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0015 MAPLE AVE
. _ ----------------r ' i Town of Barnstable .: PostThis Card:5o That�t�sVisible:From the.Street"-.A `roved Pfans Must be:Retained on:lob and"this Gard;.Must bezKe' � enxxrrwe�c ,, m pp . • � ° Where a Certificateof Occu anc �=�s-Re uiretl�•such Buldm .$hull�Not;be Qecu �edunttl a Ftnal;lns ection'�has been`m„ade�� Permit Permit No. B-18-2890 Applicant Name: BRANSCOMB,SUZANNE V&H ERIC Approvals Date Issued: 09/05/2018 Current Use: Structure Permit Type: Building-Shed-Residential-200 sf and under Expiration Date: 03/05/2019 Foundation: Location: 15 MAPLE AVE, HYANNIS Map/Lot 307 082 Zoning District: RB Sheathing: Owner on Record: BRANSCOMB,SUZANNE V& H ERIC � , Go� ractor Name Framing; 1 Address: 15 MAPLE AVENUE Contractor License 2 HYANNIS MA 02601 Est Project Cost: $0.00 ._ '� � Chimney: , y r, Perm��t Fee: 35.00 Description: 8x12 Shed Insulation: Fee Paid " $35.00 Project Review Req: a Da#e 9/5/2018 Final: Al z Fi Plumbing/Gas Rough Plumbi ng: .... `. ..- �� s A .. Building Official , . Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzedi by this permit is commenced within six months afte issuance. y, . R I Rough Gas: All work authorized by this permit shall conform to the approved application ap0' he approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for�pub is i ispect)on for the entire duration of the work until the completion of the same. 411, _ Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the I3uil iingandf Fire Officials are provided on this"permit. Service: Minimum of Five Call Inspections Required for All Construction Work ; � � � � g .�',�Or 1.Foundation or Footing ` Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection ` 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Fin al: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department , tj Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT F 1� Town of Barnstable DIME tati Building Department Services °l/SJI F Brian Florence,CBO * sysTesi,E. Building Commissioner MASS. f0,3g6 ��e� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us BUILDING DEPT Office: 508-862-4038 Fax: 508-790-6230 PERNIIT# _i , ,�zqa, WN OFBARNSTAF ,E: $35.00 SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less 6 ,/e- 11yall /I -S Location of sbkd(address) Yfflage E call sc,20 03 - 19V 16 2 Property owner's name Telephone number 5' x lz 7 Size of Shed Map/Parcel# �a Signa ' e Date t Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? You must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITIiIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:08/6/17 ebrcnscarv.b M0.CICaVIN- Town of Barnstable Geographic Information System February 23, 2018 1 s 307081 307082 #93 307083 � #15 #21 i I a'�r t ; > l; �r J`a v fah b 307078 307080 307077 #14 #109 #22 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:307 Parcel:082 boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel ED 1"=100'may not meet established map accuracy standards. The parcel lines on this map Owner:BRANSCOMB,SUZANNE-V&H Total Assessed Value:$216700 are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: Acreage:0.18000459 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:15 MAPLE AVE such as building locations. Buffer 3; Legend • r . , m R a : , � ,,��• .,; - Parcels F, Town Boundary 368168 ' Railroad Tracks x #i18 3 �fi 3Q8 lli Buildings E ,•! 3 Ea Y p3 ;,u el— „u .' ! ."° i 3. } ix } t;� Painted Lines � �� Parkin Lots r' 9 Paved •� : - 1 Unpaved 31816 : .,.. ' Driveways #Q+l Paved s unpav ----— ._ � a � Roads� . EN Paved Road Unpaved Road a Bridge Paved Median Streams 1 Marsh Water Bodies € : 0 g4 307083 ,.. . , 367684 7 3 F. 317Q84 367078 #10 3p7476p, 37Q77 #`t , I[[ 3071179 -- ----.. '� ..•:... �,, :.. ,a ._ ,� Rye, � M1 .❑� a. Ica\ �>.. :. .� .�..-. #a �R..0 �� 0•.. • Map printed on: 2/23/2018 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 02601 0 42 83 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 508-862-4624 ! reflect current conditions,and may contain such as building locations. Approx.Scale: 1 inch= 42 feet 0 cartographic errors or omissions. gis@town.barnstable.ma.us Ti TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map `/" Parcel Application # Q?0 (�Lt" Health Division Date Issued Conservation Division Application Fee 1 Planning Dept. Permit Fee �\ Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address JS AAM5 ,AWE Village Owner RICK B RIMCOM B Address _5.A`A5 Telephone Permit Request ►h16N (3A-51=�� — Fib` tL '(Zom, to pacL y1D . Square feet: 1 st floor: existing "6I 6% proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation -fl a,000 Construction Type UI-©(Y) Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ` Two Family ❑ Multi-Family(# units) Age of Existing Structure �R Yjj• Historic House: ❑Yes M_No On Old King's Highway: ❑Yes 14 No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other ' Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new D Half: existing 0 new r> Number of Bedrooms: existing D new Total Room Count (not including baths): existing (o new First Floor Room Count 6 Heat Type and Fuel: bGas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes 6&No Fireplaces: Existing V New Existing wood/coal stove: ❑Yes V No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use 9P xw %_n r- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ���r'Iw (�t) �� Telephone Number Address s 51[105h] rl License # CS —020 q b YWO U,<<T PUF-T /'IA %0 _ Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO YA-"dLA SIGNATURE DATE cT 17 a i E t - ,�, FOR OFFICIAL USE ONLY APPLICATION# V DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 4 27m Commoszxs t gfMassachuseft Dg7arftnmt