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HomeMy WebLinkAbout0038 SQUARE RIGGER LANE �(1 C� �i�C�l 1Z_. ��/�f /� j��€ l -- - - - ---- - - '�� ti l I i } _ _ • Q I r (oxf(20rd NO. 7521/3 ESSEL'TE 10% w110 L�_ - PRiU p-T�� P..is 42S PEi.zq � JP�w L. �! S � LoT 113 I ; � ,D ' a N i c- V �e• Lo ' i 1 A. m I N Pie. �N�. 2 i `i a es IDS± a { l-.dr 114' 6 1 �►73 u 0 4 v0 - s a 14.00 I Qa. j u} ?as s U , FPANiC iJ;r+Ttt'3 �! 0� Fi TOWN OF BARNSTABLE ZONING i .�GGfX /SIGNS �oZ BY-LAWS DATED SEPT 14 1987 _ ( . SETBACKS 17 s1 /' FRONT - 20' SIDE. 7.5' i REAR a 7.5' PROPERTY LINES SHOWN HEREON WERE COMPILED i FROM PLANS OF RECORD AND 00 NOT REPRESENT PROJECT NO, 3.3035.20 I AN ACTUAL SURVEY ON THE GROUND, — =; ! THE STRUCTURE DEPICTED ON THIS PLAN WAS LOCATED -�. ` PLOT PLAN _ ON THE GROUND BY SURVEY ON DEC 19 i988 I in AND EXISTS AS SHOWN AS OF THE DATE OF LOCATION. ! BARNSTAa E MASS. THIS PLAN IS FOR PLOT PLAN PURPOSES ONLY AND SCALE:i4 - 20' DEC 23 1988, , SHOULD NOT BE USED FOR ' OTHER PURPOSE. THE BSC GROUP-CAPE COD INC ROUTE 28 MADAKET PLACE B12 I I— DATE-- PROFESSIONAL LAND:_SURVEYOR MASNPEE, MA 02649 (5081477-2525 _�- �J rt"}t�`� 7��#{r''�'° r � , . .; .. +,��"�°��' v`'p -;�� '�r�d�:�,°�A'•° I�am'�`�w'f�"'�`w,v... D�'TOE TOWN OF BARNSTABLE .Permit No. 3.2527 BUILDING DEPARTMENT 4 iaun Cash J'// TOWN OFFICE BUILDING //.I/(..,y%J. 7 ■Y9 W i619• X �''tawr► HYANNIS,MASS,02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Capricorn Realty Trust Address Lot #113, 38 Square Rigger Lane Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD (- THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Nov , L�' � ............ember.....20.... 19......89........... � ... Building Inspector TOWN OF BARNSTABLE BUILDING DEPARTMENT _ Iks8iar = TOWN OFFICE BUILDING rut i631. � HYANNIS, MASS. 02601 �o iur w MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit $ ...... .Z..J2 7 ............................................................. .... . .._...... .........._....._......_ ........».... ...._ issuedto ,0�'i c v tJ.... ... ........................................................... ...». ....__......._. ... 4 Please release the performance bond. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) m ��C&I- DATA • �..A '''f, ,' +.. L.. "'Sa `, 1(- sc 13+y�7PiLVS j i 7i^t 1 i M'O SF,4� A i it .:' ^xf '• -gEt �A�"` -+e s�:�«.Z,a..F► t.': n "( �, •y�;". •" � ,.� - t� • ' �'��'��t.� r��``.kw.yS. .1 . , �i is , a'a• „r s ; �r. ,.+. ,ht-' DATE - 1 9' r>F +. k'.'' �+$1" a ap{ # 4 s , '�'- s.<.,. -'"✓r F,, r APPLICANT rS34TSx �.< �t n ;.t:0 a J t T • u ADDRESS w t 4�' `» ',i•F -� • IN0.) (STREET)' - s 'ICONTR'S LJ QE NSFI PERMIT TO + .,.t.i7 " 3»z ... (_) STORY ` Y r .s r r n y xtl iY_ �3"F. NUMBER. OF DWELLING UNITS (TYPE OF IMPROVEMENT).y N0. (PROPOSED USE) F " �.�3 3HJQ 4i .. ZONING AT (LOCATION)�� .,, (NO.) (STREET) DISTRICT ° s fS c T .BETWEEN AND ' (CROSS...STREET) (CROSS-STREET)ks ' i br a k c, i w :S`*D -','.� .�.. .^• t �swi' G9e ta' ��R a �h '3 2 t�a E,.e'LOT.:IVISION t� r� 'rrLOT SIZE U B ' BLOCK •x T y ,y. BUILDINGAIS TO BE = FT WfiDE BY FT:LONG 8 Y4 41. FT INyHEIGHT AND"SMALL.CONFORM IN CONSTRUCTI r •a. ^" a } x TO TYPE USE GROUP BASEMENT WALLS OR,FOUNDAT ON (TYPE) a .». 6_ ` ,e 7yNaf k• 3* 4r „mow P REMARKS. Y �.� r d tt, ,,;w 'k•r3 c e.n r .,ate, r^• '¢+` '' e f r $;�" t4 t.•� _ .., � 4 ep S ,� :;fir!'e � }'��•=�cx� 'EF�� A+ � � `r2 ORP E�,pJ x�"P�'a`}SttWS AREA .a- ,t» t• -. {. 7`'- a L tqx °2 <!VOLUME° t,.*z Rw a z '�S �� PERMITS ESTIMATED COST� a FE $ Y'- (CUBIC/SQUARE FEET) .y a y. :OWNERz; s 1'1�elaL+ ADDRESS y; » '`BUILDING DE PT :6Y� jv0. THIS PERMIT. CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK.OR ANY ,PART THEREOF EITHER TEMPORA"RIIY c piG s x�aPERMANENTLY: ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED9UNDER THE BUILDING,;CODE, MUST BE A F'ROVEDirBY.,THE JURISDICTION. STREET OR ALLEYGRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS`MAY.'BE OBTAINE c. ® FROM THErDEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT.RELEASE THE APPLICANT FROM THE CONDITIO: O'F ANYtiAPPLICABLE;SUBOIVISION RESTRICTIONS �MISPECTION THREE: CALL -APPROVED PLANS MUST, BE RETAINED ON JOB AND THIS WHERE' APPLICABIE'SEPARATE INSPECTIONS REQUIRED FOR ' �A�LL-L CONSTRUCTION,WORK i CARD KEPT POSTED UNTIL FINAL INSPECTION,iH.AS:BEEN PERMITS AREt;REQUIRED FOR M1 sr v 1.sFOUND,ATIONS OR.F,00TING3. i MAOE: .WHEREQ:GER,T}I,FICATE OF,'.00Cf}UPANCY IS. RE-: MECHANICAL INSTAL'LATIONS.D S ; 2.iORIORfTO."COVERING STRUCTURAL + P MEMBERS(READY"TO'LATHI r; QUIRE.D,SUCH BUILDING;SHALL NOT BE-OCCUPIED�UNTIL � F����� ��� IV kry� 9 OCCUP_AJSPE,C,TI ,bBEFORE a ,' Y FINAL INSP ' ION HAS aBEEN MADE ., POST�THIS� :CA b 0� S f _� .. I VI 1B4: FROM' STREET�`SPs BUILDING INSPECTION 4PPROVAL$ es L RING INSP PPROVALS""� ,• .,@a F ?ELECTRICAL INSPECTION .PI?�JVALS � � `, �:�£ �"��; iJ@',a � °.a•a"w r•�t "+d.s.� W :�.�* to :: `�' �� P b V � ,,� • c : S -�' ,��"'^ i fib`, �"'�"��Svsv�S.�,..�e -. t^x� .r*yY t i'�""" }L�' �"- '"1• '1 s�x ri a V atS tas r ` hG�� C1�1Wi T VIA h ` _,�� fi Y� Z s5{,W,7-�A .�iQ' [��} �. � 1; S '',�`}k• .,at a` sty �3I HEATING INSPECTION APPROVALS ENGINEERI G DEPARTM T- Poll 7 OTHER nr 2 '� Q • Z BOARDHEALTH3 K r r 4+"� ' a•_ 4 `E• n la_ a ^� t tµ t 't a r :, ,v7r , n .., R WORK SHALL NOT PROCEED UNTIL THE INSPEC PERMIT WILL BECOME NULL AND VOID IF C{JNSTRUCTION ' ' ]TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS"NOTST,ARTED';WITHINiIX MONTHS OF DATE THE INSPECTIONS INDICATED ON THIS CARD CAN ~ CONSTRUCTION :I �, ARRANGED FOR BY TELEPHONE OR WRIT] } } { PERMITS ISSUED AS NOTED ABOVE. a NOTIFICATION.. r *✓ k < f°' �" t f�"syLG J'L ,d••' :'Tc k �l y :+ � j p .'*a. � r#�' � s�ti �, aF ~~i�:��'a�`,or•�'a;�xr" '� ''i-a-�� s`-rr yn���' '� c'K<,.•,"'t.6� ..yy._ .. f'� ,� -•�`�, �,;me {;,,� �a�: E°ha t'�a"arc'"�^"as"'�` �a "�G,-'x;,�`"r. �-o.,..r,�*,�,",. �.,.r+�-'+�•e.-.•���� r� �t 'ti:t�q'•.y.,� _ w,�0 �. 6 ,r air"- ou��` -y.� �+-i�'�'S.�t1 '`� �`. 't�~`K'�<.2-% .: xa.., .,. w �4✓--r"�+� yn � , �}_a x w....t rt• A a 4`-' � a- .�..'S�y�q va..'' e`/' `"""o t�.�-iay���'`a ce rM.a,- 7'�+ ;aP.,,ri"���'�-k•"`'^" �..A- •g'•.a-'Sp•`. per• .. -. '+�Z.a'»�•`f`..`i�t..a_.. `�:, ��^6r`'-�`4k+s ;.'!rS�- �.'air.f•-79!f.�I:d�i� i���'als.T `Yi"a-� °3�/y!'u���?�,{',c.a. 5•� ¢� � '!^'"'S'Y ��:� —+S4mmu]1 f.... �'.. T9'!" ,r�. ✓a.:R"`"i'T�^N�•-._ %=��Jek. ''. �i+Re-'i,s 3 c REQUEST FOR WAIVERS FROM SUBDIVISION RULES & REGULATIONS FOR A PLAN OF LAND ENTITLED : " COBBLESTONE LANDING LAND SITUATED IN HYANNIS BARNSTABLE, MASS. .PREPARED FOR CAPRICON REALTY TRUST DATED MAY 59 1986" The Petitioner seeks a waiver from the following provisions of the Subdivision Regulations of the Town of Barnstable Planning Board: 1 . Section 4 , Paragraph B, Streets , Subparagraph 3(a) Length of Dead-end Streets - Petitioner seeks a waiver of the five hundred (500) foot maximum length dead-end street for Aurora Lane as shown on the subdivision plan, said lane being in excess of 600 feet in length . 2. Request for Reduction of Intensity Requirements of the Zoning Bylaw Under the provisions of Section T Open Space Residential Development, paragraph 5 . Minimum Requirements , subparagraph (b) Intensity Regulations , the Petitioner is seeking a reduction in the intensity regulations of the underlying zoning for the cluster subdivision plan as follows: a . A reduction in the minimum lot size from 15,000 square feet to lots ranging from the smallest lot of 6 ,503 square feet to the largest lot of 13 ,727 square feet . b . A reduction in the frontage requirement from 125 feet to a minimum of 33.73 feet for each lot shown on the subdivision plan. I C . A reduction in the side and rear-yard requirements of 15 feet each to 7 1/2 feet of both side and rear-yard setbacks . d . A reduction in the frontyard requirement from 30 feet to a minimum of 20 feet for all lots , with the exception of lot 74, a corner lot in which the reduction sought from the minimum frontyard setback is a 50 per cent reduction of 15 feet . e. A reduction in the required 50 foot perimeter strip to 20 feet in those areas as shown on the plan . 2167j ok Assessor's offioe Ost floor): �J �J /( /ae p ..091..1�...�...�4!..,�.D( � fTHEt Assessor's.ma and lot number Board of Health'(3rd floor): ,^ /s-.