Loading...
HomeMy WebLinkAbout0105 TARAMAC ROAD �D� `qr�m� ���, j. /' `�1 \r yc Town of Barnstable x � 4Building •; � is Car So That it is Visible From the Street-Approved;Plans,Must be'Retained on Job andthis Card Must be Kept Posted Until Final,'Inspection Has"Been Made ` x 16�g p1 a ^t e ' s' '` .. . a Where a Certificate of Occupancy�s Required,such Building shall Not:be Occupied until a Final Inspection has been made Permit w, .. � a ..M... �' , 11 �..�ire . _. . . . _. Permit NO. B-18-3675 Applicant Name: todd leduc Approvals Date Issued: 11/05/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 05/05/2019 Foundation: Location: 105TARAMAC ROAD,CENTERVILLE Map/Lot: 169-050 Zoning District: RC Sheathing; Owner on Record: Silva, Holly Contractor Name: TODD LEDUC Framing: 1 Address: 105 TARAMAC ROAD Contractor License.- CSSL-106019 2 CENTERVILLE, MA 02632 Est. Project Cost: $2,423.00 Chimney: Description: Insulation;See work Permit Fee: $85.00 Insulation: , Project Review Req: fee Paid:" $85.00 Date: 11/5/2018 Final: / Plumbing/Gas Rough Plumbing: _ - g g Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or`road and shall be maintained open for'ublic inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all_applicable signatures by the,Building`and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work:, 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low.Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT r i"'i� S rim T Town of Barnstable uilCiin •. 9 i and 5o That it isNV�sible=;From the.Str. et A rovedf..Plans•Muss.be.Retained on lob and ahis,Card�Must'be Kep Post Th s C �r pP, @A1tKSCACiL& ' ., : », `.t'✓ :, '�,; �j�. t• p '' , fE i' �'.- / a Postec!Until`Final Inspect on Has Been Made _ sgsw R ,� ,; _ . ' �„ IIgNot be 0ezu red untrl a°;Final Ibis ect�on,has been:made Permit Where a Ce ificat�of Occupancys Required,such 8uilcJng sha _P xs.. p. . , �. -: . ,� Permit No. B-18-2478 Applicant Name: SOUTHERN NEW ENGLAND WINDOWS LLC. Approvals Date Issued: 08/01/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 02/01/2019 Foundation: Location: 105 TARAMAC ROAD,CENTERVILLE Map/Lost 169-050 Zoning District: RC Sheathing: Owner on Record: NORMAN,SARA AContractorName • ""BRIAN D DENNISON Framing: 1 s �r �Gontractgr License: CS 095707 2 Address: 105 TARAMAC ROAD CENTERVILLE, MA 02632 Est Protect Cost: $8,068.00 Chimney: Description: window replacement(3) Permlt Fee: $41.15 F Insulation: , ProJject Review Re Fee Pald $ 1.15 q• q final: 4 Date 8 1/2018 Plumbing/Gas �. Rough Plumbing: r . . .: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work au horize' b this permit is commenced within six months after issuance. p Y p :. Rough Gas: All work authorized by this permit shall conform to the approved application and th6approved construction documents.#vr Which this permit has been granted. All construction,alterations and changes of use of any building and stru&Dres,shall be in compliance with the local zoning by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street orlroad and shall be maintained open for public inspect16n for the entire duration of the work until the completion of the same. ,� 00 Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Built �d Fine Officialssare provided own this permit. Service: Minimum of Five Call Inspections Required for All Construction Work \ 1.Foundation or Footing Rough: 2.Sheathing Inspection w 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final' Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT lima Application number.......... y ~ e 01 2018 , Date(ssued...................1 ..... .�. ........................... $AR.w15TA$I,E, o. _ 2639. � . [ABLE TOWN ���-b.