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0029 ERIN LANE
�l-�-�Z, � \_ .-r �, ;. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION CD Map Parcel 1 Permit# 1� f Health Division • Date Issued j o Conservation Division G U Application ee o'o Tax Collector' 0k Is-10© — C- j Permit Fe Treasurer (7 10 — l /p(� �..� 1N COMPLIANCE Planning Dept. I VATW TITLE 5 L, 07,'ON IENTAL CODE ANE. Date'Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic OKH Preservation/Hyannis Project Street Address a Village Hyyg Vyl J II I fI g- Owner A-�!'� e?0 1O1PO Z Address w Telephone /',� g,RLI— &gl 9 Lv✓ i'�.� A� Permit Request !Lb EX 7-15 O c'ST'' 7 5 P ` S&& 6e"-ef46-�- . Square feet: 1 st floor: existing proposed 2nd floor: existing p osed Total new ° Zoning District Flood Plain _ Groundwater Overlay Project Valuation Construction Type 6,I) Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. ° Dwelling Type:,Single Family W/ Two Family ❑ Multi-Family(#units) Age of Existing Structure �� �Q5 Historic House: ❑Yes a o On Old King's Highway: ❑Yes Q,4 Basement Type: BIKIl ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft,) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new % Number of Bedrooms: existing_ new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas 2 Oil O Electric ❑Other Central Air: ❑Yes /No . .Fireplaces: Existing _� New Existing wood/coal stove: ❑Yes ❑No. t 'Detached garage: ❑existing ❑new size Pool:❑'existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new. size }' r Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan.review# �. Current Use '� �s � Proposed Use SAML-7 41: BUILDER INFORMATION Name � ti�� ��ra z1vt.� Telephone Number Address 43 U� L �s�u,�jtg PA= License# L's b Home Improvement Contractor# I-5 O o e( ` "/. Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1-7 SIGNATURE DATE �' ' r� FOR OFFICIAL USE ONLY 3 .I I PERMIT NO. -% DATE ISSUED _ . t MAP/PARCEL NO. r � •� ADDRESS j t - •' VILLAGE % ^ • I OWNER a„ DATE OF INSPECTION: FOUNDATION - 1 FRAME INSULATION x FIREPLACE - ELECTRICAL: ROUGH FINAL-I- PLUMBING: ROUGH FINAL - f GAS: ROUGH • FINAL f FINAL BUILDING. DATE CLOSED OUT }- J ASSOCIATION PLAN NO. f _ The Commonwealth of Massachusetts Department of Industrial Accidents __ 600 Washington Street Boston,Mass. 02111 Workers, Com ensatlon Insurance Affidavit-General Businesses name: }` address: 43 6 L city e-p V L t state: )414 , zip: D Zfo, Z phone# ` zo " 7 5 4 6 work site location full address I am a sole proprietor and have no one Business Type: El Retail❑Restaurant/Bar/Bating Establishment working in any capacity. ❑Office❑Sales(including Real Estate,Autos etc.) ❑I am an em to er with ein loyees(full& art time). ❑Other I am an employer providing workers comvensation for my employees worldng on this job. coulpany Il8me: ..•. -• . address", city: pbone#:-.. . insuraa a I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: _ company name: • ' address:.:... city: phone N. insurance co. :='`• 7ic'`:# V111117117111711,, .. comnany name: K address city::."' . . .. .. ..:: . .. tihone#: .. • - insurerica olicv Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,S00.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that is copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certi under the pains and pen ie of perjury that the 'formation provided above is true and correct Sipature Print name Phone# i official use only do not write in this area to be completed by city or town official city or town: permwlicense# []Building Department ❑check if immediate response is required ❑Licensing Board p q ❑Selectmen's Office � ❑Health Department contact person: phone#; ❑Other (revered Sept.20M) _. v Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employ=. As quoted from the"law", an.employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association,corporation or other legal entity, or any.two or more of . the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the 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 section 25 also