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z � , 55 Town of Barnstable *Permit - { FxPires months fro issue date Regulatory Services Fee 0 * i639, Richard V.Scali,Director ` ;�� g ��� Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 3 �^� /'� Not Valid without Red X-Press Imprint Map/parcel Number O'Y O J Property Address % '*%] SO r t h a S f- �� '"Y}7 c O Z C�0 I ❑Residential Value of Work$ & Z,r--n_ c7-6 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 19rL l uY Kin g� Contractor's Name /�Cj 26 &C-hC-0CIA— Telephone Number S ^ 7 7 S 7 7 Home Improvement Contractor License#(if applicable) / [n 5 ri o '] Email: Te,d h/ co c,t Construction Supervisor's License#(if applicable) 0 9 g 2 Q �/Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner YI have Worker's Compensation Insurance Insurance Company Name ,' r a✓ o^,5 Workman's Comp.Policy# 2 L_�O`&qY Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ale-roof(hurricane nailed)(not stripping. Going over existing layers of roof) [Y Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is �4quired. SIGNATURE: C:\Users\Decollik\AppData cal\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOIDHR\EXPRESS.doc Revised 040215 flee Conrntan.wealth of Massachusetts Departneent of Industrial Accidents Office of Investdgations 600 Washmgton.Street Bostoeep ALA 02111 ww":neass govldia Workers' Compensation.InsuranceAffidaviit Builders/Contr°acturs/Eiectt c auslPh mbers Applicant Information Please Print Leeibly Name Gor-_ , Address _S_S L, ,4 c, LN City/State/zip: Phone* s--Z)9- 7 7 5---I 7(g. a Are u an employer?Check the appropriate box: T of project uire 4 I am a general contractor and.IP l (� . �` 1 I am a employer with 1 , ❑ g 6- [-]New coast auction. employees(fall and/or part-4me).' have hirer the sub-contractors 2..❑ I am a:sole proprietor or partner- listed on the attached sheet. 7- ❑Remodeling ship and have no employees. These sub-contractors have g- [:]Demolition c to and have workers' working forme is any capacity �' 9. ❑Bugg addition [to wodoeW comp.insurance comp required.] 5. We ar 10. Electrical or additions ❑ e a corporation and its ❑ 3.❑ I am a homeowner doing all:work officers have exercised their 11.❑Plumbing repairs or additions :myself[No workers'comp_ right of exemption per MGL 12.❑Roofrepaairs insurance require&]1 c.152,§1(41 and we have no employees-[,No work' 13_❑Other comp.insurance required.] •Any.applicsm that checks box#1 must also f ll out the section below showing Bien workers'compensation policy infotmnatimn_ Z Hameawaes who submit tbis d&Wm indicmiangithey are daigg all work and then bite aumite contrecton a mst submit a new atfidnit.indwAting such- tContmams that check this b wt must amiched.an additional sbw shorting the mime of the sad-cotmmcwn sud:state whetber or not those entities have employees.Uthe sob-contmams hm employees,they must provide their wmtken'camp_policy numbez- I ant an employer that,is,providittg workers'compensation insurance for myemptoyem Below is dtepolicy and}ob sfte information. Insurance-Company Name: ' ro./vLvrS Policy#or Self-ins-.Lac-# 2 L d O 1 q L4 F-Viration:Date: 3/ Z-C,/ / Co_ Job Site Addtess: 12 7 S p('t ti,5e s f lAw au.h -s city/Stateizip: [oZ co a l 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 maybe fomwded to the Office of Investigations of the DIA.for insurance coverage vwification. Ida hereby c n the pains andpei!wqUksAg4w4ury#fiat the information provided above is trace and correct Simmdure.. Bate_ 3 l 6 '-k Phone#: c -1 7 '— Z 7 (o ©ffidal are only. Do not Write in this area,to be completed by city or totva offlciat City or Town: PermitUcense# Issuing Authority(circle:one): 1.Board of Health 2.Building Department 3.Cityffown Clerk 4..Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: i r�trtsrea�„ MAW Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, kri Nur ram\Yl Ct ,as Owner of the subject property hereby authorize -T-e"C� Wt�clylc -CAL to act on my behalf, in all matters relative to work authorized by this building permit application for: 7 Q OA 1 (Ad&Jss of Job) Signature of Owner Date kkniq Print Name kj— If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOlDHR\EXPRESS.doc Revised 040215 :101'i5 _cense CSSL-099828 ICED L IRTCI3COCK SS LISA LANE: West Bacnstabte 1►1fA 42668: J , k. Restricted To: Failure to pos ess a current edition of the Massachusetts_ State BuildinwCode is cause for revocation of this license: For DPS Licensing information visit: www.Mass WDPS y__ Office of Consumer Affairs&Business Regulation' License or registration valid for:indmdul use only a� l E IMPROVEMENT CONTRACTQft before:the expiration date If found refYirn to. Registration:' 165907 Type: Office of Consumer Affairs and Busmess,Regulstion_ r Expiration: 4!6/2016 Private Corporatic 10 Park Plaza-Suite 5770: ' Boston,MA 02116 TL HITCHCOCK CONSTRUCTION SERVICE INC. THEODORE HITCHCOCK 55 LISA LANE' /�F "WEST BARSTABLE,MA`02668 Undersecretaq Not valid wi i e. Client#:291'172 TLHITCHCOC1 ACORD. CERTIFICATE OF LIABILITY INSURANCE °723;2o sY"`) THIS.CERTIFICATE ISJSSUED AS A MATTER,OF INFORMATION ONLYAND CONFERS.NO.RIGHTS:UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELYAMEND EXTEND OR ALTER THE'__COVERAGE AFFORDED BY THE.POLICIES BELOW.THIS CERTIFICATE OF INSURANCE`.bOES:NOT CONSTITUTEA CONTRACT'BETWEEN THE ISSUING.,INSU RE. R(S),AUTHORIZED:. REPRESENTATIVE DR PRODUCER,.AND THE CERTIFICATE HOLDER:. IMPORTANT:If the certificate holder is anADDITIONAL INSURED,the-pollcy(ies)must be endorsed If SUBROGATION:IS WAIVED,subject to the terms and conditions of>the pol►cy,certain policies may require an endorsement.A ttatement on this certificate does not confer rights to the; certificate holder in lieu of such endorsement(s), PRODUCER 'CONTACT NAME: Anne Santo HUB International New England. PHONE, FAX EXt:508 945=7863 No.,508=945=9136 265 Orleans Road 'E-MAIL... North Chatham,MA 02650 ADDRESS: NAIC 9. 508 845-0446 INSURER(Sj AFFORDING.COVERAGE iNsuREk A-:Essex Insurance Company . INSURED T t Hitchcock Construction w§uReR s:Mount Vernon Fire Ins'Co Theodore INSURER c:Travelers': L Hitchcock 933 Falmouth Road INSURER D Hyannis,MA :02601 wsuReR Es: INSURER;F':. COVERAGES CERTIFICATE NUMBER. REVISION NUMBER: THIS IS.TO;CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE;BEEN ISSUED TO THE:INSURED,NAMED.ABOVE.FOR THE POLICY':PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR.CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH:RESPECT TO WHICH;THIS CERTIFICATE MAY BE isSUED. OR.MAY PERTAIN, THE:INSURANCE AFFORDED BY"THE POLICIES DESCRIBED. IS SUBJECT TOiACL THE TERMS;. EXCLUSIONS AND CONDITIONS OF;SUCH POLICIES LIMITS SHOWN MAY HAVE.BEEN REDUCED BY PAID CIAIMS.. TYPEOF'INSURANGE ADD UB POLICY EFF LTR INSR WD POLCY NUMBER MMIDD/YYYY MPMOILDICDY : LIMITS. A GENERAL LIABILITY: 3�U2424. 5/. :05/2015.05/05/201, EACH OCCURRENCE $1 000 000 DAMA( T D�ENTED X COMMERCIALGEidERALLIABILfrY PREMISES Ea occurrence $100000 CLAIMS-MADE �:QCCUR: MEDEXP.