�KI�� Building Inspectors Initials.....:....: MaOarcel....:. 6 .... ....1�... TOWN OF BARNSTABLE R EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/ST4VES/WEATHERIZATION PROPERTY HWORMATTON Address of Project: /O S V1,'I,P _ NUMBER STREET VILLAGE Owner's Name: C,'✓G Phone Number 7 7 5,z Email Address: 51us4;n�0ysCBr&Co-vn-d cd Cell Phone Number Project cost$ $,o��k — Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with.780 CMR Owner Signature: Sep A-{,z ck"a 06,4(a-4 Date: TYPE OF WOE ❑ Siding Windows (no header change)# _3.❑ Insulation/Weatherization ❑ Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than l layer•of shingles) r Construction Debris will be going to Grl s-�e-/�'1 A�I4 PAP - �� o/s.► !� i CONTRACTOWS INFORMATION, Contractor's name Wei J'nJOWS Home Improvement Contractors Registration(if applicable)# 17 37 (attach copy)y) Construction Supervisor's License# y9 S`7 07 (attach copy) Email of Contractor Phone number L101- Z 2 R ROCS ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY 1511v A HISTORIC 1)1STRIC'T, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE.ISSUE®.- APPLICATION NUMBER *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes, No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a:for profit non-profit event ' Check one:Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s)of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3:30 pm-4:30pm.Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES x Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:front back left side right side HOMEOWNEWS LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. 'I understand.. the construction inspection procedures;specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date N PFLICANT'S SIGNATURE° Signature ..Date All permit applications are subject to a building official's approval prior to issuance ReneWwal Agreement Document and. Payment Terms byAndersen. dba:Renewal By Andersen of Southern New England. Holly Silva ALACEMENT Legal Name:Southern New England Windows,LLC.. 105 Taramac Road Rl#36079,MA#173245,CT#0634555, Lead Firm#1237 Centerville,MA 02632 wieoo 10 Reservoir Rd I Smithfield,.Rl 02917 : H:7745213880 Phone:866-563-2235 1 Fax:401-633-6602 I sales@renewalsne.com ' Buyer(s)Name: Holly Silva . Contract Date: 07/19/18 Buyer(s)Street Address: 105.Taramac Road,.Centerville, MA 62632 Primary Telephone Number: 7745213880 Secondary Telephone Number: Primary Email: blushingoyster@comcast.net Secondary Email; Buyer(s)hereby jointly and severally agrees to.purchase the products and/or.services of Southern New England Windows,LLC d/b/a . Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in,this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any.other document attached to this_Agreement Document,the terms.of which are all agreed to the patties and incorporated herein by reference(collectively,this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor.has as completed.all work under this Agreement. Total Job Amount: $8,068. By signing this Agreement;you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $0 Balance Due: $8,068' : Estimated Start: Estimated Completion: 8-10 weeks 8-10 weeks Amount Financed: $81068 Method of Payment: Financing We schedule'installations based on the date of the signed contract and secondarily on the date in which:we complete the technical measurements.The installation date that weaare providing at this time is only an estimate..We:will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. Notes: Plan 2541 Buyer(s)agrees and understands that this Agreement constitutes:the entire understandings between the parties and that.there are