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HomeMy WebLinkAbout0135 SUDBURY LANE __ �� �5� csvdh�� Ivy . � � - - - �- � --- --- --- -- -- _ f O�,THE P •a �,, �y Application o� L aAR.NsTABLF- " Date Issued.......... �... ....... ............. ?r R1639• ( Building Inspectors Initials........... FD Mp�i a ('0 ' .......... Map/Parcel.......a.�..v....Z q:' ......................... T® OF A ST LE I l`�� EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHER IZA TION PROPERTY MORMATION Address of Project: NUMBER STREET VILLAGE , Owner's Name: , , Po YeAeT phone Number Email Address: e i looLrr y �ot�a:1 cow Cell Phone Number,;V Project cost$ _ :- Z i L-/G W _ Check one Residential Commercial ONMR'.S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK ❑ Siding U Windows #e no header char ❑ ( g ) // Insulahon/Weathenzation ❑ Doors (no header change)# ICommercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to lil!c s�e-/''�Gi1a�,Pi✓/�� - �,Y�c o/r i /� L- CONTRACTOR'S INFORMATION Contractor's name I�r�Gn `74n�;sc✓� - S,r(-�•2cn 4/ej ! &, 1ev,&P r,J,'n JOWS Home Improvement Contractors Registration(if applicable)# 17 3 L.q_S (attach copy) Construction Supervisor's License# yq S 7 01 (attach copy) Email of Contractor QS'Jea ; C bM Phone number L101- z 2 R -9 goo ALL PROPERTIES THAT HAVE STRUCTURES VER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS 11V A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED, APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X I X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a: for profit non-profit event Check one:Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMTTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CM[R the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 C1R and the Town of Barnstable. Signature Date PLICANT'S SIGNATURE Signature Date Z - 1 3 - 1 All permit applications are subject to a building official's approval prior to issuance. Renewal Agreement Document and Payment Terms = V byAndersen. dba:Renewal By Andersen of Southern New England Erik Barry Legal Name:Southern New England Windows,LLC 135 Sudbury Ln RI#36079, MA#173245,CT#0634555;Lead Firm#12.37. Hyannis,MA 02601. WINDOW RE LACEMEMT 10 Reservoir Rd I Smithfield,RI 02917 - - : H:5087750340 - Phone:866-563-2235 1Fax:401-633-6602 1 sales@renewalsne.com ' C(508)280-6213 Buyer(s)Name: Erik Barry Contract Date: 01/30/19 Buyer(s)Street Address: 135 Sudbury In Hyannis, MA 02601 Primary Telephone Number; 5087750340 ; : Secondary Telephone Number:.(508)280-6213 rY Secondary' Email• Primary Email ejbar @hotmail.com . Buyer(s)hereby jointly and severally agrees to.purchase the products and/or.services of Southern New England Windows,LLC d/b/a.. Renewal By Anderset of Southern New England("Contractor"),in accordance with the terms and conditions:described in this Agreement . Document and Payment Terms;any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by,the parties and incorporated herein by reference(collectively, this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under,this Agreement. Total Job Amount: $22,468 By signing this Agreement,you acknowledge that.the Balance Due;and the Amount Financed must be'made by personal check;.bank check,credit:card,or cash Deposit Received: Balance Due: •$10,000^ -'..Estimated Start:,, ati Estimated Completion: Amount Financed: 8-10 Week9 .8-10 weeks $20,000 • . Method of Payment: Credit Cdrd : We'sch6dule installations based on the date,of the stg ned contract and secondarily on. r the date in which we complete the technical measurements.The installation date that, we.are providing at this time is only an estimate..We will communicate an official date,- a nd:"fime'at a Later date.,Rain.and extreme weather are the most common causes for delay Notes: $2,468 dep+ %50 paid by GS; %50 paid by GS at compl.;Taxes paid in Barnsta Buyer(s)agrees and understands that this Agreement.constitutes.the entire understandings between the parties and that there are no weibal understandings changing or modifying any.of the terms of this Agreement.No alterations to or deviations from this Agreement,will:be. valid without the signed,:written'consent of Both.the Buyer(s)and Contractor.Buyer(s)'hereby ackriowledges that Buyer(s) 1).has read this Agreement, understands the terms of this Agreement;and has received a completed,signed;and dated copy of this Agreement;including . the two attached Notices of Cancellation,on the date first written above"and.2)was orally informed of Buyers right to cancel this Agreement NOTICE TO BUYER: Do not sign this contract if blank.:You are entitled to a copy:of the contract at the time you-sign. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 02/02/2019 OR.THE THIRD BUSINESS PAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New EnglandWindows,LLC ' dba:Renewal B uthern'New.England. Buyei(s). ,. Signature of Sales Person:.. Signature Signature ; Kevin Desmarais' ' Erik Barry Print N'me of Sales Person Print Name Print Name' UPDATED.:."01/30.09 ; Page'2./ 14 . ''lJ/fCGti /C^�Pf�+- Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement-Contractor Registration Type: supplement Card SOUTHERN NEW ENGLAND WINDOWS, CLC.> ;:`", Registration: 173245 10 RESERVOIR ROAD Expiration: 09/18/2020 SMITHFIELD, RI 02917 ScA , a 20rvi-05i17 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 1.73245 _: 09/18/2020 1000 Washington Street-Suite 710 SOUTHERN NEW ENGLAND WINDOWS,LLC Boston,MA 0211 BRIAN DENNISON !\j�rrGL:a- 10 RESERVOIR ROAD �Ti SMITHFIELD,RI 02917 rwvL ai WI$ffAUg SI r18tUPe Undersecretary 9 Commonwealth of Massachusetts Division of Professional 1_icensure Board of Building Regulations and Standards UP nstruct-0n Supervisor CIS-095707E p i res : 09/08/2020 tl IAN ® ®E N9SON 8 BLACKWEL ®REVS CHARLTON A%01307 -4 a Commissioner The Commonwealth of Massachusetts Department of Industrial Accidents 7. I Cona ress Street, Suite 100 a Boston,"MA 02114-2017 www mass gov/dia NForkers'Compensation Insurance Affidavit:Builders/Contractors[Electricians/Plumbers. TO BE FILED WITH THE PEItNMENG AUTHORITY. Applicant Information ' L Please Print Lezibly Name(Business/Oreanization/Individual): 5 UeNJ�u- t e r Py, Oe O G JCj I A L Address: f U &SeY VD/r City/State/Zip:Sty t-H1tl e_J4,R-- ! 4ZQ 17 Phone#: Are ye an employer"Check the appropriate box: Type of project(required): 1. 1 aim a employer with 20-1—employees(full and/or pa'n-time).• 7. [] New construction 2. I am a sole proprietor or partnership and have no employees working for me in 8: Remodeling any capacity.(No workers'comp.insurance required.] 3.[]l am a homeowner doing all work myself.[No workers'comp.insurance required.]r 9. ❑Demolition Q ing addition 4.M l am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Build ensure that all contractors either have workers'compensation insurance or are sole 11.[]Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 l am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.a Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.❑We are a corporation and its officers have exercised their right of exemption per bICL C. 14.[► Other tarn LVJ 152,§1(4),and we have no employees.[No workers'comp.insurance required.] 1—e O 14 e el-, 'Arty applicant that checks box fil l must also fill out the section below showing their workers'compensation policy information G 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-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is pr9Wd1ng workers'compensation insurance for my employees Below is the policy and job site dnformadon. n- /) Insurance Company Name: T![MIE ,STAIS Ufa Am_ t o . o OF b, (i , Policy#or Self-ins.Lic. Expiration Date: e Job Site Address: l (j ur y L►n City/State/Zip: A Attach a copy of the workers' compensation policy declaration page(showing the policy nuna er and ea iration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A.copy of this statement.may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby kerb under the pal i1ndpenaffies of perjury that the information provided above is true and correct Signature: 1AOP. Date: 2 Phone#: Q()1 ��'T�it 91 � Official use only. Do not write in this area,to be completed by city or town official 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#: DATE(MMIDD/YYYYI ACo CERTIFICATE OF LIABILITY INSURANCE 1 2/2 81201 8 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 CoBiz Insurance, Inc.