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0095 HORSESHOE LANE
r. -�. ,.� u � � .. . ,. ,.. � _ .. _ 11 I - k .. d v ..� .. d .. .. _ ,. _ SAjv 90€-&&3—00155 ?`o%Z t S ti 'h 0. w t�css a a e I o � ail { i IL e 14_ , Y �zKKEr Town of Barnstable *Permit4A l 03SO 2 . O Expires 6 months • m issue Regulatory Services Fee &UMSTAB Ell V 9� MASS.3639 i Richard V.Scali,Interim Director .. �� A,E p 22 2014 Building Division TOWN Perry,CBO,Building Commissioner TOWN OF BARN MILE' 200 Main Street,Hyannis,MA 02601 www.t6wn.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint tMap/parcel Number Property Address k-�Vt (- l ` U IgResidential Value of Work$�(�� / Minimum fee of$35.00 for work under$6000.00 Owner's Name&AddressUll sass �. o Contractor's Name JC- ciz�. (_6 0 QxR Telephone Number Home Improvement Contractor License#(if applicable) A LZ2;b Oul�;_Email: Construction Supervisor's License#(if applicable) o EKWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Namel.�L� Y Workman's Comp.Policy# 7k 9171�� —e)if q �3 YL-' 1 3 Copy of Insurance Compliance Certificate must accompany each permit. Pemm st heck box) ,Q , -roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(no pping. Going o ❑ r exi g layers �# W�in � Re-si (m .3 e nt W s/doors/slide ue❑ Repl xim t #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans mar],.,] required. Separate Elect • 1_&Fire Pe uired. *Where required: Issu ce of t 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: - ljrJl Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc �✓�, Revised 061313 IV 9 9 ' : ® 6 9 1 Commonwealth of Massachusetts =�= o o• e "Department of Public Safet�r o Hoy+tmg:Engineer License'H&086392 • � • EMO R SHIAPPA� ill HATHAWA X ST WAREHAMALA 02571 i �< �. J,•�"" JJ Expiration: i Commissioner 10/15/2015':_ Massachusetts,-Department of Public Safety Board of Building Regulations and Standards Construction Super<isor Specialh License: CSSL-101061 Yr EMO R SHIAPPA, 111 HATRAWAY.STREET Wareham MA 02371 r ,�.: ; Expiratio"n Commissioner 10/15/2015: G`�`^ i Office of,Consumer Affairs and Busmess Regulation 10 Park I':laza Su1te:5170 n IVIas'sachusetYs 02116 B®sto , Home linprouelnent Contractor Registration -= Registration: 112280 Type: Private-Corporation _ Expiration: '2/10/2015 Tr# 236188 .. . TRADE.CO"NSULTANTS/CAPE"6,"'ROOFI EMG1 S:CHIAPPA F - 1'11"HATHA' AY - GIIAREHAM, MA 02,571 ra ! t , pdate:;Address and return card.Mark reasoh f6P.change. " .rg Address' . Renewal ] Employment "Lost card SCA 1 0 20M-05111 d. �6.1111Z?11,"'lk11:C 1�lC�flJdl[Cl1/[r4ll _ _Office of ConsumerAffa�rs&�usy�ss Reg>alahon License or registration valid for ndividul,use only �IIE IMPROVgh§Ef�7 CbRITFL4CTQR before the expiration date If foupd return to eglstration: 112280 Type: ®ffice of Consumer Affairs and Busyness Regulation y� y pirati n 2110/2015 Pnvate Corporatic n 10 ParkPlaza-Syute 5110 Boston,MAIM TRADE CONSULTANTSICAPE COD ROOFING EMO SCHIAPFA 3` i 111 HATHAWAY ST ate_ WAREHAM MA 02571 :Undersecretary lNot valid hoot sygnature :N0TI.0 as . i N NOTICE `.' TO d TO Ary®' EMPLOYEES ` �= EMPLOYEE.►J / V �he Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston., Massachusetts 02111 61.7-7274900 — http://www.mass.gov/dia As required:by Massachusetts General Law,Chapter 152,Sections 21,22&30,this will give you notice that I(we) have provided for payment,to our injured employees under the above mentioned-chapter by insuring with:. THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY P.O. BOX 1450 MIDDLEBORO;, MA 02344-f 450 ADDRESS OF INSURANCE COMPANY (7PJUB-GB21827-3-13) 09-07-13 TO 09r07-14 POLICY NUMBER EFFECTIVE DATES ROGERS & GRAY INS AGCY 434 ROUTE 134 a SOUTH DENNIS MA 02660 m� NAME OF INSURANCE AGENT ADDRESS PHONE SCHIAPPA ENTERPRISES INC DBA 111 HATHAWAY STREET CAPE COD ROOFING & SIDING' WAREHAM =_ MA 02571 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment;is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees,are.hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS`` 003843 w20P1G02 TO BE POSTED- BY EMPLOYER , 3' .�'M. S`ffi+.J@s # Yy • i - .:¢ .. .-. a ?N if +� "' +. 440 ® rn terra Proves It ,There is a calm before every storm, but Certain'Teed.Roofing is calm during and after, Landmark- Series shingles are designed#o defend ybur`home against'updrafts, crosswinds, and ail manner of gusty, biustery weather.The Landmark.'" Series features the industry's toughest fiber Bias§mat and strongest materials available.And with in leading warranties;you can',be certain your hoiaie'is,protected-because . your roof is covered., Landmark Series . Landmark TL' 110 . 130 77 Landmark Premium' 90 130: atidmark Woodscape Premium. ;90 . 13 t0 Landmark Solaris 90 130 i t_aridmark Speciat 90 . 130 - Landmark Pius 80 130 , Landmark Canada t30 130, Landmark 70 Landmark Woodscape 70 ~110 (Sea actual wawa my tocdetaris) - } . Landrriaric�° Series shngtes feature an entanced_wlnd warranty for winds up to MD . V1/orking`in concert with CertainTeed hip and ridge materials, and CertainTeed starter, these shingles`are•your,horne's able guardians against:Wlnd damage: Upgraded 130 IYIM warranty for llrst 10 years onty and f f0 NIPH upgraded warranty for frfst 5'ears on Y ty Provided the foflowing criteria are rrret Landmark series shingles are Trot applied over extsSng roof shingles(roo€-overs are'not permitted). CertaMTeed Swiftt staffer shingles are installed atorig the roof eaves and rakes(Universal starter forCandmark.Woodscape shtngfes). CertainTeed Shadow Ridge or Mountain Ridge hip and ridge accessory products are installed:a$cap shingles. s y Nf1X2(t SW Ce, - Qrinted on FSC'certifaed paper Pfai EH, IHi Yell ASK ABOtlT®l&R"O>r!-lER OEf;I'>i'Af NE. CT PRODU S A SYS7'Et01tS: ._EXTEFiIOR:'ROOFIN'G S1.DING -'WINDOWS FENCE RAILING TRIM,;• DECKING- •`: EOUNDATIQNS PIPE %INTERIOR: INSULATION—,GYP SUM, CEILINGS' -:::CortainTood Corporatlon ..Profarrimnal:20 -233-aQQ RO.Box860. Consumer:800-782-8777 Ceftain Valley Forge,PA 19482 www.certalnteed.coir2 " . :•Code No.20-20-3090,.051o9 CertalnTeed Co rporation,.Pdnted In:U.SA oFmE rof, Town of Barnstable Regulatory Services HnxxsrABI E 9 Mesa Thomas F.Geiler,Director,. <. Fo { Building Division Tom Perry,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 If Using A Builder I, �T o e subject property hereby authorize- `"� J- L � {gyp act on ray behalf, in all matters relative to work authorized by this building permit qs jjor_�s�,_ L cuki_�_A (Address of Job) �*Pool fences and alarms are the responsibility of the applicant. Pools are not to be.filled or utilized before fence is installed and all final inspections are performed and accepted. i ttzre of Signature of Applicant _ Print Name Print Name Date QTORMS:OWNERPERMISSIONPOOLS 62012 IR, The C'oas7aamazinfeadth of MassachuusdYr DeparhnentafladmftialAccidents . ... 600 W=haragton Street Boston,MA 02LII www anass-gotldirx Workers' Compensafidnt Insurauce Affidavit:Bu Tders/Con ctoMq�cianMumbers plk-ant Information S G k t% 1z Please Print,Leyibly Name 9IuZm sl0,g�onFIndividual): CityfstatelZip phone 56T- Z5� Are you an employer?Check the appropriate box; T • of o ect ,r ��. � Yl Ir, (eq P Y 4_ I a3n.a contractor and I 6. Q New ctim- I am a eui to er with. $�� employees(full andlorpart the}* avehirerithe sub-contractors 2_❑ I am a sole proprietor or partner- Eited on the attached sheet 7. ❑Remodeling slut and have no employees These sob-contractors have g_ ❑Demolition working for me in any capacity_ employees and have workers' _ ❑Building addition [No workm, camp-insurance comp_insuranm required_] .5_ We are a corporaticnand ifs 10_.0 Electrical repairs or additions I El I am a homeowner doing all work X officers hmm exercised their. 1 l_.0 Plumbing repairs or additions myself[No workers'oomp_ right of exemption per MGL of repairs S himra,ce regnued_]1 c_ 15?, 1�4},and we �e no employees_[No ' 13-0 Other comp-insurance regi fired.