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0040 BRETWOOD LANE
;�� �. .. N. a v s a o � g u e n n q ,. ®° o Town ®f Barnstable �Permit# @� Expires 6 months from issue date t Regulatory Services Feed. • t�xxsrast.E, • $ 'a"M p s634. Richard V.Scali,Interim Director ��R7' �Fp MA`S Building Division PERMIT Tom Perry,CBO,Buildingft Comm a"'issioner �[� S 200 Main Street,Hyannis,MA 02601 � www.town.barnstable.ma.us SEP 112014 Office: 508-862-4038 Fax: 50`-7Q- 3� EXPRESS PERNUT APPLICATION - RESIDE [ (�►j� 1 7 _ ' Not Valid without Red X-Press Imprint Map/parcel Number � Property Address �(�Xle W L ®Residential Value of Work S Ij i4�Qa . ntinimum fee of$35.00 for work-under$6000.00 Owner's Name&Address G o(don t lb r s& Thyp 7 -1 40 BkEyn jd L r, �11 Q Contractor's NameS, Telephone Number ��vun Home Improvement Contractor License#(if applicable) E-mail: Construction Supervisor's License#(if applicable) CJCJ 17r j()I XWorkinan's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ lam the Homeowner I have Worker's Compensation Insurance Insurance Company Name�(�C�CL1���15i)fd h c'� C& Workman's Comp.Policy# ,271 q 32:3j�2 3 qG} Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) WReplacement e-side Windows/doors/sliders.U-Value . 30 (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of tWs permit does not exempt compliance with other to-,.n department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is requ' SIGNATURE: (� T-AEVIi`I D\Building Chang esMPRESS PERMITI MESS.doc Revised 061313 Aug.28.2014 22:31 PAUL COMBO" RP-MIRWAL AND—SR 781 545 1293 RAGE. 5/ 5 ~ .Fi k'ueNK:s::trrV .. Renewal RENEWAL BY AINDEME1\1 - ® � @��. � xe inaMs,e,aszes moor iierucsrur o+�.. r,.,s.., 16 Atbioi,Ruad • Uncmhs.RI 026i35 Lvli:a, iweseaas t 6Uq.f,3 2295•Ftix�tt1.G33.fiGi3$ iemh���hmum r' p 9authot'a Ntw Brgland HYndp�?LLQ d/hJa §6 t 1 v �i r x4nesnI by Ande=aen of$oetbsen 14ex Eggtand CUSTOM WINDOW AND DOORRrAirovELLNG ACREEh1$N-r . '1 �yo:tp.+twsc _.�.7Yi/ei(PR.19.. , 'JP/CSB�✓QZ`Z/ �f ._ 6urei(r}Saeei, t.ai r�e�.fni fn�e rr.�a.em•. ,.�a• a�rC:'.lG`Ge7cr•�^•'s�. E,'istlAdyx,i, / ,�i[3�2:f,t ►//Circe tearer ��•.._p,�./ter .__ .. ,• c�;,ontrr, ` ll�"'tax/'"/OI tw�ewtphcnehln,�iiw.:. ISury ei(s}6ena�g jnitslly and aetu rang agrees to pmrximor the p.cxl,m:r.,slid/ar.rvwrs of bputhcrn"1Vc�r iiuKl uid 1MandatsY,1 t G d/11/t liesecwtij by Ahct117racn el$uulJii.rn oti w I iii l Intl("Contracioi' fih xnvuidnntx w:th the ci?aiae anti i'Aiaiiouns drxxib:d oil dte lrmt asul the teveiac cal• 15i3 uW :suacixdspai fr.;udnn ahiatO)(so16iivcah ih4-A re anent"). �O Historic Condo 'O EiCtd17 rrzrltcnt aril wi L4a: Total jopAmqu lste�hato S-Anme y9stir ticthod of Payniant 0 i;" l'.1 Cuh �Fs+anaod 1. Credit C.6"hsacucrpwd for depeGhonly-ff,-xetwm Iraofthe Mnee at Spirt of)ob(j*): ProCotcooma tfiheuie see CmdV Caid Papftn irotrnd By iWiirg this Ertli tod Corph*nDaw r Agrewmilt,yint ndmewiefge oi,at tfv aalu oe at Stars o6lob ant the t�h',nxon Svhei�tl 9a.,� .7 V«!�•' Ba'atsie an 54+ASfdnt�al Co:npkeltin afiob cannot Ee madohy trvtit. Conhpled6o of Job(33°b)e�__ wd ai4mtde be mido byperroral check:bw*flack or s-.L& 8uyer{s)agrocs and hmrdscstaniis that this Agrsrittieat eonsritutoe.t11a cadre vadeeaGroding between ths.paeties,.ead that there are no vtiebal hhadetgtondinp ehen�ng any aP;the terms of>iris Agrtseme&L�Buyes(s)acli air6ledges thstt Buyers) II)has read chit Aeireenteat,uadorstaads the ternin os We ASSreesaeat,and bag reiii"Ita:completed,sigued.1 and dated copy af'thisAgeeemea4 ludiadingtha two otteclzed Nedeei of Gamelladvinr'ou the dare Br'nwritten above and(11 was orally ieformedefBoiyor%rl�ttto.d�odttioAgf*mmut$ONOT'8IL}NTHLSCOlk'TRAcTIFTFI $Ee1 ANYBL.RNRBPACEg. I*RJtoda IelettdSefes dnlyj Nat,ee loBaycet(>f)Do not sign this Agreement if any of the specasintended fo>ebd ag;tied terms to the extent of then available Lofornration stye left bian]L(2)You are audded to a copy of this Ag.,eEmex�at the blue you afgu it.18)Tau may ai aiaty time pay oil the full unpaid balance due umtostthi9 Agrr.emeat,mad in s o doing you essay be entitled to -coin o pasdal rebate of the finance"a"hmurauoe charges.(4)The sollt r bxa ao r)gbt to waltiw�fUUy'enter your psrau■es. ercoh»tmW breach the", .. peacctoreposae.s"goodspurrhaeeduuilert$BAgrtnioteat(3)Yote>staye:ancelehi9!►g>reeinene iP.it bits cot been sired at the;maio aiste Ora braps:h a1�ce of the selle4*tivided you turdfy the Seger at ills or her main oL 169orbraacboffltxsl7wwitmthcAgree.;enetyregivieredor•certified=Q,whichShanbe'postednotlatcr.thaumiduight af'tho third lend dAT 44cr the day ou rihich the bnyaeaigas tbeAgreemeptr mchiting Suadayptrd any hoiiday,oftwl icl. eegularmalldeHveries are catmatte.Seesheaccomlrosyl.raeotieeofcaneeLiatioaforIn bi;aseaeplanatioaofboyar'sr�rirts. jya?r r i e a..... f.,444eileQiti0.