The URL can be used to link to this page

Home My WebLink About0295 SUDBURY LANE 0?`1 S S��l bar Lame f SIAStc 28 44 8, .50 CAPE SAVE Weatherization 508.398-0398 December 14,2011 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, This affidavit is to certify that all work completed for permit application #201105467, Status A, Parcel 269257 at 295 Sudbury Lane,Hyannis,Permit type: RADD, and issued on 10/03/2011 has been inspected by a certified Building Performance Institute (BPI) Inspector. R-18 Cellulose insulation was added to the attic.All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey Cape Save 7 Huntington Avenue Suite C, South Yarmouth,MA 02664 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION p 11 C) Map 9 Parcel ¢ice 5 T Applic �'on Health Division Date Issued b ( 311 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 5"b Lr-J L-00c, Village t`} q� "Ill S Owner p�P c�,' �'� Gh �r Address 'am Telephone ^ 3 Permit Request gir Sge`1 "�'� G ► 1 � WN G S , a: +e.!' �.11�II d01R)Yl 51'Q.)f'Gt��e �Y'1 YI C3 iA)/-650� y C . �r�,6� i,, n 16 Go e_ 9— ��s�jr��1^ r-In eeuk eoC cry^ asp A 'n.l..1+ ,)is Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family > Two Family ❑ Multi-Family (# units) ;e Age of Existing Structure U Historic House: ❑Yes ❑ No On Old King' Highway ,,,W Yes zU No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other X. Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 1 Number of Baths: Full: existing new Half: existing new.—= Number of Bedrooms: existing _new 01rn Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 14 Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes %No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - /(BUILDER OR HOMEOWNER) n R_ ,e W i 1' I c-C key / as Sw Telephone Number 508 - 3 7 0 03 78 Address +1 y� License #�, �4 S 6 ,4 Y"nou'A nk �� V1 Home Improvement Contractor# �� 3 Worker's Compensation # q l 5 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO �C&MOWJA SIGNATURE DATE FOR OFFICIAL USE ONLY F APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER f ; DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE i ELECTRICAL: ROUGH FINAL . PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ' DATE CLOSED OUT ' ASSOCIATION PLAN NO. t ; .r� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations v 600 Washington Street Boston,MA 02111 www mas&gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Auulicant Information Please Print Leltibly Name(Business/Organization/Individual): M10 a Ar-(e ALC I iC" D1181k cdee &A Address: u►n!11 N(c,,M:1 1-3 City/State/Zip: • YamosL t A 6VAgone#: � - � �' Are you an employer? Check the appropriate box: Type of project(required): 1.CK I am a employer 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 Working for me in any capacity. employees and have workers' insurance.*. 9. ❑ Building addition ! [No workers com p.insurancecomp. required.] 5. ❑ We are a corporation and its 10-F Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE] 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 ' 13.®Other'Iasol employees. [No workers' 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-contractors 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 the policy and job site information. Insurance Company Name:_t T f,5 t o s U mbi c'e Policy#or Self-ins.Lic.#: Lt3 C- 3C � _ Expiration Dater I¢ r Job Site Address: C>v 15 Sy® L u q ��e City/State/Zip: V 4 6-M 1 Attach a copy of the workers'compensation policy declaration page(showing the policy num er 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 under the pains d enalties o JRerjury that the information provided above is true and correct Sianafore: Date: „ _ Phone#: 3� Official use onh?. 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#: CERTIFICATE OF LIABILITY INSURANCE D1/1/uoDnYYr) �....