HomeMy WebLinkAbout0026 DEEPWOOD CIRCLE ems- ���� .. �� �-�
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tTo n of Barnstable
w a sable ���
,�T"E'Owti Regulatory Services
Richard V.Scali,Director
=" MA-Sa Building Division
1639.
'Drfo 3.�► Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403.8 Fax: 508-790-6230
PERIMUt �/ ,s�Zq q� FEE: $35.00
SHED REGISTRATION
RESIDENTIAL ONLY
200 square feet or less
CADW �r r (M
Location of shed(address) Village
Property owner's name Telephone number
Size of Shed Map/Parcel
v„h'.
4-7
# f ab
Signatur Date
c�7
9p.
Hyannis Main Street Waterfront Historic District?
W r:�
Old King's Highway Historic District Commission jurisdiction?
If over 120 square feet,you must file with Old King's Highway
Conservation Commission(signature is required) f G%
Sign off hours for Conservation 8:00-9:30&3:30-4:30
PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
THIS FORM MUST BE ACCOMPANIED BY A
PLOT PLAN
Q-forms-shedreg
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+.f> TOWN OF BARNSTABLE 35147
Permit No. ................
_• BUILDING DEPARTMENT
I "JU"'� TOWN OFFICE BUILDING Cash
HYANNIS.MASS.02601 Bond ......X..........
CERTIFICATE OF USE AND OCCUPANCY
Issued to BAYSIDE BUILDING CO.
Address lot #5 26 Deepwood Circle, Centerville
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
August 12 19 92 !�
.... ............
Building Inspector
BUII:,)IXG .FERNUT NO. D / c/ 2,D
ASSESSORS PARCEL NO.
CONTINUATION OF ROAD BOND ,. 4.
z
The undersigned owner/contractor hereby agree to maintain their road bond in
farce unt_1. -the follow-ing,work itzms are completed to the satisfaction of the
Engineeri:.g Section of the Deoar en. of Public works: `$
loam and seed shoulders as soon as
weather pe=its:
`, j, T e-rolain
. / Vz, pen- /dw
I
_x
LOCATION:
SiGN;E (G:Y.:E /CC:ti%.ACT03) (print name )
G
cs GINEE= ' G AC�-3.RIZAT=ON _
i
k` TOV�,:N OF BARNSTABLE, MASSACHUSETTS r- BUILDING PERMIT
1: mI69 013.005 June 22. 92 0 {'}147 4
DATE 19 PERMIT NO. e e
[r APPLICANT Owner ADDRESS Owner
( (NO.) (STREET) (CONTR'S LICENSE) {
PERMIT TO Build dwelling ( li) STORY Single family dwelling NUMBER—DWELLIN OF G UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) -
lot #5 26 Deepwood Circle, Centerville ZONING RC
AT (LOCATION) DISTRICT--
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET) I{
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
A
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION _
(TYPE)
REMARKS: Sewage #92-11
BOND
AREA ORVOLUME I124 6C�• ft. ESTIMATED COST $5,V00 FPER$ EEMIT s 80'75 .
(CUBIC/SQUARE FEET) -
Bayside Building Co.
OWNER
F. • box 95 Centervt1le, MA 02632 BUILDING DEPT. (Na .� {
ADDRESS BY •` r ,
DE F ARTMENT OF PUBLIC WORKS THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND
I.
FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
I. PRIOR TO COVERING STRUCTURAL.QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MINAL INSPECTION
TI TO LATHE FINAL INSPECTION HAS BEEN MADE,
3. FINAL INSPECTION BEFORE
OCCUPANCY. t
POST THIS CARD SO IT I$ VISIBLE FROM STREET
i BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
3
P
t,.
2 2 2
do (
/Ilsldf�R Op����G
fJJ /7 /,9
3 HINSPECTION APPROVALS �/�S' ENGINEERING DEPARTMENT F
I SU C t W W eA, i
r 2 OF LTH D
7
OTHER SITE PLAN REVIEW APPROVAL 4`7
l f
C:C
r
WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT L B E OM E �L AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE
TOR HAS APPROVED THE VARIODUS STAGES OF WORK iS NOT START?�OTED
T THIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN
CONSTRUCTION. PERMIT iS ISSUEgA ABOVE. NOTIFICATION.
ry �
y.
frOF BARNSTABLE, MASSACHUSETTS ry BUILDING PERMIT
W.
