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HomeMy WebLinkAbout0133 ANSEL HOWLAND ROAD �33 a��� �� � �� 7'f i ` y ,. <. n '. .. � � I �, �.. �� .,. na _ .. � _ �. � ..' ., _ e � �i .� � I �. � �. - .e .. .. i a ,� n F - ., _ n o ua - ,.' _ -, . ., ..�� Town of Barnstable Building 7 Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job'and this Card Must be:Kept ` MAR& Posted Until Final.lnspection Has Been.Made. - Permit 039 �1� Where a Certificate of Occupancy is Required;,such Building shall Not�be Occupied until a Final Inspection has been made. Permit No. B-20-1148 Applicant Name: Ashley Walters Approvals Date Issued: 05/05/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 11/05/2020 Foundation: Location: 133 ANSEL HOWLAND ROAD,CENTERVILLE .Map/Lot171-233 Zoning District: RC Sheathing: Owner on Record: VALOIS,STEPHEN N&NANCY A Contractor Name­;Kenneth D Kendall Framing: 1 Address: 133 ANSEL HOWLAND ROAD Contractor.License: CS`-075153 2 CENTERVILLE, MA 02632 'T Est Project Cost: $ 1,334.00 Chimney: Description: remove and replace front entry door j Permit Fee: $35.00 i Insulation: Fee Paid:: $35.00 Project Review Req: ? �b Date: ' 5/5/2020 Final: Plumbing/Gas ! Rough Plumbing: g g _ 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. All work authorized by this permit shall conform to the approved application and the`approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with.the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or,road and shall be maintained open for.public inspection for the entire duration of the work until the completion of the same. m Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are.provided on this permit. Minimum of Five C611 Inspections Required for All Construction Work:` Service: 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 contracting 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 / r' Z All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT o� � Final: TOWN OF BARNSTABLE BUILDING:PERMIT:APPL.ICATION l TOIL Map Parcel 4FNRNSTAB;� plication V �� ' 6 Health Division 7012 OCT .) 7 pH 2: 03te Issued 7— Conservation Division Application Fee Planning Dept. sm Permit Fee Date Definitive Plan Approved by Planning Board DIVT Historic - OKH _ Preservation / Hyannis Project Street Address AOt1J\0 to C\ c� Village _Ce,(Ntx�,L\X\L Owner Address \''S3 Azsg.� \kii \o,\d Telephone Permit Request NA A ay\ , ceyx\osx., � csr-Qn c&-��c. ,A:r Sa_,o.N. \,OCA<.2 Mm9nc\!%. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 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 ❑ 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) Name C_0, dNO ' Ca A\2 Telephone Number 5 Address ` Utl\�2 \? SL&z,� G License# \ C)a riris Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE l lit, 12 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED 4, MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSUI!ATIONI= FIRERS CE . ELECTRICAL: ROUGH, FINAL f 1ST PLUMBINGP. ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ' DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents - Office of Investigations 1 Congress Street,Suite 100 Boston, NIA.02114-2017 ` www.inass.gov/dirt WorkeW Compensation Insurance Affidavit: BuilderslConteacfors/ElectricianslPtumbers Applicant Information Please print Legibly Name.(Business/Orgatiizationilndividual):CONS ERVE ENERGY INC. d.b.a CONSERVISiON ENERGY Address:376 ROUTE 130,SUITE C City/State/Zip;SANDWICH, MA 02563 Phone #: 508-838-8384 Are you an emmployer?Checkthe appropriate box: Type of project{required}; 1. 1 am a employer with 6 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_ l isted on the attached sheet. 7. ❑ Remodeling These sub-contractors have. ship and have no employees 8. ❑ Detnolitott working for.me'in any capacity, employees and have workers' 9 [No workers'comp, insurance crimp..insurance.+ ❑ Building addition required.] 5., ❑ We are a corporation and its 10.17 Electrical.repairs or additions officers have exercised their 1I am a homeowner dung all work 1111 Plumbing repairs or additions myself-.[No workers"comp, right of exemption per MGL i 2.❑ Roof repairs '.insurance required..]t c. I°52, §l{4};and we have no WEATHERIZATION employees. [No workers' 13,91 Other comp- insurance required.] *Any appl'icant.that:checks box#1 must also till out the section below showing.their workers'compensation policy infonTiatiorr. r Homeowners who submit this affidavit indicating.they-are doing all work and then hire outside contructom must submit a-new affidavit indicating such. tContractors that check this box must attached an additional`sheet showing the name of the sub=comctor,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 trig employees. Below is the policy'and job'site information. Insurance Company Names SELECTIVE INSURANCE COMPANY OF THE SOUTH Policy#or Self-ins: Lie.