURER A: AIG Companies INSURER B: - George Davis Builders, Inc. INSURERC: George Davis 9 New Venture Drive-Unit 7 INSURERD: South Dennis MA 02660 INSURER E'. COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurence) $ CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE - $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- JECT LOC - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMS MADE - AGGREGATE $ $ DEDUCTIBLE If RETENTION $ $ WORKERS COMPENSATION AND X ITORY LIMITS ER EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE WC1768491. 03/05/07 03/05/08 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE}$ 100;000 If yes,describe under j SPECIAL PROVISIONS below E.L.DISEASE-PfOLICY LIMIT-_$501 000 OTHER .., Q,._. 771 77 Ia1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS v 1 4!: CD a.J i rt CERTIFICATE HOLDER CANCELLATION BARN_ STA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Town of Barnstable NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Building Dept. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 200 Main Street Hyannis MA 02601 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Mar aret .Herlih ACORD 25(2001/08) ©ACORD CORPORATION 1988 04 TOWN OF BARNSTABLE BUILDING PERMIT ( PARCEL ID 343 010 GEOBASE ID 24973 ADDRESS 64 CEDAR STREET PHONE HYANNI,S ZIP - LOT , . BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERV1T 29029 DESCRIPTION RESHINGLE ROOFf � Pr .11IT TYPE BROOF TITLE BUILDING PERMIT ROOFING CONTRACTORS: DAVIS, GEORGE Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $25.00 BOND $.00 �� CONSTRUCTION COSTS $1,000.00 753 MISC. NOT CODED ELSEWHERE 1 PRIVATE P .,c:J'E� j' * BARNSTABLE, • MASS. . FD Mp►l BUILDI�, ISIO BY DATR ISSUED 02/20/1998 EXPIRATION DATE s. •r 5 � 1 _— BUILDING, PERMIT 40- { PARCEL' I1). Wc6 ;�3Id3 CSC "E� ID �.4�"l:� , ADDRESS 64 • DAR- TRIVET PHONE HYANNI,8- I '; zIp. LOT BLOCK LOT I Z ' w� , Ia►► VEWpHI'M DISTRICT Hy I PERMIT 29028 DESCRUTION RE BINGtlq. R OFj PER.IT ':TYPE = MOO TTTL BUILDING PERMIT ROOFING CONTI A6TOR f' 'DAVISr EORGE � Department of Health, Safety ARCHITECTS. '' and Environmental Services wNlls.00 GONuTfiS3CTI4N COST9 $1,000.00 ; r t��t '�1 as � .. �^ 3�p' t� �!53 MIS ::,, NOT CO, ED ELSEWHERE �. . � .`f 3 PRIV�s'.+»t�k s I*''��� f � * STABLE, I; t F' MAS& ' BUILD �V. SLdN BY I}A`rR ISSUED 02;2G}/,I '98 EXPIRATION I) i' ` THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT.FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH-. (READY TO LATH). PANCY IS REQUIRED, SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. � • m � ® ' • BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING.DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL II :I WORK SHALL NOT PROCEED UNTIL PERMIT WILL.BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON .THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. BUILDING PERMIT Engineering Dept. (3rTfloor) Map Parcel -? Permit# House# ` fig �,� Date IsWOD d 02 Q Board of Health(3rd floor)(8:15- 9:30/.1:00-4:30) Fee, D Conservation Office(4th floor)(8:30-9:30/1:00-'2:00) Planning Dept.