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T.- . _ ,, a ' ",/ _' �. ..a a-.� '; +t ,. �'}f; 4 �, 4-y,' t ✓1. , C• Y .,�, 11 • , .: a R 1F, � ,1. T %' y, " r -� -.. •., r, l .,, ,,, . .. , - . . < •ti ,R - . u r , .- . t,: a. . rv. a �w . .. r_ _ .t , q, fi ' ,1 *' •. a n ryiR y,. r .y,r� �— e ,. • ., , .., 1. __ - '- to yr - [ Town of Barnstable *Permit#• �' 7 / Expires 6 mondu from issue date Regulatory Services Fee /, Sv >�tvsu►at� MASS. Richard V.Scali,Interim Director 'Building Division - Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.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 2 S - r Property'Address S A t co r r, ``I ✓P ( a&�Cy;j/e— [`Residential Value of Work$ 8. 138 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Ctin ril ,,Gt Ke (e y S r6. (f-e.-Wectli Ile, M 02 Contractor's Name E&W t ISOAJ Telephone Number 101-zzr—fSW Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) 07S70 7 Workman's Compensation Insurance Check one: � ❑ I am a sole proprietor I am the Homeowner MAY 12 2016 :I have Worker's Compensation Insurance Insurance Company Name &A01JAW_ IIUS 7 TOWN OF BARNSTABLE _ Workman's Comp.Policy# W�iQoZ gQ� 9 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 i ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side [replacement Windows/doors/sliders.U-Value 3 (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required.. *Mfheie 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. 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W4Ji )rN' 1DAY 01MEk IRE' DATE Of T�1 S"1 l CT'11.�►NP kfi H � g i 1° e' 1 v1 f ' 11 I #` WIN �f1 FOR -A �o a I ,`& Kingt i�iria i� 5.ili�, V' r5�_rni F't�fic !'alriw, 9'ti,lic N'aaii , Southern New England Windows d.b.a Renewal by Andersen of SN E ` Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction supervisor ' License: CS-095707 �Y.il♦ BRIAN D DBNNISON r' 7 LAMBS PONDz. - Charlton MA 01507 f Expiration Commissioner 09/OB=6 � �fZP �t1/I�9/j72«OZLljPaiLfitG Q� ��%�'LfdOOf2�?iffllPW.i Office of Consumer Affairs//ana d Business Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement.Contractor Registration Registration: 173245 Type: Suppkutw t Card SOUTHERN NEW ENGLAND WINDOWS LL Expiration: 9ne20116 DENNISON BRIAN 26 ALBION RD LINCOLN,RI 02865 Update Address end return card.Marft reason for change SCA1 0 2OU401 Address C Renewal 0 Employawat []Loom Card Met of Conseaer Afain&Bssiaos Reeatstion Lieeoae or registration valid for ladMilul use only E IMPROVEMENT CONTRACTOR before the eapuation date If found return to: Office of Consumer Affairs and Business Regulation re 173245 Type 10 Park Plaza-Suite 5170 Exp4atlon: 9ISM16 ,SLmplemerdLud Boston mA02/16 SOUTHERN NEW ENGLAND WINDOWS LLC. RENEWAL BYANDERSON DENNISON BRIAN 26 AL BION RD LINCOLN.RI(>?865 U yn Not valid without ir"- tare The Commonwealth o,f'144assach usetts Department of IndustrialAccidents Office of Investigations VI 1 Congress Street, Suite 100 J Boston,M4 02114-2017 www mass>gov/dire Workers' Compensation Insurance Affidavits Builders/Gontractors/Electricians/Pl>lallnbers .Applicant Information Please Pritat JL,e i Name (Business/Organization/lndividual): SOUTHERN NEW ENGLAND WINDOWS Address:26 Albion Rd City/State/Zip:Lincoln, RI 02865 Phone#:401-228-9800 Are you an employer? Check the appropriate box: - Type of project(required): + a general con tractor and I I 1. � I aiirt a employer with 20 4- ❑ I am g 5. New construction ❑ ..- ❑ employees (full and/or part-time)_'r . have hired the sub-contractop 2.❑ 1 am a sole proprietor or partner- 7_ Remodeling listed on the attached sheet.. ❑ ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9 Building addition nsurance.* - [No workers comp. i comp.insurance 10. Electrical repairs or additions required.] 5. We are a corporation and its ❑ 3.❑ I am a homeowner doing all work- officers have exercised their 11.171 Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.[] Roof repairs re aired. c. 152, §1(4),and we have no insurance q ] 13.0 Other �r�_ employees. [No workers' - comp. insurance required.] lace�\e a d S *Any applicant that checks box 91 must also fill out the section below showing their workers compensation policy information. 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. ram an employer that is providing workers'compensation insurance for my employees Below is the policy and job site Information. Insurance Company Name:ARGONAUT INS. CO. Policy#or Self-ins.Lic.