Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0015 GRAYTON AVENUE
/� �--ram, �.-�n �„�. , - _ �, I� 4 1 O _ Town of Barnstable Building Post This Card So That rt�s;Visible From the Street Approvetl Plans Mustbe Retained on Job and`thisCard Must,beKepx :s SAMWABLE. s 6 Poste! Until'F�nal Inspection IiasB;een Made y' � � , y �.'.:. Permit Wherea Certificate ofOccupancyis Required,such;Build�ng shall Not be Occupied,unt�l,a Final Inspection has been made a Permit NO. B-20-864 Applicant Name: JOSEPH RENNIE Approvals Date Issued:. 03/30/2020 Current Use: Structure Permit Type: Building-Deck Expiration Date: 09/30/2020 Foundation: Location: 15 GRAYTON AVENUE, HYANNIS Map/Lot:: 287-036 Zoning District: RF-1 Sheathing: Owner on Record: CANCIAN, ROSEMARY Ss _ : Contractor Narne .JOSEPH A RENNIE Framing: 1 Contractor License CS 086728 Address: 201 COMMONWEALTH AVE I; 2 CONCORD, MA 01742_ _ # :' Est Project Cost: $ 14,000.00 Chimney: ('. Description: build a 16x27 azek deck along backside of house Harvey sliding Permit Fee: $ 110.00 , glass door installed lattice placed along front of deck :small landing Insulation: Fee Paid;; $ 110.00 with stairs out to yard include a 4x6 landing Girtr4'm;from deck Final: posts 46 with footings placed evenly along girt t Date 3/30/2020 Project Review Req: Lateral load device or equal to be installed r �tlt��s Plumbing/Gas S Rough Plumbing: { � Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless.the work aulhor�zedEby this permit is commenced within six months after;issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents fgq wh chAkis permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and strucfuresshall be in compliance with the local zomng'by laws and codes.. This permitshall be displayed in a location clearly visible from access street or road and shall be maintained open for public',mspectio6 for the entire duration of the Final Gas: work until the completion of the same. ); 4 4 z Z Electrical - The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Offic16!s are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work _ � g Service: 1.Foundation or Footing ' Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 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: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: �� ^ 5�p Application Number.... .....4... � ...................... * 1ARNSPABL1r, + ? MASS. Permit Fee .........................Other Fee........................ . .. . �EO Mfg 6- TotalFee Paid............................................................... ...... �j TOWN OF BARNSTABLE Permit Approval by....zo...............on...l. ®.......... BUILDING PERMIT Map............ .: 29 �...........Pareel.............� .................... APPLICATION - Section 1 — Owner's Information and Project Location Project Address (5 -i r Se Village Owners Name L U�N SCANNED APR 0 6 2020 Owners Legal Address____ _„Z / 60 02,mo n f/V City A-ddj Y 2z State 12-7 Zip D Owners Cell# E-mail F— Section 2 —Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet I' ❑ Commercial Structure under 35,000 cubic feet 03 Single/Two Family Dwelling 'Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ 'Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild Deck Apartment © Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify. Section 4 - Work Description &I/a a- e-c gc OL.- for -A 5 z - Wa rGtrele- ih- -ka l C,,dQ l Q"M(°O �V L.ec C� �C'{,fDYt�> YDh�' , o 616 i 0-- yX Q 'IG W I -60 i arg= n( 17A- e ok e104-41-Ac n XA l.cN os rk-Sift- r , Application Number.................................................... Section 5—Detail Cost of Proposed Construction` Square Footage of Project `3;2— 5 Age of Structure Dig Safe Number # Of Bedrooms Existing '� Total#Of Bedrooms (proposed) ~� 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics Wiring Oil Tank Storage Smoke Detectors .j="4e1A0k ❑ Plumbing ❑ Gas ❑ Fire Suppression 'v", r fig6 ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway I Debris Disposal Facility: (4a& ,2 y� 4J b�p . I am using a crane Yes ❑ No t Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District / Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No 'E _ T act nnAot-+ 1 1/I IMM 9 BOO 6ISPA 46 7 • PEOEAEO A;WAECaROEO .. eT � . IRIIEe-e P 1,33 LOCUS INFORMATION r , eM1[^l:�tv Go cos TAu • P=, ,.Aa:. wRaEMT oMmc RD90lARY GANAAN cr a .. .. M MEMOM• BOOM NM PAN M RAN REFERE M BOON ML PAN 37 F� - `.' AssamMs MAN.= 3 P6. ARos, 30, SETBACK& M T M x AurATaesAOAo REAR 15 MR REOI9TRY USE i Ee1L TAOTTAN,EA: 20' tt S Owner To O THE ;M — MOM"WNOWM IOT B7E: L. NDT 10 SCALE PROTEon" NM nos P.N 4 - ' TOTAL OOYONED LOT AREA: 2R.e0Bi e.7. TO eBu RULES AND RAN 1AeNAA LOT NWTM 12V THE RMRMGMM OF DEEM 9 LOT a GAT 3A k - PROPOS[O LOT Al"Kom tes.31, .P. 0"01 1P. p LOT WDD1 161A' R0.RE' SW' ZONE O19TR R FTMA rum ZONE'C AS 4MIWr ON PANEL 2E00M GM O GATED 7/2/B2 a"AY NSAOOP NOT N A ME O GRO NOMM OVERLAV O RRM AP Ih,O 91NNEYOF ---- --- BARNSTABLE PLANNING BOARD PLAN /� p r APPROVAL UNDER SUBDIVISION GR/A�'QN-AVENUE VENU -�------- _-.._-_-__-- CONTROL LAW NOT REQUIRED OF LANE ' ---------- - ,1 VL E T.�,;,,La� #15 �• - GRAYMN AM ....� �A •� �L;1-- ._._.� � r2.- 1R ow"RSA. 1oP MASSACNUSE \ _ - (BARNSTABLE COU DATE. '06 ANR PLAN Q No 097oft UTI"A9 W OawMroE YAIN BE EOM ONONANN AEg19EMUM HAS WAY 18,20M NNL YN[ \1\OVA 1 7v iOGm1 w d NIDOfD we INK ADM 10u10 \\`�• 1 R Adsv M:"Q AL \ UR 4 N Mx1,nyAP�AtDT \ 1 Ae>mNp YN Le7� - Ill,'AIM ice• mum 6L TAI LO THE NAM of - W O rs PLR W LA 1MN�Ate LAY f IED GO 3 NPIORO GAM A PUN a M � AME R a 04055IN PLAN B 7K M.PAW 57 REIBON9: 9NRP•. GAGA, LAo AMMO�YIPYV sp NIO LOTS to AMPA W. GATE OEM APPROOWATE 9E X LOOW ARE BARD ` \ •.�.�M \\ PARm i7 qi N/ORMAIM PROVIDED BY AE CANER- . \ hnv - .- OLC tW1mN UM OF URNSTABLE ASS ROM= . 004"BOTH GAB ON INS PLAN As PARCEL \ r0. - e 1 -1 79 ON NAP 257 AND A9 NAWIO AN AMM89 \\ ♦ ---.- 1 � O7/16 ARAYMN AWN& \ ---_--- { inIW Al -__ WINCHES - T - «M ------ '] ------- � VEN eMNP .Aoum MA! --- UE ---- --- tq Y4-WW --- I .01.Na- C �AUSL E1oRRsoN 77 MAR PATH RC llSC Vn 657M&Sft LUNk6 W.Yo"Mth Musechnsm 07bfl 508 778 SCANNED APR 0 6 2020 e® PRW.Nap:A.f= . FEEk 0.0A22W.0 J.NctlJt GIG./OKS":P.NAGMT ORABN: P.HAM PEP BB.2+VOCBAA ORO.N0: B7DP-0, NO/-MM200 , k.. ,... '� ,s.•;f: ,.e....... •. OR . '.' i f:-.,. 'r ....�.,._ .v.. T y rr.,� i+ew"akaM r"�n"' z."•-: .h ^,._ a'drdlen. ,k' r., .k 5' J• BGs� tts •¢'r'3i. ,. ,ra '., �.. ,.a...� .- ,-,... .