(Anyoneperson) s5,000. PERSONAL&ADV INJURY_ $1,600006 GENERAL AGGREGATE ; 2,Q00 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPlOP AGG.:.$2,000,00O: POLICY: 2R0. LOO $ AUTOMOBILE LIABILITY CQMBINEO'SINGLE LIMIT (Ea acddeni) ;$ y�ANY AUTO BODILYINJURY(Per:person) >$ ALL OWNED SCHEDULED` BODILYINJURY(Per:accldentj;>$: AUTOS' AUTOS,...._,: NON-OWNED PROPERTY.DAMAGE HIRED AUTOS`: AUTOS Peraccdent $ UMBRELLA UAB- X ;occult: XSL015A20A9 06/15/2015 06115/201 EACH OCCURRENCE, <$1 000 D00'. xEXCESS.'LIAB CLAIMSNIADE AGGREGATE' $1.000;00I DED _RETENTIONS` g C WORKERS COMPENSATION WC STATU- AND EMPLOYERS'LIABILTY YEN RI,L.LIMITS 'ANY PROPRIETOR/PARTNER/EXECUTIVE N E L EACH ACGIDENJ `$'I,000'000 OFFICERJMEMBEREXCLUDED? NIA (Mandatory in NH), 2E1.01644 0312612015 03I261201._ E.L.DI8EASE-EAEMPLOYEE;$1 OOO'000 If yes,describe under. DESCRIPTION OF OPERATIONS below EL DISEASE POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS 1l1EHICLEss(Attach AGORD 101;.Additional Remark S66ddle,if m6re space'is O6ired) CERTIFICATE HOLDER CANCELLATION For Evldence.Ortl SHOULDsANY OF THE:ABOVE DESCRIBED POLICIES BE'CANCELLED BEFORE. y THE .EXPIRATION DATE THEREOF; NOTICE: WILL BE, DELIVERED. IN ACCORDANCE: WITH THE: POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE • 6198872010 ACORD-CORPORATION.All rights reserved ACORD.25(2010105)- 1 of 1. The ACORD nam6 and logo are:registered marks of'ACORD Town of Barnstable. dF"'E Regulatory Services 'i=0 Thomas F.Geiler,Director ; , JUL s a '"M mma ' Building Division 2$ i 9- q i639, � 1 3+A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 'v www.town.barnstable.ma.usfl ti Office: 508-862-4038 Fax: 508-790-6230 PERMIT# (9 D l G FEE: $ 0'o SHED REGISTRATION «. 120 square feet or less I�7 iAj� sue. MAI �S Location of shed(address) Village Property owner's name Telephone number A Size of Shed Map/Parcel# 5V4 y Z v z Signature Date 1 e Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? u Conservation Commission(signature,is required) ° Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN 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:042506 ^ 11 OH TGA.Gam' 1]VS ZC Tj01V pf A]v APPLICANT: KING TOWN: HYANNIS `J y 10� PORTION OF S L LOT 16 15' PORTION OF LOT 16 //,rrrr VJ ! HECK I /r,,,//........//r.i...� r/ .LOT 15 ^ 4 - ////,fll rr/ J/ 89,,qg, .LOT 14 ��L M ' F�j,kAA4,� 4r F� FLOOD PANEL: 250001 0005 C FLOOD ZONE: "C" DATE MAP REVISED: 03/19/1985 I NERF_BY CERTIFY THAT TI•IIS MORTOACE INST'ECTION PLAN HAS PEEN PREPARED FOR; BLRKSHIRE BAN►( DATC: 07/2-4/08 SCALE: 1" = 30' THE LOCATION OF 1HF, DWEWNG ShIOWN f10ES NOTFALL 69THIN A SPECIAL FL00] HAZARD 20NE. DEED REF: 19704-205 PLAN REF: 37-77 PER TAPED INSPECTION THE DWELLING APFEAR9 TO CONFORM Tp THE LOCAL 7,ONING pr,AWSiN EFFFiT TWE STRUCTURES SHOWN ON THIS MORTOncE IN T`[CnbN PLAN ARE LOCATED BY TAP[SURREY At THE TIME OF CO VIOLA ION ugTH RESrECT TO HgR12CNTAL DIMENSIONAL SETBACK REquIREMENTS ONLY, NO INSTRUMENT SURREY WAS PERFORMED AND LOCATIONS SFIOWN ARE APPROXIMATE. OR SECTION EXBMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MA GENERAL LAWS CHAPTM 40A AN IN.STIiUMENT SURVEY IS NECCESARY FOR PRECISE DETERMINATION pF BUILDING LOCATIONS PASEQN 7,R RESERVATIONS DEF,p D REST TO AND WITH TIIE pENEgT OF ALL RIGHTS, RIGHTS OF WAY, AND ENCROACHMENTS, IF ANY EXIST, EITHER WAY ACROSS PROPF,RTY LINEG. YANME LAND EASEMENTS, RESERVATIONS AND RESTRICTIONS OF RZOORD, IF ANY THERE SHALL BE, AND INSOFAR SURVEY COMPANY INC, SHALL NOT 6E HGLD LIABLE FOR DAMAGES RESULTING FROM ANY USE AS THE SAME ARE OF LEGAL FORCE AND CFFECT, OF THiB PLAN FOR PURPOSES OTHER THAN MORTGAGE INSPECTION. TELEPHONE: 508-42.8-0055 AN. E LAND SURVEY COMPANY, INC FAX: 508-420-5553 40 Industry Road, Marstons Mills, MA 02648 yankeesurvey@comcast.netI www,yonkeesurvey.com 39845 SH Town Of Barnstable Permit# . 