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Ul, } ifdi'1 � ip 7 (. n rr �1 7' ( 1 ', Town of BarnstableBuilding , p wtv[�rn 's Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept "' Posted Until Final Inspection Has;Been Made. Permit 039 e a e T }R`a aired,such Buildin shall Not be Occupied until a Final Inspection has'been made. t Where a Certificate of Occupancy is R q -gig „oyq Permit No. B-19-2164 Applicant Name: Henry Cassidy Approvals Date Issued: 07/03/2019 Current Use: Structure Permit Type: Building- Insulation-Residential Expiration Date: 01/03/2020 Foundation: Location: 270 GREEN DUNES DRIVE,CENTERVILLE Map/Lot: 24S-026 x Zoning District: RD-1 Sheathing: Owner on Record: BROUILLARD,JOHN C& ELAINE F Contractor Name"-,HENRY E CASSIDY Framing: 1 Address: P O BOX 412 Contractor License: CS-100988 2 WEST HYANNISPORT, MA 62672 �. Est. Project Cost: $3,300.00 Chimney: Description: Insulation ` Permit Fee: $85.00 4, Insulation: x; e i J Fee Paid:0 $85.00 Project Review Reg: i ' Final: Date: ,�' 7/3/2019 Plumbing/Gas Rough Plumbing: -- � `'A:Building Official Final Plumbing: v This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after-issuance. All work authorized by this permit shall conform to the approved application and the`approved construction documentsfor which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structuresshall be'in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or,road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. ` Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire`Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing "p Rough: 2.Sheathing Inspection - 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund." (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-,ISSUED RECIPIENT 0 Town of BarnstableBuilding BA s Post This Card So That it is Visible From`the Street-Approved Plans Must be Retained on Job and;this Card Must be-Ke MSTA pt am a Posted Until Final Inspection:Has,Beeri Made., ; er it Where a Certificate of-Occupancy is Required;such Building shall Not=be Occupied until A Final Inspection has,lioen made. '- Permit No. B-16-2361 Applicant Name: Russell Cazeault Approvals Date Issued: 07/16/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 01/16/2020 Foundation: Location: 270 GREEN DUNES DRIVE,CENTERVILLE Map/Lot: 245-026 Zoning District: RD-1 Sheathing: Owner on Record: BROUILLARD,JOHN C&ELAINE F Contractor Name: ,PAUL J. CAZEAULT&SONS, INC. Framing: 1 Address: P O BOX 412 Contractor"License: 103714 2 WEST HYANNISPORT, MA 02672 Est. Project Cost: $21,500.00 Chimney: Description: Remove existing shingle roof on remainder of roof not already Permit Fee: $ 159.65 complete and replace with new GAF HD architectural asphalt Insulation: shin les. F, 7' Fee Paid S 159.65 g € Date. f'F 7/16/2019 Final: Project Review Req: FIRST MADE AWARE OF APPLICATION 7/16/2019 Plumbing/Gas Rough Plumbing: ""Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within'six months after issuance: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for,public inspection for the entire duration of the Final Gas: work until the completion of the same. e -- '` Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials aie;provided on this,permit. Minimum of Five Call Inspections Required for All Construction Work:) - Service: 1.Foundation or Footing f� Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough:- 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. - Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund11 (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable VVV *Permit# 150t&N Expires 6 months from issue date Regulatory Services Fee on 0a * snxxsTasLE, MASS.1 . ,0� Richard V.Scali,Director ArFp�,�a Building Division z1aA ftst? Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601. D r Z www.town.barnstable.ma.us �' �� 1 6'Z ! 740? qj Office: 508-862-4038 ®W/V OFF Fa 08-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL � AB� Not Valid without Red X-Press Imprint Map/parcel Number 9-45 /O Property Address L--7v D Uej 0 S -DQ 1 v L;: G 1 1- esidential Value of Work$ 1&OGd Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address l-tN t5�o v I L -.�-� PO Sox q/a w. H> �1-1s Po►92-7-1 MA- O -z677Z Contractor's Name A V L-J. CA ZC A U L-1'' -4-- Sc_,3N-S" Telephone Number 56 S- Lf ZU—%I_T+ Home Improvement Contractor License#(if applicable) Email: l Construction Supervisor's License#(if applicable) S (u ( s r4- ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner �ve Worker's Compensation Insurance Insurance Company Name L-+ Lo 1_.-P Workman's Comp.Policy# kf C— J - i S' 349 66 -q-6 02- Copy of Insurance Compliance Certificate must accompany each permit. Permit Request heck box) e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to yAJ�MOUI} ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is required. SIGNATURE: C:\Users\DecollikWppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIO I DHR\EXPRES S.doe Revised 040215 1 :h I 1 f 1 i Property Owner Must Complete & Sign This Form i If Using a Roofer I Builder. i I (print) v as Owner / Agent of the subject property hereby authorizes Paul J. Cazeault & Sons Roofing Inc. to act on my behalf, in all matters relative to work authorized by this building permit application for: Z -7 0 6r�e� b0"le- SD4- Gn01s d0 AddressofJob Signature of Owner C �.`. Mailing Address of Owner X Telephone # 150,�; ` -73> 1'--Z9 l o Date Please return this form to Paul J. Cazeault Roofing along with your signed contract. It is needed for us to obtain the building permit required by your town to complete your roofing project fax#508-420-4555 office@cazeault.com r y 1N. --- —_ ��d'?�% fll�?ie'd'��•��•��.��'C�Li�'�. f�- �'��Y.J<:�•��i�i��i�E��d�C[�: -_- Office of Consumer Affairs and Business Regulation 10 Park Plaza -- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 103714 Type: Supplement Card Expiration: 7/9/2016 PAUL J. CAZEAULT & SONS, INC.'. RUSSELL CAZEAULT ----- -- ----- 1031 MAIN ST -- OSTERVILLE, MA 02658 Update Address and return card.Mark reason for change. 6CA i 20M-05111 Address Renewal ❑ Employment Lost Card k�-=—Office of Consumer Affairs&Business Regulation License or registration valid for individul use only lCME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation j Registration:.;1,0371.4 Type: 10 Park Plaza-Suite 5170 Expiration ;::7j9120.16::_ Supplement''ard Boston,MA 02116 PAUL J.CAZEAULT&'S0NS;INC: RUSSELL CAZEAULT:: 1031 MAIN ST OSTERVILLE,MA 02658 Undersecretary Not valid withovInature 1 Massachusetts - Department of Puuiic Safety Board of Suiiding Regulations and Standards Construction Supervisor cease. CS-108157 RUSSELL CAZEAULT.. 2071 MAIN STREET _ > i Brewster MA 02631 ✓.�,-� .11�,G EXo?;at4on, Corvim ss4nr,er 11123/2018 The Commonwealth, of Massachusetts K Department of Industrial Accidents a I Congress.Street,Suite 100 Boston IAA 02114-2017 www Haas..gory/dice Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers— TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please]Print Legibly Name (Business/Organization/Individual): P0,4t-( �� C --2-0— �44- Address: 10S/ M `� City/State/Zip: OS Phone#: J0 09'`-(25 1 3 Are you an employer?Check the appropriate box: Type of project(required): 1. 