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Richard V.Scali,Director Building Division Tom Perry,CBO,Building Commissioner NOV 2 2016 200 Main Street,Hyannis,MA 02601 lq �� ���n'N��� �� www.town.bamstable.ma.us rOWN Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 1 I—).a/�t� Not Valid without Red X-Press Imprint Map/parcel Number Property Address 0(a 0,6 ) l ta4 1 CC41*�o WLQ C 24..3_.) ❑Residential Value of Work$ S)�1 SO ." Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address _':2k a 'O S"l� YD(:�Ise Contractor's Name Sprinkle Home Improvement Telephone Number 508-775-1778 Home Improvement Contractor License#(if applicable) CS-006643 Email: sprink ,comcast.net Construction Supervisor's License#(if applicable) 103757 JZWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name AIM Mutual Insurance Co. Workman's Comp.Policy# AWC400700943 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Town of Yarmouth Disposal �Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum .32)#of windows #of doors: El Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Please see'attached C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOlDHR\EXPRESS.doc Revised 040215 6. For.inside remodels (i:e additions; kitchen& bath;basements, etc.); we will take.reasonable care to G� keep construction related dust acid dirt to a'.mmimum;'however; homeowner will be responsible.for a their own housecleaning at end of project.. 7: All agreements`are contingent upon strikes, accidents;:or delays.beyond'Contractor's:control. Should a contract be terminated or cancelled after.the_mandatory rescission penod,.contractor will recover costs including all time.related to this job.With.a reasonable-fee (including profit).for all completed work and'materials purchased'or.ordered:. 8'. Homeowner is.to.carry. .re,and other necessary insurance..Contractor's workers are fully covered by Worker's:Compensation Insurance: 9. Fencing,:carpentry, painting,.plumbing;"electrical, dry wells;etc:, and all other.work necessary:that is not contained in this contract..shall be the responsibility of the Homeowner. 10 For roofing,the above pricing is based on a single layer.strip unless otherwise.specified. "Should there be an of or.layers of roofing theywill be.removed:and disposed of at-an additional cost. Re-leading of the:chimney is hot:included in.quote*unless spcifiedandillbwe'bill additional; if required: : 11 For Window installation, contractor is not responsible for removal or reinstallation of window . ..treatments. 12. C.ontracts not fully executed within thirty-days of contract date aze subject,to pricing:adjustment if .,:: applicable: . • . . . . . . . . . . � .. .: 'RIGHT -.CA STNCE : II , The 0caner may,cancel.this Agreement-ifit has beemsigned-by.alie Owner.at a-:late.6ther than the.address of the Contractor, which.may be his rnairi office orbranch.thereof-.proyided:that"the Owner,notifies the.Contractor . in writing at"his.main office; or:brancli.by:ordinary mail posted,:by Telegram dent or:by delwery, not.later,than midnight,of the-third bus ss.day�folw ' ' nf thi " gei. he oAerent:: WARRANTIES The Contractor warrants that the work furnished hereunder shall befree from"defects in workmanship for a period of two(2.):years following completion and:shall comply with the.requirements of this Agreement. :In the event any defect m.workmanship;or damage caused the Contractor;his'sulicontractors;employees or agents; is discovered within two;years.after.completion of any job,-including clean-up,.the Contractor shall, at his own expense, forthwith.remedy;:repair;:correct; replace, or cause to.be remedied,repaired;or replaced such damage or uch.defect in:workmanship:as long as.the:owner:has.paid their agreed contract:in full:.: The foregoing -warranties shall.survive any:inspection performed in connection with the agreed.upon.work: All warranties for product supplied bhContrator- nde his Agreement shall be those:given'by the manufacturers of.such product;..whict AAll.be'and hereby passed°directly to`_the.Owner.