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HomeMy WebLinkAbout0103 CENTERBOARD LANE _ _: �103 �E�1T���3oy9,QrJ L✓✓. �Y�NN�S ,��'.�' � _- i ,� i :, z �WE p�dg. Application number. 'f _I Date Issued.. ...�..z „�„ „ srAB[.E. A�� 2 42011, ............ .............. MAM p.. � uilding Inspectors Initials.......... ... RAIN Map/Parcel... .......................1............................ TOWN OF BARNSTABLE S,. 5 . D 0 EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERTZATION PROPERTY INFORy1tA'lt'>ION Address of Project: 103 t30kP,,6 4A). ER STREET VILLAGE Owner's N I UQ Phone Numbe�7 7 y Z'�L- F16 Email Address: Cell Phone Number Project costs ���Z Check one Residential Commercial O VV l EWS AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: See Mc.r .�eQ G25('(-a,- Date: TYPE OF WORK ❑ Siding Windows (no header change)# 3 ❑ Insulation/Weatherization ❑ Doors(no header change)# Commercl ai Doors require an inspector's review !❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to W a-,4 �,, Q � ,�� , ,fib �-1,A CONTRACTOWS INFORMATION Contractor's name A� � a,Y,e / Vr.,z\ Home Improvement Contractors Registration(if applicable)# 1/2--7 S (attach copy) Construction Supervisor's License# d Z ' 6_ (attach copy) Email of Contractor sae 5—cp a Q �'ti Phone number °yo/-71V-63' 9 ALL PROPERTIES THAT HAVE STRUCTURE OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS[IV A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUE®. APPLICATION NUMBER............................................................ a *For Vents ODIV* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a:for profit non-profit event Check one:Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s)of each tent If food is being served at your event please obtain a Health Department approval between the hours of So 00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:front back left side right side HOMEOWNER'S LICENSE 1CiXEN JL IO Homeowner's Name: Telephone Number Cell or Work number i understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection psroceduris,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date /APPLICANT'S SIG AT tlJ JLV..tl.M Signature /4111� Date 6 Z � All permit applicatio are subject to a building officials9 approval prior to issuance. 4 J Home Improvement Agreement: Page2 b0. Finance Charges: *Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement, to which The Home Depot is NOT a party, and will be in addition to Customer's payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or loan agreement, as applicable. No funds should be made payable to Service Provider; however, Service Provider may collect Customer's payment(s) made payable to The Home Depot. Insurance proceeds will will not be used to pay some or all of the total amount of sale. Description of Work to be Performed: Installation of 1windows A more detailed description of the work to be performed is included In the section entitled Scope o Work which appears on page F7 of this Agreement. Anticipated Delivery Date/Installation Schedule Approximate Start Date: 04/30/2019 Approximate Finish Date: 05/28/2019 All dates are approximate and subject to change based on unforeseen events including inclement weather, permitting delays, and delays in confirming insurance coverage of Your claim for any repair, if applicable. Electronic Records Authorization: You are entitled to a paper copy of this Agreement if you choose. If you consent to an e-mailed copy, your consent applies to this Agreement and all subsequent documents and written communications related to this agreement. By contacting your Service Provider, you may update your email address, withdraw your consent, or obtain a paper copy of the Agreement or related documents at no charge. By providing your consent and verifying your email address above, you confirm that you have access to a computer that can receive and open emails and PDF documents. By initialing this paragraph, I consent to receive only electronic records related to this transaction. nitial Acceptance and Authorization: By signing below, you authorize Home Depot to (a) arrange for Service Provider to perform Installation and/or (b) order and arrange for the delivery of special order merchandise, including special order merchandise that may be custom made, as specified in this Agreement. Do not sign if blank or incomplete. (Service Provider's/permitting information may need to be provided to You later.) By signing, you acknowledge that you have read, understand, and accept this Agreement in its entirety, including the General Terms and Conditions and State Supplement, if any. You further acknowledge receiving a complete copy of this Agr ment. Keep it to protect your legal rights. X 03A 11 V /I I —/05/2019 The Home Depot Custome S' n r Date Service Provider Name X . 03/05/2019 908 Boston Turnpike Unit 1 r (if app 0 able) Date Service Provider Address X 03/05/2019 Shrewsbury MA 01545 Si On ehal o o e Depot Date City State Zip R-I-073-13-00016 Service Pr eider Phone Number Service Provider License Number The Home Depot-2455 Paces Ferry Road, N.W.Bldg.B-3,Atlanta,Georgia 30339-Customer Care: 1-800-466-3337 460FI HDE Customer Agreement(24 Jul.18) v 0.1.8 Home Improvement Agreement: Pagel Home Depot License #'s - For the most current listing www.Homedepot.com/LicenseNumbers MA: 107774, 112785 Janice Campbell Salesperson Name: Registration No. (if applicable): Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/ or service the equipment listed below at the price, terms and conditions as outlined on this form. SULLIVAN BOB New England South 1-F1514H1 Customer Last Name Customer First Name Store #/ Branch Name Customer Lead/ PO# 103 Centerboard Lane Hyannis MA 02601 Customer Address City State Zip (774) 242-7845 worcmass@hotmail.com Home Phone# Work Phone# Cell Phone# Customer Email Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 908 Boston Turnpike Unit 1 Shrewsbury MA 01545 Address City State Zip Or Email' I customercancellationnortheast@homedepot.com Service Provider Email Address BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF YOUR RIGHT TO CANC . Acknowledged by: 03/05/2019 Customers u Date Contract Price and Payment Schedule : Payment of the Contract Price is due upon signing unless a different payment schedule is required by law, specified below or in a payment addendum. Contract Price: $ 15142.00 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 10.00 (If applicable) *Maximum deposit ONLY applicable in MD, MA, ME(33%), NJ, Wl(999yo) Dep. 1 25.0 % Deposit Amount $ 11285.5 Remaining Balance $ 3856.50 The Home Depot-2455 Paces Ferry Road, N.W.Bldg.B-3,Atlanta,Georgia 30339-Customer Care:1-800-466-3337 460FI HDE Customer Agreement(24 Jul.18) v 0.1.8 i I 7 l nwaaltn 6t Massuhusetts �ivis%On of PttfteSa onat Li�nsur@ ions and�tanctar¢s Ooaret of Euiiding Ragi, Ia� �ires:isor O9123la020 IELUY a t JOHNF � F. � � 4 OMM S4 s wilof fa .. ( �... _ cori missioner (�`� The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street,Suite 100 Boston,IVlA 02114-2017 www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/organization/Individual): Address: ZQ City/State/Zip: tit 'r-f t Phone#: FI -oL/ Are you an employer?Check the appropriate box: Type of project(required): l.