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.] 9. El Demolition 3Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]' 4.Fj 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 I I.❑ 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.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance.' 6.❑We area corporation and its officers have exercised their right of exemption per NIGL a 14.�er 152,§1(4),and we have no employees.[No workers'comp.insurance required.]- 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: WC Jam' 3 L — j.` 66 a b Expiration Date: Job Site Address: City/State/Zip: 11V- �''�f►nO� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. f do hereby certify under thepains andpenalties ofperjury that the information provided above is true and correct 2 S i ature: Q Date: Phone#: :�71 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building(Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 78/11/2015 TE(MMIDDIYYYY) ,a►co�rn® CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER-THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES.NOT CONSTITUTE,A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. .. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement."A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER DOWLING & O'NEIL INSURANCE AGENCY INC` •' NAME?cT � 973 1YANNOUGH RD PHONE FAX PO BOX 1990 AIC No xt• A/C No): HYANNIS, MA 02601 E-MAIL ADDRESS: INSURER(S)AFFORDING.COVERAGE 'NAIC# , INSURER A: LM Insurance Corporation 33600 INSURED INSURER B PAUL J CAZEAULT& SONS INC - 1031 MAIN ST INSURERc OSTERVILLE MA 02655 INSURERD. r - INSURER E INSURER F: .. •-:: - _, - .. .. COVERAGES , CERTIFICATE NUMBER: 25918664•, REVISION.NUMBER:' ■ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR•THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER.DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY.THE POLICIES DESCRIBED HEREIN IS SUBJECT'TO`ALL`THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER - .POLICY EFF POLICY EXP LIMITS . LTR -POLICY NUMBER MM/DD/YYYY MMIDDIYYYY COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE 1-1 OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ - { { PERSONAL&ADV INJURY. $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO JECT ❑'LOC r -# _. PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY - -- - " COMBINED SINGLE LIMIT $ _ -. Ea accident ANY AUTO - BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB !OCCUR - - } EACH OCCURRENCE $ EXCESS LIAB 'CLAIMS-MADE - _ �. ¢ AGGREGATE - $. DED RETENTION$ - $ A WORKERS COMPENSATION WC5-31S-386670-025 8/10/2015 8/10/2016 STATUTE EERH AND EMPLOYERS'LIABILITY - - - ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N • E.L.EACH ACCIDENT $ 1000000 OFFICER/MEMBER EXCLUDED? ❑N NIA - - . - (Mandatory in NH) - E.L.DISEASE=EA EMPLOYE $ 1000000 . If yes,describe under - - DESCRIPTION OF OPERATIONS below - " - - E.L.DISEASE-POLICY LIMIT- $ 1000000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) WORKERS COMPENSATION INSURANCE.COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION, SHOULD ANY OF THE ABOVE.DESCRIBED POLICIES BE CANCELLED BEFORE PAUL CAZEAULT 1 THE EXPIRATION DATE _THEREOF, NOTICE WILL BE DELIVERED IN 1 031 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. OSTERVILLE MA 02655 - 'AUTHORIZED REPRESENTATIVE LM Insurance Corporation` o ©1988-2014 ACORD CORPORATION.All rights reserved.' . ACORD 25(2014/01) The ACORD name and logo.are registered marks of ACORD w ' s 25918664 1 1-386670 1 15-16 WC 1 shankar.gadaleolibertymutual.com 18/11/2015 4:45f09 AM (PDT) I Page 1'of.1:: - 3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION.,, Map Parcel Application# 0 5 Health Division Date Issued 6 Conservation Division Application Fee i Tax Collector Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board r =,' Historic-OKH Preservation/Hyannis Project Street Address 2-70 Village L2,3 s- V Owner ��e,— r W ' � � �� /,ri e Address �ytAn-C `��► �h�� Telephone � � ` 2 Permit Request y�-a cat 1 _ ° TG r� k, _ CCc�� he, Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District // Flood Plain Groundwater Overlay Project Valuation Q/ Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Y ze.,r5 Historic House: ❑Yes No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: -Zoning Board of_Appeals Authorization—U Appeal_# _ __Recorded-❑- Commercial ❑Yes ❑No If yes, site plan review# Current Use yr -e. 1--'Z. Proposed Use BUILDER INFORMATION Name Z�� K) k.-, _Sc jA Telephone Number Address 6 License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO CC-:)n7�2-l n e -e- s u SIGNATURE DATE FOR OFFICIAL USE ONLY ` APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION F FIREPLACE ^ ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 2,1 0-9 DATE CLOSED OUT` EF < ASSOCIATION PLAN NO. F. ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington Street Boston, MA 02111 , www.mass.gov/dia Workers"Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information )) ) Please Print Legibly Name (Business/Organization/Individual):. Ge r1)4 0)-Xl . —5 G•h'I /'Z,e✓ Address: r S• City/State/Zip: Phone.#: �5- 7-7 Are you an employer? Check the appropriate box: Type of project(required):, 1. I am a employer with 1-- 4. (] I am a general contractor and I employees(full and/or part-time).* have hired the stab-contractors' 6. El New construction . 2.El am a•sole proprietor or.partner- listed on the-attached sheet. ; 7. ❑Remodeling ship and have no employees These sub-contractors have g• E]Demolition workingfor me in an capacity. employees and have workers' , Y P tY• $. 9. []Building addition [No workers' comp. insurance= comp.insurance. 10.❑Electrical repairs or additions required.] 5. 0 We are a corporation and its t officers have exercised their 3.❑ I am a homeowner doing all work 11. Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12•0 Roof repairs insurance required.] t c. 152, §IN, and we have no employees. [No workers' . 131-1 Other comp. insurance required.] . 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. iC6ntractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policynumber. Iam an employer that is providing workers'compensation insurance for my employees Below isthe policy and job site information. Insurance Company Name: �7 tJ � � � Policy#or Self-ins.Lic.