0 C7 6A_ c3 r,Q� Fa Gnionths�,ypris�su��te vl Regulatory Services Fee - �j,•�" SARNsrant.e, 'Thomas F.Geiler,Director rases. �m 039. Building Division rya rd1� Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PENT APPLICATION - RESIDENTIAL ONLY / of Valid without Red X-Press Imprint Map/parcel Number ~1�=�CJ y✓� Property Address l ✓ ���� v�-- �� E Residential Value of Work ��� ��� Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name_.�� N�L�� o/N, � /1� Telephone Number(` / 6 J" �4 Home Improvement Contractor License#(if applicable) [Korkman's Compensation Insurance Check one: R € ❑ I am a sole proprietor ❑ I am the Homeowner Q I have Worker's Compensation Insuran N O v 1 2 20 0 8 Insurance Company Name al,�l/►n-it//b� TC kAIN OF BARNSTABLE Workman's Comp.Policy Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) 2 xe-roof(stripping old shingles) All construction debris will be taken to 571—T ID:✓� l�/1 /' S ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A•copy of the Home Improvement Contractors License is required. i i SIGNATURE: CD I Q:Forms:buildingpermits/express _ Revised 123107 �,' Town of Barnstable 1ARMABM . NA bs�a1 Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I ' V �"J ,as Owner of the subject 1 property hereby authorize L'116 to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) V Signature of w r Da Print Name Q:Forms:buildingpermits/express Revised 123107 " The Commonwealth ofMassaehusetts Department of Industrial Accidents Offace of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/individual):. �� (+G K C014 o c 0 STC, Tn(c . Address: I eR.Kf bO C. 5TK EE City/State Zip: �`A J 2 15 MA bAbI Phone.#: C1� Are y an employer?Chec a appropriate box: 'Type of project(required):. 1. I am a employer with 4• ❑ I am a general contractor and I 6. ❑New construction employees(full and/or p -time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the'attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have S. ❑Demolition workingfor mein an capacity. employees and have workers' Y P tY• t 9. ❑Building addition [No workers'comp.insurance comp.insurance. required.] - 5. We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Phnnbing repairs or additions myself o workers'co right of exemption per MGL ys [N mp. 12. Roof repairs insurance required.]t c.152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] `Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;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-contmctors 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 thepolicy and job site information. ( Insurance Company Name: /V Q-T 10 fJA Policy#or Self-ins.Lic.M W Expiration Date: (p 5 0 1 Job-Site Address: 1a-7_._� .�. City/State/Zip: f1 n I S 62 G6 Attach a copy of the workers'compensation policy declaration page"(showing the policy ntmr r 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify and an pen o,perk the information provided above is true and correct. Si ature• 40 Pho Official use only. Do not write in this area,to be completed by city or town offrciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Binding Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone ii: .-.