states that every state or local licensing agehey shall Mthhold 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name,address and phone numbers along with a certificate of insurance as all affidavits 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 arty questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns 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 pernrit/license number which will be used as a reference number. The affidavits.may be returned to the Departrnent by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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 Imsugatlons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext.406 oFTME,�. 'Town of Barnstable Regulatory Services a,RNSTAB E.$ Thomas F. Geller,Director Building Division . Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. _ Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, -improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: L� �o� �1� Estimated Cost Address of Work: 9 e l Owner's Name:f�Yl t2 c �dl�D f, Date of Application: '- I hereby certify that: Registration is not required for the following reasou(s): []Work excluded by law ❑Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERMY I hereby apply for a permit as th gut of the ow.;er: g :�q Date Contractor Name Registration No. OR Date Owner's Name ` RESIDENTIAL BUILDING PERMIT FEES . APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 � ` Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= co plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= • (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) r^ ® . Permit Fee ©�> projcost S ofTti Town of Barnstable Regulatory Services swxx Thomas F.Geller,Director KAM 1639• ``� Building Division �PTsa rui' g - Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-8624038 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Using A Builder Y as.Owner..of the.subject property,- hereby audiotize . L� U `': L D_ .S-/ L✓Z-:% _.to`act ontq behalf,. in all mattets relative to work autho: zetl•bp this building•permit-applicationifot: (Address of Job) Signatute of Owner Date AV Print Name fie ��ea/ o�,/�aeaacfivaelta 1`. BOARD OF PIMPING REGULATIQN;S Licen se:\CO STRUCTION SUPERVISOR rn Nuber.�G5, 055025 BiqQate, 0L04%q7 t. �C1fe81 �/g2,.05 Tr.no: 7214.0Ull f ResSr�; e EUGENE E DU' A13 43 BRgLEY J,ENKIIJaS-]�,;�-�,%/ L•E'o«��i��:��� ,,s CENTERVULLE, M]4 OL632" Atlministrafor As. { p E148NT C a IV INIE E D1U • X J 0'/J a Board of Building Regulations and Standards m � - HOME IMPROVEMENT CONTRACTOR Registration 1,300 ^ Expiration I Type I-di" Ual EUGENE DUSSAULT _ EUGENE DUSSAULT 43 BRALEY JENKINS CENTERVILLE,MA 02632 Administrator , a r , lz q , f s XiVA 6 ro s 4--TV e E Z. V Afl ITJ JL- `e.�► 4 a � . d• - - --- - -- ---•- ca.__4 } ' Eo r .- �. -� .�"'' ._ -- .,. �« x }, .. y�r� z �9a�v,,,� $ � .. .� •,: �`i, ��s�', -;fie,l ',,�- `z�"� '` r s � re2s`•-'3,� _.'?��t �,�.� '�� "� a ^r ""'��S' .7,.:�• ,z� —�`3.`�`r� ',. �,. ,crsz,.� .- '' ''"-�"�,7.3,-"k�H �'sr-�s w�`k .°.,''r�' .,�:-� Y "'^�� �^` S'�^'+�'T.j`~•o�,s,. �' ��.am +,r. "��g. '� �,e:e w.� -1 ,,.-CFI ` , �^}.:_ '�'� .S�-r �..'�"°.j}sL.-'r, �-_.. �Y u�a'9�`°'^'a+•-V �.- a�,,, y y v '� $--r' - :i �I' `.[�'�4�'� ,��xx'- ." 7t.- _ � r yCc 4 '- l7 4 PC— YS -N.�,�,.�*_ ,.�3 ``z'-}•-a� µu .tT tom^'.. _� � �w�tc����_ _ ,ra.v `"s t't f r.e_ V"R Y a�.,+v..- "f y:. ��M � ... Y.,,.� ..��'Y• 1 J'3" �' a'r"Y� '"r-t'� � -�' -- �-T - ' 1 _ - t'r: �'f r'•�' '£` --ems. -. ���'E: : �', `-, '�{ � ...vi*�;,, `�z�:� � :.. -grw�� s..,_ a ';.z�• - z so a f. Y � _ k �µ.4 -`f' - �i PL T } t I —Ro'n"00i AN o4 Aa S' "i �l 406 UT .c r :+ ..� - ^<-�`",«✓- ? Zi -�—,..a l ,.sr„'`r -+j,..,t,' z v, rf3• ,r�5. -.rac u .. - 41 rr _ E � t W - fir. --•'�`+- - .'� a 'A re_ t R r The Town of Barnstable HAM�,�¢' Department of Health Safety and Environm ervices Building Division 367 Main Street,Hyannis MA 026 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commission SHED REGISTRATION Location of sited(address) v i►N atl e Property owner's n e Telephone number Size of Shed MaglParcel# K 0 s 9 9� - Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) (5K I-SaA,11 _ THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedm �s�+r�- `�x..w' a+. 