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(3rd floor) Map Parcel LLirmit# House# 42Cd Date Issued r 9!O Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) as n Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) Pla ldg.) 6 efiniti d 19 `�� y �, �<e'�A4wSTABLE M r sb39•st' 1 V '•� _• !g TOWN OF BARNSTABLE Building Permit Application ject Str et Address Owner b ��n—V_ Address Telephone al_2A Permit Request First Floor square feet Second Floor square feet Construction Type Wj 4•2 Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family $j Two Family ❑ Multi-Family(#units) Age of Existing Structure�,r 5• Historic House ❑Yes C&No On Old King's Highway ❑Yes ANo Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing _ New_� Half. Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas Zd Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name e9lde r-S ,�� er Telephone Number J Z., 7 7 Address 2 � � L ld2.4 tv ���,L�.,G S License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO &g�_5 p- �2 4' SIGNATURE DATE -,2"/3 BUILDING PERMIT DENIED FOR HE FOLLOWING REASON(S) I . , _ ,. . � . . �, � �.,. S .� .,,' ._ � •' . � f _.. F,.__._...__ ._.....,.._ •. t; _ �. . �_ _ � _ . .� .. '� _. � �._ _ _ _ _____._ _ s . _ _ p � i EAVE SPACE EWALL-4'-9"HIGH 24'-11 1/2" 11'-9 3/4" PLAYROOM/OFFICE f3'-10 3/4" 0 . K STORAGE BA TH CLOSET EA SPA CE E S C MR AND MRS.JOHN V.SMITH a9. c 461 BAY LANE 11lCENTERVILLE,MA. PLAYROOM/OFFICEADDIIION x. Pew @]C 2@I'S - � wwxmron P.F.C. 7/20/96 1/4"=1'-0" Al 4y oFT►�roly Town of Barnstable �CrIC�I�Q? �' *Pcriuit 11 • Lapin,C renlUhs front uxuc ddic •. D&"SrAL1Lr_ Regulatory Services �.MASS, Fee o 143q. Thomas r. Gciler, Director A. E PERMIT Building Divisiozi. _` I13)11 Tom Perry,C130, Building Coillruissioucr_ _.. � 2 9 i; 200 Main Slrect, Hyannis, MA 02601 www.Lown.barnstab leama_us Office: 50&18q-,403 8NOF RA.RN r . FIX: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL,ONI.,Y Not Yalirl ivillioul Itcd X-Prd.y Irnpriuf. Map/parcel Numbers y l Property Address vX+ eaesidential Value of Work � �. � � �`�`� Mill imuuL'fec'of$25.00 for work under$6000.00 Owner's Name&Address 14ry' Contractor's Name Telephone Number�Y��u�J Home Improvement Contractor Licdnsc It(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: I am a sole proprietor Eam the Homeowner t -111have Worker's,Compcnsation Insurance Insurance Company Name Workman's Comp.Policy It 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 Rc-roof{not stripping. Going over existing layers of roof) IZo-side ❑ Replacement Windows. U-Value (maximum.44) •Where rcyuired: Issuance of this perrtiit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Honic provement Contractors License is.rcquircd. .SIGNATURE; Q:Foims:cxpmtrg Rcvisc071405 i - i The Commonwealth of Massachusetts Page 1.0 of 10 Department of Industrial Accidents, f Office of Investigations t ill P1 600 Washington Street Boston,MA 02111 r www.rnassgov/dia v Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lep_ibly (� L S C2Zeav1 - e Sons I-�oo-t-tn� UNL Name (Business/Organization/individual): 1 A tJ Address:�0'� City/State/Zip:��� � •P r'U SS Phone#: So -11 -1-1 Are you an employer?Check the appropriate box: Type of project(required):. I am a employer with 4. Q I am a general contractor.and I 6. []New construction., employees(full and/or part-time).* have hired the sub-contractors listed on the attached sheet i ❑Remodeling 2.❑ I am a sole proprietor or partner- _ , ship and have no employees These sub-contractors have 8. E]Demolition working for me in any capacity. workers''comp.insurance. 9. 0 Building addition [No workers' comp.insurance 5. We are a corporation and its 10:0 Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 1 I.❑Plumbing repairs or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.R Roof repairs insurance employees.required.]t loyees.