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HomeMy WebLinkAbout0121 WINTER STREET r Town of Barnstable Building T PMAW ost d his Card�So�That�t,is'UisibleFrom,the„Street Approved�Plans�Must be,Retained on,Job�and�;thisCard Mustbe„°Kept '� * 1ATlNS.TrA$IJL • Foste �Until'Final Inspect on Has'Been M tle 3 � *i Where a Certificate of O upancy':�s Regw red,such Bu�idingFshall Not bezOfccupied until a F►nal Inspection has been made Y �i Permit Permit No. B-18-3447 Applicant Name: Brien Langill Vivint Solar Developer LLC Approvals Date Issued: 10/24/2018 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 04/24/2019 Foundation: Location: 121 WINTER STREET, HYANNIS Map/Lot: 309-107 Zoning District: RB Sheathing: Owner on Record: COHEN,CECILLE V&ELI TRS Contractor Name BRIEN LANGILL Framing: 1 Address: 84 ROOSEVELT ROAD Contractor:License: CS=106675 2 MEDFORD, MA 02155 Est Project Cost: $9,240.00 Chimney: Description: Installation of roof mounted photovoltaic solar.systems,`14 panels Permit Fee: $97.12 Insulation: Project Review Req: Fee Paid; $97.12 :Date 10/24/2018 Final Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six�months after,issuance. Rough Gas: All work authorized by this permit shal[conform to the approved application and the`approved construction documents'for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zornng by-Jaw codes. Final Gas: This permit shall be displayed in a location clearly visible from access street`o�road and shall be maintained open forpubhc inspection for the entire duration of the work until the completion of the same. d a` Electrical The Certificate of Occupancy will not be issued until all applicable signatures by"the Building an&F'(*9fficials ar6vovided on thispermit. Service: Minimum of Five Call Inspections Required for All Construction Work:b,`,:- 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons Con-tr-a-cbqg with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: 2l All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT c ALTERNATIVE WEATHERIZATION DateAr /l✓ O�Q Town of Barnstable Building Division l 200 Main$t. Hyannis,MA 02601 , The insulation work at has been completed in accoF.ld4 k.� CM. othy Ca far, President CSL 105454 58 DICKINSON STREET ( FALL RIVER,MA 02721 (508) 567.4240 I ALTERNATIVEINEATHERIUTION®GMAILCOM Town of Barnstable y Y l i t` `::.fir, _ .,u - . ,,.. ..,.:. .. .F.. :. a:�.. N.- ,«. �s. .��. ....., E 3 ,. r *. o This-:Card. That•t.is V s�ble:F. m he' A ved„R ansvMust•be:R tam"6-n Job�andAhis.Car!'W, s t r r: a �t �Qby �,�. � �rO� t4_ 5� � .pl? o .�, � CO�e�,R w .a Posted.L1 :tl Final Ins ecton Has,Been Made r a Fa i Permit Wfiere a Certificate-ofi Occu anc 'cis Re u sec Stich�ualcllra ;shall•Not be Occu red until a Final Ins' ect�on has tJeer♦,made R �,. Y.:, .. .w '% �, ,*a p _,o M , _ .-K 4-Mp �` Perrriit:No B-17!U52 ;, , , 'Applicant Name 'ALTERNATIVE WEATHERIZATION, INC. Approvals. Date Issued ', 30/16/2017 Current Use`... Structure_ Permit::Type.: Building l'Insulation-Residential Expiration Date: 04/181 2018 - _- -: Foundation Ltcation:`:121 WINTER STREET,HYANNIS, Map/Lot 309-107 -Zoning District: RB Sheathing: 3, Owner on Record: COHEN,CECILLE V&ELI TRS ConactorgName ALTERNATIVE WEATHERIZATION, Framing: 1 Address: 84 ROOSEVELT ROAD ��� ¢4 INC. 2 �.�•-_ _.Contractor:License: 175683 MEDFORD MA 02155 �` = Chimney: V Description: Weatherization � EstProlect Cost: $5,878.00 Insulation: it, 'ePe m $85.00 Project Review Req: � final Paid $85.00 r Date 10/16/2017 Plumbing/Gas — . . .. _ Rough Plumbing: • „FE' �� RAJ .. Final Plumbing: � 3 A� Building Official a, a&• Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized y this permit is commenced within six months afterissuance. Final Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structure shall be in compliance with the local zonings by laws and codes. � �. This permit shall be displayed in a location clearly visible from access street or road and%shall be'malntamed open for publicnmspection for the entire duration-of the. Electrical work until the completion of the same. J � �` Service: The Certificate of Occupancy will not be issued until all applicable signatures by,the Buildang a F re Officials�are prov ded on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work. - _ - - •- = 1.Foundation or Footing Final: 2.Sheathing Inspection . 