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Co. � ADDRESS CantcY'Vllle.� MA #d05645 (NO.) (STREET) (CONTR'S LICENSE) '9 ti." l 'NUMBER OF t BL111� Dwelling 1 6131 �le .F cf,mil,� Dwe1.11ag DWELLING UNITS t PERMIT TO_ � ( ) STORY y (TYPE OF IMPROVEMENT) NO. (PROPOSED USE)... ' RD-1 AT (LOCATION) 156 Beech Leaf 1slan Road ' c'� DIISTR CT— (NO.) - (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) - - LOT. SUBDIVISION LOT BLOCK SIZE i BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION f TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) `[ Sewagf #91-356 " REMARKS: _ Bond AREA OR VOLUME 2160 -sq...� f t. � - ESTIMATED COST � 170�000. 00 FEE � 173 . 00 (CUBIC/SQUARE FEET) - - - OWNER Us t e r v i e. Concorde 11jTD - BUILDING DEPT. ADDRESS C/o CCB&Z , H j a r I n is BY UB IC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. i MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI To BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE ' OCCUPANCY. POST THIS CAR® SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS f f 1 2 2 �'�nwt ►�16 z /5w�e `„✓ 3 1 ('0 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT G 2 1A H,5-Z 1 CJ 2t OARD OF HEALTH OTHER SITE PLAN REVIEW APPROVAL 4 PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK SHALL NOT PROCEED UNTIL THE INSPEC- INSPECTIONS INDICATED ON THIS CARD CAN BE �. TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN s CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. $ ) TOWN OF BARNSTABLE Permlt No. .35p$1,...., BUILDING DEPARTMENT I 'A"n TOWN OFFICE BUILDING Cash .ML u ' HYANNIS..MASS.02601 Bond ......X.. ,..� J CERTIFICATE OF USE AND OCCUPANCY Issued to Osterville Concorde Ltd. Address 156 Beech Leaf Island Road Centerville, Mass. 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. August 26, 92 ( ......... .. .......... ....... 19................. f................ildin8 ns ec�........... ��..� �•�aw TOWN OF BARNSTABLE BUILDING DEPARTMENT S INsanTAIM _ TOWN OFFICE BUILDING rua 1639• �� HYANNIS, MASS. 02601 �o rnr�• MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by Building Permit $k................. ... ................ .........................................................................................».................. � ....... . issuedto ............................................. ................_.......... .. . M. . ... _........... Please release the performance bond. II Assessor's office(1stFloor): ) G Assessors map and lot n mbar/ �C �� / 3 �Q d S���{� ��� ;a„0 {. �D E INC Conservation INSTALL 4 3—� `� .Z � Board of Health(3rd floor): �/{�°N 'I°{'T S Sewage Permit number y/- 3 s� �' ENV{R®6 ��� 4�'AL ,T.BLZ . Engineering Department(94floor)': / TO N 6. House,number L ^11 Definitive Plan'Approved by Planning Board ` 19 � APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only r TOWN OF BARNSTABLE k BUILDING INSPECTOR APPLICATION FOR PERMIT TO �'�Li� TYPE OF CONSTRUCTION 3 19 TO THE INSPECTOR OF BUILDINGS: The undersigned by applies for a permit ac rding to the following information: "4. 16 Location ' // fir Proposed Use / 2 Zoning District ( Fire District —� MM Name of Owner Address �� C��`�% MWI.5 Name of Builder ��'�%(�t'a �'c� (dJ. Address Name of Architect Address 1 1z Number of Rooms Foundationi � Exterior �r,� Roofing Floors � � Interior < 4ue Y zW4 ,W1 Heating �[X � `/ Z(1 Plumbing �� L-9 Fireplace 9� A pp ' G�L roximate Cost lr Area ©,)d 040 Diagram of Lot and Building with Dimensions Fee 4\k P 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 / LCt/✓c Construction Supervisor's License 00 SG y5 - f OSTERVILLE CONCORDE LTD No 35081 Permit For 11 Story Single Family Dwelling Location 156 Beech Leaf Island Road