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0025 EVENTIDE LANE
��� - , . e �/ �I�� � � / \ i� I �4 II 1t �� .. �. 8 `t I Town of Barnstable Building Post:ThisCard So;That rtas.Visible Fromahe Street Approved Plans;Must beRetamed on Job andrth�s Ca�dY Must be Kept s 1 (�Y PosteilUntil F�nalInspectionHasBeen.Made fib' y h k �� +° Where a Certificateof Occupancy is Requred�such Buildug shallNot,beWOcupie+ ntd aaFrnal In pectaon,has been made Permit' Permit No. B-17-4344 Applicant Name: Kevin Blute Approvals Datelssued: 01/08/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 07/08/2018 Foundation: Residential Map/Lot: 273-085-007 Zoning District: RC-1 Sheathing: Location: 25 EVENTIDE LANE, HYANNIS Contractor Name: SCHOOLHOUSE CONSTRUCTION, Framing: 1 ,. /CJJF Owner on Record: TIMPANO, DOMENICK J&JOAN T INC. 2 Contractor,License: 171444 Address: 25 EVEN TIDE LANE a . Chimney: HYANNIS, MA 02601 Est Project Cost: $50,000.00 Description: Kitchen Remodel to include removal of an existing closet and add a Permit Fie: $255.00 Insulation: V opening in the wall between the kitchen and dinmg area-both �. Fee Paid: $255.00 Final: are not stuctural. New cabinets and appliances # , �. = Date 1/8/2018 % Plumbing/Gas Project Review Req: KITCHEN REMODEL Rough Plumbing: ' r ; Final Plumbing: Building Official �. Rough Gas: This permit shall be deemed abandoned and invalid unless the work aathonze -by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application:and theapproved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by lawsa id codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintamed�open for publiclinspection for the entire duration of the Electrical work until the completion of the same. Service: The Certificate of Occupancy will not be issued until all applicable signatures by;the Bwldmg and FireOfficials are provided on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work. g 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site ON 4�-+t'E All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT r'� .tom -5r-j T Town of BarnstableBuilding ..� - Say:That��t=as;1/isiblewFrom;the.Street=-A roved�Plans,Must be Reta� ..•_, ;= ;► . ,,. . .Posted Until=Fm-al�lns ection-Has�Been Made 9�,, - „` z .� ♦ « :�.'>�`" �z.. 3h ,, L':'. ,,2., �'.,. >. ...,s.,,, fig'-,. ., ;.': „ Y :.,' :2 h R ermi Wher Certificate of Occu anc ls�Re cared'such.Buildm stiallNot'be Occu ied unt�t aFnafanspect�on has been made •�e�%��G:'^ �,..�,zF.:_ .,>�',a�._ � ...,.s«y '�..p�;s., .,.'�m.�. :.�;:�. .,.�� g.;:,>.. . ':r,,: .� .- � '�". +K.,..,Y.�"�: _, � :;?,:."�- ,:.,�: _ fir;, ..,, .. 3=:: Permit NO. B-17-216 Applicant Name: DOMENICK TIMPANO Ap provals Date issued: 02/14/2017 Current Use: Structure Permit Type: Building-Shed-Residential-200 sf and under Expiration Date: 08/14/2017 Foundation: Location: 25 EVENTIDE LANE, HYANNIS Map/Lot:�273-085 007 Zoning District: RC-1 Sheathing: z z Owner on Record: TIMPANO,DOMENICK J&JOAN T Contractor Name; Framing: 1 Address: 58 KAY AVENUE • Contra 2 ctor License 41 MILFORD,CT 06460 •' ,Est�ProJect Cost: $3,629.00 Chimney: Description: 8'x 12' Patriot-style A-frame storage shed. To be purchased from and Permit Fee: $35.00 Insulation: installed by The Shed Place in Mashpee,MA(508 477 6888) Fee Paid: $35.00 F' Project Review Req: 8'x 12' Patriot-style A-frame storage died To be purchased r Date 2/14/2017 Final: from and installed by The Shed Place in Mash pee, MA(508 477 6888) �x:: �r--.. Plumbing/Gas Rough Plumbing: a`.. 8 � "� Building Official Final Plumbing: g: This permit shall be deemed abandoned and invalid unless the work authored by this permit is commenced within si(month's afi:erssuance. All work authorized by this permit shall conform to the approved application es and the approved construction docume n •for whichthis permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structur shall be in compliance with the local zoning�by law and codes. Final Gas: This permit shall be displayed in a location clearly visible from access streettlor:ad and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Z., , ,. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire,Offici Is are provided n thispermit' Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection - m g 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: ersons contracting with'unre Isterecl contractors do.not have access to-t.e uarant fund" as set-forth'in MGL c.142A. g g g y' �. ) ". `Fire Department" ++ Building plans are to be available on site Final �,f All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Jan 31 17 ''`�:30p DOMENICK J TIMPANO 203 8785637 p.3 V* Town of Barnstable RECEIPT BAR- 200 Main Street,Hyannis NL4 02601 508-862-4038MAW —+ Application for Building Permit 0 Application No TB-17-216 Date Recieved: 1/25/2017 '= ; fob Location: 25 EVENTIDE LANE,HYANI•TIS --t Permit For Building-Shed-Residential-200 sf and under CO taa Contractors me: State Lic.No. Address: Applicant Phone: (203)209-5180 (Horne)Owner's Name: TINIPANO,DOMENICK J&JOAN T Phone: (203)209-5180 (Horne)Owner's Address: 58 KAY AVENUE, MILFORD,CT 06460 Work DFseripti n: 8'x 12'Pattiot-style A-frame storage shed. To be purchased from and installe v The Shed;Plac'�n Mashpce,MA(508-477-6888) u.,•t - C> �Ct t1 co •• 130 Total Value Of Work To Be Performed: $3,624.00 m Structure Size: 0.00 Width Depth Total Area I hereby sw and attest that I will require proof of workers compensation insurance for every contractor,subcontractor,or other worker before he/she engages i work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a rotporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the propriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. t hereby cerl ify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized 1 o make this applica-tion. I undemand that when a pernut is issued,it is a permit to proceed and grants no right to violate the Massachusetts S to Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. A Il information contained within is true and accurate to the best of my knowledge and belief. All permits zpproved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: DOMENICK TU%IPANO 1/25/2017 (203)209-5180 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees i Total Project Gost: S3,629.00 Date Paid Amount Paid Check#or CC# Pay Type ' Total Permit e: $35Ap IIZ5P-G17 $35.00 Visa:3CKXX-XXXX- Credit Card 't XXXX-0160 i Total Permit Fee Paid: $35.00 J THIS IS NOT A PERMIT Town of Barnstable Permit kA �ou - �' `'tip Expiresb m ,�thy„[rom issue e Regulatory Services Fee < MASS. �' Richard V.Scali,Interim Director 1639. 5 LL:SS5 PERNT Building Division Tom Perry,CBO,Building Commissioner APR 14 2016 200 Main Street,Hyannis,MA 02601 OffiTe� 8�8 nn C Q'F-4 8"R N STAR LE www.town.bamstable.ma.us Fax: 508-790-6230 EXPRESS PERMT APPLICATION RESIDENTIAL ONLY 73 I Not Vafld without Red X-Press Imprint . Map/parcel Number a Property'Address Z V Tt 4F- S v)MResidential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address z�'�v41tZW 0"6 BRin,v Contractor's NameOJIM0 A)F-(k)tW&06 A46 !SO/LJ Telephone Number'101-2Zg"-f SW Home Improvement Contractor License#(if applicable) 732YS- Email: Construction Supervisor's License#(if applicable) 0 7J 7d 7 AWorktnan's Compensation Insurance - Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance /� Insurance Company Name Aa0A)AVr I P5 L'fjlnP�W 7,/ Workman's Comp.Policy# Wei 9 9,05 Ri7 9 y Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑.Re-roof(hurricane nailed)(stripping old shingles) "All construction debris will be taken to. ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side XReplacement Windows/doors/sliders.U-Value '3� (maximum.35)#of w' ows #of doors: . ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. ;Wheii:required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. .***Note: Property Owner must.sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is'. required. SIGNATURE: i QAWPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 Jan.01.2011 00:-00 PAU1 CONEOv RENEWAL AMMER 791 545. 1293, -AGE, 2/ 5 h%ynr IIIe06„ LV N eP4A0[Ms�i n.•C yt[m1�F fl3 ERSE �' 'IA tit%:W4iT"?A', nn R6axi •I in.ps]n,RI 0,9r1C,5 Phone 8616A ,=5•Tar,4t79,v'99_C.6&,) U4FtnnkLSE:. _ j ItoutLerat lYerY t3±e Loa F rv-xnl vti:ra x.v.,asn3 V I�hewol by Aodarsen of q.,t d ru New En100nd O� CUSTONIWINDOY1F&ND DQgIi REFNOD]II l�1GAta y� Ctia o7 aq Sa�:dtAae b t`y. . / '+f@ter - / ✓�' ^f�l rers,C Sotmted Dace tPdl.em,;_ l . B-/ `W h6reinr rointly and sevenilly 291m s W puNhwe-fie pmr31_tu i uz-d}cyi Ecr i'4$of Southern New 1 1h 11r�dtrlcn of 9araE.?EtQ i�Ie+ lr_ f= y e.0 Fr�a,d�tlnct�.s,LLC,d/Wra jix1je al ,�yrp,R .-C'fil trac!rr^55 jay 4. L .S+"" t lb �rdlV.�'J {'t:t1Y LiL'C.QL IrfLi 1tQd e�.r•' t}aa aA�m,attt--d 6 the at admi vt? fir_ZL�Go e16 t1s)(toKlicli ew ehis'A re on ittcrosl d 9B die frv�nY Land the revs air.of �y n >d4dtatela [] (endce 0.rl"? TowlJottar»afcit: i/' �� E9tL,utrtS+cMJnB�F!cx Mac '" of ox; t( k,a�Ctp d �R —+� are t;ecegpeIt only-roorhnine,im3 iakaBafarx_as Snit offee i33X1: fora aftnan tie; pro)ect em(Mase°et cr a ftfnq By.stplog this Y�+usxHatv±rle fja me ae Scut oflob and the BalulCmOnSubluicii +tb9arW, Carrfobearwciotil5n-A byeM1dlt ofl efee�e iai�cllpe{t,ar®sle:• 13"ft(�)jtgriSn and Qoden tavds Ybtat tttift Ag tine,co®etilutes U►e rage+:adf3raamre din tw*ea the pardes,:and that_ d me am no verbal pnaesytysodipgs<ehasglag pay oft terms of lyia Agreement.$stye tck.►en«ivd tie thasf g � ()(1)hwrs'riagl this+�gtCeeeneaY,uisdecstaads the terms of t$sa�grectneot,sad bust reeeiVttd II+pteted;ugaed,and dated.Capp of t6as Age merit,tncIu the avo attached Porlte�of Qtsnecll t�Eiont on the daui.$set'_ tien sbo��e and(�I was bra* info imedof)lii.yet'arig'hilo'eanwlthlsA$a etinent.DONQT$t('t4Tt lSCONTR C.TIPT 11R0 ANY BLANK SPACES, fRAodqj&knd irnF On aJ,4vatico to.$awt(I)Do out.ign this AVeemeut if may of the tip evaded foie the agaraedl terns to the eMeet lrf thee Mble avai itArmaitoa are left hlnnk J$}kevx era totLYk d m a copy of. f : e- t g tho tinge}aa- 'd M ft (3).1'aumayartanytitasepatyaffthefall;unpaidbehavedae:a,ederthisAgroonna4aatd.in dais$y0a tn&v b:eexicixledto receive a Partial re8ste of the t1Y nee aad Inau c6 s:�4)The otlltr ;4fu e hearten itit#o aticer �. y. 5 'paroraisca or oodam3t any b`neatie of the pcacc m rt�r ■e■■god baled t4ndea tW4�g i i,amest nev cancel thie Agree terse It leas nett have sf sad at flee male eE6ee ei n hrmch cis7ce of the aellea prertdad YOU:aa ilea seder at his or her m21u oiFioe or 6raenk ei a 4}iown.Ivkthe.agreemeet regi9t.ead oa<erhficri MieJ4 y+ideh ill sted sot Inter dian midoigbt, et the third asteadatr dap�not alit day on srlsich the lnager etgr s the Airur®nraY3 atcebe tng lay and aniy Itol3day em Wit" tegWd at`u$de$v riea are not metde.gee ahb ao44tngauyie g aoSice of eaecel6iioa f'er for plenndiaa of hnyer'o raft■: 4tj)td.4'L celvc+i4.tlta:couguatere&r•a. ': feartor3 tritiaa k 1 (Arpfr ifraitl Renewnitby Ande3sieo of Sov ¢/n/�p/Y�r England. ..Bv}e s�_' � y�{�) $y of Pnnduet futatger S1v'a �� 5rtaiurr. is'ttt Name mf.F.-drlct biauatr&,tr Peind Mine � P3ictt 1(tm� i YOC>,'THE li A-M(S), MAY CANCEL THIS TRANS_•1GTION AT'VVY Tlmx PFlfQR:TO MGHT-OF THE D': i3U'ams- $DAT ArriR TE' DATAOFTHIS T1tAD gACTIO3 tT.SM T`HE AT'TACiH$O NOT P:CANCELLATION FOR1M1;3 FOR AK EXPI.A.NATIQN OF TMS RIGHT: 7. Data ofTF�at�atcicts .- .You may far�af i Date o(Transaction lrou y catteet this transaction,withm�alty or obligation,within tls4sa'transactions without tensity or obilgatiom within- thrim businew t frem tle.abavtf.4ace.If att►teE.any,I titre bttsFreots.deya from.sfi date-lfyou cancel,a.t7' L, pproperty traded n any payenertts made by you uredar the I property traded in,fairy pa ta made by you''u nder the Contract or Salle,and any ne$atiable inatrumorit oxoctrted I Conzrgit or Sale,and'any tiatble instrument executed by yott`tivill be rtt><tPttiBd wlthrn nets'btraent ss'days folCnvring l by ye�u will be returned w, tin.buslness days killowirtrg i*eeipt by.this Sailer of your eaneollation notice,and arty l receipt by O 5elltr of yo ancellation notice,and any Zurit}i interest .arising out, of the transaction *111 be' security 'tnte►e4t artaitig..46 t Df the `transatstaon wiil be, canceled lfyoucancel,your►.ustmakemfalfabletotheSeller I eaneeled.lfyoueon eel,you LI mak-6avallabiato the Sell— atyaurres4denee,in substgtttially tW Sc od condition as when I at your resldence;in swh€tart ly as good condition as when reti eWed,any goad;;deltrered to you under this Contract or I received,any goods deliver. ' you under thlf Contract or Salt,or you may,if you wjsN,colslply with the instructions of I We.or you may,'lf your wP4h, ply with Elie inserucefons of the Seller regarding the t�stfrrs a pmeist of dse goods ac the tlse Seller regarding the yet me"of the goods at t ho Seller's eexxppeense and risk,lfyrau do make the goods amilable Solleres expanse and risk-If do make thei yaaads available to the Seller and eta Sailer does not pick t#tem up within, to die*5wl„r>t►+4 the Seller rd es net pick them fop widhin tw.eafytys of the date of t ancelfatiaA.Iroln assay rtstml§1 oC I twet_I#y�days of.dfe dote of eellatnon,yqu mazy retaain or dispose pf the goods without any further obli�cion,if you i dispose of the goods witho furti►er obl1g*14n.if You fall to malts the goods.availabfe to the Seller,or If You agree l fail tD make the goads avail i to the Seller,or if you agree to return the l�ooads co the:Sailor arts#fall W do so.skten you i to return the goods two fire r and!fail to de,to,then gnu remain liable for pe`forrnancs of all obligations under the � remain F able for perferma of all o6lFgndans under the ConNetTo cancel this transaction,Rosh or'deilver a signed Contratt.To cancel this tmn on,mail or deliver a s4gned and dated copy of this cancellation ieotice or any other and dated copy of this cau c iadon naticc or any other written notice,or send a tale ram to Renewal byAndersen of t writEso notice,orsend a telej ri m ca Renewal byAndersen of Southern New En. land at 2fAlbion Road, in cln, l 02865. 