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0364 MITCHELL'S WAY
3(oy mi �cl, clls wan f `' i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map L t Parcel -, Application U 7� Health Division Date Issued, • Conservation Division Application Fee V C> Tax Collector Permit Fee 10 , Treasurer P 1 Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project StreettAddress Village �\ OL,,AVk S �-c. Owner i�V � C- A SAddress S4ee C. roc Telephone W 61 — 4IR- 0 I Permit Request 1 NUA A r Square feet: 1 st floor:existing 14 proposed �2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation % 2006 Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family idl Two Family ❑ Multi-Family(#units) - Age of Existing Structure 19 :7 0 Historic House: ❑Yes 2V0 On Old King's Highway: ❑Yes W1110 Basement Type: dFull ❑Crawl ❑Walko ❑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 o Fireplaces: Existing _ New Existing wood/coal stove: Yes_ O o i Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing dnew -size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: :S] r" z Z?ning Board of Appeals Authorization ❑ Appeal# - Recorded❑ fir, Commercial ❑Yes k(No If yes, site plan review# CC <Prop� . Current �t�� z , ,�-;�y --f— fI -(�.;-------•---�—----- osed Use BUILDER INFORMATION Name 1 S G t Telephone Number fdSP -I( Address. Ql Sr License# 2 6.3 F� Home Improvement Contractor# 10 (oq!3 Worker's Compensation# go ( y I q G' 0 -7 ALL CONSTR C N D RIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �qtt°kmk. LWJ d , 1 v AAS SIGNATU DATE FOR OFFICIAL USE ONLY " c , APPLICATION# DATE ISSUED l MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION �l'� FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Department of Ad,ustr al Accidents r Office of bivestigations +`X 600 Washington Street Boston,MA 02111 wivw.mass,or/dia Workers' Compensation Insurance AM, davit; B-ujlders/Cot't._ractorsll ,ect ncial)s[,Plu -nber,5 Apylicant Infor mati_on Please Print.Ltag bly Name sine €7rgatizaiiou,'77 ividuzLl i � t..�_���; Address: CityJS'tate/Zip: > � . ) J, &Pi, �,4one#:�{ Are y u an employer?-Chec- appri �'� Type ofproject(rcAuret); l in apio�e; i3 IaD a gcner�l contractor and I- 5. El i'\Tcw . construction . employees(;full and/or part-t me), U've Nixed the sub-contractors 2. 1 am a sole;proprietor or paler- listed on the attached she�ct t remodeling ship and have no employees These sub-contractors have 8. ,( Demolition working for mein any capacity, workers' comp.insurance. 9. El Building addition [No wC�Y'1 n' co'nv_�?_1-SWanc ❑ 1�ie are ec�tporatFom i�nd,its r (lttlted-� officers have exercised their 10.0 Electdcal repairs or additions 3.❑ I am a bomcowner doing all work right of exemption per I4IGL. ILL Plumbing repairs or additions myself [No wcarkeas° cep., G. 1,52E§1('4),and we have no l2_E1 Roofr a- insurance required.]t employers. [No.vorkers' JIL4-Tt4 CO. rustrranMretauxtod, 13. t]er *-Any appliu 1 ttai checks boi#1 must 4so fill out the section below stowing their workezz'co atpe mition rrvhcy information., 94 Hertneownels.vbo mi ttit this at`&%v t indicating they are doing all work-and#here hire outside contr,Om muse sub tiit a new affidavit in cating such. lContracto 'ihatehmk This box must aftacbed an additional Sheet showing the»erne of the snli contraclors and their workers`cones.policy infonnetion. lam an employer that is providing workers'c©mpe rsetuo a insurance for my etnployees. Below is the policy and fob site anformatoat, Insurance Company Name; Policy f or Self-ins.Lic . (} ( (] Expiration Date. Job Site Address - CltyJStat + ip Attach a copy of the tivaa'heas' compensation policy declaration page(slaorwingthe policy nunaber and expiration date). Fail=- to secs a coverage as-regrtit° cl under Section 25A ofMGL c. 152 can lead to the imposition-of cri ninal penalties of a fare up to SI,500-00 anti,}car one-year mpt sorcm.en� as well as civil penalties in the fort of a TOP'WO.WK ORDER and a fine of up to$250,00 a day against the violator. Be advised;that a copy ofthis statement may be foravarded to the Office,of Investigations,of the DIA for insurance coverage verification. I rho lzereyy&, er