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I - , , �" : -, ,, , , , I � I .1 : �, �I�� " ,� ��,��, �� �� � , I� I :',!......i�.,�,�, � ,� . . . . 7 11 ," ,I �_" -1_,, - � ;,. - � I�",'��, ­�,:, - " 11 .00, 40" , III I �, I,,- ­ - �, , �,,I , " I � , � �, , , -� ,,�,, ,�,� , , �" . - - , , ........... , , , I ., , !���""I,-, "��;"'"'��,-L��� '�,Z,��,,�,�,,,,.��,�,,,;,,�-,,��,,.4��,�� ,", ,,, - ,-A&1", 1v�� TIA A L�:On a�:� '�:� " ,. ­ - -,=L� `V,�,z".�:-,v'i :�,.,, 1`111.�kal_ � ,. � .L� ii` _- �` - :, . � loan 72's at Q 0 w , , Town of Barnstable Regulatory Services THE Thomas F.Geiler,Director Building Division BARNSTABM Tom Perry,Building Commissioner 9� , 39. ,0� 200 Main Street,Hyannis,MA 02601 RFD MA'S A ' Office: 508-862-4038 Fax: 508-790-6230 November 14,2013 Dennis Babineau 53 Lietrim Circle Centerville, MA. 02632 RE: 53 Lietrim Circle, Centerville, Map: 169 Parcel: 055 Dear Mr. Babineau: This letter shall serve as notice that an inspection.was conducted at the above referenced address for permit application number 201305408 and the following deficiencies were found: 1) Joists do not have proper lateral restraint at supports (R502.7 ) 2) Ledger at chimney does not have proper connections. ( R502.2.2.2 ) 3) Girder does not have proper bearing at support posts. ( 502.6 ) You must make the necessary corrections and arrange for an additional inspection. Thank you for your cooperation and please do not hesitate to contact this office with any questions. Respectfully, Lauzon Local Inspector (508) 862-4034 jeffrey.lauzon@town.barnstable.ma.us Q zoning5 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION U-3 Map: Parcel D SS Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee , c) Date Definitive Plan Approved by Planning Board - Historic - OKH _ Preservation/ Hyannis Project Street Address -5-3 Z_,1,Z.e IA4 Village 1/1 f1E Owner : AE;AJEAu Address •6_-3 Telephone - Z 5 —Permit Request 4-4 eG J K 2 —6 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed ' Total new Zoning District Flood Plain Groundwater Overlay Project Valuation f14a o� Construction Type Lot Size G'randfathered: ❑Yes ❑ No If yes, atta supportiN donentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) . w AJ 9 C Age of Existing Structure 'VOW, Historic House: ❑Yes ❑ No On Old Gin, 's Highw'y: ❑ges ❑ No Basement Type: Q Full 0 Crawl ❑Walkout ❑ Other Basement Finished Areas .ft. Basement Unfinished Areas .ft Number of Baths: Full: existing I new Half: existing mew Number of Bedrooms: existing —new Total Room Count (not including baths): existing �Z new First Floor Room Count Heat Type and Fuel: n Gas ❑ Oil ❑ Electric ❑ Other Central Air: [ Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size . Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed_Use_ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �1b40;C &&1 Telephone Number ZPO Address _3 IA4 ��.eGG� License # AITE/Z IS/Z-L.�� Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNAT DATE ;w FOR OFFICIAL USE ONLY t APPLICATION# Y DATEISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER i x DATE OF INSPECTION: ; u_.-FOUNDATION 4 c,i.o FRAME INSULATION FIREPLACE s� ELECTRICAL: ROUGH FINAL z PLUMBING: ROUGH FINAL ;y GAS: ROUGH FINAL x s FINAL BUILDING a tZ�o3 i F DATE CLOSED OUT ASSOCIATION PLAN NO. i The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Invesfigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit::Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: ..5_3 / (21 Iled L.C_ City/State/Zip: — 1�L� , Al)�4 D hone#: 41_�'f S Are you an employer?Check the appropriate bog: Type of project(required): 1.❑ I 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.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp. insurance comp. insurance. $ required.] 5. ❑ We are a corporation and its l0.