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HomeMy WebLinkAbout0189 PATRIOT WAY . � _ _ . t G A.' .. .. r»v. a'. . .. u, . � .e o ,. ,. � _ _,. .. ,. „ .: - _ o P. y. a .. ... .: _,� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION `flap 193Parcel Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis , Project Street Address 1 <3 9 P L e a Village 0,1��� , rl Owner J Address 1,� Pao� (,j a �t Telephone 012,7 8 4 oZ 8 - -7 2 D- V Permi Request -6 A \ O C-et/(j l s � v1 vi ci k — 1 v �o►� ls . �,� Pa 1 V1 R k: c ✓t � � S �►'LP�I Square feet: Vfloor: existingfproposed 2nd floor: existing 1proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0 Construction Type 'lA►n r Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family O'/Two Family ❑ Multi-Family (# units) Age of Existing Structure q7 c6 Historic House: ❑Yes On Old King's Highway: ❑Yes a-N!5� 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 Number of Bedrooms: existing _new Total Room Count (not including baths : existing new First Floor Room Count Heat T n Fuel: ❑ it ❑ Electric Other ea Type and ue Gas O ect c O e _ r? 3 I Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove❑Y s ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: gJexisting Ubew size_ Attached garage: a,6xisting . ❑ new size _Shed: ❑ existing ❑ new size _ Other: - e CD �i Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ s .3 Commercial ❑Yes ❑ No If yes, site plan review # r Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name O�e Telephone Number yo Address s4 , '{dQ License # . 73 a a" Cl 016V,e teQgC Home Improvement Contractor# l p a Worker's Compensation #WCo1-31.5- 3 7osa3- oy( ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -i' � 4y'r1ht, Dgoad v J J3 (f' SIGNATURE DATE ( � FOR OFFICIAL USE ONLY r u APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER i DATE OF INSPECTION: FOUNDATION FRAME .a INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r, The Commonwealth of Massachusetts Department of Industrial Accidents bw, Office of Investigations' »F 600 Washington Street Boston, MA 02111 www.mass.govldia Worker's compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly . Name (Business/Organization/Individual): Ae --vve✓` Address: Cl r on Oo�C�_ City/State/Zip: Z QV-A.S ,Phone#: �dg l�' ` Are you an employer?Check the appropriate box: ' Type of project(required): I. I am a employer with 3 4•❑ I am a general contractor and I have 6. ❑ New construction . employees(full and/or part-time).* hired the sub-contractors listed on ❑ Remodeling the attached sheet.$ 2. ❑ I am a sole proprietor or partnership These sub-contractor's have 8• ❑ Demolition and have no employees working for employees and have workers' comp. 9. ❑ Building addition me in any capacity..[No workers' insurance.$ ` 10. ❑ Electrical repairs or additions comp insurance required.] 5.❑ We area corporation and its ` 11. EJ Plumbing repairs or additions officers have exercised their right of 3• ❑ I am a homeowner doing all work exemption per MGL c. 152§(4),and 42. ❑ Roof repairs ' myself. [No workers'comp. we have no employees. [No workers' 13. ther , insurance required.] t comp.insurance required.] W P C0_+ r I z 01/2 *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 attach an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees.If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. Insurance Company Name: S MG 1 e usl Mess' _L Ir1 S U raw C f_(N—W~Pkt' y v� G Policy#or Self-ins.Lic.#'.we a — S 3 7n sa 3 — 6 Cl I Expiration Date: ., L — a Job Site Address: O I P. r1 4 City/State/Zip: l .en4 -rUtl(p l Attach a copy of the workers'compensation policy declaration page(showing the policy number4and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 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 eby ce under the is= lties f perju that the information provided above is true and correct. Signature: Date: Phone#: 7 g !R 11 YD z Official use only:Do not write in this area,to be completed by city or'town official City or Town: Permit/License# ' Issuing Authority(circle'om): 1.Board of Health° 2.Building Department 3:City/Town Clerk 4.Electrical Inspector ° 5.Plumbing Inspector 6.Other Contact Person: Phone#: DATE(MM/DDIYYYY) ACC)o® CERTIFICATE OF LIABILITY INSURANCE 9/7/2011 THI�RTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIF16ATE 