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0052 FOX RUN
foxes r � yl n 3� 0 II c v s►+e T Town of Barnstable *Permit# "' I ' Expires 6 mo om issue date � .. . Regulatory Services Fee - Thomas F.Geiler,Director ArED - Buildiiag Divisionommissio poA Tom Perry,CBO,-Building Cn 200.Main Street,Hyannis,MA 02601 �8 www.town.barnstable.ma us Office.' 508-862-4038 t�f, M ` - ,08-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY j.-> Not Valid without Red X--Press Imprint Map/parcel Number Property.Address sf,}, F h 'Residential Value of Work ita o — Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address- fL0 46G C Telephone Number Contractor's Name— Home o Home Improvement Contractor License#(if applicable) 419 University Avenue Construction Supervisor's License#(if applicable) ow, orkman's Compensation Insurance F Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 0-1 have Worker's Compensation Insurance Insurance Company Name qG 6� ia•M 0_r C.iaP Workman's Comp.Policy#.W 1" G q g 9 3 319 �{�I I ► b Copy of Insurance Compliance Certificate must accompany each permit. LE 1 S Permit Request(check box) ❑ 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 #of doors ❑ Replacement Windows/doors/sliders.U-Value - (maximum.35)#'of windows 0*`Smoke/Carbon Monoxide detect 4 floor plans m ed with red S and inspections required. Separate Electrical&Fire Permits require *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-th ome Improvement Contractors License&Construction Supervisors License is Y required. � I SIGNATURE: *ti h Ems_. Q:\WPFILES\FOPMS\buildingpennitfonus\EMRESS.doc Revised 053012 The Commonwealth of Massa chusetts ii Department of Indrtstirial Accidents (y s I Congress StFeet,Suite 100 Boston,MA 02114-2017 www mass.gov1dia z,\5.�N� •r . Workers'Compensation Insurance Affidavit:Budders/Co€tractors/Electriciatis/Plumbees. T6,BE PILED WITH THE PERNUTTING AUTHORITY. Applicant Information ADM LLC Please Print Legibly Name(Business/Organization/Individual): 4 10 University Avenue Address: Westwood, MA 02.090 City/State/Zip: Phone#: 7 1- 3 S S - c. ►q Are you an employer?Check the appropriate box: Type of project(re.quil-M): 1.I am a employer with q S employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Q Remodeling any capacity.[No workers'comp.insurance required] 3.❑I am a homeowner doing all work myself[No workers'comp.insurance required.]t 9. ❑Demolition 4.F-1 I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 ©Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5. I 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. 14POther A 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant thaf 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 isproviding worms'compensation lFwnrance for ncy employees. Below is the policy sand job site T irc�orttcatiort. ' Insurance Company Name: I1'C Policy#or Self-ins.Lib.#: V`) �. Q�,q V6-q 3 31 1 Expiration Date: b- Job Site Address: 51-�" City/State/Zip: 4,. V¢'Gl-I Attach a copy of the workers'compensation pelicy declaration page(showing6epolicy number and expiration date), Failure to secure coverage.as required under MGL c. 152, §25A is a criminal violation pul Ishable,by a fine up to$1,500.00 and/or one.-year imprisonment,as well as civil penalties in the form of a STOP WORKORDER 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. 1 do hereby cafify utidei lkm arts dadvendkies ofterjnry dial Me i t orw ataon,&ovided above is true acid correct. Si atilre: / Date: Phone#: `)q ( ®,*iaal use only. 00 hot write M' Dais aired,to be coMpleted by city or town.tif*ieaL City or Town. Permit/L,icense# 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#: DATE(MMIDDIYYYY) Ali o CERTIFICATE OF LIABILITY INSURANCE 0912812015 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 endomement(s). PRODUCER CONTACT NAME: Marsh USA Inc. PHONE FAX 1560 Sawgrass Corporate Pkwy,Suite 300 A/c o Ext• Alc No): .Sunrise,FL 33323 E-MAIL Attn:FtLauderdale.Certs@marsh.com ADDRESS: INSURE S AFFORDING COVERAGE NAIL¢ 048953-ADT-GAW-15-16 INSURER A:ACE American Insurance Company 122667 INSURED INSURER B:Agri General Insurance Company 142757 ADT,LLC INSURER Security Services suRER c:ACE Fire Underwriters Co 20702 1501 Yamato Rd. INSURER D: Boca Raton,FL 33431 - —INSURER E: INSURER F: - COVERAGES CERTIFICATE NUMBER: ATL-003442307-05 REVISION NUMBER:1 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 ,ADDL SUBR POLICY EFF POLICY EXP LIMITS LTRTYPE OF INSURANCEINIRD WVD POLICY NUMBER MMIDD MM/DD A X COMMERCIAL GENERAL LIABILITY XSL G27400954 10/01/2015 10/01/2016 EACH OCCURRENCE $ Z000,DA AGE TO 000 X� PREMISES(Ea occurrence) $ 1,000,000 NTED CLAIMS-MADE OCCUR X SIR:$500,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 MOTHER: ❑PRO- �LOC PRODUCTS-COMP/OP AGG $ 4,0D0,000 JECT $ OTHER: A AUTOMOBILE LIABILITY ISA H08865073 10/0112015 10/0112016 COMBINED SINGLE LIMIT $ 1,000,000 Ea as dent X ANY AUTO - - BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS • Peracddent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE - AGGREGATE $ _t11TD TETENTION$ $ A WORKERS COMPENSATION WLR 048593318(ADS) 10/01/2 115 10101/2016 X STATUTE E A R AND EMPLOYERS'LIABILITY B ANY PROPRIETOWPARTNER/EXECUTIVE YIN WLR C4859332A(TN) 1010112015 1010112016 E.L.EACH ACCIDENT $ 2,000,000 C OFFICER/MEMBER EXCLUDED? N/A SCF C48593331 WI 10/01/2015 10/01/2016 2,000,000 (Mandatory in NH) ( ) E.L DISEASE-EA EMPLOYE $ If yes,describe under 2,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION ADT LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn:TOM LEE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 410 UNIVERSITY AVENUE . ACCORDANCE WITH THE POLICY PROVISIONS, WESTWOOD,MA 02090 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukher)ee �'LcLvl�esk ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD r _ 'J rt COMM,ONW M ALTH�OF ASSI�CHUSETTS • • • • ii �t s �B01��C�iFr F " E�ECTI�CITANS ISSUES THE FOrI`:LOWING I,IENSE AS to REG t 5T7=R'ED SYSTEM CONTRACTOR z I � A`DT,LLC;DR ADT SECURITY f `•'" I THD`MAS `.l tiFE , ; # 14 QiF,,UN51 UERS t TY A11E W - WESTWOOD MA 02090 2311 i W. 86 I a Commonwealth of Massachusetts Department of Public Safety Sec uHtc SN<I.rme-S-Lic enIt I License: SS-001779 Thomas J Lee 410 UniversityAvel Westwood MAr 020:90 n i Expiration: ! Commissioner 05/16/2016 f uxxsrn$�. i . �pl �a1m Town of Barnstable 1 5 Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street,- Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862,4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section -60 jLiva((UQ <rH as Owner of the subject property hereby authorize A SN1 to act on my behalf, in all matters relative to work authorized by this building permit application for: 5 0,L: I—L ,iJ (Address of Job) Signature of Owner Date rc Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on,the reverse side. 0-\WPF[L.ESTORMSUilding permit forms\EXPRESS.doc f ` The Copt-irnonweaith of Massachusetts Department of Ind-ustricalAccidents 1 Congress Street,Suite 100 Boston,Ili 02114-2017 www m ass.gov1dice -� Workers'Compensation Insurance Affidavit:Budders/Contractoes/E[ectricians/Plumbers. T64BE FILED WITH THE PERMT'TING AUTHORITY. Applicant Information DT. LL C Please Print Leeibiy Name(Business/OrganizatiorAndividual): 4 10 University Avenue Westwood, MA 02090 Address: City/State/Zip: Phone#: 7% 7' 2 S S - SG q Are you an employer?Check the appropriate box: Type of project(required): 1'O I am a employer with employees(full and/or part-time).