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I , W t,;�i,� .!��,,�Z, 'I ""�i";.11"M .1, , �);�. � r - ,"'; .�,,""f- , , , �,"' ,��`��,�V ,�_ : . - "��,",�4,f��,ff,;",-,I�,��1.1:�Jj,�j�,Y . _��,�' ';'i us go U V e,� � - , -- , ., �`,N-- ATRE 19P� , �iL-�,R,p,�,�5.-',,p,�.�"';���i'�i""?�'l',,,, " , NEW , � � ......"' W-0- M-1 , I � ��i,- '­ � �,i "� M �,, .1.11,11 I",-: �,, ', � .",1 ", , I� ,i,.�','; - , �,, I �1 `�� �r' -, , ; 1 z 00,�, I ; W �"114� 'I I" .,I �'11. rl-,,� I M_ a ", E 2 IV-R(IT� , 5 jq�a wmwl- �T,I`Dl...���4. ­ I , F 'THE r Town of Barnstable Permit E,tpires 6 urontl ron srr Regulatory Services Fee • DARNSTABLE, + r 'KASS' $ Thomas F. Geiler, Director pTfD MA't A Building Division Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 ,vww.town.barns table.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red,Y Press Lnprint Map/parcel Number Property Address Residential Value of Work L Minimum fee of$25:00 for work under$6000.00 Owner's Name &Address A4\_ Contractor's Name _ elephone Number Home Improvement Contractor License#(if applicable) /t'��SC�i�S� Construction Supervisor's License#(if applicable) F � _ ZWorkman's Compensation Insurance .PRESS Check one: J�C Zo�g ❑ I am a sole proprietor ❑ I am the Homeowner T®WN OF BARNs q:I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# 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 fwtrr11 � #of doors Replacement Windows/doors/sliders.U-Value 0 .(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 Contractor .License & Construction Supervisors License is re . *red; SIGNATURE: f Q MPFCLESTORM Vidjng permit forms\EXPRESS.doC . Revised 090809 r 1e:14 5089937877 SERVICEMASTER FHVN PAGE 02/02 10h) Town o.f. Barnstable Regulatory Services Thomas K Gene•,Director Building Division Thomas Perry,CRO . Building Comminiioner 200 Main Street, Hyannis,MA 02501 www•town.ba rastebk.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete aad Sign This Section If Using A Builder its C VIWry 1'i)f Lite subject prop hereby auth0&C/-0 GJ.Q`,s to act nn my behalf, in au matters relative to work authorized by this building permit application for: �(41 d re a�Job} tgnaturc fir. Date Print ame If Property owner:is applying for permit,reverse Bide. t,Please cvmpiete the Homeowners Li censc'Exemption Form on the ` C:Wscrsidecoltil�tAppOatatl ocatiIMi�rosoftlWindows4Tcm�nrary Inttsr�ct FileslContent.0utloox�MY7NB41r, Revised 100508 �1sS.doc I 1 S Sub -�D � - 5ohIL Azezqm/e, F/-m K J� '{le lsomQI1WeQ ! , '1t�assachusetts Department ondr� rl Accu�fies' e, ' nvestc ., d(lO;WgsirngQn,Street_ Bosto rt,11�A`U,21�1 www.ma:�sgo�%r�i`a Workers' Compensation Iosu�ance dxvx# $�iuitez's�Contratorslleach-icianslPlbers Applicant Information Please P wt .She, Name (Rudnewc ganization/Iidi vichial): Address: Gas g-f z CitY/StaNtelZip: Gy, -aviPone# 7 Are you an:emploW_fIbea.the appropriate: a• i 1.❑ I am avhvloyer with 4 ens ageneral coetrac ►r d RrO}ect(re$wu-ed): emPloYces(full and/or part tmie). 1+aYe h�retl tl Sub�cxiatractors b New aII 2. -I am;a sole prop ietor or '� partner ILsted on the;a'ttache$sheet' Readehng . ship and have DO employees. These sub-contrarxors have' g x.[]I�earolion working forme in any capacity workers'conr� nosurance [No vwo=keis'comp`Insurance We are a corpoxattori aac ,i{s 13wldmg addition l •1 Ofbcrs have e ercbsed their 10 Elentncal repaIIs or additions 3.