Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0027 BROKEN DIKE WAY
Fero('� I�? :,�.� ! ,� a P`�F>, �`( w ;• ,�C �, tirap•-�F, s i .d r-; . . .!y _ ..�..,.. " -.. „ �tixc°-- i-'' . .,�.. . -,ems o d" t `i-. -N.{n; ..,rs pn��'.� J�r•.J".,J's .y � r�!'d+yxH�., v<.- ,..;. .IrI k.' �/v.� v.. +k.'7N-.Y� ..��� r .�5w.�"�'�. • �I'.r ", e rX'!k�� 3r�g'3� F���- �t�}' �# 0'.5S�kiti.... �f W ���y �.x /" R "�� �7:��,r{ a�.•��,� re�.yq �p y p ,i �Ilx,� tt it .x c ,y e a f F'' - •( - t0 + k a trl itt I� s� k 1 V � 4 a E. 9 F { i r F 4- t t I f° X� � e ! , . r 11: n tl k C i 3 n 4 5 6 rx w t i. { r3 - { .i a ff r; .,. p. �..; .+�.1. :.:.. ,. ..: ..... ...:.. .. .. ,.:..., ♦. ... . ..:.�.. .,x. ,. 'r, � :.i a to Ih t' .H3f =F +.. '. \ ... .r ,:, ., „ <. �..,:,�,.. I .�..:.::. ,. r , ...�:..,. � :. .... \. e, ryb 4, f 5 i f, f # :,•;S .,.�. ,. � '.. -. f ;,f a .. k ,. ...1. �4 .. � �-..'•. �:r-.;;.'v L: 4,. 13 fS 5 S fr: J f 1 k + 1 :.t t. s t ! A' k ! V e k' {y ,.. .- . -� � �. ,. •,Ana �. 'p-.�. , 1 A - ;.# Sr �{ t t•• kS F; f ! k�+Gd J �l ��� e't l� 1 �i• t. A i f �f f. } 3 1 rf l v�- t F. t 1 T i •N r! 11 V .f xx .,<.,, ..>s",,,... ,,,__ �. ,.,...fi..., ,. _.;,. .,, ,��,;�. �s,�..,, .;;t .,. ..... .• .,._... ., ., ,3-,e,... ,.,�eia,,,.n�s.�.w�...., ,,..;#.,a4sE ....,,..,, �.... ,..... }. ...,.,,.,�,i:?,�.._.+>.0 �.....�.�k tt..>:k s .,�Sc�datbpt .. ,..rAeti,�t;� �;f:-r.�,.:._ hr.�,` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 22'7 Parcel d "l S Application #&6,14 42*, Health Division Date Issued 31 �& Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ErhA�-` SEw Historic - OKH _ Preservation / Hyannis Project Street Address 2 Village Cw�&Z� Owner Address Telephone - Permit Request k4W) V, (A4 Dm� CW05-_( 40ZZl�i Qack Dv, �U Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation oa• Construction Type ' K 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 ( J. (l ay: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq. Number of Baths: Full: existing new Half:efstlNgOF BARNSTABLR9w 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: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) q Name M Vd L"("wTelephone Number fj�_0 Address V�,� License# , UW "V Home Improvement Contractor# 3 Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS , PPR,OD CT WILL BE TAKEN TO VAV VW U� �rk JW0 SIGNATURE DATE Ito V FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-100988 Construction Supervisor HENRY E CASSIDY 8 SHED ROW WEST YARMOUTH M 2,p l� Expiration: Commissioner 11/11/2017 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 p Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation " Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY — -- 18 REARDON CIRCLE - SO, YARMOUTH, MA 02664 >'Update Address and return card,Mark reason for change, 3CA 1 Co 20M-05/11 E] Address Renewal ❑ Employment Ej Lost Card C�J/te�anroraa�acue�c�G�o�C�/��warcc�ccae� \ •Office of Consumer Affairs&Business Regulation License or registration valid for individul use only U OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to; egistration: ;153567 Type: Office of Consumer Affairs and Business Regulation xpiratlon: :;1:2/15/20.1.6 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATFM,:,!NC HENRY CASSIDY 18 REARDON CIRCLE SO. YARMOUTH,MA 02564 Undersecr•etar Y No/valid wi ut sign e i The Commonwealth of Massachusetts Department of Industrial Accidents rJ 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 Le ibl Name (Business/Organization/Individual); Address: f f City/state/Zip': 1 �, b Phone #, �: 1�l Are you an employer? Check th- appropriate box: am a general contractor and I Type of project (required): l.. ,l am a employer with �� 4. ❑ 1 g 6, ❑-New construction employees(full and/or part-time),* have hired the sub-contractors _ p ) 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [] Remodeling shipand have no employees. These sub-contractors have 8; [] Demolition working for me in any capacity, employees and have workers' [No workers' comp. insurance comp, insurance.$ 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10,0 Electrical repairs or additions 3,❑ 1 am a homeowner doing all work officers have exercised.their - 1 I.El Plumbing repairs or additions myself, [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,�,'.] Other comp, insurance required.] J *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. 3Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees, If the sub-convactors have employees,they must provide their workers'comp.policy number, 4 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information, Insurance Company Name; ,L' Policy or Self-ins, Lic. #: or If 15; Expiration Date: J �(j✓ Job Site Address: Z City/State/Zip: Attach a copy of the workers' compensation policy decl ration 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 insura covera e verification. I do hereby certify d 'the pat an penalties of perjury that the information provided abov is true and.correct, z Signature: Date: ' Phone 4: Official use only. Do not write in this-area, to be completed by city or town official; City or Town: Permit/License ft 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#! CAPECOD-27 BDELAWRENCE ARO` DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 6/3012015 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 endorsement(s). PRODUCER CONTACT NAME: Rogers&Gray Insurance Agency;Inc, PHONE Fax 434 Rte 134 AlC o I• Alc No: (877)816 2156 South Dennis,MA 02660 E-MAIL ADDRESS: INSURERS)AFFORDING COVERAGE NAIC i✓ INSURER A:Peerless insurance Company-see LIBERTY MUTUAL INSURED INSURERB:ATLANTIC CHARTER INSURANCE GROUP Cape Cod Insulation,Inc. INSURER c 18',Reardon Circle INSURER D South Yarmouth,MA 02664' 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,PA(D CLAIMS. ILTR TYPE OF INSURANCE R POLICY NUMBER MM10 MM/DD�YY LIMITS _ A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR CBP8263063 0410112015 0410112016 PREMISES Ea occurrence $ 100,000 IVIED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY a JECT LOC PRODUCTS.COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY - - _ COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident) $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIREDAUTOS AUTOS Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4CE XCESSLIAS CLAIMS-MADE AGGREGATE $ ED RETENTION$ $ WORKERS COMPENSATION I SPER OTH•. AND EMPLOYERS'LIABILITY YIN' TATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE WCE00431901 06/30/2,015 06/30/2016 EL.EACH ACCIDENT $ 1;000,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEEI $ 1,000,000 Il'yes,describe under DESCRIPTION OF OPERATIONS below E.L.,DISEASE•POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers Compensation includes Officers or Proprietors.' Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED.BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED' IN 18 Reardon Circle ACCORDANCE WITH THE POLICY PROVISIONS, South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE M^ 47 F ©1988.2014 ACORD CORPORATION, All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered,marks of ACORD low% Town of Barnstable Regulatory Services `• w.rc. Ricliard V.Scali,Director t63A �0 �I � 639. Building Division Tom Perry,Building Commissioner 200 Main Sig�eet Tl:yannis,N10260l mvw.town.barnstable_maxs Office: 508-862-4038 f ax: 508-790-6230 Property Ownex:Must Complete and Sign This Section. If US in A Builder i, Jeremy F. Gilmore _W a �. zs Owner of the subject[JI—gxTTY Cape Cod Insulation herrl�y autlir�nr� .., .Y to act.on rnybelzalf, , m ag matters relative to work authwiz d by this h-ldi.ng peimut application for __27 Brokell_Qi,k�WaX.Gent._e_„rvi,ll.e,_L\Lt/�Q26��_ (Address of fob) "Pool fences and alarms are the respo sibzlity of the applicant. Polls are n.ot to be filled or utilized before fence is installed and.all,f uial InspeGtons are perfom-ied and accepted._ awre of rner Signature of ilpplicain Print Nan - - rrint NarM, Dafe - - '- - D FEB 1 1 `2016. Q:FORMS:o'v;NF_RP;- JISSK)..\'POO ti I CAPE COD N S U L A T I ONY. ' {Q e FISIROLA4S SIAALLESS SIRATFOAM 9YSNN0[O+•ID+aPc*+.w.N+Mw.km-.:.v;vMrA.ur a+s ,.yy.M". RATE$ GUTTERS INSULATION CIILINOS �+ 1-800-696-6611�"`` 0�j Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc.performed& completed the insulation and weatherization work at the property listed below. Cape Cod p P P Y p Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property_Address Villaize Jeremy Gilmore 1�27Broken-Dike Way, t Centerville Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted , Ceilings' ( ) ( X ) (R-30) Slopes Floors ( ) ( ) ( ) ( ) ( ) Walls ( ) ( ) ( ) ( ) ( ) Sinc ly H Wulation, Cape �tHE W TOWN OF BARNSTABLE Building 201106288 Permi BARNSTASLE, * Issue Date: 11/16/11 t MASS. 9�A i639• �� Applicant: CASSIDY,HENRY rF0 MAC A Permit Number: B 20112514 Proposed Use: SINGLE FAMILY HOME Expiration Date: 05/15/12 Location 27 BROKEN DIKE WAY Zoning District RC Permit Type: RESIDENTIAL INSULATION Map Parcel 227079 Permit Fee$ 35.00 Contractor CASSIDY,HENRY Village CENTERVILLE App Fee$ 50.00 License Num 100988 Est Construction Cost$ 1,100 Remarks APPROVED P NS MU AINED ON JOB AND INSULATION OF 8 MAN HOURS AIR CEILING. 9"LAYER OF R-30 THIS CARD MU E PT POSTED UNTIL FINAL CELLULOSE 40 SQ FT, 224 SQ FT EXTERIOR FLOOR OVERHANG CL SSINSPECTION HAS MADE. WHERE A CERTIFICATE O CCUPANCY IS REQUIRED,SUCH Owner on Record: GILMORE,JEREMY F&SUSAN T BUILDIN ALL BE OCCUPIED UNTIL A FINAL Address: 27 BROKEN DIKE WAY O eT EN MADE. CENTERVILLE,MA 02632 Application Entered by: JL Buildin ermit Issued By: I PEC THIS PERMItbiNVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY;OR SIDEWALK OR ANY. T THEREOF;EITHER ORA Y O ER NTLY. ENCROACHMENTS ON'PUB LIC PROPERTY,NO SPECIFICALLY,PERMTTTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDI N. ST. T OR AL - DES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE - OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NO LEAS APPLICANT FROM THE CONDITIONS OFANY APPLICABLE SUBDIVISION .. RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR AL CONSTR TION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT VEL BEF RE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUM ONS TO BE COMPLETED P R TO F ME INSPECTION. 4.PRIOR TO COV G STRUCTU MEMBERS(REA TH). 