Loading...
HomeMy WebLinkAbout0287 BUCKSKIN PATH y — H r . r f. I : �� .R�, .Y.u•, i"/i°'t� f!•;KJ,1t4i�.�f; � i��{1✓>ti• .iPu)f�� y F tr f �, +� aY yy , ,� 4 [ c it q ° ` ° u a. ' N ' w,[', "40, a '' A �, " t� 1.. J M a 1 a'a �, N . , I ;mli," � Imm i,On. 'si.r. '1: .i� t, ry❑I .t).,,ttp ax ,,,11 o '' a. _4 .,i:jAt r,t�3ti �I,n> ,4 n. ". °.° II - Lal '.tl uMy VIVA 'tit 1 a. +) �M..' Air' z4�`s.,r �'' ',. n ,� ,t* .9a�"p .^'�' +N:' '` �r, 11 , ,': •n s pA, 1 ¢H d x,b r,, P.'{k ,1 'ir q { };: ��r Fk.;;;1.. 4. "i ^d'', `ic„ �' a '.>D".. ti,:. u �y��ty '" ° n i r n:i �"9F ,: 1 a ar u •� y u e I �r 1, w * 1 . u , ".R'�., n a ua r„i a N9 �A d ' U^ W y fir it ,� F. d L aF�R tr ,„ YY. I d e" y r �!11 � ° u` Y e r 4 t„p,a �, xi t` .1r F. "U a ! :b l., ;[, r % " t� 6,�t tr11 L .Y r a' t F "} 11 e ':t1iior ir" Q I 'P f P .,i Fr, ,A IMr. k 5F4 v `" 9- ) 1 F >s rr. 9 `1,yt } S a y1. P .a+ ty 'y, :' m,w � F he n, ti F"' f �y " n`S1 �tl, {r` e. 'La. .�� t v" qe+' tt: ! n r tl° q. y '} o �� A a ° ,y w, �" A jr 'F )P T{I 4 o V „' SLFr4: 1 1 k }� -4 yl... .y,, .niF°i Q� ,l, , • r u it i , , N. ti J ,.� , i//' ..`, "' '.1{ a't, ¢ n ,. .: Nr� pe ,�u j.Y ,g x:�.{a iLL.:<i+, p w R1. "',„z p y a„ ! % 1a °a'. r.q �p4,t' ,' ' u ns, 't�A,,,, .tMF ,Mrr. ,t).� ode:, t s F It) .t f °, d, A 1" �;fF MY� N d a,.: tl. 4L I a r �. ' �- I• ,) {' 0 x k H )a ti, J 4 P, y !m tl' y 1 F[ " x t' I. 'm,. Fr i A �a i r 5 T, •�4i Y 4 F L. 0 ao c ,'t, -°" � Y+ 4 9 a d fF t. )v. z 0, } j1 ��; � .A 'e.�� t �, f ��, 5 M% A A x 1 >'' h '4 ) { ! u �� 1,- 1 'q tt ','� ill. F }t'i [r 6 1.4F ..t ty, A S .� q, t .o s t. <,5 i• ti! a Y t' rf o ,p 5 4N'; al Y I t — y� tl. + ) . p.',{ `t ,9� I `A , i,a A .sx ,,.a 7 Y' » „§ t f R�, 'i 11 '❑a 4 1 �ix�: ,p a +y� Ax A , u { aq 9y I ,w ,11 .,..,,r, ;,v:,'. ,:,� i,o ,:?. . .�+., yi .2 ....A , ,,jt ',2{ �'y - !r. ,tr 4M t r a , `F ,,,y4' , q,.. ,F...,..,is• p' ,:': ,-.:::1 11 ,r..t4i ,", Ya r '"�` � �N T. Hoo7r � ix, r n .A ,j� i, .f �• •ltx oar '.{t 'p l' hW •ian 1 1° - 4+, x ,jt 's,,% 1 +,' rt:" .s9 : L ton1. "{ .a .� r�yf - 1�7 t}. a .'d.4 [ x'F ;. 11 N ) �� 1 y' +I i t�,[lt d7 a ' b'" i yt . a �r 1N q�\ G ! H' f�4' ^� it ! F r �, 0'p '� Va sx t+ .+ 'it' '�a '.i , ". r�G ..tl i�f'Sr. A, •,,, r S %V ;a, qFI w i..:;`.. 1a d. t ul a, a ,t" w. < p n '" :.` It- A , N a, v s. .,.LLx..., 71 p.. .a. 11 a." x', ''o a ti :+ ,q, e} , °,.• + 4 r ''e 411, [er':':t .x, �) �, w.. 1 ,x.. I. ,i, tQ b,�`f Al n �L�"4 ' FYit. 4,4 v!!- ll l {4' .,,4. I- , Is st t,p"i, ,� 9sr,• h;• i . k s f' '� '° '''.i a 4':'A tFd r '�' •,A;; A 'i, +9! ,, .�. �'' I. e , :'�1ttq ] r ts:. k+ �"wt i it:n y "t�' d y {. "It, is V .,4 '�. ��'t .) 'ray v. r,b 8_-� ,u 1 x '1, , .�.` h Nq.. .5, 1. .�. n' i yy d ii a+1., t e' d, ,N o µp _ n -k I' s for [t` ql: ,g: 't,,+; "y n . 't}, Zt, :ti ' A a t ty v ,,' r. , t b i ., ,i, f C NI• - . P r ; ) MAN . a T" 7 pI „� i ' ,A` l Ni 1 rlt % "S.. ) ,i� : n r -d+ ,r it xk " W 1[ _ 1. gy �, `A M1Ft !1. %., 'U R, t94 iJ, V;. e d la 9, ,. '� r [q u lfl , tk ,E 4t• t n 'f, 4 [)A"4,' w� i tr° 4 .fr,.4 .::� ,L ,�x �U t b ,crab 1' ed h. 'u h1 , taA.. q 1 na 3A. -.(,.: A' at>•,. 1, ,q ':.W ': �} '. 6 . .) 'f Y" a y,• }i-"k,Q,::° u)a 4xr:r k•iN q:' GP +bv�. ,t ,� 't9 rt,D` a I " . 1 ,.., rR -. tt4•re If ,; A•( N '..,6 fi y u,tr a q c� g 9 z,N J, a' y0i Si, a fir ' N n '� "'` F +t W i "ii'AI 9 g� rA,� LL "1: 4 r d aP ll ! 'N N i u 9 t-�F' '',', 1 '!