[No workers' - 13.0 Other comp.insurance required.] 'Any applicant that checks box#I 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 anew affidavit indicating such. tContractors 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:. &411 4 z d i ew 1. !'f�' Policy#or Self-ins.Lic.#: t(1C' - i1 h 1- Zi2> �� 97. Expiration Date: / Job Site Address: City/State/Zip: l Attach a copy of the workers' com ensation 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 certify under the pains and penalties'of perjury that the information provided above is true and correct . Signature. Date: /- Phone# 66g 2-5 - U—1 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#: 91te Office of Consumer Affairs and usiness Regulation 10 Park Plaza - Suite 5170 Boston, Massao. etts 02116 Horne Improvement 6" for Registration `! Registration: 103714 �= 71 Type: Private Corporation r-`�' Expiration: 7/9l2012 Tr# 297676 PAUL J. CAZEAULT &. SONS, IN Paul Cazeaultci 1031 MAIN ST / OSTERVILLE, MA 02658 Al`lam' Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card )PS-CA1 is 50M-W04-G101216 ✓/Z¢ 'E007Y/mNYI2lIICU�CiL ,Q✓l�Gl.LddCLCIiUbC/.�b �OSrO ----'�' License or registration valid for individul use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: � HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation y Registration �1:03714 Type: 10 Park Plaza-Suite 5170 Expiration 7C9i012 Private Corporation Boston,MA 02116 � PA L J.CAZEAULIf 'v l° f Paul Cazeaultc� 3 = d : , � 1031 MAIN ST <N t;' � f e OSTERVILLE,MA 026$$_ Undersecretary Not valid without signs w N z .�—..n-��_ ���C''Fx-'��.,.�-�a""f '''��1'_,,z.�. -.-�^r�f i to - r -�w� 3 �T:,•-r.,..� -rr�-'� -��,v.sc - '� �-ci�.���` � +� '� - r NOW 'L i- -� 8-,s..y's� �a�r'�a�S�' �a � �-�._...._ _ zi �1�.f1ti1EkIt1E.t1ti � [f�YRFnf:IFtC)t ]'lflhlif( `'f f"o�-- y,c 4 j O.Ir Qt BU7�( 461a 1aslYlalll(?rl CFRI tan. aCEC1S g. CQriltrtrCan SUQeCFSO1 �._ � s _sus' .r-.. '*'Tr RK a' -=„s.." ".s�"4-'. "_ �--�-'�-�- ., :� NN . RPSeCQ 00 x,s- s.�.:z-1 .�.�.-r Diu "'"�a - ` PH ,� 'T"`> ''`ram, ..�+� - '' {lz .,.� ^c�Y-: # *a.. ^`, F� tyresf rs � � 35 �s s , Taco _ t�'r WNW �r��-t �t.•"�x��z�°5: s s �-�� �--rz- � �?',.� � �� X s�i` , `r` '�`t,.`�y, T.t�`-----a P ''`�O I;L NE 0 a,.-�g a. �1-,,,w„ s� � � �•,�„ @-I'�-��C+�,� �•y�„ ,�,�- �.r� "`�' -rn r.a,tr..-, 7 v- ,+ n 5 ...:sc'�'` --- �, y 6 E?V.' MA aZ655 v ,, _ t jam. -.. n. - r ""_. ,-. v _ xS F 4 --�. F "r;4 r ..,�ry a. L � _ ,c..-��-- r•- , ���_f Z. �rMUM ^ `rFkp[r3tf0'R' r =s 1 f omnFi.�nxtrr 3 ern �0$$� - a ° 4 a -�. - .-�iz r' 'v.'c,-7 .b "fs't F �" x 3$IN R s Kz� -:t �.c a,-cf}� x 41. ON c .,s x ti t}a E ti e.-r '� .� �ti v .' h - X --r, •., y , .yam d x3 ,,+r -F �- 'a` s y _ s "" ^'K _' x,b„ '.7 }`i. !Julrf s =4 _t a Client*.19989 2CAZEAULTPA ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE(0 0 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE' Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 973 lyannough Rd., PO Box 1990 ALTER THE COVERAGE AFFORDED BY THE POLICIES BEL6W. Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIL# INSURED Paul J.Cazeault&Sons,Inc. INSURER A: First Mercury Insurance Company 1031 Main Street INSURER B: National Union Fire Insurance C Osterville,MA 02655 INSURER c: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANCIING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR 1 MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN 0 POLICY EFFECTIVE POLICY EXPIRATION " LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/Y LIMITS A GENERAL LIABILITY FMMA0027012 04/30/10 04/30/11 EACH OCCURRENCE $1 000 0100 X COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED $50 000 MSE occu CLAIMS MADE a OCCUR PRE t.MED�EXP(Arry'one person) $0 X BUPD Ded:2.500 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRODUCTS-COMP/OP