� ...� Z �p �3M3S NMOi 01103NN00ISM Sewage Permit number 'L . 2 INA"STODLE, Engineering Department (3rd floor): p �SS oo NA39 e�+ House number ....................................... ............................... ,sue 'Fa ` APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..C.QXIS.tr>dingle „family dwelling TYPE OF CONSTRUCTION .....�?ood...frame...................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....Lot..11.3........................S.quare..Rlgg!�r...Lane...............................Hyannis.....MA.......................... .. ProposedUse ............................................................................................................................................................................. Hyannis Zoning District ............R.B.r..................................................Fire District ....... ................................................................... Name of Owner ..Capricorn Realty. Tru_st.........Address ..7 65 Falmouth Road, Hyannis'.', MA ............................................... ........... Name of Builder ...Franco.••R.E. Dev.Co. Inc. _.Address ...�65 Falmouth Road, Hyannis, MA Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....S.lX......................................................Foundation ....P C. ................................................................... ExleriorCl,apboard,,,and/or•_•shingles....................Roofing ..As}?,halt Shingles Floors .....Car.P!at.................................................................Interior ...SheetrOCk Heating ..... ......................................................Plumbing ......TWU—CojDper ....................................................... Fireplace e s ....Approximate Cost $5 0, 0 0 0 . 0 0 Definitive Plan Approved by Planning Board -----11_-/____.______ 190_-_� Area ....1122 sq. fit: Diagram of Lot and Building with Dimensions �?� V / Fee ........ ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTHQ�"' I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above I construction. Na a ..... ... ... - 0 Construction Supervisor's License ....0 0 0,9 8 9................. t .s�CAPRICORN REALTY TRUST e Permit for One S to Single FamilyDwell a...... .............................. .................?,i�lg.......... 'r Location .140.t...#.11.3.........39..sgnar.e...R.j. er Lane �. ...................H.y.a.nn is.......................................... . Owner ...Q-dP -i-C,0xa..Re-a.Ity....T-rus.t..... t: Type of Construction ..Frame••....•..............••• L;. Z................ .......................................................... Plot ...:-...................... Lot ................................ 4 , Permit"Granted ....... eGember...2,9,,,�..19 88 Date of Inspection .....................................19 Date Compl ted .. D . .....F...............19 € �� r, L—U yC5 s f L i r C3 �' , - Assessor's offioe (1st floor): Assessor's map and lot number .. ./. ..l..</..lJ.7t.0/1�lp Q�OF YNE Tod` Board of Health (3rd floor): Sewage Permit number ���'�� \, NARISTLEIL Engineering Department (3rd floor): O ��� �`: � _ Apo t6 9 House number ..................................................................... r r. s• �a YP APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2 00• P.M. only, TOWN'- 10F BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..construct„a (4 ' 'le family dwelling ... ..... .. .. .. . .. .. ..... ................................ TYPE OF CONSTRUCTION ..Wood Sframe ................................................................................................................ ........................... 19......-. K~ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......Lot. 113 Sq ...Rigger Lane Hyannis' �....... ........................ 0 ............................::.: ..... .......................... 1 ProposedUse .............................................................................................................................................................................. `\..R.B. ....................................Fire District .......Hyannis Zoning District :................... ............................................................... Name of Owner ..Qap , corn Realty Trust Address .....65 almouth Road, Hyannis, MA Name of Builder . ,Franco R E Dev Co.Inc Addr'ess6Falmouth Road, Hyannis, MA d.......Y.''