•'at i!l' f �, Cp:'. b ' 4 ' :,:"R '4 A x .w .✓,I.. ",L'� A t t°, if,.,.,% r tR:^: PN x-,... vh., r ' v^`: , ,I -, � , ¢ ta..% u9� r' .:e.w ^,':: ' t_jar l r {P .: iN a Si .it)":d:,,'iys -41,igi, it ,�r o„' t•i"ryr i=j ro l t v,�0/off 4 y��9s T t#� Arfl �a I *Feet# Regulaiar_y Services 6:1 Ai// rteBmas F.t e�3er,t reetsr Buildlinft Division ,- l Vt11 TGt7 Y�1.:1D17� DTtrittittlg i-.itttl2AtDDttfttCT '. , 2101v ivintu�niyct.,uyriirrii5,NIA uasr,., co Vtul"•G. :ivo-ot�c-�u,io - - rQ1►,.ivo-i7ii-iii.Iv eT,•P�DII00 1[)VnI&eW APDi�Ti"A'''MA"'iv nL QT"'Vkt'e'E t AT d'%% Xr - Map/parcel Number /? /f So C 1✓�'�`� (�.17�f..t•i.�w�� _ _ Fj liesidential value of W o Minimum tee of 535.00 for work under SbODU.UU Home improvement lontractor'License#(it applicable) ZZ� Workman',+Compensation insurance X PRESS PERMIT 2 1. L_E-tli2 3!5U3?.iiP ii�r12'ICT_� JUL �/1 pq �/1 �/f Lj t tiS 11tA1lKrtNlll.r _ - At 6 2012 ! rssvr m tvxri���atxnrru.Ltueas intieir�urr.. insurance uompany Name ur BARN STABS copy of,insurance Compliance Certificate must accompany each permit. f<Ciiiiis iiril�c�i�t:ilt`>:�YK*;d L._! Re-root(hurricane nailed)(stripping old slang les) All construction debris will be taKen to T RC-roof In'urnsttse hai uaiieu ihtlt 3iiiiPiu�', irtt�,0i1tI rXISI.i�n<'1uvr�+�.tl Yt�trrl L_i Ke-side 001OF. FcCs*!$GrtRt:rit YYttTtiltl@`A,r _ - ttnli�!!!ltstlt.�Jlt!tdt taktlta.11N� Zbr"' *Alhere reQire!!: Isawn.-c of this permit does not exempt compliance with other town dep'!meat r pilaticam ie.Historic,C-'onse vatiolt,etc. "^^NtJtt.': FrvoCitY 1-'cwjjcr nyot si—ud Froperry Owner LeI ter of Permission. es-a•uFry Ulf enc'vutc Imp vvesuea.t a_.ouiraz.evr a=,:�.cn'sc�e�.•visaQ.i«6.cscen ISIuPea ilso s zia.cu^sc. - I`t,YltlilYli_ f.;lil.Ka;kletpflik�Anpt)ritult.t, alWtisrp5uft\Wiyrlows\Tprl+npraryiittsrnetl'ilk\CnntantChrtlnaknVR7AN.\I7PPI SS.ilnc 1. d3Af.'mv._1Ib3 FRG i4xa :€ auxaaua#axaTun aa� :€s •a arm ) `:exe �'�xa�ras� :� �i��4.: *f�a� e: - .l. -- — -- ---- -- - ............ — . ----------- ---. -- some : ::: :::----: ::: :: ... :.: TM asa.u•#Fe,�rsF..��c6:,ui:�T t`1`-�$`E:.�p�:s:. �� � t44,,- S { ...� 3�7","-i?Sl�P.CYffi�'PiIF 'T?3'�iR�i_�P•Y .. line,ab g vlsm lama ija fo "^'1♦,i ,l.._......o:).,:. i f ik;�s�•s�z� t°�x vt�s�!Y�;s?tx .;xr4arffs.. /� 4. �a " � �j rar.s;:1c; �ta�s�ra+;u �IYWl.I�+�?K�C:1Pf Y2-`1'Sx;:.� 4 f L adC 2+9f TY9fS €.k°w &€A E' �... F�S4•a�3? aY a�33 3•�E• Y33J$6533 b Sasau Vitt" ?�stcarsae#$ y y« -. ovza+caFsw.awroc;c:.�a�'�-`s`aa�[,w saa.sz .. �:.S�s�ss �.# �s�5?'c�:43�t�-t"R3.•-?�' A v,f is w &-im,KOA USNM%•. M I. %;note?�s)w,.a,�».t„ € ` 4. _ _ — �r S Gad{\ •� 4..�... I • - u..�„s.,,u x?z}. ,as-s"mzc r.£�vs:�r i #• M y,....� -s�a:�. ems •:� ��'�° �� �. � ;:<.,.<,,..«»,«<,<:,,)...».,.»„«<H)»<,,. I I `�^��4it3x+r�x �« ��e�x>a^ao�€5s�i' ���•�•� las�rt.�c '�&'� a I=� ��'z:�t x r, ., •t au •�I� �. .'�i�4?,? �4x a3�,az asss`a* �+, .a�>ti,t���s s a.M,r,�:��i?,s w��f"I,a�.'-s3��J:'a�t�A1x sakA, iE sk�x-Qa s f#z�� tt,%�r ss<. zuax stwaa dw" w Y nest/a�w:.;tian>t<$n'v w<.4�m4iiy:,o<+:acd',8k"ao1a:s)�s�'.q:*o?ascwnnwa::oactiaoa xw�o�ma,�.xmw�a�iA aaa�rawc�wMfv,��:wno �:a�s:»'. O:,c45:«ao wnYdf.,a<mai�a+3a.-liFn: 12 fT .. �i%a4ii'��aw�� �H,ei��n�-..+;+�:±a`+<,-`•'^[^4'. � ...4+.?t!?^?...e<±?ee4++±:�,v.+:.+.