AGG $7 000 O00 PE O- LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ (Ea accident) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) HIRED AUTOS NON-OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident). GARAGE LIABILITY '. AUTO ONLY EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: qGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE DEDUCTIBLE � - RETENTION $ $ B WORKERS COMPENSATION AND $ EMPLOYERS,w►Blurr WC003603096 08/10/10 08/10/11 X we sraTu- oTH- ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500 000!. OFFICER/MEMBER EXCLUDED? - NO If Yes,describe under E.L.DISEASE-EA EMPLOYE S500 000 SPECIAL PROVISIONS below OTHER E.L.DISEASE-POLICY LIMIT $500,000 -bESCRIPTION OF OPERATIONS/LOCATIONS-fVEHICLESI E7FCLUSIONSADDED BYENDORSEMEHTt.SPECYgL PROVISIONS -77777777777777 Operations per#ormed by the named Insured subtect to polrc cortdttrons s xclusions CERTIFICATE HOLDER 7- CANCELLATION. _ SHOULD ANY OF THE ABOVE DESCRIBED POIJCIES BE--CAN BEFORE_TFIE E7(PII�tAF10N PaW:J.Cazeault&.SCI1S DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR.TO MAIL Roofing,lnc. 11-1 _ DAYS WR[7TEN _ NOTICE TO -37 THE CERTIFICATE HOLDER NAMED;To THE LEFT BUT FAILURE TG DO SO SIHACI 1031 Main:Street y IMPOSE NO OBLIGATION OR LUIBILITY OF ANY IOND UPON:THE.INSURER,.ITSsAGENT$✓'JR Ostervllle MA 02655 REFtRESENTATIVEs.. AUTHORIZED REPRESENTATME ACORD 25(2001108):1 Of Z. 729 ��i✓f....�rG - #571.730/M71. LS1 O..ACORD CORPORATIdN'1988 _ Property Owner Must Complete & Sign This Form If lasing a Roofer 1 Builder. i 1 (print) as Owner / Agent of the subject property hereby authorizes Paul J. Cazeault & Sons Roofing Inc. to act on my behalf, in all matters relative to work authorized by this building permit application for. Address of Job Z/X/ 41 Zit 4/�e VI/6 Signature of Owner Mailing Address of Owner Y�9 /t/L a�3z Telephone# 77f yyQ,Z Date ,f 2V10 (Please return this form to Cazeault roofing along with your signed contract; It is needed for us to obtain the building permit required.by your town, to complete your roofing project, thank you) fax#508-420-4555 r+E , The Town of Barnstable . . . . H ma Department of Health Safety and Environmental Services 6�. Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-790-6227 Building Commissioner Fax: 508-790-6230 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work• Est.Costd � 6 Address of Work: Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN DEALING PERMIT OR HOME DWRO MENT WORK DORNOT HAVE CONTRACTORS FOR APPLICABLE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the a of the owner. -3 me Registration No. Date Contractor OR The Commonwealth ofjlflassachuse& IJ , i Department of Industrial Accidents ` • ' _.. � = � �ceo�/m�esagg�eirs - . 600 Washington Street Boston,Mass 02111 Workers'Compensation Insurance Affidavit I ;lip ate: 19G11ion• wit phone it ❑, I am a homeowner performing all work myself. I am a sole proprietor and have no one working In any capacity ❑ I am an employer providing workers'compensation for my cmployexs working on this job. I:Q an n L_ ��-: ��(L-U L. /c '�•. .. �:'tom•— t : . insurance ce: polieV N •• • ' .. ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers'compensation polices: rS1tnD8nv natal:_ a ddrscs:. ally: instarince co. �0 1EX In Ian name city :. .. :ph�lf g•• insurance ce. .. SHE I Failure to secure coverage as required anger Section 15A of MGI.152 can leaf to the imposition of eritoinal penalties ota fiat up to$1,500.00 and/or one years'imprisonment as wall as civil penalties in the furm of a STOP WORK ORDER dad a fine of$100.00 a day against me. t understand that a cotry Of this statement may be forwarded to the 0171ee of Investigations of the DJA for covemge verification. I do iacirhy ccrtiJ' •the yams an pe>aaltt¢s ofperjrary