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0076 STATICE LANE
ce Ln . ` IL Town of Barnstable Permit# Expires 6.months from issue date Regulatory Services Fee BABNSrABIA Thomas F.Geiler,Director Ir Mass ED 39. "•� 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 / Not Valid without Red X-Press Imprint Map/parcel Number 2-7 3 d Property Address �3 Residential Value of Work 0e wMinimum fee of 5 0 for work under$6000.00 Owner's Name&Address R R M A ✓} 7( 67/�7) (f LPM YAX) kh s Contractor's Name I L-- N 17C HCO Cy— C10 6J S 7 R U Q blu S—C, Telephone Number(5%) 775 7763 Home Improvement Contractor License#(if applicable) t/-3 Y F 2 14Workman's Compensation Insurance Check one: ❑ I am a sole proprietor X-PRESS ERIA IT ❑ I am the Homeowner I have Worker's Compensation Insurance S F P 2��8 Insurance Company Name 0]v h-(, IQ M-t,�2, TuO n iA a EN BARNSTABLE �vvi� Workman's Comp.Policy# 7 5 0(0 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ] Re-roof(stripping old shingles) All construction debris will be taken to S L a W n S i G ❑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:- *"Note: Property Owner must sign Property Owner Letter of Permission.. A copy of the Home Improvement Contractors License is required. SIGNATUPE: ' Q:Forms:buildingpermits/express Revised 123107 - The.Commonwealth ofMassachusetts Deparfinent of Industrial Accidents Ofce of Investigations 600 Washington Street ` Boston, MA 02111 , www.m ass.gov/dia Workers'.Compensation Insurance.Affidavit;.Bugders/Contractors/.Electricians/PIumbers A licant Information Please Print Le 'bI Name(Business/Organization/Individual):. . 7 • �. " G�i,COt.�L S apdG CSh� ,yrc�s .Address: /O -5 ,r,rz2doC_ Spy, City/State/Zip: y /t//1�/S /Phone.#: S?>g ' s— "�y� 3 Are on an employer? Check ,appropriate box: Type of project(required):• / 4. am a general contractor and I a employer with I_ � g 6. -0 New construction . employees(full and/orpart-time).* have hired the stib-contractors 2.0 -lam a'sole proprietor or partner- listed onthe'attached sheet. 7. 0 Remodeling. ship and have no employees These sub-contractors have g• 0 Demolition working for me in any capacity. employees and have workers' insurance,#' 9. 0 Building addition [No workers' comp.insurance COMP. 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.❑Plumbing repairs or.additions myself [No workers'comp. right of exemption per MGL 1 f re airs C. 1 . P • insurance aequired.]t , 4� ( )'and we have no • . employees, [No workers' .13.0 Other COMP.insurance1equired.1 . *Any applicant that checks box#1 must also fill out the•sedtion 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 sbowing the name of the sub-contractors and state whether or not those entities have employees. rf the sub-contractors have employees,they must pravidb their workers'comp.policy number. I ant an employer that is providing workers'compensation insurance for my employees Below is the'policy and job site information. /l Insurance Company Name: Policy#or Self ins.Lic.#: 306 Expiration Date: D s- Q 9 Job Site Address: City/StateJZip- 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 ofMGL c. 152 can lead to the imposition of criitrinal 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 bIA for insurance coverage verification. I do hereby certi ' s nd pen s of perjury that the information provided aba a i/sftue and correct Sienattire: Date: AM 9 _ Phone#: o _ / �S _57-0/3 Official use only. Do not write in this area,'fo be completed by city or town ofjiclal City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 'I , . ✓feto>�orureafl�o�J License or registration valid