±H•.......................................... a,. �S.,r'3SS..0 M✓S. ��y�Jf-?:Si.37�•:??......................... ................................................................... ... ... AN Zoo Aisiivi'4%'. t�ksta T v�+�v a_f 9 .wa nr4:»»a y;,aae agTao.tU T! 9 ra sE�o-T can ar'yx�.' a. o T»ail»x�a,,3--Y ees M14-v 404 2FtE�•�3u Ye�4.#2����r�'a. ��n:Y�i �#'EYd3l ;�:Y3�YFa .tip.&�k�ei � E`F.c�oeik�'a+�n. �.Gr.ec�E.�sa in 3.aaa"Fiss�ei�kbia�:a v'�� ' y s WW` #YxiZ''YS3�+ ��i�r# 'S#2# !1 f.'ki�`i`IF�Yb�'w`iY gi�D1�9...<-�#��• s �'' 3�i H: F M. {" R{c 3"'2 a.S.a. aah. w 4 i'SFe�. t# BRA: z`!'�I. .�i i � ,'z i•.si+<;�c,4 iF ttiz a� .i,>awq#:s:«�.F. 3 ,�,�i 't a.dD! City .•R' .....n........1............................................ , 1 w'ir h _.SJ'_ �.Ye ..�w '_��S+f , O. �X! KO t'� C 03'N !0 a.rRlr<ds'rgc f-Y`:t,r�r:fl3zsoxy x E6' .. ? ----- ------ .... :.... Z3 ax¢r V ... z � nm.. ;� nY•u q,� an���. !! Ir p:,';�,>�d ::.< ' s - - - • . u� ' . � ;a+ > £a a - �• ax 3 _cypilve Oak 4;D-f�..Aa.A �csr.r amv �°. ix3x� a riayx+za xsaa ... is ,�• �` #-^ � f Massachusetts.Department of Public Safety Board of Building Regulations end Standards Construction SuperN isor License: CS-o16981 " DOUGLAS L 33 LLLAMS SR �11�' 222 PINE ST Centerville 02632i Commissioner Expiration 03/07/2014 Office o onsumer airs mess egu atton License or registration valid for individul use only. HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration: T102227 Type: 3 10 Park Plaza-Suite 5170 Expiration. TL1014 DBA Boston,MA 02116 D S L WILL1�G§TOM BUILDING - 4, DOUGLAS WILLIXMS � � l222 PINE ST. I CENTERVILLE,MA d26 `4 ` Undersecretary Not valid without signature F } - E [!�$ L�,-«r er 3.s.'::.W. f`►!'tiCw4kiaS 1 .: 'fLIF 6P91 i OF M-:minCM- ter' ry 6�429G78 ASi A i1�J4 i l tJC Vr A °^- - — s Mq `4. _ � �_ .v.....- ..r. a a aj-: --- '=-T_'-': _ Aii =-� -•� 1w�.�US" &SuR'-.`S) A ieaai est ems+ � $ =n f B&sj4O° _ OR 5 n:. �C T-�_•�n.wa2."v� �7B 8ii86P59�• W�4ffiSKVESBti R+a¢'�evriga�"'�'♦28�D10-a oar o :-s� ;w•..•_- -- � OIW&r DS an A�QFYiORAL E�13t1�.�Pon --�<.,.�a.+-c,�rtt€i�a des not confer !� • gTA 'G8i'fili I A ww-• - - .�ry f@O77lf8 6'It a ._. ° ate..twins w+_vn..i_�in•i�ax m uw __ _ �1... C�O� HI w u Of seGh Ci °1 s .,..,., �3 8i.1P18 The Fair Insure Agency - kathl�dthe€airageaeY_com+ ° 1619 maim- {P.O- sox 430 1Ceimt ervills a_ stable $rsck -CO I= EM ,c�ainEaG: 1_ -Doug.i�iAY i axiPt C tiv ss m+�S 222 ]?itslg St--e--t }$A 02632 Ra: REWWR WOW Centex iI18 eerATC nntertR�a_CL2253000274 -- sSlG rC°in:Y Par— C . ;•,,•••-•� u�vF W-N msuFll i[S TWE INSU[ MANED At3p1tE t !- COV>=tAfa�, yyt};{ 'L Ci Av vvras a ei;s7 )i ' ���p� i�i i5 i b sue+. TttiS is TO CUUIFY•ivi T PoPRs�S.U1 i CONS7TftON&M Y CONTRACT Aii OTttER Dg 811$X-CT To ALL TF1E TERM, �lCAT£D. I�YFlTE iSTRNDtW ANY'MQtJIFW: -W.IPERM.OR� By�`?4t IFS pFSCttt t3 —- i E P.F�tT_7ElCATE NitAY BE MUED OR P4AY YEKiABo,THE ii+�+ O' RFfri1f F tiYPAR? . 1'L7UCIES-L firm5fiei`�;;-.`°ro�`sai ExCLUSSONIS Mail CDHSri ilOWO OF J "n . pOtiCY ; !GAt2i s i +.�� , , t ! UR nLilla�-� {3 �,o rr ovnnrenrsl $ l --Wd tu.Ws^r CLMWAAAM cerar�u- '•°E a —�! ! AaPAGG 5 pm PoL „^�= LOC It ' a.+raaenw¢c!> !. t'a♦+N-i titiv�•�•�;.....�; _ - i uQuRf(Per AW AWO _ t . ! ! rem Auras -- MROs I - 3 E-- 1 ! ! LAU 1e TE� s ! 1 1�g� /9/2 ls;20" ! ea EWP W f—wp= is-Psg ,•�j i�SdAR� �WM014354012022 son.00 {) i t4a.�e4agy in t0i1 ! ! Esc-�'�+�s�°�°'�sa�isr<oca�toasrveace+=s.