5.INSULATION t t 6.FINAL INSP TION BEFORE OCCUPA Y. WHERE APP CABLE,SEPARATE PERMITS RE QUIRED F ELECTR L,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SH L NOT PROCEED UNTIL THE IN EC HAS AP OVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT BECOME NULL AND ID I ON RUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE T E PE IT IS ISSUED AS NO D ABO PERSONS ONTRAC WITH UNREGISTE D CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). u BUILDING INSPECTION APP VAL PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel D� Application #C3 l "U2 CJ Health Division Date Issued Conservation Division Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project S eet Address ik& /T 1���. C& 9 , III Villa e ' 1L , k ISO, MW Owner d`- G' k Address � -O Telephone a ' ?J 7i Permit Request �- �?, VG L Square feet: 1 st floor: existing proposed -,Cnd flo xisting proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation L106 . Qd Construction Lot Size Grandfa ere ❑Yes ❑ No If yes, attach supporting documentation. Dwellin ype: Single Family Two mily ti-Family (# units) Age Existing Structure Hist ouse: ❑Yes &a Ao On Old King's Highway: ❑Yes ❑ Nei Bas e Type: ❑ Full ❑ Cr a I ❑Walkout ❑ Other Basement Fi ' hed Area (sq.ft.) Basement Unfinished Area (sq.itg : Number of Baths. ull: existingnew Half: existing r , _{ -new,,-;-g Ff Number of Bedrooms: existing _new Total Room Count (not inclu b ths): existing new First Floor Room,,Count Heat Type and Fuel: ❑ Gas Oil ❑ Electric ❑ Other c� Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes 54 If yes, site plan review# Current Use Proposed Use /J APPLICANT INFORMATION ( � 5G BUILDER OR HOMEOWNER) Name el /d l G �GU rG Telephone Number 54- 7 Address License# l Home Improvement Contractor# 1 3. 67 Worker's Compensation # A)K©d yZ !�161 ALL CONSTRUCTION DEBRI§YESULTING FF P IS PROJECT WILL BE TAKEN TO SIGNATURE DATE � I , � E (� u h FOR OFFICIAL USE ONLY I APPLICATION# . z DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER , DATE OF INSPECTION: � 3 FOUNDATION , i FRAME INSULATION FIREPLACE y t M gF' ELECTRICAL: ROUGH ,FINA oL t si PLUMBING: ROUGH -`FINAL'"' h � GAS: ROUGH FINAL .I �. 's FINAL BUILDING ,i DATE CLOSED OUT ASSOCIATION PLAN NO. f The Cominonl�)ealth of Massachusetts r ,Department of Industrial Accidents 1 Office of Investigations 600 Washington Sheet t� Boston, MA OZXXX y www.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/El ecti-iciarls/Plurnbers A.ppl.icant Information Please Print Legibly Name (Business/Organization/Individual):_fA 5ljj,a j tr7A,__ Address: J ►'' City/State/Zip: C( Phone #: ro 7 7 Y', j J Are you an employer'? Check th appropriate box: Type of project (required): 1. I am a employer with_�Q_ 4 ❑ 1 am a general contractor and 1 6 E] New construction employees(full an etor.or partner-d/or part-time).* have hired the sub-contractors.. 2. I am a sole propri listed on the attached sheet.. 7. ❑Remodeling ❑ ' • ship and have no employees These sub-contractors have g, ❑ 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 of additions 3.❑ 1 am a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions per MGL myself. [No workers' comp: . right of exemption p 12.❑ Roof repairs c. 152, and we have no insurance required.] t ❑ q , employeeets's. [[No workers' 13. .Other Af 4U tI 0I comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.• t Homeownars who submit this affidavit indicating they arc doing all work and then hire oulside 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, lf.thc 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 informatiori n Insurance Company Name: Policy# or Self-ins. Lic. #: (A-)l A WrL,5 ! Expiration Date; G Job Site Address: A 4 City/State/Zip: Attach a copy of the workers' compensation policy Jeclaration page (showing the policy number and expiration date). on 25A of MGL c. 152 can lead to the imposition of.criminal penalties of a Failure to secure coverage as required under Secti fine up to $l.j500.00 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. B&advised that a copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. Ldo hereby certify lit e pa' and penalties of perjury that the infortnation provide ab��ove its true anrjlpcorrect Si nature: Dale; VUr 11" _M Phone # 0 7 ?S Offtcial use only. Do nor write in this area., to be completed by city or for+n nffieiaL City or Town;, Permit/License# Issuing Authority (circle one): 1. Board of Health 2, Building Department 3, Cit3,/Town Clerk 4, Electrical Inspector S. Plumbing Inspector 6. Other _ Contact Person: Phone#: Lc0grt1:s. & Gray'.Lns. Vage: Client#: 4597 CCINSUL ACORD,, CERTIFICATE OF LIABILITY INSUI NICE DA,'k(MIYIIDDIYYYY) [REPRESENTATIVE IS CERTIFICATE IS ISSUED A°,A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE oL7/01/2411 ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY HOLDER THIS ELOW.THIS CERTIFICATE pF INSURANCE DOES NOT CONSTITUTE A CONTRACT ALTER THE COVERAGE AFFORDED BY THE POLICIES OR PRODUCER,AND THE CERTIFICATE HOLDER. TACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must he endorsed.If SU I the terms and conditions of the policy, certain