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HomeMy WebLinkAbout0070 HIGH SCHOOL ROAD '70 ��` � �G� �®I i��o AGRI BALANCEO Joe. Company Name CAPE COD INSULATION Phone Number 1-800-696-6611 Scott Peacock Builder 10-21-2020 Josh & Val Installation Date f70 High School_Road,-Hyannis---j GE019629 Jobsite Address A-Side Lot#'s Permit Number B-Side Lot#'s P1391326220 Attic Roof 91, R-40 950 square feet 5.5 R-24 270 Square Feet Slopes Slopes 3.5 R-16 290 Square Feet Sherwin Williams Vapor Barrier Paint Attic&Slopes 17 mils wet DC 315 Attic areas 17 Mils wet www.Demilec.com cODEMILEC tF1E licatio - -�l App n Number. rows OF. a STAKE p MASS. Peraut Other Fee: r 313, FD MA'S Total Fee Paid...............................GJ.-...ve ...... ...... TOWN OF BARNSTABLE. t valby..A,k......... .onJQ:'3Etq BUILDING PERMIT Map......2�9:...................Parcel....... .................................... APPLICATION Section 1 - Owner's Information and Project Location Project Address f4o H I I�Sc� a o L ) Village 9)JVAIIS Owners Name —TOA-W H 0-(1,45 Po 1-0�t,i2q, e 171Pr�v�t-�tAs Owners Legal Address S Arm e City State Zip Owners Cell # $13 q4F- 253 E-mail Section 2 —Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet 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 7 '�° i N1•�21 /� a ni y Section 4 - Work Description Rey`foy/e S4ee7-,2�r,�� F4oalzv4, 11V511L4-ne.4J -4/wvq� N7&ivaA— 0v-e- To rl I?.- ArC W A yeti D4,"•4 ge- vo -5T�4,crwlre Tact nnrlatPri• 11li sn 11 R T Application Number..:................................................. Section 5 Detail . y Cost of Proposed ConstructionSL�n — Square Footage of Project Age of Structure Dig Safe Number, # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ' MA Checklist 0 WFCM Checklist ❑ Design x , -, Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression i ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom Water Supply El ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: �ku5er 0JUi X,,u-1leN7`kL` I am using a crane ❑ Yes ❑ No t4A(—aw5 MA 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) E Setbacks Front Yard - Required Proposed Rear Yard Required Proposed a Side Yard Required Prop used, Has this property had relief from.the Zoning Board in the past? Yes ❑ No k Last updated: 11/15/2018 � ro 20 orb o - ✓2e l�i�ruzo2G o�/ala�l2�u�e�i Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE�Suwlement Card before the expiration date. If found return to: Reclistfafiort Expiration Office of Consumer Affairs and Business Regulation � i10/14/2021 1000 Washington Street -Suite 710 MULTISTATE RE CAPE COD DIVISION,INC. Boston,MA 02118 rj- RICHARD LAURIAf•`"' GL 21 PEOUOT RD. , valid without signature MASPHEE,MA 02649`"� Undersecretary Commonwealth of Massachusetts ® Division of Professional Licensure Board of Building Regulations and Standards Constructior,SVt 6 iW,,1 & 2 Family CSFA-051784 "Pires: 04/Cs1/2021 st RICHARD D CAURIA. 1 LEAH DR ROCKLAND MA;-?237.:.Or Commissioner i � 1 a MULTI-STATE RESTORATION, INC. 'FIRE* FLOOD*WIND* SMOKE*HURRICANE*VANDALISM Fed ID#050515889 CONTRACTORS REGISTRATION#140427 AUTHORIZATION TO PERFORM SERVICES AND DIRECTION OF PAYMENT b",,M';herein referred to as "Customer",authorizes MULTI-STATE RE TORATION,INC.,herein referred to as "MULTI-STATE",to perform any and all necessary cleaning and construction services on Customers'property at: -7L �-t�1n 5�klccl � 1��nn��5 fin 8 0 D1,U l" 1 Telephone: 13-469-3� 3 and with respect to items that need to be cleaned at a remote location,to remove and clean such items as necessary. ` Customer authorizes P Insurance Company,herein referred to as "Insurance Company",to directly and solely pay MULTI-STATE. If for any reason the check should come to be or be made payable to the Customer, Customer then agrees to pay MULTI-STATE immediately upon receipt of the check from the insurance company. In order to expedite payment to MULTI-STATE, Customer hereby appoints MULTI-STATE as attorney-in-fact, authorizing MULTI- STATE,to endorse Customers'name,and to deposit Insurance Company checks or drafts for MULTI-STATE services. Customer agrees to pay Customers' deductible in the amount of$ that applies to this claim. If the loss is not covered by insurance,Cu5iome grees top the total amount to MULTI-STATE upon receipt of the inv(11c . _ c . Signature of Owner It is my understanding that the services to be performed by MULTI-STATE will be limited to those,which are authorized by my Insurance Company. Insurance Company Name Policy Number Customer agrees that MULTI-STATE is working for the Customer and not-the Insurance Company or agent/adjuster. Additional remarks: _4::�,,(P.. ) ve read thus document and completely understand and agree to same. C9--V) Signature Date c rrr.1 'nr ekMg 6f qs Printed Name P.O. BOX 2210•MASHPEE, MA 02649.866-921-9111 •FAX 774-238-4422 A�" CERTIFICATE OF LIABILITY INSURANCE °A�,ti2;,2o;9YY' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Laura Turchetta NAME: Cross Insurance,Inc.-RI PHONE (401)431-9200 FAX (401)431-9201 A/C No Ext: A/C,No 376 Newport Avenue E-MAIL Turcheta@crossagency.com ADDRESS: P.O.BOX 4830 INSURER(S)AFFORDING.COVERAGE NAIC# East Providence RI 02916 INSURERA: Nautilus Ins.Co. INSURED INSURER B: ' Multi-State Restoration Cape Cod Division,Inc. INSURER C: 68 Nicoletta's way - INSURER D: INSURER E: Mashpee MA 02649 INSURER F: COVERAGES CERTIFICATE NUMBER: CL191774420 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 BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AULJL1bUt5K1 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MM/DDIYYYY MM/DD/YYYY LIMITS - X COMMERCIAL GENERAL LIABILITY' EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR IDAMA TO RENTED PREMISES Ea occurrence $ 100,000 - —^ - MED EXP(Any one person) $ 5,000 A ECP202804710 01/02/2019 01/02/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: �- GENERAL AGGREGATE $ 2,000,000 POLICY JEC LOC PRODUCTS-COMP/OPAGG $ 1,000,000 OTHER: Pollution Liability $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED - BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY - Per accident UMBRELLA LAB OCCUR , EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ - $ WORKERS COMPENSATION T PER OTH- AND EMPLOYERS'LIABILITY Y/N - -1 STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 1 Job_70 High School Road Hyannis MA-3 t CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis - MA 02601 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD TE(MM/DD[YYYY) ACC CERTIFICATE OF LIABILITY INSURANCE °A9/17/2019 9/17/2019 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 CONTACT Maureen Roderick NAME: Horgan Insurance Agency PHONE (508)775-5830 FAX (508)775-6688 A/C No Et): A/C,No): 44 Barnstable Rd. E-MAIL ADDRESS:maureenr@horganinsurance.com P.O. BOX 250 INSURERS AFFORDING COVERAGE NAIC# Hyannis MA 02601 INSURER A:AmGuard Insurance Co. INSURED . INSURER B Multi State Restoration, Cape Cod Division, Inc. INSURERC: PO BOX 2210 INSURER-D: INSURER E: - - Mashpee MA ' 02649 wsuRERF: COVERAGES CERTIFICATE NUMBER:CL1972401334 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 MAYBE 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. INSRR ADDLJUW SUBRWVD POUCPOLICY NUMBER - MM DDY EFF POLICY MM DD EXP LIMITS TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE 1-1 DAMAGEDAMAGE.TO RENTED Ea occurrence PREMISES $ - - MED EXP.