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to frame Inspection - 5.Prior to Covering Structural Members(Frame Inspection) LOW Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Final: Where applica¢I,e;sepa:rate:permits,are required for-Electrical,Plumbing,and Mechanical Installations._..... .. Work shall not proceed until the Inspector has approved the various stages of construction., - Fire Departm ent "Persons contracting with-unregistered contractors-do not'have'access to the:guaranty fund" (as set forth`in MGL c.142A). Final Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION` Map Parcel O Application #:;�?11_ Health Division Date Issued BUILDING DEPT Conservation Division Application Fee Planning Dept. OCT 05 2017 Permit Fee Date Definitive Plan Approved by Planning BoardIOWNOF BARNS! LE Historic - OKH Preservation/ Hyannis Project Street Address Village �nn �5 Owner 1�;�°�1`e- C.�0/2Px, Address 07 1 mod' #ita"s 4A lvc�- q f Telephone Permit Request -�- S4U ej6n �&_&c�vk d ts -16 lW .. `a Square feet: 1 st floor: existing,/ proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation5870,p-&b Construction Type Lot Size Grandfathered: ❑-Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new` First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing 0 new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑existing ❑ new size _ Other: oning Board of Appeals Authorization ❑ Appeal # Recorded ❑ 4� Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION _ (BUILDER OR HOMEOWNER) Name � Telephone Number" OZJ Address License# Az Home Improvement Contractor# r EmailadhGL Q.L0 01,49 I. Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS P OJECT WILL BE TAKEN TO Q S S S — SIGNATU E DATE /�/ / FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE f OWNER DATE OF INSPECTION: FOUNDATION ` FRAME INSULATION ' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ,I FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. I , Ta Town of Barnstable Regulatory Services Aa sxAxtr, Richard V. Scali,Director MASS: v,. Building Division Ar�D m o Paul Roma Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section I, CECILE COHEN , as Owner of the subject property hereby authorize Alternative Weatherization to act on my behalf, in all matters relative to work authorized by this building permit application for: 121 Winter Street Hyannis, MA 02601 (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form. i C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\L7U69LF2\EXPRESS(2).doc 01/25/17 The Commonwealth of Massachusetts Department of Industrial Accidents VV a 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual):ALTERNATIVE WEATHERIZATION, INC. Address:2 LARK STREET City/State/Zip:FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate box: Type Of project(required): 1.Q✓ I am a employer with 16 employees(full and/or part-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.] 9. El Demolition IM I am a homeowner doing all work myself.[No workers'comp.insurance required.]' 10 Q Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 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 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.*- 14.❑✓ Other INSULATION 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no 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:STAR INSURANCE COMPANY Policy#or Self-ins.Lic.