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0092 SUNNY-WOOD DRIVE
f ZHE T� Town of Barnstable *Permit# Regulatory Services �ee 6mo • saxxscnat.E. 9� Mass. 1639. Thomas F.Geiler,Director �0 Building Division 0 GB2�913Ut Tom Perry,CBO, Building Commissioner �y 200 Main Street,Hyannis,MA 02601 www.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 9 73 2`2-( ` Property Address- q 2 's da� — 016 31 o "Z i e35 Minimum fee of$35.00 for work under$6000.00 f�Residential Value of Work$ �, ( , Owner's Name&Address t-�z. L ;t (0,)(00A, C12a jctv���- (AY&c�.r) .fir- U -.yc -a N C�zb32� Contractor's Name _U ,4' C am- Telephone Number Home Improvement Contractor License#(if applicable) / 2-4-75/3 Email: VCcSCo y2 garr►ca �• CGIM Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: RrI am a sole proprietor • ❑ I am the Homeowner ❑ 1 have Worker's Compensation Insurance PZ Insurance Company Name I`'1 � � C� . SUN a y 8 5 t �.«� i k aC�C Copy of Insurance Compliance Certificate must accompany each permit. AI Permit Re d u h ��R ��q est(check box) T'°t 19(W ❑ 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 ,Replacement Windows/doors/sliders.U-Value O 3 I (maximum.35)#of windows #of doors: I,Ounc 8c5cxr by ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q/lricr C:\Users\decollik\AppData\Local\Microsoft\Windows\Te orary Internet Files\Content.Outlook\8R76BDVA\EXPRESS.doc Revised 061313 ,a The Cotttrnorrrvealth of Massachusetts Departrnerrt ref Irdnstraal Accideras Office of Investigations +600 Washington Street Boston,MA 02111 tivnw mass.govfda`rr Workers' Compensation Insurance Affidavit. Builders/Contractors/Electiicians/Pl mbers Applicant Information Please Print IAwb VASCO NUNEZ Name(Iiasines tiondudividual)- 79 May &Rd: "SOWH DMIS,MA 026ti0 Address: City/StatelZip: Phone# 5613 Are you an employer?Check the appropriate boz: Type of project(required): 1.❑ I am a employer with. 4. E I am a general contractor and I employees{full and/or part.-tiros}: have fired the sub-contractors b. El New construction 201 am a sole proprietor or partner: listed on the Attached sheet. 7. Remodeling strip and have no employees Theme.sob-contractors have S. �Demolition. working for me in any capacity.. employees and have workers' 9. ❑Building addition, [No workers'comp.insurance comp-insurance.i required.] 5. 0 We are a corporation and its 10.E Electrical repairs or additions 3.❑ I am a homeowner doing all:work officers have exercised their 11. Plumbing repairs or additions myself. 'co right of exemption per MGL �o workers'comp. 12.❑Roofrepairs - insurance required.]l c. 152;§1(4),and we have no employees.[No workers' 13. Other (LCQ trl&i,4 0 comp.insurance required-] d0*1-1 *Any applicant that checks box#1 mast also fill out the section below showing di&workers'compensation policy information. I Homeowners who submit this affidavit indicating they are dieing all work and then hire oxide contractors must submit a new affidavit indicating such. koatractors that dkeck this box must attached an additional sheet shooing the name of the sub-contractors and state whether or not those enuties have employees.If the sub-contmaots have employees,they must provide their workers'comp:policy number_ I am an employer that is providing tuorkers'courpensation insurance for my empt lee&'Below is the potky raid job site information. Insurance Company Name: i_N5 cc) Policy#or Self=ins.Lic. Expiration Date: c(' l`I 2 l za 1 2 Job Site Address: -1-�( CYS� City/State/Zsp- i((a 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 NTGL c. 15:2 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 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 fy under tiro s and penalties of perjtuy that the irtformation provided'above is true and correct Si tore: V Date.. 7-t '20 I� Phone#: 6 9, UJj`icial use only: Do not wMe in this area,to be completed by city or town of cial City or Town- Permitflicense# Issuing Authority(tdrele one I.Board of Health 2.Building Department 3.City Town Clerk 4.,Electrical Inspector 5.Plumbing Infector 6.Other Contact Person: Phone#: . 6 Office of Consumer -/I nl'L?•i ads' , Massachusetts -Department of Public Safety ./rc � ttt • ?�l� ac/cc�eCl� !