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0136 TERN LANE
/ � T- ��.. Town of BarnstableBuilding P "TR Post This Gard�So That�t is..UisibleFrom the Street,, Approved�Plans Must beRetaned on,J,ob and this CarcJ Must'be Kept , wsss �., :. FiriaPlris eeton Has Been Made - ` ` 3 • Posted Until ';,, �� f ermit Where-a:Certificate.o#'Oocupanc"y is Required,such Building shall Not be Occupied until a Ftnal Inspection,;has b�een�made Permit NO. B-19-121 Applicant Name: Dean Fraser Approvals Date Issued: 02/06/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 08/06/2019 Foundation: Location: 136 TERN LANE,CENTERVILLE Map/Lot:_ 212-014 Zoning District: RD-1 Sheathing: Owner on Record: MCLEAN, NORMAN D&NANCY K � Contractor,Name DEAN C ERASER Framing: 1 Address: 136 TERN LANE ) Contractor License. CS 097668 2 CENTERVILLE, MA 02632 Est Project Cost: $50,000.00 Chimney: Description: Remove and replace sheet rock and insulatio `m krtchenlatea only, Permit Fee: $305.00 remove and replace kitchen cabinets and counters t'K. f ' Insulation: i Flee Paidt $305.00 Project Review Re : EXISTING KITCHEN REMODEL. NO STRUCTURAL CHANGES. Date z, 2/6/2019 Final: Plumbing/Gas Gas g/ Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work autho'zed by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application a d the'approved construction documents h d- s permit has been granted. ,Rough Gas: All construction,alterations and changes of use of any building and structures sh zonmg'by laws,and,codes. all be in compliance with the local This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. �3 Electrical 3_ The Certificate of Occupancy will not be issued until all applicable signatures�by the Building and Fire Off"", Tare provided onithi permit. Service: Minimum of Five Call Inspections Required for All Construction Work:;" w 35 1.Foundation or Footing y 2.Sheathing Inspection _ � '„ Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT op Final: ARL3 15�T a . � � o►1�31►s T �f Barnstable *Permit# l$ —3 79 din Department 6 months from tissue date g P G0 RAM Brian: �. Brian Florence,CB0 3 1639. �' o� �-L 111uildin ommissioner �6,� , 1 200 at �� yannis,MA 02601 V'+ � � .own.bamstabie.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 l��o rcr, Gh/ -tin port/[ ❑Residential Value of Work O 0 O Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address NAnI u f drrnAn /r/ �Gw/L Contractor's Name Fi-aisLr� Cohs�,- � , Telephone Number 5108 -19-S a Zq z Home Improvement Contractor License#(if applicable) //Z S 3 G Email: D irfC: , TIa kce-r'C •C9 Construction Supervisor's License#(if applicable) 017&6 ': E31 orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner [a'I have Worker's Compensation Insurance Insurance Company Name &A""S�- Workman's Comp.Policy# 4vt O 2.Ll /$//3 2— Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) 2"Re-side [�Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: I 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 required. SIGNATURE: C:\Users\decoll ikWppData\Local\Microsoft\Windows\lNetCache\Content.Outlook\9NNOKXYW\RESIDENTILONLYEXPRESS.doc 09/26/17 f The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-201.7 www massgov/dia ,Corkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plutnbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information r , Please Print Legibly Name(Business/Orgmia3tion/individual): �rq i� �d✓l4ir�re�,o/L Address:.3,—f� ea✓o�:a_� City/State/Zip: 0aLJg,&e= of'V OZ6�11 Phone#: -0k—VZ rr-Z Z 9 Z Are you an employer?Check the appropriate box: Type of project(required): 1. ✓�I am a employer with 10 employees(full and/or pan•timc).' 7. ®New construction 2.