❑Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their l 1.❑Plumbing repairs or additions myself. ' right of exemption MGL y �o workers comp. on per 12.❑Roof repairs insurance required.]t c. 152, §1(4),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: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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$1,50.0.00 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 pains and penalties of perjury that the information provided above is true and correct Si ature• , E� ��„ - Date: 5� f AL. Phone#: 5 nk Z g'D Z/2!-5 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance.. requirements of this chapter 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,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the 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 may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit 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 (city or town)."A copy of the affidavit that has been officially stamped or marked by the city 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 be filled 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 bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations 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 Industrial Accidents Office of fnvestigatiens 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSME Fax# 617-727-7749 Revised 4-24-07 wvMmass.gov/dia > - Town of Barnstable Regulatory Services * � ' Thomas F.Geiler,Director 59- 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 HOMEOWNER LICENSE EXEMPTION Please Print DATE JOB LOCATION: ,`ram /5rxz,�l 1 xCf number street 'L village "HOMEOWNER":�EiU.(��S .�°i.�%IV�/CI�'I ✓y�'—Z.RD `Yf/c—7 name home phone# work phone# CURRENT MAILING ADDRESS: L� ZZ ill city/town state up 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 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, r bylaws,rules and regulations. , r The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection rocedures and requirements and that he/she will comply with said procedures and requirements. W. Signature of Hom / J I Approval of Building Official l 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 form/certification for use in your community. - C:\Users\decollrk\AppData\Local\Microsoft\Windows\Temporary Internet Frles\ContentOutlook\QRE6ZUBN\lD2RFSS.doc Revised 053012 �TME Town of Barnstable . . �; Regulatory Services y���'� Thomas F.Geiler,Director 16.19. r�rt' 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 as Own of the subject property hereby authorize to act on my behalf, in all matters relative to work a olized by this building p t (Address of **Pool fences and alarms are the resp sibility the applicant. Pools are not to be filled or utilized before fe ce is installe d all final inspections are performed and accep d. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNMERMISSIONPOOLS 62012 GRA PEL DRIVE LOT 39 00, r LOT 38 =_= sE _-_�+ DECK SUED � f o�. NOTES.- PRE-EXISTING NONCONFORMING. RECOMMEND INSTRUMENT SURVEY Ins ZONE nRC" This MORTGAGE INSCTION Plan is B °ank Use � FLOOD Zoe '"Cu TOWN: C-V T�EyZF,- _REGISTRY 0 R: x48Gdw-z- P�D.N,� �c L 1T1Y� N DEED REF: 3�19"$- _ ——— _BUYER: _DENT ,L B�B�IyEd —_ DATE: � VV— _ —_— _ PLAN REF =. ,!93 _—— SCALET'- _3O_—_ _FT. I HEREBY CERTIFY To YANKEE SURVEY THAT THE BUILDING SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS CONSULTANTS SHOWN AND THAT ITS POSITION DOES __ ' CONFORM put TO THE ZONING LAW SETBACK REQUIREMENTS OF THE A. 40B (SUITE 1) TOWN OF BAMMA&Z� — AND THAT Na MTHM H INDUSTRY ROAD IT DOES—Nf LIE WITHIN THE SPECIAL FLOOD HAZARD 9f MARSTONS MH T , MA. 02848 AREA AS SHOWN ON THE H.U.D. MAP DATED. / /B5 TEL 428-0055 2500 00 5 C tom! 'PLAN FAX 420-5553 PAUL A. THlS NOT MADE FROM RU AWRAMENPL9 SURVEY NOT TO BE USED FOR MCM. ETC. 15076 BJS QC H e-� .4 t 4 s S j F i WAl+UrAI/� 9 � `s J t< 4 i 0 i - W 4 .a 1 4 o 9 C� 4 i Town of Barnstable- . ermtt.# .� Expires 6 mont- om issue date Regulatory-Services Fee « SAWWWABLE, yb MASS' Thomas F.Geiler,Director 1639. plir ) Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY of Valid without Red X-Press Imprint Map/parcel Number �0 q 1) Property Address �.-/`E t"!"/tn'l % 'Gf/4e, ,may[Residential Value of Work w cro Minimum fee of$35.00 for work under$6000.00 n Owner's Name&Address -DeWAJ/6 Cc 1 Ne-Q.(. 53 st �' -t'1+i /�� ft/id� iris�Pt1Gnl � ayisoyu Telephone Number qd'l- age-9900 Contractor's Name Home improvement Contractor License#(if applicable) �' a �� Construction Supervisor's License#(if applicable) 0 9 J ! 0 / Pen[31(yorkman's Compensation Insurance k Check one: •� - 1NOV a ❑ I am a sole proprietor ❑ I the Homeowner " � �9 have Worker's Compensation Insurance SARA Insurance CompanyO Name A C TA' ALE Workman's Comp.Policy#; ►TJ�-C- %OIL Copy of Insurance Compliance Certificate must accompany each permit. Permit Re uest(check box) [� Re-roof(hurricane nailed)(stripping oldshingles) All construction debris will be`taken'to ❑Re-roof(hurricane nailed),(not stripping. Going over. existing layers of rool) Re-side a #of doors` [�Replacement Windows/doors/sliders.U-Value0, d (maxim= 35)#of windows © Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required; Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.- ***Note: Property Owner must sign Property Owner Letter of Permission. s - . ,A copy of the Home Improvement Contractors License&Construction Supervisors License is requir SIGNATURE:• C:\Users\decollikWppData\Local\MicrosoftlWindows\Temporary Internet Files\Content.outlook\QRE6ZUBN\EXPRESS.doc Revised 053C12 i P � , a ny ...- °, 6` w r •.. a E,. .. ' n tr Fart y9!- - The Commonwealdt 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/Plumbers Applicant Information Please Print Leaibl Name (Business/Organization/Individual): FjAh Vq 14a LLB`' Address: a (n l oA/ 9-0 City/State/Zip: 4/A/d0& , 91T. 0.1865 Phone#: 4101 • 7 P 2- goo Are you an employer?Check the appropriate box: Type of project(required): 1.[11 I am a employer with A Q 4. E] I am a general contractor and I employees(full and/or part-time).* have hived the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers' comp. insurance comp.insurance.# required.] 5. 0 We are a corporation and its 10.❑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,§1(4),and we have no employees. [No workers' 13.( ther comp.insurance required.] S '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 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: 5l111-aW C62tMOAA10 Policy#or Self-ins.Lic.#:� /6 as 7.1>I0 3 Sot J Expiration Date: g ,:�t L'l� T� C,�(e C ` e, Job Site Address: City/State/Zip: // Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date)9-"6' 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 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 pains and penalties of perjury that the information provided above is true and correct Signature: c Date: t " Phone#• �D l' 07 v9 — 9 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person Phone#: Y y - Client#:30124 SOUTNEW DATf ACORDr. CERTIFICATE OF LIABILITY INSURANCE -8/062013YYY)_ - -8/(►612013 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 COMENTACT Anita Little Willis of New Jersey,Inc. PHONE 856 914-4660 aIC No Ext: A/C No): 856-914-1881 1015 Briggs.Road,PO Box 5005 E-MAIL ADDRESS: anita.liftle@willis.com. PO Box 5005 INSURER(S)AFFORDING COVERAGE NAIC# Mount Laurel,NJ 08054 INSURER A.;Selective Insurance Co of the S 39926 INSURED INSURER B,Argonaut Insurance Co. 19801 Southern New England Windows LLC INSURER C:Beacon Mutual Ins.Co. 24017 D/B/A Renewal by Andersen INSURER O 26 Albion Road INSURER E:I Lincoln,RI 02865 INSURER F i COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISOUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.., LTR TYPE OF INSURANCE NSR SWVD POLICY NUMBER UBIR MMIDDY EFF POLICY EXP LIMITS A GENERAL LIABILITY S202945900 8110/2013 08/10/201 EACH OCCURRENCE $1 1000,000 X COMMERCIAL GENERAL LIABILITY �1 A GE7 RENTED PR�'I�ISES Ea occurrence $100 000 CLAIMS-MADE �OCCUR MED EXP(Any one person) $10'000 PERSONAL&ADVINJURY $1,000,000 i GENERAL AGGREGATE $3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: j PRODUCTS-COMP/OP AGG $3,000,000 POLICY PECOT- LOC. $ A AUTOMOBILE LIABILITY CMBINED SINGLE LIMIT S202945900 8H0/2013 08/10/201 EOa accident 1,000,000 X ANY AUTO - - BODILY INJURY(Per person) $. ALL OWNED SCHEDULED �. BODILY AUTOS AUTOS INJURY(Per accident) $X HIRED AUTOS X NON-OWNED - -AUTOSPeOPERTY $ tDAMAGE - $ A X UMBRELLA LIAB OCCUR ; S202945900 8/10/2013 08/10/201. EACH OCCURRENCE $5 OOO OOO EXCESS LIAB HCLAIMS-MADE AGGREGATE s5.000.000 DED RETENTION$ 4 $ C WORKERS COMPENSATION 0000068028-RI 8/21/2013 08/211201' X WCSTATU- OTH- AND EMPLOYERS'LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVEYIN AIC927818352394 8/?1/2013 08/21/201 E.L`:EACH ACCIDENT $1 000000 OFFICER/MEMBER EXCLUDED? � NIA (Mandatory in NH) E.L:DISEASE-'EA EMPLOYEE $1,000,000 If yes,describe under* DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $1,000,000 ._ .1 ..: . DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION i Southern NE LLC SHOULD IANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 26 Albion Road ACCORDANCE WITH THE POLICY PROVISIONS. -_:.Lincoln,RI 02865 _ 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 z- #S215109/M215088 (. AXL w Southern New, England Windows d.b.a Renewal by Andersen of SNE 'Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-095707 BRIAN D DENNISON �' I 7 LAMBS POND CIRC'. c Charlton MA 01507 .`J.�e.y . 'i i+' Expiration Commissioner 09/08/2014 �f2G Z 3 t?/IfGCL0611�J2LIQ �iJ Office of Consumer Affairs n Business egu atlon 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration " • - Registration: 173245 . _ Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS LL^ Expiration: srlsnola DENNISON BRIAN 1137 PARK EAST DRIVE WOONSOCKET,RI 02095 Update Address and return card.Mark reason for change. su°o zau:vu ❑Address [—j Renewal C]Employment ❑Lost Card r mee.rCon—,ARairs&Bud—Reguladoo License or registretion valid for Indlvidul use artily xOME IMPROVEMENT CONTRACTOR before the expiration date.If found return to: . n Office of Consumer Again and Business Regulation Ezlradon: 9/19/2014 .. Regpiration: 178245 Type: I0?ark Plara-Suite S170 Supple - I. ment 77ard Boston,MA 02116 . ° SOUTHERN NEW ENGLAND WINDOWS I.I.C. ' RENEWAL BY ANDERSONDEN ,. PARK BRIAN 1137 - - 1137 PARK EAST DRIVE - WOONSOCKET,RI 02895 Uoderserremry Not valid without signature - Qu7��0;7fl: . �•"[-..� '�d"' � �F'l4 EF'� IL#a!'6�.�SI�+C+�IY1!IYL'. � �� - . r, A�'fiFN` avid 'CO& J RO- �. � .�� t 9: ZOO Addr n; � d� e�'M �1 eLf1 i" c4jq a 121a+"'IrI 1A15,' fs W44.4. / 11_'.."`0 P� kTUgptQ, .K"ot Bm sl htrcby Wittily and mvcv111,% ms to pws~t l i,aes cif Soitthrmr,.N,cw Emeland S 7widrn m LIP.dfh/m Renrti►al i F aWmc i of Uutherrr ltieir"EeSWId C .ettractof ki,acotnt mnl c md5Lh tlt<c mW MW e(judW- M dr6�cd on t' c fmat and the meme cai' n �iaoa IFfi ►r>A d axr r T Vote, e, it�rlmo�i ce'E}ymrer� 0,Chock OCOA i ced a�i,ld#a.hrarol� '� I Credit Cord's are aoaee�ad oaf�e � � & Md�J' !31i��araplo�� �i:ioe�s `r�rrc,ycw bdrracw t.`�at.the dance et Start oh`joi3; i Uzice.oh,�5I.° - t d, —; ,i e<A lMr=cm 505sx miol ,.cWation w fob umm be�imde by&aiit: compWilon of lot,� �.. ! I cira and roust Da nPan C,r perso"i cfte.0 c,itxartk Clge"k or cigh ` Beayeq ) a. a asr!w-ndersumdee thm,01 A.greeaanitn't eonq titikkWtke a:ndre Ram a ct3t an; bF er;n,flat i metics ; 1 thalst, air-re.Mne no;erball, changing.nNY of the terms of chk 4.ri!effienc, :Buayvz(t4) acicn 'la d,ge.b rclmt' u,�*rl`Q (1)hate nrnd tl6i6r Agmement,tmcicrstaands the tcu�sn of reememt, &nii; i ri4�s�tl.au caaani. Ictsad. �� - + -P a M'910ed,a mad cleated aapy Hof lib- reement,14dud4ing the two imttsched,Naiticcs a:l' ancellil4.ion,arra i6e date first u+Atitem AmNe.em-dl w mr yr' infor=ed ldf'.Baaper"jx rir�'fca r�rr1� allgliscrm nt.DO NOT SIGN'. HIS�I�ONI T'.��3;fWT'IF THERE Atu AN ' L, AC--:K�;pAc. A' dtt k e cauic s,'ib�0 h S`a9,a�a ilwll Pm isifar;a•aans t Gax�ara,le'Iit b�� i. ��q'It�tiu ucatitle�l ta,a:i6 d 1IbiF,h�r�er cicA u.i; « 4!1 YOU. TSM. Jre &TIti 1,;Pa'y a&lf tli c€nll n)?rtaif#1 Iat4l lulce t1;u1e n r i 16i t1 =eess. stt; ��:raa.claiaag v=vx,a>ruA.y'be-r it�ed.to rti ps�z+t�nl rebk a' tlac finance aodl d1�s��asacc ch€;nget;. ��) Q�ce smeller tu:a3i:rya right>,xci tiazllaiwrfi-ill t eau tes fro r-pe es tar ty,UMMM11 may lbreracI of tl,e; cc r+ryrc.�a�e s s oo l_Prtambasvd i der dais s r*r emen c (5) o u,mmy is tacda`2-is Ag re emea!t: if it hjtS siot be.e&Idgned.st t r W'n.afcc or a lymacla a,lrizes of, the gViler,proA sd)wu"odry the sr_-9ller a1 hum order man od]°a or los-3 eLu al ece s.�m►�iaa thr,��g.r� mea3t bFre",g�teted.or ere�fc»tl;aaina�,'atit uh�a s:�19�c p+ i¢d i�n0 bs� ertheaa tlaas 4 -of sthe:third eaendmr dray Am the day an which the buyer.signs the Ag ree=ent 6E.clniliAg.'%Une aj and.aasgY.h6liiday an Leh raiarsm;ti!tdela.�eiPiv�, tarotmar8¢. eflee'scccrn�p aags5oticeofcc ccMatmuafarm.foram.sVslaa�maia.ta,af'I�i�yer-sri m. b'uJ�tKs: Mved Mc r`i i mtr er[ut-ifim,ru�kc =rs��arlf» _ -u *clsn ' .s:rtiutr:�a>:rcL ��';Iw .' �'ara►ti+i�,:'i lane+ . _ of �:+� l:Irc .4 Mite t2.iYarmt.nf'Phuct t1lTana _ ii „r;i�gusrc Drina `'k 4? , `A't�lX.B�Si y 1 L&Y �v 1'C]C 'In' .% AN"C 1:J �k. AM '.�'NEE, 8'R O T10' W DNIEGI f" �:1 .!'. 'Tti f,FC �' YWrSih1ESS DAY A THE DATE OFTE3TSTic. NS�►t.�M SEE l HE A TACBEID NO TICE OF CANICIELWJ l011UP CiWS FOR AN 0W..iU.N. TION OF THIN RIGHT.. _ .,P OfA9 I FwiI�TICE 1 C.l'W;hMQfiWMP_ff Date of Trmm,saetion, — .You mm27 cancel i Date of Thosar_t'oas >%too may�cancell this trance ibis,without smy penalty bw oE�i �i9aor�, wirthin this Cr��isectlnn, w�itFiat t aun�r petn�l �r abli ashaaatia wi#hirt three I u i tt,play fronts.tha abow date If you; can +el,,.at�y I' three bmirtess days'timorn, ,ohe slate;Ifi_y�tr cai oCl,ranyr prop". ttr c9ad iia, g5aiyrirtua its; rnar o by. oui nun:d r 6t1e I property ceded Ent,asap' ;pmymeents made by you undicr the Contract tn;r S,�Ike,; piitp a y im cll tla blo istn)rmlenx rexiectrted !I Contra cit cv:Sault,an,d' any.negod We lins�trtr;itrient e�oc td by you v/JI1 be,rebirned 'vithirm tern Ikaratacness days. fbito wing I' by you Wr Ill Ibe uecurrted twi W,n yeas busirkess days f6llawing receipt by the Seller of Your eancnlllat any nat m. and ,any [receipt by the SOIer of yrosur camnelliatiora notice-, d anmy secussi`tY ,Intei;est arising opt atf th trurisac�tionn will be �secu°rrtyr intern aNsing� out of the lrtrrue io�a-awilil I garmo�d If y ea tars e'14�you tsaust ma M r7labl'.e bra flag:S0Icr 'I car cclicdAl'you s-nv�IFy�€ru rte�use ni ce aws 8:able`to the Se llesr �tyoalr agcsidernccFiin sathstaea�rally Sid'eonAidon as When .. ot. -.'u:r p. idemmifin subsuntiaily as; cod corn-4itlon Wf en II 1r c d'y nnypot d'oli�l dl toy ye-a lundaer tlti�Caaatrmct:or U irecic-ewedl,a><ny,g9ods dclov€red try you under this Cotter rat eut ;Salt;*r'you sweaty,if you Wish,complywwlth,doe Ins�tsctlons oP' p �a t►w you r�nay,if you w�17,coRrrp1yr�iittu t'he Instrsueitions of il,e Ilcr r g trding the re#xvrru slielarrrent.offloe;goo+ds:at the t',h-t Selltcr gardit� the;return shipm, ent,of the goons at the 5nllbir+ir,rasp ne�aridl nil If yrmu dfl,raisslre,floe a o-ds aaraitl�+61 I 'Scltlr is rae rnsc,a3n rill¢,.Ifs you'dltr m�i ,gybe goods areal ls�1 -to tklae;S01cr-and, the Seiler days rent pick t eir-�,up 0iin '� to tht; S�cCler ansd the Seller dorms user pick th ern iup �wwlWIn- twrr j des of the'date f daracelBatlomy ynaae try rreri err at,r I twrenity days an;( the datum -of ca mellatiora,:,you mays :Petafn: j dj$p a Qf,t tr�ovc s vrttit:last ,y dnert her olalpSgbtioun:'If y 6U ,I disp n:'ef"n goo-di 'Without any fiurith,e r 4bli<gatla n, If you Ifatsl oca iranakc'R110 goods a4affaNe to the selter,or lf'y ou'apee :1 W11 to rnalgb tht goods avallable th'e'Sellelr,or if you; me t to ro om thaggimAsto the S;eEler aredl fafll to d:o so,theta vou: l .to°1r t -m-was;goods to ttm Sci_er rind UK to do sq then you mrn im J1a.ble, for performance of all oaligmitions under th,n rorn,illn linhi+c fairIperfmim.ances of A! obligations under the, �Gorrtr rt.Fo caunsoi'this transaetii mt,malls or deIWer:a.Agned' Co ntract iTo C-I'n L thus traaysactncara,p imail or deriver a:sag;net �rr►d meted boPy of truss rtteGiatIon motic.'e Or afty otleew .P and ':dat�cl copy .al -t"h-5 c notice or any other '18 TOWN OF BARNSTABLE u'1 ' r �VHE Tn,. g 201205852Permit• BARNSTABLE, Issue Date: 10/03/12 y MASS. �Ar16 339. A Applicant: QUINN,ANTHONY S Permit Number: B 20122435 Proposed Use: SINGLE FAMILY HOME Expiration Date:'.04/02/13 Location 53 LIETRIM CIRCLE Zoning District RC Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 169055 Permit Fee$ 38.25 Contractor QUINN,ANTHONY S Village CENTERVILLE App Fee$ 50.00 License Num 68599 Est Construction Cost$ 7,50C r Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND REPLACE EXISTING TOILERT AND SINKIVANITY,NEW TILE AROUND THIS CARD MUST BE KEPT POSTED UNTIL FINAL EXISTING TUB AND ON FLOOR,NO EXTERIOR WORK INSPECTION HAS BEEN MADE..WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: BABI.NEAU,DENNIS J BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 53 LIETRIM CIRCLE INSPECTION HAS BEEN MADE. CENTERVILLE,MA 02632 h-& lik,Ac== Application Entered by: JL Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET;ALLEIY;OR SIDEWALK OR ANY PAIRT;THEREOF,EITHER. P,ORARILY Y. ENCROA HMENTS ONPUBLIC PROPERTY NO 34. sPECIFICALLYTERMITI'ED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION:'STREET OR'ALLEY.'GRADES AS WELL AS;DEPTH AND LOCATION OF PUBLIC SEWERS.MAY'BE.r OBTAINED FROM THE DEPARTMENT.OF PUBLIC WORKS.:.THE ISSUANCE OF THIS PERMIT-DOES NOTRELEASE THE APPLICANT FROM THE CONDITIONS OF`ANY-APPLICABLE SUBDIVISION RESTRICTIONS MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(asset forth in MGL c.142A). FWP,., o c�' ..wr r ,is `istr. .�,2�'d�: „t•, ,',»� k.,• '. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 Bowl/ lit YVfl� pR: oIV 2 2 : wt� �� ,� 2 S FT: Qs F")13 3 3 01@6pg F3.-OAL- V 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel - Application Health Division Date Issued A /Q1,31` Conservation Division Application F Planning Dept. Per Date Definitive Plan Approved by Planning Board �o13/jZ Historic - OKH _ Preservation/ Hyannis Project Street Address 15 S (-T N'2t C I acL& Village CCY- r C�ZU► Owner N( S �J �J L'�'y Address I Telephone 4570�5 2S0 14-39 3 Permit Request '&Lqtk— awi S;�mt x A-N-C> S 1 N K V AN NC-0 'rl 1 C e i�T1N�r L -rue fw0 . N v No eta Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation '0 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 l-No On Old King's Highway: ❑Yes 2<o Basement Type: Ga'Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area Number of Baths: Full: existing new Half: existing °r": new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stogie: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name. r�—t H om4 Telephone Number Address ` t License # - C5 ` t SJ: I�I ��"�"`� rn �2-�{ Home Improvement Contractor# 2��3�' Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO S 5 E 7 " ".)t. S (A/ - SIGNATURE DATE G 20 2 FOR OFFICIAL USE ONLY