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0058 DOLAR DAVIS ROAD
MY I�A A Alt ag OM 1� afg-w, I% S I IMP. ON RN DO pgr 1g, IBM WIZ, A�V n� �!A,V, OUPY, �d gg�`K 0, qo W."', =,Pon if It % —X� OR F m goo gf�;,4 v"t Ut�o,,1g, x R11 R, X-110'..I.- 'All. gwq p gft I gal Im �U 40"M'AA pzq�- g N, RiW 4, a -MN VIEW ,pt WMEW.V 7,31M f 11""M k, IFOW U', Ji, " 't Ali -MON �,P 14 �4'vs' M 1A 0" bi -pk Mot, 112'1�, I'm V M, g i �,,N -W A N!"*," A�� 1p 4, gm I --"0it-;' W g�, Mi.* �,,ffi"'P �l DIV W7 V,12 V !QT m z 4ig �', y-, , A;",4g 1, E �T , , --Ag, - -g- "4�,"N gg -, u Mil Nil, C 1 C � p Application number...r8' :? `:.:1....... .� .� Date Issued............... ,1. � . ............................ BAMSTABLE. so �a�� ��,� Building Inspectors Initials...........a................. A L� z....9�Map/Parcel.............. 7.�....... ...........a................. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: .5"8, �>o Iar PA t; NUMBER STREET VILLAGE Owner's Name: ,T�.., s Ifanc rJa l s Phone Number tad--77I- 5-�(6 Email Address: i 0- "'d-c'oM Cell Phone Number �;'J&- 72- 7-? S 71— Project cost$ 7-�c, — Check one Residential ✓ Commercial OWNER'S.AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: 5p-e 4,acf,4 cantra,--- Date: TYPE OF WORD 0 Siding CEWindows (no header change)#_/D E Insulation/Weatherization ❑ Doors(no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to W SAP Ma.cA- e, '�O(7� 1,.. CONTRACTOR'S INFORMATION Contractor's named S'hQe(e I,,I c:•�.a�./ W o r (rQ , �o S l�n Home Improvement Contractors Registration(if applicable)# ,/ 6 2 02 5 (attach'copy) Construction Supervisor's License# CZ 2 7 7 2- (attach copy) Email of.Contractor wee e " 1.cis rn Phone number 7 d'/ - ALL PROPERTIES THAT HAVE STRUCTURES O#ER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE PERMIT CAN BE ISSUED. APPLICATIONNUMBER............................................................ *For Tents Only Date Tent(s) will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent dff food is being served at your event please obtain a health Department approval between the hours of 8:00am-9:30 am or 3.30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/C®AL/PELLET STOVES X Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEN2TION Homeowner's Name: Telephone Number Cell or Work number I understand nay responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date LICANT'S SIGNATURE Signature _ Date 7- 3/ t All perms a ions are subject to a building official's approval prior to issuance. r Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards onstruCtion Supervisor CS-072772 Expires: 04/07/2020 JEFF C STEEI 24 SHERWOOD AVE DANVERS MA 01923 Commissioner Office of Consumer Affairs&Business Ragulatlon HOME IMPROVEMENT CONTRACTOR TYPE:LLC 169020 04/11/2020 WINDOW WORLD OF'BOSTON,LLC. JEFF C.STEELE r Tc C1�x. 15A CUMMINGS PARK WOBURN,MA 01801 Underswetary The Commonwealth of.:Ylassc�c''tase;�s Department of Industrial Accidents I Congress Street, Suite 190 B.oston Iti� 03111-2017 www.mass.sov/dia 'Workers' fofleers' Compensation insurance Affidavit:Builders/Contractors/ElectriciansiPlumbers. TO BE FILED WTTH THE PEXN11T1T IG Ati 1'HORITY. Applicant Information �f ' Please Print Le6ibi Name (Business/Or;anization/Iudividuai):L><i-�) Son �LP/m/•4 c </J!' �ei4f� y�1 Address: 1 5 /k Ct )m City/State/Zip: W M Phone#: 7 k I - 19 S Z-q,?n 5 Are yo an employer?Check the appropriate box: Type of project(required): 1. I am a employer with employees(full and/or part time).* 7. 0 New construction 2.❑I am a sole proprietor or partnership and have no employees working for me is g. Remodeling any capacity.[No workers'comp.insurance required.] 3.7 I am a homeowner doing all work myself[No workers'comp.insurance required.]t 9. ❑Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Q Building addition ensure that all contractors either have workers'compensation insurance or are sole 11. Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5. I am a general contractor and I have hued the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp. insurance.+ 1�.❑Roof repairs r 6.❑We are a corporation and its officers have exercised*heir right of exemption per MGL c. 14.f I W Other I'� o-t✓ h2,§1(4),and we have no employees.[No workers'comp.insurance required.] rep le,e e-,P'1 Any applicant that checks box:#1 must also U out he section below showing their workers'compensation policy information. 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 antities have employees. If the sub-contractors have employees,they must provide their workers'oomp.policy number. I am an employer that is providing workers'compensation insurance for n:y employees. Below is thepolicy and job site information. Insurance Company Name: A Sark i eJ e d El`pl uyP r 5 Policy#or Self-ins.Lic.