(1st floor/School Admin.Bldg.) THE Defi ' ' e an Approved by Planning Board 19 4 ' BARNSTABLE. /�,s.,\ f TOWN OF BARNSTABLE! r Building Permit Application roject Street Address Lk Village =-- --�5 .. Owner Address Telephone Permit Request —sue s s First Floor square feet Second Floor square feet Construction Type , Estimated Project Cost $ — Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family (d Two Family ❑ Multi-Family(#units) Age of Existing Structure I pp .k Historic House ❑Yes EtNo On Old King's Highway ❑Yes ❑No Basement Type: ❑Full @<rawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing_� New Half: Existing _ New No.of Bedrooms: Existing New Total Room Count(not inclu 'ng baths): Existing New First Floor Room Count Heat Type and Fuel: Gas Oil ❑Electric ❑Other Central :��tached No Fireplaces:Existing— New Existing wood/coal stove ❑Yes 2<0 Garage: (size) Other Detached Structures: ❑Pool size ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name ��� � �-� 5 Telephone Number -;�l`1—0a— Address 'I License# Home Improvement Contractor# 10-133 3 j k Worker's Compensation# p- —mil` 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 '�>_ :-s -12 SIGNATURE DATE BUILDING PERMIT DBE ,IED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY .. � A -. _i _ •} t a i •_� r<. - r7 '? '.}. r - .• fs r. 4 'i r e ... ^. ` '�. ' PERMIT NO. DATE ISSUED MAP/PARCEL NO. e tt + ADDRESS VILLAGE ' ' OWNER r � a x - ' � t , .. _ •- - � DATE OF INSPECTION:, FOUNDATION FRAME INSULATION FIREPLACE � - ' u i ' • ' . .. ;`' ^" . • ELECTRICAL: ROUGH + FINAL - PLUMBING: ROUGH FINAL f T �. GAS: ; ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT . , _ ' • ~ • f 1. ` ; ' } ! • ASSOCIATION PLAN NO. t A vr►THE r� d o,� The Town of Barnstable •`u�rsr • g1 Department of Se2Ith Safety and Environmental ervices Building Division 367 Main Street,Hyannis MA 02601 Raipn C•n:=: ME= 508-790-62Z7 Building CJr. Fax: 503--,90.6230 For office use only Permit no. Date AFFIDAVIT HOME MOROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION ` u , modernizzzion. MGL c. 142A requires that the reconstruction, alterations, renovation, repair conversion, improvement, removal, demolition, or construction of anII ditton to any four dwelling an3�a ing to owner occupied building containing at least one but not more y registered contractors, with structures which are adjacent to such residence or buildia be done b regis certain exceptions,along with other requirements- Type of Work: Fat Cost 1 O L' Addrrss of Work: Owner's Name AT, Date of Permit A iication: I hereby certify that: Registration is not required for the following ren_son(s): Work excluded by law _Job under 51,000. Building not owners-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIlZ OWN PERMIT OR DEALING WITH UNREGI TM= HOME EWROvEMENT WORK DO rqT HAVE CONTRACTORS FOR AP-- GRAM OR GUARANTY FUND UNDER MGLO 142.E ACCESS TO THE NITRATION PRO SIG;qED UNDER PENALTIES OF PERJURY SI I hereby apply for a permit as the agent of the owner. G EA / L-2�� Cantraczor Name Registration i�io. Date ., Tilt. Clow11u11wea I 1 (I a.Tsac w.yc .L ? --_= pep1Ir1111ent of ludustrial Accidents a1 ONCZ011ayeS11gatlonS i•w• h(!0 if uslthigialr Street Btarvir. 1 ayx. 03111 Workcrs' Compensation lnsurance Af idavit •Aliliiirinr fntortnatinn • •--• Plc't5e PRINT led►ijjv'•�—�r~--��—Y -_-_ i, -- r na-Tr• - XC-•t(1n• rite• nhnnr� I am a homeowner performing all work myself. 1 am a sole proprietor and have no one ivorkinq in any capaciry .. ... --/ .- .-ter sti.-.++- �+-.._•• "- -.