-] "Any apptixxut flat checks boa#1 n cast also f11 out the sectioa beIow showing their wodsecs'compenudoo perlicp iu&mm dm �Homeowners who submit fis affidavit n dicstaq ttey.are doiag all uut and then hide outer&contractors nmst sn—bm_4t s new atdavit mrVtating.Mrh_ kbntractors that check this ban mast attached an additional sheet shivering the name of the stdr-eaiftmcton and state whether ornot dense i Beat employees I€the sub-contisdars have employees,they must pmuide their warken'comp.policy aumbrr Iam an emp£nyer thatisprmidirrg tt'orke-ts'comperundan irmirance for My employees .Be&ty is fhePaHi}and job site informat9wL Insurance comp myName: Policy g or self-ins-jjc�#: q 6 cy; N later -.,K-1, Expiration Date:_ Job Site Address: City/StaW2l p: 4-L4 ec y—A�,C, �iU- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coy enge as required uuder Section 25A of MGL c. 152 can lead to the imposition ofer urinal petrauies of a fine up to$I,500.0a andlor ore yearimlarisonment,as well as civil penalties in the form of a STOP WORK ORDE£tand a fine of up to$250_00 a day against the violator. Be advised that a copy of this statement may be forwarded to fltie Office of Investigations of the DIA for insurance coverage veepcation I do hereby ce,`i fi ttr£penaWes(o�f ury tiiattlic information prinrided about is his and correct Signature: 't-1 S V 1,-LDate_ 1) Phone iWk al u w only. Do not write in this area,to be completed by city or town olficiaL City or Town: Permi#lLicense ff Issuing Authority(circle one): 1.Board of$ealth 2.Building Department 3.City1rown Clerk 4.EIectrical Inspector 5.Plumbing inspector 6.Othes F• , 1♦ - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map oC7 Parcel Application #n2&/o?e_6: � Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee C -1 I ! 0 b 0 Date Definitive Plan Approved by Planning Board cZ1�/�L Historic - OKH Preservation / Hyannis ` Project Street Address 9111cc � ram. Lane- Village ['e�T2f�)A) le-Owner r�d KerlrieV Address tS )arse C ae Z✓le-. Telephone 0 Permit Request f— ?ro�c�. r w ��o �' Ct� ��c rawdc� r y Square feet: 1 st floor: existing(/50 proposed 2nd floor: existing.7 8 1 proposedTotal new eo— Zoning District _ Flood Plain Groundwater Overlay UUU. 1 j, Project Valuation Construction Type <- 7®r'a'I; Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family La/ Two Family ❑ Multi-Family (# units) Age of Existing Structure qb Historic House: ❑Yes U�No On Old King's Highway: ❑Yes ❑ No Basement.type: R(Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) 6 Basement Unfinished Area (sq.ft) #90 Number of Baths: Full: existing new Half: existing / new Number of Bedrooms: existin _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: W(Gas ❑ Oil ❑ Electric ther Central Air: ❑Yes I/No Fireplaces: Existing ❑ New Existing wood/coal stove: ❑Yes M 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 U(No If yes, site plan review# =? Current Use rf,es�Joy'►g Proposed Use SaAA C, ` APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name I 2� S �; ' `- Telephone Number �/!/- % �Q�� Address �T����u ,4 coy e License # _C.5 10 q 3 `7 S" cb�,:4 f ✓ A 04A3 Home Improvement Contractor# KK 9 Worker's Compensation # 65G aU 3-yd 1 P 95 x- lit ALL CONSTRUCTION DEBRIS RESULTING FROM HIS PROJECT WILL BE TAKEN TO t) l _ 1./ e SIGNATURE61?QX' DATE k 6 I FOR OFFICIAL USE ONLY APPLICATION#. , DATE ISSUED -MAP/PARCEL NO. ;Z ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME 9V?, INSULATION D MZ.V IZA k FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ` FINAL BUILDING - 1 - 'r DATE CLOSED OUT ASSOCIATION PLAN NO ,� r , The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street . Boston, AM 02111 www.mass.gov%dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electnicians/Plumbers Applicant Information Please Print Le 'bl Name(Business/Oro nization/IndMdual): �� �t I.� AS ,3c�a e 1 � Address:_. � , f,41 C a y ,e- City/State/Zip: AAA. C. 4 3�- Phone#: 617<0 Ayou an employer? Check the appropriate bog: Type of project(required); 1. am a employer with 4• ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.El am a sole proprietor or partner- listed on the attached sheet. •7. ❑Remodeling . shipand have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity: employees and have workers' coin insurance. 9. ❑Building addition [No workers' comp'.instirance P• required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner.doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp-, right of exemption per MGL 12.❑Roof repairs insurance required:] t. c. 152,§10), and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, tContractors 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:_. AC Policy#or Self-ins.Lic.#: 74%9jP9-5 —A-Q Expiration Date: 6 blo Job Site Address:_ a @ / State/Zip: C0P�✓I !! ``, city/ Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage.as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up.to$250,00 a day against the violator. Be advised that a copy of this statement may be forwarded to the.0ffice of Investigations of the DIA for insurance coverage verification I do hereby c under the pains and penalties of perjury that the information provided above is true and correct. Si ature: Date: J Phone Official use only. Do not write in this area, to be.cornpleted 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 Contpct Person: Phone#: Town of Barnstable Regulatory Services • saxxszaa�, • v Mass. Thomas F. Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.barnstable.mq.us Office: 508-862-403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sign This Section If Using A Builder I, See -N11�lc.� e4 T6-rYV1 as Owner of the rop subject'P ertY f J hereby authorize �' . �;�1 SSDCI ale S to act on my behalf, in all matters relative to work authorized by this building permit arse- Shoe Ce✓lert/> (Address of Job) *Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. J I dr>r-I Signature of Owner Signature of Applicant o,k / Print Name Print Name . Date - Q:FORMS:OWNERPERMISSIONPOOLS 6/2012 t + I �t t Town of Barnstable ; " Regulatory Services t BARNSTABLE, : Thomas F.Geiler,Director y MASS. n �p i6gg. Building Division TFD MA'I a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OFHOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be-considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a forrn/certification for use in your community. Q:forms:homeexempt O'REILLY & ASSOCIATES Builders — Developers — Woodworkers 11 Cotuit Cove Road, Cotuit, MA 02635 "Serving Southeastern Mass and Cape Cod" 508-737-4711 617-699-8055 www.OREILLYBUILDER.com DenOReilly@hotmail.com Work Authorization Form hereby authorize Deems O''Reilly°of O'Reilly 4 Associa s'Buiwing Remodelin ,to perform':work at the following address �, J ":".'*'^ `s,..,,.,.� p:fi'" +r''"p` •,.^;."7�"w"w't""w"`"'. ,` "n "";. 'YI �"'�;' '""""-»;-Nm .+ Homeo r ttt � �,t,' 'r�:' � +:�:: � .: °`.� � - ,u.=ice. �'� �• .x�. ygj NY 3 �. r w a,- r ys m � rh� P 1• ,fie� � �{'.� 4 e�� �,, .. a 4: .t, '. .tic. .J` 1 VDAC 10. ace group WORKERS COMPENSATION AND Ll EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 { A) POLICY NUMBER: (6S62UB-4697P95-A-12) RENEWAL OF (GS62UB-4697P95-A-11 ) INSURER: ACE AMERICAN INSURANCE COMPANY �. NCCI CO CODE: 12165 INSURED: PRODUCER: O'REILLY, DENNIS ROGERS & GRAY INS AGCY 11 COTUIT COVE RD 434 RTE 134 COTUIT MA 02635 SOUTH DENNIS MA 02660 Insured is AN INDIVIDUAL Other work places and identification.numbers are shown in the schedule(s) attached. 2. The policy period is from 06-08-12 to 06-08-13 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers_ Compensation Law of the state(s) listed here: MA a� m B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 100000 Each Accident o Bodily Injury by Disease: $ 500000 Policy Limit Bodily Injury by Disease: $ 100000 Each Employee o_ . �— C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A m= d� D. This policy includes these endorsements and schedules: o� SEE LISTING OF ENDORSEMENTS - -EXTENSION OF INFO PAGE 0 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating m-- Plans. All required information is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 05-29-12 . WC ST ASSIGN: MA OFFICE: ORLANDO DA ACE 24M PRODUCER: ROGERS & GRAY INS AGCY 2342X ` 013874 Fill Office o o sWi MW si es WhWP License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date.~If found return to: Registration: 166842 Type: Office of Consumer Affairs and Business'Regulation Expiration: 7/14%2012 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 a LY&ASSO,CIATES BUILDERS/DEVELOPERS I i DENNIS O'REILLYi� � �_ t � i;•; 481 DEPOT STa HARWICH,MA 02645 k Undersecretary Not valid with signature N'la,ti`,tchu.ctt.`. Dcp*u-tment of Pohlic S<rfch �kCll;titiiBtiildin'r Rer ulation.s und:Stund :•construction Su .