#: wr—c- -S()0- So ci- 2 O/ 9 A Expiration Date: L/—_�, Z 0 Job Site Address: 5,? Dc)(a,( <r✓i S 2 d. City/State/Zip: �i�it'L�!y. �{. /`7 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under 1bIGL 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 Aolator.A co n this statement may be forwarded to the Office of Investigations of the DLA for insurance coverage verific 'on. I do hereby certi and he pa' a enalties of perjury that the information provided above is true and correct Si afore Date: Phone Official use o 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#: i IYYYY) �- CERTIFICATE OF LIABILITY INSURANCE o DATE(MMIDDMMIDD9 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 pol(cy(ies)must have ADDITIONAL INSURED provisions or 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 GON FACT NAME: amy roberts FAX M.P.Roberts Insurance Agency Inc. AICNr o Ext: 978-683-8073 A/c No): 978-6834147 1060 Osgood Street North Andover, MA 01845 ADDRESS: amy@mprobertsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: WESTERN WORLD INS COMPANY INSURED INSURERS:_MERCHANTS INS COMPANY L&P BOSTON OPERATING,INC INSURER C: ASSOCIATED EMPLOYERS DBA WINDOW WORLD OF BOSTON INSURER D: 15A CUMMINGS PARK WOBURN,MA 01801 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR PREMISES a.DAMAGE TO HF occurrence $ 100,000 13 MED EXP(Any oneperson) $ 5,000 A NPP8525379 04/05/19 04/05/20 PERSONAL BADVINJURY_ $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JECTT LOC PRODUCTS-COMP/OP AGG $ 1,000;000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 a accident ANY AUTO BODILY INJURY(Per person) $ B OWNED X SCHEDULED MCA1002569 04/05/19 04/05/20 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident - 8 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AN065362 04/05/19 04/05/20 AGGREGATE $ 1,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY Y 1 N ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 C OFFICERIMEMBER EXCLL f N N/A WCC-500-5018609-2019A 04/0$/19 04105/20 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN EVIDENCE OF INSURANCE ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REP E*TATIVE O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Window World of Boston MA HIC Registration Offices&Showrooms Number: �016A Cummings Perk U 985 Old Oak Street Q 1000 Boston Turnpike 186026 Woburn,MA 01801 Pembroke.MA 02359 Shrewsbury,MA 01545 Federal ID# (781)932-4805 (781)828-6281 (SOS)845-6676 82AS98432 www.WindowWorldolBoston.com Customer 1�"16�3 Phone(h) InstaUAddrasa �'b lFr-Ci/i 'D)';dff a�— Phone(c) �P-77)•7S� City Slate:MA Zip D USA t:11ie11 /-,gC.jNP9 eblm-- "'7 WINDOW WORLD GLASS OPTIONS 1000 6edea Single•hung All Weld $249 200DSagesONAIi•Weld $269 �Solar2ane Elite-Dual Pane 6129� 0 � -y-4000 Series ON All-Weld $269,M& __THpte Pane SZ89 _6000 Swiss OHAll-Weld $309 WINDOW OPTIONS _2 Ute Slider $429 3 Lile Slider _elassr Breakage Warranty(40OW60DO) 9151NCLUDED e0..0.r>H +ua ro.rsr $669 PiolureI Fixed t8e(0.83 UI) $419 -1/2 screens $9 CLUDT4 DEED `L Picture J Fixed Lite(84130 UU 5539JW Foam Insulation on Jambs and Head $11 INCLUDED Awning $359 __Double Strength Glass(40DO/6000) $15 INCLUDED _Casement Plus$49(OH Sash Rall)$370 _Double Locks p 26'1 $5 INCLUDED _2UIeCasement $659 _FuliScreens $26 _^3UISCasemant iumixrm ir.`r.vLV4 $1029 —Colonial Grids(Contoured/Fiat) SOS Basement Hopper $489 _Prairie Odds S76 _Bay Window-Soffit Mouh17,INS Seat 52869 Simulated Dlvlded Lite $182 _Bow Window-Soffit Mount/INS Seat32999 �TemparedOHSash(080)(TSO) $76 i _Gallen tMrtdow $2178 _Obscure Glass(850)(TSO) $75 Bay,Bow,Darden Overalze (+109 U)3978 Oriel Style(40/80 or 60140) S75 8e1ge/Almond $49 Foam Enhanced Frame 335� i Wood Grain Inferior&/his 400 16ow all')$1 DO (right Oak]Dark Oek/CAarry r Fax Wood PRE 1978 BUILT HOMES(RRP SAFE RPOVATiON) Rfoh Maple) MY HOME WAS BUILT IN THE YEAR 7 -> V) _BtwmFAedor(AWL BiomeI American Teae)$1O0 i _Deslgner Color Exterior $170 MISCELLANEOUS _-Speciality Window S ,-Custom Exterior Alu num Cladding(IWo-Bend) r c o Textured$90 H• Smooth$8o SL9, 0 Window Color (i.1 ft� !� Facing Color &fsrJe ourstae Mu"end Cladding $2G NON CUSTOM DOORS Install IntedorlEaderlor Stops $64 lrsayi Rolling Palo Door Sit.or Oft. 6121B Inatelummier Casing tet-T Starts At S95 Z4 Vlny1 Rolang Patio Door OIL S1328 ^`Repair Sill.Jamb or replace s01 nosing $75 Add to bats plea(a Custom RaeMg Path Door S1269 Full Sub-Sill(Single)replacement $175 _French Rall Sliding Patio Door60.or eh. S153B _Insulate Wright Boxes S20 ' French Ras Sliding Patio Door 8h. $lose Mull to Form MuBi Unit 530 r_ _ { �Cu Custom ch teriorr Silding aUeOooren. $tt4B Mullion Removal $so�D _Custom Exterior Gadding S300 _SotarZone Elite $309 -Metal Window Removal $75 -_._tertde Palo Door Sale _New Construction Vinyl Removal $175 i _Woodgroin Irxetiots 5309 Now Conon.ExL Retro fit $160 _Fxtenwoaelgntn colors asaB _Roof for eayl8ow Windows $500 _Mitarior Caslhg 21-41 31la $278 Removal of Existing Bay/Bow $250 _Handleset OpUoria S +Say/Bow Conversion Ext.Ratio