#:0849257 00 Expiration Date:4/4/18 Job Site Address: / � L cJ City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy num and expira on 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. I do hereby certify unde th ins an a#ies ofp rjury that the information provided above its true and correct Signature: Date: �(J Phone#:508-567-42 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#: ALTEWEA-01 SNERONMA AC4C>KAf DATE IMMQDfYYYYt CERTIFICATE OF LIABILITY INSURANCE 05/2612617 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 I REPRESENTATIVE ORL PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED.provisions or 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 ftWto the cartlficats holder in lieu of such endorseme s. Ing j PaotwceR CT Christine Costa Mason&Mason Insurance Agency,Inc. lP"Arc Na E>ds:(781):523-M7 I Arc Fi°x 458'South Ave. Nos: Whitman,MA 02382 •etosta@miisoninsure.com INSUROM AFFORDING COVERAGE NAIL d. NSUJ lJt A:Evanston.Insurance Co. 353fi8 1 INSURED #mRER a:Safety Insurance Com n 3946 Alternative Weatherization,Inc. INstiRERc:Star Insurance Company '18023' 2 Lark Street INSURER D Fall River,MA 02721 t INSURER E: —,-•.------J INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED.BELOW HAVE BEEN ISSUED.TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. i EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCEDBY PAID CLAIMS. 'EFF ADM POLICY iNSR' 3 SYl$R I' E� , TYPE OF INSURANCE POLICY NUMBER LIMITS. A ; X COMMERCIAL GENERAL!!ABILITY S EACH:OCCURRENCE I S 4,000,000 —� 100 DAMAGE 70 RENTED ,000 CLAIMS-MADE ° X OCCUR 1 i3Ca2os8 , 0810712017 osltt7raa18 i 1 , D EXP An arse rson` I$ S,iiDO ME _—+ Otto PERSONAL&ADV IN3URY !S 1,0001000 ^vEN'L AGGREGATE LIMIT APPLIES PER; i GENERAL AGGREGATE S 2,000,000 i H r-- Pp 2,000;000 PadCY %C, LOC �. PRODUCTS-COMPJDP AGG .$ I i ;OTHER' $ $ COMBINEDSINGLELIMIT ; 1$ 1000000 AuTOMo✓u.E UABIurf ANY AUTO 16237702 ;04 RW2017 t 0410812018 BODILY'INJURY(Per person) 15 NRJ O SCHEDULED # —!kUTOSEO ONLY AUTOS f E 180D URYper�acatlen!" I£ HIR NON QWN X Ali ONLY AUTcc��::OOL 1 1 iS UMBRELLA uAa` :,X ry OCCUR EACH OCCURRENCE S 91000,000 j X ;EXCESS LIAB , cLAiMS MADE y t COBWBE 1984810610712017106 107t2098 AGGREGATE j$ — 4,000;000 —� I ?DED RETENTION$ Iis C 'INtNERB COMPENSATt I I X i PTR ; ;OTH j AND EMPLOYERS'LIABILITY Y f N i i �094925700 1 OdJOd1209.7 i 0410412018 t---�` �� 600,000 AN!PROPRiET01t PARTNERrzXECUTIVE P 'i! El,EACH kCCIDENT S ' FFICER MEM 3NER A,EXCLUDED N I I N r ;� 6600 000 Mandatorylt�� H) i i El. Yc S ' if yyes,describe UrKw DESCRIPTION OF OPERATIONS below I 'E.L.DISEASE-POLICY LIMIT 5 51i0,000 1 I DESCRIPTION OF OPERATIONS./LOCA1fONS I VEHICLES(ACORD 101,AddWanal Remwits Schedule, Le attached if more space to required! Action Inc.and National Grid USA,its direct and Ind irect'parents,subsidiaries and"aftiliates shall-be named.as additional insureds an Commercial General Liability policy per teens and conditions of forms OG2010 and CG2D37 and Commercial Auto Liability policy per ternts and conditions of form SCA 005(02 18),Fonns Available Upon Request f - i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES:BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE VWLL BE. DELIVERED IN National Grid ACCORDANCE WITH 114E POLICY PROVISIONS. 40 Sy.Ivan Road Waltham,MA 02454 1 AUTHORIZED REPRES£idTATiVE. ACORD 25(2016/03) 01988-2015 ACORD.CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD n r "� ;_: = S 9h.a.t ;c;FA w•e ..,�4,4 y.,,.c g4 A jtp 7t ! '. , s i� i�tt &errs � ` t .{ +s Y £ fj f hg ,04 SCE""", re, :: ,' r %-p• _ . t Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Biston, Masusetts 02116 Horne lmproveme wQm'4 tractor Registration Pw; " .. Type: Corporation ALTERNATIVE WEATHERIZATI©N,INC �� Registration: 175683 r� Expiration:, 05/28/2019 2 LARK sT FALL RIVER,MA 02721 Update Address and return card. Me*reason for change. SCA' 0 20M-OS?t1 _.......