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 INSU"RER(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 SMALL BUSINESS INS AGCY INC - CONTACT NAME: 542 MAIN STREET PHONE 508 795-0635 A/C No: 508 798-5008 WORCESTER, MA 016150022 E-MAIL ADDRESS; INSURER(S)AFFORDING COVERAGE NAIC 9 INSURER A': Liberty Mutual Group INSURED - INSURER B RESOLUTION ENERGY INC INSURER C: 49 HERRING POND RD BUZZARDS BAY MA 02532 INSURER D: INSURER E: ' INSURER F; COVERAGES CERTIFICATE NUMBER: 11075950 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. ADDL SUBR POLICY EFF POLICY EXP LIMITS /Y INSR TYPE OF INSURANCE POLICY NUMBER MMIDDYYY /Y MM/DDYYY _ LTR EACH OCCURRENCE $ GENERAL LIABILITY DAMAGE TO TED PREMISES ERENa occurrence $ COMMERCIAL GENERAL LIABILITY �� MED EXP(Any one person) $ CLAIMS-MADE �OCCUR PERSONAL&ADV INJURY $ • GENERAL AGGREGAT E $ PRODUCTS-COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY Ea accident BODILY INJURY(Per person) $ ANY AUTO ALL OWNED SCHEDULED , - BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE NON-OWNED Per accident $ HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR 4 - EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE _ AGGREGATE $ DED RETENTION$ - WC STATU- OTH- A WORKERS COMPENSATION WC2-315-370523-041 9/2/2011 9/2/2012 TORY LIMITS .ER AND EMPLOYERS'LIABILITY YIN E.L.EACH ACCIDENT $ - 500000 ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? - N N I A - E.L.DISEASE-EA EMPLOYEE $ (Mandatory In NH) If yes,describe under + E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS below r DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more.space Is required) Workers Compensation Insurance:Part One of the policy applies only to the Workers Compensation Law of the State of MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE HOUSING ASSISTANCE CORP . THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IIJ 460 WEST MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS MA'02601"3698 AUTHORIZED REPRESENTATIVE r " Jeff Eldridge ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.: 11075950 CLIENT CODE: 1558558 Deb Derochemont 9/7/2011 7:15:23 AM Page 1 of 1 This certificate cancels and supersedes ALL previously issued certificates. - c - p z( ( L r _ 4610 V CSt i t<?l1" �STYc:C'I R 11"'' - TT I an aill IMLl wy is.;:<<c r.rnca )C'(fJCt.OF HOME OWNER WEATHERIZATION WORK PERMIT& FUEL. RELEASE: PLEASE FELL OUT-AND.SIGN TMS TORM IF YOU ARE THE APPLICANT HOME OWNER. IT Aam. : hereby consent to and agree that weatherization work may done by the Weatherization Program'of Housing Assistance Corporation (herein after referred as "Agency")on the property located at: '. The weatherization work done will be based on programmatic priorities and availability of funding and _ it may include all'or some of the following measures: . Weather-stripping&caulking of windows and doors,insulation of attics, sidewalls &basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows.In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to the "Agency" its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weathen,zation , work on said property. - 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more,than five (S) years after the weatherization work is completed. I have read`the provisions of this agreement as listed am freely give my consent. Home Owner: (Signature) n,0 o~r.A . Date: ► .___...___.Agent:-_(sig-nature)_ ._._... _.__......,---.._._.._ Date: I '2. HAC approved Weatherization.Company Caliber Bi ilding&Remodeling,' Cape Cod Insulation Cape Save Creswell Contraction Frontier Energy Solutions Lohr& Sons Peter Smith Resolution Energy'. Rock Solid Construction All Cape Insulation M ' .Q4IU4-G 101no p ' Massachusetts - Department 01' PUhllc SafctN i�oravnzo.zureczl o�' � czc�uaelld Board of Building Regulations and Standards Office of Consumer Affairs S Business Regulation Construction Supervisor License HOME IMPROVEMENT CONTRACTOR Registration:.4,')62158 Type: License: CS 53202 Expiration_-; 1/26/2013 Individual JEFFREY R.TO[ E JEFFREY LLO R TONELLO PO BOX 1516 JEFFREY TONELLO SAGAMORE BEACH, MA 02562 60 STATE RD. SAGAMORE BEACH,'MA 02562 Undersecretar e— y ��_ i� Expiration: 7/14/2013" ( nnniia.i nc1 Tr#: 21481 I _ Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. t' t Refer to: WWW.Mass.Gov/DPS i �4 �tHe Town of Barnstable Regulatory Services