�i.d•� pervisor License License: CS 104375 ` DENNIS OREILLY 481 DEPOT ST HARWICH, MA 02645 ('unun� .0 ncf� c Expiration:. 5/15/2014 Tr#: 104375 f . THE COMMONWEALTH OF MASSACHUSETTS Registration: j y Office of Consumer Affairs and Business Regulation Home Improvement Contractor Registration Program Expiration: 9//q/a.D a 10 Park Plaza,Suite 5170 Boston,MA 02116 Received: o APPLICATION FOR RENEWAL OF REGISTRATION r HOME IMPROVEMENT CONTRACTOR OR SUBCONTRACTOR �V MGL Chapter 142A,780 CMR R6 (PLEASE READ INSTRUCTIONS CAREFULLY) 1. Name of Applicant as on Current Registration: CvY1d1I J t 2..D/B/A used by Applicant(if differentfrom that used with current registration): tg j Q--� &tom ACO 3. Address of Applicant(if different fro address on current registration): C Cct1T.C'aVedar� 4. No.of Employees: 5. If Applicant is a Partnership,Corporation or Trust,state the name of the individual responsible for Applicant's work: First Middle Last Telephone No.: 6. Does the Applicant hold any other construction-related,state,city or town licenses or registrations? _Yes No Construction L Expires: /xv Supervisor License: Motor Vehicle Repair Expires: Shop: 7. Is the Applicant claiming exemption from the,registration fee?(Please see instructions) .Yes No 8. Registration Renewal Fee enclosed:$ Vy ®L? Make all certified checks or money orders payable to "Commonwealth of Massachusetts." ONLY CERTIFIED CHECKS OR MONEY ORDERS WILL BE ACCEPTED Pursuant to Massaehusetts General Laws Chapter QC§49A,I certify under the penalties of perjury that,to the best of my. knowledge and belief,I have filed all state tax returns and paid all state taxes required under law. 0 ()JA ey - Signature of Applicant Title held with applicant D to A FALSE ANSWER TO ANY QUESTION IN THIS APPLICATION CONSTITUTES` GROUNDS FOR SUSPENSION OR REVOCATION OF THE APPLICANT'S REGISTRATION. 4 i ., �+- �-- .. ,� :� � -� �� � �, �,� ,y� .. � r,I �- vv p�,.,. t ,� > � . (e) Maximum building height: [1] Maximum building height in feet: 30. [2] Maximum building height in stories: 2 (2) Grandfathering. Within the R-2C District, any frontage requirements of the RF-1 or RF-2 Di Pond Village DCPC nomination of August 26, Acceptance Decision dated September 15, 200 §240-13. RC, RD, RF-1 and RG Residential Districts. A. Principal permitted uses. The following uses are p (1) Single-family residential dwelling (detached). B. Accessory uses. The following uses are permitted a Districts: (1) Keeping, stabling and maintenance of horses s C. Conditional uses. The following uses are permitted Districts, provided a special permit is first obtained provisions of§ 240-125C herein and subject to the in this section: (1) Public or private regulation golf courses subject http://www.ecode360.com/6559171?highlight--autom( THE COMMONWEALTH OF MASSACHUSETTS Registration: g �� Office of Consumer Affairs and Business Regulation':'" Home Improvement Contractor Registration Program Expiration: 10 Park Plaza,Suite 5170 ' Boston,MA 02116 Received: APPLICATION FOR RENEWAL OF REGISTRATION r HOME IMPROVEMENT CONTRACTOR OR SUBCONTRACTOR MGL Chapter 142A,780 CMR R6 (PLEASE READ INSTRUCTIONS CAREFULLY) _ o?e,` 1. Name of Applicant as on Current Registration: dl l ' ' t l PP g stration: eyl t: 9 �lJ 2..DB/A used by Applicant(if different from that used with current registration A 3. Address of Applicant(if different fro address on current registration): 4. No.of Employees:, r Al 5. If Applicant is a Partnership,Corporation or Trust,state the name of the individual responsible for Applicant's work: . . First Middle Last �s }` Telephone No. r ®� r, ..c,.• 6. Does the Applicant hold any other construction=related,state,city or town licenses or registrations jYes I No Construction xpi joi y Eres: Supervisor License: ` 5 r Motor Vehicle Repair r* Expires Shop:. C•_.so of 7. Is the Applicant claiming exemption from the registration fee?(Please see instructions) Yes' allo X . 8. Registration Renewal Fee enclosed:$ Iwo •,Make all certified checks or money orders payable to "Commonwealth of Massachusetts." . ONLY CERTIFIED,CHECKS OR MONEY ORDERS WILL BE ACCEPTED " Pursuant to Massachusetts General Laws.Chapter 62C§49A,I certify under the penalties of perjury that,to the best of my knowledge and belief,I have filed all state tax returns and paid all state taxes required under law: E Signature of Applicant Title held with applicant D to 1 ° A FALSE ANSWER TO;ANY QUESTION IN THIS APPLICATION CONSTITUTES GROUNDS FOR SUSPENSION.OR REVOCATION O Tur+, APPIh REGISTRATION., I �4 E + . SEP 01 2012 FFICE OF CONSUMER AFFAIRS TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel t 0 Permit# Health Division Date Issued _ Conservation Division Fee Tax Collector Treasurer r Planning Dept. Checked in By. Date Definitive Plan Approved by.Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address 5 4c)r5e_,Vl,u e. La,n-e— Village GAT�J(V I C Owner Uh Address Telephone 9 Permit Request J0 aEc t e ESL Squar et: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation a� '-I � Zoning District Flood Plain Groundwater Overlay 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 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 r�-; news lJ ..tll F 3 Number of Bedrooms: existing r 1 newW w w Total Room Count(not including baths): existing new First Floor Room „ount f 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:0 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 - BUILDER INF R ��C_� Nc Name umber Address 1p++�, l� License# -OK 16 3 �Jh&t -F- Home Improvement Contractor# 6 G J 3 -2 V Worker's Compensation# l S6�"�03 — ('f ALL CONSTRUCTION DEBRIS RESULTI FROM THIS PROJECT WILL BE TAKEN TO cA, SIGNATURE DATE �- FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of 1`ridrtsMal Accidents ' office.of Investigations : 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors(Electricians/Plumbers A licant Information Please Print Le 'bl Name (Bu4iness/0ro*n'ation/hdividuaD: � Address: • _ • ty/State7Zip: Pone#: � c f D Ci. Are you an employer? Check the•appropriate box:. Type of project(required): 1 am a employer with 4. ❑ I am a general contractor and I .6 ❑New construction employees(fu1T and/or part-time).* have hired the sub-contractors 7. ❑ Remodeling listed on the attached sheet# 2.❑ I am a sole proprietor or partner- and no employees These sub .contractors have ,S. �❑ Demolition ship workers' comp.insurance. 9• ❑ Building addition working for mein any capacity. [No workers' comp.insurance 5. ❑ We are a corporation and its 10•❑ Electrical repairs or.additions required] officers have exercised their ri t o exemption per MGL 1.1.❑ Plumbing repairs or additions 3.❑ I am a homeowner doit<g all work . lion c. 152,§1(4),and we have no.. 12.❑ Roof repairs myself.-[No workers'comp. employees. [No workers insurance required.] 1.3:❑ Other comp.insurance required.] *Amy applicant thet,checks box#1 must also fM out the section below showing their workers'compensation policy information `6 - fiHomeowners who snbmitthis affidavit indicating they ate doing all-work sad theabire outside contractors must subaut anew affi&a itindicating such tConvactars that check this box must attached au additional sheet showing the name of the sub-contractors sad their wworlcers'coagx`:poiic�srf°rlYiati°n. I am an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site information. Insurance.Company Name: i Y12JrlC�-ll� t�tX l #or Self-ins.Lic.#: 1�-''�d lJ Expiration Date: j Policy L � Ci /State/Zi J Job Site Addressa�rd Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Fafiure to,secure coverage as required under Section 25A of MGL c. 152 caii lead to the imposition of criminalpenalties of a fine u' to$1400,.