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0016 AURORA AVENUE
4VE0 v � ~ Application Number.......... . �1... ......... * Permit Fee..........En..o.................Other Fee........................ ��FD Mfd Aim Total Fee Paid...a . .:........................ ......... TOWN OF BARNSTABLE Permit Approval by.................................On.............:............. BUILDING PE ` Map...... ...............Parcel........//!�.......................... APPLICATION Section 1 — Owner's Information and Project Location _ rodect Address_-�� &VO L �,U4 f Village V.1 Owners Name Q if CTO n L°S C::70wneriI:e_a1 Address IL QU�� 0 U2/ City=-eq 4e ti 1, 7State 'Owners Cell# 'Tog 33J 3 r---E-mail j- N �1/i OYS �a k oo : COrrl Section 2 —Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet FT Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling CSection.3- Type,of.Permit:) ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ['Finish Basement . ❑ Family/Amnesty ❑ Fir*Alarm �G Rebuild ❑ Deck Apartment ❑ Sp*er ste ❑ Addition ❑ Retaining wall ❑ . Solar o VQ ❑ Renovation ❑ Pool ❑ 'Insulation 2 � � Other—Specify. Sect 6n.4-=Work Description_ .- 71 i ce Iilu(I ��l[X�Yi'/JU� �QOlc q mi�t{ Qho�. i'►1 'CY�YyI shee.� ryc.ktcttlls �YQ17 t L Last updated: 11/15/2018 Application Number.................................................... Section 5—Detail Cost of Proposed Construction a 00 _ " `_Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors t ❑ Plumbing ❑ Gas ' ❑ Fire'Suppression ❑ Heating System ❑ Masonry Chimney "' ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes,❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed t _;Rear Paid � `:-� ".R quired ' ' Proposed'" Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 • Vf{i A.o R�6 P a>ee..P• • e e.._.._._.�:.__..... . 3 p 7— BUILDING DEPT. 4` NOV 16 Z019 TOWN OF BARNSTABLE AdVA Game P,00m rn 16 � .., .. 13, fir/' • 30 -- qo S Cc, 1 .9 Slid; ��r PT. �' gUtLDING DE -�— � NOV w 6 2019 APQII TpWN p k xlS "� 1 s ':d.v a The Commonwealth of Massachusetts Department of IndusftidAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly -Name(Business/OTganizatim/kdividual): Ql �`otl e Address: Q,U Yr7Ya, U`� City/State/Zip:Ceniru1 lit wt a, oa 3 a Plione#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I * have hired the sub-contractors 6. ❑New construction employees(full and/or part-time). + ° . 2.El am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor in an capacity. employees and have workers' Y P , tY• ° 9. ❑Building addition [No workers'comp.insurance comp.insurance i •Wqwr�]. 5. We are a corporation and its 10.❑Electrical repairs or additions 3.VI am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or;additions right of exemption per MGL myself[No workers comp. 12.❑Roof repairs insurance requir eA]t c. 152,61(4),and we have no, employees.[No workers' 13.❑Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowner;who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating suck tContractors 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 thepolicy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: 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 MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coveTage.verification. I do hereby certify under the pains andpenaldes ofperjury that the information provided above is true and correct. 