* 7, ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $, ❑Remodeling any capacity.[No workers'comp.insurance required] In I am a homeowner doing all work myself[No workers'comp.insurance required]t 9. El Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 D'Building addition ensure that all contractors either have workers'compensation insurance or are sole l l.®Electrical repairs or additions proprietors with no employees. 12.D Plumbing repairs or additions 5.[—1 I am a general contractor and I have hired the sub-contractors listed on the attached sheet These sub-contractors have employees and have workers'comp.insurance.t 13.❑Roof repairs 6.❑We area corporation and its officers have exercised their right of exemption per MGL c. 14V OtherL.Li -�,�Q 152,§1(4),and we have no employees.[No workers'comp,insurance required] 'Any applicant tliaf 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. f am an employer that is providing workers carilpensadon inssurattce fop my e#1p10yees. Belatry 1s thepolley and prib site in fiermation. Insurance Company Name: Pr C TT46wfi-p rN ,6 4-kj Policy#or Self-ins.U6.#: V4 Expiration Date:- b— Job Site Address: F 10 �w N City/State/Zip: C a" €n_1l Attach a copy of the w®Areas'c®mpensation 011dy declaration page�shovding the policy nun►ber and expiration date):. Failure to secure coverage.as required under MGI,c. 152, §25A is a criminal violation ptirlishable by a fine up to$1,500.00 and/or one-year imprisonment,as Well as civil penalties in the form of a STOP WOR.KORDI R 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. 1 do Hereby certify under the hips Moties dfPerjMay tkat the tttfoimii n of ov ed above h true and correct Si attire: / Date: Phone#: ®fficW use only. Do not write in this area,to be completed by city or town€ifftciaL 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 Pe Son: Phone#: DATE(MM/DDIYYYY) AC40R!3s CERTIFICATE OF LIABILITY INSURANCE 09/28/2015 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(fes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: Marsh USA Inc. PHONE FAX 1560 Sawgrass Corporate Pkwy,Suite 300 A/c o Ext• A/c No .Sunrise,FL 33323 E-MAIL ADDRESS: Attn:FtLauderdale.Certs@marsh.00m INSURE S AFFORDING COVERAGE NAIC 6 048953-ADT-GAW-15-16 INSURER A:ACE American Insurance Company 22667 INSURED INSURER B:Agri General Insurance Company 42757 ADT,LLC ACE Fire Underwriters Co 20702 ADT Security Services INSURER C 1501 Yamato Rd. INSURER D: Boca Raton,FL 33431 INSURER E INSURER F: -EJ COVERAGES CERTIFICATE NUMBER: ATL-003442307-05 REVISION NUMBER:1 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 SUER POLICY NUMBER POLICY EFF MMIDDfYYYY EXP LIMITS LTR A X COMMERCIAL GENERAL LIABILITY XSL G27400954 10/01/2015 10/01/2016 EACH OCCURRENCE $ 2,OOD,000 DAMAGE-TO RENTED CLAIMS-MADE M OCCUR PREMISES Ea occurrence $ 1,000,000 X SIR$500,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 1$ 4,000,000 qPOLICY❑ PRO- LOC PRODUCTS-COMP/OP AGG $ 4,000,000 JECT El OTHER: MBINED SINGLE OMIT g 1,000,000 A AUTOMOBILE LIABILITY ISA H08865073 10/0112015 10/0112016 (CEO accident X ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ - HIRED AUTOS AUTOS Per accident Is UMBRELLA LIAB OCCUR EACH OCCURRENCE $ .. EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION WLR C48593318(AOS) 10/01/2015 10/01/2016 X STATUTE EERµ AND EMPLOYERS LIABILITY B ' Y 1 N WLR C4859332A RM 10/0112015 1010112016 E.L.EACH ACCIDENT $ 2,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A WI 10/01/2015 10l0112016 2,000,000 (Mandatory in NH) ( ) E.L DISEASE-EA EMPLOYE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION ADT LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn:TOM LEE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 410 UNIVERSITY AVENUE ACCORDANCE WITH THE POLICY PROVISIONS. WESTWOOD,MA 02090 AUTHORIZED REPRESENTATIVE of Marsh USA Inc Manashi Mukhedee @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD COMMONWEALTH:OF.MASSAC:HUS s BOA R CF l I SStJE�S THE FOL;L0�71 NG L i GENSE AS � ` 3. i .REG k S'f 1=RED 5$Y3STEM CONTRACTORS �:1� A�[T LLC+DBA ADT SE.Cl1RI1Y THi]MASht.k LFE 4�l O��UNI uIRS t`fY AVER ., r W WE;STWt70;D MA .(ND 231 i i 7fz c o7/31/16 ... :33986 t t Commonwealth of Massachusetts i Department of Public Safety Svcurilc S%cIem<-S-license License: SS-001779 Thomas J Lee ' 410 UniversityAvey: Westwood RV 02090 3 ii Expiration: ; Commissioner 05/16/2016 /'w - I `Sa- �6sr RU � t . �o U. So � SC.k$A a I ,1.� (1 r ; ate_ r c r , _ .L I : , I �Tce� i I�{ ` - r , r I i , r I i I I I- I , , r ; .......... ....... ...... I ........... ..............r i I 1 , I t t � ' 0000!r I4 , t j 4 LE BUILDING OEPT, - f i DATE ' _ I '. .FdIRE bEPARTMENT1 .....I I DATE ...I SDI MMAWr� . ARE REQVIREP FOR PE',RMITTINC r r r ' , , r I r I, • , I ' I i � � '' �jl 153'h• �� ;h V61� le �•_o�4.. I ... � I "'�S�ISbm�; �,( . -�-� -- i r i i — Gfr fi `�r✓l �w r r , I - ; . Ru,nRol) : I LX : to, - � - �_ - I _ i 1 : � 1 , : : I : I S : i 1 , I I _ I , I j i : f i I I : I I : , , : I 1 I. I 1 I , : I I I I I L L�ALIC 1 : I 1 t3 � ' awl , i i ' I i r : I , r _ r r r I � r I I r I I r i r i • I I I I. . I I I I r r i i I , I. i i i 1 I• i I I • I I r � I I f • i I I � ; I I I t��c�•1ecL I I I (_. I..__ .._ I I I I . I _ I _i 1 - , I I I I ..._ I I I i I 1 I : I - I i i i. 1 Sor� no :It olc old r I r I : I i I I r I � 41 w fir p` -- , I I r , ._.i.. ,t/i��T�.� �✓1.o�. p5�- �l�sY' � t �� .Sc,l►� I R 5a: �d Rum, rur f • : I i _ it I • , , , r io , n , i I v k , I I i I I I I ' • ' I I I 1_ I i , i r '• .. I - r I I , .................... _.__.. . : I I � j �...... j r. — , , i i 5C! E' d DI RATE;100 T � � E(�T E�A CvfE�T , 1 —`ATE 1 � D ' I I:�'lR� RT� . / ...... ;. - .. i _ ,. OTH. ICrMA�iIFt. AP RE tJ; ED-FOR P'E'R T77MG ..I I I I L.. .I- _ , I , � ,I' i 1. r- -' �'� ;BLS , �� I� co G , w a la�� Rabe + A-N� � I �"�. - UA 4el : R - i 1 , I I 1 I I : Del C�, , I I I ` ` i I : : I 1 i I 1 : I I , I : : u : SOT 13No , S ke- , , r. . i , " , ' 1 : • I ' � I • , I I i , i I , i j ` I I r i r e : -- I . .. i I I , - dF r eo� i �U0 _. _ - .... I i • I iI , ; L.. ' I} I i i 1 J I G , ' � I , 1 , I &r,•+r Ic,.,,, 1 .,I +i. E , ok g1i5) I .. TU PPE R CONSTRUCTION CO. LLC 546A Higgins Crowell Rd,WEST YARMOUTH. MA 02673 PHON E: 508-778-0111 FAX: 508-778-5011) 6MA W.TUPPERCO COM Date: VIM? Town of Barnstable Thomas Perry CBO Q 200 Main Street z Hyannis, Ma 02601' NO 4M (508) 790-6230 fax, Re: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for permit application # �-olSQldl � Issued on has been. inspected b a ce i •. - p y rtif�ed Building Performance Institute (BPI) inspector. All work performed meets or exceeds Federal and State requirements. i Sincerely, :Permit 1.60 1 f r, Y i Address: 6,-,-2- Richard Tupper License # CS-69058 r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 22 , Parcel l 66a Applicatio Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH — Preservation / Hyannis Project Street Address Village f?x- Owner A Address X &Jn Telephone t Permit Request In !