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0257 BUCKSKIN PATH
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A.,,. . . v, ,>.. .,:.x, ,.,.,.,:.: .,;.:x..w.c 2�.,>.a_ .,,,,.�,�:s.. ... :..:.....ex ' ,.d ,.?xu,.i�v.,,m>:wNal,..r..ceaw�s.,�.£.,...rsuwY,..�.,e,',�',..,, ..,.>r.,l..t..y.,..-reaweab. �,..<_,,...,�..,.t��,.�,. w.,.i. �...�1�,.s+i.,,A�nfewi/-.e..._.a�rmrd+..-,�..r,,.....,t.rJ?-z. - - ` ' ►.� Town of Barn stable IlIl . . g xxsresce Post This Card So That it is Visible From'the Street-Approved Plans Must be Retained on'Job and this Card Must be Kept KAS& Posted Until Final Inspection Has Been Made. ° ��,° .� Permit �,�,r• Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made.' Permit No. B-19-1518 Applicant Name: PROCACCINI, MICHAEL V& KATHERINE A Approvals Date Issued: 04/13/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/13/2020 Foundation: Location: 257 BUCKSKIN PATH,CENTERVILLE . Map/Lot: 171-022 Zoning District: RC Sheathing: Owner on Record: PROCACCINI, MICHAEL V& KATHERINE A Contractor Name: Framing: 1 Address: 1001 PITCHERS WAY Contractor License: 2 HYANNIS, MA 02601 Est. Projetct Cost: $5,000.00 Chimney: Description: SIDING Permit Fee: $35.00 Fee Paid: $35.00 Insulation: Project Review Req: Date: 4/13/2020 Final: Plumbing/Gas Rough Plumbing: \Building Official e Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced withinsix months aftertissuance. All work authorized by this permit shall conform to the approved application and thelapproved 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 zoning 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 public inspection for the entire duration of the Final Gas: work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 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 co 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: .1 l Application number...... {{�� V ....� 3 \. . .. ....... BUILDINGFee..........................�.s........................................ DEP T. uAX . ...Building Inspectors Initials... ........................... FEB 212020 Date Issued.:.. -+ :�I.Z® TOWN OF BAR , � �NSTABLE Map/Parcel........ ...&... .......................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION SCANE PROPERTY INFORMATION Address of Project: 2. 15'] NUMBER STREET VILLAGE Owner's Name: mx air.g-t } ;r« Lou-tvil.Phone Number_ So& 3C,`7 3"1 CI S _ Email Address: c. C)u,4 nLctsal,v\.-# I, Cell Phone Number J0f� tin 2 `7 1 Ci Project cost$ 1�>, Go y Check one Residential_ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK I3 Siding 0 Windows (no header change)# ❑ Insulation/Weatherization ❑' Doors(no header change)# Commercial Doors require an inspector's review Roof(not applying more than I layer of shingles) , Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. _ w APPLICATION NUMBER a *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have;sides?Yes . No (If yes please attach floor plan with exits marked) Dimensions of each Terit X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event i;„, Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or> Yes No ,if yes, a gas permit is required. Natural Gas Yes No , if yes,a gas permit is required. L If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Yn% cfi,-,CA_-k 4- GMC C.L[rc, f vi Telephone Number SO$ S Lo n 2,`) Ci Cell�r Work number I understand my responsibilities under the rules and-regulations M P for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature OLQa_Q-A, J Q,rt�� Date APPLICANT'S SIGNATURE Signature ����, � c�ere�[°,[►� .,►.�' Date 3\ All permit applications are subject to a building official's approval prior to issuance. ro, A<he Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston;MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 'Please Print Legibly Name(Business/Organization/Individual): A1--up V,tki 2,ro ' .tri r Address: Pcag y\ City/State/Zip: Cf-\w Phone#: S02; 39C18- Are you an employer?Check the appropriate box: Type of project(required). 1.❑ I am a employer with. - 1 4. ❑ I am a general contractor and I .' employees(full and/or part-time).