1 Southern New England at 2' ' ion Road,Uneoln;RI 02865, (NOT 6ATFR THAN MIDNIGHT OF - ��r l Duo )LA,ER THAN NIIDNI T OF Date)HERIEBY CANCELTHISTRANSACT,ION, I HEREBY CANCEL'THISTI A 4SACTION. R 1ROW�MtrwWr. Print Nam auym4 tlinimrl rrIr_ Mm.a Date 6A Cupy:White Buye,Copy.Yellow Buyer Copy:fink Southern New England Windows d.b.a Renewal by Andersen of SNE 2 . } Massachusetts-Department of Public Safety �f Board of Building Regulations and Standards Construction SupersUor License; .0 - 7 . �' •_ BRIAN D DENDIIS6N 7 LAMBS POND Charlton MA 01507 Expiration Corrtntissiorner 09)08@D76 Office of Consumer Affairs d Business Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Regiatratiwn: 173245 Type: Supplement Card Expiration: 9/1972016 SOUTHERN NEW ENGLAND WINDOWS LL DENNISON BRIAN 26 ALBION RD — LINCOLN,RI 02865 Update Address and return card Mark+sawn for change_ ❑Address C Renewal p E000Ymeot p Lost Card EE of Consu AtfstnLicense or registation valid for individul use only QIPROVEf/T CObefore the espiratien date.Iffound return tu: ot�tx orCommoter Affsin and Business Regulation i7324510 Park Plea-Suiite 5178xpiratlon 9/19l2016 SuPDlm,erd.-ard Boston.MA 02116 SOUTHERN NEW ENGLAND WINDOWS LLC. RENEWAL BY ANDERSON DENNISON BRIAN _ 26 ALBION RD LINCOLN.R1 C2865 Iy Ryn Not valid vAthout signature The Commonwealth of Massachusetts Department o,f Industrial Accidents = r Office of Invesfigations I Congress Street,Suite 100 h % Boston, MA 02114-2017 wwty►Hass gov/ilia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Al>�t�licant Ianforffiation Please Print Legibly Name (Business/Organization/Individual): SOUTHERN NEW ENC7 LAND WINDOWS Address:26 Albion Rd City/State/Zip:Lincoln, RI 02865 Phone#:401-228-9800 Are you pn employer? Check the appropriate box: Type of project(required): 20+ 4. I am a general contractor and I 1. I am..a employer with g 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 g. 0 Demolition workingfor me in an capacity. employees and have workers' Y A tY• 4 9. ❑Building addition [No workers' comp. insurance comp. insurance.- required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.Q 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 Wlndow Replacement employees. [No workers' 13.0 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 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 any employees. Below is the policy acid job site information. Insurance Company Name:ARGONAUT INS. CO. _ Policy#or Self-ins.Lie.#:WC 928058352394 Expiration Date:8/21/2016 Job Site Address: 7,`6/ V EuTiA 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 6f 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 forVsurance coverage verification. I do hereby certi under the " s and penalties ofperjury that the information provided abov is 7;Z nd correct. �a Si ature: Date: f Phone#: 4012289800 % 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 pi*: 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person:. Phone#: SOUTNEW-01 SHETTYSHT DATE(MMMDNYYY) � �® CERTIFICATE OF LIABILITY INSURANCE, 8/1912015 THI5 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELYINSURANCE DOES NPO IOT CONSTIVELY TUTE UTE EXTEND CONTRACTTBETWEENER THE O HERISSUING INSURER S),GE AFFORDED BY THE POLICIES UTHORIZED BELOW. THIS CERTIFICATE OF 1 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT VYillis Certificate Center PRODUCER NAME: Willis of New Jersey,Inc. 877 945-7378 FA C.No),(888)467-2378 PHONE AIC No Ext:( ) C/o 26 Century Blvd A nAILss:certificates@Iaillis.Com P.O.Box 305191 Nashville,TN 37230-5191 INSURERS AFFORDING COVERAGE NAIL# INSURER A:Selective Insurance Company of Southeast 39926 INSURER B:OneBeacon Insurance Company 21970 INSURED 19801 Southern New England Windows LLC INSURER c:Argonaut Insurance Company D/B1A Renewal by Andersen INSURER D: 26 Albion Road Lincoln,RI 02865 INSURER E: ' INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFlCATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. E)(CLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IL SCR POLICY NUMBER M�1DG EFF POLICY LIMITS TYPE OF INSURANCE INS 1,000,00 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ S 2029459 0811012015 08/1012016 $ 100,00 CLAIMS MADE OCCUR PREMISES Ea occurrence MED EXP(Any one person) $ 10,000 PERSONAL'&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPOP AGG 3,000000 POLICY®EJCTT FK LOC OTHER COMBINED SINGLE LIMIT $ 1,000,000 IEa accident AUTOMOBILE LIABILITY 08/1012015 08/1012016 BODILY INJURY(Per person) $ A X ANY AUTO S 2029459 ALL OWNED SCHEDULED ALL INJURY(Per accident)1$ AUTOS AUTOS PROPERTY DAMAGE $ X NON-OWNED Per accident HIRED AUTOS X AUTOS $ EACH OCCURRENCE $ 5,000,00 X UMBRELLA LIAR X OCCUR 5,000,000 A EXCESS LIAR CLAIMS MADE S 2029459 08/1012015 08H 012016 AGGREGATE I$ Is DED I I RETENTION$ X T OERTM WORKERS COMPENSATION 1,000,00 AND EMPLOYERS'LIABILnY YLN 0000068028 08/21/2015 08/21/2016 EL.EACH ACCIDENT $ B ANY OFFICERIMEMBER IXCR UD;EXECUTIVE � EL DISEASE-EA EMPLO $NIA 1,000,000 (Mandatory in NH) 1,000,00 If yes,describe antler' EJ_DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below 08121/2015 0812116 120 See Attached C orkers Compensation C928058352394 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached ff more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ExPIRATION DATE THEREOF, NrMCE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Evidence of Insurance ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Town of Barnstable *Permits O,a, Etpires rs rom' re date a �axrtszt,Br.� Q Regulatory Services Fee �$ KAM 163 � Richard V.Scali,Interim Director .eT�Q�Yla -Ruilding Division Tom Perry,CBO,Building Commissioner 200 Main Street Hyannis,MA 02601 ltrwnv.town.bamstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMU APPLICATION - RESEDEN TIAJL ONLY pp Not Valid without Red X-Press hwrirrf Map/parcel Number_7 3 -(�O S-6 o 7 Property,Address_ 02 S ¥ -ti e 4717 _V- nn I S . residential Value of Work S_ /S .7,7 — Minimum fee of S35.00 for work under$6000.00 Owner's Name&Address ' met) t C � ___Tn_a ei JT;,m�nR�!n �J e_ ��.S ✓wn 1 v�nn < MA - Contractor's Name 1,7,1 [fin n Telephone Numberao1 12-9-gkzo Home Improvement Contractor License-.-'.'(if applicable)_ 17 3 Z y 5 Email: Construction Supervisor's License (if applicable) 7 -7 ZWorkrnan's Compensation Insurance Check one: Nfo NEB ❑ I am a sole proprietor 6i1UDU� ❑ I-am the Homeowner I have Worker's Compensation Insurance NOY 19 2015 Insurance Company Name_ A rem n gi it .1-nSutg yj ce _ ��G,,,, TOWN,OF BARNS TABLE Work-man's Comp.Policy ��C�2.$p�$ 3�52 3 9 H Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping Going over _ existing layers ofroof) ❑ Re-side p Q"Replacement Windows/doors/sliders.U Value . 3 U (maximum 35)_of windows 0 of doors- El Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. xWhere required. Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. "'Note: Property,phvner must sign Property Owner Letter of Permission. A copy A the Home Improvement Contractors License&Construction Supervisors License is f required.� - SIGNATURE: Q.-%,PFILES1F0Rit4Skbuilding permit forms\MRESS.doc Revised 061313 11/0212015 69;'26 17815d5366d FEWESSV K&S PACE L35/06 a .s�sr� r 'aAzi igNvAL BY..AmARSEN �mr,o..r ems. �+ i,- t e +�Re d •I nColi�Ri02d5 Fhame a66.563.2235«>ras•4At.Ea 8,661p • 5tt'ra3 T.'r•rt5��r,-ct�rao3 9oatAft,&New Kngtsmd Vrmd4wN LiA d/bla Asuffvrmi t y Aiid of southerd Ne.c R ghat, (y7 CUSTOM WIND UT AND DOOR$F�.'fO1}735.}NG AGREEMENT, �v RnFf+i`�•xc4A��.Q4'� -5acnZ�C>�1e:$.� �� ,-.3Er?�.t �1Cil'9�� „__ bssi2p9msa _ �.a •F�- �Cai�kasl��aa�v .