/ I �GJ L S \fwfi, v) era. 1 1 VISWI r, ('a 1Acx .Square feet: st floor: existing proposed 2nd floor: existing, proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation a5 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) gym, Age of Existing Structure f'g g `"� Historic House: ❑Yes ❑ No On Old King'sighway `0 Yet ❑ 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 nerd f x�� rp 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 XNo Fireplaces: Existing New Existing wood/coal stove: 0 Yes ❑ No 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 ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number o 77 —� f ppAddress64 License # WQ � (e q 0 �5 '� MA11--1� Home Improvement Contractor# I Worker's Compensation #(&L6V55��[Xi* ALL CONSTRUCTION DEBRIS RESULTING FROM HIS PROJECT WILL BE TAKEN TO c ( 5 _ a)/0fWA [Y�A 02�al SIGNATURE DATE I S { r FOR OFFICIAL USE ONLY AIOPLICATION# E DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER ,. DATE OF INSPECTION: Y �E0UUIVDAIION4DA-f UN;N'H—:UND.kilk- ? FRAME — — — A,INSULATION FIREPLACE " ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 's FINAL BUILDING DATE CLOSED OUT �= ASSOCIATION PLAN NO. E I E. ENcrbee¢iric OWNER AUTHORIZATION FARM (Owners'Name) _. . _ ... owner of the property located at; (Property Address)a (Property Ad .ress) e hereby authorize - J C. . (Subcontractor) an authorized,subcontractor for RISE.Engineering;'to act on my behalf.to obtain.a'building permit and to perform.work on my property: This form is only valid With a,signed contract: Owner's)Signature Date s - RISE Engineering 5 Dupont_Avenue " South Yarmouth, MA 02664 . The Conwonwea Uh of Massachusetts l�eeartment of Indastria!s�cc denift- ��i�of ltwestigi�iaras: 600 Mish ngtdn,SYreet AvWon,AM 02I11 iv wa..rriassgov/dru Workers' Compensation Insurance Affidavita.builders/Con tracton/Electricians/Plumbers ,—AlWicantinformatioO Please Print Le ihi �1it�(�ustncsslOrgeiti ttaneltidivtdual):_ TqP er constzu�c� :on Cc. ,. .LLC Address: 546A Higgins Crowell Rd pity/fit*/ : westa. ��trtgaut> , p 02673 Phone Are you an waployer?Check the appropriate box: hype of project(required)= 1, I ztnr a employer with : ❑ 1 am'a general contractor and I A. New e'onstrutuon employeesfultd/or part-time), have hired the sub-contractors 7. Remodefi 2.n 1 gun a sole proprietor or partrter- . . listed on the:attached sh'�t� ❑ b ship and have no employees these sub-contractors ha�1e 8. []Derarolition . . . . working for me in any opacity. workers'corop,insurance'.. 9., []Building-addition [No workers`wmp,insirwanct . ❑ fie:area corporation and its t• 1U❑Electrieal repairs or a"tions -- required,_] officers hive exercised tlterr 3,❑ 1 a,m a hotneownt'r 401"ng aft work rygllt of.ekwiption per M(,;L l l_ ❑ Plumbing repairs or adtitttons myselt�(No Workers'tomp, c 1S2�§t(4)3 and we have tip � 12( Roof rt parrs tnsuratice ri�utretl.�.t' errlployees.INo workers' _13;[ over At-ghenzation --- __conth:,rtl5trratiie Any upplii;uut that t:he&faux#1 anust alsn till OvIi thu' tltiit beiury showyn�thciP warrkur3 touipcaisahon policy sntomaataon_ r-tr3inewmm%*Iio submit tins aMdavit indicant theY M d0ifig all work and then hire outside coiitmetors angst submit:a nc%v awidavit i idirating such. 1t)Mtra$o-s that chef k this box.must ti athbd an additional shz.ct showitig the name of the situ cc9i►tr ius mid their workeis'Comp polio infonmativn. f t an enspl,pw did is providing workers,coaknensadon irtc"ce for trty MWIPyeM. Beloit?.is die policy and jib.site.. #aPf�1a'i/aiit�DJ. tttsurance �t om1 Name- ARI C Nficy g or Sell--ins.Lse.#; Dice _S O.S:S 93 U 1?U 14�; �Cxptration Dom: 10/3115 Job Site.Andress:. _ 0 X city/state&ip I V,7 > Attach:a col►y of the workers cotts�enstthdh po3aep oed2ration Pik (sltowrng the policy number and otpiratiou.'date). Failure to secure ctiverage as t equitt d,Under Section 15A Of MOL c l S2 can it4d to the imposition of crimtnat penalties of a fine up to$1.500.00 andlor one year Imprisonment:us well as civil penalties.rn the to of a 57['OP WORIf C1RI3ER and a fine i�fup to�25©.dt)a is} again"st t}1e'v olator: 1Be advised that a copy of this"statement rna}°be-forwarded to the Office of ItivestigahanS of'the.CIA for insutatlee t0trage verilicaObn. 1 do hereby certi >riitder the fj , prints..ft penaltres of perj►y that the infmrmatirra provided dbove a tr a and ciirrec i,nature, Dat • Official use o ip. Do riot►mite ill finis area,to be 0M ted by ah'c` ar tuam offlriat . .Cityor`l'tiwn_ PertYt t icense.#. Issuing Authority(circle one): 1.Ilbard of Health 1 Iluilding Department 3.City/Tovvn Cleric 4.I+:leetr cal Inspector S.1Nrauabiag Inspector b.Other Contapt;Nerson: Phone :. 1 OR& CERT - �IFIC�•- AT 0 f LIA�ILI�If I�ISURANC E 12/i/2Qi4 THIS CERTIFICATE"IS ISSUED AS A MATTER OF ItdFORMATION ONLY AND CONFERS NO RIGHTS UPON-THE CERTIFICATE HOL©ER.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 certWficate holder is an ADDITIONAL INSURED,the the terms and conditions of the policy es)must be endorsed; If SUBROGATION IS WAIVED,subject to policy,certain policies may require an endorsement- A statement on this certificate does not confer"n Certificate holder in lieu of such endorsemenUsj, gtrts to the NAME: r Lora FitzGerald .. : Name: Southeastern Insurance -Agency " �� i508)997-6063 FAx. 439 State Rd. smart. r14.(509) -2731 .l iita@southeasterai ns.com P.O. Box 79395 North Dartmouth 2aA 0�7d7. . INSUR AFFORDINGtovERACE " xa� ttiSUREb �� .. - INSURERAArbella Protection Insurance 1360 Tupper 1NS!lRET B AssociatedYEmployers ins. Co.-. Construct-ion, "Co ILG tatSttRERc- 79 Mini Tech Dr,. ve Unit B : . INSURER_ Dc . . .INSURER E - West Yazmauth. MA" 02673. . .. INSURER F c _ COVERAGES " CERTIFICATE NUMBER�015-1' REVISIO14 NUMBER: THIS 15 70.CERTIFY THAT THE POUGIES OF INSURANCE L15TFA BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED-NOTWITHSTANDING ANY REQUIRmENT,TERM OR CONDITION'OF ANY CONTRACT OR OTHER DOCumENT WITH IiESPECTTO:%,*IICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEO HEREIN IS SUBJECT"TO.ALL THE"Ti:RMS' FX0.USIO,YS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, :usR; LTR TYPE OF.INSURANC�E : AM 39M - .. 76�CYEFF t�EOLICY EXP I -: � _ ". .�� . . . . POLICY!UMBER- . GENERAL LIABILITY ". - �.! � . --� £.,CH OCCURRENCE ; . 1,000,000 1 X I COMMER�1L GENERAL LiA81UTY A PRcha15E5 rF aeeu rerte 5 100,000 lJfr NTE - :A,. + CLAMS-VADE OCCUR ..i - ' d _ . 500008743 2/1/2024 1/1/�015 S � � - � MBDEitP(An cn'e� - -)� : :5 . . �. - . . "$,000: . . . . - . . . z -PERSONAL S 1t000,000 GENERAL AGGREGATE s. 2 000,000 GEM AGGREGATE MIT APP14ES PER;• _CO3.PICTP AGG I.9 � 2,000-,000_ X Pt LILY PRE- : Pei(30UGTS... Lam- - - - --. AUTOM08StELIABIUTY s+xGt IS c aBIN €L1m1T 1 000 000 ANY AUTO - i SWILY.$NJURY,(Perpersm) �S . .ALL SCtsEtSiREO 020069389• 2/.1/2014. "2/1J2015 v1 !! (E ate) AUTOS X!AUTOS BODILY)?JURY(Per t2T der,1 5 ItRR AUF05 $ Avr[yr WNED_ J _ ( UMBRELLA une" OCCtri2 t U+area motarst Fl s .