(AiiM Y 9I Ij i CANCELLA - Hyannis, Na 02601 $ah1►g SilvialF81 ®i�8-21N0 ACM= 3 ACMD 25(2D90t05} Ate'-`= The dCOftP�►�e anti �� "�' 07/16/2012 11:02 Stockton,Barker Mead TAX)5184351939 P.0011001 Town of Barnstable BAMM_ Regulatory Services `��' l Thomea F.Geller,Director i0'� Building Division Tom Perry,Auliding Commissioner 200 Main Street,Hyaauis,MA 02601 www.tcwn.barnstsble.ma.us Offioe: 50"62-4036 Pax: 504-790-6230 i Property Owner Must ; Complete and Sign This Section If Using A Builder I I, 19-r 1 GG A ,as Owner of the subject property hereby authorize 60114A 'C L '• Ill/I JAJA a-f . Sk,- to act-on my behalf~ in all'matten reladve to work authorized by this building pem it ?�87- iLuckrwr�j Par".C�E�ir ,2y�t,C6 m,4 , (Address of Job) **Pool fences and alarms are the responsibility of the.applicant. Fools are not to be filled before fence.is installed and pools are not to be utilized ur til all£anal inspections are performed and accepted. SiP$Ltu're of Owner Signature of Applicant �ToI1dV /J" , f"�41nA I- Print Name Print No& ~ Date Q:F0RM3:0WNWERM33I0NP00L3 ' . arnstable er Pmit�E Town-of B Evira 6 m Regulator Ser ces Fee f f Thomas F.Geiler,Director 1639. d Building Division TomPerry,.CBO, BuilditCommi;ssWner 200 Main Street,Avazmis,MA 02601 www.townbarnstable ma us Office: 508-862-4038 Fax:508-790-6230 EXPRESS-PERIIIIT APPLICATION _- RESIIDENTIAL,QNLY Not VaW without Red Y Press Imprint Map/parcel Number i Q L Property Address .Z,�ij` da—mdential Value of Work s,rl-rno Nfinimum fee of$35.00 for work under$6000.00 Owner's Name&Address A-`d �i Contractor s Name 4>` L. C � Telepbone.Numbers -'T -IHomeTmprovement Contractor License#(if applicable) LL CaliConstruction Supervisor's License#(if applicable) _ �0�mkmanlsCompensationInsurance XPRES Check one: ' S PERMIlf ❑ I am a sole proprietor ❑ I am the.HomeGwner [,have Worker's-Compensation Insurance �UN 2 12012 Tnsurance Company Name 1-&r OF SA Rf11 � worltirtan s Comp.policy# 604 Copy ofInsuranse.Compliance:Certific�6x.anust.aecompany eaehpernnt. Permit Request.(ch box ❑ Re-roof.(hurricane nailed).(stnppmg old_shingles).All construction.debris.�t�ill be taken.to Re-roof-(hurricane..naffed)(not Stripping.'-Going 01=d existmg.layers of roof) S-Re-side #of doors ❑ .Replacement WindOws/doors!sliders.U-Ntalue maximum 35)ft of windows actions,Le-T-r,stonr—Cansctvation-etc =Where required: Twunce of this.permit does nut exempt compliance with other trnvn department t ***Note: Property Owner must sign Property Owner Letter of Permission -AL copy of the.Rome Improvement Contractors-License,Construction-Supenisors-License is required. SIGNATURE: C_\Use[sidec d&\AppDamU.ca11\=snft\Windovrs\T-V-,uy IntemeCFiteslContenCE)tulook\DDVft7A�ZiF�RESS.doc Revised 072110 06/08/12 FRI 08:42 FAX 518 402 6201 COMPLIANCE Q 001 o� HE► Tows ofr� d�b� .: Regulatory-Services. . '* s,cstvsrnats, s Thomas°F:Geilery Director " Building Division Tom Perry,:$uildbg 60missiitner... 