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HomeMy WebLinkAbout0022 KALMIA WAY v►Qtit3i�lldl� a�Si i � � ;1� �y Ifi'ukR�[ .k _ !�� 2 , P r " a F a 1: ''' •� � ^Yy ,� e, a .�� 5� 1 A 1 Yqy ��1 ❑ �� s� pw OKP N , . . 1 � aq ,. �. to � ^f •1 � t t ayt,. �. 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map d Parcel Z -14 ® Application #CQD Healthy Division Date Issued Conservation Division : Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH — Preseivation / Hyannis Project Street Z /Address /� 112'1 (6�t Village I' v'I I.�' Owner Ui% �.h am,'� Address,?q? � Z S �l°ePPG�►1� ,�l�/ Telephoner Permit Request 2OR/-uy_l�e4 0_4 onw— r, 1 G �—. � _ � � 7 Square feet: 1 st floor: existing proposed 2nd floor: existing 170 U proposed /�U Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type G/W0 Lot Size ° �� — Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) w Age of EmtingTtructure ���_ Historic House: ❑Yes -dNO On Old King's Highway: ❑Yes -a-No Basemer3 ?Type= ,Full ❑ Crawl L7 Walkout. ❑Other /� -- Basemerlt Finiq§ed Area^(sq.ft.) C ._ Basement Unfinished Area (sq.ft)_ 6M Number4Zf Bates: Full: Existing new Half: exiting _ new ,Numberf Bedrooms: = o �_ existing Oew Total Room Count (not including baths): existing _ _new First Floor Room Count Heat Type and Fuel: A Gas ❑ Oil 'Lll Electric ❑ Other Central Air: VYes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new -size_Pool: ❑ existing U new size — Barn: ❑ existing ❑ new size_ Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size'_ Other: Zoning Board of Appeals Authorization LI Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ''", M�Zwl (> Telephone Number _. �G - 72 49 f?_7 Address 1�t"F �� i _ License # '50131 90 xxlli,�0, 11 6V d2/64` Home Improvement Contractor# 135W7 Worker's Compensation # kJ4)C 7-y0g194 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY s • i APPLICATION# , DATE ISSUED Y .,MAP/PARCEL NO. ' ADDRESS VILLAGE , k OWNER :X '$ DATE OF INSPECTION: FOUNDATION "t FRAME z INSULATION Q0 a FIREPLACE r ELECTRICAL: ROUGH FINAL a PLUMBING: ROUGH FINAL—. L , GAS: �_•• ROUGH FINAL ,FINAL BUILDING DATE CLOSED OUT ASSOCIATION'PLAN NO. f r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia ; Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbe'rs Applicant Information Please Print Legibly Name(Business/Organization/Individual): /'' I `� )Q Address: a City/State/Zip: SptV Y40M0V(KVY►4-6,&,tPhone#: -nI --,q1'Z7 Are you an employer?Check the appropriate box: Type of project(required): I am a employer with 4. ❑ I am general contractor and I 6 ❑New construction employees(full and/or part-time).* have hired the sub-contractors ' 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. . workers'comp.insurance: 9.'❑Building addition. [No workers' comp. insurance 5• El We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. c. 152,§1(4),'and we have no 12.❑Roof repairs insurance required]t employees.[No workers' comp.insurance required.] 13 J Other W/OL>>/mu:p &X.04 Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policyinfdnnation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information: I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. ,/ Insurance Company Name: /C/47L M4 Policy#or Self-ins.Lic.#:_ V�Csw�02�0�� Expiration Date: : Job Site Address: �.� p, 11'y►i rk bv-a-Il City/State/Zip: (�M of�l� /�— 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 Office of Investigations of the DIA for insurance coverage verification. I do hereby pert j&under, pains and penalties of perjury that the information provided above is true and correct Signature: a Date: 3 `rz Phone#: a Official use only. Do not write in this area,to be completed by city or town official i City or Town: Permit/License# Issuing Authority(circle one): 1. Board of health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Persons Phone#: . Office of Consumer Affairs and 9winess Regulation 10 Park Plaza- Suite 5170 Boston,Massausetts 02116 �. ., . oi Registrationiome�nProvement —t ct —:,- Repistration: 135887 �•. _�---;,''?: Type: Ltd Liability Corpar. Expiration: 5/16/2012 Tr# 295044 M J NARDONE CARPENTRY LLCT- MICHAEL NARDONE � 947 RT 6A ,. '--�:�� • ;.; YARMOUTH, MA 02675 Update Address and return card.Mark reason for change. Address Renewal E] Employment Lost Card ii DPS-CAI v SDM-04J0?G101216 I •_ Massachusetts-Department of Public Safet; I Board of Building Regulations and Standards j Construction Supervisor License i g.Scense: CS 81139 ' MICHAEL I. NARDONE i 299 WHITE�SPAT# ' S YARAAOLT , MAV2664 >-� _ • Ex#ation: 9116/2013 , ('ummi5siuner Tnt 1706 License or registration valid for individul use only - before fore the expiration date. If found return to: 1 Park P a Consumerfice Of Affairs and Business Regulation . office of�onsumer A airs mess e . on Suite 5170 .: ?.I _ Boston,MA 02116 ' HOME IMPROVEMENT CONTRACTOR Registration: y%135887 Type* Ltd Liability Cotpor Expiration: Ltd �' I M« RDONE CR J- M� i of valid without signature i MICHAEL NARDO,�E_�= _ ; g ✓'i; i j 947 RT 6A j YARMOUTH,MA 0267 Undersecretary i i z x NOTICE 4 - Y NOTICE To TO EMPLOYEES EMPLOYEES 4 . 