^tsmWA4 r 3!ni[rrlt} Renewal Inr n of Son era New Engimd a of Pypduc t tt t:r „a(ua Sguanav j2 Pnnl NAmc iif Paii(ucl Asnw.i• Nut Naaur Psiuti\otaie. YOU, THE BEJM(S); AgAY,CAlvCE1.THIS TR14 gACTfON AT.ANY TIME PRIOR TO IIIG>;i'£ OF THE.THQtD IIUSINESSDAYAFr=THsasaTEQ1',TfUSTRANSACTIObN.SEE iLTHEATLiCHEDN0110EOFQW40 ATIONFORMS FOR AN EXPLANAMON OF THIS RIGHT.. NOTIC Pam._ CE OF ANCEL [late of ThostuUnn You may cancel � Date cf Transaction You mai,c mock ,this transudon,'without'any.p¢etalty'or obdigatlon,within this tiFansaidon,without any penalty or obltgatiort.within three business d�rs fraut this'above date;If you cancel,any I three budnoss dais from the above date,If you caned;any property traded.Trh,any,parMitnts made by you under then I property traded P%ariy payments made by you under the Contract or Sale,and any siesotioibits instrument executed I Contract or Sala,and any n, abie instrument executed by you will be returned"within ten business"days following I' w by you will be vieturried within ten business dagis following recaps b�tree Seller vf'your cancellation notice,and any I reooipt by tlhe Seller of your•ciWcellculon nobc%and any security nEef^cet.arising but;at the transaction will be 1 :semrty.interest 'arising out a die t atrtaeaon"w;H'ba CanceledWyoucanoe4youmttetmakeavailableW the Seller, caneeletllfydu,cancel,yyoouumuet make availabCemtheSe er a!your wesideiaee;in,substantialiy.aa good Condition ohs wrlhen I at your maidenee.in substantially as good eondldoti as wheti reWviod,tay goods delivered to you under this Cenermct or, i reoarved,any goods defivered to you;hWer d,ls Contractor Sal or you m4h if you wish,comely.with the-ieseructions of i Sab;or y�titt t *W..you wlsk omgly with the insl�tsctlons of the Per regarding the'Iretum shipmentof the goods at the the Seiler regarding the reta m■iuprnent of the goods at the Seller's eex'�ieense and risk.It you tie make tho goods crallable `Seller's expense and risk;If you do maim:the��o0oft airailabla to.tho Sickle,and"the Soffo does lice pick ern up within t to the Seller and Nee Seller does nail pick tflern up wriEhin twenty,days of elhe dice of onFellation,you may,retain or. i twenty desyys of•the date of cancollatlorsii you'mey calash or di tc of the goods"wi(thiwt air further oltsption.If you 1 11112 ei a{thin goods witNvut any further ablisatlw,If.you to t makes tdto soods.avatiabla ou else Seiler,or if you agree I W te"tttake the goods available to.the Seller,or if you agree to ieturn'tha goods.to the"Seller and Lail to do so;then you I 'to return tits goods to the Seller and fail Do do eo,then you remain,liable for pot4otmanoo of all obligations under.the reitnaln liable for performance of at!obligations under the ContractTo ee.0 this transaction,rniii or deliver a signed I Cont Tact To cancel this transactions mail or deliver.'signed and dated copy,of this cancellation.notice.or arty'other I and dated copy`a(this ennceliation not;cw or any other: writtennotice,drsendatelepramtoAenowalbyAndarstinof I writtannotiea,eraendsteleggmmst*Rentwal:byAndewicnof Southern New England.at 26Afblon_Read. ' " n,�t 02865, i 56utliem New England at 26Alblon Road, i n RI OI863; NOT LATER THIN N113NIGMT OF �� NM LA TER TKAN:MtDNIGWT OF 7 �/�' (Date (Date} HE BV CAPICEI,Tt1151 RANSA1CT10N.' I HEREBY CANCEL THIS TRANSACTION. *• .. ' ,e ar,sigyiy,a,. WIN name o®m euyarflenae,n apt Nam .Yale'... : . RbACOP)r hgo Boyer CoAe renew Bur@'tear:Pink r Southern New England Windows d.b.a Renewal by Andersen of SNE kiassacbusetts-Department of Public Safety x Board of Suilding Peguiations and Standards i s Construction Supen-isor 3 1,m-t nss..CS-095707 BRIAN D DENNISOIV l � 7 LAMBS POND C1RZ �q Chariton MA 015l17 � � w r Of:3 Expiration Commissioner 09/0812016 `. Officeof CC�c�o�r.��zinrrrrserf-ffairs�an/�•r��:•��'����,,;c�. 7 L � onsumer Ad Busmcss egulation 1.0.Park Plaza=Suite 5170 Boston,Massachusetts 021.16 Home lmprovement,'ontractor'Registration Registration: -173245 - Type: Supplement Card SOUTHERN.NEW ENGLAND WINDOWS LL Expiration 91191201e DENNISON BRIAN 1137 PARK EAST DRIVE -----•._� _ _ __ WOONSOC.KET,RI.02895 Update.Address and return:eord.dark reason.for change sca o 2C.—Gil 7 Address I-Renewal -Employment a Lost Card .-.