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No: CS-084358 Address: Swansea, MA 02777 Applicant Phone: (508) 567-4109 (Home)Owner's Name: RAMOS, BETH L& OSVALDO P a Phone: (508)292-5420 (Home)Owner's Address: 86 AUTUMN DRIVE, CENTERVILLE,MA 02632 m � Work Description: Insulation& Air Sealing p tp srx+ 00 Total Value Of Work To Be Performed: $7,174.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that 1 will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers'. Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he'files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Carl Rebello 1/11/2018 (508)567-4109 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $7,174.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $86.59 1/11/2018 $36.59 Paypal Paypal Total Permit Fee Paid: $86.59 M v__...._1/11/2018 $50.00 Paypal._. Paypal THIS IS N©T A PRIVIIT � { Town of Barnstable *Permit# Expires 6 mo {hs from issue date Regulatory Services Fee ® F Thomas F.Geiler,Director Building Division . MAR 2 12007 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA.02601 b FASLE 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 r Property Address tqc a tum rt a., [Residential Value of Work Z 600, Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address &A A m o 5 X ufu w.a 0r <f e n f eP��Ile /1/X o,��3•Z Contractor's NameT f A e me DeacT At dame e Telephone Number " 5���� 9(,o cl y: Home Improvement Contractor License#(if applicable) fad 922 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner . []-I have Worker's Compensation Insurance Insurance Company Name Ale 02 s ,r e h _ G o Workman's Comp.Policy#_ a 7a i a 08 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders. U-Value i 3 (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: 24 Q:Forms:expmtrg Danya Mahot 7743230034 p• 4 HOME IMPROVEMENT CONTRACT WON Sold,Furnished and Installed by: Branch Name: r>US�ON Date: � THD At-Home Services,Inc. d/b/a The Home Depot At-Home Services 345A Greenwood Street,Worcester,MA 01607 Branch Number: JJVQ2D 1 Job#: . Toll Free(800)657-5182; Fax:508-756-2859 Federal ID#75,2698460 ME Lie#C 02439 Rl Cont.Lie#16427 MOMN �+CTLic#565522; MA Home improvement Contractor Reg.#126893 Installation Address: <1L V(1 (e4t 'uj 0e, '" 6�M_ City State Zip P chase s: Las 4 Di its of Driver's Lie.#&Exp.Mo/Yr: Work Phone: Home Phone:v A v N7 o f0& I (5 OYA-M Home Address: <7-Nhe (If different from Installation Address) City State Zip E-mail Address(to receive updates and promotions from The Home Depot): Project Information: I/We/You ("Purchaser"), the owners of the property located at the above installation address, offer to contract with Home Depot U.S.A., Inc. ("Ho g pot") to furnish, deliver and arrange for the installation of all materials as 4 described on the attached Spec Sheet# W b 1 ,incorporated herein by reference and made a part hereof. Home Depot reserves the right to cancel this contract if, upon re4nspection of the job, Home Depot determines that it cannot perform its obligations due to a structural problem with the home,pricing errors or because work re o complete the job was not included in the Spec Sheet or Contract. DEPOSIT PAYMENT OPTIONS �U1 (Subject to fund verification and/or credit approval.) 1. Check,Cashiers Check or US Postal Service Money Order CONTRACT AMOUNT $ 7 (Made payable to The Home Depot). *LESS DEPOSIT $ 2. Credit Card*and/or other payment options-Circle One Below Visa MasterCard Discover American Express BALANCE DUE The Home Depot Home improvement Loan he Homc Depot C it Card -- ON COMPLETION $ b New Account 11 Existing Account (Hill,&HDCC ONLY) *Minimum 25%of Contract Amount due upon execution of this contract. Available Credit: }0,� (HiL&HDCC ONLY) Acct#. Fxp.Date: Name as it appears on card: Indicate Payment Method For **: *By my/our signature below,I/We agree to allow Home Depot to BALANCE DUE ON COMPLETION charg Albe ab need credit card for the deposit indicated. ry `sSrB rc Date **May be subject to Credit Approval,Fund HIL or HDCC Authorization Codes Verification and/or Credit Card Authorization -Deposit Final Pa meat Purchaser agrees that, immediately