ofladtrsfi fid Accidents - Ge o,}�'�v�stigatiorrs . ' 600 ffikyhingtoa.meet Boston,M102III wn'ty Mass.gM,1dia Workers' QtmpensafiunIns-urance (davit:Builders/ContractorslE ectriciansOumbers A-ppEcantlufarmation Please Print,Legibly Name 0 smeW0rganiZationFl&idan-�) Adzes_ 5'1 Q UE I,/ -S7 city/StatrJzLP.'AXAO PXT 065 Phone47 P$ -34-1S3b Are you an employer"Check the appropriate bow: T of, o ect r 4. I am a contractor and I Type pT 3 C cqukeay L❑ I am a employer with ❑ 6- ❑New constrict tioa employees{full an&brpattAime�* lravehiaedtbe sub con}ractozs 2 I am a sole proprietor or partner- listed on the attached sheet y. �&Remodeling slip and bate no employees These sot-contractors have g- ❑Demolitioa working for mein any capacity employees and have workers' El guildmg addition [Mo.workers'Cam ur p.insurance comp-insance - A 5. ❑ We are a corporaticu and its 10-0-lectrical repairs or additions 3.❑ I am a homeowner doing all work officers lm-e e=cised their II-'Plumbing repairs or additions myself[No workm'mmp- right of exemption per MGL 12.❑Rnofrepaits instrance required_]F c-152,§1(4),and weh"Mna employees-[No wo&eas' -❑Other comp-immnance required.j. *Any spptikEntdat checks bmc-9lmastalsoSIlovttir�setfioabeTow +*efbeawaciceis�mffipes�tiaupnTie}an t i T ffnmeowne s vrho subaut this affidavit indiLstiag they are doing vff wa k sad dies hfre outside contmcwm mnsi submit a neu:si{dnit mdueting sash_ Mars t w dma ibis box must sttached as addiflaru l sheet shotrmgthenmeof the sob its mdst deuhether ocnAtffiose Mfiiies have emPh3"ees• Ifthe sob coattactots hafie empIgwA they tmtat gmvide their warTien'comp.policy number. Iam art emplrjr that is pez+tlid&rg nrorkers'compen=tion iasrerance for ruey empLaysers Rail tr is StepaYcp acid job site infot-erterdolL Insarmce Company Name: Policy#or Self--ins_Iic- ExpuationDate: Job Site Address: ctty/Statelz p. Attach a copy of the workers'compensation policy] decIaratiou gage(shoring the policy number and expiration date). Failure to secure cos,-.rage as regaireduudea Seetioa 25A of MCL c.152 can lead to the imposition of criminal penalties of a fine up to$1,500.OD and/or one pearimpziso as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250-00 a day again q the violator. Be advised that a copy of this statement maybe frtrwarded tn•the Office of Investigations of the DIA fix insurance coverage vetffic atim I do hereby ch2rti t tkepanis and ponaitias r f`.perjFury that'tha err,formation prm2d11edabm�e cs his und.correct Si tmm: Bate: �-rl use an[y. Da not(prigs in this area,to be cmnpisted by city or town of f iciaL City or Town: PerEmitlLicense# Issuing A mtharity(drele one): 1.Board of Health 2.Budding Department 3.City]Towu Clerk 4.EIecttical Inspector 5.Plumbing Inspector 6.(Other w_• �Corttact Person: _ Phone 9- 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursumtto this statute,an employee is defined as".._every person in the service of another under any contract ofhire, 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, §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance or renewal of a Iicense 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 presented to the contracting authority" Applicants Please till 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 n o emp)oyes,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 Deparbnent of Industrial Accidents. Should you have any questions regarding the law or if you are required to ob'a.,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 pennitllicense applications in any given year,need only submif one afida.vit 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 of 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 (Le.a dog license or permit to bum leaves etc.)said person is NOT required.to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address;telephone and fax number. The CoD=Qavv aTth of Massachuactts Degaltmeat of Ind al Acckde nt office Of Javesfigatxoxxs ' Goo wawngtoa Suet Bostoz> MA 02111 Tel.#617 727-49QG W 406 or I4 MA�WE Revised 4-24-07 Fax# 617-727-7749 Www.mas&gov/dia I EVE r Town of Barnstable Regulatory Services * K+as. Richard V.5cali,Interim Director i639. Building Division Tom Perry,Building Commissioner 200 Main Street;Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete.and Sign This Section If Using A Builder as Owner of the subject prop" hereby authorize_ � ��G' C— to act on my behalf, in all matters relative to work autho:dzed by this building permit MvL6 k6z,- I&Ad,015 (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Seim Print Name Print Name Date Town of Barnstable Regulatory Services oFttu ropy Richard V.Scab,Interim Director Building.Division a AsFiacrARir`. - Tom Perry,Building Commissioner 1 ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6250 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB 10CATIW- number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year periodha11 not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities'of a supervisor (see A endix Q�Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often .PP results in serious problems,.particularly when the homeowner hires unlicensed persons. In this case;our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. `,»«a,%.,'r a,. .ems "� .�� J � �..T" _'°�� z..�- '�-�. . :,�•` - r"�',-",x^..a^�t•,•y`T�.e,� '�„l�,c w;s3.w.r.. r�".,�. --a...�s � :,r .,, *., n'9 �+WS .w+�,. ,'" ws+ :rFa w Gs '+4a-ti4 t a i "' � 4cxfi.»-�88' "Jgx Yi' `w'"" _w }3�t* �"'$.,: "'%'.,p -- -.� ��w^�,a,'�-� -�»P**,.s.a ,"�j- _;:.w' �y;` �"y.,+. �'3•- ��a�,t\+gy ^'�`n" ��' ap '7r*."fray. '� .�. p•,�^ _.��+ �„ - icy.`°,}-> +»++'+:s;' .q x.ni y�� k� .• +c .' - - aR�R�'''�F:;t�' "^+v�'Nr:. z$. -.W±F. is.'.��F ,,��r,'�`'sxs.'q -:s '-+a.