� Board of Building Regulations and Standards Consumer Affairs&Busl ess Regulation rr�isnr l & _' Fumii�. ii. 'ME IMPROVEMENT CONTRACTOR Cunstrurti+>n 5u f p �� 'V' egistration 1N793 Type: License: CSFA-069880 5 k xplratlon: 8/25/2D13 Individual Vasco E.Nunez, II! VASCO E iW1VEZ#II ' ; 79 r AYFAi R RD i s Y South Dennis Al 0266® i Vasco Nunez, III i 79 Mayfair Rd. Ors ft 9�� I 1 Expiration S. Dennis,MA 02880 Undersecretary ? I Commissioner 10/03/2014 i Restricted-One-and two-family dwellings or any accessory building thereto, irrespective of size. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. I For DPS Licensing information visit: www.Mass.Gov/DPS j i 7 p. 2Ly3 2'z( PROPOSAL 441 oez a, 79 Mayfair Rd South Dennis MA 02660 MA Li c #069680 47 capecodwindows.com Ii,I:C. #1293 (866) 398-1511 a Toll Free (508) 398-1511 0 Dennis, MA PHONE DATE TO: Ms. Lori Coppinger 508 <681 5990 4I23/2(}13 92 Sunny-Wood Drive Jos NArviErtocarioN Centerville MA 02632 Andersen "Narrowline" Gliding;Doors JOB NUMBER JOB PHONE 5990%Gliding Doors SAME .:We hereby submit specifications and estimates for. 1. Remove three wooden glding'door, ( onie 5' ;°door from upstairs bed room, - two 6.' :doors from: downstairs dining/sunroom.;areas and "replace/install;rwith:Aridersen "Narrowline" gl, ding `doors. in same locations. * New Andersen "Narrowline" gliding doors will have a white vinyl exterior with a' clear pine interior, gliding screen, auxiliary ,foot ock oak threshold, NO grilles, and "Tr3beca" stone colored hardware on the interior with white hardware on :the ,eater "or 2. Supply interior/exterior trim and framing materials where °neede'd New interior:.trim..will be 3 1/2" clear colonial casing, and the, :exterior trim :will PVC:;plas"tic trim :,to fit: the openings. 3. Insulate the cavities of the new:'doors, F. 4. Take old doors, and any :debris to the '.town ;landfll 5. Make arrangement for delivery ofnew Andersen doors 6. Supply town of Barnstable building permit a:t cost, ( 'estimated cost':of 3500 ) , payable in. advance. ,: .. * This proposal does not include any pat;iiting ,staining,: or other work :not described .above r - *. All Andersen products described above ;will Y:e prepaid by the home owner. * Any changes to this proposal must.;be done in writing and accepted by both parties ** If this proposal is satisfactory,' please sign the YELLOW copy and return with payment schedule. ** Please make a check payable to Vasco Nunez: Carpentry,::in th amount of $ ;37.61.35 for your new Andersen products described above and please :n:clude: this: check with your. signed proposal Allow 3-4 weeks for delivery: 7. We Propose hereby to furnish material and labor--complete i' accordance with:the above_specifications;for the sum of: Six Thousand One Hundred Sixty One and 35/100 Dollars dollars.($ 6, 161.35 Y Payment to be made as follows: Labor: 50% Down payment to start at' time:.of .start. $ 1200.00 Labor: 50% Upon completion at time.of .completion $ 1200..00 All material is guaranteed to be as,specified.All work_to.be completed in a professional manner according to standard practices.Any alteration or.deviation from above specifications Authorized a involving extra costs will be executed only upon written orders,and will become.an extra Signature t charge over and above the estimate.All agreements contingent upon strikes,accidents or. ; delays beyond our control.Owner to carry fire,tornado.and other necessary insurance.Our Note:This proposal may be workers_areJully covered by Worker's Compensation insurance. Withdrawn by us if not accepted withi 30 days. a Acceptance Of Proposal—The above prices,specifications and con- ditions are satisfactory and are hereby accepted.You are authorized to do the work as nre a specified.Payment will be made as outlined above. Sig - --- Date of Acceptance: Y 1,//3 Signature PRODUCT 13128G USE WITH T71C ENVELOPE Deluxe For Business 1-800-225-6380 or www.nebs.com PRINTED IN U.S.A- A Q �- - �oFTKE� Town of Barnstable *Permit#A 9 9 0 Expires 6 mouths from issue date Regulatory Services Fee a +, HARNSTABLE, + 6 �� Thomas F. Geiler,Director s39. ArfD MAy A Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601. (_,?