�98 r. . ;i -,., c. +e'(rE.•N� -vW• .'- ^'"nssr,... a ..e, enr a .. .. , .•:'`�R„, I -. .. .a ,":';' ,,: .: ..�, are+.m'2tt -"C ;:'wuhf+na^F`1 :. k1�W►1 ,., '.; �• �• r z: '. ..: : &,., N., ' ..:.�,a r. �R>-''s�' �..':! , ., , ,.r , +k:�q^ '�� 3wu... '�s ��4'�ns'+F� a„�A{';.. i �:.. /ns �, r 1�. . '.. , ,. -... sF„� ......":. ;.,,.re •�: .� ,.,t. .' ,,:g .. � ,aes:„ .as�.3 u,. ,:,p;., � .� ,,,�. �' ,y ,' aH. /✓•� ,<a: : .e + .• m+nm ',.,,�. l„y,..,. _y961 , ..�,a.�:„;'x.'+,F'�. ., i: § ,r '�.,u* ,...,.-:..i� n n. , ^y:^e'o •. , a,:✓•. I1:T,S: ,,! R.:.: AF 4r1. vw , '+Aff, +ivr,:'.k �,. u.`r . :;::x. Nq .;: ,', ;i " a<,«. c.°, A ..x,:.,.. N•EP.+,�.:. yr ,vh �t R'u. »"�e, u Y .•�'�y�.,<* .y.,"z+�U4¢ .. •" "� ...,;. ,,,,,;:'1'. -..,,, btr., •.. :� ." ..":1... ,f.:'. ;. .,•gba v +�%' sstac :wm.. � ,:,r !„'i�,a m:�c ..�+2a aw w� w ,..,,a,;n• ° , -�; ..... .., w, ..a,P -,'. q Y� `^, ,: ,.: �i"P � ,r5s�"?:� �$ t�+� �r��- a':Y'a' . .�. ,. ,.,',. ase,,. , ,:,"-JIB � , '..,m .::r,. '_,; .r,...,.. ... w a ,�', d$t .'ap•` ''_', atpY °':!*�.o,`,. .„ "r�°.ka,,:�.,.rt,"„r ',. a. ^ ;" r.rh m3 r;,.'x�^±x •' ,'.;AY � "@ .,P �� "n .. Y�- �rr^� ,y*ra '�"'^r'. �: ^�" •...*+• '�,,>s. N 4d+ .. ",. .. ,<,,: .'' ,sti r�asgazF:r .: :'� _a:,-.:, ::.1, '.:;; •d,h® � ";. ,.°.+ai�F°k,.n ,,.:. a .Yr�:.r, „n,a �:..;, ,�;:'�.. :..„;:,qk, ,.- ,,. a, ,41.,,}o z,;�. � �r:' ..cSG* s:'"mau•+ '". „�•k:�3 tM.✓: ",w w .';kx„vu,•x.ds!,+c,,.,;„,M ,,.,, M. 'r R: ? wp, vm a r ,�i,.. :«.� ^�v ,.,r,,.a.:. .m• r1 "^, r'yg„•',y;F?^k�°!rR'Ikr .s• lr ':a'[+MAf+4a>Pw•. a++,a1nE�- •a'�'�W,'J:".,. +aa, , ,..;':�,•, ,,s+,t M::•A;. ,.V a, ,..fRd :, , � -.:.: ., v �•" ..: .. ' '$ki4".' �.., RR+Ww 341pw,t. -;.:._. :'^A.P ..., „ r: {t.i"<'gbr.'10 ¢ � ,,.v:,a rN ,e.,';,p ,;}t.`.�• ,vgx 4wr;.`."�, ' -Y�. 'rM9Ft`g[k..'.,r �F^�a+r' ^^` :': :+ x,,- .. ,,,.+ . . ;... _ c ,.:,, �',...•,.: ,:..,-. � �,.. ;: a.¢., Ati7 ,.� � - -�°�� mx<�,�+.'.:'"�s, �' ,.b?r" xr: ,.e,,;o, �', ., M , ,.a• -�:. ,M.- •R tr;' -¢,,:. i., :�:� 4, t .� yr, d;;�,5 •�,k i3 ': '4kH,^' rAr•w ,.'h k;q v=_a• rKAd+'ffi7,- - ,-,"•-.. ,fin.e .'. ,^ `:- • >. ..:. ,:.:- ,a,"'� °,rrr�r, i,i •^a�,+q.�, ags�,.,, ,ws"Mms+€w ,rse;aa,"s'r. -:p'.:s ' ,� .,.. ;e:.. "n, k '..�;ak ��+' ':i't '; '�.,. .'�;, c,:..�, - �:,ty,A- '-:. +h,:i•.'' "4e. _ �".. s'm•F', �k4��` " c.YAK .�. >"n�:;.rr<,mr„ d{`., >~� i .N, - c r' w . s ,., .•c ';, +" s+:+�'.:r ." � Y a, qz.; .. :. -. ,��,w t5.< '.N•,•.�+f 4. }} �. '�" ti ix1A� OR �. y.... WF'E, ' �A ., •., > "3;�' h ,^ :� e,lfl 4,°• � � �� '{"':'� �'k' °'�. - @ r an r•�•..'s�:iw �� x:" R." Ir - c^. >4:' ,s. 'a,. ,25* {, : ` °'^. ` � .4'_ �(' '.,: r .• , _ .1 'y ek:,.. �.,• � .k�a, � '�,..' n»xr ,b,.,?:tJ., ,k,'- .,: rtr. vmr ..�11• .k; c 1 ;v ' �p.� �.,.� .0 .•. .I „{- •.° .1 .:, 5th. �,. I'�, ',•w,,�p,� �Y:. � �,,, {ra x3 9`• r. �y �vy&t +{'�, w m,�trt"`Y .r..ry.• 3 ,z. 4^` M11m+tw °�^�'v9" � .�"y Av`, ��9, '��,'y3' F•` N"- n`t 'i'd'i 1t+: x S.. ��„° �,yn,,`s +x ���', '•uwy ,z k k' m. 'sk{al f.a• Pfi.° S� i' ��� "� J'},i'� ie' `M54+� 'Y�' V � � ,"' I ll• '�'g A P,�L^ Y ..�.^ •`x+r"��:•� ..a vx".�i tl.b..:y'sk1. :.,...: �� f „ty:. _ 4 M. ,.,4 `t' N 4 •Pd-. Aflb '. � M �9 e 6 �$^<'x' - s`� �:rlk • E ,:, , a='.':: ::,r' ..p?',4. .: e'. •. .i � i1G,.�., R t.1,uYe':r,r q .S:� % YAK T'H ti4'-` al Y � milli._. ,'u+v; ,.,,em .,,...,y_. .. ,:. t.,. :, IVEC •w .•.� '�( (` " we'xty M° -:f��! va::c„. `Urx..:i . ., ..4. .. ::, - , .. �m �`.. �✓�V �� m +� rF.: t� sa,1S - �� dk 6.. Ik,.� i +� : ' n t , , ,. .., qi.;:': � i Y. ,\.:,� 3.: ,.r.'k ., "� v ::: YJx' e✓. „ Y''S?��\ .p,. nS•:, ..4 ''..79. y,x +'"`... ,,• .. & ?' .' ,� ,•u yde}};v.•� �;*;,f �� .,. ,„. . � �°; ,n xl„ ,+. .k<�' E' fit, .3`'.; �: � w i,. F .`":• a.tiF'.:Iv r � :t, .ab T p � m$ r �, .. :�:,, t; .,, .., ;.,.. :. : ;'.u w., �... ,.. •,.. ::.-e. -.,: r 4 .t*:: t i<a..al?_ y�'�f 3%w, �,,,�.: .r.x '�. ,�. ., fir r..: .': .. ,, , ,,.. �x�::� .:. ;:p t:. '..r.' :. 1t ... .y .-. ,s «e, ,tStC +4h.•'-'a, +1+�Pbk%'.",:'...� a, Y qR" '0 �m { ,.4.,yir �„#a, �,� ,:. ;,. , -• E y� ,...... :'� u. .. ,�-.'t ire max, `s'°',�"p L�:w. `.'�h ... ;x � _. ..a L F.tr.. 1 �'rAn �.� .�, •g �,. ,a. .. e� �!� �. �� �,:'rc F' c ',k' w,, .� - - ' : '' ,ar• .. rct ar,..: :'. .'sw r. ,., ,a: ,rk,"-�' �= ,fit t,:p.' :1;, +E,: pr � f� • ^ ,,a,:. .• ..�;:.: , :. • ( v.:N ,.: -,a 'wF;• is-: k§e ;;'. ,q�m, '��.. :wx+w��`� 'n k .Viz: y{( E f � ..,. .. ,' ..W p ...:. . ;r.. ., , d:' t.;i , ,.-...� .,. •M_ y, Y p' �.� , `:` �,g6�wa, ,. -,a. ..�:,. II .. ,, ,., ;: ,q• ,",!'8+ �,,. ,.. „ .:;. �'"�+ An.. tip: Is r. ,' ;C' a `. , ;-. :. .. '..ir, ,� ,,,� "' i•a, Ar,.: ... `' � � 'ei AE," I y� a t•.7: ::,.-. ,. ,. :, .e, , .:'.; ..r ,..:�� ::b:..q. ... 1� ,,t ,' `,F,n:: r.. Jl �, EM �,g .�'.': t'' 4 i e;,: �W .:.,.,:,,, _... , y .. �' .ti ii.�. � , -.,,�,,¢... ,,.. m as}8•, t�"w.: ,::ftt ,?;. ��tt k' : ;:,; s ,; ,. r_: s, �. , �?4, , r. ,'. ,,,, Ir,: �:.,,,<.-e�^ ri �� rs 'u"�� 'd'• + ta't.# .:,,, ,• Yw_ ',.. .. � ..{yam• x.ry,...:..'. 1 y E ^S A. .ut YG ��' (� r yy tia* w,w'�. 1 .:;.,. ,_ :, r ..:, ,::,.,.>... '°k.• a. ,. , ..r ,: IW :m ^":,w .�¢ ��^��•I• :. .. v .,,•, e. .. }Tp i r... , ,..:, .t :�`. .. ,. .:. .;.. � ! .,M• .. .,:t•." :�'• �'o;Y4'r y �..t�1 �Sr 1 . ;�.F,a 'uR9d,X.• rf "�' roi � .f� y�,'.,- :1.,•. � gr.'-PP::a wr• k "' pee ,. '•bks.«w ��, ,� .'^., s.l 4. ,,.^a+a,:5w' , .- ,;: ..: , ": CWr,�_'.•' wsu ..7 •u ie Fn'. a' sGr �tir: ,� �E .tsgi' �w t, _ :. ,,n,,.� .,,,: n, w,:�,�} w•:-t.':. ,'- :. -.x<.. ^`' ,�„ { ><, dad;,:as ;-,&' y�'� A �'.F.�r• w,. •.,: ,re 9�� � ek,... .:.. ..,� ... .. „ ,_ , o.', sy _.' ,.: � sal -: r" ;.fir •� � d r •' xs',, .t, y ° :.. -,.,,w: .'..� �. -;�,,. tl , �:. .'�,'d.#'!�{a .:.>+ .. wa, r's+nF e..s +�: •i ^, ""li ,rl.. 1. .,I ': ,.R t, i. ..,,. 'a' ..f ,:,.. , .:e':5)feyt. -!r..¢t,:k -., w•1 Gn `:•i �R{ ."q, /i. � ',,k, ir. 9 ..� _ ,<�' .�l .: ,...a '...., .!. .kr� .. .- :.° a,,.. .;' ,,.. ,.,w i, .,,r�-�a .., ,�, ._. ,. .. II a,ar+�,•, �t` _!S .a° ,tys:y�..r. fi. .1„w..�i '`.'"v ,lt'. I � st,,. ,.::, , ,tr. v c:. ,, - .� ... ,� � v .. .:..,. . ,L»..,:.n ,.., 'Ilaz.• t - ..W p s�„ � � •Nj+p i�ra hd ti.xn pp ..,i {pp �.:�,m#. ks? f€;.. v �t.+s...� ,ak. ,.;5�' �3r', •r ," f i� .+a.•.', ,, r� '4t �•i I 1 , ::.. .A .:. y;;,F, ., �," `�.h :: . .,..., _:.:.. ...:..:: c.-.^':.;,:.. ., 'r' .'R•. '�, :w.":,u ��^ a _ n-w. �� ^ rs,.".�:c•e `-q.a•:� SCANN t APR 0 6 2010 t r ' t � �'tmah��' SGY,�✓ t r P�sO %�RbS Qj�yCt/!�.