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0080 PARK AVENUE
lg IV, mum Elm " ORD 1PUNIMP 'k pill UN A; Off WU 441 E!"W fn# WAR; whjp"'�J. kit ny gap No iu�__Pwpji, 'T P:z P1 WN P-M "Mm"M ,0 fz,i 'A� y,f?,j0C qi'jqk�,VIR 'Y li� W,11114 1611IXIIAZ� V2 NNINVA if g% U moo AU Nk"'RA, 14 QAF YIW h- WOW-1 Imp stogy.) YW�&Ar I mum If 1 -ymt� Ism V HIM Rol 511i I - U, Al i1b fffj�l 4" WIN f, IWO A 4XV 110 i '11 Pfw� p f _ff Pi'll 1 ."01 1 gg�gql I , UJI14k jfj, N1 Y, V�l t f 111'a 9� SI an I Yf AN WIWI W.1-111 P 0, %I, VIA N WINN ��31 gi, Ko!yw"!mA�0 I Mae No"" 01. T1 Iwo OWN 114- 1. �P`11 Mill MIMI Evil N H 1", 7 11011 W, , I I ,ft I el H, M4 Ail VIE, RA I 4M Plvnz ,g,fit Mq� of AP vw, 1,6 ;4'NSIF �if �AW WIN, 9 ,ttm`rA,� If All 1"4iY444 TrIlp d xg or 4, ,Hi, mm Jan,i,'I 6 M IS thif pA- w, 20 TWA A, fj f �cl NAM " j Ism A,-' 1-1 17�,g�4� !Amu UPI- 0M WINNON I 1�!k " R4 ;'8V X oil Ilk "n ",F, 1l1tPv,) 710 A 0, Ut soma MM 11M Map pill I - �i� �.1 �- P i'71", 3'q % , . 'i Owg - 6-1 H'Ift MIX gg "t AMU A Wjdo W it, 0 Inn Amu!of motif g, rin �je ;AT�fij it M. PAI K11 FV 11111 Puma fm 1,y V""j 'p-I I I bgjj, Rrql 1K, ig i ,I-�U 01 1jg&jr wA4y'b. )d NP00 lip 11 immall 51 '11 t,464R' )i0 'N , ,I �y WAU Oil ,-�gfuft p �jq A�U�I q� J r i N� h 2-k", ` Pyq MvI q . AM00-152A.- IN INN 1"p-i moo ��k4 4' 22 Bill it 6q MAN"' em �cl NOW— .............. I RV 111"� I, a T�i'H N t THE T� Town of Barnstab re *PermitS 162 �Z3 P p Expires 6 months f issue date Regulatory Services Fee (� * BARNSTABLE�x` %f7' y" i1639.�lkrg�.��� Richard V.Scali Director �ArfD MA'I A at�L 2 1 1 �n Building Division .. T®�/�jn 1 Tom Perry,CBO,Building Commissioner �l/!U AHIVS IA13L� 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address 7 II �2esidential Value of Work$ II' D) Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address J n NO, Contractor's Name �V ,� � �-� �1S , �D Telephone Numbeq��_(14,11 Home Improvement Contractor License#(if applicable) Email: Ott I CP-- Construction Supervisor's License#(if applicable) CS I CR �rkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I a the Homeowner have Worker's Compensation Insurance Insurance Company Name (- Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. . Permit Request(check box) [�e-roof(hurricane nailed (stripping old shingles) All construction debris will be taken to EN ( pP g g ) ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) �an* ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#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. - copy of the Home Improve nt ntractors License Construction Supervisors License is r uired. SIGNATURE: - C:\Users\DecollikUppD a\Local\Microsoft\Windows\Temporary Internet Files\Conte nt.0utlook\2PIOIDHR\EXP SS_.doc Revised 040215 The Commonwealth of Massachusetts ' Department oflndustrialAccidents ( ' F`✓ 1 Congress Street,Suite 100 == Boston, MA 02114-2017 a WW.mass. ov/dia Workers'Compensation Insurance Affidavit:.Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTIiNG°AUMORITY. Applicant Information (Please Print Legibly Name'(Business/OrganizatiorOndividual):, 1 U L— `./—' 6AZt✓5 U t'"J 'T So�J_� Address; 10 3 j AIA 1 iv S %�G'1=1= J City/State/Zip: Phone#: �—�7✓� ^<« � Are you an employer?Check the appropriate box:- � Type of project(required): 1. a employer with employees(Ml and/or part-time). 7• ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. a Remodeling any capacity.[No workers'comp.insurance required.] 3.Q I am a homeowner doing all work myself.[No workers'comp. 9, ❑ Demolition- insurance required.]t , 10'❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. [will ensure that all contractors either have workers'compensation insurance or are sole I I.❑ Electrical repairs or additions proprietors with no employees. - 12.D Plumbing repairs or additions 5.❑f am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.E]Roof repairs These sub-contractors have employees and have workers'comp.insurances 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c., 1 4,01Otherx�_ 152,§1(4),and we have no employees.[No workers'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. `*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. lam 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.#: VV C 5' —3) S 3 Q 667 626ZExpiration Date: V Im Job Site Address:aLga Ave City/State/ZipCeCdn1 Oa(na)a. Attach a copy of the workers'compensation policy declaration page(showing the oUcy number and ex�te . P p y p g ( g P � P ) Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.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 Sienature: L , . � � a I �} i . Date: Phone#: !�:)0 Official use only, Do not write in this area, to be completed by city or town official, City or Town: 1� .� �( Permit/License# Issuing Authority(circle one): 1.Board of Health 2, Building Department 3. City/Tow' n Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ® DATE(MMIDD/YYYY) Ac"R" CERTIFICATE OF LIABILITY INSURANCE 8/11/2015 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. Astatement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER DOWLING & O'NEIL INSURANCE AGENCY INC NAME: 973 IYANNOUGH RD PHONE FAx PO BOX 1990 A/c No Est: AIC,No HYANNIS, MA 02601 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: LM Insurance Corporation 33600 INSURED INSURERJ CAZEAULT& SONS INC INSURERS: r 1031 MAIN ST INSURER c: OSTERVILLE MA 02655 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 25918664 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 - ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAM TO CLAIMS-MADE 1-1 OCCURPREM SES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRO- ❑LOC PRODUCTS-COMP/OPAGG S JECT OTHER: $ AUTOMOBILE LIABILITY_ COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PeOPERTntDAMAGE $ HIRED AUTOS AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATEH $ DED RETENTION$ _I $ A WORKERS COMPENSATION WC5-31S-386670-025 8/10/2015 8/10/2016 ✓ STATUTE ERH i AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN NIA E.L.EACH ACCIDENT $ 1000000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1000000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA. This certificate cancels and supersedes all previously issued certificates,only as,they relate to workers compensation coverage. r CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PAUL CAZEAULT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1 031.MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. OSTERVILLE MA 02655 AUTHORIZED REPRESENTATIVE LM Insurance Corporation - ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 25918664 1 1-306670 1 15-16 WC 1 shankar.gadaleOlibertymutual.com 1 0/11/2025 4:45:09 AM (PDT) I Page 1 of 1 Ju,, 14, 2016 10: 22AM t No, 0 10 5 P, 1 r� Property Owner Must Complete & Sign This Form If Using a Rooter / Builder. (p)int) D iOft `-� Oe-3i , as Owner / Agent of the subject property hereby authorizes Paul J. Cazeault & Sons Roofing Inc. to act on my behalf, in all matters relative.to work authorized by this building permit application for. Address of Job R d ea A v yit)L Signature of Owner Mailing Address of Owner 7 R Lr,N G- A C E NU L Telephone # Date /3 2-01(o Please return this form to Paul J. Cazeault Roofing along with your signed contract. It is needed for us to obtain the building permit required by your town to complete your roofing project fax#508-4W-4555 office@cazeault.com iv» st { .: =l -- t G Off ce ofCons le aizsp, nd szr-I R-gulation 10 Park Plaza --",5uite 5170 Boston,,,Massachusetts G2J 16 Home Inptove elnt Contractor Rc isttation Registration. 103714 Type: Supplement Card PAUL J. GAEAU�T& SONS, INC.'. Expiration: 71912096 RUSSELL CAZEAUL T : -=-- --- _ --- 1031 MAIN ST - OSTERVILLE, 1VA;6.2658; _.._. CJ date Address and return card.Martz reason for change. SCA 7 0 20M-05l17 Address Renewal � Employment � Lost°Card - • _ • '���r `(nC7Y'1.9J80Jf/fL�L(��o/C'.;!tialcrc%r:,'elT;i \ cs ` Office of Consumer Affairs&Business Re'aladon License or registration valid for individul use only 7 ' 'NOtYIE IMPROVEMENT CONTRACTOR before the'expira4on date. If found return'to: I ' Office of Consumer Affairs and Business Regulation ` ,ti Regisfra#ian;i b37�4• %YAe;' 10 Park PIna 9irite5170 P 7/9l2016:. Supplemerii"`lard - Boston,IYIA 021x6' PAUL J.CAZEAUf-t-9t0N8 t!NCt RUSSELL CAZEAULT:'.':'..`: 1031 MAIN ST OSTERVILLE,WfA 02658 — Un ilersecretar} Not vale d'w?thotyt%}Jgnature (( t j AJlassactluset s -C part-ment - p t1G aTeTj :3curd o7 BuudOg Regulations and Standards j Comt1'liClll]IS r` • N. R yyME 77 L/�A ry'[+A .