200 Nkib Streit;Hyai mi KA 01OQ 1 ww.w.town:bamitable,ma.us r 3 j Office: 508 862- R3:8 Fix: _ 0o_7 42 0 gaper n+ k Mittst:::.: Complete and-.Sigel This-SeC# on If of.the subet property hereby autho to act,on my behalf; - j in all matters relative:to w6rk autho zed by diis but-ding p�im€ (Address (A ju 1:: r Pool fences and alaffins are the re;; ty of.th ap Cant :Pool are not wbe' filled before>.'fence ire;installed-and:pa±ols ale not t is utilized until all firialinspecl ous.:are�erfOrined aid acc f-,, di . Si afore of bviner Signature 4AAg..iicatit. - ell a l P y t Name 1'tintam .. D to ;.. .. .. .. ... Q:FOR vM:0 Ra WBRM§SIONPOOLS i DATE(MMIDDIYYYY) .Aco CERTIFICATE OF LIABILITY INSURANCE 5/30/2012 THIS,CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT.CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must 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). CONTACT PRODUCER NAME: Kathy Silvia PHONE (508)775-3131C No:(506)790-1 The Fair Insurance Agency Inc. 677 ncy com 61"9 Main Street EpE�;kathy@thefairage INSURERS AFFORDING COVERAGE NAIC# P.O. Box 430 6158 Centerville NIA 02632 INSURERAAIM �tN$URED INSURER B West H Stable Brick,.Co Inc DBA - INSURER c: bong .W llia>$s Custom Buildsng INSURERD: 222 Pine Street INSURERE: Centerville MA 02632 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1253000274 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. NOTWITHSTANDINGANY REQUIREMENT;'TERM.OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT.WITH RESPECT ALL WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AD L WEN POLICY EFF POLICY EXP LIMITS INSR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LTR GENERALLIABILITY - EACH OCCURRENCE $ D GE ED $ PREMISES Ea occunence COMMERCIAL GENERAL LIABILITY . MED EXP( one person) $ CLAIMS-MADE �OCCUR PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS-COMPIOP AGG S GEN'L AGGREGATE LIMIT APPLIES PER: S POLICY PRO LOC COMBINED SINGLE LIMIT AUTOMOBILE LIABILITYEa accident $ BODILY INJURY(Per person) $ ANY AUTO BODILY INJURY(Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE $ NON-0WNED Per aaidentl HIRED AUTOS AUTOS $ EACH OCCURRENCE $. UMBRELLA LJAB OCCUR AGGREGATE $ EXCESS LIAR CLAIMS4AADE $ DED RETE"ON$ WC STATU- OTH- A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN E-L EACH ACCIDENT $ 100,000 ANY PROPRIETORMARTNEIVEXECUrIVE� NIA /8/2012 /8/2013 OFFICERIMEMBEREXCLUDED? C6 014 3 5 4 0 12 012 E.L.DISEASE-EA EMPLOYE $ 100,000 (Mandatory in NH) ff yes,desa�be under E.L DISEASE-POLICY LIMIT S 50 0,0 0 0 DESCRIPTION OF OPERATIONS below _ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.' Town of Barnstable Hyannis, MA 02601. AUTHORIZED REPRESENTATIVE Kathy Silvia/FAIKSI ©4988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) INS025(201005).o1 The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts ., Department of Industrial Accidents Office of Investigations g 600 Washington.Street ; hX Boston;MA 021.11 www.mass.gov/dig fi Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):- ' t� t/c6rz c ( li' Address: ®� LC�'l c c l(L c Phone M �D `7 J 7 City/state/Zip:, - Are you an employer? Check the appropriat box: Type of project(required): 1. aim a em to er:with' 4• 0 I am a general contractor and I P y 6. ❑New construction employees(full and/or,part-time) * have lured the sub-contractors 2. I am a sple Proprietor or partner listed on the attached sheet.,., 7. ❑ Reiiiodcling These sub-contractors have ship and have no employees .. 8.' ❑ Demolition working for me in an ca acit employees and have workers' y P y 9. ,Building addition cone .'insurance P - [No workers"comp. nisurance , required.] ; 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a lionicowner doing all work officers have exercised their I I.