73' -�bY'yigR+�: '�a�.' 'r..`1 'f' ,��-*a"`r '#` ._"4G'asi 'i°''6T-i' .3�J"'"""+"" '7. ^ar "t u ,u,+ _- - „t" I :,.Tt i +.Fa r �'`r-M tv� ; _ '" ... zyx ,.,,,s, cc,r .�-3 r a� 'm ..5 m ram"' ..,C. 'f k x ,.LY.✓--c as 4r A' { �._�` 'nf' #t ,j: .✓ 11e 3>' t-,r o r ,�, a `,. 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Town of Barnstable *Permlt# 2 Expires 6 months from issue date Regulatory Services Fee_ to r ESS PERMIT Thomas F.Geiler,Director ' EP 2 6 2006 Building Division Tom Perry,CBO, Building Commissioner Y T N OF BARNSTABLE 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number �� / O /7 0 V/�]� Property Address M- esidential Value of Work ZJ Minimum fee of$25.00 for'work under$6000.00 Owner's Name&Address Contractor's Name / Telephone Number 9,-'Pip HomeiImprovement Contractor License#(if applicable) /aY2 7 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner have Worker's Compensation Insurance /J Insurance Company Name Workman's Comp.Policy# Zl;? 25GX Z2,b Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) 21�e-roof(stripping old shingles) All construction debris will be taken to 1��e ❑Re-roof(not stripping. Going over existing layers of roof) �Re-side �Replacement.Windows/doors/sliders. U-Value ®%�;Y (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home rovement Contractors License is required. SIGNATURE: Q:Forws:expmtrg Revise061306 Department of Industrial Accidents - Office of Investigations 600 Washington Street = Boston, MA 02111 www.mass.gov/dia = Workers' Compensation Insurance Affidavit: Builders/Contractors/Electiicians/Plumbers applicant Information - - Please Print-Legibly. _lame (Business/O ganizatiowbdividual): address: :ity/State/Zip: j,�IM6 zVj�± O��o Phone#: T4EOT0- re you an employer? Check the appropriate box: Type of project(required): I am a employer with 4. ❑ I am a general contractor and I 6. ❑ N construction ;zVloyees (full and/or part-time).* have hired the sub-contractors I am a sole proprietor or partner- listed on the attached sheet Remodeling _ ship and have no employees These sub-contractors have 8. ❑ Demolition . . working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers'comp. insurance 5• El We.area corporation and its 10.❑ Electrcal repairs or additions :- required.] � officers have exercised their . ,. I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or,additions myself. [No workers'. comp. c. 152, §1(4),and we have no 12.❑ Roof repairs. insurance required.];t employees. [No workers' 13.❑ Other comp. insurance required.] ;y applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information 3meownets who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ntractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. . _ .. w an employer that is providing workers compensation insurance for my employees. Below is the policy and job site urance Company Name: ;icy#or Self-ins:Lic. #: -�`�� _Expiration Date: ^ Site Address` City/Stat,-Mn: OC j( - _;ach a.copy.of the workers' compensation.:policy declaration page.(showing the policy num er and expiration date) lure to secure coverage as required under Section 25A of MGL c. 152.cari lead to the imposition of criminal penalties of a - e 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 fiiie e ap to$250.00 a day against the violator.. Be advised that a copy of this statement may forwarded to the Office of estigations of the DIA for insurance coverage verification. 