policies may r S WAIVED,subject to equire BROGATION an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such t:ndorsernent(s). YRODUCtR CONTACT RDgurS& Gray Iris. -So. Dennis NAME: _Margaret Young "�. PHONE-- 5 -434 Routes 134AI 08-760-4602—_ _� G N`of SQ8-258 2102 P.O.Box 1601 ADDRESS: youngma@rogersgray,corn " RDDDCER South Dennis, NIA 02660,1601 CUSfONIER106: _._--�-- INSURLO - - INSURERS)AFFORDING CUVERAGL NAIC N_ Cape Cod Insulation Inc INSURER A:Peerless Insurance _ 18333 455 Yarn'touth Road INSURER B:Ohio Casualty insurancs�Company - Hyannis, MA 02601 INSURER c:Atlantic Charter'Insurance INSURERO,Commerce Insurance Company— 34754 INSURER F: - --- COVERAi kS CERTIFICATE NUMBER: iIS IS 1'i)C:ER'nI7y THAT THE POLICIES OF INSURANCE LISTED BELOW HAVREVISE 86EN ISSUEDTD THE INSURED NAMED AIdOVO OR TMBER:IGY PERIOD IIvDI%ATLD.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOGU(s1ENT Wn'H RESPECT TO WHICH THIS 'CFRIIHCATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES 06SCRIBED HEREIN IS SUBJECT TO ALL.THE PERMS. 'c.(:UISIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L SR rIH I'YPE OF INSURANCE RDDL OLIGY EFf POLICY EXP till D POLICY NUMBER NM1(DU MPNUOlYYYY MTI S q vrNkliAL LwauJry LI CBP8263063 17' 12011 04/01/201 x eAcl-I • 41Q occuKft itNcla $1 000 000 i_uNln,IeK�lrt 4ENt:R,�,LLIAt11Lr ". bANl1CGETORENTEI� i --I I AIS.Pb1Qt l_x►�,��4n PREINISES '8 YJ P. C $100 000 (wet)exr-(nny alp pulson) $5,000 _ ----�-._ PERSONAL 4 AUV INJURY _ $1,000,000 -� --- -..--...._--.-----__:,...._-_-.-. � GENERAL AGGRC-GATC s2,000 000 f'Ij0- PnooucTs-CC)MPIQP AGG �2,000,000 PULIi:'r i=•• LOG ---- U Au1ol"oWR.tLwBILnY 11MMBCKVMK 4/01/2011 04101)2012 COMBINEDSWGLELIMIT ANY AU Io (Ea acadom) �1 000 000 Al.L.OWNED A01 O5 - • HODILY INJURY(Par per un) $ -X ti:Pu=UUL kU AUl q5 BODILY INJURY(Par ami,14nl) $ ^-_— X rnh�o urns PROPERTYDAMAG6 $ ._.• - (Par ac49Uanl) X NUN:.IVVIVt=11 NUIpS B - uranRl LLa uAn X OccUR 0001254514645 4101/2011 041011201 EACH OCCURRENCC 0 000 000 CIAIMS-N41DE - - - AGGREGATE yi QQQ 000 . DL Dirt 1IULr X I+rrrNllclly +' 10000 - (, WORKERS COMPENSATION AND CNiPLOYERS'LIABILn-Y WCA00525902 06/3012011 06/301201 TATuTs DTrI- AhY PROPK EI OR/PARI'NER/tXECUTIVE YIN - OFFICER,MtMdtREXCLUDED? „� NIA (N4uaatu(Y In NH) E.L.EACH ACCIDENT $S0Q,000 ' .. - - Il Vos ad;;,¢a unuar - E.L.DISEASE-EALMPLOYEE $500,000 St:RiP110IV(`F 11PE kAl1l)Nti elnw F.I_DISEASE-POLICY LIMIT $500.000 UeScrovnuN CM`JvLKATIUrJS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Rcmancs SchaduIi,it more space is required) Workers Comp Information Included Officers or Proprietors " (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES OE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (01988-2009 ACORD CORPORATION.All rights rasarved. Ft,S6 1CORD 6 (8575/M5JM 9)68179 1 of 2 The ACORD name and logo are registered marks of ACORD MEY 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration r Registration: 153567 Type: Private Corporation 44 �• Expiration: 12/15/2012 Tr# 206433 CAPE COD INSULATION, INC . % f5_ HENRY CASSIDY 1 5f -- 455 YARMOUTH RD. HYANNIS, MA 02601. - pUpdate Address and return card.Mark reason for change. Address Renewal Employment Lost Card DPS-CA1 it 50M-04/04-G101216 Otticc o 'mer Affairs 13us ne tiegul lion License or registration valid for irdividu!:use rs! HOM PR�{%'E`I /iC�� before the expiration date. If found return to: Registration: 153567 Type: Office of Consumer Affairs and Business Regulation Expiration 12/15/2012 Private Corporation 10 Park Plaza'-Suite 5170 A Boston,MA 02116 OD INSULATION INC HENRY CASSIDY r r; a` 455 YARMOUTH RD e _ HYANNIS,MA 0260t1 Undersecretary t slid ith t si lure f. Massachusetts- Dcp:u-tmcnt of Public Safety' Board of Building Regulations anti Standard's Construction Supervisor License License:,CS 100988 HENRY CASSIDY „ 8 SHED ROW WEST YARMOUTH', MA 02673 y -~ Expiration: 1.1/11/2013 Commissioner Tr#: 7620 - s II96S OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at Zap iLt5-m DI I V, k 4 (Property Address) PA (Property Address) 9 hereby authorize ecr S (a+k:o Y L . (Subcontr or) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building Ci permit and to perform work on my property. OwTW Signature Date d TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map_ Parcel ' Application # :� 5 Health Division Date Issued l 0 1 Conservation Division _ _ Application Fee Planning Dept. _ Permit Fee 0u Date Definitive'Plan Approved by Planning Board Historic - OKH _ _ Preservation / Hyannis Project Street Address 9 D/lip ' ' Village Ile- Owner y CZ,i�h,oyL� Address I� �� � � !�` a Telephonel �'f-Z _ Permit Requester S uare feet: 1 st floor: existing g_—proposed 2nd floor: existing_ proposed . Total new Zoning District Flood Plain Groundwater Overlay Project Valuation/D!0 d,1 D-e Construction 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: U. Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.)