-.Such.rnanufacWfeIr's. warranties, the Owner may.be required.to register or mail in a warranty cazd or.otherevidence of,ownership.and= use of such product in order to activate such.warranties. The Owner'sfailure to.send in or register such documentation..which failure voids that manufacturer's',warranty;,shall-not create any responsibility for the Contractor to warranty such product. . Note Any changes in the contract during the.duration;of the project which results in additional monies due: iff be.paid in full-to the contractor at the time.of the change,; I authorize.Sprinkle Horne Improvement to act on-my:behalf n' all-matters.relative to the. to:be p orrried.on this job (Le'..p.E; niits;-ap Lions etc:) if necessary: Ho.. eowner ignature .Date Contractor Signatur. Date Lisa Goodwin . Brad Sprinkle.- Registrafi number; 103757 02 Ashley Drive, Centerville; MA 02632 The Commonwealth of Massachusetts Department of IndustrialAccidents 4 I Congress Street,Suite 100 Boston,AM 02114--2017 www massgov/dia «Yorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Letibly Name(Business/Organization/Individual):SPRINKLE HOME IMPROVEMENT, INC. Address: 199 Bamstable Rd. City/State/Zip: Hyannis, MA 02601 Phone#:508 775-1778 Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 10 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.] 3.Qd am a homeowner doing all work myself.[No workers'.comp.insurance required.]t 9. El Demolition 10 Q Building addition 4.M 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.E]:Electrical repairs or additions proprietors with no employees. 12.QPlumbing repairs or additions 5.rJ I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.QROOf repairs These sub-contractors have employees and have workers'comp.insurance.t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.00ther 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: .A.I.M.Mutual . Policy#or Self-ins.Lic.#:AWC40070049432016A Expiration Date: 1/1/2017 Job Site Address: CO ��y 1�P_t�1 ��l9-� City/State/Zip: eSd14nU4 p 4\14A 02L 3,--.). Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration 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 d d penalties of perjury that the information provided above is true and correct Si ature: Date: I acl Phone#: 508 775-1778 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# f 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#: Office of Consumer.Affairs and Business Regulation 10 Park.Plaza-.Suite 5.170 Boston,Massachusetts 02116 Home,Improvement Coy udotor Registration. Registration: _io=7. - r Type: Private Corporation Expiration: '719R018 ' Tr9:419291 SPRINKLE HOME-IMPROVEMENT,rl 1 Brad Sprinkle 19 -- 199 Bamstable Rd. ;�, �• � ,4 � Hyannis,:MA 026.01 Upd ate Address and.return card:.Mark reason foreAange.' scn, a zoM os,;; E.Address F.Renewal F.� Employment E.Lost Card ' . a/e'flnntairo-ni[n:nr'!lf u`G-'NC(7aHiatuJrl!!d. .• - Omee of Consumer ARatrs&Business Regulation, Lieense or registration volid'for individual use only i OME IMPROVEMENT CONTRACTOR. before the expiration date. if found return to: Registration: 0g7rr/. Type: Office of Consumer Affairs and Business Regulation ExpiratlonA_77B12618: Private Corporation 10 Park Plaza-Snite 3170 Boston,MA 02116 SPRINKLE HOME IMPROXEMENF;INC. Brad Sprinkle 3i a 199 Bamstable Rd. Undersecretary. : v Not valid without s ture j Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS4)OGW Construction Supervisor r, BRAD K SPRINKLE"' 189 BARNSTABLE HYANNIS DNA 000 t . ,r-jz k `��-- Expiration: Commissioner 10/08/2017 Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet("IM )of enclosed space. Failure to possess a current edition of the Massachusetts State Bufldlr g Code Is cause for revocation of this license. For DIPS licensing information visit: www.Mass.Gov/DVS I SPRIN-1 OP ID: DS ,4�oRv CERTIFICATE OF LIABILITY INSURANCE FDA0110812016TE Y) 01/08/2016 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 RAPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Bryden&Sullivan Ins Agency HONE Kelley A.Sullivan Fax 88 Falmouth