-�_AfGmnf Coo mer AgnngOusiness ReGulatiaa LicenxorrcRisirah m on valid far dividtil use only as HOMEIMPROV,EMENT COIJTRACiOR beforcthe expirmt date,if fo nd returnta: Office of.Consutner.Affairs and Business Regulation - e Regigtra0on 173245 Type: 8 .rN - lOPark Plaza,-$talc 5170 ' E><P rahon:�:e/19201a Supplement':ad -Boston,SiA 02116 SOUTHERN NEW ENGLAND WINDOWS LLC. RENEWALBY ANDERSON:�.. - DENNISON BRIAN: 1137 PARK EAST DRIVE.' WOONSOCKET;RI 02895 Undrrser wy �•1--�X.t:v.Iid wilhoutsip.turc: ' The Commonwealth o f Massachusetts ,1 Department of IndustrialAccidents t- r Office of Investigations I Congress Street,Suite 100 y;G Y Boston,MA02114 2017 { www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers APIRlicant Information Please Print Leidbly Name (Busimess/organizationadividual): SOUTHERN NEW ENGLAND WINDOWS LLC Address. 26 ALBION ROAD City/State/Zip: LINCOLN, RI 02865 phone#: 401-228-9800 FAirey�ou em to er?Check the P y a ro ratePP P hog:employerwith 20 4. ❑ I am a general contractor and I Type of project(required): yees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction . sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have working for me i ion n any capacity. employees and have workers' 8. ❑Demolit [No workers' comp. insurance comp. insurance.t 9. ❑Building 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. Plumbic re myself ❑ g pairs or additions [No workers comp. right of exemption per MGL 12.[]Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.A Other wiruuowRePtACEMErvr comp. insurance required.] *Any applicantthat checks box 9.1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. -'Contractors that check this box must attached an additional sheet showing the came 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 I compensation insurance for my employees. Below is the policy and job site infortnation. Insurance Company Name: ARGONAUT INSURANCE COMPANY Policy#or Self-ins. Lic. #: WC927938352394 08/21/2015 Expiration Date: Job Site Address:_ Qo e wooa LzjEe City/State/Zip: jj ��- Attach acopy 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 the pains and penalties of perjury that the information provided a ov is true and correct. Si ature: " I L� Date: Phone#_ 401-228-9800 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.PlumbingIns ector6.Other Contact Person: Phone#: r A`� CERTIFICATE OF LIABILITY INSURANCE 0 2/20 s/12/aoi4 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), AUTHORRED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the eertificabe holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the tents 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 Oeu of such endorsenumt(s PRODUCER Willis of New Je rsey, Inc. C/o 26 Century Blvd PHONE FAX Y.O. Box 305192 E{IAIL 1' N0.1- 8 - 67- Nashville, TJt 372305191 USA AO :certiticatesewillie.coa S AFFORDING COVERAGE NAIC a 9MR A:Belective Insurance of 8R 39926 M�JREDBouthern Now England Windows LLC B:The Beacon Mutual Iasuraaca a{017 D/8/A Renewal by Andersen 26 Albion Road C' t InsuranceLincoln, RI 02665 DE: INSURER P- COVERAGES CERTIFICATE NUMBER: S29160 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 Yin 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. aLTR NBR TYPE OF INSURANCE POL pY EFF POUCr E70' POLICY NUMBER Lam X COIB19tCMLGENERALLIABILITY wyn EACH OCCURRENCE $ 1,000,000 CLAIMS4IADE OCCUR A Es $ 100,000 S 20294s9 08/10/2014 08/10/2015 NED D� am pemm $ 10,000 PERSONAL&ADV INJURY S 11000,000 GlM AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000 POLICY X � �LOC PRODUCTS-COMP/OPAGG S OTHER 3,000,000 AUTOMOBILE UABLITY a NED SINGLE MR X ANY AUTO Ea N S 2,000,000 B=LYIDWRY(ParPeMM) S A AUTOS SCHEDULED 8 2029459 08/10/2014 08/10/2015 BODILY 841URY(Persodded) S X HIREDAUfOS � PROP Wff5 MACE $ A N UMBRELLA LIAB x OCCUR $ EACH OCCIIRRHNCE S 5,000,000 �� CLAIM3lrADE 8 2029439 08/20/2014 08/10/2013 AGGREGATE S 5,000,000 DED RETENTION �EUPL�� IIIS ILITY' XPER OTH- TNER CUTIVE N $ 1,000,000 STATUTE OFFICEIMMEMBEREXCLUDED? NIA 0000068028 08/22/2024 09/21/2015 E.L.EL EACH ACCIDENT be E.L.DISEASE-EA EMPLO S 11000,000 11,1=PnONU0nFd09rPEPA7IONSbs1owcove EL DISEASE-POI ICY LI"Err S 1,000,000 CrkC=V/BL Covg: NC927930352394 08/21/2014 06/21/2023 .L as. Accident - $1,000,000 tutory Limits - NC L. Disease policy Lmt - $1,000,000 .L Disease as, amployse - $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addidonal Rertwrks SdwdWs,may be a tadwd ff more spa=1s re* ) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVER ED IN. ACCORDANCE WITH THE POLICY PROVISIONS. ' Sontharn ss LLC AUTHORIZED REPRESENTATIVE 26 Albion Road A` /► ' cola, RI 0286S=0000 a►►�tas�J ®1f188.