``, - -,�1✓. www.town.barns table.ma.us Office: 508-862-4038 ,t \ `V Fax 608,790;621, LF EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint. Map/parcel Number . Property Address `jam 'Dr. Residential Value of Work 247 -Z Minimum fee of$35.00 for work under$6000.00 Owner's Name& Address u Contractor's Name y.ASLc, QLk"-tZ Telephone Number ; j`i-i� Is(I ;'0 AL Home Improvement Contractor License#(if applicable) low Construction Supervisor's License#(if applicable) O(n�f�f p ❑Workman's Compensation Insurance Check one: [i"-'I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company.Name C-(V1t Workman's Comp. Policy# M y S((7�T k 20 it ti Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ 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 0 0 36 (maximum .44)#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 copy of the Home.Improvement Contractors License& Construction Supervisors License is required. SIGNATURE: Q\WPFILESTQRMS\building permit formsTXPR oc D u..:-_J n�n �RG J� 283 79 Mayfair:Rd so w South Dennis, MA 026.60 . .. MA Uc. #069680 capecadwindows.cont H.I.C. #124,793 (8.65)_398-1511 ® T Toll Free (5(3d)- 98-1511. © �Yeasnis; MA DATE':: TO Ms Lori Coppinger 508 7Z_f3 8407 11/4/2010 92 .Sunny...Wood Drive JOBNAME)IOCATION Centerville MA 02632 Andersen Windows JOB NUMBER JOB P.HONE ..: 8407 508-681 `.5990 We:hereby submit specifications and estimates for. 1: Remo:ve seven wooden double hung windows:'=, { one mullion window from master bed room aid twq singles.,: two singles from upstairs bath rooms, one single _from 'downs.'tairs bath room: and` one single from over kitchen sink. Replace/install with Andersen "Tiltwash" 4'00 series;:double hu'n windows in same locations. 44 op New .Ahdersen "Tiltwash" windows will have a white'__vinyl; clad exterior with ::a clear pine interior, stone colored hardware, full screens, ;tiltwash ability, and wood removab3e,gr ;lles with a .:6/6. pattern. New windows will ,qualify for the .0 S :Government tax-.::credit prggram-per conversation. 4. 2; 'Supply interior/exterior trim and,framing materials where needed...' :3 Insulate cavities of new windows 4'.. ,Take .old windows and any debris from this job to. the town landfill 5. Make..arrangement for delivery. of .new windows'. 6i. Supply town of Barnstable building permit at<cost;; ( estimated cost of $ 25 00 ), payable upon :first scheduled payment. * Thi's proposal does not include any.parnting,: staining, or other repairs *. All' Andersen products described abo- ve will be;^.prepaid by the -home`owrter ** If this proposal is satisfactory, 'please sign the`-:YELLOW copy and return with payment schedule. ** Please make a check payable to Vasco Nunez Carpentry in the'=amount2 :737.:02. for:.your ... new Andersen windows described above and` pleas.e include this check * th,your:signed proposal_..'; Allow 3-4 weeks for delivery, this is a factory"order. . ePV0 OSe hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: Five Tousand Two Hundred Forty Two and 02/100 Dollars dollars(�. 5,242.02 Payment to be made as follows: Labor: 50% Down payment to start at time of start, plus permit fee. . . . . . . . . . . .$ 1,265.00 ..Labor: 50% Upon completion at time of completion. . . . . . . .'. ... . . . . . . . . . . .$ 1,240.00 Total labor and permit fee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . ...$ 2,505.00 All material is guaranteed to be as specified.Ali work to be completed in a professional manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upof1 written orders,and will become an extra Signature - charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tomado,and other necessary insurance.Our Note:This proposal may be workers are fully covered by Worker's Compensation insurance. withdrawn by us if no(accepted within Y15 days. Acce lance 0f PrOPOSal—The above prices,specifications and con- \ ditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.Payment will be made as outlined above. Signature 11/D j Signature Date of Acceptance: a. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street %j Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: M Aic Rd City/State/Zip: 90 , D1 -910t5 Phone #: SAS ZaB (SW Are.you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2�1 am a sole proprietor or partner- listed on the attached sheet. t ? ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. workers' comp. insurance. 9. Building addition Y ❑ [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their ]0.❑ Electrical repairs or additions 3.❑ Jam a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' Other "Nddl us comp. insurance required.] *Any applicant that checks box#1 must also rill 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. lContractors 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: KJ M Mk-M C-40 Policy#or Self-ins. Lic.# V P 05(( 7_ J Expiration Date: f Z 2-0/f Job Site Address: �� S�ti�►� Quo J k, City/State/Zip: �,Q(.t�citri t(,(,Q Q 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 t e ains and penalties of perjury that the information provided above is true and correct signature: Date: /2 ZZ 2Dl Phone#: 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#: 6 r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed.to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business onto construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees.other than the members or partners, are not required to carry,workers' compensation insurance. If an LLC or LLP does have employees,a policy is Tequired. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit 6ne affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has'been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone,and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www.mass.gov/dia T T ti Town of Barnstable Regulatory Services xsrAs Thomas F. Geiler,Director was 16sp. 1) Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis',-MA 02601 w".town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property wrier Must Complete and Sign This Section If Using ABuilder I, as Owner of the subject.property hereby authorize to act on my behalf, is all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner isapplying forpemiitplease co' jete. the Homeowners License Exemption Form on the reverse side. �ofY�ray Town of Barnstable Regulatory Services �� Thomas F. Geiler, Director BARNBuilding Division ea µa'�° . Tom Perry, Building Commissioner 200 Mairi.Street, Hyannis,MA 02601 w".town.b arnttable.ma.us Office: 508-862-4038 Fax: 508-790-6230 IIOl%�OwNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state rip 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- superyisor. DEFINITION OF BOMEOWNER 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 borneowner. 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 Build ing.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 requirrd shall be exempt from the provisions of this sccdon.(Sccdcjn 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner argages 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 arc assuming the responsibilities of a supervisor(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 Supervisoris ultimately responsible. To ensure that the homeowner is fully aviary of his/her respotuibilitics,many communities require,as part of the permit application, that the homeowner certify that he/she understands the rrsponsibili6cs of a Supervisor. On the last page of this issue is a,form currently used by several towns. You may care t amend and adopt such a form/certification for use in your cornmunity. r Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license.�. Refer to: WWW,Mass,Gov1DPS License or registration valid for individul_use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation i 10 Park Plaza-Suite 5170 �. Boston,MA 02116 J Not valid WA11W4ns Massachusetts: Department of Puhlic S.►fetk Board of Buildin-Regulations and Standards Construction Supervisor License One-and Two-Family Dwellings License: CS 69680 VASCO E NUNEZ 11): 79 MAYFAIR.RD S DENNIS,MA 02660 y i Expiration: 10/3/2012 c�mmisiuner Try: 3426 • � �/ie{ov�;aouue�a�✓�anaaa/eueel� "` . Office of Consumer Affairs&Business Regulation;;;;;. HOME IMPROVEMENT CONTRACTOR Reglstiation� ;124793 Expiration 8/25t2011 Tr# 286910 i type, lridnridual Vasco E.Nun i ez,11r Vasco Nunez,.11t 79 Mayfair Rd. � e S.Dennis,MA 02660 �— Undersecretary' iT t ti Town of Barnstable *Permit# ��� = Expires 6 moiths from Jssus date X'PI�ES ������ Regulatory Services Fees%/� 0 C T 1 8 2006 Thomas F.Geiler,Director -Af- V-L�l LBuilding Division / TOWN OF BARNSTABLETom Perry,CBO, Building Commissioner U i�12.