`.... ............................... Nameof Architect ..................................................................Address .................................................................................... u_. Number of Rooms ......c�..1'X.................. :.............................Foundation .....P.'.C.'................................................................ E*ieri ;.Clapboard and/or shingles Roofing ........s ha Shingles Les .......................... ..................... ' _Floors �..,•Cappet : ee ock `\ ............................................... ................Interior ....,.. ....................................................................:�.... Heating ....Gas.-F..W.A......................................................Plumbing Two-Copper ..........................................:................... Fireplace .... .es............................ Approximate Cost $50, 000. 00 ....................... Definitive Plan Approved by Planning Board ----- .,-/__.,_.__-__- 19 Area 1122 sq. ft. Diagram-of Building with Dimensions -le - Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS _ I hereby agree to conform to all the Rules and Regulations of the own of Barnstable regarding the above construction. , Na e ....... .. ...�..�/�4. .. f—z5�. .. G y / Construction Supervisor's License ....000989 GAPRIOORN REALTY TRUST A=272-004-018 o?7-q 0o d74 No t.3.2.5.2.7.. Permit for .,One...Story.......... SincTle Family Dwelling............ .................................................. Location ....Lot #113, 3 8 Square Rigger Lane .................Hva.n.n.i.q............................................ Owner ....q.c-�p.Kicorn Realtx,7 Trust . ................................................ Type of Construction ....Frame ...................................... ............................................................................... Plot ............................. Lot ................................ Permit Granted ....,,December 29., . . 19 88 ...................... .. Date of Inspection ....................................19 Date Completed ......................................19 ' �C-PI�E � DERit# � z 2 G C 2C9B P 'TTown of Barnstable *Perm Expires 6 hs from iUate .. ; 17 2012 Regulatory Services Fee . aw�srtaers, • — . Thomas F.Geiler,Director BARIVST,qBLE Building Division~ a Tom Perry,CBO, Building Commissioner ` 200 Main Street,Hyannis,'MA 02601 t www.town.bamstable.ma,us Office: 508-8624038 t Fax: 508=Z90-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY_, Not Valid without Red X-Press Imprint Map/parcel Number p?-� Property Addressv t'1V In lS r' p�,�, U tdential Value of Work "' d, 133 Minimum fee of$35.00 for work under$6000 00 Owner's Name&Address SS - t ca f �C�r-fIZ-1' L.�Y� k4YUY1Vt Ls' Contractor's Name Sprinkle Home Improvement Telephone Number 508 775-1778.: Home Improvement Contractor License#(if applicable) 1 M757 Construction Supervisor's License#(if applicable) C,5 91Workman's Compensation Insurance Check one: ❑ I am a sole proprietor - ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name ASSnCjegfpd I ncii IStriPS nf MA Workman's Comp.Policy# AW(; 700494301201 - 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 ❑Re-roof(hurricane nailed)(not stripping. Going over, existing layers of roof) ❑ Re-side m #of doors . ASI—Aeplacement Windows/doors/sliders. U=Value ' (maximum.35)#of windows _ ° *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 o efWbie Improvement Contractors License&Construction Supervisors License is equ SIGNATURE: - C:\Users\decoliik\AppData\Local\N icrosoft\Windows\Temporary Internet Files\Content Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 �I.i..t:hu..•tt. . U� Ir-;rtni:nt + I I'ui,i�+ .� ,iri. _ // �� 19 - /r _o frc-arnrca n..vs! tc/ra;;e�ls 4` Kuanl t liuililin_ Oftic. offnsumerA airsK��iness egufanon " `� .