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01)' The ACORD name and logo are registered marks of ACORD 8R ID:6629625 SATCR:Batch p: 79627 � ,. Town of Barnstable Building , Post This Card So That it"is Vis�ble;frorri the Street-Approved"Plans Must beRetarned on Job and this Card Must be Kept NAM Posted Until Final Inspection Has Been Made ., « , x�" s ." '`�` J. ° 7A ♦ s: Y Where a Certificate of Occupancy,is Required,such Buildin shall Not:be Occupied until.'a Final ICIl 'IlIl Ins ection has;been made . � Permit NO. B-20-1774 Applicant Name: Francis Sheehan Approvals Date Issued: 07/16/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 01/16/2021 Foundation: Location: 40 BRETWOOD LANE,CENTERVILLE Map/Lot: 168-131 . _ Zoning District: RC Sheathing: Owner on Record: TAROZZI,CHRISTOPHER G& MARY A Contractor Name Framing: 1 Address: 40 BRETWOOD LANE Contractor license; 2 CENTERVILLE, MA 02632 Est Project Cost: $3,600.00 Chimney: Description: 10.0 Sq Ft R-38 FGB to attic, 1302 SQ FT R-14 Cellulose to attic,Air Permit Fee: $85.00 Insulation: Sealing, 152 R-19 FGB to basement,64 Sq Ft 10 ml poly to crawl,95 Fee Paid: $85.00 SQ Ft 2" rigid to crawl, Date, 7/16/2020 Final: Project Review Req: f pp L/ J~�' Plumbing/Gas Rough Plumbing: °Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afte ,issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoming by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for�ublic inspection for the entire duration of the Final Gas: work until the completion of the same. . Electrical The Certificate of Occupancy will not be issued until all applicable signatures by"the Building and Fire Officials are provided on this permit. Service:Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing 2.Sheathing Inspection 1 ✓- Rough: 3.All Fireplaces must be inspected at the throat level before firest flue Irving is installed` �' 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 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. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: I�MI L 's f r�T F5.+� Town of Barnstable *Permit# . vl o� Ex�ryes 6 months from issue date Regulatory Services Fee snsrtsrMIX *` o y rrnss Richard V.Scali,Director . � c Building Division Paul Roma,Building Commissioner JUN 1 1 `�0�9 200,Main Street,Hyannis,MA 02 www.town.bamstable.ma.us ��►!�%8A H.N MAW90-6230 Office: 508-862-4038 .EXPRESS PERAHT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint /Map/parcel Number +� Property Address �JY aj—LC,_�DC41• - Residential Value of Work$ (a 10 Minimum fee of$35.00 for work under$6000.00< . q i er's Name&Address Contractor's Name AID- 0,fL- Telephone Number 4S -715-- Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) C_ ❑Workman's Compensation Insurance Che k one: - r"-` ❑ I am the Homeowner I have Worker's Compensation Insurance .LL Insurance Company Name Lit, tr^°rC, __ .{� V+ US- Workman's Comp.Policy# W Ci"'�}- ' 3 15 g �'� $� " '1 Copy of Insurance Compliance Certificate must accompany each permit. Permit Re uest(check box) Uli��i� Re-roof(hurricane nailed)(stripping old shingles) All Construction debris will be to T6✓l ❑Re-roof(hurricane nailed)(not stripping..Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *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&Construction Supervisors License is required. SIGNATURE: i� Q:\WPFILES\FORMS\building permit forms\EXPRESS.doC 01/25/17 1 I The Commonwealth of Massachusetts _ Department of lnrlustrialAccidents 1 Congress Street,Sirite 100 Boston,MA 02114-2017 www.mass.gov/dia 11rorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH.THE PERMITTING AUTHORITY.` . Applicant Information do@ Ki*pq � Please Print Legibly Name(Business/Organization/Individual): 36 ChankerheCr L�nA Address: West Yarmouth, MA 02673 Phone: -7 15-b448 City/State/Zip: •, Phone#: Are you an employer?Check the appropriate box: Type of project(required): I.1p I am a employer with_employees(full and/oCP. rt-time).* '7. D New construction 2.r_�I am a sole proprietor or partnership and have no employees working for me in - ' $, O Remodeling any capacity.[No workers'comp.insurance required.] 3TI I am a homeowner doing all work myself.[No workers'comp.insurance required.]t. 9. ❑Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property, I will 10 Q Building addition ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions. proprietors with no employees. 12.Q Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp,insurance.= 13.MRoof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Q Other 152,§1(4),and we have no employees.[No workers'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.. tContractors 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: 1A ' Policy#or Self-ins.Lic.