❑ Plumbing repairs or additions • myself. No workers'"com ;. right of exemption per MGL y [ A .12:❑ Roof repairs , insurance required.] c. 152, j 1(4),at d,we have no x employees. [No workers' -13.0 Other a 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'pro ding workers'compensation insurance for my employees. Below is the policy and job site information. M, Insurance Company Name: 3 O � Expiration Date: Policy#or Self-ins. Lie. #: � ��® I p Job Site Address. � (��°`t- `� City/State/Zip: l' 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of" Investigations of the DIA for insurance coverage verification. Ido hereby certify under thepains and penalties ofperjury that the information provided above is true and correct Signature Date: Official use onlp. Do not write in this area,to be completed btu cio,or town offrcial. City or:Town: + Permit/License# Issuing Authority(circle one): *, 1.Board of Health 2. Building Department'3. City/Town Clerk :4.Electrical Inspector 5.Plumbing Inspector 6.Other i 4 Contact Person: Phone#• t.-. J Massachusetts-Department of Public Safety Board of Building Regulations and Standards I Construction Supcn isur License: CS-016981 VT. I:S , � . DOUGLAS L WLLIAi[S SR ,.r, 222 PINE STr Centerville MA 02632I ►y =� - o v ac i4 o Expiration Commissioner 03/07/2014 V1 3 > M• i J SS o i Office of Consumer Affairs&Aims Regulation t a' HOME IMPROVEMENT CONTRACTOR " Registration• Type: 102227 Expiration 7/1/2012 DBA y D LAS C.WILLIAMS CUSTOM BUILDING f l u Douglas Williams �F i 222 PINE ST. CENTERVILLE,„MA 02632 Undersecretary I, e •f,__-:, 1 I.'U3T BE Assessor's map and lot number I.,I i- 1i,S$STALL ED IN COMPLIANCE �)le . ' q 9) WITH ARTICLE II CI u STATE � Sewa e�'Permit number ........... ... 1 9 SANITARY CODE AND TOWN M REGULATIONS. TOWN OF BARNSTABLE J yQi THE i BARNSTABLE, i M6 9 ;•� BUILDING INSPECTOR i°�Fo aaY a' APPLICATIONFOR PERMIT TO .... .................................................................................................................... TYPEOF CONSTRUCTION --� �........................... ........................................ ...............19. .�`^s TO THE INSPECTOR OF BUILDINGS: The undersigned he eby ap lies for a permit according to the following information: Location ......... .......................e.. ..... _. ..... ..: ...... .....:........ ......,..::.............?� ::�.................... ProposedUse ...... ..................... ................................................................................................................ Zoning District ........... ...................... :............... ......Fire District ....... .............. eri4;& Name of Owner . : .......Address 0 Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address ............. ..j. .......................... ................................:.... Numberof Rooms ........... ................................................Foundation .................. ............ . . . .... . ... . r Exterior ....................Roofing .......... oe- Floors ....... ' ''` .........................................................Interior ..... ... .... .. ... ........ .... ............. .............................. Heating .... ` ;,,,,'.......G".4 ..................................Plumbing ...... .... ............................ 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 n� v. C- Ic I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding a above construction. Name ............................... ..... ............................. %ruuI1* Alan E. � � . No ��*��' -----'' Permit— for ......