%L , s I ; f i d h�5 _ < . t : f I t 55 j I /vim I y 1 Al Lv , 1 t Y � 1 ! , I i ¢ t a 1 d < i X , , : , T t , , f X e eo (Z I ! ) Ito, z E i ! i 4 . j r f • f •4i Fo s f { 3 Legend Parcels own Boundary 2703 _ ' Railroad Tracks I 2�7935E��1 � � � #2.6 _ Buildings sH x A Approx.Building �;�:• '"�` s � �� L]Buildings ° s . Painted Lines Parking Lots N7356102 f ._ — € r; h m u Paved sP #6 Q a Unpaved F 3 w 2,8703 Driveways C; Paved �i Unpaved � r '3 Roads Paved Road ` Unpaved Road 1 Bridge Paved Median Streams •.�F{ E •'S jF { _ �. ice` �,. r- � �. l i ! Marsh a Water Bodies 16: n r 287036 2870.1,40 � #15. f +fix F ." #59 .t - 4 Y- 2070144E11 #63a ' „ ^ #621� a Map printed on: 3/4/2020 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026oi O 42 83 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: i inch= 42 feet cartographic errors or omissions. gis@town.bamstable.ma.us ny{\ 1 i too � \ S00%A%PdOB69 1 i - i 1 it ».= - , 1 S hl �, W ' If Iit it O a QQ C g P a IRS � � a 9 ° c y a a a acz D.N. 9 N1— . I , .{„_}v ,gWr,;..A x Yt •z;::, .^ram,y '�}" ",. p' t�t� Py r<iY1.". <t" < �g.;4Jd ;.'="w:iy �,--�--�' - w:4?1,.. 2� � ',:,' 1 .y> `� to,s'. sg ,� L`t, A e jt�A'iG ah�< L ,:,,, �. ,;: ,e. �:'V t✓�'.�/,!,t„ �r, .�,,�:ttt`. ,� •-i':: +. '.t{ ,:fi,'``fits� . ..c1 m ;v.., � ,<.7 �, � ,s[ � I ;,e' •k+ sk t 1 )� .r,'�,,: s+„d^t' � '"r�;y. ,S„a, �7 :'.: ^.ei'�' _r•'�.' "t kv�, ° ,:_ .,rx. ! �,f.. ,,, , • '4 boa ,�)'" Z�����; ,.i' , v?Xa'.,<,. , -., ... t :, :,.� ,.. �: d:, - - S .:� < Y t kxxM tbV .m;•x..,✓. .. . ;: .y rrt `t ty4. t "e.. :n:: U.., < ,A +,bV, a:,`i.N n, ,:. ., ,•_, .: r.G.. v. .. :,�....:x' kl '...,„ ,... .,'.. � a:., q.. k F" "F� d^t^'+°.�.. d},�,a �'"� t', "F ,! I:.i•t d 1. lr.� ♦..1�;&4:..t. .I„ `.•3. { .YU`fS.:P,. .•� �Y ,�.' �'3�. aA,N' ,., t'• :..,.r. HH 4 � ,. ` .. .: .,w 3s. n�:,. .,•.r..,� :frt S. �i ,.�x. ,t.,M.. .S a :. pft ,.. 1 t� �•:'+{�' :U,t :.4'a... ,,. ,: r h:. Y .•>,ir .n\ .. a, Jn r,.. .. f. ..�,I. ,ir .S( ,L.-.. ..,,.:. :. N .Y' 'kS ,. ...a f, :r ,:: ._,: '�::,I±t „ ..n,w ;#; _..<.. ,�,: ?.,.��.,e,trz Iw 1 -'�• - *rr.,., •=s >;. a pp �t :`�`.:. ...,Yt. .. .,^ : 1a.P...r'Y" ♦.�,�...x n. .. ��'. '.:e�,; S,l•'b,. .r rry, .:,. •. .:'na XY,�"� ^i� to �'.V -e. , '...raa.:. ... :•„ � ..,f r. .,:: .,,: ,, 0 6.: � a:- :,.. '�. ..:. .. .r' �'� +Lr<'f. �aa.v'� ,e, �rvrvy ..t".;. �L:.11- ¢ •4.r,.�:x'�'., 7 '�'. ;;;.,,.,. ' � .2.. .a. • :tt .' .�.;: ;,.,_yz ',:.s :. rea61. :,.. *,{ 11:nF. i,Tf"Fp - •'.S�a t 4�N,`N: ..O.f. T, i(' '�VZ.nI ,r :�" 'i'?AN. 4•. t '� . `� .�.... : .:t ,y err. ;:�.. ,�,<,�.r ,:, eA,• .1..„y;:u -,,.g:..,, '"vA'.•«.,. ,.. a.-. _' •,_. .,..: :. ,. .. ., '�. _.*. t !+ .:•z4,rfR� r,r ...-.. r ..:.;,. r _l R S� ••:.V:.'... .. .: +'•x�4s3 , '`�.' � M,. ,r�, .:x•' 'ki Y`1!F i .�"f kt �.;3.;£•,c� .. .. ,<s. � 6 r :.' .:;..:: .;: ,...x„c`�.v, a a.�', ,rs": .u,t�: ra:MA'.p �:t.�.,,, , . ! P f �,.,, �N,r�, r, 5 =.r w u �s t >,e ,..�� `�-;,a.,,�. ,�, .�F , .0 fit• .�. .. V.> :.t :.A ,as..,� ).Y.'>ti�r ,.}1 ✓:,� .1.. 374'>;' +. '3, :n'. v,,:. .v ,. ..A. la �.. Y. �,':r*,+"p-. t... .. Yam,. �"P li•�' 4r t y,� •'i. '. l M .,Tr c, ,af.�,..t.:., � �.:,:.. , -.� �,.: a , ...kk'>�`. ..... e,�6,.#a;,. �.:'�F. :>'r� r.�'. •.4' 3t. `k`"•y I ..;,. ..ry i� r: :. I ....: Fl"a; -•,,:a�" �o. '.:C`,' v: ;'+r. -,R�`. .ra:'N „ '�+;`. .,1.'Yr.' ', "" f..,k, 4 p ;. }F` ;•z.. 5 >A� <. • .t.. '( dWr "ta. r & � p �;..:rs,. t.!�*N /r; ka hl 3 •r�rU s;,�. (, Ut , � ..�*. .=1'.�'r'r,r��`�> .t- 't. `ryI OWN •; a�;f.. ',y , '; wf�' p}}��:n, p1t t �'� 4�"F - '- r to �`. M. �"!. �� ..,. ,:.�'..l �. .t�,,. ''rt:''� _+«�. ,PC�;Jy� % ".:F" , 4'f,. ri. d• � P .� a � L:'`"# '.'Y u3:. K;t3 � "t f�• ,,: S.z'� .r., - �uk`r a�': r rty.85 T w°-` � s.x'=� ';t:. '%t$I•`A �M �'�F% 8• ):. S �t,,"9.S,f�•�` ,i''qe. � 4..�',y `£yr. F ./� 'Y ,�"'., ..A :;Ki . ti. '�� >r n,`f,'''i,r: ,, ,- ".`• t fr:m,+:t t t "rR;II :I "3 .,.�, w?� �, T. 1 ?c1 y,s yk� '� .'rw�.� g;•� ,iy_.;:'sy r v .. y .ti'... M1..'., k.JL� ,. 9�':W''� "'d- f b'yi �. -'s Ar •� f' ,.�' ,�.J. p� �. 9Va• �'d y, }.,., �H:'Pa �¢ �'.: sln - +z '� ,t�: .7ti .� � 'ta ti ,?1;'r i,�� _,,'t�r ,.-. j;➢,v •� t-�i .� rt, � � � a �, .r:, x a � cr. .. �, �a���n r�?-�' ,g '•?. n a � � _ - 'S� iz"4 �,a R,�yMr�. R`, '�Yk �� �.�, ��u a �n�Y• Rdsir+ � 1 a •,8 a1 �. Y� ,YiY 'T''�'`Ps.krj 1 IK•. Fib x te'>� :G �i,i.: , ,r;•' ';V it. `k .` 'f• d't'p, i�n€a' ^fit "{t�r Iwo zL s t s- ��s h, , -. .s., ., ,,. ,.,.,.. .�..:. .... ,:n r 4'�"'� -„�im b A •.. _... x «N"J. .. ,1 .., .. kt� �`•: yy �*�� A ;R .�"7,M, .... ,. �,:� .. ... 4 .. r'r � � .Y -. - ... ., .."� ... ..e.rd.. >i.^.g [�} :: As l •+ �'t, 1�'. b. >r: � <.�r >�•,;:.�.''.: QJi::. d✓�ya :: ., .... .:. - "'.. .,. .r,.. .ii;�;•.'�'. ,.#,.-- ,;�" .., Y'yti ➢ t °`.�"}} '�'«.F7zE+kr •;+2rs sn�, ,n z „. �M fit' �Isdv,:•�!� 4�:. r . ('.i .r-+ •,::.,t �y ,Ut:tY fia�]J� � a �:� s �' - k `� 4 ptw`,'� 4 'tGU d• t �� t +,`�`6 ,My, "Cwr.�„ "�, a •xq• ru - a ,t 'al Z w�f.S '� � r 1,Yuk. d;. -d _ ��--r9:m �."'e I Y i ,i rat t�t t:�. :fit .��:•^^� �. � 4 ,"�. � :c+'Y,'�,t y �.,�� •��,� h.. I .r� a. � s sk:`,�r� A�� b .n• t A";' S a �,'�" f' -k3 PIT `S' .. t. ,Fj, tt;: '.'b -tl ir, j Y t•'•i;, `i, j },� �� .�'•4 tea. ,a `r iGt 1' ,4 .4•. S is�"^' „A y � ,.MWS r/,r. Ul aa'1, Y I a , I y: 'k t�,.�r tG x• � e w j}t 1 �f•' ':C t= '�a y A •k � ;",`. �'�4M z.�.k.las;.' -`�k. @ :4� -i t� f P r a•9'- a+� r : , .M,. .::: , .. � •�� ,:"' ... ....,, (... ^gay.. ,.,1:,r, y;. '' p' .:R4" sty L.:, 5 I , ,g .: •.. ,.:.; +�.a `yam .F� ,. x�''h ,v..: � ,,�, r�;... I "`�,t,#.. � r a , r w r � , P WV` , a Y ' 4 f 1. IRr�d k dtr K< n "RIP. r,h. ,a: ,�z. '• 6;. ;-, h7r !Y ,:. :>',§U .' .,t, ,.. ,P,.+,w ... :.it. :,.. ,'�t<.. .... .ih1....'_ ,. �,ra'. r..� .,.4. ,...r...x Y-...,,r �::: .:. .,x..r•:-..... .:, r .1. -, .:,%. �.. q�Y �r'+d r t. YI ,,✓ , tr��d<:,.�•u:,. ��R.xz...c.. .., k '.a..a )&� .,rl, fi, -�'NA:,� e, ��islit .