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HomeMy WebLinkAbout0085 LAKEVIEW AVENUE l. I .aa.lcev: ew v e, 4 i r ,- wW z TO -7 Town'of Barnstable *Permit# Expires 6 months from issue date i,. Regulatory Services Fee. s,►cirr ics�, _ _ , � nt;►ss $'. Thomas F.Geiler,Director . pTFD N1A� Building Division Tom Perry,CBO, Building Commissioner' . 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us .Office: 508-8624038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number aS a )O Property Address 35 CO-LC yi C'.v-) Ole C`oy��2r Residential ` Value of Work ' �.� Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address MC L f ►I Mr kcd e �� ls•.1L-� �l ie Idle CaAe-s ,f'It e o(I.A Contractor's Name �3 . r 'n l g__ Me_ -1M r6 -e_M e j Telephone Number `50 -7 -7.S-11 rl 8 Home Improvement Contractor License#(if applicable) .1 0 3 15 7 Construction Supervisor's License##(if applicable) C:5 (p(o 6orkman's Compensation Insurance �. Check one: + !)1 1 �, t ❑ I am a sole proprietor t�>>N l OF BARNSTABLE ❑ I am the Homeowner 51Thave Worker's Compensation Insurance Insurance Company Name U,��0 Gt C: v 1C�t fSi-� (Yl Workman's Comp.Policy# Copy of Insurance Compliance.Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) r ❑ Re-side #of doors [ ] Replacement Windows/doors/sliders.U-Value a 3,c (maximum.44)#of windows 1� */Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,eta t ***Note: : Property Owner must sign Property Owner Letter of Permission. A copy of the Improvement Contractors License&Construction Supervisors License is I quir SIGNATURE: Q:\WPFHM\FORMS\buildingpermit fonns\EXPRESS.doc Revised 090909 The Commonwealth of Massachusetts Department of Industrial Accidents Office oflnvestigations 60 0 Washington Street Boston,.MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciaus/Plumbers Applicant Information Please.Print Legibly Name(Business/OrganizadorAndividual):S A t;A Y04eL lGV fYtE'�� Address: ,Lqc{_, r ble R a City/State/Zip: a OoZ(00 -Phone#: Sn L 7 7.5- 1-7 7 g Are youan employer?Check the appropriate box: Type of project(required): 1.I� i am a employer with 4• ❑ I am a 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• :❑modeling ship and have no employees These sub-contractors have employees and have workers' 8. ❑Demolition working for me in any capacity. 9: C]Building.addition. [No workers'comp. insurance comp.insurance._ 5. ❑ We are a corporation and its required.) 10.❑ Electrical repairs or additions .. . 3.❑ I required.] a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions co right of exemption per MGL 12. Roof airs elf. o workers ❑ nP mp. c. 152, 1(4),and we have no � j 13 insurance required.]t § P employees:(No workers' . Other e comp.insurance required.) 'Any applicant that checks box#1 must also fin out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hint outside contractors must submit a new affidavit indicating such t ontractors that check this box must.attached an additional sheet showing the name of the subcontractors and state whether or not those entities have C employees. If the subcontractors 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: Q Ssn (� �:CL, CA -t',,.e�.t�t 5 fie' ak AMA Policy#or Self-ins. Lic.