no verbal . understandings changing or modifying any.of the terms of thiss Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s);and Contractor.Buyers)hereby acknowledges.that Buyer(s) 1)has read this Agreement,understands the terms ofthis Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER Do not sign this contract if blank.You are entitled to a copy of the.contract at the time you sign YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 07/23/2018 OR THE THIRD BUSINESS.DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT., Legal Name:Southern.New England Windows,LLC. dba:Renewal By Andersen of Southern New England Buyers) Signature of Sales Person: Signature Signature Eric Woods Holly Silva Print'Name of Sales Person Print Name Print Name UPDATED: 07/19/18 Page 21 10 l f Offiee of Consumer Affairs And Business Red:]adore 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 173245 Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS LL Expiration: 9/19/2018 BRIAN DENNISON 26 ALBION RD L+NCOLN, RI 02665 Update Address and return card.Mark reason for change. Address Renewal _. Employment Lost Card _-- -Office of Consumer Affairs&Business biegn➢ation Registration valid for individual use only before the :- HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: _- Office of Consumer Affairs and]Business Regulation Registration: 173245 Type: fQ Park Plaza-Suite 5170 Expiration: 9/19j2018 Supplement Card Boston.MBA 01-116 )UTHERN NEW ENGLAND WINDOWS LLC. iNEWAL BY ANDERSON s��1 IIAN DENNISON ALBION RD - JCOLN, RI 02865 QX dersecreiary Not valid without signature carns CS-09,15 a' 7 B€I"AIN D DENNISON LAMS POND CIRCLE CHART T ON VIA 0160-47 The Commonwealth of Massach usetts Department of Industrial Accidents 1 Congress Street,,Suite 100 Boston,MA 02114-2017 www.mass.govldia Workers'Compensatibn Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. APPfient Information Please Print Legibly NTaMe (Business/Organizaiion/lndividual): ` e ii ow- Address (a � A City/State/Zip: p Phone-P: �,b{ _ 2�g— p Are you an employer?Check the appropriate bm I Type of project(required): ,XI am a employer with ZO femployees(foil and/or part-time).; 7..Q New construction 2.F1 I am a sole proprietor or partnership and have no employees working for me in any capacity.[-No workers'comp.-insurance required.] &. Remodeling 3.Q I am a homeowner doing all work myself No workers'comp.insurance required-1` 9• ❑Demolition 4.a I am a homeowner and will be hiring contractors to conduct all work on my proper ty ro . 1 will 10❑Building addition , � ensure that all contractors either have workers'compensatior insurance or are sole 11.[]Electrical repairs or additions proprietors with no employees. 1 5.❑7 am a generalcontractor and I have hired the sub-contractors listed an the attached sheet 2.[]Plumbing repairs or additions These sub-contractors hive employees and bave worker.'comp.insurance t 13_F�Roof repairs o 6. We are a corporation and its officers have exercised their right u,exemptior,per MGL c. ' �' Utter (,✓r^r J 152.F1(S),and we have no employees.[No workers'comp.insurance required-] cr°iy. ;Any applicant that checks box*1 must also fill out the section below showing thec workers'compensation policy information Homeowners who submit this affidavit indicating they are doing all work and then hire outside contactors must submit t 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job size information _ Insurance Company Name: brepiens 1ps. C#j M. Policy tr or Self-ins.Lic.;6:_WU31��7 2 7 — 2. Expiration Date: / 1 _ Job Site Address_ tO 5- Tra.� a c �ZQ. City/State./Zip:Ce.. Attacb a copy of the workers'compensation policy declaration page(showing the policy number and ea iration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation pdaishable by a fine up to$1,500.00 and/or one-vear imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator_A copy of this statement may be forwarded to the Office of Investigations ofthe DIA for insurance coverage verification. 1 do hereby certify under th sins andpenalties ofpe6ury that the information provided above is true and correct Si ature: — ( — D2'te: Phone P: qD$- U.e Official use only. Do not write in this area,to be completed by city or town offidat City or Town: Permit/Liceme Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector. 5..Plumbing Inspector. b.Other Contact Person: Phone#t: CERTIFICATE OF DATE(MM)DDIYYYY) LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A M E H2/29/2017 ATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATOLDER. 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). 'RODUCER CONTACT CoBiz Insurance, Inc.-CO NAME- PHONE 1401 Lawrence St,Ste. 1200303-988-OW X No 303-988-0804 Denver CO 80202 An AIL AM : COMail cob¢insuranc,.com INSURERISI AFFORDING COVERAGE NAIL g NSURED ESLERCO-01 INSURER A:Acadia insurance Company 31325 Southern New England Windows, LLC. INSURER 6,Firemens Insurance Com an of WA,D.C. 21784 dba Renewal by Andersen of Southern New England INSURER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D Smithfield RI 02917 INSURER E: INSURER F :OVERAGES CERTIFICATE NUMBER:1252851165 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. ISR ADDL SUBR TR TYPE OF INSURANCE POLICY NUMBER NINWUD EFf POLIE EXPIMMIDDI YYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CPA3158728 1112018 1/'12018 CWMS-MADE =OCCUR EACH OCCURRENCE S 1,ODO,OOD DAMAGE 10 RENTED PREMISES Me occurrence S 300,0W ` MED EXP(Any one person) S 1C.DD0 PERSONAL&ADV INJURY 2%000,00D GEN L AGGREGATE UMR APPLIES PER I I GENERAL AGGREGATE 5 2.ODO.ODD X POLICY D PECO,T LOC I - i PRODUCTS-COMP/OP AGG $2.ODO.00D OTHER s A AUTOMOBILE LIABILITY N CPA3156726 I 1M2018 111201C COMBINED SINGLE LIMB Ea accident 5^ODD OW X ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) 5 X HIRED AUTOS X pN(OJ7OSED i PROPERTY DAMAGE Per accident S 1 iS A X UMBRELLA LIA6 X I OCCUR i CPA315872E 111201E 1/12011: I EACH OCCURRENCE S 10,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE S 10.WD.D00 DED I X RETENTIONS S E WORtKERS COMPENSATION WCA3158725-2D i 1112018 1/1201£ X PER OTH• AND EMPLOYERS LABILITY STATUTE ER ANY PROPRIETORMARTNERI )MCUTIVE Y/N OFFICER/MEWER EXCLUDED? N 1 A EL EACH ACCIDENT 51.000,000 (Mandatory in NH) If yes dewribe under ( E-L DISEASE-EA EMPLO g 1,000,000 DESCRIPTION OF OPERATIONS beim, I DISEASE-POLICY LIMIT 51.000.00r, C Pollution Liabift 79300733400DO 1/12018 1112MS I Each Occurrence Cl 51.00D:000 aims-Made Policy Retroactive Dale 052012012 Aggregate S1.DD0.DM Deductible $10,000 A IESCPJP71ON OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional.Remorks Schedule,may be attached if more space Is required) :ERTIF.ICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED,BEFORE THE .EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. kCORD 25,(2014/01) The ACORD name and logo are registered marks of ACORD *Permit# 'I r I,� Town of Barnstable � 00 Exp�T r Building Department Services ires6moFee romissuedate BARxsT,tsi.E. : Brian Florence,CBO v� KAS& ��' Building Commissioner16 9. S1, . QED MA't►1 200 Main Street,Hyannis,MA 02601 www.town.barmtable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERAUT APPLICATION •- RESIDENTIAL ONLY O��� Not Valid without Red X-Press Imprint Map/parcel Number Property Address �Q > �h7?11 esidential Value of Work$ a16 v Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address s.,11/1 V/`— /ffl �''�:J7ZnvA1-t,0_� Contractor's Name 'Det,U Telephone Number S7oy -?(n Home Improvement Contractor License#(if applicable) Email: 1�. y E L LL (P, yltl�Wla�I �� Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: &I am a sole proprietor ❑ I am the Homeowner x ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request tcheck box) 1 e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to V2f: 1Y101f.-t f ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *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 req 'red. 4 SIGNATURE: , QAWPFILESTORNIMbuilding permit forms\E)PRESS.doc 08/16/17 .7he Commonwealth q,f Massadiusetts Dep art ment Q,f Indastriat Acdde?ds - Qffw.--of rmestrgati,9xrs _. 600 Washington Street -- Bastorl! A 02111 fvYsn-v dl as&gvv1dia Workers' Campensal on Insurance Affidavit Builders/CnntractursMectricians/P'iumbers Applicant Infun atiQn ( Please Print Le 'bt lane(3nssgt�aui236onllndivizi 3e): i 1 Address Cify/Stat&Zip: '• U L Ile ti 1 V li�— !' —? Are you an employer?Checkthe appropriate ba=: Type of project(required)- 1-❑ I am a employrz with 4 ❑I am a general contractor and I 6- ❑New construction employees(full andlor part timed* have ltiimd.the sub-comtrattms 2. I am a sole etof or partner- listed on the attached sheet. 7. ❑Remodeling ,,,-..- ��. / These sib-contmc#ors have $., Demolition ship and have na.�playees;f' ❑ � ' e to es andha;e workers' wQ[l7ng for me in may;capacity 9. ❑Building addition. [No❑,orlaecs' Caing „re comp-inenrarr 1�:❑Electrical m additions required] 5. 0 We are a corporation and its g 3-❑ I ama homeommer doing all work officers have exercised diek 1L❑Plumbing repairs ar additions. myself,[No wo&ers'comp rightof exemption per MGL 12-❑Roofrepairs insurance require&]'a c.152,§1(41 and we have no employees.[No workers' 13.❑Outer camp-insurance required-] 'Any spplics tffist IockslwxFlnmstalsofillo-athesecdon below shomngdieirwoAffecompoimdoupolieynx5mrsdam- � I Mmeov ms who submit this ariidaut m&ratiag they ale&=Z all vat=4 then hire outside canliacinrs=st Submit a near affid'-qR huhcstm• p such fCon>zacMn*2t ehxY th€s bra mast attached!Fu additional sheet sb=ing tbenmeof the sub-conttctom sad statewhethet or not these eatitieshrm enTloyees.Ifthesub-cantactam hive employee%they mnstprmmietheir wQrkers'romp.policym=ber- I arrt au eiatpr tftcrt isgrmzdirig turra�eas'aotrrperasatiart iaasutaitce,for�x}*eniplo}�ees $eTaav is�tlt�z ptxtfcy ru�t�3 jab spa in,jormatiotz Insurance Company Nam: v policy,or Self-ins.I.ic- lxpisaton Date: Job site A&re&,- i o 5 CitylStatdzip: Tvzy 1 U E, 1114 AEtach a copy of the workers'compensationpolicy declaration page(showing the policy number and espa-ation date). Failure to sernre coverage as.required.under Section 25A of MGL c 157 can lead to the imposition of criminal penalties of a fine up to$1,500:d0 andrtor one-year ituprxsoun=j�as well as ci-71 penalties in the form of a STOP WORK ORDER and s one , of up to$r250-00 a day against the_�olatar. Be advised that a copy of this statement maybe farvmded to the Office of Irrestrgattons.ofthe DIA.for insurance coverage verification. Itta frer-Rby -erti and t ttr as r psrtaTtrs o .arjrtt}'thatf7Tte infatgranfiart protzrfd abm�a is true aaarf correct Si Santoro Date Phone ik � / _7 ( Q OjgE ai use anfy Da itat svrke in tfais strea,try be cmnpfeta bg city or toorn o;Q`ici at City or Town: PernaitUcense# c Issuing Authority(circle one): 1.Board of$ealth 2.?Budding Ilepart m-ent 3.Cityfrown Clerk 4.Electrical hmpector S.Plumbing inspector 6.Other Contact Person: Phone#- -- -- ---- --- 6 +h. EVE Town of Barnstable Building Department services � R�RNcrAti_�Ay i Brian Florence,CBO 6 ►`� Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town-barnstable.ma.ns Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I / L v A ,as Owner of the subject property b Jt v o C.Al2,,(�0 L C hereby authorize CRP t �-b KGh dot I,1/J6- -Q-D j.6-• to act on my behalf, in all matters relative to work authorized by this building permit application for. # `� AMA VLE, (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. gfgnaatge of Owner Signature of Applicant 14&L'--YS'j L fj4. Print Dame Print Name • -3ZWl � Date z QTORMS:OWNMERMISSIONPOOLS Rev:08/16/17 ?iGG,2E�' - Re uiation Office of Consumer Affairs and Business9 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Registration fs Type: . Individual S l Registration: 123111 .:: j." 1, �4—_ 1w,I— Expiration: 12/09/2018 DAVID A. CARROLL 12 Frederick B Dou glas Rd. ,� N.Falmouth, MA 02556s L, Update Address and return card. Mark reason yn G�.e,lO�rmn.•a r SCAI ._} 20M-05111 dCcc�uuJeLtJ .. /!G' lPa'�/�/7.0%GGGReCL.C�G 0 Registration valid for individual use only GL( office of Consumer Affairs&Business Regulation before the expiration date. If found:.return to: HOME IMPROVEMENT CONTRACTOR :uoi _ TYPE:Individual Office of Consumer Affairs and Business Regulation `~^ Expiration 10 Park Plaza-Suite 5170 Real_strati°n 123111 12/09/2018 Boston,MA 02116 DAVID A.CARF015 D/B/A Cape Cod Remodeling and Design n F DAVID CARROLL` ' 12 Frederick B Douglas Rd: Not valid without Signature ... nncGC Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSFA-060265 Construction Supervisor 1 & 2 Family :y DAVID A CARROLL 12 FEDERICK B DOUGLAS;RDP N FALMOUTH MA 02556 �rta�-- Expiration: Commissioner 03/08/2019 i j y s Parcel Detail Page 2 of 3 8/25/2015 12:00:00 AM Nancy Finch In Office Review 7/19/2013 12:00:00 AM Jeff Rudziak Sale Review 7/30/2012 12:00:00 AM Denise Radley Change of Address 7/3/2008 12:00:00 AM Paul Talbot Cyclical Inspection 1/26/2000 12:00:00 AM Donna Dacey Desk Aerial Review 12/8/1999 12:00:00 AM Donna Dacey Meas/Est Sales History Line Sale Date Owner Book/Page Sale Price 1 6/27/2012 NORMAN, SARA A 26451/213 $194,000 2 12/15/1994 SCHREYER, JEREMIAH Q & BETTY ANNE 9484/164 $90,000 3 11/15/1993 MACCHIONE, NANCY M & DEPASQUALE, 8885/135 $100 LORRAI 4 2/15/1988 MACCHIONE, NANCY M 6149/179 $1 5 1/20/1977 MACCHIONE, FLORIANO & NANCY M 2457/314 $0 6 3/23/2018 SILVA, HOLLY 31153/277 $238,500 - Assessment His Save Year Building XF Value OB Value Land Value Total Parcel # Value Value 1 2018 $85,600 $23,500 $2,700 $110,900 $222,700 2 2017 $79,400 $24,500 $2,700 $110,900 $217,500 3 2016 $79,400 $24,500 $2,700 $112,000 $218,600 4 2015 $66,900 $20,200 $3,300 $109,600 $200,000 5 2014 $66,900 $20,200 $3,400 $109,600 $200,100 6 2013 $76,900 $23,300 $3,500 $109,600 $213,300 7 2012 $76,900 $23,000 $2,800 $109,600 $212,300 8 2011 $101,800 $3,200 $0 $109,600 $214,600 9 2010 $101,700 $3,200 $0 $109,600 $214,500 10 2009 $101,000 $2,600 $0 $146,700 $250,300 11 2008 $117,300 $2,600 $0 $152,900 $272,800 13 2007 $116,700 $2,600 $0 $152,900 $272,200 14 2006 $102,700 $2,600 $0 $158,600 $263,900 15 2005 $97,600 $2,600 $0 $144,100 $244,300 16 2004 $79,200 $2,600 $0 $108,100 $189,900 17 2003 $71,700 $2,600 $0 $48,200 $122,500 18 2002 $71,700 $2,600 $0 $48,200 $122,500 19 2001 $71,700 $2,600 $0 $48,200 $122,500 20 2000 $50,200 $2,300 $0 $33,300 $85,800 21 1999 $50,200 $2,300 $0 $33,300 $85,800 22 1998 $50,200 $2,300 $0 $33,300 $85,800 23 1997 $50,800 $0 $0 $29,600 $80,400 24 1996 $50,800 $0 $0 $29,600 $80,400 25 1995 $50,800 $0 $0 $29,600 $80,400 26 1994 $51,300 $0 $0 $29,900 $81,200 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=11134 4/6/2018