✓..4 , �+.¢,°ao �s "�q-°-.,+" e'. --- =-_ ._ �., :. -3��,•i*,.�.* 'ae 'sus, i�c K -..�- _` rA� SAILTISEZ'TS . .. T :,� DRIVER S _._ Y C •. x �-` 3 y,';� '_�`..� +5•.� ��£. �'} x. � j rc �k(4 'Y'����,�L4\"&�,S14T'k�ri�'"� i'�.._ � lT r � '.�,� �X �'� ��"cm tom. t"..� < *""' dy`'BaC� *r"`„ � C� .'y+ - --�x: •c �:,, �� -_— •s d C mu '. �+ S ':y�� f1.. Y y ,e . _ * e; �`,*r�e 8a END'M,4tliNUMBER r � 0 6 - +`." y r,`'",e' '.f' "�•4z-':' � .'"k.� FI �� yy.x.'��'a2F"*Y.. 3�s +s >4 � •sw.* 'r,'.�'` '��"'r'x'9�'{"¢� sY3n-. t ' E F"T,.`�"#;^^.��i/�V !- _ �`' rt�,e�.•'ti>:' '�r -+�y .,£ U4, w .'y'4a- �•.as» .* iN s;V1��2AGC3.� ; 2 'S a ', i� x`.x ,ra„ 'r „�*.+ ° �it, yncra4+e.oi .x ZI k n « x a YARMOUTHPORT MA.11.10 ..a.. ? 's y �yaa'{�--,ate �-' -t't r #. •-r .`.nFL??l-C f .Y rt - t .s ." u: t .+s^ - =' 34. '`._ ,"'� -eq"��,,,,}"r�„� .,,r N; '•.s� _ - +x ��'„[ .*-sae _: Y .r�'s;�Y✓i,, �` -`'. yy,�:,�* '�h"�`Rfi''�a +����'"�` : '. "'� 'in .,,.w ' „'$,ate'�"S�ewe^'T�z'�� -�S x - �., "w*+fe: ;�..-r•�-zt�`s ^°dic 'fl r ..<`.s� r"w�°i+�b^�-'�" M,.A..� L .,q s: .K� � .o- �A -r y.. ..s.:k. �y "' .�•ws r,vet" s x,-. va ee iOom�raoaau�ea�l�o��C�/G1JaC�crJeC/J -XL fi t Office of Consumer Affairs&Busidess Regulation N � OME IMPROVEMENT CONTRACTOR r� a �° egistration 149773 T •� -, e; = an.�.,a:�+4.. ..daa'..• « -yH.c YP xpiration 2/7/2016 _ Individual 4 ��- �--=� � � •`� � :.� � v , JEFF Y WRAGG v �".'_r JEFFREY WRAGG may, r 54 EILEEN STREET ;% � YARMOUTHPORT,MA g "�, ..�- `F•_ W� Undersecretary -Y„ 2- -.,-s ':- ,1.' `. '.az�„�-,sw�.et���'.'gS°•a.�"i sx'-u:q �a a.a.'t Massachusetts -De e ' partment of Public Safety Board of Building Regulations and Standards b ` yin constructionSupen'isor ^� a,x - License' 075 4Q - .. , JEFFREY L WRA(3`G ..� , '-- 54 EILEEN ST. r Yarmouth Po rt&fA 02675 sww sct a^ s.€ g. aa - k xt"h -ncr2;m- x _ Expiration Commissioner 0 /20/20rJ 'a¢y .z+y'";s�re..r'snA.ay n �- 3s ,g,. c s�,s+,r�i�.:' � ���*w •Z° .m a,,.f ;i YMN �c ,p . �. ,�-w'r" 'aF�..-�, M A.:�»,� atq°" #>•.:. 4b wr, -' ,.a. as" a ,�nN� .b.W.�"`�2"ak .M" R .n,'`8 a$�`"'".wMM i `.,� 1-ti,,a ti atam°'. �r q ' h "�.#xi' " '` 1.�' °'•,+°,'s✓ +i�x L' + 1xi 'e^K+: p" '7t.w'+.`„"s . *` .� ,.s e4F"• 5a..: �_-"` .,,,>G �"�"''q-..,. 4- rf* 'T.kyuwd.,� r," .�,.*wa,.-1...1 1.A,s s a�''.c.'"w'ac.:i s.:Yh3°�S* '. ^.x" ?La-axN.4.'i.' ..,ty.r,$ " a�c�r-•-d'r"s"ea'-+rd ..xz, an.. -='s' ' l ' ay'x'-.:tga+ - -w.* �.i.':}.«� �$:.#�Gmw4v,'"`x,4"" ^&.c3.3..•y,..�°"a :-'��, ..a: fix-*e .'� x t�4. S 1�I�V & } 3 : , , r , r - f t � � : t .. i s : r i t t t r ; i ` t , • t ' k t a , f a , ; , : 7 i — , OK WE Mao �-�' BARNSTABL MINNA DEPT. DATf '� T P fCS � Z FIRE DEPARTMENT; DATE 18 I M Nmoi BOTH.S/GAtATURES ARE REQUIRED FOR PEfMITING 1L1uIP i TOWN OF BARNSTABLE.BUILDING PERMIT APPLICATION w Map ®`1 Parcel c� Application # 6`_0 L Health Division Date Issued Z . Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board KH Preservation / Hyannis D Historic O _ I /1 Project Street Address 1 MAPLE Av e N u c- Village R y A N N i S Owner SUE F i2(CK Z3(ZANSCoM C3 Address 15 MAPLE AVr✓. NyANl'ils bacDol Telephone ' (D 0`3_ UI a.4 Permit Request _%NSULIP)-rio0 !F-r � CEt-L-OL-OS6 IN c0em 74r�IC. ruk4+ '1"�oY-,C- AIR- fNCi- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Aaoo Construction Type 17D A Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: -'0 Yes '❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other ( 3 a rz Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)' Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat-Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 37EVE nJ Q- LJ H I TC- Telephone Number soa- F I Address -E'FFl C( E N T 7�0 1 Lt>I N&S License # G503 UI ZAoJ SC 13 A S-n R a,J Home Improvement Contractor# j(p q �( A w i G C-d Sv1 P► Dcf)Sl9 3 Worker's Compensation # 11 L1 9 N ,T? S q C( ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO "P t2'S70 K�S ICI l LL.S X�"�- S 1 p T i o AJ SIGNATURE V DATE 1 I 1 h l 4' FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO,. :. x ADDRESS VILLAGE OWNER r DATE OF INSPECTION: FOUNDATIONS T "_ t FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 5 F PLUMBING: ROUGH FINAL F GAS: _ ''` ROUGH FINAL } y DATE CLOSED OUT t ASSOCIATION PLAN NO. I � R CALIBER Building & Remodeling , LLC 147 Ridgewood Ave. Hyannis, MA 02601 508-430-4005 fax: 508-430-4006 Proposal _ a Date: 7/27/10 Customer: Sue and Rick.Branscomb Home #: 603-424-1433 Street: 15 Maple Ave Cell #: 603-490-4695 City/State/Zip: Hyannis, MA 02601 Email: svanwert@comcast.net Contractor will hereby perform the following weatherization measures as outlined in Cape Light Compact Energy Audit performed by Rise Engineering: • Perform up to 16 hours Air Sealing $1,056.00 • Blow 8" Class 1 Cellulose to 960 square feet of open attic space $1,056.00 • Install attic stair cover (thermodome) $160.00 Total Balance Due when work completed: $2,272.00 Caliber Building & Remodeling will apply all eligible rebates to this invoice. Customer responsible for net amount of$25% of insulating measures when work is completed. Air Sealing portion is provided free to customer by Cape Light Compact. Balance Due from Customer: $304.00 Remainder Due from Cape Light Compact: $1,968.00 Acceptance of Proposal As stated in the above specification. The costs, materials, and specifications are satisfactory and are hereby accepted. I authorize the Ze. actor to perform the work as specified and payments will be made as summarized Customer Date: 1 If Date: Sig - 7 LFs /o �1 A �Ro CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) F9/1442011 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 A_T David Crawford PHONEEldredge & Lumpkin Insurance Agency, Inc. 10N (508)945-0393 1FAX AUC Not:(508)945-4048 697 Main