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HomeMy WebLinkAbout0283 CAP'N LIJAH'S ROAD �� y :.�� � 1 ,� r . e �1146E, Town of Barnstable :' *Permit#,_9 l� S-L Ex Tres 6 months m i su�d to g Regulatory Services fee ' * tARNSTABLE, * u/tb/�V v� MASS. b8p7Richard V.Scali,Director QED MA't A,� AN N Z® Building Division TQ Paul Roma,Building Commissioner ��O, 8A�i 200 Main Street,Hyannis,MA 02601 �IcA www.town.bamstable.ma.us Office: 5.08-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY , lq __tl j,l%� Not Valid without Red X-Press Imprint Map/parcel Number Property Address 'el //ke Residential Value of Work$ day• Minimum fee of$35.00 for work under,$6000.00 Owner's Name&Address M.. jcXorqjxe- Contractor's Name-4 Telephone Numb abez&Ai0t.5- lieer Home Improvement Contractor License#(ifapplicable)/6,26(2 Email: Construction.Supeivisor's"License#(if applicable) W.orkman's Compensation Insurance Check one: ❑ I am a sole proprietor _ ❑ I am the Homeowner. I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# W VL. W 00�y �( Copy of Insurance Compliance Certificate must accompany each permit. ✓Permit Request(check box) '1 Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping, Going over . existing layers of roof) Re-side - Replacement Wiiidows'doors/sliders."U-Value (maximum.32)#of windows #of doors: *Where required: Issuance of this permit does not exempt compliance:with other town department regulations;i.e:Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home.Improvement Contractors License&Construction Supervisors License is requ'red ., SIGNATURE: 4 . C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content:Outlook\L7U69LF2\EXPPESS(2).doc 01/25/17 Massachusetts Department of PubiEc Safety ' Board'of Building Regulations and Standards License, CS-009714 Construction Supervisor ' RICHARD P GARNEAU JR PO BOX,476 � � t WEST BARNSTABLE Wtt2668 ^F ? ..Expiration- Commissioner. a 04J04/2018 i ' R / / (✓ Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration « Type: Supplement Card *µ '�V Registration: 162600 BAKER & ASSOCIATES INC. Expiration: 03/25/2019 P.O. Box 923 M { Centerville, MA 02632 Update Address and return card. Mark reason for change. SCf 2GM,•0 1 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. if found return to. Registration Ex iron Office of Consumer Affairs and Business Regulation 03;`2 2019 ; 10 Park Plaza-Suite 5170. Boston,MA 02116 BAKER&ASSdG'W`ES1N&;, RICHARD GARNEAU a 521 Shootfiying Hdl Rd � Cr :ta— 'Centerville, MA 02632 :`t `-' aAr Undersecretary Not valid without signature Authorization Form: as owner of the subject property J p P Y hereby authorize Baker & Associates to act on my behalf, in all matters relative to work authorized by this building permit application for Address of property: 283 Captain Lijahs ,Centerville, MA Sign ature of owner: '( ✓�� e " Print Name: y L I> Date: y The Commonwealth of Massachusetts Department of Industrial Accidents l Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia «'orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual): Baker&Associates, Inc. Address: PO Box 923 (521 Shootflying Hill Road) City/State/Zip:Centerville, MA 02632 Phone#: 508-362-2445 Are you an employer?Check the appropriate box: Type of project(required): 1.[Z]I am a employer with 1 employees(full and/or part-time).* 7. E]New construction 2.F1 I am a sole proprietor or partnership and have no employees working for me in 8. E]Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.n I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. 1 will ensure-that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 11❑Plumbing repairs or additions 5.a 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[]Roof repairs These sub-contractors have employees and have workers'comp.insurance.' 6. We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4);and we have no employees,[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. .. '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:Associated Employers Insurance Company Policy#or Self-ins.Lic.M WCC-500-5002454-2017A Expiration Dated 4-23-18 f Job Site Address: ✓� Z1, fQf�[d City/State/Zip: Attach a copy of the workers'compensation polic declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,.