#:WC7956539 Expiration Date:3i15/13 Job Site Address: City/State/Zip: 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 MG L 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:n the form of STOP WORK ORDER and a fine of up to$250 00 a day against the violator.. Be advised that a:copy of this statement may be forwarded to the Office.of Investigations of the DIA for insurance coverage verification, 1 do hereby cerfi .under the ains and enulties o er'w that the in nrmation.:provided above is true and correct: Si aturc: ' . Date:'__ �_ 771 Phone#:508-833-8384 Official use only; Da no(write 4fi this area,to be completed by city or town offcjgl City or Towni PermtJl.icetise lssuing.Authorif (circle one): 1.Board of Health 2.Su [ding.Department 3.City/Town Clerk 4.Electrical l'nspector a'. Piumbinglnspector 6.Other Contact Person: Phone#: Client#:68880 GONSER ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM>oDNYYY, r _ 03/15)2012 TH(S`CERTIFICAT.E IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE-DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,,EXTEND OR ALTER.THE'COVERAGE AFFQRDED.BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),,AUTHORIZED REPRESENTATtVE'OR.PRODUCER,AND THE CERTIFICATE HOLDER:. IMPORTANT:If the certificate holder is an ADDITIONAL'INSURED,,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject I. the terms and conditions of the policy,certain policies may require an endorsement:A statement on this certificate does not confer rights to the certificate.holder In lieu of such endorsemetit(s). PRODUCER CONTACT NAME. Rogers$.Gray Insurance;Agency'Inc. PHONE ..-- __.......__ FAx 434 Route 934 C�c�N.o,Exli;508:398 7980 true;Noi: _- i A DRESS: South Dennis,MA 0266Q - - -- INSURE RI I'' FFOROING COVERAGE v IdAIC'iI 508 398-7980 ---- — i INSURER A_Seliciive lns.Co.of the South. L' INSURED -- Con-Serve Energy Inc. INS URER a ... 376 Route 130.STE C INSURER C.i Sandwich;MA 02563 INSURER 0: - _-u 1 INSURER E: .....___..... ....-__......._.. .. .....---- INSURER F _ - t 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 CONTRACTOR OTHER DOCUMENT'WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS,SHOWN MAY HAVE:BEEN REDUCED BY PAID'CLAIMS. INSR, _ .. ._ .. - q . ADOL Ue "�—�' T LTR TYPEOFUISURANCE TINS - D POLICY NUMBER M�QV:EFF ,.Mn M 1, LIMITS A GENERAL LlAeIUTY X 52011299. 3/14/201:2 0311412013.EACH OCCURRENCE s:1 OOQ 000 .X COMMERCIALGENERAL LIABILITY i _ # - pRA'ACES TO RENTE6 �- - `- 5(Ea occurrence) 5180 QO® CLAItdS MRDE �'OCCUR' { MED_EXP(Any one person)_;S B,l)oQ t .PER$ONAL&ADVINJURY ,i$1,000,000 .' ------- i I GENERAL AGGREGATE_ '`s3,000,000 GEN'L AGGREGATE LIMIT,APPLIES PER: 4 I PRODU.... COWN61'AGO $3 000 000 X'POLICY h JPECaT LOC $ 1 AUTOMOBILEiUABiLiTY -- �- li i M INED SINGLE LIMIT -- j I I �(Ea a=denit �I.S_ ANY AUTO 1 ?BODILY INJURY(P@r person) l$ ALL OWNED SCHEDULED --- AUTOS El AUTOS ± it 1_BODILY INJURY(Per acddeni) $— — E—I'NONOOWNED -._. ' rPR0cRTY DAMAGE i$ - ;HIRED AUTOS- i AUTOS � E �(PeI accident) A UMBRELLA UA8 X. 'OCCUR � X � 92011299 3114/2012 63/1:4/20'1 EACH OCCURRENCE 1151,000,000 �. F EXCESS UA9 CLAIMS-MADE( IGGREGATE $3,000,000A ` _._... ' 'DED_ X.RETENTION$.O___ 1 I $ WORKERS COMPENSATION a—— - J._ ---- - WC STATU_ ;OTW_ A WC7956539 3114/2012 03/14/2013`X iT� AND EMPLOYERS'LIABILITY Yl N ANY'PROPRIETORiPARTNERIEXECUTIVE OFFICER/IAEMBER EXCLUDED? P�y NIA I E L.:EACH ACCIDENT i$100 000 it(Mandato In NII � 4 r - - #lI yes; E.L.DISEASE_EA EMPLOYEEi$100,000— 1 DESC describe under RIPTION OF OPERATIONS below I ±—. E L.DISEASE-POLICY LIMIT jt$500,000 i } I . n I i � DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD.101;Additional Remarks Schedule;if more spate-is.required.) - Excluded officers ut derWorkers'comp-:Conor`:and Courtney McInerney. Blanket additonaf insured'coverage appiies:Itnder CGL. CERTIFICATE HOLDER CANCELLATION Thielsch Engineering,Inc. SHOULD ANY OF:THE'ABOVE DESCRIBED POLICIES BE'CANGELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 196 Francis Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Cranston,Al 02910 AUTHORIZED REPRESENTATIVE ©198 -2010 ACORD CORPORATION.All rights reserved'. ACORD 25'(2010105j 1 of 1: -The ACORD name and logo are registered marks of ACORD #S788991M78888 DDR I 0Mee o ons Gwe CO��Tr�y� a� ,(e umer airs usmesti 2egnlaaIIon License or registration rand for indIvidul use only ` HOME IMPROVEMENTRACTOR before-the expiration date, If found return to: RegistratibT 071251 Type: Office of Consumer Affairs and business Regulation v Expiration 3/1inu Partnership 10 Park Plaza-Suite 5170 ` $95ton,,MA.03116 C 'ERVE ENERGY `- 1 ar C.ONOR NIGINERNEY s. f 376 ROUT€130:SUITE C � SANDWICH,MA 0256 Undersecretary Not valid wlthautsignafur8 M �i`1ussachusttts- Deirartmn nt stf Public-S.Af is+=: t� ' BuSti��>f Bt�iltiitt�Ftt;!ulati+tns��n� Stanai:tr�l,� Cori 6 Supervisor Specialty License: `• License: CS SE. 102-n8- ! Resthctet try IC N r:CONOR= MCINERNEY� "SIA�CONSET DRIVE '' r SAGAMQRE BEACH, NIA 02562` �_• ' ''^G`- -� - ,Expiration.: 8119/20112 4- r, M f'�ricrrtlS4innr 'To. 102778 f 'massaEhus2cts Boara of Builoing Reguiaticr,s ana Star,.caros s �iln�irti Cfluq �U 17C f'1 J�Ui' speciOl(A _ir-ense CSSL-102778 - CONOR D MCINERNEY e� 39 SIASCONSET DRfVE' SAGA-MORE BEACH MA 02S62 J,.G.