* .have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the'attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have`` g, ❑Demolition workingfor me'in an capacity. employees and have workers' Y P tY• 9: ❑Building addition comp.f - . insurance? [No workers comp.insurance p . Quired.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.Lvff am a homeowner doing all work officers have exercised their I I.❑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.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: 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 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 andpeenaldes ofperjury that the information provided above is true and correct Signature: JVNCLp�� JR Date: 9, at , dga6 Phone# ._..5 `�- `�)-. �1 �1�5. .- _.- _._ --- Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions i 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." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to 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 commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the 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 bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 vwvw.mass.gov/dia 12ea /+9R P" i/ .. . as Assessor's map and lot number .......................................... py�(i: ' SEPTIC SYSTEM MUST BE N 1 INSTALLED IN COMPLIANCE -ISe a Permit number �i` g ... ...:.....:....................... WITH ARTICLE 11 ST^:TE _, t`r'r�1noY ��r�r nor TOW Q�oFTNETo�° TOWN ®_ F "DARNST�A.RLE �° t ,BARNSTADLE e ti Mb 9 r ' IL' INO` INSPECTOR APPLICATION FOR PERMIT TO � ...✓...te ... J.�,� �9.....47.'/.9/.?h&. ............................. TYPE OF CONSTRUCTION .... .0.Q l�l1)..... ................................... ...... 'C 1, IP6 . ................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .40.T.17.......CeN.17Y.A Vl�.1�r�:�'....��.�T�/���.�..��:...Ceen7ZXVI.4441...��S51 ProposedUse .. / / .L^.............................................. ......................................................................,...... ...... Zoning District .. ..0..........................................................Fire District CkW �...y'. / •...................................... Name of Owner M.40,..... ...................Address ?VCR XIN..A)9 -� �t..4 4!�I rr" Y k4.L-r Name of Builder -e ... -.F". . r�1.!r.......Address /iSJ. ..1.. A.. /��Y.. IT ........... Name of Architect ......,l,V,,.,/✓................................................Address ................................. ............... n ter/ E.Number of Rooms ....�17................................................Foundation )POP - Cl�oK aR.457-4 , Exterior X. ........ ...Roofing .... Re// �Lr,.....cJ,�.!..`���' .5.... Floors .4�41/.Z,� p........�0.1V.�ll.�.a7.9........interior ..�4A............................................................ - Q d Heating ./...V`4 ....Plumbing Fireplace / ...........Approximate Cost ... ' Definitive Plan Approved by Planning Board -------------------------- T `. s f77. ------�9--------. Area Sg 'Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH o7 j7 pda L PI I c>�a � ) ar 31 ,. r IQ ®g `, q e do • �0 iP 1 J , Y f 6 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ��P Name ............... ....v............... ................................. l Mueller, Arlo gdd to garage No ...............,.. Permit for .................................... ......................................... .................................. Location ........Buckskin........................................ Path ' Centerville ................................................................. . ...... Arlo Mueller "` � . V Owner .................................................................. "� Type of Construction ...........frame.................... r 4 ...................................................... . ...................... +T Plot ............................ Lot ................................. ',,• � � "+ `a ice, 78 Permit Granted ......OG�S?b��:..�$';�.......:19 . f� f • Date of Inspection .. . ..L. , .`-q...i...19 ,.✓ , Date Completed ... J � PERMIT REFUSED �� +'. `, � tit •.� �� f ! � . ....................................................... .... 