❑ I am a homeowner doing all vwrk nght-of a empoan er M 1, 11 mysef [l�io workers'''comp= c y 152,� { and we haue uo Phtmbmg repaus or additions . f 12 hoof repairs insurance required J : employees jNo worker$' Leo ��.msui'�aee 13 Offer, s ) �Yoat checks btx#t m also.fiq ou39e sedronb�Ioi�sbowmg b Homeowners who sabra tads sInarc�mg they ire a poh4ry ro hop VW diock thtic�ou.mu & work anal is u m a new s�idnv8 iach g h ,. ed�n�ddihvnal. hget s}s�w�� of I am an e>.sployltgctbrs atr �er��votrR Pdl 'mfon er;that&pr workears'eo ` ntpeateo II tRsru�etree or 610MAS ow, as f ' P s. Xte is the policy djob sae; Insurance Co Ply Name: Policy#or Self--ins.Lic #: _ Expxratiot►Ante: Job Site Address:3a1 City/S�atelZip :; Pn �� (,P Attach a copy of the worken coinpen on pol y declaration f pale(s�tot ing tl►e policy namber aid ezruafioa date). Fadune to secure coveFage as Feedsonder Sefton 2�A of,MG c 152,ean lead to ; fine up to$1,500 00 and/or o a�posrtron of nMmW penalties of a -yprrsonent :as wellas pealtes m tie toram of a�TbP Wpm ORDER and a fine Of up to$250.00 a day against thec►.latctr Be advised thaCa copy'o#this,statement may;be forwan} m the Office of Investigations of the NA for insurance ceverage yantic�tron. : >, . I do/�ereby e�rtt,y r thepatns and penalties o s fP�Jru1'thin the tnfermauon provided above is t►ue and..comect S• rr ; Phone.#: O, ial use only. Do not write in this area;to be completed hy;ery or toNm ataL City or Town: Per mrt/l.icense hubg Authority(cirele onej: 1.Board of wealth 2.Building Department 3 ;CrtPyTowu Clerk 4:>Eteetresl 6.Mer IaspeGtor;;5.Plumbing Inspector Contact Person. bone#: V, �. 81AA4 � Office. � h0'�. License or registration valid for individul'use only... , HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration Office of Consumer Affairs and Business Regulation Expiration' gggg g�Zp11 10 Park Plaza-Suite 5170 Boston,MA 02116 t Card .. LOWE'S HOM JOHN CABRA I ' 136 TURNPIKE SOUTH BOROU tf I�ai Undersecretary Not valid without signature t Ga�rrt�p� �►�11� • ge�o�iemF of�ulr �x` �cci�es !J. o .ISyestgi5 1�llilasi` , tvrtfStreet . Boston, - - Yrvw w'h%g rota Workers'CompRensabol�, A hcaet �O rCot�trtctriribers" DD1fla, Name( slOr � Address: t z - - City/sbitdzip; Are you as e�mployter'►; e the appropr g� ;: F �_ 1.�] I am'a employer with 4�: ►I ..(rq 'ed): i AM agefte l c �mod% I am.a sole' r or ship and haveer: oa °3 g working employeCs �'h�st sub-c�nvac�oz�' g for me in any+capacity,- workers:.c mop fi,§uiaace. 9 woskets comp: C� s1 VIA a co , „� ids ;Qmg actwn z girt r�airs or add 3.❑ I am� Ohs vna doing all work rofexe4 p I1+IY, 1 az}+Se [I�o workds' off. p or addidow- comp ms�nnce Y.crquired. t n0 t� I�cwfrepars e1cYeewo�?cer5' tow msuir�aeg ] I3 der 'AmY_Wbcemt$etr> s t sx#1 t ado dui t b�iai .' t Homoow�as who�b4nt�us ada�tm@Y '�Gagtrschns flint cheek fins#�ogc ,p t r o a *' •�chcg r�f6lS A' sr; gd I a yp,:, B/i inn Ob Insurance Company Name: S h _b ! p011cy#of se" ifs.Lic. lob Site Address.: n - -�- , Attach a of the ( stain �PF orlaers'ceti�pen $ dertara p` sitog Failure to secgrt coverage F ° 'andA. as dated. r {under Seon ? '.of c 7ea " fine up ld$1;500.00 BtalE1✓OF Peres of a Of up to$250.00 a day agai>tic a wt i as pehaita<es m e A of a$ �llOJER and a fi>� hWatigations of the DIA.for' a d t a cry o stattme t mad a for e e Uffice of msaatraace coverage venticatioa. ado 1 by Or rdieparrrs 4Ad uMl c f eery fermu�iaq provided above fs mid correct phone. EC1Ql lL4e O7JIj: Do not wrke In atlas aiaL to be co ple d y e t ott a City or Town: ermitl�c # Issa€ng A6orlty(circle 1..Boat d of$ealth Z:Bnildtitg D u"t } rewn .�.4 Megr"c 5,Piambing Inspectoa' 6.Other Contact per sow. - I 2009-12-09 15:46 >> P 3/3 � ' 01 �n° egufafds ann Stan nrds 8o f f t�ft�° B?A �9 i��fi�lbh3"aria S'C� a a H'pIi .!.'M?kOVEMENT CONTRACTOR Construction Supervisor License R$§istt on. 155850 3828 License: CS 82082 EXplratlon: 511412011 7Y?®: Pr\rate Corporation Expftoil 4/6/2010 Tr# 21313 ABOVEE&BEYOND HOME IMPROVEMENT INC �.I�eslncxiott 00' : JOHN REIS , . JOHN L REIS ;:. .y. 21 W.WEIR S f 21 WEST'WEIR ST ' .