#: l 30 Expiration Date: Job Site Address: �`-� �l-ems L , t4 Mz: City/State/Zip: for Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date), Failure,to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP.WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investi3zations of the!)IA for insurance coverage verification. I do hereby certify:ender 55.the ains-and penalties of perjury that the information provided above is true and correct: Sienature: Date: ' f 0 - 0 Phone #: Official use only. Do not write in this area,A7 be completed by city or town a 1 tcial City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: �TME,, Town-of Barnstable yP °� Regulatory Services * sARrrsresu�, x Thomas F.Geller,Director MASS. BOding bivision Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax; 508-790-6230 Permit no. Date 1 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. k'4 ryIn•Type of Work �/<P:w,,, �C Q Estimated Cost ,Address of Works-�,� Owner's Name: ��/Q f a ��[� ! V 4 Date of Application �" d I hereby certify that: Registration is not required for the following real on(s): ❑Work excluded by law []Job Under$1,000 []Building not owner-occupied ❑Owner.pulling own permit Notice is hereby given that: OWNERS PULLING'THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO TBE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES.OF PERJURY I hereby apply fora permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name I ti�F ' ti Town of Barnstable: Regulatory Services eBi,E,$ Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-403 8 Fax: 5 08-790-62 3 0 Property Owner Must Complete and Sign.This. S e ction If Using ABuilder as Owner of the subject property hereby authorize /�1 �� 11�9 Vj,/—Zlc�" to act on rnY behalf, in all matters relative to work authorized bythis building permit application for, . 2 70 arc en un I,Je s (Address of fob) Signature of Owner Date Print Name - Q:FOP�S:OwNERPfiRMI55I0N Results Page 1 of 1 f Home Improvement Contractor Look Up .Enter Search terms separated by spaces. Search terms can be Town/City, Name, or License number Select Search type: AND C OR Search Results Reg. No. Applicant Street City State Zip Name Title Ex iration [�4 FITCHBURG102943 MAS R. SCHULZETOWNSEND 01469 Schulze, Thomas President 7/3/2008 THO CUSTOM BUILDER RD. � I 112049 SCHULZE B CEDING CROCKER ST 65 CENTERVILLE 02632 V IHLLI � OWNER 2/19/2009 CO., �� 151550 WILLIAM G. 370 MAIN STREET WEST 01474 SCHULTZE, OWNER 6/9/2008 SCHULZE, ENT. LLC TOWNSEND WILLIAM Total of 3 Records matched. Back to Home Page BBRS Privacy Statement http://db.state.ma.us/bbrs/hic.pl 9/11/2007 I tole] , THE INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA 75190-0000 WC 683-89730 13889 --------------------------------------------- 013-82-0507-00 a••.•• -. PENNSYLVANIA P O CHULZEBOOX 288BUILDING COMPANY LLC Member Companies of CENTERVI LLE, MA 02632-0000 l4M American International Group EXECUTIVE OFFICES: 70 PINE STREET, NEW YORK, N.Y. 10270 SEE NAME AND ADDRESS SCHEDULE - WC990610 I.D# MA QI#d ., ,,• PMC INS AGENCY INC WORKERS COMPENSATION AND EMPLOYERS 50 CABOT STREET ' LIABILITY POLICY INFORMATION PAGE PO BOX 920179 NEEDHAM MA 024 2-0002 INSURED IS PREVIOUS POLICY NUMBER LIMITED LIABILITY COMPANY RENEWAL 008940 48 OTHER WORKPLACES NOT SHOWN ABOVE:SEE NAME AND ADDRESS SCHEDULE - wc9go6lo ITEM 2 POLICY PERIOD 12:01 A.M.standard time at the Insured's mailing address FROM 05/1 1/07 TO 05/1 1/08 ITEM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work In each state Iisted_in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 500,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ ;00,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed hero: AK AL AR AZ CO CT DC DE FL GA HI IA ID IL IN KS .KY LA MO ME MI MN MO MS MT NC NE NH NJ NM NV NY OK OR PA RI SC SD TN TX UT VA VT WI ITEM 4 The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Estimated Total Rate Per Estimated Remuneration Premium Classifications Code Number munerat on Annual ❑3 Year 0 Annual E1 3 Year SEE EXTENSION OF INFORMATION PAGE ,- WC7754 TAXES/ASSESSMENTS/SURCHARGES $562 c EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) $284 MA MINIMUM PREMIUM $500 MA TOTAL ESTIMATED PREMIUM $1 3,8 2 3 If indicated below, interim adjustments of premium shall be made: Semi-Annually Quarterly Monthly DEPOSIT PREMIUM END ORSEMENTS(FORM NUMBER) SEE ATTACHED FORM SCHEDULE - WC990612 03/24/07 PARSIPPANY 82` Issue Date Issuing Office Authorized RepresentiLtive- we 00 00 01 39907 INSURED'S COPY 9 Lewis and Weldon Custom Cabinetry Elaine Brouillard 111 Airport Road 270 Green Dunes Drive Hyannis, MA P.O. Box 412 508-778-5757 West Hyannisport, MA 02672 Fax 508-778-6111 [09-07-07] 608-862-2452 Cell 508-737-0662 #3 Not To Scale 169 15/16 m 1 24 13 518 48 13 5/8 2s 1n 13 113 I/A 131/ 1 24 1/2 21 6.0 „ 2=34,. 6 221/2 rz 6 3/412 4 251/2 13 1/4 8 tjgl -14 33 � 6 31411 ' Custom Elite Frameless Euro 131/4 y.. Shaker Flat panel with Applied [z`s a/a 251/2 molding Inside edge. _ #9 Frosty white with Carmel glaze.Match sample door. �#6 15 221/2 217/ 2 3/4"Ek21 Crown with 3 1/4"Band molding. 271 251n13 1"light rail to match door outside edge. 24 1 /2 21 1/2-1 141/61/4 14 1 1/2"Cherry wood countertops on desk #2 ad 035 L 3 i1 #4 and bookcase. 207 dppq 207 99 �24 . Ionian style Cioumns ---° `' �3/4 1 `521066/2 ,.DO r 6 %16 1I I - -2 24 �; #,o -11 17 10 4.� - 33 3/430 1/4 4 . a 1/4 13 251/2 a,��761351 7 13 1/4 43 9 29 Qe27 - 6. #7 47 718 13 1/4 16 483/164 621351 L; -251/2- -21- #1 #5 " 27 3/8 27 7/8 Lewis and Weldon Custom Cabinetry Elaine Brouillard 111 Airport Road 270 Green Dunes Drive Hyannis, MA P.O. Box 412 508-778-5757 West Hyannisport, MA 02672 Fax 508-778-5111 [09-07-071 508-862-2462 Cell 508-737-0662 Room 1 - Wall 2 Not To Scale sr'to left edge of trim 3 upper built in ep's 13.25 w X 48 ht 2.875 S & R 9.75 top opening I 107.75 to center of window 1 base built in 24 w X 30.5 ht —43 - t window size with trim 1 Restoration glass door 81.5" Wood shelves 3 43 3«--17�_ —163/4—«--163/4---» —24 « +�---- _ �. .. ,strz I/ \at 1/2 46 1/2 10 11 12 9 ..Win82 / \ 151/2 151/4 `,151/4 145/32 \ 3 net re set 53" off a floor �� \ t07 - 9 so that h 1 IEght rail, ere is 16 171/4\ between ht rail and c nterto Cutlery Divider e in top drawer Super Susan 1 va Gs 1i4 o s 1i16 2-Tilt out trays ties o s 1i1s o s 1118 24 Ili3/16 i' 11 13/16 29 341/2 341n 34 1/2 0 \ 341/2\ « /22 p 8 9 11 3/8 --,,2 Rol - 233/1� 233/16 11 3/8 \ • 0 22�3/Pe��. .31 1/2 22 1/8 18�3/4 12 1/2 «3- «3 14-- —23111/16-1 tC3-33 3N7 235/8-181/4 36 1.875"d/w EP(Miele) 43 1/16 - +scribe 207 Lewis and Weldon Custom Cabinetry Elaine Brouillard 111 Airport Road 270 Green Dunes Drive Hyannis, MA P.O. Box 412 508-778-5757 West Hyannisport, MA 02672 Fax 608-778-5111 [09-07-07] 508-862-2452 Cell 508-737-0662 Room 1 - Wall 3 Not To Scale 26.25"to trim 1 (118 (.2512)—� 24— »-13 5/8 48 13 5/8--• L % j131/4 r - / - - ,•\ 2512 + L I 20 60 Y/ 18 12 \ j 46 12 48 i 48 46 qg 6 i 13 3/a 61 \. 13 as 12 86 as 12 101 U1451'3 / % 437/16 j 121/8 , Deck-mounted O 121/8 \\ �\ 107 of Filler 316 Custom Spice Custom Spice Pull-out 3 shelves 171'4 Pull-out 2 shelve ffull sides. doweled sides. ..Door43 1 1/4 j 0 ® �B v..ST36 ® 0 —5 1%16 O 24 j3412 29 E�36 1 115/16 11 13/16 Cabinets are set 5 ' off the floor ' 341/2 o so that with 1" lig t ail, there is 16" 341/2 1 2%9 26 029 between light rail countertop ° - 1013/16 113/11 j O 1134 •51 3412 .51 111/4 «— 361/2 7 36 - 7—+«-123/4— ° 1 (1 Ve— (-251/2) 16915/16 Lewis and Weldon Custom Cabinetry Elaine Brouillard 111 Airpart Road 270 Green Dunes Drive Hyannis, MA P.O. Box 412 508-778-5757 West Hyannisport, MA 02672 Fax 508-778-5111 [09-07-071 508-862-2452 Cell 508-737-0662 Room 1 - Wall 4 Not To scale left upper panel 13.25+.875=14.126-1.6-1.5=11.125 w X 65.25 ht 2 pnl left base panel 21 +.875=21.875-1.5-1.5=18.876 w X 30.5 ht panel 32.75 w X 56.875 ht l Restoration glass --183/4-- 1(-1,Rj---- --(-271/ --- .