� 1 /1/2010 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 endorsements). PRODUCER al Shannon Sperrazza Risk Strategies Company PHONE (781)986-4400 (FAAC�NI,,(781)963-4420 AIL 15 Pacella Park Drive ADPRESS:soperrazza@risk-strategies.com Suite 240 PRoouCER 90018476 Randolph MA 02368 INSURER(S)AFFORDING COVERAGE INSURED j INSURERA:Seneca Specialty Insurance Cc INSURER a Heating Group Ins Services Michael McCluskey, DHA: Cape Save INURERC:Chartis Insurance 7 C Huntington Ave INSURER D INSURER E: South Yarmouth MA 02644 INsuRER F COVERAGES CERTIFICATE NUMBER:CL1011132675 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, TERRA 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. BISR i i POLICY EFF 1 ppppLICY EXP t LTR TYPE OF INSURANCE i POLICY NUMBER M/ INM/D 1YYYY ; LIMITS GENERAL LIABILITY L_ # i f�EACHOCCURRENCE $ 3,000,OOfl i 'COA48dERC1AL GENERAL LIABILITY PREMISES(Ea aoaarencel $ 50,000 A CIAIMSAAADE ; OCCUR W1002606 10/16/2010'10/16/2011; 1MEDExP(AnYone ) $ _ to aoo PER &ADV INJURY S 1,000,000 t t GENERAL AGGREGATE $ 1,000,000 GEN L AGGREGATE LIMIT APPLIES PER: I PRODUCTS-COMPIOP AGG ;S 1,000,000 X 'POLICY 1 JECPRO- j LOC -�--- AUTOMOBILE LIABILITY ,COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO j6208200 11/6/2010 "11/6/2011 (r-Eeaccwem) j BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident)?$_ X ;SCHEDULED AUTOS i PROPERTY DAMAGE $'HIRED AUTOS rPer accident) S 1 X NON-OWNED AUTOS j S s s i X 'UMBRELLA UAB OCCUR EACH OCCURRENCE $ 1,000 a 000 �— EXCESS UAB �?CLAIMS MADE' j :AGGREGATE S . 1,000,000 1 j DEDUCTIBLE ( $ B RETENTION $ 1023578601 XO/16/201010/16/2011: $ WORKERS COMPENSATION Michael McCluskey ' WCSTATU- ;OTH-1 AND EMPLOYERS'LG181LITY YIN! ' X TORY LIMITS. ER ` ANY PROPRIETOR/PARTNc'RIEXECUTIVEis excluded from coverage" 1 OFFICERIMEMBER EXCLUDED? a j NIA'i I E.L.EACH ACCIDENT $ 500,000 (Mrandatm in NH) 19930951 10/21/2010;10/21/2011; E.L.DISEASE-EA EMPLOYEES 500 040 yedescfte DESCRIPTION OFFOOPERATIONS below I }, i E.L.DISEASE-POLICY LIMIT i$ 500,000 ( i ! DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101.Additional Remarks Schedule,If more space is required) Issued as evidence of insurance. Contractors-Executive Supervisors or Executive Superintendents. CERTIFICATE HOLDER CANCELLATION (508)790-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Housing Assistance Corp ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Ruth 460 Hest Plain Street AUTHORIZED REPRESENTATIVE Hyannis, MA 02601-3698 - Chae1 ChrletlarilSMB �°""�`.• -�_�' _�'...�-c--.�<:�-.r._:,... ACORD 26(2009M) ®1988-2009 ACORD CORPORATION. All rights reserved. INS025(2009m) The ACORD name and 1090 are registered marks of ACORD :,. &mmomveald 91te Office of Consumer Affa' s and Business Regulation - , 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 164432 Type: Supplement Card CAPE SAVE Expiration: 10/6/2011 WILLIAM MUCCLUSLEY 8201 S. HOURD CT -.--.__--- CHAPEL HILL, NC 27516 Update Address and return card.Mark reason for change. JPS-CA1 0 5010-04!04-ci101216 Address Ej Renewal :] Employment E, Lost Card y. �� dlPP9YLfYNIU@QLlil 0�.`tla�,u,.c�iuc�s Office of Consumer Affairs&Business Regulation License or registration valid for individul use only {yHOME IMPROVEMENT CONTRACTOR P .., ... before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation . N Registration: 164432 Type: 10 Park Plaza-Suite 5170 Expiration: 10,V2011. Supplement Card Boston,MA 02116 CAPE SAVE WILLIAM MUCCLUSLEY 7C HUNTING AVE, S.YARMOUTH,MA 02664 Undersecretary Not valid wi ou signature Massachusetts- Department of Public �.rfets Board of Building Re;;ul:ttian.;irttl ttmidards Construction Supervisor Specialty License License: CS SL 102776 Restricted to IC WILLIAM MC CLUSKY 37 NAUSET ROAD ; WEST YARMOUTH, MA 02673 r ; Expiration: 6/28/2013 ( +.