(Any one person) $ PERSONAL&ADV INJURY $ GENIAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY F_1 PRO JECT I LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS - Per accident $ $ UMBRELLA LIAB - OCCUR _ EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE - AGGREGATE $. DED RETENTION$ $ WORKERS COMPENSATION - + - _ - PER X OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER i ANY PROPRIETOR/PARTNER/EXECUTNE E.L.EACH ACCIDENT $ 500,000 A OFFICERIMEMBER EXCLUDED? � NIA _ - (Mandatory in NH) ' -� R2WC031669 7/16/2019 7/16/2020 E.L.DISEASE-EA EMPLOYEE $ - 500,000 if yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I-LOCATIONS-I VEHICLES-(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: 70 High School Rd. Hyannis, MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 200 Main St. ACCORDANCE WITH THE POLICY PROVISIONS. ' Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE - - Maureen Roderick/MPR- 9>ft"AU 1APO ,a ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) ( (T'cke 0 -��-- r� Kp . O H 9 U oat t^� KLrAriu tS U Sr rivvR P—An r� Pt91, �3�aex B l o r4 I.to� it . t sr 1~/OQA_ P)- 7Z®Q vh v S / Z-3 a t I _ Z ,vc� �`!v Ott The Commonwealth of Massachuselb Deparbnent of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 . www mass gov/dia Workers' Compensation Insurance Affidavit:Bulders/Contractors/Electricians/Plnmbeis Applicant Information Please Print LesibIy Name(Business/Organizationlbdividual): I�u�.T I J i'f e 2e5rb��i-J Address: G 0 Le,rrA - City/State/Zip: - � e-e A 0 a 6 Phone#: 5b67' 4 77-33-33 Are you an employer?Check the appropriate box: Type of project(required): L a l am a employer with- -3 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New conshnction 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 workingfor mein aci employees and have workers' �Y capacity. 9. ❑Building addition [No workers'comp.insurance comp. •trKidred. 10. Electrical sits or additions J 5. ❑ We are a corporation and its repairs 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions on myself[No workers camp. of exemption Per MGL 12.0 Roof repairs insurance required.]t c.152,§1(4),and we have no employees.[No workers' ME]Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'coition policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hie outside contractors mast submit a new affidavit indicating such. =Contractors that check this box must attached an additional abed 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. lam an employer that is providing workers'compensation insurance for my employees: Below is thepolrcy and job site information. Insurance Company Name: /" Qu A Policy#or Self-ins.Lie.M Ka W CO31 1614 9 Expiration Date: Job Site Address: city/St&JZip: iA4A-�Jjut5 h,4 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 certi and the panes and penalties ofperjury that the information provided above is true and correed Siprtatvre•. Date: /`Z—3 0 --1.2 Phone M --?R I D 6 q—!,—b ::7L t*rkid use only. Do not write in this area,tro be completed by city or town o,04cial City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: f Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person M 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 throe 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 grommds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MOL 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 bnildhW In the commonwealth for any applicant who has not produced acceptable evidence of compliance with the bmwance coverage required." Additionally,MOL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority" Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)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 Acciderits. Should you have any questions regardmg 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 pmmit/license number which will be used as a reference number..In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for fume permits or licenses. A new affidavit must be filled out each year.Where a homeowner 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 Me 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 Massachusetb Department of Industrial Accidents Office of Investigations 660 Washington Street Boston,MA 02111 Tel.#617-1/27-49M ext 406 or 1-877 MASSAFB Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia Application Number........................................... Section 9- Construction Supervisor Name L jot 4 2 to Telephone Number 7g( 26`f- Z ;2;7 Address i LCA K De City (zyclC G d State P A Zip 6 a 3 V License Number CSFA 6Yr 7FY License Type 1-2"An Expiration Date `(-1'21 Contractors Email L A u?-rA a t 7(0 !YS N, c01" Cell # -7�?/ a6f{-56 -7 7 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 l� - Section 10 —Home Improvement Contractor Name l�ICkAd Z AG�r��fl Telephone Number -70l —26 y- 5�7�9 Address 2r PAQo 1- a4- City t4• -5A P4.? State/M Zip 0--io9 Registration Number ND� 7 Expiration Date 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 H.I.C... Signature Date % Z 3a 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 80 CMR and the Town of Barnstable. Signature Date 12 —S'� APPLICANT SIGNATURE s Signature Date/2-3D-/;F J Print Name R-[ cN a!�-c� Telephone Number E-mail permit to: A u/L j A Last updated: 11/152018 Section 12—Department Sign-Offs 9 Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ j 1 Fire Department ❑ Conservation ❑ k, For commercial work,please take your plans directly to the fire department for approvak Section 13— Owner's Authorization L , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of j ob) Signature of Owner date Print Name 1 E J t Last updated: 11/15/2018 i .� Town of Barnstable Building -�+,«;.w- ... ,�.: * enn vsrws�e - gPost This Card So That it Visible From fhe Street ,Approved Plans Must be'Reta�ned on Job and'this Card Must be Kept 6' ` IPosted Unt�I Final Inspection Hos.Been Made Per$Where a Certificate'of Occupancy,is Required,such Buildmgshall Not.be Occupied until a Final Inspection has been made 'Permit NO. B-19-4117 Applicant Name: AMERICAN MOBILE HOMES INC. Approvals Date issued: 12/10/2019 Current Use: Structure Permit Type: Building-Trailer Expiration Date: 06/10/2020 Foundation: Location: 70 HIGH SCHOOL ROAD, HYANNIS Map/Lot: 308-256 Zoning District: SF Sheathing: Owner on Record: MORRIS,JOAN L Contractor Narne` AMERICAN MOBILE HOMES INC. Framing: 1 Address: 70 HIGH SCHOOL ROAD "Contractor License: 106386 2 HYANNIS, MA 02601 Est Project Cost: $0.00 Chimney: Description: install a 12x60 tem mobile home to be used as living quarters while Permit Fee: $25.00 the family.rebuilds thier fire damaged home $ Insulation: Fee Paid,, $25.00 qe-a..riy,.t _A.W �f - Project Review Req: >3 Date�.� 12/10/2019 Final: Plumbing/Gas k Rough Plumbing: This permit shall be deemed abandoned and in unless the work authorized by this permit is commenced withins�x;months after issuan fflclal Final Plumbing: All work authorized by this permit shall conform to the approved application andthe approved construction documents'for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall 6e in compliance with the local zoningby laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street'or road.and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. , The Certificate of Occupancy will not be issued until all applicable signatures bythe Building and Fire Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work:; ' Service: 1.Foundation or Footing 2.Sheathing Inspection Fireplaces must be inspected at the throat level before firest flue I gm�n isallei . Rough: 3.All Fire P P ,_ nsta d 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "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 Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Application Number..... .8 ....V&.2. ...................... BARNWABLE, KAS& Permit Fee.... ......:...:......Other Fee,....................... 