19 .......................................................... .................. ....................t ..................... ........................................................Y. ...................... .........................'........................... ... .......... ,...... , PPA roved ................................................ 19 f . .t -,,• ., ' a ♦ ."`r r � � /`• ..ate. ................................................ ....................... J F i ........................................ ............................ �/.. i j ssesPr s map and lot number ............................................ 4 iage Permit number .......:.........:........................................ j y�fTHE tp�t TOWN N OF BARNSTABLE Z IMUST"LE, i M1639. , BUILDING INSPECTOR APPLICATION FOR PERMIT TO :: �. '_.%'....% !'� -�''� f l idr t"ti'!- i?,A['�-/- ..................... .................................................. TYPE OF CONSTRUCTION ....?.:............................................. ............................................................_ ............... ............................................ .19........ 'fO-THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..........!�....:. ..... ... ��.�''...�..V I 1-.1,:.J".....:7 Ir,R k 4Al f� � �'�/YT �i' V1.1..�.!= ....'..:1....` ,�. .. ..... ... ... .. .... .. ............ ......... .... . .;. ................... ..... . .. Proposed Use ..1.. .......j tz.1:=........................................ . ..........:...................................................................................... .. Zoning District . ..........................................................Fire District Name of Owner 's r�� !) !"i f/F'-i-/_/=I� /i�(�le S AVA/ ��1H C,r_!F!T/ A V ..................... ............... .........................Address ,...,.......................................... Name of Builder ` ' I `•- 4-40API/1, LIA-A!'.......Address /.1F5 i` fS�'i` t`►�/J.�'. +.'. :................... ..t.......................................................... � Nameof Architect ......,'. ... ..................................Address .................................................................................... Number of Rooms .. .................................................Foundation '.'��1= 1. l t................... 4 Exterior ............'.f 7.......`.>1;'r (::..r..'-. ................... Roofing .....��! f �` 1........: .:.. ..r..�.'......F......... ..... Floors ................ ..................................................I........�............Interior .................................................................................. . .. F rtUa7mg ......................................:...........................................Plumbing .................................................................., � r Fireplace -'.....................................................................Approximate Cost ... :. ............. ..........:............................................. Definitive Plan Approved by Planning Board _______________________________19________. Area .........!.... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. Mueller, Arl-lo A=171-22, --I!F 0680}ermit for .,add to garage No ZS�Location ........uckskin Path ........................................................ Centerville ..................................... Owner Ar.lo. ..Mueller. ..... . .. .... . ......................................... d d Type of Construction frame` ........ .1 .................... 4 ' Plot ............................ Lot ........................... � I Permit Granted .....QCtobery1$............19 78 Date of Inspection .......... ........................19 Date Completed 7***'*1*** PE T I*EFUSED ...................... . .... .................. 19 ........ ........ .�.. .yl. .... .............................. ... .. .... ........................................ .�... r. Aroved ...................... .........�...�....... 