the fiat sandpenalties ref er,fury that titer itVarniationprovtded.abr�ve ds trac .acid`correct Date: . Phone Qff7cutl use reedy. Do not write in this area,to he cola pleterd by city or town Official City or''I own Ft?r,mitliaicense#1 suing Authority(circle one) 113oard of Health 2,8ailding Departinent 3.Cityl`fo+wm Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone M O� Sao Oa° o AASS We make disasters disappear. Town of Barnstable Building Department 367 Main Street Hyannis, MA 02601 October 23, 2008 To Whom It May Concern: This letter is to inform you that Randall Florence is an employee of Disaster Specialists. I give him the authority to pull building permits on our behalf of Disaster Specialists using his own construction supervisor's license. He has consent to work under the Disaster Specialists Home Improvement Contractors registration on Disaster Specialists projects. Finally, he is authorized provide information and signature to all matters in reference to the building permit process including workman's compensation affidavit, building permit application, etc on all Disaster Specialists projects that he brings forth. I will update this,document annually. Please contact'me at 508-888-1113 if you have any questions Sincerely; hard Lennox, President isaster Specialists cc: RJF Disaster Specialists • Post Office Box 480 • Sandwich, Massachusetts 02563 508-888-1113 • 800-675-3622 • FAX: 508-888-2951 • info@disasterspecialists.com UG-14-2008 10 :22 AM OCEANSIDE INSURANCE 5087907955 P. 01 ACORDn CERTIFICATE OF LIABILITY INSURANCE a is 20 08 PRODUCER (508)775-0500 FAX: (508)790-7955 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Q Oceanside insurance Group ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR Oceanside Insurance Agency Inc ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, 52 West Main Street H annis MA 02601 INSURERS AFFORDING COVERAGE NAICt� INSURED IN8URERA:Arbella Protection Henabby, Inc. , DBA Disaster Specialists INSURERS; R. 0. Box 480 INSURER C; Sandwich MA 02363 INSURERE: 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, 'A kTF LIMITS S OWN MAY HAVE 4 REDUCED BY PAID CLAIMS, INSR AOD'L TYPE OF INSURANCE POLICY NUMBER POLICY P C !POLAICY EXPIRATION LIMITS 06NCRAL LIABILITY EACH OCCURRENCE 1,000,000 X COMMERCIAL GENERAL LIABILITY AMA fi TO RENTED 6 100,000 A X CLAIMSMADE ❑X OCCUR 8500038944 1/1/2008 1/1/2009 D FXP 10,000 PERSONAL A ADV INJURY 6 1,000, 000 GENERALAGGREGATI 6 2,000,000 0EN'L AGGREGATE LIMIT APPLIES PER; pgoQWcTsQomplgpAGa2 000,000 X POLICYF71PRT AUTOMOBILE LIABILITY COMBINED BINDLE LIMIT ANY AUTO (EamccIdenl) 3 1,000,000 A ALL OWNED AUTOS 47610400003 1/l/2008 1/1/2009 BODILY INJURY X SCHEDULED AUTOS (Per person) $ X MIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per eeddenl) 6 PROPERTYDAMAOE 6 (Per accldem) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT 3 ANY AUTO OTHER THAN AUTO ONLY; EXCESSIUMBRELLA LIABILITY 1,000,000 X OCCUR ❑ CLAIMS MADE -AGGREGATE A X DEDUCTIBLE 46000ae943 1/1/2008 1/1/2009 a RETENTION 810,000 A IMPLOYER3'LIABILITY WORKERS COMPENSATION AND TA p ANY PROPRIETORIPARTNERIEXECUTIVE 500,000 A7o OFFICER/MEMBEREXCLUDED? 9098140207 I/1/2008 1/1/2009 Ryes,doWbe under f MP YEE 6 500,000 SPECIAL PROVISIONS kglcw-- A11 Ofticeza included F.L.DISEASE•P 1 Y LIMIT 111 300,000 OTHER DESCRIPTION OF OPERATION111LOCATION&OVEHICLENIXCLUOIONa ADDED MY INDORSEMCNTIaPI!CIAL PROVISIONS ADDITIONAL INSURSDI HAVRICS & FLORA CURTIO CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Maurice and rlora• Curtis EXPIRATION DATE THEREOF, THE 18SUIN0 INSURER WILL ENDEAVOR TO MAIL 364 Mitchsll r a Walt 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LBPT,BUT Hyannis, MA 02601 FAILURE TO 00 30 SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE - ALINE&IT AGENTS OR REPREIGNTATIVES, AUTHORIZED REP Jo Cerue ACORD 25(2001/00) ®ACOR ORPORATION 1088 INS026(ot0spaa Page I or 2 ✓ Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration 108642 One Ashburton Place Rm 1301 w Expiration 8/20/2010 Tr# 272667 = Boston,Ma.02108 Type Private Corporation BENABBY INC/•p.ISASTER_$PECIALIST RICHARD LEW 9 Jan-Sebastian Way` � ,,�, .