` Construction JuUarvrsor l.rc.,ise t HOME IMPROVEMENT CONTRACTOR Registration: " 103757 Type: `"' 6643 4 '? Expiration: 7/9/2012 Private Corporatic y` SPRINKLE HOME IMPROVEMENT,INC. BRAD K SPRINKLE 190 LOTHROPS LANE t Brad Sprinkle W BARNSTABLE, MA 02668 199 Barnstable Rd, Hyannis, MA 02601 Undersecretary 10/&2013 6004, License lot-registration valid for individul use onh• Failure to possess a current edition of ttie before the expiration date. If found:return to: Massachusetts Statc'Building Code Office of Consumer Affairs and'Business Regulation is cause for revocation of this license. 10 Park Plaza-Suite 5170 Refer to: WWW.Mass.Go%•/DPS Roston.MA 02116 ore Not valid without sign y` w Town of Barnstable Regulatory Services Tbomao F:Geller;D4eour Building Division { Tbomas Perry,C80 4 Commieeiouer° 00 Ib1am Street, Hyannis,'t- l�Nb{n/1 2 www.town.barnstabl�`ma.ns � � - . x m � Office•'S08-862-4038 Fax• 508-790.6230 Property Owner Must fi Co*plete And:SignT its Section If�Using A�Builder " § ,'� '� ' Owt er of th as In°e subject "perty hereby authorize.Spnhkid'Home,im prove,ment g act oiifm .. ...yam lo is all matters relative to work,authorized:by this bwldiag peraut application for ` of Job) , r "*MUM of OW:ler Date a Pe der . '®rho,; a w PAW Name r�4 if Property�O6r tip*bg for P �P complete the Honieownere License Ezemptlon:Form`on he y,. a C:WsasWeooWk�AppDa�alio�llMim fllWiodo T'Cmpocary 3 InDemet Fiks�Co�otsOutlooklDDV87AAZ1B7Q'RBSS.doc Revised Onl i CERTIFICATE OF LIABILITY INSURANCE DATE;; �2010Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Bryden & Sullivan Ins Agency PHON: PONE FAX Inc (A/C. No. Ext): (A/C. No): E-MAIL 88 Falmouth Road ADDRESS: PRODUCER Hyannis, MA 02601 CUSTOMER ID®. INSURED(S) AFFORDING COVERAGE HAIC f INSURED INSURER A: A.I.M. Mutual Insurance Co Sprinkle Home Improvement Inc INSURER B: 199 Barnstable Road INSURER Hyannis, MA 02601 INSURER D: INSURER E: 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 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 HAVEBEEN REDUCED BY PAID CLAIMS. sa°r POLICY EFF POLICY EXP L<: TYPE OF INSURANCE POLICY NUMBER (MN/DD/YYYY) )xN/aD/Y Y) LIMITS GENERAL LIABILITY EACH occuRAHce $ ❑COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ ❑CLAIMS MADE OCCUR PREMISES(Ea-ccurrence) ❑ NED EXP (Any one person) $ PERSONAL 6 ADV INJURY $ ❑ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES ER: POLICY nP..IECT nLOC PRODUCTS-COMP/OP AGO $- $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT ❑ANY AUTO (ea accident) $ ❑ALL OWNED AUTOS BODILY INJURY (per Person) $ SCHEDULED AUTOS BODILY INJURY(per accident) $ ❑HIRED AUTOS PROPERTY DAMAGE (per accident) $ ❑NON-OWNED AUTOS ❑ $ [:]UMBRELLA LIAB ❑ OCCUR EACH OCCURRENCE $ []EXCESS LIAR ❑ CLAIMS MADE AGGREGATE $ ❑DEDUCTIBLE $ ❑RETENTION $ $ WORKERS COMPENSATION ® at'A'+'O-IMI OTx- AND EMPLOYEES LIABILITY TORY LTS ER THE PROPRIETOR/PARTNERS/ EXECUTIVE OFFICERS ARE E.L. EACH ACCIDENT g 500,000 A ® inCl ❑ exCl 7004943012011 E.L. DISEASE -POLICY LIMIT $ 500,000 o1/01/2011 01/01/2012 E.L. DI96ASE -EA EMPLOYEE $ 500,000 COMMENTS /DESCRIPTION OF OPERATIONS OR LOCATIONS: CERTIFICATE HOLDER CANCELLATION NATIONAL GRID CORPORATE SERVICES LLC DBA NATIONAL GRID ACTION INC. DBA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE COLONAIL GAS COMPANY AND N-STAR POLICY PROVISIONS. 460 WEST MAIN STREET HYANNIS, MA 02601 AUT»ORIEED REPRESENTATIVE 12/20./2011 9 : 35 : 33 AM 8740 2' 02/09 CERTIFICATE OF LIABILITY. INSURANCE DATE 12/o 201i`' Dame CEarIrlCArs z8 IMUM As A WdMIR Or IRrORYATION-ONLY AMD CONVERS NO Sleets UPON'THE cERTIFICAI4 EOLDsa. raze CEaTIFICATE Dose NOT ArrmiuDlrmVELY OR NNRATIVZLY AIDSND, Z=RND.OR ALTZR DRZ COVERRaa "FORMW By THE rOLmCIas aaT.OE. Dams CERTIFICATE Or INSURANCE DOER NOT COMMITOW A CONTRACT EETME THE zsBOise mE8ORZR(8),' AMORIiED REPROOMMATIVE OR PRODUCER, AND TEE CERrlrmcars ROLDER. NPORTANT: If the certificate bolder it an ADDITIONAL INBOam, the'policy(ies) must be endorsed. It BOaROGATION I8 VANED, subject to the terms and conditions of the policy, certain policies may require an andorsem at. A statement on this.certificate does not confer rIghts1to the certificate holder in liau of sucb'endozssment(s). {coum _ CONTACT Bsyden 6 Sullivan ins AgencyVOWED t „� Inc (Aft. ■.. Ere): M/C.