�//0 6 200 Main Street,Hyannis,MA 02601 www.town barnstable.ma us - ofiice: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint NIap/parcelNumber 9LI3 221. 0-41�n 1 s gResidential Value of Work 1 j nb() , ,0U Minimum fec of$25.00 for work under$6000.00 Owner's Name&Address (CI S o L-or'l (�a �'o 8 --778- �Fo'i- �a 5 oZ432- Contractor's NameTelephone Number 52A S58 /6// - Home I133Provement Contractor License#(if applicable) / 2�F ��� Construction-Sager_4or's License#(if applicable) ❑Workmaa's Compensa#ionInsurance Che one: I am a sole proprietor I amthe Homeowner' ❑ I have Worker's Compengatio//n Insurance Insurance Company Name 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 J(A gHMVLq lain", u)-+ ❑Re-roof(n9t stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows. U Value 3 (maximum.44) 4 h&ZerzSe h 0 hdet v" 'C'yam 51``"fT) •Wh=required: Issuanct 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. Home Improv Contractors License is required. SIGNATURE: f Z� Q:Fasns:expmtrg Revise071405 . Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR t" Registration: 124793 ExPiration: :8125/2007 Type: individual Vasco E.Nunez,Ili Vasco Nunez,III 79 Mayfair Rd. S.Dennis,MA 02666 Administrator 4........ r I I RE '1 . x1 t5 ✓O Q CATIONS License: CONSTRUCTION SUPERVISOR 7 Number CS 069680 �v Birthdate 10/03/1:948 Expires 10/03/20Q8 Tr.no: 2714.0 Restricted 1G 'i VASCO E NUNEZ FII 79 MAYFAIR RD S DENNIS, MA 02660 Commissioner r 1 The Commonwealth ofMassachusetts Department of Industrial Accidents Office of Investigadons kip 600 Washington Street Boston,MA 02111 www.massgov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electiicians/Plumbers Analicant Information Please Print Legibly Naine (Business/OrgaWzationWividual):. C-0 ca v � Address: 111 (QAj ;_ , City/State/Zip: eSo . �rj t S `' 0 Phone M 5� Are you an employer? Check the*appropriate box: 1.❑ I am a employer with • 4. ❑ I am a general contractor and I Type of project(required): mployees(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. t 7. ❑ Remodeling ship and have no employees These subcontractors have 8. ❑Demolition working for me in any capacity. workers'oo;V.insurance. [No workers' comp. insurance 5. ❑ We are a co 9' ❑Building addition requined.j corporation and its . Officers have exercised their 10•Q Electrical repairs or additions 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 required t 12.Q Roof repairs insurance r W ] employees. [No workers' 13. Other 1 *Any applicant that checks box d t must also till out comp: insurance required.] �Qre section below showing @reir workers' mby t Henwwoers who submit this affidavit indicatingco�nsahon policy infonmtioa: �ry a�doing all work and then hire outside contractors mug aubmit a new amdavit indicating such. ZGoaSaebrs fiat check Qrisbax must attached an additional sheet showing the name of the sub-contractors end their workers'ootnp,policy iaforrrration. 1 am an employer that Is providing workers,compensation Insurance lnfornuttlon. for my employees Below is the policy and job site Insurance Company.Name: C1u' ( .e��lctt,vr u Lw i 11S, 6a . Policy#or Self-ins.Lie. #:_ L3 2 7 a . ? �. � Expiration Date:_ � 12� G7 lob Site Address: C:ekzc)T,_1, City/statelzip: 6e c�-�'trU�(,(.Q �- OZ632_ lkttach 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. 15.2 can lead to the imposition of criminal penalties of a be 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 >f up.to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of nvestigations of the DIA for insurance coverage verification, do hereby certify under the a' s and penalties of perjury that the information provided above Is true and correct 1 ature: Dater /6 7 A o (P 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): I.Board of Health 2. Building Department 3. City/Toim Clerk 4. Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: r lntormation anci instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the -owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant diereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the Issuance or renewal of a license or permit to operate a business or to construct buildings In the commonwealth for any applicant who has not produced acceptable evidence-of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.". Applicants Please fill out the workers'compensation affidavit completely;by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of `insurance. Limited Liability Companies(LLQ or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not die Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on die appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of die affidavit for you to fill out in the eventthe Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permidlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit' icatmg ent policy information(if necessary)and under"Job Site Address"the applicant should write"all locati in (city or town)."A copy of the affidavit that has been officially stamped or marked by the cityor town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial.Accidents Office of Investigations 600 Washington.Street Boston;,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE .evised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia i a73 - Zz( Town of Barnstable Regulatory Services - Thomas F.Ge-1er,Director Building DivWon Tom Perry, Building Commissioner 200 Main Street, HYmmis,MA 02601 - www.townbarnstable.ma.ns • _, - - • • •' ' Office: 508-862.403 8 ' Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder C,09 as tJwnex of the subjectpropettp hereby authorizej`a � —` --�--- to act~on my,behalf, __. Iicatwn fos: ..._ in all matters relative to work authorszed by t]ais bvslciw.g p eat a Pp ' ( dtess of Job) LLD� signature of et Date Ptmt Name gp0?4:0WMMWaMs10x o2 A" essar't map and lot number ....d 2-3 ,:;2 ) ........................................ %THE ITEM MUST .... ....... K� ALL N COMPL!A 1,Sewage Permit number .................E.— WITH TITLE 6 t 33AUSTAXLE, 2— .............. House. number ... ............ ENVIRONMENTAL CO DE P 39- Ei-,JOWN REGULATIONS , L# TOWN OF BARNS'"B' K�dz` BUILDING INSPECTOR 0EPTIC SYSTEM SLED- -m il .. r APPLICATION-FOR PERMIT TO ..........C.QnS.trUict...Single..Fami: yS.!. .......*....... TYPE OF CONSTRUCTION ....................Wood...Frame.......... ..... .. .. .. .......... ................ To P JanuarY...31.0...................19....a5 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........1.Q.t...#...32...�'.umy...Waad...Dr...AiZannis............................................................................................ ProposedUse ............................................................................................................................................................................. Zoning District ................ft�....... .........................Fire District ..........Hya nni s................................................. Name of Owner ............Address ...... ............... Name of BuilderFranco Real Estate Dev. C Address ......$9,Me.................................................................... .................................................................Q. Nameof Architect ....................o.............................................Address .................................................................................... Number of Rooms .........5.i7.................................................Foundation ...............P...0....................................................... Exierior Clapboard. and/or. S A iDg;W A.................Roofing ..As� pb;a:I.t...Shingbas....................................... Carpet Sheetrock Floors ......................Interior .................................................................................... Gas-F .W.A . Heating ..................................................................................Plumbing ...Kw97.9.9 P.Re r.................................................... Fireplace ..................None.......................................................Approximate Cost ...........$ 000. 