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HomeMy WebLinkAbout0129 PARK AVENUE n XIA »} t ac.;�t,9 c,Y nr,,hir uk. .y s:,".+•-. a n+. i .,; ,. .�ti �. �'�'�,: �4 49 G r :9�. F,fvt. f,..,.,�.;,,;. y v.. t.��,_. da far �tdh°. `�rf�+ �rF (,���• ae "�i�k'v + �%C .�' � i, " n a F ° o " B c ° r , ° e a , oe 0 o a n n _^ e h o , 0 a , , a , « Ea 4 o _ e _ r < , ° _ v , ap ° r s° , o J Town of Barnstable *Permit# /d ��3 7 Expires 6 months from issue date Regulatory Services Fee � ",o Thomas F.Geiler,Director �/�2 dlb 7 Building Divi$ion 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 Not Valid without Red X-Press Imprint 'ap/parcel Number 7 0 -operty Address z•� �/ Art Aa-', ]Residential Value of Work e Minimum fee of$25.00 for work under$6000.00 wner's Name&Address 1 61 / L ontractor's Name ��'� i ✓L'.- Telephone Number 7.76 ome Improvement Contractor License#(if applicable) g6 �nsft��:t+�soi's-L-icErts {'rFappiieable-) ]Workman's Compensation Insurance Check one: -` ; _vs P � ❑ I am a sole proprietor II rntheHomeowner APR 2 0 2007 EL4 have Worker's Compensation Insurance TOE ��F BAFR y�STABLE :surance Company Name 'orkman's Comp.Policy# opy of Insurance Compliance Certificate must be on file. mnit Request(check box) - [/Re-roof(stripping old shingles) All construction debris will be taken to I- l2'u1.?-4r � Re-roof not stripping. Gomg over existing layers of roo � � . ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *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 conv of the Home Improvement Contractors License is required. fGNATURE: Forrns:expmtrg :vise061306 . �� ✓lie`` '. {:� _ ' _.. �,f3Ut dish f e ul +mar✓uur� 1 HOME Al, EI1E a!i ns and Stanilar�JJ• ROV NT Regtstratton CONTRACTOR { Cxprr'atto' 13428E kt' -" n 22/2007 RON CNST INC OE3q jst^ t +z rv1E 7gyLOR IUtNG& ROOF' C1RCL F; ►N c ,4 The commonweauh of Massachusetts .Department of Industrial Accidents Off ce of Investigations ' 600 Washington Street Boston,MA 02111 'w www.mass.gov/dia " Workers' Compensation basuraace Affidavit: Builders/Contractors/]Electricians/Plumbers Applicant Information Please Print Letzibly Name(Business/Organization/Individual): . 7 ,p Address: 3/ 40 City/State/Zip: �o►�i Phone:#: 77 6 Are ygu an employer? Check the'appropriate box: Type of project(required):. 1. II am a employer with 4. ❑.I am a general contractor and I employees (fall and/or part-time). . have hired the stab-contractors 6. ❑New construction . 2.El 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' com insurance.$ 9. 0 Building addition [No workers' comp.insurance P• required.] 5. ❑.Vice are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing.ill work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per exercised. 12.Z-Roof repairs insurance required.]t c. 152, §1(4),and we have no 13:❑Other employees. [No workers' comp, insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infomiation. 