-135/8—+�--271/4 135/8=11/2 �4+�--22 1/2 33 22 1/2—�«3+ - Y , 13 1/4 21 21 151/2 j26 15n6 -Tra Id@ 28 15/16 i 25 3/4 equallypa zs /8 5 48 48 ae 76 24 62 .. a81/2 16 461/2 for 010 102 221n / 3/4 \ 25 3/4 101 101\\ 44 1/4- ` \ - ! 27 12 1/8 12 1!8 \\ ab ets are set 53"off the fl \ 107 j 6 15' o f t with 1"light rail,there i za 4�Roll-ou Roll-o a en light rail and counter 17 1/4% "rays O O rays 6713/16 6713/16 _ .:D00r44 1 1/4 15 7/8 \ . 81/8 j C51%16 61/8 29'IR 4 /8 C51%1 29 7/8 ii` - C 7 3/4 .27 C 7 3/4 \ , 31 1/2 34 1/2 i 28 3/8 1-__2 rL4 1121 �71� 5—/110 12! 444 at - -4 22112— 33 221/22- 3+ .q 1 U2-14— —14-1 1/2 (44}—(-15)—+3 7/8 1 207 Lewis and Weldon Custom Cabinetry Elaine Brouillard 111 Airport Road 270 Green Dunes Drive Hyannis, MA P.O. Box 412 508-778-5757 West Hyannisport, MA 02672 Fax 508-778-5111 [09-07-071 508-862-2452 Cell 508-737-0662 Room 1 - Wall 9 Not To Scale 21 1/2 1 1/2 (-2 5/1 �(-22 11/18 i Restoration glass 2615/16 22 Uv r 4 4 6 13.26 + .875 = 14.125 -1.5 - 1.5 = 11.125 29 3/4 3313/1 11.125" w X 62.25" ht 721/2 single panel 15 + .875 = 15.875 - 1.5 - 1.5 = 12.875 20 12.875 w X 33.5 ht ..Door44 1 1/4 71/237 37 1/2 32 , 4 JA2'0- [4) 1 1/2 21 1/2 1,1/2 - (-2 5/16) -(-22 11/16)-(•15/16;) •- 25 -+ Lewis and Weldon Custom Cabinetry Elaine Brouillard 111 Airport Road 270 Green Dunes Drive Hyannis, MA P.O. Box 412 508-778-5757 West Hyannisport, MA 02672 Fax 508-778-5111 [09-07-07] 508-862-2452 Cell 508-737-0662 Room 1 - Wall 6 Not To Scale 4 - base island ends 13 -1.6 -1.5 = 10 10w X 30.5 ht pad btm of warming drawer 1" to 10" finished pad sides of mid opening to 25.5" finished - Warming Drawer- mid Microwave end cabinets step out .75" - 1.5" on both sides?. Double Pull-out confirm with client on install Trash 1 1/4 10 O 51116 O I116 51116 10 187/8 11 0 34.112 341/2 3 40 77 23 3116 12 3A8 28 1/2 17 1/4 �32 94 -- ,a__- �a] C4� 48 30 18 3/4 33 3/4 1 5/16-(-11 3/8:1 9/16 (A 5*(-101/2)-5/8 106 1/2 Lewis and Weldon Custom Cabinetry Elaine Brouillard 111 Airport Road 270 Green Dunes Drive _ Hyannis, MA P.O. Box 412 608-778-5757 West Hyannisport, MA 02672 Fax 508-778-5111 [09-07-071 608-862-2452 Cell 508-737-0662 Room 1 - Back of Wall 6 Not To Scale 1 1!4 10 10 21 1rz 21 M2 21 1/2 • 3 34 1rz 54 so 301/2 41 8 24 1rz 24 1/2 24 1rz 45 a 94 761/2 (-718}-(-9)-(-3 3N 1/2 1(-2 9/16)-(-9)-5/15 106 1/2 Lewis and Weldon Custom Cabinetry Elaine Brouillard 111 Airport Road 270 Green Dunes Drive Hyannis, MA P.O. Box 412 608-778-5767 West Hyannisport, MA 02672 Fax 508-778-5111 [09-07-071 508-862-2452 Cell 508-737-0602 Room 1 - Wall 7 Not To Scale 40 7/16 101/4 101/4 3811116 e 3 i' 86 1/2 �\ 68 68 90 - 76 1/4 87 .9 ' 661/2 661/2 1 14 7/16 22 13/16 -1515/18 -245/16 - 3 3/32 4 27/32 47 7/8 - Lewis and Weldon Custom Cabinetry Elaine Brouillard 111 Airport Road 270 Green Dunes Drive Hypnnis, MA P.O. Box 412 508-778-5757 West Hyannisport, MA 02672 Fax 608-778-5111 [09-07-07] 508-862-2452 Cell 508-737-0662 Room 1 - Wall 10 Not To Scale -271/a 1 1/4 [311/2- 30112 51 91 54 - 253/4 deco feet ep's to floor 25 3/4 - 4 45 L 11/2 11/2 (-13M6r---(-233/16)- (•1/16) 30 1/4 Lewis and Weldon Custom Cabinetry Elaine Brouillard 111 Airport Road 270 Green Dunes Drive Hy.annis, MA P.O. Box 412 508-778-5757 West Hyannisport, MA 02672 Fax 508-778-5111 [09-07-071 508-862-2452 Cell 508-737-0662 Room 1 - Wall 11 Not To Scale 1 1/4 D 34 1/2 301/2 A49 - - - 3 z9 , i 944 1 1/2 271/4-1 1/2 - - .�-(2619/32-� 301/4 To Date Time WHILE YOU WERE OUT M W ll d 0-40- 0 of_,/q C C Y e.eo Dv/tas Phone -7 7 S 3 7 7-7 Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTSTO SEEYOU URGENT RETURNED YOUR CALL Message 70 c-reed �v✓t�9 ,,� s Operator dohAMPAD 23-021-200 SETS EFFICIENCY® 23421-400SETS CARBONLESS TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a5 Parcel O ; , - =;. s Permit# G is, Health Division f 111310 �0 —�� p�.` ;�1 Date Issued — � Conservation Division �� , M a Application Fee Tqx Collector Permit Fee !L1 SEPTIC SYSTEM MulW T EJ9 Treasurer A:NSTALLE®IN COMPLIA%'i m Planning Dept. WH TITLE 5 ENVIRONMENTAL CODE ANC Date Definitive Plan Approved by Planning Board TOWN REGl1LA°I IAh` Historic-OKH Preservation/Hyannis l Project Street Address 2-70 C VZE_IE-N LAA14 Village 1 CR,h lie, Owner SAoK _L. ia. Btot1t LLARR Address 5AME / 206 CaENE.SEO ROAD Telephone 6500175- b454/ (2.10) 024-6620 Swa A w P20 io TX 78209 Permit Request F r915N •Or—K I NTEEIR1oR QV �;Rn FLOaR . i�RQVIDI G 12I.Z=1JAL 7nlab BERR�5 ALID ONFL Bhnmmm Square feet: 1 st floor: existing 21100 proposed_0 2nd floor: existing 2 000 proposed _0 Total new 20 Zoning District Flood Plain Groundwater Overlay 3Ro Fi.aoR Project Valuation -b42,OU0 Construction Type W= RAW— Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 34 Two Family ❑ Multi-Family(#units) Age of Existing Structure cJ Historic House: ❑Yes �4% On Old King's Highway: ❑Yes ❑No Basement Type: 4 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 0 Basement Unfinished Area(sq.ft) Number of Baths: Full: existing - new Half:existing new 1 Number of Bedrooms: existing 5 new _ 2 Total Room Count(not including baths): existing 10 new_ 2 First Floor Room Count 6 Heat Type and Fuel: W Gas ❑Oil ❑ Electric ❑Other Central Air: id Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 1W No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garaged existing ❑new size Z4 Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes N No If yes, site plan review# Current Use R.51DE.NTiAL Proposed Use fzwt BUILDER INFORMATION Name Will ,.IAM �,,_Gx-;a 4L29: Telephone Number 506 "IT— 8604 Address 65 CQQCKF,;2RQE_ License# M540 -C_,Q_UTF:„ Vu_ 0 2 6 2 Home Improvement Contractor# 1 l 2049- Worker's Compensation# WC 123655 i ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO CnNrA1tJj! 1Z �C SIGNATURE J DATE 12- 04 ' r FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED �' - •• MAP/PARCEL-NO. 1 ADDRESS y VILLAGE � • OWNER :) 1, DATE OF INSPECTION: FOUNDATION - I'«, FRAME L G 4 INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL"i � I I ;"• - GAS: ROUGH- FINAL FINAL BUILDINGlvlo DATE CLOSED OUT ASSOCIATION PLAN NO. y ` • r ' f Jan- 12-04 06: 50P Elaine Brouillard 2108240122 P.01 • ..1. -�,�! _.CIIY 1- . ._ _ _._ ' J lJ Yl .'!!.L—.1r� g.. _L—l. �.4. .!� Town of arm table Rectory Services a � ThozsawF.Otter,Dimetor ® BaUding Divlkon Tom Perry, Btfttg Co=mbslour 200 Meta ftat, Flya=s,MA 02601 . b Office: 509-862-4038 Fw- 508-790.6230 Property Owner Must Complete 94d Sign This Section If Using A Builder ;$9.0umtr of the.tub}cct ptop - �, go'act on M7 bah4 i�ali watters selasive to watts nuthotixe-by this bZ ng pexmk-appli"don f= <reC.j ,4�id ys_ /✓r r!^Uf'_ we,57 ly C-n rI r 6 r 7 (Ad&ess of job) sip"t of Owtez Date . 7V CMR ApPc*dh I Table,tM1H(earstiaued) with ra"11 Fuel pi-e�°rlptzt°Parkigd far Oaa%Ad Twa-F'smify R�ddentW 8nitdia�t FTr�ted M TahjVM •Hcaring/Ccoting Slab hYAXtM S Ceiiing Wall floor �5 pr EquiPscrnc F.11i°iazc Astor VM t1�Yalue= R-vuIuc� R.yalue� R-vttluci r Fi-Ya1ua� R-valsu Prr�3c 37g1 to 65gq H�tiag Dr�r°�Dsy�' 6 j�armsl 38 13 19 I0 6 Normal 19 IO 6 1S Anm R IZ.A 0 30 13 19 10 NIA Normal 6 15% 31 13 � NIA 6 Norrrsal IS'/. 