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0007 BAY VIEW TERRACE
a �zx . r , N t , v 6 a 4� A I+. JY r, w F V � •1 F � � . a r I , x � J N I ns cec9 O� t7� �h t ' ' `1 Pam- 1oJ ¢, o�s;tg--�.ewC¢ J4Sp S,(I V SNAssacsor's Office(1st floor) Map Lot Permit# F _d. conservation Office(4th floor) Date Issued C�a�1Qt►iDevA L �.•- Board of Health(3rd floor)(8:30-9:30/;1:00-2:00)`* �' 7 ee Engineering Dept. (3rd floor) House#1' 7 69'YYi,04-- Planning Dept:(lst.floor/School Admm'Bldg.) SYSTI IiNsug Definitive.P 'Ap rove by Planning Board 19 4 M- TOWN OF:BARNSTABLE—, � .,n�A� wilding Permit A lication s Project St eet Addresses Village Owner Pwo g-/4r1 n �-.�e lr D PAYS 7'� a, Address 4� Telephone 71�-- 3� Permit Reques"t ti i ®n 7� �x 15 Y 1.'?G� DI,yELL i.y C9�- i Total 1 Story Area(include 1 story garages&decks) (eVl7 square feet Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ j ! . Zoning District le I/— I'1 Flood Plain AI/9 Water Protection All) Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use , s i fir )A 1. Proposed Use Construction Type 0 i:;-, f=-)?4 fV Commercial Residential Dwelling Type: Single Family : Two Family Multi-Family Age of Existing Structure 3 yr 5 Basement Type: Finished Historic House / Unfinished Old Kings Highway A Number of Baths / No.of Bedrooms Total Room Count(not including baths) J First Floor 1 Heat Type and Fuel dd7'4$TE��,..4 S Central Air YE-S Fireplaces — Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name RA-ti dad Telephone Number 7 7 Address 1,5- RA1 L LJ Ad l3/uC�_s License# Z a37.5� n h�� S 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 ,rT�lc1S7-,�8/ L 6 SIGNATURE DATE BUILDING PERMIT DENIED F R THE FOLLOWING REASON(S) x �l T FOR OFFICIAL USE ONLY 7 7-5 r , PERMIT NO.' _S7�d - DATE-ISSUED 1995 , MAP/PARCEL NO. ©lZ ADDRESS a_,e . VILLAGE OWNER J DATE OF INSPECTION: r G FOUNDATION . FRAME INSULATION 'FIREPLACE ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT 140 ASSOCIATION PLAN NO. _ 3Za 32 ...............................................................------------------------------------........................................................................................................................................................................................................................................................................................... ---------------------------------- .................... --------------- ......................... ........................................................................................................................................................ 8" POURED CONCRETE-WALL 16"X8" FOOTING TYPICAL U') C) ------------------------------- --------- ................................................................................. ... .........................................................................................................................------------.....................................................................................--------------------------........................................... 23 Dr. and Mrs. Paul Foraste, x 5 ;r 141 Scudder Bay Circle C'p_nteryflin Ma- FOUNDATION PLAN Date: 4/19/1 1 M Scale: Drawing:AO 32 BATH o MASTER BEDROOM WALK-IN r (`1 (1CFT- 23 (OLD MASTER BATH) OFFICE/STUDY (OLD MASTER BEDROOM Dr.and Mrs.Paul Fo . 141 Scudder Bay Cir Alla PLAN 4/19/1995 Al DeR: Scele: '"n9: Dr. and Mrs. Paul Foraste 141 Scudder Bay Circle Front Elevation Date: Scale: - Drawing: 4/19/1995 1/4"=1'-0" A-2 a_3 r Dr. and Mrs. Paul Foraste 141 Scudder Bay Circle - Rear Elevation Date Scale: Drawing: 4/19/1995 1/4'=1'-0" A_3 .: r. i , K 'l41'Scudder Bay Circlee Centerville, Ma. ;. Side Elevation Date: Scale: Drawing: 4/18„965 1,4.=1.Orr A-4 ,J 2X6 EXTERIOR.WALL 9 1/2" TJI FLOOR J01ST 8 POURED CONCRETE FOUNDATION WALL 4 CONCRETE FLOOR 16"X8" FOOTING Di. alid MIS. Plan! Fuldste 141 Scudder Bay Circle Centerville, Ma. BUILDING SECTION Date: Scale: Drawing: , . -- _ � � ; ���. �� � � .. a���� r 1 _ _ ._ � . _. _ - hi �Poc30706 Town of Barnstable *Permit# Expires 6»?ouths front issue date Regulatory Services Fee . • RAMSTAEIE,KAM i 1639. Thomas F.Geiler,Director, . :Building Division ������� PERMIT Perry,CBO, Building Commissioner, 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma:us O C T 3 — 2013 Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION =RESIDENTIAL ONLY Map/parcel Number � ' Not Valid without Red.X-Pressbaprittt TOWN OF BARNSTABLE Property Address_ �c,a V:a ,I (rre(ce Cam:. 1 e e- t p�Co3,� Residential Value of Work SOO- Minimum fee of$35.00 for work under$6000.00 Owner's Name&,Address rune e o(eLS\�,., 7 lie" t<¢.J I Q(rz�e e f �'to�g�Q,eel �\r 4 8—:)6-30 Contractor's Name qC,\'C'10.k kkr.no v - TelephoneNumber (570y� a6.!—0;1(o3 Home Improvement Contractor License#(if applicable) b 0 5 c\ Construction Supervisor's License#(if applicable). .CS ` 0-c�1 $%LS ❑Workman's Compensation Insurance Check one: Q I am a sole proprietor - ❑ I am the Homeowner I have Worker's Compensation Insurance — Insurance Company Name 1 '�o_ya l r. Workman's Comp.Policy# 1 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) El Re-roof(hurricane nailed)('stripping old shingles) All construction-debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) E Re-side #of doors ' Replacement Windows/doors/sliders U-Value o_,6 0 (maximum.35)#of windows �( 0 Smoke/Carbon Monoxide detectors 4 floor plans-marked with red Sand inspections required. Separate Electrical&Fire Permits required. *Where required:.Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note-.- Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Con"itruction Supervisors License is required. SIGNATURE: < C:\Users\decollik\AppData\L6caiUmic.osott\Windows\Temporary Internet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doc Revised 053012 , r — q` 3 ?Tie Connnontveal i of Massacliusetls t _-_ Deporimei►t oflnduslrial Accidents t Office of lnvestigatib s 600 WashingionSStreet , - i Boston,MA 02111 v►vtA:11ass govaia , Workers' Compensation Insurance Affidavit:Builders/Contra"ctors/Electricians/Flumbei-s ` . Applicant Information ( ,Please Print limbIy Name(businewftanizadonllndividwl): Rr%,,t. Address: �r4naes } City/state/Zip: 1W ,^A-,(-L. - ttA 6o15.Sj Phone 01Q --oc ad� 4 Are you an employer?Check the appropriate box: T;pe of project(required): 1. I am a employer with��0_ 4. ❑ I am a general contractor and I employees(full an dloryart-time).. a Have hired the sub-contractors & ❑Neu constriction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7.` Remodeling ship and have ao employees These sub-contractors have S. ❑Demolition working for me in any capacity. employees and have workers'.° [No workers'comp.insurance comp.insurance? 9. ❑Building addition ra . ., required] 5.❑ We are a corporation and its= 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their'. I LEI Plumbing repairs or additions right ofex lion per myself[No workers'comp. �P P iIE3 Roofrepairs, insurance required:]Y c.152,§1(4),and we have no employees.[No workers' 13.❑Other b comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below sbottiing their workers'compensation policy information. Homeowners who submit this affidnit indicating they.are doing all wotk and then lure outside contractors must submit a new sM&vtt indicating such. kontrsctors that check this box must attached sa additional sheet shorting the name of the subcontractors and state whether or not those entities have employees.If the subcontractors have employees,they must pmtdde their w orkers'.comp.policy number: ' I a a„emtploy.er that is protdrling workers'cou pensadon insurance for n;v employees. Below is the policy a„d f ob site infonnatio,a Insurance Company l\'ame: \r�v¢�\�(s ,;��a:�Ce Policy#or-Self-ins.Linc.#:_ Expiration Date-, Job Site Address: City/State/Zip:_ o�S d.-Ne'3- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date.).- Failure to secure coverage as required under 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%tiolator. Be adtYsed that a copy of this statement may be fom arded to the Office_of Investigations of the DIA for insurance coverage verification. I rho hereb certi under d a air and eitalties o e 'ury titdt the in onnation rosdrled abore'is tree mid correct y .f3 P. 0 rJ, f p Signature: Date: [7 ' Phone iicial use only. Do.r,ot mite in this area,to be completed by city or town official o wi, . .. Clty or Town PermitlLicease!# ? Issufag Authority'(ch-de one): - 1.Board of Health 2.Building Department 3.City/Tomi Clerk 4.Electrical Inspector S.plumbing Inspector 6.Other, ,. Contact Person: ..,_ Phone#• v 6 t MARVIN DESIGN GALLERY a complete win-dow.and 400r showroom by MHC Permit Authori2a`t"ion as Owner of the subject property understand that Marvin Design Gallery by MHC is a e department of Marine Lumber Qperator located at. 134 Orange ;St:, Nantucket,,MA and hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for; (Address of J . C� o� Signature of Owner Date Print Name 73 Falmouth Road Hyannis,MA 02601,j(%8)7716278'(508)771-f 279(Fax) www mawindesigngallerybymhc.com Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-091884 VINCENT J MARINO 58 LIBERTY LANE MARSTONS WETS J. �� AI ` Expiration" Commissioner 01124/2015 . -- (, � �aynzarcWeaCfi;a�./ iu�elC OffiEe of Consuu►er Afiares Busutess Regnlahon License otregrstratton valid for ndividutuse only OMB IMPROVEMEN T CdNTt2gCTOtt " fore tfr 'zprrat o Ate If found return to: be ee nd tronsumei~Affairs:attd Business Regulation f' Ruglstratt6t'�6 �9:.1 TYpe 10'P kPfaza' S f '1 ar u to 51.7t)' Bxpira 14 Supplement3ariioston,MA 02116' ` MARfNE LUMBI , ��� s UIN;MARINb: V n IVANlUCKT .; : T)ndersecretary of v fid':ivtt6out.signature 3/2013 8:36:06 AM PST (GMT-8) FROM: 100005-TO: 15087716279 Page: 2 of 2 A�" CERTIFICATE OF LIABILITY INSURANCE DATE(MMroomYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . RODUCER Risk Strategies Company Co E• Christine 15 Pacella Park Drive Suite 240 Randolph, MA 02368 PHONE (A/C.No): 781-3364445 E-MAIL ADDRESS: 0 INSURER 9 AFFORDING COVERAGE NAIC ff sk-strategies.com INSURERA: ISURED INSURERS: TraVBlerS Marine Lumber Operator, Inc. DBA Marine Lumber Co., Inc, INSURERC: 134 Orange Street INSURERD: Nantucket MA 02554 INSURERS: SURER F.• :OVERAGES CERTIFICATE NUMBER: 15686723 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. OR TYPE OF INSURANCE D S B POLICY NUMBER MM/71 UDD1YYY POLICY EXP LIMITS TR GENERAL LIABILITY 7140075780000 8/22/2012 6/30/2013 EACH OCCURRENCE $ 1000000 G TONTED SOOOO ✓ COMMERCIAL GENERAL LIABILITY MISS a occurrence CLAIMS-MADE Q OCCUR MED EXP(Any oneperson) $ 5000 PERSONAL6ADVINJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEITL AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OPAGG $ 2000000 POLICY M PRO- ✓ LOC $ AUTOMOBILE LIABILITY ADN-8739221 8/2212012 6/30/2013 aegis eetS G $ _ 1000000 ✓ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per ecaccident)� NON-OWNED PeOreed enl A G $ ✓ HIRED AUTOS ✓ 'AUTOS _. $ 7140075780000 8/22/2012 6/30/2013 UMBRELLA LIAR ✓ OCCUR EACH OCCURRENCE $ 10000 000 EXCESS LIAR CLAIMS-MADE AGGREGATE S 10,000,000 DED 'RETENTION$ $ 3 WORKERS COMPENSATION YIN 6KUB0167N03512 12/18/2012 12/18/2013 TO wCsTY LLAM1S �TI AND EMPLOYERS'LIABILITY ✓ IMIT ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED9 ❑N NIA (Mandatory in NH) E.L DISEASE.EA EMPLOYEE $ 500,000 If yes,desorbe under DESCRIPTION OF OPERATIONS belbw E.L.DISEASE-POLICY LIMIT $ 600,000 IESCRIPTION OF OPERATIONS I LOCATIONS EVEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) 'ertificate Holder It additional insured where required by written contract or agreement. :ER IF CAE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Marvin Design Gallery THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Bernard Gitlin 01988-2010 ACORD CORPORATION. All rights reserved. kCORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1T NO.: 15666723 CLIENT CODE: MARIN-2 Christine Watson 3/8/201.3 8:32:36 AM Page L of 1 Town of Barnstable *permit# Regulatory Services � 6mo�fro °"e MAW Thomas F.Geiler,Director -Building Division (2� 6/l Z? Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.townbarnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERAM APPLICATION - RESIDENTIAL ONLY y� Not Valid without Red X-Press Imprint Map/parcel Number �' v Property Address( y1 ViV i-P�n/ �� r. ��r►-�-C� f V 1 - —PA- 0;9 )30 [ Residential Value of Work# i�n , /90 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address�YL l'1_ S o hie Contractor's Name -4:LSe 1- onvs&r, L C.0 _Telephone Number_ -s—oa)y�- �c.7� Home Improvement Contractor License#(if applicable)_ �Z 5 J'J ro Construction Supervisor's License#(if applicable) [71Workman's Compensation Insurance Check one: - ❑ I am a sole proprietor I am the Homeowner MAY 2 9 201Z- - I have Worker's Compensation Insurance r Insurance Company Name �A�ro+,a Qnior)- Fire lasso 11�1' nt OF BARNSTABLE' Workman's Comp.Policy C.O b cj°I 4?O(o d Copy of Insurance Compliance Certificate must accompany each permit. . Permit Reque checkbox) y Re-roof(stripping old shingles)' AU construction debris will be taken to ❑Re-roof(not stripping.. Going over existing layers of roof). Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.44)'#of windows *Where regairod: Usuanoo of this permit does not exempt compliance with other town departmad regulations,Le,Historio,Conservahlon,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is r SIGNATURE: Q:IWPFTLI TORMSIbuildirg permit form TMRESS.doC Revised 090809 - i The Con ofMassachtese#s f Dgab"ent oflndrat W,4eddentsj Offrce Oflr vaWgallons 600 Washhgzoh Sjllva Boston,MA 0211I Workers'Compensation wwu�mass'g°v/dia �—Iicant orm 'o .BailderalCoe ' IV . cftns/l'Inmbers Name(B»SiIIessJot Please P f L oa/ladividnai): G1.Se Y n Address• Ca s-Mu c-{`Co L F[Ji4=pl�07jool] lZi 1�(a4 4�b 3 5 ph�nte ; �fmyio=aemployeryift eloyer?Checkthe appropi�boon �1 4 ❑I am a general and I Type of Project(rem) j ees(full a Wor pie have hinad the amale Proprietor orpmts) listied on the 6 Q New ctuction have no employees Titase � �R�rwdeling I forme in M&contractors have �3' tY emPlOYOM and have workers'Did 8 Demolitign f comp-insmance 5 comp ios+nance t 9 [�Bti I*g addition 3. I am a hom ❑ We are a COMO�ion and its 10-11 Electrical,repairs or additions eowner doing all war$ officers have ea:ereised myself[No wor3cers'COMP. ri&of exemption Per M01 11.11 ptwabmg repairs of additions immancer elp&eij t c 152,§1(4),wd we have no 11C]Roof:epa employes [No woricets' 13, ].Other ` Y eppl&w=t5at abecks bra€I,m,s<also sn cut the secli�bctow showfag the Wig• t H who submit Ibis a�idavftallwak you policy mformatioa i ae�rs that check is box m,ffit additiaagl aheetshowi�the acme of oimdde tears=Wt submat anew affidavk indicating such empioyeea IYtbe have�n9*,ft mt F0v(h**v atkcs• end state f or aotffiose enWics bare f comp Po1ia3'nmaber. .. 1 mn�r�leper�ts�rnerkps'co o n. °a br raoce for mY¢mP1oy Below Es saePo&y mcd job sate Insu M=COmPapY Name: J70r a l ��715'U!`C$ ee (raln n j Policy#or Self-ins I ic.# W C D.( C p �-- Expiration Date: O Job Site Address: V e�V r. Attach a copy of�e wo 'wm Pogo'declaration '�n-{e r V i l (� 30�! Failure to semen co (showing the policy namber and expiration date). verage as ragvhed tmdex Sedioa 25A ofMCiL c 152_Can lead to the imposition of criminal fine up to$1,500.00 and/or ore- ear nor . Y. PrAwmerA as well as civil penalties of a Of uP to SZO-00 a day against the vMft• Be advised that a o�is the form of a S TOP WORK ORDER and a fate Investigations of the DIA for lea Covina verffication copy this moment may be forwarded to the Office of . 1 s !do hereby eer ®ofPJ►that the Ii foron rev ) ,. P �edabotieas truearrdcori�t_ . . � 2 ItOffldd � we only Do Went xnffe fit tT,7s�to bee omPle�d b3'�or totva o,�� City or town: Permit/I,iee>yse Issuing Authority(eir*one): "':Board of Health 2. Building Other Department 3.City/Towg Cie'* 4.Eleariral]inspector S.pinmbntg mr � comactoa: i Phone#: i I s AC R FMSCON-01 MOW �- CERTIFICATE OFLIABILITY INSURANCE DATE""'°°'Y" 9126/2011 PRODUCER (508)676-0309 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION viveiros Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 376 Airport Road HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fall River,MA 02720 INSURERS AFFORDING COVERAGE NAtC# INSURED Fraser Construction LLC INSURE:RA.National Union Fin:Insurance Compan P.O.BOX 18A5 INSURER 8: - Cotult,MA 02635- IIEIi c INSURERD: ,. INSURER E: COVERAGE$ 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADM IRANCE POLICY NUMBER M6MWA 161WMEMXPr f1bEi9 GENERAL UA69JTY - '- EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMI S CLAIMS MADE ❑OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE S - GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGO S POLICY F1 Spa LOC AUTOMOBILE LIABILITY COMBINED SINGLE OMIT ANY AUTO (Ee acddeM) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (P-Persan) H IREDAUTOS BODILY INJURY 110N-0W NED