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 ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policynumber. I am an employer that is providing workers'compensation insurance far my employees. Below is.thepolicy and job site information. nG� Insurance Company Name: vr' Policy#or Self ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: l� G' 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 tip 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 s Investigations of the DIA for insurance coverage verification. I do hereby certify u er he pains and alties of perjury that the information provided above is true and,correct,' Si afore:. !J7. • Date• —/�'— _ Phone#: fO f 7 7 & �9 official use only,. Do not write in this area, tb be completed by city or town offrciaL City or Town: Permit/License# I• Issuing Authority(circle one): ..,..Board of Health 2,Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6, Other Contact Person: Phone#: Inf®r ation' and Ins4tucti®us 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." An employer 'defined as"an individual,partnership,association,corporation or other legal entity, r any two or more of the foregoing engaged in a joint enterprise,and incl=ding the legal representatives of a-decease mployer, or the eiyPr or trus a of an individual, assoc lion or other legal entity, em to -e 1 ees. However the owner of a dwe .house having not more than three japartments and who resides therein;or the occupant of the dwelling house°o another who employs persons to dotmaintenance,construction or repair work n such dwelling house or on the grounds r building appurtenant thereto shall not because of such employment be dee ed to be an employer." MGL chapter 152, 25C(6)also states that"every st�te or local licensing agency shall wi old the issuance or renewal.of a lice". or permit to operate a business or to construct buildings in the co onwealth for any applicant who has'` of produced=acceptable evidence of compliance with the insurane coverage required." Additionally,MGL,hapter 152, §25C(7)states"Neither the commonwealth nor any of' political subdivisions shall enter into any contra t for;the performance of public work until-acceptable evidence.of mpliarice with the insurance requirements of this apter have been presented't f the contracting authority." Applicants Please fill out the wor rs compensation affidavtl completely,by checking th oxes that apply to your situation and, if necessary,supply sub-c actor(s)name(s), addr ss(es)and phone number( along with their certificate(s)of insurance. Limited Liab t,Companies'(LLC)o Limited Liability Partne 'pa(LLP)with no employees other.than the members or partners, are o't required to carry wo kers' compensation ins ance. If an LLC or LLP does have employees,a policy is re uAd. Be advised that affidavit maybe s mitted to the Department of Industrial Accidents for ccnf= do ofi ."reuse coverag . Also be sure to s' n and date the affidavit. The affidavit should be returned to the city or t wn that the applicatio><i for the permit.or. =sense is being requested,not the Department of Industrial Accidents., Sho yo�i have any questons regarding thaw-or•if you are required to obtain a workers.'- compensation policy,please call the Department t the number 1 ted below. Self-insured companies should-enter their self-insurange license numb on a appropriate ' e. City or Town Officials. Please.be sure that the affidavit's co ete'and I rinted le 'bly. The Department has provided a space at the bottom of the affidavit for you to fill ou ' the a ent the Office f Investigations has to contact'you regarding the applicant. Please be sure to fill in the permi 'cense umb whi will be used as a reference number. In