Fit $45( _Interior eilnda(sbc loot only) SBSB (New Slding Will Not Match) s .. ROUND-UP FOR WINDOW WORLD CARES Door Color / V Si.Jude CAlldron'sfleasrehHoapllA S i f o prlafee Customer deol nes exterior wrap and underatancisp,lnling end/or repair maybe required inl fa( Customer declines grids on t. windows/doors Initial w pi6&1AI61EB;CaslamerlsraspomklalatlhetdlawinginaanaetApnva�ltWswapaaePatnUng.StaWng,NarmSystemdfswmecr+ecannacl suYafigPelmateeem acass al 523,0D,Romeawnaaad orCafmoAssada@on r�pproraL Nis[ode Otsldcl ApDravaLCiy fd Boston pandnp 8 eidevraxPetrinteatn comuUontiah iostdiatba. Customer agrees to the terms of payment as o ows:. NO EXTRA WORK iP NOT IN WRITINOt �( 1 Extra Labor&Materials $ Z�//5• Site Set Up,Permit,Disposal&Delivery Fees$ 3 9 00 E V "M�l U ah rT Total Amount 7 Custom Orde►Deposit M%$M Gk#ti i Project Start Payment 33% $ Balance Due Day of Installation S j AmounlF(nanced S yglndewyygtlgal Boston aaUcipNasaladllg this warkon ! amibelnpsubslenUaUyumpteladin�diy69ew yNieresl:Yes No i Any dsposO ragatred(n advance of Oro start of We work SHALL e o 1/3%of the iota;contract fulto or the adu tort of any matenal Or equu Mont 4 coedit omerar as10i11 made nature.which must ao ordered In advance of the start of the wok to assure that the ptopci Will Proceed(in609(kils.No Anal Payment ahat be the Coa@att IS completed to file sallSlac@on of born Vamp. R Alf hems tmpmvemaat contractors and subcontradots Shelf be raghlored artd that any boluses about a ramrod of gubcounclor retallng to a faglshia@on should be > directed for:Office of Consumer Affairs and BuvineraReUtdollon,Too Park Fists.Suits 5110 Boston.MA02tt6.none:(5171973.70D No walk shell begin prior to the dining of the contract and transmittal to the owner d a COPY of such contract, ; Window WOW of Boston under provlslon 41 Chaplet 142A of the general taws is isquhed to apply 6Wyr and oblatn an consuuc lonrelated parrW[L Window World of Boston shag not be deemed tespunsibe(01 delays In thin wonrdescdbed In(his agreement C4use dwoulatay,permit atanlle a a agencies,authorities or ladlvldud i NOHes:IltheFORCHASER(a)ohlydnehisownrroraauCllaoretateddermiblorthewortdaaribe uadorlbliappraemealrHdeel:wllhurva islSfadconlnolora, the PURCHASEB(Sl4s herebyadadsed that to the event of a tits ppule,)udgemont and nanpsymaat the PURCNASER(8)oil not he anUllo fit make a dfafm or { collodion ham the Guaranty hind a dabl abed by chaplet 142A,M.OA. oa a u Y!r may canoe t s ronsao on al any 1 me pr r to ml n g 1 a the h business day after a ate o this rawad ari. ttolIce oI cancailetldn muss be in wilting posimarked no later Than midnight*1 The following third business day. ThIss OWy(mid'f11AChbe Is ladapenbrOl award and Operatedb L&P Boston Operating,Ina under amuse hanrwhrdowil Inc. JOvmji, nn~or Npn raCi^'GY In k.Pcae..�(o.t. 1 emaxnan:Dorat no any Via mt*Rao »a ante Oerrerson alp lteh.n art any blank appoae Dole 1 '!.ra.aere vaturcupy-Ddglnet Ydlortoppy•Id* Pink copy.C.etorner nyw/Hnp7MNr11�i I I i I Town of Barnstable Services Regulatory „ Thomas F.Geiler,Director snxxszwate, 9 MASS. . Building Division 039. pTfD MA'1 A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 r O�� OP PERMIT# Q R'Zi FEE: $ SHED REGISTRATION 120 square feet or less L Location of shed(address) Village. Property owner's name Telephone number Size of Shed Map/Parcel# r Si tore Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? _ Conservation Commission(signature required) , si /D3 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 REV:121901 S:�t 145.01 200- 0 I c) 146.26 JOB # ' 85-420 CEPTIFIED PLOT PLAN PPEPAPED FOP: LOCATION. L-10 DOLAR DAVIS RD CVILLE '. SCALE. 1 It 30= ' . DATE: :7/22/86 , REFERENCE: r Pe 403 PG 27 LEBEL-SOL` LOWS u. I HEREBY CERTIFY THAT THE BUILDING SHOWN ON THIS PLAN IS LOCATED ON THE `IA Of GROUND AS SHOWN HEREON ARNE c �H. down cape engineering °s34e 4 o CIVIL ENGINEERS LAND SURVEYORS PmJTF FA Y4PmmlTH Md C __ ter,• ,,, TOWN,OF BARNSTABLE BUILDING PERMIT APPLICATION Map /Z/ Parcel A6 t; Permit# 3"7 Health Division '/0 r/ Y/� f ` �. Date Issued r2 Conservation Division r ` Fee Tax Collector' a_ Aar 044lq'f' SEPTIC SYSTEM MUST BE Treasur ` l! INSTALLED IN COM PLIANCE MPLIANCE Planning Dept. WITH TITLE 5 ENVIRONMENTAL CODE AND Date Definitive Plan'Approved by Planning Board TOWN REGULATIONS , Historic-OKH Preservation/Hyannis a Project StreetAddress A P, V U-- Z n '• t Village r P A T1 e► _ v 1\`-i -Owner -3 1A^� W A I-S Address Q(4"V t 'S Telephone S V (o ° Permit Request / L/Y I 1 4 0'D I ` 0 w rr -'i n,e/j✓^C 1 h A-1 C P Z t c 0 ti 2 S �-�� a• l` 400 116%' 0 T T- c ke t G t 11m Square feet: 1st floor:existing /0.b 0 proposed !9(� 2nd floor: existing proposed Total new' / 9(, Estimated Project Cost,,A I1 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size /S OU o Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family C� Two Family ❑ Multi-Family(#units)'-• s