1639. BUILDING.DUIT. TotalFee Paid:............. .................................................. ...... DEC' 0 2019 0 % � -1.1 Cox. TOWN OF BARNSTABLE Permit Approval by.... ................On TOWN OF BARNS ABLE BUILDING PERNUT Map..............3 ...........Parcel.......o-asK.0..................... APPLICATION Section 1 - Owner's Information and Project Location Project Address Village 46Imkt, is Owners Name. -J70�� Aar,- s Owners Legal Address 70 LC City nLL <s State vit-ck- Zip 7)2 4 o 7 Owners Cell# 325-3 E-mail PSection 2 -Use of Structure Use GrOup- ❑ Commercial Structure over 35,000 cubic feet 0 Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section. 3 -Type of Permit ❑ New Construction ❑ Move Relocate EJ Accessory Structure E] Change of use. ❑ Demo/(entire structure) 0 Finish Basement El Family/Amnesty El Fire Alarm Rebuild El Deck Apartment El Sprinkler System ❑ Addition E] Retaining wall Solar ❑ Renovation ❑ Pool El Insulation Other-Specify--- r-�-O- Section 4 - Work Description 7-1IIrL51-q&- 0 12-kc.0 -Jeg:14 vvL6LJe- Ltu-,,P- :A &— L):S:e-Z z,� 114,A-Y F 7 T sot 7 ,-A.+.A- 11/1 ICMnl 4 Application Number.................................................... 'Section 5—Detail Cost of Proposed Construction ,� — Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 3 110 MPH Wind Zone Compliance Method' ❑ MA Checklist ❑ WFCM Checklist ❑ Design 3 Section 6_Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors < , j ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry y Chimne ❑ Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site i Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No 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 Last updated: 11/15/2018 office of Consumer Affairs&Busl^®RAC OR I HOME IMPRO MENT trO 1r TYp CoroaahF air ton 1 07/22/2020 -AMERICAN M(f FRANCIS V.WAS 51 MOORE RD ; UndersecmtM E.WEYMOUTH,MA 0.., . r. • TO °�i d 116 u t .. ° N I c id+ C Commonwealth of Massachusetts °. 0 o_ u ` 0.0— f7! Division of Professional Licensure 3 > >Im'. Board of Building Re ulations and Standards v. c ! Cons'ki�ff�tfQl� rvisor ? U)• t _ 7 , $S i `v! rn 3 CS-057291 Spires:0911712021 c o `o c,a m v FRANCIS V 1{01RD c'i �" �.21 E a10•0 is 51 MOORE ROAD I °o" V, = c N. _> 'EAST WEYMt]y1 r f 7 - l0 y w N y C 0'.O r O O r• l P.Mc Z °U. { 1 o { c 1 ID o$ Commissioner M d ca d u.N Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint 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 bean employer." MGL chapter 152,§25C(o 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 contract buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public.work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the'contracting authority." Applicants Please fill out the workers' compensation affidavit completely;by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),addresses)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 insurauce. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.° Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application'for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office'of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe 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: A The Cominonwealth of Massachusetts Dgwtmeat of Industrial Accidents Ofte'of Uavestigations 600 Washington Street Boston,MA 02111 - Tel.#617 727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www;mam.gov/dia The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information-'/ Please Print Legibly Name(Business/Organization/Individual): Am-e is Pa, Ad2 t A" r1 �� Address: City/State/Zip: Lt� A 4_" Phone#: I " D3 3 Are you a"n'employer?Check the appropriate box: Type of project(required): I am a employer with- ►"Z 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. Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp.insurance comp•insurance.: required,] S. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs 152 C. and we have no insurance required.]t '§14( )' 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 Homeowner;who submit this affidavit indicating they are doing all work and then hire outside contractors most 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: &_ra_k � 1-K`>• Policy#or Self-ins.Lic.#: WC 02-4- ZY— CAgy Expiration Date: Job Site Address: D + 4 L City/State/Zip: Attach a copy of the workers compensation policy declaration page(showing the policy num er and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify der thepains abdpenalties ofperjury that the information provided above is true and correct. Si store: Date: Phone#: —2�1 3��- D333 Offtial 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#• TOWN OF BARNSTABLE ,AM PERMIT.CHECKLIST Sign off hours for Health and Coaservationire.8-9.30 a.m. and 3:3":30 p.m. A comttkte p"it Wlkadon inctades,illing ark 1. NEW STRUCTURES/REMODELING/RENOVATION/ADDITIONS ❑ Site Plan showing setbacks of proposed and existing structures ❑ Commercial—One complete set of full sized plans one reduced 11"xl7" (plans may require a stamp by an architect or engineer). ❑ Residential - 5 Sets of floor plans no larger than 11"x 17"smoke/co detectors marked ❑ Worker's Comp.Affidavit and policy(if required) ❑ Res Check or COM check from the 2015 International Energy Cod Council(IECC) D Letter of financial Interest for new houses only(not required for rebuild after teardown) ❑ Performance bond made out for$4.00/foot of road frontage(new construction only) 2. DEMOLTION OF A BUILDING (NOT PARITIAL) D Everything above plus shut off letters from following utility companies: D Gas . . ❑ Electrical ❑ Water ❑ Sewer(if required) 3.-DECKS/PORCHES/GAZEEBOS/INSULATION/SOLAR/POOLS/SHEDS ❑ Site Plan showing proposed location ❑ Construction plans showing framing detail(if new framing), 0 Pools—Barrier details,pool specs(engineers design) ❑ Workman's Comp Affidavit and policy(if required) FAMILY APARTMENTS ❑ Section 1 Plus: ❑ Family Apartments are subject to approval from the Building Commissioner. Agreement must be signed, notarized and recorded at the Registry of Deeds and returned to the Building Department. F Application Number............................................ Section 9- Construction Supervisor Name Telephone Number Address City State "`Zip License Number License Type Expiration Date Contractors Email Cell # . 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 Section 10—Home Improvement Contractor Name Telephone Number Address City State Zip - Registration Number Expiration Date 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 H.I.C... Signature Date Section 11 Rome 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 /z-)a-Zv Print Name T;'av_LWaf1— Telephone Number E-mail permit to: --P uJcf P��c� ploi�����✓✓►Q�• C&u1 Last undated: 11/15/2018 Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required), ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation Fr e r For commercial work,please take your plans directly to the fire department for approval, Section 13— Owner's Authorization i I, Jam,,, yt ,n dy;S , as Owner of the subject property hereby authorizei►�o�,�c�.-.