`� ..s- 250,000 CLAI' . £ACH OCCURRENCIE. . S EXCESS LIAB f AG�iEGATE S CEO RETENTION 600058368 1/1/2014_11/1/2015. T - WDMMRSCOMPFNSATMN S .AND EA6PLOYERS tJABiLITY 1'i NN'C�T A U OTH- . . . ., " . . ANY PROPRIETOFUPARTRER?E3CECUTIVE . . . . - - -- - - - 01 FICMIMEA:EER EXCLUMD9. to t A . - I . .. EL EACH,ACCIDENT 5" 1 �000 000 . . .(Mandatory in NH). CC5005593012014A 0/3/2014 I7 0/3/2615 it Vas.oesor Da user f E.L"DISEASE-EA EMPLOY' s 1 000 000 Di naNOFOPEI2AT'LNS iE,��-FOucYUMr s 1,000,00 I - DESCRIPTION OF OPERATIONS I LOCATTOms t vEId]CLES'(AttaM ACORD tOT,Addition.]Ramarfm Seh Ift if more - . .. space is]etlutieGl .. CERTIFICATE HOLDER : "- CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 'EXPIRAT'ION DATE THEREOF, NOTICE .WILL BE DELIVERED IN INFORMATION PURPOSES" ONLY: ACCORDANCE WITH THE POLICY PROVIS.MS. TUPPER.CONSTRUCTION CO" LLC :546 A:fi.Imin: CROWELL ROAD. - .AUTHORIZED REPRESENTATIVE - - - - MST .YlgwouTH;. t+lA 0267.3_. - DE Lora PitzGeiald/LBL ACOFIa 25(2010t05) 1M-2010 ACORD CORPORATION. All.rights reserved. . I.. . . gritriifslll7 - Tt�n_4f.:Aprl namn_ae�ei tnn�oYn ron:efv.+ro.,i mattrc of A:r`Ag11 _ . . - .. . . . - - . . . . . . . 8 Zltllee at ihnsuutei`fif:airr 14 i'ativititav:liif}ttl7iintr Lyi6nsv ov l iflistittiioa valid for iiidi'idui da o Wily time fi iv33Vmo3 r, to t me iffouoid k-lo a u). •§OgN tt << Urt{aou Y►irstUii i3n.ttirs+kr iut:ttiou �, �. i�°tiptr8fioli. dt{tili:U(ti LIC `i'tpN't—F."06Ntf i�idR".*ON CAUtti'!�r'�fl�t_14`,t. t 7c g Ah{[3=7i-:H OR �V,YUnti:lttY'i,'.iu1AU13ra st :r:,ti'. - - itdPi3r,�1`Ztctt!` -. tVtit"c�SiitiC�S�'ititlit4�9�j41�lftlYv- . tiii3a tt t'litA li+>zti t![i�ittl �fJ c1��ttu, t4.i,tt C.; o rtt pit a,etitiir{ Oc.g uiatioris and Sta o t;s i�ia`PS�,i�3'Si�t L'cin�4P\lia tuft�ti6irl't taut - - 546 A �in.Ck � �, iVCtf Yaf titibah M# vv- Richard supper _ .1 ..x.'N_'.T' �ti tli•Qta ' ' sr{€i���c�trpRvESr�?t+.ctr7S�,yiDsY- Y: xi. t,s.u,,.,si,:siUnirt ��4t'�'l� . . • :. _ � urt�l:dz ti`u ai�nvx 1r: ..,. , W , F'�on6eNlUtpittgP►edpt�$Uitdae5afer��nrkd�'. {' 'o e ' tF4dC�' Y RiOard T; ppq T upper.cotfstrucfion t .' i. . � 6uUr3in�Sat2t)Prctt�astO.wa_i McMber#:8'158119 - Exp;`4f30t2015 Robert A. Schulte C"" �"`- ` 52 Fox Run `Yh - h Centerville,MA 02632 " .. , • I'I�nlr'1�1'�n'Ililul'Iln��l �'" Mr.Tom Perry` -. Town of Barnstable Building Services-Inspections 367 Main Street Hyannis, MA 02601 . s. - rJ-:G.¢..rt��.'rt'•�=r�C.•!•�•� �71�[11.117-11t��i1��i 11114���.ii��lll�t i�:�ili�i�l1.1111i�1 4 i+i'ik if=.t E4{ttti'i U tiit ii 9 lit t i I !! lti�t} ,t}}} lltitt}�! � �1 �llil_ }! ! :'}!i 4(t l t!„ SCHULTE 52 Fox Run Centerville,MA 02632 (508) 790-3856 March 31, 1999 Mr. Tom Perry Town of Barnstable Building Services—Inspections 367 Main Street Hyannis, MA 02601 Re: 50 Fox Run, Centerville,MA - Residential House Construction Dear Mr. Perry: Thank you taking the time to speak with me on the telephone yesterday regarding the house being constructed at 50 Fox Run, Centerville, MA. My home is located next door at 52 Fox Run (we are the other house set back from the street with a long driveway.) As we discussed;the individual building the house, Mr. Hugh Sirhal, had his excavator raise the elevation of his driveway (which runs parallel to ours) approximately 12 — 15 inches. This increase in the elevation has created a drainage problem in the center of our driveway. After the snow we received earlier this year, a�small "lake"approximately 15 X 25 feet and 6— 8 inches deep formed across our entire driveway. It has been there for the better part of tliree months and-gets much worse after each rainsiorm" 0� We have obtained several estimates for the repair of our driveway and it has been recommended that we install a drywell drain to alleviate the drainage problem. We recently sent a letter to Mr. Sirhal requesting he inform us in writing of his intentions regarding the repair and restoration of our driveway. As you requested, I have enclosed a copy of the letter sent to Mr. Sirhal for inclusion in your file on this property. We understand that it is the responsibility of the builder to correct and/or repair any structures built or alterations to the land which cause damage to or which adversely affect an adjacent property. It is our hope that Mr. Sirhal will promptly respond to our letter and will repair our driveway as he originally agreed. However, we felt it was prudent to make our concerns regarding this matter known to your office prior to the issuance of a Certificate of Occupancy for the property. If you should have any questions about this letter or require pictures documenting the drainage problem, please do not-hesitate to contact the either at 617-342-7366 (work) or 508-790-3856 (home). Thank you again for your help.: - " 11... --a. -? M _ . , . 11 - , - _ ,t Sin ly•. Robert A. Schulte Enclosure .__ . .._._.._. _.._. SCHULTE 52 Fox Run Centerville,MA 02632 (508)790-3856 SENT VIA CERTIMD U.S.MAIL.AND FAX March 26, 1999 ugh K. i�fi Washington Financial Group Summerlield Park 800 Falmouth Road Mashpee;MA 02649 ; ugh: We are pleased to see that your home construction is progressing. However, as we have heard nothing from you following the damage done to our driveway by your excavator, we now felt it was appropriate to contact you regarding its repair and restoration. As we are sure you recall, you sold us on several occasions that you would repair any damage to our property that was caused by your contrmc--tors during tree course of their work. We have obtained several quotes for- the completion of this repair work and N-.ouid be happy to provide you with copies at your request. The quotes range from $2,400 to about $3,000 and include the price of installing a drywell drain. Installation of such a drain has beer recommended to alleviate the drainage problem that has been created by your decision to raise the elevation of your driveway approximately 12" above ours. We are sure_that you have seen the large "lake which has developed across the entire width of our driveway. In the event you have not noticed this,we would gladly provide you with numerous photographs which document the condition. Additionally, we estimate that it will cost approximately$150-$200 to prepare and to reseed the lawn area that was covered with dirt by your excavator. The lawn on the northeast side of our driveway has been killed as a result of his work. We kindly request a written- mponse summarizing your intentions regarding this matter within ten(10)days of your receipt of this letter. If we do not receive your written-response within this timef-ame, we are prepared to take appropriate action to ensure that you meet your responsibility to repair this damage. Respectfully, ,X'gaa, Robert A. Schulte Anne®. Schulte Robert A. Schulte 52 Fox Run Centerville, MA 02632 Mr. Tom Perry Town of Barnstable Building Services— Inspections 367 Main Street Hyannis, MA 02601 _ _ . �� �� �� i �, '� _.