Age of Existing Structure l Historic House: ❑Yes O'lq-o On Old King's Highway: ❑Yes' Basement Type: O'full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) / �d # Basement Unfinished Area(sq.ft) /DSO � Number of Baths: Full:existing new Half:existing new t Number of Bedrooms: existing 3 new Total Room Count(not including baths):existing new I First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑ Electric ❑Other` Central Air: ❑Yes D'�lo Fireplaces, Existing / New Existing wood/coal stove: ❑Yes Flo Detached garage:❑existing ❑new size ^ Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size --- Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization, ❑ Appeal# Recorded❑ Commercial ❑Yes a 0 If yes,site plan review# Current Use 7 e a e,v-TA, l Proposed Use -Ile , I o c..--T wr l ' r BUILDER INFORMATION Name M cl'�A R t t e�V 1- L Telephone Number Address 3 �5 ) P W i ti N C` 1 ( Qe License# 015 Z G Home Improvement Contractor# 1 1 Ell Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE - DATE _lAO/9�' FOR OFFICIAL USE ONLY _ PERMIT NO. DATE ISSUED Ama MAP/PARCEL NO. `. F r '` IT ADDRESS. VILLAGE %t .. , r - - . ,. • ..• y •• ,i _ -. t a _� OWNER tr DATE OF INSPECTION: FOUNDATION _ FRAME INSULATION E' �• .-I � ;,f ' , .^ i FIREPLACE ' 1 ELECTRICAL: ROUGH FINAL t , PLUMBING: ROUGH t FINAL` r GAS: ROUGHS ' FINAL ` FINAL BUILDING .; .- � rq DATE CLOSED OUT NJ t ASSOCIATION PLAN NO. g 145.01 200= J � I 33 3 L,c.� n . 146.26 Inc 9 - L 5 — Boa # 85-420 CERTIFIED PLOT PLAN PREPARED FOR: LOCATION. L.-10 DOLAR DAVIS RD CVILLE SCALE: 1 "=30 ' DATE: 7/22/86 REFERENCE: PB 403 PG .27 LEBEL-SOLLOWS . I HEREBY CERTIFY THAT THE BUILDING SHOWN ON THIS PLAN IS LOCATED ON THE 6NA OF GROUND AS SHOWN HEREON ARNE OJALA H down_ cape engineering #26348 4 CIVIL ENGINEERS LAND'SURVEYORS lA ROUTE 6A YARMOUTH MA DATE. , �f REG. LAND SURVEYOR THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I m 7A DATA , :'x ti .st 3� 2g �• �,• .. ,{ ,7 s g #� ��n''¢s�'#�y . ' '� �.�G � i�.. �,r„�_ 3�1 j �-�>tx:� �. ��`��iia C �r� ��„r,,t<•�' � �" a� t � '� ,�. -a'` SLY r f_,3, � � �a r r •y_ _ e� ASA•� s ". t l 4fi,�� f£` X£�i� ���ykr �� � ���• � r {� -C fi '�3(i �a'A'. � r 3 � � c, �,�� Y �-"� a T -, o'�F�.' �_. yy�wry.,,Ss� t d*£..a .: ,: -_. -. "Y �; • "�<1 'i'�- �`a- ti �� 'is �� t,�.a " ��" � 'ra--y,• .r.:� x.:-u ' ,�"r` .• � � t s+x aP �}"it��� k �': � 4 r _.>.sw,; +w.. .,..n>--�`,'^ :^>pY-•a--a' is -�.:-.-. K., �`" ac.r�...... a.k*.aY"^',-' -aw..-� ` 4"'r�.- � $ �,YF � *. k ksT}. '� M _. .,r c �, -� �T" �� d... i2 iy ""} u. 1_S Kk it'"yi^ft I�✓ f' III �,�. .p 52i e. ��'�,�"iv'3'y�j�•-P^�,. � �'y $ i + .. '_w, 1, •1*ram - 41 3{ :s' 4` �`r '. i 2 'k..� e r,�'t 'y;VIL04* > xe'>• "�a ev' -'� a t r - ; ,:` f.,>' .. s ji. "' *� t `` r �YY t t r_t +"�'•S+-'. � ." �. r k `�r3 �:s' �-- p �,.s�"� ,3�'3, k �� .7>t`' '� �+1.� y c `�. Cs� <b da;�.�sfii rP' -v � g`''�. .tom, ? _' a {• • � £ x *A a F ty �21 ��.et' ., et is"i yy yy: ,i_.�Y-x b k 4 � - .' t ' t' •IY The Town of Barnstable Department of Health Safety and Environmental Services s Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date J 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: A r7 D Jig Estimated Cost Address of Work: S 0 14 r\ (+ ✓1 ) R 9 Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work 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 IMPROVEMENT 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 the agent of the owner. / Date Contractor ame Registration No. OR Date Owner's Name q:fbnns:Affidav - = The Commonwealth of Massachusetts Department of Industrial Accidents M. ::. ONCe otlnsesagations < 600 Washington Street Boston, ; Mass. OZIII Workers' Com)ensation Insurance Affidavit name: -1A 1 K e 17 P,U°Z\ location: I FS O 0 1.4 y1, O A U city C eA I -e h U1 I\ t, phone# ❑ I am a homeowner performing,all work myself. Cam a sole proprietor and have no one working in any ca acity ❑ I am an employer providing workers' compensation for my employees working on this job. COmpnny name• Le \ Ps address: city: Phone#• l( $ g 9 S insurance co. Q oiicy# O Z 3 ❑dam a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the follo«ing workers' compensation polices: company name• ..:. ... ...:...:.:;,::::;::. address: city: .. . ;;;, ... phone#: msurnnce ca. olive#- «:<>•;.::;;:.:.::,:::. comnanv name: address: cilh- ... phone#: ... Insurance co. .; olicv# »: `: ........ Failure to secure coverage as required under Section 25A of MGL 152 can lead to the Imposition of criminal penalties of a tine up to S 1,500.00 and/or one vears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a One of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature "N4k.z;A ul9A::4 Date Print name An k C kn,r1 J Z t ti`• Phone# 7>/ fcontact e only do not write in this area to be completed by city or town official n: persnit/Ifcense# ❑Building D-t f immediate response isrequired (]Licensing❑Selectmen❑Health Derson: phone#; ❑Other m maw 9,95 PJAI ...:::::.:...... ...,...... Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for the;.r employees. As quoted from the "law", an employee is defined as every person in the service of another under any co=-.::. 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 receive: 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 renewa: 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 corttracti= 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 permit/license number which will be used as a reference number. The affidavits may be retinned io 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 lnvestleatlons 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 MAScheck COMPLIANCE REPORT I { Massachusetts Energy Code I Permit # MAScheck Software Version 2.01 { I ( Checked by/Date i I I CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family. Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 4-19-1999 TITLE: Michael Renzi PROJECT INFORMATION: Dola David Rd. Centerville, MA COMPANY INFORMATION: All Cape Insulation 6 Supply Inc. P.O. Box 645 E. Dennis, MA 026,41 COMPLIANCE: PASSES Required UA = 75 Your Home = 66 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA CEILINGS 280 30.0 30.0 5 WALLS: Wood Frame, 16" O.C. 400 11.0 11.0 22 GLAZING: Windows or Doors 22 0.310 7 DOORS 42 0.550 23 FLOORS: Over Unconditioned Space 200 19.0 19.0 9 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the.Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date 1 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Michael Renzi DATE: 4-19-1999 Bldg. l Dept. l Use I CEILINGS: [ ] I 1. R-30 + R-30 Comments/Location I WALLS: [ ] I 1. Wood Frame, 16" O.C.. R-11 + R-11 I Comments/Location I I WINDOWS AND GLASS DOORS: ( ] I 1. U-value: 0.31 ( For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No ( Comments/Location I DOORS: [ ] I 1. U-value: 0.55 i wuuudu%ail.u%a`�,iOA I FLOORS: [ ] i 1. Over Unconditioned Space, R-19 I Comments/Location I ( AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When j installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than'2.0 cfm (0.944 L/s) air movement from the the i conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. I it I VAPOR RETARDER: [ ] I Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. i MATERIALS IDENTIFICATION: [ j I Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. I DUCT INSULATION: [ ] I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: ] ( All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not ( permitted, The HVAC system must provide a means for balancing air and water systems. I ( TEMPERATURE CONTROLS: [ ] ( Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: [ J I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified ( in Sections 780CMR 1310 and J4.4. [ l I SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. [ ] I HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids ( below 55 F must be insulated to the following levels (in. ): ( I PIPE SIZES (in. ) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 1.0 1.5 Steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 . 1.0 1.0 1.5 1.5 [ ] I CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in. ): I I PIPE SIZES (in. ) NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F): RUNOUTS 0-l" I 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 I 1.0 1.5 2.0 i 140-160 0.5 I 0.5 1.0 1.5 i 100-130 0.5 I 0.5 0.5 1.0 i ----NOTES TKO FIELD (Building Department Use Only)------------------------- . 1 I DEPARTMENT OF PUBLIC SAFETY—, CONSTRf1GTION SUPERVISOR LICENSE ICuaber Expires: I CRAEE` y�07I 387 PNINNEYS"LN I' CENTERVILLE, MA 02632 OME IMPROVEMENTONTRACTgR` Reytstratlon oN 21i859 F WOR cis +Fr`' af ICHAELzRENII CONSTRUCTION NICHAE�,hJENZI s 4 off, Dx PNINNEYI LN nonni isrRnrug CENTERVILLE NA t62632r `} I--- 0-k r s i-ses dr's map and lot number ...... ....................... . Fer M SF S'rEM P-VIC SY R Sewage Permit number ....... ..................... IN CO �S.s............. INSTALLED ......................... ..................... ........ IMENTA House number ........ 13WIRot AM A 5 010 b., TOWN OF BARNS�TABLE BUILDING , INSPECTOR APPLICATION FOR PERMIT TO ............... ............/........ ...................................................... TYPEOF CONSTRUCTION ......................A_)0 a et-................................................................................................................ ..............................1.5............19.... TO THE INSPECTOR OF BUILDINGS: The undefs'ignecl hereby applies for a permit according to the following information: Location ........01 - .......... ...................................................................... ProposedUse ...............!j ........................I...................................................................................I............................. Zoning District .....................t?