�,y(�1�,(�� Z-v�c_ to act on my behalf, in all matters relative to work authorized by this building permit application for: 2 Dr 4�S��ionOA cf, (Address of job) Signature of Owner date J Print.Name i { t • t Last updated: 11/15/2018 i MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston,Massachusetts 02108-1904 (617)723-3800 Ma Only(800)392-6108,FAX(800)851-8424 12/3/2019 Form.of Notice of-Casualty Loss to Building Under Mass.Gen. Laws,Ch.139,Sec.313 HYANNIS BUILDING DEPT. 200 MAIN STREET HYANNIS MA 02601 _ Re: Insured: JOAN MORRIS Property Address: 70 HIGH SCHOOL ROAD,HYANNIS, MA 02601 Policy Number: 1436696 Type Loss: Fire(including Fire caused by Lightning Date of Loss: 12/02/2019 Claim Number: 444552 Claim has been made involving loss,damage or destruction of the above captioned property,which may either exceed$1000.00 or cause Massachusetts General Laws,Chapter 143,section 6 to be applicable. If any notice under Massachusetts General Laws,Chapter 139,Section 36 is appropriate,please direct it to the attention of the writer and include a reference.to the captioned insured,location,policy number,date of loss _ and claim or file number. MPIUA Claims Division —4' CIO 0 CMA00021 7a- CP tA _ w -�y-`6 rr own of Barnstable *Permit �� Expires 6 mondis from issue date gulatory Services Fee s * BA WABM i J U Y O 92016 MAM>< Richard V.Scali,Director pF BABNS�-AB ' _- -_ �U'LD��� nl�R� L�uI><d><ng DIVISIOn JUN Tom Perry,CBO,Building Commissioner 0 9 2016' � 200 Main Street,Hyannis,MA 02601 ww rn w.town.bastable.ma.us 7 O WN OF 13ARjVS7_A- y Office: 508-862-4038 Fax: 50 '790-6230 1t"TRESS PERMIT APPLiCXMN - Rr.SltiuEIQ TIAL Vl�l'L Y' i. Not Valid without Red X-Press Imprint -` Map/parcel Number p� Property Address lo 5UM S pcf JResidential Value of Work$ S® 0 w-nimum fee of$35.00 Or work under$6000.00 Owner's Name&Address a6�w M6 lo �,IA SCAQ01 9A *(Ytj;� Contractor's Name (/ i Telephone Number 54 f ?K0 2 702 Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ Lam a sole proprietor ❑ I am the Homeowner Qi I have Worker's Compensation Insurance Insurance Company Name C/I/./ Workman's Come.Policy# s s< O 2 2 ��3 7 <<j Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ st(check box) Re-roof(hurricane nailed)(stripping old shingles) All constr tion debris will be taken t -L� I: e fo/ G,,'PC s' S�,Glll �cH«� wh,� ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) U Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows r #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. - l 'Where required: Isstiance 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: 'r C:\Users\Decollik\AppData\Loca]\MicrosoR\Windows\Temporary Intemet Files\Content.Outlook\2PIOIDHR\EXPRESS.doe Revised 040215 • aaaxsrML% • t Town of Barnstable Regulatory Services Richard V.Scati,Director Building Division, Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us D Office: 508-862-4038- Fax: 508-790-6230 f Property Owner Must Complete and Sign This Section If Using A Builder I crv� ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: l Y1 0 (Address of Job) ignature of Owner Date naw 66 r-�-[E Print Name ` If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Usc.\. -co!lik\.hppData\:.ocal\MA icrosoP.\Windo,:.\Tcmpo.-ar},stcmc:Fi!cs;portcr:.Ouaooie�2PIOIDHRIEXPRESS.doc Revised 040215 .aco CERTIFICATE-OF LIABILITY INSURANCE DATE(MMIDDYM) 3/21/16 THS 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 polic>fies) must be endorsed. If SUBROGATION 1S WAIVED,subject to the beims'8i�d cofiditioire tifthe jioltoy,ceitain pbliCies may"require'an endorsement A d6l merit on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). ,PRODUCER Sch el Schlegel NAME- JIM HT'NDMAN Schlegel egel Ins Broker PHONE (508 771-8381 rPX N (508) 771-0663 4 Main Street -MAIL ADDRESS: sclAe elinsurance'O all.com West Yarmouth, MA 02673 INSURE $ AFFORDING COVERAGE NAIC 0 INSURER A:MOUNT VERNON INSURED INSURER'S:CNA 'Tn4OTHY HEATING DBA HEATING INSURERC: CONSTRUCTION INSURER D 54 L'OW91k tAOOR '10 INSURER E e SOUTH YARMOUTH, MA 02664 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 AN 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 POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER POLICY EFF LTR TYPE OF INSURANCE INSIR WVD r POLICYNUMBER mtmfy MMlDWYYW LIMITS v 'A GENERALLIABIWTY GL 4148134 3/2O/16 3/20/1.7 .:�CH-Oc�URRENCE a Z 0�. (JC111 v I DAMAGE TO RENTED X CONMERCIALGENERALLIABILITY �. EMISES(Ea occurrenW $ 500,000 CLAIMS-MADE o OCCUR MED EXP(Ahrrona person). $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERALAGGREGATE a 2 000 000 kGEN'LAGGREGATELIMITAPPUESPER I PRODUCTS-COMPIOPAGG $ 2,000,000 POLICY PRO LOG i I$ AUTOMOBILE LIABILITY ONSI C rDR IN LEtI R $ ANYAUTO I BODILY INJURY(Per person) J$ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ _ NON-OWNED � P.f:OR€ri�DAMAGE HIRED AUTOS _AUTOS Peraccident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ B NpRKERBCObIPENSATION 6.cf•CJ9UBO224N37214 3/9/16 3/9/17 1 wCSTATU l OTH AND EMPLOYERS!LlAB;LSTY YEN Y,LIMI,TS_I_:,_, -.ER'_ - ANY PROPRIETORIPARTNERIEXECUTIVE I E L:EACH ACCIDENT $ 100,000 OFFICERANEMBER EXCLUDED? N � NIA, (Marda(ery in NH) F--EgL L.DISEASE-EA EMPLOYE 100,000 If yyees describe under DESCRIPTION OF OPERATIONS below .DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERAnoNs I LOCATIONS I VEHICLES (Attach ACORD 101,Adctional Rermdm Schedule,if more space Is.requlred) TIMOTHY HEATING HAS ELECTED TO.-BE CORED UNDER HIS CURRENT WORKERS. COMPENcATION POLICY A, CERTIFICATE HOLDER CANCELLATION SH61ULDAN�Y OF THE ABOVE DESCRIBED.POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED N ADAM 1AMNTE ACCORDANCE WITH THE POLICY PROVISIONS. h PO BOX 1032 SOUTH YARMOUTH MA 02664 AUTHORIZED RE TAME 01 2010 ACORD CORPORATION. All rights reserved:. ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD Phone: -''- Fax: E-Mail: ADAMLABONTE@ROCKETMAIL.COM The Commonwealth o,f 1# assarcJir �s ���r�rtmer:t:of Ii�ustirial`Act�tte,�ls Office of Invesp. ahans AMi'a�shuigta►n Street stir:, A 02111 nWW mass aCia Workeils' Cunt nsation Ius is Affi& $mild+ers/ tractors trici gs}'I' het Ant3licaut blercoation Please Print L e�biy Naxr (Busltozla� vdua�; �, o��_ Addre � ( cy�� Qr J Criy/Stareli G l m rJJ - i!✓� /4 Ine Are you an effipioyer Check the appropr#�te baa Z nf-PmJect itir [Tama v6th ❑ I am a:geuerai cantor and r (;employem(fA as�i9lor pa t�tame *: have the y-cea ixac s:- lr�evsr a 2 ❑.I am a sole or test x on tiae`attached: et. i avcte tr aboaactrns tta AT and have no,empiayees S: ElDemaht:on S .for sae m any'c�pact esnp loye� a have �PIo Ivor 'comp msuYance cofaP inswa t I ❑$ sishug ddataon require d :: lie are a cflrppmtion and its t'd❑]rtect:xcsi repaars tar acititt otas 3 offcs have exercased ❑ am a homwnes:doaag all v�ork a'i ❑Pitbg s lcdahtaoals a r�rffike�s ri;�f e ri2 _. I10 Roofregsrs inst�tce j s c i52a it't we no, envj a wod mew Y_. ❑Other comp.tnszanm required.j 'AayapgBt tl�acci dcstints#imu�i.st ofillottt sec `�abttnrts swi gee a�oakazs' parkF a Res who submit Ibis af6dsait indi ag Ue:6mg all roifC end t bite ou e c nxust submit a ngw affidavit&icating such. fbgt check th%5 Dont:most attached ea additional shot ttnsuie of the svb-caz=t=s aad,stue whedwr or not thane ento-tw have: emplayees-lithe sat,-cstnttactats Lm awtayees ffiay mint pwidetb&wmtam q#cy der. I am a amP !fiat is prat�i tta ta�or. s"eao o ius�tal a fig evix j es�:Be9.oso is.tiicpirrtie�aa�,�esh site. inforrrtaiota �.Comg�ny ititams ��� Pohcy�t�Self rss Lac.;#t ,�.5 CJ � job Ca:y tat rztp g ra gpaAach a.cpofhsor r 'emnPeuHtma t .hp i date Fatter:to escort:cavesnge as rtid under Se etoa 2 A©f iCL c f can lead tca t2te:ispos3tioa of cristai penaitiea of a fine up to$U00!OU asu `or one=year p6so t,as Wei as cstrs7 penal es m time fcrmt.of.a TfJP ihiQitX'ORDER aad 3'me ofup to. 254.Ot#a day agamst. viaiator. Be adv that a cop .of tit> ste t of stay be fasw ed to.tite Office of I nmstigations athe DIAL, i ac`e coverage mtkn I do hereby cerh y tanra?er aePMW P a +� 3u die# fle uafor�aa ra`p t�ta d ai vve is tme Arad carry d. Date arcs o I3ei'.not write in.