Cerite—vi.11ey Owners Osterville Concorde LTD Type of Construction Frame {� t • • � t rr Plot Lot I t Permit Granted may 26 , 19 92 Date of Inspection 19 " Date Completed S 19, < x - / r J r t � • . t. ! f aj S LOC jO156 PARR' AVENUE YCTY l o TDS 1300 Co KEY] 328112 ----FLAILING ADDRESS------- Pr.:AJ1301 PCS J00 Y.RJ 4 PARENT] 108154 OSTERVILLE CONCORDE LTD PT MAP] AREAJ43AB JVJ MT070000 FARNHAM, HENRY C SP1J SP2.J SP3J F 0 BOX .1180 UT1 J UT2J .70 SQ FT] S YAitMOUTH MA 02664 AYBJ EYBJ OBSJ CONSTJ 0000 LAND 76200 IMP OTHER ----LEGAL DESCRIPTION---- TRUE MKT 76200 REA CLASSIFIED #LAND 1 766,200 ASD LND 76200 ASD IMF ASD OTH #DL LOT 10 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #PL 156 BEECH LEAF ISL RD TAX EXEMPT ¢RR 0204 RESIDENT`L. 76200 76200 76200 OPEN SPACE COMMERCIAL INDUSTRIAL SPLIT100985 EXEMPTIONS SALEJ07191 PRICE) 10 ORBJ7599/326 AFDJ I B LAST ACTIVITYJI0122/91 PCRJN -F.t' "4 + Via_. � .!_„.., l-' �,_ ws i •{�r 1. 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Nh t t F ULATIOI� 1 ,T e I 3Vt L:ALLY CoLU/�N 3, �j ri t s .> rr vie b� / I mL ` � ; •� L'•O '11'O I � � :��., � r t !( o •_.t0� P� J � 14• 0 14�ot , t t t A dr #. � _ �v �NN�a - 4 Y at ¢CGR-W/a LL AS 12CC1vltt(17 �+ Y a 7 atl SI� � O e Cy,p. -r �p +' ;r 7. iyy I 1 r,,.. two ti ,. f ,�„ ` Nrs.�t `�+,'� }ui'��n ry. I ni�' .^Ff�I�.•: jt Y. { t ,'�c + Y,�T ,1 U Yt���..PFR,09Tr �A.L.1C51�� �I6M.rAf � `tit I�.( ' ry f'g 7L1 P>Y �!4 91 E..F3 U 1 1. G;Go t G 6 N T B RV 1 LLE. ^t f t '4nt .y . .. t Qriwfj Jg.vrt I i • l OfQ1 IKGT.E(L6D�D �• t � ---- r j • Assessor's office(1st Floor): a f ;- Assessor's map and lot number of THE To Board of HealtH(3rd floor): ./ ' ' ' d�Q� 0 . SewageRermit number t ��� 5� j r r P r, , TXD Engineering Department(3rd floor); t� t, Barns prr. sW1%M 07, t;t S ... g� House number. Definitive Plan Approved by Planning Board y' c 19 '��-€�- ' I6 0 T10 YAY i APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M'.only �� 1 ; x { TOWN OF RARNSTA s uLA N 1 j BUILDING INSPECTOR APPLICATION FOR PERMIT TO Construct single family residence r TYPE OF CONSTRUCTION Wood F r,a m e { August t2► 19 91 , TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 35 Location 156 Beech Leaf Island Road , Centerville ( Map 187 , Lot 63-8 ) Proposed Use Single family residential Zoning District R D- 1 Fire District C-0-M M Osterville Concorde P . O . Box 1180 , South Yarmouth Name of Owner l i m i t e d P a r t n e;r s h 1 p Address Name of Builder Silvia & Silvia Assoc . , Inc Address 619 Main St . ,. Centerville Name of Architect Silvia & Silvia Assoc . , Inc Address 619 Main S t . , Centerville Number of Rooms 8 Foundation Poured Concrete Exterior Wood shingles and clapboard Roofing Asphalt Floors hardwood Interior s h e e t r o c k Heating forced hot air b v oil ,Plumbing copper & P V C Fireplace 2 Approximate Cost $2 5 0 , 0 0 0 Area Diagram of Lot and Building with Dimensions Fee See attached plans Also see Order of Conditions SE3-1421 Amended 4/ 17/90 and Extension issued 4/17/90 valid through 5/ 06/92 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 016931 Construction Supervisor's License No Permit For Location ' Owner'—! ' •' /Y, ... i f , _ 1` - Type of-Constructior ` ' c r � Plot Lot `.Permit Granted' i 19 Date of Inspection' ; ' - 19 - ! Date Completed 4 j 19 41 F r..; �4 ���J�Ci�y,(��'t�`,'�'�.•� .rs R i�r� 'i'.��4A��"�1%'�'��'T°Y"q � '*7�+'�+�TM�mx*�^+ e..:,••. -„+•. .,,�,� �,+ ;4g�. Assessor's office(1st Floor): ,If / 09 Asps' is map and loi number / d bj,`U �/3 a Hof THE TO` Board of Health(3rdfloor): :' f, r .