�.i. - •�. I am an empiover providing workers' compensation for m} empiovees working on this job. ennm•mv n•tmt•- •tticlrr�c• cin nhnne 0! incnrinrr rn nt►iict tt [ I am I a sole proprietor. -enerni contractor, or homeowner(circle otte) and have hired the contractors listed beiow W c the �0110%ving workers' compensation police:: SIGN HERE �tirlrrcc• cin• nhnne a• incur^-trr rn nniicv _ — rmmnnm' natnt-- atitirrcc• rite•• nhnne et• incur-arc rn - nniir`• Attzcit additional sheet if nrceisarv_.::_. '_.., = .::.� .. _-......cr. •...._...,.. _..:.....a,._._..- _ ::-- w...:= Fait urc tit s-ecurr covernec as required under�ectton--A of f11GL 152 can Iead to the imposition of crtmtn21 penalties of aline up to 51.500.00 ana,ur tine cars' imprt.nnment a. %%cil as ciiii penalties in the form Ufa STOP WORN ORDER and a fine ofS100.00 a daq against me. I understand that:: cop% of this statement rttn% lit funrardcd to the orrice of investic2tions of the DIA fur coverage verification. I rio h chr ccrriit uar/rr the pains anri penalties of pctjury that the information prorided above is true uttd correct. Datc print mate Phone; otTiciai use oniv do not writc in chi,area to be compictcd by city or town 0tTci21 - Et r ` city or tnwn, prrmidliccnsc>Y t'Ttluildin_Department QLlcensina llurrd t_ t.. ;. :: chcci; if immediate respunsc is required QJclectmen's Orricc t. r 11c2ith Department phone tt• r tUtttcr contact ncrscin: Information and Instructions Massachusetts Gefle:.^.tl Liws chapter 152 section 25 requires all emplovers to pm%,ide wort en* ct I'll Pensa:ia►t etnnloyces. As quoted from the "laW".ati cmPtnree is defined as even,person in the sen•ice of :111od.ler under;::: contract of hire. cmpress or implied. oral or«•riven. Aw An c•mpinrcr is defined as an individual. PIIRnCrshtp, association. corporation or other fc-ml entity. or any two er the forc�_aim_ cn�_ __%d in a joint enterprise, and inc'udinu the lt::.^1 represcntativcs of a decca scd employer. or a:c rccciN•er or tntsice of an individual . pannership. association or other iegni cmity, employing employees. Ho«'e•. oN't•ner of a dwe ling_ house hnvins not more than three apartments and who resides therein. or the occupant of the dw ellinu house of another who employs Persons to.do maintenance ,construction or repair work: on such dweili►:_ or on tite __rounds or Ijuilding appurtenant thereto shall not because of such employment be deemed to be ::n eMr. ytGi. banter '�= section _5 also starts that erer�•state or local licensing agent}'shall withhuld the issu:ncc c •• ,%,al of a license or hermit to operate a business or to construct buildings in the eommon11 ealth for::n` r :r.:nt who has not produced acccptnb1c evidence of compliance with the insurance coverage required. ,eL�.:ion.;i1%.. neither the commonwe-nIth nor anyof its political subdivisions shall enter into any contract far:he ::cc of compliance with the insurance requirements of this c:::.c; pc::�rntz::ce of public work until acceptable evide he.:: Prczz:ac-,; to the contrnc:inc authorin•. A ppi►cants P'=asc 'ill in :hc %vorkers* colnpeiisation af%ida%-It completely, b. checking*fie box that applies to your situ:,ion suz:pivine company names. address and phone numbers as all affidavits tnav be submitted to the Department of The 'tic atrial Accidents ror contirmation of insurance coN era_c. Also be sure to sign and date the afTidavit. 