__ Basement Unfinished Area (sq.ft)_ Number of Baths: Full: existing_ new _ Half: existing = _r-a Number of Bedrooms: existing —,new f", = Total Room Count (not including baths): existing new _First Floor Rgom Count- Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other ul Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood%coal stout: ❑�Yqs ❑ No sv Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size — Barn: ❑ existing -a new size— Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes -&�No If yes, site plan review# _Current Use— _..Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name* Q��� ,� ��, Telephone Number 7�,5- /Z / Address � � „ /��//�_ License Home Improvement Contractor# 16 .3 5 G 7 Worker's Compensation # !a/C ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECTWILL BE TAKEN TO/` SIGNATURE _ _DATE %t,P ZJ 1/i/ i FOR OFFICIAL USE ONLY APPLICATION# -DATE ISSUED :MAP,/PARCEL NO:,.,., ADDRESS. VILLAGE OWNER t7 , DATE OF INSPECTION: C, FOUNDATION-A* i FRAME t INSULATION'': FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL s GAS-- ROUGH', FINAL 4s 'FINAL BUILDING-= DATE CLOSED OUT s' ASSOCIATION PLAN NO: k The Comoro mvealth of massachusws ; = r �-, Department of Industrial AccideiTts Office Oflnvestigations 600 Washington Street Boston, MA 02I1.1 y ww).v.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectricianslPlumbers Applicant Information Please Print LcF_ibly Name (Business/Organizationftndividuaf): CA�� 1')/� _EN SV a f -r;U ro-- Address: ✓� City/State/Zip: too� Phone #: r0 Are you an employer'? Checic th appro,priate box: Type of project (requited): 1. 1 am a employer with -- — - 4. ❑ I am a general contractor and I 6. ❑New construction employees(fit11 and/oz part-tirtie). have hired the sub-contractors 2.❑ I am a sole proprietor•or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, Demolition- , working for mein any capacity. employees and have workers'comp. Building addition No workers' comp. insurance, comp. insurance.# , _ 5. We are a corporation and its 10.0 Electrical repairs or additions. required.] 3.[] 1 required] a homeowner.doing all work officers have exercised their 1 L[] Phunbing repairs or additions ' myself. [No workers"comp. right of exemption per MOL 12.❑ Roof repairs' insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.0Otber(,�� � �� q+trot 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 arc 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 cmployccs. 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. ZILi�_ Policy# or Self-ins. Lic. #: ��A O��Z�� O Expiration Date: 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 Section 25A of MOL c. 152 can lead to the imposition of criminal penalties of a fine up to$1„ m 500.00 and/or one-year imprisonment, as well as civil penalties in the fonn of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ldo hereby certify u e pa andpenalties of perjury that the information provided above is trice and correct. Signature: Date: Phone#: ok 7 5 L f T Official use only. Da not:write in this area., to be completed by city or town offieiaL City or Town; Permit/License# Issuing Authority (circle one): ' 1. Board of Health 2. Building Department 3; Cite/'Town Clerk 4. Electrical Inspector,5. Plumbing Inspector, 6. Other . Phone Contact Person; #: - ., tiogars Gray'.Lns. ?age; vus Client#:4597 CCINSUL ACQRD- CERTIFICATE OF LIABILITY INSUFZANC DATE(MMruUIYYYYI THIS CERTIFICATE 2011 IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTI ICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsernent(s). PRDuucER Rogers ks<Gray Ins. -So. Dennis coNTneT ;. NAME: Margaret Young' 434 RouLC 134 A,c.No Exit: 1. (ac No) 508-258-2102 P.0.Box 1601 A.DO ESS: youngma@rogersgray.Corn _- South Dennis, MA 02660-11301 t>tsDl E --_ cus-romER ton: INSURED --- INSURER($)AFFORDING COVERAGE NAIC 0 Cape Cod Insulation Inc INSURERA:Peerless Insurance 18333 455 Yarmouth Road INSURLRB:Ohio Casualty Insurance Company Hyannis, MA 02601 INSURER c:Atlantic unarterinsurance INSURER D:COmmerce Insurance Company 34754 INSURER E: - COVERAGES F INSURER F: CERTIFICATE NUMBER: REVIS1'FiIS IS TO CEFCI'IFY TI-IAl THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE OR THtBPOLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACTOR 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. 19 EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L TR "(YPE OF INSURANCE OLICY EFF POLICY EXP - SR D POLICY NUMBER MMIDD MNJD.Y EXIT LIIYIr15 A GENERAL LlA81L(TY .. CBP8263063 4101/2011 04/01/201 EACH OCCURRENCE11,000,000 X nINIERi:IAL GENkRAL LIAgILI(Y AIMV E-TO RERTEO—'- ' c�'mis DOE �OCCUR PREMISES Ea D enr 5'I QO,000 _ HIED QXP(Any a)q pi)mn) $5,000 . PERSONAL&ADVINJURY $1,000,000 GENERAL AGGREGATE $2,000 Ooo _ GEN 1.AGGREGATE t MIT APPUES PER: - - �O I'OL.iCY LOG PRODUCTS•COMP/QP AGG �2,000,OOa s D AUl'OIVIOBILE LIABILITY - 11MMBCKVMK 4/01/2011 04/011201 COMBINED SINGLE LIMIT ANY Auto (Ea acddant) $1 000 000 ALL OWNED AUTO$ BODILY INJURY(Par person) X SCPU70ULEU AU FO5 t - BODILY INJURY(Per accidanl) $ X rnRED Au'ros PROPERTY DAMAGE e. (Par acddonl) ' X NON OvVIVEI)AUTOS 7-UMBRELLA LIAR $ EC UR 0001254514645 4101/2011 04/011201 EACH OCCURRENCE EACESSLIABIMS-MADE - $1,aaO,OOa AGGREGATE $1 OQO,000 -- DEOUC1I8LE _ X RFI'FNILIL0 10000 s C WORFi6R5 COMPENSATION $ --- - AND EMPLOYERS'LIABILnY WCA00525902 06/3012011 06/30/201 X tivc sTATu• o7'H ANY PROPRIt10R/PARI'NEFUEXECUTIVErY---!