AUTOS (PFY axident} S PROPERTY DAMAGE $ (Per ac6denI) GARAGE UABLLnY _ - • AUTO ONLY,EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG S EXCESS I UMBRELLA LIABILITY - - ... EACH OCCURRENCE� $ . , . OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $. RETENTION $ $. WORKERS COMPENSATIONAND X WC ATU OTT+ A ANY PRommwARTNERrmcnivE LIABILITY YIN 009930601_ , 0/26/2011 9/2612012 E.L EACH ACCIDENT OFFlCERAIE7JIam E7CCLLIDED? � � (IY�daLoN to NH) - E.L DISEASE-EA EMPLOY S MYea,�desalDe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ - 500,00( - OTNER DESCRIPTION OF OPERATIONS I LOCATIOHIS I VEHICLES I EXCLLIMONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION . - - SHOULDANYOFTHEABOVE DESCRIIBED POLICIES BE CANCEILLED BEFORE THE EXPIRATION Fraser Construction,LLC DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAL 30 DAYS TVRRTEN PO Box 180 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,IUIT PAiLURE To Do So SWILL CoWit,MA 02635- IMPOSE NO OBLIGATION OR LIABILITY OF ANY IOND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 26(2009M) 01918-2009 ACORD CORPORATION. All rights reserved. The ACORD rmme and logo are mgis%md marks of ACORD. Ne Office of Consumer Affairs and: uslness Regulation 10 Park Plaza,- Suite 5170 Boston, Massach' setts 02116 Home Improvement.Cotx for Registration Registration: 112536' �? Type: DBA: Expiration: 3/23/2013 Tr# 209024 FRASER CONSTRUCTION CO. DEAN FRASER P.O. BOX 1845 COTUIT, MA 02635 ;. Update Address and return card.Mark reason for change. Address .[� Renewar Q Employment ❑ Lost Card OPS-CAI 0 50M-04104-GlOI216. - .. L� License or registration.valid for individul use only Oflice of�ooswner"�{a is�c��4es�on HOME IMPROVEMENT.CONTRACTOR before the expiration date. If found return tor: Re®lstratlon: 112536 Type: Office of Consumer Affairs and Business Regulation Explration: 3b83013 DBA 10 Park Plaza;Suite 5170 Boston,MA 02116 TF CONSTRUCTION CO. DEAN FRASER 104TWINN VIEW 1.4,NE E FALMOUTH,MA&636 Undersecretary of va I_ it ut si re r _ . Massachusetts-Depatrtment of Public'S. -ty Board of-Buildiog Regulations and Standards Conatruct6on Supervisor License License: CS 97668 ' DEAN ��R } K� . . t � } • a 104 T1A/ll .h��LI=vV��tlE: EAST RAL'NI JTI A 02536 � Expiration: WIM13 C'onunissiouor, Sr#: 46692 • Fraser Construction, LLC CONSTRUCTION P:O. Box 1845, Cotuit MA. Q635 Email: fraser_construction@verizon.net agw2mamijumm www.fraserroofing.com FAX 1-508-428-0123 508-428-2292 HICL#112536 CS#97668 WHITE CEDAR RECEIVED SIDEviTALL PROPOSAL y1�3 f�Z Date: March 29, 2012 Phone: 508-755-4636 Name: Annette Foraste Mail Address: 7 Bay View Ter. Centerville MA 02632 Job Address: Same Email: aforaste cr comcast.net FRASER CONSTRUCTION hereby proposes to perform the following services in neat, professional like manner in accordance with the manufacturer's specifications and local building codes. XXXXXWHITE CEDAR SIDEWALLxxxx Supply and Install 16" WHITE CEDAR R&R Shingles Supply and Install 30 lb Synthetic underlayment Supply and Install Galvanized. Fasteners, Stainless Steel last course Clean and Remove Debris from work area daily Price labor, nails, and.underlayment only. Shingles provided by homeowner. Price-$ 5,595.00 Initial Note: Price`includes far left section main front and back and 2 cheeks facing felt section rear. Remove corner boards and.inside corner rear bay window over deck, back right dormer corner boards. Price7$595.00 Initial�� NO MONEY DOWN NO Payment AT THE STARTbR PART WAS'TIIRII - PAYMENTS ARE DUE IMMEDIATELY AFTER JOB COMPLETION. Paynients aeeeptecl are:; CASH—CHECK—MASTER CARD.=VISA—AMERICAN EXPRESS—DISCOVER ` *Any payments not made within 30 days of completion,will be charged 1 '/z%for every.30 day the payment is late. Possible Extra = Any rotted_ or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry;rieeding rreplacement will be done and charged for as an extra at the'rate of$68.50;per hour; plus 20% mark-up materials: Any alteration or deviation from above specifications will be executed only upon written orders and will become an extra charge over and above the estimate. All agreements contingent.upon strikes, accidents or delays are beyond our control. Owner should carry - fire, tornado,.and other•necessary`insurance upon the above work: FRASER CONSTRUCTION,;,'LLC carries Work Compensation and Public Liability` Insurance on the above work, cerfificate,avdilab16 upon request. This proposal maybe withdrawn by us if not accepted,-within thirty days: DATE OF,ACCEPTANCE: Q. '.' ,HOMEOWNER FRASER CO ST CTION;4LLC a For company.use ontg,i.` Date Started: Date Completed Job estimate: Dean/Mike # of squares: Billed Material ordered Extras 5 . 'aid° z:- Available Discounts r . Atr , �f �r a t; Town of Barnstable *Permit# Expires 6 months from issue da Regulatory Services Fee ( . Y Thomas F.Geller,Director X-PRESS PERA4 Building Division /Ok7/09 C C r 2 7 2009 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTABLE 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 127 Oil Property Address 7' /"—.Lj � residential Value of Work o Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name FA aAk'c- CjPZ .c tt_,66, Telephone Number 50 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) S [AWorkman's Compensation Insurance Checl one: ❑ I am a sole proprietor ❑ I am the Homeowner 0,I have Worker's Compensation Insurance Insurance Company Name T�Yo- UC—Al C11 /1 Workman's Comp.Policy# _ v _ 3 Ll I rSli 1 j,5� —d f y Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) O-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 (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: Q:Forms:expmtrg Revise061306 ` —� The Commonwealth 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): �/L a�.