� '� � �` � ,� � -. �� .,'- �'� SCHULTE 52 Fox Run Centerville, MA 02632 (508) 790-3856 May 17, 1999 Mr. Tom Perry Town of Barnstable Building Services—Inspections 367 Main Street Hyannis, MA 02601 Re: 50 Fox Run, Centerville,MA - Residential House Construction Dear Mr. Perry: I am writing this letter to confirm our recent conversation regarding the above-referenced property being built by Mr. Humam Sirhal. During our conversation,you indicated that a Certificate of Occupancy(CO) for the property would not be issued until the drainage problem on my property(52 Fox Run),which was caused by Mr. Sirhal's construction, is corrected. Assuming you are still the;inspector assigned to this project when a CO is requested, I am confident this matter will be resolved prior to issuance of the CO. However,in the event another inspector is assigned to this property,I thought it would be beneficial;to summarize our conversation in a letter to be included in your department's file for this property. As you know,we have requested axesponse.from Mr. Sirhal(both by certified mail and fax)regarding his intentions for the repair of our driveway. He has failed to respond to our written request and in fact refused to accept our certified letter. Additionally, as we discussed on the telephone,Mr. Sirhal began moving his personal goods into the house last Monday. On Thursday,May 13t',,a Cape Cod Moving van delivered a large load of personal goods to the home. Based upon our conversation, it is my understanding that until a Certificate of Occupancy has been issued, Mr. Sirhal is violating the Town of Barnstable's building and health regulations by moving his personal goods into his unfinished home. I am mentioning this final fact to you merely to reiterate how difficult it has been and continues to be trying to deal with Mr. Sirhal during his project. I appreciate your.help and willingness to assist us in resolving this matter prior to issuance of a CO to Mr. Sirhal. Thank you again for your help. Sincerely, Robert A. Schulte Robert A. Schulte 52 Fox Run Centervilie, KPA 02622 Mr. Tom Perry Town of Barnstable Building Services — Inspections 367 Main Street Hyannis, MA 02601 I I r' 1 C I r • ' SCHULTE . - - 52 Fox Run ' _ ;Centerville, MA 02632 -(508) 790-3856 April 15, 1999 - . j Mr. Tom Perry _ Town f Ba:nstable Building Services-Inspections ~t r 367 Main Street - Hyannis, MA 02601 _ Re: 50 Fox Run, Centerville, MA Residential House Construction Dear Mr. Perry: As follow-up to my letter to you dated March 31, 1999, enclosed are pictures that show the severe drainage problem in my driveway that was caused by excavation work performed for Mr. Hugh Sirhal during the construction of his house. The picture labeled#1 (on back of photo)was taken from the street looking down the driveway' toward our house at 52 Fox Run. As you can see, the"lake" which now forms in our driveway following a rainstorm extends the entire width of our driveway(approximately 15 feet) and is close to 40 feet long at its worst. Picture#2 was taken looking west across our driveway and shows the increase in elevation by Mr. Sirhal that has caused the drainage problem. I request that this letter and.the enclosed photographs,,along with my March 31, 1999 letter, be included in the Building Services' file for the construction of Mr. Sirhal's house at 50 Fox Run. _ Furthermore, I kindly request Building Services' review of this situation and assistance in making sure that Mr. Sirhal corrects this problem prior to the issuance of a Certificate of Occupancy for this house. If you should have any questions about this letter or the enclosed pictures documenting the drainage problem, please do not hesitate to contact me either at 617-342-7366 (work) or 508- 790-3856 (home). Thank you again for your.help. Sinc ely,.. Robert A.-Schulte Enclosure _ � 3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION_ MapParcela Application # ��c� J� Healtfi`Division Date Issued O Conservation Division Application Fee IT D Planning Dept. Permit Fee lk Date Definitive Plan Approved by Planning Board ff Historic OKH Preservation/Hyannis Project Street Address ��Z 11,0, = L40 �af-yt c.Lf--AAA, Village y Owner -7 Az i) SC"tA L-tC— Address S? 1;,:X44) �C-�7c�.✓ c Telephone 5vs? 110 . 3�S�(� Permit Request DG� 1� -Y - ►-� t , 12emov &,i.4C6 c rr v2 Y C3t7• l turn # S GPLCc-,-v A"aa i) o 9W. i� �� C � �fL Square feet: 1•st floor: existing 1/00 proposed 2nd floor: existing//00 proposed Total new 0 Zoning District Flood Plain Groundwater Overlay - Project Valuation 0-000 Construction Type 9,e�nbet- Lot Size Sig ac Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure �-� Historic House: ❑Yes ANo On Old King's Highway: ❑Yes UKNo Basement Type: *Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) r7 Basement Unfinished Area(sq.ft) //00 Number of Baths: Full: existing_ d1- new O Half: existing % new G Number of Bedrooms: existing 0 new Total Room Count (not including baths): existing _�new 0 First Floor Room Count 4-- Heat Type and Fuel: ❑ Gas Oil ❑ Electric ❑ Other Q Central Air: ❑Yes ),No Fireplaces: Existing New O Existing wood/coal stove: ❑®s No G Detached garage: ❑existing ❑ new size_Pool: 9 existing ❑ new size _ Barn:"0 existing nevb size_ Attached garage:Xexisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: ii Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ w rn s � Commercial ❑Yes �$(No If yes, site plan review# Current Use 11( -�I-�I •D%n Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ` 117 �.�/u��=s !�L,c Telephone Number sv s ¢=2g Address �� I�DX 7(,3 License# 9�l 2-7 3 �-•7/"ZFi2V LC..C,14 ja Home Improvement Contractor# 14-331;S, Worker's Compensation # �¢ �(� /4-?Z- i ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Mal 4 FOR OFFICIAL USE ONLY a APPLICATION# y � ' DATE ISSUED MAP/PARCEL NO. ` ADDRESS VILLAGE ; OWNER ' DATE OF INSPECTION: FOUNDATION , FRAME pj�m INSULATION "� FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING d12 1aCo DATE CLOSED OUT j ASSOCIATION PLAN'NO. 4 Lt � Y L • �' The Coarnroawealdb ojMassachusetts ' 'Department ojlndaslrlal Accldenti k OJjice o1.1 vw7dgadoes 600 Washlngtou Street Boston,�K.4*02111 www.atassgov/dla Workers''Compeassdo® Insurance davit:-Builders/Contrsctors/ElecMclans/Plumbers "'ADD a----rmaNtisi Pri>at Leaibin Name(9ustitesilOrgatt ea notvindivtduai); .��' l 17C P � -L-C _Address: . 70 CityiStatdZip C /._-6CiOi_ca.0 Are >ott ao employed Check the appropriate'bos: I, ham a emplayerwith 4. ,0 1 airs°a gentslrcontrectar and I 1'ype`of pro)eet(rEquh*edjr :,z ernplo trill audlor time • have lured<ttie'sub-contractors 6 ❑New-construction " yeea�'w' hated on the`attiched sheet 7. 2.❑ 1 am a sole proprietor Or patmer- ling ship and have no ernplo ea Wiese sub=contractors have Y 8. []'Demolition working for me in any capacity. clmloYees and have workers' g. Q gwldh addition`;` [No workers'com c p. insurance n4• insuranceJ S required,] ❑ We!"a corporation and its 10.❑Electricalrepairs or additions otlscers have exercised their`` 3 DPI airs=a.:homeowner dowg;all wock. . 11 Plumbing repwW6� dditioas myself.