Road a/c No Ext:508-775-6060 ac No)-508-790-1414 Hyannis,MA 02601 E-MAIL Kelley A.Sullivan ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Associated Industries of MA INSURED Sprinkle Home Improvement Inc. INSURER 8: 199 Barnstable Rd Hyannis,MA 02601 INSURER C: INSURER D: INSURER E 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE POLICY NUMBER MM/DDY EFF MM DCDI EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-WADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRO- LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per.person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PeOaaciRdenDAMAGE $ HIRED AUTOS AUTOS $ UMIIREL A I" OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ - DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN NIA WC40070049432016A 01/01/2016 01/01/2017 E.L.EACH ACCIDENT $ 500,00 D?OFFICER/MEMBER EXCLUDE (Mandatory in NH) E.L.DISEASE-EA EMPLOYE9$ 500,00 IF yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Add@lonal Remarks Schedule,may be attached B more space Is required) CERTIFICATE HOLDER CANCELLATION SPRNKHO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sprinkle Home Improvement,Inc ACCORDANCE WITH THE POLICY PROVISIONS. Margo Mack 199 Barnstable Rd. AUTHORIZED REPRESENTATIVE Hyannis,MA 02601 Kelley A.Sullivan ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD j �c?l7zII: ow of Barnstable Permit# . Expires 6 months from issue date Regulatory Services Fee • s*snsrneu • M"m' 639. Thomas F.Geileri Director. Thomas , Mid -.Building Division Tom Perry,CBO,'Building Commissioner 200 Main'Street•Hyanni,s MA 02601 www.towmbarnstable.ma.us, Office: - 2-4 _ - 508 86 038 Fax: 508 790 2 6 30 EXPRESS PERNUT APPLICATION _ - RESIDENTIAL ONLY Not Valid without Red X-Press I rint mp . . Map/parcel Number Property Address e s S o A s 1-e..(- o r,4 L�U1:2 Residential Value-of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address L�.SCi �cr)c�Lzss,Yl C . �h Sprink a ome mprovement . Contractor's Nante 199 Bamstable Road; Hyannis MA 02601. . . Telephone Number 508 775=1778 Ext. 1'A Home Improvement Contractor License#(if applicable), Construction Supervisor's License#(if apphcabl'e) .CS-006643 'PRESS ERMI�'. tWorkman's Compensation Insurance SEP 3 0., .3' Check-one: 20� ❑ I am a sole proprietor ❑ I am the Homeowner. I have Work er's Compensation Insurance TOWN OF BARNSTABLE. Insurance'Company Name.. A I.M Mutual Insurance Co: Workman's Comp.Policy# '7004943012013 Copy of Insurance Compliance Certificate:must accompany each permit. Permit Request(check box) Yarmouth Transfer:Station ❑ Re-roof(hurricane nailed)(stripping old shingles).All•construction debris will.be taken to ❑Re-roof(hurricane.nailed)-(not stripping., Going over. existing layers of roof). Re-side #of doors Replacement Windows/doors/sliders;U-Value' (maximum.35)#of windows. . _ I .Smoke/Carbbn,Monoxide detectors 4 floor,plans marked with red.S and inspections required. Se arate Electrical&Fire p Permits required.' -*Where required:.Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation;etc. ***Note: Property 0 'ust sign Property Owner Letter of Permission. ome Improvement Contractors License&.Construction Supervisors License'is,, r it SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\Windows\T porary Internet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doc Revised 053012 ` The Commonwealth ofMassachusetts< Department of Industrial Accidents, Office of Investigations ,00 Washington Street ` Boston, MA 02111 w►vw.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractor`s/Electricians/Plumbers ' Applicant Information - Please Print Legibly Name(Business/Organization/Individual): Sprinkle Home Improvement Address: 199 Barnstable Road city/state/zip: -Hyannis, MA 02601 Phone #: 508 775-1778 Ext.10 Are you an employer?Check the appropriate box: Type of project(required): .[X I am a employer with 10-12 4.-❑ I am a.general contractor and I. .. . . . employees(full and/or part-time). have hired the sub-contractors 6• ❑New construction 2.