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Home My WebLink About0019 MARRICK COURT F 6 o w . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ° Parcel ` �� ;Application # 3c)-� Healthbivision Date Issued Conservation Division `.Application Fee Planning Dept. Permit Fee; l Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address Iq MA22)CK CDUeT Village ce ti 7-6-PEY Owner FA 1 Tl-4 )40014 e S Address �cl MAR-Pair 'GT,,Cr NT&/u1u Mp Telephone y©8 7170 o� Oo'1C�3 a _Permit Request Ail 5 ;�1LfN� . 10JsQ1-n- fr0J SQFT IeN6-66,4LL 11 0 S.P°FT a?3 CAL Lt�t,05� o t) G Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �GDa°, 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 ndw Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Counts , co � Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/opal stovaq❑Y ❑ No Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size Barn: ❑ e stin �rnew size 9 9 9 — 9 — 9 — 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 ST6V6N (BUILDER OR HOMEOWNER) GJ�I i Name 0-.-QQ96PZ CRO11-piN6: ¢ P26MO06'z- G Telephone Number 5600 10 ;j Address 9 7At1 Yf&45-rjA,l) NZ. I o License# C3 5v 3 T 5ANDOIC a, MA ba5(, 3 Home Improvement Contractor# Worker's Compensation # 'N q Lf P911 q ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO PA A>Q,STo n!5 M i L LS X-F6P— S i(471 o 10 SIGNATURE �� DATE FOR OFFICIAL USE ONLY ^- APPLICATION# y r :DATE ISSUEa i` MAP/PARCEL_N0_ _ ADDRESS__ VILLAGE 7 OWNER f ' DATE OF INSPECTION: r � - 4WFOUNDATION "r _' . FRAME s_':INSULATION' r : FIREPLACE ,F f ELECTRICAL: ROUGH FINAL <Y PLUMBING: ROUGH FINAL r rt GAS _ ` '�+ROUGH ..=M .. FINAL . FINAL_BUILDINWE £3 . -DATE CLOSEDDLIT_ tK ASSOCIATION PLAN NO. t' e 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/Plumbers licant Information t Please Print Le ibly '�a me (Btisiness/organization/Ludividual): ` A-� �� `i��1/l �r� L LC_ Address: �4� Cie STiQir1 �►�te- l� �.�" G City/state/zip:Scxn&w�A'1,VAA, O250�3Phone#: 506-SEE ` I I k G__ :ire u an employer? Check th ropriate box: Type of project(required): I. i ant a employer with 4. ❑ I am a general contractor and cmployres (full and/or part-tinic)." have hired the sub-contractors G. ❑ New construction ❑ 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 4 employees and have workers' %vorkinl- for me in any capacity: y. ❑ Building addition [No workers' comp; insurance comp. insurance.* 5. We are a corporation and its 10.❑ Electrical repairs or additions required.] ❑ I am a homcrnvncr doing all work officers have exercised their 11.[] Plumbing repairs or additions :� clt [tio workers' comp. right of exemption per MGC 12 ❑ 10of repairs .;urancr rcquircti] _ c.. 152. §1(4), and we have no employees. [No workers' 13. Other i comp. insurance required.] t:.:r.nccc,nt that cheeks box iil must also fill out the section below showing their wprkers'compensation policy information. c(�:Pe:.•.:ae-s who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. - eor_that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have i f the sub-contractors have employees,they must provide their workers'comp.policy number. i urn an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site ,,•j�,rmatio►r. e Company Name: 1r0� or Sell-ins. Lic. #:__-44_9.4 LH Expiration Dater J -2 — zc k? tc;h Site Address:_ _ City/State/Zip: attach a coPy of the workers' compensation policy declaration page(showing the policy number and expiration date). _:1-_:, to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine ao 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of s pions of the DIA for insurance coverage verification. l do hereby c•ertif er the pains and penalties of perjury that the information provided above is true and correct. Date: Donor h-rite in ;his area,to be completed by ri(y or torn official, Permit/License# .azrir. scircle one): r <I Draltt-, 1 Building Department 3.CitvfTow-n Clerk 4. Electrical Inspector 5. Plumbing Inspector Phone#: r ACORD,,. CERTIFICATE OF LIABILITY INSURANCE E03A4/2011 ATE(MMIDDIYYYY) PRODUCER S08.94S.0393 FAX S08.94S.4048 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eldredge & Lumpkin Ins. Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 697 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Chatham, MA 02633 Alan Long INSURERS AFFORDING COVERAGE NAIC# INSURED Caliber Building and Remodeling-LLC, Steven Wh ns C INSURERA National Grange Mutual Io _ 14788 DBA: INSURERS: Commerce Group CIG001 8 ]an Sebastian Drive #10 INSURERC: Ace American Ins. Co. - ARWC 22667 Sandwich, MA 026S3 INSURERD: 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 EFFECTIVE POLICY EXPIRATION LTR NSR V TYPE OF INSURANCE POLICY NUMBER DATE M DATE IMMIDONYM LIMITS GENERAL LIABILITY MP027360 09/1S/2010 09/1 S/2011 EACH OCCURRENCE $ 1,000.000 X COMMERCIAL GENERAL LU4BILRY _ - PREANSES ERENTE e xwnenoe) $ S00,0001 CLAIMS MADE Fx-1 OCCUR MED EXP Wry one person) $ 101 00 A PERSONAL 3 ADV INJURY $ 11 000,00 GENERAL AGGREGATE $ 21000100( GEN'L AGGREGATE LIMB APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00( POUCY JECT LOC AUTOMOBILE LIABILITY BBNVCS 02/16/2011 02/16/2012 COMBINED SINGLE LIMIT ANY AUTO (Es accident) $ 11 000,00 ALL OWNED AUTOS BODILY IlWRY $ B X SCHEDULED AUTOS (Per fin) HIRED AUTOS ' BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY - - AUTO ONLY-EA ACCIDENT S ANY AUTO - OTHER THAN - EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY - CW27360 10/01/2010 09/1S/2011 EACH OCCURRENCE I$ 1,000,O0 OCCUR L—.I CLAIMS MADE AGGREGATE -$ 1,000,000 A $ HXDEDUCTIBLE $ RETENTION $ 10,000 Is WORKERS COMPENSATION 4494PS44 03/02/2011 03/02/2012 IAND EMPLOYERS'LIABILITY TORY LIMBS ER ANY PROPRIETOR/PARTNERIEXECUTIVEa E.L.EACH ACCIDENT $ SOO C OFFICER/MEMBER EXCLUDED? (Myaendatory In NH) - E.L.DISEASE-EA EMPLOYE $ 5001 0 ibe under SPECWAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ S00 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECML PROVISIONS - rpentry CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL i Town of Barnstable - IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR Building Department. REPRESEHTATIV - 200 Main Street Aun*OrJM BE Hy nnis, MA 02601 ACORD 25(2009101) 01988-2009 A90RD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACO f ♦la�.aihu.ctt• Department tit'Pul"lik �:+tCt.% � Beard��f Buil�lin�_ Kc�ulati�m. antl �tandartl� �. Construction Supervisor License License: CS 95038 Restricted to; 00 STEVEN WHITE 147 RIDGEWOOD AVENUE HYANNIS, MA 02661 Expiration: 2t28/2012 i „Mill i'li„u1 r Tr=: 19311 Office of Coosae9er (fairs&Bd>�aess Regntattoo HOME IMPROVEMENT CONTRACTOR 11; RegbtraBon: 954359 TYPs {` Expiration: 2/2812013 Ltd Liability Corpoi CALIBER BUILDINGAN04RE FLING,LLC. a STEVEN WHITE 8 JAN SEBASTIAN',DRIVE4J41T 10 SANDWICH,MA 02563 Undersecretary License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation ati 10 Park Plaza-Suite 5170 Boston,MA 02116, Not v9W without signature -� I, A r TH as owner(s) of the subject property at: /� MA�2ICIC COL)P—T CON l L j-t hereby authorize Steve White of Caliber Building And Remodeling, LLC (contractor)to act on my behalf in all matters relative to the building permit application. signature of owner date signature of owner date Efficient Buildings, LLC 4 October 31, 2011 Town of Barnstable Attn: Thomas Perry, CBO 200 Main Street Hyannis, MA 02601 re: 19 Marrick Court, Centerville, MA 02632 Dear Mr. Perry: This affidavit is to certify that all work completed at 19 Marrick Court, Centerville, MA 02632, has been inspected by a-certified Building Performance Institute (BPI) inspector. Work included air sealing, door and hatch insulation, and installation of 720 sq. ft. R-23 to kneewall floor, 243 sq. ft. of Polyiso to back of kneewalls. All work performed meets or exceeds Federal and State requirements. Sincerely, C� 66 ' Steve C. White Owner/Managing Member Efficient Buildings, LLC k- s. a C:) i 8 Jan,Sebastian Drive, Unit 10, Sandwich, MA 02563 Tel: 508-888-1110 