-CO NAME: PHOE 1401 Lawrence St., Ste. 1200 WCNNo, o Ext: 303-988-0446 alc Ne:303-988-0804 IL Denver CO 80202 ADDRESS: COMail@Gobizinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO-01 INSURER B:FiremenS Insurance Company of WA,D.C. 21784 Southern New England Windows, LLC. dba Renewal by Andersen of Southern New England INSURER C: Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:787175890 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 TYPE OF INSURANCE ADOL SUBR . POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIOD/YYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY CPA3158728 V1/2019 1/1/2020 EACH OCCURRENCE $1,000,000 CLAIMS-MADE a OCCUR A $300,000 PREMISES Ea occurrence MED EXP(Any one person) $10.000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ❑ LOC PRODUCTS.COMP/OP AGG $2.000.000 X JECTPRO " OTHER: $ A AUTOMOBILE LIABILITY CPA3158728 1/1/2019 1/1/2020 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ A X UMBRELLA LIAB OCCUR CPA3158728 1/1/2019 1/1/2020 EACH OCCURRENCE $15,000,0D0 X EXCESS LIAB CLAIMS-MADE AGGREGATE $15,000,000 DIED I X I RETENTION$0 $ B WORKERS COMPENSATION WCA315872924 1/1/2019 1/1/2020 X PER ERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑N N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000.000 C Pollution Liability 7930073340000 1I1/2019 1/1I2020 Each Occurrence $2,000,000 Claims-Made Policy Aggregate $2,000,000 Retroactive Date 06/20/2013 Deductible $25,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. FOR INFORMATIONAL PURPOSES ONLY AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Town of Barnstable *Permit# > ' Regulatory Services. EFee 6 i i sa iE ns � Richard V.Scali,Director s639• �0 Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www:town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Numbe& Property Address j 0 7 Q �'� Nll�l k ,+ DZ-00 5a Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name 1/��t.L4 40vtor, ` Im 'C__ Telephone Number SO& 501 'k{b'4 Q Home Improvement Contractor License#(if applicable) �� _ Email: 14g4gpq G & G 1CIc-Gv4 � Construction Supervisor's License#(if applicable) _- ES; _9 0 ❑Workman's Compensation Insurance JUL 2 8 201 Check one: - ❑ I am a sole proprietor TOWN OL -BWRNS ABLE `. ❑ I am the Homeowner g'l have.Worker's Compensation Insurance Insurance Company Name JaCA1'w8YZt"-r Workman's Comp.Policy# _ (J Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) gRe-roof(hurricane nailed)`(`stripping old shingles) All construction debris will be taken to W ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors%sliders.U-Value (maximum.32)#of windows #of doors: '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 equired. f, � .U SIGNATURE: 1 41 .. QAWPFILESTORMSUilding permit forms\EXPRESS.doc k, 01/25/17 Town of Barnstable Regulatory Services Richard V.Scali,Director muse. Building Division. Panl Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 . www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, LAM ,as Owner of the subject property A , hereby authorize OLAMef- 4 to act on.my behalf, in all matters relative to work authorized by this building permit application for: Ob 0 (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final' inspections are performed and accepted. c Signature of Owner Signature of Applicant Print Name Print Name Date QYORMS:OWNERPERMISSIONPOOIS } Town of Barnstable Regulatory Services °U Richard V.Scali,Director Building Division Paul Roma,Building Commissioner 1639. �� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number strut - village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner . engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor t (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against*the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\E3tPRESS.doc 06/20/16 r wt o'. :66 . o IVshmt $ 02M warkwe cunwmixffm AEf! deislf at -JRl� bers PlemeAiddre= Prfidbmffily�. Am as a q&yer?.AMecktheag�raPriafeba Laota�IQ—r - Z:asta T ofgraject regmwe*- 57311 a _ * felt 6. ❑ Ter$ Q argar Ire ed flee 7 E]RemndeFog Demal&Da any caps Ira a leis' �,.