___...._-_..,................. Q Jkidcl ae 171 Rgh", Al P -Vj nt n- ort. a3 t1 yr � Office at Consumer Aftrs&Business Regulation HOME IMPROVEMENT f',OI+3TRACTOR Registration valid for Individual use only n TYPE CorDoratimbetare the expiration date. H found return to: ' l3lSLEtt! 3SD3C I fI Offles of Consumer Affairs and Business Regulation ^y Fy 1 05/28/2019 10 Park Plaza-Suite E170 Ai TERNATIVE Wii ?ATION,INC, n,AAA 02116 TIMOTHY CABRAL Q L-r 2 LARK ST FALL RIVER,MA 0272 UndersecretaryOt t!' 8iitre TFIE ram, 'Town. of Ba.z"astable *Permit # U �� P� O Expires 6 mouths from issue date � MASS. Regulatory Services Fee —1 �S.s. g Thomas F.Geiler,Director . P PERMIT Building Division APR 0 4 2007 Tom ferry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: .4-s£i2.90RN STAB L Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press 11j prutt Map/parcel Number Property Address I OResidential Value of Work j' q Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address :ontractor's Name��i piZ'z,-t �� Telephone Number Z-b' .CiS g Tome Improvement Contractor License#(if applicable)_ j d 0-1 y 0 ;onstruction Supervisor's License#(if applicable)_ITC oL4 0 _lWorkman's Compensation Insurance Check one: 3 am a sole proprietor 1 am the Homeowner .1 have Worker's.Compensation Insurance tsurance Company Names 7orkman's Comp. Policy# � —�j opy of Insurance Compliance Certificate must be on file. ,rmit Request(check box) (] Re-roof(stripping old shingles) All construction debris will be taken.to El Re-roof(not stripping. Going over existing layers of Too fl VRe-side U(rjvL Replacement Windows. U-Value ( 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 better of Permission. Home Improvement Contractors License is required. ;nature orms:expmtrg- ise063004 f' Page 7 of 7 CAPIZZI HOME IMPROVEMENT INC. SPECIFICATIONS AND ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT OWN THE PROPERTY LOCATED AT IN ��WCA n B MASSACHUSETTS. . I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER(S): OWNER'S ADDRESS: OWNER'S TELEPHONE LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: ` atk APPLICANT'S ADDRESS: 16 Newtown Rd., Cotuit,MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: " RESPONSIBLE OFFICER TELEPHONE:. G 21 Home Improvement Inc. I, Gary Gustafson, Production manager Of Capizzi Home Improvement, hereby authorize Lisa Haworth,to sign on my behalf for permit applications filed through the town. Signed: A Gary G stafso ` Date: is: #rth Date: 1645-Newto wn Road Cotuit MA 0263 -5 (508) 428 9518 (800) 262-5060 FAX (508) 428-1547 � Client�: 47,293 CAPIHOPA •AC©RD,_ CERTIFICATE OF LIABILITY INSURANCE DATE(liMrLQfYYYY) rRoggars; &Gray Ins, Agency,lnc. ON!LYANDICONFERS NO RIGHTS UPON HE CERTIFICATEFICATE IS ISSUED AS A MA-117ER ICN 434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P, 0. Box 1601 ALTER THE COVERAGE A=FORDED BY THE POLICIES BELOW South Dennis,MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC INSURED Capizzi Home Improvemant, Inc. It"SuRERti National Grange Mutual Ins, Cc. INsuRFR3; Amarican Intamational Gr Capizzi Enterprisss, Inc. 1W Newtown Road INSURERC; ` Cot it, MA 02635 INSURER D; I INSURER=. COVERAGES I HE POLICIES OF INSURANCE LISTED BELOW HA`JE BEEN ISSUED TO THE IUIRNSURED NAMED A80Vc;=OR THE POLICY PERIOD INDIC TED.NOT VIT ISTAVD NG ANY RERTAIN, ENT,Tc4i•1 OR CONDITION Or ANY CONT'�qCT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS Cc f IF!CATE MAY BE ISSUED OR MAY PERTAIN,7HE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL HE TERMS,EXCLUSIONS AND CONC(TICNS OF SUCH POLICIES.AGGREGA,cc LIN•!ITS SH6, N MAY HA.'E BESV,REDUCED BY LAIC CLAIMS. IN L LTR 1,SRd TYPEOF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION A7 Mf I Y AT=(51Aif IYY 'LIMITS A I IGENERALLIAaILfrY MP010707 06108MIS I06M8/07 EACH OCCURRENCE $1000,000 X M1.IERCIAL GSVE=AL LIABILI7Y DAMAGE TO REP:TEO CLauns;naoE �DccuR PR-, - r $500,000 I I AHED EXF(Any cne pescn} $1 D DDD PERSONAL d ACV IN OURY $1,000,000 GENERALAGGRECAT'c 32,DDD DOD GEML AGGR-ECAT ME U11111 APPLIES PER:: POLICY I PROOU CTS-OCM PLOP,AGG $2,000,000 JECOT LOC AUTOMOBILE LIABILITY Ili ANY AUTO :C'MSINFO SINGLE LIMIT $ j iEa accident) I! .ALL ONM ED ALTOS SCHEDULED AUTOS BODILYINIURY $ (Per person) ll HIRED AUTOS BODILY INJUR. u-NON-04VNED AUTOS tperaccdaN) $ I PROPERTY DAMAGE $ (P-racd.N) , GARAGE LIABILITY Al,-rO ONLY•EA ACCIDENT $ ANY AUTO OTF-ER THAN EA ACC $ AUTO ONLY: RGG $ ED(CESSiUMBFCELl-A LIABILITY -CH OCCURRENCE $ j OCCUR ❑CLAIMS MADE E AGGREGATE $ I Lam_. . . I i Or-DUCYIBLE - I I RETENTION $ I WORKERS COMPENSATION AND- 1764953 12/25t06 121251D L`r STAT U- G7H- ENPLOYE. 'LIABILITY TOR, "'IT' R ANY'PROPRIE70RJPARTNERtFXECUTIVE SL.EACH ACCIDENT $SDO,DOD ' CFFICE="iEMSER EY.CLUDEC If yes,descrtz under E.L.DISEASE-:EA EMPLOYEE $500,000 SPECIAL PROVISIONS ce ov -OTHER El-DISEASE•POUCY UMR $500,000 DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES EEXCLUSIONS AOCED BY ENDORSEMENT)SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD AN Y OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATioN O.ATETHEREOF,THE ISSUING INSURER WILL ENDEAVOR TO PAIL 10 DAYS WRITTEN NOTICE 70 THE CERTIFICATE HOLDER NAM ED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE INSURER,ITS AGEr17S OR R_PRE3ENTATIVE3. _ AU TH ORI2ED REPRESENTATIVE ACCORD 25(2001ia8) 1 of 2 26435 i WAW ` © ACORD CORPORATION 1983 !ne t,omrnonweairn of massacnusetts Department of Industrial accidents Office of Investigations a 600,Washington Street �! Boston, M 02111 s w"-mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plu)oabers Applicant Information Please Print Legibly Name (Busm--sJQrga=-ationfiacividual): Address: 1-645 Newtown. Road 44 MZ35 City/State/Zip- Tel. 428 9518 800 262-5D6D One#: e .on an employer? Check fhe-appropriate box: Type of project(required): 1 am a employer with 4- [� I a a general contractor and 1 6. Q New construction employees (foil and/or Part-time).* have;hireci the sub-contractors 2.Q I a a sole proprietor or partner- lasted on the attached'slieet $ 0 lZerriodeling ship and have no employees Tf2ese sub=confractois have S_ Q.Demolition working for me in any capacity. workers' Comp msivance. 9. [Q Building addition 11Vo workers' comp_ insuuance 5. Q We:arc a corporation and its regnsreel] officers have exercised;t3ieiz Electrical repairs or additions 3.Q I airi a1onieowiier doing all work 41t of exeprion per ivIGI 11.Q Plumbing repairs or additions myself' o woikers'comp_ C 152,.§1(4},and we have no 12-[]Roof epaas insurance regzured.] fi •,e>�loy�es {No workers' comp tisuraneeregiia ] 13_0 Other *Any applicant that cliecks.box m 1 must also fill:out the section below showing-lit workers'coon policy mfo=mation' t Homeowners who submit$iis affidavit mdica mg They are doing sIl work and they hire outside contractors mast submit a new affidavit iudieatiag such #Coutractars that efieckthtsbox must sYtached an additional sheet showing flie name.o . e sub-c a'tractors.and then woFkers comp policymforniation lain mz e�nployer'that isproviding Wor. rs',compensatcorz:insurance formy employees $e�ow is.thepoluy'andjob site informadon Inc*Tr�rir ( inn 'am �lini�� �: /�i `� :••r�r.C 'r vA Policy##or Self-ins. Lic. #: < Exp lion Date: V Job Site Address:. CitylState/Zip: �,tfach a copy of the workers'.compensation policy declaration page(showing the-0olicy number and expiration date). ?aihi Te to secure coverage as required under Section 25A of MG.L c_ 152 can lead to the imposition of criminal peiialties of.a .me:up to$1,500 00 and/or one-year imprisonment, as weU as civil penalties in the form of a STOP WORK ORDER;and,afine >flzp to$250 OO a.rlayaa instthe,vioi for Be:advasecl that�a copyol this sfatementmaybe forwarded to the�Dili of nvestiga:tions ofthe,DIA for ir+s„rance coverage verification do hereby,ce, under tliepaii s:aind n.aities ofpe ' ry Mcdthe fgrxation provider)above is true and correct _ is Date: 'hone#: O ffixial use only. Do not.wrUe in this area,to be.completed by city or town of cial. . City or Town: Permit/Licease# issuing Authority(circle one): 1. Board of Health Z.