addition, an applicant. that must submit multiple permi ease a lice o any given year,need only submit one affidavit indicating current policy information(if necessary) d under `Job ' e Address"the applicant should write"all-locations in (city-or town)."A copy of the affidavit thaNas been f. ally stamped or marked by the city or town may be provided to the applicant as proof that a valid affida 't is on r future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obta' license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum le ves- c.)s l person is NOT required to complete this affidavit. The Office of Investigations would lili o thank yo, ' advance for your.cooperation and should you have any questi please do not hesitate to give-ass a c �e The Department's address,telephone.and fax number 1 , o1xkID0!W of Massalz usutts �e~pa ent f.W. al A.C4.&-nts fee ¢ v s;ag�#�tr�s �00 Washington Street Bostan\MA€211\1 1 Tel.#617-727-4900.ext 4.06 or 1- 77-MASSAFB Fax#617'-727-7749 Revised 11-22-06 • Www.II23SS.gEiYl(dia �''� might?-ax Norcross Z/Z/ZUU'/ 11:44 PAUL UV4/VV4 rax berver DATE(MM\OD\YY) PRODUCER THIS C R IFICAT I ISSUED AS A MATTER F INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MDWARD A GRAZUL INS AGCY HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR FO BOX 337 ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW. COMPANIES AFFORDING COVERAGE MARSTOVS MILLS NLA 026�8 COMPANY AHP-RTFORD UNDERWRITERS IKSURA CE QQlylFANlP INSURED COMPANY R L T CCNSTRUCTION IN'C B _ 31 MANNI CIRCLE COMPANY C7=ERVILLE ALA 02632 C 30M PANY D �OYERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISPED BELOW HAVE BEEN ISSUED TO THE INSURED NAIv1E6 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LT DATE(MM,DD',YY) DATE(MM\DD\YY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERALLABI_RY PRO DLIC-S-COMPlCP.AGG. g C-AIMS MADE=OCCUR. PERSONAL&ADV NJURY $ OWNERS&CCN-RACTORS PROT EACH OCCURRENCE $ RRE DAMAGE(Any one ire) $ MED.EXPENSE(Any one perecr) $ AUTOMOBILE LIABILITY COMBINEDS!NGLE $ ANY ALTO LIMI ALLOWNEDAUTOS BODILY INJURY SCHEDULED ALTOS (Per Pewn) z $ HIRECAJTOS BGDILYiNJUR'f NON-OWNED AUTOS (Per kdden£ PROPERTY DAMP 9 GARAGE LIABILITY , AUTO ONLY.EAR !DENT � AN"AUTO 0-HE3 THAN AIr '' NLY: - EAC 1 CIOENT AG' GATE $ • EXCESS LIABILITY EACH OCCURRENCE $•• L UM3RELLA FORM AGGP.EGATE $CD r- O-H Er?-HAN-UME RELLA-FORM_ WORKER'S COMPENSATION AND �- _� _;,r� S iA �`A �EMPLOYEWSLIABICRY�._(UB 1071CU -5-061 12-24-C6 12-24-07 STATJTNT LIM-S 'THE PRO'RIETOR!`-" _ =�. EACi A� IDcM �` $ y �,,) i • PARTNERS/EXECUTIVE T—INC 'µ~"""•" �^ •-� --- -y*-- DISEASE PGLICY LMIT $T 'y� OF=CERSARE EXCL DISEASE-EACH EMPLOYEE Is CO.OCIL, OTHER DESC IP_ION-OF OP_ERATIONS.!LOCA ION&V EHICLES'R EST RICTIONSJSPECIALITEMS - - TFE POLICY-' CES=C-NA= APOeE -_S`CANCELED'�`1 EFFECTIVE 02i 19%07 -- �-- -- - 1 A•THIS R3PLACF�'ANY`PRIOR CERTIFICATF ISSLiED TO HE'`CF.RTTFICATE'H1tiPEF:P.FFFCTIIIG WOF.I:FRS CJXP CCVFRAGE ,C— T OLD ' .......: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL TOWN OF BARNSIP.PLE 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE ATTN: BUILDING DEPT LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 2CO VIRIN STREET LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES HYANRIS MA 02601 AUTHORIZED REPRESENTATIVE 25rS�3X93) IsfandS Roofing a division of RGTConstruction,Inc. Proposal To: April 10, 2007 Doug Mullen Re: 129 Park Ave. Centerville. We are pleased to submit the following specifications and estimates for reroofing: Strip existing asphalt shingles and flashings Install new copper drip edge, valley flashing, and pipe flanges. Install 3 ft. Ice& Water Shield to eaves, and entirely on dormers. Install 151b. Felt paper to remaining roof. Install 18" red cedar perfections using stainless steel fasteners. Install lx8 red cedar cap using stainless fasteners. I Clean up and haul away all debris to landfill We hereby propose to furnish material and labor- complete in accordance with the above specification, for the sum of: TWENTY ONE THOUSAND EIGHT HUNDRED DOLLARS $21,800.00, For 30yr. Certainteed architectural. $8900.00 V PAYMENT TO BE MADE AS FOLLOWS:. No deposit, Payment in full is due upon completion. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alterations or deviations from the above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents,or delays beyond our control. Owners to carry fire,wind damage and other necessary insurance. RLT Construction,Inc. carries General Liability and Workman's Compensation Insurance. Certificates of Insurance provided upon request. ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and hereby accepted. You are authorized to do the work as s cified. Payment will be made as outlined above. Date of Acceptance- Signature Start Date: Signature 31 Manni Circle • Centerville, Massachusetts 02632 Telephone 508.420.5243 and 508.833.5249 • Fax 508.420.1776 • Email caperoofer@caperoofer.com 05l133J,2007 09:36 5084204474 EDWARD A GRAZUL RAGE 03 C1A'dE(M TPiIS CEFiTiFi ,47de i5 ISSUED A9 ,A NiA'f PER �� !'{fie ctS pwaDUCFSi - iMFOidRlATiE9N1� . EDWARD q GRAZU! INS AGCY LDE DTW[B CERTdFiCA9"EiDf?�S3 NAT Al♦RERID CEXTEF LATE PO BDX 337 14LTER TWPc COVE�IGE AFFORDED BY THE HOLlIrlE�BELOW. OR MARSTDNS MILLS MA 02649 _ —COMPANIES AFFORDING COVERAGE I I G`O ANY i �c,8Y2K I IlNsust6D a��� a H,ARTFDRD UNDERWR. ITEP LN _QL Cp11±PFANY �I COMPANY R L r CONSTRUCTION INC B 31 1 CIRCLE COMPANY CENTERVILLE MA 02632 . C — _— ICMIPAky +rw THIS IS TO CERTIFY THAT THE POLICIES OF 'NSURANGE LISTEN i3ELOlW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY>�@Plpp IN4IOATED, NOTWITHSTANDING~ ANY REOU!REMENT, TERM OR CONDITION OF ANY CONTRACT OR 4TMEp OOOUMENT WITH RESPECT TO WHICH THIS � CERTIFICATE MAY O ISSUED GAR IdAY pLF!TAIN, TN`e INSUctpNCE AFFORDEE) 13Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, t_EXCLUSIONS AND CONDITIONS OF 9LIGH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY RAID CLAIAMS, Ctl TYPE OF INSURANCE j —.------ POLICY EFFECTIVE. PatrclY EIIPIRATfb - LiA POLICY NUMBER _ _ I BATE(M WDG1YV) GATE{i!/M% IA" LIMITS WENERAL LIABILITY -GO - OENERAL,A00MEt3A'% g MMFRGAL OE NERA',LIABILITY -I i ��P�LRWNAL •CphtP/CP�AGIGI,. �CL419A8 fl�AGE CC,C:1F, - ONI IWl' OWNER'S b C0wlAACTCR'S PpOT, :JRR8NC8 -^+ —^�— 5 .. ! j FIRE CA (AnY one il�.