_151..........................................Fire District .........................C-.-<D........................................... Name of Owner ...........SLS..............7j7e_.'0:5..1. ..........................Address ..........Ze I.?.............................../. 1,3?. ................ Nameof Builder ...... -5i ...d.--V............Address .................................................................................... Name of Architect ......../...V..O...C...T.Y....S...�.C.(.c........�S 9.rk. ....Address ........le--t.................... L/ PC) ............................... Number of Rooms ......................15..........................................Foundation. ..................... ........ Exierior ...................... .......................................Roofing ...................G.4-r..................................................... ,t Floors ..........................OL�.LOQ:Q..�...................................Interior ............... t—e—)......�ck ....... ................................................. Heating ........................... .................................................Plumbing ...... 2 .................. ......................... Fireplace ............................y ......................... ............ .....Approximate Cost ............. -05;!�Q.............................. . j .... Definitive Plan Approved by Planning Board ---------199 __. Area .......... Lj Diagram of Lot and Building with Dimensio s Fee ......W-//, SUBJECT TO APPROVAL OF BOARD OF HEA6H ......I............................... OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable orclinehe above ,construction. Name . . . . ................. ........ Name Su Construction Su isor's Licen., > /4/.. I S TRUST No Permit for ....One...S t or.y............ ..........S-iAgIp...Ealmuy.,.D.W.elliag..................... Location .....L-Q.t..#J.Q......5.a..DoIar..Day.;Ls...Road Center ill.e.................. ......................... ........ .. ............... Owner .......S L S Trust ........................................................... Type of Construction .....FKAMP........................... ........................................................................... Plot ............................ Lot ................................ Permit Granted ........j14Y..R5.................19 86 Inspection. ... .......................19 elz Date of I F, Date Completed ........... ......19 i 1 145.01 20.0 I n 146.26 JOB # 85-420 CERTIFIED PLOT PLAN PREPARED FOR: LOCATION: L-10 DOLAR DAVIS RD CVILLE SCALE: 1 "=30 ' DATE: 7/22/86 REFERENCE: - - PB 403 PG 27 LEBEL-SOLLOWS I HEREBY CERTIFY THAT THE BUILDING SHOWN ON THIS PLAN IS LOCATED ON THE /Nor GROUND AS SHOWN HEREON J1RNE cy� OJALA H down cape engineering #2634 4 CIVIL ENGINEERS Af ER LAND SURVEYORS ROUTE 6A YARMOUTH MA DATE PEG. LAND SURVEYOR TOWN OF BARNSTABLE, MASSACHUSETTSPERMIT' - JOB WEATHER CA 0 ` y3 11 DATE 19 PERMIT NO. APPLICANT_s�C� ADDRESS IND.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO (_) STORY DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) �T`® Do L ,- Avi 5 ZON' DI-- ;T (NO.) (STREET) BETWEEN AND _ (CROSS STREET) (CROSS STki i; --- LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: AREA OR PERMIT VOLUME ESTIMATED COST $ FEE (CUBIC/50 UARE FEET) OWNER BUILDING DEPT. ADDRESS BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE A:' PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINE.. FROM THE DEPARTMENT 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 PERMITS ARE REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MI NAL INS RE INSPECTION TO BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTIOIJ BEFORE - OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING.NSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS i 1 2 2 2 /, 3 HEAT;NG !NS. ECTiNG APPROV REFRIGERATION INSPECTION APPROVALS I, r i 1�! MOu,-10 ' . WORK SnA.LL NCT PROCEED UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION iNSPECTiONS INDICATED ON THIS C%PC, NSaECTCR AS APPROVED TtiE VA�I CJS ( WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR By TELEPHpNc STAGES OF cDNsrauCTinN' PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION. _7/7 oFTHE>o TOWN OF BARNSTABLE Permit No. ....2970?..... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash 'tquY� HYANNIS,MASS.02601 Bond .....X......... CERTIFICATE OF USE AND OCCUPANCY Issued to S L S TRUST Address J lot #10 58 Dolar Avis Road, Centerville USE GROUP FIRE GRADING OCCUPANCY LOAD z` THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL. f SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN " REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. r December 4 ............................ 19...