upon completion of the work, Purchaser will execute a Completion Certificate and pay any balance duc. Purchaser also agrees to be jointly and severally obligated and liable hereunder. Entire Agreement: This agreement and its attachments, including any financing agreement, contain the complete agreement between the parties and can not be amended or modified unless in writing in a separate agreement signed by both parties. NOTICE TO PURCHASER Do not sign this contract before you read it. You are entitled to a completely filled-in copy of the contract at the time you sign. Keep it to protect your rights. Do not sign a Completion Certificate before this project is complete. Law prohibits home repair contractors from requesting or accepting a Completion Certificate signed by the owner prior to the actual completion of the work to be performed under the contract. You may cancel this transaction any time prior to midnight of the third business day after the date of this contract. See Notice of Cancellation for an explanation of this right. -There will be a service charge equal to 10% of the contract 'rolect Information: I/We/You ("Purchaser"), the owners of the property located at the above installation address,offer to ontract with Home Depot U.S.A., Inc. ("Ho on to_,furnish, deliver and arrange for the installation of all materials as lesctibed on the attached Spec Sheet# W b ,incorporated herein by reference and made a part hereof. come Depot reserves the right to cancel this contract if, upon re-inspection of the job, Home Depot determines that it :annot perform its obligations due to a structural problem with the home,pricing errors or because work re o :omplete the job was not included in the Spec Sheet or Contract. DEPOSIT PAYMENT OPTIONS (Subject to fund verification and/or credit approval.)r CONTRACT AMOUNT $ ( l•, Check,Cashiers Cheek or US Postal Service Money Order y+ J �/ (Made payable to The Horne Depot). '7 *LESS DEPOSIT $ 5O 2, Credit Card*and/or other payment options-Circle One Below Visa MasterCard Discover American Express BALANCE DUE The Home Depot Home Improvement Loan a Home Depot Credit Card ON COMPLETION s 91% G New Account ,-I Existing Account (HIL&HDCC ONLY) *Minimum 25%of Contract Amount due upon nnf� Available Credit:$ flUn+� (HIL&HDCC ONLY) execution of this contract. Aeet#: p.Date: Name as it appears on card: Indicate Payment Method For 'By my/our signature below,I/We agree to allow Home Depot to BALANCE DUE ON COMPLETION": c1hargpilic ab need credit card for the deposit indicated. / O s Silgyarum Date **May be subject to Credit Approval,Fund HIL or HDCC Authorization Codes Verification and/or Credit Card Authorization Deposit Final Payment # # Purchaser agrees that, immediately upon completion of the work, Purchaser will execute a Completion Certificate and pay any aalance due. Purchaser also agrees to be jointly and severally obligated and liable hereunder. Entire Agreement: This agreement and its attachments, including any financing agreement, contain the complete agreement between the parties and can not be amended or modified unless in writing in a separate agreement signed by both parties. NOTICE TO PURCHASER Do not sign this contract before you read it. You are entitled to a completely filled-in copy of the contract at the time you sign. Keep it to protect your rights. Do not sign a Completion Certificate before this project is complete. Law prohibits home repair contractors from requesting or accepting a Completion Certificate signed by the owner prior to the actual completion of the work to be performed under the contract- You may cancel this transaction any time prior to midnight of the third business day after the date of this contract See Notice of Cancellation for an explanation of this right. There will be a service charge equal to 10% of the contract amount if job is cancelled by Purchaser AFTER the third business day,but BEFORE materials are ordered.There will be a service charge equal to 25%of the contract amount if job is cancelled by Purchaser AFTER materials are ordered. BY MY/OUR SIGNATURE BELOW, I/WE AGREE TO BE BOUND BY THE TERMS OF