�� �S- 02780 Administrator TAUNTON,MA TAUt\i'ON,MA 02786 ' . , CommLasioner,. e THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) IA- m C&' ,L DATA yC�' y L { y r _ STORE_CO. Y `,�,• _% n..a-:.,. -_�:'i ...c.�..rl. 'iLYti-`, _ _._r LCynt.,:`i:�a %_.e.ri:�1,�L�.+n'. aSiRi - .'�'..a� �FY - a f - - - r rk� - ry rEISr= r. V g '-- At3B=� ► a_ta�AM' FRNF `R LAI�ASz."�~ R�' D 1#174 .. f'7•'...a. gv;`�; ;' d tb..:.nr -'k - '. r f-a�r"?i^` :> j _.: rs._.=x-2 i '• i�'� a,_ I k , >f�.k �.�.,.. �......_ "� ''$ �a...a_ r' t' -.i�:y- _t•��ai.:: r. _ - � _ _ - i:i, ♦'-'.gr S`� �p�l `V_,E A, DhQ� . y i=FLEREBY kJ;TUA � z,t4R'EIM;A-.UA"�l�.E l HAI E.JV 1�FT:LOt E S.H ; A b.F'-P T€ CONCENIN _ �� ' AS Tk 1.1S, CNTRA� , �2 't- F "' $ E rA ,PFOV�E® THEC sP�RI''O 7 s y�3� A�C..�. 3r;}��<+.-+F,. +`.•�. �.-.�%'..r• >S•�y �+t - ��+�G�'", M"��5��c�`_,, €L�B�' �1.�'� � .��'J�����'�'Y��'v��A� r;�,� s f' �•..-d'.r .ar.�*�-L'' v `�4-,r r � r'- �=k 4,1T �� +'ate�•] I Sv E _ `t M 3a'rs ,rK `�' ':Y.�. 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'-_:..,r.. ..-- =�;•'.ems'.' .o -[.~ F` ��22 -:}�y'- �`i s ,3'. _'.t`-?'1 "`.?,1 �. .. :�'.s t.-_:"xtl. ;: C :q,,,, ...:.>�:�j-• - ��•-,-r r.':� '� _ '✓.r.•+c ".:�:..� \ Z t _ L'r�- - .i _ ;.-v&._.3. N.SY, }'1ayP1�^- .,1. 'ts.`4:-r .,�';1Y�S'-'KS5•�- ]_ .��%.7' � '11..1:/�e ,.�l :.h tT-- -? ��� }- x ✓j' �i CJ(. "a '7 yS,�.J �++ t"" �,t � ri:•+' 7, _ w i .tic., y z .r ,.,'. Y-' z.x Y- "t<- � va. ��_ � - ,[ ''„ �... .,.,._ •�.,.. —rS- :}... e•.'��-::�,^i.,"'a7 !•. �fi r< t��.,;? �.- .x rr-..sy,4,: _:i t Y _ ,ti.: ';.-C; -e 'r.i', - "' .,.}---r,. -ii'; j''t .r_ �r ••i i�'� .5��.. -w8' 'r. ,#31'". ''c r'� ."�i'1rc:.�„. :3 --;r.. >? r _ :•r'i" ��:NtS�e.. .c —t�..-,. f 'cc`r.-,,`Fl• �ti,.. �a a ,r..a ,:'r 4:'�' -�i°:r.•' � r �t J,�.. .i.......� x,...t: :.--.. ).r,?,lr�..,w ,i"•'._,s-. 4., his. _ .,7'., f�L y �.+. F t - �1- °c��a ..v-a_.t,..•�--5f .t•..1 _�s.. „r,.�t,+tip. �,�- ./z`tvc .-!-r1; r 'i = ...r ,i s... �, a' F 7, _ `- r ^-- � ;r ;;,.,'. _'!�". -}� ' '...`.': •. 7- :i .�:,is; �.. ,_.. -^ y.Y •..may- _ ..�. sty:r.-.�: ;f-. =,1r_ ee• .t �:eE �k_ ,c_::'�� t `f? i=�-i NF17iES'� -THEP�PrRTf - a6. ;/ �PRLY- N2Y'T.A SAFE-1 REME( T P ALT�RNAxJ�/E DSRUTExRES3LUTtOf�l Ili= T t - .ti L 't �- 5 £ 2 L=SYL sw`• T °a 8 `U �S�JANT O..M � L c 14�A T - ���HE�O.Uf1Y,N�R MAY BErPEI�TTED T INITIATE A�.TEFt � 2 - � _ --- O 'NATIVIZ DJSPIJSE RE`Si0L=1JTION E�/J�N'' 17V�FIaR .T H.Eti E' 4 ;` L Pz } Iy Ch;IO�N.ABOVE IS�IOT S.EPERATELY'S_I �I�DBY THE �'ARTIES -:�.� act y - � ,- - ' WIT ESS;G-,0 HANDaS AND S!==A'4 "BELOW THIS DAB .; r* Low,e's Home Centers,.Inc - _ By. PrrntNarraet � x = Addressbr (Seal) - - _ :';Owner _ t - F City _ State/Provin Zip/Postal Code Print Name Spouse (Seal) Print Name Store 2376 Project No. 274967952 for RAYMOND DUBOIS Page 4 of 8 I 7 -7 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map_ Te- Parcel 0 Application# Health Division Conservation Division Permit# Tax Collector Date Issued 6-:1 Treasurer Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Z 'A. Ley )0s1 ( V C Village �' C-� (&-t w ( C C Owner �2ifl ge- i 6 � Address m-C Telephone -7 7 S-z Permit Request Pow w "U o Uo /\— S ( In PL-C oe !2,( n ��O©IJ sty (�� 1 Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total'new._ -- Zoning District Flood Plain Groundwater Overlay Project Valuation ( ®d©• 0 e Construction Type Lot Size Grandfathered: ❑Yes ;Q No If yes, attach supportin`g'tlocumentation. Dwelling Type: Single Family l Two Family ❑ Multi-Family(#units) .Age of,Existing Structure q S Historic House: ❑Yes 2Mo On Old King's H ghway: ❑Yes Flo Basement Type: -.Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) `— Basement Unfinished Area(sq.ft) Z� Number of Baths: Full:existing Z- new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new -- First Floor Room Count �S_ Heat Type and Fuel: <Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 2:No Fireplaces: Existing :L New Existing wood/coal stove: ❑Yes E.No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:y4existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use S( �`err► ( ��i' Proposed Use BUILDER INFORMATION Name . @��C- �C� C��l C�l.P� c { C� Telephone Number 4-2� -5 4-'®0 Address 5_0 - Z V License# o?qZ C©Tu 17 Home Improvement Contractor# CI 3 3 T Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIRE —�, D E~- � Z'L - 'LOU' r FOR OFFICIAL USE ONLY e i PERMIT NO. DATE ISSUED y _ MAP/PARCEL NO. ' ADDRESS VILLAGE y r OWNER DATE OF INSPECTION: ; FOUNDATION FRAME INSULATION ` o FIREPLACE { ELECTRICAL: ROUGH FINAL ". PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ^" ASSOCIATION PLAN NO.; / E •1 v TT u V 1 i-J KA JAP&94"A V Regulatory Services Thomas F,Geller,Director 9 ses9 Building Division �'OrFD MPS{�' '. • Tom.Perry,Building Commissioner .200 Main Street, Hyannis,MA 02601 www.town.,barnstable,ma.us &ce: 508-862-403 S Fay: 508-790-6230 Y permit no. Date AFFMAYtT HOME ZuROVEMENT CONTRACTOR LAW -SUPPLEMENT TO PERMIT APPLICATION MGL c, 142A requires that the"reconstruction, alterations,renovation,repair,thadernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units.or to atructures which'are adj agent to such residence or building be done by registered contractors,with certain exceptions,along with other . 1equirements. GA "000 �r 'f� S[�t�Rr! Estimated Cost 10 a oType of Work: Rkl Address of Work:. 2.2 Date of Application I hereby certify that Registratign is not required for the following reason(s); E]Work excluded by law []•Job Under$1,000 []Building not owner-occupied []owner pulling own permit Notice is hereby given that:IR _ O�E� TOR FOR APPLICABLE HOME0R DEALING WITH 3MPR VEMENT WORK DOISTERED NOT HAVE CONTRACTORS ACCESS TO TEE ARBITRATION PROGRAM OR GUARANTY YLIND UNDER MGL c.142A. r SIGNED UDDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner; 3 ZZ "Zoo-7 Do-towGontractor gnat ems_ RegistrationNo. OR Date Owner's Signature ' Q;wpfiles.farms:hpmeaffi dxv Rev: 060606 AB M TEATIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYIY) 4 10 20 6 PRODUCER, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION McShea Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3 Y� HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 Main Street, Suite#H ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. sterville, Ma. 02655 --508-420-9011 INSURERS AFFORDING COVERAGE NAIC# INSURED Capewide Enterprises, L.L.C. INSURERA: United States Liability Ins Gr INSURER B: Commerce Insurance Company P.O. BOX 763 INSURER C: The Hartford Insurance Company Centerville, Ma 02632 INSURERD: 508-428-4028 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BEL6W 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. INSR D'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR NSRD TYPE OF INSURANCE DATE MM/DD/YY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000 X COMMERCIAL GENERAL LIABILITY PREMISES Eaoccurence $ 50 000 CLAIMSMADE CI OCCUR MED EXP(Any one person) $ 5,000 A TBI 04/30/06 04/30/07 PERSONAL&ADV INJURY $ 11000 ,000 GENERAL AGGREGATE $ 2 ,000 ,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANYAUTO (Ea accident) ALL OWNED AUTOS BODILYINJURY $ 100, 000 X SCHEDULED AUTOS (Per person) B X X HIREDAUTOS O4MMRHQ081 04/20/06 04/20/07 BODILY INJURY $ 300, 000 X NON-OWNEDAUTOS (Peraccident) PROPERTY DAMAGE (Peraccident) $ 100, 000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANYAUTO EAACC $ OTHERTHAN AUTOONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CI CLAIMSMADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ W STA U- OTH- WORKERSCOMPENSATIONAND X TORYLIMITS ER EMPLOYERS'LIABILITY EACH ACCIDENT $ANY PROPRIETORlPARTNER/EXECUTIVE E.L. 100 ,000 `+ OFFICER MEMBER EXCLUDED? 