1��Signat=: _ tk on e S r Date: Offtcial 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 M Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage`required" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLQ or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: ` The Commonwealth of Massachusetts , Department of Industrial Accidents =` Office of investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAM Revised 4-24-07 Fax#617-727-7749 viww;mass.gov/dia Lauzon, Jeffrey From: Lauzon,Jeffrey Sent: Thursday, December 12, 2019 10:51 AM To: 'kajinteriors@yahoo.com' Cc: Lauzon, Jeffrey Subject: ViewPermit, Permit No:TB-19-3994 Applicant, Please be advised that the above application has been reviewed and the following is noted: 1) Construction documents are incomplete. Stairway details missing headroom,tread depth and riser height. Basement headroom not shown. No details for insulation submitted. No details for bedroom emergency escape submitted. Floor plans are unclear. (R107.1.1) The application is denied pending the submission of the required documents.And, if aggrieved by this notice;you may appeal to the Building Code Appeals Board within 45 days in accordance with M.G.L. c. 143 § 100. Respectfully, Jeffrey Lauzon Chief Local Inspector (508) 862-4034 ieffrey.lauzon(cDtown.barnstable.ma.us . 1 Application Number.......................................... ' Section 9- Construction Supervisor Name Telephone Number Address City State Zip License Number License Type Expiration Date Contractors Email Cell # I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. a . Signature Date Section 10—Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section-11--Home Owners-License-Exemption l CCHome Owners S p 33a 3 rsCell-or Number- �of b'33 D 3 Tele hone Number— I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. C:jSign ture S r"Date =- APPLICANT SIGNATURE Signature Date F Print Name s n e,S Telephone Number, 09- 4r�,' �3 3 Jr, E-mail-permit.to: ka ( t,) eV i o Y S u"oo • corn V Last updated: 11/15/2018 T— Section 12 —Department Sign-Offs P � Health Department ❑ Zoning Board (if required) Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13 — Owner's Authorization I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name ' s Last updated: 11/15/2018 Town of Barnstable Building`.•""',""».,`�'°a.,w°�..x wnr�°' -'""'�u� �•`�'" s ",�'.w.a"�..' ..,.,: °�`�.'';�P {{Post This Card So That rtyis,Visible;From the Street Approved*Plans Must be;Retamed on Job and;this Card Must be Kept 8ARC7S'I'AB1.E. `e* >?: v :'" x;&' e`•- s"i..� "r .i,°3 xm i�r Posted UntiF Final,Inspection Has Been Pe rm %639 ♦ a - F r i iii�� Where a Cert ficate' p y q g p ,p ,e of Occu anc ;is Re wired,such Buildm stietl Not��be Occu ied`until�a,final.lns ection has�been made ��� Permit No. B-18-581 Applicant Name: Craig Bishop Approvals Date Issued: 03/02/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 09/02/2018 Foundation: Location: 16 AURORA AVENUE,CENTERVILLE Map/Lot 251 116 Zoning District: RD-1 Sheathing: Owner on Record: JONES, KATHERINE 'x + Contractor NiE a eCraig P Bishop Framing: 1 �. Contractor.License CS409777 Address: 248 CAMP STREET UNITS 3 � 2 WEST YARMOUTH, MA 02673 .` Est Project Cost: $2,302.00 Chimney: Description: Air Sealing&Weatherization Permit F e': . $85.00 Insulation: Project Review Req: ' F Pa id:- $85.00 ee Date: 3 2 2018 Final: gt / / g Plumbing/Gas _ - Rough Plumbing: w wilding Official Fina(Plumbing: z This permit shall be deemed abandoned and invalid unless the work authorized by,ths permit is commenced within six months after issuance. Rough Gas: All work authorized.by this permit shall conform to the approved application and thelapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or,road endsha11 be maintained open for public inspection for the entire duration of the work until the completion of the same. 3 F ` Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are:provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: p q nd 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 S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy -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 Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT oFWE Town of Barnstable *Permit# :D 3W3 ��• S4 'L� Expires 6 mo ills fro issue date Regulatory Services Fee ®° v RAM 39- Richard V.Scali,Director RFD MA'l9 Building