❑ 1 am a sole proprietor or partner-- listed,on the attached sheet. 7. ❑ Remodeling ship and have no employees' These Y sub-contractors have g, ❑ Demolition 1 working forme in an act employees and have workers' w Y capacity.h _. 9. ❑ Building addition. o workers comp. insurance r.comp. insurance:+ i required.] 5. ❑. We area corporation and its 10.❑ Electrical repairs or additions officers have exercised their 11. . Plumbing repair's or additions 3.❑ 1 am a homeowner doing all work, -. ❑ 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' I P. Others In comp.insurance required.] *Any applicant that checks box#l must also till out the section below showing their workers'compensation policy information. Homeowners who 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: A.I.M Mutual Insurance Co. Policy~#or Self-ins: Lic.#: 7004943012013 Expiration Date: 1/01/2014 Job Site Address: -f a2 -/�Sh1 �/ ��c e— "'City/State/ZipLRAK/V Ch �G 'Attach a copy of the workers',compensation policy declaration page(showing the,policy number and expiration date). Failure"to secure coverage as required under Section 25A of MGL c.'152 can�lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the forni of a STOP WORK ORDER and a fine . of up to$250.00 a day against the violator. Be advised that a copy-of this statement maybe forwarded to the Office of Investigations of the DIA,for in a coverage verification. I do hereby c un nainsnd penalties of perjury that,the information provided above is true and correct. Si nature: f Date: Phone#:4 508 775-1778 Ext. to. , 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#: SPRIN-1 OP ID:DS ACIORL�" F DATE(MM/DD/YYYY) `...� CERTIFICATE OF LIABILITY INSURANCE, 12/21/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER CONTACT Phone:508-775-6060 NAME: Bryden&Sullivan Ins Agency fax 508-790-1414 PHONEo, FAX 88 Falmouth Road C Ext: A/c No: Hyannis,MA 02601 - E-MAIL s: Kelley A.Sullivan _ INSURER(S)AFFORDING COVERAGE - NAIC# M SURER A:Associated Industries of MA' INSURED Sprinkle Home Improvement Inc_. INSURERB: 199 Barnstable Rd Hyannis,,MA 02601 INSURERIC: INSURER D _ INSURER.E: - 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR RODL SUBRPOLICY EFF. POLICY EXP LTR TYPE OF INSURANCE - POLICY NUMBER MMIDDIYYYY) IMMIDDIYYYYI LIMITS GENERAL LIABILITY „ EACH OCCURRENCE •$ COMMERCIAL GENERAL LIABILITY TL , PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY.- $' GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO. LOC $. AUTOMOBILE LIABILITY - - - - COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE NON-OWNED Peraccident HIRED AUTOS AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB ' CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC LA OT AND EMPLOYERS'LIABILITY €R - A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN TO Y ITAWC7004943012013 01/01/13 01/01/14 E.L.EACH ACCIDENT $ 600,000 OFFICERIMEMBER EXCLUDED? F—] N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 600,000 If yes•describe under DESCRIPTION OF OPERATIONS below. E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERA71ONSi LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SPRNKHO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE`WILL BE DELIVERED IN Sprinkle Home Improvement,Inc ACCORDANCE WITH THE POLICY PROVISIONS. Margo Mack 199 Barnstable Rd. AUTHORED REPRESENTATIVE Hyannis,MA 02601 Kelley A.Sullivan ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD THME Town of Barnstable "�. . Regulatory'Services H MAIM Thomas F.Geiler,Director` Building Division . +Tom Ferry,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 If Using ABuilder I, L. C�b VJ �•1J ;as Owner of the subject property hereby authorize' S •.izi VA to act on my behalf; M all matters relative,to work authorized by this building permit application for ` (Address of Job) T Signature of Owner Date Print Name R If Property Owner is applying for permit please complete the ,Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPFRMISSION Unrestricted - Buildings of any use group which contain less than 35,000 cubic feet (99Itn')of 'A ass acauserts - Depaif-imenT. of enclosed space. 