7 The Comm' onwealth of ' Mass achus etts' DEPARTMENT OF INDUSTRIAL .AC CIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 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: NorGUARD Insurance Company NAINIE OF INSURANCE CONIPANY P.O. Box A-H 16 South River Street Wilkes-Barre, PA 18703-0020 r ` ADDRESS OF INSURANCE COMPANY MJWC240996 10/07/2011 04/25/2012 POLICY NUMBER EFL ECTIIr DATES ROGERS &GRAY INS. AGY: 434 Route 134 P.O. Box 1601 508-398-7980_ South Dennis, MA 0.2660-1601 NAME OF INSURANCE AGENT ` ADDRESS PHONE MJ Nardone Carpentry LLC 299 White's Path South Yarmouth MA 02664 EMPLOYER ADDRESS, 10/06/2011 EMPLOYER'S WORKERS COMPENSATION-OFFICER (1F A M 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 -%;zth 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 ser vices 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 TO BE POSTED -BY EMPLOYE. �t Town of Barnstable Regulatory Services MAB& g Thomas F.Geiler,Director 1639. �m oy& 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, 1[ I Mh CMIV ,as Owner of the sub'ect l, property hereby authorize AA I/ihrV to act on my behalf, in all matters relative to work authorized by this'building permit { (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. signa er S• e of Applicant r [�IImo• el Print Name Print Name Date Q:FORMS:O WNERPERMSSIONPOOLS THE Town of Barnstable Regulatory g atory Services * an �na9.MASSar,E, ► Thomas F.Geiler,Director 9`b 1639 .�� Building Division ArFp�� 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 `1 ' ,Zip ccdel 4 j 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 OF HOMEOWNER 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. 4 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 i %HOMEOWNER'S`EXEMPTION �'• r• 1 The Code states that: "Any hom6o'vner performing work for which aIbuilding 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 a es eng ag 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 Sup ervisor. The homeowner p m owner actin Su is ultimately g as Supervisor p y responsible. To ensure that the ho meowner 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 form/certification for use in your community. Q:forms:homeexempt TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map V Parcel U �� `� Application # 3S_ Health Division Date Issued Lea LI Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address d�-� 4Ln-- 'A INS_ Village Leti Te,Lv-ti _ Owner Address Telephone StIS 9LZ� 89r'� Permit Request Ptsr<.- ©N Cr`! o F w krelL- ID /-1 q edl CsMn-,e�T�rt L-Oo Iii ii S Sore c W y�-r3 VA X J• Le 0 5 r-*/;4 A0414 /ems . �•{-�-L- fJ o w n S TVA- A's 7 C-7y N 4 Lk- 4 N6 00A-'t'n'-C Square feet: 1 st floor: existing _proposed 2nd floor: existing proposed Total new Zoning District ¢ Flood Plain Groundwater Overlay Project Valuation? 3 G °a 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 _ 1 new- Number of Bedrooms: existing _new Total Room Count (not including baths): existing new _First Floor Room"Count ` 51, Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New _ Existing wood/coal stover 0 Ye$" U No tea Detached garage: ❑ existing ® new size--Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # — Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - /I =__(BUILDER OR HOMEOWNER) Name _ �tCll,*tidy �.:A k!L%A Telephone Number -7$1 Z6Y-5_'-L77 Address LE-)"H 'D2-- License # C 5 P-0 cr—LAM d nq- 0 2,3-M Home Improvement Contractor f# /0t14Z? Worker's Compensation # 0 a WecTK a 3t a ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO D>A S I T'e CA,t4 S�Ru�.rt�rl f�uMr�s�e�i SIGNATURE DATE Z$-/Z�- FOR OFFICIAL USE ONLY APPLICATION# ti DATE ISSUED -a, :7. MAP/PARCEL NO. .s ADDRESS VILLAGE OWNER DATE OF INSPECTION: DrFOUNDATION 'x FRAME INSULATION! w t. N. FIREPLACE ELECTRICAL: ROUGH FINAL . PLUMBING: ROUGH FINAL GAS: ROUGH A .w, FINAL FINAL BUILDING`F t • v 'Y x . DATE CLOSED OUT ASSOCIATION PLAN NO. Y 4 The Cornmortwectlth ofAlassachusetts Y Department of Industrial Accidents . Office of Investigations 600 Washington Street t l .Boston, MA 02111 sy www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): l`' ttul- 5TA= �ps�c/1' larJ Address: pe C�u e R� City/State/Zip: N I-Sk Ae MA' D26Y9 Phone #: y�-_" -7 Are you an employer? Check the appropriate box: _ ; : Type of project(required): 1. I am a employer with 4. [] I am a general contractor and I 6 [�New construction have'hired the sub-contractors.. _ employees(fii11 andlorgart-tune).. - - 2.