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"i, , rie, '-, ;� 1 11-14 I IV I "',""', I : So 1 �,��190 iiiiiiiiiiii",......�,�,,�,,,,,,,,,,,,,,,,,������,!,-4`�,�,`1,"!"... c,E 1 MH��11 I 1 z'1�"Ill,��4.1. I "'I"N �; �,'. ilhi"Y,�"Ii'�j is Ubl'f�-!",.' ��,i L I'll , I /a`l-710 Town of Barnstable *Permit# Expires 6 mont from issue date Regulatory Services Fee wexsrna�, Mass.1639. Thomas F.Geiler,Director A1� �p MA'I 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 PERMrr APPLICATION - RESIDENTIAL ONLY ' Valid without Red X,Press Imprint Map/parcel Number Property Address 91 /Y2NIt dt X /i l „t,,�,rt,Jk , MA W 63-L_ - Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 44A-S. t� Contractor's Name 'foS Gr, Telephone Number Home Improvement Contractor License#(if applicable)/ Email: Construction Supervisor's License#(if applicable) q r EIW LPff-bir'kman's Compensation Insurance Check one: �CT°10 2013 ❑ I am a sole proprietor ❑ I am the Homeowner have Worker's Compensation Insurance ®v: 13ARNSTPLIBLE Insurance Company Name t f L9tt 670WN Workman's Comp.Policy# &Lt3 70 Copy of Insurance Compliance Certificate must accompany,;each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken'to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers'of roof) [�Ife=side ❑ Replacement Windows/doors/sliders:U-Value (maximum.35)#of windows #of doors: ❑ 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. A copy of the Home Improvement Contractors License&Construction Supervisors License is aired. SIGNATURE: C:\Useis\decollik\AppData\Local crosoft\Windows\Temporary Internet Files\Content.outlook\8R76BDVA\EXPRESS.doc Revised 061313 f 9. Massachusetts -Department of Public Safety Board of Building Regulations an&Standards F?431c zat Construct ron-SypenisbrSpecialty License: CSSL-099913 �.rrs TROY A 499 NOTTIINGHAMtDR1lVE CENTERVILE MAOZ632 -� r Expiration Commissioner' 04/13/2014 T r, .. ,. (92" l('Q797/i7ZQl'LLLW00G/2 6�U(�GG/J:ICLCI LL�8 6 Office of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR, ,regs p 15954 TYPe xiration: I 3/15F2015. Private Corporationt' ` s DOYLE+THOMAS CONSTVING V - 5 TROY THOMAS ti} 01 k' 499 NOTTINGHAM DR g CENTERVILLE,MA 02632 - Undersecretary t ' f r Tlie Commonrswalhh of Agassachusetts Department ofInduslyial Accidents Office of Investigations 600 Washington Sheet Boston,AM 02111 tivi on mass govtdia Workers' Compensation Insulmuce Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Nsme(BosmeesslOgwizatiourtndrriaual)= etr &AkA, �+`�-..e..c�ie.v ..•c. Address: P 6 &A City/State/Zip: (e MA Phone# 6 A;�Ira employer?Check the appropriate boa:' Type of project(required): 1. employer with J_ 4. Q I am a general contractor and I employees(full and/or part-tirme).* have hired the sub-contractors 6 ❑New construction 2.El I am a sole proprietor or partner- ship on the attached sheet 7_ ❑Remodeling ship and have no employees These sub-cofactors have 8. Q Demolition w for me in an capacity- employees and have worms'. working Y � i tY- 9_ Q Building addition ' [No workers'comp.insurance comp.insurance.i required.] 5_ Q We are a corporation and its ME]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I L Q Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.Q Roof repairs insurance required.]I , c.152i§1(4),and we have no ' employees.[No workers' 13.[�'Qther Solis-9 comp.insurance required-] •Any app4tant that checks box#1 must also fill out the section below showing their nmrlters'wnvpensation policy information. ?Hameoemers who submit this affidavit indicating they are doing all wok and then hire outside conuactars mustsubmit a nes affidavit indicating such- +Contractors that check this box must attached an additional sheet showing the name of the sob-c maacto s and state whew or not those en aiw have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is prmiding worlrers'compensation insurance for my engdoyees. Below is the policy and job.site. information. / Insurance Company Name: Ir, Policy#or Self-ins.Lic.k 'Dad/ w b 90 Expiration Date: 9 � Job site Addrim: CitylStatie/Zip: 0ap— Attach a copy of the workers'compensation policy eclaration page(showing the policy number