+19ililJ��M41YY Trot: 102776 CAPS SAVE Weatherization 508-398-0398 s August 22, 2010 To Whom It May Concern: William J. McCiuskeY an employee loyee of Cape Save. He is authorized to negotiate p contracts and building permits for our.company. Michael McCluskey Cape Save—owner.. . 9i9-s93-5939 cell X Huntington Avenue,South Yarmouth,MA 02 4 i N° 460 West Main Street HOUSI Hyannis, MA€12601-3698 ENE,RG & HOME REPAIR ASSISTANCET (508) 7771-5400 F (508)790-2425 CORPORATION TTY on all limes urww.haconcapecodxi g HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE THE APPLICANT HOME OWNER. I �e`�Yip+ �'�• { hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation ( herein after referred as "Agency") on the property located at: o I The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather-stripping &caulking of windows and doors, insulation of attics, sidewalls &basements,attic and other ventilation measures and possibly replacement of badly deteriorated windows. In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to the "Agency" its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (S)years after the weatherization work is completed. I have read the provisions of this agreement as listed and freely give my consent. Home Owner: (Signature) �� /� . •' ';'fit.v.; -ti r Date: Agent: (signature) Date: p �'� O ' HAC approved Weatherization Company : Cftp 'S Caliber Building&Remodeling Cape Cod Insulation Cape Save) Creswell Construction Frontier Energy Solutions Lahr& Sons Peter Smith Resolution Energy Rock Solid Construction All Cape Insulation js-S03-4O 'ij l'Jr•1.3c._sL1 tort permit r_`c�s2 tiick.cf}c � i Town Of Barnstable *Permit Erpires 6 months from issue date nnatvsrngte Regulatory Services Fee ` Q ,0b i639• Thomas F.Geiler,Director AlfDN"''A 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 o240Q f c�5 ,r pp��,Property Address� 5 5uc J(.(.. (7 n Y-) i 5 02 Residential Value of Work k:�55 0v.6-0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 'E�bci.ra- CL,/r' 0-G 5 5UJ C t Z.1 Z( c'1 /Cron r 5 fL/ C ?- 0 Contractor's Name_ 1 C'_.Clil f, RCU�/ 1'C�F(� Telephone Number. 779 &)3/-�--(C,2 Home Improvement Contractor License#(if applicable) )L4,I a-a 5 Construction Supervisor's License#(if applicable) C-Q:-->' , a v E3'4rkman's Compensation Insurance I Check one:❑ JUN 18 2007 I am a sole proprietor ❑ I am the Homeowner EKI have Worker's Compensation Insurance TOWN OF BARNSTABLIE Insurance Company Name r-(2 V1 1-)C, Workman's Comp.Policy# MQ L} w `Q Q--a- (o Copy of Insurance Compliance Certificate must be on file. Permit Request(check box). L. PRe-roof(stripping old shingles) All construction debris will be taken to �. ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side n , , ❑ Replacement Windows. 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. tl rl b',� g I fi ,102 Home Improvement Contractors License is required. SIGNATURE• �(� 31St?l -. �-, CFI n Q:Forms:expmtrg Revise071405 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations , 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): (S eCQ 01�osiorneE Address: (a5 F_beh 6M+mil �2 C City/State/Zip:Cerr�-_rVil k-, Hh 02,(o 3,-D Phone #:- �� .�3 - .2,t Are you an employer? Check the appropriate box: Type of project(required): 1.04'am a employer with �3 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10. Electrical repairs or additions required.] officers have exercised their ❑ 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.�oof repairs insurance required.] t 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 hue 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: CQ}' i 4c) CS-fok Policy#or Self-ins. Lic.