❑ I am a sole proprietor.or partner- ; listed on the attached sheet. 7.. Remodeling ship and.have no employees *. These sub-contractors have , K. Demolition working:for me in any capacity. ` employees and have workers' 9. [] Building addition ^ .' comp. insurance t No workers comp. insurance 10.E] Electrical repairs or additions required.] 5• Q We area corporation and its. 3.❑ I am a homeowner doing all work ' officers have`exercised their l 1.❑ Plumbing repairs or additions ++ right of exemption per MGL 12.[] Roof repairs myself. [No workers comp. , insurance required.] t c. 152, §1(4), and we have no 4 ] employees. [No workers' -13.❑ Other comp.insurance required.]', "Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they arc`doing all.work and then hire outside contractors must submit a new affiidavit indicating such. f this box must attached an additional sheet showing the name of the sub.-contractors and state whether or not those entities have that check h Contractors h employees. If the sub-contractors bay employees,e the must provide their workers'comp,policy number. Y lam an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information / Insurance Company Name: Policy#or Self-ins.Lic.#: 6GT K a 3`a Expiration Date: «►"l Z Job Site Address: Z Z— K4 N r R CG�t-ftt ACity/State/Zip: a a�6 S2 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$1,560.00 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 Office of Investigations of the DIA for insurance coverage;verification. I do hereby certify under the ins andpenal ies ofperjury that the information provided above is true and correct. Signature Date Phone# 7�1 a 6�/ 3,: 77 Official use only. Do not write in this area, to be'completed.by city or town official ,E City oM1r Town: Permit/License# Issuing Authority,(circle one): 1. Board of Health 2. Building Department,3.City/Town Clerk 4. Electrical Inspector 5:Plumbing Inspector 6.Other , Contact Person: Phone#: _ h information and Znstr uetiOPS Massachusetts General Laws chapter 152 requires all employers to prlhe�servioce workers'ofanoth com P underon for their any contrac of Ihye, Pursuant to this statute, an employee is defined as '.,.every person i express or implied, oral or written." An employer is defined as "an in partnership, association, corporation or other legal entity, or any.two or more of the foregoing engaged in ajoint enterprise, and including the legal representatives employing ms of a gecease employees. Howeveoyer, or r receiver or trustee of an individual, partnership, association or other leg entity, p Y owner of a dwelling house having not more than three apartments and who resides therein, or the occupant el the dwelling house of another who employs persons to do maintenance, constriction or.repau work on such dwelling house or on the,grounds,or,building appurtenant thereto shall not because of such employment be deemed to be an employer." A MGL chapter 152, §25C(6) also slates that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." "Neither the commonwealth nor any of its political Additionally,MGL chapter 152, §25C(7) stales tical subdivisions shall e of compliance with the i enter into any contract for the performance of public work until acceptable evidenc ns�rrance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out.the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,'lf necessary,supply sub-contractors)name(s), addresses)and phone number(s)along with their certificates) of ce, Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the insuran members or partners,are not required to carry workers' compensation insurance. if an LLC or LLP does have employees a policy is required. Be advised that this affidavit maybe 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 pen-nit or license is.being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy;please call the Department at the number listed below..Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials , E - Please be sure that the affidavit is complete and prinied legibly,-;Tbe Departrrient has provided a space at the bottom of the affidavit for you to fill out in Lhe event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the.permitllicenserumber�vhich will be used as'a.reference number. In addition, an applicant that must subrnit multiple permit/license 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 town)."A copy of the affidavit that has been officially stamped or rriarked by the c]ty or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or.licenses. A.new affidavit must commerledcial out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i,e, a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of-Investigahons would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a,call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Indtistrial Accidents Office of Investigations 600 Washington Street Boston, MA'021 I I Tel # 617-727-4900 ext 406 or,1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia Client#:34309 MULTISTA ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 2/08/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT - - NAME: Sandy Benigno Starkweather&Shepley PHONE FAx PO Box 549 A/c,No Ext:401 435-3600 A C,No): 401-431-9678 E-MAIL sbeni no starshe com ADDRESS: g p• Providence,R1 02901-0549 INSURER(S)AFFORDING COVERAGE NAIC# 401 435-3600 INSURER A:American Safety Insurance INSURED INSURER B:Beacon Mutual Ins Co 24017 Multi-State Restoration Cape Cod Division,Inc. INSURER C:Hartford Ins Group 19682 1135 Charles Street INSURER D: North Providence,RI 02904 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS•SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT R TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP - LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/VYYY - LIMITS A GENERAL LIABILITY ENV0307221201 1/01/2012 01/01/2013 EACHOCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY - DAMAGE AMAG ETO a E TE aPREMInte $50;000 CLAIMS-MADE Fx_]OCCUR MED EXP(Any one person) $5,000 - PERSONAL&ADV.INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG -$2,000,000 POLICY PRO- JECT LOC $ C AUTOMOBILE LIABILITY 02MCPHX6227(MA) 1/01/2012 01/01/201 Ee.ccideDt SINGLELIMIT $1,000,000 C X ANY AUTO 02UENHX6545• 1/01/2012 01101/2013 BODILY INJURY(Per person) $' ALL OWNED SCHEDULED AUTOS X AUTOS _ BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED - - PROPERTYDAMAGE AUTOS Per accident $ X Drive Oth Car $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ - $ - - B WORKERS COMPENSATION 50845 RI 12/01/2011 12/011201 X WCSTATU- OTH- AND EMPLOYERS'LIABILITY ( YIm ER - C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 02WECTK2360 7/16/2011 07/16/201 E.L.EACH ACCIDENT $500 000 OFFICER/MEMBER EXCLUDED? a N/A _ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500 OOO If yes,describe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $500,000 A Pollution ENV0307221201 1/01/2012 01/0112013 $1,000,000 Each Occ. Liability $1,000,000 Aggregate $5,000 Ded. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) - Re:22 Kalmia Way,Centerville,MA 02623 CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE - ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD ` #S378024/M376405 SSB MULTI-STATE RESTORATION, INC. FIRE* FLOOD *WIND* SMOKE*HURRICANE*VANDALISM Fed ID#050515889 CONTRACTORS REGISTRATION#140427 AUTHORIZATION TO PERFORM SERVICES AND DIRECTION OF PAYMENT BA AARA 14A R M4 d ,herein referred to as "Customer",authorizes MULTI-STATE RESTORATION,INC.,herein referred to as "MULTI-STATE",to perform any and all necessary cleaning Apand�onstruction���services on Customers'property at: 9 a I<41 M i q w4y l.G��I k ��"��,! /'/W Telephone: and with respect to items that need,to be cleaned at a remote location,to remove and clean such items as necessary. Customer authorizes C v�!� Insurance Company,herein referred to as "Insurance Company",to directly and solely pay MULTI-STATE. If for any reason the check should come to be or be made payable to the Customer, Customer then agrees to pay MULTI-STATE immediately upon receipt of the check from the insurance company. In order to expedite payment to MULTI-STATE, Customer hereby appoints MULTI-STATE as attorney-in-fact,authorizing MULTI- STATE,to endorse Customers'name,and to deposit Insurance Company checks or drafts for MULTI-STATE services. Customer agrees to pay Customers'deductible in the amount of$ / that applies to this claim. If the loss is not covered by insurance,Customer a s to pay the total amount to MULTI-STATE upon receipt of the invoice. Signa.TNre of Owner It is my understanding that the services to be performed by MULTI-STATE will be limited to those,which are authorized by my Insurance Company. . C V gO Insurance Company Name Policy Number Customer agrees that MULTI-STATE is'working for the Customer and not the Insurance Company or agent/adjuster. Additional remarks: Wgr&L& D,.A�»w I have read this document and completely understand and agree to same. tSign a.. A/ Date M 'v Printed Name P.O. BOX 2210•MASHPEE, MA 02649.866-921-9111 •FAX 774-238-4422 --- ✓1ze -�o�.7�aw�.x..uea/C/ o�✓�/laaaaclauaet7a 1 Office of Consumer Affairs&Bu ruess Regulatron License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Re tstrat�on Office of Consumer Affairs and Business Regulation 91„4,.0427 Type: . 