9 hereby certify un r the pains and penalties of perjury that the information provided above is true and correes: mature: Dater 6 - 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#.: Information and Instructions [assachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. arsuant to this statute, an employee is.defined as"...every person in the service of another under any contract of hire, gress or implied,oral or written." n employer is defined as"an individual,partnership, association, corporation or other legal entity,or any two or more. f the foregoing engaged in-a joint enterprise,.and including the legal representatives of a deceased employer,or the :ceiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the weer of a dwelling house having not more than three apartments and.who resides therein, or the occupant of the welling house of another who employs persons to do maintenance;_construction or repair work on such dwelling house r on the grounds or building appurtenant thereto shall not because of such-employment be deemed to be an employer. QGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or enewal 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 .nter into any contract for the performance of public work until acceptable evidence of compliance with the insurance equirenients of this chapter have been presented to.the contracting authority." kpplicants ?lease fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if iecessary, supply sub-contractor(s)name(s), address(es)and phone numbers)along with their certificate(s) of nsurance.-Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the nembers or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have -mployees,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 of ddavit. 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 [ndustrial 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 affidavitfor 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 permittlicense number which will be used as a reference number. In addition, an applicant that inust 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 bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. _ the Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial.Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 :vised 5-26-05 www.mass.gov/dia �oFt Town of Barnstable P Regulatory Services BARNSTABLE, 9 Mass. $ Thomas F.Geiler,Director 1639� 'EE3+► Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1, Af' A poodo 11A ,as Owner of the subject property hereby authorize_ A - �U� '� to act on m behalf y in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name QTORM&OWNERPERMISSION r, DATE(MM\DD\YY) a';®list®� G�RTIFICATE OF ItVSIJRANCE PRGDI�CER_ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 0 BRIENS CENTERVILLE INS HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR +I PO BOx 6 1 O ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. CENTERVILLE MA 02632 COMPANIES AFFORDING COVERAGE COMPANY 28SBK A THE TRAVELERS INDEMNITY COMPANY INSURED COMPANY i HOLMES, STEPHEN M B P.0. BOX 2537 COMPANY HYANNIS MA 02601 C COMPANY —� D COVERAGES:<: 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 I CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, o`(nLl lcl(1n!c AND cnNn1TI0N.C-OF SUCH POLICIES, I.IMITS SHOWN MAY HAVE RPFP!RFDUCFD BY PAID CI.AIMS. I COI TYPE OF INSURANCE I POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LT RI LIMITS I DATE(MM\DD\YY) DATE(MM\DD\YY) GENERAL UABILITY GENERAL AGGREGATE S COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. S CLAIMS MADE a OCCUR. PERSONAL 8 ADV.INJURY S II OWNER'S&CONTRACTOR'S PROT. I EACH OCCURRENCE S i� FIRE DAMAGE(Any one fire)F-11 S i MED.EXPENSE(Any one person) S AUTOMOBILE LIABILITY COMBINED SINGLE S ANY AUTO LIMIT ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) S j HIRED AUTOS BODILY INJURY NON-OWNED AUTOS _ (Per Accidem) S PROPERTY DAMAGE S i GARAGELIABILITY AUTO ONLY-EA ACCIDENTRI 5 ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE S EXCESS UABILITY EACH OCCURRENCE 5 I E�UMBRELLA FORM AGGREGATE S OTHER THAN UMBRELLA FORM_ _ I WORKER'S COMPENSATION AND A I STATUTORY LIMITS N/A EMPLOYER'S LIABILITY (U6-743X126-3-06) 04-24-06 04-24-07 EACH ACCIDENT `- na �THE PROPRIETOR/FARTNE.RS/EXECUTIVE INCL DISEASE-POLICY LIMIT S ()n GOO OFFICERS ARE: X EXCL DISEASE-EACH EMPLOYEE S 0 0 OTHER S i i 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS I i THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE CERTIF:ICATE<MOLDER; `' ;: ;: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL I 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION`OR UABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ;'ACORD 26 S{3193) -: 6 CORD CORPORATION 1993 O A � 33 '{ sa°� rii � �Yi d i ^out€'t�c?,.. y.'