Fax: 508-888-1109 r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application#;L66&4� c Health Division Conservation Division Permit# Tax Collector Date Issued &a Treasurer Application Fee w' 60 Planning Dept. Permit Fee 66_, 06 Date Definitive Plan Approved by Planning Board u'®6 dw- Historic-OKH Preservation/Hyannis Project Street Address Village Owner �C�t � �� eS Address l°l A"CCC,�, Telephone 56$"qqo s -girl t5 Permit Request ASAo11.e. t CLk 1wSAsc,,-L (60W Square feet: 1st floor:existing proposed_ 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation d© Construction Type U)60 Lot Size J� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑ l�Yes No On Old King's Highway: ❑Yes 2<o Basement Type: 2/Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) �7 b Number of Baths: Full:existing n new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: as ❑Oil ❑Electric ❑Other Central Air: 2"es ❑No Fireplaces: Existing t New 6 Existing wood/coal stove: ❑Yes ®'No t Detached garage:❑exi ing ❑new size Pool:❑existing ❑new size Barn:0 existing ❑new size Attached garage: existing ❑new size Shed:❑existing ❑new size Other: `_N Zoning Board of Appeals Authorization, ❑ Appeal# Recorded❑ - Commercial 0 Yes' 'O No If yes, site plan review Current Use Proposed Use BUILDER INFORMATION Name U C�fl kLL e k we, &A 1 kXQs e Telephone Number !I_1 q-t J L— (, Address License# N41 tc If— f MA 41-60t Home Improvement Contractor# JL� Worker's Compensation# CNIII� �ri�� 6q ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE 1. 0 h FOR OFFICIAL USE ONLY O - PERMIT NO. DATE ISSUED MAP/PARCEL NO. + " ADDRESS VILLAGE M {{ ' 1 OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION i FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL " r . GAS: ROUGH FINAL FINAL BUILDING C64 M, Z : ' DATE CLOSED OUT ASSOCIATION PLAN NO. l fm 4-VII""VIS/rGµi H• V, 11J NYYNV.�/�✓✓��.. _ ` Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation'Insurance Affidavit: Builders/Contractors/Blectricians/Plulubers Ap plican t Information Please Print Legibly v Name (Busiuess/orva�ation/Indivi.dual): Address:(o.`�_ 9ber) SYn-i-fe-) 2 Clj2 Q , City/State/Zip 'L�f, 14PE- 0Z6322 . Phone#: ::7-7 �L k 3(, -� Are you an employer? Check the-appropriate box: Type of project(required): 1.[�'�!am a employer with 4. ❑ I am a general contractor and I 6. �7emodeling construction employees(full and/orpart-time). havehired the sub-contractors listed on the attached sheet I 2.❑ I am a sale proprietor or partner- . ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. g, ❑ Building addition o workers' Comp.insurance 5. ❑ We are a corporation and its [N 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption,per MGL ` 11.❑ Plumbing repairs,o:'additions myself.[No workers' comp. c. 152,§1(4),and we have no 112.0 Roof repairs insurance required.] t . employees.(No workers' 13.[:1 Other . comp,maurance 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 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 infozrnativn. 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 rCi/'l i c� -e xS��- �,P 60rn�� U Policy#or Self-ins.Lic.#: WC y W 3 2--2 Expiration Date: Z-oU Job Site Address: �� ry�`c.ic Cy�,t'' City/State/Zip: -CPr71'0-W 1P�^v 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 Iead 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 certi ands the i and penalties of perjury that the information provided above is true and correct Si atnre: D ate: i7 d I. Phone#: `7-7 F10ther e only. Do not write in this area,to be completed by city or town official. own: Permit/License# uthority (Circle One): of Health 2.Building Department 3.Cityffow n Cierk 4.Electrical inspector 5.Piu?mbing Inspecter � erson: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to 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." i 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 n`a individual,partnership, association or other.Iegal 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 bean employer." e 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 wo,"til acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants !Y 8 Please fill out the workers' comppensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contraetor(s)name(s),addresses)and phone numbers)along with their certificates) 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 thisl affidavit may be submitted to the Dep artment of Industrial Accidents for confirmation of hisu face coverage. /Also be sure to sign and date the affidavit. The-affidavit should be returned to the city or town that thA.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 the number listed below. Self-insured companies should enter their self-insurance license number on the appropriatellme. City or Town Officials . 1(� 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 eve the Office of Investigations has to contactyou regarding the applicant Please be sure to fill in the permit/license nurbea which will be used as a reference number. In addition,an applicant hat mast submit multiple permit/license applications cations in any given year,need only submit one affidavit indicating current -00licy 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 beenloffi'cially stamped or marked by the city or town maybe provided to the applicant as proof that,a valid affidavit is ouf affuture permits or licenses. Anew affidavit must be filled out each ' year.Where a home owner or citizen is obtaining la 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 r Inc 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 andifax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Iatvestigations 600 Washington Street j Boston, MA102111 / 4 Tel. 617-727-4900 ent 406'o 1-o77-MASSAFE Fax#617-727-77.,49 Revised 5-26-05 www.mass.gov/eia r �FIKETph, Town of Barnstable Regulatory Services i ■ SARNSTABLE. t v MASS. Thomas F.Geiler,Director 1639. ,0� 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 i Permit no. Date 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. dd qq Type of Work: 6�/�� d. Xk W NOVA S-Aq Estimated Cost S a 00'0 Address of Work: lR R04-rl G(A- ODLL41- C`��S`P•�t�l L� �L(!d 64-,6 .2 _ Owner's Name: FaA)" 14• 14"Ltir-S Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work'excluded by law ❑Job Under$1,000 ❑Building not owner-occupied . []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE 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 age of the owner. Date Contractor Signature Registration No. OR Date Owner's Signature Q:wpfiles.forms:homeaffidav Rev: 060606 Town of Barnstable Regulatory Services L s XA �, aS& Thomas F.Geiler,Director .� ss. $ Building]Division. Tom Perry, Building Commissioner 200 Main Street, Ijyamis,MA b2601 v ww.town.b arnstabl epa.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section. If Using A Builder I, f r�! � q��S ,as.OWner of the subject property hereby authorize Sea�,v, R6YGr0FJ - to act on mybehalf, in all matters relative to work authorized by this building permit application for. (Address of Job) geld Signature of Owner Date Print Name Q:FORMS:O WNERPERMIS S10N 08-08-06 10:04am From-SOUTHEASTERN INSURANCE AGENCY S08-7900557 T-996 P-01/01 F-834 _Ter mare�e ee e�. a a a— va ' �aa %cares a a 011 erT®e111vb- Iudjualmb PRODUPER, (SOS)997-6061 FAX (508)991-3283 THIS CERTIFICXM 18 ISSUED AS A MA ER OF INFORMATION Southeastern Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPOI I THE CERTIFICATE 662 State Rd. HOLDER.THIS CERTIFICATE DOES NO AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED 81 THE POLICIES BELOW. P.O. Boa. 79399 1 N. Dartmouth, MA 02747 INSURERS AFFORDING COVERAGE NAIC# INBUITED Roycro t & Kuehne Builders Inc 1NSURERA, Arbella Protection Insuirante 6S Eben Smith Road INsumRs. Merchants Ins Group Centerville, MA 02632 INSURERC: Granite State Ins INSURER D: INSURER E: ' COVE RA THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I YDICATED.NOTWITHSTANDING ANY REGU.REMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIF CATE MAY BE ISSUED OR MAY PERT,%IN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIO S AND CONDITIONS OF SUCH PDLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR D' TYPE OF INSURANCE POLICY NUMBER POLICYE CTNE POLICY EXPIRATI N UWTS GF,IERAL LIABILITY SS00022738 07/03/2006 07/03/2007 EACH OCCURR'4CE s 2,000,000 X COMMERCIAL GENERAL LABILITY DAMAGE TO REJ TED S SO 000 CLAIMS MADE ®OCCUR MEO EXP(Any q I>,x 0n) S 5 000 A PERSONAL&AD INJURY S 11000.000 GENERAL AGGR GATE E 2.000.000 GE1rI AGGREGATE LIMIT APPLIES PER PRODUCTS-CO PIOPAGG S 1,000,000 PO ICY PRO- LOC JECT AU':OMOBILE LIABILITY COMBINED SING.E LIMIT S ANY ALrro (E9 8C1_-) 11000,000 X ALLOWNEDAU1TOS 7AM027701409S 10/19/200S 10/18/2006 DODILYINJURY B SCHEDULEDAUTOS (PNPNenn) S HIRED AUTOS BODILY INJURY S NON-OWNED AUTOS (Par eccdwI) PROPERTY DAM,LGE S (Per emdenl) incl. ISMIAGE LIABILITY AUTO ONLY-EA 1CCrDENT b ANY AUTO OTHER THAN FA ACC S AUTO ONLY. AGO f FXL ESSIUMBRELLA LIABIUTY EACH OCCURREICE $ OCCUR CLAIMS MADE AGGREGATE S S DEDUCTIBLE S RETENTION S S WORKERL COMPENSATION AND _ V I WC STATI} TH- EMPLOYEAS'LIABILITY C AN"PROI RIETORIPARTNERIEXECUTrVE E.L.EACH ACCIO rNT S 100,000 OFFtCEReAEMBERFXCWDED9 WC4W392269 09/01/20006 09/01/2007 6.L.DISEASE-FJ EMPLOYE s 100,000 If yes.dens ribs under SPECIAL IROVISION6bolow El DISEASE-PC LICY LIMIT S $00,00 OTHER DESCRIPTION OI:OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS - For any a►Id all operations perforated during the policy period. CANCELLAIJON 5HOULD ANY OF THE MOVE DUCRIISW POLICIES B E CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER LL ENDEAVOR TO WAIL Towa of Barnstable 10 DAYSWMTTENNOTICETOTHECERTIFK;A HOLDERNAMEDTOTHEL£FY, Atta: Bldg Dept BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE o OBLIGATION OR LIABILITY Wei St OF ANY KIND UPON THE INSURER.ITS AGENTS OR RE PREUNTATNE& Hyannis, MA 02601 AUTHORIZED REPRESeRYAYNE loan Martin ACORD 25(2001/08) @A CORD CORPORATION 1988' r: :� .: ✓fie T�aninxareu�ecc� o- ✓�uc"ucae� BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 083280 Birthdate: 11/29/1964 Expires: 11/29/2006 Tr.no: 83280 Restricted: 00 SEAN J ROYCROFT 65 EBEN SMITH RDA CENTERVILLE, MA 02632 Administrator E ✓�ee -t�a��vr�zo�raurecz� o�✓��u�.aella lugBoard of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 141225 Expiration: 1/22/2008 Type. Private Corporation ROYCROFT&KUEHNE BUILDERS,INC. Sean Roycroft -- / 65 Eben Smith Ros r, Centerville,MA 02632 Administrator _ _ C Ie 1/7 t r-v I -- fit °e �on-d' �e $a.ltiStz�S. 3P� ctd . code. .J EE 16' Y „ icLivirtl A 5 -egg or - �jj —1 fi —AT L, inn s, S 6- 1a t� 1. i. LOT ,�.R. t LOT 20 e SE _ - - - oorD 1®6 5� LOT 19 i „��"”'• TOWN OF BARNSTABLE Permit Nod�' '` st - „�n�, ; Building 'Inspector _.... PAIL J y" CashANo -- 2639. ,x l ''+6rar►`.. OCCUPANCY PERMIT Bond --- ---- -, - _ No building nor structure shall be`erected, and no land, building or structure shalIbe T used for a new, different, changed,.`or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall.be occupied until'a`" certificate of occupancy-has been issued b'y the Building Inspector." Issued to Spirts Balodimas Address Carla Road y Hyannis . lot 620 19 Mari ick Court. Cent-e il4b wiring Inspector ." Inspection date Plumbing Inspector (..r�,E.r3 rtt• f�i Inspection date Gas Inspector _ ,- Inspection date Engineering Department /tse/J ell 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. ' _ r -27 ' �.. 19_- ....................� Building�Inspector ._.._ c L Yy k 71 r Y 4 d �• 1 A f �'4. y "r ,, 1 e 1p T a 4 t r I ,r, r .;s, 3... < f yy ti f _ f ' .:1_ kri.. + f.Y If a a� �i 1 t S :;S g < r.K' it R *.� i t._ •1 �r M P + I; f J il,Y j } #i. e t !';k v,r'r{�'b, "'' -Wi" s�s t. '� r'H`i $ 4 v �+ .I r.,9 flk. ; ;..-r '! w # t:.. a rty r.T l �S� ti4 X^'" ; t � ': -i. $n i�Jr' fi r'ya svr' a #t t r r y ?S r M1 a{ E . rw bf r , it r t' ti -'c r } <.. �, Y. .,,p d t '-k. 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CONSTRUCTION ONLY : r L �: ., .-�" - ;�tV, E r•.:r s is ✓ P r 1 :w. :. :TOP `OF:. FOUidDATI-ON IS 3 .FEET ' - , _, r; ,Y ,, tr{ >I 'r r J �N' a� ^.3e E .1 r .7 1. 4'` A A wrA�'OME 101�l POiNT OF' A1. DJACENT 1. , j ,11%A TA.6L, -� . ® " . o ." 'DATE- . 9`' Iz y' L. . ')1 .6�®I��®�� V/I•�ERIN C®•'/� " - ' L-A1 Z_0 J.,l IVA. - �. .Fo un/D�4Ti.'ON Jry; CLIENT 4 I CERTIFY THAT THE ` r ` EQOSTERED REt31STERED q SHOWN ON"' TH13 PL'AAl 1S= LOCA4�® ^",.� JO®a NO �T�_' , '.ON THE GROUND AS ONDICATED tD . CIVIL I LAND '' hJ /t/ CONFORMS TO THE ZONING L�A '!S ENGINEER SURVEYOR D.R. �Y OF BARNS TAB MA S �'';' �t�'; . I- NO" MAIN ST�'� 712 MAIN ST CN a®Y R ! I �pf �/j 2 79'' ' SOj YARMOUTH� MASS. = 'HYANNLSf`�MASS� /��` r a .S T '.0p 4# . HEE F �, . ._. :ATE : REG. LAND SURVEY ,. x . r _. . .� y � THE AsgdAsor's map and lot number M TOWN OF BARN9 T=L PODE LATIONS B ING -INS P EC T 0 R RLD APPLICATION FOR Pmsmmv: TO --GL4^d ---------.---_--.—.---....~.—.~~--.r.—...- ' TYPE OF CONSTRUCTION '�^x yl ' �3 ___.��_._8r�� ____.,_.___�,_,.,_._.__,____'___. ` &w:� �.� --.----x ..�—..x ......... 11�� TO THE INSPECTOR OF BUILDINGS: - The undersigned hereby applies for o permit according to the following information: Location —/ ..... ��J��&�....... at _ .__________...�`.. Avis's Proposed � . Use ............ �m�,,___________________________________.______..._.. � � � �� ' Zoning District -------_--.------------..Rne District �� .��4��---. | � �� Name � Owner �� d�� --i�~°`�'~—=~^`~�"""=" ~°----'' --"~=°,~=°°' ''*"'��`p �".01'h'w`cs.—. Nome of Bvi|6a, ------_.-SA ME............................Address ---- �hq��--..--_...___'__----_.` . - Nome of Architect ----------------------A66res -----....—'._-----------,—______ - ^� Number of Rooms ----..4��---------------.Foundation �M. --a ............. � �� Exterior .6n�/r�'�' .�,�'�n�u��*�*�-----�Ro��ng - ' »m------------- F|oo,s --WAm�/. ----------------|nherior' --.--____'_______.. ��i� � 0i Heating —'v�. �"=^---�x.��................................................Plumbing .Ly ...*......K'.»«. ....................................... lvo 'Fireplace ------.^L............................................................Approximate Cost.......... ____,,_.__,,__._. . . Defn�va �dn Approved by Planning Board Q»�� . /\n*m '—.. � -----' Diagram of Lot and Building with Dimensions Fee ___ ................... "^-�J � SUBJECT TO APPROVAL OF BOARD OF HEALTH � f�u�u y �� -��_.- ~- � � � � � � ` � � � . ^ � | |� � | hereby ogee to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. � � . A ` . ' Nome��—' ..~ .^� ----_. � N ' | N | = ' Balodimas, Spiros 4911,11-- 21715 1 1/2 'story ................ 'Permit for .................................... single family dwelling ............................................................................... 19 Marrick Court Location ................................................................ Centerville ............................................................................ Spiros Balodimas Owner .................................................................. frame Type..of 6onstruction .......................................... < ............ ...........................L.o..t.........................2..0......... :Plot ....................... . .............#...........October 4 79 ,Permit Granted ........................................19 Date of Inspection .....................................19 Date Completed PERMIT REFUSED r fn r. ......... ......ti:�.............................. 19 CC C 0..%.............................................. M .. . ..........................................Ct S .......... ........................ .................... .......... . ................................. ......... .. 0 M S Appro ...... ..................................... 19............................................................................ ..... . ....................................................................... C r - �Z&