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other r x r . lie Laarrimaruuec�� a����uaelYa 5 fi Board of Building Regulations and Standards Construction Supervisor License License: CS 74640 Expiration:. 11/29/2008 Tr# 6430 Restriction: 00 GARY GUSTAFSON 8 SHORT WAY Commissioner SANDWICH,MA 02563 Y t �� ✓fie �aminu�uuoa/�/ o�,.G�saol�uaetta Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registraton .::.100740 Board of Building Regulations and Standards ,Expiration fi/23/2008 One Ashburton Place Rm 1301 r : Boston,Ma.02108 Type _Supplement Card CAPIZZI HOME IMPROVEMENT-tj r0 r VARY GUSTAFSON-� 1645 Newton Rd. Cotuit, MA 02635 Administrator4 t valid with t Sig tune Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home ImprovementC)ontractor.Registration Registration: 100740 / Type: Supplement Card Expiration: 6/23/2008 CAPIZZI HOME IMPROVEMENT,°INC - .�. GARY GUSTAFSON M ,a 1645 Newton Rd. Cotuit MA 02635 -- ' Update Address and return card.Mark reason for change. )PS-CAI 0 5OM-04/05-PC8698 Address Renewal Employment Lost Card r s SINE►anti Town of Barnstable *Permit# L 0 Expires 6 months from.issue date Regulatory Services Fee �® 0 9. PERMIT Thomas F.Geiler,Director �lEo �a T 2 0 20 Building Division 06 0� Tom Perry, Building Comnussioner TOWN OF BARNSTABLE 200 Main Street, Hyannis,MA 02601 F_ Office: 508-862-4038 Fax: 508-790-6230, EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid wit/lout Red X-Press Imprint Map/parcel Number 9 Property Address KResidential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 12_1 V A�. Contractor's NameWm� ,2NQ , Telephone Number L/8 Home Improvement Contractor License#(if applicable)_ I `"'(0 Construction Supervisor's License#(if applicable) Q��� ]Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner �I have Worker's Compensation Insurance assurance Company Name LIA ED 7:U E�' 4-0 Vorkman's Comp.Policy# Cj �� �� � Copy of Insurance Compliance Certificate must be on file. 'emut Request(check box) IRe-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ 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. H e Improvement Contractors icense is required. signature nw(OUA I 1A (0 I:Forms:expmtrg .evise063004 - APIZ G 2f Home Improvement Inc. 1,Thomas Capizzi Jr., owner of Capizzi Home Improvement, hereby authorize Lisa Haworth, to sign on my behalf for.permit applications filed through the town_ Signed: Thomas apizzi, r. Date: aworth Date: 1645 Newtown Road Cotuit, MA 02635 (508) 428-9518 (800) 262-5060 FAX (508) 428-1547 Date: 6/13/2006 Time: 8:40 AM To: @ 9,1,5084281547 RAG Ins. Agcy. Page: 035 • Client#:47298 CAP I HO M �f ACOR1D,M CERTIFICATE OF LIABILITY INSURANCE 061131066°" ' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers 8r Gray Ins.Agency,Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW. P.0.Box 1601 South Dennis,MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: National Grange Mutual Ins.Co. Capizzi Home Improvement,Inc. INSURER B: GUARD Insurance Group Capi2zi Enterprises,Inc. INSURERa 1645 Newtown Road INSURERD: Cotult,MA 02635 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION LIMITS - I LTR NS TYPE OF INSURANCE POLICY NUMBER DATE MMIDD DATE MM/DD A GENERAL LIABILITY MP010707 06/08/06 06/08/07 EACH OCCURRENCE $1 000 000 v X COMMERCIAL