#hts.areQ, 6e b ©t:totvn aclaL Cfty ae T'o�u Perma#/I�eeatse Issuing Aathof ty(&eke one}. I.: ard of Health. I BUflIhng Department.'3 t1it ;rTov► Clerk :£teetrical a #or S.Plumbing I ctor � t;�ther Contact Person one 6 IA � � ,j. "`•�s' c a, �+� License or registration valid for individual use only '� Office of Consumer Affairs&Business Regulation :Y N before the expiration."date. If found return to: W c `M � HOME IMPROVEMENT CONTRACTOR Office of_Consumer'AfTairs and Business Regulation � +° ii a Registration ;�" 143053 Type: cn w c 10 Park Plaza-Suite 5170 r Expiration �lf412018 DBA Boston,MA 02116 o_ o j •KEATING CONST. Y .r1 *� TIMOTHY KEATING 3- � 02 ER BROOK RD 54 LOW SO.YARMOUTH,MA t?64�" " Undersecretary Not valid without signature p rn p Z o �. N Z�� I m U 3 Mo N D c O O u mO = U m —� O � Hus N ,1 U i" r . r _ d r i . F r r nstruction Supervisor Specialty stricted to: SL-RF-Roofing SL-WS-Windows and Siding h L '��Flui'e�t0' tfssess a current edition of the Massachusetts State Building`Code is cause for revocation of this license. DIPS Licensing information visit: WWW.MASS.GOV/DPS t `` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1 c, Map ParcelPermit# 7 / Health Division 49 8 63 Date Issued y 0 3 Conservation Division. Application Fee Tax Collector Permit Fee _ Treasurer _ Planning Dept: pC CONK C ON ftRw NA SEWER Date Definitive Plan Approved by Planning Board ENGRVP; OD RMT FROM T:F CDJVBUC�+ION.IVISIAN PRIOR TO Historic-OKH Preservation/Hyannis Project Street Address -0 m/ q- g- Village Owner -7-v"w w&UJ' Address . e. Telephone Permit Request �.4faAeA7; Y lae_o KL< /Ff2�d d77Zy6e Square feet: 1st floor:existing proposed 2nd floor: existing proposed Total new Zoning District 2 Flood Plain Groundwater Overlay Project Valuation ✓ i �� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. r� Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 4 Lz—f Historic House: ❑Yes ANo On Old King's Highway: ❑Yes No Basement Type: ❑Full Z4,Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing �' new Number of Bedrooms: existing new .Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: 0 Gas ❑Oil O Electric 0 Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: O Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:0 existing ❑new size Attached garage:0 existing 0 new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded O Commercial ❑Yes 0 No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name . l) .� � / G�'r i Telephone Number 7P7 he 72�z 2� Address S_'�U License# C—P OC217 j 027 Home Improvement Contractor# ?7 P17 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1,67U1FR &-E `u**, C/ll��teG�'C� SIGNATURE - ! . �---~ DATE L// LO 7 >: FOR OFFICIAL USE ONLY 4 PERMIT NO. _ DATE ISSUED MAP/PARCEL NO. S 1 } 1 ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL FINAL BUILDING �S �.-> �✓ k /400' d 3 " ti VATE CLOSED OUT ASSOCIATION PLAN NO. t. _ The Commonwealth of Massachusetts Department of Industrial Accidents Office ofinyestfgations 600 Washington Street t Boston,Mass. 02111 Workers' Compensation.Insurance Affidavit name location S`I 4 � 7'zn✓' f7T city A51-t e `kcS' &t4i- . 02-.?S hone# 7�—�Z 7,v Z [J I am a homeowner performing all work myself (] I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this fob #q _ -,::t`:`.,- � c'�"T'•."x ;`'k' ar'� ..t.:.., a`r'� �"�"y 1y,:.,F t �..;4 ,r cr ztf:.r -Y ' t..�[ri.�,r ''4u ,: � v"�.4tt Mry�+`,��� Y-1�1 .,+4,,.','N+ ..q.��'.{,�. _"dE' yrt�.{� sTSVq .r' £,::,a <' n 7 :z^sy d 1 t31i 2 fss t h. � 'r s.a�-Y r h ..r.. d4 �r,,. !,a ,l..�,'' '+ .fi.. -a.HIype e'•s� Oill{3TM FQflme�5 1 e` s,m� :l+r;.s' '":�.=•.all ,3 f�i..'':-,.'`"3't >it•.-R �.-a ..; i.''i `�" -4 '� �'r' �-''sit i t..r.•,z_; 3 zt ¢w-, l 'y�,"i'.�'�''S 7J}{ �+ t�Tetrs-I$r'.v�r+1.✓ ti Yiia•�y, r2€ r ,4x�trs�r3��a fr 'vri t4� F4'r ' .Nu uY tyy�kh r e Lt3N siF v s # MT? u 3 to `1. t' r.>; .g7x"•�aa��+! a✓ h ?•"Lt' i"'1' 7:+F r.4 a 4r•'t t *'ty �..:si '�,'1 M�'s`l.. ?' ur+.As1arL�'t �.. addres's �,• -Mmr �:{� '.c*-e t'tdr.-YY' ><'y` ' + j .v'?`k tk s at r• j.5:.r'Y r�`r`�" _ s 't"v- ',.1pr r�+"'i�'` y "� � •;s "gyyt..yy�2:_' a�-'�i'r j fir v`�.ri-,s'.t'."' 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'��*�.����,+� addr•:ess ?3a�t a y a r 3 e 't- r 3`d@` +.a-.i'r✓'-d� LT.u"4k tY>T�1,��'" ,t„ sY7!„M t'� -1 � .t's"t�.w's,,^.Ft•''4 : Sx�}t�F'��•c+ji l!h') l.h{ .t�,'r-1r s r�ast xi*a,M1�ri��� .r�,S�M *'�°'�} zf�vs++.s.•g' '.S1 {-i��n�ea`��'�*,'J,�,,`,�,�yrtr.l'�•eC :.. r�t�r' t r' r �i}ti G�..J+i y �"{_XYk�x'k t t.s+ <,✓ �}r�,,,4..�.X��.r�ta^ r 1,��� 1FC1 � YIz'w '.'�� 4:':•G�"Rr' ��'c=:�x 2. T( - � r 3..a..a Y s i i r t�k rd W^..3'1`�C.'.� 1''3„�k�� Fr s1 }Ina s.iL -Yt+ �3'rvfi -c'tii sUF y, f <a sP ri T A .ta r3 r�•r '� b� Y i v.t>< r �`w- a ate,.;n` �� h,- Y... r -�> ti 3 a t 4 '.'3'�,?`r4 �-l7F{�F'wt-_ �� -1jr ^�,�,' 3 _. rs4� ti .1�''•7� S� •::�t� h :S & :y '�'�r��x-�. [E '%sue y �S � d 1a v� r:t.� ra .�. m � G ix t -< Ys'<.�;+-•t � �' ter- i !Ga-,r.k���t�a 5r'i,+ri�S{�•:�.ke'�f'a`„-t�� ""k. t��. ..0 ,c''�� a. - �: '4.: -y, 'S.� 3^;` t a ':::"C.'"�4 �•'>',��"'11i��,.'?+ }Insurance co��•r k �y'4,�'�'�xa'xr�e e.�•tzx` ci� t't' a '.R k r r ' <4 Po1�G�^# t :x, a� e..§..'�t..,.3.>. ,+` Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 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 cerd nder thepains and ppeeenna�lties of perjury that the information provided above is true and correct Signature '-� — Date � 6 7 .3 Print name �/�T/I�� !� /zFt;G/libe/ Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# F—Building Department ❑Licensing Board n check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; FlOther C (revised 9/95 P!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. 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 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 along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should.you.have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please cal the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out.in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to 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. IN The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406 °pIME row Town of Barnstable Regulatory Services B' Sr`BL Thomas F.Geiler,Director nsnss• 9`bpr16;A�A � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type.of Work: PWI 0A91AK -1 €2 A2 Estimated Cost ®d Address of Work: '7� �1 s�fy oL 12;J• t�Yir�s Owner's Name: Date of Application: Y�7 03 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law El Job Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MROVEMENT 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 agen a owner: V_?Z0-7 c-P 0 6g17,9 Date Contractor Name Registration No. OR Date Owner's Name .J RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings;Additions $50.00 Alterations/Renovations $25.00 n' Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEw iIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES (attached&detached) square feet x$32/sq.ft. ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf-1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) . Deck x$30.00= • (number) • Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground SW1mming'P001 $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee r NE BR NEW ENGLAND ARCHITECTURAL BUILDERS & REMGDELERS 611 Washington St. Suite 12 Pembroke, MA 02339 (781)826-7212 fax(781)826-0240 WORK AUTHORIZATION & PAYMENT REQUEST FORM Wednesday, October 30, 2002 NEABR JOB #: 6205 CLAIM #: N0372003 INSURED: Joan Morris Address: 70 High School Road Hyannis, MA 02763 I, Joan Morris, Title XOm eay4-6z do hereby direct New England Architectural Builders and Remodelers, Inc. to perform any and all necessary work' •-r® (L-1Af,,R i),4w4ee 7V ac(icle 1`Z3l/W�i9770��. 71 P&X 6Z'X r4apE dx �'U2l< #6Z4W I also authorize my insurance company, Harleysville Insurance to pay NEABR, Inc. directly for the work performed and request that their name be included on any check issued to me relative to this insurance claim. I am also aware of my responsibility as the property owner to pay my deductible of$500.00 to NEABR, Inc. ,o GAF *vItco ow OR ay 'Vay. S' o-Q..-� � 7�-a•-ti.,,�-�. i o�3 0 �o z Sigffature, Joan Morris Date NEABR, Inc. Mike & David Account Executive �lze C�o�fiireawiea a�.�aaaac/u�art7a BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Numbe�t;� 069179 B ; 1. ipf MI8 Rest DAVI'D M REG(itI 59011 HI'N'GTO � PEMBROKE, MA 029 Administrator i Board of Building Regulations and Standards lugHOME IMPROVEMENT CONTRACTOR Registri i6li�'AZ.7817 Nt e.