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 Investigations of the DIA for insurance coverage verification. I do hereby ce der the p ins nd penalties of perjury that the information provided above is true and correct. Si atnre: Date: Phone# �d .. Off lcial use only. Do not write in this area,to be completed by city or town of City or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department I City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions efts General Laws chapter 152 requires all employers to Provide workers' compensation for their employees. Massachus erson in the service of another under any contract ofhire, Pursuant to this statate, an employee is defined as"...every p express or implied,oral or written." p ' * association, gWPoration or other legal entity,or any two or more erg �. . . . . An employer is dfined as`: dividal,•,P plo er,or the of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased emp y arts , association or other legal entity, employing employees. Ho�telrer. e receiver or trustee of an individual,partnership, ant of the owner of a dwelling house having not more thant three apartmentsC��v'��n or ep�w°o�ro�dw;Vmg house dwelling house of another whoemploys persons or on the grounds or binding appurtenant thereto.shall not because of such employment b c deemed to be an employer." MGL chapter 152,§25 C(6)also states that"even.',state or local licensing agency shall withheld the issuance or enewal of a license or permit to operate a business or to construct buildings 1n the commonwealth for any. T . Hcant who has not produced acceptable e�dence•of compliance with the insurance coverage required."-.. a Pli ter 152, 25C states"Neither flee commonwealth nor any of its-political subdivisions shall Additionally,MGL chap .. § (� of public work untilacceptable evidence of compliance with the insurance enter into any contract for the performance iequirements of'this chapter have been presented to the contracting authority." Applicants •' Plea se fill out the workers' compensation affidavit by checl&g the boxes that apply to y4 completely, m situation and,if of necessary,supply sub-contractor(s)name(s),addresses)and phone number(s) along with their certificates)other incur ance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the ve members or partners; are not require advised workers this affidavi may be submitted to the Department f'Induensation,insurance. If an LLC or LLP does strial employees,a policy is required. Be davit. The affidavit Should. Accidents for confirmation of insurance coverag . the Permit or licensaend date the is being requested, not the Department of b e retuned to the city'or town that the applicationf Industrial Accidents. Should you have any questions regarding the law or if you are required to t hOil their Identet compensationpolicy,please call the Department at the number listed below.. Self insured comp self insurance license number on the appropriate lime. City or Town Officials e bottom Please be sure that the affidavit is complete and printed legibly The Department you regarding thvided a space ate hap'plican of the affidavit for you to fill out in the event the Office of Investigations has n y licant Please be savi to fill in me perwit/hcense number which wiU be used as a reference number. In addition,an aPe that mast sure'to 0ltiple permithicense applications in any given Year,need only submit one affidavit indicating current policy information(if necessary)and under"Job site Address"'the applicant should write"all locations in (city or "A co of the•affidavit that has been officially stamped or marked by the city or town may be provided to the town). copy applicant as proof that•a valid affidavit is•on.file for;mense or ermit not related to any busainess or cobmmercral v ttiue year.Where a home owner or citizen is obtaining a he P (Le. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit d like to thank you in advance for your cooperation and should you have any questions, The Office oflnvestigations woul please do not hesitate to give us a call. 'I'heDepartment's address,telephone and.faxnumber: The Commonwealth of Massachusetts . ' Department of Indtistrial.Accidents ., gations s Office of I�avesti ,. 600'Wash ngfon•Street V .BostOn,MA 02111.• ` `Tel. #617-727-4900 ext 4G6 or-1-877-MASSAFE Fax#617-7274749 Revised 5-26.05 wwW.mass.govIdle na�nLrax l,'J—L L/;3/'LUIZ 5:43:47 AM PAGE 2L002 Fax Server ACORD. CERTIFICATE OF LIABILITY INSURANCE 02/03/201.2 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 and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemert(sj. PRODUCER CONTACT NAME: DOWLING&ONEIL INS AGCY PHONE. FAX (A/C,No; FAX 973 IYANNOUGH RD (A/C,No): EMAIL ADDRESS: HYANNIS,MA 02601 PRODUCER 76RNJ CUSTOMER ID# INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: ANffMCAN ZURICH INSURANCE COAIPANY EMERGENCY CONTRACTORS LLC INSURER Bt INSURER C: 73 IYANNOUGH RD.ROUTE 28 -INSURER D: HYANNIS,MA 02601 INSURER E: COVERAGES ' CERTIFICATE NUMBER: INSURER F: REVISION : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FORTHE.POLICY PERIOD NDIICCA ED. _ NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT.WITH RESPECTTO 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. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - - - ADDLSUBR - POLICY EFF DATE POLICY EXP DATE TYPE OF INSURANCE POLICY NUMBER (MMIDDIVVYY LTR - -INSR WVD ) (MIMDMYYYY).. - - UMITS-. - - - GENERAL LIABILITY x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MADE OCCUR. DAMAGE TO RENTED $ PREMISES(Ea occurrence).` MED EXP(Anyone person). $ GENT AGGREGATE LIMIT APPLIES PER: PERSONAL&&ADV INJURY $ POLICY. PROJECT LOC GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGO $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE $ ALL OWNED AUTOS LIMIT(Ea accident) SCHEDULE AUTOS BODILY INJURY $ HIRED AUTOS (Per person)` k' BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) , UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE EACH OCCURRENCE $ DEDUCTIBLE AGGREGATE, $ ' RETENTION$ $ WORKER'S COMPENSATION AND We STATUTORY LIMITS OTHER EMPLOYERS LIABILITY YIN UB-456SP038-11 03/03/2011 03/03/2012 E.L.EACH ACCIDENT ANY PROPERITOR/PARTNER/EXECUTIVE Y $. 1,000,000 OFFICER/MEMBER EXCLUDED? - _ E.L.DISEASE-EA EMPLOYEE $ - 1,000,000- - (Mandatory in NH) II yes,describe under - E.L:DISEASE-POLICY LIMIT $ 1;000,000. DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED T0:THE CERTIFICATE HOLDER AFFECTING NORMtS CONIP COVERAGE CERTIFICATE HOLDER CANCELLATION .,TOWN,OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED REGULATORY SERVICES BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 200 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS,MA 02601 AUTHORIZED REPRESENTATIVE linder W A Bo ACORD 25(2009/09) 1988-2009 ACORD CORPORATION.,All rlghtS reserved. . - Ftie - omwwna" aI-1I6w6ac1w4eda, _ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR' :, `before the expiration date. 1f found return to: Office of Consumer Affairs and Business Regulation' Registration ;164370 Type` 10 Park Plaza-Suite 5170 Expira5M' '10/1120.13, Supplement aid .Boston;MA 02.116 EMERGENCY CONTRACTORS.LLC RANDY FLORENCE 73 IYANNOUGH HYANNIS,MA 02601 No ithout signature Undersecretary ` " r A Massachusetts-Department of Public Safety :t * Board of Bu ilding Regulations and Standards C'un%tructiun.Super%isur License: C$-086385 RANDALL Jr"RENCE 5 ANDREA WAYS q FORESTDAI,E */�g4 Commissioner Expiration 12/19/2013 J iWIF 73 Iyannough Road/Rouge 28, Hyannis, MA,02601 * 508-775-1120 * Fax.774-470-1575 EMERGENCYT ASSIGNMENT AND AUTHORIZATION TO PAY The undersigned, herein called claimant, has authorized and ordered from Emergency Contractors LLC the materials and/or.services-as'ag reed upon. 'his agreement shall not be considered a release and/ proof of loss: Claimant hereby assigns to Emergency Contractors, LLC any unpaid proceeds due or to become due, under the claimant's policy with the insurance company.to pay direct to Emergency Contractors LLC or to include Emergency Contractors LLC name on check or draft. In the event that Emergency Contractors LLC.claim herein Is not covered.by, or paid by, insurance company, claimant.agrees to pay Emergency'Contractors LLC Within.sfkty (60) days after work has been completed: Claimant understands,that Emergency Contractors LLC is working for them, and not the insurance company or the adjuster.. F -Payments remaining. due.and payable .after_ claimant"has received:,payment from the _ insurance company shall bear interest at a rate of one arid'cane-Italfr (t-1/2°l0) percent per month. In the event of breach by claimant of any of the conditions of this agreement, Emergency ,. Contractors LLC shall be entitled to recover,as additional damages,attornay's fees, costs and any other collection.expenses reasonably attributable to said breach. If payment is not received within 60 days, collection action will,corrimence`withdut further notice,tes claimant Date: Claimant's Signature: Print name: ,f Phone Address: MS Insurance Agency/Agent } - r ti, €fi Ln j . ✓ J r, / 'toll Free 866 888-7750.' e _ CONTRACTORS .. MOLD Randy Florence SALES&OPERATIONS MANAGER CeI� (508)889-8741 Randy@EmergencyContractors.com Office(508)775-1120 www.EmergenryContractors.com - Fax -(774)470-1575 24HourEmergencyCleanup &Fu115erviceConstruction . h• Y 1 e r • I F 1 f 1 1 lYi t 100_3816(3648x2736)c16M jpeg) 4 a 100_38W(3648x2736xl6Mjpeg) Y.^ AWF ga t j d F [[ G _ b .a 9✓ 3 - r � � 100_3818(3648x2736x16Mjpeg) / y � e TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Mapy Parcel `� U Permit# r7 7 7 3 b Health Division �� /% Date Issued l y Conservation Division S !� © 3I J°LN Application Fee ': 00 Tax Collector s/�g�D� I�eNNe� Permit Fee e �� SEPTIC SYST _ Treasurer INSTALLED IN r MUST Be Planning Dept. ��,., ENVIROIwj<W, Date Definitive Plan Approved by Planning Board TovvN .� aNf�- Historic-OKH Preservation/Hyannis Project Street Address 95 )'Ibis h()-e (-c-'(0 -, Village eel 4'-eri)i f I' A An Owner �-erl n Address Telephone Permit Request 3 b ce - - 14 , �J Square feet: tst floor:existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation f` 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 L4 e� q r-S Historic House: ❑Yes �No On Old King's Highway: ❑Yes 'Mo 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 I ao A-� 1 new First Floor Room Count Heat Type and Fuel: W Zas ❑Oil ❑Electric ❑Other Central Air: ❑Yes C 4410 Fireplaces: Existing I New Existing wood/coal stove: ❑Yes OAo 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 BUILDER INFORMATION Name tDoi-C kafar c e Telephone Number 5V9_ ��-7 0 Address NfVAAdA j C License# ;MA Home Improvement Contractor# Worker's Compensation# 1 1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE t, 2,J 6 FOR OFFICIAL USE ONLY , $ PERMIT NO. ƒ D& SUED , MAP/P RCE&NO. 7 . , • , , ADDRESS 2� . VILLAGE / OWNER z .ƒ, \ . . • , . . . fDATE OFINSPECTION: { FOUNDAI N . . . K f FRANE \ INSULATION ® FIREPLACE S � \ ELECTRICAL \ROUGH FINAL : { PLUMBING: ROUGH- FINAL GAS: RQe�- % FINAL \ FINAL BUILDING � � • , . - � DA \LO§ED OUT/ . } ASOCAI»PLAN NO. 0 q , & f �� �oonzrxcn�zrvea�'i o���aaaac.�ueae%,ta Lino;_s� dl N0*0 Ti®'N S,um tSOR r -- (aliu; . Tr.no: 3715 y Elie��naiuuea.�= Beard of ' e wRatrons and Standards g . b LOdIt1L 1=1NEM CONTRACTOR L ! 1/2004 + 'F _ � _ K€NINETM POR c�diaunstatier The Commonwealth of Massachusetts Department of Industrial Accidents 600 Washington Street _ J Boston,Mass. .0211I Y Workers'..Com ensation.Insurance Affidavit-General Businesses yiP+K•rs5#�`/'t'�t�L+.. 7"�" s..r' tra••. .'•`artL`r'Y"p r e y. - •a F"wteY1 ... • - rX t - is•' - " ` '1• .. • state: - hone:# P7. •Y - work site location(full address : I am a.sole r ' rietor and have no one Bpsiness ec • Retail❑Restaurant/Bar/Eating Establishment ' oP 'I�'P ❑ ❑ p ytor]Qng in any capacity. ❑of ice'[]Sales(including Real Estate,Antos etc.) I am an ena to ex with . em'to ees full& art time 0 Othe IFFIV/00/001//// %// ,. //%�/� I am an;em 1. provi v�orkers'compensation for my employees worlang on this lob t rti re '�:t' .•±�i•4 .'.: •,•ti. !3.'.:7' r t:'lr t7`. l :':.• ` '3i.. :.i .. 19. a8�t Ft • ;fir ..,, .Kira^.,.i;•,r, _ f..�:'• Y..y1i`ag9•• '4:{';� z"�' .@..I. �"';'r,' Ltd' '�i'' •�:,'. ... .r� . "boric:#:��.`. ,f�L., '•�'.' •r'' :.-.:.r t .lam +1. l� '4: a..,. •` :�.t•' _.. `• ''. '.. :S• :`• Insurance.co: :..t:�; ,':�, :.a ;1,.w.•xr:.. ohc.'.#'' I'am a sole proprietor and have hired the independent contraetots'listed-below who have the following workers' .compensation polices: ' ••.•5 ••s� - � •t 9 � r r S " _7y •7ti-y,t{b +r .r,.'•t t.•.t, it coin 83i••'n'ame. �< '•�•:•. •' •. t• •.: r,y;�.t4 ..,,'-• r+ -'r.{-e••• .. .ax'•, )it':;is rrt tr,.•',I, ,ii ;1•r:f�..5 e�:•� '!•.. .. F:•.:',r• .;::'.�•. r •' , address:. " Cl ... �.}: .'•.1....L•i^:e :},`�:• „�r+..at L;•• .nit,.. :.;.`j. Jd:': ':ZF'�M1:;•S�� '`,,• gx MIN com u:y a: •r - ••'r a: •:'z' .sa rc1j;' t' •'�.'•' -r:•.r:'�• YO'l1C :#: .;+,r:2-::.' f`:,;,�:•:.. "•fr.:; frisursnce co. -r=.rr•: ::' ':' �/j//////j//////�/ 'r.:% :'S,• a: in?'•�.. .•���-q } :; Sit. ��'-:��. •i'•+•� _ t; •:C+ y-::i' .'�•• - t� Y: 6�:J'i: •C•ty, .'`f.Ncl:•'• ,':�,�••t••. azt• Hard address.. r t r t au tr r Cl. l.r••'a;4•.�'i_ ;.•r•'a: :�...�, t _•• -.-.9 - , r � _tY F ti PL• t 1 insurance sh:�- c lb Ir - —- ----Failure to,secure coverage as required:under Section 25A of_MGL 152 can lead to thcimposition of criminal penalties of a fine up to$1,500.00 and/or ' - --cone years'-imprisOnmenYas well.as civil penalties is the fo m of a STOP WORK OItDFt and a fine of100 DO a day against me.I understand that a ._ copy oatement maybe forwarded to the Office of Investigations of the DIAfor coverage f this st ver�iieation w.x - '•- - .—„ .^ :„.r_':G•- ...tee?" - I do hereby certify rider the pains an pe- ties o ury t)iat the�nformatton provided above is Prue dndrar�eet -. ,. . . _ . . �_� •�-- Date - .. =�r ignature _— _ _ -7 J Phones official we only do not write in this area to be completed by city town oMciai city or tower permit/license# []Building Department' L]Licensing Board ❑-checkif immediate response is required []Selectmen's Office []Health Department , contact person: phone#; 00ther (revised Sept 2003) oF�HEro� Town of Barnstable Regulatory Services s us i s, • Thomas F.Geller,Director 9� sb39• ,Q� Building Division ''lED MAC Tom Perry,Building Commissioner -- :-200 Main Street,_Hya=s,.NiA 02601 Office: 508-862-4038 Fax: 508-790=6230 Permit no _: - _ -Date- - - - ,. ` .� - .. _ , _ ., - . -• -. - -- ' _ -- - _ .. ..__ _ .� - AFFMAVIT HOME hYIPROYEMENT CONTRACTOR LAW _ SUPPLEMENT TO PERMIT APPLICATION MGI,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 thaw 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 o er requirements. Estimated Cost v j -- - Type of Work: Address of Work: Owner's Name `F Date of App I h reby certify that: Registratzoa is sot required for the following reasons} � b - :� • ... _,. � � -[]V1ork excluded y law - 3 r� [Q17ob Under$1,000 _ 4[]Building not owner occupied - - - .� - - _ []Owner pulling owri permit" Notrce is hereby given that° _,v �,.-w•. _ �_ - -ownRB=PULLING TSEIR OWNTERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FORAPPLICABLF HOME ZIPROYEMENT WORK DO NOT-H.AYE y ACCESS TOTHE-ARBITRATIO-N-PROGRAM_0_R GUARANTX FUND UNDER MGL c.142A Y Y ERPENALTLES OFTERTURY the b ply for- permit as the e o er• Date Contr toi Name R gistrationNo. OR Date Owner's Name r r �ofT°�ti Town of Barnstable Regulatory Services SON ARNSTASU.$' Thomas F.Geller,Director �pri►,� Building D.vision Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-8624038 Fax: 508 790-6230 Property. Owner Must Complete and Sign This Section If Using A Builder _: ....: ....._:.,;as.O ner.,ofthe.subjectproperty ...._..._. .: hereby authorize l to"Ict on my behalf; in all msttets relative to work authoiize.d•by.this ding pe=it-applicationtfot: Let (Address of Job) = L (1 . Signature�of et t Name F V V V �ammo m Oml �imm ' �nw ►o os2cd n94,ti o TH H H I sc��ene n o<�t0.) te4 L-�i sf-t'� DfccL� C aX3a �s 5 i a ��. r Hill ab SCAM ' .awn MOUMPOM— MEr.MMSCREM HBO E 40 Nnn anean acs im 9T= i FLASM LR as TiAO At77111LT. 13 LA MT.PN111.... PLI�I t ='FM RAND. EXISTING HOUSE in L4' "M C«.Pwn RTWON'SCKM 0 es000 mmr Lon Fu,® CONCAM 3M LLB PSI 1 TUBE ��e 36' HIGH HANDRAIL 7,75' RISE , 11' TREAD iZ }.`"yes 4 i r _ nay 6b DECK Lf4 v�� 1,Z -h�hes 7 r CONCRETE 3000 LB PSI ,ice TUBE 4 FT. DEEP 6.3 FT, CC r � h �� y • DECKING IS SECURED WITH STAINLESS STEEL AD NAILS n 5/4' MAHOGONY DECKING, • x ' 1/2X3.5 GALVANIZED LAG SCREWS STAGGERED EVERY 16' 2X10 JOIST i 2X10 JOIST-HANGERS s, OF 11.a000 ` 12' CNT r MAIN BEAM 3, 2X10X62 PT a s 2X30 PT JOICTES ` sfi w `-"(� 161NT Sc,veeA -x--,c y 5 EXISTING HOUSE "0 T MWU 64 RATU warm n M NCR ETE 3W vLB PSI i 2- 12 Tube C(L ' COPPER FLASHING i DECK CONCRETE 3000 PSI 10' TUBE, 4' DEEP 50.00� y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION � P1 Ma , V �% Parcel /o/ :. �V g; `T���-� p ,;,, Permit# iv�o7`7 Health Division : 511210 U N Date Issued S Conservation Division �. M AOR Application Ne AND 1�7T/�Ke� Tax Collector ' d _ Sk ,h p_,tt,, Permit Fee Treasurer d 3 Planning Dept. / SEPTIC SYSTEM PP.Us y C r INSTALLEI)IN COMPL6.'e�: Date Definitive Plan Approved by Planning Board VIM TITLE 5 ENVIRONMENTAL CODE f"' Historic-OKH Preservation/Hyannis ®1sG"�I�EO L., %,--_, Project Street Address 5 , I Village . t t r v+ 1\ Owner �h ir�., n � � �� Address Telephone Permit Request au ,,P fa, x. C _ SU Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3e }_ 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 I!S Historic House: ❑Yes 'i No On Old King's Highway:tYes No l Basement Type: ull ❑Crawl ❑Walkout Uf0ther Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 3 Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing First Floor Room Count YP Heat Type and Fuel: O,Gas ❑Oil ❑ Electric ❑Other 4� Central Air: ❑Yes Cy'No Fireplaces: Existing New Existing wood/coal stove: ❑Yes [<o Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:Cl 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 BUILDER INFORMATIO S-bF)__ Name PI -effuTelephone Number H 2_0 — CP- 1 tv 3 Address 1 r�x 1 I f'c ld License# (, S D -7 la- 0 l en+e r t l �p /`�( 6i► o p L.3 ;I-Home Improvement Contractor# 2- Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Rh) f �. FOR OFFICIAL USE ONLY PERMIT NO. _ DATE ISSUED MAP/PARCEL•NO. r' i ADDRESS VILLAGE ---- N OWNER � • i r DATE OF INSPECTION:, `- FOUNDATION. �o. FRAME INSULATION.--- FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ►. t GAS: ROUGH FINAL i FINAL BUILDING 0 q DATE CLOSED.OUT j ASSOCIATION PLAN NO. t MORTGAGE INSPECTION PLAN SULLIVAN SURVEY jN OF MA f P.O.BOX 2513 �j► dry f t WOBURN,MA.01888-0913 SARRY �yG rr TEL. (781)944-8750LIVgP1 y FAX (781)942-2437 . �d /4 7 > CD sic- i ��✓ zco n D rn D �. 1 Deck S/f 76 4. . THIS TAPE SURVEY, CERTIFICATION & MORTGAGE INSPECTI❑N PLAN ARE MADE FOR THE USE OF FOR MORTGAGE PURPOSES ONLY — ---- �-BASED ❑N-MYF,KN❑WL,EDGE,-INF.ORMATIDN & BELIEF, I_ CERTIFY_THAT' THE; BUILDING CS] CONFORM -CS TO THE ZONING BY=LAWS CDIMENSICINAL'' fi'" REQUIREMENTS] ❑F THE /CITY ❑F_4&4f&Hrr MASSACHUSETTS THE STRUCTURE IS] IS/AR N � IN THE SPECIAL FLOOD HAZARD AREA AS S WN ON THE FEDERAL EMERGENCY MANAGEMENT . ❑ /CITY ❑F BQIZfdST/te3�� AGENCY MAP ❑F THE MASSACHUSETTS C❑MMUNITY PANEL NUMBER FLOOD INSURANCE RATE MAP; EFFECTIVE DATE REVISE 7 Z /rl9Z T❑ / CITY . DATE REGISTRY REFERENCE SCALE 1 IN. =Z�j N i N i (T) 1JEw m i b ac• a) A ,S6+J O �!2 N a ae AILL W DECK q L q _ J ' �i rr w ee amm rm Q, 70•SlmE.4•AMr ^ lO N O O CD - n 300 q m - ►JE UJ Z8(c6f'i bEfW ASS DOO2 cu — tt O - 1 i m " OJ i m O LD W . U C 4 ' L LL U J r] HAPIDtIAA 76' g. 6K6 PT POST lD N m ' O �HAIIDRAiL 36• PJOE STAIR STRI1ST7iS , O H1ITOIRAiL ab• , CD woos n q EXISTING HOUSE 4 . OMAN30W RAIL CAP 8S4 L4 OC RALISTERS S VCH OC MFFlE M PLATES C13NCRETE 3000 LB PSI 10' TUBE e � 36' HIGH HANDRAIL 7.75' RISE 11' TREAD - c . _ 30 'ld V9 d33Q'.0 ti 3on1 .oi Md Hl CODE 313tl7NM r ro �ADCD ' DECKM IS SECURED VITH STARLESS STEEL AD NAME 001 NAHOOM DECKM - - L49M GALVANDEL LAG SCREWS STAGGERED EVERY W OW JDDET . EKID JDDIT HANTiFRS lop NAM HEM S.EXMM PT •. em PT.GICTES f a T M FLASH G _ ETAD1 STARS 36. DECK GN aeTE'SOM PSI M'TUBFE 4•DEEP START II.8fi' DRAD..86' Town of Barnstable M nnaxsr�sr�. Department of Health,Safety,and Environmental.Services MASS. 1639. Conservation Division `fig' 200 Main Street,Hyannis MA 02601 Office: 508-8624093 Robert W.Gatewood FAX: 508-778-2412 Conservation Administrator NnNOR ACTIVITY REGISTRATIONS Property Owner Telephone number Mailing address 9 I�r Project location v) Le Map/Parcel# deck, Project description The following minor activities will be reviewed,under Art. 27,by Conservation staff instead of the Conservation Commission,as long as they are constructed at least 60' from a wetland resource area or top of a coastal bank * Pathways 4' in width Fencing that does not create a barrier to wildlife movement,6"above grade * Conversion of lawns to decks,sheds,or patios that are accessory to single family homes,as long as: -house existed prior to August 7,1996 -alteration within the buffer zone is less then 250 sq.feet. -sedimentation and erosion controls are used during construction * Stonewalls(this does not include stonewalls for retaining wall purposes,grading and/or fill) . 30 Signature Date 6 Reviewed by Date c e lan) �5k(?A-- r. ov e Lo7� l� minoract.doc e � , Df t°�ti Town of Barnstable Regulatory Services ?� $ Thomas F.Geiler,Director �pl AM Biulduig Division Tom Perry, Building Commissioner 200 Main Reef Hyannis,MA 02601 Office: 508-8624038 Fax: 508 790-6230 Property, Owner Must Complete and Sign This Section If Using A Builder 1,,AS.0avnet.,of the.subject prope�y- ...... .-. .: hereby authorize t? .:. .to`act on rny..behalf, in all mattets relative to work authoiized-by.thisLdi-ag'.pe=oit.apphcgt*L'ontiot: La (Addtess of Job) ; 4Si4onazxttateCer—) ate Print Name ;�' �.. G'fie {v�am�vmovz+uea, �✓t BOARD O�B11!L'DINGRE?�ULtATIONES License:CONSTRU.CTLO.N•S�UPERa)/IS.®.R N';umlb 0 Tr.no: 37115 U'5 ESN ETHsO, Jd CE=NTER��°/sIILO LE, MA 31s gdministaor . f/xe-Pomvnzo�uuealt! o�✓�«aaar.�ivaeQ'a Board ofunlding Regufations and Standards HOME INIM.OVEMENT CONTRACTOR - gis�tcaf�n'` 1�`2282 y,Fxgllr tan 1 1 -004 mi t K P R'EMO'RELINI t _� KENNETH PERRXti�c� 19 GUILOFORD Centerville,MA 02632 `---- r. Adinthistratior pt •�:J r�w -..R- - /r. �i'. ,. ... .1 _ .'•p.�"r '•-r'-,�'t .. �:v .+y. -.`a? -:� - v. .t. :8 S +,s..�,•.,.4,r,, ��g€' achusetts . e Commonwealth o 1Vlass . _ h T f _ Department of Industrial Accidents J _ _ Ise oflNr�sd�ad�s' • 600 Washington Street - Boston,Mass. 02111 Workers'..com ensation.•Insurance Affidavit-General Businesses •••""'''"%%%//////%/%%///%%/////////////��/ r %/////////%%�////%%///%%%%////:::: / 'Y:7PC�.5iiel .. ^'1'•:c�:`�"m.' ,tra`�A."'S-a .`• .- 'k — '.3�a:97 , name: ._ _ ',X , ;:.: - •. •"� • address: ... • ' state: zi hone# - _, • . work site location full address): • - • . []Business Type: Retail❑RestaurantBai/Eating Establishment I am.a sole proprietor and have no one working in any capacity. []Office[] Sales(including Real Estate,Antos etc.)vg ❑I am an em to er with . em to ees full& art timed ❑Other . %/%/%/%%%/��%%//%//G%%/%%%////////O//%////%�% I am 1 provi viorkers compensation for my employees working on.this job. com an .us sitl�re'ssE` t hone:.#.::. 43611 e-AjftamWa///so,'1e proprietor and- hired the independent contractors listed below who have the following workers' .compensation polices: cow an 'nam i. .. T I:1:• i+ Cti.i':•x�r.i .:i'•;l'� "`'k^ia•;' �<'1,.;i .I: '�.c=.• 's.'n,• •r 7, com'an. nanfei.J a ..1.. .. .. .• •• 1' . fib' .•r .. address �• r. lloriE cl r'.. C. '.:rs.ti .+k: r. i.1 ::%>: A•.' 1;`.c: 1:7".:,.: <::''.:I,y iiisurane--c 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 andlor one years'imprisonment as well as civil penalties in the foi-m of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that p copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify nder the pains an pe ties o 'ury that the information provided above is true and correct Date J t name Phone#_ — D e lb Print official use only do not write in this area to be completed by city town official city or town permittlicense# ❑Building Department h DLicensing Board ❑Selectmen's Office 'check if immediate response is required ❑ ❑Health Department contact person: phone#; ❑Other • (revived Sept 7A03) 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 mare of the foregoing engaged in ajoint 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. •Howevei.the owner of a dwelling house haying.'not'inore than three apartments and who resides therein, or thepccupant,bf the.dwelling house of another who ernploj�s persbns to•do.maintenance, construction or repair work on such dwelling house or on the grounds or appurtenant thereto shall not because of such•employment.be deemed to be an employer.'.:. : .. building app .. MGL chapter 152 section 25 also'states thaf every. state'or local licensing agency shall iwithhold the issuance or renewal 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 t�a insurance requirements of this chapter have been presented to the contracting . authority. Applicants Please fifi is the workers' compensation afftdavit'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:workert!compensation policy,please call the Department at the number listed.below. City or Towns . Please be sure that the affidavit is complete andprmted 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 pern-it%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 like to thank ybu in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. ' The Department's address,telephone and fax number: , The Commonwealth Of Massachusetts' Deparbnent.of Industrial Accidents 8t W of Wesfigmens 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 nhnna#;(617) 727-4900 exf:406 ofIHE roe Town of Barnstable Regulatory Services 9gatss r,E,$ Thomas F.Geiler,Director Building Division rFD M Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. Date AFFIDAVIT HOME MROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the'Feconstruction,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: -Q� Estimated Cost Address of Work Owner's Name: Date of Application: 5-1/3 ' I hereby certify that: Registration is not required for the following reason(s): 0Work excluded by law []lob Under$1,000 (]Building not owner-occupied []Owner pulling own permit Notice is hereby given that: • OWNERS PULLING THEIR OWN PIMUME Il12PROVEMENT WORK R DEALING WITH UNREGISTERED CONTRACTORS HAVE CONTRACTORS FOR APPLICABLE OR GUARANTY FUND UNDER MGL c.142A. ACCESS TO TEE ARBITRATION PROGRAM SIGNS ERPENALTIES OF PERJURY the b ply for permit as the e o er• Contr to Name R gistrationNo. Date OR Date Owner's Name 1i- - Assesses map and lot number ................. � D ..=. ...�.. - of THE to Sewage Pilermif number : - _ i2 3 Z BAUSTADLE, i F House number' :.. 7,3...... ... :...., 5�'L/-� oo M639 i m a 3 �MAI + . TOWN Of BARNSTAB ( ESTEM MUST BE, COMPLIANCE ISI TITLE BUILDING 1 SPECT0&i 0bJNIEITAL APPLICATION FOR PERMIT TO .. ........ ... .................. TYPEOF CONSTRUCTION ... ...........:.................................................... ....... ............................... V.....................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... .. ......... ................................... ProposedUse Y•-W.M... ... a ................................................................................... Zoning District .. ................................Fire District...............��'�,....... .................... ................ �................... ..Address .. ��1. ~� W ..� � Name of OwneG%/fi� �... 7�� ................ Name of Builder .: ^......................Address . Nameof Architect ' .. ..................Address ..........".......................................................................... 4 -7�Number of Rooms .........Foundation .......... ..............��!?...:�.:?�+.V ......... ......:. :.. . ........ ....................................... Exterior,......... .................:. •. ...............Roofing ..: �(-G' ............ Floors ....... .....Interior ?. `~ .... �� ...........1 yLv�-�- Heatrn Plumbing Fireplace ........Approximate Cost ... .f. :40.lykl�"4 Definitive Plan Approved by Planning Board. _ _____________________________19________. Area ....... .. all Diagram of Lot and Building Fee with Dimensions // — .... .,l..�t :........................ SUBJECT TO APPROVAL Of BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable reg ding the above construction: d'+ Name . Construcfron Supervisors License ................ .......'..... MURPHY, JAMS 2b497 � - +, No ................. Permit for ...51iild-Dormer....... Slug]. .Family...Dwelling...................... . Location -;s .HOrSjE!ShOe..Lang...'.................. t oF s Centerville Owner . ..J1Rea.21irphy................................... i- t r I ^ f Type of Construction ...Trame........................... r r �- f" }, •. .�:....... . .. 'Plot ....:...................... Lot 4' Permit Granted .... ....................19 84 Date of Inspection ......................5.......19 Date Completed 4� lee - If I 1 tit• u � � � - i THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR- QUALITY ORIGINAL (S) M �G&' L DATA . r P -Page No:W ,of Pages i OPOSA 1COMPANY co* PHON l:t F� xr I''».rs�rN��d•i,�». C� ' � f.PROPOSAL.SUBMITTED TO ; ''° : 3' 146r ?yyy i STREET J OB NAMEp c '.. CITY STATE AND'.ZIP�rCODE JOB LOCATION '7 or y , Ltd•,5..l.L $, f4"GEC tn' +fr. :ARCHITECT, ":'- ' DATE.OF PLANS o .. . . d . .. . >ti JOB PHONE t I v l We hereby submit specificat;ons'and estimates for:5 yy¢q//`q•�s q F- «: }:•� �.y.-r Y �.:f:1 { ;�CYtle{td 1!� i, tie X, �ux9�.r�i�.4.L ��e a,ti,5�.� a�"T. �v���. �]�`..'fi.���4 �ep�q t��t ,� 1� S s i tE 1E3 . f1"x '� sU 7iyr 7T£ }7 r r:�r rl- �-:., .�:�Nv t: .._�. ,.�,.1 ' .� •� -`^ �•.<«,- 5,r :-rc...uC _ �-fry;'.--. -i. f � t �" '" � r"' 'th "�'ro§ •,i'_ �f�: � "k a r^wY':� . '4 r�L4 y: � 'i^ �` - 'Y 1. y -W,.t .,.4 .3j- •rs � .,:� �K�.7.. ,�+V. _�` �r+-�.• ,�...y� T"a'. m 3 Y.'��t�ti.. r?'/...d:i:,>F�n� f�.r.�L�,'4:-.'s.f�r� •..a.4 4r, .. 1 {n�.Z. 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'Atl �*rc< Ls 1 'c. �f ,. _' ,..�•r3r� � stY� ���: � ' 1.:�f x!C _ _ _ f R•b 'C rj•,. 1� .]:101 r•^t'T `Lt ..iv1 y^c rY_tfY l'1 (�� r•� d t /j.t�� .,-�.f.x (�..'�.•.y.'".."•`p.+��y �TJ ,� n !"i- t ',6 S+ .rL. •,'V�'4'F t"r'T' •. L.�lr 0.J T::'Yd .,tLY NJ' A.1\J"F'M�S.- L6 f..r�.,U.r,] Jf.- 'p+L-�G14i ..i .a. .td�•�. fr < i.e tryx': �'t ; .`� �rr. gjt CJ , _ _ �13�'' ¢41 e: G&?k �Cl`f3 t' 110 f1d3.^k4i 6s l'ar cib.'asr , ] k ;l; saY ti t 'ii rk c6v_erg, `"Orlm%ns rn r -^-'/c� '`'t,rd"i..VF`S•x,� '�` '"u. '�'� i`?�t'i:�4..� C.'f� � .�••�,,fj'�,iE.. � i _ Propo$e hereby to furnish-material,and laboru4jcomplete in:accordance with,above' specifications, ;for.the-.sum of.. § ; I %scr ec1' +ti ��r 'trttl *CsrYtF Y'i3� do 1Oit � n Pa merit to-be made as 'follows w dollars,($ r n s t � Ila 4. ti All material is.guaranteed.to betas=specified A' W work-to'be-.completed in a•workman ,like m8nner;atco�ding to .standard'-•pracheesr Any:alteration`or deviation.from isabove `,_Authorized ' ,specifications' involvmg. extra' costs will be executed only upon wntten-.orders, and Signature will become an.`extra ;charge oven ands above.the estimate `:All_,agreements'contingent a •'` _~ upon ;strikes,-,accidents.or''delajs :beyond our';control: Owner,-to,:carry'fire,r to {. and other. necessary insurance Our'workers' are fully covered by Workmen's Com Note`.'This.proposal may be withdrawn by- us if noY acce ted'wlthin'' da s pensahoff Insurance. ' _ .7 _,R.•.. r- to, pt . i :a y s i y `.pub -Atctiptahce ®f.. Prop®Sal =The above.prices;-'specifications Y LJ-Y and conditions are satisfactory:and.are..hereby 'accepted. You:are authorized Signature to do the+work as speufied Payment will}Fier madesas outlined above.'` :Date of.Acce : � 4r`' ' j a 4 J Signature lance p Cry .PACC-692 3 r r { a " - r � b i , f I.w I I I { r -� � 1 t �� F __ �. i. __.__ __ � —_, _ _ ._.� _.__—_.___. __ .-___ _. _,. _.___ _ _� _ _._ _. � p a _ ...- 1 .. �._ t _ _ _.__._ _ �. _ _ ... _ .__ ___ .._� _ __-� _ __— �_�.�� .. _ _. ._ _— -•- __ - - - i-- - - - - _ . _ . .. _. _ . - - �' � . _` it ' '. I F _ _ .. _ -: -- - - 1 _ _ 1_ � _. .__ _... _. __ _ _ _.__ _. _ _� _.___ _ ._ /` n�^ Assessoc.s ma and lot number ....................... ....................; a p ypF TH E t��4 l� Sewage Permit number +�s ....,✓t� .................... Z //` Z MARNSTADLE, i , 1 House number 7: -if,6................ MMIL AY a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ✓"'�`� : /3...... ...............J ! -.... ......:�... TYPE OF CONSTRUCTION .... �y .?aZLZ....................................................................... .............................. ....:ZZ......................19..r•�'r. , TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according too the following information: Location ......f,3 A 6. ....... ............................................... y Proposed Use ../............................................................:...................... .a............................�?�!�J?...........�........!'.�:�a%L Zonirig -District . , :. a%tid% J / Fire District "7�" Name of.Owner .. ...�. ... . ........Address ...�5�� .IJ7�? z5!-... - ................. Name of Builder €... .. �... ..............Address .� �1- ..... ... , Nameof Architect ... ................................................Address .............................................. .............................. Numberof Rooms ...... .....................Foundation ............................................................. .................. 44 Exterior ...... s�<e L.:... P ... �n . . .....Roofing ,r-r�/ t%. . ...'� ..[ a.va/-�,........... Floors �f/ / �.r... .. �! �1,v r r ...................................... .�.,........... � ...................Interior ..._................................................................................ Heating ......... ...Plumbing ....................................................................... -............................................................... Fireplace ..................................................Approximate Cost :..5` N..� Definitive Plan Approved by Planning Board. -------------------_-----------19________. Area ..�.,. C !... c%� Diagram of Lot and Building with Dimensions Fee z��s......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH r rl OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable reg ding the above construction. Name.. ..` .. ....;.. f. `...... Construction Supervisor's License ..........�.*.�........... 8{CRPIY, JAMGS v =207-101-000 "No 36-497 .. Pern for . ����� �--.---- -� ---' ....................... � | Location - . �-------.. -----'' .................................... Owner -..����s....�k�����-- .......................... of Construction' J��om� Type .. ............................ ' / --------------------------'' Plot ............................ L ° ___________ Permit Granted __2� ...................lg 84 Date of-Inspection ------------lA ^ ` Date Completed ......................................lq ' ^ � � ` ' ' . ' ' . . ' ' - / ' . ' ^ _ r Assessor's map and lot number ............................ SEP TIC SYSTEM MUST SE INSTALLED IN CO"!iPLIANCE Sewage Permit number-! V,1TW. ..... ..... -. � A: TICLE 11 STATE SANITARY CODE AND TOM, rl�FINE TO�y TOWN OF B.L-�1�. MX�LE BABB9TdIILE, i Q y Ma86 � �p 1679• ♦0 �O tlPY a �� ��D I N G I awnS C T e APPLICATION FOR PERMIT TO ............... ............`.- .... ........... ....... 1 TYPEOF CONSTRUCTION ............. .••`.............. ................................................ ,. �r ............... ..A .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applie for a permit Paccordin . to the following information: Location .............C�1J........ .............. .... ......................................................................................... �� ProposedUse ....������2'•�•I••................................................................................ ............................................................. jj�� ZoningDistrict ...........................I•�•�.................................Fire District .......... ... .................. ..-........................ Name of Owner .. ... .................Address ..... f ....... ....... ....... ......... v Nameof Builder .. `........� . .... --.............Address ....... ..... ................................. .................................. Nameof Architect ...................................................................Address ..........:......................................................................... Numberof Rooms .........../.....................................................Foundation ...... ... ............. ...... ............................................. Exterior ..............L4P y- ................................................Roofing .................. . ..... ? ............................... Floors ............. .. ..... ..............................................................Interior ............ ....... ...... ............................ Heating ................. . ................ ...........................................Plumbing .............. .......��.�.............��............. Fireplace ...........................................Approximate Cost .......................l. ....�y.p .............................. ..... Definitive Plan Approved by Planning Board .-------------------_-----------19________. Area .`. J. . .................... Diagram of Lot and Building with Dimensions Fee l........... .... .o....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH "1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ' i Name \................ ................................................. Murphy, James _ i 16704 add porch i No ................. Permit for .................................... to dwelling ' .................................................................... ...... Location ..........9 ...5 Horseshoe. ...Lane........ ...... .. .......... ........ ........ Centerville ....... ............................................. James Murphy, ! t Owner Type of Construction ..........................................frame ................................................................................ st 111 Plot ............................ Lot ................................ November 2 73 Permit Granted ...........19 ; Date of Inspection .�.�{..�� '' � ! — ""` / h I Date Completed ...���°���1�41� PERMIT REFUSED ................................................................ 19 r+ } ,.7 1. 00 �.. i........... ................................................................. ............ .- ........................................................................ f' �a /• i ,.may y' ` ��Y' f,./� Approved ................................................ 19 ............................................................................... t • � .................... ..................................................... y1✓ � r 3- F t FEE A'Cf,d C3 03�' TOWN OF BARNSTABLE, MASS. a pb � 19 0 +� NgpU o� THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TO 03 00 O V 03 O 4 (PROPERTY OWNER) (ADDRESS) EO 0.� O e b rr 3 TO ............................................................................................_..............._.........._.___................................................................... (BUILD) (ALTER) (REPAIR) a ..................................................................................................................................._._...__...._............................... .................................................... (TYPE OF BUILDING) (APPROXIMATE SIZE) cmR LOCATION .............._._..................................._.. ................................................_..... ..._......................................................................A......4E1................... ISTREET AND NUMBER) IVILL w H NAME OF BUILDER OR CONTRACTOR ............._._....__._.................................._................_.................................. ._............_�_......._....._..........._.... _ °)Q APPROXIMATE COST ba b I HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN y OF BARNSTABLE, REGARDING THE ABOVE CONSTRUCTION. j o Pa 0 ea �= _......................_......._............_.... i _........................................................................ .......__............ ...................._....................................... td (I) W (OWNER) (CONTRACTOR) � 03q 03 o 00 +r d __.._....._.._.....'_"._........_._.................._.................._............................................................................. �a BUILDING INSPECTOR Subject to Approval of Board of Health. �, ]' � � I - 3 .��. �p/{�� 1 �/=}� pA1 q i NETp� TOWN OF BARI�ISTABLE ��Q ydn BAHH9TABLE, : ASSESSORS' OFFICE MA86. �p %63q. ` D MAY k' 367 MAIN STREET, HYANNIS, MASS. 02601 775-1 120 BOARD OF ASSESSORS DIRECTOR OF ASSESSING MARY K. MONTAGNA ROBERT D.WHITTY , ALFRED B.BUCKLER GLORIA W. RUDMAN s P ) 07 - "r t t 1 5 _ 4 e i a F a� _ _----=— C+'1_l cr✓._,_L_Lt��_/'la . .Ool6 � ; /► f aw�/Y eleva oLc r, cci ��,•,5 � d l=_k w I rr 77- a NRour, eel f�r� S . sfsj' J'F� tea,.+-> ►v► _ k i3 ax_ N Nofcs - .- S Qom_ - S`� SOrI Jo. e� i rt ( `7 _4 . �:` ; Fl r s-It 'Flo or 'c en-1!c►-_ ! , I Zz _ 5,8„ i A71 .x•i S i v\ O'.REILLY&ASSOCIATES '- v- c ' 11 Cotuit Cove Road Cotuit,MA 02635 • ) (617)699-8055 a� 95 �lo�s� � Ce Ma va6 a , ` i ad E. 3 + �_ :�-►-�. a ov_,L_ lo a� r/b_b�. To s a oo J 9. Neu). S 3-1 ; ... A 4 _ _ _ _kw - Ll < No w_ e o�e Craw. SP4Gt_ Above _ �i - TL� r al. . .. " I [ . I :: I. F— 1 O'REILLY&:ASSOCIATES 11 Cotuit Cove Road Cotuit,MA 02635, I � -647)699-8055 l� 1`11sn�ey .t��stc,��n�e, - - —�- rA f In — _ 1 ++ =6" r CIO s _ !J_o . 3 e" �e e " ryw �►?'IJVE a 6 U(AOQ :S4 U►1!nn• i v - ice? s� '� �aSevhtYl Close" col r-0 o E _ 7�1 I-L -39 O's :o - ES{ C O RE�ILLY&ASSOCIAT C twt 1 'Cove Rbatl otwt,'IVIA 02635 ; ;(617)699 8055 ' ., tjenne�/� e � G�C►�±G2 1-10r/ c s.� _L �,—e- le_ -- 0 0 r_ - d e_n_ - — _. _.. _ ff _ 4R U��u�aJT IZCr�ovec� 3=0 _ _ Wa,1 close .q„ \ I4.0 l �� �- ( - —1—.VY Q+ o _NdfS 3Athca, 40 o„ �CIb3e—}' C�oSe - CLrY,n e mm . aa1 S.c a FVf _ ° � 'REILLY&ASSOCIATES � 11 Cotuit Cove Road 055 Cot. , MA 0 2635 (61 7 699-8