■.): 88 s'almouth Road Hyannis, M 02601 •••••a• cN{Ta1RI(IN. I•{Ym(s) AFFORDING COMMADS NAIL a INSOPtD uUnm•. A.i.M. Mutual Insurance Co 33758 Sprinkle Homo moprave®eat Inc 199 Barnstable Road fir, Hyannis, M& 02601 . cNSURRE Z: r COVERAGES cmirICAn.NUMBER REVISION NOM$ER: VEZZ Zs To coorm 7Nir YEN POLZCZO Or XMIRANCE LZEM ERIA/NAPE Nm ISSM so m-Z•soasn XWWo Asom NOR-WE POLZC)[&== laim m. NoaNaasram�a ANY 3029 NAP, '!m as CONDsrrON or am cONs7AC'r OR osse(OOo�l;VVIN RNirWr a0 wrCN rsla ca==WN aw sN zssPm OR NOW POatt, we asnma arrosow By=POLzczzX Enron RERUN:is x0sa T VO'ML'Am msE, iNammoss AND OONDZraoss or.sscs Po=xss. LZOTE stows an Natty ENO RZ OP®my Pam CLEsm. - - w POLDCY■�O RQLZCY am POL=Styr ym� TZPN Or zosmases ,.uoAte�n uD�NN�r+n GROW"LZAEII'117t - , sea oegRaNee - { �COMMSRC LL"Ulu LLLOn.iT! OaYRD TO®TO { saracs(s......::..o.) ❑6AIle MADE OCCUR m EE< (lMw O pers.0) { O - FYlOW.;i{DY IOY>t7t.. { . NE'L AGOREOAT{LIMIT APPLIES ER: AG=Gwz { ElCLICI 0PR=CT OLOC :wT - - FEDDDCTS- CUzr/0P EEO { • aOiOrDNII,N LIANZLIrr - - COO Min An(GIa LIMIT PACT AUTO (.a.rota.t) f c ALL OWED►Oros DODILT-IMMUM (Pr F.r.m) { ' 1:13CRIDULID AUTOS - WDILT IQIRltpr.meant) f 13EIRED AUTOS (,-my DAae� - . lO.r OWE-CAMEO AUTOS - - WeRPLA LIAR OCCUR anex OCCIRmCs { 11ETC13E LIAO 0 CLAIMS NAPE AGGOESETs ' - { ORMETION { OaQOParSON - - - tCR LM Onl- allo■fLOYOs LIOZLZTY ac TM PROPRIETOR/PAR7MRS/ . EXEM'In Orrzcs",ME Z.L. sea(seene;NT { 500,000 A ® incl ❑ excl 01/0 l 11/2012 Ol/01/2013 ..L. DlssDss-1.LICT LIMIT f 500,000 700d9d3012012 X.L. DISEASE -EA:EMPLOr6E - -{ 500,000 COsOIs I EEsa3PINK W WEOTIGNS WE LWA Z=t - WORKERS' COMENSATIOB'CGVERAM APPLIES TO,MASSACHOSETTS EMPLOYEES ' s 0WIFICATE HOLDER CANCELLATION PROOF OF INSURANCE :.mwm my or Tax�AEom ww aso POLDCZis as�CANCiL=NNMRZ� ., isttaa'M Da'171 '17a0tRDl,'-:/O'PICs t'= w`0=VXNm.la'7100oaamwi VI4N'1� POLIcy PROPIEIm)s . .YRNOEIm IRPELmiatzw 5289 The Commonwealth of Massachusetts Pnnt-Form De partment:of,Industrial Accidents t - ; $ °;Off ce:of Investagations . '��. •,� - 1.Congress Street, Suite"100 k :Boston;MA:02114;2017' ' www mass gov%daa Workers'Compensation Insurance Affidavit:.Builders/Contractors/Electricians/Plumbers Applicant Information "' w ;. a/Y Please Print Legibly S Home Improvemen * ` Name (Business/Organtzation/Individual) '•' prinkle t , . . Address:' i99 Barnstable Road ¢r Y H annls, MA 0260.1 `' 508 775 1778 Ext 10 City/State/Zip. y- . Phone# , Are you an employer?Check the appropriate bog Type of project(required) 1. ✓❑ I am a employer with .`10-12 `-_ 4 0 I am'a,general contractor"and I 6 ❑New construction'` employees(full and/or part-time)* have hiredtlie sub-contractors r <.listed on the attached sheet: 7 ❑ Remodeling 2.❑ I am a sole propnetor or partner These sub-contractors have f ship and have no employees.° ; . 8 ❑ Demolition working for me m any capacity employees and have workers' coin insurance 0 Building addition," [No.Workers .comp insurance p� re uired 5 ❑. We are a corporation-an 10 ❑ Electncal"repairs:or addttioris q. ] ' officers haveexercised their 3:❑ I am a homeowner doing all work 11 ❑ Plumbing repairs,or addrfions myself.'[No workers'.,comp: ., right of exemption per MGL ;12 ❑.Roof repairs insurance required]t« c 152, §1(4) and we have no n e s". mployees. [No worker ,. 13y�Other comp. insurance required.]; *Any applicant that checks box#1,musf also fill out the section below showing their workers'compensation policy information. ; t Homeowners who submitthis affidavit indicating they are doing all work and`then bli".utside contractors must submit a new affidavit indicating such::' :Contractors that check this box-must attached air 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 ahem workers'comp pol cy.number.4. I am an employer.thdt is providing.workers'compensation insurance for my.employees, .Below is the policy and job site `information. Insurance Company-Name$-` Associated-Industries of MA J.A.IM Mutual lnsurance Co Policy#or Self ins Lic '# ` 7.004943012012 Expiration Date 01,.01/2013 a� • x Job Site Address: <Ctty%State/Zi In'1 Attach a copy of theworkers compensation policy deelarahon pageu(showing the,pohcy�.number and-expiration date)..