MAN. $, Thomas F.Geiler,Director i639 '0renra Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 March 1, 2012 Jeffrey Tonello 60 State Rd. Sagamore Beach, Ma.;02562 RE: 189 Patriot Way, Centerville, Ma. Map: 193 Parcel: 496 rt Dear Mr.Tonello: This letter is in response to an application number 201200143 submitted t6 do work at the above referenced address. This office has attempted to contact you at the number provided with no success. Unfortunately the application can not be approved at this time for the following reasons: 1) There is no documentation submitted that shows you are in any way associated X with Resolution Energy. ` 2) Resolution Energy does not have a home improvement registration as required by Massachusetts state law. Please be advised that failure to follow the requirements of 780 CMR can result in further action taken including, but not limited to, the suspension or revocation of your home improvement registration and/or construction supervisor license; Respectfully, We Lauzon Local Inspector (508) 862-4034 Q:zoning5 i 49 Herring Pond Road Buzzards Bay,MA o2S32 P.508-888-1740 P.508-833-3377 312411 Resolution - E N E R G Y March 25, 2013 Thomas Perry, CBO Town of Barnstable Building Division 200 Main Street r` Hyannis, MA 02601 Re: Insulation permits Dear Mr�Perry: 00 This affidavit i to certify that all work comple ed for insul ion wok at 189 Patriot"Way, Centerville has been inspected by,.ai cer if ied = Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal'and State requirement. � f Sincerely, Lisa M. Haglof; Executive Office Coordinator oF1HE rqt, Town •of Barnstable *Permit# P� p Expires 6 monthsfroin issue date ' Regulatory Services Fee w BARNSTABLE, v� MAC $i63q. Thomas F. Geiler, Director' �� 'OIEn��rs Building Division QS7/14 A�v Tom Perry,CBO, Building Commissioner 200 Main Street, Hyannis, MA 0260.1 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 Property Address el 7 residential Value of Work')_," , Minimum fee of$35.00 for work under$6000.00 Owner's Name& Address ��A U Contractor's Name, ��.�nS' �r+3' �T/Q G,.� Telephone Number_5101YY Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) �/� J:; rkman's Compensation Insurance Check one: 01�- R ®M S PERMIT ❑ I am a sole proprietor �IUL_ 0 Z0?0 ❑ I m the Homeowner ` have Worker's Compensation Insurance TOWN OF BARNS TABLE ABLE Insurance Company Name g4^1 `2041lc7 Workman's Comp. Policy Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) `2--Re-roof(stripping old shingles) All construction debris will be taken to f ^-� y �J �y►i�®� ❑ Re-roof(not stripping. Going over existing layers of roof) �`� ❑ Re-side #of doors ❑. Replacement Windows/doors/sliders. U-Value (maximurn .44)#of windows *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 re uired. . SIGNATURE: Q:\WPFILES\FORMS\building permit formS\EXPRESS.doC Revised 070110 r f . 508-328-1635 SPECIALIZING IN ALL FORMS OF ROOFING & SIDING doyleandthomasconstruction.com P.O. BOX 168 BBB. CENTERVILLE, MA 02632 Fully Licensed & Insured Construction Supervisor Lic# 99913 Doyle and Thomas Inc. Proposes to perform the following work: Location of proposed work: Ms.Jayne Pierce Patriot Way Centerville, MA 02632 Date on which construction should begin: Summer/Fall 2010 The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that cannot be avoided by the contractor shall not be considered as a violation of this contract. The contractor agrees that when such delays become known to the contractor,the contractor will advise the homeowner as soon as possible. The homeowner hereby acknowledges that in certain remodeling work,the demolition process may reveal defects in the existing structure which must be repaired, creating additional work which may need to be carried out in order to complete the work described in this contract. In such case the homeowner agrees that the duration of the work and the scheduledate of completion may differ,and that such variation is not to be considered a violation of this contract. The total cost for labor and materials under this contract: $10,250.00 30 yr.GAF/Elk Timberline Architectural shingle In the event that while stripping the roof 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 fora carpenter and$30.00 for a carpenters laborer, plus the cost of materials. Thank You For Giving Us The Opportunity To Help You Improve -Roof to be stripped and cleaned of all old shingles and debris -Roof to be papered with weather watch leak barrier and#30 felt paper, and installed with Timberline architectural shingles using galvanized nails. (Storm nailed) -All new 8 inch drip edge and pipe flanges to be installed -Cobra ridge vent to be installed on all ridges -Timberetex premium ridge cap to be installed -10 yard container 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 ten . 