��� - �[] �Te�a o�taaan�£ ts ��❑��cal tepaus ar adrf�.oas 3_Q Z�a a e�s have wed sir • II-❑ sepsis or awns ' myseuo�',�- Of=urgfifla per M4M Yoa - iv�rwd-m-d-1 T §I(4)6 andwe mew ' y emgloyees,[No ceis'. �-0 Offlw _ c �gmreELl 'AqrqFffamtasarmsbmiR 'amim fly a.beIava .a�i,ao � p Y smt ffaa�vr ata�osat �s�darSi gftyMAd*a Sff .&.dtbm as c �srsn r:ngmmmd� it sarh �Cais87stc�Cir ¢s bmcmast sum addiS�at sheet sbouiagti�enof tlzeaad staff srhe atnotthase eeshz� mmb em Ifti soh c sbacee�i Pavu?d t s.lam aa"euig-c w ffm t'k.., � ss,av es ton i}rsaiaass nr $eTn�v is itts prrlic� arm jab sifa = AtJft ®a(:�O1 A 26{-coW Ofte Wor1O'c=peasafiaapolm, &r.I�rafim pap(shmieg#a PoHCY der aad��oa date cavesage zegmiednader Sectiog 2�of I4�t$,¢]�inn lesd'bo ffie' � a .. ,- fim up to SL500 oa im&ar ajs - t'�mis A penames of a gears�ogme eIl asitl peualii�is fi� aS�OP�iPT[3R1 ]BTfF.L��d a of QQQ a,dap a ffie vin3afor. Be adrised #roppaf s maybe hatred f;m'&e bffice of h asSofffteM&fm&=a=covecagececs�s#zti.w Zero hwgby fundardwpa*w 40fg�rMuy i3�ai€�,fartaafactsprndabora�'s a a ussrmF� 3ia u�st rites ib sa �r be CMRAted by cyy artolm City or Tav= r Lmdng-Auffimity 1.Board of Heal& 3 Cdyfrovm Cl=k 4.Ekdric;dhvecftr S. ' 6.afher ConbctFerson: " I AC 0 CERTIFICATE OF LIABILITY-INSURANCE DATE o5-;5=2017 Z 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(!es)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. NAME: DOWLING&O'NEIL INS PHONE FAX 973)YANNOUGH RDINC, o Ex : a No): HYANNIS,MA 02601 E-MAIL INSURERS)AFFORDING COVERAGE NAIC# INSURER A:ACE AMERICAN INSURANCE CO INSURED INSURER 8: KELLY ROOFING INC INSURER C: 8 RHINE RD YARMOUTHPORT,MA 02675 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE R: 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. NbTW1THSTANDING 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 TYPE OF INSURANCE ADDL SUB POLICY NUMBER p90MLI/DCY EFF POLICY IEXP LIMITS LTA INSR WVD ( D/1'YYY) MM/DD GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILr Y ' DAMAGE TO RENTED $ CLAIMS-MADE OCCUR PREMISES Ea occurrence MED EXP(Any one person) S PERSONAL&ADV INJURY $ GENERAL AGGREGATE . $ GEN'L AGGREGATE LIMB APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY JECOT 171 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ O B' ent ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED OPERTY AMAGE AUTOS tier acGde t $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED I I RETENTIONS $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNEWEXECUTIV� N/A E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? IN NIA UB 05-10-2017 05-10-2018 $500,000 (Mandatory in under 8HO85809 E.L.DISEASE-EA EMPLOYEE $500,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It more space Is required) CERTIFICATE HOLDER CANCELLATION TOWN OF YARMOUTH BUILDING DEPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE 534 WINSLOW GREY RD CANCELLED BEFORE THE EXPIRATION DATE THEREOF, SOUTH YARMOUTH,MA 02664 NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE JOHN J.LUPICA,President ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Massachusetts Department bf Public.Safety Board of Building Regulations and Standards L"tcense:CSSLAW167 Construction Supervisor Specialty. 8 RHINE ROAD _ 1fARTH PORT . R i �./t -- Expiration: s Canrrn ner 09,=4017 Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvem6k.zontractor Registration Type: Individual OLIVER KELLY r Registration: 12-8957 8 RHINE RD Expiration: O6/13/2019 YARMOUTHPORT,MA 02675 rN Update Address and return card. Mark reason for change. `CAI v 20MAW11 - — QAdtl nm.21[+;mtArtt_C7._L�stCard �iavr,�aa�rcae�cll���C%l�rcasaccctelt� �— Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only 1W-1 '. TYPE:individual before then expiration date. It found return to: R-99 istration ggpiration Office of Consumer Affairs and Business Regulation 128957 06/13/2019 10 Park Plaza-Suite 5170 i TIVERFri!Y 5O Fi;W, 02116 YA: Irl �zr,MA'S Not valid without signature` s t Aa. TOWN OF BARNSTABLE Permit No. 25585 { NAUSTAU Building Inspector Cash --------------01 -4ril OCCUPANCY PERMM Bond -------------X_ . r Issued to Capricorn Re it'y jrust Address Lot 30, 135--Sudbury MLane,.�,.Hyannis Inspection date Wiring Inspector > 5( / ��' /-rs Plumbing Inspector Inspection date Gas Inspector cm- � y � ��'���{r�A � Inspection date � 41---t- A X g p Q r!