�'�%�P"=�f7s�fGt;,m,e�Jwry �,. a'� �, B�)bratbykdImdy cad ses—&Uy a %0 pu trace tha P rot to aad/or K nim of s mthsxxe Ncw EnyandWiadom%LLG4 W-,Rcnewrl Gy" drxsm of 5oa6hcra Nem FnRtacul aeoerclmisr►Lich the c us smd an"aons d i6d eaTi.the fruit and 6P rrm Or this sr_ 0vn=ftt and an die mitac9,cd flPcdfi sd0'ft alive i� -Z'n''d"ii'Aircdmene'),. %do OAT ToWgO e►MUM Method of Pnm4M ID e d Dapussk llaecP+xcl }a Cre+fi cuff are tmVte4fbr ceposir.emyy,-m mmm 143<4 ft $aoics a3Stit a`Jo3 3, It Er> mtad e5a rt�tamn t3ore . projects. Gtia 9i9�mse<�aj sp's: Litz Rr1tleirGakrtot z at?ac.mw�,SCrtof}�bmMilte a.ante on +��;6>! �t>�7rd�••+E�N`, 6a°titse en SrJbsr rl Gamp7erion etc jt b mr mt thael:'t e3edli i ��r�Ja6{'83fFk[� • c4rd avid dig aiadra blp.pert�cnal€heck,;bartfche�yr cuFr.`"' Suc(s) aiad,U8eaaads eat t&ia neat rpaMtittt ibe .aadrisodiag he3Tireea dot+ coiloat. there.aR eot nu.#trtT�+tc11® I+ s�rp p6 the cdrane,er this Agtee.nenk soya,4s arlknq�o >�ae.Ever® 11�taas za$tlsis Agrrstuemt;eedc rta cha cactus eiC this ¢many and.bw recer'sed s commpkmed, and datad ac�ei cede olCnelArtfngthet et tdNo e4uf��ni tSan;aather�lse.amtte aab6WZA0iA4eaia* ftti"mnerri cd nfi "t au�aecall tba��grea�t.DQ}�t�BI�t C9�1�A�°i`tit�`�i� Ahi'i�>3L i�d: i � A�D.fm.YJrS�F J!'NOb�e�'Suyer•{��.D'ad+O.tm_n�eLrsAgfela.eedit.t',v�y a th "aces ra$eeded for-d.e weed tlartlllr tD C Cd�ltlt Of ea'&an avaa7al�ii!8HF4e ab��!!�!'�Wm�lfy�`Y hLL °l�ttid_L'd bb v C'0f im4' iti F3}Yaa zvsy zn aay�me peg o�t fiaR ut pidd balsa! G tiad tr tti.$A and iei xo driisrg Fla Y. eatitiaA fir' sflvr a prs�anl s re 6aspec soil nl9ae¢uR Ct. (4)Tie"ae�tt�r tistg a o saigbt;o'ui�lAjwC�}Iy enter pom!p+eGe oon�f>a br; li aF`t$t t#!i y �d[e obis mend. 5� Pt'sc retp9s9Ss4 b'�edel ptirs. 4)W°ntary�cQi t>>� ' ;F it tcei.cat bcen ts�ed aEcC#,ttfcs pr a>araerh of6at cf the selFer,psa� ded you notifye 4e1rrt tit hid Qr ter e eliice ar Preenei►cdlics ahavre"in tad vet bFie or esrtrHedl;J61LA i41ti4eb sEisil6e go d tad not�4 + midst of tbcis>itrd ealrneis `itt't,�c titt' oa'w>mtc$toe s _art d$y ��s_ , iaa��t.iv�elad�g 8`andoy.asdl NO`sp>tafidap oii ccblreh' iiaSol mrif!aefiSvores src ace esada:$aea 8 antm�of ixaace�Fn4an faa� an uatloa a bn �;& . H rct�uzdthcca t]Ls nr elsltnd(�'onrn6to lE g»rn3) ansi: Rsae�+albg ". HY Psise®w-`of Frvdnct FuEranee Print VasuG:" �rnG' a F � YOW THE,NUM(Mi I tPW:-TKU zUaa0AGM0N AM', PW()P t!cf._'NKM OF TJ;9 THIRD 15l INEs!i_DAYAFrPE$TRHDATE.OFT169 N�Cg00 TlUAft= >SfOTIC73OT' �QNFQRIkt3 OF NOTICE C*SANCELLA MON Qstte ofTra aooleti. ou resat kancel •! Date ofTnm5' ai`en '•�` 1 n riiftv cim -1 thus bmns�etr iaridiim a p fty or o ett;;wrtftin l efrSa ta+art�e+dorty°+Fanut enalt�j or.obteg{tioca, .retilirl three biWiZ or-fro+, the a'ays�date,if par caelcef,art} th businesY do- front ttba aberee da# .'Ff xc►it eaa�csl�anryr .f�d'ed nr,any Pey�nts m� bjr yo1°u.Ytl2r the 'I trad'i'd im,'ny pa! —nt€-ad*by you uedcr rite CaotS�ct or Side,and any"*bla in nt t osaccittod ',I �trao t or Salou and any"admbre fnseeneat' a by Xou iirlll be returned;ry tfhen tart bubr.ess ds!s fcllowiing..i 6Y will he re a.rnmd wkb7j n tan busiat s tl s fbilovdng reeeipe by dhe Seiler of y"�catl�olliadoil ii+ot e`and aio�. -j reed b the.Seller of rt Unbr•Rs�S &tfee.,"dt eel. ifs iiiMmt arising oux 'n of die tra n will.' rn be s tereic anls3rt5.out of tl� rac�o#i will bc' nina5tmaem aria ame eh tPte:S�fe-. castcdt?d tfy�e��eeli, must nuke imaib"m to d,a S■ia�r >• ..._ -your t; t rttsas IkT e good e;oi ditian as ivlwn l ale your reudenee�.by 5utimntiaCPy►'�s PC dF-on'a wtioce recenred,:'!'7 loodt.deleree ed to you rmide8 this. tract or. 1 we d.WT Sned's d Lased go yew and r tms coma sft ar �alot o`fyou maK yoci wishN eantQip t#to'sfrstrucgoms ofI Salto or,vW It*of yang .tiootFti*moth d+6 inst r esiena of tiie SeiJef regardFrpg trite r®tt¢ir Sldpmar.c o#tom gPad s:t lRe Omt Seller reW"i the r..tvrn sh*rmnt of the good at tine Satle>rs'eei se and t4sk.ff You rib nreka she ` t at�ailttbte " Sdkr's"i nso,I, I eft If you do rrltUae Effie gpor�aua11im tau'the Seiler"aind th®Seller"d6as it®t pig tm uF wivtia I to tK73M er avid five''eamllmw'40es"nat tern up withim tier d of the.dam.of cartcellatMatt�you mn�rettttn or ! twenty dMo of the date of canceilatib*you n*tocsin or d of dw gootfd wittkoart anp Rireiter abilga on•If you I ell se" the §wltlieue any der oblis;W91,ff yoir fai to rgake late mob a.ra@Ia6te m the selli-i an firm arm i lei maim ti.e goods aiiaibitife to thm Seffee,i7r[ii rou"agm., 15640611Y.1 the goods�tothCSiefler and Ail imirbo 9rn.titefv you- .l to etipa:tt tlha goods tlte'Seil'orAnd W bo'dd*Am YOU rerriRaia,l6h6 for per 16J..tiam*'of,all obtiga ions under the. 1 relhmti Liable fair perf6nrartca of at[ob$gat$ons ugrder the CoeitrecLTe cancel Otis traremedor., sir daii t a Amd C9atC.To caneti dtb a mAsaction,mime.am dsEver a nig txd and dated copy'of this caamilatiae'ciotice or arge"otter ! and darned copy of Wt amcmil�rtion notice or 2ny other ita vtlodct,orsesetdogranstpitenewalblr/ iders�nai'i rrrCstenriaslce,orsendatpl �QaiewaftryAndMenof Southern Piaw E giant at AIbEon ftoadl;t f " n. I a ; l SoalRitTi.ld�w S' attel at iilhinci ttoad; I QUA HOT)LATER THAN KtDNil 'OF � � 1 {NOT LATERTM N LMI9f�ftaaNT Off. " P HE HEREBY CANCEi:THISTRAINSSACTION. i f HEIM-B f GAi.MTHISTRANSACT1orc t►,ems ss evra ettins Tiler. itirr DUPU r 4VWIUM PK"low" Dam RhA LbpT.1hNiec k9m,Cam YeLrow �uy�L"bFyr.PSh� Southern New England Windows d.b.a Renewal by Andersen of SNE Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License:CS4)95707 BRIAN D DENNL6N 7 I.AA03S POND' s Charlton MA 01507 • Ali• �J Expiration Office of Consumer Affairs find Business Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement:Contractor Registration Registrafbn: 173245 Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS LL:,'- sutsrzoTs DENNISON BRIAN -- -- 26 ALBION RD -- LINCOLN,RI 02865 'Update Address and return card.Marls ream for ebauge. SCA1 p 2%~1 C3Address ❑aestmal 0 Employment I"Card a of Coneeaxr A16irs A Badness Regulation License or registration valid for individut use only IMPROVEMENT CONTRACTOR before the expiration data if found return to: Met of Consumer Affairs and Business Repletion epiatratlon: 173245 Type. 10 Park Ph=-Suite$170 Expiration: 0Vlw 016 Supplement.;and Boston,INA 02116 SOUTHERN NEW ENGLAND WINDOWS I.I.C. RENEWAL BY ANDERSON DENNISON BRIAN 26 ALBION RD LINCOLN,RI MB65 Undersecretary Not valid without signature f The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations " I Congress Street, Suite 100 Boston, MA 02114 2017 www mass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/Individual): SOUTHERN NEW ENGLAND WINDOWS Address:26 Albion Rd City/State/Zip:Lincoln, RI 02865 Phone#:401-228-9800 Are you an employer? Check the appropriate box: Type of project(required): I.M I am 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 g. n Demolition workingfor me in an capacity. employees and have workers' Y P tY• t 9. ❑Building addition (No workers' comp. insurance comp. insurance. required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.El I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions right of exem tion r MGL myself [No workers comp. p I2.