❑1 am a sole proprietor or parmcrship and have no employees working for me in $. ®Remodeling any capacity [No workers'comp.iruumnce required.) 3❑Lam a hornco%knet doing all work myself:[No workers'comp insurance required J t 9• ❑Demolition 4.01 am a homeowner and will be hiring contractors to conduct all work on mypropeny: I will 10❑Building addition cmurc that all contractors either have workers'compensation insurance or are sole i L[3 Electrical repairs or additions proprietors with no employers, 12.®Plumbing repairs or additions 5C]I am a general contractor and I have hired the subcontractors listed on the onached shect. these subcontractors have employees and have workers'comp insurance I 13.0Roof repairs 6. We are a corporation and its offices have exaeised their right of« 14.[]Other ❑ No gh a,tption per MGt.C. 152,fi 1(4),and we havc no employees JNo workers'comp insurartcc required) 'Any applicant that chocks box#1 must also fill out the section below showing their workers'compensation policy information. I IlomcOwnuas who submit this affidavit indicating they are doing all work and then Dire outside contractors must submit a new affidavit iodiating such. 1contractors that check this box must attached an amitioml shoe,showing the name of the sub-contractors and mate whether or not those entities have employees. lfthc sub-contractors;have employees,they must provide their workers'comp.policy number. I am on employer that is providing workers'compensation insurance for my employem Below is the policy and job site information. '']^ Insurance Company Name--Ag-_14etft "><sl� ro Policy 4 or Self-ins.Lic.q: Q� �//fj//3 Z Expiration Daic:,J�/Z,6// Job Site Address: ,/yl �h I City/Statrjzip: Attach a copy of the workers'compensation poll y declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,p25A 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 D1A for insurance coverage verification. I do hereby certify under the pains a aides ofperjury that the information provided above is true and correct Signature D e: 0C,- - z z 41 Z Official use only. Do not x rite in this area,to he completed by city or town official City or Town: PermillLiceitse q Issuing Authority(circle one): 1.!Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical inspector 5.Plumbing inspector 6.Other Contact Person: Pbocc H: FRASCON-01 ALEYES .4`ORv� CERTIFICATE OF LIABILITY INSURANCE °ATE 10/01/01/2018 ) 018 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 ISSUING1NSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,,the,policy(les)must have ADDITIONAL INSURED provisions or 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 endorsements. PRODUCER c N cT Ashley Levesque Bearingstar Insurance,Inc. PHONE FAX Commercial Insurance Center Arc No Een: 844 898-9151 arc.No:508 837-6573 375 Airport Road M I Fall River,MA 02720 INSURERS AFFORDING COVERAGE NAIC 9 INS RE A:AIG INSURED INSURER B: Fraser Construction LLC INSURER C; PO BOX 184S INSURER D! Cotult,MA 02636 INSURER E: INSURER F: COVERAGES CERTIFICA NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY,THE.POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER -POLICY NUMBER POLICY EFF POUCY EXP MiDannorn LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE OCCUR DAMAGE TO REMISr ENTED Dommerml S M DEXP(Any oneperson) S PERSONAL 8 ADV INJURY GENL AGGREGATE LIMIT APMzESPER: GENERA LAGGREGATE POLICY ECOT� lul LOC PRODUCTS-COMP/OP A OTHER: AUTOMOBILE LIABILITY COM&NED SINGLE LIMIT ANY AUTO BODILY INJURY Par arsan AUUTTOSONLY SCHEDULED BODILYINJURY PoraoddM Ms ONLY AUTOOO W PCE AMAGE S UMBRELLA LIAR OCCUR EACH RRENCE EXCESS LIAB HCLAIMS-MADE AGGREGATE DED I I RETENTIONS A AND EMPLOYERS'LIABILITY PER OTH- 0O24181132 