� �� e L LC, Address: 0 go-x- City/State/Zip: C�jb_U�t MA- Oo'�(,3� Phone #: 560_Yag — CV P_ 90-� Are you an employer? Check the appropriate box: Type of project(required): 1;,2�_I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 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. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance. $ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.M2oof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#:U a 'y 3 Ll( M55f0 -44 -�% 3`i� '-i� .r,�x iia�iori -ma �' c Job Site Address: (d� City/State/Zip: Attach a copy of the worke ' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi hV- ndpe Ides of perjury that the information provided above is true and correct Si ature: Date: 10 ,�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 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: I RightFax C2-2 9/29/2009 5 : 35: 22 AM PAGE 2/002 Fax Server ACORD. CERTIFICATE OF INSURANCE DATE(MM\OD\YY) 09-29-09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE WISE&QUINN INS AGCY IN HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 449 PLEASANT ST ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE BROCKTON,MA 02301 COMPANY 24WCB A EIARTT,ORDGROUP INSURED COMPANY B FRASER CONSTRUCTION LLC COMPANY P.O.BOY 1845 C COTUIT,MA 02635 COMPANY D COVERAGE 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THETERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMODIYY) DATE LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL PRODUCTS-COMP/OP AGO. $ CLAIMS MADE OCCUR. PERSONAL&&ADV.INJURY $ OWNER'S&&CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY(Per Person) $ SCHEDULE AUTOS BODILY INJURY(Per Accident) $ HIRED AUTOS PROPERTY DAMAGE $ NON-OWNED AUTOS GARAGE LIABILITY ANY AUTOS AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGREGATE $ EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WORKER'S COMPENSATION AND A EMPOLYER'S LIABILITY UB-0341 M556-09 09-26-09 09-26-10 STATUTORY LIMITS X THE PROPRIETOR/ EACH ACCIDENT $ 500,000 PARTNERS/EXECUTIVE INCL DISEASE-POLICY LIMIT $ 500,000 OFFICERS ARE: X EXCL DISEASE-EACH EMPLOYEE $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THUS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE FRASER CONSTRUCTION LLC EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT PO BOX 1845 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES, COTUIT,MA 02635 AUTHORIZED REPRESENTATIVE ACORD 25-5(sres) Raman Ayer t f °T � e, 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: ReglstOACLL6�; 112536 Board of Building Regulations and Standards s t -V3/2011 Tr# 281021 One Ashburton Place Rm 1301 Types DE3,Q Boston,Ma.02108 FRASER CONSTRUCTIO N DEAN FRASER "P 104 TWINN VIEW I!�NE !l E FALMOUTH,MA 02536 ~ Administrator Not re hoar o u11 g egula ons an �an s One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement-Contractor Registration Registration: 112536 Type: DBA FRASER CONSTRUCTION CO. Expiration: 3123/2011 Tr# 281021 DEAN FRASER P.O. BOX 1845 COTUIT, MA 02635 Update Address and return card.Marls reason for change. Co 401VI-0a(08-DBSLIFORMCA108212008 AddressEj Renewal Ej Employment Lost Card L I i i Fraser {. CONSTRUCTIONMilli 1101311 Construction, LLC P.O. Box 1845, Cotuit MA. 02635 Email: fraser construction@verizon.net www.fraserroofing.com FAX 1-508-428-0123 508-428-2292 MCL#112536 CS#97668 RE-ROOFING PROPOSAL. DATE: August 19, 2009 PHONE: 508-775-4636 NAME: Annette Foraste MAIL ADDRESS: same JOB ADDRESS: 7 Bay View Ter Centerville, MA 02632 FRASER CONSTRUCTION hereby proposes to perform the following services in a neat and professional like manner and in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Supply and Install - CERTAINTEED LANDMARK /WOODSCAPE PREMIUM: Limited Lifetime Warranty, 10 year sure start protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10-year Warranty against ALGAE Containment. 10 year 110 mph wind-resistance warranty Wind warranty upgrade to 130 mph when CertainTeed starter & CertainTeed hip & ridge are used. See actual warranty for specific details and limitations. Fraser construction includes six nails in common bond area at NO additional cost. Color: PRICE- $22,800 Initial Supply and Install - CERTAINTEED LANDMARK ULTIMATE: Lifetime Warranty, 10 year sure start protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, triple-layer thickness, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 15-year Warranty against ALGAE Containment. 10 year 110 mph wind-resistance warranty, Wind warranty upgrade to 130 mph when CertainTeed starter & CertainTeed hip & ridge are used. See actual warranty for specific details and limitations. Fraser construction includes six nails in common bond area at NO additional cost. Color: � '�Z V *�RICE- $24,800 Initial.