GENERAL LIABILITY - - DPREMISES(Ea AMAGE TO RENTED $5OO OOO - 4p CLAIMS MADE a OCCUR MED EXP(Any one person) $1 O OOO PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 r GEN'L AGGREGATE LIMIT APPLIES PER: - _ - PRODUCTS-COMPIOP AGG s2,000,000 I POLICY JERO P LOC A AUTOMOBILE LIABILITY M1010707 06/08/06 06108107 SINGLE LIMIT $500,000 (Ea accident) ANY AUTO ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ (Per accident) X NON-OWNED AUTOS + X Drive Other Car PROPERTY DAMAGE $ (Per accident) GARAGELUU3WTY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ A. EXCESSIUMBRELLA LIABILITY 00010707 06/08/06 . 06/08/07 EACH OCCURRENCE $5 000 O00 i X OCCUR �CLAIMS MADE , AGGREGATE $5 000 000 I DEDUCTIBLE $ X RETENTION $10000 $ r. WC STATU- OTH- I B WORKERS COMPENSATION AND CAWC702365 12125/05 12/25106 x I t EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $500,000 g€ , ANY PROPRIETORIPARTNERIEXECUTIVE F§. OFFICERIMEMBER EXCLUDED? - _ - E.L.DISEASE-EA EMPLOYEE $SOO OOO G j If es,describe under E.L.DISEASE-POLICY LIMIT $500,000 t ' SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS t LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAL 11) DAYS wRIrTEN NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #M22681 MEE O ACORD CORPORATION 1988 ' ;-�; :}} (l��r�f r+j tr,�'f•,tiri�irirl�lti' ttJ +600 . � T'Y q4 �1 S�1 �fU11 t�I�1'f:f! C()X,)7>c3?sa#.oil I S0f-23)CC,A##�t#�� >x : �3�7ilc3ca IC�3��3-:�cir�rsJ i;#c:c.�.z-i� axas/ 'Iuzr�i:►c: case. �'�in# 1�c>�x?rl�r 37?7C; (33�sia�csSlU� ariixaii.o�7/17adi>>adua))= Capizz! Houle Impmve ?1ent Inc. (y1' rto,4r(]_Rnad 3d c;Ss. Cotult, MA 02635 TeL 42E9518 ���oxa �.z, e�aploper7�laecla f.;ae•ap�rop�aai,�e.l3ox: ' Typc of project(reclxx-r red) : a a en�ployer wiib 4. a s general co3aizaciara3 d T ,e3r�p?oyees{ az�dlox a3 L-iirae).�' have lamed fbe sub-coDinders �' ' ��e��'rAz�s�x,�.c#�on =.n sold -Opfieiorozparbaer_ 13sied"on flee a-t(acbed sleet l emodelzflg slbip'andlla reho-eraployees Tbdsesub-coniractO3sla�>e• 8. El DamDlIfdon VNI07-leg z03'Me in any capac'3:ty. -workm, comp.msx3 aum o ro I Ins' �_co3ii�_��;,tar � 9. D 13�ding add�tio�' El v e,az-e a co3poratiflx3 aad� - x�rzare�� officers have e ercisecl iUeir " 1D � Dl cal repays 4r addiiioz3s -nua a b-pine vimerdoing all Wolf, riglf of exemption per MGL 11-E] Plnmbmg=pairs 0i addi--bons myself No,worbers' Co c.352,§1(9),and vrehaveno 7:?C x- ce wired_ s 12-E] loofrEpaus . cPpl.°,rees- [No-V%Torkers' Other co333p_Msmace 3equimLj r�+_cQni Yt-t Ca3-l;sboa t3.must also M3 ont-ibe scoijon.bejop,!slaoti giizeu ozlters' axi 33' miom iou - or nc s Wj_0.4��i�is$ Gdsvit iri3i ffic, ci o �sY e-1 fibs g i �s115. ai3 zmoz �d men im e ors(side coniYsnYors u�issi stioaiit e mi--w affidavit idck;sf� g sneer �+s+-.1Jei1 as add��iona7 slreei slaota�in d3e�ffiue o� e su - -b. .g ilz 3t co�iracio end Y]ie off.rs � cs'cam_ o'i% �orsaaiaon.•' ,� o��-�`J'zrr�rs prat>u�ixxg�i,Qzl�ers'+cnzrcp.gzs�iarz fzzsxct�zrzce,�oz-m3>r>��Xo�rees_ �3�nr��.s�zE � �rlr�,�v�i a��e ' aee toxapany o Se ins.l ic. 1: CA WC-7 0cIZ b J a l✓ zratia33 Daj e: /c /9,5 x clay Of e?'�a ers'co pc sat ox�po;icy decL of iwa page{slaor il3c olicy 3aambz-wad eyzpi atio)a d2de-)- to sec ' ('rotirerage as X-eql&cd 1?acicr.Secfima 25A o� i+1CCL c_3 2 canlead il�e ositdon o c al pe3i lfdzs o a :. i$ 2 0-00 a30 a3adlor one yea pxisonme33 as"AreIl as citrRPcmltiesia iiae fo�zof a STOP'WORK.ORDER.and a�e 3 $-t?_t?D a day against:tine v olatoz. Ee advised that a copy ofil3is sbtcxxrmt may be f"orsxr".arded to#sae Q�.ce of gaido-as offat DIA for j-asurauce coverage ire caf zxn x�e x�r�zin az�, roxTr, d aVe zS -ae JW14 con-ezt are: " '- •- - - . .. ./� _ Date: 0 czrr use ex,11_..0p rz�rvr z�z��xs+w err,�tic CoXzz Xe�ea'1S � , or TOWA: 5.1ag A�zt�flx�.� �'`ex'3oa��ccrise� (circle o�aej_ oarr3 0l Realt1i2 �Brult epa#`faacz��ai 3:'� '1;poY n C)ierk _ Iccirxeal�3specioz _rkx3xpbmgInspec(.or'tai3tt'r 'tam 3E'eksou_ _ —_—.