0.36 10 T r 0.46 19 19 NIA 15 AF U8 �$ U 31 13 25 NIA 6 15 ARM V fSYi 0.44 19 19 10 Normal 15'h 042 3G 25 NIA NIA W xarrnat I3 X 19% 032 3a 19 25 NIA NIA �AFUE Y 191/4 0.42 33 13 l9 I0 6 31 6 9b•AF(m x MA G.42 t9 19 to 0.A0, 30 1. ADDRESS OF PROPERTY: 270 E 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: (64 3. SQ vARE FOOTAGE OF ALL GLAZING- 0 � 4. GLAZING AREA(#31)NIDED BY#2): % ° 5, SELECT PACKAGE -see chart above): G ENERGY REQUIREMENTS OTHERMORE INVOLVED ORTKi5 TNFORMA ARE AVAILABLE'. ASK U ` ,,UIDING IrISPECTOR APPROVAL: N0: YES q.forrns-fl8g303a RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE • New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE _ 0 square feet x$96/sq.foot= x.0031= w plus from below(if applicable) ALTERATIONSMENOVATIONS OF EXISTING SPACE ff _square feet x$64/sq.foot= 53 x.0031= 1 6D.65 plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0031= O ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 --- >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: _square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck — _x$30,00= (number) Fireplace/Chimney x$25.00= (number) - Inground Swimming Pool $60.00 — Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee • 1 projcost • '�`-=— The Commonwealth of Massachusetts Department of Industrial Accidents 600 Washington Street .' ; '' Boston,Mass. 02111 Workers'Compensation Insurance Affidavit-General Businesses address: (n C J cite) f-- V1LLr state: MA zip_02432. phone# 508 / !1"(U� work site location(full address): 270 CyggEa i��TL� Nt�(1�MA ❑ I am a sole proprietor and have no one Business Type: Retail 0 ResfauradVar/Eating Establishment working in any capacity. ❑Office❑ Sales(including Real Estate,Autos etc.) ❑I am an employer with employees(full& art time). ❑Other �%//%% I am an employer providing workers'compensation for my employees working on this job. comnanv name: L:i� 7 ILDlN7 L L C address. �5 CLXY_KLR '3i ll=T city: VILLV-- Phone#: institance co: tRAN lT ' 40 F olic # I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: company name. address: , city. phone#. insurance co. / / comnanv name:.,.. address city::. 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 fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under thgea�ln s p nalties ofperjury that the information provided above is true and correct. Signature // „ J� Date Print name WILLIAM L. : e"UL Zl Phone#(5—QG ) 771-9&0 ► official use only do not write in this area to be completed by city or town official city or town: permittlicense# ❑Building Department ❑check if immediate response is required ❑Licensing Board P 9 ❑Selectmen s Office i ❑Health Department contact person: phone#; . ❑Other e (tweed Sept 2003) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written An employer is defined as an individual,partnership, association,corporation or other legal entity, or any two or more of A the foregoing engaged in"a joint enterprise, and including;the legal representatives of.a deceased employer,-or the receiver or , trustee of an individual,partnership, association or other legal entity, employing employees. Howeventhe owner of a dwelling house having not more than three apartments and who resides"therein,•or the occupant"of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for,any applicant vvho has not produced acceptable evidence of compliance with the insurance c6verage required. Additionally,neithe`r'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. Please supply company name, 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 returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would Ile 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: . . , t ,. '. ,• ... +; • ; The Commonwealth Of Massachusetts Department of Industrial Accidents ODIN of Imsugawns 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext. 406 f o��Heroy, Town of Barnstable Regulatory Services I swxx ss I,E,$ Thomas F.Geller,Director 9�A 1639• k,� Building Division lFD MA'S ' Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862.4038 Permit no. Date AFFIDAVIT HOME Z2ROVFN1NT 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 adj scent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: �l 1J 151-1 7 -D F L Off k Estimated Cost 54,000 of Work �umL- S DoyE �vflN i�DOit1' Address 1 Owner's Name Date of Application I hereby certify that: Registration is not required Ffor 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 TEE OR ARBITRATION PRO GRAM OR UARANTY FUND'UNDER MGL c 142A. ACCE55 TO THE . SIGNED UNDERPENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: 112049 Date Contractor Name Registration No. OR Date Owner's Name Jar#-12-04 10:07P Elaine Brouillard 2108240122 P.02 22 .3 ' 272..47 LOT 18 LOT 59 1 O WATER EASEMENT v. (1 C WIDE) CS 17 -1 - NO. 270( ( CUSTER ST ASPHALT DRIVE 273.09 GREEN DUNES DRIVE NOTE: WAYS AND EASEMENTS ARE AS SHOWN ON LC PLANS REFERRED "0 BELOW, STATUS OF EASEMENTS AND WAYS ARE NOT DETERMINED MERE. MORTGAGE LOAN INSPECTION MLI2155 SAGAMORE SURVEY ASSOCIATES SCALE: 1 IN.= 60 FT, P.O. BOX 28 DATE- AJGUST 8 2003 f<�-RO00,#4 ,# SAGAMORE BEACH, MA: 02562 rsrh y (5D8) 888 8667 i `� ; qua. I CERTIFY TO CAPE COD BANK AND TRUST COMPANY, NA TA THAT THE LOCATION OF THE BUILDING SHOWN HEREON CONFORMS 9met•34314 � TO THE ;CONING OF THE; TOWN OF BA.RNSTABLE i Art ►` I CERTIFY THAT LOCUS DOES NOT LIE WITHIN THE FLOOD HAZARD ZONE AS DELINIATED ON MAP. 0008C COMMUNITY NO. 250001 PLAN REFERENCE: BARNSTABLE REGISTRY OF DEEDS BOOK/PAGE: LC NO 1.5694—D, SH 2 & LC NO 15694•—I LOT NO.: 18 & 59 PLAN BY: BEARSE & KELLOGG & NELSON BEARSE—RICFIARD LAW DATED: MARCH 29, 1954 & OCTOBER 18, 1963 THIS I45PECTION NOT MADE FROM AN INSTRUMENT SURVEY AND IS' NOT TO 8E USED FOR FENCES, HEDGES. OR TO ESTABLISH LOT LINES. FOR USE OF BANK GNLY. t — —-- BOARD OF B,VILDING Llc nse: CONSTRUCT IO RE''ULAT-toms Numb `:• N SUPERVISOR @ram 056340 ' ( Tr.no: 4172 .... t I; WILLIA`M L Res r��t : 0a PO BOX 288 CHUB W < CENTERVILLE, Adminisfra#or i fie .� _. ......- -.. JBoard 6f Building I2egulatious and standa HOME IMP OVE rds ' 'MOVE CONTRACTOR y, FJ'�✓pF1 �/1 t � �/2005 YP� jTvidual SCHULZEBUILD `1 a WILLIAM SCHU�` I PO BOX 288/65 CRDIE � CENTERVILLE,MA 02632 Administrator TOWN OF. BARNSTABLEBuildingYHET Application Ref: 74359 BARNSTABLE, Issue Date: 01/26/04 Permit MASS, 9� i639• �� Applicant: Permit Number: 74359 Proposed Use: SINGLE FAMILY HOME Expiration Date: Location 270 GREEN DUNES DRIVE Zoning District. RD-1 Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 245026 Permit Fee$ 221.66 Contractor , SCHULZE,WILLIAM . Village CENTERVILLE App Fee$ License Num 56340 Est Construction Cost$ 53,760 I Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND ADD 2BDRMS/BATH THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: BROUILLARD,JOHN C 81 ELAINE F BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: P O BOX 412 INSPECTION HAS BEEN MADE. W HYANNISPORT, MA 02672 Application Entered by: Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR AN ART THEiVMHtRTEMPORARILY-ORPERMANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET ORALLY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION.RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR-ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4,PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health tl eIFoO/ue W 1 eB !