#:WC 928058352394 Expiration Date:8/21/2016 Job Site Address: - ZS Aurora A J2 City/State/Zip:Lo c'( V i 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 25Arof;IGL 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 Investigaations of the DIA foA insurance coverage verification. I do hereby certrfv under thi at and penalties ofperjury that the information provided above is true and correct. 1 Si afore. Date: Phone#: 4012289800 Official use only. Do not write in this area,to be completed by city or town official City or Town: PermitlLicense# 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#: -—J SOUTNEW-01 SHETTYSHT DATE(MMIDDIYYYY) • `�®�® CERTIFICATE OF LIABILITY INSURANCE 8/1912015 IS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELYD EXTEND OR ALTER THE COVERAGE AFFORDED BY THEPOLILY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOER.GIES ITUTE A CONTRACT BETWEEN THE ISSUING I►dSURER(S),AUTHORIZED BELOW. THIS CERTIFICATE OF INSURANCE DOES•NOT CONST REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. subject to IMPORTANT: Ifthe conditions of the policy,holder is an certain policies may NAL SreqURE ,n ndor eml ent. A statement on thises) ust be endorsed. certificateAdoes not WAIVED, confer rights to the the terms and certificate holder in lieu of such endorsement(s). co CT Willis Certificate Center PRODUCER NA F* )888 467-2378 PHONE 945-7378 Willits of New Jersey,Inc. AIC No Ext:(877) c/o 26 Century BlvO E-MAIL ce�Cates@+lyillis.com P.O.Box 305191 ADDRESS: NAIC# Nashville,TN 37230-5191 INsuRER(s AFFORDING COVERAGE INSURER A:Selective Insurance Company of Southeast 2 91-0 `1970 INSURED INSURER B:OneBeacon Insurance Company 19801 Southern New England Windows LLC INSURER c:Argonaut Insurance Company DBIA Renewal by Andersen INSURER D 26 Albion Road E Lincoln,RI 02865 INSURER E: • INSURER F: REVISION NUMBER: COVERAGES CERTIFICATE NUMBER: BEEN ED TO INSURED ABOVE FOR THE POLICY PERIOD LICIES F INSURANCE BELOW HAVE I THIS HI GATED. NERTIFY OTWITHS AN THE D NG AONY REQUIREMENT,REMENT TERM OR LISTED CONDITION OF ANY CONTRACT OREOTHER DOCUMENT WITH SUBJECT RESPECT ALL TH TERMS, M, INDICATED. CERTIFICATE MAY IT ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THETE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN RE CU CED F P P DLCD - LIMITS ILTR TYPE OF INSURANCE INS WVD POLICY NUMBER MMIDD 1,000,000 EACH OCCURRENCE $ A X COMMERCIAL GENERAL LIABILITY $ 100,000 S 2029459 08/1012015 OW1012016 PREMISES Ea occurrece n CLAIMS-MADE DO OCCUR MED EXP(Any one person 10,000) $ • I PERSONAL'&ADV INJURY $ 1,000,000 - GENERAL AGGREGATE S 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 3,000,000 POLICY®JECTT LOC I$ OTHER COMBINED SINGLE LIMIT S 1,000,000 IEa awdent AUTOMOBILE LIABILITY S 2029459 08/1012015 0811012016 BODILY INJURY(Per Person) I$ A X ANY AUTO BODILY INJURY(Per accident) $ ALL OWNED SCHEDULED �$ AUTOS AUTO OPeaaiUentDAMAGE X HIREDAUTOS X AUTOS WNED $ EACH OCCURRENCE $ 5,000,00 X UMBRELLA LIAR X OCCUR S,000,ODO 0811D12015 0811012016 AGGREGATE I$ 5 2029459 A EXCESSLIAB CLAIMS-MADE Is DIED RETENTION$ PER OTH- X STATUTE ER WORKERS COMPENSATION 1,000.000 AND EMPLOYERS'LIABILITY Y 0000068028 08121I2015 0812112016 E-L EACH ACCIDENT $ TO 1,000,000 B ANY PROPRIERIPARTNERIEXECUTIVE ® NIA E-L DISEASE-EA EMPLO $ OFFICERIMEMBER EXCLUDED? 1,000,00 (Mandatory in NH) E.L.DISEASE-POLICY LIMIT $ IT es.describe under' DEySCRIPTION OF OPERATIONS below C923058352394 0812112015 0812112016 See Attached C orkers Compensation DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached ff more space is required) CANCELLATION CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE A / Evidence of Insurance ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 1 _ �M} CCARTHY °" � �� � � •y. Hd�x ){Y � 1 {) L tt 4 �6 1�A • f RUCTION CO AS `"ry et�sid fiaI and Commercial Builder ' a loN SPECIALIST' �1 Ws � �QU�A�'14�[JLA�jlO n�;•.�..,r . .fie" � # CCARTMYC T4 GStka / � 1 w:ZYEB' WWW. 70 . October 21,2014 Town of Barnstable Q` Thomas Perry CBO Building Commissioner 10 K) 200 Main Stret Hyannis, MA 02601 c� RE: Insulation Permits ^ Dear Mr. Perry, This affidavit is to certify that all work completed for permit application#201404022 at 25 AURORA AVENUE has been inspected by a certified Building Performance Institute(BPI) inspector.All work performed meets or-exceed Federal and State requirements Sincerely, Michael McCarthy McCarthy Construction TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 5 Parcel '' Application #_o�� Q?"� 'i6Qa Health Division Date Issued 361�Y Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address Ax. Village Owner 1<<11c y Address r Telephone _ Sb� - ors- 6'7tx Permit Request �n.�t.