9 8 4 5AO 3 3 0 4/14/0 6 0 4/14/0 7 E.L.DISEASE-EA EMPLOYEff$ 100,000 Ifyes,descdbe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ .5 0 0 0 0 0 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TOWI! Of Barnstable DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL �J IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD25(2001/08) ©ACORD CORPORATION 1988 .. t a FZHe,q,; Town of Barnstable. Regulatory Services BARNSTABLE, Thomas F.Geiler,Director y nsnss. $ � � i6 �Z p 39• A lFD MA'I Budding Division Tom Perry, Building.Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barwtable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, LZO 6 l �� '� ,as Owner of the subject property hereby authorize carp E UJ t C•�.' C-t�®�l J C-'� to act on my behalf, in all matters relative to work authorized bythis building permit application for: . a A<�Vtc--� 0/3 1 C- (Address of Job) .� 0 - I ,6 0 Sign atur o er Da e Print Name Q TORMS:OWNERPERMISS ION i a � k Y rIJ�P��zISORt u►r,�� ;p82i h _ - Elie i�arrunzoryuuea,�,CCLc o,�✓�aaoar�ivaelta .l Board of Building Regulations<and Standards a HQME IIMP3 0i�E..N�ENT CONTRACTOR {Tegmratior# 143358 aw: Mq 4p atiolt v S �idfL4abiNty<Corporar on 2D5�61�C K� F } lk tR,• MILL MA D6 Deputy el;dnl�;n�stratur i y .4Co. s # a * -7a5V�. Town of Barnstable Permit Expires 6 months fron 4ssgg datERPAe I r Regulatory Services Fee `' MAR 2 0 2007 Thomas F.Geiler,Director Co OF S � Building Division 3f zo/0-7 "ABLE Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA.02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY . jj Not Valid without Red X-Press Imprint Map/parcel Number C Property Address zz S RLC, Dot rJqResidential Value of Work t SOC9. 0 C12 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name Number'- Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 0 819 Z, ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Com pany Name I —� T -Oc i �- Sv ��s�1 mP Y . C Workman's Comp.Policy# 9 4,G/4 33 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 ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders: U-Value 4. 3 3 (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. opy the Home Improvement Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revise061306 I ' UILD 'iKfm.L�ATIONS IN jl licenseCONSTRUC�TIONSUPERUISOR } I t= �• i"' tg��2� j9�65 u�, pt r RICHARDM C� x F n s �r�srb N� ;�I MARSTONS MILLSI - � . Commissione� � + o�rn�rw�u�s BOard of Build►'g Rggulat�ousr:and•Standards HQME'IMPROVEMENT C0NTRACTOR Re9lstratior� 1433 .0 1 Expiration 7/8/2008 14 It x Typrte L td�l�a0 -ty,Corporation CAPEWIDE�ENT RPRISES L L cI RICHARD-'CAPEN7,1 BLACKHORN R[S= MARSTQN MILLS MA 02648 Deputy Adrruri�strator The Commonwealth of Massachusetts Department of Industrial Accidents _ Office of Investigations _ 600 Washington Street Boston,M4 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name(Business/Organization/Individual): •C,y`,per 0 C am.l V C-- &;J 'kC— On I I c �— Address: C -t City/State/Zip: O f i( } Phone.#: G Are you an employer?Check the appropriate bog: Type of project(required): 1. I am a employer with `� 4. ❑ I am a general contractor and I employees(full and/or part.time). * have hired the sub contractors 6. ❑New construction . 2.❑ I am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition employe e d 's an have workers • working forme in any capacity. 9. ❑Building addition [No workers' comp.insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.0 Other W L' Ccz•,r 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 bale 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: 1 -�' P76 c`) . 