�j B I M ED.EKKNBH(Any ene pumon) S AUTOMOBILE LIABILITY ANYAUTO 1 SINGLE LIMIT ALL OWNED AUTOS I i3Oil!,Y INJURY BGHEDL4Ep AU103 �,� l (per Person) 8 HIRE]b.UTCR NOWOWNED AU-05 �-✓ 1.a BODILY INJURY c , o (perAccdont) PRCPERTV DAMAGE L I j OITNAflE LIABILITY •+�-- I - � AUTO ONLY-EA ACCIDENT S ANY AUTO + II OTHER THAN AUTO ONLY ( EACH ACCIDENT g ��_ AOgREG1ATE i EXCE"LIARILITY ¢ i �cH GOCURHENCE g UMBRELLA FO M A,G©RE©ATE 9 �� ! OTHER THAN UN IBRELLA FORM f A WORKER'N COMMOSATION AND 01Y)PLOVER'SLIA9ILIty (US-1051G04-5-06) 12-24-06 12-24-07 VATUTOR-LIMITS THE PRCPPITTOPr/ EACH ACCIDENT g PAMNERaIDECUTSvs uS INCL f B -> i OFFICERS ARE: DICE I DISEASE-POLICY LIMIT i FYI DISEASE•-EACH EM.FULyi-E 3 1 r. ! OEIsaRlFri®N tlF OPEfIAT10xs1LOL;A710Na(VEHIOLESIR 6 t aNs�sPECIALirerag . , i� 6»14' ��� ERTIFICgTE WULaER AFFECTING WORKERS COMP CO'JER.4CE- 7NS5 REPLAcE� ANY PR10R CERTIFSC4T� ISSUED rp TWE c �' SHOULD ANY CF THE A89VE D>:EICgISED PpLJCIEB B4T C � ANBEf3®BEFOFIE TH2; P]fPIAA1YnN DATE T IeNE4F, Twe ISSUING caItIPANYwfta ENlfEAVOR TD M1AIL TOWN OF ATTI'J: 6UILDZNv De 6aRNSTAPARTMENT 13 E DAYS NBlittEN NOTICE TO THE CERIMICATE HOLMR NAMeD ra THE ! 10 200 MAIN STREET LEFT, BUT FAILURE to (MAIL SUCH NOTICE IWALL IMPOMR No OVILIGATU ap HYANNI S MA 02601 LIABNJTV OF ANY KINp UPON THE COMPANY,IT9 ANNTS dR REPf1rEENTAnVES, i� AUTHORIZED REPRESENTATIVE 05/0212007 09: 36 5084204474 EDWARD A GRAZUL PAGE 02 , CORD CERTIFICATE OF LI PRQ>3UCkA ABILITY INSURANCE - DATEtInNVD&yyYY Edward A. Grazul Irnsurance Agenr ;17C, THIS CEFiTIFiC� ISS A WCffFI� +—� p ; .�; Box 337 ONLY AND CON PER MO RlGHT'S UPON -tOF CEflTi Ar" ICAT Mars to Mi11s, MA Q2648 �CTER A. THIS AG A�IRQE� I TN fC1 STB Lo 1m INSURED INSU"'E' AIFF(�R1�IPiG CC1�ERAGE I �T 1a roux estce Lttua NA1G RLT Canstru�:Grorl, Inc. INBUq>:gA; —.:-- •--�—.------.. 31 Lanni Cirtle wsL IJR6R6_ ^--� 'Centerville, NA 02632 INSUREAC; I wSugERa: -- COVEAAGEs - PHE POLICIES OF INSURANCE UST;C EEI.dVd NAVE BEEN ISSUED Tp THE INSURE®NAMED ABQyE FpA,7HE POLICY'PERIQD IND1oATEo:NtaTUVITH$TA�IQINC ANY REQUIINTHEREMENT,TERM DA-CONDITIOiN OF ANY CONTRACT GR pi°kl`R DGCUMI NT'WITH RESPECT Y "O' I�ERTAG REG tNSURRiVCEgPF RDED 9Y THE PQLICII $DES lag HEFt>=IN IS 3 p�►RICN THIS Cf;RTtFlGA1E MAY RE ISSUED pF 'Gt!GIES,A�3GREGkT=LIMIT$SHOWN MAY HAVE®EEN RE®UCED 8Y PAID CLAIMS, _ UIECT 1Q ALLYhE TERMS,'EXCLUSIONS AND CONCiTION$OF SUCh TYPE ne u4,s.. POLICY NUM$EA Y FCTiV@ POLICY EitPIAATION f CENERAI LJABIL TY —'— UM a l 1 C@mIrIIEFiCIALaENIjFj 1ABiLlTY + EACHOCCURREN0r �... CLAlM$WADEJ OCCUR+ ��— _—_....__—.._—_.. ' MEDEkF Any Awlepwgpn) $ ��� CFP 0053448s� PRR80NALdAOVINJURY 5 1�0 11/�r1, GcN'L A&31AEGAT@ LIMIT APPLIE6pEft' I 1 2—2 4 0 6 1 2-2 4-Q :aEfeERAL AtadREt3AT� vv PROD Aft � Itd�ED SINIXLE LIMIT A ALL O'dVNE IE D AU r0a III 11_ 711y ECHEDULEDAUT05 ; SODILYINJURY 1$ r H1WED AUT48 i NON•4WNEDAUTOS acQebYYINJURY $ _ �.... i ct FROP�FAACCE-'— ANYAUTC; `GARAGF LIASILITY ^�-�""i'"^�—�--�- IPQi ) AU OTHER THAN EA ACC`t AUTdONI Y: --- I EXCESSIUNMBROLLR LIA02UTY' AGO!$ �" -'- �_ ;occur, I—;CLALNIS MADE j EACHOCCURRENCE s AGGAEUAtC RETENTION W QAK1AS CpMPFwsATiON ANO I $ EMPLOYERS'UARIUTY W Y I ANY PROPRi<FOA/PARTN£q(YZCUTiYE OFFIOEgiMcMBEAEXC4UDEDp I 6.L.EACMACCIDEN�' deacibip under F I SPECIAL P OVISiONSbelow E.LDISEASE•EAFN OT4IER E.I.pISEA2E-POLICYLIMIT 0EBCAldT10N OF OPERATIONS ILOCATION&)VEli+C6&S/EXCLUGiQMa ALhpO gY-7p®pgEp,gN'�C�6 PROVISIONS CERTIMCATE MOLDIER CANCELLATION 4-- TOWN OF $A RZVS T, B L SHOULD ANY Cp r'iq ABOVE DESCAISED POMII1169K CAyr�E4�8ERORE THE EMPtpA t10N 200 MAIN STREET $UILT}I N� DEP'I'. DATE THgREGF,THE ISSUING INSURER wal.CMEAVOR T4 MAIL__,oAVS WRITTEN HY.ANN I S, MA 02601 NOTICE TO THE C>:MCATE HOL09R NAMED TO THE LRFT,$UT FAILURE TO DO SO SHALL PAX# 548-790-6230 ATTN' SALLY ItAPOSO No RE RE9fiN ATIVOAL gATIONORLIABITYOF ANY KING UPON THgINSOAEA, ITS AGENTIOR ACpRd�25(2W 1/148} ==:&ptC0L0RP0RAT!0N 1988 I Map �O ' Parcel �:� Permit# �� House# a- Datsued 1 2'✓(� J pr/ Board of Health(3rd floor)(8:15 -9:30/1:00-` j —2n� F�al6 , C��_ . Conservation Office(4th floor)(8:30-9:30/1:00 2:00) --10k; - NV/ �>O �®AP. TyrZ rd 19 TOWN OFEBARNSTABLE F° F uildi Permit Application � ' p Project Street Address Village Owner Address Telephone Permit Requesst�^, �[ b e � E i `First Floor square feet Second Floor square feet -Construction Type Estimated Project Cost $ � Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure rj O Historic House ❑Yes Clo On Old King's Highway ❑Yes fNo Basement Type: ❑Full Crawl ❑Walkout ❑Other r 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 N0 Fireplaces: Existing i!9 New Existing wood/coal stove ❑Yes [S&o 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 "<a"& _ Builder Information [Address ame ���/a �/1JC-�� Telephone Number 0 8 7 & ,6 A q/ /+ C License# Q®,-� yy �lll fir' , ,�, � Home Improvement Contractor# JI ,3 5�`3 �.p Worker's Compensation# EW CONSTRUCTION OR ADDITIONS REQUIRE A-SITE PLAN(AS BUILT)SHOWING EXISTING,-AS WELLAS ROPOSED STRUCTURES ON THE LOT. {" r ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMITLWNIED FO E FO OWI G REASON(S) �_ FOR OFFICIAL USE ONLY _ PERMIT NO. - I BATE ISSUED "I A - E MAP%PARCEL NO. ADDRESS {` f VILLAGE, «- OWNER DATE OF-INSPECTION., FOUNDATION 1 ! ` FRAME � - � ,, , '_• '. � r t � � , INSULATION FIREPLACE ; ELECTRICAL:k ROUGH FINAL ' , 1 , PLUMBING: ROUGH FINAL GAS: ,ROUGH FINALE FINAL BUILDd•N . f DATE CLOSED OUT t ASSOCIATION PLAN NO. _ _ t �-� 1C►�r� S'[�-fly/�G � . iI A 11/1I1 flAAn M 11 WALL f � r� ! - OG { C � } ► C Ck%-A 6 iro S� IL ' rs �- � I . .. t . . • •a w .« The Town of Barnstable (� S/7l/NGLF_ S OV,61e `EG i �PFFR Roor PLY • Cl-G J 01-5 S c �x1srr,v6 CI-G 1 .rocs-r I i ok tA) /AUDvu �PEFL �"oJST' /-f/9NCTF�S NEApr-Rs (-ryp ) ,�XI STIN ( lj)/)LL -ro BE RE1noVED— i FLO O 2 F.. T. AS 14P •T `p FRAMING SECTION a2F f - - - - - ALL DIMENSION LUMBER SHALL ' oe- BE KO SPF N0.2 OR BETTER. x COLLAR TIE @ 4b" O.G. 2 x RAFTER ! � i 2 X CEILING FOIST @ IINGLE O.C. W/Is L8. FEL i Ix PINE FACIA R-30 KRAFT FACED FG BATrs R- UNFACED FG BATTS -J SOFFIT VENT W/(6-MIL POLY VAPOR BARRIER (i sT E 2ND FLOOR) PINE SOFFIT II i i• .. i 2x FLOOR JOIST 0 ~nr r-- SKETCH ADDENDUM Borrower/Client Thomas Connors Pro ert Address 129 Park Avenue City Barnstable county Barnstable state Ma Zip Code 02632 Lender Cape Cod Bank & Trust 13 x 10 = 130 I Ii7 i 2 x 4 8 i 33 x 13 429 �_ I Total Gross Living Area - 1318SF j 29 x 10 {= 290 k { 33 x 13 '= 429 i 4.x..8 62 ff t . 13 13 j 10 ' . �... _ bedfoom bath bath bedroom - - i 4 a 6 i I _ 6 6 10 cl cl i 9 i N ' cl cl i cl _ V utilities ` I 13 j WAD 1 .c attach d familyroom - livngrootn "` t 23 i £ kitcti n i 10 i 4 € i14 ! t 14 foyer, i j , . ! t .. ,y.,�• ,.. i ._ «.�..., ..a....,..,. r�,....r..„..1•. r-....., _.}._1....x. 1 .«. _,. ,. e_ ._ i.._. ..._ ... { � _t_ t s,�.! { i } j Sk..etch :is A roxim to PP a' 1 T 1 � I r v ' , � 0 j i t 4 , i I � j I t Ill t i I, : }} 1 y , I ; I n1QRO FnrmqqndRO �'?!AlMht"FqmRAryAd 1(R00I 241-454R HP 5/HA Item x ,iPono F;R-R