§25A is a criminal violation punishable by a fine up to,$1,500.00 and/or one-year imprisonment,as well as civil;penalties.in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this.statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u er the pains aNd penaId s of perjury that the information provided above is true and correct Signature: Date: `Q Phone M 508-362- 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#: X J f Client#:9742 2BAKERAS .A.CORDTM CERTIFICATE OF LIABILITY INSURANCE UATE(MMIDD/YYYY) 4/28/2017 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). PRODUCER CONTACT Dowling&O'Neil - Dowling&O'Neil Insurance Agency ac°Nr o,E.1:508 775-1620 FAX No): 5087781218 973 lyannough Rd,PO Box 1990 EMAIL ADDRESS: COIOedoins.com - Hyannis, MA 02601 INSURER(S)AFFORDING COVERAGE NAIC#. 508 775-1620 INSURER A:NGM Insurance Company 14788 INSURED INSURER B:Associated Employers Insurance 11104 Baker&Associates,inc. INSURERC.: P O BOX 923 _ Centerville,,MA 02632-0071 INsuRERO: - 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 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER ADDLSUBR MM/DDmYY MM/DDNYYY LIMITS A GENERAL LIABILITY MPJ7223M 4/19/2017 04/1912018 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE REM SES(E.oocu enoe) $5009000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $110001000 ` GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY I PRO LOC - 1 .$ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT - Ea accident ANY AUTO • BODILY INJURY(Per person) $ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ - NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS -- Per accident) -$ UMBRELLA LIAB HOCCUR - EACH OCCURRENCE $ " EXCESS LIAB CLAIMS-MADE AGGREGATE $ - DED RETENTION$ $ B WORKERS COMPENSATION WCC50050024542017 4/23/2017 04/23/201 X We srAru OTH- AND EMPLOYERS'LIABILITY Y/N - 0 yTL I E ANY PROPRIETOR/PARTNER/EXECUTIVE - - _ $SOO OOO OFFICER/MEMBER EXCLUDED? � N/A E.L.-EACH ACCIDENT- (Mandatory in NH) E.L.DISEASE-EA EMPLOYEEI$500,000 If yes,describe under - - DESCRIPTION OF OPERATIONS below - - E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,.Additional Remarks Schedule,if more space is required). Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE.HOLDER CANCELLATION Baker&Associates,Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE' THEREOF, NOTICE WILL BE DELIVERED IN PO Box 923 ACCORDANCE WITH THE POLICY PROVISIONS. Centerville,MA 02632 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. .. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S190160IM190159 CBD ao TOWN OF BARNSTABLE '(WE 201201 630 Building ' BARNSTABLE, Issue Date: 03/23/12 PerMit 9 MASS. �A i639• Applicant: NIALL HOPKINS BUILDERS INC. rFG �A Permit Number: B 20120630 Proposed Use: SINGLE FAMILY HOME Expiration Date: 09/20/12 Location 283 CAFN LIJAH'S ROAD Zoning District RC Permit Type: RESIDENTIAL INSULATION Map Parcel 193136 Permit Fee$ 35.00 Contractor NIALL HOPKINS BUILDERS INC. Village CENTERVILLE App Fee$ 50.00 License Num 84916 Est Construction Cost$ 1,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND WEATHERIZATION,INSULATION,AIR SEALING ATTIC THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: KEELER,RONALD E&GEORGETTE BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 283 CAPN LIJAHS RD INSPECTION HAS BEEN MADE. CENTERVILLE,MA 02632 Application Entered by: JL Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT,TO OCCUPY.ANY STREET;ALLEY OR'SIDEWALK;OR ANY'PART THEREOF,EITHER TE -ORARILY P _ Y"ENCROACHMENTS ON PUBLIC PROPERTY,NO SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE.IURISDICT ION.,.,STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS',MAY BE' OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS THE ISSUANCE OF THIS PERMIT DOES NOT REL THE APPLICANT FROM-THE CONDITIONS OF ANY APPLICABLE SUBDIVISION, RESTRICTIONS.' t , MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CO UC ON RK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THRO LEV B 0 FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETE RI FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(REA 0 L TH). 5. INSULATION. 6. FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPAR%LANDX,10 AQUI'RED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. e WORK SHALL NOT PROCEEDSOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECO IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT I ISOTED ABOVE. PERSONS CONTRACTIN W ERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(asset forth in MGL c.142A). ME. ta s ,, ,.,. •,: l k e, BUILDING INSPECTION APPROVALS 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 �w Parcel A lication pP ze Health Division Date Issued Conservation Division Application Fee Tax Collector -Permit Fee Treasurer Planning Dept. C v 3��ilz Date Definitive Plan Approved by Planning Board t Historic-OKH Preservation/Hyannis Project Street Address yrd Village t� . Owner PUT& hWA9X1Address Telephone 6m q`^� �oa ermit Request 1zA1 LWOO ,vJnW4cn A" Ll Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total now Zoning District Flood Plain - Groundwater Overlay o Project Valuation Construction Type 1C Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:LLexjsting ❑new size e Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: ' o Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes LdNo If yes, site plan review# v Current Use Proposed Use_ ? BUILDER INFORMATION r-n Name i s �L)Mlks �r Telephone Number �Kl� Address2 k& R A" License# bq q �lX a A l7 Home Improvement Contractor# Worker's Compensation# clilOLr:_0 ALL CONSTRUCTION DEBRIS RE TING FROM THIS PROJECT WILL BE TAKEN TO Url1 ' SIGNATURE t` DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER r t DATE OF INSPECTION: FOUNDATION FRAME INSULATION �> FIREPLACE ELECTRICAL: ROUGH FINAL f PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO.. a ' I , .Y - The Commonwealth of Massachusetts Department of Industrial Accidents w - - Office of Invesfigations ' 600 Washington Street Boston,MA 02111 -- www.mass govIdia Workers' Compensation Insurance Affidavit:Bailders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 3 lai_; -c- Fair.. Address: City/State/Zip: - rf t AA---% C)Qr U1 Phone#: Are you an employer?Check the appropriate bog: Type of project(required): l-,ETI am a employer with �i 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I a a sole proprietor or partner- listed on the attached sheet I ? m - ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity- workers'comp.insurance. .9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required-1 officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required]' employees.[No workers' ' .f-.. comp.insurance required.] 13�'Otherl:. � , OAny 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 subcontractors and their workers'comp.policy information I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site W information. Insurance Company Name: (A LG, i1 � Policy#or Self-ins.Lic.#t k �' Expiration Date: � x � Job Site A r City/State/Zip: " ! Attach a copy of the workers'compensation PO WY 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�Iaarnst the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations insurance coverage verification I do hereby c ' r the pains and penalties of perjury that the information provided ve' true and correct Si true: Date:` Ph ne#: Offmial use only. Do not write in this area,to be completed by city or town ojWaL 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#: CERTIFICATE OF LIABILITY INSURANCE DATE 011M11/2012 Y) I2012 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 WANED,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: Mark Sylvia Insurance Agency PHONE FAX 771 Main Street 508 28-0440 ac No:508 20 9227 E-MAIL ADDRESS:mark(cDmarksylviainsurance.com OSterville,MA 02655 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Farm Family Casualty Insurance INSURED INSURER B: Niall Hopkins Builders,Inc. 118 Lakefield Road INSURER c: . PO BOX 231 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 PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLtCY NUMBER MMlDD MMfOD A GENERAL LIABILITY 2001 L6275 10/30/2011 10/30/2012 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea oav rence $ 100,000 CLAIMS-MADE XM OCCUR - - MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 1,000,000 X POLICY PRO-JFCTLOC S. A