®I a a employerwith employees(full and/or part-time).* 7. D New construction - am I am a sole proprietor or partnership and have no employees working'for me in $. Remodeling any capaci capacity.[No workers'comp.insurance required.] 3.Q I am a homeowner doing all work myself[No workers'comp.insurance required.]r 9. ❑Demolition Q 4.❑Ihomeownera homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition . ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees.. 12. Plumbing repairs'or additions 5.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13:❑Roof repairs These sub-eontracto¢ insurance--have employees and have workers'comp.insurance-- 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 14.M Other 152;§1(4).and we have no employees.[No workers'comp.insurance required.] *Arty applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. }Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating suchr +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 �r information. Insurance Company Name: (a de-Jr r S 0-0j&r t X Policy#of Self ins.Lic.#: T6 L 10 2 D l Expiration Date: Z 2- Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and explratiq,*.date). Failure to secure coverage as required ugder MGL 6. 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 An 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 certi u er the pains and penalfi .of perjury that the information provided above is true and correct Si ature• Date- Phone#: Official use only. Do not write in this area,to be completed by city or town off cial., City or Town: Permit/Liceuse# 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#• - e The Commonwealth o.f Massachusefts Department of IndusfrialAccidents r 1 Congress Street,Suite-100 Boston,MA 02114 2017 www mass govhffa Workers'Compensation Insurance Affidavit:Builders/ContraetorsMeetricians/Plumbers. TO BE FnZD WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leagibly Name(Business/organization/Individual): Hot-le— ice,O n Address: q OAS S-Cfln Tt�r.�o K2� City/State/Zip: S 6v I'Y, 11 Ot 5 y 5' Phone#: 71 -)--1 15 - Z 1 S 5' Are voaan employer?Check the appropriate box: Type of project(required): 1.Q i am a cmployerwith,__employees(full and/or part-time).* 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working-for me in $. Remodeling any capacity.(No workers'comp.insurance required.] 3.Ej I am.homeowner doing all work mys �elE(No workers'comp.+nas +oe required]t 1 ❑Demolition 10 Q 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.Q,Plumbing repairs or additions 5.9I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑R of rtpairs These sub-contractors have employees and have workers'comp.insmenee t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. OtllerJttJ]��y8�✓ 152,§1(4),and we have no employees.(No workers'comp.insurance required.] !1e 14C "Any apgliaant that checks box#1 must also fill out the section below showing their workers'compensation policy information- 1 Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a now affidavit indicating such. #Contractors that checkthis 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 mimber. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. .�l/-. ,/ �_ rr Insurance Company Name: N�`/b�7GLl (IA;C,/1 . , 6-e- Policy#of Self ins.Lic.#: X r �S 5 5 `�/-7 Expiration Date: 3 C7 Job Site Address: l0 3 �2f��rP/ oa d � City/State/Zip: nA,`S Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonm as ell as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. py this statement may be.forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certifji un an ersalties o information provided above is true and correct Si attu : . Date: —1 Phone#: 110 � ✓`� Of 5dal 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#: A 7 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvemet:_Contractor Registration Type: Supplement Card mrn '= Registration: 112785 HOME DEPOT USA INC — — Expiration: 04/22/2021 P O BOX 105451 ATTN: LICENSE MGMT TEAM ATLANTA, GA 30348 _ -- - -- --- Update Address and Return Card. SCA 1 20M-05i17 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Stioolement Card before the expiration date. If found return to: ReaistMtion__ Expiration Office of Consumer Affairs and Business Regulation _ 04/22/2021 1000 Washington Street Su" 10 HOME DEPOT -- Boston,i1flA 02118 ANDREW SWEEI<,,=_ 2455 PACES FERR` i Mg-11 HSC ATLANTA,GA 30339 J Undersecretary N® Slid It ut sl nature A�®® DATE(MM/DDIYYYY) V CERTIFICATE OF LIABILITY INSURANCE 0210612019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - CONTACT MARSH USA,INC. NAME: PHONE !FAX - T'NO ALLIANCE CENTER WC,No. (AC, No): 3560 LENOX ROAD,SUITE 2400 E-MAIL ATLANTA.GA 30326 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# CN101642069-HomeD-GAW-19.20 _ _ INSURER A:Old Republic Insurance Co 24147 INSURED INSURER 8:New Hampshire Ins Co 23841' THE HOME DEPOT,INC. HOME DEPOT U.S.A.,INC. INSURER c:HomeRisk Captive Insurance Company 2455 PACES FERRY ROAD BUILDING C-20 INSURER D ATLANTA.GA 30339 INSURER E INSURER F.: COVERAGES CERTIFICATE NUMBER: ATL-004353439-28 REVISION NUMBER: 21 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 i ADDL`SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE WVDPOLICY NUMBER MMIDDIYYYY MMIDD/YYYY LIMITS A I X COMMERCIAL GENERAL LIABILITY MWZY314574 0310112019 03/01/2022 EACH OCCURRENCE 3 1.000,000 DAMAGE TO RENTE I CLAIMS-MADE I OCCUR PREM SES Ea occurrence) 3 L000,000 X :SIR:S1.000,000 MED EXP(Any one person) 3 EXCLUDED PERSONAL 3 ADV INJURY '3 1.000,000 GEN'L AGGREGATE LIMITAPPLIESPER: GENERALAGGREGATE 3 1,000,000 X :POLICY dJ PRO- LOC 1,000,000 JECT PRODUCTS-COMPIOP AGO S OTHER: 3 A AUTOMOBILE LIABILITY MWT8314573 03101/2019 03/01i2022 