09/26/2019 09/26/2019 E.L EACH ACCIDENT E rA ER ANY FICERPJME r,IEXCLUDR/EXECUTIVE YIN SOOOOO WndaRRryF��BEREXCLUDED9 NIA 500,000 ndato tJN) E.L.DISEASE-EA EMPLOYE $If yyas descrlba under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 500,000 DESCRIPTION OF OPERATIONS!LOCATIONS t VEHICLES(ACORD 101.Additional RomaUm Sdwdulo,may be a tachad If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES.BE CANCELLED BEFORE Town Building Department THE 'EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1 ' , { Commonwealth of Massaehusetis Division of Prolesilonal Licensure Board of Building Regulations and Slandards Gpns(r�ciibr{'SiYpervisor I CS-091665 = Eapires:0610712019) , DEAN 0 FRASER i 104TIVINNvi,yU LANE,?_ EAST FAL610UTH f%02¢38 tCommissionerp` • 1 i - - - - . . - . . . . . . . . . t { i I th t i I I I t F� Office of COImD er Ad Wm and.B.Lsinew F?egfiaton r 10 Park Pie 5170 BostDn. 5chus�S 029'16 Home Irromvem� �r Reoftaffon LC fiiASER CoNsTRucnoN Lid- OWMAM P.O.Box I CotW, VIA 02M C , ..._ J dae�steacsx�e.e�.ac4�scee:�onaoraaasc. smi C.ZOwaas O Adds=0 Mmovold 13�13 Los!C=d ! cseodC /i�C?c6R4sCG�On saonsEtevimnr�r Ro�e�v�FdraeUffiNCdexardy taa�- xsnb IP.ASMOEM CO E3S: Und Q � ifsWVMY - M92V�id(L /SEtg me � I ' Sl Work Permit - I �C Sin Namegive Fraser Construction permission to pull a w k permit for the work at f J��o �UIrn (Address) FRASER CONSTRUCTION, INC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: C If6 meowner r nstructi®n9 Inc Town of Barnstable . *Permit# t�egu€�a��>r� Services )xpires6monthsfrorzis=edaze + HAR1ySTA8Y.E, s' � v$ Ya3 ♦ Thomas F.Geiler,Director Bnilding DMsion 1 I 0 Tom Perry,CBO, Building Commissioner 200 iVL*Street,Hyannis,MA 02601 www.town bax stable.ma us Office: 508-862-4038 lax:508-790-6230 EXPRESS PER1%MT APPLICATION - RESEDENTL4,L ONLY Not VaUd witlwut IW X-Presslmprint Map/parcel Number- .... Property Address Residential Value of Work-13Z _ Minimum fee of$25.06 for work under$6000.00 Own s Name&.A.dd-ess rn — o iulk & 6 16�z - Contractor's Name_ n�e r � it��2, L C Telephone Number (�C -- -� Home Improvemtent Contractor License#(if applicable) Construction Supervisor's License it Cz£applicable) 9—+(0 6 g �{ dWorkman's Compensation Insurance X-PRESS PERMIT Check one: ❑ I am a sole proprietor [f Z am the Homeowner JUL 0 9 2013 l[J X have Workez's Com pensation Tnsm-auce ` Insurance Company Name NA4 n a l LW o ri f"i re -r� Workman's Comp.Policy# VQ C-6(5!q 1i igo f avvN OF BARNSTABLEaO f Copy of)nsurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(stripping old shingles) All constracnion debris will be taken to � C'(9.5 I Cd ❑Re roof(not stripper. Going over existing layers of root) ❑ Re-side . #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximtm,'.44)#of windows *W2are rcgauad: ]tsua=e of this penult does not exempt compliance with other town deparmuent regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home . rovement Contractors License&Construction Super visors License is req Q--XWP \F0Tt SV=5 rms s e Revised 09080.9 r The Con wnwed&h of_*,,,,.&reseus -bcpa fisentofInrdustriaL,4ccider s Offxe afIrzV&ag �Ot?1�ashi�agton.Steei • � 02-711 I vW.Mms gov/dia r Workers'Corapensabolt 'ance.Afcla��alersfConimdorsfzl ARggirt Uformataon ectricianslpiu�bers Please Leggk Name(Bnsiness/4rganizaion j Y2Se Y7 (fans-Vt.),- Address: :> City/ axe/Zip: �s�c3r` 1�r4 60 3 5 Pie*. 513, y c�a Am sa employer?Cfrerktlreappropniafie boa: , T, I aru a employer wAh_ 4 L(I am a,;caeaai c oMacto and I TY°e Of Pr*d(t'�d): l employees(full anc�lorj�T-t e)* have Izi-eithe soh 2-{�i am asaIe -�'rrtractots 6 �New cons�,tcbon Propd�'m Perez- listed cathe stf-ached sheet 7.. t]Remodeling l ship and have zto anplayee§ These sob-cozcizatdors bave worlciag for=inazzycapacity employeesandbavework=s' 8 QDerrmoliiion [-No wozicers'comma ias¢=C,.. ❑ 'army iMMrM e t 9. f BmIding ada en 3,[ Ir a h meomzierdo' 5. We 8m a eoxpox dm and its IQ.