3aaru of Buticimg Reguiation_. ��.- S,ahvar;s ru'cto,n ♦ujw r\ n e CS-006643 BRAD K SPRINKLE Failure to W BARNSTABLE MA 190 LOTHROPS LANE q�76possess a current edition of the Massachusetts � State Building Code is cause for revocation of this license. Fnr DPS Licensing information visit: www,.Mass.Gov/pp$ 10/08/2013 -Office of Consumer Affairs& Business Regulation License or registration valid for individul use only =t(OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: j6. a` lIeglstration: 103757 Type:T Office of Consumer Affairs and Business Regulation = Expiration: 7/9/2014 Private Corporattor. 10 Park Plaza-Suite 5170 Boston.MA 02116 'SPRINKLE HOME IMPROVEMENT. INC Brad Sprinkle 199 Barnstable Rd , ...a..._ Hyannis,MA 02601 --�; t ndersec-retary Not valid witho signature 4 yO%THEt TOWN OF BARNSTABLE fe�Q� ow Z BAflHSMLI, i " 9 am BUILDING INSPECTOR � ar a' APPLICATION FOR PERMIT TO Z ...... l"4....... .. .. ..... .. ... ............... ................................ TYPE OF CONSTRUCTION ........ ...................A4......... ............................. .............................1!1. ............19.32, TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following'inforation: Location .... ..... qAP..... t.j. f......PC^!c...........�� ,��0.��.:'L4.�........... Proposed Use ......Q..I.A...../.4.tM.l.4..... 14 ................................................................................. ....:..... ,p — Zoning District •...................................................Fire District -1VKe.,!� k1A.4.L=....�C���t/ eiLA. .....C.. .. ........ . ................. Name of Owner 1. s' ./�/oYJe��� 1�9G.s.........Address ... ./..f��j ...E°�. R-/,p 60.�,t� �t 80............... Nameof Builder ..................� .........................Address ...........................:0.:� . r.p ............................... Name of.-Architect ................ ql ...........................Address ........................... ... ® i Number of Rooms ...................4� . .. ........?✓......... ............................................Foundation ..��.........®�................ . ....... Exterior ...I4fI4 ...................Roofing ... ......... ...... U Floors ..................................... .......14 ..............Interior ....... .... .. ................................................. Heating � l .'..�'........... ...... .. ....................Plumbing ..............................13 ............................... e Fireplace ..... ....�....... ,,�................................................Approximate Cost L Difinitive Plan Approved by Planning Board _____________________��`�____19_Z_l__. Diagram of Lot and Building with Dimensions Li LU � 0 � H � N 0001\� z< �' t Nrl��rz 70 000 �, � 41d ��ve�. 769 f1Y < LL O �. ;Z ocnQ o � n0CL wZDLu ! _j -a y Z F- Qry �� W V �Z Cr) Q (\ x � d i.w ® ( L! + q HZ ❑ � C. Q < I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... ��. .... .L!* ,�".�:f� ................ � ^ 0orzmaot Bwmneo» Inc. , ' . . ^ twostory No —..��1��, Pern�kfor ----.��'�:----.single ' � � lling �...... �.. �' ...............'...`' Location ^--^^----���—^^^^--------' { ...--- ` . � ---^^^----^~—^---'' ' ----' } Owner Wozmest Io�mao Imc° t � ----.-------.----.----.—. Typo of Construction ............frame.............................. \ —^'--'^^—'---'--'—'-~----'-----''' \ Plot ............................. Lot ..............#94---- � | k ' , January ^ ��2^� Permit Granted ---..������—�.--.—]V � | Date of Inspection .....................................lg ^ Dote Como��a6 —.������^�.�����--..lg � . � ( PERMIT REFUSED .----..----.—...—.---.--- 19 ~^^^—^'^--~^^^^^^^^^'~~-------'—'— .~._.....----...------.-------.., / '''-~-^—^'`'-^'—'—^^^^'^'—'--^--'—^—^—^ � ----.—..~~........—...—.~,...---~.- � � � � Approved .............................................. 19 | ' -------.--.--.—~.....--..----.— . `--------.—,~---------.......—.' / / ' | | Assessor's map and lot number I7a Sewage Permit number ...... �vii . /+GGtC�st�ri y�FTHETO�I TOWN OF 'BAR.NSTABLE i •H9$H9TADLE, i 0039. II .