That the iafarmafi0n provided above is era,a,d cvnw. Sign", r-7 ff Print name Phone 0 f. 7 Ccheck only do not wnie in this area to be completed by city or town cincitll , permilAiccnnc M Building Department ❑4ittnsiog iitaard mmediate response is required 0Cclectmen's Office ®Health neparimcnt uo: phoseR; r•tOther J freviied lro5 Plm NOTICE OF ASSIGNMENT I37.324 :MPLOYER: ' L 0'CE., C A P U I L 0'EIR S I lN C BUREAU FILE NUMBER STATUS OF EMPLOYE' E­ P u, e u X 529 251253Y C r)RP 0 R A T 10N 14 ARW 1 CIA HA 0264-5-0000 ADDITIONAL INSTRUCTIONS COVERAGE UNUER THIS ASSIGiNW& THE WAIVER OF .0U.R.:.R.I.GHT TO RECL -E,R FRO.M - APPLIES TO MA. OPERATI.,ONS F —X;'.JCjR.SEMENFT IS AVAILAE,LE ON POOL -RAGE OUTSIDE 3THERS C L: UNI-Ya, FOR COVE ?- p OL I Cl E 3 CIDN'TACT Af,-,EEN'T FOR DETAILS, OF MA. , APPLY T,3 APPROPRIATE POOL OR PLAN* AGENT ELDFIEDGE L LUMPKIN INS AGCY INC INSURANCE COMPANY: OR HARWTCH IF PLAZA AIM MUTUAL INS CO PRODUCER: RTF 39 137 MS. JUDITH BARRY PUL PROD HARWICH MA 02645-0000 11 NORTH AVENUE BURLINGTON MA 11303-9-10 (800) 97,6-2765 TAX IDENTIFICATION NUMBER: ,-14-279-719,55 CLASS ESTIMATED CLASSIFICATION OF OPERATION TOTAL ANNUAL RATE ESTIMATED CODE REMUNERATION PREMIUM CARPENTRY—NICIC 5403 22082 CARPENTRY—DIETACHED PRIVATE RESIDENCES 5645 100,400 15.25 151311� CARP Lf':-'NTPY—DlWlELLiNG'S-3 STORIES OR LESS 5651 I5.215 EMPLOYER.S 1.140111-LITY 100/100/500 9,145 STANDARD 'r*'R,1:;ll,rl,),M 15, 311 EXPE'NS7 CONSTANT 0900 19 0 ESTIMATED ANNUAL PREMIUM 15,?50'1 DIA ASSESSMENT '�.2`.l OF STANOARO) PREMIUM 643 .EST. AIINUAL PREMIUI-M PLUS ASSESSME"'INT 1,5, 144 AUDIT BASIS 4l`iI' UAL REQUIRED DEPOSIT PREMIUM � I6' 14�. COMMENTS CJVERAGE EFIFfE-CTIVE, 12,01 A*t4,s ON 07/17/96 'WITH A30VE I INSURANCE COMPANY* DATE OFNOTICE 07/17/915' PREPARED BY ESTER TRINTOAD E M I"L 0 Y EIR COPY THE WORKERS'COMPENSATION INSURANCE PLAN OF MASSACHUSETTS r 2X8 PLAYROOM/OFFICE BATH 2X6 LJ 2X I 0 SECTION MR.AND MRS.JOHN V.SMITH 461 BAY LANE CENTERVILLE,MA. PL&MOM/OEEKE AppracN � � BBAYm&L" 2Q'{S' ESAIe$ DMWQID• .:. .. lle3 /,z,-� -C�r/ �aa r r DATE MM/DD [ .:::. I.:: I BIL ::L::::::.E .. :. :. :::.:::::::::::::::::::::::::::::::: : :.::::.:: ...............:............::::::::::::::::.:::: 07131196 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Eldredge & Lumpkin Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 697 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Chatham MA 02633 COMPANIES AFFORDING COVERAGE COMPANY -- —- A Northern Assurance'Compan INSURED COMPANY Olde Cape Builders,lnc. B PO Bo: 529 COMPANY Harwich MA 02645 C COMPANY D t~Y#1lEAAY3 .. ............................................::: ...... ..... ««.:<.: 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMBS LTA (MM/DD/YY) DATE (MM/DD/YY) A GENERAL LIABILITY NBF824444 1 07/10/96 . 07/10/97 GENERAL AGGREGATE $ 2,000,000 x COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 1,000,000 CLAIMS MADE F x1 OCCUR PERSONAL&ADV INJURY $ 1,000,000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE(Any one fire) $ 100,000 MED EXP(Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ t HIRED AUTOS i ! BODILY INJURY $ NON-OWNED AUTOS f_ - _ (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND WC STATU- OTH EMPLOYERS'LIABILITY EL EACH ACCIDENT $ THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ PARTNERSiEXECUTIVEF1 OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONSrLOCATIONSNEHICLES/SPECIAL ITEMS CARPENTRY -ER L . ....... CAI ICEfit7[O1V'. > >< > > SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE TOWN OF BARNSTABLE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL CIO BUILDING INSPECTOR 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 367 MAIN ST. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY HYANNIS MA 02601 OF ANY KIND UPON THE COMPANY,IT ENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE DONNA L. DROWN 14 . C0 ... CORD>COAIx4F1 BO TOWN OF BARNSTABLE BUILDING DEPARTMENT _ »iIT TOWN OFFICE BUILDING MARL HYANNIS, MASS. 02601 Ml MO TO<;_Town Clerk FROM: /Building, Department DATE: lQ ;?j YZ. An Occupancy Permit has been/issued for the building authorized by BuildingPermit #.......»:� �»© !»»»...»........................................ ..............................._.».. ................._......._........».».... .»......»»»». issued to ',�/ Please release the performance bond. COUECTED COPY 7/16/93 JMf TOWN OF BARNSTABLE Permit No. . 30306 BUILDING DEPARTMENT I """ I TOWN OFFICE BUILDING Cash � Ml 6J V. �'�ra,urk HYANNIS.MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY a Issued to SILVIA & SILVIA ASSOCIATES Address lot E 463 Bay Lana, Centerville USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. !; ..... June 26...... ..... 19.....92........ .... ee�-� : tf, C uildin In ! ' B g Inspector r o TOWN�OF BARN$TABLE, MASSACHUSETTS BUILDING' ' PERMIT DATE `.';: '1_•' 19 <` _' RMIT APPLICANT _ - _... . ADDRESS 1V i RE 67 fo3_L FC EN S E) NUMBER OF PERMIT TO = • - - ' O STORY - _•1 - DWELLING UNITS t u('T�'PFOF' R)'PR+OVetNf-NTIJ ''NO-. °•�- °:�•�('PROPOS'E-'D1USfl,; 1J'.b�:.ilic;'•_ I ZONING AT (LOCATION) -- DISTRICT— L�T•I- NOT) D ­''(SYREE )•.' — 3 J. S• (�-1�.�;3 j; BETWEEN AND (CROSS STREET) (CROSS STREET). i LOT SUBDIVISION LOT BLOCK SIZE j BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS ORTOUNDATION (TYPE) REMARKS: AREA OR - PERMIT VOLUME './Ul; < s i:t ESTIMATED COST $ 2 ?I: e cJf3O . 00, FEE (CUBIC/SQUARE FEET) - - OWNER BUILDING DEPT. ADDRESS BY t OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE { IN5PECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND 1. FOUNDATION'S OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALLNOTBE OCCUPIED UNTIL MEMBERS(READY TO LATH). (FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 �,r✓,��i 2 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT OTHER 2 BOARD OFHEALT WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. j PERMIT )S ISSUED AS NOTED ABOVE. NOTIFICATION. 4...:., .r. ,r TOWN OF BARNS..TABLE, MASSACHUSETTS BUILDING, PERIol117� TE t•y .,.�2.:^.:.i c��-b�19 _' 1�L"R M I T APPLICANT r^ n: ADDRESS , , PER 4.T TO NUMBER OF -f a L_1 STORY DW LLING UNITS +OF 'MPR9 ftl I i•1 'a J '(PROPOSE`U l!5@I.j' 11C . .r..,.;• AT (LOCATION) , M`" IISTR T Z G NOD D IC T1 F Is YR E.E 1•-.. a} 461 BETWEEN AND (CROSS STREET) .. ) - ' (CROSS ST REET'I-�` SUBDI,. .., g ..LOT VISION LOT LOT BLOCK SIZE -' t mac - BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION. �ITYPE) - REMARKS AREA OR 1 r r- PERMIT VOLUME 00 ,,(�. LLS. ESTIMATED COST $ 2 t n (CUBIC/SQUARE FEET) _ ,y •r._,, .a-. FEE OWNER y t V1' IC fti1 i V1 7 {��`c lr C y ADDRESS ' } BUILDING DEPT.' �' va s=del i.-p—C-.�. 4,•t:�-��.t--i. BY :. f f C+ OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPE'C TIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL G'ONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRI;oR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MESA l- INSPECTION TO BEFORE FINAL INSPECTION HAS BEEN MADE. i 3. FIN�AI INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ",'', ELECTRICAL INSPECTION APPROVALS T a 3 HEATING INSPECTION APPROVALS ENGINEERI DEPARTMENT a. OTHER BOARD OF HEALT a; WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HA3.'APPROVED THE VARIODUS STAGES OF EP ORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. ERMIT IS ISSUED AS NOT.ED ABOVE. NOTIFICATION. i �•' FILE NO. 85-5 o 0 i )MU3T1HL� ■YL vO 2639' 0VA-Y Order of Conditions TOWN OF BARNSTABLE WETLANDS PROTECTION BY-LAW, Ch. 3, Article XXVII FROM:'BARNSTABLE. CONSERVATION COMMISSION To Silvia and Silvia Associates, Inc. Same (Name of_Applicant) (Name of.property owner) 619 Main .Street Address Centerville, -MA 02632 Address This Order is issued and delivered as follows: ❑ by hand delivery to applicant or representative on (date) ® by certified mail, return receipt requested on fir; 1 g, 1 A85 (date) This project is located at Bay Lane :(Lot E, Beech Leaf Landing .at Scudder Bay) , Centerville Barnstable Assessor's Map # 187 Lot 3 ' The property is recorded at the Registry of Deeds in Barnstable Book 4383 Page 235, 240, 242 Certificate (if registered) Notice of Intent dated March 11, 1985 Date of Hearing March -19, 1985 This Order is issued on April 9, 1985 Findings The Barnstable Conservation Commission has reviewed the above-referenced.Notice of Intent and plans and has held a public hearing on the project. Based on the information available to the Barnstable Conservation Com- mission at this time, the Barnstable Conservation Commission has determined that the area on which the aroposed work is to be done is significant to the following interests under Article 2-7 of the Town of Barnstable by-law: ❑ Public water supply 21 Storm damage prevention XX Erosion Control ❑ Private water supply 451 Prevention of pollution )LX Wildlife 0 Ground water supply ❑ Land containing shellfish ❑ Recreational Flood control 0 Fisheries 0 Aesthetic Therefore, the Barnstable Conservation Committee lierey fin ds that the following conditions are necessary, m accordance with the Performance Standards set forth in the regulations, to protect those interests checked above. The Barnstable Conservation Committee orders that all work shall be performed in accordance with said conditions and with the Notice of Intent referenced above.To the extent that the following conditions modify or differ from the plans, specifications or other proposals submitted with the Notice of Intent, the conditions shall control GENERAL CONDITIONS 1. Failure to comply with all conditions stated herein,and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. This Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights; 3: This.Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state-or local statutes, ordinances, by-laws or regulations. 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: (a). the work is a maintenance dredging project as provided for in the Act; or (b) the time for completion has been extended to a specified date more than three years, but less than five ate and the special circumstances warranting the extended years,from the date of issuance and both that d time period are set forth in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill, containing no trash,refuse, rubbish or debris, including but not limited to lumber,bricks,plaster,wire,lath,paper,cardboard,pipe,tires,ashes,refrigerators, motor vehicles or parts of any of the foregoing. 7.. No work shall be undertaken until all administrative appeal periods from this Order have elapsed or, if such an appeal has been filed, until .all proceedings before the Department have been completed. 8. No work shall be undertaken until the Final Order has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be'noted in the Registry's Grantor Index under the name of the owner of the landupon which the proposed work is to be done. In the case of registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is to be done. The recording information shall be submitted to the RarnG v tahI e roncexat nn Commission on the form at the end of this Order prior to commencement of the work. N/A 9. A sign shall be displayed.at the site not less than two square feet or more than three square feet in size bear ing the words, "Massachusetts Department of Environmental Quality Engineering. File Number N/A 10. Where the Department of Environmental Quality Engineering is requested to.make a determination and to issue a Superseding Order,the Conservation Commission shall be a party to all agency proceedings and hear- ings before the Department. 