\7,17+~ • , LYti'f�+ r a 2071 N STR Br6-ste"MA 02631 — r i�m,`S/�Illr�er 1 1 12312 0 1E 3 Office of Consumer Affairs & Business Regulation- Mass.Gov Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business-Regulation(OCABR) Consumer Affairs and Business Regulation ; Home Consumer Rights and Resources Home Improvement Contracting i HIC Registration Complaints i I� Registration# 103714 Home Improvement Contractor Registrant PAUL J. CAZEAULT& SONS, INC. Registration Home Pale Name Paul Cazeault Address 1031 MAIN ST City, State Zip OSTERVILLE, MA 02658 Expiration Date 07/09/2018 J Complaints Details No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Back To Search ©2012 Commonwealth of Massachusetts. Mass.GovO is a registered service mark of the Commonwealth of Massachusetts. i https:Hservices.oca.state.ma.us/hic/licdetails.aspx?txtSearchLN=3703 7/21/2016 Jul. 27. 2016 10: 10AM No. 2594 P. 1 12� ��i� J� �ti.�.�CY lrl� Office of Consumex Affairs d us1ne s e u at s gG � ion 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Ymprovem.nt Contractor Registration Registration: 103714 Type: Supplement Card PAUL J. CAZEAULT & SONS, INC. Expiration: 7/9/2018 RUSSELL CAZEAULT 1031 MAIN ST OSTERVILLE, MA 02658 Update Address and return card.Mark reason for change. BCA 1 Z) 20A,1.06111 ❑ Address Renewal Employment Lost Card ffice of Consumer Affairs&Business Regulation License or registration valid for individual use only t�OMB IMIROV�M�NT CONTRACTOR before the expiration date. If found return to; Office of Consumer Affairs and Business Regulation R®aIstratlon_ 1,ogg— Type., 10 Park Plaza-Suite 5170 Ezpiration;.'7/9f2e18 Supplement Card )Boston,MA 02116 PAULJ.CAZEAULT'&'SONS;•INC.'•:. RUSSELL CAZEAULT 1031 MAIN ST �t rl.�l� OSTERVILLE,MA 02658 Undcrsecretary Not valid without ' nature En neerin Dept. 3r8'floor Ma Parcel _ / Permit#1 -: g� p ( � p � 7 I 0:7 House# Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fees'. Conservation Office (4th floor)(8:30- 9:30/1:00.-2:00) Planning Dept. (1st floor/School Admin. Bldg.) �tNE►p,' Definitive Plan Approved by Planning Board 19 i BARNSTAB6E. MASS. TOWN OF"BARNSTABLE 'f°"�''�� Building Permit Application Project Street Address Village CA-IV IMA&I a L , } Owner tir 4dA0 to"6u,��D Address A9& AvJE Telephone .SVd- 7 W- 9615- 'Permit Request e'RxW �® First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ X 1 _� Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑, Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review.# Current Use Proposed Use / Builder Information - Name ��/�,,,?' li_ �.�5►Rrys�uo. �-7V /Telephone Number Xd dress �.Z6-<S-emz[11A 1W, ✓ License# d yJ--d n Z 144.0 , 6Z6 G C/ Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ATE ' "�S`_ .7 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) - FOR OFFICIAL USE ONLY PERMIT NO. Z _ DATE ISSUED ' •� MAP/PARCEL NO. •A ADDRESS VILLAGE OWNER DATE OF INSPECTION: 1 FOUNDATION FRAME INSULATION FIREPLACE , £ ELECTRICAL: ROUGH FINAL + PLUMBING: ROUGH r FINAL • t. t GAS: ROUGH 3 FINAL ' , FINAL BUILDING - - DATE CLOSED OUT _ 4 ASSOCIATION PLAN NO. ' Assessor's office(1st Floor): a� Assessor's map and lot number / ��TN[ Conservation(4th Floor): Board of Health(3rd floor): ; , Z O� L t D�MOL` Sewage Permit number ;.i, �p rua Engineering Department(3rd floor) �o , `' �i630 House number ( �/5i�,tC �j/�,�/�/� gL'lJs: 0Mai Definitive Plan Approved by Planning Board 19 ; SEPTIC SYSTEM MUST BE APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only INSTALLED IN COMPLIANCE TOWN O,F BARNS 'T�!TTLE5 AL CODE AND 'BUILDING , INSPECTORN REGULATIONS APPLICATION FOR PERMIT TOu, c TYPE OF CONSTRUCTION (,,o,>D t 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location so e--?o-, S+ t;e^.VCVu, Proposed Use Zoning District —1 Fire District O Name of Owner flu cQ eA 4L----k:>d1-J C-ti Address 50?c,,r C.e�,. V:u" v t x Name of Builder DC,G,.. r. Address I(- CANLIC �S�c•a.�c1[. Ce�.�wv✓L(.� Name of Architect Address Number of Rooms Foundation `you v ecwA-CIrl� Exterior �' e�G� Roofing Gc Floors Interior Heating Plumbing Fireplace - Approximate Cost ci000 Area 3 5,x Diagram of Lot and Building with Dimensions Fee 41 i + , 4 t 3S 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 C��� � �� ✓/ Construction Si ipervisor's License 02 l O.7 f /-// C- DEWEY, MADELINE 0 �r No 36259 Permit For Build Ga age - Accessory to dwelling Location 80 Park Street _ Centerville Owner Madeline Dewey ti Type of Construction Frame Plot Lot Permit Granted October 26, 19 93 Date of Inspection: r Frame 19 v-+ r insulation 19 e r Fireplace 19 - Date'Completed /1� �� 19 { i - { V�, a is —MIT I 4 e bti h A f Shy - vI ly •r f q' t