[No,workers'comp.. right of exemption per MGL 12. ..Roof <insurance-required:J;t c 152,{ 1(4),'snd wr'have o0 0repo� errQloyees"[No workers' 13.Q-odler, comp.insurance reytitred:J �MyzappNant thu chxb,boa NI rtwt abo,fiq out the sacpon beloM ahowin theb worken`.cortge�ian PoNeY mfamstioa._ Homcowmea who wtxntt ttii.aBtAav�t indicion i - .,�; � i- � .. � w F., i��e dory aU wak end thm hire aubd�canb�eion nNut wbmit�new NHdwrt indicalini'tuch. tt:ontnctoe thu ehe�k thi•tea eivt uhched an°�dditianal iheet sbowin��th nari"ie of thr'wt►contraceori and�toe;wheFha ar not>thae antitipMw ' engbycea�'If'tlM.wbcaetnctoritwe;ertiVloyeis,dw�'�rnuttpwide=.theh�rorloeea'.e n - •^9 Po�Y,umber - l awow=tweP�Y�`µ�`�Provlrin�workers'eoatpewaaMow"Gut�r�iiet• of-in ' -, ` lnjotwrodow. j r ei�ptoysea, flitotr is ulrPoucy on/Job�r Insurance C,ornpany.Nacne:�� l� SA- . Pohcy`p or Self ins Lic M _7&/U:' L Expiration Date: / Job Site Address SZ. �)C U�(At� - CityiStiwzip �, 7C�21/1 LLC attach:;a copy of the workers'eompenaatloo policy"deeliiratlon page(ehoi►ing't6e'poUcy numtier and a:pitadordste). Failure,,to secure coverage as required under Section 2SA.o f MGL c.:I 52 eaa lead to the;;Unposition of criminal peaalttea_of a fine,up t9zS14-99 00 and/orone !+ear mpresonment;as well as civtl:;penaltlthe:form.ofa:STOP.WORK.ORDER and a fine of up to 3250.00 a day_�4gpiW the violator tie advued tliat,axvpy.of thisstatettxat may be forwartied.to the OfTice of Investittations of tite-DIA.foc insurance coverate<venfication. I do lit►ebr cerNJj►anQer'tbe pofwssawJpiwa/Nei ojper/wryv'tJlor tbt lnjoot/iw pre�laNaabow lsftiruil co'► ct i Q Phone : t�j c a ate only. o not write/n i , arts to u"conk of c or Vww"o,Q7elat City or Town: =Pernt/License 0 Issuing Authority(circle one): 1. Board of Health I. Building Department J.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone M: DATE(MWDD/YYYY) ACORDM CERTIFICATE OF LIABILITY INSURANCE 0411512009 PRODUCER (800)782-0251 FAX (781)261-2099 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC - Commercial ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 77 Accord Park Drive HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Unit Bl Norwell, MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED Capewide Enterprises LLC INSURER A: Hanover Insurance Co. 22292 PO BOX 763 INSURER B: ACE USA Centerville, MA 02632 INSURER C: 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. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY LBN5336555 0413012009 0413012010 EACH OCCURRENCE $ 1,000,00C X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,001 (Fa amurence) CLAIMS MADE rX]OCCUR MED EXP(Any one person) $ 10,001 A PERSONAL&ADV INJURY $ 1,000,001 GENERAL AGGREGATE $ 2,000,001 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG $ 2,000,00( POLICY PRO LOC JECT AUTOMOBILE LIABILITY TBD AUTO 0412012009 0412012010 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1100010015 ALL OWNED AUTOS BODILY INJURY $ A X SCHEDULED AUTOS (Per person) X HIREDAUTOS BODILY INJURY $ . X NON-OWNEDAUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY UHN5336545 0412012009 0412012010 EACH OCCURRENCE $ 2,000,OO OCCUR CLAIMS MADE AGGREGATE $ A 2,000,000 $ 2,000,00 RDEDUCTIBLE $ RETENTION $ 10,OO $ WORKERS COMPENSATION AND C45761472 0411412009 0411412010 WC STATU- OTH- TORY LIMITS I ER MPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 50O OO B ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ 500,OO If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,006 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL Town of Barnstable 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Building Division BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 200 Main St. OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE � C� Ronald CleaveslM ACORD 25(2001108) ©ACORD CORPORATION 1988 00 35,000 cf enclosed pace lA-Maso ify oridy, 1.G-3 2 Famiay Homes ' Failure to possess a current•edition of•the 9 assa,'eh Musetts:;Stabe Bitildmg Code is canse for resocationof this�licen'se. I is -- — =.. k • o b i _ • K aauo�ss�wwoo._ 8097�0�daC�V ltf1�103` . la4/ �� b' 4 - L; 06016 #il • asuaoi�aosinaa;ing uoi;;�n�3suo;�, a spaepueaS pue;su i}eln�a��mpl�!?$3o puegg �lce emvrno... s Board of Standards 1Q]fAff.Cl[k0a/ A11EtJT GO�1TlACTOkt y.'. 143058 --— iwmw Tr# 272627 i i I _�&ability Corpor i , I '��I�r ;�5 j.. Atl�ni,n�scranor i I � i! License or rei-�stration valid for individul use only before the e g r from.date. If found return to: Board of Building Repu'lations and Standards One Ashburton Place Rm 1301 Boston,Ms.02-1 l8 ji. a it i tdw�thtiu,t igna�tu:re Sep 24. 2009 1 : 58PM Valuation Research Boston 1 -617-342-3606 p. l 09/23/2009 15:00 PAX 5084283928 CAPEWIDE @ 002/002 4 Town of Barnstable. Regulatory Services s � Thomas F.Geller,Director Building Division Tom perry, Building Coam9ssioner 200 Main Street, HY321is,MA 02601 wwwAcwn.barnstab1b.ma.us Office: 508-962-4038 Fax: 50rg-790-6230 Property Owner Must Complete and Sign This Section ' If Using A Builder 117n e &1V1 XC/ Me as Owaer of the subject property . hereby authorize C�P to act on my behalf, in all matton relative to.work awhorized bytL6 biuldin permit application for: , zr, ('�0 t ril/ Me Mil dress of job 0 Siguature of Owner ate rri n 4/��/� fc'h� /f T' =Name Q.FORMS:O�YNERYh"RMLSSION . �Z�o9dyS's3 ► I ' I�C� - c C-r v o `=2- Fox r2v� s i 4 C uo G- v Nj G�I�t��u awe s �, .Town of Barnstable ,..:_ CFTHETp� fit`' r tBI P Regulatory Services 0 Thomas F-Geiler,Director * BARNSTABLE * 'MASS. n 9 � Buildl Division cb 1639. �m g .orEDMP'�A .-,--Tom Perry,Building Commissioner " " °200TMam Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PERMIT# G S �S FEE: $ 7— s" SHED REGISTRATION 120 square feet or less o C'C=titI�v«�� X , NIZ- Location of shed(address) Village. Property owner's name Telephone number 1 Size of Shed Map/Parcel# ignature Date T C. Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? � J ..•- Conservation Commission(signature required) 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. I THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 LOT 15 I LOT 16 Ar70'44'30"W 13.88'.. S68'4835"E 143, 48' - i y o o � w LOT - LOT / 2A.3 4 `J�- 2�2�A5E oj: 7Tt ttAicD o �� 0 0 o LOT 6 w o co cn cp o LOT 3 0 'o 84 60 10 E s RUN FOX RES, ZONE- "RC" This MORTGAGE INSPECTION Bean is For FLOOD ZONE- "C" TOWN: _UNT,B"LE - - - _ - - REGISTRY OWNER: RQp�ET g �r NL�91v�IL�,�C1Yf1LTE _ DEED REF: -1012Q 8 - - - - - - -BUYER: _RED'IYANCE - - - - - - - - - - - - - - - - DATE: .�/Z9L9_6_ - - - - _ - - - _ PLAN REF: ,326Y73 _ - _ - - - - - SCALE: 1-"-=-50- -' FT. I HEREBY CERTIFY TO P-LZ&QLf1H_AO9RTCAfE YANKEE SURVEY ___THAT THE BUILDING �y��� �F CONSULTANTS SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN AND THAT ITS POSITION DOES _ - CONFORM ��� PAUI. ti INDUSTRY ROAD 40B (SUITE I) TO THE ZONING LAW SETBACK REQUIREMENTS OF THE �gRRHEyy �, TOWN OF ---$B$�fZ-------------AND THAT No. 32099 IT DOES_ NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD MARSTONS MILLS, MA. 02648 �fClST�R�� AREA AS SHOWN ON THE H.U.D. MAP DATED_�?�,/�Z \,f+r,�, SJ0 TEL: 428-0055 Communitv- .4 ?50001 0011 D `'� °a< <��+`� FAX: 420-5553 41 , 1ti�.��_______ THIS PLAN NOT MADE FROM AN RUMENT 13A17L A.-MERITR{ PCS SURVEY NOT TO BE USED FOR FENCES ETC 22597 ✓F TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION, Map Parcel G �"i Permit# T 3 Health Division /�S��J/ �/` GI�-/— j"', Date Issuec l, Conservation Division k ` 6 ! R , Fee �> ' 1 Tax Collector; - Treasurera�cn_Q6' CP SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address - -0X +w� f•-, Village Ce--J Owner Pp6 L°y Sc V/ Address . a X 1Py� Telephone Ok 79 D 3 95 6, Permit Request 00 Square feet: 1 st floor:existing proposed 2nd floor: existing proposed Total new /� ac Estimated Project Cost !