�-:Su" lenient Card , _ ' i NEW E-ROL--AND 66�,My , pO B JttS REG'GLANI,�-1- 590 WASNINGTO'N P�EMBROKE,MA 02359 Adrn►ni Air ator e SENT BY: NEBR,INC. ; 7818280240; APR-7-03 3:28PM; PAGE 2/2 9ECeXVE0- t /;jOjO3 t 1 :69AM; -}NISEA®R INC; IPi.Ayo; "qua a »;Amy Kelly At:Aalti+on Ryan Iraure»ce To: D!YID Faso:(781)293.7943 Dots: 1/20103 11.34 AM Page 2 FF16.6,;Centsm CERTIFICATE OF LIABILITY INSURdANC RR M " 12OL 1E�rxc of 20 0� TNIB CotTrICAIR 18 NO=As A aTTVII OF INFONMA n-1Ryem Insurance ONLY AND COMM$NO RODS UK"THE Cs1tY MATO Associates, Inc. HOLDER.TW CtRT�AU DOES NOT Amew m I r OR St., P.0. Box 437 ALTER TW COV0006 APPD WD BY"M POLEM BELOW 8embrobe UK 02 339 W"mRs AFiORDWO COVERAGG Phone: 791-293-3300 F":781-293-7943 p INIA019RA Central Inaarame Co Nawrna Nov England guild "&&tote Inc � 590 Wo>tosl20[ 0�359 ko evelAeR E� COVHRAGES THE POUaES OF INSURANCE LISTED BELOW MAVE 699H ISSUED TO THE INsuREO NAMED ABOVE FOR THE POLICY PlR100 W&i1GATE0.tgTyylTMgTANDINO ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO NMICM Y► S CERTIFICATE MAYBE 14WIDOR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DERCRMED HEREIN IS SUBJECTTO ALL THE TERMS,EXCWSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SMONMMAY HAVZ BEEN REDUCED By PAID CLAIMS, reUCTinocYMI remy ►y1AnaN Laere awl �oLBaYNwAtfA TaOEM= eATr LTn TnaaalalralBca eACN Op0UR11aNCE I l,000,000 COMM&U#BLITT A z COAAIERmALoeNePbWCllTT CXR7971633 11/01/02 11/01/03 FrdowAoatAlw --i f 300,000 CLAABSMAOC occuR w0vwMq aBnN+l_ S 5000 PIWSONALaADYKLWY $1,000,000 QRMPALACOIIEGAT! S2,000,000 oaoouct•f-Cowop AGG s 1,000 000 OEM ASGRAGATE UT APPtlf PER ..... PODGY PRO La AUTOMOGLO LW9ILRY COMIalE06rN:4.E VLR - f tfl�ucuvrl ANT AUTO ALs.oveEDAUT08 000LLYNwRY = (Per re W) 9CMf01AFD AUTOS . MlBED.VJTOS 900LYPWRY f {Per r:c10IIQ NOT+CMA1eO AIITOf PRWFiM DAMAGE f 1Per BCO Mn NJFO ONLY.FAACCIOERr s 9AKO ELWILITY - EA ACC L ANY AUTO OTHER rM44 AUTO QKT.. AGO s E/;CN 00CUQRENCE f IYefaf/1AjILITY f OCCUR CWM9 Mace AGGREQATS �. f _ 1 DP.f7uCTBE f PETIIKPQN f WC f ATtL OTM woPxeMf COMreBIfATIpN AND IMrlorEnf'LlAmuiT WC7071634 00 11/O1/02 11/01/03 EI-EACMACCIDENT $100000 EL.dfF,eE•CAEuvLOYee 1100000 E.L.01WOE-PWCILLRT Y 500000 OTIMR 01iGA1rTNSN Or OPEWLTIOMtCDCATNBNUMGCLe '49LUf10Ni ADDED By ONOORfIMBNtAVICIAL PRDVMCNf usual to the insured CERTIFICATE NOLDER N AoarloNALa+as+Ilao;INsua®NLnT� CANCELLATION 'TOWMUA Qe/O1La A'dv or TTar"an 964eroaao rOLJCNNt w aANe:uaO eargea Tw a%/wLrMie� OAT@TkOr,TNa 111tW UO INIumpt IIL►INoaAYom Ye MOO 10 pAYl rrRITIEN TIi MT7TNta To TB0 C%j"W1CAT0 NOLO/BI NAAIao YO TNa LarT,$UT FAILVM TO 00 sO W— IM►eBf NO OaLIOATIOM 00 LYIAITT OF ANY TONA UPON TW INEUAIIR BTI A*Kws on . 1largaaMABMf. Hannon- an m ACORD CORPORATION 1988 ACORD 25-8(/197) RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT SUMMARY ;. STREET -7 LAND 0 Hi School Rd. anni s H 0I BLDGS. - 308 256. OWNER TOTAL LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: BLDGS. Hall ren Carl G. & Marie A. 9 30 55 921 46 TOTAL LAND -P5 an�yiNNF S �9 �-�✓rE�v��t,E rY1A.o�.`32 � BLDGS. TOTAL LAND BLDGS. TOTAL LAND BLDGS. TOTAL LAND BLDGS. DI TOTAL LAND BLDGS. O TOTAL LAND BLDGS. INTERIOR INSPECTED: !" x TOTAL DATE: l 1 I LAND a ACREAGE COMPUTATIONS : BLDGS. ND TYPE # OF ACRES PRICE TOTAL/ DEPR. VALUE TOTAL HOUJ ,f 0-7/ .G �GJJc 8�00 0 0 0 LAND CLEARED FRONT BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. WASTE FRONT TOTAL REAR LAND 0) BLDGS. TOTAL LAND !1 m BLDGS. LOT COMPUTATIONS AND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT:PRICE TOTAL DEPR, CDR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. I HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. BLDGS. --- LAI'JU CUS I' ' Cone.Walls Fin.Bsmt.Area Bath Room / Base /�- BLDG.COST Conc.Blk:Walla Bsmt.Rec.Room St. Shower Bath Bsmt. � � Cone.Slab Bsmt.Garage St.Shower Ext. PURCH. DATE Walls � PURCH. PRICE Brick Wells Attic Fl. &Stairs Toilet Room Roof RENT rR?CNT Stone Wells Fin.Attic Two Fixt.Bath ? .U t[ L 8E Floors -- // �f'='):, 110 fs/y 5 .I f= Piert INTERIOR FINISH lavatory Extra I ! Bsmt F 1 2 1 3 Sink ).�,va {` 3 w2 0 1/2r Plaster Water Cie.Extra Attic -E „� 7/Q ry 1 12 EXTERIOR WALLS Knotty Pine Water Only Double Siding Plywood No Plumbing Bsmt.Fin. c, Single Siding Plasterboard Int. Fin. LVt)oohingles TILING/��lr'1(• — �- G Cone. Blk. G F P Bath Fl. Heat 4-• /0 1 Face Brk.On Int.layout Bath!t¢&Wains. Auto Ht.Unit 4- 3.2 I I lO f Veneer. Int.Cond. Bath Fl.&Walls Fireplace I Com.Brk.On HEATING Toilet Rm.Fl. plumbing f- rj//0 Solid Com.Brit. Hot Air Toilet Rm.Fl.&Wains. _ Tiling .. Steam Toilet Rm:Fl.&Walls Blanket Ins. WOOHat Water 8 L.- St. Shower Roof Ins. Air Cond. Tub Area Total Floor Furn. ROOFING COMPUTATIONS ' Asph. Shingle Pipeless Furn. 9 S.F. av j j Wood Shingle No Heat S.F. / &' Asbs.Shingle Oil Burner S.F. Slate Coal Stoker S.F. Tile Gas S.F. OUTBUILDINGS ROOF TYPE Electric Gable Flat S.F. 1 2 3 4 5 6 7 8 9 10 112131415 6 7 8 9 10 MEASUREL'. Hip Mansard FIREPLACES S.F. Pier Found. Floor Gambrel Fireplace Stack Wall Found. 0.H. Door LISTED FLOORS Fireplace Sgle.Sdg. Roll Roofing Cone. 110 LIGHTING Dble.Sdg. Shingle Roof Earth No Elect. DATE Pine Shingle Walls Plumbing Hardwood ROOMS Cement Blk. Electric Asph.Tile Bsmt. I 1st TOTAL -� Brick Int.Finish CED Single 2nd '1 3rd FACTOR /3 3 d REPLACEMENT o7 ;�'0 F.• S� OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep• ACTUAL VAL. DWLG. J,0(1,t /9 :K T U 1 2 3 4 5 . 7 .I 6 - I ; 9 I'� TOTAL PROPERTY ADDRESS I I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CSTATE LASS I PCS I NBHD y KEY NO. 0004 HIGH SCHOOL ROAD 07 R8 400 07HY 07/09/95 1041 00 1AC R3U8 256 LAND/ THER FEATURES DESCRIPTION ADJUSTMENT FACTORS Y UNIT 'ADJ'D.UNIT Lana BY/Dale sae o�menswn LOC./VR.SPEC.CLASS ADJ. CONO. P PRICE PRICE ACRES/UNITS VALUE Deacripuon MA S 0 N. J 0 Y C E M T R S & M A P- CD. FFDe ttllAgres - #LAN D 1 22,000 rAPPR�AISED RDS IN ACCOUNT - L 10 IBLDG.SIT 1 . X .2 =10 251 34999.9 87849.9 .25 22000 #BLDG(S)-LARD-1 1 80,10001 OF 01 A #OTHER FEATURE 1 7.300 109400 N BATHS 3.0 U x C= 100 10500.0 10500.0 1.00 10>00 8 #PL 70 HIGH SCHOOL RD ET 100500 D - 1/2 BSMT S x C= 100 3.6 3.6 776 2SOU-3 #RR 0705 0121 ME A RG1 DETGAR S 18 X 24 198 C= 87 19.3 16.7 432 7300 F EXT FIREPL U X C= 100 1300.0 1300.0 1.00 1300 S VALUE D ' D A 109P400 A uPARCEL SUMMARY T g LAND 22000 A T BLDGS 80100 M -IMPS 7300 E TOTAL 109400 F tNST E N DEED REFERENCE Tyw MO DATE R« dro PRIOR YEAR VALUE A T Beek Pageyr D "I-Pace -AND 2 2 0 0 0 T 3650/318: I106/93 F 100 3LDGS 87400 U 8650/325p9I;06/93 F 100 rOTAL 109400 R P0215-EF09I94/89 A 1 E I BUILDING PERMIT ' S Numper Dale Type Armunl LAND LAND-ADJ INC ME SE SP-BLDS FEATURES BLD-ADJS UNITS 22000 7300 9000 328423 9/85 1 AD 7600 i Class Const. Total Base Raie Adj.Rate Ayear Built Age Norm. Oesv. CND Lec %R G Rep] CoSt New Act, Re Velue $lenes Mei M Rooms Rma Battle a Fix. Put U oils Units A 1� 11� Depr Cone. 1 PI 9 ywall Fee. i I 1 107C+ OU0 100 100 62.75 62.75 20 80 14 87 90 77 104017 80100 1.5 7 3 3.0 11.0 r-Description Rate Square Feet Repl.Cost MKT.INDEX: 1.00 IMP.BVIDATE. ML 5/88 SCALE. 1/00.61 ELEMENTS CODE CONSTRUCTION DETAIL j S i 8AS 100 62.75 776 48694 GROSS AREA 2010 SINGLE FAM.+ APARTMENT(S) CNST GP:00 FSF 90 56.48 458 25868 *---14---* T 815 42 26.36 776 20455 STYLE _ _U4 APE COD 0.01 ! *-8--* DE5I6N ADJM_T_ 00 --_--------_--_-_-_-_-_-��0, R 6 EXTER.WALLS 06 LUM/VINYL 0.01 C 4EAT/AC TYPE 075AS-H0T WATER -- 0_0 T 24 *-6-* --- --- ----------- INTER.fINISH US CASTER 0_0, ! INTER.LAYOUT 12 VER./NORMAL 0.0l ------ --- --- --------------- ------- R ! ! 12 NTER_3UALTY 02"AME AS EXTER. 