�5,�, r H,.�• �t- ,�„ �Es r, ,��,�.;�` -'s {,�, '�_, �, ,►� � �� "```� na �'� Y.r��' ,� .t��1rc�ir3a� '�il-atln>;�C�xl1c�'ror i�ci�`�rl's�G','*v �) } a zm e t .t k y y a I11�12C�,UIa1111115 aad' fgl tIA�Ci� i 72is'. } t �►? bltitdn nldcc Rni 1301 Ma:02)08 3 `�. .s.. >,rxt k tdn!tit3"t� K ! .�i� sit 'S`l �1�1oIl�IS� ••�i+L�r'" p^, �`'a. y�C ... .. _.. .... x3e.. M1"+u+.t.ra-•rx,: � . .. �3s.�.,�.,. ..�.._..... ��L' ..i�.6ti'' c h�$r�T 4e� . 00277' r � 1 (y, V I - y'S•i i A ner .. s" YY - 1 BARBST Lt. t639- BUILDING INSPECTOR ��0N 0 0_0� N ���� � �����=��0m � 0N �� �� �� � ��=~ � �� �� � °�~~� ��~� � �r �� \ APPLICATION FOR PERMIT TO --.. m�7r_.^44��/�~�_._______.._______.____,__~__... TYPE OF CONSTRUCTION -----..!�,! --..—,--.—.--_..--_..---..-.----.---.- -- -------l9K���' � ' TO THE INSPECTOR OF 8U|i0NGD The undersigned hereby applies for o permit according to.,tha following information: - '� Location ---..+px./....................... ..:.,�—,-----.---..-------_..... ............................................................. � ' Use . ^������—���!��/� —.J1x+��.//��.� -----------..��-----------.------. -- ' '-'�'-- ' —T `~ �r—' _ ` Zoning District ................ --.------------.Rva District ........ ............................................. U Nome of Ovvne, �}L0.. --.. .. . A66reou ---���. ' . -----.-----.. � ----- --�}--�--'-- '7-- � ------'' ---''' ' 'r� � ^ Nome of Builder ----.'-,*p��\-------------A66reu --..--��V����..—.—..—.—.....—....., Nome of Architect ----.--.~---------------..Ad6resu ---'�=�--..--.......--.......------. ` �� ~^Nom6o, of Rooms ------..�---------------Foundohon --����/�,?��J/7 .................................................. ' r` �v ~ �)� � / . 1/ E�1erior —���. �—�«�/c.. ��� ..----Roo8ng ---�c�s�/��<<-----.-----------.— � ' ~/ ' /� Floors --�*x ..<��� —.---------.---.]ntehor —..�\�7t�/.�����----------_---_—_. /��+. Heating --^�x/—.. ---------..—Mumbing ......../........................................................................ ' � Fireplace -----. ------------------Approx|moneCmo --��.�� —_____________ Definitive Plan Approved by Planning Board l9---_. Area —.7S-0---------. ` Diagram of Lot and Building with Dimensions Fee _______________ ^ SUBJECT TO APPROVAL OF BOARD OF HEALTH � ) ' ^ . ' 0 � ! \ , ` , � � / � | ` ) ' x ` OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ' ` | hereby agree to conform to all the Rules and Regulations ofthe Tow of �arnstable regardinvhe above construction. ' Name ./�[ . —.^.. v / // (~/ Y , Construction Supervisor's Uoense —�/�/ �}—....—..-- ' l OLD STAGE INC. A=291-17 ,oq 25792 12 Story No ................. Permit for ..................................... Singj!��..ZAMily Dwell' .................. ...... Dwelling ag........... Location ...14QJ .....29,..gX.in...Lan.e........ Hyannis ......................;..................................... .................. Old. .Stage Inc. Owner .................................................................. Type of Construction Frame.......................................... ................................................................................ Plot ............................ Lot ................................ November 18 , 83 Permit Granted ........................................19 Dateof Inspection ....................................19 Date Completed ......................................19 Z6 'sraiNz... `•''�"4 k 4Y''r " i ' . ... L r .. ,.} ,f;'( s ti VI'CIt . •rr a .�vanyrcwc°u. '"9 ' v TOWN OF BARNSTABLE permit No. __.25792_" t ; ., Building Inspector 2 �.���.� . "..4 Cash - ; - - °e .e)o. ` er NO >OCCUPANCY,:> •PERMIT z Bond- :-- - , r . Issued to Address OldStaae Inc, Tani- 9. 