1 ............................................................................... i - - 'Milli TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r / I Map Parcel D Application #. Health Division BUILDING DEPT Date Issued q'Zy 7 Conservation Division APR 19 2017 Application Fee C� Planning Dept. Permit Fee 0F BARNSTAiC3L T®�� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address C. -s-e Village Cam-°, V 1Ile Owner Address Telephone_ a Permit Request G- Square feet: 1 st floor: xisting proposed 2nd floor: existing proposed Total new Zoning District, Flood Plain O}-e Groundwater Overlay Project Valuation (Co S-00,d0 Construction Type 1_ Lot Size ��� 6 s Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family .❑ Multi-Family (# nits) Age of Existing Structure L, f9-S Historic House: ❑Yes o On Old King's Highway: ❑Yes ❑yNo Basement Type: 21 ull ❑ Crawl ❑Walkout ❑Other U►'� c t- 1`S Basement Finished Area (sq.ft.) y�' f �-1 Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 2— new Half: existing new Number of Bedrooms: existing —new Total Room Count (not inclu ' g baths): existing new First Floor Room Count Heat Type and Fuel as ❑ Oil ❑ Electric ❑O Central Air: ❑Yes �d No Fireplaces: Existing L� New Existing wood/coal stove: ❑Y �N p g g o es o Detached garage: ❑rxisting g ❑ new size_Pool: ❑ existing ❑ new size Barn: ❑ existing ❑ new size_Attached garage: ❑ 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 G�V'�1'►� "fit ��N'`c ram. Telephone Number Address 6 C C''` S"► o U�' ° 2 3 License# ' G 1 �)4e Yl S ��` M 0 2 63`'� Home Improvement Contractor# I �� Email 5 U 76k ,,000 Cr� 7'6l`\0®, CO"I\ Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 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. • inntvsrns�;. MAW Town of Barnstable Regulatory Services 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 If Using A Builder as Owner of the subject property hereby authorize 'no V\ A 1-3 'C-A 1A�(A-4'J to act on my behalf, in all matters relative to work authorized by this building permit application for: ZS � �jv G��S)L� ✓� �p��--L. , CP-a,-�r V��f 1� , , (Address of Job) f Signature of ner Date N�E� L I S'S U LMA 1\J Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\lNetCache\Content.Oudook\L7U69LF2\EXPRESS(2).doc 01/25/17 Tlae Coniniomvealth of Massachusetts Department of Industrial Accidents Office of Investigations WJ 600 Washington.Street Boston,MA 02111 wrvot mass gov/dia Workers' Compensation Insurance Affidavit:Bmilders/Contractors/Electricians/Plumbers Applicant Information `1 Please Print Legibly Name(Businesslolganization/individual): 1 "/�`o �Y Y\,A G.'1) iNl icy Address:6 C2 City/State/Zip: e\11,S 0 � Phone# o g V1 7.-(R Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I a employer with 4. ❑ I am a general contractor and I loyees(full and/or part-time).: have hired the sub-contractors 6- ❑New construction 2. I un a sole proprietor or partner listed on the attached sheet 7. ❑Remodeling sbip and have no employees These sob-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp_insurance comp.insurance. required] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LEI Plumbing repairs or additions right o lion myself [No workers'oomp. f 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] 'Any appticam that checks box#1 must also fill out the section below showing their workers'compensation policy iufmmation. i Homeowners who submit this atfidAMI indicating they are doing all work and then hire outside contractors mast submit a new affidavit indicamig such. ;Contractors that check this box must attached as additional sheet showing the name of the sub-contactors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide*eir workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy it or Self-ins.Lic.#: 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 MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under thepains and penalties o perjury that the information provided above is true and correct �f Si ture: Date: Z -7 Phone#: ®� y I 2— tJ O icial use only. Do not write in this area,to be completed by city or town of cial City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Citylrown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: 6 r f , CONTRACT A00 Cape [RanowaN01M 66 Center Street, Unit 2-3, Dennis port, MASS Unrestricted CSL # 105918 MA 02639 HIC Registration # 173492 (Insured) Mobile: 201-248-9156 New Construction, Addition, Renovation, Kitchen Suza2000@yahoo.com ft Bath Design and Installations