AUTOMOBILE LIABILITY 2001 C53575A 6/25/2011 6/25/2012 CO aMB�1��ISINGLE LIMIT $ ANY AUTO ' BODILY INJURY(Per person) $ - 1,000,000 ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ 1,000,000 XAUTOS AlJ10S NON-OWNED PROPERTY DAMAGE g 1,000,000 HIRED AUTOS AUTOS - Per accident s A X UMBRELLA LIAR OCCUR TBA 1/11/2012 1/11/2013 EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ $ A WORKERS COMPENSATION 2001 W6459 9/8/2011 9/8/2012 wC STA s x O R AND EMPLOYERS'LIABILITY ANY PROPRIETORWARTNERIEXECUTIVE Y N E.L.EACH ACCIDENT _ $ 500,000 ❑N N A OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Carpentry,Electrical CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Conservation Services Group THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 40 Washington Street Ste 3000 Westborough,MA 01581 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1 ` ,s _ �1:tk aChu.ctit� Uettsw{ari+�n.and!- a dard� ai►ard of Buitdin�'lic, -Construction 5upe:jisor license Licq`;e= CS 84916 ` NIALLJ#4OP'NS' ' BOX 231 SC YARMOUTH=:MA p2M64 Expiration: 4r2W3 Tr--: 145D4 t:smn=i�siunrr Qtfiee o onsumer A airs s�aesc. egwa on License or regist3ration vaiid:forindividul.use ogiy FJOIiAE IMPROVEMENT CONTRACTOR before't6e expiration date Iflouad return to fge9istra00n 181773, Type; Offiee of Coi►su►ner Affairs and-Business 7ta grtial5on p, ExP►rations t/202012 Private Corporation l0'Fark Plaza Suite 5170 �i 131istot N HOPKINS BUILDERSINC_: A-0" NIALL HOPKINS 21 G rRUEAN AVE' SOUTH YARMOUTR.4d 822 .: Undersecretary y �Yot Va-I vPit}tout signature , -- 3 • 4 - F + 1 • OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at (Pro;erty Address) (Property Ad,ress) hereby authorize /\J ",\, (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on.my property. Owner's Signature Date JAN 1 S e112 f e� C-c, FfZM i 2 F C-N4 C�l'n o v b, `2 5�� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map c Parcel t3 6 ,- BARN,,"RN,, �,�;t�LP rmit#_ ;� Health-Division `XV 0 m 753 Z°7 03 Date Issued — ? Conservation Division ' 23 3 ( 43" �� Application Fee//�� p/�I/ Tax Collector Permit Fee "� 2 w 6'(o Treasurer ove Planning Dept. MrALL6 N N,: Date Definitive Plan Approved by Planning Board ENVIRONPIEWy AL CODE,Ati6 Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address C a f^J L; t Ii1 S (�l�C Village �'��. cJ L L e' Owner 7R-ory e e-e Address "�- TelephonePermit Request Request ofv S K C- Se e _/Ue 61r2Ck ®-) ^ �s i%v G L eez P1',vs Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 16' 5w Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. pDwelling Type: Single Family Two Family ❑ Multi-Family(#units) izz Age of Existing Structure Historic House: ❑Yes J1�410 On Old King's Highway: 0 Yes 10 o j Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) O._ Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new A Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes Cl No Fireplaces: Existing New Existing wood/coal stove: O Yes ❑No Detached garage:0 existing ❑new size Pool: 0 existing ❑new size Barn:❑existing Cl new size Attached garage:0 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes Jam' If yes,site plan review# - Current Use - Proposed Use I BUILDER INFORMATION �Q� �� �,�(� . Name �-L -V 0. Telephone Number � Q l® f r_oto 10 f Address License# �" Wnr-c i ' — Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �� j--- t _._.,, FOR OFFICIAL USE ONLY PERMIT NO. - DATE ISSUED MAP/PARCEL NO. ' ADDRESS VILLAGE F OWNER DATE OF INSPECTION: FOUNDATION - '{- - 3 FRAME . INSULATION i' FIREPLACE - ELECTRICAL: ROUGH FINAL i V PLUMBING: ROUGH *,, s FINAL GAS: ROUGH, ,: - • FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Town of Barnstable ANSTABLL Department of Health Safety and Environmental Services MASS. f6jq' � Building Division fD MPy 367 Main Street,Hyannis,MA 02601 508-862-4038 508-790-6230 PLAN REVIEW Owner: 22 l e 1�- Map/Parcel: j 1.3 �0 m Proje�tAddressQCOl IZ� Builder: The following items were noted on reviewing: e g( S f e�irn� 1 V- Reviewed by: Date: I _ ` _�_ The Commonwealth of Massachusetts Department of Industrial Accidents Office o/imrestiffatfoes . t 600 Washington Street Boston,Mass. 02111 Workers' Co m ensation Insurance Affidavit name: location city phone# ❑ I am a homeowner performing all work myself. . ❑ I am a sole r rietor and have no one worku%in /l/% ca achy / %///1,12% / I am an employer providing workers' compensation for my employees working on this job. : . ... :rom ....