COMBINED SINGLE LIMIT 3 1.000.000 _ Ea accident) X ANY AUTO BODILY INJURY(Per person) 3 OWNED SCHEDULED '.SELF INSURED AUTO PHY OMG BODILY INJURY(Per accident);S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY ! (Per accident) 43 UMBRELLA LIAR OCCUR i EACH OCCURRENCE 3 EXCESS LIAB -'CLAIMS-MADE' I AGGREGATE 3 DED RETENTIONS 3 8 'WORKERS COMPENSATION WC 012717099(AK,NH.1NJ,VT) 03/7 I 03/01/2020 X ST.anJTE �RH B AND EMPLOYERS'LIABILITY YIN N NC 012717100 ' (WI) - 0310112019 03101020 ANYPROPRIETOR/PARTNERIEXECUTIVE 5,000,000 E.L. 4 CCIDENT 5 OFFICER/MEMBER EXCLUDED? N I A .. (Mandatory in NH) E.L.DISEASE-EA EMPLOYEEI S 5,000,000 If yes,describe under Continued on Additional Pa9 e 1 5.000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 3 C :Excess Auto .297110011002019 03/0112019 03/01/2020 Limit 4,000,000 A Excess General Liability MWZX 314580 03101/2019 03/01/2022 Limit:' 8,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)' EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF,,NOTICE WILL BE DELIVERED IN BUILDING C-20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA,GA 30339 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee �CaLuao�.: twy�e ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN IO 1642069 LOC#: Atlanta A�E0 ADDITIONAL REMARKS SCHEDULE Page —2 of _ 3_ AGENCY NAMEDINSURED MARSH ISA.INC. THE HOME DEPOT,INC. HOME DEPOT U.S.A..INC. POLICY NUMBER 2455 PACES FERRY ROAD BUILDING C-20 ATLANTA.GA 30339 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 _ FORM TITLE: Certificate of Liability Insurance Workers Compensation Continued: Carrier:Indemnity Insurance Company of Nonh America Policy Number:'NLR C65890549(AL.AR.FL,ID,IA.KS.KY.LA,MS.MO.,NE,NM,ND,OK,SC.SD.TN,'NV.WY) Effective Date:031012019 Expiration Date:03101020 (EL)Limit:55.000,000 Carder:New Hampshire Insurance Company Policy Number:INC 012717098 (DC.DE.HI.INAD,MNAT.NY.RI) Effective Date:03/01i2019 Expiration Date:03/0112020 (EL)Limit:S5.000.000 Carrier:ACE American Insurance Company Policy Number:'NCU C65890586(OSI) (AZ.CA.IL,NC,OR,'/A,'NA) Effective Date:03101/2019 Expiration Date:0310112020 (EL)Limit:34.000,000 SIR:31.000.000 SIR for the Mates of.AZ,CAAAC.OR.`/A.WA Carrier:National Union Fire Insurance Company Policy Number XWC 5565596(OSI)(CO.CT,GA,ME,MINV.OH.PA.UT) Effective Date:031012019 Expiration Dale:03101/2020 (EL)limit:$4,000,000 S1.000.000 SIR for the states of CO.ME,NVAI,OH,P.A,UT $750,000 SIR for the stale of GA $350,000 SIR for the state of CT Carder:National Union Fire Insurance Company Policy Number:XWC 5565597(OSI)(MA) Effective Date:03/0112019 Expiration Dale:03/01/2020 (EL)limit 34,500,000 ' SIR:3500.000 TX EMployers XS Indemnity: Carrier:lllinios Union Insurance Company Policy Number.TNS C65221019(TX) Effective OaW 03101019 Expiration Date:0310112020 (EL)Limit:310.000.000 .. SIR:31.000.000 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD J 1 , • VE„ Town of Barnstable *Permit# Le-AZ - 6 S. C Expires 6 moieths om rssue drae Regulatory Services Fee s ,narsr,►ar�, Richard V.Scali,Director Building Division ooat Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 APR 2 2016 www.town barnstable.ma us Office: 508-862-4038 TOWN OF Qi cS§1-1,030 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number. c>? 73 - a 3 Property Address n Olesidential Value of Work$ "f Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address pn&pW C f- C PW(rj 'l.: r(2_ Contractor's Name Telephone Number b& - Home Improvement Contractor License#(if applica le)-J) 6 �l 3 Email: �i!'I C�,CO✓/(� U•Cc�.l1'1 Construction Supervisor's License#(if applicable) 0r(�� ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor „ ❑ I am the Homeowner L?f have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy#_(b �pn�C(�� (P± of 1�e (-0 . Copy of Insurance Compliance Certificate must accompany each permit.' Permit Reque t(check box) VRe-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to y ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.,U-Value (maximum.32)#'of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electri cal&Fire Permits required. "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Prope er m sign Property Owner Letter of Permission. y of th ome provement Contractors License&Construction Supervisors License is uired. SIGNATURE: - Q:\WPFILES\FO \build' permi rms\EXPRES oc Revised 040215 7'he'C'otnmonwealth of Massachusetts 1 Mrint Fo ; De," artfnent of Industrial Accidents ' Office of Investigations 600 .Washington Street Boston,MA 021, 4www.mass govAdia Workers'`Compens 1.ation Insura»ce Aft davit; builders/Contractors/Electricians/Plum ers A liaant Information Please Print Le ibl Nan1e (Business/OrganizationdIndividual)' C� cn Address: City/State/Zip: Phone C8^ �O' jG8Mo Are you an employer?C ek the appropriate box: Type of project(required): 1.C91I am a employer with general contractor and:1 6. 0 New construction, employees(full and/or part=tune).* have hired.the sub-contractors 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7 []Remodeling ship and have no employees These sub-contractors haye', g; [�Demolition working for. me in an ca aci employees and have workers' g Y P t3', 9 ;Q)Building addition [No workers comp. insurance comp ,insurance.$„' 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: oof repairs insurance"required.]t c, 152,§1(4),and we have no employees. [Na 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. tContractors that check ibis 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 worlrers'campensalion insnrance for n:y employees. Below is the policy and job site information., Insurance Company Name: X_( t�Q �Q' ( Policy#or Self-ins.Lic. Expiration Date " �I:Z �_,QQ Job Site Address: 1� ����QrDOQ1�Jl �� City/State/ZipQYII'11"S Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date): Failure to secure coverage.as required under Section 25A of MGL c:152 can lead to the imposition of criminal penalties of a " fine up to$1,500.00 and/or on imprisonment,as well as civil penalties in the form of a STOP.WORK ORDER and a fine of;up to$250.00 a'day against-therviolator ,Be advisedthat a copy of this statement may be forwarded to the.Office of Investigations of the DIA or insurance coverageverification. I do hereb nder ains and penalties of perjury tl:at the information provided above is true and correct. Si nature: Date: 25 2 c7 Phone �� ' �91 �6$ Official use only. Do not write rn this area,to be completed by city..or: official City or Town: Permit/License#- Issumg Authority(circle one) - 1 1 aid of-health 2:Bailding Department 3.C ty/Town Clerk: 4.Electrical;Inspector 5.Plumbing Inspector 6..Other Contact'Perion: Phone.