Division NOV O 1 2911 Tom Perry,CBO,Building Commissioner i1 200 Main Street,Hyannis,MA NN (k hAK1\161 ABU ,vwNw.town.bamstable.ma-us Office: 508-862-=1038 Fax: 508-790-6230 EXPRESS PERMIT APPLfCATION - RESIDENTIAL ONLY tVot Valid without Red V Press Imprint Map/parcel Number Property;address lie ` residential Value of Work S C — Minimum fee of$35.00 for work under$6000.00 Owner's dame&Address ffal-lerr�3 e_ /o/l e S LL , Ad< oro ✓c- Tel✓i ff- M A 2— Contractor's Name WIULU2 �1/0�� ./cFF S >F.FU r—_ Telephone Number 78-1" 9,32 of 3Vsr'DK-) Home Improvement Contractor License E(if applicable) /66 D2_15'_ Email: Construction Supervisor's License n(if applicable) (57 Z:72— - N<Vorkman's Compensation Insurance Check one: 5 ❑ I am a sole proprietor - ❑ I am the Homeowner [ I have Worker's Compensation Insurance Insurance Company blame AkKr�;Otm A)vttlZ Workman's Comp.Policy# r-u--T 21 zs" 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 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ' ❑ Re-side ,- q @Replacement Windows/doors/sliders.U-Value Z q (maximum.32)#of windows #of doors: , ❑ 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.c.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 SIGNATURE:C Usets\Deco),4equired. Micros. tndotvs\Temporary Internet Files\Content0utlook\2P101 DFIR\EXPRESS.doc 1 Revised 04021= I °Window World of Boston,LLC MA HiC Registration Offices&Showrooms Number; j CJ"(rd�G Cl 15A Cummings Park O M Old 0ak Street 166625 Woburn,AAA 01801 Pembroke,MA 02359 Federal ID i - "Simply the Best for Les3" (781)932-4805 (781)823.6281 27,1481685 wwwWndbwWGrldofOoston.com Customs / Phone(h) Instal Address:19 A402ZI AIV Phone(w) City PLC 0,4 State:MAZipaZa Email WINDOW WORLD GLASS OPTIONS' " _1000 Series Sing;'e-hung AIFWedd $189 —�P—SelarZone Elite _ ,2000 Series DH MechlWalded:$ash $215 _Triple Glazed TGr $195 40,M Series OHAIPNeld. $226� (tS'?rfe 9MOV _60M Series DH AIWUeld $260 WINDOW OPTIONS _2 Lke Slider $354 . Mass Breakage Warranty $1S INCLUpEp. 9 Life Slider oximirm timixuo $540 — 1/2Screens 39jNGI_llDFD Picture/Faed Lite g354 —�✓,/�Foam Insulation on Jambs and Head $11 INCLUDED —Awning $280 Double,Strength Glass. $15 mCDAED. _Casement, $310 DcubfeLocks(>281) S5_INCLUDf6 21]te Casement $6g5. Full Screens.. $22 3LReCesemerrt ;ue+a:iinu rua,rs,w= Sip— - —rCnInN�I rari+e mentOYYedIFIBt) $45 _Basement Flapper $61 -,_ $69 Bay:Wmdow-SolfitMaur: / rdUte $i82 _Bow.Window-SoffitMour rsh(830):fiSO) v65 Qardan Weldaw 3SO)(TS0) $38 _Specialty Window or 040) Be' /Armand ram wooed Grain Interior fflWtesgr P RES(EPA LEAD SAFE RENOVAT70IN4 01&Q*DwkOakl QlmW r :es Required Sao DmmAaaa) N THE YEAR/Y lnitial e9esignemtokir Exh.Rrorae/i ICELLANEOUIS _ jW Designer Ceidr Exterior_ minum Cladding Window Wtora NJ _. u iextu(et S7 IW 6 Smooth$75 11 4za arsdo Cublde facing Color NON CUSTOM DOORS Metal Window Removal $50 _Vinyl Rotting Palo Door al.or(1%. 51055 _New Construction Vinyl Removei $175 Wnyl Rating Polio door tilt $ties —Specialty 4llindow Exterior Trim $ _A1dia boo pdcatarDidom"FMUcd'$125d _NluiltoForm Multi Unit $80__ frenoh MSliding Pago Door 5%.or6R $1995 __Install hsterlorlExterior StOR9; $50 _Frmnch Rail Slkfing Patio floor ed. $149! _fnswi inWor Casing Starts At $95 _French Rail Sliding Polito Door.9R $1595 elnsulate Weight Boxes $20 Custrunaiterio,Cladhing $teo _Row for Bey/eowwindows wa0 �9alarZone:4xeorEXGlass $905 Existing Now Const,,Ext.Retro.Fit $1g0 Gft Polio Door` $14e Rernoual of Ex"Bay/Dour $250 _woadgraln interiors $295 / Repair Sill,Jamb or replace sill nosing $60. G _£1detral Designer Cators $M / Full Sub-Sill(Single)replacsrniant $15ti 1 -0 • tntenorCaaing.Z-.3tm Stt6 _Mullion Removal S30 Handlesat Options $ _ Say/Bow Conversion Fxt Fiat ro R. $350 l S (New siding Will Not Match) Door Cdar_ � • L Customer declines exterior-wrap and understands painting and/or repair may required