� JJiSLgc. c.�;:)iratior Canut ss.c«e. 08/19/2014 Y Oftice4Mifinsum r airs �13u;incs egula`firi i� License or registration v,11id for inJivitlul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If founts return to: G Registration: 171251 Type: Office of Consumer Affairs and Business Regulation c =' Expiration: 3/1/2014 Partnership 10 Park Plaza-Suite 5170 '\•_8L. Boston,MA 02116 CON=SERVE ENERGY CONOR MCINERNEY f 376 ROUTE 130 SUITE C SANDWICH,MA 02563 Uudcrscu�i,iry Not v►hd without sign cure w.. f .ta#oi4 �Vol mass save' PAATICw^ATINS CAR, CtDA �sra+asi7n�.dW cnc+ev�-�c PERMIT AV HORIZ TI.O.N. FORM , �Qt. b6 i owner of the property'located at: (Owner's Name;printed) Alcl {Property Street Addre s (0ty/Town) hereby'authorize the Mass Save.Home Energy=Services,Program assigned Participating Contractor-lsted'below to-act on-my behalf and obtain a building permit to perform insulation andlor weatheriaation work an my property. Owne: ignat-,e pate FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following.Miss Save>Home energy Services participating°Coritractorto the above referenced project: Participating.Contractor Date, Rev 12132011 c"m .. - By,�- A-,, CC4 (YACA-* 4t(. ins. C A -- - 1 x i &A tr ,e t y LA uja4 c�sZ " 00 { A Liq Town of Bay �� u( Barnstable. s Permit# �uaxsr,►at a, : F Re'gllj a t0ry S ervi c S Fee 6 mom rom ' die i . Thomas F.Geiler,Director Building Division Tom Perry,CBO,.Building Commissioner . .200 Main-Street,Hyannis,MA 02601 Office: 508-862-4038 E. www.town.bainstab9e-ma.us" EtESS PERiV T APPLICATION Fax: 508-790-6230 RESIDENTIAL ONLy f Not Yalid without Red X-I#ress Imprint MaP/Parcel Number Property-Address € E b Residential Value of Wor s t Minimum fee Owner's Name&Address of$25,00 for work under$6000.00 . € C. a Contractor's Name _ 3 Home Tmp j Telephone,Number 7 7 rovement Contractor License#(if applicable) f L Construction S upervisor s Licensel#(if applicable) S E l� 6orkman's Compensation Tnsuzance Check one: ❑ I am a sole proprietorEJ E , -PRESS T am the Homeowner 04 have Worker's COMP nsation Imuraace AUG 9 20, 1'. Insurance Company Name TOWN OF BARNSTABLE Workman's Comp.Policy# C I J Copy of Insurance Compliance Certificate must accompany each e Permit € P rmit. Request(check box) :. ❑ Re-roof(stripping old s 4ingles) All construction debris will be taken to 4 ❑Re-roof(not stripping. going over existing layers of roof) . ❑ Re-side U� „ j --� lac eme - eP nt Windows/ ors/shd #of� ers.U-V doors slue . m( a 9u d: ximum.44 Issuance of this e' it.does )#of windOWSS P oes not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property O er must si A co of gn Property Owner Letter of Permission. PY Home Improvement Contractors License& required, s Construction Supervisors License is SIGNATURE: QAWPp naEs �oxM.. S16uilding permit forms\FJCpI�SS dM ' 'z' k. 3r fzk � xc. 3 £# aL "..�y r• r•`: CONTRACT# 0000989 - 61- a {M�SSACH�IS��'F L`- £7ER�10} S� L may ,S&-Sfii�ct�,fD�S�c�F�ECO�VAt�ACT ^" INSTALLED SALES SPECIALIST NUMBER CUSTOMER .F 1,+,I >y' ; T is VA 016 w STORE NO STREET ADDRESS a"P,n k- y STREET ADDRESS i 2u37 cr1^ni e�R 33 NSe/ hE u,l do r�d� CITY STATE ZIP " "' CITY STATE OZaP TELEPHONE rc. sp TELEPHON DATE LOWE S HOME CENTERS 4868 LCC REG � Tu ,/ FEIN 56-0748356H CHARGE ty. s "' gThis rs onlya quo(e4or tire merchandise en¢seMFesPriMe¢ T,�w y*rh"(a� -;aQf� "merd uponPKprrleni?')�oa P8y[ent,lhe en8m sgreemen6lneluding the ypedilcala complelS"d Rageot�this'r c :,sresdocLma337,tF�e Terms and-.ConalUposlntlGdedv/fth m t'�" $^X! entiaa a"1taCFf a,{{t,&,I,le}etos 3helFhe reierted toherei a;<th�s'Contred x i.4 rS �. _�� - c btFLEA$�E-13lAEL TERMS AND CDNDITIpNSON T}iEFfF�VE E$IDE O,wF T�#iM:PAG� QING AAGESBEFORF,,SIGKING -�> & T,, .�e4��y,4 . r F ..0 2 `J' .x. v. .y v,• S" _ INSTALLATION STREET ADDRESS CITY STATE ' ZIP 119 dgS 11 vve L 3201 % , e ✓oS 1-UR qQ u.; ✓C Co g- ho e ` s4,0.se F All S7o S DL of sH Contract Total Are permits required for this installation?:KYes [ ]No *applicable tax included NOTICE TO CUSTOMER: Federal law requires Lowe's to provide you with the pamplet Renovate Right.By signing this Contract,Customer acknowledges having received a copy of this pamphlet before work began Informing Customer of the potential risk of the lead hazard exposure - from renovation activity to be performed in Customer's dwelling unit. PHOTO RELEASE:Customer grants to Lowe's and Lowe's employees the right to take photographs of all work performed at the Premises related to this Contract,and irrevocably grants to Lowe's all right,title and interest in and to the photographs for use in all markets and media,worldwide,in perpetuity. Customer authorizes Lowe's to copyright, use and publish the photographs in print and/or electronically, and agrees that Lowe's may use such photographs for any lawful purpose, incI ' b not limited to,marketing, advertising, publicity, illustration, training and Web content. By initialing here,Customer agrees to the foregoing. [Customer to initial to the