#: WG 9 W 9 Expiration Date: g' I _ ao O 7 Job Site Address:a ct 5 �Stjd 0 L vt J L-M-je City/State/Zip: C[r)n I S4 Y pr- 02 6 of 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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si-gnature: Date: b1/810 Phone#: '7 t1 9- .3 b 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#: . 08-08-06 10:04am From-SOUTHEASTERN INSURANCE AGENCY 508-79005ST T-996 P:01/01 F-834 -7y roe o a roe .e . a a r- vie a®aa savor r■ u e BB l�YVi,iC��MB,.e ua/ua/GU116 PRODucr: , (508)997-6061 FAX (508)991-3283 THIS CERTIFICATE 18 ISSUED AS A MA rTER OF INFORMATION Southeastern Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPOI 0 THE CERTIFICATE 662 State Rd. HOLDER.THIS CERTIFICATE DOES NO r AMEND,EXTEND OR P.O. Boa. 79398 ALTER THE COVERAGE AFFORDED 13 THE POLICIES BELOW. N. Dartniouth, MA 02747 INSURERS AFFORDING COVERAGE NAIC 0 mauRrx Roycrof t & H.uehne Builders Inc INSURERA. Arbella Protection Insurance 6S Ehen Smith Road INWRERB. Merchants Ins Group Celoterville, MA 02632 INSURERC: Granite State Ins INSURER 0: INSURER C: COVERAGIS THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 1 4DICATED.NOTWITHSTANDING ANY REQU.REMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIF CATE MAY BE ISSUED OR MAY PERT,UN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIOI S AND CONDITIONS OF SUCH POLICIES.,%GGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. INSR O' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY-EXPIRATION LIMITS GENERAL LIABILITY 8500022739 07/03/2006 07/03/2007 EACH OCCUAR CE $ 2,000,00 X COMMERCIAL GENERAL Lw61LITY DAMAGE T RE TED s SO 000 CLAIMS MADE ®OCCUR MED EXP(A y o a pamen) 6 5,00 A PERSONAL S AO INJURY S 1,OQp.00() GENERAL AGGR GATE 8 2,000,000 GE,IL AGGREGATE LIMIT APPLIES PER PRODUCTS•CO PIOP AGO S 1.000.000 POuCY %CT LOc AU':OMOBILE LIABILItY COMBINED SING Z LIMIT ANY AUTO (EA Accident) 5 I 1,000,00 X ALL OWNED AUTOS 7AM02 7 7 0140 9S 10/19/200S 10/18/2006 BODILY INJURY SCHEOULEDAUTOS (Perperaen) _ B HIRED AUTOS BODILY INJURY 6 NON•OWNED AUTOS (Per Accident) PROPERTY DA GE $ (Per awWril) incl. GARAGE LIABILITY - AUTO ONLY-EA CCIDENT d ANY AUTO - EA ACC $ " OTHER THAN AUTO ONLY. A00 I Fx(ESSIUMBRELIA UABIUTY EACH OCCUAREI ICE $ OCCUR ®CLAIMS MADE AGGREGATE E S DEDUCTIBLE 3 RETENTION $ T WORNBRL COMPENSATION AND y W STATI} IT EMPLOYEAW LIABILITY C AN"PR01 RIETORIPARTNERIEXECUTIVE E.L.EACH ACCIO NT $ 100,000 OFRCER4AEMBER EXCLUDED? WC4W392269 09/01/2006 09/01/2007 E.I.DISEASE-FJ EMPLOYEE S 100,000 II yes.deer r,0e under SPECIAL 1 ROVISIONS Wow El DISEASE-P LICY LIMIT S 500,000 OTHER DESCRIPTION O-�OPERATIONS l LOCATIONS!VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS or any acid all operations performed during the policy period. CANCELILATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES B CANCQLL£0 BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER (ILL ENDEAVOR TO MAIL a TOwa of Barnstable! 10 DAYS WRITTEN NOTICEITOYHECER'nnCA HOLDER NAMED To THE LEFT, Atta: Bldg Dept BUT FAILURE TO MAN.SUCH NOTICE SHALL IMPOSE 110 OBLIGATION OR LIABILITY Mai A St - OF ANY KIND UPON THE INSURER,ITS AGENTS OR RE PRESENTATIVE& Hya-1nis, MA 02602 AUTHDRiZEDREPRESeNTATrvE Joan Martin ACORD 25 12001/08) OA CORD CORPORATION 1988 .. ,�_ ��e Cn�»7,i�ra�r�ue��l/l ol��alaJJ�cferrJe%l4 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR s • ��I�._ • ') Registration: 141225 Expiration: 1/22/2008 Type: Private Corporation ROYCROFT&KUEHNE BUILDERS,INC. Sean Roycroft 65 Eben Smith Roe.. Centerville,.MA 02632 Administrator �� •^� C�/ .�;' 2` fir,t'ur- .,s<Board of Building Regulations and Standards �. . Construction Supervisor License , .