Customer Name and Location: Melissa Uhlman/Denise Date: 4/14/2017 Holbrook, 257 Buckskin Path, Centerville, MA 02631 WORK DESCRIPTIONS UNIT PRICE TOTAL V`floor Take out existing vanity. Install floor tiles and bead bath board on wall. Also paint and install new bath Trims/ 2200 2200 Hallway hardware I"floor Take out existing vanity. install floor tiles and bead Master board on wall. Also paint and install new bath Trims/ 2200 2200 bath hardware Kitchen Replace kitchen cabinets following existing layout. Also 11500 11500 replace appliances Dumpster 15 yard 600 600 Note: Customer to provide Vanities, bath hardware's Kitchen Appliances SUBTOTAL $16,500.00 SALES TAX TOTAL $16,500.00 Upon job approval,a deposit of$ 2500.00 is requested for project scheduling and materials acquisition.All change Orders and/or Additional Work Authorizations shall be in writing and signed by both Owner and Contractor and charged at a Rate of$40.00 per man hour.Balance due at completion of project.Any alteration or deviation from above specifications involving extra costs will be executed only upon written order,and will become an extra charge over and above the estimate.All agreements contingent upon accidents,or delays beyond our control. .r. i Approval&Acceptance Quotation prepared by: Mohhmed Rahman This is a quotation on the goods named, subject the co ditions noted above: To accept this quotation, sign here and return: Thank yoVor our business! • ' -- � .. _ �e Tpoonirreo°ruuea��C>�ac�u�oetG.t - i .,, Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR a hype Individual _------ 'ration Expiration " 92 10/08/2018 �RI` Mohhmed Rah - = I� D/B/A All Cape, _ ,I Mohhmed Rah 66 Center St Unit 2, Undersecretary Dennis Port,MA 02639' III:. II r Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-105918 Construction Supervisor MOHHMED S RAHMAN 66 CENTER STREET. ` UNIT 2-3 DENNIS PORT MA 07- 9 Expiration: Commissioner 09/15/2018 Registration valid for individual use only Y I before.the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 1:0'Park Plaza-Suite 5170 Boston,MA 021IS Not valid without Signature Construction Supervisor' • Restricted to: Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. / Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. /r DPS Licensing information visit: WWW.MASS.GOV/DPS � d�ooasi�ute wearc _. .•• , and is intended to benefi.i the BUYER and SELLER and each of their respective heirs, devisees, executors, administrators,successors and.assigns;and may be canceled,;modified or amended only by a written agreement executed by both the SELLER and the BUYER.I I%vo or more persons are named as BUYER their obligations areJoint and several, If the SELLER or BUYER is a trust, corporation, limited liability company or entity whose representative executes this i Agreement in a representative or fiduciary capacity,only the principal or the trust or estate represented:shall be bound;and neither the trustee,officer,shareholder or beneficiary:shall be personally liable for any:obligation.express or implied.The captions and any notes are us only as a matter of convenience and ate not to be considered a part of this Agreetneat and are not to be used In determining the intent of the parties.Any matter or practice which has not been addressed in this agreement and which is the subject of a Title Standard or Practice of the Real Estate Bar Assocf anon for Massachuseu formerly known as the Massachusetts Conveyancers Association-at the time of performance shall be governed by the Standard Of PeOCtiM of the Massachusetts Real Estate Bar for Massachusetts. 