• d� Sewage:Permit number Engineering Department(3rd floor),: USA L e t DATE House number' �J�p pp moo f639• Definitive Plan;Approved by:Planning Board APPLICATIONS PROCESSED 8:30-9:30 A.V and 1:00-i:00 P.M:only 11, TOWN OF RNSTABLE BUILDING I SFECTOR APPLICATION FOR PERMIT TO C 0 n S t r u C't s i n o 1 e f'a m i l y- residence TYPE OF CONSTRUCTION W o o'd Frame lh Au9u`st t� i 19 91 TO THE INSPECTOR OF BUILDINGS: ! , a: he undersigned hereby applies for a permit according to the following information: _ - Location 156 Beech Leaf Island Road , Centerville ( Map 87 ,' Lot 63-8 ) Proposed Use; Single f a m i l y r e s i d e n't' a l Zoning District R D-1 Fire District C-0-M M t k Ostervi i le Concorde ° I— P . O. Box. 1180, South Yarmouth W Name of Owner I i.m.1 t o p�r t n@ r h j� Address Name of Builder Silvia & Sflvia Assoc . , Inc -Address 619 Main St . , Centerville S,,jlvia & Silvia Assoc..,. , Inc .Address ,.619 Main �St . , Centerville �`' Name of Architect Number of Rooms 8 Foundation Poured Concrete Exterior Wood ! s h i n g l es and clapboard Roofing A s p h a l t r Floors h a r d ub d d „ Interior. ;" s h e e t r o c k forced hot air by oj1 co,p.pery& PVC Heating Plumbing $ Fireplace 2 Approximate Cost $'2 B 0 ,0 0 0 1 Area I� Diagram of Lot and Building.with Dimensions Fee See attached plans Also see Order of Conditions SE3-1421 r° Amended 4/17/90 (� and Extension issued 4/17/90 valid through 5/06/92 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. F 0 . Si_lvvi�a k.r � Name r i f` Construction Supervisor's License No Permit For Location Owner Type of Construction Plot Lot Permit Granted 19 Date of Inspection 19 Date Completed 19 Town of Barnstable Buildingi i Post,�This,Card So That it�is U�sible Fromthe Street Approved:Plans,Must be Retained on Job and,this�Card Must�be Kept _3 * SARNSTA Post d U�nt�IFinal Inspection Has BeenMade � 3sPermi F. ;" R Whe"re a:Certificate,of Occupancy is Required,such Building shall Not be Occupied until a Finallnspectn;has beenmade Permit No. B-20-488 Applicant Name: BERTJ. deMARTIN Approvals Date Issued: 03/16/2020 Current Use: Structure Permit Type: Building Addition/Alteration-Residential Expiration Dater 09/16/2020 Foundation: Location: 156 BEECH LEAF ISLAND ROAD,CENTERVILLE Map/Lot: 18 063-008 Zoning District: RD-1 Sheathing: x_ Contractor Name-, §BERT J DEMARTIN, III Framing: 1 Owner on Record: MULLENS, PATTY KERNS g ` "` Contractor License: CS.040711 Address: 156 BEECH LEAF ISLAND ROADTy ? 2 CENTERVILLE, MA 02632 Est Project Cost: $20,000.00 Chimney: Description: remove existing 15 x 30 deck and replace wit ,,same size Permit Fee:, $ 152.00 # ; Insulation: Pro ect,Review Re Fee Paid $152.00 j q Final: Date E 3/16/2020 ( Plumbing/Gas �A � 53 Rough Plumbing: Building Official g Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months%after.issuance. All work authorized by this permit shall conform to the approved application ai d�he;approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and st uctures shall be in compliance with the local zoning' codes. codes. This permit shall be displayed in a location clearly visible from access streetorr toad and shall be maintained open for public Anspec Aon for the entire duration of the Final Gas: work until the completion of the same. L ° Electrical The Certificate of Occupancy will not be issued until all applicable signatures bythe Building and'FEire Officials are provided onthis permit. ,., Service: Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing Rough: 2.Sheathing Inspection m �> .:;.�s .x -• :•� � ` 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 1HE Application Number. �,,,,,.... ..W. BARNSTABLE, 1_7 r, MASS. Permit Fee............. Zoning District........................ 