❑ Roof repairs insurance required.] T c. 152, §1(4),and we have no employees. LNo workers' 13.Fg�thera]1l 7�bl„) comp.insurance required.] *Any applicant that checks box 91 must also fill out the section below showing their workers'compensation policy information. ' t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name-ARGONAUT INS. CO. _ Policy#or Self-ins. Lic. #:WC 928058352394 Expiration Date:8/21/2016 Job Site Address: "2 S E%1tei-t E Ldl - City/State/Zip:��yg� - 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�fMGL 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• urance coverage verification. I do hereby certi under the and penalties of perjury that the information provided above is true and correct signature: -- Phone#- 4012289800 _ 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.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: SOUTNEW-01 SHETTYSHT ACORO° CERTIFICATE OF LIABILITY INSURANCE F11191(MMIDDIYYYY) 2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ACT NAME: Willis Certificate Center Willis of New Jersey,Inc. PHONE FAX c/o 26 Century Blvd A/C No Ert:(877)945-7378 A No):(888)467-2378 P.O.Box 305191 n p ESS:certificates@willis.com Nashville,TN 37230-5191 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Selective Insurance Company of Southeast 39926 INSURED INSURER B:OneBeacon Insurance Company 21970 Southern New England Windows LLC INSURER C:Argonaut Insurance Company 19801 D/B/A Renewal by Andersen INSURER D 26 Albion Road Lincoln,R102865 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR TYPE OF I ADDLSUBRNSURANCE POLICY EFF POLICY EXP INSD WVD POLICY NUMBER MM/DD MM1D - LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE OCCUR S 2029459 08/10/2015 08/10/2016 DAMAGE ENTEIT- PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY a PRO_JEC LOC 3,000,000 PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 A X ANY AUTO S 2029459 08110/2015 08/10/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per acc dent X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS UAB CLAIMS-MADE S 2029459 08110/2015 08/10/2016 AGGREGATE $ 5,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN X 0000068028 0812l/2015 08/21/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C Workers Compensation WC928058352394 08/21/2015 08/2112016 See Attached DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4 1 Evidence of Insurance 11 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD �t„E,gl Town of Barnstable *Permit# Es 6 from issue dat Regulatory Services Fee xpire + wttvaresix NAM Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERWr APPLICATION - RESIDENTIAL ONLY p j Not Valid without Red X-Press Imprint 5 �O Map/parcel §cel Num 1/oO 1/ Property Address ZS b:\1e MDR 20 . Residential Value of Work 0 / Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name v� 'C a�iLEs �n!T�VV1 Telephone Number 7-7`7 —7 F7 " `7 Home Improvement Contractor License#(if applicable) 72�G// Construction Supervisor's License#(if applicable) U ✓l 0 `7 "ter"R ES S P G O a wI T ❑Workman's Compensation Insurance Chec ne: JUL 102012 I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF B ARNSTABLE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ff-Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 13Al2�J5—IA-0 t� ❑Re-roof(hurricane nailed)(not stripping. Going'over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows *Where required:'Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: : C:\Users\decollik\App ocal\Microsoft\Win \Temporary Intem/- iles\Content utlook\DDV87AAZ\EX2RESS.doc Revised 072110 The Coninionswalth of Massachusetts _ -- Department of Industrial Accidents Office oflnvestigations 600 Washington Street Boston,M4 02111 nivtt:mass:gmldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name{Busines.3/0rgmiza€ionebdhidunD: Address: 1' • 0 City/state/zlp: W- H V�lIs10 n wt� 1Q�� :Z 77z1— �� —�17 /�F Are.you an employer?Check the appropriate box: Type of project(requites: 1.❑ I am a employer mith 4. ❑ I am a general contractor and I 6_ F-1 Neu construction loyeey(full andlor part-time).* have hired the snub-contractors 2. I am a sole proprietor or partner listed on the attached sheet 7. ❑Remodeling slip and have no employees These sub-contractors have g_ Demolition working for me im any capacity_ employees and have workers 9_ ❑Building addition [No workers'comp_insurance camp.insurance. required-] 5_ ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all Rork officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.E<0110f repairs insurance required.]s c. 152,§1(4),and we have no employees_[No wmrkers' 13.0 Other comp.insurance required.] •Any applicant that checks box#1 must also ftllom the sectionbelon,showing theirworkeW compensation policy informadou_ Homeownan who submit this affidavit indicating they are doing all walk and then lure outside contractors must submit a new affidavit indicating such_ =Contractors that check ibis boot must attached an additional sheet showing the name of the stab-caauartars and state whether of not those endues bane employees. If the sub-contractors have employers,they must prondre their narkers'comp.policy number. I atn an ernpIoyet tJiat is prmzding ray©rlrers'corn usntiott ittsatrnttcP for rt{y eittpioy ees. Below is the policy mid job site ittforrttafrot�, lnsurance Company Name: Policy;�or Self-ins.Lie-*: Expiration Date: Job Site Address: City/StatelZip: 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 51,500.00 andfor one-year imprisonment,as ivell as chil 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.fan-.corded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penaties of . that tire information pm sided abmw. is true and correct Si tare: - ` Date: v Z— Phone#: -7 7`C `CS -7 `t 7 IV Official use only. Do that►write in this area,to be completed by city or town official City or Town: PermitlLicense# Issuing Authority(circle.one): 1.Board of Health. ?.Building Department 3.Citylfown Clerk 4.Electrical Inspector 5.Plumbing Inspector . 6.Other Contact Person: Phone#: 01F� • a + TiARN.YI'ABIE. s MAM 19. Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 wwwAown.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, `�" '—'�'�� ,as Owner of the subject property hereby authorize n f-f�s bLM7 l-Z7c� 40 to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) L 17i t� e of Date oxbw Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 ii t ! Office of Consumer Affairs and usiness Regulation CU, 10 Park Plaza - Suite 5170 `) w c Boston, Massachusetts 02116 ,� M _ a Home Improvement Contractor Registration .� rw.;• o� p c Registration: 140251 EoN. Type: Individual Expiration: 9/25/2013 Tr# 216687 v a�'i co F �0 CHARLES WHITCOMB JR. ---- --- ---- --- - -- — J, a N CHARLES WHITCOMB JR. ;Gl 7 N P.O. BOX 501 — s m U 'on . A W. HYANNISPORT, MA 02672 o v "' U) 1 Update Address and return card.Mark reason for change. 