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; y 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: HomeownprContracto ACORDTM CERTIFICATE OF LIABILITY INSURANCE °ATE 07/08/2010 ' PRODUCER (508)428-0440 - THIS CERTIFICATE IS ISSUED AS A MATTER OF4'INFORMATION Mark Sylvia Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTVFICATE . 771 Main Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Osterville MA 02655 INSURERS AFFORDING COVERAGE NAIC# INSURED Doyle& Thomas Construction,Inc. INSURER A: Farm Family Casualty Insurance PO BOX 168 INSURER B: Centerville,MA 02632-0168 INSURER C: INSURER D: 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 IM CLA S. ILTR USE TYPE OF INSURANCE NSR DDIE1 POLICY NUMBER DATEYMM/DD EFFECTIVE PDAT Y MM/DD/YY N LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A 2001X0485 7/21/2009 7/21/2010 DAMAGE TO 50,000 X COMMERCIAL GENERAL LIABILITY PREMISESS(Ea occurence) $ CLAIMS MADE a OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ GENERALAGGREGATE $ 2,000,000 NXGEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY PRO- LOC AUTOMOBILE LIABILITY , COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS • BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- X OTH- 2001W6390 7/1/2010 7/1/2011 Tau I ER A EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under SPECIAL PROVISIONS below YeS E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS, Carpentry Troy A Thomas, President; Shawn Doyle, V President are not covered by the workers compensation policy. CERTIFICATE HOLDER CANCELLATION (508)790-6230 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable Building Department DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08) / `©ACORD CORPORATION 1988 I Th.e C'orntmorriveadth of 1#aI sadntseift - - DeprrrtnientofIndirsirial accidents Office of InvestlglJ.oqs 600 Washington Street wativ rriass.goi9, div "'[Yorkers' Compensation Insurance Affidavit.; Builders/C'ntr tcto -slElectiicians/Plumbers Applicant Information Please Print Legibly Name,(Businem'OrganuationlInclividual) Address: Ctty/statejzM: ea;2 :g. rare ytam n employer^Check the appropriate boa: Type of groaect(required): I_ I a employer with _ `t. ❑ I am a general contractor and I employees(fu:11 and/or part.-time).,* have-hired.the sub-contractors 6_ ❑Il�eu cons rctiou 2.❑ I am a sole proprietor or partner- ' - listed on the attached sheet 7; ❑"Remodeling ship and have no employees These sins-contractors have g_ .❑'Demolition working far nee in a capacity- employees and have workers' any I , 9. ❑Building.addition ` [No workers' comp.ins�uance comp_insurance. required] ' 5. ❑ We are a corporation:and its 10:❑Electrical repairs'or additions 3.❑ I am a homeowner doing all work officers have exercised their 11..❑Plumbing'repairs or additions self. No workers' right of exemption per MGL �' � P � L. oafrepairs - insurance required.]T c. 152, §1(4),and we have no employees,..[No workers 13.E]father comp_ insurance.required]. _ •Any applicant that checks box#1 ron:st also fillout the:section below showing their workers'cauapensation policy infonrnstioa- t Homeowners who wbrnit this affidavit indicating they are doing all work and then hire outside contractors must submit a.new affidavit indicating such_ lContractors that check this box must attached an additianA sheet show tai.the name of the sub-contractors and state whether or not those entities have employees. Ifthe sub-contractors have employees,they untst provide their workers'comp."polio•number. I am an employer_tlhal is proezding workers'compensrrt on insurance,f br uty einployees.� Belot,is the palPcl.'ajid job site information. Insurance Company Name: Zh+! IIZV. ija is,4Z / �, —77 Policy's or Self ins.Lic.