�s License: CS 83280 g � - ' Expiration: 11/29/2010 Tr# 5313 Restriction: 00 SEAN J ROYCROFT 65 EBEN SMITH RDG-- �J CENTERVILLE.MA 02632 Commissioner B 'BIX Town of Barnstable A ,••� Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize _5CQ-n to act on my behalf, in all matters relative to work authorized by this building permit application for: (�-q S-- SUGObcta LanLo—i ictri ri z5 �i- (Addr6s of Job) 2 Signature of Owner Date Gkr;il ct V'- Print Name Q:Fomms:expmtrg Revise071405 Assessor's map and lot number .........0.70..7..� g...... .. P�Of THE t0� Sewage 4rmit• number ..............................................`:....:.... BASBST&B E. i House number .................:......... ....... .... .......................'............ r MAea 1 4po,i639. 00 RFD MpY p TOWN OF BARNSTABLE t BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...........Construct Single Family Dtretlincf TYPE OF CONSTRUCTION ...Wo.d)d.,Frame ............................................................................................................ ....December ti3A............19...83 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a• permit according to the following information: Location .....lot # 11{ : '= Suc3buxv Lane, Hyannis NiA 0260. .. ......................... P................. ProposedUse ............................................................................................................................................................................. Zoning District R'B..............................................................Fire District Hyannis, MA ............ .............................................................................. � '1 Name of Owrier, ;�rico.rn Realty Trust ..Address Falmouth Road, Hyannis, MA .. ... .... ..... .. ...... NamFe lof Builder Franco Real Estate Dev. CCAddress65 Falmouth Road, Ivanns,F,,, SA,,,, ............. • i , lnc. Nameof Architect ......... . ....... ........ ............ ..................Address ............................................. ..................... .............. Numberof Rooms ....Six...............................:..............................Foundation ..P,,C................................................................... Exterior Clapboard and/or shingles ,,,.Roofing Asphalt shinales� ... ....................................... .... Floors Carpet ................................................................Interior ..Sheetrock ................. .......................................................................... t _ Heating Gas — F.W.A. Plumbing Twg .....QpppP .................................................. Fireplace None .......................Approximate. Cost $M.,000.00 Definitive'Plan Approved by Planning Board ---------------_---------------19________. Area .1.056 sq. ... ft. J .............. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH { a 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. Pres . Name ........ ... ... oo98g Construction Supervisor's License o f/as-7 CAPRICORN REALTY TRUST A=270-229 No A1e 90... Permit for 1 z Story................ Single Family Dwelling,,._,.,,,.•,• ; Location ..,Lot 14, 295SjV.dl?txry,,.Lane ..................Hy ann i s........................................... Owner .....CapricorIl,,,Rt.4.1 tY...T rL15. ... Type of Construction .....FXaXae........................ ................................................ ................. ....... Plot ............................ Lot. ................................ " March 22 ' Permit Granted �.............19 84 •�........................... Date of Inspection ....................................19 Date Completed -A: t TOWN OF BARNSTABLE 26i90 Permit No. __ Building Inspector I Cash ----------------------- - 9�A x w [ OCCUPANCY PERMIT Bond _____________________ ______ Issued to Capricorn Realty Trust Address 7/65 Falmouth Road, Hyannis, MA lot #14 295 Sudbury Lane, Hyannis Wiring Inspector Inspection date /ems .,l'�:i.I „t ..�. Plumbing Inspect orf j' Fly -� L Inspection date f Gas Inspector ', Inspection date 7 A w r-A4 f Engneering Department �f�s�*, � r.