left]. Work is to commence upon reasonable availability of Contractor and/or any special order or customer made Good(s)which is anticipated to be A—02� — /y [fille in date].Estimated completion date is 9— r2—1 [fill in date]. Said estimafed completion date is not of the ess nce.A statement of any contingencies that would materially change said estimated substantial completion date is as follows: (if applicable,inserta statment of such contingencies). IF THE CONTRACT TOTAL IS$1,000.00 OR LESS Customer must pay infull. COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00: Customer to Pay in Full; OR [ ]Customer to use the following payment schedule: Deposit $ to be paid upon siging contract.Deposit should be 1/3 the total contract price;and (2)Payment of$ to be paid anytime after this Contract is signed and before commencement of installation,I/We authorize Lowe's to do one of the following(check appropriate box below): [ )Charge my/our credit card for the amount of the payment indicated above anytime after the date this Contract is signed; or [ ]Deposit my/our check for the amount of the payment indicated above anytime after the date this Contract is signed;and (3)Final payment of$100.00 to be paid upon completion of the installation and both parties'satisfaction. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L.c 142A LOWE'S AND OWNER HEREBY MUTUALLYAGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT,THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUT- IVE OFFICE OF CON UMER AFFAIRS AND BUISNESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION AS PROV _ By: Date: q— L e Ce ters,Inc. t Date: �' ♦� Owner Signatur THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED " BY LOWE'S PURSUANT TO M.G.L.c.142A.THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE SECTION ABOVE IS NOT SEPERATELY SIGNED BY THE PARTIES. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND CONDITIONS CONTAINED ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CONTRACT. BY SIGNING BELOW,YOU ARE ACKNOWLEDGING THAT YOU HAVE READ,UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CONTRACT.YOU ARE ENTITLED TO A COPY OF THIS CONTRA5 AT THE TIME OF SIGNAT RE. WITNESS OUR HAND(S)AND SEAL(S)BELOW THIS, DAY OF U O Lowe' Ho at os� S eci i or Above Owner Co-owner or Witness r Gusto er acknowledges receipt of a true copy of this contract which as completely filled in prior to Customer's execution hereof.You,the buyer,.may.` ! cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.See the attached notice of cancellation. form fora explanation n of this ri ht. 9 FILE COPY o 2co4 ar Lowe's.0 Lom and me game tleslgn.:., #90981(Rev.12/10) a e reglsteretl tradema ks o<LF Co,bole don. f The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 , www.mass.gov/dia Worker's compensation yosmance A,Mdavfit:BWders/Contractors0ectniciansslPlambea s Applicant Information Please Print Legibly Name(Business/Organization&dividual): S Address: V City/State 6p:� �f>�A7)7 i rn as'� Phone#; -7 q— -;z A 0©� Are you an employer?Check the appropliMe bus: 1•❑ I am a employer 4.� TYPe ofPro�(regtdred): nth __ 5f'�am a general contra r and I have 6. New construction employees(full and/or part time).= timed the listed ❑ Remodeling 2.❑ the attached sheer.# ❑ I am a sole proprietor or pmtnetship T)ese suboonttactors have 8. Demolition and have no employees working for employees and have workers'comp. 9. MUM addition ' the in any capacity.[No wo&ml insimmot$ 10.❑Electrical repairs or additions comP tusmanee required.] 5.❑ We are a oorporabion and its 3•❑ 1 am a homeowner doing all work officers have exercised their right of 11.❑PlindbilIg repairs or additions myselL[No weuicers'camp. exemption Per MGL c.152§(4),and 12❑Roof repairs instaance we have no employees.[No wows' 13. otherrequited.]t comp.insmaQoe required.] ❑ `Any aPPlicatu that checks boat 01 mast also fiR our the section bdow ahawing their check wasto::s' t H osmpeasetion Policy into�etim #Co omeown na who submit da affidavit Meeting fpey are dfg all wtak and dou hire at�ide eoanacoma mast submit a new affidavit' nnactots that this boat most attach eo additlamd sheet dawmg the rams of the sab•oonaaaoca and sorts whetber oar tftw a If the sobawilrattars have employees,tbey mnst provide rhea wt dwe cam Ply m011M an entPk3er that is provrdiirg wogs'coxtpefisattoa inatatoneef ormaltioaz. or my eerpbYees,Below k the po&7 andlob site Insurance Company Name: Policy#or Sell ins.Uc.#: Expirati`J on Job Site Address: atyrsratp: �a e"��/�.c/f 8a Failure Anach�s�ecaree�worker' m Ply pa V(showing the pansy wmAw and a date). �+',� S one ear' average as re�wider Section 25A ofMGLe.152 can head m the i>�aram Of--'-' of afore ib$1,5W.00=Nor y tmlaisonment,as wen as"ptmalties in the form of a STOP WORK ORDER and a Ste of up ro$25000 a agaim the that a copy of this atafeootmt may be farvvatded to the m Of of Investigations of the DIA for hwirmnce coverage vemScBri violator.Be advised I do testify wrderthe and psadges of pffj tAat the w{farntakon provided above is true and sourer. Signature: Date Phone#: O,frcid use only.Do not write is dis atery to be eompided by dly ormwu o," City or Town: # Issuing Aathurlty(rude one): L Board or Health 2.Building DgwbneM 3.Clty/Town Cleffk 4.Zed rical Impedw S.Plumbing Intgteator 6.Other Contact Person Phi ThelewMAO Brsto 1lA Olj7 Work rs'CemRe A b+caet. i 's'JFb�rs '. Name Address: sty/sb&lZip _ r Are You aQ:e"nploper'�C.he r r, I.