Street I ILRESS.david@elinsurance.com INSURE S AFFORDING COVERAGE NAIC Is Chatham MA 02633 INSURERANational Grancle Mutual Ins Cc 14788 INSURED INSURERB:Commerce Group IG001 Caliber Building and Remodeling LLC, INSURERCAce American Ins. Co. - ARWC 22667 Efficient Buildings, LLC. INSURER0: 8 Jan Sebastian Drive #10 INSURERE: Sandwich MA 02563 1 INSURERF: COVERAGES CERTIFICATE NUMBER:Housing Assistance Corp REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF"ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. tI TA TYPE OF INSURANCE POLICY NUMBER MADDLSUBR M�/YYYYY FF POLICY UCY EXP LIMITS LTR GENERAL LIABILITY - EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY R DAMAGE N occurrence) $ 500,000 A CLAIMS-MADE F OCCUR 27360 9/15/2011 /15/2012 ,MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG -$ 2,000,000 X POLICY 'EjPRO LOC AUTOMOBILE LIABILITY - M I IN LE LIMIT Me.accident) 1 000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BBNVCS /16/2011 /16/2012 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS - Per $ X UMBRELLA LIAR OCCUR .. EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB HCLAIMS-MADE AGGREGATE - $ 1,000,000 DED RETENTION$ 027360 /15/2011 /15/2012 $ C WORKERS COMPENSATION IT WC' ATU- OTH- xAND EMPLOYERS'LIABILITY YIN - - L " ER � "PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 5DD QOQ -=FICER/MEMBER EXCLUDED? ❑ NIA 494PS44 /2/2011 /2/2012 1(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 "pes cescrlbe under -=S..RIP-ION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 500,000 i TION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If ire spare is required) rp Caentry. In conjunction with the Weatherization Assistance Program, the following entities are named as => tional Insureds for Liability coverage under Pol #MP027360: National Grid Corporate .Services LLC DHA ',a*ional Grid, Action Inc., Colonial Gas Co. 6 NSTAR Electric. CERTIFICATE HOLDER CANCELLATION! SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF NOTICE,WILL BE DELIVERED IN Housing Assistance Corporation,— ACCORDANCE W17H THE POLICY PROY►SI�IS,,, Att: Ruth Bechtold g AUTNORffED REPRESENTATIVE 460 West Main St. Hyannis, MA 02601 David Crawford/ELDDCl Q • Y +. CORD 25(2010/05) I ©1988-2010 ACORD CORPORATION. All rights reserved. TAo if 1Y?r1 nARfo arui inns arn,ronie:Mr0A markr of arnRn • f ih., i w r 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 �--p Please Print Legiblv Name (Business/Organization/Individual): T D U l t-D 1 W6-S 1. L C Address: City/State/Zip: SA M D GJI C H, MA OcMP 3 phone /D Are you an employer? Check the appropriate box: 1. I am a employer with 4. ❑ I am a general contractor and I Type of project(required): employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7: ❑Remodeling ship and have no employees These sub-contractors have g, 0 Demolition working for me in any capacity. employees and have workers' [No workers' comp:insurance comp.insurance.$ ti 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.7 Electrical repairs or additions 3.❑ 1 am a homeowner doingall work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL insurance required.] t c. 152, §1(4),and we have no 12.❑Roof repairs employees. [No workers' 13.YOther 3tV S U -AT-1 a t,3 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, :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: ,A ce5 GRD U p Policy#or Self-ins. Lic. #: 9)4 P g �1 V Expiration Date: —c>')—oP ©IQ 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 thepains andppeenaides.ofper'ury that the information provided above is true and correct Sip-nature: Date: Phone#: d 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#: ,_Alli.. MIss;tctiusctts- Department 4►f Pub'Iic Safcth Boarthof Buildin!„ Rcolittions and'Standards . Construction Supervisor License License: CS 95038 Restricted to: 00 , STEVEN WHITE 147 RIDGEWOOD AVENUE , HYANNIS, MA 02601 -'Expiration: Z28/2012 (" iiuui�civxcr Tr#: 19311- -��` c.nnonu ealt/�o�✓ aa«*�ivae�a License or registration valid for individul use only Office of Consumer Affairs&B s�oess Reguladoo ? HOME IMPROVEMENT CONTRACTOR before the eapjration date. If found return to: Reg+sua6on: 1 ggg44 Type: Office of Coaaumer_Affairs and Business Regulation ` Expiration: 811912013 LLC 10 Park Plsza Suite 5170 s 90400,MA:02116 t EFFiC _.,,_DiNGS,LLC- ; STEVEN 4 V•= =} Undersecretary Not valid without signature EOki; 47 s - _ _ ._ _ F V ��J 1 i f �- I f i F .�la � i � � � .�� - Efficient Buildings, LLC October 31, 2011 Town of Barnstable Attn: Thomas Perry; CBO 200 Main Street Hyannis, MA 02601. re: 15 Maple Ave., Hyannis, MA 02601 Dear Mr. Perry: ' This affidavit is to certify that all work completed at 15 Maple Ave., Hyannis, MA 02601, has been inspected by a certified Building Performance Institute (BPI) inspector. 8" Class 1 Cellulose was added to 960 square feet of open attic space. All work performed meets or exceeds Federal and State requirements. Sincerely, -9 Steve C. White a Owner/Managing Member Efficient Buildings, LLC - N1 w 8 Jan Sebastian Drive, Unit 10, Sandwich, MA 02563 Tel: 508-888-1110 Fax: 508-888-1109 14 Ridg®wood Ave..Hyannis I IA 02601 Fam T ,: Paul Roma From: Steve White i Fax- 508-790-6230 Pages: 3 Pi ane: - — Data: R CC. ❑ Urgent ❑ For Ref lew O Please Comment ❑Please Reply ❑Please Recycle 15 Maple Ave f T C) i Cor« ... - , W i i I ' oX + r �� • J � d\-Of TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION C9 o l lbb, Maps Parcel ®^ F Application # Health Division Date Issued _ Conservation Division „ Application F y � Planning Dept. Permit Fee : Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address t I a.0�Q ky.'e_ Village L-S, Owner_ roC ___1r7 Address Telephone Permit Request Sd v p 2,e- J�6 -s g e e �'Wc7Se r ttisdzZ�d1 Cc� ,s l .esr Q'c� � 6e�r 6y� SQ cr e1 e `�2�, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3,Daa Construction Type D Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway:—b Yes`µ; ❑ 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 Number 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 Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION C` / C (_(BUILDER OR HOMEOWNER) Name Telephone Number 5_0 8 -2 4(aq Address � 00L +/R- License # c6 S �Sn 8 2,G4 Home Improvement Contractor# 5 3 Worker's Compensation # cisaS ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE o:. FOR OFFICIAL USE ONLY iu APPLICATION# DATE ISSUED MAP/PARCEL NO. y�. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Y - 600 Washington Street t Boston, MA 021I1 y� www,mass.gov/dia Workers' Compensation Insurance Affidavit: Build ers/Contractors/ElectricianslPlumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): l t66/ 0—J" Address: %A�au,.a0_0C� V-0— City/State/Zip: q p Phone.#: Are u an employer? Check the appropriate box: Type of project(required): 4. I am a general and I 1. I am a employer with_ g 6. (]New construction - * have hired the sub-contractors - _ employees (full and/or part-time). j Remodelin listed on the attached sheet. ❑ g . 2.❑ I.am a sole proprietor.or partner= These sub-contractors have, ship and have no employee employees a s nd h ave workers ' Demolition 8, [ working for me in any capacity. 9: ❑ Building addition comp. insurance. [No workers' comp. insurance. _ 10.E1 Electrical rep airs or additiot required.] 5• ❑ We are a corporation and its . 3.❑ 1 am a homeowner'doing all work officers have exercised their 11.[� Plumbing repairs or additiot mysetf.JNIo workers',comp, right of exemption per MGL 12 ❑Roof repairs . insurance required.] t c. 152,§1(4), and we have no employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their.workcrs'compensation policy information. t.Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box most attached an additional shed showing the name of the"sub-contractors ind.state whether or not those.entitics 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 1s Company n urance Com an' Name: T c Policy#o Self-'ns:Lic.#: T� Expiration Date: 2- Zo l 1�1a l-e. V Job Site Address: 4 - City/State ip: /Z Attach a copyof.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 fine up to$1,500-00 andlor one-year imprisonment, as well as civil penalties in the form of a STOP:WORK ORDER and a f of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forw ded to the Office of ar Investigations of the DIA for insurance coverage verification. I do hereby certify a the pains and penalties of perjury that the information provided above is true and correct. fa Si attire: Date: Co Phone# J� -9� O tctal use only.` Do not write in this area, to be completed by city or town official 0. a. t.. City or Town:.,f Permit/License# Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector S. Plumbing.Inspector 6. Other * Phone Contact Person: #: Information and. fijStrUCfi10n*S to rovide workers' compensation for their employees. Massachusetts General Laws chapter 152 requires all employces r Pursuant to this statute, an el foyee is defined as "...every person'rn the service of another under any contract of hire, express or implied,oral or written." •ation corporation or other legal entity, or any two or more individual,partnership, associ rp ed�as an uid, ,p or the toyer is defined employer, An errr !o a deceased em y , py of the foregoing engaged in ajoint enterprise, and including the legal.representa�tves o P receiver or trustee of an individual partnership, ass ociatio❑ or other legal entity, employing employees. However the owner of a dwelling house having not more than to do maar t ents n onstnlctioneor repwho resids a occupant.or the ir work on suchdwelliog house j dwelling house of another who employs person or on the grounds or building appurtenant thereto shall not because of such employmcntbe 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 buildings in the.commonwealth for any rage required." applicant who bas not produced acceptable evidence of compliance with the insurance cove ns shall Additionally,MOL chapter 152, §25C(7) states"Neither the cometon teviden.ce of co plli'tical su ance withdthe Wisi Insurance enter into any contract for the performance of public work until acc`eplable requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'.compensation affidavit corrmpletely, by checking the boxes that t situation and, if their ertificcate(s) of necessary,supply sub contractors)pame(s), address(es) and phone number(s)alongrv� insurance, Limited Liability Compaives (LLC)of Limited_Liability•Partnerships(LLP)with.no employees other than the members or.partners, are not required to carry workers' compensation insurance. If LLC or LLP does have. _ . em to ees a policy is required. Be advised that this affidavit may be submittedao the Department of lndustria.l P .Y, P Y q Accidents for confirmation of insurance coverage. Also be sure to sign and date the affrdavit. The affidavit shou ld 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 to you Self-ins erged companiestai sho Id enter their plea se call the De pariment at the number listed.be w ' n policy, 1 P at�o co m ens Y,P P P 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 afd.avit for you to fill out in the event the office of Invesus ations ahas to oecon number:ct You rl�additgion a the applicant. Please be sure.to fill in the permit/license:nurnber which will be that muss submit multiple permMicense applications in any given year, need only submit one affidavit indicating(CAYD policy information(if necessary)and