initial Customer dedtnes grids oil L wlndows/daors intti� /a� g1=1111111;-Cratomu1reiuhsr'bbfordutofWingiaeanaedi with tigsranoaa1:NMI M1111111,Alum*win sse named SuddapPerrdt"gain ,r�C`�' esoas57t&ffi.00.Hartes�nerandar0oaaohsseeia'mnAppiweadll�dc�ietApprard.C&7Iot13ostmrPaiahgllsidav�ffikFlaia&tteasktcaneeCmelr�hicsta�oa t /� � NO EXTRA WORK*NOT IN WIIfTiNG1. Customer agrees tote terms of payment as folims, Extra labor&Matestals s-3.V1 ~ � Site Bet Up;Permit;Disposal&Delivery Fees$ $369.00 ToW Amount $ 4-060 Custom Order Deposit 50% $ Ck# Balance Paid to installer upon Completion $— �A Amount�-p,n-erroad $ ,360. / / r, Ewdq�n Mild is 6ostmt xUl es sonlag iris:aodt on � and tteiRl submilhilly=.I dldirrr-aye Sege Q ltdetastyea_No�[ L/ nay dap requatd to advamat of the slaK of the work& N en. .21 oft me late!ccmra+a price arfie actual e�of any materd ar tpPme ova special order orcrGtommaderiatixe,vddelmustbeorderedinadvanceofthestartattiewolkt wilivre that this Rolact will Mooed(in aetredtna,Nopsipaymert, snap be demanded until the consaat Is complo edto the Slifi cdon of both parries. All home impmjinent coninicie s and witcontaaeMrs and be repsiorad well tlgt any inquires about a contract or micarbraetdr redht9la a radstradan should be ddected an 09tce of Conniver iver AHatrs and Bootees KnOtiBa9,TeoPalt Plan,Srdie 5170 dsslan,MA 02116,Phone:(817)9734T00. Ns.wwt sban be&prlorto the sighing of the conlrad and traamdNal to nw Geller of a wpg at sack contract. Window Raid of Boshin cinder provision of Chapter 142A of the general lave is Mufredto appip tar and obtain all csnsb ref arrelated Permits.WildoW Vlortd Of 9ostaesM not be deemed respansibleigrdelays in the work described In Iris agreameM=$Oil by regulatory,paimtt granmig agencies,ardhorttes orindividualL. Notice 0[be PURCHAMS)obtain life amoaestraedtasrelatedperrnitl(Of lbaxlsR described waderirisagreeAentor deals with11 teredconlraolass, The PURCHASERS)is basely adg9ad rid in Re actor el a dispute,0dgalaaid add aoapaymerd,Me PURCHASM(B)00 not be eotiUed to male a Beim Of clillBctod[ram go glere fad e0brrft9 Byshao l4YA,11M. Massachusetts Department of Public Safety �- Board of Building Regulations and Standards License: CS-072772 construction SuperJisor JEFF C STEELE 24 SHERWOOD AVE DANVERS MA 01923 ; Expiration: Commissioner 04/07/2018 OMee of Consumer Affairs&Business Regulation ' HOME IMPROVEMENT CONTRACTOR .- Registration: 166025 Type: = Expiration:. .4112I2018 LLC 37 WINDOW WORLD OF BOSTON,.LLC. JEFF STEELE 24 CUMMINGS PARK SUITE 15-A — WOBURN,MA 01801 Undersecretary License or registration valid for individual use only before the expiration date. If found return to'Regulation office of Consumer Affairs and Business 10 Park Plaza-Suite 5170 Boston,XA 02116 s r ,,jqot valid without signature The Commonwealth of Massachusetts Department oflndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia «'orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERNIITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Indi'-ridual): (dt a/a,,,1 44 r/d )-r &.sd/1 L C, I Address: /55 f1 C t�/i,/✓. YIDS' K City/State/Zip: 1t),oburAiA O o I Phone#: —7f 1 —9 3 z - q,8 0� Are you an employer?Check the appropriate box: Type of project(required): l.Cq'i"am a employer with _employees(full and/or part-time).* 7. New construction 2.F_�I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.l 9. El Demolition 31-1 I an-,a homeowner doing all work myself[No workers'comp.insurance required.]t 10 Q Building addition , 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensue that all contractors either have workers'compensation insurance or are sole l l.Q Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.i 14.[v�Other 1N 1 n C(O k, ) 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] / 0i Ce,-,'I•erlr> *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 thepolicy and job site information. Insurance Company Name: (4aJ-1:-Ca-r9 Fre TnSJRA/�Cf- CeD - Policy#or Self-ins.Lic.