61 0 Address Renewal . ❑ Employment Lost Card 3` DPS-CA1 0 50M-04/04-G101216 ,r t r TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 273 085 007 GEOBASE ID 37647 ADDRESS 25 EVENTIDE LANE PHONE Hyannis ZIP LOT 11 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY 7 PERMIT 12668 DESCRIPTION SINGLE FAMILY DWELLING PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND $.00 CONSTRUCTION COSTS $.00 756 CERTIFICATE OF- OCCUPANCY B MAS& OWNER COBBLESTONE, LANDIN 039. EC ADDRESS P 0 BOX 274 13ARNSTABLE MA BUILPWG DIVISION, BY 6 DATE ISSUED 01/10/1996 EXPIRATION DATE fl 1 TOWN OF .BARNSTABLE - a BUILDING PERMIT PARCEL\11) 273 085 0.07 GEOBASE ID 37647 ADDRESS ' 25 EVENTIDE LANE PHONE Hyannis ZIP - LOT 11 BLOCK LOT SIZE DBA ' DEVELOPMENT DISTRICT HY PERMIT . 10587 DESCRIPTION SINGLE FAMILY DWELLING L'ERMIT TYPE 'BUILD TITLE NEW RES/COMM BLDGW#Wi'`l��nent of Health, Safet, CONTRACTORS: MARKWOOD CORPORATION and Environmental Services ARCHITECTS: TOTAL FEES: $108.60 BOND $-00 � Qi► C014STRUCTION COSTS $60,000.00 . 101 SINGLE FAM HOME DETACHED, 1 PRIVATE P * ' ABLE, • MASS. OGINER COBBLESTONE, LANDIN D � ADDRESS P 0 BOX 274 BARNSTABLE MA BUILDING DIMS N DA'Pr ISSUED 09/25/1995 EXPIRATION DATE BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS ✓lam d/ rs� �,� ' 1ee- .4�6- /•/s=9.sr?�/!l, a K lC L s 2 2 2 3 1 HEATING[INSPEgfION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER:4 ISITE'OLAN REVIEW APPROVAL I ` . WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. 508-790-6227 i F N O► N n, N v 4 o LOT C0NCREr y M �s•: F04404r vN 24 o U1 . � O M Z 4 8574 # SF N 88.25.07'W 89.97' TOWN OF BARNSTABLE ZONING ZONE : Rf- 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' f _Y PROPERTY L 1 NES SHOWN HEREON WERE COMPILED FROM AVAILABLE C. FRANK s PLANS OF RECORD AND DO NOT a WHITING N - REPRESENT AN ACTUAL SURVEY O N°•2986 ON THE GROUND. �' 9FPSTE. THE DWELL/NG DEPICTED ON THIS -PLOT PLAN PLAN WAS LOCATED ON THE GROUND / IN BY SURVEY ON OCT. IO• 1995 AND / BARNSTABLE. MASS. EXISTS AS SHOWN AS OF THE DATE OF LOCATION. SCALE: 1'-40' OCT, l I. 1995 f THIS PLAN I$ FOR PLOT PLAN FACIE SURVEYING d ENGINEERING.INC. PURPOSES ONLY AND NOT FOR 10 Seaboard Lane RECORDING, DEED DESCRIPTIONS Byannls. Afa. OZ601 OR ESTABLISHING PROPERTY'LINES. ($08) 778-4422 THIS PLAN IS VOID IF NOT STAMPED AND S I GUYED IN RED. 0 20 40 80 PROJECT NO. 95-321 Assessor's Office i1st floor Ma Lot CIS:. 00 Permit# conservation Office 4th floor `h a s Date Issued B (Ord floor) 9 &q Engineering Dept. Ord floor) House# Yf' Planning Dept. (1st floor/School Admin.-Bldg.): i RAMSTANX _ Definitive Plan Approved by.Planning fi-Board - t~ /:r / 19i6 9 -- (Applications processed 8:30-9:30'a.m.& 1:00-2;00 .m. TOWN OF BARNSTABLE Building Permit Ap lication, / 'rwcivTi' Protect Street ddress ( � C)3 L 6 Village &402 Fire District Owner Address W,011 //-, 10 Te1c hone 77f--O73 Permit Reg nest: Zoning District �G Flood Plain Water Protection Lot Size �'� /�7 Ste. Grandfathered Zoning Board of ADDeals AuthorizationA Recorded Current Use L Prop2sed Use ZY Construction TvDe U Existing Information Dwelling Type: Single Familv Two family Multi-family Age of structure Basement type Historic House Finished Old Kinp s 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 Other Builder Information Name Telephone number /r� 7 —(/fJ Address Uni 10 // ��_, License# A/# Home Improvement Contractor# Worker's Com usation # /,), 7 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Project Cost 7Z Fee SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T #10587 � FOR OFFICE USE ONLY I `-_ 273.085.007 ., ADDRESS- 25 Eventide Lane VILLAGE Hyannis, MA 02601 - OWNER pMarkwood'Corno`ration tf DATE OF INSPECTION:. FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: °ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL , FINAL BUILDING: DATE CLOSED OUT: ASSOCIATE PLAN NO a 5 1 p 1 j I mom HOME IMPROVEMENT CONTRI5.QTORS. REGISTRATION I Board of Building Re ations and Standards J One Ashburton .,Place - :Room 1301 I Boston , Massac.husetts.,.,021081: I. HOME IMPROVEMENT CONTRACTOR _�-----_- _-----_-------._---------____-- Registration 100871 Expiration 06/24//96 I Type — PRIVATE CORPORATION HOME IMPROVEMENT CONTRACTOR Registration 100871 MARKWOOD CORP -; , Type - PRIVATE CORPORATION TIMOTHY M . PEARSON ! Expiration 06/24/96 307 FALMOUTH RD HYANNIS MA 02601 r 4 i MARKWOOD CORP TIMOTHY M. PEARSOM , � IscoMco 'i07 FALMOUTH RD . t .. 1 � HYANNIS MA 02601 '�*Y I ' ADMIMISTNATOR a. COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF ONE ASHBORTON PLACE : MASSACHUSETTS BOSTON,MA 02108 Cu:�51 s r' ucstlon i_.:L CEt�I:=:E of this licwra". 11 . CAUTIONS .',;:•, "ERV I =(D EXPIRATION DATE 3. :1. a IT ' ' :JN: Th ; I I ' T FOR PROTECTION AGAINST EFFECTIVE DATE LIC NO.. RESTRICTIONS ;Wq THEFT, PUT RIGHT THUMB 1`1 h4lE E. 6/3(,)/1.9iP3 Ca05:=*,.67 ,; PRINT IN APPROPRIATE a 6 g BOX ON LICENSE. Z T I'MI il'HY F'I::AFi'_,I_IN BLASTING OPERATORS (I( _ m : :; ' !;. = Liu._1 1 -1CF MUST—INCLUDE PHOTO.:'::.....::: = ` MA , 7 1 PHOTO(BLASTING OPR ONLY) FEE:-. - - _. 0„ (.7 NOT VALID UNTIL SIGN BY L SEE AND OFFICIALLY HEIGHT: STAMPED-OR- F THE COMMISSIONER .J UJy(�I DOB: THIS DOCUMENT MUST BE ' SIGMA RE OF LIC ENSEE « SIGN NAME IN�9@Q OS�T�URE LINE CARRIED ON THE PERSON OF THE HOLDER WHEN EN- OTHERS-RIGHT THUMB PRINT GAGED IN THIS OCCUPATION. COMMISSIONER W1. -mac CUMMUN WLALM Ur- MASSACHUSE TS - DEPA rM N7 OF LIDUSTRIAL ACCIDENTS _ 600 WASHINGTON STREET ames Cary^oei: BOSTON, MASSACHUSEM 02111 Or'''r:5 SiOne' WORKERS' COMPLISATION INSURANCE AFFIDAVIT IV�' OR D (liccnsmJpermincc) ' with a principal place of business/residence at: r 4 (aryistatA.p) do hereby certify, under the pains and penalties of perjury,that: I am an employer providing the following workers' eompensaoon coverage for my emplovecs working on this Lul �� . Insurance Company Policy Number [) 1 am a sole proprietor and have no one working for me. [) I am a sole proprietor,general contractor or homeowner(eirde one)and have hired the eontmaors listed b=ox who have the iollowing workers' eompeasarion insurance polices Name of Contraaor Insumna Company/Policy Number Dame of Contractor Insurance Company/Policy Numbe.- Name of Contractor Insurance Company/Policy Number 1 am a homeowner performing all the work myself. NOTE_ Please be aware that while homeowners who employ persons to do mainteaana,construction or repair work on a dwc?ling of not more than three units in which the homeowner also rcsidcs or on re the grounds appurtenant thereto a not genera!].• eonsidcrccr to be employers under the Workcrs'Compcasation Ae.(GL C 152,sea. 1(5)),application by a homeowner for a lice=sc or permit may evidence the legal tutus of an employer under the Workc s'Compensation Att 1 undc:stand that a copy of this sucement will be forwarded to the Deparmcn:of lndustrial Accidents'Of-nee of lnsu.=a for Cove:a--c VC.i:tcation and that failure to secure coverage as required undo Section 25A of MGL 152 can lead to the imposition of criminal pc.L*os eorsisong of a finc of up to S1500.00 and/or imprisonment of up to one yG:and civt]penalrics in the form of a Stop Work Order anc a finc of S 100.00 a day against mc. Si ncd this " day of , 19 Licc:rsrclPerrninec Licensor/PermitTor , To Date r Time -� WHILE YOU WERE OUT M of Phone 0 Area Code Number Extension TELEPHONED . PLEASE CALL CALLED TO SEE YOU WILLCALLAGAIN WANTS TO SEE YOU . URGENT RETURNED YOUR CALL M sage- Operator AMPAD 23-021-200 SETS EFFICIENCY® 23-421-400 SETS CAR NLESS The Town of Barnstable SAE. 