#:QLAjC, 7 q 9 q 3C)J 2:b[C) Expiration Date: nt 16( Job Site Address: ew �lP City/State/Zip: N nki yille.JM CQ63.Z Attach a copy..df the workers'compensation policy declaration page(showing the poUcy number and expiration date). Fail a to secure coverage required uired under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a g fine up to S 600.00 and/or one-year imprisonment,as well as civil penalties in the form of it 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 fo igIgNac.coverage verificatio I do hereby ee Srth s and penalties of perjury that the information provided above Is true and correct Si r — pc- Phone#: 506. Offlcial use only. Do not write In thisarea,to be completed. y city or town ofJiclaL 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.OtherJ1 Contact Person: Phone#: rr 2'0 2011 9: 54AM Spr-inkle Home .Improvement 5087751350 page 1 ev CERTIFICATE OF LIABILITY INSURANCE OP ID DS DATE'"'''II°°`rr SPRIN-Z 01 12 Z1 PRODUCER THIS CERTIFICATE IS I SUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Bryden & Sullivan Ina Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 86 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Hyannis MA .02601 Phone.1508-775-6D60 Fax1508-7$0-1414 INSURERS AFFORDING COVERAGE NAICN INSURED INSURER A: Associated 3o4ustriwe of NA T INSURER a:. 8ppTinkle Rome Im$$ INSURERD rovement Inc. aNSURERC: 199 table ila Hyannis NA 02601 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BEl OW 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 RESPECTTO WHICH THIS CERTIFICATE MAY 6E ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 18 SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ LTR NERN TYPE OF INSURANCE POLICY NUMBER DATE MWOONYYYJ W(MKwynom LIMITS _ GENERAL LIABILITY EACH OCCURRENCE S COIA ERCIAL GENERAL LIASIUTY PREMISES jEs ocwrertce S CLAIMS MADE OCCUR MEO EXP(Airy one person) S _ -- PERSONAL&AOV INJURY S GENERAL AGGREGATE S GENLAGORE13ATELIMTAPPLIESPER; PRODUCTS-COMPJOPAGG S - POUCY &RC LOCY AUTOMOBILE UASLITY COMBINEDZINGLE LIMIT s; - , (Es Sodden! S ANY AUTO . ALL OWNED AUTOS. BODILY IWURY SCHEDULED AUTOS (Per peisan) S HIREDAUTOS BODILY INJURY S '= NON•OWNEDAUTOS (PeraocidelM) __ PROPERTY DAMAGE SJr7 (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY ALRU OTHER THAN ACC S T ` AUTO ONLY: AGG S EXCESS I UMBRELLA UABIUTY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S S _ DEDUCTIBLE S RETENTION S S � WORKERS COMPENSATION :DRY LIMITS ER AND EMPLOYERS'LIABILITT YIN A . ANY PROPRIETO(lAaeOtorylnRIPARTHERIEXECUTN AWC7004943012011 01/01/11 O1/01/12 EI.EACH ACCIDENT s 500000 OFFtda"I NH)BER EJ(GLIJOED7 EL_DISEASE-EA EMPLUYE;E S 500000 _ uyyees,deselib0undo, E.L.DISEASE•POLICY LIMIT 6500000 SPACIAL PROVISIONS below OTHER DESCRIFTION OF OPERATIONS I LOCATIONS/.VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION SPR1=0 DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.SLIT FAILURE TO DO SO SHALL Sprinkle Home %ZProvementr xna IMPOSE NoOBUGATIONORLIABIUTYOF ANY KWO UPON THE INSUFA3%ITS AGENTS OR Fax #508 775-1350 REPRESENTATIVES. Margo Mack I A,UTHOR¢EOREPRESENTATIVE 199 Barnabable Rd. Kelley B.Sullivan annia MA 02601 ACORD 25(2009101) 0 1988 2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are.registered marks of ACORD r ti Town of Barnsta'bl'e ° Regulatory Services MAM i axsr�ss e, ' Thomas F.Geller,Director., Building Division Tom Perry,Building Commissioner .200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-86214038 Fax: 508-790-6230 Property Owner Must tt Complete and Sign This Section If Using,ABuilder I, •�I ,11�(� [ ,as Owner of the subject prow erty ^—T ' , hereby authorize to act on my behalf, in all matters relative to.work authorized by this building permit application for. 5 Lc W C.,,3 . avir r�A( �'IIe M r- vat 3 .(Address of Job) Signature ofpwner Vate Print'Nank If PropeitY Owner is applying for permit please complete the Homeowners License Exemption Porm on the reverse side. • fl•Ff1RMC•f1WNTiRPF.RA4i.CC1(�N Oftice�t o�m i'`�' ays Niue- ss xeg"uiaboa License or registration valid foi individul use only 10111111111011111 HOME IMPROVEMENT CONTRACTOR before the expiration date.. If found return to: Registration: 103757 Type Office:of Consumer Affairs and_.Business Regulation Expiration: C2gl2 . Private.Corporatic; 10 Park Plaza Suite 5170 Boston,MA 02116, S KLE HOM 11Ai" T.INC. Brad Sprinkle i 199 Barnstable RdHyannis,-M7-4 A 02*1 y` Undersecretary Not valid without sign ture Ni.iss.1chtnctts- Dcpartnicnt ot•Puhlic -*;tfct� Restricted to: 00 Board of',Buildin�o Regulations aild Stand;u-ds pp. Unrestricted Construction Supervisor•License 1G 1 2 Family Homes License: CS 6643 Restricted to: 00 BRAD K SPRINKLE ` Failure to possess a current edition of the 190 LgTMROPS LANE Massachusetts State Building Code W BARNSEIBLE, MA 02668 a i is cause for revocation of this license. Refer to'. 