_ �� En ineering,Department �. -�`-'c'"�A Inspection date 7 Board of Health L ~� Q� v Inspection date 14 THIS PERMIT WILL/NOT'BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE tBUILDING INSPECTOR 'UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Building Inspector l P 4 FROM " a 'TOWN OF BARNS"T LE • BUILDING, DEPARTMENT r Mr. Framis Lahteine> Y ,, �f.<t.. <.R s*. %367 MAIN STREET HYANNIS, MA, 02WJ Tom Clerk Phone: 1 qr 4 1 A( . 53`a}i.' aQ ac s 4 c 4 r A q t'w w♦8 rt }1�5-1 i�2 - rtl � SUBJECT FOLD HERE DATE ,� - MESS F Work has been c!mpleteq. ,Be4ity.,.T a.st) PRedse release Borid. r SIGNED - REPLY - - SIGNED - - Ne7•RMI - RECIPIENT:RETAIN WHITE COPY,RETURN PINK COPY • ` !yy r PRINTED IN U.S.A. -SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES-WITH CARBON INTACT. Vi• h ' L o T 3 U 41 a L v .7- it P OF v-7 -1o• � En .otoMus H fh M 'A 2M7 0 �Q/3TB��p� R sc[����., RL ��tTE 4-0' wo� CERTIFIED PLOT PLAN .3 yip ; IN t ECALE� / � 0 DATE t _ r 7. 1 CENTIFY THAT THE �'�•'"<� ' v N KNOWN ON THIS PLAN 18 LOCATED =0N THE AROUND AS INDICATED AND , OL�i1L LAW :. .. } : : i 001 "u$ To THE ZOMINO LAWS 4. .� ♦��i�^ I�' N••'8 T� �C .' +` i," 3, + yam•, !Q_..• .? M YQ N It I�, 1111'I� a' R all LEG. L ANO SURVEYOR 71 E' * . . . 3� � 07 3O . 140 0S,r . v-rLl �o L) Nd Fvn.,2.E l 46 i4 :c PAQs�ea � j N aaQnn b:.vLs N Fu0 EL= .410 0 _ Zvi � 5 GT Ste✓ �03 3 4 QN LR rgR^!GG Ali 44 S' I t M I4 ys - 5 / �tOta44 EIE�lAT'1c]tJS I3 N.e. V D:•:' ' LEGEND: : . CERTIFIED , PLOT PLAN 'EXISTING; SPOT ELEVATION . Ox0 EXISTINQ. CONTOUR =_-- 0 j�OF L o r 3AI'c— FINISHED . .SPOT ELEVATION � s 'FINISHED CONTOUR : 00�3 yam IYA IN APPROVED BOARD -OF HEALTH DATE AGENT � 4 0 SCALE DATE : su l �- LOREDGE ENGINEERING CO. IN i rnA„VC--o. CLIENT i CERTIFY THAT. THE PROPOSED W EGISTERE REGISTf`RED ,I08'pIQ. ,BUILDING SHOWN ON THIS PLAN 7'> CIVIL. . LAND , CONFORMS TO THE ZONING LAWS ENGINEER SURVEYOR DR.BYt �!' OF BARNSTABLE , MASS., 71.2 MA1 N ..STREET 4 H Y A PJ N°i S NI A S S o _ _ . _ -- SHEE"T�L.,OF' . DATIr R . LAND SURVEYOR t,' . Assessor's map and lot number �� 7 7,' . SINE Sewage Permit 'iYR7i1'Ibe .=, '.......,. .; . ... . .... 2 0 d`�Q o �♦� r .. 3 Z BABBSTABLE. i House number ......... ... ...���. .. ..........................::..... so NAM p MPY a' TOWN OF BARNSTABLE • 4 BUILDING INSPECTOR APPLICATION FOR PERMIT TO .,Construct Single Family Dwelling TYPE OF CONSTRUCTION .......Wo.o.d Frame C�. . ....................,9.. 3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: . Lt b ...........................................L cation ....... .......-. .... anriS,. .. ................Proposed Use ............................................................................................................................................................................. Zoning District R'B' H a% i.s ........................................................................Fire District ......,,Y..................................................................... Name of Owner qapK ic,orn Realty,..T.rjA0,i�,,,.,,,,,••..gddress,7.6s Falmouth. Road,,.. Hyannis„ „ Name of Builde7ranco Real Estate Dev. Co�gddress '7.6.5..,F.almAuth..RAad.,.:.Hyannis................ Nameof Architect ..................................................................Address ..............................:..................................................... f Number of Rooms SlX ,,,,,,,,,,Foundation Exierior Clapboard and/or shingles ....Roofing ,Asphalt S.hingl.es..................... Floors Caret ..Interior Sheetrock ..... ................................................................... Heating Gas..... F.W.A...................................................Plumbing ........Two...- C ............... - - Fireplace NOrie .......................................Approximate Cost ...4 000.00 ...................... .............. Definitive Plan Approved by Planning Board ___ __________________ .... . . ______19_______. 