11.' Immediately following completion, the project shall be certified to be as per these conditions and plans, in writing, to the Barnstable Conservation Commission by the project engineer who shall be registered in the state of Mass. •:12. 'Upon certification by the project engineer the applicant shall forthwith request, in writing, that a Certificate of Compliance be issued stating that the work has been satisfactorily completed. 13. Prior to any work being done at the site, all legal advertising bills incurred by the petitioner in relation to the Wetlands Hearing held on this project shall be paid. 14. The Barnstable Conservation Commission or Conservation Officer shall be notified no more than two weeks nor less than two days prior to the commencement of work, and have the authority to issue an Enforcement Order if the terms or intent of this Order are not complied with. 15. It is the applicant'"&responsibility to provide all contractors with a copy of this Order and to ensure that all workers are informed of the conditions of this Order before they begin work at the site. 16. The work shall conform to the following plans and `special conditions: PLANS: Title Dated Signed and Stamped by: On File with: Lot E Commission Preliminary Site Plan March 11, 1985 C. Frank Whiting, R.L.S. Barnstable Conservation Sewage Disposal System ' Jan. 24, 1985 Stephen Wilson, P.E. Profile Key Sheet DesignMarch 11, 1985 C. Frank 'Whiting, R.L.S. " Special Conditions (Use additional paper if necessary) 1. There shall be no stockpiling of fill or excavated material between the building and the top of the bank. 2. Prior, to the start of work at the site; a double row of staked hay bales shall be set at the work limit/lot line, and these shall be maintained throughout construction. 3. There shall be no disturbance of the site within 20 feet of the top of the bank; this area shall be maintained in its natural condition. Any areas disturbed within the 20-foot buffer shall be replanted with indigenous shrubbery planted . three to. four feet on center (rosa rugosa, bayberry, inkberry, etc.) . 4. The driveway for the residence shall be constructed of gravel or other..pervious material. 5. Dry wells shall be installed to handle roof runoff. 6. All disturbed areas shall .be revegetated immediately following completion of work at the site. No area shall be left unvegetated or unmulched for more than 60 days. 7. The site shall be inspected by the Conservation Commission in June 1986. Prior to June1, 1986, the project engineer shall stake out the limit of .the *.vegetated buffer as required by Special Condition 3, above. Any areas that.have not been re-established with indigenous vegetation within these areas shall be replanted with indigenous shrubbery prior to September 15, 1986. 8. This approval is contingent upon Board of Health approval of .the proposed on-site sewage disposal system. ...................................................................................................................................................................................... (Leave Space Blank) Y • Issued By Barnstable Conservation Commission Signatur This Order must be signed by a majority of the Conservation Commission. On this 9th day of. April 1985 before me personally appeared Gilbert Newton , to me mown to be.the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as his/her free act and deed. November 28, 1991 t"lic My commission expires The applicant,the owner,any person aggrieved by this Order,any owner of land abutting the land upon which the proposed work is to be done or any ten residents of the city or town in which such land is located are hereby notified of their right to request the