under"Job Site Address" the applicant should wite"all ]ocahons in r town)." A copy of the affidavit thatbas been officially stamped or marked by the city or town may be provided to the out c applicant as proof that a valid aff davit is on file for future permits or licenses.trlated to an business or GD nmerc avit must be fillMal venture year. Where a home owner or citizen is obtaining a license or permit q r. r {i,e, a dog license orpermit to bum leaves etc.) said person is NOT required to complete this affidavit, The Offce 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 Depariment's'address, telepbone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4400 ext 406 or 1-87.7=MASSAFE Fax # 617427-7744 R P,icr.rl 4-24-0? „r , occ r rn��lllA ACORDM CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) 03/30/2010 PRODUCER 508.945.0393 FAX 508.945.4048 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eldredge & Lumpkin Ins. Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 697 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Chatham, MA 02633 INSURERS AFFORDING COVERAGE NAIC# INSURED Caliber Building and Remodeling LLC INSURERA: National Grange Mutual Ins Co 14788 INSURERB: Commerce Group CIG001 147 Ridgewood Ave INSURERc: Granite State Ins. Co.-ARWC 13102 Hyannis, MA 02601 INSURER0: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITH ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUE MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITION£ POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DDIYYYY DATE(MWDD/YYYYI LIMITS GENERAL LIABILITY -MP027360 09/15/2009 09/15/2010 EACH OCCURRENCE $ 500 X COMMERCIAL GENERAL LIABILITY DAMAGE T77ERT917- PREMISES Ea occurrence $ 500 CLAIMS MADE M OCCUR MED EXP(Any one person) $ 10 ,004 A PERSONAL&ADV INJURY $ 500 GENERALAGGREGATE $ 1 OOO GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000.0 POLICY JECOT- LOC AUTOMOBILE LIABILITY BBNVCS 02/16/2010 02/16/2011 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY B X SCHEDULED AUTOS (Per person) $ 250 HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) 500 PROPERTY DAMAGE $ (Per accident) 100,000 GARAGELIABWTY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ HAUTOONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE RETENTION $ $ WORKERS AND EMPLO ER$LIABILITY YIN.NSATION WC7425405 03/02/2010 03/02/2011 TORY LIMITS OERH ANY PROPRIETOR/PARTNER/EXECUTIVE F-j E.L.EACH ACCIDENT $ 100 C OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE POLICY LIMIT $ 500 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Carpentry CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town of Barnstable IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Att: Bldg Dept. REPRESENTATIVES. - 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis, MA 02601 Alan R. Long, President ACORD 25(2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD VA e .. - 4A ; f a t1f � "�+L F) +,,. To r [ a 7v )I vq6m � �f Massachusetts- Department of Public safety Board of Building- Regmizttions and 't:mdards Construction Supervisor License License; CS 95038 Restricted to: 00 STEVEN WHITE 147 RIDGEWOOD AVENUE HYANNIS, MA 02601 Expiration: 2/28/2012 ('nnmi��i uur Tr#: 1931.1 " 9X. UaCr�rrzanure o�✓Gaaaclr Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR ; ReSwstra in`.,;:154359 2R812011 Trll 280764 Ty�'W ttd 1ftility,Corporation CALIBER BUILDItG' 7:RJ3DELINC;tLC. STEVEN WHITE - 147 RIDGEWOOD AVE HYANNIS,MA 02601 Administrator. License or registration valid-for individul use only, before the expiration date. If found return to: Board of Bylding::Regulations and Standards One Ashburton Place Rm'•"1301 Boston,Ma.021.09 . Not"va nde:wall out>sign ature 7 W I, Suzanne and Eric Branscomb, as owner(s) of the subject property at:, 15 Maple Ave. Hyannis,MA 02601 hereby authorize Steve White of Caliber Building And Remodeling,LLC (contractor),to act on my behalf in all matters relative to the building permit application. _ r 5111110 signature f owner date signature ceowner date TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 4 ;Application # 61 a )3 7 Health Division Date Issued l d v Conservation Division `„Application Fee .5 Planning Dept. Permit Fee , Date Definitive Plan`Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address MAelt.. AN+�- Village his Owner t 22V!A6V%5e.r1deL Address Telephone Permit Request T)avm -e..�i�trv�a b�.' �roow► �r �.a�.�c�sce+�'�" C,1A5a."�3 csnn. v'. OF Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation O 0 a Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. 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 Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Roojn Count— Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑ existing ,q nevi size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use'` Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Namegui�Ov%VATelephone Number ' Address �T� �,, o �cy� - License#— (f,S g S _;a fa� Home Improvement Contractor# 3 Worker's Compensation # OL 5-;;,- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO e4vc�v-,% , -L `L l5 SIGNATURE DATE 5_ 17 111D FOROFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. 4F rl ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL"', PLUMBING: ROUGH FINAL.,� GAS: ROUGH FINAL--J, FINAL BUILDING f- . Q' DATE CLOSED OUT ASSOCIATION PLAN NO. r r The Commonwealth of Massachusetts Department of Industrial Accidents �_ Office of Investigations Y 600 Washington Street c� Boston,MA 02111: may` www.mass.gov/dia , t actors/Electricians/Plumbers ilders/Con r Workers Compensation Insurance Affidavit: Bu , Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/ fate/Zip: CLup , tj Q O Phone #: 92 A; ,am ou an employer? heck the appropriate box: Type of project(required): 1. a employer with 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. 