10 Park Plaza-Suite 5170 Expiratwn �1`01 f5/2013 Supplement t%ard Boston,MA 02116 MULTI-STATE kETOF��T�ON •IN,C.CAPE COD RICHARD LAURf R O. Box 2210 MA$PHEE, MA 02649i r;�" Undersecretary Not v lid withou signature -'�- Nlassachusctis- Drlru'trrrcrrt of Public Safct� Board of Buildin�� Rc�ulations and Stand:ii'tls � Construction,Supervisor Cicense One-and Two- Family Dwellings S License: C .51784 - f - , RICHARD D LAURIA a r 1 LEAH DR t ROCKLAND MA 02370. ti Ezprration: 4/1/2013 ('vnmiissiuncr ' Tr#: 12672 f e S Z _ J E - A .s� n Za�cs,� � - J f v I " ICP W m � � CID lob yu Z E. u� ' g�� EngineerinjoDept.(3rd floor) Map /99' Parcel—//,?,, OO.Z6 et e it# House# Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) "7VT/,ra&W a-Fee 5 , Conservation Office(4th floor)(8:30-9:30/1:00-2:00) ➢]on;i�n r1,,,,a C'I..a FIB,,.../C,,�,�1 A'lmin R� SEPT06d S 67 ' 19 INST/ALLE : R 1AN+CE TOWN OF BARN5TABL VIA6W Y "i ®DE AND Building Permit Application TOWN REGULATIONS Project Street Address 'Z Z '(-A 6vk;fA (-31gq Village Owner � ' ,/� '� �L�f�� ,� Address TelephoneO Permit Request r" D Y First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ 000 • o 0 Zoning District Flood Plain Water Protection Lot Size Z.p , �d S�= Grandfathered ❑Yes ❑No 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 New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garagd:-❑Detached(size) Other Detached Structures: @Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name '?dvA,-- �°�n.C_-:> . Telephone Number I Address t U ,fc_ C-A c,Y." _ License# 07f--3�j Home-Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE I BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) • .. /, -a r . '�:M ="Kx'w?;,'+.:.•-�' :.,:x'k.�iu>c;X�:s<!aicac>;sl:svia:cs i:�:,t.�u�k.:�t..tr.�.r-a�.s�, •: # �r ,.,.'h�45.;.�..�Xd:_,g - �' ���� ��f� Y�;::trs:s��T?T'.;?►.�i'f�x'- ayx�::.. j �� �t'•4�75�1 ��II 3IS G�sn' ! a 1 1 f 1 4 S � : UNREGISTERED LAND ' FILE NUMBER: 92100 {` DEED BOOK:`7708 PAGE:260 ' ATTORNEY: STEPHEN DAWLEY is PLAN BOOK:,,;,, PAGE:- LOT(S) LENDER: _ PLAN NUMBER: OF OWNER. GLEN k SHEILA TOBIN — REGISTERED LAND ApPIjCANT: WILLIAM CAIN & BARBARA HARMON;; - REGISTRATION BOOK: PAGE: DATE: 05/02/96 SCALE: 1"=40' r'. -- CERTIFICATE:;OF TITLE: _ FLOOD HAZARD INFORMATION PLAN NUMBER: 41567—A2 LOT(S):_2 a FLOOD MAP COMMUNITY NO.: 250001 Z 1.ONE: C _ ASSESSORS MAP PANEL: 0016C 08/19/85' DATED: _ _ MAP: BLOCK: PARCEL: MOR T GA CE , IN,S`PE CTION PLAN 22 KALMIA WAY, BARNSTABLE, MA t:= A Al t •`����� �I� 0��.1 rLQ k' It , ^ l � Dal T'lTv lek 40-I S CONC4E�E 1� `''��` g0.46 coNcaESE gp11N0 1v1�`�1 A { wA� MORTGAGE LENDER USE ONLY THIS IS THE- RESULT OF TAPE MEASUREMENT, NOT THE RESULT_ �� ����� OF A'N INSTRUMENT SURVEY AND IS CERTIFhED TO THE TITLE CC T A INSURANCE COMPANY AND ABOVE LISTED E TTORNEY AND LENDER. & ASSOCIATES, INC. 130 WEST STREET, WALPOLE, MA 02081 THERE ARE NO DEEDED EASEMENTS IN THE''`ABOVE REFERENCED TEL.:(800)287-8800 'FAX.:(508)668-4512; Y- DEED OR ENCROACHMENTS WITH RESPECT T;0 BUILDINGS SITUATED ON THIS LOT EXCEPT AS SHv�"1N. 40,: 0 40' 80, The Town of Barnstable , AULA"ML .$ De artment of Health Safety and Environmental Services 1"9. `� P Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date if 7 4 1 G'1 AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. a c� Type of Work: ��­J oo Est.Cost Address of Work. Owner's Name Date of Permit Application: 1 1.0 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000- Buijding not owner-occupied Owner pulling own permit Notice is hereby given that: EGISTERED OWNERS PULLING Tim DEALING PERMIT OR HOME IMPROVEMENT WORK DORNOT HAVE CONTRACTORS FOR APPLICABLE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR Date Owner's Name *� ' :•"-• TheCommonH'eullh of?I fassachmetts Department of Industrial Accidents Affeea flat SD9dDOds f� - ifE' zz'.._ ..a� 6pa !t as/10,170n Street y �� ��`:.:� �w Bns7ol1.111(ras. 02III , �--' Workers, Compensation Insurance Af idavit enniicnnt taot•mation ~-- Plea a PRIUM" iv name,CitV ❑ 1 am a homeowner performing all work myself. ❑ 1 am a sole proprietor and have no one work-in_in any capacity 0 1 am an employer providing workers' compensation for my employees working on this job. cemn�nt name k Ccity: ry 0 phone 0. CTJ C incurTnre co. Balky f! ` V� r•' ... s •R �• Tarr. r.w ■n. ...._i•... s ❑ 1 am a sole proprietor.general contractor,or homeowner(circle ore)and have hired the contractors listed below wi the following workers' compensation polices: Comflany n ci ' phone If• - tU'- o. T'^'a,.