#: ' � ''/�c 1%ni�riircinucrr�/�n�'ir'•llri.;.;rrc�n.rcll. 9 Massachusetts -Department of Public Safety 1_ Office of Consumer Affairs&Business Regulation Board of Building Regulations and Standards 11 .@ HOME IMPROVEMENT CONTRACTOR Construction Supervisor Spechilty i Registration 164213 Type: License: CSSL-101,072 ' Expiration 9/23/2017 Private Corporation FALCONE ROOFING GO INC ` John R Falcone 6 Lauren Road t£ s JOHN FALCONE Plymouth 1VIA 0260 f J 126 LONG POND RD _ PLYMOUTH, MA 02360 Undersecretary c- �� „ �� "' Expiration Commissioner 07/19/2016 Restricted To: CSSL-WS-Windows and Siding License or registration valid for individul use-only CSSL-RF-Roofing before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 Failure to possess a current edition of the Massachusetts � wt out signature State Building Code is cause for revocation of this license. ot valid '�- -- For DPS Licensing information visit: www.Mass GOvn iFALCONT- Company Incorporated 126 Long Pond Rd Unit 7 Plymouth,MA.02360(508)746-6866/Fax:(508)746-1411 www.falconeroofmjzco.com Andrew Sullivan November 20,2015 103 Centerboard Lane Hyannis,MA. 02601 (774)242-0597 GAF Thnberline 1,z me_FlD, hirate In regards to the above referenced project Falcone Roofing Company Inc.proposes to remove and replace existing roof for the sum of49-,266.00 this scope of work includes the following: gs4c)CO • Remove existing roofing down to deck and dispose of debris to a recycling facility in dumpster provided by Falcone Roofing Company Inc.,house and grounds shall be protected by tarps during demolition. • Homeowners are responsible for covering any and all items stored in the attic. If you require assistance please inform your project manager. (Tim or John) • Re-nail all loose roof decking. • Provide and install GAF ICE AND WATER SHIELD to all eves,valleys,step flashings,pipes, chimneys,skylights etc. • Provide and Install GAF Starter strip around perimeter. ��� • Provide and install GAF Tigerpaw underlayment on entire roof deck. '��j�►� �� ® Provide and install 8" drip edge at eaves. �A_z A(..P Provide and install new vent pipe flashings. • Provide and install soffit vents if needed. Provide and install GAF Lifetime Timberline Shingles on entire roof deck. Provide and install GAF Cobra Ridge Vent at entire ridge and cap. All gutters related to work shall be cleaned free of debris. In the event of roof deck replacement there will be an additional charge of$4.00 a square foot for plywood,$5.00 a square foot for boards, $12.00 a foot for fascia or rake replacement in Primed pine or$16.00 a foot for fascia or rake replacement in PVC. ® Debris shall be removed from ground and placed in a container on a daily basis.Grounds shall be cleaned and raked free of nails with magnetic rake. Provide a full roof inspection 2 years after completion date,upon your request.There is no charge for this,just call to schedule. ® Provide a 5 year workmanship warranty A job foreman shall be present during the entire project. 6 Tim or Owner John Falcone will make daily visits to job site. . Shingle Color Choice: �lGi l * Upon acceptance of this proposal payment shall be as follows: $500.00 deposit mailed with signed contract, 113 contract balance due at start, with balance due upon completion. .Please sign Acceptance of.Proposat and lines 12 and 13 on the contract. 7hankyou? ACCEPTANCE OF PROPOSAL CLitw b 6'A-'&�l (Signature) i Print name Aafew Sv n�,VOLr Contractor Tim Hickey I i FALCONE ROOFING COMPANY INC.IS FULLY INSURED WITH LIABILITY AND WORKERS COMP INSURANCE. i Thank You Falcone Roofing Company Inc. Proposal will be honored for 30 days O � i�ai Gladly accepted on repairs and deposits only ! i Town of Barnstable Permit# Regulatory Services >c mnrk rye d am Fee ,raaxen+Nit1639. • Richard V.Scali,Interim Director Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY - Not Valid wNwut Red X-Press Imprint Map/parcel Number �_ Property Address G dlvlot?v/-,�j S CK Residential Value of Work$ b Minimum fee of$35.00 for work under$6600.00 Owner's Name&Address T � O- Contractor's Name AAS QA.(Zt, Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) Q--7®®-7 Wo %in's Compensation Insurance �� Check one: X-PRESS PEA ❑ I am a sole proprietor ❑ I am the Homeowner NOV 2,5 2014 I have Worker's Compensation Insurance Insurance Company Name 5 e / Sw F BARNSTABLE Workman's Comp.Policy Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Rc-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side Replacement Wmdows/doors/sliders.U-Value r (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other twwrn department regulations,i.e.Historic.Conservation,etc. ***Note: Property er sign Property Owner Letter of Permission. A copy of H Improvement Contractors License&Construction Supervisors License is ' required. SIGNATURE: TAEVIN DBuNing Changes S ItESS.doc Revised 061313 aZ _..,..............._.........,... .....—..•L t ' 3'•+3+�D'p"��v.�. TP~:'A_f!r It.•�P.s�', t+,�-i.�.a� �(�; �b,•.'�s Sy�l� 1 i1 Az]hT'rrr+�s�; f`TFi '. i€s i:s tP 4 6t>t',°i}iit XWO) ZOITA E#�.`J1^(7�'' '��f. :,t:i""• .:f.1?:..t,Y���fJi+.�'. :.`S:i2it{.1 • tiw w... i;,!'SS;�:51�.d ?;'i�:Ei�b::`i�Sl1Gi9'�f'Ft�+1e c >_r��1� V•n�• „•G,•• l 5 �$}N5ttJ7a:��?�l#:E.ii,rY'S;T'i!'�yj;t C.��sCt�<�•t2�'�?l L:4r.,s;itfAiia ,,, _.^..,.._..�...._.......�......._.,_.•,� i�'IC24x�'EQ.`�.lPfii� IL.'?I`.'lil 7�J 1�1. r.................,.........._....._....._......,......_...._.....�.. ...,..,....._ •_.+.Y•-�._+...._.,.._._ .......•..."�..._.�.»..., �...... ,���:itit1{.�f,r> kf �t".l;:i`ls�i+�<, T.T�.'.SCIT.^,i�!.a f1�`?t.F fl�f:S�;fft)..'I ' i 6 >fi!aF:1?IL1'i=6iA;rz2 "(;#'ii3 k-:7iiUsx7 ;'fzt� ,' 1 ,. + 'J'Ai ". i e tq"V'$ :`i R! _ tii,�i'ifli n.F' _ ..'JikLS.J„ l fotlffl:j 1 A f llV: OA '..m ti!2 1310;1eF3 �'f� ? 7 ias6t,t% td .w i t ais�s� :'J i7•�.`'� �� _ twLTw s l .is i Ffr'. 'Iti7 S�'.J:i i.'•?iYt 31F i'! �ai(�tf; 1 J 7}L`1)10 t °`r6xi},r .,tt,,'c"_k?ati9l lnx A,'w; if" s4 ff4FCl:fa.� :•itt(1tC7 { � 91Li'i:.";3Ci 4 ;17,rz:t.1€t? au,:,9i;�)ri,;.,. ::s(r.3` :i*tarnirci:.hrrf�;tszlin:l;ts•1.,mst,Sr.tq:.lgmjx�'oil 2!fl z'urr;:•� ir3i'io�!rzar_4.3 ,ur:.}7,°ia.0 ±:: ;la„t'..s �i�,�9"•Y'I:kL;f1t £"{'.S6^IE"s`�+'f!!}�°h``a a;•'1�'17�,,� e1�>irJ;'«�tiskR`s 1'!I.°Pykd`;!39:�3'3AZ`o{€# �`a 3Yr��tr?1(e](?;;tr;. .�;l+.S.f!flh��p_�i^:f��u�":L39�.P"�>�Z9�,^,tiu!.