APPLICATION# ' `. DATE ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: i FOUNDATION FRAME O 0 0I 14112 - - INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL t GAS: ROUGH FINAL FINAL BUILDING '811 -3 DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts- Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,'AM 02111 - www:mass govIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciar's/Plumbers Applicant Information Please Print L6pibly Name (Busin(-ss/Oro nization/Individi e): A`NTh1) l N(J Address: A61i i<i City/State%Zip: �SJJ c yl 'N-V"Nks rn4-0 Phone#: Are you an employer? Check the appropriate baz: Type of project(required); 1.❑ I am a employer with 4. ❑ 1 am a general co7sh(-,(.,-t. employees(fiill and/or part-time),* have hired the su 6 ❑New construction 2. I am a sole proprietor or partner- _ listed on the atta7. [ modeling ship and have no employees These sub-contractors have g ❑Demolition. working for me in any capacity, employees and have workers' [No workers' comp,insurance comp, insurance.$ 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doingall work officers have exercised their ❑ g pairs or additions 11. Plumbing re myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other COMP.insurance required.] *Any applicant that checks box 01 must also fill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp;policy number. X am an employer that is providing workers'compensation ins information urance for my employees. Below is the policy and job site Insurance Company Name: Policy#or Self-ins. Lic.#: ' Expiration Date:. = Job Site Address: City/State/Zip: 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. 1,52 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 ao$250.00 a.day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of DIA for insurance coverage verification I do hereby cer nder the pains and penalties of perjury that the information provided above is true and correct. Si afore: Date: Phone#: FEth only. Do'not write in this area, to be completed by city or town official_ n: Permit/I,icense# hority(circle one): Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector. 5:Plumbing Inspector rson• Phone#: r oFTME r Town of Barnstable ' Regulatory Services BasxsxABIZ, vQ MA & Thomas F.Geiler,Director . Op 16;y.. ,0 jEo ►� Building'Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 . Fax: 508-790-623 0 Property Owner Must Complete and Sign This Section if Using A Builder I, E. lj,(4 X4 l�EWV , as Owner of the subject property hereby authorize A-f4 a h O N I a i NrJ to act on my behalf, in all matters relative to work authorized by this building permit i (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. Signature o Owner Signature of Applicant 6N-J UlJ I N Af Print Name Print.Name Da Q:FORMS.:OVrlMRPERMISSIONPO0LS 6/2012 ��z r Town of Barnstable "} Regulatory Services . STABLF Thomas F.Geller,Director .r MASS. i639. A 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 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 r 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 i i 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 form/certification for use in your community. Q:forms:homeexempt .a Lin M c� �J L,I.. CN J I �� 'f Massachusetts - Department of Public Safety ✓/ae 'anv.,Zoouueal ._/Glaaaaclu�aelta Office of Consumer Affairs&Bdsiness Regulation' i _ Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR. Construction Supervisor ` Registration ,A255V Type: License: CS-068599 j Expiration 1/1512014 Individual i { ANTHONY S QUI$N � ;-. AN ONY SEAMUS_QUINN° —mot 17 ASfIIQNS DR _ - r SO �.