�:�� .tw".rt,? ,9 ,� � ;� ,..F¢ ��' •�,.. ..Mu .e,:..,, RIM, ■ ® ■■■■■■■o■■i ■■■■■■■■■ r NONE ■ MEMEMEMMEMENOMEMEMom on MEN■■■NEE ■■MME■ME OEM■■■ ■■■ OEM on MEMEMMEMESEMEMEMM■EME■■E■EM■s . MMMM No MMENEMMOMMMEMMEOr� , , a SEES■■ a ;A, MEN■M■■EEE No �_� ■ , ■ SEES ■■� ■■■■■■■■ ■.. _ ■■ ■■■ ENE SEEN ■■■m■■ ■■■■ - MENNEN ■NNE■■■■ E■■■■ ■ iME■EM M ■ MEM■ON MONSOON MEMOMNo MMEM■ME■ ■E■■■■E E■■E ■ ■ ■ ■EMMME■ ■EEMM■■ ■ i NEE No ■ ■ ` ■ E0 MENNEN ■ ■ EFOE /. ■■ ■■■■ESE ■ ■ ■� ON M ■ ■ ■ �� NMEN ■EM■E ■ ■■■ ■■ N■ ■ ■■ ■MM■ SEE■■■■ ■ ■EMN■■ ■N■ ■ ■ ■ ■ ■■ mog MMEMMEM■ ■■■■■■■ MENNEN E■■ ■ ■ EE MOMMEM■eMEN, 0 MEMEMMEM NONSENSE ■NMENE■ ■ ■E■■NE■� EN ■ ; ■ MEN mom OMEN ME MENNEN ■ ■ No SEEM Ell EmIlIll MENNEN ■■N■■■■■ SEE INMEMINMEME MEMOS MEMMEMEE No ■N■■■ ■ M MOONS ■MMMMMMM �■.) ■ESE■ MMMEMEMN NONE e OMENMEMNON 31 EROSION MENNEN MMMMMMMMMMMEN■■ /� EMEMN■■ ■ESN■■ ■■NENEME■EN■E■■■ OMENS mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmimmI mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmI mmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmmi mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmI mmmmmmmmmmmmmmmommmmmmmmmmmmmmmmmI MMMMMMMMEMMMMMMMMMMMMmmmmmmmmmmmmI mmmmmmmmmmmmmmmmmmmmmimmmmmmmmmmm mmmmmmmmmmmmmmmmmmmmm mmmmmmmmmmmi �iiiiiiiiiiii■iiiiiiiiiiiiiiiiiii immmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmI immmmmmmmmmmmmmmmmmmmmmmm mimmmmmmi immmmmmummmmmmmmmmmmmmmmmmmmmmmm moommmmmmommmmmmommimmmmm MMMMMMmMMMMMMMMMMMMmMmMMmmM mmmim immmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm immmmmmmmmmmm mimmmmmmmmmmmmmmmmmm immmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm mmmmm ME mMMmmmMmMmMMMM ME ME ME mmmmmm ME mmmmm ME MmmmMMM ME ME ME MEMESIMEMEEM mmosommom ME mossmommonommommoom ME MENSENEEM ME No ME mommom ME ommoommsmo MENEM ism ME ME ME MONEMENOMENOMEM mommom NESIMMEMESSISOMME mimmmommsm. mommommom ME on MEN MENNEN ME MENOMONEE MENOMONEE ME No ME nommommommommommom iiiiiiiiiiio�origiiiiiiii�iiii 1OON■■! ■!■MONO ■■ ■■■■■■I■■■MMEIt1 I1� ■■■■■■■ MENO■■■EE■ _ _ ONENESS MEMMEMMEM■EN Mu EMMONSS EMEMEME■MEMEM MI / ` �. MMMMM■ MEESE NONE M SEEN■ SEMMEN MEMO ■■ on NOON ■EMME■ ►6 NONE ME NM son ME ! ■■■E! ■■NOON■S ■■■■1MME NOON � ■■M■MMMMMMM■ N■MEMMN , 1 NM■�■ ■ ■ENE■■■■■MEE ME SEMEN ME ENE MEN E■son S►� ■�S ESN SEEM ME ■ ■■ [ISO MLHCA ■NSENE■ \ NNM ■ NNE ;; ' E MOM■1 '!!�■��.. , . . �. , ■■■ MNMm ■■■M ■■■ ■■M ■ ME CNN ■ ' . NN ■ ■E ■■ OMEN E iN ■ N■■ ME■■ NME MI , HE SEMMES MN OrN �. O SOMEONE E so MESONS■ mom on MEE SEMENM M■MM■MEMEME S. S SEMEN MOSEEMEMEMSEElls so mom SE■NMMEMEMMN NEMESES M■MEMME■ ■M MEESEMN ROOM No MEESEE■ MOM■ M ■ME a ■ k ■ MMM EOE■ ■ NN ■ mom@ ME NONE M ME m ■■■■■■■■M! EMMNMM m M■EMEMER ■E■■E■M■M M M■■M MEN■insMMr ' NNMN■NON!■M , MENM M■S■EEM■ ■ M■!■■■■E■■ � NONE NMME■■■■■OEM ■■■MME■E■N M■■ EMM■MEMEMS � NME■■MONEE SEEM ■■■■■■■■■■■■■ ■■■■■■■■■■■®NOON■■■ ■■■■■■■■■■■■■■■■■■■■■NONE■■■■■■■■ ■■■■■■■■NEE■OEEEEEE■■■EEEE■ENE■■■ ■■OEM■■MMEEMMMME■MMMMMMMEMMEN■EE■ ■■EEEEEEEEEEMEE■EMMEMEEEEEEEEEEE■ MMMMMMMMEMMMEMMMM■ ■■ MOMEEMEMEE■ ■EMOMEOMMEMEE ■MMMMMMME■■M■M■MMME ■EMMOMMMEMEME ■MMMMMMMMMMMMMMMME■ ■E■■EMME■■E■■EM■E■■E■■EMEEE■■E■■■ EE■■■■■■E■OE■■■NEE■■EEE■OE■EEEEE■ . EEE■■■■E■■NEE■OE■■■■■■■■■E■■■■NEE ■■■■■EEOO®■EEO■■E■NO■■■NEE■■EEEOEI ■■E■E■EE■�E■■■■Ee■E■■EEEE■■E■■EEC ■■■■■■■■■ME■E■E■■■■E■■E■■■■■■ENE■ ■EEEEEEEE�E■■■■■EON■OEEEEEOOMEE■ ME■■MONEEONMOE■OMME■■MEMOME■EMMEE ■■■■■MEME�ME■■n■EE�E■E■■■■■■EEC SEMI EMEMMEMEMEMMM MMEMMMEMMM■MMO■MMMI O Application Nurnber....& ..................... .p f s s BA8N18TABE.E, s pp 11�A88. Permit Fee..... .........................other Fee........................ Total Fee Paid........ ._.... ......... ................................ ...... TOWN OF BARNSTABLE Permit Approval by... ........ ..................On....... ................... BUILDING PERAHT c;29 Map. ...... ... .........................Parx,............................................. APPLICATION Section 1 — Owner's Information and Project Location Project Address_ ( L r o,s4-to in a-v, Village: Owners Name Owners Legal Address 2 D/ 60,o2 m.y n 4-74 Ali" City � &2 tr d State 19?cx- Zip_/ Owners Cell# E-mail Section 2—Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Single L Two Family Dwelling "Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild Deck 'Apartment ® Sprinkler System ❑ Addition ® Retaining wall ❑ . Solar ❑ Renovation ❑ Pool ❑ .Insulation Other—Specify Section 4 - Work Description _ a e _P6kr5 y X(o LJ -�O `I., . The Commonwealth of Massachusetts t � Department of Industrial Accidents t Office ofIn'vestagrati'ons 600 Washington,street } Boston, MA 0211.1 www mnass gov/cfia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Agillicant Information ry _ _- -____-- -- Please Print Legibly Name(Business/Otganiration/Individual): S-moo 1i4, .0 e/L"l i e- Address: S< ,it r sd cl a-� a`CA City/St ate/Zi : 0/Ce .� Phone#- r0 9 3 6 ® lz D Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. 1 am a general contractor and 1 6. New construction employees(full.and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp.insurance comp.insurance.t required.] 5. We-are a corporation and its 10. Electrical repairs or additions 3. 1 am a homeowner doing all work officers have exercised their 1.1. Plumbing repairs or additions myself. [No workers'comp, right of exemption per MGL 127. Roof repairs insurance required.]t c. .152, §1(4),and we have no employees. [No workers' 13, Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a-new affidavit indicating such. tContractors that cheek 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: _City/State/Zip: Attach a copy of the workers'compensation policy,declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the iris and penalties of perjury that the information provided above is trace and correeL Si Lure: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#- i -r.-s,_._... y�y vw,ws.'„'^R.�"�:.r+f 4.,��*-..i.^s+r�-^-+,a F±i_'f�.•y.,F .—. _ _ FF.' '.e.t y R5 t � Vke n��w�tuuett�l.�a�U�2aaaiar✓utaslld i Office of Consumer Affai4&Business.Regulahon HOME IMPROVEMENT CONTRACTOR Re9istration,valid for individual use only . >TYPE:individual . ::before the expiration"date. If found return to; {- Reaistrati0n: Exairation` `Qffice of Consumer Affairs and Business Regulation i j5gt._ 06/10/2020 One Ashburton Place Suite 1301 JOSEPFi FiENNIIR -� a i Boston,MA 02108: a ,;OSEPH F ENN 4 WAYSIDE LN ;(dCt ya0i�tNitllout signature SANDYdICH VIA 025fi3 v°` � Undersecretary01 > �, .