'MASS Department of Health Safety and Environmental Services 039. �0 °rEo►�� Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location — �\'t� (, Permit Number � `� Owner 17 o C>W Builder � 4\,LQbbY> One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: 1A Pox) CAA 44 z, -70 V-s\ V Please call: 50/8�-790-6227 for reeinspection. Inspected by V� Date ,Z 2 O, � C-L - — _ _ 40M,4iiTfitl ArL414.�F19S_IS�D.M. LS•L�:ntq,/,.c+,.AN. --�— t I .- :- $GALE DATE - 4,o 91'M5*_ 508.428.6191 a evlin Qustom o es igns ' copyright Q7995 All Rights y.+14t � Res erve0 __...... - - — - aa 9•T Dock_: , fsSY—.7ilelSt.C-- �q:'� -----------FRa.Yt.1;tEVAT10N�'_':::... . rw preliminary plans And layouts by DC O.Are 101 1he use of them Customers only Any other u)e II stl-Ctly PToni D,Ie - i . s j ------------------ rm u•z� LLS4L_ rl an .._L5.241tilSUt_-GL:AH� ---�- _.-Gs..�Js:.L611.1lDIJ - --- LEFT�T�/ICCi a N srxt o.a 508.428.6191 • o evlin @ustom o esigns copyright 01995 ' - - All Rghcs Reserved T � I 00 i yy ------ i I Prrnminary plans and layouu by DC Darr for the use of their customers only:AnyOthe,use rs st ric tl I � y prompite o - 0 too- J .. b1_ r 15�4. %midc__ to - 10 / J 0 Y.a+ Ill Ef Fh � r 4- i SGtF 508.42B•0191 1 I •� 9 evlin Ii b @UstOm w. a esi9ns c opyrrgr,t C7995 All RghU r �. � I � •; � Reserve0� r• Idddl Fouury.�ou F Prehmrnary plans and layouts by OCDare for the use or then customers Only.Any other use is 11, Prom Dnc . a3}:-: 1 I �rI O -1zv.17.rfcy _— 0 l 1 ry— P4t � st5rc 1 .. t.' - �; .:.a.•a --- �'E'Li63ti�FACB- N g,4 oaE_ "ly� - 28.6191 i n C2UStom a eslg s copyright 01995 Q - All RM1Jnt1TW " Res erveC CAN .f I l _ l Preh Trnary plans and layouts by D.C.O.are for the use of then customers only.Any Other use is strictly promi Oite i I111 � f I I iI ;.I it j I I III I ' ! III Ii! , L' II t 1 I I I.I I III; ;i I , I I I ' � I b LOFT- I - -- --'--------'-- I I I I I � Il.j t �• tll ' II 508.428.6191 III II I !1 II I I� ,I ' I aevlin II II II' II ryjl! i ,Ililllil.l I I Ij I llo 1. i I �II II II. .•Ij: I. :III I I:Ii1. I, Li. ,I. _ .i.,.,.1, �., ,II I I;I, ; •I I I, (custom El IIII 'I I -- _{a-it—� �Ilili illlil lil) + i it III . a esi9ns COpyr,gnt C7995 - i! (I II•I 1 III I �11 I I ______ _ _ � All Rrgntf j .S, '. �.�. �•.� � .� � � ,III: .I ��I iI {{{I�� I t: II 1 I I II � I I T • I .I Prehminary plans and layouts by 0C.D.are for the use of the,r Customers only.Any other use rs str,Ctly PYomartr I 1 �I mom .. YJb !�nYwooD ��t4!F.IZ___.=..,.._—__... ,, -Z...'C/RM•._._. -.Z:f.Cif':15 1, .. —[LJt;FR1E)T'pDAEC1T—__—_.—..• — • .yL.LrO.TIttltX i li _ Ly Sturm .FjT Ff1��L L•ac' o o'er .. ?14 ..... i`i i trno . .. .'WAtE1C7FLopMC,_ .:• � _1K�t.11tAPP1N -- r�- i n •j R�So 1r391V: IL -._.L�1'LTMgoD" t11CIRs i i La EnunsavcraOlt= a� -- I AM TC4I TMSID.. ..n SOS'4ZS 191 ` <. r s _xswc+sseo r C3'UstOm aasww I a' _ o esigns Cogright A 1995 �s '::. .. All R+gnts ke O Reserved 47LTvc": -- n an+ ........ uai�al:r3K -_ L: •,rbi:.�R,�' .. �c� .L�.y � v,,\ .',/ i y se ...^''•TALI,CAW—rthD ., .. ._: .3.mAWJL'.c*W- A 5ECTiOa A Gi td. Preliminary plans and layouts by DC.D.are for the u$e of their customers only.Any other use n st,,ctl y pron�Wte i ..._._____._ Z41L_tHA1�IS..D.M. - L1•Z1:1'LAL 6�_11N� ''!— � -.>rv*:a*Jdt�s�t�3'ZS-.' I WNifFaaD+•x::5�ituCSES='.:_.—...__...,. i I i ---_...... __.._..._ _._-.----�.__RICaL•kf.EL6YA'f101J....__._ ' SCALE O�iF 11 T9TI5 - 508.428.6191 aeviin . Qustom . oe signs .. t:opynght 07995. All Rrgnta Wtta Reservetl DOM . Ls•21 tAISVI.LLLN. ��'., 1' '— � "� �� -----------.___..FROI,tT.l;LEVA?10N_.__:_... . . e I •�< . Preliminary OfAns And layouts-by DCD.are for the'use of their Customers only.Any other use rs 11nCtly poNbne ,� ...lSPFiA1T._SVIlN4L8S—+ r 4-DIM.. -CA-MA-_ . -=::_SiIHN'c-rr.y+tC.�Ht�Y,ti-S r 0 ri r �rE 508.429.6191 • - �@Usto m o esign s copyright p19 95 ^1I Rrgnt$ Reseve0evlin n . � -�wtt•F ctnng3Y111cT--- .. I �I i I.r Preliminary plans and IJy0ut3 by DC D.dre for the use of them customers only.Any of her use if st rr Ctly Pram Drlr . f 0 J ` N jtl � f.2'� ilt• . t - ! } I l A J f {, l, -- SI0 8-428.6 19 1v @UStom esig evin t cf9nO19 i ouuvo ��r r� e p pl , Ado I i Preliminary plans and layouts by DC Dare for the use of their customers only,Any other use 4 st Wetly PrOM Dill 7,1 1 rjrlcw— � Nam= i� cj �t chi• a t�s s.G tGs Y s b c f 0 IlMaLly ` � 08.42&a191 xo a evl i n ri t . •< .tr. r - Cai U 5?O mo e signs C. py Al R gntt, ve O 999 Reserd . ej .; . .. ... _.. �'� 'mob-=•: �f._'C Q O^_.r TC•---.. .'. .1.�. t . .......... . Vrefrm,nary, plans and layouts by DC.D.are for the use of their customers only.Any other use n st,ctiy prOnowl, I I� I I ' Illi � i III I I I ICI; ' IJ I 1 i. Ii II. II ' - 1 J r! _ +l, sc o rE r7-7 i II:I i I! f i 508.428.6191 -ua:_- evlin III I:II is ..I,! ?jil (' III�III.iI rl! IIII `%-:1t:l: '' jl li•I I�,I !� 'I i III{, �Ustom I�IIIII'fI1� i ;l _''�+' i.� ! I o esigns Il llilly,1111�II � �III II I I i , y_.� _ —11I111 .. copyright A 7995 IIIII� II II Ill i I All R,ynti I. ;, Rcs erved i. I IS i l it ! I li II � i -— - i .. I i 1' I I i . I II I �I : II I Preliminary plans and layouts by DC.D.are for the use of their customers only.Any other use is strictly prom,bile l � ..L sD Vt&"EJCS` _ .••..X9NNT-5%UWC,LZ;S.. - 11 .-._AIu1e.G4L)1LR .1 I . ' � ..-Lw.[-F�TCJ�___-..... .'� t�tAc42�..:•___:: T..4 C.U,.. r ji �fSFFiTfSITJCI Q;r - AID to ------------ it 10 • LtD - Zy£te6c�5 , _ ..... •f •. e.,O Rmct - SC/aE, wee P-w%All 508-428-6191 Nj y a �. 1 -rn- .i o -"�; 1, ; i ;i -- r• —:Sr)5s�CLr94nPFa,$ .. li! v)in st C�u o rr,<7A w.rnc of ia. 5 esigns s '9_� •tl copyngnt Q 1995 Kr All R tnati Rele �.�y� �• ,. tusrn. ::wnt>o�r{mosw. APR 1 :...SEGtl011 AA _ ECT1011 B D R if G :' i Preliminary plans and layouts by DC.D.are for the use of their customers only-Any other use a stncuy pron,one i Assessor's map and lot number THE job Sewage Permit, number [ � T " "ir ° '...............:....SST.C�.!���.���.:::� ��3�+Jti SEWER iB i AHBSTADLE, House number .......................... ...�Z...`.�.....FSS.......:.......:.... 900 0� MAB6 1639. 9 i 1 'F0 YAY A, TOWN , OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .................................... -TYPE OF CONSTRUCTION ..........,wood frame .................................. ..................................................................................... Jul?L1 XY...X.l...................19...8.9. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... ..............Eventide Lane HY.annis.e... ........................................................................................ ProposedUse ............................................................................................................................................................................. Zoning District R.B. ..............................Fire District ........Hyannis.................................................... Name of Owner Capricorn Realty Trust Address .765. .Falmouh Road, Hvr1�, , , ........ ............ Name of Builder Fr_anco...R...E.......Dev... . .Co.jnc..........Address .765,,,Falmo,�l . .. .. .. .. Nameof Architect ..................................................................Address ..................................................................................., Number of Rooms .........S.ix.................................................Foundation .......P.r.0.............................................................. Exterior ,Clapboard and/or Shingles Roofing ..:Asphalt Shingles Floors ...... .................................................................Interior ...ShPetrock ......................................................... .................. ..,_ . —Copper...Ga.s... W ..................................... Plumbing .........Two . .. ............................................... Yes ........Approximate Cost ...... 5 O r 0 0 0. 0 0 Fireplace ................................ pp ....................................... ................................:......... Definitive Plan Approved by Planning Board _______�1a3------------19�___. Area 10,50,,,9g....f t,,,,........ Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Construction Supervisor's License ..0.0 0.9 8 9 . ................... No ................. .Permit for .................................... ............................................................................... Location ............................................................. . ................................................................................ Owner ......................:............................................. Type of Construction .......................................... .................................. ...... Plot ..t......................... Lot ................................ Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed .......................................1,9 Assessor's map and lot number ..... - .. .. -1 aa1. ........ �pF TN E t0 Sewage Permit number �JS Z BAWST/1DLE, i Housenumber ......................................................................... 9� "A66 O 2639• `e0 TOWN OF BARNSTABLE } BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... le... .m? y...dwe.I Ag.................................... TYPE OF CONSTRUCTION ,,......,..wood frame ..:................19..F;a TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...Lot...A.11...............Eventide Lane ..................Hyannis,—MA.............................................. .............................................. ProposedUse ............................................................:................................................................................................................. Zoning District R•B .....................................Fire District .......Hyannis Ca ricorn Realty Trust 765 Falmouth Road Hvan �s Name of Owner ..... ?................................_........:....................Address ......................................................,...... ?......:.... .... Name of BuilderFranco R.E.. Dev. ............................ . Address 76,5.„F41lltouth Road,,,,,HYA. a s,,,,, Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ........)SiX.................................................Foundation .......P.C. .................................................................... Exierior Clapboard and/.o.r...Shingles.................Roofing. ..Asphslt Shingles....................................... Floors Caret .Interior ,:.s..heetrock ..... ...................................................................... ............................. . . ........................... ....... Heating .... ... .W.A, Plum bin g Two-CO. ??er........ ....... .. ................................................. Fireplace ... .. ..................................................................Approximate. Cost 550, 000.00 Definitive Plan Approved by Planning Board -------4_1a3-___________ Area 1Q50...Aq. ...ft........... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. j Construction Supervisor's License A0,0989 No ................. Permit for .................................... ............................................................................... Location ................................................................ ............................................................................... Owner .................................................................. Type of Construction .......................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ........................................19 I Date of Inspection ....................................19 { Date Completed ......................................19 i FISOALILM- Pc&n".'f r P Q �EQUAQU 4v vy Q - Cl U o z8 N LOCATIOM MAPscA e : p-r 2 e�1 `-4 � 0 ,,E 8'5, .�2, 4 o E 41 I � I � as ► � o r Cp SOT 10 �1 U �4�`SK CF�vq.S- y, RENWIC:K 'a B. r',1 v CHAPMAN tsl p No. 2155£ f; �rF� TEP� ��ar T �� ta�Jli mz :.� The BSC CroL�_<--C r F I'vladaket Pace B`2 U E"','CH M'S"P" U S D: I Route 28 1 10 C E!_-E`J . - 75 . 68 N . G . V . D . Mashtpee MA 02649 ZONE RC_ SETBACKS: (OP-EN SPACE) 617 471 2c,0S FRONT 20 ' SIDE 7 . 5 , REAR 7 . S ' f 1 FOR SEWER MAIN DETAIL SEE PLANS BY KALKUNTE ENGINEERING CORP . LOT 1749 CENTRAL STREET STOUGHTON MA . 02072 IN E ARNS(Hyannis) ]11"rj,rB�}�°�.E ',ASS . FOR, I. ALL UNDERGROjUD UTILITIES SHOW-4 ViERE COMPILED ACCORDING TO AVAILABLE CAPR CORN RE,4,,LTY TRUE)-# RECORD PLANS FROM' THE VARIOUS UTILITY COiF PAN ES AND PUBLIC AGIE-NCIES AND ARE APPROXIMATE AT'E ONLY, ACTUAL. L.C?CATIONS DUST ESE DETERMINED IN, THE FIELD. TIDE- CONTRACTOR MUST NOTIFY UTIL4TY COMPANIES 72 HOURS IN A1:7VANC-E: SCA„.F Of CO-�STt UICTIO`;. THIS M."SYSE DONE BY CONTACTING THE DIG _ SAFE CENTER i ETlr� E FEET 0 10 its vo s 2. ALL WORK AND MATERIALS SHALL CONFORki TO THE TO` !N OF BARNSTAII.BLE ..�. DEFT. OF PUBLIC Wf)PKS CONSTRUClION SPECIFICATIONS AND STANDARDS . J PRIOR T O S f.r?.�'"L S O F CONSTRUCTION � 5 7' }E CONTRACTOR # LAST ®DTAIN l= O{' TrIE TOWN OF Z E A SEWER TIT; - Its PCERK! IT" A�iD A R()AD OPEN INC Plr:RMi`I'. CHECK. � �: �a� . �• ��' , g' (may - �..._.,.__-... -..�,.... _..._ ._,r ...,-..... FILE _ -__ t z ri W. . _ .. t. -_._ _MOM WoUr . .. . .. . .,,... .. .. ,., „3 .. a.. .:. .., a >. .. ,r._ -S fi.- ... ... ..,„. :r•..$. a 7t: -fir... -.. ,>.. .. ,,. .. ..,- .. .. f.. ... .. a .. .•. ..x:.. ..-. r. .: . .. .. ... , , 1., ..s': ,. y . t I'm r. GENERAL NOTES PROPERTY LINES WERE COMPILED FROM �T AVAILABLE PLANS OF RECORD AND DO 1 I NOT REPRESENT AN ON THE GROUND SURVEY. 1 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE TOWN OF BARNS TABL E DEPT. OF PUBLIC WORKS CONSTRUCTION SPECIFICATIONS I AND STANDARDS . 3. ALL SEWER PIPE SHALL BE SCHEDULE 40 OR APPROVED EQUAL , 4. BEFORE CONSTRUCTION CALL 'CjIG-SAFE' . LOT 12 1 -800-322-4844 FOR LOCATION OF UNDERGROUND UTILITIES. 5. VERTICAL DATUM I S : NGVD 6. BENCH MARK USED: M. U. S. I I OC. EL -75. 68 OQ. oA _ i LOT i •9? ' . 8574+ S. F. J�'�_ R� -- SETBACKS: (OFEN SPACE) FRONT - 20 ' / SIDE & REAR - 7. 5 ' o GARAGE PROPOSE-' EWq OR/V �._._.� y ROP D PVC SEWER � S-0. 02 MIN � I SPA C E � PROP EO RE o BOOROaM p�'E�C PROP__aSED WATER LINE _ _.___ - '24'= _ I DECK j 1 I N 88 25'07'W 89.97' I � r l i � ;r o i i PREF'� RED FOR S Ca L E : / - 2 O S EP TEME'ER / 9 / 9 9 S ,vk E'�4 GL L' S UR L NG 'NG I Ne!-i,,E R I NG . I NC . s' 4 r 1 S`e a f6 o cr r- ar L cx n 7 -T CHECK: LCF�W]� DRN: SA40 .JOB NO: 95-321 FIELD• RVB\PDR CALC• SAH -• ,. �. - :'�<..: ..ice� �.�: :