� SOUTH DEN1VISfi�IA 02 ' - ---- , �u o - �, � ANTHONY QUINN`�y� 17 ASHKI,NS DR. ,� i—' " "l Expiration SOUTH DENNIS MA'02660,y Undersecret ry Commissioner 04/06/2014 i --------------- License or registration valid for individul use only before the expiration date If found return to: Office of Consumer Affairs and Business Regulation • 10.Park Plaza-Suite 5170 Boston,MA 116 :Not Valid without signature y�fTHErO�♦ TOWN OF BARNSTABLE BARNSTABLE, 63 19. BUILDIN - INSPECTOR G APPLICATION FOR PERMIT, TO build (residence),, . ........................ ................ .................................................................... TYPEOF CONSTRUCTION. .......framp..................................................................................... .............................. October '3 ...............................1 ..2.............19.72. TO THE INSPECTOR OF BUILDINGS:__ The undersigned hereby applies for a permit according to the following information: Location .......... ...3�..�,ietrim Circle,...Centerville mass. (Centerville Crossing) . ................................... ........................��.l.......................................... ..................................... Proposed Use .....re.s.id.enc.e..........................................................................................I...................................................... ..... .. .... ....... .. C Zoning District .....RC...................................................................Fire District ................................enterville......... ...................................... Name of Owner .......John...A......L.emo.s.....................I „Address ....1.31' Main Stret.t.-. West Yarmouth ....... .. .. . .. ....... .. ................. Street .................................... Name of Builder .... AddressShootFling Hill; Rd; �..Centervilleames D. Lester...J............................................................. Nameof Architect ..................................................................Address ................................ .............................................. concrete..... Number of Rooms ............................... .....................Foundation .... ..................................................... Exterior .......... .....................................................Roofing ...S.hi.n.gl.e.s........................................ Floors ............hardwood. . ...and...file..............................Interior .drywall .... .. .... .. .. .... .. ...All and wallpaper ................. . ............................. ............. ........ Heating ...........f.Q .................................Plumbing ..cqpppr....(Xitchen and 1 bath) ........................................................ Fireplace ........b.rlok............................................................Approximate Cost ....6A-7-1P9NPQ.......... Definitive Plan Approved by Planning Board S_e_pt_.___9j------------1968---. Diagram of Lot and Building with Dimensions 1_1 Ld SUBJECT TO APPROVAL OF BOARD OF HEALTH LU a- wri\ 0> Ld N < < 0, a- 0 U) :2- > 0 _j CO _j CL C LU _1 j �j iL,j L JLJJ U'� Uj < < w I 113*—,00 JET-Ri %I C &C L_rz I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. C Name L.......V.. .. ... � Lmmoo° John A. ' ' � Permit . m � ���No - ��� - ... � .---single family / . / } -'-------'--'~^--'----'~-'^^'--'- ' `� / ~ Locofk`� -.-.-�������.."�������------.- ..---.-----Centerville.---^-.—^-^----~----- CJvvnar John A. -'-------'^^-^~^~'--'-----` Type of Construction .................f rmmy----.. � > ' ---.~....----.---.--...-~----.--- / $ku� Plot ---------.. Lot --.��"------ ) . . ^ ` r 2 �� Permit Granted --.���.����.-----.]g ^- / . � . Dote of Inspection lA ~ Date Completed . ` PERMIT REFUSED ,_--....-----.-..-------_' 19 ` . -----.--.-.-------.-.-------- . . ^._..---,--.-.-.-----.-----~,_-. . . / . -.._---------~..-.-..-~-.~--_--' ' - ' ---.-----.~.-.-.-..-.-.-.^~-~--~.. � ~ ' 1 lQApproved _'-------------''' [ ' & _______._______~,._._,_~_,_,,_ -------.-------.-.---.--.--.-. | � | '