29 Erin ,Tanp. ,W nnnic Wiring Inspector ���r p - Inspection'date p ~~ Plumbing Inspector/� ; � Inspection date. Gas Inspector k"i Inspection date Engineering Department- �' ,�? Inspection date- Board of HealthIlk- Inspection Inspection date THIS PERMIT WILL NOT BE VALID, AND/THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH-SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .{ 19 Buildino Inspector t• I T' e-atvs`.,�,. rt.�-5 a" "F.� ,.:.: r 'p .a' `&"a'°- 'fir. 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Viz. ay r* ..a -'� .07 mum z e ^. tr'�.._ „ a-r +.� r.x ._F zk s -L= _ .TM .� :. 7w.5.«,.{4:•„�-+' -s. -3 a a a-", € -�- ^ 1`F� s,so-s;,,-."ir: ...� t ;,t -Y.i•- —sue r�' -'s" F s "' 1.• '�"`.+-�a.'-�.• s a '.- �' _""�'�' -' ` -L -:tea' f t id Asyssor s map and ;lot number .,,4�r ,.. ..... 1 !7.... f p �G 1+� 1� ol,,.UST BE 4 ,, 'L ¢�L�r O�'T THE r. °Sewage Permit number , r - 's y B9SHSUBLE, i House number ' ...... �i�E�"s+��/�'� +r��la3'T �ls� .. 90 % Z .. .............. ............................................. _ TOWN, OF WARNSTABLE BUILDING I,HSPECTOR w M �f f6 ' c�:�l/� APPLICATION FOR PERMIT TO ...:....��5�............. .............�.............................................................:........ , TYPE OF CONSTRUCTION ....................... .......nn. ..... !.' ^l l',r+w�e................................................................................. �o� i� �3 ... ..... ........................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 9... rih �" ............................................................................................... a .. ..... ProposedUseK.!.��f..... ..JIrH.. ........................................................................................................ Zoning District ................ ...............................................Fire District ........14+101!.�.,T............................... Name of Owner .... v-c.........................Address ..; S. t�..�&. Name of Builder ..............&mott.,.................................:......Address .................S�Apoil` ....:.............................................. Nameof Architect .................................................................Address .............. nn.................................................... Number of Rooms ...................`{...........................................Foundation ...... .................................................. i ' Exierior ....C��A t ..`.... 5-..dKdrtlS,6�. .............Roofing ..........� i �0 k,4#...................................................... l o/ Floors .......4"2r�_V.0 /............................................Interior %E.Afrr.��'t ,k Heating / s�f :�+ �f ..'.. ?if...................................Plumbir g ......./.. 4................:........................................ Fireplace ................ .......................................................Approximate. Cost ....... © Definitive.Plan Approved by Planning Board ---------------____-----------19--------, Area .... ..................... Diagram of Lot and Building with Dimensions Fee ..............'ems_................ SUBJECT TO APPROVAL OF BOARD OF HEALTH r A �3f OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Tow of arnstable eXrding above construction. Name ... . . ... ... ..... .... ..... ..., . .................... Construction Supervisor's License .................................... SIlDi�TAGE INC. Permit for ..1 ..StorX............. 5 ...... ••.••.Single..•Family•• Dwelling Location ...... Lot 9 29. ....Erin. . ...Lane. . .......... i ...............i. .. . .... .. .. .. .... .. r Hy......................................i .......:........... Ownerold ............................................. n Type of Construction Frame....................... ............................................ ..................... ...... Plot ............ ............... Lot'................................ F� Permit Granted .',:November...18•r....1.9 83 f Date of,Inspection . ` ..19 t Dote Completed .................19 A _ + r i l