$5......... ....................... Building Inspector TOWN OF BARNSTABLE BUILDING DEPARTMENT S IARISTAU TOWN OFFICE BUILDING rwa t639• HYANNIS, MASS. 02601 �o r�r►• MEMO TO: Town Clerk FROM: Building Department DATE: f f An Occupancy Permit has been issued for the building authorized by BuildingPermit #.....-�.. .. '`......................,........................... ......................................................................_..............._. issued to `- ,....��.. % ......... .. GL /.. .!1 Please release the performance bond. a - U Assessor's map and lot number .�e>l� .... ......... ,. g. .. .:. OfTF1FT0 Sewage Permit number ................................. ..":.•v•iU Z MARNSTADLE, i { House number•,...............................r....�.. ::.............................. '� 16 9 I .• O 39• � TOWN OF BARNSTABLF t BUILDING INSPECTOR APPLICATION FOR PERMIT TO .............. c.............. ...... .,...................................................... TYPE OF CONSTRUCTION .......................A10 0. ... ..::1. t .................... .................. `.......... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to thefollowing. information: Location. ..... 4P. .. ......... ? ...A. .�.. .. .... ........................... ................................... ProposedUse .............. �L � i.............................................................................................................................................. '._ 7 ZoningDistrict ....................�...........................................Fire District ....................... C. ....................................................... Name of Owner �...`.. fZ..U`. 1_'•. .......................Address tLc.u.r�•� i 5 .....................................................................Address ...........................C�....R.�� .�:......... ........... .�i..... ............. ...... . ............................ Name of Builder �.....{:::�.....:-» �.u�"5 .'.......... k Name of Architect �L1 f/ . ....��'.�.�L.`.............Address ........!.c-' ...............................................,q CfC,�.t..,cv /;tea r!7 ....... ..................... ......... ...... Number of Rooms .................... .............................S ................Foundation ..................... .. '�.<..`.../ •.r.lr 't .,:........ . Exterior :.................... ......................................Roofing ..................GZ. f..................................................... x t �F>} cj u�- Floors ........................? .................................. .Interior �.. Heating t��c<<s .....Plumbing,......✓GCc� ?;.IC�_ •i 5. Fireplace ........................... 5..............................................Approximate Cost .............'a ��r .............. 00 Definitive Plan Approved by Planning Board _______________________ -----19-------- Area ...t Li........'a.Q Diagram of Lot and Building with Dimensions Fee .... SUBJECT TO APPROVAL OF BOARD OF HEALTH F .4 OCCUPANCY PERMITS REQUIRED FOR NEW .DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Ba/,Ta ,regarding the above construction. Nar. .. ... ... ....................... Constructio S ervisor's Lice n /.'� ........ S L S TRUST A= P 17/- 28? No ..,29702... Permit for ...One. StorY............. ............Single... amily..Dwelling................... Location ..Lot. .��jp.......58. Dolar Davis Road ............................... Centerville ............................................................................... Owner .......S..L S Trust ................ ..................................... Type of Construction ... rame ................................................................................ Plot ............................ Lot ................................ Permit Granted July 25, 86 ................................19 Date of Inspection ....................................19 Date Completed C.�MP4Crc- 11187 Wi I DEPARTMENT OF PUBLIC SA FETYMONWEALTrFETY- =� OF 1010 COMMONWEALTH_"E. MASSACHUS � '- BOSTON,MA 02215 LICENSE CAUTION EXPIRATION DATE"Y o7 CON STR :c:IJPE RV I:=UIR FOR PROTECTION AGAINST EFFECTIVE DATE tIC-NO. THEFT, PUT RIGHT THUMB RESTRICTIONS Y { I� cjE/c'_i i/_1 =�'1� c;� El--,/, a PRINT IN APPROPRIATE •1FAM I l...Y H_MESS 6 BOX ON LICENSE. y, f 3 F 6 • _ ' - M I I_:HAEI.. •i . RENZ I. BLASTING OPERATORS c Z MUST INCLUDE PHOTO. :n 387 PH . I�NEY:3 LN m PHOTO(BLASTING OPR ONLh I: EN"1 ERV I LLE MA 02i-•::2 1 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER THIS DOCUMENT MUST •, « SIGN NAME IN FULL ABOVE SIGNATURE LINE CARRIED ONTHE PERSON QF .SIGNATURE OF LICENSEE " THE;HOLDER WHEN EN .- OTHERS-RIGHT THUMB PRINT GAGE-DIN THIS OCCUPATION. r Z't. 1 t. �jll}7y e3 13W�gg$ �ALLSINIPyp"j r 13f1, x }�. 