}:.:.::•:....s»:.}. ... ..y..: :.. .;; �:�ami:�!!�::�:�i::;�::is�i:�':�>:::.:;.;:<'i`:;�':%::ci:l: ��:::�:�5:�i�:::<%22::::::;::`;;: 22%�;::�:Y>':;":�':�::�:i>:�i:���i:�:J'.22�:::r::i:;:�:`•':�:3 ;:�:;i: ::: .::;�:�:;t:;:�:�::: :'{•: �:��•:<::�: X. 3nstitaric(•>co;>::;««:;::�.::��".�'�•:<;{.}..::...: •'`'��.:.,:.::.:, ,��.;-.:.:.:Li., .�.,::..,:,,::.::_.:.::::...:::.:. oh. .;:�<: :� .':. ::;> . ...:. ...� ❑ I am a sole proprietor, general'contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' co ensation polices: «s> :> »<:'airs »:: ::>:<.::::>::>:::<:>:<:»::>:: ..on » . r. :%%i ii'•:.:::::;::i:;:;%:::;;;:;:2::`::<:`::)::::}:E;::`:;':Y:•::}:r:::;:{.... ;:{;;}:;;:<;;:;?:;:;r.;:;:i%;:;:;':}`%;:.'•:;::;:'y'} :'::;{ t <:J::<::::<:::::::::ri;::%:::::::::;;:;::;:'-`:::<.......:::n.::::::::::•...}}::{^}}:........... ::....::........:.:......:...:..:•}:.}'v::v:iv::::::::::::::::;i::•}},•. :... ..........................:.:::.�:.�::.�::.L}i::%}{iii}}:{�}i:::i:::..'.vC•:v:.v}..' •if{{v:Si�w: ...fh'i<::'{.}:.i:.:4:::i::Yi}>:{i:!:}:•:}:.::::•is4:•}:•}`:::A+}:^:•}}:4}}:t•i}i}:::::}}::n�}:w:::}}}i:,:•:i{.}:•: > '< adifi ess ....:: }} ........::.: ::::::::::::.:::::.::::.......:::.::::.:::::.:::> ''`h irtsnran . XXX Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that s copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby ce the sins an penalties of perjury that the information provided above is truo and correct Si�ature Date ®� Print name Phone# (:contact e only do not write in this area to be completed by city or town official wn: permit/iicense# ❑Building Department ❑Licensing Board if immediate response is required ❑Selectmen's Office ❑Health Department erson: phone#; - ❑Other (revised 9/95 PJA) I Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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 section 25 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns 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 permitllicense number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 . r p °FTHEt � Town of Barnstable P Regulatory Services r. awgrA MAM Thomas F.Geiler,Director Mass. 0 .t A`0� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-962-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the`reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: SC96'e,.,6d�D„�'_4 Estimated Cost d Address of Work: A - VI9 VilleP Owner's Name: I W a-C Date of Application: I hereby certify that: Registration is not required for the following reason(s): OWork excluded by law ❑Job Under$1,000 Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as th ent of the caner: . Date Contractor ame Registration No. OR Date Owner's Name a f RESIDENTIAL BUILDING PERNUT FEES APPLICATION FEE New Buildings,Additions $50.00 2� Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE 4 square feet x$96/sq.foot= x.0031= �5f plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming-Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) 4 z Permit Fee i 4 °Fs rw,ti Town of Barnstable Regulatory Services BMUMAULEv Mass. i' Thomas F.Geiler,Director QjA 039. TFDMA'�A Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 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 l property hereby authorize L S Ct e_.. 44 Sto act on my behalf, in all matters relative to work authorized by this building permit application for: 2- C (Addre of Job) �e/W Signature of Owner Date . I Print Name " Q:FORMS:O W NERPERMIS S ION F77 �JLE -VO?lYIILOIL[!/P.CLGLiL d�/UGQ10C7.ClLU.QP,�6 Board of Building Regulations and Standards - == HOME IMPROVEMENT CONTRACTOR Registration: 137899 &Expiration: 1/23/2005�_? Type: Individual PAUL SAVAGE&ASSOCIATES PAUL SAVAGE 10 BAY Pine Road. � � EAST HARWICH,MA 02645 Administrator ✓sae t�anv»za�uueai o�✓ ¢c`iu6e4 BOARD OF BUILDING REGULATIONS x icense: CONSTRUCTION SUPERVISOR Number: CS 061012 Birthdate: 07/26/1955 y , " Eitpt . 