\�V_ _ ULTIMATE Shingle price includes copper valleys Both prices include: Copper cricket at family room/main house lower section of valley .Copper flashing between dormer and lower roof section between roof& sidewall St[RplY & Install - CertainTeed Winter - Guard: (ice & water shield) Waterproof Underlayment System (3ft. on eves and valleys, 18" on rakes, walls, and skylights) ARP21V &_ Install - Roofer's Select Underlayment Paper (as recommended by CertainTeed) Sup tAKA Install - hick's Ventilated Drip Edge or 8" Aluminum Drip Edge Sup 4 & Install -Aluminum & Neoprene Soil Pipe Flashing SuPply & Install- Shingle Vent II (as recommended by CertainTeed) Clean & Remove - Debris from work area daily. *4 Star Warranty Upgrade will be applied if proposal is signed and returned within 10 days. (see enclosed brochure) SIDW WALL: Rear upper wall (dormer) and cheek left of dormer Owner to supply shingles SIDE WALL Labor aprox 1.5sq PRICE- $495 Initial 2% Discount if paid by check immediately upon completion NO MONEY DOWN-NO Payment at the start or part way thru Payments accepted are: CASH- CHECK- MASTERCARD - VISA-AMERICAN EXPRESS *Any payments not made within 30 days of completion will be charged 1.5%for every 30 days the payment is late. Possible Extra -After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installer the Plywood over and then re-installingtheplywood. g Panels, turning the as an extra at the rate of$6.00 per panel including Materials & Labor. Thee are 6for Panels per sheet of plywood. Possible Extra -Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$60.00 per hour, plus 15% mark-up materials I� FRASER CONSTRUCTION Warranties the labJor for 12 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the Sure Start Warranty depending on the shingle that was purchased. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: Homeowner Fraser Construction, LLC I' (YOWN,.OF BARNSTABLE BUILDING PERMIT APPLICATION p Ma Farcel CE 1R � i.^= y Application# Health DivisionF. r'V V 28 Pik 3. b Conservation Division Permit# t3 2a-o(-I933 Tax Collector Date Issued 12�bl61 (>�� Treasurer iVIS{Cl >0 OD 1��1 Application Fee t Planning Dept. Permit Fee /Z3, o0 Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address I irn&zc Village' Ceti�ev- V Is H e_ Owner r rA y Pao I romAt Address 1eii l;or-rVZC1 Telephone Permit Request &hAeq Re.n & ex)6 p) a b TA .L&SAd l #►et b Square feet: 1st floor:existing proposed 2nd floor:existing / proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio QL Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structur 44 e Historic House: ❑Yes No On Old King's Highway: ❑Yes Flo Basement Type: [Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /.- 6V Number of Baths: Full:existing L, new Half:existing �_ new Number of Bedrooms: existing new Total Room Count(no/Ga aths):existing VrZzt4f new � First Floor Room Count ��OAi Heat Type and Zs' Oil ❑Electric El Other Central Air: O ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes C1 ie a D Pool:O'existing ❑new size2©x B Attached garage:®'existing ❑new size201 Zr Shed: sting ❑new sized Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION _ o Name Telephone Number�� 4k D I T Address a,en License# o ¢2.(ou l All s �► Mills In A Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION..DEBRIS RESULTINGFROM THIS PROJECT WILL BE TAKEN TO &rJ1 6 _.�_rn�n 4e".- Is Wr,3 SIGNATURE DATE it ` -L 0 FOR OFFICIAL USE ONLYI PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE 3 OWNER DATE OF INSPECTION: FOUNDATION II FRAME `y2'11�IL1��, & j� ' INSULATION �lc 1 f FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL e GAS: ROUGH FINAL I t � , FINAL BUILDING t DATE CLOSED OUT T ASSOCIATION PLAN NO. . The Commonwealth-ofMassach usetts ! Department of Industrial Accidents t• i 6 Office of Investigations 600 Washington Street Vy 1 Boston, MA 02111 { www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name (Business/Organization/Individual): j yam, Address: City/State/Zip: &' S. sfik Phone#: 3b 4,1,v 45-1g Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I a employer with 4. ❑ I am'a general contractor and I ployees(full and/or part-time).* have hired the'sub-contractors 6. ❑Ne onstruction 2. I am a sole proprietor or partner- 'listed on the attached sheet.t 7• emodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity, workers' comp;insurance, i g ❑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),andwe have no 12.❑Roof repairs insurance required.]t employees. [No workers' comp.insurance required.] 13.❑ Other 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 1Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. t am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site W or anon. [usur ce Company Name; Poli #or Self-ins.Lie.#: Expiration Dat fob ite Address: City/State/Zip: Att ch a copy of the w rkers' compensation po 'cy declaration age (showing thepolicy num er and expiratio date}. ?ail a to secure cov age as required under Sectio SA of c. 152 can lead to the imposition f criminal p allies of a . .me to$1,500.0 and/or one-year imprisonment, as s civil penalties in the form of a STOP RK ER and a fine �f up to 250.0 day against the violator. Be advised that a copy of this statement may be forwarded to the Office-of Jnvestigations of the DIA for'insurance coverage verification. IT ado hereby certify er pains nd penalties of perjury that the information provided a ve is true and correct 3i afore: Date: / 22 ?hone#: jIto Officia se only. Do not write in this area,to be completed by city or town of 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#: Informati®n and Instructions 1 . 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 d 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 applicant who has not produced acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or.Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance, If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to.the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department.of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense 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 Strut Boston,lei 02111 Tel, ##617-727-4900 W 406 or 1-8.77-MASSAFB Fax##617-727-7749 Revised 5-26-OS wwwanass.govldia I /TME p� 1VYrll VA ""AJL&laL"LyA%, Regulatory Services s " ' Thomas F.Geiler,Director Ec 19. � Building Division Tom.Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.towAbarnstable.ma.us Face: 508-862-4038 Fax: 508-190-6230 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. Q 1 Type of Work: / 1�i�0 G�'✓� k1 AC 4 6. 1, Estimated Cost !/ate 000 •v Address of Work:. 11 �� en �''�) Owner's Name:- Date of Application ki'l 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 PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE AC CESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER TIES OF PERJURY I here apply for a permit as the agent of the Dat Contractor Signature Registration No. OR Date Owner's Signature Q wpfnes.fm=-.homeaffidav I Rev: 060606 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $ 50.00 ,V Building Permit Amendment $ 25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE S square feet x$64/.sq.foot=_J�� ��2 x plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 ` >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open P orch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00=' (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25,00 Relocation/Moving $150.00 (plus above if applicable). Projcost Permit Fee . c� Rev:063004 f Table J33.1D teauttou"o Prncriptixe Packages far One and Two-Family Residential BnOdings'H=W with h=0111eb MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basernent Slab Heating/Cooling Area'C/a) U-value= R-value' ' R-vaiueo R-value? Wall Perim-w Eopmcnt Emciency' P=kLge R-value' R-value' 5701 to 6500 Heating Degree Days' Q�. 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 10 6 35AFUE T 15% 036 38 13 U N/A NIA Normal U 15% 0.46 38 19 19 10 6 Nonni V ISM 0.44 38 13 25 NIA NIA 85 AFUE W 15% 0.52 30 19 19 10 6 85 AFUE X Is% 032 38 13 23 NIA NIA Normal Y IS%. 0.42 38 19 23 N/A NIA Normal Z 18'l. 6.42 38 13 19 10 6 90 AFUE A.A Io/. 0.30 30 19 19 10 6 90AFUE 1. ADDRESS OF PROPERTY: �&u V cky / Ciri d-e,, --.v l 2.' SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: I 4. %GLAZING AREA(#3 DIVIDED BY 42): ® o S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK.US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES:. NO: q-Por=-®50303 a f a Town of Barnstable .snarraraate. Regulatory Services Thomas F. Geiler,Director Building Division Tom Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Dffice: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and � Sign RThis Section 1f Using A L77-1-1- as Owner of the subject property hereby authorize . o ��r� �ri✓ to act on my behalf, in all matters relative to work authorized by this building permit application for: ddress of Job) Signature of Owner Date Print Name Q:Forms:expmtrg Revise071405 � - ---. � ✓!e i�aramw�tiuealt! o�./Gla°°`�tic6el�`a r' BOARD OF BUILDING REGULATIONS §> icense: CONSTRUCTION SUPERVISOR: " Number "CS O42651. aHtda'ie� 0 Expires 12102I2007 Tr.no: 10650 - Restnctetl OQ r ; JOHN 32 COLUMBIA AVE. MARSTON MILLS, MA"62648 Commissioner 5 . . ✓fie.-oarr�rreaiu.�sea�i a�,,/�a�aactucaelta ( 130ardof Building Regulations aqd Stu�darcist HOME IMPROVEN ENTC TRACTOR H1 , egistratot: 1143 Ezpi ration.::0/3/2007 S � TYPe� Inds%idual. , JOHt� V IEIRA F: 32 COLUMBIA MAASTOI"�1 iLt.S,MA 02648 4uministrator p Assessor's offioe (1st floor): 0 Q!' �' 'L Assessor's map and lot number ... ... . 1wE TO Board of Health (3rd floor): 22 ,� nF- i Sewage Permit number ............ ... /�... J� —'�� Q `'UAL LED IN C0 1 � � „ . !' Z B8HIIMBLE. i Engineering Department (3rd floor): ���� �['" + ""°a House number ........................................................................ L`v".701:0NMENT�paPfl APPLICATIONS PROCESSED 8:30-9:30•A.M, and 1:00-2:00 P.M. only ��OWN REVeu�L�ll A Q'P R ° v E Tffm0SWN 'OF BARNSTABLE , %a s ble cor ervatlOA � - UILDING INSPECTOR Date J S 0eaAPPLICATION FOR PERMIT TO �v/LU oC TYPEOF CONSTRUCTION ......&.-V..4v..................................................................................................................... .......................11.3..............19 TO THE INSPECTOR OF BUILDINGS: I The undersigned hereby applies for a permit according to the following information: Location ...I/I��...,?.�v.Gi.�!. ✓..... A.y..... /{�G�� �V� Al ProposedUse .5�yl /.'v�Ct.....P.. .4R....�.................................................................................................................................... ZoningDistrict ........................................................................Fire District .....6s '............................................................. Name of Owner .14 uy '*e TDb-AS�e C F� e..l...Address I'Vl SCvdalZ't/ i4....�;/YCL. .............. ..... y/..................................... ..... ..... Name of Builder ..J`�/it!C�°l.D... .......Po� S...............:...........Address Nameof Architect .....7...........................................................Address ....T�p............................................................................ Number of Rooms `— ...........Foundation f?' .Xl.1/`� D Exterior ...l/T. ..............................................................Roofing .................................................................................... Floors .......:r^.........................................................................Interior .../ ic1Y�/J .........................................................I................ Heating . ...............................................................Plumbing Fireplace ..................................................................................Approximate Cost ....Af;�.�j U0� — . f Definitive Plan Approved by Planning Board ________________________________19-------- . Area .................. Diagram of Lot and Building with Dimensions Fee �©..................e........