1 jy J Q`KL 4nJ-C a Policy#or Self-ins.Lic.M q S d"7 3 3 - Expiration Date: Job Site Address: z.ZS L C `1 LkjC1 City/State/Zip: C Attach a copy of the workers'compensation policy declaration page(showing the,poliey 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 against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of WA for insura ce coverage verification. I do hereby c un r t ains-nd penalties of perjury that the information provided above is true and correct; Si ature: - Date: '0 3 '.` 7'O _ Phone#: 2,9 C i 09 Offccial s 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#: Town of Barnstable. Regulatory Services BARNsrABLE,AS&Mass. Thomas F.Geiler,Director v M �' `�AtFo;p�a,0 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, Lza'e) l G/1 e ,as Owner of the subject property hereby authorize C-Af C W 1 rJ (- C--A-) C—f[.R1 to act on my behalf, in all matters relative to work authorized by this building permit application for: . A � H 0 (Address Job) ® 3 / ,C O Sifnaturd-b-fAwner Da e .2 p C-T- 07 Print Name Q:FORMS:O WNERPERMISS ION -7 DATE(MM/DD/YYYY) ACO M',CE,RTIFICATE OF LIABILITY INSURANCE 4 10 20 6 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION McShea Insurance A enc NLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3 Y. Inc.. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 Main Street, Suite#H ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. sterville, Ma. 02655 08-420-9011 INSURERS AFFORDING COVERAGE NAIC# INSURED Capewide Enterprises, L.L.C. INSURERA: United States Liability Ins Gr INSURER B: Commerce Insurance Company P.O. BOX 763 INSURER C: The Hartford Insurance Company Centerville, Ma 02632 INSURERD: 508-428-4028 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 LIMITSSHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 40D1 POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000 ENTtU X COMMERCIAL GENERAL LIABILITY PREMISES Eaoccurence $ 50 000 CLAIMSMADE CIOCCUR MED EXP(Any one person) $ 5,000 A TBI 04/30/06 04/30/07 PERSONAL 8,ADV INJURY $ 1 ,000,000 GENERAL AGGREGATE $ 2 000 000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000 ,000 POLICY JECOT PR LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 'ANYAUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ 100,000 B X X HIREDAUTOS 04MMRHQ081 04/20/06 04/20/07 BODILYINJURY $ 300, OOO X NON-OWNEDAUTOS (Peraccident) PROPERTY DAMAGE $ 100, 000 (Peraccident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANYAUTO OTHERTHAN EAACC $I R AUTOONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CI CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X I TORYLIMITS I ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE C OFFICERIMEMBER EXCLUDED? 9 8 4 5 A O 3 3 0 4/14/0 6 0 4/14/0 7 E.L.DISEASE-EA EMPLOYEE $ 100,000 Ifyes,descdbe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town,.of Barnstable . DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL10 DAYS WRITTEN - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL �J IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD25(2001/08) ©ACORD CORPORATION 1988 � fFd q m x, „M`, i s i c.. � '�. �.g •� �.�,� �F ,• mar r�'+ ,� {' 4" ..# T-S M IL Ind �F p i f: t A` i � 9 a� 1 .1, '�@ � !�t�@ �J }�,.�s�O a�� 'r`v'S, +'''k it�i f .,. - �i6•n: �� ♦� M \,1►�l�a�•.s� gyp, • 3R�q\ r �i � ' /,� �'�M°to=aRlf�a► � I ff + � ,f,'\_ �,,, w.•1t�y���; �+�;t, s ..