%..:'.t:)?73/•��f�t '1;'..Jlr•�, FROM :jam9ad FAX NO. :5083622271 May 18 2011 1:59PM P1 HOME IMPROVEMENT CONTRACT PLEASE READ TIM Sold,Furnished and Installed by: Branch Name:Boston North&South Dater/ 1/ THD At-Home Services;Inc. "a The Home Depot At-Home Services Branch Number.31 and 33 908 Boston Turnpike,Unit t,Shrewsbury,MA 01545 Toll Free 877-903-3768 Federal ID#75 2699460,ME Lie#C 02439;RI Cont,Lic#16427 CT Lic#WC.0565522;MA Home Improvement Contractor Reg.#126893 Installation Address: 'QQ Q �-ke &Wma , �g �4 a/ City State Zip Purchaser(s): - Work Phone: Home Phone: Cell Phone: va in [ J [ J J T 3a 33 [ J [ l [ J5 Home Address: (if different from Installation Address) City , 1 State Zip E-mail Address(to receive project communications and Home Depot updates): ❑i DO NOT wish to receive any marketing mails from The Home Depot Prroiect information: Undersigned("Customer'),the owners of the property located at the above installation address,agrees to buy, and TFID At-Home Services,inc.C'The Home Depot")agrees to furnish,deliver and arrange for the installation("installation'l of all materials described on the below and on the referenced Spec Shecl(s),all of which are incorporated into this Contract by this reference,along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(collectively, "Contract"): Job#: (mm a aderaece) rodads S Shee s # Proiect Amount Roofing Siding Windows U Insulation ❑Gutters/Covers []Entry Doors ❑ $ — Roofing USiding Windows U Insulation ❑Gutters/Covers ❑Entry Doors ❑ $ Roofing LjSiding LJ Windows LJ insulation ❑Gutters/Covers ❑Entry Doors[I $ Roofing Ljsiding Ll windows El Insulation ❑Gutters/Covers ❑Entry Doors ❑ $ Minimum 25%Deposit of Contract Amountdue upon emicution ofthis contract. Tel Contract Amount $ Maine Purchasers may not deposit more than one4bird of the Contract Amount Customer agrees that,immediately upon completion of the work for each Product,Customer will execute a Completion Certificate . (one for each Product as defined by an individual Spec Sheet)and pay any balance due. As applicable,each Customer under this Contract agrees to be jointly and severally obligated and liable hereunder. The Home.Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s)included herein,at its discretion,if The Home Depot or its authorized service provider determines that it cannot perform its obligations due to a structural problem with the home,environmental hazards such as mold,asbestos or lead paint,other safety concerns,pricing errors or because work required to complete the job was not included in the C ntct_,/ Payment Summary: The Payment Su mnary# /d��ra F`7 0 . included as part of this Contract, sets forth the.total Contract amount and payments required for the deposits and final payments by Product(as applicable). NOTICE TO CUSTOMER You are entitled to a completely filled-in copy of the Contract at the time you sign. Do not sign a Completion Certificate(note: ' there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before wont on that Product is complete. In the event of termination of this Contract,Customer agrees to pay The Home Depot the costs of materials,labor,expenses and services provided by The Home Depot or Authorized Service Provider through the date of termination,plug any other amounts set forth in this Agreement or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENTS MADE,WITHOUT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Acce fence and Authorization: Customer agrees and understands that this Agreement is the entire agreement between Customer ati The Home Depot with regard to the Products and Installation services and supersedes all prior discussions and agreements,either oral or written,elating to said Products and Installation.This Agreement cannot be assigned or amended except by a writing signed by Customer and The Home Depo Customer acknowledges and agrees that Customer has read,understands,voluntarily accepts the terms of and has received a copy his Agreement. Acce Subm" by: - X X D ` 7 Customer's Signature Date Sales tant's Si f e Date C� , X _ Telephone No. Customer's 5igriature Date Sales Consultant License No. CANCELLATION: CUSTOMER MAY CANCEL THIS (As applicable) AGREEMENT WITHOUT PENALTY OR OBLIGATION ' BY DELIVERINC WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING THIS AGREEMENT. THE a STATE ' SUPPLEMENT ATTACHED HERETO CONTAIN$ A FORM TO USE IF ONE iS SPECIFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STATE. NOTICE:ADDITIONAL TEILMS AND CONDITIONS ARE STATED ON THE REVERSE SIDE AND ARE PART OF THIS CONTRACT 08 19 1 S White—Branch Rile Yellow—Customer F j t , a . �. ' V r � t t; , ._,. # s' + � ' .- � fps .. .}. ' . ' .. � �r _ c� ,�� r � � � ... . . � ._ A ... � 1 � / - ti .. ♦ .. .e. a i � � ' r _ .k • � ,. - '.t !, S � � f s • .. y I r •. t j 1! 1 ' � _ 1 � � , � k - rf .� - x ^ � � .�� 3 � ` *.+ of " � � �. � � _ � � L f i � r i F i ..,J � � ' ,.. f _ ., `st G •y «li�` .m.F - Ci `"T 'F,s'�-�' "kx '1'^l` .,.t� t' r` lr3i. ,. s � The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 _ Boston, MA 02114-2017 1 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): T/nQ /ILxo _ Address:_ City/State/Zip: l l korac, d `�� Phone#: 7 7� 76� �L3 Z Are you an employer? Check the appropriate box: 'Type of project(required): I.❑ I am a employer with _ 4.'❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.S� I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees'and have workers' 9. ❑ Building addition [No workers' comp.insurance comp. insurance.t 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.❑ 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 anew affidavit indicating such. . 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insuranrie Company Name: ��.) _J� s 1A)S Policy#or Self-.ins.Lic.-#:. 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 nder the a' s acid pen . ies of erjury that the information provided above is true and correct. ----- - - - Signature: -------"-- — Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street,Suite 100 Boston,MA 02114 2017 www.mass.govldia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/tndividual): HOME DEPOT AT HOME SERVICES Addre :2455 PACES FERRY ROAD 4am te/Zip:ATLANTA, GA 30339 hone#:774-265-2139 n employer?Check the appropriate Type of project(requiredj: a employer with 20 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 7: ❑Remodeling ship and have no employees 'These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance.t 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.