for individul use only Board of Ballding Reguhwons and Standards before the expiration date. H found return to: HOME IMPROVEMENT CONTRACTOR Board of Building Regulations and standards Reglatrat[on;.i58587 One Ashburton Place Rin 1301 E,Ipratlan: 218i2f110 Tr* 26d153 Bolton,No.02108 Vie: Private Catporallon T.L.HITCHCOCK SS-WICESANC. TED HITCHCOCK 105 NERIUDOC � Not with t.signature HYANfVIS,MA 02668 Administrator �LISSitchusetts- Depil"tment of Puftlic Bu:u-d of Buildings Rc�ulatiuns and Standard Construction Supervisor Specialty License License: CS SL 99826 Restricted to:.;,RF,WS TED HITCHCOCK •;" :.55 LISA LANE WEST BARNSTABLE; MA 02668` Expirations 6/1/2012 ('nnmi'�imcr Tr#: 99828 .��\ fl Bo ar aon4an� � Wadfsdeoj One Ashburton Place - Room 1301 Boston. Massachusetts 02.108 Home Improvement Contractor Registration Registration: 158587 Type: .Private Corporation Expiration: . 2/8/2010 Tr# 264153 T.L. HITCHCOCK SERVICES INC. TED HITCHCOCK 105 FERNDOC RD HYANNIS, MA 02668 Update Address and return card.Mark reason for change. • 0 s010-07107-Pc84e0 Address Renewal Ej Employment host Card e � , Town of Barnstable Regulatory Services Thomas F.Geller,Director . Building.Division Tom Perry,CBO Building Commissioner 200 Main Strut, Hyannis,MA 02601 www.town.barnstablema.us Office: 508-862-4038 r Fax: 508-790-623.0 Property Owner Must Complete and Sign This Section If Using A Builder r r _ ,q ,as Owner of the subject property hereby authorize ! , . ��i1i�1/.� to'act on my behalf, in all.matters relative to work authorized by this building pernut application For. (Address of Job) Vomm � o Date Print Name Q Forms:expmtrg Revise071405 105 FERNDoc STREET HYANNIS,MA 02601 ` (508)775-7763 TEL (508)775-7763 FAx DATE:AUGUST 26,2008 T.L. Hitchcock ConstrucCion Services, Inc. MR.&MRS.NAJARIAN 76 STATICE LANE HYANNIS,MA 02601 TEL:508-775-4138 RE:PROPERTY LOCATED AT 76 STATICE LANE, HYANNIS,MA 02601 FURNISH MATERIAL AND LABOR TO RE-ROOF HOUSE AS FOLLOWS: • REMOVE EXISTING SHINGLES FROM ENTIRE ROOF AREA OF HOUSE. • INSTALL NEW ALUMINUM DRIP EDGE ON ENTIRE EAVE AREAS. • INSTALL ICE AND WATER SHIELD ON ALL EAVE AND VALLEY AREAS OF ROOF. • INSTALL ICE AND WATER SHIELD AROUND CHIMNEY,SKY LIGHTS,VENTS AND OTHER PENETRATIONS. • INSTALL# 15 FELT PAPER ON ENTIRE AREA TO BE RE-SHINGLED. • INSTALL CERTAINTEED 30-YEAR WOODSCAPE SHINGLES ON ENTIRE ROOF. • INSTALL NEW ALUMINUM PIPE FLANGE. / , • INSTALL RIDGE VENT ON ENTIRE RIDGE AREA OF ROOF. CAAo F _(�ram- • CLEAN AND REMOVE ALL TRASH FROM JOB SITE. • LABOR WARRANTY= 10 YEARS. • MATERIAL;WARRANTY=30 YEARS. PRICE:$9300.00 PAYMENT TERMS:DEPOSIT OF$3000.00 IS DUE AT CONTRACT AND THE BALANCE OF $6,300.00 IS DUE UPON COMPLETION OF JOB. ACCEPTANCE OF PROPOSAL:THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND.ARE HEREBY ACCEPTED.PAYMENT WILL BE MADE AS OUTLINED ABOVE. SIGNATURE OF CONTRACTOR: DATE: �� r SIGNATURE OF CUSTO DATE: v t7C/11/Zt)ut1 u7:ou outs-r717—uzgj LiULLIMAN & A55UU. PAGE 01/01 ��-®-�., CERTIFICATE OF LIABILITY INSURANCE cSR A8 PRO e-p DATRIMM1131) Vy)• COLDMAN 6 AS80CIATES TNBURANCE THIS CERTIFICATE 1S ISSUED AE A I ATT6R OF INFpR 08 11 08 FINANCIAL SERVICES INC. ONLY AND CONFERS NO RIGHT; UPON THE CER11F1C,4ATE�N 933 FALMOUTH RD. HOLDER.THIS CERTIFICATE D0�'S I�pT,ply)ENE EXTEND OR HYANNIS MA 02601 ALTER THE COVERAGE AFFORD:D 8Y THE POLICIES BELOW, Phone:508-775-6010 Fax:508-790-0249 INSURED INSURERS AFFORDING COVERAGI INSURER A: NATIONAL UNION ENAIC#T. L. HITCHCOCK CONSTRUCTION INSURER8: ATIppt� SERVICES INC ^RANG) NUTUAL 105 FERNDOC ST INSURER c: HYANN-TS MA 02601 INSURERD: — — COVERAGES lNauRER E: AN REOUPOLICIES OF INSURANCE LISTED