#: Z Z WE C L— 1 Expiration Date: /�/- 2- 7— �9 Job Site Address: L6 4yrti r Q A16 City/State/Zip: l eI7 Pll(j Ile i M 4 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 Rtatement may be forwarded to the Office of Investigations of the DIA for insurance coverage verifi 'on 1 do hereby cer under a pat erjuiy that the information provided above is true and correct Si afore: Date: Phone#: _ 3�-" �5. use only. Do not write in this area,to be completed by city or town ofjriciaL 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#: l WINDO-2 OP ID:HI ,ZIt,C�RD CERTIFICATE OF LIABILITY INSURANCE D 05,041201 YY) ��. o5roa12o17 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(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 I CA E"cr Carli Witcher CISR,CBIA,CIC Marsh&McLennan Agency-GSO PHONE 336-272-7161 FAI'c,No• 336-346-1397 3625 N.Elm St AIc NoEMA Ext Greensboro,NC 27465 ADDRESS:Carli.Witcher marshmma.com C.Timothy Ward,CPCU,CIC INSURERS AFFORDING COVERAGE INSURER A:Hanover Massachusetts Bay22306 INSURED Window World of Boston,LLC INSURER B:Allmerica Financial Benefit 118 Shaver Street INSURER C:Hartford Fire Insurance Co. 19682 North Wilkesboro, NC 28659 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. lPOLICY LTR TYPE OF INSURANCE DLiSUBR POLICY NUMBER MWDDIYYYY MIWDDNYYY i LIMITS LTR . I INSD'.WVD�, A X 1 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,00OI DAMAG O R NT 500,000 CLAIMS-MADE X OCCUR OD6790252708 04/01/2017:04/01/2018 PREMISES Ea occurrences MED EXP(Any one person) s 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,000 . POLICY ' PRO- LOC PRODUCTS-COMP/OP AGG S 2,000,00 JECT S OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,00 (Ea accident) B X ANY AUTO tAW68757615 06/16/2016 06/16/2017 BODILY INJURY(Per person) 5 ALL OWNED SCHEDULED BODILY INJURY(Per accident) S -AUTOS =AUTOS - - AUTOS NEC. PROPERTY DAMAGE .S HIRED AUTOS AUTOS (PeraccidenU S X UMBRELLA LIARX .00CUR EACH OCCURRENCE S 2,000,000 A EXCESS LIAB CLAIMS-MADE; ;OD6790252708 04/01/2017 04/01/2018 AGGREGATE S DED RETENTION S S i X WORKERS COMPENSATION ' PER OTH- _ � �STATUTE ER AND EMPLOYERS'LIABILITY - C ANY PROPRIETOR/PARTNERIEXECUTIVE YIN i22WECLJ2635 O1/27/2D17 D1/27/2D18 E.L.EACH ACCIDENT S 500,000 I OFFICER/MEMBER EXCLUDED? ❑!NIA 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S I If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMrf S e 4 I «a - I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD *Permit own of Barnstable 'T Expires mail6s front issrte r(nIe Ask Regulatory Services hiAm f`? Thomas F. Geiler, Director r � " Building Division 1 . 1 1 `� Tom Perry,.CBO, Build ing.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 Not Valid without Red X-Press Imprint Map/parcel Number 1 I I l D Property Address -7, mum fee of$25.00 for work under$6000.00 [�cesidential Value of Work Mini Owner's Name&Address Contractor's Name r C, nfi..J� Telephone Number Home Improvement Contractor License#(if applicable) W� L t Construction Supervisor's License#(if applicable) r C ❑Workman's Compensation Insurance Chec -one: 10"I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp . P olicy# 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. U-Value (maximum .44) .*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License&Construct Supervisors License is required. SIGNATURE: Q:\WPFILES\FOkMS\ExpTess\EXPRESSPERMIT.DOC Revise060409 iNlassachusctts - Dcpar [licit t of Public Sarct� Board of Buildin.- Rc.