1639n. Total Fee Paid ..... TOWN OF BARNSTABLE Permit Approval by.................................On............... ........... BUILDING PERMIT /Map.. 0 ......Parcel.......... ..... . Il"APPLICATION ki CA Tr%VVU_1W Section 1 — Owner's Information and Project Location MAR 17 2020 Project Address 68CA RxId Village -Ile Owners Name PciAricia %A I co) _S Owners Legal Address si( ae-e-ck Rac4_a City__(t�n �Jffc State MA- Owners Cell# E-mail Section 2 — Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet El Commercial Structure under 35,000 cubic feet Pe"Single/Two Family Dwelling Section 3 — Type of Permit ❑ New Construction El Move/Relocate E] Accessory Structure R Change of use El Demo/(entire structure) El Finish Basement El Family/Amnesty El Fire Alarm Rebuild F�I�Deck Apartment ❑ Sprinkler, S6 . sW F-] Addition ❑ Retaining wall F] Solar BU101__ El"Renovation El Pool 0 Foundation Only FEB 2 0 2020 Other—Specify Section 4 - Work Description Remove-, &)C1JJ,1Ad I S—A-'go CAeek, 0 Last updated: 2/14/2020 Application Number.................................................... Section 5 —Detail Cost of Proposed Construction _Square Footage of Project S S 4 F I" Age of Structure Dig Safe Number #Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6 —.Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom Water Supply if Public ❑ Private Sewage Disposal ❑ Municipal 9 On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: s 5 EX(O I am using a crane ❑ Yes 11'No Section 7 — Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8 — Zoning Information Zoning District Proposed Use ks Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes No Last updated: 2/14/2020 Application Number........................................... Section 9 — Construction Supervisor Name etry Je VHWR n Telephone Number ,S-o$ -D 4&-'' 3-73q Address 5 1 k_sS C1,*f'-' J)rl,,- City Jh State (M/V-Zip O�3bl'o License Number / 5- 04o7/1 License Type CS Expiration Date//30/2 Contractors Email Cell # SQ a' 32,4'— 3 7 3 y I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation req�byCMR and the To f Barnstable. Attach a copy of your license. AS/20 Signature Date Section 10 - Home Improvement Contractor nn Name 1�� (�/NC.— Telephony Number TO-8'3Ak 373`4 Address CLwr d-RCity State Zip 0�b Registration Number pi gIto S Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Attach a copy of your H.I.C... Signature AJ Date '210 Section 11 - Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature g Date Print Name &e-+ de IMAM kn Telephone Number 90.8 -3241— 3 7 3 AI E-mail permit to: d oA 8NAiV demar Po dyAaM Ga IVI Last updated: 2/14/2020 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board (if required) ❑ Historic District ❑ Site Plan Review (if required) ❑ Fire Department ❑ Conservation For commercial work,please take your plans directly to the fire department for approval. Section 13 — Owner's Authorization as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name Last updated: 2/14/2020 f a� Town of Barnstable Building Department Services KAR&� Brian Florence,CBO 9. Building Commissioner 200 Main Street,Hyannis,MA 02601 ww-w.town.barn sta ble.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must ' Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize er ^ to act on my behalf, in all matters relative to work authorized by this building permit application for: Road CQ.,IcN /e /*4 (Address of Job) **Pool fences and alarms are the responsibility of applicant.pphcant. Pools. are not to be filled or utilized before fence is installed and all final ections are performed and accepted. Signature of Owners` " a Signature of A` li =Est pp cant t , 1-4444 t Prlt NameT ak f:. fl 4�a 't ++�4 ' .em u$ k-G 4""m'y. fix, "_ :s�,. -•e s "�' �r�k x�, '�'� as �.U> �i. F�,�` �rf't� f<`"'�' �"a f" � �a � .