�N- Y I I S _ - OFFICE ury In NH) EXCLUDED - `, ..1 NIA - E.L.EACH ACCIDENT $500,000 (h4ntlntury In NH) - Ityes, 1PTI0N urloar QF 0. E.L.DISEASE-EA EMPLOYEE $500,000 I1C-SCRIPI'ION OF OPFFtA'I IONS elnw E.L.DISEASE POLICY LIMIT $500,000 , DESCRINf10N OF UPEIZATIUNS!LOCATIONS/VEHICLES(Attach ACORD 101,Additional RcmarKs Scnadu@,G more space is requeed) - Workers Comp Information Included Officers or•Proprietors (Sec Attached Descriptions)' CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. - - - AUTHORIZED REPRESENTATIVE ACORD 25(2009109) 01988-2009 ACORD CORPORATION.All rights reserved. #S68575/M68179 1 of 2 The ACORD name and logo are registered marks of ACORD MEY T 5.. >� 10 Park Plata- Suite 5170 Boston, Massachusetts 02116 Home Improvement Captractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2012 Trg 206433 CAPE COD INSULATION, INC HENRY CASSIDY 455 YARMOUTH RD. HYANNIS, MA 02601 ;Update Address and return card. Mark reason for change. I Address ❑ Renewal (=1 Employment L_ Lost Card UrliCed Or S gICI'Atraur5 us nr:'Regul tiou License or registration valid for irdividu!use only only • HOMIE fINPf�Q ` 1 la before the expiration date. If-found return to: Registration: 153567 Type; Office of Consumer Affairs and Business Regulation. Expiration: 12/15/2012 Private Corporation 10 Park Plaza-Suite 5170 , Boston,MA 02116 N 0D INSULATION,Rj1C.,._ C_NRY CASSIDY' I r 55 YARMOUTH RD YANNIa,MA 026a1 - Undersecretary t alid ith t si tare _ :`lu��at'husc[t>- pctuuTnrcn[ lif Pultlir �ufct� . .� Buartl trf 13wiltlin� 1 v . Ewe.,ulatinn�and ltandards ' Construction Supervisor License r License: CS 100988 Restricted to•. 00. �•,:: HENRY x - CASSIpY rf ��;i� • S:S't iED R�1N NEST YARMOUTH; MA 02673 `�i'`'� Expiration; I1/11/2011 100988 4 .,. ll . ' e OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at -Ni (Property Address) (Property Address) hereby authorize ' Cr S (q,+,—VO VL (Subcontr or) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building (IF N C) permit and to perform work on my property. OwqW . S Signature Date F TO Permit No. ..�•� TOWN OF BARNSTABLE nnn- o �...... ° BUILDING DEPARTMENT D°8E I TOWN OFFICE BUILDING Cash \' HYANNIS,MASS.02601 Bond .....F�....: . CERTIFICATE OF USE AND OCCUPANCY Issued to Address 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. April 9�...... , 19.....87......... Building Inspector 0 r ` TOWN OF BARNSTABLE BUILDING DEPARTMENT Z INsaaes►U = TOWN OFFICE BUILDING rum HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has gbeen issued for the building authorized by BuildingPermit #........�PA. „/.....�1........................................................................................................._....................................... issued tot .. .� v3 %P......... ,, ,. ... � ,, ....�/?!..G'..... Please release the performance bond. 1 I, ILDING + g•' ri TOWN OF BARNSTABLE, MASSACHUSETTS PERMIT t A-227-079 JOB. WEATHER CARD „ DATE February 5 19 86 PERMIT NO. UW APPLICANT Bayview Corp. ADDRESS BOX 2048 Centerville 027521 IN0.) (STREET) (CONTR'S LICENSE) PERMIT TO Build dwelling ( 1i) STORY Single family dwelling DWEBLLIRNGOF UNITS 1 (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) lot. #7 27 Broken Dike Way, Eenterville ZONING AT (LOCATION) y• DISTRICT (N0.) (STREET) x BETWEEN AND (CROSS STREET) (CROSS STREET). SUBDIVISION LOT _ LOT BLOCK SIZE 7 BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION vx TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE). REMARKS: Sewage #85-698 BOND AREA OR B ft. '. VOLUME 80,000 PERMIT 119.75 ESTIMATED COST,.$ FEE (CUBIC/SQUARE FEET) Joseph lafrate i f OWNER z fig' / CUILtervtlta, MA 02632 BUILDING DEPT. a y, ADDRESS BY "/ 1 THIS PERMIT CONVEYS NO RIGHT t"O OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART TH REOF,'EITHER TEMP RARILY OF PERMANENTLY.'ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER T E BUILDING CODE, UST BE AP ' fr ► PROVEDBY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION.OF P IC SEWERS MAY BL-' OBTAINEC !. _F_R A THE__D.EPARTMENT.OF PUBLIC.WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITION!ANY:A�PPLI'CABLE SUBDIVISION RESTRICTIONS: � -MINIMUM,ZOF-''', THREE CALL APPROVED PLANS MUST BE RETAINED,ON JOB AND:THIS WHERE APPLICABLE SEPARATE F tNSPECFI0NS'REQUIRED FOR ALL CON.STRUCT,ION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING AND �'• �.„,• 1. 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 hl p it AL RS(READY TO LATH). FINAL INSPECTION HAS BEEN MADE. # . FINAL INSPECTION BEFORE 3 OCCUPANCY.' 4 POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS. ` PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS s 2 2 i 2 X 3 / -- -- e ` 3 - HEATING 'NSPEC ING A PROVALS REFRIGERATION INSPECTION APPROVALS z;; t 07HE 2- 2go J 7 WCRK SHALL NCT PROCEED UNTIL THE PERMIT WILL BECOME NULL AND-VOID IF CONSTRUCTION NSPECTIONS INDICATED ON THIS CARE :NSPECTOR 'AAS APPROVED 'HE VARIOUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPHONE 1.. STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. OR'WRITTEN NOTIFICATION. ` Assessors ma and lot numb •� , . _ ��/�- �/3���/S� �r p . .