�� BUILOIHG INSPECTOR O'�£ PY Ilr APPLICATION FOR PERMIT TO ......... ..............`" ...�.. '0 �........................................................................ y TYPEOF CONSTRUCTION .................' .... .r'................................................................................ ................ a..l..� ..............19 . TO THE INSPECTOR OF BUILDINGS: . The undersigned hereby applies for a permit according to the following information: Location ............ ...c..........lam�.,.�. ' :.� .....`�,,t,) ,1��,................ ..0, Y Y...t 1.t.�.�.��............ :: �........................ .. . . . . .... ProposedUse ........ 0+'-. .A. . .1r.Qt�.1!a..:................................................... ................................... ....................... ZoningDistrict .........................................................................Fire District .............. ............ ............................ Iy Name of Owner .` � ?./.3_rR .....�..�`�..�..�.�1. .....................Address ... � ... ..�.�.c�c! ....�: t!... .:................................. �....�. ....F C' Name of Builder ... ....�4 ..►. .��.. .....................Address ....... ... ... ... .r `".:............................ Name of Architect .........Address Number of Rooms .............��..1�.:a. �..:.:................................Foundation ��' >+ J " c ta^ ��-►�....... 1®fit• �..... Exterior ..1..�� t . ?. fi(,..M ..C.. ..` . 1:�'. iar ....6���.......Roofing .�.. Via: >� [��Y? ............................................ 1 .Interior ..�).. �? .� �� Floors .1�1.`1,...... .... e1 .1 .!�0�'�I ...................... Lt;cr......e..........................................:......... Heating1...:. ......1.� :`��''..... ` .� ...................Plumbing ...... 1 ................................... .. ........ Fireplace ..r`i+.' .�� ..................................................4` Approximate Cost ....... .. � . ( `!! ...............r}..... Definitive Plan Approved by Planning Board --------------------------------19________. Area .... �........... ........ Diagram of Lot and Building with Dimensions ��� Fee ........... ram.-..............� o v SUBJECT TO APPROVAL OF BOARD OF HEALTH 126 'Fi-0w 4- l I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ................................................. CTillis, John F. No ... Permit add to single for # family dwelling .......................5 y...... .... ..................... Location 2 Ashls Drive t. ................... Centerville f ............................................................................... John F. ('Allis Owner ............................................................:..... Type of Construction frame Plot ............................ Lot ................................ 9 April t Permit Granted ............................19...........19 74 Date of Inspection I�f g�/�`Y.... � '`�-..19 .. .. Date Completed .. ��`�'�"`'� 19 PERMIT REFUSED .......................... ... ... 19 .................................... ....................................... ............................................................................... ............................................................................... [ V I Approved 19 ............................................................................... ..................... ......................................................... 1 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I A m / �GL� LI DATA FEE—, a�Q TOWN OF BARNSTABLE, MASS.till ` 19 f Soobe V I, q o�.1i THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TOJ > O 0o — (PROPERTY OWNER) (ADDRESS) �I m, c' 1 O..'§py oN 3 .._.TO ............................................... ......__.................................................................................................................._... I.El U b (BUILD) (ALTER) (REPAIR) (TYPE OF BUILDING) (APPROXIMATE SIZE) _ O 0 op LOCATION .............._._............................................................................................