THIS CONTRACT. I/WE ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION. BY MY/OUR SIGNATURE BELOW, IIWE UNDERSTAND THAT THE AGREEMENT 1S SUBJECT TO REVIEW OF MY/OUR CREDIT HIST RY AND 1/WE AUTHORIZE HOME DEPOT TO VERIFY AND REVIEW MY/OUR CREDIT RECORD WITH AN IN P DENT CREDIT REPORTING AGENCY AND RELEASE THEM FROM ALL LIABILITY INCURRED FRO INA#V MISSIONS OR ERRORS. SUBMITTED BY: Date: b7 -sac ACCEPTED BY: Date: Ho eowopr Date: I lomeowner NOTICE:ADDITIONAL TERMS AND CONDITIONS ARE STATED ON THE REVERSE SIDE AND ARE PART OF THIS CONTRACT , 10-24-06 C-SC White—Branch File Yellow—Customer Pink—Sales Consultant The of Massachusetts Department of Industrial Accidents Office of Investigations 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): t? E} Address: �� 5�� L� F . /L G' A 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 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 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.]t 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. ­_- $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site , information. Insurance Company Name: f' ]IS - Co Policy'#'or'Self=ins.Lic.#: '! 1 �, Expiration Date: D. Job Site Address: City/State/Zip:6411_�,// �,4 o 3.2 . ,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 a B2 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 certify under the wins and penalties of perjury that the information provided above is true and correct. Signature: Date: �.— �-.0 Phone#: r� 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#: 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 bean 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 i nt who has not produced acceptable evidence of compliance with the insurance coverage required." applicant p p P 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 ,— ...Accide..nts for.,confrmation of.insurance coverage. Also be sure to sign and to 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 ?y Please be sure that the affidavit is complete and printed legibly. The,Department has provided a space at the bottom of th&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-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia zr CERTIFICATE NUMBER _ 3 ' MARSH ������: �� F��� ������i��i�c�►�E�oF���N�U�ANG� ATL-001234410-01 PRODUCER THIS"CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS MARSH USA,INC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE hOmedepOt.Ce.fVEQUest@maPSh.COm POLICY.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE FAX(212)948-0902 AFFORDED BY THE POLICIES DESCRIBED HEREIN. ... .. 3475 PIEDMONT ROAD,SUITE 1200 ATLANTA,GA 30305 COMPANIES AFFORDING COVERAGE COMPANY 00492-THD-IPUSA-07-08 IPUSA A STEADFAST INSURANCE COMPANY INSURED COMPANY HOME DEPOT USA,INC. B ZURICH AMERICAN INSURANCE COMPANY 2455 PACES FERRY ROAD NW BUILDING C-8 COMPANY ATLANTA,GA 30339 C AMERICAN HOME ASSURANCE COMPANY. COMPANY D NEW HAMPSHIRE INS COMPANY COVERAGES, � �k�Thls certlfcate su„persetles and�replaces any prevlouslylssued celtlficate fordhe policy penod.notetl below „�2,,,THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MMIDDIYY) DATE(MMIDDIYY) A GENERAL LIABILITY OR 3757 608-02 03/01/07 03/01/08 GENERAL AGGREGATE $• 4,000,000 X COMMERCIAL GENERAL LIABILITY 'LIMITS OF POLICY ARE EXCESS' PRODUCTS-COMP/OP AGG $ 4,000,000 CLAIMS MADE OCCUR 'OF SIR:$1,000,000 PER OCC' PERSONAL&ADV INJURY $ 4,000,000 OWNER'S E CONTRACTOR'S PROT EACH OCCURRENCE $ 4,000,000 FIRE DAMAGE(Any one fire) $ 1,000,000 MED EXP(Any oneperson) $ EXCLUDED B AUTOMOBILE LIABILITY BAp2938863-04 03/01/07 03/61/08 COMBINED_ SINGLE LIMIT $ 1,000,000 X ANY AUTO ALLOWNEDAUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) " X ELF-INSURED AUTO PROPERTY DAMAGE $ PHYSICAL DAMAGE GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: Mh EACH ACCIDENT $ AGGREGATE $ A EXCESS LIABILITY IPR 3757 608-02 03/01/07 03/01/08 EACH OCCURRENCE $ 5,000,000 X UMBRELLA FORM AGGREGATE $ 5,000,000 OTHER THAN UMBRELLA FORM $ C WORKERS COMPENSATION AND 2921209(CA) 03/01/07 03/01/08 X ORYLIrn s T EMPLOYERS'LIABILITY E 2921210(FL) 03/01/07 03/01/08 EL EACH ACCIDENT $ 1,000,000 F THE PROPRIETOR/ X INCL 2921211 (AZ,ID,MD,,VA) 03/01/07 03/01/08 EL DISEASE-POLICY LIMIT $ 1,000,000 PARTNERS/EXECUTIVE 2921208 AOS D OFFICERS ARE: EXCL ( ) 03/01/07 03/01/08 EL DISEASE-EACH EMPLOYEE $ 1,000,000 C OTHER 2921213(OSI) 03/01/07 03/01/08 E WORKERS'COMPENSATION 2921212(KY,MO,NY,WI) 03/01/07 03/01/08 G TEXAS EMPLOYERS TNS-C44642086(TX) 03/01/07 03/01/08 EACH OCCURENCE 25,000,000 EXCESS LIABILITY ISIR 2,000,000 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESISPECIAL ITEMS CERTIFICA>E HOLD Ra a h F CANCEI LATION a a :.1 M .a _ _...