0_0 --------------- --- ----------------------- LOOR STRUCT 02 D JOIST/9EAM 0.01 A 0- - ------ ---- D W 46 BASE*-6-* * c LUOR COVF_R_ 05 ARPET 8 HDWD O.O L 1234 ! ! ! OUF TYPE 01 SABLE-AS_P_H_ _S_H____ 0.01 !Areas Auz Base= BUILDING DIMENSIONS ! ! ! ELtGTRICAL_ 01VERAGE 0_01 AS W2U N46 E14 S24 FSF N18 E08 ! ! ! ------TION J2 ONCRETE 9LOCK 99.9 A I506 E06 S12 E03 S22 W11 FSF N22 ! 22 22 --- -------- - - - - - - - --- ----------- ------ W06 .. BAS E06 S22 .. 815 N22 4M;H80RH08D 51AC HYANNIS LiW96 N24 W14 S46 E20 .. ! ! ! LAND TOTAL MARKET ! 615 ! FSF! PARCEL 22000 109400 *-----20-----X--11* AREA 2848 VARIANCE +0 +3740 STANDARD 25 rROPERTV ADDRESS I ZONING I DISTRIC SCODE SP-DISTS.I DATE PRINTED I CSTATE LASS I PCS I NBHD KEY No. 0004 HIGH SCHOOL ROAD 07 RB 400 07HY 07/09/95 1041 00 61AC R308 256 LAND/OTHER FEATURES DESCRIPTION i ADJUSTMENT FACTORS TY UNITADJ'D.UNIT Land By/Dale S�se Dmen.on LOC./YR.SPEC.CLASS ADJ. COND. PE PRICE PRICE ACRES/UNITS VALUE De:pription MASON i J O Y C E M T R S & MAP— / CD. FFDe thlAcres .#LAN D 1 22,000 CARDS IN ACCOUNT — 10 18LDG.SIT 1 x .2i =1oc 251 34999.9S 87849_9 .25 22000 43LDG(S)—CARD-1 1 80.100 01 of 01 a 40THER FEATURE 1 7.300 OST 109400 N B S 3.0 U x C= 100 10500.0 10500-0 1.00 10500 3 #PL 70 HIGH SCHOOL RD MARKET 100500 0 2 BSMT S x C= 100 3.6 3.6 776 26OU-3 tRR 0705 0121 INCOME A R DETGAR S 18 X 24 198 C= 87 19.3 16.7 432 7300 F USE p EXT FIREPL U X C= 100 1300.01C 1300.0 1:00 1300 3 APPRAISED VALUE _.-. A 109P400 4 - PARCEL SUMMARY r U AND 22000 S T LDGS 80100 M —IMPS 7300 E OTAL 109400 tNST N DEED REFERENCE Type DATE—, R--d- �RIOR YEAR VALUE T Book Incl. MD._ DI S.1—P6_ A N D 2 2 0 0 0 r S 3650/318: I:06/93 F 100 LOGS 87400 J 3650/325P91:06/93 F 100 OTAL 109400 1 P9215—EF09I:04/89 A 1 — I BUILDING PERMIT Number Dale Type Armunt 3 LAND LAND—ADJ INC ME SE SP—BLDS I FEATURES BLD—ADDS UNITS 22000 7300 9000 828423 9/85 AD 7600 Class COn st. Total Base Rate Atll Rate Year Buill Age Norm. Obsv. CND Loc %R G Repl Coll New AO Re Value $tones Hp 1 Rooms Rms Baths I Fix. Pvt II F.c. onus onus A� ltg Dept. Conti. w eh Yw• 000 100 100 62.75 62.75 20 80 14 87 90 77 104017 30100 1 .5 7 3 3.0 11_0 e sc ription R.I. Square Feel Rep_.Cosl MKT.IN DE%: 1.00 IMP.BY/DATE. ML 5/88 SCALE: 1/00.61 ELEMENTS CODE CONSTRUCTION DETAIL BAS 100 62.75 776 48694 GROSS AREA 2010 SINGLE FAM.+ APARTMENT(S) CNST GP:00 FSF 90 56.48 458 25868 *---14---* STYLF 04CAPE COD 0.0 f ----- -- ---------------------- B15 42 26.36 776 204.55 ! *-8--* DESIGN ADJMT 00 0.0 --- --- --------- --- ---------------------- 1 6 EXTER.WALLS 06 LUM/VINYL 0.0 --------- ---------------------- • ! ! MEAT/AC TYPE 07 AS—HOT WATER 0.0 ! 24 *-6—* INTER.FINISH 05 LASTER ---------_ 0.0 ! ! ! INTER.LAYOUT 12 VER./NORMAL 0.01 1 ! ! 12 NTER_QUAIL TY 02"AME AS EXTER. O.OI 1 - ! ! LOOR STRUCT 02 D JOIST/BEAM 0..0 D W 46 BASE*-6—* EFLOUi2_ COVE_R_ _ 05 ARPET 3 HDWD 0.0 E Total Areas Aue 1234 ! ! ! ROOF TYPE 0iuABLE-AS_P_H_ SH___ 0.0 T BUILDING DIMENSIONS ! ! ! c L E C T R I C A L_ 01 V E R A G E _ _ 0_0 BAS W20 N46 E14 S24 FSF N18 E08 ! ! ! ODUDATlON J2 ONCRETE A BLOCK 99.9 S06 E06 S12 EU3 S22 W11 FSF N22 ! 22 22 -- - -- ------------ - - - -WOb .. BAS E06 S22 .. 815 N22 ! ! ! NEIGHB-- --- --ORHOOD 61AC HYAyNIS L W06 N24 . W14 S46 E20 .. ! ! ! LAND TOTAL MARKET ! 815 ! FSF! PARCEL 22000 109400 *-----20-----X--11* AREA 2848 VARIANCE +0 +3740 STANDARD 25 RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT STREET SUMMARY _ 70 High School Rd. Hyannis 73 LAND o , 3o8 256. OWNER H 0) BLDGS. / 9 5 v TOTAL 7 > LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: BLDGS. Hallgren, Carl G. & Marie A. 9 30 55 921 46 TOTAL LAND 25 BLDGS. Gn TOTAL LAND 0 BLDGS. TOTAL LAND BLDGS. TOTAL LAND 0) BLDGS. TOTAL LAND BLDGS. m TOTAL LAND INTERIOR INSPECTED: BLDGS. 1 ' TOTAL Its-.DATE: ,i�{`;!r�.,.,, � �. � � �� N �� r LAND ACREAGE COMPUTATIONS BLDGS. LAND TYPE 7 # OF ACRES PRICE TOTA/L DEPR. VALUE TOTAL ',HOUSE LOT f d/ ��� /G-%>�� �c��7 G o 0 LAND CLEARED FRONT - BLDGS. R TOTAL WOOD ROUT FRONT LAND REAR BLDGS. WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL LAN D BLDGS. LOT COMPUTATIONS L%D FACTORS 0) TOTAL FRONT DEPTH STREET PRICE DEPTH % FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD.. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. BLDGS. TOTAL TOWN OF BARNSTABLE, MASS. UNITED APPRAISAL CO., EAST HARTFORD.CONN. ------ --'---- — - v: 6LDG. COST Conc.Blk.Walls Bsmt.Rec. Room St. Shower Bath ny',' jo'" Bsmt. PURCH. DATE Conc.Slab Bsmt.Garage St. Shower Ext. -------- -- Brick Walls Attic Fl. &Stairs Toilet Room Walls --- ----- PURCH. PRICE . .�� �4 A r• Roof RENT I o �' f Stone Walls Fin.Attic Two Fixt.Bath -- --- —�— i Floors i v _ �i •�•,;: 'I0 f' -- • Piers INTERIOR FINISH Lavatory Extra -- r! Bsmt. F 1' 2 3 Sink •' ✓ i 3/4 r/2 r Plaster Water Clo. Extra Attic_ EXTERIOR WALLS Knotty Pine Water Only lfJl >n `'/-• p j �2 Double Siding Plywood No Plumbing Bsmt. Fin. _ Single Siding Plasterboard V, Int. Fin. hinHles TILING Conc.Elk. G F P Bath Fl. Heat _F- i f Face Brk.On Int.Layout Bath Fft Wains. Auto Ht. Unit Veneer, Int.Cond. V Bath Fl. &Walls Fireplace Com. Brk.On HEATING Toilet Rm.Fl. Plumbing -f- If/i/O Solid Com. Brk. Hot Air Toilet Rm.Fl. &Wains. Tiling Steam Toilet Rm.Fl.&Walls Blanket Ins. Hot Water � -'P,i L,,,' St. Shower Roof Ins. Air Cond. Tub Area Total Floor Furn. ROOFING COMPUTATIONS Asph.Shingle — Pipeless Furn. P D 9 S. F. 'Wood Shingle No Heat S.F. i-. Y Q l i .�•J Asbs.Shingle Oil Burner S.F. Slate Coal Stoker S. F. Tile Gas ROOF TYPE Electric S. F. OUTBUILDINGS Gable ✓ Flat S. F. 1 2 3 1 4 5 1 6 7 8 9 10 1 2 3 4 5 6 7 1 8 1 9 10 MEASURE[ Hip, Mansard FIREPLACES S. F. Pier Found. Floor Gambrel Fireplace Stack Wall Found. 0. H. Door FLOORS Fireplace LISTED Sgle.Sdg. Roll Roofing Conc. LIGHTING Dble.Sd Earth No Elect. g• Shingle Roof Shingle Walls DATE Pine g Plumbing Hardwood ROOMS CementBlk. Electric Asph.Tile Bsmt. 1st TOTAL ° -7 O. Brick Int. Finish #1 PRICED Single 2nd 3rd FACTOR / REPLACEMENT �•;0 i` OCCUPANCY CONSTRUCTION 7 SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.DeP. ACTUAL VAL. DWI-G./ 6H111 / 60V f ,. /`> / 'ft ,1K �1� �; — 0 ! 2� i 9G G a l `JG 5 U t' 2 3 4 5 . 6 7 8 �.9 TOTAL TOWN OF BABNSTABLE REPORT S*LDMENTASY/CONTINUATIO.REPORT NAME (LAST, FIRST, MIDDLE) DIVISION 102" PL,2 4. �Owi,4- NOTE DETAILS i BSERVATIONS-ITEMIZE EVIDENCE, SERIAL tS ETC- U r S hOG7 I �'( A IiNi s F25 le Y SUBMI PAGE i / TTED� / I 91'' BILDIN.... V.... +..... ..... ....: :.:.:.:.aaa.::::.�:::::::.�::...:::..... �::.:... ........ ..:. ::::..............::::. ::3:.;9:.>: 308:•2...>: x::> < ILDIN '< .:MA SON i ........ ...........a:.:.-::.vvvi:•i:6:^::::::i}:•.aw:.vvvvvvvv:�:+•iiii'•:::.}aw:::.�:::n.;.............. v'•<:i i::v is H... .:a. G SCHOOL:<. .> H I < ' !a Um •'ri:iiiiii.... .'.y•: ..::::::::::s:::.,.a.. ....:...:::::.::•.:v.t......,,...:..::...:::• :•::::•::::::•::::r::;:; :::::...::...:. .:.::•:•:.::.:•.:::.:..:.;:::v:{�w.vvv;:.;•ni..;:;:.::}:y;w.:yyx:;wm}vv;::;n::rr::•r:..;. n:vvvvvvvvvvvv.�:::v::::•.vvvv:�i:i::iiii ZONING zx .... ... .:..::..::..::a:..:.::::..a...:::::.:::..::::a:;:i:.i.::.iiii>::i:::>,::::::::.:..>:.;....:..a>..:.a..::�ai•�>••::;<:::::>:::<::::::ii:::::;::::::.:.:...aaa.aa.aa iT :.:..aaa.... ................ ................WIN ........................ ...... ............ :<iw .: .< aaa :'.LE AL.a PPPPP. . . .......::::::::::::::::::::..::...:....:.... {< ......... . ... . SEARCH Assessor's map and: lot numberQ.. ..` -�� 6 �• ' - f OF'rNE �4cc�f'2 3 ^7 Sewage Permit nu b ro R J Z EARESTADLE, i House number .......f........ .............1 ........................:....... 9 rasa �p i639. \00 �E'p ypY Or. TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..:c.ons.tsuc.t...a...I....car—g-a—a.