* `r�r• '"e y +, ice; Z2� Permit# /S9 9 Parcel Date Issued -- 'r LY—U,112-A ft—It tQ.,c n In i,iFee Engineering'Dept. (3rd floor) House# J/' THE BARNSTABLE, ' 19 • 'q,��MeASS.s9. fD MPS A TOWN OF;BARNSTABLE Build' Per it Application , Project r Address { Village , Owne Address 4- 1 Telephone 17 Permit Reqdest First Floors square feet # Second Floor square feet Estimated Project Cost $ /'J,,r?), Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type ,4 &44M a Commercial Residential Dwelling Type: Single Family �' Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other c Builder Information Name t a� Telephone Number Yid Address License# 4: Home Improvement Contractor# /lS cS Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR Lz,. DATE BUILDING PERMIT DENiZ FOR THE FOLLOWING REASON(S) i FOR OFFICIAL USE ONLY PE' MI IN DATE($SUED P/ ARCL NO 6 + 1 R SS 4 VILLAGE �'• OWN DATE F INSPECTION: FOUN ATION I' FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL. PLUMBING: ROUGH +FINAL r t GAS: ROUGH FINAL FINAL BUILDING 1 1 DATE CLOSED OUT ASSOCIATION PLAN NO. f Assessor's map and lot number ...... . f� uowC-C .x... ....:.. r�l..r'./!!'`�'G....��0®�a��rS Sewage Permit number f� firic yYc.� Housenumber. ................ ................................................ CO TOWN 'OF RARNSTABLE ` �`� "�� ®w� BUILDING 11SPECTOR APPLICATION FOR PERMIT TO c--'�:1..(../. I............................. ..... . ........ TYPE OF CONSTRUCTION �L ..................................:............................................ ............. r.(.. .19.7. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location a r 1. = y''`" ............................................:........:.....:.................................... ...... .....s .. f. ProposedUse .............. ..� .. ..... . . .. .......... ....................... ...................................................................... ZoningDistrict ........................�.. .................................Fire District .............. ....... . ....................................... Name of Owner L..II.(..�. 0�. 1 - ............ ....�I✓'.`.:!:!l....�,�. .... ........ ......Address ........................................................................ Name of Builde ` t?!Cu ........ ...:....Address ...... -YtT�...... .�.....� L . -........... Nameof Architect ..................................................................Address .................................................................................... j Numberof Rooms ....................I.............................................Foundation ............ L.( ............................................ Exierior .......................... ..C....,...........................................Roofing ......... , c /� Floors .. ......................................................Interior .......... Heating ..........<" .-....... ��..!t�.....................Plumbing .......................................... Fireplace .............:..................................................:.................Approximate Cost ...:...., ..... Definitive Plan Approved by Planning Board ________________________________19________. Area ...... .�'�.Q..... ................ Diagram of Lot and Building with Dimensions Fee .... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ......... ........ . . ......... .......... Wall, Be2nard add to dwelling. No ....20775... Permit for .................................... .............................................................................. Lbcation . .....2.2...Ash.l.ey..Drive...o...................... . . ...... . .... .. ........ -Centerville ............................................................................... Owner ...........Bernall .....a..rd.... .. ....................................... Type of Construction ...............frame........................... ti .............................................................................. Plot ............................ Lot ........ ................ November 6 78 Permit Granted ........................ ..............19 ...................Date of Inspection ...... ........19 Date Completed ....... ..f.... ......................19 PERMIT REFUSED ................................................................ 