'WWW.Mass.Gov/DPS Expiration: 10/8/2011 Tr#: 547.8 ('nnn�iisiuncr . Tod, Town of Barnstable *Permit expires 6 months from issue date - Regulatory Service s, MASSat�. g Y $ Fee , d Thomas F.Geiler,Director prEDp Building Division Tom Perry,CBO, Building Commissioner OK I6Ilo6 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508- 790-6230 EXPRESS PERMIT APPLICATION - -RESIDENTIAL ONLY Not Valid without Red X-Press Imprint. Map/parcel Number 5 Z, I D Property Address S L.AKC-V I E �V � Residential Value of Work t 0©0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address AAC 4x L 5 L_/�1�� 1 6 vj AV a C uN V.I Contractor's Name Pi-V L ( A-Z -e Telephone Number_A7O8 —q Z8- ( n-7 Home Improvement Contractor License#(if applicable)_ /OxE 71 14 Construction Supervisor's License#(if applicable)_ QZ(p 2 S 14Workman's Compensation Insurance Check one: X-PRESS PERMIT ❑ I am a sole proprietor un' ❑ I am the Homeowner O C T 2 Zfl�s �I have Worker's Compensation Insurance Insurance Company Name TOWN OF BARNSTABLE Workman's Comp.Policy# U d Q g Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) �,Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof.(not stripping. Going over existing layers of roof) ❑ Re-side a ❑ Replacement Windows. U-Value (maximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,ctc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home pr vement Contractors License is required. SIGNATURE: Q:Fortns:expmtrg Revisc071405 t, y� a The Commonwealth of Massachusetts Department of Industrial Accidents -� Office of Investigations �G 600 Washington Street i Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):�\j L_ �.1 C A z /�tV -�- Roo F ( )% t �. Address:3 0 31 City/State/Zip: n S T c I e #:—SOB - y `Z Are you an employer?Check the appropriate box: Type of project(required): Co I am a employer with 1 Z— 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors ❑New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 1 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. ❑ We are a corporation and its required.] officers have exercised their '10.❑ Electrical repairs,or additions 3.❑ 1 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 12XRoof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13•0 Other *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and 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:TQ m F 9 ,5� ��S Policy#or Self-ins.Lic.#: U rJ OO q 5 R) (p L Q Expiration Date: O ZOO Job Site Address:$5 )N V E City/State/Zips Er t,,j't''[1:N L`% MMIIZZ 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 certif nder the pains and penalties of perjury that the information provided above is true and correct Si nature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 6:Other 5. Plumbing Inspector Contact Person: - Phone#: r Town of Barnstable ti Regulatory Services W MASS. t Thomas F.Geiler,Director v as,►ss. � ' �479 �0 A'En►an�" /. Building]Division. Tom Perry, Building Commissioner 200 Main Street, iiyannis,MA b2601 Tmw.town.b arnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as.Owner of the subject property hereby authorize blu l A Z ed V f t f Smcs T7i2 e, to act on my behalf, in all matters relative to work authorized by this building permit application for. ui ,W, Rd¢-��(��2 (Address of Job) Signature , Owner Date Print Name Q:F0RMS:0WNER?ER YSSSMN &V ra Board of Building Regulati ns and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 10371 Typ Private'"or oration Expiratio 7/9/2008 PAUL J. CAZEAULT & SONS', INC Paul Cazeault - 1031 MAIN ST OSTERVILLE, MA 02658 Update Address and return card. Mark reason for change. Address .C---I Renewal Employment !. Lost Card DPS-CAI CP 5OM-05106-PC8490 -Te �arr�nsw�uuea// a�/�Ciaoac/u�aella Board of building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:-,103714 Board of Building Regulations and.Standards _.. _ One Ashburton Place Run 1301 Exp;iration:: 7/9/2008 Boston,Ma.02108 Type: _Private Corporation PAUL J.CAZEAULT:'&,SONS INC . Paul Cazeault 1031 MAIN ST OSTERVILLE, MA 02658 ' ? Deputy Administrator Not valid without signature i Board of Building egulations One Ashburton Pi�ace, Rm 1301 Boston, Ma, 02108-1618 License: CONSTRUCTION SUPERVISO - E Birthdate: 10/20/1959 Number: CS 026325 Expi s: 10/20/2007...; Restricted To: 00 ..3 ' t .k.,:: PAULJ CAZEAULT 1031 MAIN ST OS.TERVILLE, MA 02655 Tr.no: 7696.0 Keep top for receipt and change of address notification. ' DPS-CA1 G 50M-04105-PC8698 i ✓/te V�umirno�w�eall� a� oaac�iuoPl� BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR �! i Number, ,CS. 026325 B l Nate':!te: 10/20/..1959 �. �I I Expires- 10/20/2007 Tr.no: 7696.0 - •_...,- +.; Restricted 00 PAUL J CAZEAULT r: 1031 MAINST 77 GATE _ PaooucER` -THIS CERTIFICATE IS ISS115D,AS A w.ATTER C+F INFiFiTRCKI; DOWLING & 0 NEIL INS AGC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE: 222,WEST:MAII; .STREET. HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND'''OR 1990 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELpW_. .''HYANNZs PIA 02601 COMPANIES AFFORDING COVERAGE '22LGR Cu AtN . INSURED A' TRAVFLERS PROPERTY CASUALTY COMPANY OF' AMERICA COMPANY :'PAUL J CAZEAULT 6 SONS INC. B 1031't1A.IN STREET •OSTERVILLE NIA•02655 COMPANY C - COMPANY COVERAGES`:` «:_:,;<.. D Y S.'S i ::2:'�:. S:k:L is}:.'� s.. b :YM :'I::r 05 THIS IS'TO }' s'•I •}�:. T HA :`s:: r:rH .:�. EPO )LC� IES" F IN SURANCE N E LI �' "� a STED'rBElOW H V^„INOICATED;'NOTV4THSTANDING ANY REOUIRMAGNT A EBEEN ISSUEDRATO'THE'INSURED NAMED'AHOVEyFt7R7}{E IC TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO CH T 1-. i.` IOU "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.LIMITSSHOWNMAY=HAVE BEEN REDUCED BY PA1DCl'AIMS. LT ; TYPEOFINSURANCE POLICY EFFECTIVE POLICY EXPIRATION' LTR POLICY NUMDER DATE.Ir=0n\YY) DATE(MOd\DD\YY). LIMITS `GENERAL LIABILITY CUMMt HG'7AL GtNtIiALiNyIL11Y' GENEIIAL AGGI'IEGATE S VIIUUU(:ly-('IjMMYIUi^AUC;. j CLAIMS MADE a OCCUR. PERSONAL r<ADV.IN.IIIRY .0wi4'H'S A CONTRACTGR'6 PA61. g EACH OCCURRGNCC j FIRE DAMAGE(Any one tire) g AUTOMOBILE LIABILITY- MED..EXPENSE.(Arry one person) g. ANY AUTO COMBINLD SINGLE j LIMIT ALL OWNED AUTOS SCHEDULED AUTOS HOOIEY INJURY ' HIRED (Per Person) S�� •;; !` NON-OWNED AUTOS BODILY INJURY (Per Accident) 3 `t t PROPERTY DAMAGE q GARAGE LIABILITY' ANY AUTO' 'AUTO ONLY I EAACCIDENT' g+ 0THFRTkAN AUTO ONi.Y: 767d:<ia<. ETd:H ACCIDENT. EXCESS LIABILITY AGGIIEGAIL g UMBRELLA FORM FoACH CK'.CURRENCE g OTHER THAN UMUHELUI FOHM - - AGGREGATE j WORKER'S COMPENSATION AND. A EMPLAYER'SuAwLITY (UB-0095B69—A-06) 08-10-06 08-10-07 STATUTORYLIMITS 'THE PROPRIETOR! INCL EACH ACCIDENT PARTNERSIEXECUTIVEFq OFFICERS ARE: EXCL DISEASE-POLICYLIMI'T g UIMLK DISEASE-EACH EMPLOYED j 00, ... t• lTr TtII REPLACE;, ANY PRIOR CERTIFICATC I;,;,UED TO TtIE CERTIFICATE HOLDER AFFECTING WORKER^ C •.u,:FiG�::� OL R : :::::Fv coMr cov'GRACE. f. Xirr: . SHOULD ANY OF^THE rABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE"', " Paul J.Cazeault&Sons EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Roofing,lne. 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE 1031 Mai a Street LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO ODUGAT16N OR LIAWLITY OF ANY,IJND UPuNTHECCSAWl,K'f,)TSA�c�►TSOR RGVRES,EKTlnTt11G5.,. Ostervillo, MA 02655 AUTHORIZED REPRESENTATIVE - ... jQ�411U:' I .0 ..:.............:n. ii:.:c;o;A:{:i:'i"=.}i:f:Y:2,,I :;r•+ �i:>:?5,.3':.3i43 .,..,y.,,,..:•.;:;.,•,,<.o+',•....:..:...::�•':..• ..•ii:•:,,:Er, :.r:';5;•;., g:r..•:;:.c::>ss :x;. :: ......:..E.. > ..7 v,..vi:„r'•.$:;:RYG�`';�.::io c,'t ;:<':a,+ rA Oilp CnHPdRAlJQKt993 4 Client#: 19989 2CAZEAU LTPA DATE(MM/DD/YYYI� ACORD- CERTIFICATE OF LIABILITY INSURANCE 05/1�,os . PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 222 West Main St PO Box 1990 Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED - - INSURER A: Western World Paul J.Cazeault&Sons Roofing,Inc. INSURERB: 1031 Main Street INSURER C: Osterville,MA 02655 wsuRERD: INSURER E: - COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTNE POLICY EXPIRATION - LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD DATE(MMIDINM LIMITS A GENERAL LIABILITY NPP1012091 04/30/06 04/30/07 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY - DAMAGEPREMISES FRS occurrence) $5O OOO CLAIMS MADE M OCCUR MED EXP(Any one person) $2 500 X BI/PD Ded:1,000 PERSONAL B AD INJURY $1 0OO OOO - GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $1 000 000 POLICY j�T LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F-1 CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE _ $ RETENTION $ $ 1 WORKERS COMPENSATION AND WCRY STATU- 0 TH- 4 EMPLOYERS'LIABILITY ' ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICEMMEMBER EXCLUDED? I E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS �I Certificate of insurance will be issued directly by the insurance carrier. i r �i CERTIFICATE HOLDER CANCELLATION I' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Informational purposes only DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL P P rP Y lin. DAYS WRITTEN j NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 1 REPRESENTATIVES. AUTHORIZEDPRESENTATNE ^! ACORD 25(2001108)1 of 2 #42866 LS1 O ACORD CORPORATION 1988 11 ,i ., ,. 4� 0 �'Assessor's map and lot'number .�.....................��,.., SUBJECT �'/' THESewage Permit number •� / . •. , ARN ABLE ; d�A ? A A li USTGDLE, • ' House number ...............?5 ....................................... "� 18i�1 d�c� � b a r�. Ci� •�6� :. TOWN OF BA STAB. : E�r . WITH TITS. C, r4. W011002- APPLICATIONk NTAL LBUILDING L ..g•-..+ FOR PERMIT TO j Crg�? C g'E c .S �isy? ....... irJ. L/...../I c!.!... ..................... TYPE OF'CONSTRUCTION ........,C1'109—?.. .r ''� ...................:....::.................:. ..........19.. ' ' TO THE INSPECTOR OF BUILDINGS:, ' } t y The undersigned hereby applies for,a permit according to the following information: Location ..........Mk?&jel' 1"L !' . ........... C.9 t+r�'.' ..........:.........4: 'T�'��!:. 5�'.... ProposedUse . ...... '�.. .. ... :.................................................................................... V� Zoning District �� . . .--../J ........ District ......Lim!V ..'.....USA....................................... Name of Owner ... ...... �f7�!aS i......... .........Address ..:.f�. ...... �� .. C_G;�✓i�.��/fC: ...... Name of Builder' v........................................................' 'eAddress .....��..' � �............�c`� ': New--E,fi �........................... ................... .........Address ......................... .. ............................. ................ Number of Rooms .. <.. 1?: .......................................:Foundation . . 6PVj�.: ' .................... Exterior ......eeoe-K_... ...........................Roofing . <� .................... Floors /9!.lU�pC.,,.................. ..................... ....Interior — ``3 fir' " Heating �l�1r...��<.. '..... r' ... ..`....!?........... ...Plumbing Firep'lace^ ..... .......:............:........ Approximate Costy vODU......:..........:........................ Definitive Plan Approved by Planning Board -----------________s-_______19____ . Area §X::.. '.. Diagram of Lot and Building with Dimensions Fee .. .. ............ SUBJECT TO APPROVAL OF BOARD OF HEALTH a OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS y I hereby-agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. � -Name .... . . . . ............................. (7 - 1 DAVID TRUST No 2 4 8 5 l.. Permit for .l? ory ' Single FamilX Dwe . p ...... , •• .. . llin........g............... - r Location Lot 109, 85 Lakeview Ave. .................................................. .......... Centerville ........... ................. ................................ i.,A -A/K `a! ,A''` ^ T . ' y, •7-.. t David Trust 4- Owner ...... .................................................... a r ; • - "r Frame...................................Coruction ... ..........!......... .................................. ................. Plot ............................ Lot• .................................. March 15, rt 83 Permit Granted .....................19 f Date of Inspection .............. ........W..... :19 3 Date®Completed ..... r f 1 JOHN F. THIBBITTS ATTORNEY AND COUNSELLOR AT LAWe " 255 MAIN STREET - POST OFFICE BOX 276 HYANNIS, MASSACHUSETTS 02601 (617) 771-2690 May 17 , 1983 Mr. Joseph Daluz Building Inspector _ Town of Barnstable "� a - South. Street Hyannis, Mas.s. 026011. - Re: Lot 109 , Holly Point, Centerville, Mass- Owner: David A. Sauro, Trustee, David Building Trust Dear Joe• Enclosed you will find a revised certified plot plan in th.e above file. - This should re.place. the. plot plan dated 2/23/83 pre.sentTy in the fi.le.. If you have. any questions, please: give my- office. 'a call, Very truly yours:, John F. Th. bbitts. Encl. cc:. Mr. William C. Nye-, Engi,ne.e.r cc: David A., Sauro, Trustee. I .,. ...`• L A ICE VIEve/ A � 1`I �• t � Z7 �. .. L o-" l o q 000 0 0 �J Lj IIZ.•4' I LOT, 12 S �p►iP��N OF A44 WILLIAM cyGv, 112 - 7i . �f N Y E y — - §r ,F ` :3 No. 19334 t: f ���C E�T�.F�•_"T'1-1Ar"' "r'N�_ �Fa v v�-r�o�.1 ��, '�F w° .'A C.SZTIr-M=) �Lt'.�)V t le am WI-S GN vVks -r"E Zot� NCB �?eI orb LoCATIOW C EN'r•2.V 1 LLG G1-lh.MbE 'fv °s 3�' A Z- Z3-� 1 L ` 3 u4 `3"1G , 9 .83 � 4,y"r�"'`�',�k t•S. rrG v N�a►"t'1 U� � S Nv�' PLA►.l �Z�FEILE►.IG 6D 11' 41 LOT 1 oq .I. \� .u7A E-NT" �J tZ`�l E'( Fs B A)(TM Vt �= uYI_ IwC.. 6 0o sS,&Yo Qt kt { . ahP�.t ca►.,-rr �Rv tD SAu zo I j .' - Assessor's map and lot number .......................... /, ,5 � �• .,.�__.._. � Cf THE T�� Sewage Permit number ....................... ... .... BARNSTABLE i House number ................ .. �. .... ......... �o'rr ' rasa ,.. sIL•nG Op 039. OypYd� TOWN OF- BARTNITA IE � -- BUILDING_-,,1flSPECT0 R APPLICATION FOR PERMIT TO �''::: .�. tte7...... ° . . ...`.......`.....¢............................................. ;ter TYPE OF CONSTRUCTION ....*.�x4 P..... ........................................' ' .......................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ,location ....X.C?:+�......... r�nfr.d' ..... r 7�tv7.. ...., .4 t"U�f'kf...!` ..................� f .;:TF'rr/, 10.................. Proposed Use �' �...cam........ ` ... .... Zoning District........ <:� � � .. ................... j .... ...... .Fire District ... e.--.N7.......... w.�...................................... Name of Owner .:1, .......7"9V U:. .... ...Address; .... 14... .. .el;?�. .. .... "A,__/7 Name of Builder' v/, �`...... ........: .........Address ..... .:.... : ............ t� ............................' N.om,e of Architect:............:.....................................................Address ................................................. Number of Rooms ........ �.�0. '.....:. Foundation ... ffPc hL9, "?` '.. :.............. f Exterior ..... :?'6�/ /D .S �X7Z7 v`./7�rr✓/ .....: ......... �........ .....:. . Roofinc+ ....,.... ....... ......... ............... .. Floors -'�' �....................................................Interior --�/ .. . .... .. .................... G. Heating ....... .! h tom' �� Plumbing .,� 1./� � ............. ... ............... Fireplace ... � !` .. ...t�}�'r� � .................................Approximate Cost:. . 000. . ..................... ........ Definitive Plan Approved by Planning Board _________.__________ -------�9-------. Area .............. ........................ Diagram of Lot and Building with Dimensions Fee ....... � f.................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH � P � !' �' y /'�, � ^,- y OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Ncme ... . `...................................................................... DAVID TRUST . A=252-101 24851 12 Story No ................. Permit for ..................................... Single Family Dwelling ............................................................................... Location „Lot #10. . 9,....8.5....5 Lakeview. . ..Avenue .. .. . .. . ....... ....... ..... .... Centerville ............................................................................... David Trust Owner .................................................................. Type of Construction ....Frame' ...................................... ............................................................................... Plot ......................... . Lot ................................ Permit Granted ...arch. 1.., 19 83 Date of Inspection ....................................19 i Date Completed ......................................19 OPT' Al t C TOWN OF BARNSTABLE Permit No. ! Building Inspector tianTau, Cash 7 YY6 A aS9. OCCUPANCY PERMIT Bond ..----- ______ ` Issued to avid Trust Address test #loci 85 LakPvip-w Avenue_ Wiring Inspector Inspection date Plumbing Inspector /► Inspection date i Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ......................................................... ` .. . 19......_.._ //�!%+Y ✓ '` / trr.- a.�:-w.-_ . Building Inspector .. - - •! _ FROM". TOWN OF BARNSTAB LE. BUILDING .DEPARTMENT'. Aar. Francis Ltd3rie``.""#""""�� - ""` °' �367 MAIN STREET p �He�Y�AlN/%�NIS, 02�! Tom Clark .O 6�4 1r t..4.11 1F 4••�3 E lF#$y� 'Y•i iM 11�t}''!, _ Phone: -775 F120 SUBJECT: FOLDHERE - DATE .. _ :Feb. 8, 1984 - . _ f1 E S S A G E Work,has been ompleted �� 'p er 'q M 'f�K •-.��.K��P�R+'y� �.��Yf/!.4i"� ..v..'i 9�ii 8� '..3 a'�I.8.,r? �4 tis+k h nY I6 X Please rele€§-e Bafid. .. ♦ 1IGNE DATE - c REPLY SIGNED - - Ne7-RMI RECIPIENT:RETAIN WHITE COPY,RE - .. i - . .. r • i - PRI SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON.INTACT. j t LADE VI EV`/ I A\J(; r ... .. _ .l .• �ouNA•4TioAj cr i ,QN II o I112.'4' I � 1F.1 vlUc��"tt�+J of PfteS�l , L oT 12 S P�s� of A4q 11.J C.� frC�-., ftc)-wJ W LLIAM- N V E v C r-9:rj FY.-rjjAn•' -'rN G 'Fo V vAcrlmtJ. :t� ,P�o. 1933�4�0 is l-CLL�T D• o N E l 410 sup�i� 5t-�o�ct�t �►tj 'r►�� s pt..t�►4 . -C°r is F��►J��6.-r�Q� GvN��,2NJ15 C6QTt1=1E0 PI_O'r ,, E -A. GN VS(A.Sil' 4S ZO tt46 •Ft?1c9t2 LoCATIo1J CGMTEQLV1LLG 'T,� tT.S► G�-II►.M 6r� 'T� � L7•� •1 til �". 3�' .�_ Z• Z 3-�3 -t ► 5 t`o Nvi4�'i o S NvT- PLAN R>=FEcZE�cE t.o c-A--r D will N l r(Tatc 'F-Lx�� 'PWN t� L oT' l o g -px-r a 3 H oLLY Po iiv r T�-4 t S P4�►N �.S t+�-r' (3a5 � A e•( �1 u►�l E-NT" �Jt��O�`( �.T � la ATC uYE t NG. c9�t=Sfc'�'S �Nw�--37 l�c�T 'ib�c USCG REGISfigr,,D "wa 5uev&YoRt -'�""� D�T��I�(i t\I E �c?-c•' �•..i N is 5► o s°rERv►�� ® �t A►SS. aPPL.t ca►.,-t•+ �R�tD SAu Mo 15IW6,Lr-- FAMILY WO GACMAGrz 6211► 0sP- pAILY RI-ow a Ito 3 = a3oG.Pv, L A,io:.e v,/ Ave :SEPT1G TA%jw- = 330x15a% =,495G.PQ 0 4� u51=- 100o o15P05AL Prr V5E 511MIMALL A?-SA, a 15o S.F 1 _ rl� 150 5.F x .2.5 t 3?5 G.PD t0 log BOTTOM AREA ..N f 5F. nt� � � 15 000 � 'TCYTA1- c 51G r 4215 G.PD. � '�u1�l.L1iJlsy Q/r" 1. I ''TOTAL- DA 1 LY I=L.OW! = 330 G•PQ i PMZC0LATI0W RATE 8 1"IM ZMIN 09-LE5S ? � ��� �x f rir I 6a112.41 u.. VA OF M.�y, � OF Aiq 416, a �c RiCHARD ALAN 1 Zr BAXTER H} ! JOtlES ^. ' 7 S �h10.2404SO r;o ^,51QD SURV,�' i 'r o P F 1.10's'4 NoLE 12� �gZF4 iwv'4 5 ii l.D�W) 1000 INV. I �jv V DIST. INV. GAL 56vtiC �`� 1 coo r4,f eax . S� PIT Q�.Z �•¢ $oa� wrTu WASMSD 1 � . 6TvNf: tt=38 GE2TIr-Iso PLOT PLA1�1 EG _ P RO F I LG L O L A'?I o N 6EATIVLO t3 � No 3� -5cA _p` (2-TZ•�Z n c�UAt'r�— p 1-A t•t REF EZSW GIr A G E QT 1 F Y 'THAT T H rc vw>=t..0 13G. SNO vYN Nr.9-sow GOMPLYS WITN'THGL SI VSUW V-- 1 I =A► P S6-ctAGK 6C7�IR.�M1=N'T•� F'tNE- . 'Ta W K1 O F`:B ZATA131:e AN-0 145 �ar LoCp.TED NEs FL 'WITNIQ T � 00 P AIN ►-tOLL�� PO I �T BAxTEcze t�l`(E INC. I. `Z.EG I'S't E.QEPV'1-AN o S u My rm I 'Tu15 PL&KI 115 NcT W 51;Q CM AN asTEiZ.vILLJE a MASS. jm5T9,uMEN1' SV2vGY �-'TNE 0r-05E71'6 6WOU0 ' No-t 6G- V%r.[)Td Lt>'r /IPPIIGA►`JT �Q,�ID S/�V�LQ i April 12,1983 JOHN F.THIBBITTS attorney and dgunsellor at law Z55 MAIN STREET -POST OFFICE BOX 27fi HYANNie,MASSACHUSETTS 02601 (617)771-2S9D LaJce-v'i^io Robert Smith,Esq. Town Counsel Town of Barnstable Town Hall South Street Hyannis,Mass.02601 u3- Re:Lot 109 Lakeview Centerville,Mass. Dear Bob: As you will recall,I recently discussed the effect of upzoning as to front setback requirements for this property with you.Since I had not given you a copy of ^ the certified plot plan furnished to.the Building Inspector s office in connection with the foundation permit,I am doing so now.You will note that the existing foundation on Lot 109 is shown as 27 feet from Lakeview Ave. My interpretation of Chapter 40A,section 6, as it applies to this property is that,since it was at all times pertinent to our concern,in single ownership,it is entitled to the benefit of less restrictive setback,requirements in effect under the prior zoning in the area,which,was RC,as opposed to the more restrictive requirements of the current zoning, RD-1. My client,David Sauro,Trustee of David Building Trust,Is willing to undertake any necessary.procedures in order to ensure that this lot is freely salable in the future.,and especially in order to assure its compliance with the FNMA requirements which,govern a large portion of the secon dary mortgage market. At this point,William Nye,who has stamped the present plot plan with the caveat that the lot is.in.violation of present zoning requirements,is unwilling to remove said caveat ftom the plot plan.I have suggested that he speak with,you about this matter,having informed him that I understood your position JOHN F.THIBBITTS - 2 - April 12,1983 Robert Smith,Esq. (and the position of the Building Inspector)to be that, based upon Ch.40A,section 6,this lot is in compliance with zoning requirements of the Town of Barnstable and no caveat is necessary-nor is a variance procedure or any other zoning modification required in order to permit the continuance of the present residence under construction on the property. Thank you for your attention to this matter. Very truly yours, John F.Thibbitts End. cc:Mr.William Nye,Baxter &Nye,Inc. Mr.Joseph Daluz,Building Inspector Mr.David Sauro,Trustee r0H^'-n¥"'»5••'=•*fiB^-z.5ZimX-ivno^-L^r^&D-35-wroj'i!£M'i'*0rr\tHC/I'CACPm-(Psl?sSmI^0£c0>.*A^?nt:^cpP*<o8X0£0Er-o^o_o(Tt"amr^m£r^torK(/vJcroH01orn5fNpiaJtoUimNH2in?"wm!