❑ I am.a ealoyer w q t:�t I a (r�Q 'ed�: 2. employcesNit"ate M4 a=- asflk t z r+��aer sbi 'and +', �o cmPyo 'h �svh- vnadus" avi k for.me in ally Y• rorks' } o Coll] o � 3.❑ Il o works' =ts2, d l► ap4 p or.IMI ao,s f � # f :� • . i3 Q Homeow�ts wlio�wic� :�eiov�o � 411111 SO � G HOC � ry• �Og. N Company ame: . Policy#or SOif-ins.Lia#: Addr Jqb Site Attach a copy orthe.wor 'celmpeagtron 'dretar Fare eIoa, ier fime up to$1'$ 00 / F.as weIl as P?�atties of of eo a vn of a D fat ao(` s.sla� mt m3*tZe h the a fine msmancc ouvcrage ice of ldo.. Will ill ill ofPe�y the rnfern pd:as#it Ltd cerriee* I Offlriol rtre Drily Do nat x7te�!�orer�to � �,�y, � .�`�• , City or Town: , �t AnthoY*.(*ge me 1..Board of$ean L BraUdIng D 6.OMer Phabl"InVeaor Contset Person: r i V ok -fly ��;Pw'�,'e�'`� �lOr►� fir,-,�o��,r,®�S ��� 5 Gi,L44 hor i �n 0-7 Po ,..,�lr/ o�� ac�cuaelZ`a - Office of Consumer Affairs&Business Regulation License or registration valid for individul use only before the expiration date. If found return to: OME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration-_-:F 8688 10 ParkPlaza_Suite 5170 Expira&X_?^W_81201.1 Boston,MA 02116 Card ,fib=apt LOWE'S HOMESCPC JAYMI RODRIGCIEz '' 136 TURNPIKE RD..-,: € 1.0 g = SOUTH BOROUGH;tiiA=olri2 Undersecretary .9�Net.valid without signature it ;I %I NI Af£,;ir f:Bdsinrs Rc elation` License or registration valid for individul use on1v a AqE HOt'RC,ijrrryEN r ro?l7pA4TOq before the expiration date. If found return to: b ape; Office of Consumer Affairs and Business Regulation <---=� iCeIIO TE. ':2,1/1202 pgA 10 Park Plaza-Suite 5170 Boston,MA 02116 tincicrscrr;::ar� Not valid without signature yyy n Hai}rit W Rui div�ff R ' nati ms 'Ind" sL<ind'j'.rg�s d 6 ice- CS 75153 kd- .sx3 KENNEL i H.D KENDALL WEEDEN PLACE 4117 FAIRHAVE=N, iVIA 02719 E xpirag;e,n: 1/1 21201 3 07/17/2011 23:45 5089973324 HC&C INSURANCE PAGE 01 --7-70" OP ID: PC i. A Via- CERTIFICATE OF LIABILITY INSURANCE DATE 07118°nYYY' 07/16111 THIS CERTIFICATE I$ ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTII=ICATE 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(las) must be endorsed. If SUBROGATION IS WAIVED,subject to the torms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the 1 certificate holder in lieu of such endamemen s. PRODUCER 508-997-3321 NOS CT Humphrey,COvill&Coleman PHONE FAX Insurance Agency,Inc. (aJc.No.Extl! 1.IA1C,Nor 195 Kempton St. P.O.Sox 1901 AIL ADDRESS: New Bedford,MA 02741 PRODUCER Brad H.Con9tant _CUsroMERIDt:KENDKEI _ INSURERIS)AFFORDING COVERAGE NAIC A-_ INSURED Kenneth D.Kendall dlb/a INSURER A:Norfolk&Dedham 23965 Clearview Home Improvement INSURERD;Commerce Insurance Co 34754 j 5 Weeden Place INSURERC; Fairhaven,MA 02719 - INSURER D; - INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: - REVISION NUMBER: THIS f8 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. wSR TYPE OF INSURANCE 0 LICY NUMBER MMIn MMIDDre Y PO LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,00 I)AMAGP TO A X COMMERCIALGENF•RALLIABILITY R0652279A 07JO4111 (12104112 PREMISE Eao Dce) $ 50,00 CLAIMS•MAD6 r—V-1 OCCUR MED EXP A and parson) $ 6,00 PERSONAL A ADV INJURY S 1,000,00 _ GENERAL AGGREGATE $ 2,000,00 PML AGGREGATE LIMITAPPLIES PER; PRODUCTS•COMPIOP AGO S 2,000,00 POLICY F1 PRO- El LOC $ AUTOMOBILE LJAIMLITY COMBINED SINGLE LIMIT I B ANY AUTO RYJ392 02108111 02108/12 (Feaccldenq BODILY INJURY(Per person) S 100,00 ALL OWNED AUTOS BODILY INJURY(Per eccidcnl) $. 300,00 X SCHEDULEDAUTOS PROPERTY DAMAGE $ 100,00 X HIRED AUTOS (Peflmldnrq) X NON-OWNED AUTOS r $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE I DEDUCTIBLE $ RETENTION $ WORKERSOOMPENSATICN WCSTATIJ_ OTH- AND EMPLOYERS'LIABILITY - JER ANY PROPRIETORIPARTNEWEXECUTIVE YIN E.L.EACH ACCIDENT $ OPPICEWMEMBER EXCLU°EI NIA - (Mandatory In NH) E.L.DISEASE-FA EMPLOYLE S mes,describe under ' SCRIPT10N OF OPERATIONS below E.L DISEASE-POLICY LIMIT 5 DESCRIPTION OF OPERATIONS I LOCATIONS!VEMCLES (Attach ACORO 101,AddB4fertal Rarnarks Sehedulo,If more Speer Is racpIred) CERTIFICATE HOLDER CANCELLATION LOWES-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Lowe's Companies,IfIC. THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN p ACCORDANCE WITH THE POLICY PROVISIONS. 