00 . . ... ............... .. .....Sq. Definitive Plan Approved by Planning Board --------------------------------19--------- Area .. ... .......... .... Diagram of Lot and Building with Dimensions Fee .............f.../.......................... 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 Town of Barnstable regarding the above construction. Name ...................... . ....... Construction Supervisor's License .doo .............................. ,,,isCAPRICORN REALTY TRUST No ..... PernOt for .... ............ Sinpxle. Family Dwelling ....................... Location,.jgt... 92..SMXtpy..Nq.qd...D.riv.e. ...................Hy lap YA ............................................. Owner .........QAR-K.i.q.o.rn......Re.....al..ty........Trust.......... Type of Construction ..F.VA'Aq............................. ....................................................................... Plot ............................. Lot ................................ Permit-Granted ........September 13,................... ............19 85 Date of Inspection ....................................19 Date Completed ......... 197`4 _ , Assessor's map and lot number 2-� � ........................................ CF?HEt0 • Sewage Permit number .............. ......... f Z EARMAELE, i House number F ........ ....... 9�0 M I �0............... ...................... . 1639. `e O M a' TOW. N OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .........�!�rt, fr� 1 • n l p Fa,..m]...1.at....'::}znr �..?..?.� ?............................:.. TYPE OF CONSTRUCTION Wood Frame ........................................................................................................................... ..................19.... .5 . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ,o Suxanu 1 .n c1 ►�x'......17A. .r LF............................................................................................ Location .........................,�.................�....... ..:....:..., � r ProposedUse ............................................................................................................................................................................. ZoningDistrict ...............F.a. ?r...............................................Fire District ...........N... D•rnn,.1.a................................................. Name of Owner ............Address ......7.6.5. rht,+,,.?--'R-A. ?uzra»T, ............. Name of BuilderFr-ancO...Rca� .. :State DeV.a...C O.Address ......C�P0.'..................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .........Six.................................................Foundation ...............P. r.:..................................................... Clapboard and/ar Shi.npleb...........:.....Roofing .. k�a7, t. � a:n... ;e.s•Exterior .................................... ............... .... ...................................... Floors Garpe - Sheetx•ock ....................................................................................Interior .................................................................................... Heating .,a5. —�' .Vd.z� . 'l'WQ—Copier' ................................................................................Plumbing .................................................................................. Fireplace Tootle.......................................................Approximate Cost E0,000.00 4`�....................................................... Definitive Plan Approved by Planning Board ________________________________19________ . Area io 56...aq......et... Diagram of Lot and Building with Dimensions 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 Town of Barnstable regarding the above construction. Name ...`..�.........A�..........Y. �.rz, Construction Supervisor'.s License < /jT/jo .... CAPRICORN REALTY TRUST A=273-221 No ... ... Permit for ...O.n..e....Story.... ............... ..........$.:Liagj.q...F4mi1v..Dwe11.i.n.g..................... ......... ........... . . Location L.o.t..32.......9.2...$.iA n gy..Wood Drive ..................Ry.=Ua............................................. Owner ......Q a p r; Q.r n...RP,.gjt_v..X.r.u.s.t............ Type of Construction ......FraMP.......................... ............................................................................... Plot ............................ Lot ................................ Permit Granted ........September 13,....lg 85 .......................... Date of Inspection ....................................19 Date Completed ......................................19 COT tia ,�TME,� TOWN OF BARNSTABLE 28415 Permit No. ................ BUILDING DEPARTMENT . Cash TOWN OFFICE BUILDING """"" i63q. HYANNIS,MASS.02601 Bond ...... . CERTIFICATE OF USE AND OCCUPANCY Issued to Capricorn Realty Trust Address lot #32 92 .Sunny Wood Drive, Hyannis 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. November 3 86 ���°., .......................... 19 .............. 4 ..... Building Inspector k I' TOWN OF BARNSTABLE BUILDING DEPARTMENT » m • TOWN OFFICE BUILDING raj t61q. `� HYANNIS, MASS. 02601 ' �o r�r�• MEMO TO: Town Clerk FROM: Building Department DATE: An, Occupancy Permit has 'been issued-for the building authorized by v BuildingPermit #........... ......................................................................................................._................. .. _ ... issued to H�1 lrJ ........... t „Z................ c/.v.r� Please release the performance bond. } r • 4 N `9 77' - N N N n N `S E 7-AFz Cks W 9 i4•o P' Q N �0 9 aM �t I lOO. op OF C. g FRANK PLOT PLAN Ti,�E .S7".G u GTueCr �C�/C TGrL� WHITING N �'� �'��.r�c.•v/V c.�qs Lo c.QTG'1� �O No. 29869 �Q f /N AF-/STER���QJ�'� C C 4Ci.eq TG- -Ire .G.v /u�a L LA.�5 / A �+ �+ �OuG. :0 , 9 R A,�o �-x�.�rs .v.r ��2�C/S�.d/3 L /11�i J �.7 . Pt/.2.00J-E- CAPE COD SURVEY �.GO�GSS/�.y�fL_G.►ivp .��,,,�,..�,o CONSULTANTS - 3261 MAIN ST.iROUTE 6A P.Ro✓Ecr h'o 03 - ¢¢8 -Ug�. BARNSTA6LE VILLAGE, MA 02630 (617) 36.2-8133 • I r TOWN OF:BARNSTABLE,-MASSACHUSETTS W A3#i-E, CARD a se . t DATE) 9 IeSE1'" 'P,0' v Franco Xp_d �i) ::1.i 13cti'. ,f APPLICANT. ADDRESS (NO.) (STREET) - (CONTR'S LICENSE) - PERMIT TO Build i�WG'.11iTil (�) STORY "iuigle tamily dwelling `.,NUMBLRNG UNITS (TYPE OF IMPROVEMENT) ,.NO` (PROPOSED-USE), a r,<� Y,y,`�.') -.•.<:cc, hir `�" }}�� iO.t 4 'mom x 1, �l .''J/ .00d Dr-; t'p u�l7Tll�l�6:r v��3v.rti<�•..� i r ' ZONIyG�" FsaY AT(LOCATION) N DISTRI�t k(NO.) rf$+' �i a-i .z i (STREET) BETWEEN r r Y .ww" .r.d A -^'(CROSS STREET) Y' � - - (CROSS STREET) d }, LOT, a ; SUBDIVISION LOT BLOCK SIZE 13UIL DIN�G-IS'T0 BE FT. WIDE BY FT. LONG 8YF FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTI TO TYPE USE GROUP BASEIINT,WALLS OR FOUNDATION (TYPE) RE RKS: 40 ARE OR i`.:i is A;00 U�1'c' PERMIT .i. VOL' 'E ESTIMATED COST W' "asn FEE . . - (CUBIC/SQUARE FEET) " • - L r' l 0Yi1 1(. ity 11 tsC r �� `OWN av fo- ...� _. y '.J z_.,.._ •y BUILDING DEPT y ADDR $ ti BY 3! THIS qE,RMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALL OR SIDEWALK OR ANY PARTifr, IS R TEMPORARILY : .� PERMAN_ENTLY..ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED_:UNOER'.*THE`IB.UILDI CODE, MUST BE / PROVED;%Y, THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF'•P S MAY BE OBTAIN FROM T; E DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THYS PERMIT DOES NOj RE E,ASEaTHE APPL`I A OM THE CONDITIC OF ANY•AIPPLICABLE SUBDIVISION RESTRICTIONS. #I'�^� MINIMUM*0 THREE CALL APPROVED PLANS MUST BE RETAINED,ON'`JOB;AND°THIS WHERE�APP (CABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: �; ELECTRICAL, PLUMBING AND I.FOUNDA ,IONS'OR FOOTINGS. MADE. WHERE A CERTIFICATE OFI'OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO'COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOfE'OCCUPIED.UNTIL MINAL INSPECTION. TI TO BEFORE FINAL INSPECTION HAS BEEN MAP ' 3. FINAL INSPECTION.BEFORE � � - - ,-POST THIS. CARD SO IT :IS VISIBLE FROM STREET - BUILDIN&'(,_SPECTION LS PLUMrBBING INSPECTION .PPROVALS ELECTRICAL INSPECTION APPROVALS 10 2 2 � A/� u� G v� 2. "HEATING !NSPECTI APPROVALS tREFRIGERA ION INSPECTION APPROVAL: TC 6 O'.HER .. -- 2 f 'y PSI 01 mh 19 ; } ±VCr+£ �e+AL' NCT PO £ED LM .L THE PERMIT YILL SEC&F NULL AfiiO VOtDiF CONS pUCTlON � ��PECTIONS";NOICATED ON TM:; i N��aC GP �d� F�KC�.7 ttK S NORK IS ?v0T STARTED ?f;THIN SIX MONTHS OF 3ATG._THE CAN BE_ARP"�NGEO FOR P {Jj TaGEg..ar CO�tS�U'' .}ON PERMITASYSSUED AS NOTED ABOM Or; WsuJ%N NUT7F-)C?TiG'N _