#: WC°.`L '31,,- tea a;L053-Q fR Expiration Date: b6—O 'dLb'0L0 � W Vyw- C)-2-6 3 r— Job Site Address: �^ City/State/Zip: Attach a copy of the workers'compensation.policy declaration page(showing the policy number and expiration.date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may befforwarded to the Office of Investigations of the DIA for insurance. coverage verification._ I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. . Signature: Date: 0 6.r it) Phone#: 7 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.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: - Information-and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under.any contract of hire, express or implied,oral or written." r atq,l; ! 3.s., An employer is defined as"an individual;part p6rship,,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 aother legal-entity,employing employees. However the owner-of a dwelling house having not moi than'th'ree 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 be an 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 connnonwealth 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 permit/license number which will be used as a.reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person i.s NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia i 1 •:i ----= Property Owner Must Complete and Sign This Section If Using A Builder as Oavner 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) **Pool.fences and alarms are the-responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature f Owner Signai6re of Applicant I� Z>f a W Print N e Print Name VDate UORMS.OWNERPERMSIONPOOIS Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards ConstructicwSirpp rSpecialty CSSL-099166 Expires:01/24/2020 JOSEPH E KING cw A 36 CHECKERBERRY WEST YARMOU M fdlA 02673 Commissioner Office of Consumer Affairs&Business Regulation Registration valid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found*return to: TYPE:Jndividual Office of Consumer Affairs and Business'Regulation Registration Expiration One Ashburton Place-Suite 1301 05/04/2020 Boston,MA 02108 JOSEPH E.KING -7 it :,. } / JOSEPH E.KIN(a \/ 36 CHECKERBERRY IS1: C , d without S ure -WEST YARMOUTH,MA 02673 Undersecretary l Town off Barnstable Building t Post.,This CardSo That it isVistble.From the:Str,.eet Approved Plans Must be Retainei anzJob andahis CardyMust be Kept �: r' � ' . nr PostedUnxtilFinal In5pectionHas BeenEMade -� � , ' :_ Permit Where a Certficate of Occupancys Regw�red,such Bu�ldmg shall Not be Oceup eduntil a F nal inspect�onhas been made Permit No. B-19-1928 Applicant Name: JOSEPH E. KING Approvals Date Issued: 06/14/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 12/14/2019 4 Foundation: Location: 40 BRETWOOD LANE,CENTERVILLE Map/Lot: 168-131 Zoning District: RC Sheathing: 3 r Owner on Record: TAROZZI,THERESA Contractor Name: JOSEPH E KING Framing: 1 Address: 40 BRETWOOD LANE � 4 Contractor License:• CSSL-099166 2 CENTERVILLE, MA 02632 Esf, Protect Cost: $6,700.00 Chimney: Description: re-roof-yarmouth transfer Rerrnit•Fee: $35.00 Insulation: � � Fee Paid: $35.00 Project Review Req: R•<� ` Date 6/14/2019 Final: � Plumbing/Gas Y� 'l Rough Plumbing: Building Official - '. - . • Final Plumbing: This permit shall be deemed abandoned and invalid unless the work a horizedbyt�his permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved applicationand the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structuresshall be in compliance with the local zoning;by laws and codes. This permit shall be displayed in a location clearly visible from access st 6t or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. �: 3 Electrical The Certificate of Occupancy will not be issued until all applicable signatures!by the Building and Fire Officials are'provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work , 1.Foundation or Footing z Rough: 2.Sheathing Inspection - 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 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ; Application # -I? s 'y 6a 0 Health Division Date Issued Conservation Division Application Fee i Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address S� L✓ _ ,AA 0d-(z,3Z-- Village Owner .o -T f� 22� Address t O `J rc,(--w yoq Telephonerk�-P�f) MAN- Permit Request Co rs�l e�Square feet: 1 st floor: existing proposed 2nd floor':existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 27.3`tonstruction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. 