[]F] j�repairs or additions . mg alb work offem have exraoised th r za,self.INo trazlM&cog. uglzt exemptivu pet MCL I LEI PImnb�repanss or additions I insorante required t c I52§1(4),and we have no Roof repairs employees-[No workers' 13.0 Other R msorance requimq ?���� �o�_x�Imas:ahn�Iloatt�esedonbe�arshawiagth�•svozsexs•co�p���j►cY�oanzboa affidavit gft9am cbbg21wo&add 11=bite OMfde tD �IIac�—thate�erk'ma 6oxma�atattact��zddirioaatsheetth °�O��sts¢5mitaaewat'ntl�v�tmgy�c,�, erapToy=ev Ifthesttbc�rshaveaa t ihcaaaacoEtBesuix�auacOorsandsbtewBetHerornoifaosaeatities5avc rhes<� PolioymuH�r -ram an MFIOyff*dis pravfdusg x�orTt�'cp i infornr�rom a/&7og iiauiance forary-JP1OyeM Setm9 is the pelz c/y�aced job site t Policy 9 oz Self-his Iic,#: iN C!.!� --�—�ZTiradmDate: <51 2�, ao{� j Job Site Address. � � �1f1� e Attach.a copy o€t3ae workers'eoa� eussfioa --'—C y�ta'xPLp 1 U�!( V y Fazes to setatre ca P ]?m 3'declaration page(showing�e I►o&cy n=ber sod i easr'e4c�tmdez'&ction25AofMGrd 152cmleadtntbe' �'pmaNesate). fine into$I,5OQ.00 and/or one-yam#prisammt,es�velT as civil penalties iufbe form oa WO 1tDF 2 andaf�te ofup to$250 DQ a day against the violator. Be advim-A d ax a copy offt smm= Investigations of�e DTA fort mrmce eovelne veffadon. Y be farwuaed to the Of ce of i u'ir iierrby cer"- [ � u dpenaFBec ofppyur9 thae the i ur,jornzmnon pavvfdeaiabave is true m2demp4t i ate., r ozie�: III aZrrseonZy. Donor whe,Inthis area,fabec°fxF&Ldb'dayortoxmOffics'oZ j City or,Town: 'ermfffLicemae Usnima A.athorify(ciccEa one): L Somd ofHeaM I Z�dingDepartmen4 3.C5dy)Towa Ck* 4.F2ecics➢ S..�fRPw Inocao:r S.mmabinglnspector CoafaetPerscna: T'bane�: - i I Y Y pD FRASCON-01 MOSU AC�- DATE(MMIDDNYYY) ��- CERTIFICATE OF LIABILITY INSURANCE 1oe5iza12 THIS CERTIFICATE 1S 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 poficy(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 lieuofsueh endorsement(s). PRODUCER - (508)676-0309 CONTACT I- Suzefte Moniz Vfveiros Insurance Agency,Inc. ac N Exc;5p8-676.0309 F 375 Airport Road E. arc.No:5a8-324-9947 Fall River,MA 02720 ADDRESS:SMOniZ Viveiroslnsurance.com INSURERS)AFFORDING COVERAGE met INSURERA:National Union Fire Insurance Company INSURED Fraser Construction LLC INSURER S: P.O.BOX IM INSURERC: Cotuit, MA 02635- INSURERb: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_ ILTR TYPE OF INSURANCE POLICY F POLICY EXP IN R WVD POLICYNUMBER FOLIC MOLIC GtdTrS GENERAL LIAeIUTY EACH OCCURRENCES�—S ]fCLAJMS-MAOE MEP.CLALGENERALLIABILIrY PREMISES Ego uc Hence !5 OCCUR MFD EXP(Any ane person) S PERSONAL 6 ADV INJURY S GENERAL AGGREGATE S GENL AGGREGATE LIMITAPPUESPER PRODUCTS-COMPIOPAGG S POLICY F7PRE LOC S AUTOMOBILE LIABILITY COMBI ED SI GLE LIMIT Ea accident S ANY AUTO BODILY INJURY(Per person) S AU OWNED SCHEDULED AU70S AUTOS BODILY INJURY(Per accident) S HIREDAUTOS NON-OWNED PRO aRTY MAGe AUTOS Per accident S S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS UAfiH11 CLAIMS-MADE I AGGREGATE S DEO RETENTION S S AND EMRS COMPENSATION TWA I.I.Il O R AND EMPLOYERS'UA81LrfY X A ANY PROPRIETORP YIN ARTNERIFXECUTIVE WC009930601 9/26120 9/26/2013 CClDENT S 504,000 OMCEIVMEMBEREXCLUDED? NIA E.L.EACHA Mandatory in NH) (f ,describe under EL DISEASE-EA EMPLOYE S 500,000 yes OFSCRIPTIONOF OPERATIONS below E.L.OISEASE-POLICYLIMIT S 500,000 DESCR)PTiON OF OPERATtONSf L.00ATIONS f V2HICLES(A[t en ACORD 102,Adddronal RemarKS Schedule,if rrrorespaee is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE oESCRIBED POLICIES BE CANCELLED BEFORE Fraser Construction LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 31 BOVVdoin Rd ACCORDANCE WrTH THE POUCY PROVISIONS. Mashpee,MA 02649- AUTHORMW REPREsENTAnvE Y - c ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 4 s Massachusetts -0epartment of Pub le Safety Board of Building Regulations and Standards Construction Supersisor License: CS-097668 d DEAN C ERASER 104 TWINN VIEW LANE. EAST FALMOUTH MA 02536' ✓.. .. J1 ,� iti� Expiration Commissioner 06/07/2015 i � `✓ f't�� ((�C�%'/?%?'GQ/1'/iLI,�GCYrLiGl2 Gv� CJ��G(,C�J�I�CiYri/�/Jf'��/.J t � E Offce of Consumer Affairs and Business Regulation 10 Park Plaza Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 1 T �\ Ex 'anon: 3/23/2015 T 237059 FRASER CONSTRUCTION CO. y DEAN FRASER P.O. BOX 1845 - COTUIT, MA 02635 Update Address and return card.Mark reason for change. SCA 1 0 20M-05111 Address ❑ Renewal 0 Employment Lost Card r��r rlyl.�it-�itri�,runrr�/�r f�C'fjGc>tJ�cr�[�aR�/,t Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: registration: 112536 Type: Office of Consumer Affairs and Business Regulation Expiration: 3/23/2015 DBA 10 Park Plaza-Suite 5170 = Boston,MA 02116 FRASER CONSTRUCTION CO. DEAN FRASER _ ,_r .-✓ 104 TWINN VIEW LANE E FALMOUTH,MA 02536 1lndcrsecrctar r y Not valid without signature f 9 ME Fraser Construction LLC �� CONSTliUCT10N � P.O. BOX 1845, COtuit MA. 02635 Email: info@fraserconstructioncapecod.cbm www.fraserconstructioncapecod.com �e 508-428-2292 FAX 1-508-428-0123 HICL#112536 CS#97668 RE-ROOFING3 DATE: May 30, 2013 PHONE: 508-771-2292 NAME: Nancy Mclean EMAIL: mcleanl'36@comcast.net MAIL ADDRESS: JOB ADDRESS: 136 Tern Lane Centerville, MA 02632 FRASER CONSTRUCTION hereby proposes to perform the following services in a neat, professional like manner in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Fraser Construction will include a 4 Star Upgraded warranty with the selection of any 30 year shingles or any Lifetime shingles. CertainTeed SureStart Plus- The extra measure of protection when a credentialed company installs an Integrity Roof System. 4 Star warrantieS have a 50 year Non-Prorated Coverage for any lifetime shingles, which will cover incase of any in warranty repair, Labor and Materials, any Tear-Off, and any Disposal Fees. Upgraded wind warranty available on the following products when special application methods are used. See description below and in the CertainTeed SureStart plus brochure enclosed. ASK US ABOUT OUR GVE. .EAD CAPE t: LM! Supply and Install - CERTAINTEED LANDMARK: LIFETIME WARRANTY CLASS A FIDE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi - Layered, Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10.Year Warranty against ALGAE Containment. . With a SureStart Plus upgrade customer will receive 10 year 130 mph wind-resistance warrant with p sax na ils in y common bond area, Fraser construction includes six nails in common bond area at NO additional cost. See actual warranty for specific details and limitations. Color: PRICE-$9,020 Initial Supply and Install - CERTAINTEED LANDMARK PRO: CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi - Layered, Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 15 Year Warranty against ALGAE Containment. Landmark PRO is engineered to outperform ordinary roofing in every category, keeping you comfortable,your home protected, and your peace-of-mind intact for years to come with a transferable warranty that's a leader in the industry. With Max lief colors, a new dimension is added to shingles with a richer mixture of surface granules. You get a brighter, more vibrant, more dramatic appearance and depth of color. And the natural beauty of your roof shines through. With a SureStart Plus upgrade customer will receive 10 year 130 mph wind-resistance warranty with six nails in common bond area, Fraser construction includes six nails in common bond area at INTO additional cost. See actual warranty for specific details and limitations. Color:��'� ¢! ®� PRICE-$9,350 Initial A�V i Supply and Install - CERTAINTEED LANDMARK PREMIUM: Limited Lifetime Warranty, 10 year sure start protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 15-year Warranty against ALGAE Containment. 10 year 110 mph wind-resistance warranty Wind warranty upgrade to 130 mph when CertainTeed starter & CertainTeed hip & ridge are used. See actual warranty for specific details and limitations. Fraser construction includes six nails in common bond area at NO additional cost. Color: PRICE-$11,220 Initial Supply and Install - CERTAINTEED LANDMARK TL: Lifetime Warranty, 10 year sure start protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, triple-layer thickness, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 15-year Warranty against ALGAE Containment. 10 year 110 mph wind-resistance warranty, Wind warranty upgrade to 130 mph when CertainTeed starter & CertainTeed hip & ridge are used. See actual warranty,for specific details and limitations. Fraser construction includes six nails in common bond area at NO additional cost. Color: PRICE-$12,100 Initial Product Installation Details Supply & Install -,(Soffit Venting) Hick's Ventilated Drip Edge or S" .Aluminum Drip Edge with existing soffit vents. Smart vents over white drip edge. Protection against damage to the roofing materials and structure. The most effective system is a balance of air intake and exhaust that creates a uniform flow of air through the attic. This system creates a condition in which the roof temperature is equalized from top to bottom, supplying a uniform air flow along the entire underside of the roof deck. Supply & Install - CertainTeed Winter Guard. or Carlisle V TIP: (lee & Water shield) (WIP- Water & Ice Protection) Waterproof Underlayment System (aft. on eves and valleys" 18" on rakes, walls, and skylights) Water and Ice Protection (WIP) is a self-adhering roofing underlayment used on critical roof areas such as eaves, rakes, ridges, valleys, dormers and skylights to protect roofing structures and interior spaces from water penetration caused by wind-driven rain and ice dams. WIP may also be used as covering for the entire roof to prevent moisture or water entry. Supply & Install - Surround tUnderlaynient (A Typar Brand) A smart alternative to felt, it is water's toughest opponent, creating a secondary water barrier that reduces the incidence of leaks caused by storm damage, wind-driven rain, ice dams and worn roofing materials. It is a waterproof, synthetic polymer material that will protect your home against moisture intrusion. Supply & Install - CertainTeed Swift Start With self- adhering asphalt starter course on all eves, and rake edges. CertainTeed requires this product for Integrity Roof Systems and upgraded wind warranties. Supply & Install-Aluminum & Neoprene Soil Pipe Flashing Supply & Install - Ridge dent - Shingle Vent II High performance ridge vent with external baffle. QAs recommended by CertainTeed) Supply & Install- Pre-Cut CertainTeed Hip & Ridge shingles Shingle Ridge meets the hip and ridge accessory requirements for the CertainTeed Integrity Roof System which is comprised of underlayment, shingles, accessory products and ventilation all working together. The Integrity Roof System is designed to provide optimum performance--no matter how bad the weather conditions are. (As recommended by CertainTeed) Clean & Remove - Debris from work area daily. PAYMENTS ARE DUE IMMEDIATELY AFTER JOB COMPLETION. 1/3 initial payment, remainder to be paid upon completion Payments accepted are: CASH - CHECK _MASTERCARD -VISA-AMERICAN EXPRESS Any payments not immediately paid upon job completion will be charged 0.005%for every day after the given 5 day grace period upon day of job completion. Possible Extra-After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$6.00 per panel including Materials & Labor. There are 6 Panels per sheet of plywood. M Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$75.00 per hour, plus 20% mark-up materials. FRASER CONSTRUCTION Warranties the labor for LIFETIME of roof. FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the Sure Start Warranty depending on the shingle that was purchased. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: �I3O��3 Homeowner Fraser Construction, LLC t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION yMap- Z--Parcel 6 Application # 0®( 3 cD Health Division Date Issued < Conservation Division Application Fee Planning Dept. Permit Fee Z ZO Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 13 ( le n A-, 1 o� Village �P,.��i Y�U X Owner /U(✓1 rVl<}.&) Q LC AN Address A,/-.- Telephone "S 0 7 !- Z Z g Z Permit Request 1ZQAn\o u-e 0 l h Ze L A AJ 'te b � � ,� �e C 'oo � �� %�- i1 I � �hOti 0 t -�O�JP �.uQa � dw•vJf2fX-'q `IIBti4 I' 1`Pf 0�: 13`t Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation L.Z l-- Construction Type t.1 0 0 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑' Two Family ❑ Multi-Family (# units) Age of Existing Structure .3S Vn/ Historic House: ❑Yes U-P 6 On Old King's Highway: ❑Yes ❑llo Basement Type: ❑ Full 016rawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) 0 Basement Unfinished Area (sq.ft) , Number of Baths: Full: existing Z new r Half: existing _new Number of Bedrooms: 3 existing ..a new e o Total Room Count (not including baths): existing new First Floor Roam Count- Heat Type and Fuel: Ltas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes 9,114o Fireplaces: Existing New Existing wood/j oal stoves ❑'As U-No Detached garage: ❑ existing O new size—Pool: ❑ existing ❑ new size — Barn: ❑ e isting anew size_ Attached garage: ❑existing ❑ new size _Shed: 21elisting ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use � - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name mil.Icka E Zg"u? N Telephone Number i Address 3�5 1^)r-��.ti P.y BAN License # ►^ J � � � Home Improvement Contractor# 1 ( I Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1.kW 0 Y, l k 4Vc/�aA SIGNATURE /'1 DATE FOR OFFICIAL USE ONLY APPLICATION# 6 1 DATE ISSUED t MAP/PARCEL NO. f ADDRESS VILLAGE OWNER F I DATE OF INSPECTION: ' p " FOUNDATION .3.No.S 0 �.SU l l FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL FINAL BUILDING ® 2 l%J , DATE CLOSED OUTt ASSOCIATION PLAN NO. r E • r1 a Tlie'Commonwealth ofMassachusetts Department of Industrial Accidents Office of Investigations a ' d 600.Washington Street f Boston,MA 02111 www.mass.gov/dia Workers" Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ..Please Print Legibly Name (Business/Organization/Individual): ,�f 7 ��v(% h d✓" Address City/State/Zip: � P n� r I1 f'. 60 3 z, Phone.#: Are you an employer? Check the appropriat x: :Type of project(required):, 1.❑ I am a employer with -`4 'am a general contractor and I 6. ❑New construction . loyees(full and/or part-time),* have hired the sub-contractors 2, am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g Demolition workin fox me in an capacity. employees and have workers'• g .Y9. Building addition [No workers' comp.insurance. comp, insurance,$" required.] 