` Sandwich,MA 02563 Not valid without signatu�- Administrator w M; '�, ,- �s 5 a•'t v r is k 411 ell nl - i E n ' ➢ F ,' V sw x1 "Afg ,r 3c. ➢, Al TS J #� ... Board ofBuiltl�ng egnlat�orfs a d t��ds construction SupanrisorLicense CS 80385 .' Expiration 12M 0/2009 Tr# 11428 t ¢� ;Restriction 00. RANDALLJ FLORENCE 5 ANDREA WAY �f FORESTDALE,MA Commissioner .................................. Oct 24 08 03;19p 5084191116 p.1 l 6 To" of Balmstabje RegiiWory Services y"bomas•Y►.Ca�er.Dlraeloe Building Dfvidon romPerry, ftNtntCaamUana' 200 Matt 9t ew. }Ire 16.MA CZZ601 w ww.rowo.bua:l:bfaaw=- •Qtfce: 508-86Z 4038 FIM: 508-790-6230 rroPert3r()'VMct Must Complete and Sign This Section If Using A Builder i_ /�ilr7 ict/�.��ll C�O/e�l2et to Chnm of t6 mboct ert P� Y bemby sutbosize I a crto nct on my$ebaFf, in sg=aattem te]ative flo yvotlt avelwdzedbr t bdldiag Petit appUmdon for. 3 H QA,� (Address of Job) a of 6wher D Ptmt Nano If Property Ow=r is aPAft£orpe=itplease complete the Homcowaers Liaceisc ExemptUm Fozm on thi mretse side. 10 'd 'ON Xd.d lid ZS:01 1 U SOOZ-bZ-100 �, Q/ 1 .. ? SEPTIC SYSTE,'A MUST BE Assessor's map and lot number .�................................ INSTALLED IN COMPLIANCE 7 ,5'- O�� - •�� - /% %- 7 7 /�� WITH ARTICLE 11 STATE . � ,�/«� rfy.�•�.c� SANITARY CODE AND 'GOWN Sewage Permit number ................................. REGULATIONS. C u 9-kc e r a � L L w tv f►rch lvA ems- /f 0#14 Az e- OFTHEr0�o TOWN OF BARNSTABLE Z BARNSTADLE, i aMAI BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............................I�......(....................................................................................... 1, TYPE OF CONSTRUCTION .1... ..... ..................... . ...................................................... ............/.4 ...../ ...............19.7.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accordingto.the following, information* L�t3tio 3by................. ..........................t...........r�' ...�t�..r:...:................ ar:(": ..... Proposed Use ............ .:........... .......................................................... .................................................................... .. ...... . . .. .. Zoning District ... J'(i ........R.,8.................................................Fire District .. .1�"1...... ......... Name of Owner .. ,..y.... .......... r.. ............Address ....y............. ........ ...... ............. Name of Builder .�. L. ...x.:. : .:1a� :fr.•��..Address7..7.: j. .lr......... ....... .. .. .... ................ Nameof Architect .......: -..........................................Address ....... . ................................................................... Number of Rooms ......W....................... ............Foundation .............................................. Exterior ..!!.. .. 4&7L, t............Roofing ,............................. eFloors .... .. . ..f. ....................................Interior L�.................................� �' .Heating .�. ..............Plumbing i.Y...C!... .f�l.,.. ;. :... ............... Fireplace .............41 ... ...................................................Approximate Cost ................3.9A.A...LJ..t......................... Definitive Plan Approved by Planning Board ______________—-----------19___—__. Area 1.1.. ((�...j .................. Diagram of Lot and Building with Dimensions Fee Ps. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of th n of Barnstable reg ng the above construction. / Name�.,....� ....... .................... . �..... 5..... ..1...'............... Curtis, Maurice No 1?7 ...... Permit for .....Pellin*............. .................. ;F . G. . ................................ Location ......Lot..16 Mitchell Way............... ..... ......... ..............................my.4; is................................. Owner ......Maurice Curtis ..................................................... Type of Construction .................Woo.d............... ............................................................................... Plot ............................ Lot X.291....L..7........ Permit Granted Nov 16 19 77 Date of Inspection ..l1�vze..........1q Date Completed ...........a`..... ...........19-fS PERMIT REFUSED ................................................................ 19 ............................................................................... ............................................................................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... .y 74 • Assessor's map and lot number ..........................................Ov Sewage .Permit number ,A. /f✓Gltr`L� 1GL141,-1GG ' b BARNSTSBLE: �FQtlPYa• �` Gl -i v AAPPLICATIONFORa PERMIT TO i i:ltr, ',i'.f.! a i � , t. ;;o?T ` ... . ... .. J TYPE OF CONSTRUCTION ....:......... . ...�... 1... k ..... A. ............ .................19........ F .TO THE .INSPECTOR OF--BUILDINGS:. ' The undersigned hereby applies for a permit according to,the following information: Location ...............a.............................................f � .... ......... . 7..1..... . .fP. ..�.' .... .... ... ......... ... 1 "�.....•. + . Rt4r '# 6 x Proposed Use ........ " Zoning District .. ..........Fire District ... L.. Name of Owner ......: °' `PsiF Ca_.14 Address t< O a».•.� �1 �"t �?!�'{�1 .... ......... .................. ......... . . Name of Builder 4 ...1-: �'•. :tl � ..`.. ..Address 9 t • .... ... t 1t t � 6 Name of Architect .............. ..:............................................Address ....... .................. ............................ ............ Number of Rooms' V .............................Foundation t,... C�7t•_4A"a. .......:....................................... fi GF fA�- t if i' is , S !............Roofing r�� .......... Exterior ...... ...... . ......................................... ............. .:......................... d A�' Floors <,�`"� 3�� lf '� °� Interior' ..5:..... � ... ,� ........ ,q ... ....... ......... .. Heating :'.' t yfi: .} ' .i' '� t ' .........Plumbing ? . u.:kr a:.. '.. ....r" °��g►............................... _ ............................. .ii Fireplace. . ....... .... ..... Approximate Cost :.. 6 ' o _........................................... .... Zb Definitive Plan Approved by Plannifng Board ________________________________19____::__ Area ' Diagram of Lot and Building with Dimensions 'Fee SUBJECT TO APPROVAL OF.BOARD OF HEALTH hereby agree to conform to all the Rules and Regulations of the-Town of Barnstable regard g the above construction. Name ...........~.....�f . .. .........'......-' :................ Curtis, Q10 Maurice No ...19756... Permit for ......WAI I i U&............ ................... ................................................... Location Ival;=FM...14:15t�chell,lWay........... .....ay 14 ......................klyanjUa............................. ........... Owner .....Mauriep—Curtis.... ........ ............... Type of Construction ............W d .................... ............................................................................... Plot ............................ Lot M..29.1....L..7.......... Permit Granted .......NOV.......1.6................1977 Date of Inspection ....................................19 Date Completed ......... ............................19 PERMIT REFUSED ................................................................. 19 ........ .... . ............................................................... ........... ............... ... .. .. ........ .4...... .�..:.�:... ... ........ ....or... ................ Approved ...................... .............. 19 ............................................................................... ................ ....... .................................................. _ LGT6 M I�! -L.O-T �f 32 h �1 30' -71 `P0 k of v4Sfn RICHARD e JAMES f o O'HEARN so.2787, �'9,y'F�/S'(F•� ,�O .t III o SURy� CERTIFIED PLOT PLAN IN MASS, 492- ' 7 - ,"9SS,PfSI'0 2 S 14WP 2 I CERTIFY THAT THE Fo&sv vr�n o.. i PIC14ARD J. O'NEARN, R.L.S., R. S. � SgOWN ON THIS PLAN IS LOCATED J9I MAIN ST. ()c?TE. -28) ON THE GROUND AS INDICATED AND WEST DENNIS ) MASS . CONFORMS TO T YE ZONING LAWS O,CL3� 2wST.9124F,V,gss. DATE: D /G 7 SCALE: JOB NO. // 6 CLIENT.• .qA;9 2 EG. lD�SURtiEYOR DR. BY: R.D IZ SHEETS OF