13,Additiooai P,jCRvtslons. . nds h an"as is"sale Sellers to_have home ern ued&in broom clean condition rior to closin x ► , 4 ------------- .... U..PON SIGNING.THIS DOCUMENT WILL BECOME A LEGALLY BINDING A:GREEf►313NT, IF t1 U ERSTOOD.SEEKL ADVICE FROM AN ATTORNEY.. aonoo�waaed ooa:.wueomce ' '. BUYER SELLS tc ,.,.W BU ER _ ate .. .a ao Date Date .O)'spousG 4 Es, my A,,sent,.. By signing: below, the escrow agent agrees to perform in accordance with paragraph`d, but does not otherwise become;a patty o. this Agreement. i or representative to 7 - Y rttals B Y Eras BUYCR'S lriuia s S - lnrtials LS * R'S intt,a s SELLER'S nit a sS�i999,2000,ZOOLZ006;2007,2008:20tt1.I012 tNASbAGfItJS>;1'i'S AtiE.9,1TtOiV 017 RISAt.TQRS� r; MASSFORMT M form u as usebi: Fam No w.w.au.mrwrrr, Usetn aulorte other thm s PVftCq nt d d►e traainWit u sand' ptolntbrted. : d0409pelgrataare:iflw7ton:rvnv.tmUiropcmntmyvcYtciibnittl ....... ,r•q g liM1SACa6Y8t'i1 AlSOGSAtN�ta�AL1'Ottr STAMAM:PURCHASE AM:SAU:AGM EWNT(#S0.3j t ) Thy paKies 14010 this a ...aay of .This and eepieces ell obligptions made is aqy prlar Ccattcac;To'ptttd or egfwMot for isle entered kft..by the pstdea. t, Ifitt�ttaed Idr.. nnscM�taariej, tier" mu..R,"agii+OEi to all andllenbeteOfb" tl 11 to w ito- , ;.. Oq t�1Q ten11!!Ct W.$ 1r1rB r C0 t0 ticoft ba:Au�de p10 1Ct paraan or taw 1 Wri(Jp011 tir�g_to SEl.i4BR�test dive' bsirtess dt}> the?ante for-xPcananoe in ptrb S. osd►of s:Nomtnee shsl�.not the Bf :f'bm atiy cbllgetioa ttsctlac tht.A »tanit BeJYER eneby sgreas w guarantea p�rft��rnt�f�bar the N ee. i Z• 1� The prernisee(tiro"Pr�miaes") of'.{a the tatui withY sad a1liildf tbeii+eoer lrtsaovn as " Wi.+�.l� WMYIIMY I 15YWYMIxulr.e.^ ". ... .. .. . ,as taore speciiatlY described Ia 8 did 16$fib-4 of D at t3ook,, �,, � .jt7ertiticete iVa, x A Dopy Qfwid D 36 jahr ose areJ4w N) and wa tts on the>ttmd and the h ou r,,Jri udirrS,;but not Uatw so any wd 41 stwm:vdndm end dock,serears,soreea doota,awniw,s Cw%Wfiftw,sbades add tips,:cwtaln.rods611Wmam;MOM had' a�tFlptaetrt,oil and;Sas burners and fidittv , hot wax tMANS,jikm 1 a6d bdkoom lixtaros, tavrtl.iaclCs Wilt-liti dishwr�tets, disp cats arui tn►th rompat crs, stoves, tames, ahatxle116r .e.Oct& and ether lighting fixttnrrs,; bttrgtar and fire alarm systems,mantdipleces,waif4( wall earpcU,stair cafptts,exter and satelhCe . adw l s► 11 Ping irrclt d! goes, slrrrova,fla�; and the faitcNutng buiit�3n compents� �f any: air condit<or►e s,vacuum.ayst+bms.cabinrrts►sheh►ea.boatccasno and stereo apcukal8t;sty •; but excluding .. leanoep to Sara,dtstnvar�trs,' rrowawa ors +18' dyers or wAre eippnc�r+tateJ: 3. iire The p prlrx fc�r the Is S. m dollars of which S >a .were paid as a flsit with Contracf Ta Pucsitase;anal a mare paid wlth:dds Agmmmt; S are to be prdd ;and S ssseoo;am to Im paid at time for performance by b mk%ens 1m% Ovum's or certified check or by ;wire teaostkr. $__ ..... Tatu 4. All thuds dapasited or p id: by rho BUYBR shall 6e held in anon-interest bexnng escrow account,. by CalliirAlt�tNor�slars _ ,85 eSLTOW'�ilfit, su a of ane andta11 be d or o9terw eel T# fy• meat a for perFciraiance.If a 8 _ B tiels BWBR'S Ini als S 5.., ..:: it nitiats SBLLBR'3.to tin . bRwts Oi"9,200q,200:20%.Z00? 2CM 2010,2012'MAmmo*O$Em AS9oa*ttw OF tYEA[TORSO 7lrefoamaiirnab�r :: ;f U bymgaremtl a�'almniickm is Iktwj2t"W flytaobr8aa$ Fam Na so ~ | | TOWN������T�J ���� �� � �� �J�� �� & �� �� �� � � ��� �� /� N� |� �� �� /� �� ���� | ` | | - | BUILDING � � �� 1 39- - INSPECTOR . � �� m� m���� � �� �� � m���m ���� � �� mm APPLICATION FOR PERMIT ---------.—'---..—.--.---~----., . TYPE OF ~ --''-'------ ..°�~.-~-----_.------.—.----------.—_----_------- TO THE INSPECTOR OF ' . . ,__= , . Lv The undersigned the following information. � Location --- ...................................... �.���.� ........ � � Proposed Use� -----.—.~-----.—...---,..—.—~..----....---......--...—..--.--.--...--.. � . Zoning District ----.—....—....-----...—.---.Rna District ... ZNoma of —.A66rsoo ---. .......................... Nome of 8ui| ����.�---.L—.A66ness --.-------------~-----'------ �~ Nome of Architect ----.!—,-----'\--,------'A66reo ----------------__—_,,______, Number of ........................................... _ Exlerio, - ---------------.Roofing ' _. ~ Floors —,----.��.����C��.----------------.Interior ---.. __ . ^� Heating ............» .����. ..................................................Plumbing .............. � . ....................... � FireplaceApproximate Cos ---. . .......... Definitive Plan Approved by PI ning Board lg---_. �� � Lot Diagram of � and Bui|6�� vvi�� Dimensions � u� -~~— ' ( SUBJECT TO APPROVAL OF BOARD OF HEALTH w� bu Uj Uj I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable reg7a construction. -'/Idi,ng the above — ......... --- ......... $mall, Alan No ..1 09.... Permit for ...... on® story........ gion siingle famil�r awellingLoca7.Buckskin Path S Centerville ................................................................................ Owner .........Alan Small ......................................................... Type of Construction ......fKame........................ ................................................................................ Plot ............................ Lot ..........#17............... I Permit Granted .....June..........................19 72 . Date of Inspection ............. .......... ..........19 i Date Completed .......... ...� 19 PERMIT REFUSED ........................................ .................... 19 o ................................................... ........................ ............................................................................... ............................................................................... Approved ............................ 19 ............................................................................... ............................................................................... r QV Fee U ( • ► Regulatory Services �u►ss. '� Thomas F.Geiler,Dtrector e Building Division Peter F.D111atteo, Building Co=4sAoner 367 Main Street. Hyannis,MA 02601w Office: 508-862=038 Fax: 508-7 90-6230 _ gESIDET-MAL ONLY. EIPRESS PERMIT`Vau j wuCsaPOz rnsloipr� i N map:parcel Number (04 �le Property Address ._. Val=of work @iesidentiai Owner's Name&Address C0- 5 a TelephoneNumber Contractor's Name 45 home improvement Contractor license (if applicable)�— 1 Construction Supervisor's License-(if applicable) ' QWork='s Compensation Insurance � C�h,/ccic one: ®� �� .. Lf 1 am a Sole'proprietor G�S O- Q I am the$omeoaaer � ��1 T� Q I have Worker's Compensation Insurance Insurance Company Name _ OF Worianan's Comp.Polio Permit Request(check box) Q Re-roof(stripping old shingles) ilm Going over elosti�layer of r0oo J Q Re-roof(not sttipp 8 gle-side Q Repiacement Windo«z: U-Value maximum.44) . Q Other(specifti•) . . t c iianea with orhas to"dot r�eg"'dons.i.e.Historic.Consen-4tion.:: *Where required: lsattsice of this permit does not exetnp omp Signature tTC:T--Y.i17060► Assessor's office(tst Floor): - _ /pas SEPTIC SYSTEM MUST BE Assessor's map and lot number / �/ 11 STALLED IN COMPLIANCE ��THE TO IN. Conservation(4th Floor): ' � ld ,,,y WITH TITLE 5 Board of Health(3rd floor): '< ENVIRONMENTAL CODE A Sewage Permit number (�,� ��7Z C> (/ ,,� TOWN REGULATIONS Engineering Department(3rd floor):' ro�Ltlns AcArA( �l�,^,�1 • 00"�%63o.r`�d° . F °. - t p rct Vp - ear House number. �� P�t oud. " D i C2C� d Definitive Plan Approved by Planning Board &.,-s APPLICATIONS PROCESSED 8:30-9:301A.M.and only C°'�S'dPrecQs�e�rooks`' �Cc0r� fib T®W BA STAWLE B�[L IN ,APPLICATION FOR P MI 0 TYPE OF CON R CTI N I TO THE INSPECTOR O BUILDING The undersigned hereby applies for a r nit ccording to the following inform ' Location RS2 wa—CR L ' LgL Proposed Use /0A 0' LOP kA.- � 1 Zoning District Fire District -d� Name of Owner ' Address ,;? �/ Name of Builder A dpR Address V2 C)MS7 41(y. Name of Architect //(/ OTC Address IN) Number of Rooms Foundation Exterior � �� �7 >� �'" Roofing Floors C�b,c�c j / Gi �� ,� Interior / Afw /o'!�— I Heating�'t`� ) 2egIZ 4 Plumbing Ah , Fireplace Approximate Cost Z-0-, 06,50 Area Diagram of Lot and Buildingwith Dimensions ai Fee SEE /f 7XcffF"O, PC-94J " 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. Named ° Construction Si ipervisor's License .J-7®/C70 49 14/C 103 a474). • No Permit For Location Owner Type of Construction Plot Lot ' Permit Granted 19 ! Date of Inspection: Frame 19' Insulation 19� 4 Fireplace 19 =4 �. ',,place =;1Date Completed 19 j t ,�'. - !�,s sU E9 fAu Assessor's office(1 st Floor): / C Assessor's map and lot number Conservation(4th Floor): '` —r"' Board of Health(3rd floor): C w //� 1 Z searsr�nct Sewage Permit number 'e �l�- �� Cf+>rLU / rua Engineering Department Ord floor): -1 - £� rar�pr�,r, � � �n eh�� �i63q'`��� House number pa,Le I acf,cee,G.