-ulations and Stan(I;u•ds Construction Supervisor License License: CS 75281 Restricted to: 00 ;t- TODD J CANTARA 10 ECHO RD W YARMOUTH, MA 02673 � Expiration: 3/12/201.1 ' ('nnuiis.i,ncr Tr#: 12753 ��e ita�uuea - Board of Building Regulations and Standards License or registration valid for individul use onty HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:- Registratiow, 159211 Board of Building Regulations and Standards Expiration: 4j;10/2010 Try 26ti397 One Ashburton,Place Rm 1301 Type: Partnership Bosfon;Ma.02108 ECHO CUSTOM CARPENTRY TODD CANTARA 10 ECHO RD. - W.YARMOUTH,MA 02673 Administrator Not valid without signature R ,;, an a.ra 10 Echo Road Phom:, 50"67-1151 i1sto m1 CaMe West Yarmouth.NAB 0,2673 Fax: -60"3+4266 E-mail:toatttaral.,rt�-vahao._pm Santos;Martha 16.Aumm Ave. Cecttavil1e, MA 02632 C T cost Roof Stfip and mmof using a 30 yea=Wtee d s rOe—ipy .$3,800 Includes labor,watedata,dump Sees Includes new drip edge,ice od w9er ba XW,felt unddlay Comlett jobsite clew at the and of the project. Total jab cost $3,M00 Ulaft Santos—homeow ex 4 4 Todd Qmta a--cootxactor f The Commonwealth ofMassachitsetts Department of Indttstrial Accidents ' Office of Investigations G 600 Washington Street + Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): _ ^ccn,� Address: City/State/Zip: Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I err�ployees(hill and/or part-time).* have hired the sub-contractors 6. New construction 2. am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' y ❑ [No workers' comp. insurance comp. insurance.$ 9. Building addition required.] 5. ❑ We are a corporation and its ME] Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE] 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:❑ Other 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. tContractors 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: Policy#or Self-ins. Lic.#: Expiration Date: 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 MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer ' r e pains and penalties of perjury that the information provided above is true and correct.. Si nature: Date: D Phone#: Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: r- Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and-who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for fiiture permits or licenses. A new affidavit must be filled out each year. Where a home owner or'citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call.The Department's address, telephone and fax number: - } The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia 3 ' THE k'6 Town of Barnstable °^ Regulatory Services y sse ' Mg" Thomas F.Geiler,Director Building Division Tom Perry,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 A Builder as.Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMIS S ION ' 6 Town of Barnstable Regulatory Services snxtvsrns[E Thomas F.Geiler;Director MASS.9q, A Building Division ArfD MA'I Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. v Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner.is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC Assessar's map and lot number'......... ...... .......... • THE r i pG Tp� Sewage Permit number1 ..�.�'�.....f....... y • � � � N AEIVR � STABLE House number .... ......t ...: :� . ........ n8a m�16 mikl TOWN OF BARNVSi .#ALBLE ; BUILDIHG ,']AS TOR T . Y am ' .: ... '� . � ...APPLICATION FOR PERMIT TO ..... .......1 .... ..... ..... ...... ..... .. ... ................. TYPE OF CONSTRUCTION: ..........,Cr!P.�r�r:..�`'` .''"' ?'!r'g......................... :...........................:..: ......... TO THE INSPECTOR OF BUILDINGS.: VThe undersigned'hereby applies for-a permit according to 'the following ' foam/, ation: Location . . G� .,�...... . .1+� ►..... " !/G .��k '0'� .. Pro osed G Use ... . . ... ...... /.... ........ ......... ......... ......... ............. Zoning District ....: ........ ...... . :I..... re + istrict ...:...... ................... Name of Owner !9Lid�L�dl/ If•� .. !�........... ��y Ad�e * ""L 4 -• e Iva et Name of Builder 9... .......Address s.. ......................... 