SEL I&'W HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOT Jlrll$TnNDING ANr REQUIREMENT,TERM NC CONORION OF ANY CONTRACT OR OTHER DocumGNT WITH RESPECr r0 VVMICH THIS CERTIFICATE MAY BE If 1Ut:D OR TA MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 18 SUBJECTS ALL THE TERMS,EXCLUSIONS AND AY BE I JU OF SUCH POLICIES.AGGREGATE LIMITS sHOwN MAY HAVE BEEN REDUCED 9Y PAID CLAIMS. LTR N TYPE OF INSURANCE POLICY NUMBER _ GENERAL LIABILITY DATE MIDp ba E MM D1yV B LIMITS X COMMERCIAL GENERAL LIABILITY '—' MP896140 05/23/08 05 23 09 Eacnc ;cI1RRENcs CLAIMS MADE F2000000 _ OCCUR / / PRE $Ee. MI: $300000 DE)'(AiY_ on,^person) $10000 PERS01 aL t ADV INJURY 3 2000000 OEMLAGOR50ATELIMITApPLIFJPER: GENFR, .AVGAEGATE 44 0000— 00 POLICY UTY LOC PRO DU rS COMP—tippq 34 00000� 0 AUTOMOBILE LIAOILtry — ANY AUTO ALL OWNED aur08 CPMS N �t INGLE LIMIT 3 SCHEDULED AUTOS — HIRED AUTOS BO➢ILY I'JURY OS (Per Pert tf g NON-OWNS➢AUTOS BODILY I.JU)Iy —~ (P(jr seek m) t GARAGE LIABILITY PROPERi 'DAMAGE(Pergogd 11) g ANY AUTO - AUTO /.,;AACCIOENT S OTHERTf W EA ACC 3 EXCESS/UMBRELLA LIABILITY AUTO ONI —— _ AGO $ OCCUR 0 CLAIMS MADE EACH OCC.IRI;EN—NE DEDUCTIBLE AGOREOA E RETENTION $ -- S W01t"AB COMPENSATION AND — 3 A EMPLOYERS'UAMLITYANY q OFFICC PRIETOR/PARTNER/eXECU7WE 27306 togrl M is I R OFFIC'RIMEMSER EXCLUDED7 06/05/08 06/05/09 E.L.EACH I M17LAIT 8 ECIA�PROVISIONGbolow — $500000 _ OTHER E.L.DISEA6 .EA EMPLOYEE 3 500000 E.L.DISEAs _pOLICY LIMIT &500000 )ESCRIPTION OF OPERATIONS I LOCATION$I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ERTIFICATE HOLDER . CANCELLATION FOREVID SHOULD ANY OF THE ABOVE DE9CIIISED POLICIES 19 CMJCELLED 13UQRE THE EXPIRATION FOR EVIDENTIARY PLT"uS ONLY bATE THEREOF,THE 188UIJG INSURER WILL ENDEA DR TO MAIL DAYS IMtITTEN NOTICE TO TNQ CERTIFICATE HOLDER NAMED TO T/ 3 UIfFT,BUT FAILURE TO b0 90 SHALL xxxm IMPOSE,NO OBLIGATION OR LIABILITY OF ANY KIND I Poll THE INSURER.ITS AGENTS OR �I REPRESENTATNES. I lj AUTHORIZED REPRESENTATIVE AM LOU R CORD 25(2001108) 0 ACORD CORPORATION 1980 TOWN OF BARNSTABLE Permit No..35101 ............... BUILDING DEPARTMENT 864. 00 6 � (s l q TOWN OFFICE BUILDING Cash 1 7 Yl 9 .650 HYANNIS.MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Bayberry Place Realty Tr. / Jacques N. Morin Address Lot #21, 76 Statice Lane Hyannis, Mass. 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. j September 2, 92G�' /� v Building Inspector s i TOWN OF BARNSTABLE • Permit BUILDING DEPARTMENT I 3AJU� I TOWN OFFICE BUILDING E' Cash $... . . ...., M� 07�• HYANNIS.MASS,02601 Bond I CERTIFICATE OF USE AND OCCUPANCY Issued to Bayberry Place Realty Tr. / Jacques N. Morin . Address Lot #21, 76 Statice Lane Hyannis, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID. AND THE BUILDING SHALL:.N.OT.,'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. . . .. .lnber 2, 92. '� "�G. 19........... ..... �................. Building Inspector 4 TOWN OF BARNSTABLE BUILDING COMMISSIONERS OFFlCE DATE 9/���`/a 'PAYABLE"TO: a ACCT.# ' a/"21do =`5 Jacques N. Morin VENDOR# �b AMT. PO# AAV APPROVED BY �, c TO'dVN OF BARNSTABLE, MASSACHUSETTS BUILDING PERM1� i��173-86-110- ( �&3 j DATE .i unc:3, � 4T� / �. 19 y2 PERMIT NO. - APPLICANT_ Jtrepheii Wilcox ADDRESS - � Wagon Wheel Larie, W. Baryl. #0001 i 1 - (N0.) (STREET) (CONTR'S LICENSE) ;PERMIT TO BUiid L"yelliaq ( S+ l 5 aridly Dwel NUMBER OF STORY J.r,i �s.L:. (PR J ' )�la DWELLING UNITS - (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) LOL 211 76 6tcat jcA:E !Jc.l�l'"' �'1"'�ii11J.':: ZONING Q - (NO.) (STREET) DISTRICT I BETWEEN AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOT BLOCK LOT SIZE kN :BUILDI lt"S:TO BE FT. WIDE BY FT, LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTI h TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: !;Ll 1c:ju '2,.m l #3620 Jac UeS N. Morro. ($864. 