_ ..................................................................................................................._.._..... ...... _.........._� ' V y (STREET AND NUMBER) (VILLAGE) be NAME OF BUILDER OR CONTRACTOR _......._._............._..........................._......._._..................................._...............__....._........_........._...........�._ d m4 APPROXIMATE COST IV boas 1 HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN �'°� OF BARNSTABLE, REGARDING THE ABOVE CONSTRUCTION. ID oWc4 ..._..._..____.._................................................................... ......_.........................._.................................._..............._............_............................................... h a VJ (OWNER) (CONTRACTOR) Iraq 6 BUILDING INSPECTOR Subject to Approval of Board of Health. r r� R:�.1r r;i• ,i "�`i:1 r,, ate.: A`-y'q: '��' 6��"u�N` ..`'�;,�. • � a F`•.r7'm y. i,r i_ ya", 1:s:t .,Eri+ ".�:A t..na?,}„i y'..M-'• ,x IA .- �+r" �•� � �.,E i- - � i a Yew i�.. 4V S i ^ 7 t F Assessors ma and lot number ' 'J .. f?ME'.t 4LIA Sewage Permit number. � o . h�4�!..�'��%��tG... .. :..../� .• d�Q� ��� tz a , • + BAUSTLU i House number ... .......................r............ : ....... . .... , 1 Mtua ON TOWN } OF 'BAR.NSTABLE BUILDINGS:_ INSPECTOR APPLICATION FOR PERMIT TO .............. . ...... r �.`.t. ..�1.. ........................................................ TYPE OF CONSTRUCTION ...............b?.OP4. ... ......' ......................... ..... .......... ................... .. .. .......19.�' . TO THE INSPECTOR'OF BUILDINGS: The undersigned herebyapplies for as permit according to the following information: Location ....... Q�.. . . .......f .1 ��. i vim` .:..... "`�4�` ` .................................................... Proposed Use .. .. ..................... .. Zoning District .. ............................................ .... .Fire District .... ..C1................... ................................ Name of OwnerOvx s G.t` .. ............... Address Name of Builder"d:".\.....1 ,:.. .C'�. ��.................Address ........L4...k�!?x................... Name of Architect ....:.........................:.........:..:.....:................Address .............:....-.................. Number of Rooms ..................�1.. .................................. .....Foundation .F4..�:(?,75�'Y`e >' ........... ................................ Exterior .......!.............................................................................Roofing .........65.p 1.................................................. Floors .....l am.?,. Y................................... ......................Interior .....lhe"it.dr)QCh......................... ........................... Heating. Pk WKIKw................................................... e . Plumbing ........................:...............................................:......... Fireplace ........... `....................................................... .........Approximate Cost ................... °. .............. WXDefinitive Plan Approved by Planning Board ---------------____-----------19---_---. Area ...................... �• ... Diagram of Lot and Building with Dimensions t `Fee //!�........................... � . SUBJECT TO APPROVAL OF BOARD OF HEALTH s eo Ig t OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the own of Barnstable regor ing the above construction. - Nam ... ........ ...... .... CHAREST, 'PAUL No 24632 Permit for ..ADDITION Srn�le Fami1X Dwe11 nc� } HI: 92 Ashley Drive - Location ................................. ... ... I ; n Centerville... .. Owner, ...Paul, CIZars.;.......... Type of Construction' ...F a.Me......................... _ +............... .......... ..... r ................ j ` + Plot ...................... . .. Lot ........... c -December 10 j 82 Permit'ranted ..................�......19 } Dat f Inspection /...J...:..... ..... ......190� r Date Completed ........................................` 19 ilk