-u Outs—I yq—(914 y 'DUCER . CERTIFICATE. CIF e �" � �I�:. "RDDucER �r���� ' PAGE 01/01 0OLbwW IL ASBOCSATzg INSURAW CE 933AATc=AL gg"TCES Z ZNe dCE THIS CSR Bt$ DATRIMN PF`1#LMO[1TE� RD. %• ONEYC911�COATEig ;Q&:- H50 h IS I� 0260j AL LDEtR.THIES C TsNo�@Hr, UIvOI.1WORMAT10N 09 s:508-775"60Z0 TER THE COI1ERAOE rgp�.0IFWATE�l.S AIOTAA9ENER'"FICAT IN31►RED FaS:SOO-790-0249 -BYTtIE -tClE40 OR ELow' INSURERS AFFORDING COVERAGI I�fYAN1J g OCc33+EC CONSTYW�1'IOa9 fiRA aOR� ZJDI�PO�T _1- NAIL# ER e: MA 0z 60IsuREa c: COVERAGES IN8LIRER D _ ------ " POSIES OF INSURAkCE l INSUANYRRE(( MAYPEOU9(EIS4EINT _ �'�DR CONDf{YO1N OP ERTgby THE/NSURANCEAFF TRAM POl IctGS.AGGREGATE UA N SHOINNDIiq 8Y TM1E RDl(q� OR 0 rnER DOOUtk�ggmRIS COVE FOR THE POLIO Of N IUAY HAVE OWN REDUCEDED BY ap��EIN 18 SUBJECT TORESPS i � K 7N(6 CE`pTfPD IyE NOT dif118TnND1AtG TYPE DPINSU Ts BXGLUS101V$AND 8E D non GENERAL LIA ftrty PDtpCY CCNDIry IN;,OF SUCH X COMMERCIALGEN fRAtllABKITY MFfi9fi�4� � E i CLAIMS —"u°Es OCCUR 05/23/os 05.123Po9 IN EAai` uM� 2000 ---.L_ 00000 DENL ApORSGATE UUM ppt YiPerson) g I0000 f 3 POLICY PRO, SPER PERS01 OL tADVINJURYCT Lac $2000000 AUTOMODILB LIADq,ITV PROD GEN T_AIS M tTAT6, 4000000 ANYnuTO 'CO '�OPnGa 0 24000000 ALL OWNEDAUT08 SCHEOULF,D ALIM3 ( �r iAtGtE LIMIT HIRF.DAUT03 _ S NON.OWINEOAUTOS BODILYI JUity (Per p. 1) t Jully GARAGE LIABILITY _ i s ANYAUTOAUTO 3XCE&%MBRELLai LfAwL►TY - �`•:aACC_ (—_ s OCCUR Q CLAgL}SlyigDE ' SON tN EAR _ AGO 9 `' DEDUCTIBLE M-/R►`ENCF RET nGGII G $ENTION 3 3 �---�—_ _ ` ORK6AS COj7P ILIrV AR10 y — A �P��'uABnlry ANY FICUR EMS,ft"RT � CUTIUE 27306ofl "�--- OFFICGRIMEtt(BE((EXCLUDEpa B ECrAL eftundl0et ®B/05`Ofi OTHER NB 6elew 06/05 09 TORY/ - / EAc"I=d7 $500000 E.t,DISEgS�F,A EMPLOYEE s C.LD►SEAS _PpuCY 500000 se IPTIONOFOPERATroNS/LOCATJONg lug IROtE9t L4�4rT $500000 >�U SA�ti D HY6ND0 isP EO(1(l vIIOY1$(aN9 7IFICATC HOLDER CANCELLATION "OR EVID=TjARy FOR ►�D SNOuLDARYOPTK4VOVZ MAVaEI �� �J+1" j. DAIT"MUNs,THE�g�NG munam ENeErtl Qa p SORE THE"pi-ATrON I QIIPDSlE P!O 0® � ax ft"FhATE HOLDER NA6tED TO 73 3 Id1iC1;.90 8 —` 6AVa wniTT6N LIQATID(i ORilA®Itf7Y�. UT FAILURE YO 110 SO SHALL II � �1TAT1I ANY WHO,P01l njERER.IT$AGENT$OR 4110ej ANN L ®ACORD CORPORATION 1988 8oarel oPHm7cW�g �s Lkease or 12915traoun valid for individut use only HOW before BOUdtf exPhRMM date. If found return to: E 0 t?ne Ashi anon Place Rzo I301 aid Sfattdards �IL PI-ate�Pme� 2847�i ISO 011, �.Q��� T.L HITCHCOCK SEIVitCC: TED HITCHCQC 105 FERNDOC RD HYANNIS.MA 02888ti Not _ �r - mature Massachusetts- Dcp:u'tmcnt�►t'Puhlic ti: '. Board of Buildim, „ tfct� Constru �c,.ut:ttinns attd titartdar ciao: dupervisor Szer- a ds License: CS SL %828 s.t1r`ions Restricted to: RF WS TED HITCHCOCK 55 LISA LANE WEST BARNSTAB LE, MA 02868 ( ,um�i..iuuer Expiration: &1/2012 Tr--: 99828 cl �oa2 © g FA al�on s One Ashby � c Ashburton Place -ltoo 1 1301 JBoston, A4assachusetts 02108 Home Improvement Contactor Re,.,,41tatioli RellistWon: 158587 T•I_. HITCHCOCK SERVICES INC. Expitaffoh' Zn81201oom°raTton TED HITCHCOCK 264�$3 105 FERNDOC RD HYANNIS, MA 02666 sore-07M,--p -loo Update Address and return card.Maric reason for change -----� 0 Address 0 Renewal 0 Employment [3 Lost Card 105 FERNDOC STREET HYANNIs,MA 02601 (508)775-7763 TEL (508)775-7763 FAX DAM:OCTOBER 16,2008 T.L. Hitchcock Construction Spices, Inc. ARTHUR KING 127 SPRING STREET HYANNIS,MA 02601 TEL: 413-563-1954 RE:PROPERTY LOCATED AT 127 SPRING STREET,HYANNIS,MA 02601 FURNISH MATERIAL AND LABOR TO RE-ROOF HOUSE AS FOLLOWS: • REMOVE EXISTING SHINGLES FROM REAR ROOF AREA OF HOUSE. • INSTALL ICE AND WATER SHIELD ON ALL