2 /� ��� /AJOR4�G ak 300Pa�Name of Architect `.. r................... �C. ............Address ... . . .............. ..... . Number of. Room n �J��2G ,.......................... ...............Foundation .......: ....,.:.........."�,,... DO . Exterior L. � ......Roofing ...: :.� ....................'= �y . ....... ,�/,� 1,4, -'ko �� /At 4nter ...:. .....✓ LZFloors ..... .. " .... ....j- for ................... floating.- �i ?�.►.......'....•'.�.... ....... g Fireplace .../�' ' !1 G' .......Approximate Cost...................................... Definitive Plan Approved by Planning Board.__ __________________________19________ Area,' ... ............................. Diagram of Lot<and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH ` S6Aj i ' • .. � � r. 1, ' OCCUPANCY PERMITS REQUIRED FOR'NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of, the Town of Barnstable egar'ing the above construction. Name ... �/�!....A� ¢'....... .. . Construction Supervisor's Li nse ...........................:........ h BAl-WSTABLE HOLDING CO., INC. tNo ....................2627.. Permit for ...Dile Story. ............. Single Fami1 L ly..I? ell.irig. y, y Location .Wit..2/.....16,.Aurora,.Ave ...4..... ... n�� v�.J.la....'................................. Y Owner ...Barnsb7 e..13ol G6l...' e�:. .. �' a r• .e r- T e of Construction' Fr r erg _ `.................................................. Plot :,n ........................ Lot ............... .............. `-, Permit-.Granted ..Apsi.l..lgy. 19 84 - Dat Inspection � . .. ,.1�9�� Dte Completed s.C�eLrr�c:.... .......19 i } - D� 4A� -� I J. .• �, ._< ,�o .M t'.V�' 't -•'*.}4'.�Si -..�. `,_.i� i. ,� +1�"7:1.'4'r1. ."..�'.i ti s � - , ; �r �� .. - z �rAssessbr s map_and lot number-..........r ......... .................. ... _ Sewage Permit number BARNSTADLE, i HOUSE number ....\. .�:...b......�:.�C....+.................................. 9�0 M639 �09 f a WAR A,• 0 TOWN OF., BARNS, TABLE BUILDING INSPECTO1t� APPLICATION FOR PERMIT TO .... ........................................................./ ;•F` :. TYPE OF CONSTRUCTION '°T r f TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 41 Location .....:.. '. .... . =........: 'r;! r,:!'.................................................... ......................................................... Proposed Use .......................................................... .. ... .`...: .......�r.�;.:.� ...: .................................................::..............................,........................... ...... ..... Zoning District r............... .. . ...............Fire District ......................................................... Name of Owner .......:'�• It ...........:.:.:..:... ...Address ................................... ..................................... . Name of Builder .. :d}l. r t� ��. .../.... .......Address ..............................................................................� .. ... . ...... .... Name of Architect L`.. ' ji .......:.. ... ..!j.:. ...::..//a' .t ..Address ....::::.. ��'... ' .. .. ....................... Number of Rooms • .............................................Foundation .� r �"a ' Exierior P, r" ' ✓' .'[r'r'f �........ ,..............................Roofing ............................................ ' a ` ' I terior ............................................Floors ::�....:..r......' ��.. ... C..: ..... ..... .... ......................................... r Heating ' .....Plumbing .. . "''� t Fireplace ..................... ...................................................... Approximate. Cost ...............r.......................... ....................... Definitive Plan Approved by Planning Board ________________________________19________. Area ....................... ................. Diagram of Lot and Building with Dimensions Fee .............