1( D Area ..ft�........... ..... Diagram• of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH c , _ a OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regar ing the above construction. Nam . .. ... . .... Rre0.A. 000989 CAPRICORN REALTY TRUST j25Z85 '­- One Story No Permit for .................................... .................. Single Family Dwelling ............................................................................... Location L.dt....30, 1.3.5....Sudbury...Lane. .................. .. .... .. =5 Hyannis ..................................................................... Ow Capricorn Realty Trust nlft ................................................................... Typi CoAstruction ,.Frame.................................. .... .................................................................. Plot ....................... Lot ................................ Per Granted ......................................September 27,..19 83 Date v 6f Inspection .....................................19 Date Compi ed 19 Assessor's map and lot number ..�.,: ..... � c� TOE ... ....................:..r..... 2 3 ��Q� . ' y Sewage Permit number ........................'. YNE Z MARISTAME, i fMAM House number ......;...'[. `.. d......... .................................... 9 039 ��✓ I?OR a' TORN OF BARNSTABLE h. BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..Construct Single Family Dwelling .............................................................. ......... TYPE OF CONSTRUCTION .......Woo.d. F.ra e................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: t The undersigned hereby applies for a permit according to the following information: Location .......T' t..#..3a......".....Sudbur�...�ns..... '........................................�van-ni�;., M�................................ ProposedUse ............................................................................................................................................................................ Zoning District R. ..............................................................Fire District .... .v a;rnnis............'........................................... Name of Owner qa:nrlA , „l gm2 t;y `T'n7at. ......Address Z6.5�...F'ad7;lnnuth Rcta d.+....ffvazar;1s................ Franco Real Estate Dev. Co. Name of Builder` - Address ��. .. Fa tnnta din• R r TH�r�2aira a lii . Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .....SIX....................................................Foundation ..... .,C................................................................. Exierior Clapboard and/or Shingles Roofing Asphalt Shingles ............................................ .......::........ ............................................. Floors Ca.rpe .Interior .........Sheetrock ..................................................................................... ..................................................................... Heating Ga.S — F.W.A....................................................Plumbing Two - C Fireplace Non@ ....................Approximate Cost $40,000.00 �o,ne........................................................................ .................................................................... Definitive Plan Approved by Planning Board ---------------_-----.---------19________. Area �0 ..sq,i....ft............. Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH � 4 t \•y f it y ` ^ 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 . �'x'e8. rJ ti9 CAPRICORN REALTY TRUST A=270-229 25585 One Story No ...................Permit for .................................... Single Family Dwelling ............................................................................... Lot , Sudbury e_ Location .............30....................135............................Lan... Hyannis ............................................................................... Owner ...,Capricorn Realty Trust ...................................................... Type of Construction ..Frame ........................................ ................................................................................ Plot ............................. Lot ................................ September 27, 83 Permit Granted .......................................19 Date of Inspection ....................................19 Date Completed ......................................19 C � I