074'26/2003 Tr.no: 665 on V Restricted: 00 I PAUL M SAVAGE 20 JUNIPER LN N HARWICH, MA 02645 Administrator 19Amwbd ---r-- 9 4 P � 193 � � t 1 90 --- 104 , # F:\dgn\conservation.dgn 05/30/03 08:50:57 AM 3 I 06/09/03 MON 15:32 FAX 1 508 775 1135 CHAGNON INSURANCE AGENCY Q 001/001 ACORD CERTIFIC/4 b.p. L��41 �LIT�t'. 1NSURA�ICE DATEE(oD" / /03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Chagnon insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 355 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 411 Route 28 COMPANIES AFFORDING COVERAGE West Yarmouth, 2+A 02673 COMPANY A Senn- America insurance Co. INSURED — _— COMPANY B Travelers Indemnity Co. Paul Savage DHA Paul Savage 6 Associates COMPANY PO Box 1617 C East Harwich, NA 02645 COMPANY D COVERAGE8 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ CO POLICYEFFECTIVE POUCTWMRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE IM YY)MIDDI DATE(MMIDD/TY) LIMITS GENERAL LIABILITY GENERALAGGREGA_TE f 2,000,000 ' A COMMERCIALOENERALLIASILITY in issue 3/03/03 3/03/04 PRODUCTS-COMPIOPAGG S 1 000,000 CLAIMS MADE U OCCUR , PERSONAL AAOV INJURY' 11 1,000,000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE S 1 000 000 FIRE DAMAGE(Any one fire) a. 50,000 MED EXP(Any one Person) S Jr' 000 AUTOMOBILE LIABILITY - � COMBINED SINGLE LIMB f ANY AUTO _ ALL OWNED AUTOS BODILY INJURY S -SCHEDULED AUTOS r (Per Person) HIRED AUTOS BODILY IruvRr 3 NON-OWNED AUTOS [Per aeddem) PROPERTY DAMAGE S GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE S, _EXCESS LIASIuTY EACH OCCURRENCE S _ UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM f WORKERS COMPENSATION AND OR LIMIT ER WC EMPLOYERS'LIABILITY _ TORT LIMITS ER EL EACH ACCIDENT $ 100,000 . 8 THE PROPRIETOR/ INCL In 199ue 2/27/03 2/27/04 EL DISEASE•POLICY LIMIT S 500,000 PARTNERS(EXECUTIVE OFFICERS ARE- REXCL EL DISEASE-EA EMPLOYEE S 100,000 OTHER DESCRIPTION OF OPERATION-9410CATIONSIVENICLEMPECIAL ITEMS CERTIFICATE HOLDER CANC:EIJATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town Of Barnstable EXPIRATION DATE THEREDF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Fax: 506-430-4536, 10 DA wRITT�NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT PAIL E TO MAIL SUCH N C LL IMPOSE NO OBLIGATION OR UABIUTY OF KIND UPON TN ITS AGENTS OR_REPRESENTATjftX r AUTN R NT � G// G ACORD 2 (1195) 0 ACORD CORPORATION 1988 M This rendered New reprepresents the designers Idea •+t 0 of the proposed screen porch. y O .. ., 3 IL W E CL Agn _ 9 O_ u 0 � X0 k � '^ E m - admwaxT4 _ e g xfr 1 d L a fAtY• f/J m y - _ 10 CM O CM _ �. , a Cc VCq C Cover Page W CO v q � O BATH `� I Q O LL c r-r x s'-to• A m a ma°o MASTER BDRM KITCHEN _.I tr •a2-r iB'-e^xtr-r' FAMI6Y �• �'—M o. g-rxt4'.r Vm 0 C M - -MASTER BATH - I ;m a= LL �.w�' Ero 4a9Luuax° ON ON DECK DECK 3W-Tx1T-T . R {V � d Scale N/A a a in se-r 6068 io 07,F fV DECK 24'-4^x 1 V-T' PORCH — —13'-4"x 11'-2" 4 w N M Y U) N O ° d - O -4'-0" 4'-1 1/4" 4'-0" Scale 1/4"=1' p C d d D CL °6 us M C ANC) Existing deck&Proposed Screen Porch Floor Plan F , m 0o - o 0 xU tp .M- " n y o c E m — I m �R O A c c u 4d�wax-i - -- - - _ - - - - v N .. 8. pp CO • In algae aanatete twtubes. — I ' •r. bretali Simpson CB45 poet base. ' •V�•••^ P.s will be 4APt. 66'.3" Girt stick 4a6pt with 2-2a10pt flitch plates(1 an each side). Ij 4'-5 3W'*I- _—4'-1 314"1 _-4'-5 314"+i-� - Scale 1/4"=1' y M d Y N N d � O O � o Ca 0 Sonotube &post locations �° N �j 3 m� � a IS a i � `t Q �m0 hi _ I5' m moo, Em 115 r� a y o c M ro E N �m y o_ _ _ _ mo ' ot —_. � I 4da�tuaxJ I o � I I yy O 2'-T' I « m r d E><Is81g flow Iwem 2xept 78"o.c. .q - 5/46 disking _ Log wdsdng Weer m loift 31e6 to-Wo.c. - I-W W joist hangers as needed. , New Stair Landing '-5 3 Exlsting Joist system Scale 1/4"=1' ' I � r o CO L. d Existing joist system � d M � NC� v!• .. M St Q .� C1 b U 'i g - °Zi A m vt • - m �m E� m��� - a c a w E m m A m t o 4dmwa.x� Cut back overhang and Install 2x4 _ knee well. M c n .. / New root shingles Will be similar to .