`(A 169 013.005 DATE .Tulle 22 19 I'9L PERMIT NO. NQ � �i7 + 47
PLICANT Owner ADDRESS Owner
(NO.) (STREET) (CONTR'S LICENSE)
jPERMIT TO Build dwelling I lil STORY Single family dwelling NUMBE-DWELLR
N OF
G UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ING
AT (LOCATION) lot #5 � 26 Deepwood Circle, Centerville DIOSTR CT_ RC
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
r
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: Sewage 092--11Ip
BOND
AREA OR 1124' sq. ft•' 85,000 PERMIT s 80•75
VOLUME ESTIMATED COST,$ FEE
- (CUBIC/SOVARE FEET)',
OWNER Bayside. Building :'Co:
P. • box 95 -Centervttle, PM 02632 BUILDING DEPT.
"-AOCRESS BY
T. t
if
L;
MENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR CARD KEPT POSTED ALL�iC ONSTRUCTION WORK: UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FORELECTRICAL, PLUMBING AND
I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PR)OR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MINAL INSPECTION
TI TO LATHE FINAL INSPECTION HAS BEEN MADE.3. FINAL INSPECTION BEFORE '
OG'tUPANCY.
POST THIS CARD SO IT IS' VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
TX
17
3 y') 1 ^ He INSPECTION APPROVALS ENGINEERING DEPARTMENT
/ SO 9&z T- to I eYt.
2
f � D OF LTH f
OTHER SITE PLAN REVIEW APPROVAL
A C
�.
WORK SHALL NOT PROCEED UNTIL THE INSPEC• PERMIT W, L BE OME L AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE
TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STAR �OTEDIJIN SIX ABOVE' ONTHS;OF DATE THE ARRANGED
RR NGED FOR BY TELEPHONE OR WRITTEN
CONSTRUCTION. PERMIT is ISSUEQ
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BDOK485i p!r,E di'] FORM G
/ CERTIFICATE OF PERFORMANCE 75864
(Covenant Approval Release)
Barnstable Massachusetts, D--cember 16 146
' I
The undersigned, being an authorized agent of the Planning Board of Barnstable, f
Massachusetts, hereby certify that the requirements for work on the ground called !
for by the Covenant dated September 1319 84 , and recorded in Barnstable District I I
Deeds, Book PageY_, (or registered on Certificate of Title No.
Document q have been completed to the satisfaction of the Planning
iBoard as to the following enumerated lots shown on Plan entitled "Plan of Lard in
i
Cenberville, Barnstablo, Mass.
Owned by William C. Nye & Richard A. recorded with said Deeds, Plan Book a
te
Page 6 (or registe et n said Land Registry District, L. C. N )
i and said lots are hereby released from the restrictions as to sale and building
3
specified thereon. Lots designated on said plan as follows:
The ontim subdivision
1
Authorized Agent
! SUBDIVISION N 520 Planning Board
of the Town of
D3op``ood Circle Barnstable
COMMONWEALTH OF MASSACHUSETTS
a
Barnstable, Massachusetts..ss December 16 1986
Then personally appeared 1,:iir►, .i r, ,n h an"authorized agent of the
j Planning Board of the Town of Barnstable, Massachusetts and acknowledged the fore-
going instrument to be the free act and deed of sa' Planning ard, b ore me.