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH 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 , .................... Construction Supervisor's License ......................... ,.F ORASTE v Air NETTS (t�No33351 Build Swimming Pool ................. Permit for .................................... j' -Accessory to DwPl-line Location :........ Centerville....... . ................... .� . ................ . .. ,........ .................... ` Owner ..Annette trFo-ras-#e p ................................................. , � Type of Construction ....!:..Frame .................. ...................... . ......................:. . ......................... �,� Plot ............................ Lot ................................ Permit' Granted .......NUvernber....l 3,,..j 9 89 Date of, Inspection ...............................:..:.19 1 � Date Completed ..............................:.......19 Y, a A a i ' Assessor's offioe (1st floor): Q /f ✓ P1, Assessors map and lot number ... ......., . - Board of Health (3rd floor): Sewage Permit number ............., .. .................... = HA"STADLE, t Engineering Department (3rd floor): moo NAM}9, 0� House -number ,sue APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE ,//,/e;BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..�����!........! '*rv*'*;v v SGv(sv1�N� v C //l�7 . ..................................................... TYPE OF CONSTRUCTION ......13"�!.!S!.! e ................................................................................................................ ....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ✓ 6,4 /t�L� C iv / e �. ...............................................................................A......................................................................................................... Proposed Use ..Sw.� Zoning District ............Fire District l357` t Name of Owner �VC/Pf' .�...Address ..���/� JC�/od . �4.� /l�L�o ....................................................... ...... .................................................................. Ai40V Nameof Builder . . ...........................Address....... .. .. ............... ...............................................................: . Nameof Architect ...................................................................Address ........................... Number of Rooms .........Foundation Cr file Exlerior ... 0 ..........................................................................Roofing .................................................................................... Floors .Interior ... !qYG/le T.....................................................x.................. .......................................................................... ' rrmbin " Heating- ..."'.'................................ .. .......................................Plu g ......................... /q> Sao, -- Fireplace .......................................................:.......*...............?..Approximate Cost ........R........................................................... �aa Definitive Plan Approved by Planning Board ________________________________19________ . Area ..................,�..................... b Diagram of 'Lot and Building with Dimensions Fee �� ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH �j�rt�YR tie S EI tots t i 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 .Q!��f /L ...,i . r. ..... ................................... Construction Supervisor's License ............................... FORASTE, ANNETTE A=187-011 /97-0/ 1 No ..,33351 Permit for ..Build Pool Accessory to Dwelling ................................................................... Location .....141 Scudder Bay Circle ............................... Centerville ............................................................................... Owner Annette Foraste .................................................................. Type of Construction ...............:............ ............................................................................... Plot ............................ . Lot ................................ Permit Granted ......November ..1.3.,...19 89 ...................... Date of Inspection ....................................1.9 Date Completed ......................................19 F1NE TO The Town of Barnstable O„Y • BARN STABLE. • Department of Health Safety and Environmental Services t63q' `0� Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection, Location V k-\4) 6CE Permit Number . Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: --A-m�� c- ka--Ccs� o \Ik ro Please call: 508-790-6227 for reeinspection. Inspected by Date �- r k t+ c. �.f 7 SEPH D. DALuz 790-622/ Building Commissioner TELEPH0NEs)M_Xk4CyX X XXXKNX TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 September 17, 1990 V Ms. Helen D. Moloney n Ms. Myrna S. Clancy Y 30 Mallard Lane Centerville, MA 02632 --Re:, 141 Scudder Bay Circle, Centerville Dear Ms. Moloney & Ms. Clancy: This letter is to confirm our telephone conversation re the Fbraste property 10(oated at 141. Scudder Bay Circle, Centerville. As I mentioned to you, I have no jurisdiction over leaves and brush. You should notify the Board of Health or the Centerville-Osterville-Marstons Mills Fire De- partment. I have contacted the property owners and I trust they will remove the ` brush and leaves as agreed. Please keep in mind, I did. my best. However. , if the problem continues You must refer to the above agencies. Peace, (Joseph D. )a.Vu:4/ Building C mimissioner JDD/gr f � 6 ��Zllar� �..av►. � Ce.,,ikev-u ; Ite M,--s 6er i Lu Z u I I1 ►,j. 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