�e D�' Zoning District Flood Plain- Groundwater Overlay Construction Type L-)q.L Ufa q L Lot Size Grandfathered: ❑Yes. ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 4 Two Family ❑ Multi-Family(#units) Age of Existing Structure 'YX_S Historic House: ❑Yes 4 No On Old King's Highway: ❑Yes No Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /100 f Number of Baths: Full:existing - new Half: existing / -new L Number of Bedrooms: existing L _ new Total Room Count(not including baths): existing new First Floor Room Count Heft Type and Fuel: ❑Gas IQ Oil ❑ Electric 0 Other Central Air: ❑Yes P No Fireplaces: Existing New Existing wood/coal stove: ❑Yes- 4No 7 Detached garage:O existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:40 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name ICI Telephone Number Address �U ��e �e T h o License# O D 6 3 Home Improvement Contractor# Z®G 00 9 Worker's Compensation# r ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE _ �- FOR OFFICIAL USE ONLY PERMIT NO. ��• l � " DATE ISSUED,' MAP/PARCEL NO.. _ 'ADDRESS VILLAGE OWNER." z , DATE OF INSPECTIO t FOUNDATION FRAME V t 'C INSULATION - • ' " f�. - ` _ � ..' - FIREPLACE ELECTRICAL: ROUGH FINAL ` z- m f PLUMBING: ROUGHrO p FINAL T ,.s # • r y GAS: L 'ROUGHI--' -,: FINAL - o -r leFINAL BUILDING DATE CLOSED OUT •,< ' ASSOCIATION PLAN NO.ri 1�; or t�l - The Commonwealth of Massachusetts _ �s- _..• . Department of Industrial Accidents :i�l =-:v�•L Office offnyestf9JUVOs 600 Waslungton Street Boston,Mass. 02111 ` v Workers' Com�lensation Insurance Affidavit ' �//%!%//%//�%%/%//% '. """, ".."Y'Y' %%!% name: 4t c4e—o ��'ew p.S t F location: 57� /d/V-- A/I- city C w��2vt C ki 4- phone# �0 (��� ❑ I am a homeowner performing all work myself. (�I am a sole proprietor and have no one workingin any ca acity %%%%%/%%///////%%G/%/%/%%%/%%%%%/%//%/G/%/%%%%%%��/��%//%%/%/%/%%%//%/%/%�%%%//%%/.:;;;:';'; ❑ I am an employer providing workers' compensation for my employees working on this job. comnnnv name: address: :. :•: city phone#- insurance ca. nolicv# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the folloning corkers' compensation polices: company name: address: city phone#:.. insornnce ca. _.... : no rev#.. ;:::.,.::.::�:.::;.;:.;::;•:::.,,.... company name: ::.•. .....:......:.....:.::......... .. address: cite phone M Insurance co. oiicv# :.:,.,..;:::...:::: // FaGure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of c riminal penalties of a One up to 51.500.00 and/or one years'imprisonment as wen as civil penalties in the form of a STOP WORK ORDER and a One of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the OM of Investigations of the DIA for coverage verification. I do hereby c rtify under a pains d pe ies of perjury that the information provided above is true and correct Siouture Date Print name fl C !G Gr�/��✓ � � �✓Ql�l Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building DD ❑Licensing B ❑check if immediate response is required ❑Selectmen'❑Health Dep contact person: phone#; ❑Other (muea 9/95 PJAI Information and Instructions Ir 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 contr.::. 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:c: 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 renews: 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 pernut/license number which will be used as a reference number. The affidavits may be retuned 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 9ffflaxnMumMberEMK The Commonwealth Of Massachusetts Department of Industrial Accidents emce of lowdstloadolls _ 600 Washington Street Boston'Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 oF� The Town of Barnstable • a�arsres�. • Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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: f'u L-� An) L Estimated Cost Address of Work: �e%/ C 12fe 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 age of the owne : Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affrdav 1 wr• --� - SIL.•11G Q+ TN[lK1R[•O aECDRD YLL K:MIl'QIILL JAT TJK I0 SL USED Ea AIR ftlRML. • n V•r 3 �. PLANS FUR L.ocAnons c a►�� �� a arKEx rrENLs�+ I �Y.'.� _ e- 1 1. eRAcel _J I I I 1 M GJLGALVATm Y IRMEL RSRICATl g.. - PRE- SI AASSEMBLYY x (peGOiAL�BpR/A�f� MID Y� WEVAND VI IdTMlEOt55 rig �pLAFtS FOR&A S® / TIfFICJtI. E-FABRICATED VINYL. LINER STAIR Aesvnr 5-3,Wo Y.BOLTS•• 6OT1ER TTENSN 8RACE STAR LNE NUTS AMD TAIEri1F36„ n IR wSSFJ+BLT VVIINYYL.L� { 1�+TLLadw STAR!LRE CEGQ MsTEm aTAR LAW NUTS�i°° s ..ESKERS T ..E,L T SERIES 550�650 STAIR CORNER I. � SERIES 750 STAIR CORNER n SERIES 850,950 G 1050 STAIR CORNER n R PLOW >E � � � —► — — —1 'A'F11AYE AssEVBL1' . i ; v•= R , 2 I i1TER -� —f - 2 + LTYPr., MAF71E SHOWN > i.i�• 1 I PERIIAIEN'TLr F —► -- ►'— ►—� RETURN 2 Y Low I I Y 3 W EP04 aD1FER�LY 1 r � I SAFETY LANEtSF1AOED•OIITIQ6 I t n SEFTTS I. SHADED PORT1016 1 EL.AT AREAS Pump AW-1 MOTOR I ti. K n3 � � I _ FLQ YC•A PIlE�71TE ' OD Q m , m t i I STADIS AM ' co G L----► ———�' MAY BE ML art f,01/,ER C 9.2< SF SLREF AREA• CAP L rATED AT I SUCTION . m •5.a7 .SF SUIEAREA b.Jfil34P 4L m P06TTOIiS - j� . —WK3G tA5_ SF SURF AREA 6 2M=LC U_CAP X'rORZ' v"' m m -2Oi-*O_Z2L SF SU F AREA&2♦11=SAL.CAP 'L— �_———J 2 - 2000 6 2050 INGROUND •A•FPAIE ASSEARAY e O TER - PU PAW - - Sae SmMm.Ok4W M4 SF,SUiF-AREA6J!NDO WL.CAP. Trvlcx IFIIERE SHOWN ID ��� '' Swum ARE OF" `firPVYSAANE ATT=IEi `� ► --——~ —/rL�'',`�''�� — TL,aI SERIES 2100 8 2150 INGROUND sLTE yla,I, ,,. �.E-�`:E slwE.� 20028 FYI•.,C" t I® - v SERIES 2000 82050 INGROUND PEwAN[9NILr 1 ATTAOIm SAFETY LNE . I rsKh=PORTIONS w AREAS i o=� w n - - RETURN F`G.� /,•o/� 'A'FRAME ASSEMBLY orn -A7�H �d e.N'i -nir, ,N^Y.tt �Lm., , •V i t-.iu LOT 15 ( 1a7T 16 1086'- 5664935E 143 48' N7a a4 30" . i ` a, O LOT / 5 LOT y�' yQ1 \ i PooL_. LOT E tD � Q LOT 3 Q - oo,10 as pox R6S ZONr OKI This MORTGAGE INSPECTION ° oftiv FL000 aaN� "c" R S Y OWNER $ � &A ' h —BUYER: �6 d-Mj a..91� P REF 3. = H c2rnpY TD _ -y- W tM a• YANKEE SURVEY THE BUILDING CONSULTANTS SHOVN ON TNIS PLAN I3 LOCATED ON THE GROUND AS � SH01PN AND THAT tTS POSITION DOES CONFo RM 40B (SUITE I) ta TO THE ZOMING LAW 9E4B CK R QUlts�rlTS Off' "E � )� INDUSTRY tIOAD TOWN OF `,A8�_____—..,_,_---AND THAT IT DOES..��tlw._ UE VWN THE SPICIAL FLOG KAZARD e�Sst� uatt3 TEL t 20_ 0 'ore-a AREA AS SHOWN ON THE li u MAP DATED.N__ *� 'fl4L a2S-aOS� 1" a HM PLAN rca 185441 DPG TOTFL P-01 fie �arrhreoouura o����aaaac�iuveCl� DEPARTMENT OF PUBLIC SAFETY CONSTRUO.10#SUPERVISOR LICENSE i Nua6er Expires: -- Restrseted�0 00 _ R ICKARD SENOSK I *•.'is Vu&00 PEEP TOAD RD CENTERVILLE, KA 02632 7771, k ,per �'�` �'he�oo�,e�xam�ea��✓ltaaadeuaefla -IMPROVEMENT:'-CONTRACTOR 4 Risgistralrion_ 10606 TYpe INDIVIDUAL Ezpi ratio m =-.01/21/00 4RICHARD T SENOSKI 40 Peep.Toad Rd ecvi11 NA.02632 ADMINIS1RAMR %78 � �►�,, The Town of Barnstable Department of Health, Safety and Environmental Services Building Division W 10�' 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration Date Name: FoC3e-TzT- Scn-1Vt1'6- Phone#: Address: 5-2 FOX (ZU AJ village: Type of Business: R lf J-�N &-ZVVt7 L--T-AC\Nb Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4.1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwellingwhich are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. ' • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering Appcant:.li (� Date: l(3 -- - Homeoc.doc t -St u.1 [DATA i3 �uGt. F.avlt��r • 3 essao�oM �8 . �- �n nGA t t..Y fit. / s 11 O X RM -' T •c-AJ-4 W. • .