1
(
otar Pu c
After recording return to: MY commission exp res: „
Town of Barnstable Planning BoardTow n Office
,, � •
367MainStreet r ,: �,OTARY
Hyannis, Mass. 02601 j\
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L.�. .T.. .. �...�.'1 T::> . . DATE: APR- 90 REVISED
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SEPTIC SYSTEM, 6jfflj',;;T BE
INSTALLED IN Comp NCE
Assessors office(1 st Floor): 7 �j -
Assessor's map and lot number ��;�/ :/ '��-S' r1 WITH TITL THE To
rx� i4
Board of Health(3rd floor) Aft ®NMENT
� � ' � c� .�'
Sewage',Permit number f/ Barnstable ConservIeVM
Engineering Department(3rd floor). �E
�+ riu
House number 1 ? e. �..:__ _.,, ' °o 1a}a9. \�$'
Definitive Plan Approved by Planning Board 19 c � 6iI' I�t>t@ OVA.4
d
APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M:only
TOWN OF -! BARNSTABLE
BUILDING SPECTOR
APPLICATION FOR PERMIT TO
TYPE OF CONSTRUCTION
Q 3 19 9
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information: Q�
Location
Proposed Use
Zoning District C Fire District
Name of Owner Address
Name of Builder p Address
Name of Architect /P Address
Number of Rooms Foundation
Exterior ( 9 C3' i�C C�:ll Roofing
Floors V � Interior 64''-k Y_
ell
Heating z�,t.C► Au !� L(J Plumbing �VG Y �-�"��I
Fireplace Approximate Cost
k5
Area
Diagram of Lot and Building with Dimensions Fee �V
1 q ,
(fir
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
Construction Supervisor's License M v 6 y
BAYSIDE BUILDING CO. .1
35147
A'No -Permit For 11, Story -Single 'Family Dwelling
¢ ;Lot
Location #5, 26 Deepwood Circle
j Centerville
,Owner, Bayside Building Co, a w
Type o)'Gonstruction Frame
Plot i -. Lot x `. -.,.,k k �` k •�� .e .} `
*" s
TI
Permit Gr.'anfed !.J unef 2 2 19 9 2
-17
Date,of Inspection! - 19 r
e d l 19
h � � I ✓ r tl :do i '�,'
u w,
' 6
a Town of Barnstable *Permit# 00�0 0-
Euprres 6 months from issue date
RP,BAS7ABLB • PER Regulatory Services Fee �'—
MAs&
A .e Thomas F.Geiler,Director
Building Division /Zj06
Tom Perry,CBO, Building Commissioner
of gp,RN 200 Main Street,Hyannis,MA 02601
�� www.town.barnstable-ma.us
Office: 508=859-4038
Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Itnpriul
Map/parcel Number
Property Address C
r �
Residential Value of Work SoQ�
Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address
y
Contractor's Name —�
Telephone Number 'S Y ^�
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable) 0 21(a 3a S
,ETAVorkman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
�0`I have Worker's Compensation Insurance
Insurance Company Name �I`� (� .. Kj S
Workman's Comp.Policy
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
)9Re-roof(stripping old shingles) All'construction debris will be taken to
❑Re-roof.(not stripping. Going over existing layers of roof) 1
❑ 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.
aome Improvement Contractors Licens required.
SIGNATURE.'
Q:Forms:expmtrg
Revise071405
The Commonwealth of Massachusetts
c I Department of Industrial Accidents
Office of Investigations
600 Washington Street
i� Boston,MA 02111
c www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): PMUTCA2�e-A-0 L
Address: �D�j\ YA Mf\ S�,
City/State/Zip: N P-z) p 6'3 Phone #: so,&--
,you an employer?Check the appropriate box: Type of project(required):
LEJ\I am a employer with _�_, 4. ❑ 1 am a general contractor and 1 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. # ❑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.] officers have exercised their `10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL l l.❑Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12�Roof repairs
insurance required.] t 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 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
information.
Insurance Company Name: V �
T�
Policy#or Self-ins.Lic.#: [)C�5 bto Nc)s Expiration Date: 0(�
Job Site Address: ap V 1UP City/State/Zip: JM A--DZCp,j'Z--
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 der the pains and penalties of perjury that the information provided above is true and correct
Si nature: Date- 31 to
Phone#: S0�
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 S.Plumbing Inspector
6.Other
Contact Person: Phone#•
t
v°F SME 1p�
Town of Barnstable
ti
]regulatory Services
Waxsresi s, Thomas F.Geiler,Director
y M"ss. $ "
Building Division.