$e........................................................... TYPE OF CONSTRUCTION ...........Wood..........frame . ...............................:.................................................................. L .......................................... .19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location High School Rd. Hyannis ....................................................................................................................................................................................... ProposedUse .......Siri;1e...ca.r....garage.......................................................................................................................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner krs Nlarle...Hall.gren...................Address .2.5.1...PHinney-A-s•••L.ane•••Cente•r•Vi•j-l:e Name of Builder .I)augla.s...W......Bill............................Address ..60...Ha:rva-rd...stI...Hyann- fi....................... Nameof Architect ..................................................................Address .......................................................:........................... Number of Rooms .One.........................................................Foundation .....paurad...GOI1o._re,U................................. Exterior ....vynl,...Siding...................................................Roofing ....fi•bre...g-IaG,--roo-fIng................................. Floors .....cement................................................................Interior .r.©Ugh...fr-a -iept.................................................... Heating ................NA...........................................................Plumbing .......N/A.................................................................... Fireplace ...............N<. `..........................................,................Approximate. Cost 7600.00 .................................................................... Definitive Plan Approved by Planning Board --------------------------------19________. Area .. .. ...' .�......S ......Ft ................. �O Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH • s� x �,le - • 11t ' e- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the To of Barnstable regarding the above construction. Name ...... :v..i•••�/�A ..................... Construction Supervisor's License ®3aa ALLGREN, MARIE No 28423..... Permit for ....Build...G.aragje..... .. . .... . ...... ...... ...Accessory...t..o.. Dwelling ag....................... Locationv.. ....................... - ................. Ay .............................. ............ Owner ...... .............................. Type of C8n'structflon ..F.rame.................. ............ ................................................................................ Plot ............................ Lot ................................ Permit Granted ........S.e.p.tem.b.6.r...13, 9 85 Date of Inspection......................................:19 Date Completed ........ ................... Assessor's map and lot number �d.��..'. -� .6........... �{ THE Sewage Permit number ,.......1/.�.... .. .�i�:.......�._........-......... d r House number . �`1 i'35 2 Basa�a LE, �9 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...fi.t:r� .r..??.r k.. a...�...r ?;^... ?._r-a—gya.......................................................... TYPE OF CONSTRUCTION ...........wood fr'ame................................................................................................ ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location High School Rd, Hyannis ....................................................................................................................................................................................... Proposed Use ....... ZoningDistrict ........................................................................Fire District .............................................................................. _Name of Owner . :�^ ?..... -;r..� .rid? .fix .n...................Address .2'�1....: g.j Nt', ...1.: ...r;.�r+ra-77;1..12.sL'.... Name of Builder 7cz1a l.a ...?.......F:.. . .............................Address .40., tia t Y d.. + ... :r-, y.. ........................ _..- Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .c?n_Q.........................................................Foundation .....rat,?.re.d,...! noratA................................. Exterior .... rrn.. .... i,rli.?n.�....................................................Roofing ...: .l?r .... 1..2. ...tr �, sE ................................. Floors ......!'.pm!.n.t................................................................Interior :.,, t�... '^*t ....................................................... jHeating ................a A............................................................Plumbing .......>�/_A.................................................................... / Fireplace �d/A Approximate. Cost >7{��{�•: ..................................................................... .................................................................... Definitive Plan Approved by Planning Board --------------------------------19--------• Area ...F.t................ Diagram of Lot and Building with Dimensions Fee / �G SUBJECT TO APPROVAL OF BOARD OF HEALTH i ' fa �tr'1f i r 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. Name .........I. ......�r .(��.-t�. .:�t`.._f...........:.......... Construction Supervisor's License .....�.........�...................... HALLGREN, MARIE A=308-256 a No ..28423 Permit for ..,Build Garage .... ...................... Accessory to Dwelling ............................................................ .f. ..... Location�I�.High School Road Hyannis ................................................................ ......... Owner Marie .................Hallgren........................................ Type of Construction ..Frame ................................. ............................................................................... Plot ............................ Lot ................................ Permit Granted ........Sep.tembe.z...1.3.....19 85 Date of Inspection ....................................19 Date Completed ......................................19 1, " [ ] [R308 256 , ] LOC] 0004 HIGH SCHOOL ROAD CTY] 07 TDS] 400 HY KEY] 222324 ----MAILING ADDRESS------- PCA11041 PCS100 YR100 PARENT] 0 MASON, JOYCE M TRS & MAP] AREA161AC JV1416062 MTG10000 MORRIS, JOAN L TRS SP1] SP21 SP31 2180 45TH AVE UT11 UT21 . 25 SQ FT] 2010 VERO BEACH FL 32966 AYB] 1920 EYB] 1980 OBS] CONST] 0000 LAND 22000 IMP 80100 OTHER 7300 ----LEGAL DESCRIPTION---- TRUE MKT 109400 REA CLASSIFIED #LAND 1 22, 000 ASD LND 22000 ASD IMP 80100 ASD OTH 7300 #BLDG (S) -CARD-1 1 80, 100 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 7, 300 TAX EXEMPT #PL 70 HIGH SCHOOL RD RESIDENT' L 109400 109400 109400 #RR 0705 0121 OPEN SPACE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE] 06/93 PRICE] 100 ORB] 8650/318 AFD] I F LAST ACTIVITY] 12/06/94 PCR] Y t R308 256 . P R A I S A L D A T A• KEY 222324 MASON, JOYCE M TRS & LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB 22, 000 7, 300 80, 100 1 A-COST 109, 400 B-MKT 100, 500 BY 00/ BY ML 5/88 C-INCOME PCA=1041 PCS=00 SIZE= 2010 JUST-VAL 109, 400 LEV=400 CONST-C 0 ----COMPARISON TO CONTROL AREA 61AC ----------------------------- NEIGHBORHOOD 61AC HYANNIS PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 220001 LAND-MEAN +0°s 1094001 74880 IMPROVED-MEAN +7% 250-. ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 10001 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR] AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] R308 256 . • P E R M I T [PMT] ACTI00R] CARD [000] KEY 222324 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR oCMP NEW/DEMO COMMENT [B28423] [09] [85] [AD] A 76001 (HMI [10] [86] [100] [NEW ] [HY GARAGE ] [ ] [ ] [ ] [ ] ] [ ] [ J [ ] [ ] [ ] [ J [P]