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 r ri OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable'rega`rding the above construction. k Name........ '..: .. ......... Construction Supervisor's License ..................................... v BARNSTABLE HOLDING CO. INC.' lit, -A=251-116 F 26279 .� s s I�o ....�.........:.: Permit for One.St.QXY................ Sin le 'j m l ,Dw r Location ...Xt..2.......16.:A1a7C0ra..Avenwe....... .................. .................................... Owner ... Type of Construction .Frame........:..................... ................................................................................ Plot ............................ Lot ................................ Permit Granted .April •„• ,,,,,,.„...1984 Date of Inspection ....................................19 Date Completed :.....................................19 r LQ 7r Lv:7 S O,T a i 14 I 4 U T' � f r / _ a • GAT" � � ;! '�: s3• _ _ o � , ` F N 30 r f p ;; RA.. A V4, F 2, Doa . 3IE 4 17W�✓iTjTl'!N CERTIFIED PLOT PLAN /4YJN'GaU .' 5 btp�� A4,{ss, 40 T ;A v R D 2.4 1/E .`: ROBER7 NEW "CONSTRUCTION ONLY "" N7,57): s,�u�E ELgREO TOPS OF FOUNDATION IS- FEE IN ABOVE, LOW' POINT OF ADJACENT' : ,$ AJIhS tAA L iWA s, ROAD ,ya suRd�y� SCALES / = 3,9 DATE 4 D EDGE E G/NEE /NG C .IN �' ^' , vv�.y�7•0.V -.—� CLIENT �'"`�,,, �'_.._ I, CERTIFY THAT THE EOISTERED RE®1$TERED SHOWN ON THIS PLAN IS LOCATED CIVIL LAND : J09 NO.Y �_" ON THE GROUND AS INDICATED AND : ENGINEER SURVEEYOR DR.BY� CONFORMS TO THE ZONING LAWS OF OARNSTA®L , MA8 712 MAIN- STREET CH.GY�. �fe', ' HYANtAIS+ MASS. SHE E'I'..LQFt{: / '` ,l.., :DATE REO. LAND SURVEYOR QMCK RESPORSE DAGEY HOMES 100 West Main Street Hyannis, Massachusetts 02601 ATTENTION: DATE: (617) 771-4400 ❑ Urgent ❑ Please Respond by ❑ No Reply Needed DATE: T0: SUBJECT: Building Department Town of Barnstable Lot 42 Aurora Avenue, Centerville Town Hall - Main street .._. .._.. .... Hyariiiis. NIA.. 02601 ... I ....... ...... ... . . ...ATTN;_Ms....Robbins... MESSAGE: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . Dear Ginny: — . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . As you requested, I am submitting all the land court Certificates for the abutters on P,urora Avenue 'and as you can see Lot #2 was a single owned lot and therefore we should be able to build on it vith ,no problem: . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Si . .erely,. . JP/mbm/enc. SIGI J anna REPLY: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DATE: SIGNED: FORM 1.12-0 THE BUSINESS BOOK,Oshkosh,WI,54906 1-800-558-0220,In WI 1-800-242-0344 Recipient Returns This COPY To Sender l_ !• `� s� a TOWN OF BARNSTABLE Permit No. ---------26279 Building Inspector 7anEMIL C Cash — = r '£OY►Y OCCUPANCY PERMIT Bond Issued to Barnstable Holding Co. , Inc'Add:ess West Main St. , Hyannis lot #2 16 Aurora Avenue, Centerville Wiring Inspector �j� ;,� � Inspection date Plumbing Inspector ��, � r��P Inspection date Gas Inspector Inspection date i ,!`Engineering Department -" f,w er . .,._Inspection date 7 r /" Board of Health d'f '' Inspection date " THIS PERMIT WILL NOT BE VALID AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL 81^NED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ............... .........�il..... ......, 7.9. ..� ... /' r • -p .....i_._....�._.......... .... .................................... w Builc?ing Inspector FROM r •+ TOWN OF BARNSTABLE. w BUILDINO-DEPARTMENT 7 Mr. Francis I Ilt �, A `p$y A..367 MAIN S'TREE } HYANNIS, i4A 02W1 Clerk ; y i. SUBJECT: ^ ' FOLD HERE "DATE June 30r 1984> AA E 5 S A G x r. Work'has 15emJJ leted utter Permit #26279: (Bams ile�•'+-�g CO.., Inc.,)4 . �s.wp S`mrt<�,.>g <., Please release Bond. SIGNED. P� .•. .. DATE i WEPLY SIGNED N87-RMi RECIPIENT: RETAIN WHITE,COPY,RETURO'PINK COPY - ' - PRINTED IN U.S.A. i SENDER: SNAP OUT YELLOW COPY.ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT.