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�pFIKE ri Town of Barnstable *Permit# 28 _LD
Expires 6 months from issue date
,nnKsr,�s Regulatory Services Fee 7'o`U DD
9eb , ; � Thomas F.Geiler,Director
Building Division
X PRESS PER
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601 NOV 7 2003
Office: 508-862-4038
Fax: 508490-6230 `'OWN OF BARNSTABLE
EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number O V
Property Address
Residential Value of Worlt � zz
Owner's Name&Address 1 0� n'�Cl R1 cf ak 1
_
Contractor's Name11\\lU i(�A f) \Y11LQ_ �W� Telephone Number_50 5_4 D ` 9.)001
Home Improvement Contractor License#(if applicable) CN 006(
Construction Supervisor's License#(if applicable) t
�Oworkman's Compensation Insurance . jy
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
I have Worker's Compensation Insurance nn
Insurance Company Name ��1 h Q� l a�l 1 d U
Workman's Comp.Policy#
Permit Request(check box)
5P Re-roof(stripping old shingles) All construction debris will be taken to MA QAi C &-ql— �LULW
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
Replacement Windows. U-Value (maximum.44)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
Home Improvement Contractors License is required.
Signature �� ----�ck�
N cu�)
Q:Forms:expmtrg
Revise053003
License or.registration valid for indivetui use only
C-Z Roar o m Ong tegu a' a before the expiration date. If found r
HOME IMPROVEMENT CONTRACTOR eturn to:
Board of�Building Regulations and Standards
Registration: 133851 One Ashburton Place Rm 1301
Expiration: 8/17/2005 Boston,Ma.02108
Type: Private Corpora
tion
NICKERSON HOME IMPROVEMENT
MARK NICKERSON
12 COMMERE DRIVE C- - Not valid without signature
ORLEANS,MA 02653 Administrator
Liberty Mutual Group
PO Box 8094
Liberty Wausau,WI 54402-8094
Telephone(800)653=7893
Mutual utu l Fax(7I5)843-2650
December 11,2002
TOWN OF BARNSTABLE
BLDG DEPT
367 MAIN ST
HYANNIS,MA 02601-
RE: Certificate of Workers Compensation Insurance
Insured: NICKERSON HOME RVIPROVEMENT INC
PO BOX 2476
ORLEANS,MA 02653
Policy Number: WCI-31S-318102-022 Effective: 1116/2002 Expiration: 11/6/2003
Coverage afforded under Workers Compensation Law of the following state(s): MA
Employers Liability:
Bodily Injury By Accident: $ 1,000,000 Each Accident
Bodily Injury by Disease: $ 1,000,000 Each Person
Bodily Injury by Disease: $ 1,000,000 Policy Limits
As of this date,the above-referenced policyholder is insured by Liberty Mutual Insurance Company under the
policy listed above.
The insurance afforded by the listed policy is subject to all the terms,exclusions and conditions,and is not
altered by any requirement,term or condition of any or other documents with respect to which this certificate
may be issued.
This certificate is issued as a matter of information only and confers no right upon you,the certificate holder.
This certificate is not an insurance policy and does not amend,extend,or alter the coverage afforded by the
policy listed above.
If this policy is cancelled before the stated expiration date,Liberty Mutual will endeavor to notify you of such
AUTHORIZED REPRESENTATIVE
LIBERTY MUTUAL INSURANCE GROUP
- - Tho certificate is executed by LIBERTY MUTUAL MSUR&NCR GROUP as inspects such insurance as is afforded by those oorripmies.
cc-.Insured: . Producer of Record:
NICKERSON HOME IMPROVENIENT INC PIKE INSURANCE AGENCY INC
PO BOX 2476 PO BOX 1658
ORLEANS,MA 02653 ORLEANS,MA 02653
wtorooz .
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a
4 1C6CER50N HOME IMPROVEMENT;_INC .: ® �
P,O.:Box 2476
HYAf�NIS, MA.,02601
PHONS DATE
(509) 790 5880 Fax (508) 255-5107
7 JQI�NAM) ,iQCAT);1N
( G3.n le�L.:,cu`- I.ve
abb
JOB NMI JOE 6�HQNE
�:, k)" �! Mr, i"IL
--cif_ve, and d—spc,cAe of arly 1 ,:iLU'_" d:.'=Cr
:: ls-_)j=iv ancJ, 1nstalI any 1 Lifetime i:.L'o5s'buck or 'equ .vc` fen- st-0rnl 0001-
�_ anId' debr1_ . .rei,oval $391 . 00 (fir
nt. _--e rolof
Renai l_ 'ad't_ .loose sheathinci
?_ "j'i_a1ar _1fi1.1 :1 i_�::til.._ l.ii1` drip `uii(jn 1 •�'T ? 21 '` rl a. 1. Lower t
t i,at.^;.11 ice & t:':F2.t�._ ,shield on. all '_cweredge-
rnsta-1. i black Lliider-lavraent= fe-It -0aper on entire root
I all. vent pipes
- n debris Uai_i1. be removed an � N � �
.�- �-� and disposed of ro�e?�lti°
A1_. state--ria s, labor and .debris removal.- $6370. 00
_install =i dqe vent at $10.0 -; per l:_nea t^=;:.}ve contY"act. Drice
i �.i s_c�ot 'ate
OPTIONS: To `Lnstall 30 year Architect shingles add $520.00 to above
t s nsta.l; 4 .t v2c�r Aruh:itect: shirrl es add $10=-,,M)iO to above
" o instal i. 50 ea.r .40_C E teat s1 ipgle-a add. $130Q.CUT to above
f.- ^vUm'" < — ty, I `� H } i �� t �I'm I 1�- (^yl T�� 1 t tl_J >0x�"'=,
P'i��,i�'SE It�iDI _� �E ,_>iI_LNGL O �R 1,4 ES 1O ANY c;_. s G_1 �i �� i_RI'I�� �Iti"i�. � I�
Re-, ai - roi-ted wood a ` �Se CJ per rn3i hour � v �t `_
_ # zlr. plus t_fl vac_ inater� +i:;
-'nl-. i tents speci -Let< above are -Li nc�1.uded �.n this proposal `ro--r
E PROPOSE hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of:
p dollars($ )
Payment to be made as follows:
500. �'(i �<"''•e``,.o _L t ii'prcn S_L nin g, progress pay-ments upon request-, balance i-ipon
All material is guaranteed to be as specified. All work to be completed in a professional
mannar according to standard practices. Any alteration or deviation from above specifiea- Authorized
tions involving extra costs will be executed only upon written orders, and will become an Signature
extra charge over and above the estimate. All agreements contingent upon strikes,accidents or
delays beyond our control. Ouner to can,ire,tornado,and other necessary insurance.Our Note: is proposal may be
workers are fully covered by worker's Compensation insurance. withdrawn by us it not accepted within :4 days.
ACCEPTANCE OF PROPOSAL—The above prices, specifications
and conditions are satisfactory and are hereby accepted. You are authorized Signature a u•.�
to do the ,ork as specified. Payme:t will b made as outlined above.
0i E Signatures
Date of Acceptance:
i
05/26/2003 21:36 915087906230
Town of Barnstable
Regulatory Services
_ KAM Thomas F.Geiier,Director
r�<
>a6�°'• Building Division
Building Commissioner
200 Maim Sueet, Hyannis,MA 02601
office: 508-862-4039 Fax: 509-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
dM _ ,as Owner of the subject property
hereby authorize l da r ,,a �Aj)fflt MQI'7)L M Yam" to act on my behalf,
in all matters relative to work authorized by this building permit application for:
A5 ' s:
(Address of Job)-i
0
Signature of Owner Date
Print Name
Q:Fotzet ONNERFEMOSnoN
{�►��l G►.,i 17tS,T A
cj1U��LE FNM/�lL�( - 31=Di�UbNl 3S. ,1 9 ' ~ {
330,e lr7O % 4-99^ 6.p.D.t
V Ste= f OOb .GAL-. 'rl
• O•t�ow ^d
12I PtT L-.)SE I:000 G46L,
> o
STeu/ALL' A(ZEA _.I�jp S.F. t V r,n� �a' r:VO Q
I� SF x 2.S - S-7S G.P.D.
Bcr TOit/l
TOTAL -r->C-SIGQ = 425
?"oT+�t_ 'tj�t��( Fc..�w = 330 6P•D. ..- �
C f1GDLQTIOt.I CZl�TE „tom Zh{IIJ 02 Lp,
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LOCATIO�,A
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tWs'f'�:Jnc�_t.l i� u;>�it_�� � 'T/�lG ter✓t-5�t`�,• ;I�IGWt_D YPl_I f t�.!- •
.6c% u-,Go fG .j-�r C M1►J1-_ LoT LI.WE:1 ��- • ii'a•..j � 1{i�
y ✓ /, 77
Assessor's map and lot.. number ......(...(�..�:.......uoq..:.......`
{ SEPTIC SYSTEM MUST BE
m '07A
7INSTALLED IN COMPLIANCE
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�.r Seyva a Permit number ............................................. ...... WITH ARTICLE II STATE
SANITARY CODE /•AND TOWN
ri:_•t CF THE Lp Y 9
W TOWN OF BARTAREE
j BAHASTADL ; • `j
M � 9 "6` BUI�L•DING INSPECTOR
O 79• �0
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APPLICATION FOR PERMIT TO .... ,,.... .............. :.
va TYPE OF CONSTRUCTION ........... ..... ........ ................. .... ................................... ........