241 Cranberry Highway Wareham,MA 02579 AUTHORIZED REPRESENTATtuE ®1988-2009 ACORD CORPORATION, All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD f /0�1 - ,4: MIT if s Town of Barnstable *Pere it Frp&u 6 mzft from issue dcu 06 Regulatory Services Fee ` ,may,= �e N$�� Thomas F.Geiler,Director TOW LE Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street. Hyannis,MA 02601w Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION Not Valid without Red X-Press Imprint Map/parcel Number J Z33 Property Address � ao - 94idential OR ❑Commercial' Value of work Owner's Name&Address Contractor's Name_ �G `� 'Y`elephone Number so e -7 7S 41498 Home Improvement Contractor License#(if applicable) Q 99 S 7 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ Lmn the Homeowner ff'l have Wort= s Compensation Insurance Insurance Company Name I—`/S lx' 1 ,-r"°TV°V i_ Workman's Comp.Policy# ('/✓ �. � :3 Permit Request(check box) �Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Valtie (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town deparmtent regulations,i.e.Historic.Conservation.etc. 4 f Liberty Mutual Group Ilibert PO Box 7202 Mutual. Portsmouth,NH 03802-7202 Telephone(800)653-7893 Fax(603)431-5693 May 25, 2006 TOWN.OF BARNSTA13LE 720 MAIN ST HYANNIS,MA 02601- " RE: Certificate of Workers Compensation Insurance Insured: OLMER KELLY 9.PEREGRINE LANE SOUTH YARMOUTH,MA. 02664 , Policy Number: WC2-31S.338804-025 Effective: 12/282005 Expiration: 12282006 Coverage afforded under Workers Compensation Law of the following state(s): MA. Employers Liabilityy, Bodily Injury By Accident: $ 100,000 Each Accident Bodily Injury by Disease: S 100,000 Each Person Bodily Injury by Disease $ - 500,000 Policy Limits As of this date, the above-referenced policyholder is insured by Liberty Mutual Fire Insurance Co under the policy listed above. The insurance afforded by the listed policy is subject to all the terns,exclusions and conditions, and is not altered by any requirement, term or condition of any or other documents with respect to which this certificate may be issued. This certificate is issued as a matter of information only and confers no right:upon you,the certificate holder. This certificate.is not an insurance policy and does not amend,extend, or alter the coverage afforded by the policy listed above. If this policy is cancelled before the stated expiration date,Liberty Mutual will endeavor to notify you of such .cancellation' .. AUTHORIZED REPRESENTMIVE LIBERTY MUTUAL,INSURANCE GROUP This Cer"Cak is caeca led byLIBERIY MUrUAI.INSURANCE GROUP as mspeeis suck insumm as is affittkd by&ou companies. cc: Insured::. ;.,Producer of Record: OLIVER KELLY SANDPIPER INSURANCE AGENCY INC 9 PEREGRINE LANE' 12 ENTERPRISE RD SOUTH YARMOUTH,MA 02664 HYANNIS,MA 02601 5/I5/2W6 1LY VVI•.u.v•.•�6nwN. , �r�wr...............—• 1 Department oflndustrial Accidents Office of Investigations 600 Washington Street • Boston, MA 02111 y ' ww mass gov/dia, Workers, Compensation Insurance Affidavit,, Builders/Contractors/Electridans/Plumbers A Jicant Information Please Print Le 'bI Name pusiaess/ ganizaticnitndividual): @t VJ E�L Address:1 �� W t �Nt , 4A-�kQJ City/Statelip: -so_ 14 Phone#: 550% A,r...e,�y u an employer? Check e•Appropriate bog: Type of project'(requireci): 1,L I am a employer with 4. ❑I am a general contractor and I 6. ❑New construction employees(fall and/or part•time)* havt:hired the sub-contractors 7, Remodeling 2.❑ I am a sole proprietor or partner- listed on 1he attached sheet,$ ❑ ship and have no employees These sub-contractors have 9% ❑ Demolition worlrmg forme in any capacity. workers' comp.insurance• 9. ❑ Budding addition o workers' Comp.insurance• S, ❑We are a corporation and its � 10,0 Electrical repai<•s or additions requn'ed.] officers have exert' ed they 3.❑ I am a homeowner doing all work right of exemption p or MGL 11,❑ Plumbing repairs or additions myself.(No workers' comp, c. 152,§1(4),and we have no 1 Za'Roof repairs insurance rcquireci:]t . employees.(No workers' 43,❑ O@ier warp,insurance°regnired.j *Any app$caat that checka box#1 asmt also fill out the section below showing their workers'oampensation policyinfcrmati t Hvsaeownen who subunit this affidavit indicating they an doing all work and1hen hie outside coati ctm must submit stew atMavit tadios sting such 1c=h=t as Ibat check this box mast attached an additional sheet shouting the tame of the sub-contrabtora cad their workers'comp,poilcy fafori3m4on. I am an employer that is providing worker9'compensation insurance for.my employees. Below is the policy and J'ab site. Information. �, Ins�enco Company Name Pa3icy or 5 .Lr '41 1 S 3 3 Z`6 O 1�3 s �l�i,.