+\ i I ' 1 I r I . •U _ I i µ.ow 1 1 NEW SMOKE DETECTOR REQUIREMENTS ARE,NOW LAW. EVEN THE ADDITION OF A -- NEW BEDROOM WILL TRIGGER AN UPGRADE OF THE SMOKE DETECTORS FOR THE WHOLE HOUSE. YOU MUST` PLAN ACCORDINGLY AND HAVE YOUR SMOKE DETECTORS aK y ELECTRICIAN TAKE OUT THE APPROPRIATE PERMIT AT THE FIRE DEPARTMENT. 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M'MaNr 41 n-« « m rnrurirrxa-: `J Engineering Dept. (3rd floor) Map Zy3 Parcel 4,;?-l! Permit# House# Ze5p ' Date Issued Board of Health(3rd oor)(8:15 -9:30/ 1:00 ), f Fee Cc Conservation Office(4th floor)(8:30-9:30/1:00-2:00) Planning Dept.(1st floor/School Admin. Bldg.) / SEPTIC MUST BE Definitiv an roved by Planning Board y19 T pUANCE AND TOWN OF BARNSTABLE TOWN LATiCNS Building Permit Application Project St re ddress D Village r T Owner zis 2, f Addresszj Telephone hermit Request - First Floor ; / 0 square feet Second Floor ' �} :� quare feet Construction Type ✓1} Estimated Project Cost $ Zoning District `rQ - / Flood Plain A '�� Water Protection �c3 Lot Size ; Grandfathered ❑Yes ❑No Dwelling Type: Single Family a/ Two Family ❑ Multi-Family(#units) Age of Existing Structure r,)C-J Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: UdFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) tva Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing --T--- New No.of Bedrooms: Existing New T Total Room Count(not including baths): Existing Newer First Floor Room Count 45 Heat Type an2es Gas ❑Oil ❑Electric ❑Other Central Air ❑No Fireplaces: Existing —New Existing wood/coal stove ❑Yes pro —ems ,Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) y3 4 9 2 c"I — 1000 S Q ❑Barn(size) • ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name <;fiG i C ) Q ,? Telephone Number / y 3 5 7 -- 3 9- Address License# 00 G 2 6 � te Home Improvement Contractor# Worker's Compensation# CO 7 (��y'9 0 0 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 C, SIGNATURE DATE )_ BUILDING PERMIT DENIED FOR THE FOLLOW ON(S) Imo'- _ s - rE - FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED a F a- • _ •. ..,R s—m. » S . y t � t _ `' • - . T 'F,N. � .k - . r r ' cy$ MAP/PARCEL NO. + ' VILLAGE ADDRESS .- OWNER a f a DATE OF`INSPECTION: FOUNDATION . - 7 FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH t.FINAL - PLUMBING:'' ROUGH } FINAL; GAS: r f � GH i FINAL FINALS BUILDINGn �DATE`CLOSED�- ;"4 tr ASSOCIATION PLNO ; , ifs J{ e - a . R7. _ BUILDING DERV- ..r T.D' 245 026 GEOBASE ID� 14813 AD6I.1. ` {:L7:0 GPXEN D•NES DRIVE k CENTERVILLE � � :, Z,P -- LOT & 58,` is BLOCK LOT SIZE DEVELOPMENT DISTRICT Co '� .« PERMIT 25� DESCRIPTION , :, 49 DESCRIPN SINGLE FAMILY 134ELLING SEPTIC NO...98 -118 PERMIT „ PE::,;..BUILD TITLE NEW RESIDENTIAL BLDG PMS `GONE" CTaRG- STEVE �'.• ID . �� $ �' Department of Health, Safety A �,'B EATS- _ -and Environmental Services TOTAL FEES: BOND' � �-coo.__. . SINE , C NtETRTJCT1CN COSTS $310,000,00 101 SINGLE EAM HOME DETACHED- 1 PRIVATE P t 'E�`.. r - * BAItNSTABLE, 4 j MASS. �. ° 039. BUILDING�DIVISION _ BY 4i 1 I.DA.TE :tssuEb Q'2/2�1998 .+ PIFA I� DATE • THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY:APPLICABLE SUBDIVISION RESTRICTIONS. e MINIMUM OF FOUR CALL INSPECTIONS REQUIRED ` FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND%' WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE:'OF.000U-. ELECTRICAL,PLUMBING AND M FOR (READY-TO LATH). PANCY IS REQUIRED, SUCH BUILDING SHALL NOT BE CH- ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN.MADE.. 4.FINAL INSPECTION BEFORE OCCUPANCY. ' BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 9 , � . �� oe. 2 � ��9 2 3 1 F EATJING INSRECTIOUAPPROVALS ENGINEERING DEPARTMENT � ry 2 BOARD OF HEALTH t OT R SITE PLAN REVIEW APPROVAL F K SH LL NOT PROCEED UNTIL PER IT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ONTHIS NSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY OUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- . NOTED ABOVE.. TION. to PERMIT ILDING 5�y f • Al ._T 0WN OF vW41 114�I t., w I LD1 NG. ttA�A a GEOEASE'A 71D .2, 26 -4if g gg: mi smix D NESt DRIVE gs (,MNT9RV.ILLE J*� .......... At X7 D RR sk LOT 'LOT ,-SI CT'�CO DEA LOWT 2_4 'ky �p "IDISTRI 5 & '11419' P! -Ait, CRIP__ ___TT --:29N �,,"DES '4�kNGLR: -FAMI LURd'v I ERMIT ti TIM ns MIR-: C,NO-28-,ila PERMIT '�PW.,,"BUILD _;7I,,:iT.ITL9, NEWARSI rt D Iit CONTRACTORS:-i.-STEVEN F.; RRIDlll -1-1 1. - RERE-1 woIJ A :574d 'Health'Safety e a ment-of C111ITECTS:AR 'low; E fifiifitalServices nviron 'T FE tORD - s i5o, 0-A!�7 N` 90" 'N TRUCTION COSTS. 4 101* 1 �--DETA NGLE'.-FAN-MOME' _ 4K IS 4 Q MASS 77 _4 ENE'4 D, EL x BU1 3 m,,��sy �yal oED DAT IZ A .- Me - NAT Lo IO - THIS PERMI NVEYS NO RIGHT TO OCCUPY,ANY-STREET,"ALLEY OR SIDEWALK OR�ANY PART THEREC TEMPORARILY OR PERMANENTLY.EN- CROACH ENMON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE-.6UILDIN&.CODE-'MUSTBE'APPROVED BY THEJURISDICTION.STREET OR xALLEYaCaRADESAsWELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS:THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE-CONDITIONS OF ANYAPPLICABLE SUBDIVISION RESTRICTIONS -4 -Am iki R MINIMUM OF FOUR CALL INSPECTIONS.REQUIRE D'- m wi APPROVED PLANSZMUSrBE'RETAINIED'ON JOB."ANA AP FOR ALL CONSTRUCTION WORK: �t�'Q It ipp_ - , I ;,WHERE 'APPLICABLE;.'--SEPARATE' NAL7IhSPECT 7,1,00164DATIONS1�6R'FOOTINGS X THIS:CARD KEP'r�k OOSTED.JUMIL�-FI "'.1,0141 PERMITS ARE FOR 2�PRIOR TO:COVERING-STR HAS BEEN MADt,&EREwXb a :,s, , '.'ELECTRICA UCTURAL, ERTIFICAT.-CPCCU;' EQUIRED.SUCH-8 -SH 'tNOT'B IS,R .A _11 :' (READY UILDING ,Ito PLUMBING AND MECH u:INSU ON. a ANICALMSTALATIONS.00CUPIEDUNTIEFWAONSOECTION HabEbtM4 - A-sFINALINSPECTION.BEFORE' t cy Ar - BEFORE' 6ti too I RK03 wi QW911 I 6-sm t ol:44 -f BUILDING INSPECTION APPROVALS: PLUMBING INSPECTION APPROVALZ�4&, j'4ELECTRICAL INSPECTION APPROVALS dOW or lit ji, H rn -it Il.Pt, 3 1 "EAMNG IN P CTimAPPROVALS' ENGINEERING DEPARTMENT. t3 4 74: t-1, 'F A, 02f 2 BOARD OF HEALTH --nHw pi r�, OT SITE PLAN REVIEW APPROVAL T , Z IIJ= M -7-1 5s WoWiXE NOT PROCEED UNTIL PER IT WILL BECOME'.NULL.ANDVOID:IF INSPECTIONS S INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS'Nor STARTED,WITHIN.SIX' CARD CAN BE'ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT`ISASSUED-AS'. TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE:. TOWN OF BARNST.ABLE CERTIFICATE OF OCCUPANCY PARCEL .ID 245 026 GEOBASE ID 14813 ADDRESS 270 GREEN DUNES DRIVE PHONE CENTERVILLE ZIP LOT 18 & 59 BLOCK LOT SIZE DBA DEVELOPMENT . °DISTRICT CO PERMIT 39793 DESCRIPTION CERTIFICATE OF OCCUPANCY PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: I Department of Health, Safety_ ,ARCHITECTS--.