0'1•�W •�0 � ��the �� r _ 9j rh 11/02/94 17:02 '$6177277122 DEPT IND ACCID z 001 Com4noitwealt{i. of Waijacfiuiettj 2apartrnent n��ndtt�trial./�ccide►�i 600 !it/a h4Vton..S&t t James J.Campbell E. Ion, Vales zcLU16 02 f f f Commissioner Workers' Compensation Insurance Affidavit 1, /V-k v k 1 . Reju-Z (tloensedperm�e) with a principal place of business at: (Gty/statelllp) do hereby certify under the pains and penalties of perjury, that: () I am an employer provid'mg workers' compensation coverage for my employees working on this job. Insurance Company Policy Number (•')/ I am a sole proprietor and have no one working for me in any capacity. () I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number O I am a homeowner performing all the work myself. I understand that a copy of d,a s:atement will be forwarded to the Office of Investigations of the DIA for coverage verification and tfiat failure to secure coverage as required under Section 25A of MGL 152 can lead to the Imposition of criminal penalties consisting of a fine of up to S 1,500.00 and/or one years' imprisonment as well as civil penalties in the form:cf a STOP WORK ORDER and a fine of S 100.00 a day against me. Signed this day of AAne. 19 9 Licensee/Pdrmi a Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 TOWN OF BARNSTABLE BUILDING PERMIT $ .3 -7 y7 �� 3oi M;D1,Sum Mh 02001 Office: 508-794-6227 F= 50 -775 3344 Ralph<koBuAdiAeu gommissioncr For offoc use only Paznit no. Date AFFIDAVIT HOME IMPR0VEM3Wr'CC0II1RA4CWRL&W SMPI12d]EliTT,O PERIWAPPIUC&'ffio I - MGL c.I42A rcquurs that theme al(emba2s rraotma<m,zcpak moderaizadon„ ampmveamtt, mnocaL demolitim or amutsu lmw of an addition to nay pm aging owner building containing at Icast one but not morn than four dueling units or to siructt=which am adjaocai 10 such residence or building be done by tcpstcrcd,contmaors,a6sh,=�exaptioas,along�piih�� Type of�bii:: 41�i 1 �U Est.Gost�iI 0 0©. 0 � Address of Work: -'6 o O k o k Q AuU%.S `Z.o Outer Name: WA Date of Permit Application:_ 3 h 4) J� I heretn certify that: Registration is not required for the follov.-inf m2son(s): Fork<xcludcd b%•12w Job under Sl O00 Euilding not<m-ncr-oazrpic-, Ovner pulling oval permit 1,�oticc is hcrcby gi«n that: O«;•* 'c PULLI;'G T SIR Off;^:F rF-%'i i Oz D-I.LI':G V Trz:U!,,REGISTERID CO;`"FRACTORS FOR APPLICAELE I:ONC T' =,0�i' i �:'O�is D-D T:OT HANT ACCESS TO THE ARETTR<,TIO';FROG:,/, OR cu/-s�kvq- FLED UNDER►..CI-<. 1<2A SICINED UNDER PLI;/,LTIFS OF pf:ratr�1" 7✓ OR D2tc 0-,,cr's nzmc m m ME ONE ■■ ■ ■MEMO■ ■■ ■ ■■■■ ■ ■■ ■■ ■■MME M ME M MEN MEN 0 ON MEN ME MMMM ME ME ME ME M ME M IN M ME ME M Erb■M M EEC. E■ MM EEMMEMism MOM m Mmmmm MME■ � ■■■�■■■f■■Mil■■11��■■�� - MMEM■ME ■MEmEumi_immilu!■■ __�� � M MEMO MMME 0 MMEMM MEN■ MMM■MEM M■MMMMMM■E �h J III 1 F I-- r ' Fl- 1 t,v o ry l I I- t � i _, .i ... ... _ T_._.___ ---' _ s � � •� -- � R � r '� f i i i I 145.01 '? 20.o o t .d o � �� o � 1 i I 146.26 JOB # 85-420 CERTIFIED PLOT PLAN PREPARED FOR: LOCATION. L-10 DOLAR DAVIS RD CVILLE SCALE: I u=30 ' DATE: 7/22/8E REFERENCE: PB 403 PG 27 LEBEL-SOLLOWS I HEREBY CERTIFY THAT THE BUILDING SHOWN ON THIS PLAN IS LOCATED ON THE `tM Of GROUND AS SHOWN HEREON AANcy� X 'H. r down cape engineering #26� 4 0 CIVIL ENGINEERS LAND SURVEYORS ROUTE 6A YARMOUTH MA DATE PEG. LAND SURVEYOR do �A ssessor's Office 1st floor Ma �� Permit z� Conservation Office 4th floor /� 3 -4 J qS 1. Date Issued 5-171 Sr Board of Health Ord floor) P5� 01G 3�� 9-5- T `°...' I Qa� . Engineering Dept. Ord floor House# Planning Dept. 1st floor/School Admin.Bldg.): M_Aea .. Definitive Plan Approved by Planning Board 19 SE M MUST BE (Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.) INSTAL COMPLIANCE VATH TITLE 5 'ENVIRONMENTAL CODE AND TOWN OF BA ABLE TOWN REGULATIONS Building Permit Application Project Street Address ` - 00/i %Z 1014 L/P.f 1Z 0 Villag Fire District (hyner -jt/i.l W Address 001#tt 0A00 7tO Telephone 7 '7 Permit Request: 7"Z-y �4 w o o n F/7. -e A Q a j T t'eJ,N Zoning District / 1 Flood Plain Water Protection Lot Size Grandfathered �' Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type W O O D V 94/4,x 9 Eaistinz Information Dwelling_Type: Single Family 4.-- Two family Multi-family Age of structure Basement type Historic House Finished �Z Old Kings Highway Unfinished Number of Baths Z No. of Bedrooms 3 e Total Room Count(not including baths) First Floor y Heat Type and Fuel Go S Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None �/' Sheds Other Builder Information Name AA%e kAe 1 1Zp,c)`Z i Telephone number SB F- 7`7/ G-f' Address 3 L -7 IF41.v,v 4e,j'3 iojA,,;g License# 0 S-S 2 (P(© C(AA-fm kA1 =NSA s) Home Improvement Contractor# Worker's Compensation # NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Project Cot �A� p Fee ` Z SIGNATURE /yl . ct,�i(Q /C¢�t�yc ' DATE 37!9 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T FOR OFFICE USE ONLY 3/7/9537;74 171.289 ADDRESS 58 Dolar Davis Road VEU.AGE Centerville E v Jim Walsh OWNER ' DATE OF INSPECTION: I r - FOUNDATION FRAM INSULATION t FIREPLACE ELECTRICAL: ' ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: N Ri , DATE CLOSED OUT: 20 yF , ASSOCIATE PLAN NOS mow _