AREAS WHERE NECESSARY. • INSTALL# 15 FELT PAPER ON ENTIRE AREA TO BE RE-SHINGLED. • INSTALL CERTAINTEED 30-YEAR WOODSCAPE SHINGLES OVER FELT PAPER. • INSTALL INSULATION BOARD ON REAR FLAT ROOF AREA. • INSTALL NEW RUBBER ROOF OVER INSULATION BOARD. • INSTALL NEW ALUMINUM PIPE FLANGE. • CLEAN AND REMOVE ALL TRASH FROM JOB SITE. • LABOR WARRANTY= 10 YEARS. • MATERIAL WARRANTY=30 YEARS. PRICE: $2,800.00 PAYMENT TERMS:DEPOSIT OF$1,000.00 IS DUE AT CONTRACT AND THE BALANCE OF $1,800.00 IS DUE UPON COMPLETION OF JOB. ACCEPTANCE OF PROPOSAL: THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTED.PAYMENT WILL BE MADE AS OUTLINED ABOVE. r SIGNATURE OF CONTRACTOR:'�.� l .,p DATE: SIGNATURE OF CUSTOMER: DATE: (� Qc fC /L,A dc' Assessor's map and lot number ..4�a .............. C�.-:` i� THE Sewage Permit number C9'►. ..�.A�, .... .P�ra4t,�..... E ' SEPTIC SYSTEM MU e House number ' INSTALLED IN COMPU A6a LE, 1639. WITH TITLE 5 yava�0m TOWN 'OF B A R N -BL ` BUILDING INSPECTOR • r APPLICATION FOR PERMIT TO f ..................................................� �la=u�.. ee � �''"' ......... ...... ... ........................................... TYPE OF CONSTRUCTION .......V ...... ..:�.......................................... ...................................... ' ................. .nZ ...........19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............................: � �..... .:........ �� �. ...................................................... ................................... (11 It Proposed Use .........k.� ........cxknc �...............l.a x.j............................................................ Zoning District ...................:....................................................Fire District {`����nk.S ... .... ..................................................................... Name of Owner.` :. Pxc?{�...... 4' � ?n ...Address .....� �( ` ...... ........ jc�rti�iS.......... ..... .... ..... .... ........ Name of Builder co *Address .. .5:...4� ...�:......... ^'mil 3 ` .. .. .................... Name of Architect .................................Address '�— Number of Rooms ........ON ................... .....Foundation Exterior ............t1't'�...... ..................................Roofing ......:: ^-�� ...:.roOT!'- ....................................... .......... \ ff, 11 Floors 1LrX .............Interior �lc�....... v'��n ........ g �x S g t A ................................... Heating F= '....:..Plumbin .......... Fireplace ........ A...............................................................Approximate Cost ............�O 00 .......... ............... ...:.. Definitive Plan Approved by Planning Board ________________________________19________: Area ' Diagram of Lot and Building with Dimensions Fee ................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town.of Barnstable regarding.the above construction. �. Lam _ Name . ....... .. . ......................................................... _ � PETEBSDN, MAIlTBA ^ . � 23I54 ADDITION No -----.. Permkfov ------------ Single Family Dwelling -------------...-----------. ' 127 SpringStreet Locohon ------..��� ------------ Hyannis. .—~--..� ����—�-------,-------. . Owner —Martha Peterson ........................................................... ^ Frame Typo of [on��m�ion -------------- ' L-------.-----------------.. 'Pk� ---------. Lot ----------' ' } May 29, ' ' 81 -Permit G,onh»6 ------------..�]V ~ . ^ ' Date of Inspection ....................................lA ' -` _ - ^ �� ���� ,Dote Completed ...