- Failure to secure coverage as required under Section.25A of MGL c,r 152 can lead.to the,imposition,of crimirial penalties:of a - ,- 'fine up to $1 500.00 and/or;one=year imprisonrrierit,as well as civtl'penalhes in the form of a STOP.. WORK ORDER and a fine '. of up-to$250:OO,a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of .a Investigations of the.DIA for insurancecoverage verification " I:do hereby.ce ns and: enalties o, er u that the in ormation provided,above is rue and correct r- Si ature: 'Date. t .- Phone#. 508 775=1778`Ext°10'' } Official use�only.,Do not write•in this area,to,be coinpleted:by city or town:offcial City:or.Town::., Permit/I:icense# . Issuing Authority(circle one): F , A: 1-.8-oard:of Health 2.Building Depart me_u'C 3 00/Town Clerk 4.Electrical�Inspect6r'5.Plumbing Inspector ro. 6.Other Contact Person? ;_ Phone#. ,3 4 C 0C Ft z a Town of Barnstable *Permit# , Expires 6 months from issue date r Regulatory Services Fee ems. $` Thomas F.,Geiler,Director Building Division t Tom Perry,CBO, Building Commissioner. . ¢ - 200 Main Street;Hyannis,MA 02601` ' w.ww.town.barnstable.ma.us •Office: .508-862,4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number -7a (y) ` Property Address cv1r` f� ch�noS - ou(�.c �. U O'ftesidential Value of Work" ��' Minimum fee of.$25.00 for work under$6000.00, Owner's Name&Address t' x` �`/�'14— r:41 Contractor's Name O> i►'�ICI e, ttcrrn.Ee � -V\1)rey F d\ Telephone Number Svc '� .S: 1 ITS S Home Improvement Contractor License 4(ifapplicable) 10 3 15 7 ' R Construction Supervisor's License #(if applicable) 5 `{ . 55,PERMIT &kman's Compensation Insurance Check one U N 7 2010. ❑ I am a sole proprietor ❑ I am the Homeowner. TOWN OF-BARNSTABL . ®Thave Worker's Compensation Insurance ```, Insurance Company Name N Q���CO C.t Zr)C�L,(S r C . tYl ` Workman's Comp.Policy# �;JC Z Copy of Insurance.Compliance Certificate'must Sccompany,eac}1`permit. Permit Request(check box) , El Re-roof(stripping'old shingles) 'All construction debris will be taken to ❑Re-roof(not stripping Going over "existing layers of roof). ❑ Re-side , ,'#of doors Replacement Windows/doors/sliders.;U-Value a (maximum.44)#of windows *Where required: 'Issuance of this permit does not exempt.compliance with other town department regulations,i.e.I-Iistonc,Conservation,etc..,., ***Note: Property Owner"must sign Property Orvner Letter of Permission. ' A:co f th a Improvement Contractors License&Construction Supervisors License is SIGNATURE: Q:\WPFILES\FORMS\building-permit foims\EXPRESS.doc. P Revised 090809 e wz - :. The Commonwealth of Massachusetts Department of Industrial Accidents+ Of,f lee 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): n f,,oY_ vy 14 fM_M2n+ Address: L99 t' u.rnS We R00A City/State/Zip: 44 V1 tl is M Ca(PC) Phone#:_,,60�• 7 I 1-7 7 g Are you an employer?Check the appropriate box: ' Type of project(required): 1.I� iey am a employer to er with 4. I am a general contractor and I 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. Demolition workingfor me in an capacity. employees and have workers' Y P h' ; 9. ❑Building addition [No workers'comp.insurance comp.insurance. required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing Alf work officers have exercised their - 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,.§1(4),and we have no kd 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. tContractors that check this box must attached an additional,sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employee& Below Is the policy and Job site Information. I (� Insurance Company Name:.' ame: S$OC. Q.� min�uSt.Ct GS dot' 1M�-! Policy#or Self-ins.Lic.#:A(,rJG 7���!9 ��(�(�b l� Expiration Date: Ol Job Site Address: O �QT.ta r� Qt`g4Q,i� LQ — City/State/Zip: ann�'S M�} da[o0( Attach a copy.-of the workers'compensation policy declaration page(showing the policy number'and expiration date). Failure to seure 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 Investip,ations of the DIA for insuranceeeveraize verification. 