- .. existing but will not match. • 151b.felt paper. « m di 1M cd(plywrood sheathing. m A White aluminum gutter a O R N downspouts. New twllywnad style aluminum Primed Pine trim boards simlar In _ screen doom 12). size to existing. Rake calling Jaiste above plate. Calling lolosts Mod 16"o.c. i Headset 2z10kd. - .. Poets 2z4pt q Existing rallirgs to remain in place . _ and rrew aluminum screen sections will be Installed from the inside. - Sonotubes 48"below grade d a -0 M CDVO Y N N d O • pf J � C Old V °: CV) c Elevation Detail W N C) D Assesso4 s map and lof-number THE T0� - Sewage Permit number . C S' T ' �.g�1............. BJHH9Ta LS.. House number ....................:. .... !li�Ad°'l��L��y`�7a�*�g�si@.06.ii`il��.E �O 2639. 0� j WtlAIH 896.E i ON Ar\ TOWN ; OF : BAD t�. 11 �� �ALBCLEAN CN RE67ULATI0 S r- �= BUILDING INSPECTOR 11 ' -APPLICATION FOR PERMIT TO -n TYPEOF CONSTRUCTION ............... °.VS-1...... .................................::...................................................... 1 ��. . ...............19........ TO THE' INSPECTOR OF BUILDINGS: The undersigned hereby applies Ifoa permit according.to the following information* Location .....,.............. � ,C:.... ......... ......... ......... .........t.......4 :..................... Proposed Use .......... .... P`Y..w '...... Zoning District ...........Fire District.� ............. ............................................ . ... ..... ....... ..... Nameof Owner ....... . .......................................................Address ........... .................... Name of Builder' .........Address ................... ............................:.......... Nameof 'Architect ..................................................................Address :........................................:.......................................... Number of Rooms ..................... G.............................. ....Foundation ...... ..... ............. ........... . ..... ... .. . GExterior ...`!`�.................`-/� .�4. . .....................Roofing � Floors ........�o..`4-.................'.. Interior ..............4.r . Heating .. ................ . Plumbing �t ................. ..... .. ... ............. {. Fireplace o o-�. _ p .................... ............ ......................:....................Approximate,Cost .......... ... ..a......................................... .. .: Definitive Plan Approved by Planning Board -----------_______-----------19________. Area ......f..1.T®. .........:. Diagram of Lot and Building with Dimensions Fee ............. C�" i SUBJECT TO APPROVAL OF BOARD OF HEALTH 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,�"�':........ .... BREEN, Jr. P. 24396 One Story No ................. Permit for .................................... z�j........51ug.le—Family...Dmelliag............. Lot #50, Capn Lijah' s Roams'Location ................................................................ Centerville ............................................................................... J. P. Breen Owner ........................................................ .......... . Frame: Type of Construction .......................................... .................. ........................................................ Plot ............................. Lot ................................ -Z .7 Pe'rmit Granted .....Sept..- 2.3.............•i'g 82 Date of Inspection ....... .........................19 Date Completed ..................I Assessor's map and lot number ,f. ......:.. ..... . 'n - "�' j0 r . ..... .� 114 E T0� Sewage Permit number ........a .......................................... _ y� ' r ..................................... y rasa • House number .......................�.�...� oo�ie3 aL� EM ` TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .............:•....... "' ��.. ............................................................... TYPE OF CONSTRUCTION ............... ?.'. :::'................................(.................................................................. TO THE INSPECTOR OF BUILDINGS: fr I The undersigned hereby applies(for a permit according to the following information:., j Location ...... °.. .�?...... .....\..: �r*•":...... ::< !.4r, z ,,` •�"�,e'." �`� .. .... . 1c?;.:: a.......................... ProposedUse w.9... .....-4..—,. t{��..... ......... .................................................................................... Zoning District .... t.. ..............................................Fire District r ` ....... E ...... Name of Owner ..............