4 itouid be re:ur t;ed to the cin• or town that the application for the permit or license is being request,-. :he Jc���t::te::t ot�Ittdustriai accidents. Should you have any questions regarding thri e "law"or if you are req :: o �otc:n c «cri:ers' cort1pe:aation policy. please c:it the Department at the number listed bolo«'. Cite :�r Tu:�ns :,e ;arc :ha: :he affida%.it is complete and printed legibly. Z7te Department has provided a spat= at the bor.:.:- the •• asp it for %•ou to fkil out in the event the Office of Investigations has to contact you regarding die appiicznt. be _ : to 5il in the permit license number which wiII be used as a reference number. 17ie affidavits may be return; :te D�!oarttne::t by mail or FAX unless other arrangements have been made. Tire CIfil►c: of Investigations would like to thank you in advance for you cooperation and should you have am que_: pi:cse do not hesitate to give us a call. _�. ... Z. The Depart:nent's address. teiepiione and fax number. The CommomveaIth Of Massachusetts Department of Industriai Accidents - office n"t investigations 600 «'ashington Street I3oston..Ma. 02111 fax j: (617) ,`-_-749 ni:unc =. 6 1�, -'900 c�::. 406. -10° or _-c �, . ,- .. .. .. . '_ - � ,. ri . r - t•,a � .1 ` .1 t �,`l iylr P�i } \ p! i .. � r... � � •i.: .i�� a.�.d.:FS.rs�r�•t�"'�'�; 'k�"`�C- k4:'�.�.tsa.::.:r:.,..r-•r:..n } . -., yr # = y�1ze �ozz�rzaax ,�uaeCla a DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Noiber x Expires: .,; Restricted To; K00 3 6EOW'F DAVIS i 1 �.rr.r7%�iytt�/ 9.HEY VENTURE OR 17 S'OENNIS, NA 02660 , 4-,f t q�p t K C,00TRAC� 4R + x 1 ts5r ,1 ._ .,• RG S BUILDERS „'��� 6eo9e tv1s` g i t ADMINISTRATOR U t2664 • .. r, ..w. ..ti. ....mow�F...�.:w.....-�.r,'',,:. ..a,.i,v,-- = - r. ",,.�"� s.....�w...'i.r.:.,.:. v:wiP.:`,Ep-••.'.5.L":`,4,.Jw.•r %Cw'^a-r."4'.+-.`'F. 4 Assessor's map and lot number ........................................'.... h' T i� S�is! ._ /F SewagePermit number ................................:........:................ y°F.T"Er°� TOWN. OF BARNSTABLE i BAHHMIiLE. i r M6 9 BUILDING INSPECTOR • �o war°'• • �� •�� APPLICATION FOR PERMIT TO `� '�.•-� TYPE OF CONSTRUCTION ' � 19.y ................................................- THE INSPECTOR OF BUILDINGS: - The, undersigned hereby applies for a permit according to the following information: k� ��/)� OIAI�--4-4r Z Location ........................._.................s:,...,........................_............................................................................................................ ProposedUse --47M....................................-r ........................................................................... Zoning District .....................................Fire District ....... � �... . Name of Owner .................Address !ff1'� � — � Name of Builder , , ? ........Address Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. p Exterior .?'........... . .......::.....?. n;1,I..................Roofing ........................ a ................................................... ....... .... ..I..............................Floors 1 .Aar.�.. I,,..........................................Interi or ........ �,4. ;if Heating ....Plumbing ` ...... Fireplace ""77'". ...............Approximate Cost ..:¢.�............................................................. Definitive Plan Approved by Planning Board ________________________________19________. Area :d..... Diagram of Lot and Building with Dimensions Fee ....::....................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH e I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. r Namer 1 ..:.. .... ..... ............................... v Johnson, William F. A=516-1-6� ~*��� No ..l88I6._ Permit. for add boiler rm9� . ---.. ' --------..=,..�`. and ladindry room to dwelling ---------~—^—^'-------''----- //� ��=Cedar Street �oc000n --`------------------'. ' 10 .--.--^---..v.�....--...—.—.-----'' / Owner ~ ' ' ' Type of C" ="` . ' ' . . --------^ . . . Plot ....-------- . . . . . . . ' - ' Date Com ' . / � . . ^ ' . / P -- ` � .� ��� . ' --.—'-' ----. 411 * . /� ----- � ' � . � . ---��—.�� ' ---.—' � & V � r W . Approved --..:-----------.. lQ ' - ^ . --------~---------------^—'' ~ ' ................. — ...... ................................................. . . �.A Y 55-2 1/2" 2T-6" 11,_4, -4,_1„ 12'-31/2" j. — — — — — — t ----------- --- UTILITY I GL05ET I w a o n BATH (m m ue• I z w•ampaa�x+.�•cez�ve�rkx.;aamu•++.z u�Aa.,w � uee� ue> B BATH P 1e'-e v6^ UTILITY 1 V � (�` :# A ry a o - - BEDR — dOM BEDROOM ''_ KITCHEN 0 m eee m z n ate - 4'-6^" -I 12, - - ( o — — — — — — — — — — — — ---- Cu BEDROOM q LIVING Existing 2nd Floor ��� CD DINING _ . 0 wo �ko" m.eo" Existing 1 st Floor 5-2 5/81' /�. . 7 7 2968 i to uS DINING 2446DH 210, REMOVE EXI5TIN6 g o m 1NINDOlN5 AND I w 4�_1�� REPLACE 1N/ a lJP I ANDER5EN TW2641.0 I o DH NINDOYV5. _ m bathroom - window I o / mop renovation replacements I " oL; BATH ,�_ I 3 - � I � / \ \ 666 RENOVATE EXI5TIN6 — s�iz�2ois BATH: REMOVE/REPLACE — - — — — — 2641OH SAME LOCATION, TOILET 10, as noted AND 51NK. ADD NEYV 5HOlNER. SHEET: F A-1 { v FBI m o0 (D a .o m < ME pol < 0 0 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - t �Q ❑ m m rn - - - - - - - - - - - - - - - < < o --- -- - - - - - - - - -- - - - - W. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ----- - - - - - --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ----- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - N .N OD0 DRAWINGS PROVIDED BY:. PROJECT DESCRIPTION: SHEET TITLE: NO. DESCRIPTION BY DATE m > � rn George Davis Inc. 33 North Main LLG N a m 508-3q4-002 64 Cedar Street existing elevations Hyannis, MA o�..�. ..� �t CD (OD - p OCD N 3 O ❑ CD O (D ❑ CD ❑ ❑ n CD Q 00 ®� v m o x � cn' .rt CD (Q Q CD 0) iU m m CD CD o � - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - m - - - - - - - - - - - - - - - - - ❑ x - - - - - - - - - - - - - - - - co a - - - - - - - - - - - - - - - - 3 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - m ❑ rr < ❑ : - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - G- Q. (p O N N -p N 0 ❑ O 3 Cr (D Q-O ❑ � D =' Q n a (D CD o Cl) a CD N (A W Q DRAWINGS PROVIDED BY: PROJECT DESCRIPTION: SHEET TITLE: N0. DESCRIPTION BY DATE m � m George Davis Inc. 33 North Main LLG existing and W m mI'j 508-3q4-0832 64 Cedar Street �^ - Hyannis, MA proposed elevations 23 ^�' rn. o 10 OUJI C � 3 rnU Al A O O O m J N S QI 10, _ O 8'-511 Y V-3° m N cn > cn U3 8'-4 1/2" 4' m = z > Drn 0 3 z 2668 rn < r > 03rn � � O rn z _ s � Q Q rn x ��11'-2 1/2" q- �?2 10rn z 3-4'rn 2066 8m x � 3T V ZD�?,i CD .