1 do hereby certi der a enalties of perjury that the information provided.above is)true and correct Signature: Date; Phone#: 5 VNA Official use only. Do not,write In this area,to be completed by city or town offlclal, 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#: T Town of Barnstable Regulatory Services 'Thomas F.Geller,Director' �Eo Building DivIsion 'Tom Perry,Building Commissioner -200 Main Strcot,Hyannis,MA 02601 tvww.townbarnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 "Property Owner Must Complete.and-Sign This Section If Usiri>*A'Builder 0 &( r h e,'''r as.Owner of the subject property to act on, behalf hereby autho`rize � r� l� 1��.,0✓rAie Y ' in all matters:relative to work authorized by this buiilding,permit application for:. .(Address b) .. 4"/lam Signatare of Owner Vate Kill Print*Name IfProperty Owner,is applying for permit please complete the Homeowners License Exemption Form on the reverse side. ' (1•Ff1RMC•f1WNF.RPF.RMi.Cfi1f1N s; ti`17t"aetiu�ctt•- f)c:p:u-tnic.rtt of f trhlit �Rtfe.t.� s"1 13uai d ref Btritt#in� 12c<�ul,ttii7ns and:S:tirttrlrrr•tlti ` Construction Supervisor` License License::CS 6643 Restricted to:`00 BRAD K 8001 "-'. 49:0 LOTIi3:R81� : ` W/f3ARh1STABLE It 02668 h, Expiratiowt10/8/201.1+ t'uiumr. i„urr Tr#: 5478 Restricted to: 00 f 00- Unrestricted i IG-,1,2 Familg Homes Failure to possess a current edition of the Massachusetts state Building Code I I is cause for revocation of this license. ' Refer to: WWW.Mass.Gov/DP.S Board of Building Regulations and Standards i HOME IMPROVEMENT CONTRACTOR r - Roglst � 1037$7 f 0I0 `Ilk# 174M- - 1 RiE# p�#e aV. #� "Q , ru5c r reg s efee the ezplrat{aIl:date:.If found return t0: pafd o`f gjjAding` egtrlations and Standards A gburton PjaCe Rnf301 A. x Y<z of:rtalYd wit ottt s:11g hire DATE(MM/DDIYYYY) CORD® LIABILITYOP'ID DS CERTIFICATE f INSURANCE OSU SPRIN-1 01/05/10 PRODUCER THIS CERTIFICATE-IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Bryden & Sullivan Ins Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 88 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis MA 02601 Phone: 508-775-6060 Fax,508-790-1414 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Associated Industries of.MA - �— — — — INSURER BB: _— S rinkle Home Improvement Inc: INSURER C 139 Barnstable Rd INSURER D Hyannis MA 02601 --- —- -- - INSURER EE - COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID.CLAIMS: P` LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM DtYYYY DATE Mww( LIMITS GENERAL LIABILITY. .- - -EACH OCCURRENCE $ - COMMERCIAL GENERAL.LIABILITY I_ -PREMISES-Ea occurence $ CLAIMS MADE .OCCUR MED EXP(Anyone person $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE I$ GEN'L AGGREGATE LIMIT APPLIES PER: , " PRODUCTS•COMP/OP AGG�$ POLICY I PRO- LOC" f JECT AUTOMOBILE LIABILITY i.. ,COMBINED SINGLE LIMIT $ ANY AUTO I (Ea accident) - ALL OWNED AUTOS i - BODILY INJURY .!$ SCHEDULED AUTOS (Per person)j � HIRED AUTOS BODILY INJURY NON-OWNEDAUTOS i I(Per accident) § PROPERTY DAMAGE "$ — - (Per accident) I..•. GARAGE LIABILITY AUTO ONLY=EA ACCIDENT $ ANY AUTO I; OTHER THAN; EA ACC S AUTOONLY. AGG $. EXCESS I UMBRELLA UABILITY I EACH OCCURRENCE< , $. OCCUR CLAIMS MADE I AGGREGATE $$ DEDUCTIBLE -- 5 RETENTION - $ t $_ WORKERS COMPENSATION TH- TORY LIMITS ER AND EMPLOYERS'LIABILITYA ANY PROPRIETOR/PARTNER/EXECUTIV� AWC7004943012010 01/01/10 01/01/11 E.L.EACH ACCIDENT- S 500000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE'EA EMPLOYEE $500000 Nes desaibe under IALPROVISIONSBelow i - - E,L.DISEASE•POLICY LIMIT $.500000 OTHER- DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION, SPRNKHO 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 Sprinkle Home Improvement, Inc IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Fax #508-775-1350 REPRESENTATIVES. Margo Mack 199 Barnstable Rd. AUTHORIZED REPRESENTATIVE Kelley A.Sullivan flyannis MA 02601 ACORD 25(2009101) ©1988-2009 ACORD CORPORATION All rights reserved. The ACORD name and logo are registered marks of.ACORD