7.1-Remodeling' ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers 9 0 Building addition . i compnsurance.$ NO workers comp. insurance 10.0 Electrical repairs or additions required:] 5. 0 We.are a corporation and its ❑ ` officers have exercised their I L[]Plumbing repairs or additions 3. 1 am a homeowner doing all work myself. [No workers' comp. right , exemption per MGL 12.0 Roof repairs insurance re e uired. c.'152 §1(4), and we have no q ] t employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their,workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site . information. . Insurance Company Name: �1 Expiration Date: 01' Policy#or Self-ins. Lic.#: ��"O� ,� ° p g— Ci /State/Zi H—fQIM�t.1`5 M.���70 Job Site Address: �� �le�D�e � ty , p� I 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. 1 do hereby certify and a pains and penalties of perjury that the information provided above is true and correct. Signature: C� `Date: ,, 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 14.Electrical'Inspector 5.Plumbing Inspector 6. Other " Contact Person: Phone#: Information and.histructi®ns 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 a.1 F of the foregoing engaged in a joint enterprise, and including the legal.representa,tives of a deceased employer, or the . iecerver of tnistee`of an individual-,pannership;.associationor 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 employspers"bns to do;maintenance'consxtniction or,repair work on such dwelling house oron the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also slates 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 tvho has not produced acceptable evidence of compliance with the insurance coverage required." •Additionally 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 nuunber(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: Shouldyou 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-insu.ired 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"I'gibly ,The Department has provided a space at the bottom -of,the�affdavit 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 whic'h"will be4usEdpasia;}eferenc'e: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 locatuons in (city or the cif or town may be provided to the r marked b Y ». been officially stamped o y Y town). A copy of the affidavit that has b y p applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be frl]6d out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or coxrmercial venture (i,e, a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Ini� sti ations would like to thank ou in advance'foryour cooperation`°and should you have any questions, please do not hesitate to give us a call. ,qq ,# The Department's address, telephone and fax number: `•• ! = v �,. ��e, c i , The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-87.7-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.inass.gov/dia ACORD M ATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE D03/30/2010 -- PRODUCER 508.945.0393 FAX 508.945.4048 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eldredge & Lumpkin Ins. Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 697 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Chatham, MA 02633 INSURERS AFFORDING COVERAGE NAIC# INSURED Caliber Building and Remodeling LLC - INSURERA: National Grange Mutual Ins Co 14788 INSURERB: Commerce Group I IG001 147 Ridgewood Ave INSURERc: Granite State Ins. Co.-ARWC 13102 Hyannis, MA 02601 INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITH ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUE MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' POLICY EFFECTNE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YYYY DATE MM/DD/YYYY LIMITS GENERAL LIABILITY MP027360 09/15/2009 09/15/2010 EACH OCCURRENCE $ 500,00( X COMMERCIAL GENERAL LIABILITY UAMAGF PREMISES Ea occurrence $ 500 OO CLAIMS MADE FTI OCCUR MED EXP(Any one person) $ 10 O A - PERSONAL&ADV INJURY $ 500,0 GENERAL AGGREGATE $ 1,000 00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 1,000,00 POLICY PRO- AUTOMOBILE JECT AUTOMOBILE LIABILITY BBNVCS 02/16/2010 02/16/2011 COM BINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY X SCHEDULEDAUTOS (Per person) $ B 250,000 HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS .. (Per accident) 500,000 PROPERTY DAMAGE $ (Per accident) 100,000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION K7425405 03/02/2010 03/02/2011 1 WC STATU- OTH- AND EMPLOYERS'LIABILITY Y TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE r E.L.EACH ACCIDENT $ . 100,0 C OFFICER/MEMBER EXCLUDED? _ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100 00 If yes,desaibe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,0 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Carpentry a CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town of Barnstable IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Att: Bldg Dept. - REPRESENTATIVES. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis, MA 02601 Alan R. Long, President ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1 . , �U-.. Massachusetts- Department of Public Safet-, Board of Buildin.1, Regulations and Standards Construction Supervisor License License: CS 95038 Restricted to: 00 i STEVEN WHITE 147 RIDGEWOOD AVENUE HYANNIS, MA 02601 Expiration: 2/28/2012 (' nmiisi ncr Tr--: 19311 Board of Building Regulation and`Standards i HOME IMPROVEMENT CONTRACTOR Registrao °;,154359 8/2011 Tr# 280764 Al �' Tyj� Ltdr126ility,Gorporation I CALIBER BIIILDING .RdELING;LLC. STEVEN WHITE 147 i21DGEWOOD A HYANNIS.MA 02601 Administrator j License or registratioh,validi for individul use only before the expiration date. H found return to: Board of Building Regulations and Standards One Ashburton Place R;m-1301 ' Boston,Ma.02168 i Not valid Vithout signature I, Suzanne and Eric Branscomb, as owner(s)of the subject property at: 15 Maple Ave. Hyannis,MA 02601 hereby authorize Steve White of Caliber Building And Remodeling,LLC (contractor)to act on my behalf in all matters relative to the building permit application. signature f owner date signature eowner date Ile - .SMO DETECTORS REVIEWED z a BARNSTABLE UILDING DEPT. DATE FIRE DEPARTMENT DATE } BOTH SIGNATUR S ARE REQUIRED FOR PERMITTING • CoS ,d IMPORTANT=UPGRADE REQUIRED STATE BUILD IN E QUIRES THE UPGRADING OF SMOKE DETER 'O THE ENTIRE DWELLING WHEN ONE OR MORE SSE. AREAS ARE ADDED OR.CREATE . I. U` NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL PERMIT DOES NOT SATISFY THIS REQUIREMENT. CARBONM!NO XIOE L M ALARMS MUSTSASS UST BEI�STALLEDPER �j S BUILDINGDE - • 1 � lok S at D lot y.a 1�' 1 � . , � � I co V � r 4F-S' To O 1 r t i V ` -----�--•--_�___e._.__:_.,,_.._...___w...., .. .._ __.t ._... .art-• ----__..__------�--- �.., 14 Ridgewood Ave,Hyannis r 4A 02601 tikx II � I 1 I Tc: Paul Roma From: Steve White F�x: 508-790-6230 Pages: 3 � Pf Lne: Wta� CC: i ❑ Urgent ❑for Re4vjew ❑Please Comment ❑Please Reply ❑Please Recycle i i 15 Maple Ave r7) FiN I.. c- 1 i i kO �. - 6,g��_ THE Tp�y+� TOWN OF BAR.NSTABLE i BARNSTABLE. i ,639, BUILDING INSPECTOR �o war a• 4,,IGl ,�i�j�Ia��2 ?-z' `-'V Zt-fs ll,,II/ PQ APPLICATION FOR PERMIT TO /!l/..�.L �� .... (Vl/ ��. ..: ............. ................................ ....... ..................................... �I'i 0 74 TYPE OF CONSTRUCTION ..........k. .. ......1.... ..���. ................. ..o... ''?....... ^'............... M ! ........................19. ...... . .......... TO THE INSPECTOR OF BUILDINGS: i The undersigned hereby applies for a permit according to the fo lowing information: Location .... .`5... !4. .t�'�'.....�l.Via/ :..`'...... ��?................................ ............................... ProposedUse ..e'y. ...... Ir.4.1..1.✓..A.......................................................................................................................... Zoning District .. ..�..�...............................................Fire District � �fir! / OL� U/Y Name of Owner 4..............S .............................Address K 4 & a Name of Builder :. ....:.........A...1 .4- ....,..................Address .4. .Q,/V/l1e� l3 i� :.....L�. Nameof Architect ..................................................................Address ................ �...�...................................................... Number of Rooms ..................................................................Foundation .... p_'�y.J�` ...................... .............................. Exterior .............(......................................................................Roofing ............ .. . .... ............ :.... :.............. 4" Floors .......................... ..........................................................Interior .................................................................................... Heating ..... ..............................................................Plumbing ............................. .................................................... Fireplace ..................................................................................Approximate Cost ................... ...................... .......... Definitive Plan Approved by Planning Board ________________________________19________. 4,1,1 z 80 f O Diagram of Lot and Building with Dimensions 0 cn —Wi to - m J X ' T IL 'L4 si", O O co 3 - 0 tL •q� cn � W --j L 1 v) X111 u, r 0 , z of. v < `ZQ I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. I Name ! .... ...' .£:........ ....................6..... - ToIdneao, 2rliao y��� � � ���� .~~~~ = ~ .~. . . ' ! 13856 add carport No ................. Permit for .................................... ' to dwelling --------------------------. . Location -----�� D�u(lo Avenue ` |/ —..--------------'' � Hyannis ' ----.----.-----------------. . Milo To]doeos [4vne, ---___________________ �a� Typo of Construction -------—------ -----^--------------------' � . � Plot ............................ Lot ----------' ' � I-Lay Il 71 Permit Granted ........................................ . Date of Inspection ------ ----.l9 ^ � � �T � ^ ' Date Completed —.,�y����—.`'---'lV ' l Y PERMIT REFUSED . / ~ .--------------------- lA / -------------------.-----.,. ' ' ' _ ^-------.---../!.......................................... / '^^—'^—''-----''''~^''----------~— � ---------~---~^^^^—'--^—'—~—'^' � | � � | , Approved ................................................. lQ -------------'—.-----.-----. / ' --------.--------..------.... ! '' . . � | � � | P�OETHE) Town of Barnstable *Permit# O Expires 6 months from issue date ,, ,SrABLE : Regulatory Services Fee 9 MASS. Thomas F.Geiler,Director �p .s6;q &�m rFc 39 Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601w Office: 508-862-4038 X—FIR ®` MH I Fax: 508-790-6230 EXPRESS PERMIT APPLICATION M A ' 0 2001 Not Valid without Red X-Press Imprint Map/parcel Number 30P) -y�� TOWN OF BARN STA0 Property Address M4esidential OR ❑Commercial Value of Work a 5 o U, o o Owner's Name&Address /* Contractor's Name - �� Telephone Number S��'��c? V Home Improvement Contractor License# PP if applicable) a (� Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance 9 k one: am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Wor!dinan's Comp.Policy# Perm)'_Request(check box) E?/Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature y expmtrg