� 0 Fair Definitive Plan Approved by Planning Board 19 `zs ;I�. r 4 s en re APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only C e r c c r J,�� -f, TOWN OF BARNSTABLE BUILDING , INSPECTOR APPLICATION FOR PERMIT TO E STar�(.0�`7" � S;t ZSAM oAr--ew- 127 c TYPE OF CONSTRUCTION Duo 3�/�.. S" 19 9. TO THE INSPECTOR OF_BUILDINGS: The undersigned hereby applies for permit according to the following information: Location Proposed Use -g/ if lA)k Zoning District A Fire District Name of Owner AA1,9/l/Mj 1 w Address r Name of Builder /1) / Y AO Address L/,;? r// 1 ,67 f- _575Ls'UV , Name of Architects Address N, !/ J Number of Rooms Foundation Exterior e:�-gz&o. Roofing A�4-)—X67— IF Floors cb 1v� ,� Q _ l Interior l'S u 1 ) /T id E7z,) 4-�JY " rr^^ Y f Heating r"ra X2- /A 71 Plumbing Fireplace Approximate Cost r Area 22 o Y Diagram of Lot and Building with Dimensions Fee "•+ Cam..- F 1 I/' 1 cff-k 4 P(/ ' IJ r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name � �/ v y . Construction Supervisor's License © � t'T f`; / No -•Permit For Location f Owner -' Type of Construction ' Plot Lot . ! Permit Granted 19 Date of Inspection: t Frame 19 Insulation 19 Fireplace 19 Date Completed 19. F ! • s • p a: COMMO�TH OF MASSACHUSETTS DFrAI,•MENT OF I.NDUSTRLAL ACCIDENTS 600 WASHI-NGTON STREET BOSTON, MASSACHUS=S 02111 lames.: carnmec ,.o—m-ss»ne, WORKERS` COMPENSATION INSURANCE AFFIDAVIT 1, (licensee/permittcc) . with a principal place of busincss/residence at: (City/State/Zip) do herebiy certify, under the pains and penalties of per)ur),, that: I am an cmploycr providing the following workers' compensation coverage for my employees working on this lob. Insurance Com any Policy Number O l am a sole proprietor and have no one working for me. (J 1 am a sole proprietor, general eontraaor or homeowner (circle one) and have hired the eontraaors listed below who have the following workers' compensation insurance politics: Name of Contractor Insurance Company/Policy Number i\ame of Contraaor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number Q 1 am a homeowner performing all the work myself. NOTE: Plcasc be aware that wbilc bomcowncn wbo employ persons to do maintenance,construction or repair work on a dwelling of not more than three units in wbicb the bomcowncr also resides or on the grounds appurtenant tbcrcto arc not generally considered to be employers under the Workers'Compensation Aa(GL C. 152,sect. 1(5)),application by a bomcowner for a license or permit may evidence the legal status of an employer undcr the Workers' Compensation ACL i undcrstano that a copy of thus statement wiU be forK•ardcd to the Dcpa:t:-cnt of Industria)Accidents'Ofi�cc o�lnsurance for.covcratc ' verifsution and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition offmina]pcnalcics consisting of a fine of up to S1500.00 and/or imprisonment of up to one year and civil penalties in the form of:Stop Work Order and a fmc o(5100.00 2 day against Me. Si ncd this day of OC S 19 —�' S r Licensee/Pcrmiticc Licensor/Pcrmittor x P 31 V,�� /d hereby g f Barnstable regarding the above agree to conform to all the es and Regulations of the Town o construction. Name .. ................ . 1 i - I ')EPARTMENT OF PUBLIC SAFETY tC I e COMMOONF EALTH 1010 COMMONWEALTH AVE. } SI j BOSTON,MASS.02215 MASSACHUSETTS ENCLOSE CHECK OR MONEY ORDER k LICENSE FOR REQUIRED FEE, EXPIRATION DATE CONSTR. SUPERVISOR t C',� 0 6/30/1993 _`1 ;-c y� �'. MADE PAYABLE TO -EFFECTIVE DATE LIC-NO. S RESTRICTIONS , "COMMISSIONER OF PUBLIC SAFETY"; NONE 06/30/1991 030908 !VEAL A . PRATT (DO NOT SEND CASH). .. 42 CHASE RD SS 11 469-46-87.18 E SANDWICH PEA 02537 PEASE NOTE FEE INCREASE PHOTO(BLASTING OPR ONLY) FEE: ! 100.00 EE FECIItVE FE.8 1 1989 . HEIGHT: NOT VALID UNTIL SIGNED BY LICENSEE D OFFICIALLY :STAMPED OR SIGNATUR F THE O MISSIONER DOB: 11 /24/1941 DC NOT"-DETACH LICENSE STUE THIS DOCUMENT MUST BE ?: SIGNATURE OF LICENSEE SIGN NAME IN FULL-ABOVE SIGNATURE LINE ' CARRIED ON THE PERSON OF - : THE HOLDER WHEN ENGAG. I /J� ; OTHERS -RIGHT THUMB PRINT EO IN THIS OCCUPATION.;, ��✓ C� COMMISSIONER y.. h �lre�om�sw.uueal!/c o�/Cfioaacl�aelG, HOME IMPROVEMENT CONTRACTOR Registration 103690 Type - INDIVIDUAL j Expiration 07/09/94 Neal A. PT'att 42 Chase Rd. E. Sandwich MA 02531 ADMINISTRATOR