-----'—' �..������..���* �ew� .............. � .--.. ~`����[ « i ^°,".""/ ---�4 `�.------ �� �°^ ^ _ . �� ����� ����~�', ~ v —..-------.',-.~.,.-~~.---------- ( � Owner .............. IiW.]0 .. ......................... ' � Type of Construction ................fxauw.............. ' ----'—^--~------'-----------' �O Plot --------_. Lot -----..������--' ' | ' � ' Permit Granted ---J4�Y.19................lV 73 / Date of Inspection lg . i ' ~ ~~'~ Completed ~ � � Y ' PERMIT REFUSED � -----._--------------.. lg /^� \ .---'---~---------------.--. ^ . --._—,..—~.-----------------~.. � ' .--------.--....--------.----.. � ^ --------,—.----~..—..------.. / \ Approved .................................................. lA ---------------.-----.-----. � . | ` --------------------..----.— � | 06/08/12 FRI 08:43 FAX 518 402 6201 COMPLIANCE Q 001 - _ �4wE. . . To ®f Ea:r�stable: Reptlatorya cts t. &UMSrAe .� r� �. W Mwss Thomas R Geilar, Director }pil, Bualding.Division. Tom Perry,.l3uilding Co&nussibher 200.Main Street,Hyannis,MA,0260 i - wwwwtowu.barnstable:ma.us Office: 5%462-4038 Fax: SflR 79Q-62 ;0 Property 0 Wne llSt: Complete and. S-i.an `I'h t Section If Using A Builder I, .,��'1 GCCGLJ ,as Owner:of the subject propestp hereby authot2e. L� : to act.on my behalf; i in all matters relative to work autho=, ed by this:biuldeng pertntt ;1'7kG =SLvu _ T " (Address of Job) Pool fences and alarms are ihe.-tesp.. nsxbility of the applicant .Pools are trot to be fined before fence is izZstalled and pools ,are not to be i utilized uxltil all final uispeC Otis are pei.fornc ed and accepted:: �Cf Signature S' tare of Owner of A ltcant pp Name PrintName - D to i i QiFORMS:OWNE UERMBSIONPOOIS :F Town of Barnstable *Permit# polo Expires 6 months from issue.date Regulatory Services Fee D O Thomas F. Geiler,Director Building Division 6k 7�2s��6 `A Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 P�-A www.town.barnstable.ma.us Office: 508-862-4038 FY,%8-7�3 9 0 EXPRESS PERAUT APPLICATION - RESIDENTIAL ONLA ��0� Not Valid without Red X-Press Imprint 'A2 6' ���► �48p/parcel Number property Address Residential Value of Work 5) Q. DO Minimum fee of$25.00 for work under$6000.00 owner's Name&Address doh(\ F. a I M Contractor's Name 11 l C Telephone Number—)go - lJ 4firne Improvement Contractor License#(if appli le) 194, 0 Construction Supervisor's License#(if applicable) rl�Workman's Compensation Insurance Che one: [ I am a sole proprietor ❑ I am the Homeowner 11 ❑ I have Worker's Compensation Insurance `asurance Company Name )�Vorkman's Comp.Policy# copy of Insurance Compliance Certificate must be on file. �trrn it Request(check box)[(Re-roof(stripping old shingles) All construction debris will be taken to nPA 01- ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner.Letter of Permission. Home Improvement Contractors License is required. SIGNATURE: Q=Forms:expmtrg ke-V 071405 S ,, I ,per �l e �omvnon+.seall�c a�✓�aaeac�ivaet�a Board of Building Regulations and Standards it HOME IMRROVEMENT CONTRACTOR ;I Registratton:, 24310 Ep /�2007 �dividual i James Curley \�y James Curley 287 Fuller Rd. �L =' j — u✓ Centerville,MA 02632 Administrator i aFTHe r�s• Town of Barnstable ti Regulatory Services • sn � � Thomas F.Geiler,Director y