Department of Environmental Quality Engineering to issue a Superseding Order.providing the request is made by certified mail or hand delivery to.the Department within ten days from the date of issuance of this.Order.A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and the applicant. Detach on Dotted Line and Submit to the Issuer of this Order-Prior to Commencement of Work_ To Barnstable Conservation Commission(Issuing Authority) PLEASE BE ADVISED THAT THE ORDER OF CONDITIONS FOR THE PROJECT AT FILE NUMBER , HAS BEEN RECORDED AT THE REGISTRY OF ON (PATE) If recorded land, the instrument number which identifies this transaction is If registered land, the document number which identifies this transaction is Signed Applicant .Assessor's mqp and lot number �� .... ��� OF T N E TO` Sewage Permit number ............. / Z HA8B9TODLE, i House number ....... : . . ��4• .�.!3 i�Js �o rAea ............. .......... p 16 9 O �D MAYo A TOWN OF BARNSTABLE Y-� BUILDING P G INSPECTOR APPLICATION FOR PERMIT TO ... / !.$.1°:......... �fl .lk�............................................................................ TYPE OF CONSTRUCTION ..........��% /? ....... tF'' !i'1i ................................................................................. ..................... .. /?......... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...1C� .-4* �. , � .......... . y............................................................................................................ ProposedUse .... ll ........... .... ........../................................................................................................................... ZoningDistrict ..................................................Fire District ..d............................................................. Name of Owner .cc.....Address lr/.f ../j ....... ElvEC.v.......1�..... Nameof Builder. ....................................................................Address .................................................................................... Nameof Architect .................................6................................Address .................................................................................... Number of Rooms Y..............................................................Foundation ..G .�iJ.........C..-P'VX '.Ck.A........................... Exterior ... .o.a................................................................Roofing .. ,I .f./!...................................................... FloorsQ..4�.A..................................................................Interior ,S�--E 1i5.o.Gr,.Z�........................... Heating Plumbing .C1..4.............CO C- Fireplace .......... ..�.................................... .............................Approximate Cost ' <*-Definitive Plan Approved by Planning Board __ ___,l �___________19__SCE. Area /� � ........... Diagram of Lot and Building with Dimensions // Fee .......l. .. ............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH 6eW�, 2 R", OCCUPANCY 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 .. ...... ................................................................. SILVIA & SILVILA ASSOC. Noy•.3 O M0 6 . Permit for ...S.t.or.v............. lli ................ .. . . .. .Y......Dwe .............ag............. Locbfibn .......... .....�W.... Cent8rville .................................................... . ................ Owner ........S.i.lv.i.a...&...S.i.l.v.i.a..As s o.q., . .. .. .... .. .. .. .. .. . .. .. .. ........... Type of Construction ........F.ram.e..................... .. ....... .. ................................................................................ Plot ............................ Lot ................................ 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