•li,ern•��-- �- �d cc.1 4- chi Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total net :.Zoning District Flood Plain Groundwater Overlay - Project Valuation 00' Construction Type103 , Y Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family GY Two Family ❑ Multi-Family (# units) 9 ��'"_ Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's L ighway: d Yes"❑ No Basement Type: ❑ Full 0 Crawl ❑ Walkout ❑ Other Basement Finished'Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric. ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - - _ - (BUILDER OR HOMEOWNER)- - - Name Mire McCarthy Construction Telephone Number PO Box 52 Address west Dennis, MA 02670 License # e280-6964 CSL-58633 HIC-169393 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE by } FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE77 M : 1 OWNER w Ira d V DATE OF'INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL t GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ti 1d y OWNER AUTHORIZATION FORM I, It,,,IleV - 16,09Wd 2 1e (Owner'sName) owner of the property located of d e Alr7exo !/i�/ /V,4 (Property Address) (Property Address) hereby authorize (Subcontractor) i an authorized subcontractor for RISE Engineering, to aj on my behalf to obtain a building permit and to perform work on my property. Owner's na re Date CIA- /v s the Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit;Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Le gib MiKe McCarthy Name(Business/organization/Individial): PO Box 52 West Dennis, MA.02670 Address: C Il t l 280 6964 - CSL-58633 VIC-169393 City/State/Zip: Phone A��a"m employer? Check the appropriate bow Type of project re 4. I am a en p ] (required): 1. employer with� ❑ g �Tractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have, g. E]Demolition working for me in any capacity. employees and have workers' comp. t 9. El Building addition [No workers'comp. mcr„-once P- �- 1equued-] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.0 goof repairs insurance required.]t c. 152, §1(4),and we have no I3. trier employees. [No workers' comp.insurance required.] *Any applicant that chccks box#1 must also fill out the section below showing their workors'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such. �Contracturs that check this box must attached an additional sheet showing the name of the sub-=tr actars and state whether or not those entities have employees. I:f the sub-contractors have employees,they mast provide their workers'comp.policy number. X am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information.Insurance Company Name: AV-1 Policy#or Self-ins.Lic.#: �t,tl�-�s,-col�76C'�I Expiration Date- lob Site Address: S /'ors.. 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$1,50-0.00 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 r insurance coverage verification. Xdo hereby certify t p andpenalties ofperjury that the information provided above is true and correct: Si ature: Date: r / 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 CIerk 4.EIectrical Inspector 5.PIuarbing Inspector 6.Other Contact Person: Phone#: Massachusetts -Department of Public Safety Board of Building Regulations-and Standards Construction Supervisor License: CS-058633 ,/ e MICHAEL J MCcAR PO BOX 52 W DENNIs MA 62670 'F s• Expiration Commissioner 04/10/2016 _ Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 r -Boston, Massachusetts 0211.E Home Improvement Contractor Registration Registration: =169393 Type: Individual Expiration: 6/16/201.5 Tr# 238121 MICHAEL MCCARTHY _ MICHAEL MCCARTHY P.O. BOX 52 WEST DENNI 0267 Update Address and return card.Mark reason for change. SCA 1 CS 20M-05/11 Address Renewal Employment Q Lost Card i acoRL7�• CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DO/YYYY)� J. 10/16/2013 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 01962-001 5R�JACT Bryden&Sullivan Ins Agcy of Dennis Inc PnH/C.No.E,t): (508)398-6060 �iuc,No-. (508)394-2267 PO Box 1497 EMAIL ---- - ---- -. _ . So Dennis,MA 02660 ADDREss: .NAIL - _L(N%48ERA A.I.M.Mutual Insurance Company 33758 - -- . _- - -- - -- - - - - - . INSURED Michael McCarthy Construction Inc UNI P 0 Box 52 West Dennis,MA02670 INgIIgEfiD 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 CONDITICNS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR! - "-"" TYPE OF INSURANCE iANSPR WUVD I POLICY NUMBER i MM/00/YYYY TMM DO/Yl YY) --- -- - LIMITS - - - - ---- _ I 1 1_! -- - - ---- _ GENERAL LIABILITY ! ! EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY I. I DAMAGE TO RENTED F$ rP3F[vllSF . I CLAIMS-MADE I OCCUR I MED EXP(Any one person) $ R ! $ GE GREGA ERY $ ONAL& NERAL AG ... ... ...___._.... ._..._..- __r ; .. I— ------------ -------- ------ . GEN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS-COMP/OP AGG $ POLICY PRO- JE.CT LOC I L_ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT -.. i I a accede _ ANY I AUTOS TO Iaccident)1$ BODILYL.. NJ ALL OWNED AUTOS I SCHEDULED BODILY INJURY(Per !HIRED AUTOS 'NON-OWNED !PROPERTY DAMAGE ; $ AUTOS ; l.(Per accidenO...._.. — ' 1 I $ UMBRELLA LIAR j OCCUR TEACH OCCURRENCE $ --- - -- - EXCESS LIAB CLAIMS MADE !AGGREGATE I $ DED RETENTION $ ANDELOYE�R��L IX _MP IABLITY yy/mi 'AVIcgM EL CH ACCIDENT o R ER —$ - --.-- XECUTIVE 5QQ X F U E�?A Y. .IN/AI QQQ;QQ VWC=100-6017656-2013A 17/17/2013 7/17/2014 I" -- -- — ---- ---- - (MandatorylnNH) -I I �ELDISEASE-EAEMPLOYEE $ 500,000.I)0 IDflfl dd ��pp ddeett _ lYSSCRII �(ON�F OPERATIONS — ---r- -----— below ( I 1— �,F L DISEASE POLICY LIMRT$ 500,000.00 ! _. — — L....... ........... DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION TOWN OF SANDWICH' Attention: BLDG DEPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED'BEFORE TOWN HALL ANNEX THE. EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED'IN Sandwich;MA 02563 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE - 7HEro�°� TOWN OF Br RNSTABLE i • i BAHBSTADLE, i "6 9 o w Pk,Y BUILDING INSPECTOR a' APPLICATION FOR PERMIT TO .... ........ '. ............. ......................... TYPE OF CONSTRUCTION S /� v�.`?', ......��`'"" . `0`...... - `.:............................................ � ssue�►► ! ........ . ...`.. '�..........19..70 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: a Location ... ��'�0✓ - �.�.. Proposed Use .... ........................................................................................................................................................... Zoning District Fire Distric4_ "`'` i � ........................................................................ ................. ......................................... 94 Name of Owner :....". /?! 0.� rAddress c � l/�it. . ........... ��� . .... • R P Name of Builder .......... ' IS !rld .....'... .... . .............Address �Y�. ...0 rJ�C�oar,�.. / ., ..... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..............................................Foundation ..... ``'!` ...... ✓ ............................ Exterior ...............................J """"........................................Roofing .... ...... ..................................... ................... Floors !" ... ............................................Interior . ..... ................................. l Heating ................... .....................................................Plumbing ..........+� Fireplace ....... ..............................................................Approximate Cost- � ©� Difinitive Plan Approved by Planning Board ________________________________19________. Diagram of Lot and Building with Dimensions o d L'a ¢ Li.. U7 m IUD F� N z V) U) D� •� kQ�il +• L(-)� flpI Z W m O F �LWo �z0`IzF PIA6e Ocn �� LL � � cc a <La L z� I Clf ��1'Y x a I w t-. w !_CL �- Z ¢ C ,f I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above .construction. _ 4?� Name ....`... e A Luzietti, Seth A. Timothy R. 31 19�1 No .... Permit for .,, one sto....ry... ......... single family dwelling ............................................................................... - Location ia(Aurora Avenue ......................................................... Centerville ................................:............................................... Owner .., Seth A. & Timothy R. Luzietti ................................................ Type of Construction frame .......................... ................................................................................ Plot ............................ Lot ........ :0................. Permit Granted ...... i q 70 Date of Inspection ...... 1979) Date Completed ......................................19 r PERMIT REFUSED ............................ ,,�................ 19 ..................A.i...........�. .u: ..�.................................. J ................................................................................ f ............................................................................... i •- ............................................................................... Approved ................................................. 19 ............................................................................... r ...............................................................................