^'��' , __ •�74RPl�Je!$�+�RT„►raslG�m^`R.""►' +`�+ m m•nit e• address- city phone dh . :. policy# • .. .. ;Attffch addltionai'shee2 if IIettl!! 'P��'�' ~ '"��'r�� ' • � � �''r �r �W Fniiun to secure coveralie as required a S do 2sA of 111GL Is2 can lead to the imposition of criminai peowdo ots fine up to SI.500JA une rears'imprisonment as•rcil as ci it pe al es in the form of a STOP WORK ORDER and a fine ofSI00.00 a day Mast ma I understand' copy of this statement ma.•be forwa ed to t e OIII a of Inv qa as of the IA f r eurenge verification. !iio hereby certij•under die pal sand calf of perjury t the is ion pmWded atone is true d cotrert Sienature air � Print name one# otliciai-use oniv do not write in ibis am to be completed 16t dal city or town: permit/lleease# rRSuiidlaq Department Otdceaone Board OSdatmeo's OMCC p check if immediate r•espunse is required Ofietrlth Deportment 1t• —other. phone contact person: TOWN OF BARNSTABLE BUILDING DEPARTMENT S �aaa�r�sr TOWN OFFICE BUILDING - °� HYANNIS, MASS. 02601 r MEMO TO: Town Clerk FROM: Building Department DATE: ,An Occupancy Permit has/been issued for the building authorized by Building Permit $�..... f... / .... .. ......._......................_ ....._...... .........._. ..... issuedto ....................... L (. ..............C.C� */ y� f;,,.�J....r...................................._...................._...._.... w Please release the performance bond. BUILDING PEMUT NO. 3 q-35-1 Dn= A&YIZ' ASSESSORS PARCEL h0. J IB,8 --i 18 Z CONTINTATION OF ROAD BOND The undersigned owner/contractor hereby agree to maint_in their road bond is force until the following wort{ itams are completed to the satisfaction of the E ngineer_:.g Sect'-on of the Deoar—ent of Public worts: Ica= and seed shoulders as soon as weather permits: other (explain) LOCATION: LOT a � �� ,LIM ilk W �A ftv� Sllsi;i (G;y«- 0:;%titiCTOR) (Print name ) I t et.pry Tw�j�+ cry iR rtipt' Fnryprwim, Ye,nw ' -t TOW1 Af,BARNS '� P � 7�•�i r�" �' r �, f,r^1 � 31 w it i } .,k s t � by r +°.�' *. � '": � 4€ 'r 's?- .,-r t r�iy� it, at. '3 p� y p Q ji4+- -h i5 :'fir 'b•F�� y�,� �{'i r�q Y.. � �"_' (� <f'� - 46 r r t � S y ! PF :iJ •�, v.+: 1 s 9' �. �, ..'. .tr ti e DATE. S xt•�?•. r� 3 � <t• T 1S.- r` PERMITNO •- 'f x e.- s y"'+P ✓.• 1 :+ i .;.. .4 +.. t34: f.,.At. '�E, 4. X `1 r ,,ddA APPLICANT x.j "� P�-.i t3c �' ADDRESS e/-*+` � • i flti` 7'.e4: � } '..r ; ,?�,;,; 4 � �l.a.X9'��j,ri 1 «7�,F S Pi ;.,� a 6N0 1 �„r 'y ^js(5T(7.EET) ,. a �� �; �„LCONTR SrLICENS EJ �` S70R.w4¢kl a s" n ,. � $u31d dsael�l tag 3} Siny+eI gm�]� dwelling ,NUMBER of {�]I n ,e;; I�Z,PERMIj TO ' -•Jy ' { $ :��I -)r,kY 6 � :� '<`.' e°.`_At'f, ,ITY PE OFI.IPROVEMENT) r't*f3S-%f9,t+:N O.�xiTrtEa sr'3`Tt+ +:'.,'';xy Sx�t..nT?t�.PROPOSEbfi USE),�.,:.,..r:ry.r,�M..x,,.'�A �. �`r" .e°' ��' ' .'3i Ay6;• ',Cc %%, '<FL�' Nl+{+, �'`.. ;��5��+�r.._.+-:fw' i-':gei�T`�»�'-u`�'' y`t. 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S, �...:, �tr .�4+�.."Ja"���:..r,�''.���,t .r-°;}.,: ,3._ t#�,'+.�#'�.�'} 'w1'? �8'�s,`^:y.,� x,"__.. j4 yT' �"}��i' +:., :y'� T;r{LOT.r -,a,:.1, , •t� ��t•.a �'_ .r'raii�er.�"i,�:1�'+s�i" •� k .*�,,.,a�. t�+.f,,,x.•v_.=..s,•S, a- f' +1�k°A.t'Ss' tl;-n°•:'�t is '� �e .,.ra d +s, ++r W:, s z T z.3 z t� r r<F � SUBDIVISIbN LOT` BLOCK SIZE •a a �- 'd e.* ( Ls wr o- w� x t rr.,� '`.,�.� x '-i t z r r � '* "1+`' a �t zy, ,{,�,,.,�. y < 4. •, -.; I e 9 ki ..;..� vU�c-r'-' i..�,`''� #'" ''�) -s', •�'S 'F.k:�t+'y et'.#'*�`J�'�tsF hew r:1 ,+ i� a ^.,�..�'1- ..:'fit `?'i,!,..�"�..�'r � r � � � ae �� z� �i�. �t; i.4 :•1J:tv'�>r.�rn,#^It'd,,-t'�Py�+.}., rD�„< .r.k:w�.e.�.,.:'��..1A_" .�. ,r�j��. ,.�t:'� .,�:1.. ++� :.'++ �•-+: ...... .�' � a{ _fi._.�"..-r' �.*�.;:•>.��,`�..,r '�.s�,.. «:`r �BU`ILDING �SzTO BET ,,a:p 7yFTWIDEBY �" '" T ',FTL"ONG BYE ` r� 'yh r F:T IN"HE.IGHT:;AND SHALL CONFORMFINCONSTRUCT.I.ON �?'.# ta...r,: R;,«+d`. '' r * ra�,r "L `...St-;r C Mb 3Li � zia lT + t u apt,:: ✓ %t w j r t ,�. 1� �,�'-a"<�ks �.at�+ik�n+tt iv,�tr* � ,`��� lN:� �� xt'•; r r te} I ��.� e... +TO TYPE FUSE GROUPz s�#t BASEMENTtWALLS'OR FOUNDATIONFj $" (TYP E) + xk wi f5 xVf t'I:.? rtT xy,E': 1` :y,.$�h+rlvxt v S;�" seWclge Yg9 745 't ct,'r'ik'y'�'§?„rk' �;,'�,�,,,�Z,��, .r',%s�"_i-��'r�t'�z<.f.0 �,�f4• Fm� ' kt.i.«.uL c r fib:--+. -d -�-yx -v S t - --'• s �, � k {' ��,.E-e..rwrk,-L�i..�: (S` y x- �t R�MAR�.Jr-� ' r 'a uL �rs� S•-` -a,��.Ya 7k1"d "1` :.vt + -t '."e: •x :-' � ! .. ``' i ,} �� 4 `nxr w _ .ts '..a.� K;�ta. trad.r'`a•F�`infi'i'z^rr3. '::'"�s 1G yi `mad `.:: >s hty r ...S .y i -a`.c, u 4 ,. P 5 vist t 2 -., ; `• u'` �,y?`:.a't r„f �+ ��3 q.a "'rt i %..�r; '�r n t :3. ..�'�'��9•• x- Y -..