+r�ref�� Inspection date ,? y &V Board-of•Health =•`/ /� , .!«1 , �_ 'i Inspection date 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. Building Inspector fA. L, d -- sc-. K l/�3yiS"� /73,00 T. iy d z),g h /o,pyA sF O a fh Mo N Q r 0 T �. 71,1 4 r2,5a S � 13vlz y P R i vA r� 6ry's..,r o/g �oQoo Slr ' /oo1W IOTA , 2.0110 b -�pof6 1 CERTIFIED PLOT PLAN ROBERT . �yCr't L o T iy S CJ d f3U R y 4.i4 N� BRUCE FLORE IN SCALE, 149 �lp ! DATE1 .S /ZiIB�i E.�VQINE£RINO COIN CLIENT FR�oNco I CERTIFY THAT THE r-OVAJ01lTi®N EGISTERED� REGISTERED SHOWN ON THIS. PLAN 13 LOCATED CIVIL LAND JOB NO. 9.,?!ys ON THE GROUND AS INDICATED AW0 ENGINEER SURVEYOR pR.0Y CONFORMS TO THE ZONING LAWS OR BARNSTAS E MASS. SY ----�� 712 MAI N STREET CM 3I2/ O F �MYAN ✓ IS, MASS. BHEET_L DATELAND REO, L AND SURVEYOR Fr'Lf^" ✓cJ J ' Assessor's map,and lot number>....... ..... OF THE to " MUST CONNECT'TO TOWNS r Sewcige -PeOmit number :. 1.............: s ..7. BABMAG& House number /� woes .j. ,63 G Mp"i�\ TOWN OFr BARNSTABLE .f 0UILDIHG+ IN-SPECTOR APPLICATION FOR PERMIT T6 ......Construct Single `Family Dwelling TYPE OF CONSTRUCTION ,, Woad Frame ' �{ f• December...1. .t............19...8 + . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for .a permit according to the following information: Location ..,,•,Lot # 14.'.... .- u b ane Hyannis, MA 0260�,. „...... ,,, ....... . .. _ ProposedUse ... ........................:................................................................... .....• .. Zoning,. District .R...B' ...... ...... ....... Fire District .H 'annis►...................................................mA Capricorn Realty Trust 765 Falmouth Road, H annis, MA Nameof.Owner ...............,.,..... .....:..................................Address........... ..................... ..X.. ........ Name of Builder Franco. Real .Estate Dev. -C(Mdress 765. Falmouth;Roa.d... Hyann s•,,,,HA...., Name of Architect ..........: .. .:.....: . .....:......:..:....:..................Address .....:.... ........ ........ ................. .............. Number of Rooms .. Six Foundation ..P.aC.. . Exterior Clapboard and/or shinq.les.................',Roofing .,Asphalt shingles _ ..... .•.....•........• Floors Carpet Interior '..Sheetrock...............:........................................ .................................................................................. ...... Heating " Gas.:.-...F.W: .A.......................... ................... Plumbing Two.. -...Col?per.................................................. . . . Fireplace None •,,,,,.,,,Approximate. Cost ....,$40, 000. 00 .. Definitive Plan Approved'by Planning Board ________________________________19_______'. Area Diagram of Lot and Building with Dimensions , Fee 0 SUBJECT TO •APPROVAL OF BOARD" OF HEALTH 0�1� ' V - t • ••4 '� .. r � - - 4 * . .. ' ,• � l ell OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town.of Barnstable regardingthe above construction. VName ... t Y 000 Construction Supervisor's License •...... 989 APRICJRN REALTY TRUST No ......§190.. Permit for . 1 ..Story............ - t. Single Family Dwelling - - ......5- .. ........................................................ Lot , Sudbury Lane � Y Location ...............14...................295................:............. . " Hyannis - = ....... .................................................... Owne�r� Capricorn Realty Trust a TYPE Constructibn ...Frame........................... V ............ ........................ F• .......................... �• • , 1 r.x - Plot ..........:........ Lot ................................ ' PerrW Granted .....Ma rc1�.-22,. 19 84 ... Date of,.Inspectio . .........k.. ..19 " `.Date�Completed ?? 3 f ..........19 gO f •; - • .;