� ,� QO /gam' lob Site Address: city ip: v Lt Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secore-coverage as required nndel Section 25A of MGL c, 152 wif lead to-the imposition of criminal penalties of a fine up to$1,500,.40 and/or one-year imprisonment,as well as civn penalties in the-form o a STOP WORK ORDER and a fine of up to S250.00 a day against the vklator. Be advised that a copy of this statement may be forwarded to the Office of J vestigations of the DIA far insurance coverage verification, I do hereby certify under the pains and penalties of the information provided above is true and correct Si tins Date; Phone#; S� $ rJ �i Lt b u• "-u. nisi asf OP4. Do or& aft area,to-U CM�d,4, ,.or tM -mid , City orTowu- Permtt/Litense# Lrtsuin,Autharity(circle one) 1.Boz*d of Health 2.Building Department 3.Chy/Tiowa Cleric a.Electrical inspector 5,Plumbing Inspector• 16. Qther Cor�act Persau: Phone#: Information and Instructions �- Massagbusem General Laws chapter 152 requires all employers to provide vkrkeW compensativnfor-beir employees. Pursuant to this statute, an employee is defined as"...every person in the icrvice of another under any contract of hire, , express or implied,.6w or written." ; An employer is defined as•"on 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 on individual,partnership, association or other legal entity, employing employees. However the owner of a dwcVmg 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 smh dw.eUimg house or on the grounds or building appurtenant thereto shall not because of such employment be deemed tob a an employer," MGL chapter 152, 125C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or penn#t to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance-w%the insurance coverage required" AdditionaUy,MGL chapter 152,125C(7)states"Neither Ihe commonwealth nor any of its political subdivisions shall eater into any contract for the performance of public work until acceptable evidence of connwih he ace� n requh=errts of this chapter have been presented to the contracting authority." Applicants please IM out the workers'compensation affidavit completely,by cheeldng the boxes that apply to you=situation and, if necessary,supply sub-contraetor(s)name(s),address(es)and phone nnmber(s)along with them certificates)of insurance. Limited Liability Campanies(LLC)or-Limi 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 aid date the affidavit. The•afl'idaYix should be rirtuned to the*or town that the application for the permit or license is being requested;not the Department of Industrial Accidents. Should you have my questions regarding the law or if you are required to obtain a workers' campensatioupolicy,-please can the Department at the number listed.below, Self-insured companies affiddId erfiheir. self insu=aace license number on•the agrpropriate line. City or Town Offidds . Please be sure that the affidavit is complete and printed le&ly: The Depar6ment has provided s space at the bot#am. off dwavit far you to fill adb the event the 05=of Imestig'ations has to contact you xegarding1he applicant - Pleasebe sure to fM in the permit/lieeme numberwhich wiIL be used as a reference number. In addition,'as applicant thatmmst sah*muldple permitllicense appEcatiow in any given year,need only submit one affidavit indicating=ent policy information(if necessary)and under Ich Seto Address"the applicant should write"all locations in__(city or tm),"A copy of the affidavit that has been officially stamped or markedby the city or town may be provided to the applicantas proof that•a valid affidavit is on file for future permits or licenses, A new affidavit mustbe filled out each ' year.Where a dome owner of citizen is obtainbg a license or permit wtnlated 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 Mee of Investigations would like to fhank you in advance for your cooperation and should you have any questions, lease do not hesitate to give us a COn P The Department's address,telephone and faz nar2er: 711e Commonweal of M- usachsetts Dgwtment of Industrial.Accidems . (mfice of la 600 Washington Street Boston,MA 02111 Tel,#617-727-4900 ext 406 or 1 o77-MASSAFE ' Fax„' 617-727-7749 Revised 5-26-OS vr,&v mass,gov/dia 91te Board of Building Regula ons and Standards s One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Dome Improvement-Contractor Registration -= Registration: 128957 Type: Individual Expiration: 6/14/2007 Oliver Kelly Oliver Kelly _ 9 Peregrine lane S. Yarmouth, MA 02664 Update Address and return card.Mark reason for change. 'Al 50M Address Renewal Employment Lost Card Qr -W04-G101216 Cu ` �1 oF�"E r Town of B o� snxxsrns�. Regulator �39. Thomas F. Ge' A'ED1A°�A Building Peter F..DiMatteo,Bui 200 Main Street, H r' Office: 508-862-4038 Building Permit Procedures for Pools (p 1. Plot plan or mortgage survey required fo must be sketched in, and distance from bo location of backwash pits. 2. Historic District Commission,200 Main St construction/demolition for any properties loc • Old Kings Highway Historic Distri • Hyannis Main Street Waterfront 3. Application sign-off must be obtained at _ Tax Collector � _ IKELLY ROOFING 9 PEREGRINE LANE SOUTH YARMOUTH PH/FAX 508 775 4498 MA. REG* 128957 MA 02664 INSURED May 8; 2006 Proposal submitted to Mr. &Mrs. Spidle of 133 Ansell Howland Road Centerville Ma.. We propose to supply all materials and labor necessary to remove and replace the existing roof at the address above .__.-.- -M-rdebrisyto-be-removed to towrt trgsfer. 8" Aluminum drip edge to be installed on all eaves. Ice and water damage protection membrane to be installed on first three feet of eaves. Remainder of deck to be covered with#30 felt paper. 