-- -- ---- ------ -- _ _ ._---- _. _. ___ and Environmental Services TOTAL FEES: BOND THE 1 .00 CONSTRUCTION COSTS $.00 I 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE R * BARNSTABLF, + MASS. 039. A� BUILD G IV BY DATE ISSUED 07/15/1999 EXPIRATION DATE `"` TOWN OF BARNSTABLE ! CERT I FI LATE OF OCCUPANCY [PARCEL ID 245 026 �.OBASE ID_ 14813 ADDI E S 270 GREEN DUNES DRIVE 1 PHONE CENTERVILLE . t ZIP - : LOT. - 18 59 BLOCK LOT SIZE DBA �"`. DEVELOPMENT DISTRICT CO ` PMIT 39793 DESCR PTIONf CERTIFICATE OF OCCUPANCY. PERMIT TYPE HCO0 TITLE. CERTIFICATE OF OCCUPANCY CCNTR'AC' TORS Department.of Health, Safety ARCHITECTS and Environmental Services TOTAL FEES: BOND INE CONSTRUCTION COSTS .00 75 y CI I TIFIC.AT� Off' OCCUPANCY' 1 PRIVATE P r * 1�ARNSTABLF, * 1 MASS. � 039. H�� Ep Mpl A 1 BUILDING DIVIOI DATE ISSUED 07/15/"1999 EXPIRA'I. OW DATE � THIS PERMIT CONVEYS NO RIGHT TO.OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE-APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED QU RED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. i BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL _ WORK.SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS I' THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX. CARD CAN BE ARRANGED FOR BY I' VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION, NOTED ABOVE. TION. BUILDING PERMIT l he Hanover Insurance.Company RECEIVFM NOTICE OF CANCELLATION MAR 14 2000 TOWN OF BARNS I ABLE D.P.W.ENGINEERING Town of Barnstable March 8,_._. .2W 2000 Public Works Department Highway Division_ 382 Falmouth Road Hyannis MA 02601 BOND NO. BLN-1629398 WHEREAS,on or about the 23rd day of February 1998 THE HANOVER INSURANCE COMPANY,as Surety,executed its bond in the penalty of Five thousand and 00/100 Dollars(SS.Dnn nn ), on behalf of Francis E. Doyle of 12 Davis Street Walpole. MA'02081 in favor of Town of Barnstable as Obligee (Nature of risk Street Permit Bond- 270 Green Dunes D and WHEREAS,said bond,6y its terms,provides that the said Surety shall have the right to terminate its suretyship thereunder by serving notice of its election so to do upon the said Obligee,and WHEREAS,said Surety desires to take advantage of the terms of said bond and does hereby elect to terminate its liability in accordance with the provisions thereof. NOW.THEREFORE,be it known that THE HANOVER INSURANCE COMPANY shall at the expiration of 10 is>malioe be released from all liability by reason of any default committed thereafter by the said Principal. Signed and sealed this 16th day of February xh@ goof) THE HANOV RINSURANCECOMPANY BY Rose Mar Dyer FORA/141-0709(6M) cc: Francis E. Doyle Patterson Insurance Agency, Westwood, MA (32-00966) Reason: Per agent, bond no longer needed i (�� --� � ��s� �� .e Ybe HAnover Insurance Company RECEIVFn NOTICE OF CANCELLATION MAR 14 2000 TOWN OF BARNSiABLE D.P.W.ENGINEERING Town, of Barnstable March_8, ,A@ 2000 Public Works Department Highway Division 382 Falmouth Road _Hyannis, MA 02601 BOND NO._ BLN-1629398 WHEREAS, on or about the 23rd day of February . 1998 , THE HANOVER INSURANCE COMPANY, as Surety, executed its bond in the penalty of Five thousand and 00/100 - Dollars ($5,000.00 ), on behalf of Francis E. Doyle f:. of 12 Davis Street, Walpole, MA 02081 as Principal, in favor of Town of Barnstable , as Obligee (Nature of risk Street Permit Bond- 270 Green Dunes Drive, W. Hyannisport, MA` and WHEREAS, said bond, by its terms. provides that the said Surety shall have the right to terminate its suretyship thereunder by serving notice of its election so to do upon the said Obligee, and WHEREAS, said Surety desires to take advantage of the terms"of said bond and does hereby elect to terminate its liability in accordance with the provisions thereof. _ NOW, THEREFORE, be it known that THE HANOVER INSURANCE COMPANY shall at the expiration J of � .10 ;, released from all liability by reason of any default committed thereafter by the said Principal. Signed and sealed this 16th dayof February 200(l•,. THE HANOV R INSURANCE COMPANY Dy FORM 141-0709(6/92) Rose Mar er cc: Francis E. Doyle Patterson Insurance Agency, Westwood, MA (32-00966) Reason: Per agent, bond no longer needed Y 4626 DEPARTMENT OF PUBLIC SAFET`i 7 ONE ASHBURT"ON PLACE , Pff 1301 LtOS`I'ON , RA6M.08--1G1.8 , CONSTRUCTION SUPERVISOR LICENSE Number: Expires: ` Restricted To: 00 ......... .. . _ .....__-_._... �11'DI STEVEN F REID r ; Detach bottom, fold sign ou 59 HA"tIITON AVE tD is 2 �996 hack, and l,im:in,_+te license c.arci.. DEDIfAH HA 0202E . Keen top for rec eip . lied r.hanq- to of 'Address not if ICli aoil .Tx4' -r077297Z092/L�62 Owl(C79d(LCl7-C/Ja,C�J - - Restricted To: 00 46267 � % - DEPARTRENT OF PUBLIC SAFETY 4 6 2 6 7 � 0 ' - COI',STP,IICTICH SUPERVISOR LICENSE [].one Rumher: Expires: 1G - 1 f+ Family Homes P,estiicted To: 00 Failure to possess a current edition of the Massachusetts State Buiilding Code - STEVEH F REID is cause for revocation of this license. ' + 59 HARILTON AVE DEDHAR, RA 02025 , PoHt . iHpooVLMEN`C COWRA&ORS RE31StRAtf0H oard of bdildihd RegUlations and Standa`rds g r One AshbUrtoh .place Room 1301 - Rostori Ma8sachUsetts' 02108 i i HOME 1MkOVEMENt CONtRACtbk L ------- --- ------------- --- __ -_ Registration 11264i Expiration o4ia4i§9 O �/ F i�0/Mgi10f1tlJPOI(T(��1111R�!/.Ir'/;' •.ty{�e = Rf2IVA'1'.E CORPORAt10N I •�.� -- t,. ONE I,NPROVENENI CONTRACTOR RAO1sEr hoi i12641 t CUStOM -NOMES b1.11Lb1NG ,& ' tbEv1=L0p 1NC i a TypA ,DMATE CORPORATION StLVt=N E RE_ib I EzpiraElo6 04%i4/99 t§' HAI' "bH AVE: x`` bE:bNaM MA 62626 r.°'' y CUSTOh HOMES i3UIb* 1 OEVEL STEVEN E: REID G� WANILtoN AVE ADMINISTRATOR b—[ All PIA O2U26 r ' a s li o6-� A/KIA 1 '--5-�,V�Sq o v . J The Connizon"'caltli of Afastiachuselty %tali Deprrrtnrcttt of Industrial Accidarits tY / • Officed/AVest/gatlons •�`1I;1°. _i;:`' - 600.11•a.dibigton Street •� .' Boston.Mass: O lII `- Workers' Compensation Insurance Affidavit c�.l�Plic�int inftirtnati�n• '� Plcise PR(1VT le�,�'•tI��-'�'"'"'�"�'^��—~��"^ � _ I r name• . — Incniion- city nhnne N I am a homeowner performing all work myself. I am as ole proprietor and have no one workingin any capacity [' ..... I .r.:.L. __... ..ate �• - -- - - ._ - -- am an entplover providing workers' compensation for my employees working on this job. cnntnnns• name- � L S'AdAf A oA �,O /.CJ�G q `l 32.1 incurnncecn. rrdJieJ/e.,-Jr?e tt9u.54.1-VgtD1O policl•# EX It 010.2 [1 1 am a sole proprietor. general contractor. or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: comnnm- name* adrirrsc� Clt�" phone�• . incrirnnrr rn nniic� d cmmnnnc natnr• addresc• 1 can nhnnr#• insurance co nnficy Attach additio_n21 sheet if neeeisary ----R• F - �-+•' ;:;. "^-�T"�'�"—w''�^�'"'� ;;;;�="•"':,.;.-.�,;. - Fadure to secure coverage as required under Section:SA of AIGL 152 can toad to the imposition of criminal penalties ol'a lineup to S1300.00 andiur uric cars' imprisonment:Is scC11:Is civil penalties in the form of a STOP WORK ORDER ands fine of S100.00 a day against me. 1 understand that a copy of this statement may be funv:Irded In the office of Investigations of the DIA for coverage verification. 1 do herchr certi I•' t cr the pains and penaltic fper' ,•t t the information provided above is true and correct. r Sicaature Print name Phone 3.2 9'�67? -W iai use unly do not write in this area to be compacted by city or town official cite•or tnsvn: permit/license i# rntluildin-,Department ❑Licensing Board ❑check if immediate response is required- ❑ Selectmen's Offtec 1.. '. ❑ticalth Department hone 1A r'9Othcr contact person: p f` . information and Instructions MassachuNetts General La%,.