�S=Y�• .s r I �v�� �` e'ar .sz .+ '<<- * 4„ '�. � •�, s�, �_, �-r ! �'�` K A 'iw�z�x z� �r ,y" ��� � xr „ �� � ^r �s. �Yr Date ON UM �.�$�g �� -•p ;e.,� �„_ .d ,� #'�-'2`-d�`x"�in„:. �r��,�✓5p�^ 4. ,. � � ;aveti+�k7�4"`�• .�'" � x . ��... � �M�� �s ,.. "vs2xi.<y.>�^Y'�`¢.ir.:•,w'.'.aa'i +��y+ w.' '���a�`pa'�`(,up � '3•� "i. x''n ,i Scanned with CamScanner T,CN e� PAD,PRDND[p0'.E[5?ETgE[x SEDUK t0"4-SiS�TD SOu.�tupES 2 aw�=� =�P—=s��l��=�{.��—��—r w/gMPSLa PDSi 855E axOnDRS --- L—J L—J L—J e C5 EXTERIOR CRAWL SPACE V ® 0 W L4 e — W = FOUNDATION PLAN Q ' 9 I_ I o�I Om� So tta FIRST FLOOR FRAMING PLAN u Lo u zc IN z W o A LL Z i n `G C Ll L�j J 1 W J 5 _ L = W Q Z I H I m J s� nE=i ROOF FRAMING PLAN A4 fi!Etl'. JD513D60 DAiE Ii/23/t3 PRnJ.NCw2,J05 I SCANNED MAR 171010 ® Commonwealth o' Niassachusetts Division of Pro•`essiona Licensure Boars o'SUilding Regulations and Standards CS-04C71 1 txp.res:01-3012021 BERT J DEMARTIN,III 54 VIESTCLIFF DRIVE ` --- PLYMOUTH MA 023" Commissioner Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTO R TYPE:in&JdUai _Registration Expiration 177785 09.10:2020 FiTIP. DEMARTBE01 F_ MWOLF DATE(MWDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 211312020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License#1780862 CONTACT -NAHUB International New England PHONE ON Fax 600 Longwater Drive (A/C,No,Ext):(781)792-3200 (A/C,No):(781)792-3400 Norwell,MA 02061-9146 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Main Street America Assurance Company 29939 INSURED INSURER B:SafetyIndemnity Insurance Company 33618 Berthold J.DeMartin INSURER C:Associated Employers Insurance Company 11104 54 Westcliff Dr. INSURER D: Plymouth,MA 02360 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDLISUBR POLICY EFF POLICY EXP LT i INSD WVD POLICY NUMBER DD Y Y M D YYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR MPT9470N 6/3/2019 6/3/2020 DAMAG ET 6a or $ 500,000 MED EXP(Any oneperson) $ 10,000 i PERSONAL&ADV INJURY $ 1,000,000 I GEN'L AGGREGATE LIMIT APPLIES PER: 2,000,000 GENERAL AGGREGATE $ POLICY 11 JJECT " LOC 2,000,000 PRODUCTS•COMP/OP AGG $ OTHER: B j AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 j ANY AUTO 6226940 1/13/2020 1/13/2021 Ea accident) , $ OWNED i l SCHEDULED BODILY Perperson) $ AUTOS ONLY XAUTOS BODILY INJURY(Per $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY Per accident $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED j RETENTION$ $ C WORKERS COMPENSATION PER XI OTH- AND EMPLOYERS'LIABILITY I ER ANYPROPRIETOR/PARTNER/EXECUTIVE YIN a N/A WCC-500-5019594-2019 10/23/2019 1O/23/2020 500,000 E.L.EACH ACCIDENT $ OFFICER/MEMBER anclatryinN )EXCLUDED? 500,000 (Mandatary b NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under I DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 i i I I i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION E SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Barnstable,MA 02630 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): _ L° M"VI _ Address: i If City/State/Zip: 1"� rr�Qv A- 340 Phone#: S4 $ - 3)t— 37. q Are u an employer? Check the appropriate box: Type of project(required): 1. 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 g. ❑ De lition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp. insurance. $ 9. � uilding addition 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 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] c. 152, §1(4),and we have no employees. [No workers' 13.0 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. 1 _ l Insurance Company Name: �V p „�n-► i'Ig 7-'r%217g 1 Policy#or Self-ins.Lic.