--�-CD Qu " - I I I I I I 41�- I U3I 068 I N OI p I I 31 I i X = zrn rn z � z o I W 2_,0,> iT / o F I — — — — 26410DH 26410DH. 264100H — — �e 1� Ln Ln OD 0 DRAWINGS PROVIDED BY: PROJECT DESCRIPTION: SHEET TITLE: NO. .DESCRIPTION BY DATE ,V m y D N George Davis Inc. 33.North Main LLG " 5 m N m existing and F-` a N 508-394-0832 64 Cedar Street ro Osed layout Hyannis, Mkt P P . . an 5 a pr jt 1 \�V o m o0 I- Kim ❑ rn ® o M. CD v 0 0 - - --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ C h m m . m m w Ell U I I 0 0 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ❑ - - - - - - - - - - - - ❑ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1� (A - (A t] DRAWINGS PROVIDED BY: PROJECT DESCRIPTION: SHEET TITLE: N0. DESCRIPTION BY DATE } m m George Davis Inc. 33 North Main LLG .' IV m CL 508-394-0832 64 Cedar Street existing elevations Ln Hyannis, MA � CD -D, (OD 0 O CD CA 0 ffDE] Cr � Q (D 0 (D (D CD n (D Q 00 ®a v m 0 x 0 o h m cQ a (D (D v m m CD CD v v o o - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 0 5 co m �. _� cQ m m [101 0 o �- - - - - - - - - - - - - - - - - - o. —I T F O N N � 0 aCD o D 5' Q n Q (D (D o �, a m UI UJ W, 0 DRAWINGS PROVIDED BY.. PROJECT DESCRIPTION: SHEET TITLE: .. - NO. DESCRIPTION, BY DATE m m George Davis Inc. 33 North Main LLG. W a m 508-3q4-0832 64 Cedar Street existing and . Ln Hyannis, MA proposed elevationsN 55'-2 1/2" 21'45" 1 P-4" —4'-1" 12-3 1/2° i4 {Jt.�i — — — — — — UTILITY — CLO! ET a . �[L2- '1/ I: a.ao» �,aso» z„� r ..:.~m .. a aa P 77 R "R to{{ Win. I uee UTILITY _ _ _ _BATH P — — BEDROOM ueaL BEDROOM '' KITCHEN A z a>=na -6 -2 5/5" I 14:_5, 13'-8 1/2" — — — — — — — — — — — — — — — —� C — BEDROOM m LIVING N - Existing 2nd Floor o DINING F X 0 N 0- Existing ego» ¢euo» =eP» 1st Floor 28'-81/2" Iwo» DINING I � � ot! r~ ov = REMOVE EXI5TING _ m 2446DH 210� o o(n . WINDOYVS AND REPLACE 1N/ i.: d ANDERBEN T1N26410 ZR UP ) DH YNINDOYN5. bathroom , m window c4 , , cSJ � � \ � � m renovation r�placernents , �� BATLL H \ _ �, V 666 � � � � � � � �� �\\\` II / • � ` DATE: , RENOVATE EXI5TING — 8/12/2015 BATH: REMOVE/REPLACE — 2641ODH SAME LOCATION, TOILET .10' SCALE: ` as noted AND RINK. ADD NEIN SHOVER. SHEET: �: � A-1 r ® ❑ ° m oo ❑ ❑ < a m < OF] o 0 LLJ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - m m m m - - - - - - - - - - - - - - - - o ' ' ❑ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 71 o by (A U1 0 0 DRAWINGS PROVIDED BY: PROJECT DESCRIPTION: - SHEET TITLE: _ NO. DESCRIPTION BY DATE n �Ep m 0 m 33 North Main LLG` George Davis Inc. IV a m 508-3q4-0832 64 Cedar Street existing elevations -� Hyannis, MA ,a 0)_ ID O O CL O Q (D OL (D ❑ (D CP (ID 0 (D Q. MOO o o ❑ m o X C' O �. Cn CDCL cQ �. (D (D v m m CD v ' O o - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - x r 0 CD — a m m ElEll - - - - - - - - - - - - - - - - n� - - - - - - - - - - -- o' El - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5' a (D O N � _ CD .A N O O (D 11E CD QL 3 � fD n Q (D (D O Q CD 1� (A U) 0 �0 DRAWINGS PROVIDED BY: PROJECT DESCRIPTION: SHEET TITLE: '` - NO. DESCRIPTION BY DATE m r- � m George Davis Inc. 33 North Main LLG existing and f W -j CD, rnr1i 505-3q4-0632 64 Cedar Street Ul Hyannis, MA proposed,elevations _