___•-------. -- ., ..._.. .......__.�__.....----- - --_--. •-•- -.- -,_ Board of Building Regulations. and Standards One Ashburton Place Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 100740 Type: Private Corporation Expiration: 6/23/2008 CAPIZZI HOME IMPROVEMENT,.INC: .Thomas Capizzi, jr. — 1645 Newton Rd. - - Cotuit, MA 02635 Update Address and return card.Mark reason for change. DPs-CA1 Co 50on-04i06-PC8698 F-1 Address Renewal Employment Lost Card 9Xe (oai���zoauue¢C o�✓�/ aac/uiaelta fil r Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 100740 Board of Building Regulations and Standards Expiration: 6/23/2008 One Ashburton Place Rm'1,301 Boston,Ma.02108 Type: Private Corporation CAPIZZI HOME IMPROVEMENT, INC. Thomas Capizzi,jr.. 1645 Newton Rd � .` - !_ Cotuit, MA 02635 Deputy Administrator Not valid without signature • � aior��ru�zwe o�../��creaar,�'zccG�, � ` .. - t -: BOARD OF SCALDING RE_G_[ItATION:s L➢cense:"CONSTi OCTION-S =i- Number::�CS. 057032 a f tExp+res 0q/2612b0-7 + ! Restrj�Y;ec7=`f.1D•� ;,; r•<j,T 7 .. . THOMASX 7cZG' ;j`-=fr�ri +i CAPI t' i 1645 NEWTOWN COTIJIT, MA 0263b� �`1 GJ-� /�/� /i _ Comrnissiorier i Page 7 of 7 CAPIZZI HOME IMPROVEMENT INC. SPECIFICATIONS AND ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT (,C �c -- OW N THE PROPERTY LOCATED AT � n Q IN 0J MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER(S):. - �,,1 OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: rcj APPLICANT'S ADDRESS: 164 ewtown Rd., Cotuit, MA 02635. APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: i° r. y r - s c ci - rn 3 V1 1C 3 No i> s r `e ta. - y � n o . I I k COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY , I 1010 COMMONWEALTH AVE. t OF .. BOSTON,MASS.02215 ' j 1 r k MASSACHUSETTS ENCLOSE CHECK OR MONEY ORDER LICENSE FOR REQUIRED FEE, u CQNSTR. SUPERVISOR EXPIRATION DATE ' 3519 i MADE PAYABLE TO s 0.6/30/i993 ' a I EFFECTIVE DATE LIC-NO. RESTRICTIONSa "COMMISSIONER OF PUBLIC SAFETY" NONE 06/30/1991 012209 DAV I D W LAMME R S NOTAND C sH> g BUCCA^SEE R WAY . IJ a;`�DENNIS MA 02670 Pi)EASE NOTE FEE IN - t f SEP f i9� r PHOTO(BLASTING OPR ONLY) FEE: F, ." ` 100.00 Ef,PECTIVE FEB. 10, 1989 { NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY a -- ,'F'�-yr`, �(`��)�� HEIGHT: - STAMPED -OR -SIGNATURE OF MISSIONER V L�✓ �;.;' I k '. O �j De NOT DETACH.. LICENSE STUB THIS DOCUMENT MUST BED 1rN ^E F LICENSEE SIGN'NAME IN FULL•ABOVE SIGNATURE LINE CARRIED ON THE PERSON OFF . UR .� 7 THE HOLDER WHEN ENOAG,( I INT ED IN THIS OCCU PTTION As_ , COMMISSIONER :a 3 1 t I Assessor's office(1st Floor): Assessor's map and lot number l c) J S C, � �� MIKE>o Conservation(4th Floor): Board of Health(3rd floor): F x t ssa»r�nt t Sewage Permit number riva Engineering Department(3rd floor):r' oo,.�t639.` House number i Definitive Plan Approved by Planning Board < 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.',and 1:00-2:00 P.M.only ; TOWN ' OfF BARN,STABLE :BUILDING :INSPECTOR APPLICATION FOR PERMIT TO 7zk �E: S y,k"�Gl_� �� /4('P f '� S Qu.'e�s5 TYPE OF CONSTRUCTION C 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Inn Location 1 w ,h A el t " 14 Vd 1A YL\ Proposed Use Zoning District j Fire District S Name of Owner 4,"' �ILlnt' Qet l Address Name of Builder V DAY\0 'h. Vk IQ LS Address Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost Area Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnst le regarding the above construction. Name Construction Supervisor's License 2 Z cl BALL, JANE a No Permit For RESHINGLE ROOF Single family dwelling Location 121 Winter Street 4' Hyannis - Owner Jane Ball Type of Construction ` Plot Lot • Permit Granted May 19 19 94 Date of Inspection: , Frame 19 - Insulation Fireplace .,C 19— Date Completed y �� 19 � I 3