#: �� ���— �'J�4�9 — 2,o Expiration Date: /O Job Site Address: G Leck Leaf Ts1c d pq4 City/State/Zip: C& I t V I/e tff,� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under thepains andpenalties ofperjury that the information provided above is true and correct. Signature: doe, � Date: d/I /�O Phone#: 968 ^ 3-46 — 3 7-3 q 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#: i Town of Barnstable _ Erplres 6mo tlis rom�tesue dale m Regulatory Services Fee Thomas F. Geiler,Director Building.Division JUN Tom Perry,CBO, Building Commissioner �t V1. 200 Main Street,Hyannis,MA 02601 ' www.town.barnstable.ma.us Office: 508-862-40.3 8 E Pnss PERMIT APPLICATION - RESIDENTL4L ONLY x: 508-790-6230 Not Valid without Red X-Press Imprint Map/parcel Number Property Address [✓f Residential Value of Work �J. Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address r� �� j Groa_rK IsIand d. Contractor's Name -,i � � Telephone Number Home Improvement Contractor License#(if applicable) ��- Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance 9 1m f : am I a a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Ly Ke-roof(stripping old shingles) All construction debris Pf( I`7 vnll 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 O er mus?si ,,Prop Owner etter of Permission. py of e Home ve ent Contract rs License is required. SIGNATURE: Q:Forms:expmtrg Revise061306 ` The Cammonweatth of Massachusetts. . — Departmerit oflndustriaiAccidents _ afftce afI"nvestigations 600 Washington Street Bost071;MA ozlrl www:rn ass.gov/dia Workers' Com,pensatioia Insurance Affidayi ;,guilders/Contractors/Electricians/Plum A licant Information b ers Name(Business/Organiza Please Print Le 'bI--------------- tion/Individual);• �`��,���� ._ . . •Address: WX3 n City/State/ZiP: �n�S 1`► ►� �2�Q(� Phone:#: vl 45 3 - e you an employer. Check the appropriate box: _ 1.❑ I am a employer with 4. [] I am a general contractor and T Type of project(required): _. ployees (full and/orpart time).* have hired the sub,contractors 6• �]Nevi construction . 2. I am a'sole proprietor or partner_ listed on the'attached sheet 7. ❑Remodeling ship and have no employees Thew sub-contractors have working for me in any capacity. employees and have workers' 8. ❑Demolition [No workers'comp.insurance comp.insurance,# 9•1 1 Building addition required.] 5. U.We are a corporation and its 10. '3.❑ I am a homeowner doing all work officers have exercised their ❑Electrical repairs or additions myself [No workers' comp. right of exemption per MGL A LE Plumbing repairs or additions insurance required.]t c, 152 1(4),and we have no 12• oofrepairs § employees; [No workers •13.[]Other comp.insurance required] *Any applicant that checks box a must also fill out the section bclowshuwing thcirworkcrs'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then lure outside contractors Policy inforbnut a new affidavit employers. that cheek this box must attached ee additionaIshect ahc wmg the name of the sub-contractors and state whether ornot those entities have, vet indicating such. employees. H the sub-contractors have tmployees,they must provide their Yyorkers'comp,policy number.. vc lam an employer that is providing workers'compensation insurance foamy employees Below islhe olic an ' inforrrcation P . Y d lob site, Insurance Company Name: x . s , Policy#or Self-inns.Lie.#i Expirationl)at Job Site Address: e: < a Cit�/State/Zip: Attach a copy of the workers' compensationpolicy dedarationpage(showing the policy number and e ' Failure to secure coverage as require d under Section 25A ofMGL c. 152 can lead to the imposition of criminal ?