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0028 NORRIS STREET
cu lvo4jeir S777 1 ► � JQ- :; BU/LDING-D'EPT JUL 16 2020 Application number-4. ........ SR TOWN Fee......)� 6 .......................................................................... OF BARNS TABLE Building Inspectors Initials.. ............................. &61 Date Issued....#)117).. .......................................... .... SC NEP 2� Map/Parcel...........13.0..(o.....0..(.41............... TOWN OF BARNST"LE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 28 Norris Street Hyannis NUMBER STREET VILLAGE Owner's Name:- Linda Waitkus Phone Number Email Address: heidiwaitkus@gmail.com Cell Phone Number Project cost$ 15,000.00 Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize Mark Macallister to make application or aolding permit in accordance with 780 CMR Owner Signature: Date: 7/10/2020 TYPE OF WORK N3 Siding rX--1 Windows(no header change)# 1 F-1 Insulation/Weatherization 13 Doors(no header change)# Commercial Doors require an inspector's review F-1 Roof(not applying more than I layer of shingles) Construction Debris will be going to S&J Exco,Dennis,MA CONTRACTOR'S INFORMATION Contractor's name Mark Macallister .Home Improvement Contractors Registration(if applicable)# 133744 (attach copy) Construction Supervisor's License# CS-079358 (attach copy) Email of Contractor mark.macaffister(a),gmail.corn Phone number 508-889-2441 ALL PROPERTIES THAT HAVE STRUCTURES OVER 7S YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER *For Tents Only* Dat Tent(s) will be erected Removed on number of tents to Does t e tent have sides?Yes No (If yes please attach floor plan with e is marked) Dimensio of each Tent X X , Additional t t dimensions can be attached on a separate piece of paper. Purpose of Eve Check one: this a nt is a: for profit non-profit event Check one: Food se ed Yes No Flame Spread Sheet o ach tent must be attached. Provide a site pla with the location(s) of each tent If food is being served at yo event please obtain a Health D artment approval between the hours of 8:00am-9:30 am or 3:30 p -4:30pm. Commercial even may require Fire Department approval. *WOOD/ AL/PELL STOVES Manufacturer# Model/I.D. Fuel Type Aback b Offsets from combustibles: front left side right side HOME NER'S LICENSE EMPTION Homeowner's Name: Telephone Numb Cell or Wo\documenta I understa my responsibilities under the rules and regulationstruction Supervi r in accordance with 780 CMR the Massachusetts StI understand the c struction inspection procedures, specific inspections anequired by 780 C and the Town of Barnstable. ignature APPLICANT'S SIGNATURE Signature 4gA9Z kcP?&� Date 7/10/2020 All permit applications are subject to a building official's approval prior to issuance. v D .s_ Commonwealth of Massachusetts Division of.Professional Licensure Board.of Building Regulations and Standards Constr tf'$A*rvisor GS=079358 ' cpires:08l12/2022 RK A_MAGALOSTE - MA 3 64 EBENEZER RD x n OSTERVILLE-VV A 02655 Commissioner U. 4' z Office of Consumer Affairs.8� in Regulation + HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only. } TYPE Individual before the expiration date if found return to: Registration Expiration Office of Consumer Affairs and Business Regulation r� 1�0144 68/02/202I 1000 Washington Street -Suite 710 MARK MACALI�FSTEf3- ��} .^ Boston,MA 02118 �, . MARK A MACALL(STER 64 EBENEZER OSTERVILLE,'MA 02655 Undersecretary'3 "' INOt Valid without Signature f 1 ® DATE(MM/DDIYYYY) A 00R" CERTIFICATE OF LIABILITY INSURANCE 03/02/2020 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 Kathy Silvia NAME: The Fair Insurance Agency Inc. n/cNr o Ezt: (508)775-3131 FAX No): (508)790-1677 619 Main Street E-MAIL kathy@thefairagency.com ADDRESS: Suite 1 INSURER(S)AFFORDING COVERAGE NAIC# Centerville MA 02632 INSURERA: Evanston InsuranceComapny INSURED _ -INSURER B: Safety Indemnity Ins.Co. 33618 Macallister Building Inc INSURER c: Star Insurance Company 18023 64 Ebenezer Road INSURER D: INSURER E: Osterville MA 02655 INSURER F: COVERAGES CERTIFICATE NUMBER: Updated 19-20-21 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. INSR TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MUBK WY EFF DD POLICY EXP M/L D uMlrs X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 500,000 CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 50,000 MED EXP(Any one person) $ 10,000 A 3ET2763 08/11/2019 08/11/2020 PERSONAL&ADV INJURY $ 500,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 1,000,000 POLICY PRO- ❑ LOC 1,000,000 JECT PRODUCTS $ OTHER: Employee Benefits $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODI LY I NJ URY(Per person) $ 250,000 B OWNED X SCHEDULED 6248835 10/12/2019 10/12/2020 BODILY INJURY(Per accident) $ 500,000 AUTOS ONLY AUTOS HIRED HNON-OWNED PROPERTY DAMAGE $ 250,000 AUTOS ONLY AUTOS ONLY Per accident Underinsured motorist BI $ 250,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 100,000 C ANY PROPRI PROPRIETOR/PARTNER/EXECUTIVE /2021 E.L.EACH ACCIDENT $ OFFICER/MEMBMB El NIAWC0632030 03/01/2020, 03/0.1 ER EXCLUDED? 100,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town Of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. South Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601y � u` ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD pUtMME roq, Town of Barnstable *Permit# 610 Expires 6 months from issue date * �S BARNSTABLE, : Regulatory Services Fee , 9 MASS. cb 039. Thomas F.Geiler,Director A'EDN10`� Building Division _1011`� Tom Perry, Building Commission�ep�E,S 200 Main Street, Hyannis,MA 026Q1 Office: 508-862-4038 Fax: 508-790-6230 n� R�STA�LE EXPRESS PERMIT APPLICATION - RESTORV �L WLY Not Valid without Red X-Press Imprint Map/parcel Number 3 ©(o r Property Address S 4-r e e- Residential Value o Work �41) Owner's Name&Address uc fir' j e e glln M 41 S Yn or Contractor's Name 1 CSC Lv w C Telephone Number Home Improvement Contractor License#(if applicable) 1196 7 fo Construction Supervisor's License#(if applicable) C 5 0 0, 83 `w❑Workman's Compensation Insurance Chec ne: am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) e-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. r- Signature Q:Forms:expmtrg Revised121901