and eViraAon date). Failure to secure coverage as required under Section 25A of MGL cv 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 certify an2,epains and penalties of perjury that the information provided above is Into and correct Si true: Date: O — E - Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/Lieense# Issuing Authority(circle one): 1.Board of Health 2..Building Department 3.City/Towa Clerk 4.Electrical Inspector 5.Plumbing Iusliector 6.Other Contact Person: Phone#: Y In the event that while stripping the siding we find rot that needs to be replaced,the homeowner then has to agree and authorize any replacement or restoration. Then in addition to the above contract price,the homeowner agrees to compensate the contractor for any repairs or restoration at the hourly rate of$45.00 for a carpenter and$30.00 for a carpenters laborer, plus the cost of materials. -Siding to be stripped and cleaned of all old siding&debris -Home to be papered with Typar house wrap Maibec Grade A white cedar siding to be installed -A Notch Above Construction would be installing the masonry proposal as discussed -5 Yard dump trailer will be needed on site;and will be removed at completion of the job -Contractor will be responsible for all building permits needed at the property NOTICE REQUIRED BY LAW With the agreement of the contract$500.00 of estimate is due. Further payments under this contract are as follows: 1/2 of the estimate due at the start;and remainder due at completion of the job. Balance of all materials and labor shall be payable in full.upon completion of work described in this contract. Payment as agreed upon shall be made when due. Any payments which are delayed shall be subject to a finance charge of 1.5%per month. . The contractor warranties the work completed under this contract for a period of one year from the date of completion. During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment,but the contractor shall not be responsible for the normal maintenance, repair due to abuse, misuse,and or normal wear and tear,which shall be the responsibility of the homeowner. All warranties for the materials supplied by the contractor shall be passed directly to the homeowner. The homeowner may be required to register or mail in such warranty card or evidence of ownership in order to activate such warranties. Homeowner failure shall not create any responsibility for the contractor under the warranty provisions;the choice of repair of replacement shall be at the discretion of the contractor. The homeowner acknowledges that the form,content,and notices contained in this contract are intended to comply with the applicable portions of the Mass.General Law Chapter 142A, and regulations promulgated there under. In the event of any instance of non-compliance,only such portion shall be invalid and the remainder of this contract shall be in full force effect. In addition, any such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and regulation. Signed as a sealed instrument on this date: Date: Contractor Homeowner 7' Massachusetts-Department of Public Safety Board of Building Regulations and Standards C'un.trucnun;SuperN isor Specialty License: CSSL-099913 `mot i r5 TROY A THOMAS ter. 499 NOTT KJ HA*DRIVE CENTERVII3LE MM,02632 T,, t . l > .' .+ ��+' Expiration Com* missioner 04/13/2014 ale�c�ra„en,etue�tlC/t.c ;_:. '�=\ Office of Consumer Affairs R Business Re;ulatiou UMME IMPROVEMENT CONTRACTOR E3egistration 145954 Type: x expiration: 3/1512015. Private Corporation DOYLE+THOMAS CONST INC TROY THOMAS 499 NOTTINGHAM DR CENTERVILLE,MA 02632 ' Undersecretary Aco® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) `� 10/07/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER- CONTACT NAME: Debbie Mark Sylvia Insurance Agency,LLC PHONE FAX 404 Main Street A c o ext: 508 957-2125 A/c No: 508 957-2781 E-MAIL ADDRESS:mark@marksylviainsurance.com Centerville,MA 02632 INSURE S AFFORDING COVERAGE NAIC# INSURERA: Farm Family Casualty Insurance INSURED INSURER B D&T Construction,Inc. INSURERC: PO Box 168 Centerville,MA02632-0168 