� . Jauolsstulul03 . p 31() f99Z0 *11 HOIMaNVS .r s `RNj:j.alSAVM V ' 31WOU tt Hd3SOr Joslni wte1suo0 sPiePuels Pue suolieinfiab (iulPllnB d0 Pjeo6 a�nsuaol� Ieu0lssa}OAd 10 uOlsgAlO sllasnUoesse to Ulleamuocuwoo e RENNIEJ002 M OLF DATE(MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE 03/22/2019 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY.AND CONFERS.NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE.DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE.A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED'provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require:an,endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements)., PRODUCER License#1780862 C HUB International New England a.N.E. 81 792-3200 ac,Noy 781)792,3400 600 Longwater Drive AI Norwell,MA 02061-9146 INSURERS AFFORDING COVERAGE NAIC$ INSURER A: Industries Insurance,Company,Inc. 23140. INSURED INSURER B Joseph'.A.Rennie INSURER C; 4 Wayside Lane INSURER D Sandwich,MA 02563 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS. CERTIFICATE MAY 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. INSIR. TYPE OF INSURANCE` DDL SUBR POLICY NUMBER: .POLICY EFF ;POLICY'EXP. LIMITS LTRCOMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $. 'CLAIMS-MADE OCCUR DAMAGE TPREMISEO Ea RENTED nQW MED EXP:(AnV one rson' $ PERSONAL 8 ADV INJURY GEN'L AGGREGATE LIMRMIT APPLIES PER: GENERAL AGGREGATE $' i� POLICY❑JECT LOC. PRODUCTS-.COMP/OPAGG $' OTHER: $' AUTOMOBILE LIABILITY COMBINED SINGLE OMIT $ ANY AUTO, BODILYINJURY'Perperson) $' OWNED. SCHEDULED AUTOS ONLY AUTOS pBODILY INJURY(Per accident '$ yyNEp PeO a DAMAGE $ AUTO ONLY AUOTO ONLY UMBRELLA LIAB HOCCUR EACH OCCURRENCE' $ EXCESS LIAB CLAIM&MADE AGGREGATE. $ i .DED RETENTIONS ... ____.. __....... :$. r A WORKERS COMPENSATION PER OTH AND EMPLOYERS LIABILITY IUI GC5005018295 01126/2019 01/26/2020 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 0ppa`CER/MEMBEER EXCLUDED? NIA (Mandatory m NH) EL:DISEASE-EA EMPLOYE $ 100'�OQ Ifyyes;describe under 500;000 DESCRIPTION OF OPERATIONS below EL:DISEASE;-POLICY-LIMIT' :$ i DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more"space 1s,required). . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED'POUCIES BE CANCELLED BEFORE THE EXPIRATION..DATE THEREOF, NOTICE WILL BE DELIVERED IN rt TowOF'Barnstable ACCORDANCE WITH THE POLICY PROVISIONS:. 367 Main Street. Hyannis,;MA02601 AUTHOR¢ED:REPRESENTATIVE ACORD 25(2016103) O 9 1988 2015 ACORD CORPORATION'; All rights reserved. The ACORD-name'and logo:are registered,marks of ACORD:- Stepkcn Duff Construction L.LC Wednesaat�, December , 201� V'586 H aanis Rd {50a-562-2jOj Barnstable, MA 02630 saclu4co2� oo.com MARIA KLUTEY 15 Grayton Ave. Hyannisport, MA Project Cost Estimate:$14,000 Level entire area-digfinstall/pour sonotubes and footings a Deck frame built-using appropriate wood type(PT/KD) Azek Decking-purchased and installed in selected color ® Skirt installed using Azek a Matching Cortex Azek colors plugs/screws installed Railings included in cost are standard white PVC-white rails/ballasts/caps All clean up and removal/disposal completed Purchase.and Installation of Harvey vinyl sliding patio door-house to deck. Trim installed Interior/eeterlor.$"1800 Option for lighting at$7 a dollars per light- materials and labor. (due upon final invoice) .t +a To be determined exact rail style-as discussed.��� - Guaranteed upon completion- 100%satisfaction on all workmanship and materials-no work will be required at end of project.VJe promise a 2 year warranty on all workmanship: 1/2 upon acceptance of tkis contract Remaining 11/2 due upon,completion Stephen Duff Construction I Ho eowner I Application Number............................................ Section 9- Construction Supervisor Name a'5. 2/*z24 AL Telephone Number S- ' 8 - 2 l R Address u ��106 :S �,..�`zState'(y1 Cam. Zip O A SS, License Number C, -C7&, a -License Type. C S(_ Expiration Date Contractors Email c� ell# I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date MaA-&k% - Section 10-Home Improvement Contractor � I Name %U ,�-/�h ®, h�.Q Telephone Number 0-G9Sr 6 Address w --City j_ StateYh.c Zip ® Registration Number l q �-( � Expiration Date a f, j K I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your HIC... Signature Date_/ha.✓ae s ir a- /C Section 11 -Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature l Date Print Name l - PA= Telephone Number 3(0. Q, E-mail permit to: U CZ ti CJV Section 12—Department Sign-Offs , Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation or For commercial work,please take your plans directly to the fire department for approval Section 13— Owner's Authorization I, M- o, 7`O` as Owner of the subject property hereby authorize t to act on my behalf, in all matters relative to work authorized by this building permit application for: 1,5 1WL/9 lu (Address of j ob) Signature of Owner date #?�,Leo_� cK_ 1 tj t.e_r4 - Print Name Town of Barnstable *Permit# 77 Q ~� Expires 6 months from issue date Regulatory Services Fee .:?7)10` •�� Thomas F. Geller,Director Building Division Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town,barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERAffT APPLICATION - RESIDENTIAL ONLY e Not Valid without Red X-Press Imprint lap/parcel Number roperty Address y &&I—o G.0 �P! ".4 - /Residential Value of Work Tr°O Minimum fee of$25.00 for work under$6000.00 iwner's Name&Address •`^7 J• a"C41i .ontractor's Name - D. i NT yV G Telephone Numberr�8� [ome Improvement Contractor License#(if applicable)___ i LNo;66 ;ou svr'�1✓icense ( applicable) Workman' Compensation Insurance X-PRESS PERMIT Ch ck one; I am a sole proprietor APR 05 2007 ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE zsurance Company Name Vorkman's Comp,Policy# 'opy of Insurance Compliance Certificate must be on file. .ermit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) f C� 5Z/Re-side r _ ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) j *Where required: issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property O er must sign Property.Owner Letter of Permission. A cop ,-of Home Improve en Contractors License is required. ;IGNATURE: I:Forms:expmtrg evise061306 The Commonwealth of Massachusetts Department of Industrial Accidents _ Office of Investigations d 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ��nnfi Please Print Legibly �� Dame(Business/Organization/Individual): �'�- C�r�i/V I T P-y AtC, CO ' Address: Sr kE a City/State/Zip: 14YkMV1 ©?-(P Phone.#: Are you an employer?Check the appropriate bog: Type of project(required):. 1.❑ I am a Y emP to er with 4. ❑ I am a general contractor and I 6. []New construction . Amployees(full and/or part-time).* have hired the sub-contractors , 2.JZ I am a sole proprietor or partner- listed on the attached'sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9 ❑ g Building addition workers com comp.insurance.t, p.insurance 10.❑Electrical repairs or additions required.] - 5. ❑ We are a corporation and its . 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp., right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no ' employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under;he pain 1 and penalties ofperjury that the information provided above is true and correct. Si ature: �v Date: 4 41 b Phone#: so 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 T. Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the ece.� r oLtwtee of an individual.vartnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartinents and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced;acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presentedto the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-conticactor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding.the applicant. ~�--,,.,Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or __Mown)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone.and fax number: The Commonwealth of Massachusetts Departmeat of Industrial Ace&fits Office of Investagatims 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-977-MASSAFE Revised 11-22-06 Fax#617-727-7749 www.mass.gov/dia c��HE,�ti Town of Barnstable. Regulatory Services BARNSTABLE �Mass Thomas F.Geiler,Director 9�ATE0 3NI9. 'Ia10 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder c4A)CIAIJ ,as Owner of the subject property hereby authorize `�- � �1T - ff L . c-X to act on my behalf, in all matters relative to work authorized bythis building permit application for: . J (Aadress of Job) Signature of Owder Date Print Name Q:FORMS:OWNERPERMIS SION n i ('fie V�om�maomureaf a�✓f/�aaaac/auaelZ`a Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ^--- Board of Building Regulations and Standards 4 Registration 144258 Expiration g%21/2008 One Ashburton Place Rm 1301 Boston Ma.02108 T)Pe DBA , f� r.< sir .fit i W.D.CARPENTRY�S'Ef2VICES Cb. WILSON DE SOI�ZAr C✓�/.e 56 DELTA ST Not alid'with HYANNIS,MA 02601 Deputy Administrator . ut signature Assessor's map and lot number .....!�� ... .....`'2` ., � ✓: ` �'�('� �-' "1 "'-� Z THE ( q� o to Sewage Permit number ........... ..........;..........................:....... d K Z SARIST_AELE, House number 1639- 90 MAB6 + 0 MAY a\ TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... ;,x; i-:e4 r ................................................ .... TYPE OF CONSTRUCTION ... ...-. 1 ''P fr 0 7 ,�r2 Aia� �.r,. :::......................:.................... ........ .................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... .. ;•< .....c ': ...... J�`!".... ....�!�: .�r.�..!.a. �.... -1i1 ...........� �+...........................r 'u ... ............. ProposedUse .....h.'.I.............Ie :.... ' ?�.%:.e.�,. .............' �����!r; ................................................... � __- ZoningDistrict .........::JC.,..`................ ........................Fire District .............................................................................. Name of Owner 1 `Zip.......Address r:.�:'..(:�-�,4r2: �:.: -a...... i+i:a;c T .....�s����' . Name of Builder .,�Z,�. .. ....4 ..`... .� rrf�r �.,�,.�AAddress `.��. ,J; ,� d, c. ter:?... .�` Name of Architect e9t,Address � � �` � e�ic{. r? /1/u•;?= t t,.. �:.. Number of Rooms ...........>.::...................................................Foundation ........y` Ir..=e [7 S r%��.'h= .................................................. Exterior ... t1aRt ..... .% .`'�::r�{ ...Roofing ...1 /Uv .... u.I inrhG......................................... Floors ...................................................................Interior .... t� Ya�S•u.y...r '0r1. : Heating .!.1 � •ias''�G::................................................Plumbing .....'Fj.:?!. 's.<r... :...:'`;/ '.................................... ✓!ld� Fireplace Approximate Cost .....r..�..... ... Definitive Plan Approved by Planning Board --------------------------------19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee ..................... ....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH r t� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... �;+ `, , ;;. ar.:..:........................ Cancian ; nosemary A=287-36 No .....21162 Permit for ...... . rMact I...dwela-ing r- 190 V\ ................................................... .................. Location ....... ton Ave j-,Z........................... ....1V.................... Hyannisp�R�:�.... .... ..................................... . .. ................. RosemaryC ciant Owner ........................ ........ ............................... I ract e-1..dwi Type of Construction frame ................ .............................. ........ < Plot ............................ at .... ................... .. April 3 ��........: .::19 79 Permit Granted Date of Inspection ..........19 Date Completed 19 ......................... ....... PERMIT REFUSED �V 1 17............I........I ......... .... ...... ...... � ��- d , \4 3 ........................................................ ..... ............. .............. .. ..T................ .......................... ........ ....................... ........... Approved ........................... 19 ............................................ ..................... ............................................................................... ZI Engineering Dept.(3rd floor) Map Yr��2= Parcel_ Permit# House# :I :_ FW, Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30)e3&A Fee: �7 Conservation Office(4th floor)(8:30-9:30/1:00=2:00) Planning Dept.(1st floor/School Admin. Bldg.) SEMC SYMEM E BE ' TALLED IN C E. Definitive Plan Approved by Plannin oard , 19 WITH TI ; ��QkS(e�cP� P' oajo_-�—, 811, 11 ENVIRONMENTA ; - D TOWN OF-BARNSTAB NN REM Building Permit Application Project Street Address l E' Village Owner Address f �_ Telephone 77 — Permit Request I First Floor square feet Second Floor square feet Construction Type ' Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House. ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use �f > Builder Information Name Telephone Number rj7S-77jp 3 Address License# 0 Home Improvement Contractor# Worker's Compensation# 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 SIGNATUREUff DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS i VILLAGE OWNER � ,,. . - i � ♦ ,. � _ .. � .. -' ' ' ��- - . =.. DATE OF INSPECTION: FOUNDATION' FRAME INSULATION - u FIREPLACE ELECTRICAL ROUG 1 'FINAL' H - t" PLUMBING: ROUGH> -' FINAL ' GAS: ROUGH T FINAL FINAL BUILDING • tip! DATE CLOSED OUT r ASSOCIATION PLAN NO. z r The Commonwealth of Massachusetts Department of Industrial Accidents ,� =• -= oxce 9115yesUffaUons G _ -- 600 Washington Street ---- J Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name RA5eZWZa location: city -- hone# "7 7Z 6 zff I am a homeowner performing all work myself. I am a sole ro rietor and have no one working in any ca aclty ❑ I am an employer providing workers' compensation for my employees working on this job.. company name ' D//ll� jTf'-���� l /JAB address I�1.11 � - .1c. city. a l 9A/t/il�[C phone# d. insurance co. ❑ I am a sole proprietor, general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: com anv name. address ci olkv# M IN cam anv name. address: c1 phone#. : insarance co. " olicv Fafiure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of crhninal penalties of a fine up to S1,500.00 and/or o�years'tmptisonntent a,sell as dull penalties in the form of s STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification 1 do hereby under the pains d penalties of perjury that the information provided above is true and correct Signature Date Print nameTC1.1SC'OC/� Phone# �5 -775 - `77 :3 official use only do not write in this area to be completed by city or town oMcid city or town:- petmitilicense# ❑Bonding Department ❑Licensing Board j ❑check if immediate response is required - ❑selectmen's Office ❑Health Department contact person - phone#; ❑Other , (tr j&W 9/95 PJN s .}t The Town of Barnstable % MUMS rA13LZ "'059."S& -'Department of Health Safety and Environmental Services AlFD �► Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 .. Ralph Crossen Fax: 508-790-6230 r: Building Commissioner 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: — Estimated Cost Address of Work: — Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 EBuilding not owner-occupied r Owner pulling own permit Notice is hereby given that: " OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED " CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A.' SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR r Date Owner's Name .. '. q#forrris:Affidav _ � ✓die -C�ayri�y�yuueacG�L �� ✓��;.:E�;:,;��:.r,.,��-�:: _ HOME. IMPROVEMENT CONTRA:CTOR.S R.._aT ,R. ,TION oard of Building Regulations anc!' t.. .nc�ard y One Ashburton Place - Room 130.11 c B:osto.n, MarssachLme_tts. :0? �G%3 k .HOME - IMPROVEMENT. . CO.NTRAGTOR'r -- `Reg�stratron 1'°089IS; Exp' i�atzo ° O€�.�2't/C.� - Type. INDIVIDUAL �� �s r amm✓ivwc r bra �'+,' ruu,ta,�inprrdelGt n ggisEr3tlf11YP THEODORE +L . HITCHCOCK Ezpir3tiuii 93!21;� PO BOX 211/` 55 LISA, LN;: W . BARNSTABLE MA 02668 T;iE!,�ORE 1 . 'r'.' E'C,K,/ f�rC''iZiOi H AONAINiSTR r-D,71 s t ap g Parcel (1 3 Permit# �7� `t House# `� Date Issued a oard C:X-�1, 0/1:0 --�-3$) Fee�- , �Co eer .30/1:00.2:0 Bldg.) °�IKE r oard 19 BARN"ABLE. °rFn 39. �( TOWN OF BARNSTABLE Building Permit Application Project Street Address A 7T •V G-v '� Village IQ AJ .S + Owner d d „1 u,A A.r—.' C, V Address S r a ..,► u Telephone ,�--p $ 7 71-- to y Permit Request F I First Floor square feet Second Floor square feet Construction Type_'A)s/--A L� 150 k R 1� a--1'LA.c,ti .,�� „, 7' w,'..Jo w,f I Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) ` Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No. Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information t'Name S__%2 a%/Co 2 C( C—K •v -t,-t L L elephone Number SU A dress P r t A o X 7 9 V Z license# / �Z k R /Jb /✓ o� .2�, /fit a-t 7-i4, W i^ I /Nome Improvement Contractor# 6 ---a 4/7 XVorker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ✓ 1r BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) a -- - •r FOR OFFICIAL USE ONLY y _. PERMIT DATE ISSUED: MAP/PARCEL NO. _ F ADDRESS i=} VILLAGE. OWNER DATE OF,INSPECTION: FOUNDATION FRAME + INSULATION FIREPLACE ELECTRICAL: ROUGH •'FINAL - PLUMBING: ROUGH ' FINAL ' ' GAS: ROUGH FINAL FINAL BUILDING r• DATE CLOSED OUT + 1 t ASSOCIATION PLAN NO. + • i .°: ci The Town of Barnstable • BAaMsrAat,E, r & A�m�' - Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only 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: t� Est. Cost v Address of Work: I /ylyc, Z- Owner's Name lz o d --k c. AJ ' l/ Date of Permit Application: 11f o, 6 / I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. 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 PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name _C-=;----- The Commonwealth of Massachusetts < == Department of Industrial Accidents 'f . -— P office of/nsest/gatioils 600 Washington Street ' - Boston Mass. 02111 Workers' Com ensation Insurance Affidavit -e: loc tion: a city phone# ❑ I am a homeowner performing all work myself. �I am a sole ro rietor and have no one workin in any ca acity ❑ I am an employer providing workers' compensation for my employees working on this job. companv name address. city phone#. insurance co. olicv# / I am a sole proprietor(general contracto , or homeowner(circle one)and have hired the contractors listed below who nave the following workers' compensation polices: comoanv name % /t# K r7 .... w 4-A: C Co address l a . is h'' 7,T_%Z ' sue++-tom a �'� - .°� phone# YW r R r Insurance ca 'L.e r �`. 7 :. t.s . .✓S t+t.�. e►t oiler# ?0 company name address. ctty- phone#: insurance:co... oiler#; . Failure to secure coverage as requited under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 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 a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby eerd .under the pains and penalti of perjury that the information provided above:7z�4 correct a p Date 4Si�ture - Print name Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selectrnen's Office ❑Health Department contact person: phone#; , (]Other 0evned 9/95 PJA) A Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees-., 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. X, MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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 a Please fill in the workers' compensation affidavit completely, by checking the box that.applies to your situation and supplying company names, address and phone numbers gong"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 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. .r j 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 permit/license number which will be used as a reference number. The affidavits may be returned io the Department 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 Oftice of invesduailons 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 Cancian, Rosemary 21162 remodel AWdw ,_l� g t, \ No ................. Permit for ........... ..... . . Location�� Grayton Ave..