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.E]Roof repairs insurance required.] t' c. 152, §1(4),and we have no WINDOW REPLACEMENT employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below shoring 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. lContractors 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 proiide 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:NEW HAMPSHIRE INS. CO. Policy#'or Self-ins. Lie. #:WC049101882 Expiration Date:3/1/2015 Job Site Address: 163 Ci.bkeLAna.&,�_l/'I City/State/Zip: ,I' Attach a copy of the workers' compensation policy declaration page(showing the policy nu4er 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 th lator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for in ce coverage verification. I do hereby certify under,t s a en the information provided abo a is Ifue and correct. Si a e: Date: Phon #: 401-714-6399 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#: f - 4 I,::_: w ��e �p�y2�a�2�r�ea:��f d- C�G�c�r�c�tl•Office of Consumer Affairs and Business Regulation • 10 Park Plaza - Suite 5170 Boston, Massachusetts 0211.6 Home Improvement.Contractor Registration . Registration: 126893 Type: Supplement Card THD AT HOME SERVICES, INC_ .: Expiration: 8/3/2016 ANDREW SWEET 2690 CUMBERLAND PARKWAY SUITE=30a:` - — ATLANTA, GA 30339 Update Address and return card.Mark reason for change. scri :_ 2M.1-05ni ; I Address j'-] Renewal i:-; Employment Lost Card L rl k- (.l r���/ltvnur•C///�h%�'•!f/�i;(Ir�!/J//; 0free of Consumer Affairs&Business Regulation f=_ rZ b License or rebistralion valid for individul use only � ,_j,-:J'IHOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: `i Office of Consumer Affairs and business Regulation Registration: 126893;. Type: 10 Park Plaza-Suite 5170 Expiration: 61312016 Supplement Card Boston,MA 02116 run AT UnNAC sr- VI-1cC .IhtC' FHE HOAAE DEPOTAT HOtvtE SERVICES ANDREW SWEET 2690 CUMBERLAND PARKsA/AY.S •���, nrcaen - - __--- d —A� /49 sscss. r.'s Office(1st floor) Map k Lot -) / Permit# C,nscrvation Office Oth floor Date Issued /0131T!l , Board of Health Ord floor Engineering Dept. Ord floor) House# Planning Dept. (1st floor/School Admin.Bldg.): s SAMSTABM r M .. Definitive Plan Approved by Planning Board 19 039. > (Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.) TOWN OF BARNSTABLE Building Permit Application �v %tJPro ect Street Address �� � � dl, Villa llkaloe v9 Fire District Owne A114, c Address /G7 Telc hone 77ol(—G7 Permit Request: Zonin District > Flood Plain Water Protection Lot Size 1oocza S Grandfathered Zoning Board of A is Authorization Recorded Current Use a Propgsed Use c r�li Construction T /L"_ Existing Information Dwelling Type: Single Family Two family Multi-family Age of structure Basement type Historic House Finished Old Kings Highway Unfinished Number of Baths No. of Bedrooms Total Room Count not including baths First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds ��oD COO Other 061J)m. Builder Information �M Name // L Telephone number W ' 27 Address ��� License# ���76 ` Home Improvement Contractor# OPY Worker's Com iisation # NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ! / �/ G+ ALL CONS //CTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Gdl�l� � G�/I Pro'ect Cost 6r Fee ` d SIGNATURE DATE /O / BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T FOR OFFICE USE ONLY ADDRESS 103 Centerboard Lane f VILLAGE Hyannis OWNER Markwood Corporation s T DATE OF INSPECTION: FOUNDATION 1 FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH a 1 FINAL GAS: ROUGH FINAL FINAL BUILDING: f DATE CLOSED OUT: ASSOCIATE PLAN NO. 1 i y A N k f N- i N ca t J cc 4 .00 S �A 0�h� io s3-sue 4B' 6870 t SF L 0 T 20 G$�� von � VO 1. Y� TOWN OF BARNSTABLE ZONING ` ZONE : RC` I TO THE BEST OF MY PROFESSIONAL KNOWLEDGE SETBACKS OPEN SPACE INFORMATION AND BELIEF THE STRUCTURE SHOWN FRONT - 20' HEREON CONFORMS TO THE HORIZONTAL SETBACKS SIDE - 7.5' AS GRANTED UNDER THIS OPEN SPACE DEVELOPEMENT. REAR - 7.5' OF PROPERTY LINES SHOWN HEREON o� M!4s WERE COMPILED FROM AVAILABLE FRANOC s PLANS OF RECORD AND DO NOT 8 WHITING N No.29869 REPRESENT AN ACTUAL SURVEY '. 9F�/SrrE. ON THE GROUND. THE DWELLING DEPICTED ON THIS PLOT PLAN PLAN WAS LOCATED ON THE GROUND IN BY SURVEY ON OCT. 27. 1994 AND BARNSTABLE. MASS. EXISTS AS SHOWN AS OF THE DATE OF LOCATION. SCALE: 1 '-40' OCT. 27. 1994 THIS PLAN I S.FOR PLOT PLAN EAGLE SURVEYING ENGINEERING.INC. PURPOSES ONLY AND NOT FOR !0 Seaboard Lane RECORDING. DEED DESCRIPTIONS Byannle. dla. 02001 OR ESTABLISHING PROPERTY LINES. ($08) 778-4422 0 20 40 80 PROJECT NO. 94-331 -. —_ -��_' -_,autxr_=cPnnsiswuruur i r - /TI�I 1 /-J _T�7=_ ;1. �1_ •. I� LFF T"E�E�/nYl y N ---- .tt`"`ia. P•TE -- --- 508.428.6191 --— ---—� rr a evl i n Oustom Le gns -- k LSn�lL.I L= i Au R.gnts zz JEBj >aw uLU&.f t p K Cr)- Plh I _._sRrucn_r*rt.w/wIt+r),cnr - h••�•o�u.mr�e_ �. �.e..wnrLxsna>s:'--- 3 Preliminary plans and layouts by DC.D-afe for the use of their customers only.Any other use is strictly promotte N "IHni1118(A:TS, rm ILL ___ffil -Yt:w 11CAL. -'TL�EstatsON— - I.74iIG.IUfsIC."'— -::...I"N.Iliwl. - n , __.'RFJ%MEV\TIflN m. -law SCALE OATS O 508.428.6191 O _ (Levi i n g LL gustom i. �• (flies igns . copyright 0 1994 All Rights Reserved N I; _._ -'Tt�4� IaTRs{:'GONL RC•faR-a'••a"� - ' (� ... -,:,'.;GONG❑IICO:UbtY COs.�.... . - v ..-- Al Preliminary plans and layouts by OC.D.arc.,for the use of shelf customers only.�ny other use is strictly pron.one � r U 01 T:: b ,� —-- i$ ISO" ':i 'v S6 14. .. 70' � ... 6'•B' _ - i -- - _ 16ETSROOM-.... A. `FFCSTCR'6u1T�...: O77 .--- b Y 41t Kwu r f JUL? MCK Sr 001 --— o ro�� rrA in 10 eVI N r j J I GG ' W p go, n wo I PUT _:F.LCX]R.PCAN .._.'J` v e WO: A3 f C ' Prelf mfndly plans and layouts oy DC.O.are for the use of tnefr customers only.Any otner use fs strictly proniotte i ! r G r r E • �I •`• y-11 ' flM_ G i . A 0 E 0 0 -MARm\ 600.- .rWILOERS >o ( N r A 0 C 1p c 0o a o = p y ..O 2 p '• N 3 r� •i COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY JOEL OF ONE ASHBORTON PLACE current MASSACHUSETTS BOSTON,MA 02108 codo/Z;ci. 8.911al"s LICENSE of this llcwj"�a "vocation EXPIRATION DATE 1 1. CONSTR. c-I'LIF'ERVILSC-IR CAUTION RESTRICTIONS r NIDNE 4L EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST 06/3,0/1 9F�— 0-1 THEFT, PUT RIGHT THUMB 5867 PR INT IN APPROPRIATE TIMOTHY F'EARSON BOX ON LICENSE. # (-ff-l—F, —4.:=- BLASTING OPERATORS 75 151 CARR14GE LN - mus7j 'BARNSTABLE MA 02630 �OLLUDE PHOTO. —0HoTo'PLAST—D"R ONLY) FEE: C) 100. 