- ? THE number ....... ... ')4g C SEPTIC SYSTEM MUS Toy♦ Sewage Permit number .................RJ••.. '..:d .•......... INSTALLED IN COMPL WITH TITLE 5 : ABLE, ` House number ......... .� rasa ..G �.................................. ENVIRONMENTAL COD ^^ 39• TOWN OF BARN S��"` BUILDING INSPECTOR` .. `�✓ , ; , APPLICATION FOR PERMIT TO .......C P.`'�...$. u c:..............1' '��'�. ....................................................................... / . TYPE OF CONSTRUCTION ...... !'`1 S L�.... R. .n.l..Y......:!.�V s�.N ............................................ .................... / 3..�............19. �/ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora permit according to the following information: Location ....... .. Q ��d cti✓ A) cn/ �� �'7 Ile �C. .............7..............--..� �..-`.......:............ � ...-......................!...................................................... ProposedUse .......... :.5. i...G�✓..1..1..� ........................................................................................................................... S� ZoningDistrict ........................................................................Fire District ........ !V. .. ............. .........................../....... Name of Owner ..... Q.. .`.. .... l. �.147 z.........Address ...... :`7..'. .... '�. ...... 1 Name of Builder Y�.....CQX.,.P..............Address ...?.`.�..`.Ayco.....Z. Name of Architect 1PAXI.. ...................Address ......... 'W... .tc!!!.G 7..................... Number of Rooms ..................................................................Foundation .... ........................................ Exterior .Z. �!.. ...i✓`! !.!!`.. ..Gf.:t.4.. .....................Roofing .........AV.d..Vti.R/v `........................................ Floors 3f -f•.....S...C7...... .. . .!^-c-.....................................Interior ...... L`P.....`!..1.."'.JW...... . .................... Heating ..... !`.�...................................................Plumbing .......... .. ! ir:7 ..................................... Fireplace ........ ................................Approximate Cost ................ ..�J.P..Y..'.................... Definitive Plan Approved by Planning Boar ZRLK� -----------197�. Area .........Fee .......... 1..9.5 .... .�, :......... Diagram of Lot and Building with Dimensions // pp ��........ ��..1............................ SUBJECT APPROVAL OF BOARD OF HEALTHd t �\ c� 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. Nam .. ......... ............................ nstruction Supervisor's License Z 7 IAFRATE, jOSEPli Nr 2890W 1i Story 4 cS� Permit for ...................... ......... Single Family Dwelling r tl .. ..... r ....................................................... y' Location ....Lot..7..'.....27..Broken Dike..Way... . w Centerville I......1.... .. .........�.................. Joseh Iafrate ....Owner, ................................................. ............. t j 1 h. TYPe of Construction ....Frame..... ! ................. T. ...................................- .............. ........ Plot ............................ Lot................................. - 'ermit Granted F a ]9 86 w . ate of Inspection .........."..... ....................19 r 07 xm—'Completed 1 Q7 1 r k+ 4YYj Mrs. .. ne. .. ^A• 1. ! • .1•r 4 :. T r i .x SHE The Town of Barnstable c r • a w + BABNSTABM • 116A 9.. `0�' Department of Health Safety and Environmental Services A Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner August 26, 1997 Rollins Insurance 13 Lowell Street Carlisle,MA 01741 Dear Sirs: Our records reflect that�27 Brok_ nn Dikp Way is not in a Coastal Barrier Resource area. Sincerely, Ralph Crossen Building Commissioner RC:lb g970826b 08/20/1997 04:27 5083695075 POLLINS INSIRAIACE AG PAGE 01 August 20, 1997 TO: Hyannis Town Hall Mr. Ralph Crossen, Building Commission FAX: 508 790 6230 FROM: ROLLINS INSURANCE AGENCY Cynthia Metivier RE: Insured: James L. & Joan Johnson 27 Broken Dike Way Centerville, MA 02632 Thank you for returning my telephone call this afternoon. Enclosed is a copy of the Certified Plot Plan for the above stated property. What l need from you is verification that this home is not in the designated area of the Coastal Barrier Resources Act (CBRA) . Today when I spoke with Mr. Rob Gatewood of the Cons. Comm. he referred to: Firm Map 8, Firm Panel #250001-0008D, with a Map Revise date of 7/2/92. Please let me know if you have any questions, and I thank you in advance for your attention in this matter. Thank you. ROLLINS INSURANCE AGENCY 13 Lowell Street P.O.Box 126 Carlisle, MA 01741 TELE: (508) 369-6883 FAX (508) 369-5075 08/20/1997 04:27 5083695075 ROLLINS INSURANCE AG PAGE 02 .+ •0610,311997 w'n 5097505351 BOUDREAU BUS CTR PAGE 93 L �-r I � 1 >J 3[C-5- wok-e ( Aw, r ose I A�.1v 1 � lyl,90� (b•o 'o e8lIP1 4��, VOW va v I • +am. 1 PLMAA A'Awbotm 4a 444 Cam, �/Me O e►OQ.w�i /tkb %GWeowb'lid J� MMYT aP�hd Mom. �Q79�1d'b l,lestiR�ln : (� i AORMW" - I AOM t —I . off.• 14. f�s►+aA1�is er�v/bN J�ae�,aelJ 4&,.