19 . .................................:............ .......7.......... ................................................................................ . ............................................................................ ................................................................ ......... Approved ................................................ 19, .................................................................................. ...................................................................... Gee.11r1eCT / y�FTHE T TOWN OF BARNSTABLE i ZISTM i 1639 y � BUILDING INSPECTOR � 20.111/APPLICATION•FOR PERMIT TO ........ .Ul../`• ........0l :... . V wPr.11t.N.... . c TYPE OF CONSTRUCTION AV.9.Q.L M.-.�.................. ..............................Y....� .....,9�. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby0 applies for a permit according to the following information: Location ... 4 .1�1....... ..... k/..✓. ..............( u f.�� ........................................................ Proposed Use ..... ..................................................................................................................................... ..................................................................................................................................... Zoning District ............jf.'..J-1............................................Fire District ..(.��"N..fP.r.✓.1.1�t..:..... .>�.7..� vo .......Dts' �klc.-r Name of Owner 4M..C.J....TAs ................Address .......�.` U11411....0a......... 1��...... Name of Builder hot1}}.eS4.... :..I?lno:..... ......Address .................................................................................... Nameof Architect ........IV. N .........................................Address ................,................................................................... Number of Rooms Foundation ....... .U..taw..C.0. �...................... Exterior ��d�n' p / / Roofing ............./...1. h✓?.1 1Y............................................. Floors 1.� 1 fl.�!.: .Interiorf�?! ��� �7 "d / 7'1 Heating .. .� ��n?.......I....................................................Plumbing ....................... Fireplace .........-Y. . S...............................................................Approximate Cost ............ .............................. Difinitive Plan Approved by Planning Board ________� _-______19______. � '�(� 'A=! Diagram of Lot an�Buitdirrg--with-Bimensi��� � _ o �'4 Lo LN G.1 t0 � � : Lil ct ?du' m r1to T0 �n < , ► � W. u; w Q� y I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ►..,....,.,.> Name . .. : .............................. Normeat }omaaa° Inc. � - -4983 ' one story C-101 No ----'' Permit for ............................... ' � single family dwelling --------------------------'hley Drive Location ....................................................Centerville . ` -----' ---.-----------------.. wr Noroest Homes, Inc. Owner ...................................... �~ � . �frame , \ Typo of Construction .......................................... � =r ----.------. ........................... +~�- #1nl \ -Plot ............................ Lot --.^^^^-----. � . / Permit Granted .......April.�7---^—'l9 7� ) / Dote of Inspection . 19 uo,o Completed PERMIT REFUSED -----_---...--------- 19 � / ~ � | � —.------------------------- , —'--^^'---------------------'' i �� ................................................ ..--.---... ) '. { ' ..-----.---~...-~—...--.----.—...... . � \ . ' | ^ Approved ................................................ 19 '--------.-------...--...--.--,, ` ' —_-----,--,---.------........., - � - -