0 NOT VALID tWL By ANDOFRO&Ly HEIGHT: STAMPED-OR THE COMMW,O&R DOB: IJUN 1*--,./1'P53 THM DOCLPMENT MUST BE CARRIEDON THE PERSONOF S*NA OF LICENSEE SIGN NAME INZ) OTHERS THE HOLDER WHEN EN. VR*q&JRE LINE RIGHT TKAot8 PRtNT GAGEOtNTMOCCUPAMN. COMMISSIONER a ` COMMONWEALTH OF MASSACHUSETTS DEFAK M:ENT OF INDUSTRIALACCIDENTS 600 WASHINGTON STREET ames Carn;aec BOSTON, MASSACHUSMS 02111 Cornm:ssione• WORKERS' COM NSATION INSURANCE AFFIDAVIT Aicenscclperminec) with a principal place f busin uidena at 7 (Cary/Sutc/Zip) do hereby certify, under the pains and penalties of perjury, that: [) I am an employer providing the following worke s' compcnsaaoa coverage for my emplovccs working on this job. Insurance Company Policy Number [) I am a sole proprietor and have no one working for me. I am a sole proprieto , feral contract ro n�homeowner (circle one)and have hired the contractors listed b-ow wh have the iollowin o e nsation insurance polio Name of Contractor Insurance Company/Policy Numb 1�a�mreo/f�Contractor Insurance Company/Policy Numbe: Name of Contractor Insurance Company/Policy Number 0 1 am a homeowner performing all the work myself. DOTE: Picric be aware that while homeowners who employ persons to do maintenance,eonstruaion or repair work on: dwc ling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not genertJv considered to be employers under the Workers'Compensation Act(GL C.152,sect 1(5)),application by a homeowner for a lice:sc or permit may evidence the legal tutus of an employer under the Workers'Compensation Act 1 understzid that a copy of this sutement will be forwarded to the Depar-cr:of Industrial Accidents'Ofnee of Insurance for eovra;c vcriftution and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal pc.a::es consisting of a fine of up to S1500.00 and/or imprisonment of up to one yc:cad dvt]penalties in the form of a Stop VGork Order arc: fine of S100.00 a day against me. Signed day of 19 Li scc!Pcr tact Liccasor/Pcrminor ; o N N C9 + H QD Al pp .pp h s sue• 9 B' 6870 t SF �'tea• p,� LOT 20 z o Gp�J91 w Fp �V o? 16 S .� 6 V TOWN OF BARNSTABLE ZONING ZONE : RC- I TO THE BEST OF MY PROFESSIONAL KNOWLEDGE SETBACKS OPEN SPACE INFORMATION AND BELIEF THE STRUCTURE SHOWN FRONT - 20' HEREON CONFORMS TO THE HORIZONTAL SETBACKS SIDE - 7,5' AS GRANTED UNDER THIS OPEN SPACE DEVELOPEMENT. REAR - 7.5' PROPERTY LINES SHOWN HEREON p WERE COMPILED FROM AVAILABLE PLANS OF RECORD AND DO NOT REPRESENT AN ACTUAL SURVEY ON THE GROUND. u6y Y'1 t. THE DWELLING DEPICTED ON THIS C' PLOT PLAN PLAN.-_WAS L0 CATE ON ,HE.-6,q0U D BY SURVEY ON OCT. 27. 1994 AND z?ly iN- EXISTS AS SHOWN AS OF THE DATE BARNSTABLE. MASS. OF LOCATION. SCALE: l '-40' OCT. 27. 1994 THIS PLAN IS FOR PLOT PLAN EAGLE SOYEYING & ENGINEEBING,INC. PURPOSES ONLY AND NOT FOR 10 Sea3oard Lane RECORDING. DEED DESCRIPTIONS JJyannts. dfa. 02B0J OR ESTABLISHING PROPERTY LINES. ($08) ?'P'8•-4422 0 20 40 80 PROJECT NO. 94-331 f TOWN OF BARNSTABLE, MASSACHUSETTS BUILDING PERMI r, A=" 73 Z37 October 31 94 , NQ __ ...7169 DATE 1(9��--ram.- P RMIT.NO. • APPLICANT TimPearson/Maritwood orP- ADDRESS Z rd11ll�utl KC.�• / yannls 876 (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO i3ulld dwelling ( 2 ) STORY Single family dwellir MBER OF 1 DWELLING UNITS i (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) lot #20 - 103 Centerboadd Lane, Hyannis ZONING CT RC (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION -LOT—BLOCK—SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: Town Sewer #3135 BOND AREA OR 1096 su. ft. 65, 000 PERMIT 184.00 VOLUME ESTIMATED COST FEE s (CUBIC/SQUARE FEET) 111ARKW00D CORP. OWNER Falmoutn Roaa, Hyannis, 14A BUILD G ADDRESS BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY .PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED 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 OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE'CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF -OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO BEFORE , FINAL INSPECTION HAS BEEN MADE.3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 I � 2 2 2 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 1' BOARD OF HEALTH OTHER SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION */,-A­Ass6'ssor's map 'and lot Aumber ... 7 Sewage Permii-' number ......... ........ MIUST CONNECT To TOWN SEWER 133 STABLE, fro BUILDING INSPECTOR . . ^ APPLICATION FOR PERMIT TO ��g�������..�� ..���g���-!��������.--.—,--.—...—_. . ' � � ` wood - frame TYPEOF _----.__.' _,,....____._._._________________.. . ` _._.,. .lI^....lA...�9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for o permit according to, the following information: ' � Location _.Lot....#2.O...................Ce�t�rboarcl_I,aue______ i.��_8�\______.__________. . . � . Proposed Use --------------------,----.---------.—...—..-----.--..'-------..- Zoning District ...........B:.B.......................................................Fire`District —.� -----.—..-------._—, ' . � Name of �na, ���i��..B�I�'���---..�6� .��'����b. � x-.���o��x—� ' ^ Nome of 8vi|6o, I7�����']l"II,—���"���,IJl��^--A66esu .T���..]���lJ�D��lJ..J����["-JJ���ll��,^..�Q\— � ' Nome of Architect ----------------------A6dres -------------------.—.--_----. ' Number of Rooms .....SSiN........................................................Foundation ...... ................................. —.UaPboard..,�nd/.ox.'S.binoLeS.----.Roofing ....aanhal±...shiaglas...................................... Floors —`.JC.ar.I.et-- -------------------|nmericv ....'5.h. Pgtrmok__________________. � Heating ..Q.45'.F,XA........................................................Plumbing ....TX}:-.(.QP.P.Qr................................................... � Fireplace .���/�-----.. ----------------.'—Approximote Cost —$5.0.1.O0.O:.0U._,,___,______. Definitive Plan by Planning Board lQ �� . An*o _.l.l7�0—�/�._.�t�-- ' Diagram of Lot and Building with Dimensions Fee .............................................. SUBJECT TO APPROVAL OF BOARD Of HEALTH � � . . � y \ \ � .. � � . � � . | ^ � � . . � � OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS � | hereby agree no conform to all the Rules and Regulations of the Town of-Barnstable regarding the above ,- -�'--'---'—'---- ... ---';r—_—'--' . Construction Supervisor's License ...0.U0.9.89----_,. ................. Permit for .................................... ............................................................................... Location ................................................................. ................................................................................ Owner .................................................................. Type of Construction ............................... ................................................................................ Plot ............................ Lot.................................. Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 TOWN OF BARNSTABV ^ BUILDING INSPECTORAPPLICATION FOR PERMIT TO ....construct sincyle...family dwellin.cj � Tb�-THE'I`NSPECT6 R�OF BUILDINGS-.. � ' The undersigned hereby applies for o permit according to the following information: Imt #2O Centerboard La�e i MA ` Location -------.��-------------------..-----..�.l�����../��.----.—.------------.. ~ ProposedUse^ ............................................................................................................................................................................. .� Zoning District ...........R~.B......................................................Fire District .....RYA A a �....................................................... Name of Owner �i�Rrioo��...Realtn'!���gt—_—..A66,mu Name of Builder ��ag�� ll�Il D�l! �Jg Ig{� A66eax —' ' ^— � "� �-- 'Name of Architect ----------------------A66res -----------------_---------- _ Number of Rooms —.S].�K............................ .........................Foundation —'jP"{�^--------------------.. ' ' Exierio, {�� j�ao�_a,It...GlljJngl�o— �m�u�+y'/���^zu��mw��u�'���—�---.xoo,'ng — �= � ------------' Floors ...... t................................................................Interior —.g'm—"trpq�.r-----------.`-----.. Heating '[�K�l�]����^J\�--_-------_--_--�Mumbiog... .._._.� ........................... ' \� Fireplace ----------------.-------Approximote [oo .... .0O0.�.0O_______,__,_,.. - ��v ll7U ' Definitive Plan by Planning Board 19~�^o� —, Area ------'S.q.---ft......... Diagram of Lot and Building with Dimensions Fee _______________ | ` SUBJECT TO APPROVAL OF BOARD OF HEALTH _~^ ^ ` ~ . \ \ .`` ' ' ' ` | 4' ' OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ' | hereby agree to conform to all the Rules and Regulations of the Town of 8onnmbb|e regor6ing the�o6ove construction. Na� ` � _$--_--~__—_------��'�y—.—__~^ Construction Supervisor's License ... OOO989.................. ' | | . I Nct ................. Permit for .................................... ............................................................................... Location ................................................................ Owner .................................................................. Type of Construction ........................................... Plot ............................ Lot ................................ Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed 19 v\ i ,I h Y=+ } TOWN OF BARNSTABLE � CERTIFICATE OF OCCUPANCY PARC ID 273 237 GEOBASE ID ,. 37662 ADDRESS ' 103 CENTERBOARD LANE PHONE Hyanniq ZIP LOT 20 BLOCK A - `LOT SIZE DBA -DEVELOPMENT, DISTRICT HY PERMIT 9337 DESCRIPTION SINGLE FAMILY DWELLING ° PERMIT TYPE BCOO TITLE CERTIFICATE OF OQUipafflnent of Health, Safety CONTRACTORS: and Environmental Services ARCHITECTS: .F TOTAL FEES BOND $.00 CONSTRUCTION COSTS $.Op `F + BAMSPABM MA$S.f �► 16.39. OWNER COBBLESTONE,' LANDIN N p ►lA`� ADDRESS P 0 BOX 274 BARNSTABLE MA ' BUI 11( °VON � DATE ISSUED 07/25/1995 . EXPIRATION DATE DIVISION APPROVALS FOR CERTIFICATE OF'•OCCUPANCY TO BE SIGNED BY EACH DIVISION HEAD UPON COMPLETION BUILDING: DATE: 4, COMMENTS: PLUMBING:, DATE: COMMENTS- ELECTRICAL: DATE: COMMENTS: GAS: DATE: COMMENTS: CONSERVATION: DATE: COMMENTS: OKH: DATE: COMMENTS: HISTORIC: DATE: COMMENTS: FIRE DEPT.: ' DATE: COMMENTS: OTHER: DATE: COMMENTS: TURN THIS IN TO THE BUILDING COMMISSIONER AFTER ALL SIGN-OFFS ARE COMPLETED.A CERTIFICATE OF OCCUPANCY WILL BE ISSUED AT THAT TIME." 41( TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY r' ID-273 .237 GEOBASE ID 37662 PARC ADDRESS . , 103 CENTERBOARD LANK 4 PHONE HVannip . ZIP- LOT 20 BLOCK � LOT SIZE DBA DEVELOPMENT , DISTRICT HY v � PERMIT 9337 DESCRIPTION SINGLE FAMILY DWELLING i PERMIT TYPE HCOO TITLE CERTIFICATE OF OCM-Ph "inent of Health, Safety CONTRACTORS _ _ ' and Environmental Services ' ARCHITWLS TOTAL 'FEES: { !I .BOND $.00 CONSTRUCTION COSTS $.00 ^ * BARN3PABLF, a 16 OWNER COBBLESTONE:"'LANDIN1 �Ep w i ADDRESS P 0 BOX. 274.. BARNSTABIX MA BUI V N DATE ISSUED 07 /25/1995, EXPIRATI N .DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS 4 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 OF THIS 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 THIS CARD KEPT POSTED UNTIL FINAL INSPECTION WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS PERMITS ARE REQUIRED FOR 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU= (READY TO LATH). ELECTRICAL,PLUMBING AND MECH- PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ,. I 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS.BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS i VISIBLE BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 I 2 2 2 3 1 HEATING INSPECTION APPROVALS -,_.,,.,ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL 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. 508-790-6227 M '�75"3P3C!'•L�r.._.-.. _ .. ' ..., .,: -. -sr: W � � 1r. Y € t y r d ?'. �. -.. TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY �s PARCEL ID 273 237 ` " GEOBASE ID -737662 ADDRESS 103 CENTERBOARD LANE r.=1PHONE Hyannis - ZIP LOT 20 BLOCK - - LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 9337 DESCRIPTION SINGLE -FAMILY DWELLING ' PERMIT TYPE BC00 TITLE CERTIFICATE OF .OcVdpWMent of Health, Safety CONTRACTORS: __ and Environmental Services ARCHITECTS: TOTAL FEES: • �TME BOND $_00 CONSTRUCTION COSTS $_00 - HARNSTABLE. * . � s MASS. OWNER COBBLESTONE LANDIN ADDRESS P 0 BOX 274 A4 BARNSTABLE MA BU ZN DATE ISSUED 07/25/1995 EXPIRATION DATE MINIMUM OF THREE CALL -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: IELECTRJCAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE - OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 01 17- ae 2 2 3 HEATING INSPECTION APPROVALS . ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL THE INSPECT PERMIT W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ,ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. t a b 's t E P .. t { 1.