25 year limited warranty 3 Tab style shingle to be installed( similar to existing) Bathroom vent pipe boots to be replaced with new. a Cobra ridge vent to be installed on entire length of all ridges with hand nailed caps. Protect all walls,windows, decks, plants and shrubs etc. during roof strip Repair Chimney flashing as necessary . Obtaining of town permit. At a total cost of$5600 For use of 30 year limited warranty architect style shingle add$420 To replace trim as discussed add$100(Fascia;on front left and rake at rear right) Payment Schedule; 30%with signed contract,balance upon completion. Respectfully submitted, Oliver Kelly Proposal accepted by, `_,__ Date / /2006 A e� " •, TOWN OF BARNSTABLE Permit No. --_------------_ l ��R� Building Inspector cash ,wa \ ------- 'Inv OCCUPANCY PERMIT Bond ---------- - -- Issued to Jan sm, 11 Address 0entervalle Wiring Inspector Inspection date Plumbing Inspector �� f!J; �� f . ' Inspection date Gas Inspector Inspection date r Z Engineering Department Inspection date Board of Health 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. .....:..:. ::. f l g ......................I...................._ . ................................. ............ ..................................................a.............. Building Inspector I 1.lO GARBAGE �jRINyDE2 Ft-OW., w 110 X = 33o G.p D, F ' 5EPT1G TAtJK = 33ox150% =a95�.P� ; i, �+ u5E 1000 GAL. 4 ¢}�q � lvoo 6AL-.D15Po5AL PIT V5E' I� I5�Dw+/A�u A>ZC.A• = 1�o S.F � � �� d4� �I . G ��'�'"`'? ��� ►50 5.F x 375 oTYOM pRE.Ar• .�o 6.F,_ G $oP �!P G.P S.r- 1 t/► r�AQb� y T car(i 'IOTA 1-. D 6,S16N s .4-2 5 - 00 " tj, i roTA1- DA►1-Y F►-01W - 330GP0- �A �r • .I,r�rZ-i. TAIIAG + P�RGoLQTrON RATE I: I''IN 2M1N oLI~gs' 'o ! AW.N yG`n RICHARD M A. ., - b BAXTER JONES t' /� ! No.24048 No. 00 E� N�L WLA so T6`�T �-G2� �G■ $� �Y� Top F{NP-Z'S� V: MIST GAL. , SO I1.. BvK �INS. SSPTIG 2' 1 coo INS!_ . R011i TANK Ml i LEAGN SA44b, PIT; I NY.. l N I14 MAE�K>3SAND WASHGp _ (r 4'D• 6TvN6' I {1= } 14, CEIZ.TI IGD P1-07. PLAtJ.;., PRZO F I LG pV'T' wAr— . } N O 5 nw - P .r GE R1'1FY ^ TNAT SHE �OVti1Da[1o� SNoWN NE.REOW GOMPLYS Y�tTN'CNE S1cE.>rIN� �.p"j"�' �b Aug 5 6T eAGK V_r=Q0I RE/ASM lawk 0F:BAU4MS .96 AND 11�-, LOGp.TED WlT T E G ooD PI.AI DATE �13 .� s; � :.; r•; R.EGiS't1GV-SAD t.AuDSuMYlc� LpS Tu15 PLAN 15 NOT 8t,5�6p old AN osTr9_VILLE MP-S5,_ I,' ►. + II45-T-R°utA 5v2.VC-y 4-r1AS oFFSET'5 •SPOULD r No'T 13E V5E•DTd C)E'TEWAIN4S L I►1E� APPLIGp�t,.IT....�,, ,,� �� ' Y1r1A�j►� %i, c. P ' • e....k...{ ,F .. Assessor's map'`and lot number ..�l.V ..,..�': ' rSewa a Permit numbe ...'l -.. ... .g f�LCt -r d`� �y'►mew B House number -$1,3?�.... . <<-M � ha: �. �,.WIT T 9SH9 E,° Z TGDL i ............ ..... ........ ..... ,6 _ i 5�� Yf � t 9'''°�o YPY a` TOWN O F ' FTT�,X MG T3 B'��Ei, Y BUILDING INSPECTOR APPLICATION FOR PERMIT TO '' TYPE OF CONSTRUCTION '.,.. . ........ .. .................. ..................... ......... . ......... ...:........... TO THE INSPECTOR,OF BUILDINGS:' The undersigned hereby applies for a permit..according to the following information: Location . ..... .. .. . ...... .... ......... ...... Proposed Use .... .. Zoning District .................................. ............... ........:..........Fire District ... Name of Owner a4wL.... .. . .....................Address ............................................ E. Nameof Builder ......................................................... .....Address .............................................................. .. ...... Name of Architect ............................................ Address ...... "............ Number of.Rooms . Foundation ......... ............................... Exterior Roofirg �✓'! .' ..................................... Floors ......�"`�.............................. .. .......Interior ...................I .. ...�j ..... ..: ..... CC��f Heating .............................................!'v :Plumbing ........L !,c� ,,•. . Fireplace ...:. ....,. ........... ........... .................................::......Approximate Cost..... ............ .r Definitive Plan Approved by Planning -Board __ _______"______19_a____. Area ................. .e.. ..... Diagram of Lot'and Building with Dimensions Fee. ,...:`.... .... ............. SUBJECT TO APPROVAL OF BOARD OF HEALTH - ' B _ 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. Nam ..................... 015 7 Construction Supervisor's License ..................I........�..... ' SMALL, ALAN E'. i 25125 One Story c = t • r ,..No Permit for ..................................... } Single Family Dwelling ' Location Lot 10., 133 Ansel Howland Rld. t Centerville r` ..........:.................................................................. Owner Alan...E' „Small.................. Frame Type of Construction , ............................................................................. sPlot .......................... Lot .............:.................. ` a Permit'Granted .Xay. .271.. .... ........19 83 4 r Date of Inspection ..... ... ....................19 ._ • F Date Complete /� ................. ..............19 t