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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. MSSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP POLICY NUMBER MM/0 MM/DD/YYYY LIMITS A GENERAL LIABILITY 2001XO485 7/21/2013 7/21/2014 EACH OCCURRENCE $ 1,000,000 X COM MERCIAL GENERAL LIABILITY DAMAGE TO RENTED— PREMISES Ea occurrence $ 50,000 CLAIMS-MADE F—x]OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&AOV INJURY $ Included GENERAL AGGREGATE $ 2,000,000 GEN 'LAG GREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO .BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED ROPERTnDAMAGE $ AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE - AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION 2001 W7501 - 7/25/2013 7/25/2014 WC STATU- X LIMITS 1 - - AND EMPLOYERS'LIABILITY Y/N - ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? - N/A (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/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Carpentry The workers compensation does not provide coverage for Troy A Thomas and Shawn M Doyle. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE D&T Construction Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 168 ACCORDANCE WITH THE POLICY PROVISIONS. Centerville,MA 02632 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD. �F'THE tq� Town of Barnstable *Permit# Expires 6 months Jrom' ue date Regulatory Services Fee � MASS. / Richard V.Scali,Director K,Prcb E � nEn 1639. �� �� QED MA't A - Building Division APR 14 2015 Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTABLE www.town.barnstable.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 1 Property Address ?91 QoD . 66,41 c-ytqc 7. &I 04201 residential Value of Work$ bLJ `� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address AIVnl &46-j $'rr AE Contractor's Name Ddo4tk �i-f-c�an, �o ;`T�2�C r i�sJ 10 L Telephone Number Home Improvement Contractor License#(if applicable) u S� Email: o�on�s c LCiYsr1 NC—T Construction Supervisor's License#(if applicable) Dworkman's Compensation Insurance Check one: ❑ I am a sole proprietor WIam the Homeowner have Worker's Compensation Insurance Insurance Company Name t',�,w-t.—*A o L� _ _.__Workman's Comp.Policy# oOi ­j `7 cc) I Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) -- —❑-Re=roof-(hurricane-nailed)(stripping-old shingles)-All construction debris'will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over, existing layers of roof) 9 Re-side ,3 a ❑ Replacement Windows/doors/sliders:U-Value (maximum.33)#of windows #of doors: ❑ 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. J ***Note: Property Owngkniust sign Property Owner Letter of Permission. o e Home Improvement Contractors License&Construction Supervisors License is r qua SIGNATURE: \. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 T'he Cotnmrrn» th�,f Massnrhrusctts Departmmt qf 1ndrrsfric 1 Acdd=ts` :. Office ofInvesixgations 600 Washington&reef Boston,MA 02111 - iu:�ra�gdia r� Workers' Compensation Insurance.Affida Baders/Contra sJF ectriciainsTlumbers Applicant Information t Please Print L�ibiy . Name - I 0�j CC Address_ PO C;tyfstatel r: - a S — Are u an employer?Check the appropriate bo= T of project 4_ I am a. eral contractor and I Type lam] (required): L I any.a employer with 3 ❑ f 6. ❑New tonstructiou employees(fill antlforpart-time}.* have hired the sob-Contractors 2.❑ I.am a sale proprietor or partner listed an the attached sheet- y. ❑Reumodding skip and have no employees These sub-contractors have 8. ❑Demolition xr forme .- employees and have workers' �� ��� 9. ❑Budding addition i [No workers'comp:insurance comp.insurauce.1 required] 5. ❑ We area corporation and its to-❑Eteclrical repairs or aditions 3.❑ I am a ho cmwii r doing all wodt officers have exercised their 1I-❑Plying repairs or additions of trou MGL F �y���o ��I - c 2,§1 d we have no 12- Rooftepairs employees- workers' 13_❑Other comp-insurancerequired-] 'Amy applieamt mar cbecim box#I nmst also fll out de section below shnwiag dMk arorieets'camapMnzfoupolieg infOrlmld= Ao awaers who submit this af5dauit im bW mg they art doim g all wink wd them hire outside contractors worst skit a ne-w zMdavR i"a�such- +Contracinrs that check this box nmst attached an additiocA sheet shoutsmg the name of the sob-conawf o-rs and state whether orzm those entities lam employees. If the sub-contr aors Fzve eauplapees,they mustpiuuide dw r workers'comp.policy mambex- I ant an emp&o,er that is pig nvorkers'comrpensa#&n insurance f or my employees. Below is thepoffty and job sd* icaformation. Inssurance Company Name: Policy 9 or Self-iris. ExpirationDate- 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 ofMGL c: 152 can lead to the imposition of criminal penalties of a. fine up to S1,50U_©d andfor one-year imprisons as welt as civil penalties in the foun of a STOP WORK ORDER and a fine of up to S25t3_tO a day against the;violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA p coverage verification_ l I,do hereby its d penat&s ofpetj thatthe`inforuu Lion protgded abos!e is and rrect ._----1 Date: 2-c Phone t?,Ocial use only: Do root w.rite in this area,to be completed by ci#,}:of town o,45cictl t City or Town: PermitfLicense# Issuing Authority(circle out): 1.Board of Health 2.Building Department. 3.Cityfrowa Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: _ 6 tt, f . 4.t. Information and Instructions Massachusetts General Laws chapter 152 requires all employers to "de workers'compensation for their employees. =re:ss tostatute,anemployeeisdefinedas"...everypersoninservice of another under any contract ofhire, r ed3 oral or written." An employer is de ed as"an individual,pmtaersbip,association,co oration or other legal entity,or any two or more of the foregoing in a joint enterprise,and including the le presentatives of a deceased employer,or the receiver or trustee of an dividuaI,partnership,association or other gal entity,employing employees. However the owner of a dwelling house ving not more than three apartments an who resides therein,or the occupant of the - dwelling house of another employs persons to do maintenance, nstraction or repair work on such dwelling house or on the grounds or building i urtenant thereto shall not because such employment be deemed to be an employer." MGL chapter 152, §25C(6)also s that"every state or Iocal lic nsing agency shall withhold;the issuance or renewal of a license or permit to op rate a business or to co ct buildings in the commonwealth for any applicant who has not produced acce table evidence of cdmpIi ce with the insurance.coverage required." Additionally,MGL chapter 152, §25C( s"Neither the co on wealth nor any of its political subdivisions shall enter into any contract for the performance fpublic work until table evidence of compliance with the insm7ance. requirements of ibis chapter have been pres to the co authority." Applicants Please fill out the workers'compensation affidavit ompletely y checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address s)and p one number(s)along with their certificates)of insum nce. Limited Liability Companies(f-LC)or L' L' ility Partnerships(LLP)with no employees other than the members or partners,are not required to cant'workers' mp ation insurance- If an LLC or LLP does have employees,a policy is required. Be advised that this affi ay.be submitted to the Department of Industrial Accidents for confirmation ofinstmance coverage. Also be re to sign and date=the affidavit The affidavit should be returned to the city or town that the application for the p or license is being requested,not the Department;of . Industrial Accidents. Should you have any questions regar e law or if you are required to obtain a workers' compensation policy,please call the Department at the num r - below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials t Please be sure that the affidavit is complete and printed legs ly. The D artment has.provided a space at the bottom of the affidavit for you to fill out in the event the Office of vestigatio as to contact you regarding the applicant. Please be sure m fill in the permit/license number which - be used as a eference number.Ia addition,an applicant that must submit multiple permit/license applications in any "ven year,nee only submit one affidavit indicating current policy information(if necessary)and under"lob Site 4ddre "the applicant o»ld write"all locations in (city or town)_"A copy of the affidavit that has been officially stain d or marked by e city or town may be provided to the ' applicant as proof that a valid affidavit is on file for future p units or licenses. new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license c permit not related tt any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person i NOT required to co ete this affidavit The Office of Investigations would like to thank you in ad ce for your cooperation d should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The CQMMO� of M&ssachusett s Departmeat of dial Accidents Q�ii�e r� .�esf gaitio-M F�4 Qn Strut B �MA 02111 TeL#617=727-4900 ci t 406 or 1-8-77 MAS Revised4-24-007 Fax.#617-` 27-7749 v .ma�_gov/dia I n the event that while stripping siding pp g the s d ng we find rot that needs to be replaced,the homeowner then has to agree and authorize any replacement lacement or restoration. Then in addition to the above contract price,the homeowner agrees to compensate the contractor for any repairs or restoration at the hourly rate of$45.00 for a carpenter and$30.00 for a carpenter's laborer, plus the cost of materials. -Siding to be stripped and cleaned of all old siding&debris -Home to be papered with Typar house wrap -Maibec Grade A white cedar shingles to be used in the installation -5 Yard dump trailer will be needed on site;and will be removed at completion of the job -Contractor will be responsible for all building permits needed at the property , NOTICE REQUIRED BY LAW With the agreement of the contract$500.00 of estimate is due. Further payments under this contract are as follows: 1/2 ofthe estimate due at the start; and remainder due at completion of the job. Balance of all materials and labor shall be payable in full upon completion of work described in this contract. Payment as agreed upon shall be made when due. Any payments which are delayed shall be subject to a finance charge of 1.5%per month. The contractor warranties the work completed under this contract for a period of one year from the date of completion. During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment, but the contractor shall not be responsible for the normal maintenance, repair due to abuse, misuse, and or normal wear and tear,which shall be the responsibility of the homeowner. All warranties for the materials,supplied by the contractor shall be passed directly to the homeowner. The homeowner may be required to register or mail in such warranty card or evidence of ownership in order to activate such warranties. Homeowner failure shall not create any responsibility for the contractor under the warranty provisions;the choice of repair of replacement shall be at the discretion of the contractor. The homeowner acknowledges that the form,content,and notices contained in this contract are intended to comply with the applicable portions of the Mass. General Law Chapter 142A, and regulations promulgated there under. In the event of any instance of non-compliance,only such portion shall be invalid and the remainder of this contract shall be in full force effect. In addition,any such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and regulation. Signed as a sealed instrument on this date: Date: Homeowner (5 Contractor C�yr Off of Consumer Affairs&Business Regulation - - OME IMPROVEMENT CONTRACTOR j` Registration: 145954 Type: . � . xpiration: 3/15/2015 Private Corporatior DOYLE+THOMAS CONST INC TROY THOMAS 499 NOTTINGHAM DR CENTERVILLE, MA 02632 Undersecretary Massachusetts - Department of Public Safety Boa d of Building Regulations and Standard_ �.•:ii+i!'LIiiFr. .1il jlc!'!i•n!'\iscii:ii\ . License: CSSL-099913 TROY A THOMA,4 _ 499 NOTTINGHAM D r _ CENTERVII.LE MA4O •. Expiration Commissioner 04/13/2016 individul use only valid for d return to: psac���aettl License or registration 1f goon a elation `7 iration date Business R g A.W.W..,,veal before the exp er Affairs and �P &Business Reg°tatj0° onsum ftairs CTOR Office of C a_suite 5110 ffice of Consume�ENT CONTRA` Type 10 Parkpl� ME IMPROVE;....,. Corporatio i Boston,MA'U2116 , egistratlon 145954 private Xpiration: 512r _ +THOMAS CON SZINC pOYLE l out signature Not v, id`� TROY THOMAS 499 NOTTINGHA`M.DR Uudersecretari CENTERVILLE,MA`02632V r DATE(MM/DDNYYY) ACC)RV® CERTIFICATE OF LIABILITY INSURANCE 09/02/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Kristine Fernandez Mark Sylvia Insurance Agency,LLC PHONE 508 957-2125 FA No:508 957-2781 404 Main Street Centerville,MA 02632 ADDRESS:kdstineiRmarksyiviainsurance.com INSURER(S)AFFORDING COVERAGE NAIC 0 INSURERA:Farm Family Casualty Insurance INSURED INSURER B. D&T Construction,Inc. INSURER C PO Box 168 Centerville,MA 02632-0168 INSURER D: INSURER E:- INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER 1IDDY EFF MMAD LIMITS EXP LTRWVD A X COMMERCIAL GENERAL LIABILITY 2001X0485 7/21/2014 7/21/2 15 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE ❑X OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 M'OTHER: LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE $ 2,000,000 POLICY ElJECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 $ AUTOMOBILE LIABILITY C a aBINENErrDtSINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LI1B OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED RETENTIONS $ A WORKERS COMPENSATION 2001 W7501 7/25/2014 7/25/2015 T } AND EMPLOYERS'LIABILITY Y 1 N SATUTE (ER � ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? Y❑ (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 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Carpentry i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE D&T Construction Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 168 ACCORDANCE WITH THE POLICY PROVISIONS. Centerville,MA 02532 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD t Assessor's Office,(L���d.i��rs Parcel Permit# -r Conservation Office(4th floor)(8:30- 9:30/ 1:00=2:00) �r �� Pe Issued Board of Health(3rd floor)(8:15 -9:30/�1:00-4:45) $3 5 3� Fee Engineering Dept. (3rd floor) House# PI oi 19 a�q! �� TOWN OF BARNSTABLEQp Q - Building'Permit Application Project Street Village 144ekA41 Le Owner rt, 4,Qis oi Address Telephone 2 -- 0 9S7a Permit Request d ! S a- G[ t P G \4� First Floor square feet Second Floor square feet Estimated Project Cost $ Q Zoning District Flood Plain N(1 Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family �"` Two Family Multi-Family Age of Existing Structure �� �{pai-C Basement Type: Finished Historic House a& Unfinished x Old King's Highway A/ Number of Baths .2 No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces ' Garage: Detached Other Detached Structures: Pool /,Y n Attached S L Barn None Sheds Other Builder Information p Name O 4& (i Telephone Number t'O.� — /.S ' Z Address f l P a S'd n ,1,k p Ag, License# 0'Z Q' 319 e4 :71jf I/['11-P Ix I as !P 3 ,Home Improvement Contractor# /49 O /D Worker's Compensation# C �} 52/ 67 D NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. / ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO d 11 S 4- d r G a4d SIGNATURE LG�^ DATE BUILDING RMIT DENIED POOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY `PERMIT NO. VI%��J DATE ISSUED - I/,PARCEL NO RESS ` VILLAGE OWNER , y DATE OF INSPECTION: FOUNDATION r FRAME INSULATION �V - FIREPLACE ; ELECTRICAL: ROUGH ;+FINAL a PLUMBING: ROUGH FINAL i 1 GAS: ROUGH FINAL k FINAL BUILDING•,+ DATE CLOSED OUT ( I I I 1 t ASSOCIATION PLAN NO. _.r r v t I � �II ,. 144 o v 1 �y41Cad l Lz s �o r s fi f/av a sS TOWN OF BARNSTABLE Permit No. ----------25559 ---__ ` Building Inspector t.a:rr.a Cash ---------— —•- a"& aj i6)9• �aMal OCCUPANCY PERMIT Bond ------------- Issued to :Z J• Haij, Address J';IteAvitte .POD: AI �4eJtMeth Woo, ftntP.hv- tte- Wiring Inspector f Inspection date Plumbing Inspector L ( ~( / Inspection date 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. is......_._ .................................................................................................................. Building Inspector FROM �— T OVM OF BARNSTABLE EfMDING`DEPARTMENT Mr, Francis Lah i 367 MAIN STREET t#YkNNtS, MA 021 Town Clerk, SUBJECT: FOLD HERE' DATE 8A ME'SS,AGE Work'has been' co pl Please releed'$ w .' �`ira i.•s w+y y.a if-`.y w+-4 vts: .