- ................... ............ Hyannisport ............................................................................ Owner Rosemary Cancian ............................. Type-of Construction frame t ............................. : r ............................................................................... .Plot ..:................... ` ...... Lot ....................:........... ..... � Permit Granted ......Apri1 3 79 .....................19 r Date of Inspection ........... ........................19 Date Completed ...... . 19 u a J h G PERMIT REFUSED ............................................................ 19 ........ .`. ....... ............................:................... ........ .................................................................. ............................................................................... • .Approved ..:............................................. 19 4i . ............................................................................... ............................................................................... Assessor's map and lot num ...: :. ...��.. ��— (9 D { • �C / �`3— 7 ...... ... �pF TH E Sewage Permit number .....�Q../k5 ............................. SEPTIC SYSTEM MUST' B INSTALLED IN COMPLIAN DAWS'TSDLE. House number ........................................................................ WITH ARTICLE II STATE '�o 2639• SANITARY CODE AND TO TOWN OF BARNgrAB u BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... r . .M. .i!t.3. .L•:....../'n,f..6T../..�r..�....!u!Jd � i-;E:�PM �:...0 ,'!`zcs�«Y<. TYPE OF CONSTRUCTION ...W 0.!01.0. ..::.....J�C�%•�/. �ls'�49......< ! !?!�.a.?<.Sr:.......................................... 1 ................................................19........ OTHHE INSPECTOR OF BUILDINGS: ~ T�undei•signeecl hereby applies fora permit according to the following informattioo Location .....11V../. !�.�./.1,� . Fz..L...../.7..G.2.... ...1 z.!v�YY b,,!....Ali..-........1../...��1(�!!�iS.C.'U�z.%................... ProposedUse ......� 5/ ?Tr/. :..:................................................................................ p� y� ZoningDistrict ......... ...........�r .,! ......................Fire District .............................................................................. Name of Owner ... ./. .Ct.S,r ,i1{�:%...../L I� Via/ ........Address / ?..l7nY!i=/�er... jJ�P...:..../ Name of Builder Name of Architect Number of Rooms ............�?..................................................Foundation - .../i<.4 .............. Exlerior lJ r7 J ,�, "7Gl•E .............................Roofin /nsV�ti'.:....................................... s U..:..........!../.........�"............ g ........... ram........ . . Floors ...... /t?o!7...................................................................Interior ....(a/DJ Heating ......E,(... .G.:/. l.v................................................Plumbing ..... F.:................................... Fireplace ........A1c.!`•1.6.........................................................Approximate Cost ........ .Q.vUU............................................... Definitive Plan Approved by Planning Board -----------_-----—-----------19 , Area .......................................... Diagram of Lot and Building with Dimensions Fee ?�5 SUBJECT TO APPROVAL OF BOARD OF HEALTH ,emu Outt� s U I I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / Name :.... .1S4:at :..... ..... . �r.��. ..!Qy -..-:................. r _. _ _. .._ .w.. v .. ... r . ♦ ., :. ., -s. .mar .... , -£ ^.+,.. ,�,."`�i :_� ••iewry , • �' 1 T't t I)i� R t I� ►E r1 t" �x!s.rlafG � �� �..•- - � ' i I v �I ! r�'�" .✓" ram"' ; j3 n/J j , I yet_.. _ _. _.... -. _.. .. SILL _ : I f } =�Iflti 1 ITI�� •.•w,.WY.••.w. _.r,u..w...w�u +w+y Al t if 1 Q i, / .•1 { ' C.'Fu,"�e,E v$lC�.'iy i 'T i 1 J I • i 1J, r � y r - �� 1 .t — __..-._�.+.,.,.-._ rri w.sra..,�ww,.,.._.nw«w,. �.,..,.:...r.w•w.�wvc.+......rww+w.r.:rww.s,�,a .w.. - r. i - � f ] _.__— -_r....w.w........_.,.....•mM...__.r.....�..<...++ ,r..u_^w,r..+ -__ _ ._.y,r._,.w,._•+w,-•_ i - li 4 I t } .r r' L • � � if '' i � � � 5, a F-7 ........... , , A .„T. • . f : . � � N I _ _"_.__-. r`•-'�..�..-•+•,.<:`�} � �A � � i,7 ems....t�..�.'lI /� �� � �./ e� i 4 — — 47 „ A obit C 111 ' ! r r • - �� — __ — I . )�,M► � fit/?•i tf•6. '?AEr,>,Ir� � •_ II 77 } 3 y _ iii tt� i - i n C RA E . ti , ' 1/ I t .._ , 4 ' ., }�_..:._--'•r ..�.-`�--...�Y-»..- -a...-_-nwO..ly .,Y,_.w6..»�-+.r.-..::, L � .i.� `.r._S.� - .. 1 , .r.+..a,...,+...�_..,,... +. .,.._. ._. ...a...vr ..,r. •!^. ♦ ,.. ... ....._..<.Nwn..rr« ..sy,...-..._.. ...•_......�.r+M,Y.•�,.•M1TMww• PRO BY LAWRI- i1L - r 7 E r . .. .. ,. .,. ., ,.,. .=a^u�.:,r.+wbawra:r.' ,....,n-.n•,.n+aww,.•:.aw::.•...�,..r,.4n„►r.n�e. - .. .. .,.w_�.- r ,.,w+�,.r„r�+.•�,.er+.ww+rrMna,..�+ .rwnarw�r�} - �,rd:.s*a.rw•-,rsw•."+� �"aM5 :.. � ro„r^.'gr""w"'".+r._.:ar:c.�cnr Ii a1:.r.r, :.-a.«__ ...,.:..;.,..._,.---•.-......:-_.e:..._,,. ,...,-...w.••n. ..,.r.._. ,. �-..iwr. �+.. .,�,...,._....:.•�.......„+.r._...ar...+..v,:.L...�„�-»a;«t+..-+,*.,..e .. ,. .:. - .' .. .. .. ..., .. .: ..1. ." a 3 -..'.�.. .... . . ',." ..+ .,�.' .-__. .a, ♦ L. .s:✓'- .s: _.. ....... __w.. ..r..r__ m..r �.w..�._ ......5...-,ie___i»w- ✓•.ir...0 .,Y. .. .: -... ... ... '. ., • ., m.v,,. .vri "•1Y y_s �+JL •v.., fiYf'•a}—•...'W ✓ S+W-w .t .. ✓ �s ..r 'tL<.di,..- .itLiJM�I' -w. .. _.V. .L _.. _.. } _ar ._._..+3ysl,ib.' �.r+Y^•• 1+_=r.�r4a -..�n•,'_r. ..+ ,.w_.w, sia...iv"ht:K. -'� :.a r ,..��sw:tla....-+F.- :n '..ra •�,. r. +.5. i -.. .....,+_>,aa✓-a .-Y,.•..... .,;:a..a.,..« i .�.+.!.a told ...x:el'o+Av.59:1s1•r.Y6....<SiY�cY+. am..- _ .y..>.s.-.-_ .. �.:.•a.�..,_..+a.i..._��-....a:rNie+._.ate,...tea. - :,..�v,..7.m...:�lr_,,._,,.,:.,....-.. . ,.....>_ ......... .-.. �_ � ::,3.,:rzn :,.,_:..,......>e.t.. ,.-.,.�,,..:x.�.,....•..R...,...J.,.,».�...►>+�fi. ...«:...�.+.....:...�-.a.:rt.. ��.ym.a.'4. .. :.. - ,_,_. y,..'. :�,x�_x,�:�. .•.+��C.'�.s:��...,_..�a�,,,.4.r.+c....___,«...C.r.:.a .�K,. :..,ate.„...._:.._... _...,.. __.-... .- _