< . ...E,.. .z. .. `..< SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL -1(1 DAYS WRITTEN NOTICE TO THE FOR EVIDENCE ONLY CERTIFICATE HOLDER NAMED HEREIN.BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR ' LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES.OR THE . ISSUER OF THIS CERTIFICATE. MARSH USA INC. BY: Mary Radaszewskl x gMM1(3102)' 01 E VALID AS OF 02/28/07 i � � s • f J (MMIDDIYY) e z�z8 07 PRooucEa - COMPANIES AFFORDING COVERAGE MARSH USA,INC. coMPANY hom edepot.certreq uest@m arsh.com FAX(212)948-0902 E _ ILLINOIS NATIONAL INSURANCE COMPANY 3475 PIEDMONT ROAD,SUITE 1200 ATLANTA,GA 30305 COMPANY F NATIONAL UNION FIRE INS CO 10 04 92-TH D-I P U SA-07-08 I P U SA INSURED COMPANY HOME DEPOT USA,INC. G ILLINOIS UNION INSURANCE CO 2455 PACES FERRY ROAD NW BUILDING C-8 ATLANTA,GA 30339 COMPANY H r ` a _�. � s 11 _ s j CERIIFICATE`HOLDER 4 .�.�`�.. .x;�..>..;,a; s�..za��.�� .i,.«•4 d.�+r.��';,:� _ram, ,w-,:,�i_,..�-,� .T�JbM MARSH USA INC.BY y Mary Radaszewskl •If 4 7 ��{� {L }!S � rn-: m -x* r €eY: xe ass^ es� as $'x•-a k' _:. r a t` `"rc. w tom°'' r eNF;.%,r,— The Home Depot ka p 6500-Series Double Hung Vinyl Window Architectural-grade, Soft Coat Low E and National Fenestration �►RatingC�ouncil® Argon Gas-filled Insulating Glass Unit ENERGY PERFORMANCE RATINGS U-Factor(U.S./I-P) Solar Heat Gain Coefficient Visible Transmittance 0.33 0.29 0.48 Manufacturer stipulates that these ratings conform to applicable NFRC procedures for determining whole product performance.NFRC ratings are determined for a fixed set of environmental conditions and a specific product size.NFRC does not recommend any product and does not warrant the suitability of any product for any specific use. ENERGY STAR' Qualified in all 50 States i ® Northern South/Central Mostly Heating Heating&Cooling North/Central ❑ Southern Heating&Cooling Mostly Cooling DP:25 Test Size:48 x 80 Test Number:05-30307.01 ,a ✓fie -Vanvnzaruuea�z o�✓l�GaaaacjiccaeCY4 �\ Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: s Registration 126893 Board of Building Regulations and Standards Expiration g/312008 One Ashburton Place Runt1301 #, �+i,� Boston,Ma.02108 Type Supplement Card =Pz,y THE Home Depot At Home_ Sery DANIEL PELOQl1INlb 'f, 3200 COBB GALL RIA PKUVY'#20 Atlantic,GA 30339 Administrator Not valid without signature Assessor's office (1st floor): Q ' �ee� c1 !qY RA MUST RE �.. � Assessor's map and lot number ...... .... ,.... ' r I - a P �.' , Q of E To�f TN SA Board of Health (3rd'floor): a. s E 5 Sewage Permit number ....asf.-.37�.:�.' ....... ........ �C{ gYggOgyp . E�V i6 �WENTAL CODE �jfl t BARNSTABLE, i Engineering Department (3rd floor): moo • rns9 House number. TOWN Yb�NS ,�la a\0i' ............:........ ............................ YP� Definitive Plan Approved-by Planning Board ---------------------------------19-------- APPLICATIONS PROCESSED,,8:30 9:30 'A.M. and' 1:00.2:00 P Mr. only w A P P R 4 V IsTO WN :OF BARNSTABLE �a a>a�mat!o Co =a `U LDIHG IHSPECTOR.i i� PUCATION FOR IT TO /' 17•l� .... X!$ :7.��G ...��u/�GLi��......... ` TYPE OF CONSTRUCTION .A10 D �i4�9mA — �a.t/c�P�i� �� e ...................................................................... .............. ...........7.^. .5 :.................:19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location /Y! A/ c ! ✓ - C,6A-11 A-2L//L 1.�' Proposed Use ..... 5!�.......cr//TN ��Ro�N► �/g3o�iE ......... .... (� ........... ...... ...... ... ........................ Zoning District ..... .,..:..J1.G.................:........... :..,..:........Fire District � fyu2c/iLL�...... Gam/ Off/�i2✓,C- ` Name of Owner �v7-V#7 /7 .