00) 300 aearse -Jay, Iiyiinrii;S AREA VOLUME 1460 ` q. It. ESTIMATED COST PEREEMITT $ 73. 00 _ - (CUBIC/SQUARE FEET) - i3ay�nc:rry Place; Real ty Re 1J. = - •`."` 30L) ADDRESS t�F ct St:S u2 , tlyzIllill5 BUILDING DE PT. 1 7 I THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART I HEREOF, EITHER TEMPORARILY t ,-PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTEDNDER THE BUILDING CODE, MUST BE A PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINS FROM THE DEPARTMENT OF PUBLIC WORKS. -THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIO OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL INSPECTIONS REQUIRED FOR -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR I FOUNDATIONS OR FOOTINGS. -ELECTRICAL, PLUMBING AND MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 21: PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL FINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE, 3, FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS.,' ELECTRICAL INSPECTION APPROVALS 771(Is a — --- �� w• Z 2 �IAAI T � 3F { HEATING INSPECTION APPROVALS ENGI ERIN DEP RT ENT t � I�gas Vv BO D OF HEALTH o.n OT ER ' SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE INSPECTIONS INDICATED ON THIS CARD CAN CONSTRUCTION. PERMIT IS ISSUED AS NOTEQ ABOVE. ARRANGED FOR BY TELEPHONE OR WR17T NOTIFICATION. k GO 4) v �l 'IV 776 A., L /Za97s - , of t- 9. s L1`9N �6' CERTI F{ EDPLOT PLAN s LOCATION �Af2/VST �3 x... . .. . . . 'SCALE . /,i_ ,3a DATE PLAN`REFERENCE BE7wG ;Cc?TZ/ i �s s�w.v oN Pl. BK �.S'✓ �aZ �` �tJA J ter, . . . . . . . . . . .. . . o� �EL i�V --EY �r � No. 26100 �R�ST/NG h?u,VO g77ov I CERTIFY THAT THE r.V�, / SHOWN ON THIS PLAN IS LOCATED ON THE GROUND Lk AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF s BA�2!ecST}9t�t E .. . . . .WHEN CONSTRUCTED. DATE ! REGISTERED LAND t�S"URVEY R Assessor's office(1st Floor): Assessor's map and lot number a 3 -�� /y4 �c�TEE ro` y Board of Health(3rd floor): w Sewage Permit number �/ �d _ � • Z 9ASIST&BLL i Engineering Department(3rd floor): .7� �o rnea House number . o 1639• \v�' Definitive Plan Approved by,Planning Board — C 19 � �a rr+r rr APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only P/yk TOWN OF. BARNSTABLE ` BUILDING INSPECTOR APPLICATION FOR PERMIT16 C O✓Lrs/ i�'ei'Ci� //1/ ! ; i• �`"` ` TYPE OF CONSTRUCTION GJ- ! 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location f"Lo i / S"A7-70k I7- T7 Y�1✓i.GV��S, Proposed Use J,�nfr r Zoning District A�L /? Fire District �___�_/' /�e r✓". 9"��'C..N /ems/���7' �i7Z/S 7� - Name of Owner I«GRy� /U� /��'�p�/� 7?eVSTEZAddress 300 23456s Name of Builder J� /7� /✓ !ii'i/G© ,Addressz�W,,)-"/d,,j Lam`'& =/ %'-mac Name of Architect Address Number of Rooms 5 Foundation �'� v� Po""r`F7� Exterior����/� �� -�`J'��l Roofing Floors */ Interior 4&Gz Heating s -Ff"A Plumbing Fireplace t`�S L��� Approximate Costs Area �712 p Diagram of Lot and Building*h N-1 ensions (� - _ Fee / om V. N �.1� �� �°� =ti Av • V 2 /Zi /G 17' ' 1 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 construction. Name .• ' .ii� Construction Supervisor's License BAYBERRY PLACE REALTY TR. JACQUES N. MORIN No 35101 Permit For 131 Story 4'w - Single Family Dwelling I Location Lot #21 , 76 Statice Lane Hyannis JACQUES N. MORIN Owner Bayberry Place Realty Tr. Type of-Construction Frame Plot Lot z Permit Granted June 3 , 19 9 Date of Inspection 19 Date Completed k Z 92- 19