#: Expiration Date: Job Site Address: City/St ate/Zip: :attach a copy of the workers'compensation po 'cy declaration page(showing the:policy Number and expir-ation date). Failure to secure coverage as required under Section 25A of MGL c. 1.52 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one-year imprisoment,as well as ciNil'penalti.es in the form of a STOP WORK ORDER and a fine of up to$250.D0 a day against the violator. Be advised that a copy of this statement'maybe forwarded to the Office of Investigations of the.DIA for insurance coverage verification: I do here4t certify under the prcins and penadties'ofpt%rjrt.ry Heat titre ireforruation pro ided aboiv is trite and correct' Si e: Date: i oJ� Phone 0: Official ease only. Do not write in this area,to.be rzompleted b1 city or,rott�rt'n�c of City or Town: Permit/License Issuing A.ffithority(circle one): 1.Board of Health ?.Building Department 3.City/Toiim Clerk 4..Electrical Inspector 5.Plumbing Inspector- 6.Other Contact Person: u Phone#: zWZ/£6/b :u01;endx3 Z£9ZO t/W 3ri1x8i N30 3A18( VYVHJN1110N 6617 �.:' '� S�dWOHl /ONI Ei666 -1SS0 :0sua317 asu831- AllmadS joS1AJa8nS ugl;nnj;suoO sparpur.;S Pup. Suol;rlrwaa ou!PI!nfl ;o piro8 {la3r.S -3119nd 3o;uawjjrdaa-sBasnyz)rssrW — —�� Bo r�Vo m mgMg�u"fatio` an tandards. —� License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards . F Registrations 145954 One Ashburton Place Rm 1301 Expiration 3/15/2011 Tr#-"26N68 Boston,Ma.02108 i�WPWNDBA DOYLE+THOMAS�CONST wf .� . TROY THOMAS� 499 NOTTINGHAM DR ,�r> ' — — ---- � y e without signature CENTERVILLE,MA 02Cr32 "' Administrator r , x - ' � 1 `WF TOWN OF BARNSTABLE Permit No. Building Inspector Cash _-------------------------- a OCCUPANCY PERMIT Bond - "No building nor structure shall be erected, and no land, building or structure shall be 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 in certificate of occupancy has been issued by the Building Inspector." Issued to lty TrTiry+- Address P--7 I". Centervil7 t Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department 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. .....................................................1 19......_... ............................................................................................................._... Building Inspector r t�. 3 f� Assessor's map and lot numb .......................... ...... • THE . Q Sewage Permit number ................................................. ................................ SEPTIC SYSTEMr MUST, B/E�• #��9 INSTALLED I COMPLIANCE i H9fiB9TsnLE. House number ............. ... ....................................................... IV r s \ WITH ARTICLE It STATE °o rb 9• e� SANITARY CODE AND TOWN am a TOWN OF BARNSITIA-BLE • t BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... uf folk-.Realty Trust .................................... TYPE OF CONSTRUCTION ..k dMi y... .................::.................................:.......... .....September.... .,..............T9.7$.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .Lot..#...26•Patriot.r..W... .............Centery lA►..I` ...........0253.2:......... ........................................... =a_ — Proposed Use .........Single„F4milt...R2clent .?....................................... :..... I Zoning District ..........Single„Fami District ..... ............... Name of Owner ,.Suffolk ,Re. a tY. ' 'Xt?St..............Address ... ...0....JRAX...3.Q$...G�TItP.z.V.ill>w,...MA...... Name of Builder .... uf.fPIX...Rell.ty...` r?4.5t...........Address .........saIpe...... ............................... Nameof Architect ...................................................................Address .................................................................................... Number of Rooms .............Qi.gbt Qi.gbt........................................Foundation .....pour.ell...cflriGretp.................................. i Exterior .........Ce�1 r...�. a,>��g�,�. ......................................Roofing ...........asphalt...shinglp-s............................... Floors carpeting over underlament Interior ......skim coat„plaster Heating forced hot...water...by...oi1.......................Plumbing ..............�Vc............................................................ Fireplace brick and block ...................•..__..Approximate Cost ........ 000.00.................._. ........................................................ ............. Definitive Plan Approved by Planning Board ________________________________19________. Area .........16.0.4.J.. o............... Diagram of Lot and Building with Dimensions Fee ...........n7-2.. ......J.............. Id SUBJECT TO APPROVAL OF BOARD OF HEALTH p G�- � �.31 { x is� :�Ouri 0 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. rr Name` 1. ..... ...... .. ..... :.... ..... .. 8uf^"l~ ^~-a^~x ^^ ~~` � ry No ......"� Parmh for .. .�--.. / ]_ �' ' single family dwe]��2zg; _ ----'--'=^^—~------^------^^— " ~p l8g �atrint Way Location -------------.-------- ' Centerville —~-----..—.----------------- . . Bealt� �ruot Owner ---.—..���������-----------.. � Type of Construction ----frame ............................... ' ---^-----..----------------.. 426A Plot ............................ Lot ----'------' Permit Granted ............G ^ l5`—lg 78 ~p�~----' Date of Inspection .......... . .lV uo/e Completed — --./9 ^ PERMIT REFUSED 9 A��* --- ' ' ��— ............ - � .......... ............................................ ---�':r�^~ ------'------------'' ' ..---_...---.....,..---.--.,,...~....—.,. Approved. lV -------------'--` . ' . . . ----.,---,�---~,—.--.--..----- � . `----.—���,---.------....—~..---.. . ^ ' Assessor's map and,lot number ... .....P.............. . ................. PyO*THE TOE♦ Sewa,ue Permit number . a?.... 6 S B9HHSTADLE. i Housenumber ............................ ./..Cl..l..................._...... 9� a �a O N O 1 39• �0 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION .FOR PERMIT TO .......................... .... ..................................................................................... TYPE OF CONSTRUCTION . ...................................... ...................................................................................... ............... .............................19........ TO THE INSPECTOR OF BUILDINGS: i The undersigned hereby applies for a permit according to the following information: Location ... ../. .. `..�Y IO�S / L !// ��� ../�'l. S ......(l.Q.!7..................... �l...... ........ ProposedUse ........ ..../.5.............................................................................................................. Zoning District ........................................................................Fire District ......[ Y�/... kK,,................ . z' Name of Owner !h `.��..�1�% �Z�...............Address ....5 ��- ......................................................... Nameof Builder . .s�lr.l.. ................................Address ......... . . �................................................. Nameof Architect ...1...........................................................Address ................................................................................. Number of Rooms , ...............................Foundation .... .�..�GC .......... ....... /.. ................................................ Exterior ......../r>r OO.d..........................................................Roofing ...f.,�---5--'c- - /.,�............................o.............. Floors moo. ........0..........................................Interior ...<:.... Heating ...........Plumbing....................................................................... .................................................................................. p ....Approximate Cost, 01% G U�' Gd Fireplace `—" . .................................................;..... Definitive Plan Approved by Planning Board ________________________________19________. Area ....../.��... :..... ..�Od Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 1" I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. PIERCE, JOHN 2.34.82_, Permit for JB14ild Tool Shedi No .... .... . ............................. . ..........Ac.c.es.s.ory...to...Dwelling D.Wel.li.n.g............. ..... .. .... .. ...... .. .. .. ....... .... .. Location 189 Patroit"4y.......... .............................. ..... ........... Centeryil.jg................. ....................................... .... .................. Owner ...Joh.n...P.....ie...r.ce................................... ....... .. .. .... Type of Construction J:KAMe........................... ................................................................................ Plot ............................ Lot ................................ September Permit.,Granted .... ..211..19......................... ..... ,Date of. Inspection ....................................19 Date Completed ........ zrm 19 PERMIT REFUSED ................................................... ..... 19 ............................................................................... ................................................................................ ............................................................................... ................................................................................ Approved ..... .......................................... 19 ............................................................................... ............................................................................... Assessor's office (_1st floor): a THE Assessor's map'and lot number ........r .`�.=......�....1.. .. a e p F C t0 Board of Health (3rd floor): Sewage Permit number - I� ... .... JaZ/ti3Cp INSTALLED IN (�®Iu,�LI ' WITH TITLE 5 9 e NAM Engineering Department (3rd floor): ; ?o ,639 .................................................................... - House number ..... �-MIRROM€�ENTAL rO�n :•Ai�oMAX APPLICATIONS PROCESSED 8:30-9:30 A.M. and' 1:00.2:00 *P.M.,only ` TOWN ;OF BARNSTAB.L.E -. BUILDING INSPECTOR APPLICATION FOR PERMIT TO .. ..... .... .... . TYPEOF CONSTRUCTION ...S5��.:.9�..1/.1.!f/,1�4-................................:...................................................... T , o�o� ........19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... 9......l.A.1 ¢./. ..... ! ............. K!7',Prv..LL ........................................................................... Proposed Use ......5.liW.Ntj(NG.....AGGC. ZoningDistrict .........................................................................Fire District .............................................................................. . Name of Owner R.' G Q in!' 4� ....Address .t. .[......A.A.-I! i�L 4'/...... �........... Name of Builder ..ltl.� c. v.r...... c�uL .........................: Address ...... .... !V.!f/.�!� ✓ Name of Architect ................Address Numberof Rooms ..................................................................Foundation ............................................................................... Exierior ....................................................................................Roofing .................................................................................... FloorsInterior ..................................................................................... Heating ..................:...............................................................Plumbing ................................................................................... Fireplace .........................................Approximate Cost ...... ....................................................... Definitive Plan Approved by Planning Board ________________________________19______ . Area .........`4J`. 0.4 �.............. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH . 6 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding a above construction. Name . .............. Construction Supervisor's License ...Q4.9 C;, .J�9........ ' y PIERCE, JOHN A=193-196 No ...293.8.8.•.:. Permit for ....Acces.aary...La...... A dwelln swimm ool t �..5...............in. ..P. �.. Location' 189...Ratr.i at..Wa i . •..•.... Centerville Owner -John..Eiex.ae....... ................................ :4 Type of Construction ...steel, &,•vinyl 1� _ " �'" l .......................................... Ail Plot-, ..:........................ Lot . Y .......... r r ' y �. y „ 19 86 4 tr'• ' 5 Permit GFanted ......... ...Ma .....................VW, , . e Date of Inspection ....................................19' Date Completed ��7..:-. Z-.. . r _ n f 1 j l; I No 7 ge'vc"w HACK /s c.B. p coR 7ES 7� 37�3-71Z�Z6 , /40.00. /95SUIV, 28- 7- O .. L o s AAJa 61 q9, se.7 GOT o FovjVD' i r EkisT 6 SS 7 JVATe7 E-1V TEWEO 1 / OLE L Q T GOT P E D H TE /1817,6 SOLE : T o L.//`/ 7-E P iS A,V A / L 43 L E /A/S P . P4U e M / A// /7CJ/"/ f3U/,. D //VG 5E7-BACK RE0Lj EMEAJTS ' F /e 0 T DR / VE I,✓AY ^/O T TO 13 E LOC TED PR O P0SE ZD 8 E D2001-75' 0 O VE e S F I✓E le AG E SYS 7"-E ' 7 UA/ SS DESIG/,/ FL o ti/ ./ D,9y l-l- zo DESIGN LOFID /1\,%G /S USE D . 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