Tom Perry, Building Commissioner
200 Main Street, liyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-623 0
Property Owner lust
Complete and Sign This Section.
If Using ABuilder.
as.Owner of the subject property
1
hereby authorizeP 01
1' n to act on my behalf,
in all matters relative to work authorized by this building permit application for.
2�o GA CCAe 6eokr-(Xl�e
(Address of Job)
Signature of OwnerD to
& rockno, O"LCA)
Pant game
VORMS OWNERPE UVaSSION
�J V � t/
— -_ Board of Building Regulafi ns and Standards
One Ashburton Place - Room 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
Registration: 103714
Type: Private Corporation
Expiration: 7/9/2008
PAUL J. CAZEAULT & SONS, INC.-
Paul Cazeault ----
1031 MAIN ST
OSTERVILLE, MA 02658
Update Address and return card. Mark reason for change.
n Address ,� Renewal I Employment Lost Card
PS-CA1 0 50M-05/06-PC8490
Board of Building Regulations and Standards License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
= Registration.:.:J03714 Board of Building Regulations and Standards
Expiration:: One Ashburton Place Rm 1301
Type: Private Corporation
Boston,Ma.02108
PAUL J.CAZEAULT&-,SONS INC
Paul Cazeault
1031 MAIN ST
.^� _._
OSTERVILLE, MA 02658:' Deputy Administrator Not valid without signature
- ..
Board of Building eguiations
One Ashburton Prace, Rm 1301
Boston, Ma;02108-1618
License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 10/20/1959
Number: CS 026325 Expires: 10/20/2007... Restricted To: 00
,i
PAULJ CAZEAULT
1031 MAIN ST
OSTERVILLE, MA 02655
Tr.no: 7696.0
Keep top for receipt and change of address notification.
S-CA1 0 50M-04/05-PC8698 0
. I ✓/ZC Z/J09)YJ)tdlLlllCCL(.UL O�✓4CQOdlLClN,[QB�d .
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number 026325
x....
61rt�date 10/20/1959
Expires 10/20/2007 Tr.no: 7696.0
Restricted;: 00.::,
PAULJ CAZEAUL
1031 MAIN ST
OSTERVILLE, MA 62655 '
�� Commissioner
Client#:19989 2CAZEAULTPA
ACORD. CERTIFICATE OF LIABILITY INSURANCE FD
5/19!6D1rrYY'
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Dowling$O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
222 West Main St PO Box 1990
Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURERA: Western World
Paul J.Cazeault$Sons Roofing,Inc. INSURERB:
1031 Main Street
INSURER C:
Osterville,MA 02655'
1 INSURER D:
INSURER E: -
COVERAGES
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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY EFFECTIVE POLICY EXPIRATION
LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YY DATE IMMIDDIM LIMITS
A GENERAL LIABILITY NPP1012091 04/30/06 04/30/07 EACH OCCURRENCE $1000000 '
X COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED $50 000
RE occurrence)
CLAIMS MADE 5�OCCUR MED EXP(Any one person) $2 5OO
X BI/PD Ded:1,000 PERSONAL&ADV INJURY $1 000 000
GENERAL AGGREGATE $2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $1 000 000
POLICYF-j PRa El LOC '
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) $
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY
NON-OWNED AUTOS (Per accident) $ .
PROPERTY DAMAGE $ '
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO EA ACC $
- OTHER THAN
AUTO ONLY: AGG $
t
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $
{ OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND WC STATU- OTH-
i EMPLOYERS'LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE
E.L.EACH ACCIDENT $
OFFICERIMEMBER EXCLUDED7 E.L.DISEASE-EA EMPLOYEE $
jIf yes,describe under
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $
I OTHER
i
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
i Certificate of insurance will be issued directly by the insurance carrier.
1
i,
i� CERTIFICATE HOLDER CANCELLATION
�! SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
I� Informational purposes only DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL _10_ DAYS WRITTEN
! NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO.DO SO SHALL
ii
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
`j REPRESENTATIVES.