„ iaR✓i LL „ „ Address ... :.:.................... Name of Builder RT�28 v✓i�� hi�G SQ S• UrclJ./✓ /D 5VIU c v s�i.cLS :Address .3............G................................./'l�JtsTd s . ............................ . . Name of Architect ..........:.......................:....:..............:'..........:Address .. ....... .................. , . Number of Rooms ........... ...... ...........................................Foundation ...CO!tlead-TL......wG.�.. .: . E x t e r i o r 4-6A-7i?/V ...................... Roofing ...`......../'h:�LT .... f•'vGG....S ` Floors ....C4..�2YW% ....... .............:..Interior ...... �2y ..... Ark .d2 t� OI L. • Heating Y..... .. ........Plumbing .r. �..: ... Fireplace .......................:.//.ice....._................ ..................Approximate Cost .....y.��,�.� .. . � .............. Are ..........f...... Diagram of Lot and Building with Dimensions m Fee ve....` ................ ... AVITIO nl Y , OCCUPANCY PERMITS REQUIRED FOR NEW, DWELLINGS A I hereby agree to conform„to•all the Rules and Regulations of the-Town -of.,Bornstable regarding the above construction. Name'.... ... ....... ................... Construction Supervisor's License d t02-6............... ............. SZMEJTEROWICZ , RICHARD 32080 Jui1d Addition , �No ,Permit for .. ° " Single Family° Dweinq:....... Location 8 ' Autumn �D eve .. ..,y... .. . .... ..... ..._...... > Q _ - t: t. �$ R char d, �5 zbmerat e: rrow.....czOwner . .�.................. Type ofC nstr Jciori ........ 'i _ . r _.Plot.. .............. Lot:......! ............... ......... 4 ' F w 'Ju1 l .. Permit Granted .............�....:�.,....:.......:19 88 � Date of Inspection "........ ... ...... .....19 ' tee Corrfileted .. , s-�r......... 19s; cv riot ti��ti r Assessor's office Ost floor): // TNe Assessor's map and lot number /� ..v..:�� .. Q�of Toy` -3oard of Health (3rd floor): ° �Sl-37 S" .. e r Sewage Permit number ........ ....................... ...................... t eAaasTsnt,t, i Engineering Department (3rd floor): °o rb 9- e� Housenumber :....................................................................... MAI a\ Definitive Plan Approved by Planning Board --------------------------------19________ . APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00.2:00 P.M. only TOWN OF BARNSTABLE / IL DING INSPECTOR 115 / APPLICATION FOR PERMIT TO .. .tOP... .... X�S /!7/G...��v�t LLB�G......................................... TYPE OF CONSTRUCTION ............. d`'D FAt9,m ........... — t 5 -FF. ...............................19......_. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location /�—V/11 Al 0/?/ ✓Li' �(Ti��� �2✓iL 1 ................................................................... ...................'...................................................................................... Proposed Use /�!7`1IiL /k1 w� Try /�^�iff?c�ril v /3ovit' Zoning District R.G Fire District Cc``?jr `�/,LJ,� 157xll ✓•LLB .................... ........ ................................................... ' Name of Owner l�.L......?� SZs�r=J i_i2o wic ............Address /�vT✓.rt.r /��2. .r/�i �2✓i L�r................. S v,rroo,v ,Nc. nT 2c v�i,vJisyi6L sQ Name of Builder l ..Address .!3a�f.-!?f'v� /v s�i.7�, e i�N,?s��vs d�.e as s, .... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ................... ...........................................Foundat�on A7GTl / [.- ....................................... � . . �ExIeriar S!����GL�S f 130A ?r Y (3/477�'di Roofing .....:. �'>���[-7 .c,,;�� GG s . ....................................................................... .......................................................................... Floors ..... �rF T...f ��` .... /� � .............................Interior !Z'?5' u/i�LL Heating i4111�?^Alp l3,/ OIL ........................................Plumbing . - ......... ...................... ....................... Fireplace �f ...............Approximate Cost�, �� p n;� ......................... . ... ........................ Area/ Diagram of Lot and Building with Dimensions Fee �!. �'� v 5 � j V t� 1 0 0LIPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name '�° Constru.etion Supervisor's License .� .ZG SZMEJT2ROWICZ , RICHARD A=168-054 No ..,32080„ Permit for .....A ild...Addition S t ..Sin g le Famil�...Dn�1.1.�Iag.............. ..... ................ .... tr Location ..... 6..:AutuTCt1?...Q'r.iS7.e.................... ' ......................Centex V 7, ..7.e............................ Owner Richard...S.z?lle.j.tQr.Qxic.z.......... Type of Construction ......FraM.e....................... ............................................................................... Plot ............................ Lot ................................ Permit Granted .......July 15, 19 88 Date of Inspection ....................................19 Date Completed ......................................19 2-- I T"E.T°�� TOWN OF BARNSTABLE i BARNSTABLjr., i 9° M6 9 - BUILDING INSPECTOR 0 MAY a• APPLICATION FOR PERMIT TO ....... ...... ........a ?......... !!�.t........................... TYPE OF CONSTRUCTION :.. �;G% ._.�-�� � /r.`e. ., - .............19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... .. a�15.. �r.. . . . ...... r��� �. .. .... .. . .. . ! � : !?,....:%��c�. ... Proposed Use _ G%�.,,.�... . . ZoningDistrict ........................................................................Fir District ............Q...................�..l.......................................... Name of Owner � . .. ®. . .. ........... ... .................Address, 1/ �,1 !� � .. ` Name of Builder �ddress ..r.�= :.�. .......�� •••......... Name of Archite +�������. .....................Address .... ..... .... ............... Number of Rooms ... ` � -Z ,e ... ....... ......Foundation .6e. ................................................ i Exterior ....... J�. 450(�. . ....... ................................Roofing , Floors �.........................................................Interior Heating .....: '........................Plumbing ...... ,,3........................................................... FireplaceA ..........................................................Approximate Cost ...... .. ..G'�r`�....................... Difinitive Plan Approved by Planning Board --------------------------------19________. Diagram of Lot and Building with Dimensions �H eoe La o � o Q -7 j V Z 1 4 G] p 0 Z 00 > d = :; � f �� M d � m LL M- O (f) ZD' U-) � w rz WSW W � �1 �✓ _ Wj J 0 � (n QQ N W W W � � © � z z adz oo / Q cwn Q cL ¢ cr z ln.1 F- Ld z o✓ Qow �' - 0 /0 J 0 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name,--� � .. ld .�.... , Hans D° � , one � No '�����—. Permit for --.—.--.�����.-- ' ...................... Autumn Drive - `"`".�"'--..^............—.........--.—.------- . ' —'--'--- .................................. \ _ . Owner ...........Hx..U,.. _______._ . -r ` ~ Typo of Construction ..................f r4mp----' ----^-----'---^'------------' | #46 Plot ............................ Lot ................................ � . . Permit Granted --Da0'. �-----.--.lA 72 � � � Date of Inspection .................................... ' � uo,* Completed .. � PERMIT REFUSED ----..._--.------------' 19 -------.—.--------.—.—.------ ^--'--^—'—'---'---~--'—~-----`'- ---..---.--.—.--------.--.—.---. � .--~...-------.--....----.~.—.....' � - � � Approved .................................................. 19 ' ----.---------.—.—.,—,—...—.—..— . � ----~--------'---'—^~—^^^^^~^'^' w � — ' ` .'n" - ,. ... '.�. -- � •ter.-..,rr+--,.�- ,n�:a+�.�.v..•-u•+.�.._ '..,LS:.- _ __ ���s«a r-Ld,+. , r z „ , + , , • e : , _ i J4L�FCLs4 FG. • -,�., ,� metro� , { ` - , „ k .,;«,,,,�y„_�,.,, aun•+ we rVawlwl:w.:!o-ffi's,•�,IX+KNi�.t.+eryyryW�9�bm„C9MrvxSz , _ • I t .. p�ltC-.. .5,G?+�'J' '.' l Ct'!•$ ,. _-:Fo:P�Yt/�,' "e + �:�. 4. - -,� mot. - u ---- - - ..--•'-- -.. ;�':� .,. - � .. • .. � Fri fir. ,,[' �j S .�' rT .. _. -�..— �! �� ".n«.r•.rn:..,wq,a..Sn•re.wav ..,..e.v, »r+.v.,,,.w4"v.�sv .�.rrw.ry -. � .: , E A IV/+N✓ /J,�erc , , 7 o _ Co� i9riT7//?���✓•_ L7/�. _ Gri7 �LU/���" fS` . t. SCALE. APPROVED BY:, r` DRAWN BY - - a 'DATE: REVISED• —�-----•-- t : 1 ` , , ' _ � .. - - `' i•' ! .i w.�- . " -DRAWING NUMBER ' „ + ,