�plratton date), fine tip to$I,500.00 and/or One imprisonment; as well as civil penalties in the form of a STOP WORK ORDER ties of a Of up to$250.00 a day against the Violator. Be advised that a copy of this statement maybe forwarded to the OfDER and a fine Investi ations of the iJIA fo ' ce coves e verification, • of I do he ce n r the i s•and nalties ofPI�er'ur1 1 the ik ,information provided have i f true and Sienaturr: l (,� cnrrec4 Date: '®. Phone ## O - Official use only. Da not fvrite in this area,'to be completed by city or town official City or Town: Termit/License�# Issuing Authority(circle one); X.Board of Health 2.BuiIdingDepartment 3. City/Town CIerk 4,Electrical In S.Plumbing 6. Qther w Inspector Contact Person: Phone#: 2'OWn of Barnstable. Regulatory s Service a,�xr�srA�rM, ; . MASS $ Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 WvWJoWn.barnstable.ma.us Office: 508-862-4038 Fax: 508--790-6230 Property Owner Must Coltnplete and Sign TMs Section If Using A Builder as Owner of the subject property herebyauthonze to act on my behalf, in all matters relative to;work authorized bythis 6i ilding pernA.app4cation for: . =k L4Lg(af)d (Address of Job) cx4 n „ . Signature of Owner V Date I�delin e Print Name Q:FOR.MS:OWNERPERMISSION Nlassachusetts- Department of Public.Safety Board of Building Regrulations and Standards Construction Supervisor Specialty License License: CS SL 99138 K Restricted.to: .RF,WS JAMES CURLEY 287 FULLER ROAD + CENTERVILLE, MA 02632 Expiration: 1/28/2012 ('unmiissiuner' Tr/#: 99138 j ✓2:&11 u 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:. Regis t_rafion-;_124310 Board of Building Regulations and Standards Expiratibn-_6"j}/2009 Tr# 130873 One Ashburton Place Rm 1301 =Types Jndividual Boston,Ma.02108 James Curley James Curley 287 Fuller Rd. Centerville,MA 02632 Administrator Not valid without 'b ure I I Ba�fou�'i ing egu7a"Ciohs a� an ar License or registration valid for individul use only _ HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 124310 Board of Building Regulations and Standards Expiration: 6/1/2011 Tr# 284683 One Ashburton Place Rm 1301 Type: Individual Boston, Ma.02108 James Curley James Curley. 287 Fuller Rd. � -` Centerville,MA 02632 Administrator _, 'Notvalid without signature neering Dept: (3rd-floor) Map t $" Parcel �ermit# 07 03� House# a�G Date Issued Co Board of Health(3rd floor)(8:15 -9:30/.1:00-4 30) e f' 0 Conservation Office(4th floor)(8:30 9:30/1:00=.2:00) E'i � N SYSTEM MAST BE IN GOMPLCOMPLIANCEINSTA LED Planning Dept.(1st floor/School Admin. Bldg.) VEIT n Definitive Plan Approved by Planning Board 19 ENVIRONM*7' E AND - TOWN 1 TOWN OF,BARNSTABLE "• Building Permit Application Project Street Address-_��� . L/>s � G LET�- Q Villagee�7 ,✓oL[.� Owner' �,ee��y Address ` Telephone 7 Z/_ 92 Zj r W Permit Request j V 5, -� F©dad /� e vecE Ar/ lLi d2 '� `First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No 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 ❑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 Uq<O If yes, site plan review# Current Use Proposed Use Builder Information Name, Telephone Number &!Z Y Addres yS a License# QcSr7 e32 - Home Improvement Contractor# 44AS��� Worker's Compensation# Q9L036L ,2 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RES TING OM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PER NIED FOR THE FOLLOWI REASON(S, a FOR OFFICIAL USE ONLY - PERMIT NO. _ mod` 17 _ _ c -� i.• , , r'` q,j;��:: DATE ISSUED Ze MAP/PARCEL NO. ADDRESS VILLAGEi OWNER DATE OF-INSPECTION:, FOUNDATION- FRAME INSULATION FIREPLACE . ELECTRICAL: i ROUGH V ` tit FINAL s PLUMBING: ' ski RO'IJGH FINALE, GAS: °-i RO�JGH FINAL` FINAL BUILDIW. -An to# 5 � �TC � • -• (,J ••� , DATE CLOSEIXAObU 0 R' f� ASSOCIATIOMRLAI�NO: } ll t The Town of Barnstable • �xrrsreatE. • 9 MASM& �' Department of Health Safety and Environmental Services fo;. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date u�—S=g 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. CIO Type of Work: 1 ! Est. Cost Address of Work: <rd ,r,/L �v�%� Owner's Name Date of Permit Application: --i 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 ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL C. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as th ent of theeoo� er: �ea7!W'JD Date tractor i ame Registration No. OR Owners Name R The CotnlntonIl'Cllll/l oj:�r[IS.Sut'1tuSCltr w , Drpartnrc�trl njlt:(lurtrial Accidctits ', Otffcc affor tfyatlarrs ,.,. N 600 111z.vhirr„tutr Street Workers' Compensation Insurance:Affedavit i lian inf•rm inn• --- _ _..._..—�� ... I'. ._._.". v """"—'r-_.___-_...__•---------_----- -- - Incminn l�P�/� /►/L~� %tJ/C� /�� citv ❑ 1 am a homeowner performing all work myself. Q I am a sole proprietor and have no one vorkina in any capacity [1 I am an entplover providing workers compensation for my employees working on this job. enotn•tns• name: atidrest- city phone#• - inclrr,ncc n^licr Z 2(+ [j I am a sole proprietor, general contractor, or homeowner(circle are) and have hired the contractors listed below who nay c the following workers' compensation polices: comminv mine* addre«- cit. • phone a• incnrncr rn cnnlniny n9rnl•• •tddretc- ref\^ phone>~' insur-tnce co ^nlicv st Attach additional _ _ dititinal sheet if neceisary _--_-•.�_�•_ --+%"'�" "' ' ""'' '-''""'^ •""" " Faiiurc to secure covcrncc:ts required under�cctton:-A of.NIGL 152 can toad to the imposition of enminal penalties of a line up to SI,500.UU andiur une,cars' impri.onment:is,.ell:ts civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a da% against me. I understand that a Copy of this statement ma., be fun.•ardcd to the OMcc of Investigations of the DIA for coverage verifteation. !do herchr cerrij•teenier the painsand pen�aftiiess o_f perjure•that the information provided above is true and correct. (� Sicnature ��' ��J Datc j 7::57 Print name c -� ��01� Phone — +v - oRcial use unh do not,write in tltix area to be completed rby city or town official city or tmvn: P ermit/liccnse# r•ttluildini:Department ClUcensing Board C tM check if immediate response is required (:Selectmen's Ofrrce t allcaith Department contact person: phone#• Bother f fie -Comm� ��e a i HOME IMPROVEMENT CONTRACTORS REGISTRATION j Board of Building Regulations and Standards i One Ashburton Place - Room 1301 ' Boston , Massachusetts 02108 I HOME IMPROVEMENT CONTRACTOR -`----------------------------------- Registration 100740 Expiration 06/23/00 j Type - PRIVATE CORPORATION -072. HOME IMPROVEMENT CONTRACTOR I Registration 100740 CAPIZZI HOME IMPROVEMENT , INC . Type - PRIVATE CORPORATION Thomas Capizzi , Sr . Expiration 06/23/00 1645 Newton Rd . j Cotuit MA 02635 CAPIZZI HOME IMPROVEMENT, INC �as Capizzi, Sr. 5 Newton Rd. ' ADMINISTRATOR Cotuit MA 02635 7 I ✓!ae�»ro�wnuao!!/ /l�wr/ DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE NuEher: Expires: Restricted Tn: le .: THOMAS 1 W122I JR 281 PERCIVAI DR DNSTA USA,. ELE, MA /2668 'I � 0 M . . N I 1 J � �c IN ld �8 rl pro/ ��F�21 ZZ SE3- JA2o LJFAF MET Pir .— to 'BE Mp1/ED 30 760 NG 2'p-I "W RCwtro A BAXM M . �4 Lop SCANNE9 'QM ', T1a 1S Pua I� 5kws A ¢Evl5 eo WoL,E Si z�. SEE MAR 17 DEQS SE 3- (ct21. ALJ- co�J�,T,oNS oiJ - N aT ZOZO O=F-Z Sg At k, A pip y to Tt 14, poor FLAN REF. BL 12ao F�,' A-�-AE55of-S MAP 16-7 PC-l. L0'r ?Lo r PLAN o F- L-A Nb IN LEND w lU-L- o ,� \g,p LXISTl►Je' SPOT 6eQoE t8 --—— �xlsft►J� CorlTbu� La�E �4�(SI DE �UL(..�I(� Ca. 'BAD i uys t WC �Ec(s-r�rL�D FAQ j soevEyoizS ti SEPInC. 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