�3v x i�0 o = 495E Ur 000 _�IsPCSa AQUA/ � PtT u;E GAL, ` SttQWALL AX" e...ISO s,2 ToZ'a;` MAX . . . . .. :.:. 7i o- BAXT NO.Mots • i u "TSY P.438 . ;. . FAX �'uA1G -30 �.. T oP Fug _ 2 ' Cc•2e B iC� ''mom err 'tIZ 4•v.� _ �.... Svc 4li�i vKr / .4A.L. 27,G a I � L Sort. 27.4 SeFTIC 17u1G i f • ¢i loco 2G wa. . k Z j t tAGW ii PIT HVITt1 S.a� t f , IE2T t Ft QD PL.oT!" pt_A 1,.1 P120 Fr l.E Y +"� +' U6QGA►TIONVt �Q/G {Jp Se•4tis do 4,V d7C� y. 1� •., n . I2�r`3� L- l CwcrtF*f r"AT T14E Poo+,MATI oW Srt-laww I' ►- IMCM 061.1„ G��c P�-Y S W I r" TtaG.� rstOE%-%"lb& '• �. C� AND 4 —T'; ACV. OF TYE P, . "1 PATE. 9 _ �--y-,.. . .. � `` ►mac,. to=z tL TW4 ?L ! ler MaT $aSED O1.t lit,! 1u4TP.oA4WT OciTrixVtt..t j- :5deves►v TtiC OGt=5F1'; uoT ISLE U,$ex> APPI-;C. y, n To -pt:.Tr-Tr LoT LtIJ6;. E • ,Asselor's map and lot number �. j •( �o•Z. ,. y0F TH E Sewage Permit number .... ....... ........,r......... - ..INSTALLED �'-• � ._ �. fO a House number ...... . - ���� �� � J. ... BasasTa B. ENVIRONMENTAL C1j®E Du Ar� . TOWN OF ;f,BARNIS7M, - BUILDING INSPECTOR Y f ; 4, ° APPLICATION FOR PERMIT TO 1,;_S�..U8.7rWC-.1....QIA,56...F,.:7 A�.�... CJ� \ l TYPE OF CONSTRUCTION` ........... -%t . .... .`CC3,. ."e............................................................. . .... .........19251. '• _t TIDE I'NS'C>!ECTOR—OF—B IlDbNGS. The undersigned hereby'applies for a permit' according to the following information: Location ............... o.l...' � ...�+.. .............�`� :Ii�. .7C �. !_1.1✓..,. ...... ,1W C.` . . .s. n. .Proposed Use (� ..... .... ..............................................:......................... ........ . .1...... ......::. .... , Zoning District •.................... ....•......... . .. `�-...... ..Fire District .�, 1(, 1���`�'•. ..... ... . ........... ... ...... .. . Name of OwnerQY.1. 3 �C&.pp��.�! ... ...Address ......1.F.`�t....7 .. j.!' `T .!............� Name of Builde .....L ...............Address ....1.®...e.D.C. �d A44l.�y..��i�.t�.�`� Name of ArchitectC..,� -C .tP ........Address .......... f�. f1 .�.. y� Number of Rooms Foundation P .. ` r: �' fJ l/C .RoofngExterior '..... Q . . � � Floors AM0,0 �..�:. :...�...�Mnterior �«5... ..�[�4.�:... Heating ....tt.A� W-: ..... ..`:C,,,..............................Plumbing C� .. �.Y............PWC............................. j ...........................................................Approximate Cost ............... .Fireplace ..................... . Definitive Plan Approved by Planning Board ________________________________19--------. Area. ...1...�1./ ... } -.:.:. Diagram of Lot and Building with Dimensions - Fee t.... :..... SUBJECT TO APPROVAL OF BOARD OF HEALTH .® IV a � 14b I hereby agree to conform to all the Rules and Regulations of the Town of Barnstab reg ing the above construction. Name .... ORIZON PiROPERTIES OF CAPE COD, , �23549 Two Stor Permit for ! Single Family ,�wellin € .............................. .....................�.............. * Location Lot # 52.. Lill::. h , , .Centerville T ............... Horizon Pron Owner .. ................. ertl r _ ..........L............�S. .Q�..Cape �„��� Inc T e-of Cons uction,. F rzXl�.. ! } ...................................... ............. :...... Plot +ter............................ Lot ....................�..� Octoper 1 ill Permit Granted ........ .. ..... �. Date Anspection�9" ........n......19 Date Completed ✓.:,t!�£. �.... 1`9 F ERMIT REFUSED h .......... °w ............................................ r try -t . j x 71 Approved .. ............ . .. .. ---K.... 19 } _ . ................................................. :U .............. ..%: ..... ......... .. .. ............ ............................ Assessor's map and lot number 10*TNEropy Sewage Permit number ..... .............................. EA"STAME, House number %6 NAG& TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO (CAL AxI-9.....T,.k.4, K.q. TYPE OF CONSTRUCTION ............... ................................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..............Lo-�- �- ) k..? .................................................... ........................................... .............. F , Proposed Use A ................................................................................... ct .......Zoning District ...............................�.C�..............................Fire District ........�4.-Ac ...... t Name of Owner Address ......... .. ... Name of Builder ... .4........ ...............Address ........ .... ......... Name of Architect ...........Address .......... ..................... Number of Rooms ......................... ......................................Foundation ........Tp. ........ . .................... -74 tT.............. Exterior Roofing ...... Floors ... &"ff....r-ev..VOIJ16—terior ..... ......... A 57tW.. ........... Heating .... ...................................Plumbing .... ............................. Fireplace ............... ...."..."Approximate. Cost............... .............................. Definitive Plan Approved by Planning Board --------------------------------19--------- Area ........................................... Diagram of Lot and Building with Dimensions Fee .........................n... ..... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstabl regarding the above construction. Name .. .. ... ....... HORIZON PROPERTIES OF CAPE COD No .�3542... Permit for ........... ........ aci ke...Family,, Dwelling,,,,,,,,,,,,, 52 Fox AL Location ... ................... ................ jCente , .. ....................... .51yLl X.q........ ................... 1ProDe ties Owner .. Horizon Properties...............p;�...Qape .Cod Type of Construction ....F.r . . ........................ ............................... ........... ........................... Plot ................... Lot ................... .......... Permit Granted ..O.c.-toblir..13.......:19 81 .... ........ Date of Inspecti•n ...r.......... .....................19 Date Complete l\.............i .....................19 RE SE® ........................ ........ ........ .................. 19 PERMIT.... .................... .... .. .. ... .......I :o:03.................... IN V ................ ................................ r ......................... ...... .............................. :� Aoz� no.. a ...... ........... Approved ............................ 19 ............ �00 ............................................................................... ............................................................................... K. , ,,� d..,3T , OF 5' f o?C 1Z�N C'EAIir;�v�cC�� �F 3 •n o TlcZze Z �vul�I N(9 AN T A-C(ZL—5 5L Fix r 5