' AUTHORIZED RESENTATNE
f� ACORD 25(2001/08) ; Of 2 #42866 LS1 O ACORD CORPORATION 1988
t�
4
:: ���®I���• � �i WT DATE(MM\OD\YY)(18-23-05
.>
PRODUCER TKIS "RTIRCATE IS iSSIIED •AS A jAATTER QF INFO*gmATLOLL:
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
DOWLING & O NEIL INS AGC HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR
222.WEST i•Lii14 STREET. ,ALTER THE COVERAGE AFFORDED RYTHE POLICIEi 6ELQW-.
PO BOX 1990
HYANNIS mA 02601 COMPANIES AFFORDING COVERAGE
COMPANY,
22LGR A TRAVELERS PROPERTY CASUALTY COMPANY OF AMER.ICA
INSURED COMPANY
PAUL J CAZEAULT 6 SONS INC. B
1031-MA.IN STREET COMPANY
O5TERVILLE MA 02655
C
COMPANY
p
.:COVERAGES
Isis TO CERTIFY THAT THE POLICIES"OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO-THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REOUIREMENT, 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 CL'AIMS.'
Co
TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
0ATE_(I` 0.2\.YY) . OATE.(M!d\DD\YY), -
GENERAL LIABILITY GENERAL AGGREGATE $
CUMMEHCIAL GENEHALUA13101Y 1+19U�UCIy{;UMFrlUY AUG. $
CLAIMS MADE F OCCUR. _ PERSONAL✓{AOV.INJURY g
OWNER'S 8 t ONIRACIORS PROT. €ACH OCCUFRENCE y
FIRE DAMAGE(Any one tire) $
MED-EXPENSE.(Any one person) $.
AUTOMOBILE LIABILITY
ANY AUTO COMBINED SINGLE $
LIMIT
ALL OWNED AUTOS BQPILY INJURY
SCHEDULED AUTOS (Per Person) $
HIRED AUTOS
BODILY INJURY
NON-OWNED AUTOS $
i (Per Accident)
PROPERTY DAMAGE $
GARAGE UA9IUTY 'AUTO ONLY-EA ACCIDENT` S
ANY AUTO OTHER THAN AUTO 0NLY.
EACH ACCIDENT. $
AGGREGATE g
EXCESS LIABILITY EACH OCCURRENCE . g
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELUA,FORM
A WORKER'S COMPENSATION AND (UB-0095B69-A-O5) 08-10-05 08-10-06 STATUTORYI.NAITS
EMPLOYER'S LIABILITY -.
THE PROPRIETOR/ EACHACCIDENT g..:.,: 1. .n..:.� n:
PARTNERSIEXECUTIVE Y. INCL DISEASE-POLICY LIMIT $ 500 000 ,
OFFICERS ARE'. EXCL DISEASE-EACH EMPLOYEF. g 100,000
OTKEff
I E l T Pe L)TE
THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE.
G T FIG fw KQI R
.. CA�IdC�ELLAL,TIQN.
---------- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Paul J.Cazealllt$Sons EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Roofing,lnc. I LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
1031 Mai-1 Street LIAWLITY OF ANY,KWU UPON THE WkWA"'J, RiPkES "ATIVk&
Ostervlllo, MA 02655 AUTHORIZED REPRESENTATIVE
A�Oti.D25j3i:(�3153�
�'�y�••'. TOWN OF BARNSTABLE
BUILDING DEPARTMENT
_ ASa IL = TOWN OFFICE BUILDING
ru
7g i039' HYANNIS, MASS. 02601
�o r�r►•
MEMO TO: Town Clerk
FROM: Building Department
DATE: 9
An Occupancy Permit has been issued for the building authorized by
Building Perm-it..,#............:.�5 ./......................... »...... . ....»
..... ... ............
issuedto .. �,t��} .......\oB'..? . ........�;:*........................................................ ..._ ...... .... ..._.. _.._ .
V ��
Please release the performance bond.