— F I DO�� P&.A 11 t.ocuao rn,a wer►�,a a PALM qua A, i®, P��whtip•.e it �.IiF arGaMlMtiee.eea.er-( AA.04mt. 1-swage 1 poo�C f eav A vs.r-wT I, . P 9 jbV ) L9=5T f'9 Go NOW47"A e t� ?%LS e-- 7M 16-'1 I%A /ea OILW ep NAd r , 164. oft I •db(dl- SC.. i ►a+� c�Q�aN°near�+� P;l�o4 1 a4-T���eeJ� Idt� •C�eP1,lC: Cep Q4mLomMd rN "o Tft 041 J eb rw !S3 J 1'1 o ta"PtA ff w w e'Ie1 T,Jes .roar e� �°Qeeawr* 9001.lQaww - �w Ac Aar, T M ..i(�- cr-I , MA.o��eo'? �� ReFaftr��+s. A.�..1,a. i4•' &I t� 6 QA CE 3 rbTS L,=ATICn&J 3 AI.10 CC IJrOU Q I&.JL7 '-a1Tp .PLAW., LGCAT101.J : 4EN1ER./It-L , MASS. � ♦�I /Ta4LWETt/4aJD ? f I N.Aq'Si be! �uQ./E-1 Cop P V/19AA0, M I PoQT, 1` J( _I y„rya 14 62 iEt6E w2T.AYDS 'T' -U R C MA-44S.DE �r n.,Q.�ev Du�•.l Cp 1 l�0 ems* 13.98 M•.S� / W A �r No r3Q© �E� DI LC40' PQ I I �/yY1Jb� 18 -a..�Tear A LEA it of IDA DQAwA&F_ EAS'MME.W � 10, i o rw OF .I� Al of PL l= 15_ C]oC.) -, F Or I c%o W I D•C F4 PQEVIaJS FILIul= SE 3 ec�4� 115 l=NNS .P,. �Lo ' dO QATLcrN5K.1 of• Its • 19 82 ,te a Qp�` a (2 5 13. to ��o0 -0a• 6X tST►�IL� ELEvA-nC" &lr rt 3LJ PJ�T PL.AI..I e. cola*rr�u(Z (� (� h E 11d L�VA' J L'c� !f I L'M DIOA D APPRoaED a RD of I�eAL I C c�1'i E L / I t_L >�,,� AF�EIdT d a' DA7t-: 3 2c� .13 G_=Lm. P nyv l w $ map.F r uEQEBYTIFY TI-{AT.Ti It PQGOR :' �L.l_IS SuQvE�1�.1lo I► Ic,. _ bi31J° : .g=� o LUILNU6 SNow►J cn J "iWIS PLAN! i , - COLIFORMS To TWF_ Zo"106 LAWS f ' r2q musef ET Lace E of 6A RLISTABLE, MASS. CL-uT62,-,11 1 F= MASS., . ... _ GI IG�T" I /'1!~ � ,"�: (�.•r�ne-�r'f1r..n ��.n •c..l',iF.YF'�Q - . 4" •r , / ���� �� �� S� l L� � ���°%1� � � , 1 � � � � \� S - C�Fzo>•c.�, D��c �.�1�y C tio' �r�\mod-ram) 133 0 11� / o Is to 1 n1eil <� a N Oa g2 o r ..� 5 0� ?- 71 Os 8 g. OF pek BA*/siLc --=vI?Va--r PLAfJ -� r \ R1V ER-PF� I - •1=LE\IA,-n o/.._I I a, cn PA. S.L P�YV I�'u./ GaP•�'�F\Tlrk.s c��''L�-f' `•-O'� � -.. ..�ROK�1�.1. �t K� �`y D(7-1 car ► DA i -:D M A-r" i DATA: I NEPAB`( c aa2riF-rl -n4A-r -n-- - GLl T: L VIEk1 COR-P. e.L-s-nLL-,=' FYt�1J�AT1oi� cuT1-11'S S t=LL I a: -rj4ULtQ !l-1G. .Icyt�`-' : 85-tz.-1 t - Ir�T' IS Lrx'A-TE(•� Itj PL- 1c)J Ta 4-7 6 E�Y; ..IEVIIZZ-) -17-IE t-=yj:ST-u 6 r K�ME�rTs �t t�wti! IF, S-T SAtJOvJtI�-1, MA •,o�s37 p� 1 1, Assessors map and lot number ............ �.,/.......�..y..... . ,. Q`'o*T"ETo�` t�K �.0 Sewage- Permit number .................lS...s.,..6..:1 ........... Z BAB39TADLE, i House number ......... ..........................:.......... r NAM d....;............ �O 39•_ �0 G �MAYA' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......Cn`l... .......................................................... TYPE OF CONSTRUCTION ..:.......1...... ...4................... ... .....:.. �.�/ N ...................... 7 . 3 r.. 19.....:s� TO THE INSPECTOR OF BUILDINGS: The-,undersigned hereby applies for a permit according to the following information: Ile Location Proposed Use � .5. iJ Cam✓ L.- ........... \................ .... ................................................................................................................................. ZoriingDistrict ..........`...............................................................Fire District ........... 1Nt* ...........5............................/...... Name of Owner ...... ......./ Z.:.........Address ..... .. ..'. ....za. .?.....................t. Name of Builder ..'•!,l�. i.. !.� ..�!A�.... m1�P Address .`....... .......�...,............ . ... . Name of Architect ..lan!r�.. /Z/��4�a/ .7.............. Address 3 = GA ��` �:........................ u•�.L Number of Rooms ...................................................................Foundation .... .......................... .............. Exterior .V. !! /1....... .......?.: `.t� .........:...........Roofing ........./.r.1.. ...!>.R .. ............................................... Floors 31 i K P1."'+ ...--. .......................... ......Interior .......... ` . ''�. ...................... o Z'....... ...... Heating i. .?�'.`ti ....:...........:.. ...:........:... . '~Plumbing ...........}�... ! '?` /j ...................................... , p yn . .. .n.N.. Approximate. Cost ............... ... Fireplace .................. ....� I ............ ...... Area ........Definitive Plan Approved by Planning.Board --��_ � %. „4 ....: .x....r.... - - �9 �--- ..... . Diagram of Lot and Building with Dimensions Fee .. SUBJECT TO .APPROVAL OF BOARD OF HEALTH l� �C.C, , 13 l,,J 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. c J-71� �6............ -, \;'off \. Construction Su ervisor s L�cense> '� Z p .... 6 IAFIUATE, J0SEPB A~227—/ 79 ' ~�o —28 9U8... Permit for ' ——St—o—r—y----- ' Single Family Dwelling ` ........... . � LocoLocationn Lo�---7 27— Drokeo Dik—— — e Way — �_— -------— _ —.. Centerville, ' ............................................................ .......... ....... . Owner .........J«ae�h Ia.f rat e_______'__ Frame ' Type of Construction .......................................... ' --------------------------' ^ Plot ............................ Loi,.---------.. - . February 5, 86 Permit Granted -------------]V Date of Inspection -----------_]A . . . Dote Completed ------.'-----.lq ' . . , ' . . . - � . — ` ' . ' . . m ' � . .