. ......19........
TO THE INSPECTOR OF BUILDINGS; 77
The undersigned he eby applies for a permit according to the following information:
Location .... . ....... ...... ....... .. ............................................ .............................................................................................
ProposedUse .........alb .......... .......c ........ .......................................................... ..............
Zoning District ......... �4-�............. ..................Fire District ,{-� D...... ......F..................................
--'Name of Owner ...... ........ "? - .............Address .................e ... ...`..... .......................................
Nameof Builder ......................................:.Address .................................. ...............................................
Nameof Architect ..................................................................Address ....................................................................................
Numberof Rooms .................... ...... .......:.........................Foundation ...........................: `.... .............I.....
Exterior ......................: / i.. .. .....Roofing.. .......................... .:............ ....... .................
Floors 61litl!.............. .................Interior ............ .. ......... . .....................................................
................. ... ......................
Heating ............1.�..�T.:.l?(:..... `'....f�j../.....................Plumbing ............. ..............................
Fireplace .............. :....................................................Approximate Cost ...c 3.4.................................................
Definitive Plan Approved by Planning Board ________________________________19________ . Area ......l... .. ..................;}
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Diagram of Lot and Building with Dimensions Feed :.... ................................... „.
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SUBJECT TO APPROVAL OF BOARD OF HEALTH
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I hereby agree to conform to all the Rules and Regulations of the Town of Barnstabl regar the above
construction. .
Name ................................ ............................. ..
_ CamennLde '��w '
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No Permit ;o'
—..�`^��. . -----.
—^---'~-----''`^------^----'--''
Location '—..2�.J8ammeor..%e��l..------^—..
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Owner —. .�e��.------.:...........
' Wood Frame -
Type of Construction .......................................... /
----'—^—'r'--^'—'`~~''---------''
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F1oi ------.--_ Lot ----------..
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Permit Granted —.. —]P 77
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Date of Inspection ....--lV
�
'�R�������.�.��---..1g
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. PERMIT REFUSED
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Approved
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TOWN�� |`� �-��� BARN STABLE
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STAILE. . .
. � BUILDING
� N0 N N �� � �� INSPECTOR
��NNU�0_�0 � ����
At �p' . . — — —�--- - -- --
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~! APPLICATION FOR
- PERMIT TO .. '�[ ,�^� ----_--________..
`~~
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TYPE OF CONSTRUCTION
..,��.�����--- 8 �. ., ���?����._—~—..'�—.---------_____..
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...--.—.��.�.c�.+....lQ.^—..
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TO THE INSPECTOR OF BUILDINGS: '
-
The
undersigned hereby applies for a, permit according to the following informatiom,
.Location —.o'----------..''— ---------------------------------.-----.---..
Proposed Use ---.� ----__--_^------------------_________
Zoning District
' ---�r
. a D �
_ _____________
Nome of Owner —.. .. Y�_ ----.A66,eo .................. ..................................... ^
Nome of Builder ----------------------'A66res ------..—.--------.----------..
� �
Nome of Architect ----_-----.-----------Ad6res ---------------------------- '
Number of Rooms ------.U?-- ----------.Foon6ohon ........ ��u ...................................
Ex1e,ior -------..............[-�. .....-----.-----RooGng ---- -------_—,_
Floors ..................W..�.............................................................. ----- .................................
Heating Heoting ----l/..............?—.�...—'/�! .!--------F1um6ng ----�r�.-----------~_____,___
/
Fireplace ..............
....................................................................Approximate Cox _ ..........................................................
5 ",
Definitive Plan Approved .n 6v Planning Buon6 lA--------, A,eo ---�� ------
u
Diagram of Lot and Building vkh"I'CUmanxbns Fee ........q� z'
. �_________.
SUBJECT TO APPROVAL OF BOA 'HEALTH
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| hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
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Nome ---....----... ����..
Cakewide Dev. 192 -89
NoL9.7.88........ Permit for .Dwelldmg..................
...............................................................................
Location ..............79.....Hawser••Bend.................
Centerville
.........................................
Owner .....Galrewad�e••Dev•.................................
Type of Construction ............Wood. . ..Frame. ........
.... . .. .... ......
............................................................................... may
Plot ............................ Lot .............25.............. \ `\
Permit .Granted .......Navesnh x.......29.....19 77 .
Date of Inspection .....................................19
Date Completed ............... ......................19
PERMIT REFUSED
.......................................•....................... 19
.. ..... . T.....
Approved ................................................ 19
...............................................................................
...............................................................................
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