� t� r .A o #. : t � t u �,.< '�& -!z+? {,a*rZY *. _,/•.`tei „v.. "!n'4 - 'R' ...-5 ra�s y y u#-z`.' :• tai y?Iun,�,X.� �S..;'yS,`o>�t _3`Sa a i n.4) „i .., y'.k• Y r. rJ..:;g, 7s r 'r. ?� 's f? d},•i,f.-,trz'!W _ `7,�. y .X- -.:.�+s r d'r'#` _% ♦,M rW t 1 i. I� g vis�z -,1': *9 ^::' `'r S. ` �,''�','% '"�{ .... y;? •±!„> s r-.. '4 a„" , t.€ 14275 i45 0 "F+ EA>OR: -.k''�c' 'k>j"Irt 3' -'."'ass. '-r�?..r.. r,..+x,.:: ,.•.k>.. �,-r s ta..i +i ? r a' r5 ur5"VOLUME a w E a S L3 a,d ESTIMATED COST Aa FEE 3 +st; �x Fp" re n�,j'�aj�';: 4:.7�..-lu x t� z 5 '(CUB1G/SOUARE.vF.•ET) Knit="',�',�i ' t ; {h '` T,., t .'. a r s is °..- �, ,#' `- k'C'i'tl .,.,�i >. _ all, f },r T 2s k .: . fli pii FYYa§i x rQ �FN4►�]},vT icy F�'� 'S A t q F� :�?N7$ l �)'41 +o ; .F. �r,{� �"V 6•j'�5.7F'� ,•�.°" ice" fd'I"F>4a•tJ'r+es, t Tir1'%t4'r t'Yt•+-n, 'ia..o• et,+ ,m ar tt�.a- sr 7'++t t r ':8Y r `�'1:F'' Zs. "'"'�,fi�y. � Xc:,r+ .,�5 .•�r ^5�. r � �t 2��� -.;t„*". tl.�y,�Sa: ¢ � � £'k` . �`.1'S;t r� 5 �.� •� "c.. .� 't t-N'4, i' i.;t .� 'J �� '-0tz�s3.:��� xr >'�,><m ��':"> �:F'�S'�.rwc+`'J�a k'1o;#��: '� h*-t• '�e.e..4F`;s�v=+ar.'` C .' _-2 .-,:k.- , :.i `.d yj7;~ }{., `x �t�r; . . . .� �'- �. dF'�•ir ca-pit}tJ,r i:y �,iC�" '�„�`�S � � �� tt� � f ye. '3 'yP 0 �. ^,-- � �:.. ,.� q... 1 �,"�y �7+ k� 1 •r. si i t rb s h s z.x 4.^J �,. a ej4 T,t r :, } �t -., v' E`ry t �'c�.a- �P ° i t '•`'a ��'ft ���st -C+.' "`Cr. Cry.. �3 -- Y'#' ...+r r,`M �, 'v ^A , 7 3 � ,s. >✓- -. e'4r� ..�?,,,:, �,• '�"�?'.�^, J ,,�lt T � ?2: x_; {d �gyp: =a• k v,4.1 Mr >, �,r s �a �, .0�i�Y nF; c r �`,Z'*` �,#' ,;:', s s. OF?'A.NY APP,LICABLEFSUBOIV.ISIO N RESTRICTIONS r j SPMI NIMUM OF •`T HRE E:.C A L9L'; ''A PPR OUED PLANS MUST BE RETAINED ON-,JOB AND THIS WHERE APP-LICABLE SEPARATE +;. InaPEC TIO NS::R EQU I R,ED FOR f°" - A. _ CARDs.KEPT POSTED:UNTIL-FINAL I'NSPECT,;ION NAS,BEEN PERMITS ARE 'REQUIREO,r+;F'OR i e r; ALL CONSTRU,CTIONvWORK .,,.; gr, v 4 eI -- ELECTRICAL;. PLUMBING it'•hi 1 ;FOrUND.ATIO,NS OR,F'OOTiNGS _-MADE WHEyR;Et A F.CE'RTIFI:CATE �OF OCC�UPANCYIS 'RE- MECH'ANICAL:INSTA�L:LATIONS �.;' 't.`•S -:,^2':PRIOReT;O:COV;ER'ING 57RUCTURAL 0, 4ED St1CH:SUIL`DING SHA.LL`NOT BE.O.CCU'PIED UNTIL y F '- t -F-u;t ,.' ,n., �.44'' ' .MEMBERS"IREAOV'.TO LA THI - :.�.,. . INAL INSPECTION.'BEFORE " �FINA L--1NSP ECTION_;H AS-BEEN-MADE. ..,t# OCCUPANCY. - ` R 4f:`H POSTIHIS CARD ;SO _IT IS:VISIBLE FFROlVI STREET =f ti Y R t;s PLUMBING INSPECTION APPROVALS ELECTRIC BUICDING:INSP.ECTICIN'APPROV4LS a., AL INSPECTION APPROVALS Yj � J S- ': �',,„ t�,t"t-" 6ajr Tt. � 3=..� Gi•e.J�+. 1 ,4 z; 1 �t ', y -. 's ✓ .�tk try � _ '. y .,, w• s:. t W t a v < r lrtj �j x i,,,.„• 3 rtr .,. ,z. r �.:�5»F?+P � b+4 C ' - - - r{R� ate4.��. r *+sue,p;�. V. a d t 4 Y xgv HEATING'.INSPECTION APPROVALS NGINEERING RTMENT ' ♦ o fy. BOARD OF HEAL OTHER a„ v -1 - „;c Pt•';: ,+,-`.�s. -'i�w SITE PLAN REVIEW APPROVAL y xr ii P x u ' t is [r •tw '' a• d, a S x x a e� r t'r,c a•t t C '"'x Htk�f•.,rS t �r 3Sg,tt � r a � r^• t'4 � +�,�`�'"�,�'3vt. f. ,5 zf. {$ �pw'�'s.'fir � �[,�'ft F7S�,..yE�z'P t S- !��I, ¢�g'�` -�Jt +�F j-"i t ;' „� ���. i 4 + �- > •t s'Y 7•'�tj�^��y ��"C. � rr 7 'WORk:SHALL NOT,PROCEED:UNTIL THE {N�PEC ' aERMITk�rLL BECOME yULI'AND`/OID'IF CONSTRUCTION . .INjpcf,T10NS INDICATED ON THIS CRC C TOR HAS:4PPROVEO THE VARIODUS T S OF r;? WORK IS N07 STARTED WITHIN SIX'MONTMS OF DATE THE aRRA.NGEJ FOR BY TELEPHONE OF W'I TEr,, f CONSTRUCTION I PERAAIT r5 ISSUED AS NOTED iABOVE.. NOTIFICATION -.,s� S`S�'{{j `54� i3af�#�u•,v£3 .A Y��Y.� .a��� r u �: - --� ' `s-�j�.��� `Jrtz'`P�'?"�•a.Y T S<� #r-l .aew°i -I°�,c ��t'+�bV+s��� ''=.'� P ."x � t i _j� R .�aa:.fs e"td#�'kG€:P�,fi+4� 3.aG* a r? .x et!`�' r•�. i�*` �, .�. + - P Y; , v'fi�s�'°0�•��r"�'�x�I;s ?�'�+sa4 r t*.a?-'SZF r,.�5. ^�Y.,=+fi!„�e+•�,:-� '` s k_.� t ti3'� �fi.:. aFTw� TOWN OF BARNSTABLE 343 l .Permit No.. BUILDING DEPARTMENT; TOWN OFFICE BUILDING Cash ..+. .eso. Sao+' HYANNIS.MASS.02601 Bond .....`z......... . CERTIFICATE OF USE AND.OCCUPANCY Issued to s{ Bayside Building CO. Address Lot #2, 22 Kalmia Way. t t Centervlie, Mass. USE GROUP ' FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT-BE-.VALID AND,THE BUILDING SHALL:NOTaBE OCCUPIED,.UNTIL;` SIGNED BY THE .BUILDING INSPECTOR".UPON SATISFACTORY •COMPLIANCE..,WITH''TOWN:w REQUIREMENTS,AND IN.ACCORDANCE.WITH:SECTIQN 1 =O OF"TIiE MASSACHU.SETTS;;STATE BUILDING CODE September 5, 19 91 '. Building Inspector ,jK OF BARNSTABLE, MASSAC SETTS :.► &, ��.. �IZ�rti r. r. i ! - :+ I r��.• .lrt' x�i,. t//7rlladt\I: Y, A-18.8 118.002 a 91 AT A �r 'bSJIIer. 4° }} L DATE s May. 23 '� c i PPPERMIT NO 170 `t` C4 �T� 1.,Ys ��: >s a e ADDRESS r: -, , . APPLICANT {, (NO.) . - ISTR EE T) x i'r0 (CONiR S LICENSEI. r Build dwelling" 1} 8ingle family dwelling ' 'NUMBER- OF PERMIj TO ti n'r ( ) STORY r� DWELLING UNITS Ji.ylo.��,is,.:la,,. raw..•r„(T.XP,E:.OF•(MPROYEMENT)""y„ (PR.O POSED USE) z10t 2. ..r22 Kalmia Way, Centervil e ON r r q DISTRICT F.:�q r L (NO ) }� , .1.+ ! r,,z -(S THE ETI .. t ) r1 h'jr v.I'r- ,.,;.. :..- AND X •: �iY t +i•�.r+ :.y..��:r.:-r,.: ...(CROS S.,STREET);...,„.,, - (CROSS..STREET) ;L-ij0:.�.•r.�r f<�" ':.� - ._. - .." 'i. .- :+_- 'LOT ;7FSU8D.IVI fON LOT BLOCK 'SIZE s, ri+4Z+th 4L.'!t./1 vip << C• ..v r . .: ._ 4BUlLDING IS TO B� +� ` FT WIDE BY '-0 FT:LONG BY FT.r1N HEIGHT AND.r SHALL'CON FOR M IN CUNST.RUCTj0N'r ��V7 '�' Y•' 'iL S .. ri _ ti 4. TO TYPE "4 USE GROUP " BASEMENT WALLS OR FOUNDATION a' - - dt'twage #89-745 (TYPE) '•, REMARKS '` )�..t a c _...: - _ .. .t< N -+ts!\. rs � $O�.�Rl�.#• £. rD�AREA ORr..-.f._'F } r;�k 1"( q ,145,,000ni42..,75' VOLUME wi.r v 1784 8 • ft.. ESTIMATED COST r'FEEM(T: +�yStr{PAt GrJI1•i (.CUBICISOUA] RE GEET) z. Y� .` s�s {Bsyede �ui � .ding pany �> _t OWNER Cain 'l\ysx stt.S: r i'••y�.. _ ..Acyt ! t7.7 BUILDING DEPT. ^ADDRESS „ BY ` x >� . .v': -...,. .Vr.-,;,.; +•.•!i•r,. .,°.'-i. x ,',Y•• : v x _ rc� .�{ y.in: �" s,F�r Y OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. _ MINIMUM OF .'THREE CALL iriSPECTIONS"REQUIRED FOR -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE j ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE. REQUIRED OR ELECTRICAL, PLUMBING :AND f: FOUNDATIONS OR FOOTINGS. MADE >:W HERE A -CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS ?' +2..PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL - - .;.r.,. ,4• k MEMBERS'(READY TO LATH). - c 3. FINAL:INSPECTION BEFORE ' FINAL INSPECTION HAS BEEN MADE. a OCCUPANCY. POST THIS CAR® :SO IT IS VISIBLE FROM STREET , BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS L-y � r - HEATING INSPECTION 4PPROVALS I NGINEERING DEPARTMENT w rrZ - _ I a�gRD F HEALTH OTHER_ SITE PLA REVIEW APPROVAL - WORK SHALL NOT PROCEED UNTIL THE IhSPEC PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION TOR HAS APPROVED THE VARIODUS ST.IZE Ov$PEfGED INDIC4TEQ ON THIS C-RO r_ti 3c ".S OF WORK T S IS STARTED WITHIN SIX MONTHS OF :)ATE THE 4RgANGEJ FOR BY TELEPHONE OR 'A?ITTE% • CONSTRUCTION PERMIT IS ISSUED AS NOTED ABOVE.. T VL,. IFICATION - - _ - i } t , I &—rF t 44 I j I I E -1` , _ - �_ i T - 1 I'-I �- _: � _i_;— _.�__€'I _7_ +--•--II+ —{�!�� I �' + t - � i(, r '-�'- +ram � I r---r-T-•r-�' i I ��� -� r a I ' t 7 1 I l L._' I I`I''I_f_ j�� 1� f ! �T � +;•.� ` 1 I j- { Y t r�f r t I ' i t I i , - i j � I' � I � { �~ , T ! - - -.17 I I i i -I- OR' - I { II r' 1 r T - 1 { 4-1-Ij F �., T I I f I ,a I I:..t t 1•� t ' _- E •_ ! }" .� _�. I O �.4.-- ( ' •� A �. I I I � � I I I i i 1 �" # , I { � i I i t "�3� ; ti` + i- --1 I ' , - I '- I - I { G ppI I �� i i � ! ...� E ' I ' ' 35� l � �� i r I � i_� � !� j j I r t 1 t��• d j I ; I _ I tT ,-# i,� i•--t 1 ,i 1 I - , �L 1' t,l 1 ���"t-l" t -r�l � ' II-_L¢. I i_7`, - ,•-,t--t. _.iI." t It _l ."'j i 1-; 1 1 I �_ _� OF _}... 1. i W I I I [ 1. # - .. .. Ft I�ER U T I( z� a I l(F EPLOL AN i I 1. t ( LO CATION , ENT�►'�E/ 1 I, CERTIFY..,THAT' THE FO:UNDATION's ,°. . SHOWN; HEREON COMPLY.S WITH SCALE .4of DATE 1`�A�' Zo 19�1 THE- SIDELINE AND'SETBACK ' PLAN�` REFERENCE REQUIREMENTS-OF'THE-TOWN OF BARNSTABLE AND IS IS NOT t 'LoT 2- LOCATiED�IN THE FLOODPLAI,N: t' DATE 91 : �^` - -.G �I�j G, B A X T E R N Y E INC.' ._T.HIS:.P 'LAN :IS NOT:.:-BASED ON AN` ' { REGISTERED LAND .SURVEYORS INSTRUMENT SURVEY AND"THE OST E RVI L LE^- MASS. OFFSETS,SHOWN SHOULD NOT BE -'USED,TO DETERMINE LOT LINES. A PPL i CANT CEP`( SI D'E 15V IL13IN6- Co. Q�•�lG►�1 "DQ.TA ��L�4��i bdt t_`.( FLow s 1 Ip ,c 3 t 33b G.P•b. .7��..�.-" --_____._._._�.___......__ -____.... _ �=� � -1 C TA,t t� = 330.E (SG % • 4-9 5 6.P D. USA l o0O GAL. CIS (o00_.G,o.t_• V` ,; ''�, �F T�. LL AMA - tSo S.F. �A 5+5=. A SO S.R D. TOT,&L -C;)ES16►.1 I -rOTA t_ mat L--(. �A PMqC0L&TlOLJ 2k,7-E : I lu 2�Srttu'o>z La5s. �r \Ur �.f Ito va ji o. 24043 Ca 10. IV floc. 7-2q.165 Tor t'ub L 40 O Afq.. 777 �•PPS 'Y t u"���.. 4 PPS IW. Gay. �;. ;. twv f pox �t T, Sc�-►c l o I oop jS' ll TA�tK Iwv- 3!;,4, CL-A►s P,T ..' Mom. W1 Fitt e. WAS>•tED � � � •' , CEQTtF i>=D P LOCATIot- - u o Sc o.LE•- � A-I-�_ 12.o�oSi�� A 7 T N G (�S 5 uow t.l Pt_4 t-1 Q= tZ c ki G a ; 'f~t51J Cc tPL�lS W ►TI•A T1-1`: SIDC.Lt►-1� ----------- tiJa I•'C:QJi:EAA&.,M; OP -rNC. Lo-r-• , '�o W t.l ot= BA2i�iTlt��W ANC !1� a �N1Tt4tN E T=r�cr3 PL41W - BA)(TEQZ <-L, Q c- tuc_ T1-�15 t7(_A►�l 1 6-10T l�A��C_'L7- U4.4 A►J OSTE2�/ILLG- o MASS, xl. !•l�C' �[_ U L O Tc, i�r�1 L c�M t��L 1_p�( l_I N�S A P P L"i