��v«------_—.�l9m �~ ' `- _ PERMIT REFUSED~ -' c - lA ---'' —^---. ----'—'' ~ -' ........................................................... ---��� � ��. —.--. .��.^�..�-----.—.--. ------` ---''�� '--''^^---''^—''�' .,'~^----' v' —.. et, -�.�. -- ��.................................................... CU 071 . + . lg � ' . | ' . . � .__.__.._____________.__.___.. . ^ . , . . ---..i_—.--------------.---.�.. ^ .^ ° i . ° Sewage Permit number . - _- BUILDING � NN 0 0 �� 0 �� INSPECTOR �� N0NN-N0N ���� == �= � ���= � �� �� APPLICATION FOR PERMIT TO -���) !-\- �.��-.---.------..-. TYPE OF CONSTRUCTION ....... --.k:�&.._____._____._...___.___.__.__.____ ......................... ~}��..........l9. .\^ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for o permit according t a the following information: \�\-) Location ---�.:�'!.......... ........... ------------.-......-..-----.------. . . ' -� \ ^ \�\ )( P Use ---��—.���.h.-.���>�±f��[!g�.-.-..-.---/'^..-----------.---....--------- \\ � Zoning District ---------.-.------------.Rne �Oix��� ..��:�������.�------------______. /| - �������������- Nome of Owner ..yY\(1-.. .. S���-..A6dres -../.A-l--.S»�/.��r -.�\".,,.[� '�����|\,,,,.. Nome of 8ui|6or� .' i- " . �A66rex '�\�-. -.. ' .�--.�' �~�� 1-~ . . . Nome of Architect ........ --------- ........ '_...............Address ....... .....--------------_________ Number of Rooms --' -...............................................Foundotion ....... ............................................................... � � Exterior ----��[...................... �---r '--------__'Roo�ng --' _..r^^�..�,_____________ � � � Floors -_---8"� .. .�--��r!_-` '�v��---- |nK��r �r -- -- - � -� ---' '' -� -- T---------^------------' | ' �\^, _\ r\ .� �� u] ......................................................Heating mo H»ep|ooe k| -4 --------._-----------Approximote Cox. .........................................................4 [ }0 --- � Definitive Plan Approved by Planning Board lQ--------' Area ...... �� .� � Lot of � and Building with Dimensions Fee _____'I...... ................. . SUBJECT TO APPROVAL OF BOARD OF HEALTH s � � ,~ " ' � ' ' � | hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re0on6nQ the above construction. / (�^ _ Name ............. .......................................................... PETERSON, MARTH.A . (EA=328:-275 No .... Permit for ............ ..... ..... Sing.jg�.....��qMi ly...p3�q.jjing............ .............. ..... ..... Location ................. .................�Y.��i.s............................................ Owner ......Mar.th.a...P.e.te.r.s.o.n.................... ........ .... .. Type of Construction Frame .......................................... ................................................................................ Plot ............................ Lot ................................ May 29, 81 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ...... 19 ................................ ......................... ........................... ../................................................. ............................................................................... ... ... .............. . . ....................................... V....... ................................... Approved ................................................ 19 ............................................................................... ...............................................................................