� .. A...:............................... .Address ........................................... .���•ez.... ,ct•r1 Name of Buildsr' .: ;� .. �:'a:-t;:�::..............Address ................................... Nameof Architect ............................................Address ......................:.....:............................ ...................... Number of Rooms ......................�..........................................Foundation ........j . .... .. , .: ' r� ................ Exterioracr'.!?�.... � r� ?r ,. .................. .Roofin ....... a;.� iGt�r ................................... Floors ................... ,r.::......:..................................................Interior .................................................................................... Heating ...... LA 1............s. ...:� ...........................Plumbing ...............:...... U..��................................... Fireplace .................. ..... ................................Approximate Cost ........... ...................................... Definitive Plan Approved by Planning Board -----------_------_-----------19________. Area .......................................... Diagrameof Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 17 •i 444t V' I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the_above construction. Name .::.: ?�^,. .•.......�' t ::-.`........... ... .. •� I BREEN, J. P. A=193-136 24396 One Story No ................. Permit for .................................... Single Family Dwelling............... ................... ...................... Location ......Lot...#50 283 Capn,....Lisaah.` s Rd. ........................... Centerville ............................................................................... Owner ... .'...P.....Breen.................................. Type of Construction ... rame ............................................................................... Plot ............................ Lot ................................ Permit Granted ..... ept.'... 23................19 82 Date of Inspection ....................................19 Date Completed ......................................19 00 �.�� i TOWN , OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING ru q HYANNIS MASS. 02601 MEMO TO: Town Clerk FROM: Building Department f DATE: ti An Occupancy Permit has been issued for the:building authorized by Building Permit {� ..:-------. .......:. ........................_. : . ... �. .. .. issued to ......... ...... � +n��....,� _.... . Please release the performance bond. a° • 1 •• • TOWN OF BARNSTABLE Permit No. __ _____________________- Building Inspector Cash OCCUPANCY PERMIT Bond _ Z, Is ued to Address a"rsto ns a!li Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .....................................................1 19......_._ .......................................................................................................... ._._ Building Inspector , C40V.S.T!@t/ C:_T/.vN _.. _ yov � c sr�_�_.arr. yn�- tom , J , Oil (2. - ; moo k - �' 7 7, 0"'•��'�. 4 t � �� -+ _ , _. : � . s �° _ , a,id Q �. / __ •�/ � . i - - t 1 : ��B S f• 777 • t 1� , f 7 , ..CO2.S. ?r GZC'td y , 1 r ..a-.-{_,__ _. _.._ .! ��}:.ram_' J _.. _ _f!.� •� vIlk 71 tV i. .[ 10 e l f G r { , t i i e p 06 J G- , 0 . l ol,Zo ea ram.' _I _..• ._ � .. , � .. �� I ..�. \ ' �. t _ r F ff 1 t _:_ w �, �" - 3�• _- o«. - ,fir ; --r-•-• . ,� /�,��:E �w g _ Cb cc at .... ..., _ i., � ,.- --�_ (fie I , ! _»��� Y..7_, � _,i ._ _ _ _ � _ _ ` _ 4 Qo, �.:���''• 'x'•� j __._._. __. J r 1 � / Yp lta Q..�'"C // J, 7 i r T` t , ,. t J A ' L w t --_ 1 CE RT I FY ' A''T '* _' THE-:-AC-TU.AL-LOCAT10-t ,OF;THE-- r_.___ _ �j� � _ i,- _• _, __ _ _-__ STRUCTURE ON-THE l`.:,AND"AND AT�_17-T -.CO TH NF.OR.MiS._._WITH =THE BY-LAWS, OF THE TOWN !�'} -PLAN"-OF" LAN®.' Vi.c kP- ,MASS. i f 0, NED BY ; tH'OF b OF , `i J , ,ss eta � - < ,1, I ` �Q ` ';1 �t `. G .1 ✓f�eS /��7_���L G 1V._ J FRANK r + Fxnn� -C NERY 12- E c0N Kr_; J CONER`1 C . BREZNr R LANE . 1 _ _ _ ., FRANIt i ! �0 _ NTERVIL . N. �s�3 N. cZ3z CE LE' MASS 02632 7, - . FG/ST'Ej� ` P�pv REGISTEREV ENGINEER"A LAND.SURVEYOR IONA su ; SCALE' 1 'IN' --fOF,T. 9