-:c� ♦ y, �v ,r e:� -, - - - - 'SIGNED 1 Pvo � DATE. AE`PLY _ 666z i ' _. + t • ... _ - SIGNED - - .N87•RM1 ' } RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY „ 'PRINTED IN U.S.A. SENDER:'SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. .�s /aa-oo ry za - c h � ,� __ ,Y,. SSG �• �� ' �y. wo f, \ r WHARD [ A. - WaT'ER Na 240" Iz T l'F I E D . P LC) R`o $u� ' LOCATI0� ,, :., p-LA►J R�FE�E►.lGE. G6RTIFY TNAT THE Fov►�l�A—lan�5uaw►.J ws-z6o►.l CgMPI.YS W►TN THE 51 VrE.Lt►..ram vIQE�E►.1TS bF TN�c `" �ow►� .,oF• t3P2�J5z'a�.31_I� A.uD �5 t�tvr' i ti :L.OG•A't�D . WIT1-11� Tt-� �'l. � �I� B,4XTCIZ �. u�F• 1�•.Ic.. '.0�tom' - RE G t S fC-•1Z�D 1.�4-1� Sly e.V c`(D i�S � 'T'.4-4.15 D LA►-I I S L-1 OT OSTEg.V%Ll.E O ti�(/�SSe I��ST�cJMEt.1T. 'iUQVC`f Ti4e UFr5f:--TS APPLtCA: -iT.; : - iNC �c)T L���� 1&Dk— g� F ` Assessor's map and lot number .. o..r..... .. .... ... ° THE fy y 3 OSr SYSTEM MUST SEPTIC Sewage Permit number ..f . .(...A'***.............. INSTALLED ALI �PJ Ili. MPLIA WITH TITLE 5 t 99HB UNE. House number ...... .. .. ..... ..................................:°.... MA66 i ENVIROMM &�TAL �D d ONpY.a\0� _Rr-Cae L TIONS TO N OF BARNS At _2 BUILDING INSPECTOR d, , �.: � APPLICATION FOR PERMIT TO ..: � mo ...LE �� ..: ?........ ....�;...........1: . ....................... ?.................................. TYPE OF CONSTRUCTION1A.04 ...... /�iGr.:...:..............:.................................................... ,. .3..............19.. .3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby,applies for.a permit according to- the following information: r , .j..�' .......... ................................... Location .... . .................. ..ai .:. ..:..................... ProposedUse .........!.. ................... ........................................................................................................ /L S �•U/ L ....................Fire, District � E/ntlJ/Lt E Q$1�c- �� f r Zoning District ................./.Ts.�............................... ..... �..... ......... .....L G� Name of Owner J?Wgo��..:`.1`... t [.5........................Address ..l „! 1 /�!1f Tf ....:�✓....4 . �C/%,{r�.��i/iLC E_ Name of Builder G�`t ...0 AC '4�/`f........:...........:....Address�� ...C.G..`..ou?f../...!. ...... Nameof Architect ........................................................ ......Address ...:................................................................................` Number of Rooms ..................................................................Foundation/�. �tA 4 6._J?......C.4&.441e P............. Exterior ........6.YeW.6.40...................................................Roofing ........ F/.L ........I................................ ...... Floors �DD� Interior ��YGl»�'� .......................................................... ............... ................................................. Heating ...... !/. ...........................................................Plumbing .....�f...�� �.�............................. . .:.... a. Fireplace ..........60C. ..................................................Approximate. Cost ...... .(Q.Q.s. ................................. Definitive Plan Approved_by Planning Board -----------____---------------19_______. Area .......:� ./..�v.S: .,...... Diagram of Lot and Building with Dimensions Fee ( '..... ............... ..................... SUBJECT TO APPROVAL OF BOARD OF HEALTH �L`R�7J66-7-11 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. Name -/Ir:... ......... ................... Construction Supervisor's License ..v!`.l 190............... ,J!,%..HAYS, SANDRA J. s' 25559 One Story E No ................. Permit for ...........................:........ Single, Family Dwelling............... .. _ Location .Lot 21,.. 81 Merideth Way .. .. t ` Centerville .. ..... Owner .. SandraJHays . ........................................................ Type of Construction Frame i ',....,•................ ...............A ...................:.......... Plot ........................: . Lot ............... :n Permit Granted 'Sept...:.20 , :..1`9 83 - _ µ• w x Date of Inspection 19 Date Completed ..e.......... ..............1;9