MASS. � Building]Division. Tom Perry, Building Commissioner 200 Main Street, Iiyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner bust Complete and Sign This Section If Using A Builder I, 10ho 1�4m ,as Owner of the subject property hereby authorize C to act on my behalf, in all matters relative to work authorized by this uilding permit application for. (Address of Job) Lure of Owner Date Print Name Q:FORM&OWNERPERMIS SIGN T he Gommonwealth oj'Massachusetts Department oflndustrial Accidents Office of Investigations Y 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),Juw6 Address: 0, 'BOY, 4,1�I City/State/Zip: KAA 04(P 0 I - Phone #: -Iq 0 - Lfa Are you an employer? Check the-appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I LJ I employees (full and/or part-time).* have hired the sub-contractors 6' El New construction 2. am a sole proprietor or partner- listed on the attached sheet 1 7• ❑ Remodeling ship and have no employees These sub-contractors have 8;. ❑ Demolition working for me in any capacity. workers' comp.insurance. 9. ❑ Budding addition [No workers' comp.insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.ElI am a homeowner doing all work right of exemption per MGL PY11 Mbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.Z Roof repairs insurance required.] t employees. [No workers' comp.insurance required.] 131:1 Other '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 anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and,yob site information. Insurance Company Name: 1- 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$1,50Q.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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the sins and penalties of perjury that the information provid d Iab ve is true and correct Si a Date: .JU — Phone#: v� `qo `C Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority (circle one): 1.Bo2rd of Health z.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: .:....:...:.......... 331 r.......... x:10 4 M196 <€ ><` .. :171-0254}} US v.4x ti tiiii p\ :{ J :t+}:•::{iLM1ti`M1>iv'M1.v'L<i}viii>.ii`vi�i�•'.};:�4v:��v�:ji$xtiiyii}? $tii{� M1{iii{tii>�ti:•,v:•;.'ii~i;.•,:t>.�? . v$ ;.. :.:i:• } i::{:tii•:tii nv n:•.....::.::.................x::::::.}.;:......:r::•r:rr......v......;........v.........:.x•.�:.:x.::x.:......: .:xvv:vvx,:..:...n:..x.x.xx.x v;;n.... �i\:iii:}:i'•ija:•.iii}}:�._vi;:;i{i{ti{?.i.ii??iiii LSTON >'{> BUCKSKIN<: PATH. x287M1•� �i :.. ........................ amNEIGHBOR ISO X. }`r,} •.i•:i•.i;;i•}:::}:ii•:i•.iiii;;.}}::i.:.:;;}:;.}•:::::•.:i:•:::•.:•. ;...:;:•:;.::;:;:;.::••}'.::.:.}:..i•: :•:r:::•:}::}:�:.,;:ii;::�s:�:<<�%<��:�•`•:�< >«<•'•:�: 4 # . . .. ......... k` W:.}NE SHINGLES—N PERMIT zz �< V Q 1 �l •V I I r... G ::.<` ����� �✓� `mod mmmF :::.s:•s:.}}:;.};:.:<i;•:.}:;•::.::•::.>:•s:•:ii•:ioi;`::•:i;}.::;i::`::ik>..;:::::;;�;:;::::::;;:....... ......................................:..:::::::::..:::.::::.::::::..::::...�::::.::.: ..:..:.:::::..::..::..:::.:::::rS;::::::::r::;::::::rrr: NOTHING N FILE-—FOR PERMIT WILL O G O E—F R E O T REFER O R.S. -BLD G.IP S N {„> » z yy���• .: x `:.....::•.:.:}.'•.......::..}.....:....:•.::............}.}...........:•.:•....:•...:•..}'.......:•....:•}}}:•}\'................:•}:•}..::....:•.:•.........:...::•..:..::4..::..........:..:.....\4i}}}} }:•..:i.yi;iix}i;:}i;;:i;:iiii$}:;