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 Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove_. ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: O-,existing q newt size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:2 I I Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ - , Commercial ❑Yes ❑ No If yes, site plan review# m Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name kbc, Telephone Number Address V w k�o.,e_ Cos--- License # l D,o 7� ! 06�'7 7 Home Improvement Contractor# Email 1 c--.,e-re-t !;--vA An 1_ Cc)—Worker's Compensation # I0 gq (,<f_6 J 16 0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO J I , SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS s VILLAGE OWNER DATE OF INSPECTION: I FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. •\ The Commonwealth of Massachusetts. Department of Industrial Accidents > 1 Congress Street,Suite 100 s Boston,MA 02114-2017 M www mass.gov/dia Workers'Compensation InsuranceAffidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE.PERMITTING AUTHORITY. t Applicant Information Please Print Legibly Name (Business/Organization/Individual):RetroFit Insulation Address:PO Box 105 City/State/Zip:Seekonk, MA 027,11 Phone#:508-989-6436 Are you an employer?Check the appropriate box: Type of project(required): LE I am a employer with 1 employees.(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in X TRemodeling any capacity.[No workers'comp.insurance required.] 3.M I am a homeowner doing all work myself.[No workers'.comp.insurance required.].t 9. ❑Demolition 10 Q Building addition 4.F1 I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.[:]'Electrical repairs or additions proprietors with no employees.. t 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.# . 6.F.1 We are a corporation and'its officers have exercised their right of exemption per MGL c. 'i 14.D Other Weatherization 152,§1(4),and we have no employees.[No workers'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 submita 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:STAR Ins. Policy#or Self-ins.Lic.#:V9WC802160 Expiration Date:5-2-18 Job Site Address:40 Bretwood Lane City/State/Zip:Centerville, MA 02632 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.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 pains and penalties,of perjury that the information provided above is true and correct. Signature: �' Date: 11/13/17 Phone#:508-989=6436 Official use only. Do not rit 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#: f awl! ` o Town of Barnstable Regulatory Services 41 41 Richard V. Scali,Director Building Division Paul Roma . Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:.508-790-6230 Property Owner.Must Complete and Sign-This Section I, Theresa Tarozzi as Owner of the subject property hereby authorize Retrofit to act on my behalf, in all matters relative to work authorized by this building permit application for: 40 Bretwood Lane Centerville, MA 02632 (Address of Job) Signature of Owner Date F Print Name } If Property Owner is applying for permit,please complete the Homeowners License Exemption Form. 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I RETRINS-01 DCARVALHO DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 07127r2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TFE 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 Diane Carvalho NAME: HUB International New England PHONE FAX 222 Milliken Boulevard (AIC,No,Ext): (A/c,No): Fall River,MA 02721 E-MAIL SS:diane.carvalho@hubinternational.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Selective Insurance Company of South Carolina 19259 INSURED INSURER B:National Llablll &Fire Insurance Company 20052 RetroFit Insulation,Inc. INSURER C: PO BOX 105 - - INSURER D: Seekonk,MA 02771 - 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP` LIMITS LT IN SD VD M D M DD A X. COMMERCIAL GENERAL LIABILITY _ EACH OCCURR=NCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR S,2187653 08/15/2017 08/1512018 DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ MED EXP(Any oieperson) $ 5,000 PERSONAL&ACV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY jECT El LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT 1,000,000 Ea accident) $__ ANY AUTO A 9100182 08/11/2017 08/11/2018 BODILY INJURY Perperson) $ OWNED X SCHEDULED AUTOS ONLY -AUTOS ir, ,. I BODILY INJURY Per accident $ X HIRED NON-AWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY - Per accident $ ` - $ 'A X UMBRELLAilAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE + S 21876513 08/15/2017 08/15/2018 AGGREGATE $ 1,000,000 . DED RETENTION$ $ B WORKERS COMPENSATION PER OTH= , AND EMPLOYERS'LIABILITY Y/N - STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE 9WC802160 08/02/2017 08/02/2018 1,000,000 OFFICER/MEMBER EXCLUDED?' N/A E.L.EACH ACCIDENT - $ (Mandatory in NH) E.L.DISEASE EA EMPLOYE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) A. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE National Grid THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 4 40 Sylvan Road ACCORDANCE WITH THE POLICY PROVISIONS. 02451 .. AUTHORIZED REPRESENTA71VE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo.are registered marks of ACORD „o• TOWN OF BARNSTABLE Permit No. 25999 !'AUST� Building.Inspector cash .... ------------- 39 -- — - ,eso. ° OCCUPANCY PERMIT Bond -,---___ ------------------- P Issued to JarnU li., Smith Address .tot #28 40 But000d Lane, Centm-cae Wiring Inspector � � ��. .�,J Inspection date Plumbing Easpectoi , Inspection date r� Gas Inspector � r Inspection date &'Engineering Department t` ��tlf "�"L' �� Inspection date jBoard of Health � � I/ f / Inspection date 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. (/ Building Inspector ``'� FROM - . ems: TOWN OF BARNSTABLE t Fes. tree BUILDING DEPARTMENT Yam CteA k 367 MAIN STREET HYANNIS, MA 6M " hone: 775-1120 ° f , SUBJECT: . j FOLD HERE DATE.. _ Apt , 13,$ 1994 - AAESSAGE r . M ?, - SIGNED 6 DATE RlPtY SIGNED - -i Ne7-Ixnti RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY ' - - PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK.COPIES WITH<CARBON INTACT..' < i►JGLe FAM►LY. No GAQBA6r G¢;NOE� t oi�►t_ F�oW ►Ivx 3:= Z�3oG.P.a �S7/o7. /� � 3\= � SEPT�G TA!JK o% ' �495G a30x15 o • GAL. `� � #� ".: - F •1vo0 GAL. � .� ;� lu o15PoSA�- 50TTOM -AREA s- o S,F. j�o S.F X 1. 0 �` SO . GP.D. .• p,� Q E�!�T. f/v� 4 ,, a- �}, E ToTA.1�. 5,1 GN _!425 -TOTAL. AA►LY 'Ft-o� ' 33°G• - F o9-Lti~55 a i Z �if/•G rr 'PE2coLAT!oN RATE F s s T. R ,.OF AS �y < x yP`�N OF Mqs fir— �,d x t _i i ALAN ' r, WILLIAM- w. a y u JONES No, 19334 Q �. f le CASTE �y0 �' �0/' LJ II T'oP FNU= GrO` I y_,. 1000 l NV• �� � - MST. INS. b�pT�G Y3'3 r 1 z . ... kt .4a 0°X �• TANK A� sy LEAGN yZ•S INV. jrs t • . PIT �Z 7 yz•9 _ n = 14 CE2T►FIG0 P1-oT PLAN : 41v N/.trteLam- 4.7 A ,L No SGAI.E CA E T� G E RT F Y ?N AT ! y{E,9 So N GoMPI..Y S 1rJITN-T HE S 1 aELIN t✓ _. t �._. f P.I.1D S6Ti�QGK R.6QV►R.1cMEN7� oF 'fNE- }' -To W N o F AN"o ►S N�"f'r" ; t I L.OGPTED -WITH IJ TEiE Loop L�.1 8AXT E iZ,a iJ Y E I N C• ; y PATE_.�L RE 1'S'T�QE,°p'I,.A►J D 5 �Y fSYa25 !I G -Tull PLAN ►,5 KIOT 5N5c A o►d AN .I INS.T-RuMENT To�[�ET W^NE L.cTET NE�t1� APPLICA►JT' ,��� /�'-�� No-T 5a v5E ...-. _ z Assessor's mad and lot numbe f..... .. i ' pFTHE TO Sewage Permit number ...0-4. .4y...//J.ut ........... vtIC-S�1 4 IS A8 aq 9� a1 4,r 4 Z BARN TABLE, 4 e 4sw' House 'number ........ .......................................... �:.• roo rb 9 CAL MPY TOWN . OF BA�RNSTABLE4 eel . BUILDING INSPECTOR APPLICATION FOR PERMIT TO 'Construct Dwellin TYPE OF CONSTRUCTION WQ.Qd..frame.................................... .a s ........Jan....20.... .............19.:84. -, .TO• THE INSPECTOR OF `BUILDIN'GS * 7 Y The undersigned` hereby applies for 'a• permit according to the following informations, Location ......... ot...2$•,Bretwgod bane, Centerville . Proposeduse ....Single...fam;?jy........................................................... ............................... .Zoning District ..RQ.,9;UQxlfi1A1.........................................Fire District ........0ent".Q.at.................................................... a es K Smith ..•.....,......Address ..........Barnstable Name of Owner ..,...:....!s.................................. .............................................................. Name of Builder)am.eS...K....5mith....:...........................Address Nameof Architect ....................................................:.............Address ...................:................................................................ Number of Rooms ..........6............................................:...........Foundation ..............poured-c.QX..pourad—c.,onarete......................... t° Exterior ....Cle.pxlQ.ard..$c..W..C.• ...:..............................Roofing ...................a,`3.Pll,` I..t.................................;:............ Floors ..............................................t0 wall ..Interior . ........dr. waL1........:..................................... :. oil warm .air , Heating ............................Plumbing 2 baths Fireplace One p ...............Approximate. Cost ......:355.91.00.0 ................................................................... . . ......... ......... ........... Definitive Plan Approved by Planning Board -----------_________AK19____ Area ................. ..._........... Diagram of Lot and Building with Dimensions Fee ..::.......... ..Y... ................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 'EdAj,�q' ' 26x50 14x24 garage N 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 ..... Cum �.Q/a. .�ti.:..�� ..�.!^............... Construction Supervisor's License 5190. . .. .... .. 8-n ITH, JAMES K. No 25999.. . Permit One...Story............ y ^` .. for 4 �ISingle*Family Dwelling ... . .. .................. .............................. ...... Location Lot 28, 40 Bretwood, Lane ..Centerville..................... CI Owner .....Ians..K»...Bmitn. ................ z Frame _ Type of Construction ........................................... Plot ... .. .................. Lot ...:....... ........ F• _ Permit Granted Jari.Liar 2.0! 19 84 Date ofllnspection ...........................r c19. Date Completed � ....1 L....`.........190 IL_ - 10 " 5 '• �,/� ice• � , • r�q�GLG 4C%G•Cli���- - - r. �� _ ,. .. r /'1_ - '- -.t//�rrw�, J `mot+ l , �� � `. ... •� ) i � �. Assessors map and lot number, .....�� ........ ,.�Zl G � G 7H E Sewage Permit- number ........ ...... /.....,� .............:.... w ~ S BARNSTABLE, i House_. number ............ S .... .......:............ r rasa 00 1639. 9� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......Construct Dwell1 g................................................................... TYPE OF CONSTRUCTION W00d fr,am .........Jar g....2.0.....................19-a'.4.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ip 23 xetwood .Lane A Centerville .................................... ProposedUse ....gingle✓„farml:V...................................................................................................................................... Zoning District a1.... Ce? t-OSt .....................................Fire District ............1!?�................................................................. Name of Owner eTa !1 p K, Smith Address ...........Barnstable? ................................ .............................................................. Nameof ................................Address .................................................................................... Nameof Architect .......................................................:..........Address .................................................................................... Number of Rooms ..........6......................................................Foundation .............M.011X..ed....onnome e...... Exterior .... naX"d...&.. .o.n. ...................................Roofing ...................a.gphpl lt.......................................... wall Floors .....to.............wall.................................................Interior .................... .............................................. oil warm air 2 baths Heating ..................................................................................Plumbing .................................................................................. Fireplace ..one ................................................................................Approximate. Cost .........�5�q.s.. . .......................................... Definitive Plan Approved by Planning Board ________________ �a ___19.7?. Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 2bx50 14x24 garage 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. to Name .... ........,C ..�............... V Construction Supervisor's License r5190 f SMITH, JAMES K. A=168-13Ar- 25999 One Stor , No ..............:.� Permit for ...................... ....... .... , Single Family Dwelling .... ...... ..................................... ....... Location ,,,Lot 28, 40 Bretwood Lane ............................................ Centerville ............................................................................... Owner .....James. . ...K......Smith... ....... .. .. . .. .................................. Type of Construction' .,Frame ............................... ................................................................................ Plot ............................. Lot ................................. , Permit Granted ,,; January..2. . 0,........19 84 .... . .. . Date of Inspection ....................................19 Date Completed ......................................19. 4 -_ Q- 1