•s chapter 152 section 25 requires all emplovers to provide workers' compensation for employees. As quoted from the an emplitree is defined as every person in the service of another under any contract of hire, express or implied. oral or writtetr. An c•mpinrer is defined as all individual• partnership, association. corporation or other legal entity• or anv two or ;nc the foregoing cnanued in a joint enterprise,and including the legal representatives of a deceased employer. or the receiver or trustee of an individual , partnership. association or other legal entity, employing employees. Ho\veti er owner of a dwelling house having not more than three apartments and who resides therein. or the occupant of the dwcllina house of another who employs persons to do maintenance. construction or repair work on such dwelling_ ?i: • t employment be deeme d to be an em ion or on the •rounds or building appurtenant thereto shall no because of such empl y P _ b PP MGL chapter 152 section 25 also states that even,state or local licensing agenc,% shall withhold the issuance or renew-il of a license or permit to,operate a business or to construct buildings in the commonwealth for any a,�plicant ��ho'has not produced acceptable evidence of compliance with the insurance coverabe 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 been presented to the contracting authority. Applicn nt Please fill in the workers' compensation affidavit completely, by checking the boy: that applies to your situation and supplying comany names. address phone hone numbers as all affidavits may be submitted to the Department of i. _ P Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. Tice 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 requir: to obtain a workers' coinpertsatioui policy. please call the Department at the number listed below. Cin• or ravens Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom the affidavit for you to 1-111 out in the event the Office of Investigations has to contact you regarding the applicant. P! be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returnee 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 questic please do not hesitate to _Live us a call. . The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents "... Office of Investigations 600 «lashington Street Boston,Ma. 02111 fax #: (617) 727-7749 nhone 1-: (617) 727-4900 ext. 406, 409 or 375 ' LoTs 59 1s IV 54,302 S. F. f C W O^l OF\ 1.25 Aces f �9Np o�Rr�N�S�££T . PAN IS 6,941 4 / � 200.,9 £ C © nN (IV / �q 681, N , ® ^ / 2 h 41 41 �p 08,5 p„ w ®/ 40, OF � 09VON / �. X 40' 10' ASSESSORS MAP 245 PARCEL 26 CERTIFIED PLOT PLAN CB/DH FOUND S LOTS 59 & 18 — GREEN DUNES DRIVE LOCATION: tam- I CERTIFY THAT THE EXISTING SCAM' 1" 100' DATE: 04-16-1998 FOUNDATION SHOWN HEREON COMPLIES WITH THE SIDELINE AND SETBACK PLAID REFERENCE: L C. PI. No. 15694 REQUIREMENTS OF THE TOWN OF BARNSTABLE AND IS NOT LOCATED IN THE �OOPPLAIN. BAXTER & NYE, INC. REGISTERED LAND SURVEYORS DATE: & CIVIL ENGINEERS THIS PLAN IS NOT BASED ON AN 812 MAIN STREET INSTRUMENT SURVEY AND THE OFFSETS OSTERVILLE, MASS., 02655 SHOWN HEREON SHOULD NOT BE USED TO DETERMINE PROPERTY-LINES. APPLICANT: ALVINA BAXTER—MORAN, TR. 97142 (CPP0I.DWG) _ .• .•' FINISH GRADE ... , • . . 14 t. WATER SUPPLY FOR THIS LOT IS MUNICIPAL WATER 04 COMPACTED FILL 3' MAXIMUM MAY BE REPLACED o . -1• _ •. "�• N Lv e. LOCATION OF UTILITIES SHOWN ON THIS PLAN ARE APPROXIMATE. WITH INSITU MATERIAL ... .. �.... w'..... +:�� I�lf . •. '� ? �L n AT LEAST 72 HOURS PRIOR TO ANY EXCAVATION FOR THIS _ -_ � < 1/alp _ 1�_... .... ' 4 PROJECT THE CONTRACTOR SHALL MAKE THE REQUIRED — ��s �o .•• '� ; '^� NOTIFICATION TO DIG SAFE-(1-800-322-4844) AND � • b LOCUS APPROPRIATE WATER DISTRICT FOR LOCATION DATA., IF ENCOUNTERED REMOVE a t . PEASONE US UNSUITABLE MATERIAL 176 INSURE THE SIDEW'ALL AREA OF SYSTEM IS IN •,, : 3/4" 1 1/2" REMOVE UNSUITABLE MATERIAL THE CONTRACTOR IS REQUIRED TO SECURE APPROPRIATE o `• • 3 - - PERMITS FROM TOWN AGENCIES FOR CONSTRUCTION DEFINED R FILL PER _ . ' ° 4 DOUBLE FOR 5-FEET IF APPLICABLE CLEAN MEDIUM SAND G ,r ° _ O BY THIS PLAN. 310 GMR 15.201 j15.293 N a .` • . y .. WASHED 17 • : :: STONE CULTEC 330 ., ., . • • , •' ` AR ' s _ - y INSTALL RISERS AS REQUIRED TO WITHIN 12" OF FINISH GRADE. ALL STRUCTURES BURIED FOUR FEET OR MORE OR SUBJECT TO VEHICULAR TRAFFIC TO BE H-20 LOADING 52" ;• - 5, 46" 12' 46 Yro HYa ►S , CROSS—SECTION OF CHAMBER LOCATION MAP NOT TO SCALE HYANNIS QUADRANGLE SCALE: 1:25,000 LOCATE VENT SO IT ASSESSORS IS NOT READILY SEEN MAP 245 PARCEL 26 LOG OF SOIL EVALUATION ZONES: DATE: 04-24-96 AQUIFER PROTECTION OVERLAY DISTRICT' No. P-8683 DESIGN DATA PK NAIL FOUND _ SOIL EVALUATOR: STEPHEN A. WILSON, P.E. EL = 20.16' TOWN OF BARNSTABLE ZONING DISTRICT: RD - 1 FND EL = 23.0 BOARD OF HEALTH: EDWARD F. BARRY SINGLE FAMILY - 7 BEDROOMS NGVD MINIMUMS rtOi WITH NO GARBAGE GRINDER AREA a' 43.560 S. F. FG 22' DAILY FLOW: 7 x 110 GPD = 770 GPD FRONTAGE = 20' EG/FG 42 9 CULTEC 330 SEPTIC TANK = 770 GP x 200 = 540 GP WIDTH 125' ri n RECHARGER UNITS EL TP #1 22.5' USE 2000 GALLON SEPTIC TANK D I FRONT SETBACK = 30' 19.0 SIDE SETBACK = 10' 20.3' 0 EL=22.5" CULTEC LEACHING CHAMBER DESIGN REAR SETBACK = '10' 20.0' 2000-GAL O RECHARGER 330R SEPTIC TANK 19.8' 17.0' 0-12" EL=21.5' ALL PIPES TO BE SCHEDULE 40 PVC PERFORATED FLOOD ZONE C �, 19.5' 19.3' BO SANDY LOAM WITH CAPPED ENDS FIRM COMMUNITY PANEL ,�' "_ " = USE 1 - 4" DISTRIBUTION LINE 9 G� 12 28 EL 20.2 E IN RECHARGER UNITS No. 250001 0008 D BEDDING AS IN A 12' x 63' WASHED STONE FIELD AS SHOWN REVISED: JULY 2. 1992 PER TITLE 5 2.5 LEACHING AREA REQUIRED: 14 12 15 10 12 770 GPD/0.74 = 1041 SF DATUM OF THIS PLAN IS NGVD to SIDEWALL AREA: 75' x 2' x 2 300 SF _STRATIFIED BOTTOM AREA: 12' x 63' 756 SF { -1 TOTAL AR'' . < O MED SAND A 056 :SF PERCOLATION = RATE </ 5 MiN/INCH .SOIL CLASS 28"-144" EL=10.5' / } I 3 DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM NOT TO SCALE t o� , r � o _ T cv / N/O STAKE FOUND EL = 21.78' `O, N G� NGVD �AApN \ w FROM �� op g � N O CpURT pNr SSF£T i LOTS 59 & 1 8 'lift N9¢, E / 54,302 S. F. 1.25 Acres f i CB/DH FND / - EL = 21.52' 20 NGVD 1 / l 1 PK NAIL FOUND / / J / EL = 20.16' . I � JJJ -0 ! / -tP NGVD 22 pCV ' w / , J N )0, l WATER MAIN PIT } N y A. 3' DIAMETER PIT 4 _ r O T 8 / o � PK NAIL FOUND l EL = 18.95' 70,l 6 A R i /w o NGVD p D. Q JJJ s 64, A. w 4 , I _y CB/DH FND EL = 22.13' NGVD 2 41 22 •' � Z 40 Al ®, w .23. LOTS 5 N 9 do-18 GREEN DUNES DRIVE WEST HYANNISPORT, MASS. / 20 a t , FOR CB/DH FND VINA BAXTER—MORAN, TRUSTEE / EL = 19.68 4.. T _�tGw I le D l SCALE: 1" 20' DECEMBER 16, 1997 / 4p 001 / BAXTER & NYE, INC. / 812 MAIN STREET OSTERMLLE, MASS., 02655 / (508)-428-9131 GRAPHIC SCALE }} 20 0 10 zo ,o ao I CCER7�FY THAT THE PROPOSED FOUNDATION SHOWN HEREON COMPLYS WITH THE SIDELINE AND SETBACK REQUIREMENTS OF THE TOWN OF BARNSTABLE AND IS NOT LOCATED WITHIN A SPECIAL FLOOD HAZARD ZONE / ,Y IN )�T ) J 1 inch = 20 ft. DA `�66' f <cF' sg 4p• \ qc STEPHEN . 4K�i11AC► � ALLYN m ` A. .. o WILSON -i I BAXTER do NYE. INC. dAX7�A No.30216 -0 9 rriL O T 10• 97142 SITE03.DWG 5,'