5. EJ We are a corporation and its 10.❑-Electrical repairs or additions 3.❑ I am a homeowner doing all work . officers have exercised theft 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12:0 Roof repairs insurance,required.]t c. 152, §1(4), and we haye no employees, [No workers' 13.❑ Other 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. TContractors 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,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site' irsfo rm ation. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: - Job Site Address: 1 �o )-,A).,t/ �.•� • City/State/Zip; 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 MOL c. 152 can lead to the imposition of criminal penalties of as 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$2,50.00 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 coyera e verification. i? � I do hereby certify under the pains•and penalties of perjury that the information provided above is true and correct Signature: .iZL Date: /l Phone# Official use only. Do not write in this area, to be completed by.city or town official" City or Town: v Permit/License# ' Issuing Authority(circle qne): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector .5.Plumbing Inspector { 6. Other Contact Person: Phone#: a 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 is defined a's "an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,,§25-C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit'to'operate a business or to construct buildings in the commonwealth for any applicant who has not pro.duced•acceptable evidence of compliance with the insurance coverage required." Additionally,MGL ehapter.152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public-work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented'to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation.and, if necessary,supply sub-contiactor(s)name(s), addresses) and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies'(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members'or partners, are not required to carry workers'.compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit.or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate-line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information-(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related io any business or commercial venture (i.e. a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please'do not hesitate to give us a call. The Department's address,telephone-and fax number.;_ The Coz oz wcc lth of l assachus_etts Department of-in st ai A.oazc eats Offipe of Ilaxest gatz aq 604 Wasriington Street B.astanx.MA 0-2111 TO. #617-727-4900 ext 406 qr 1-977-MAS.SAFE Fax# 61 7-727-7749 Revised 11-22-06 www.rnass.gQv/dia •• Massachusetts- Board of g Del)artment of public uildin�Re' iations and Safet}'" Construction Supervisor Standards License: CS License Restricted to: 1 G MICHAEL,j RENZI w 387 p , LN CENTE VIiLLEs MA ' 02632 s• ('ummisiunrrt� Expiration: 1 /30/2012 Tr#: 13520 °� License or registration valid for individul use only Office of Consumer Affairs&B siness Regulation g X HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:,��„11859 Type: Office of Consumer Affairs and Business Regulation Expiration 2%412Q13 DBA 10 Park Plaza-Suite 5170, Boston,MA 02116 TMIELRENZI tON81RU-`L-tONY; MICHAEL RENZI'•?i = =' 387 PHINNEY S LN 4 6 vB� .CENTERVILLE,MA 02632 ,� Undersecretary_ ry Not val' thout signature j Town of Barnstable Regulatory Services v� ies� `��► Thomas F.Geiler,Director , �rEow -Building Division Tom Perry,Building Commissionet 200 Main Street,Hyannis,MA 02601 www.to w n.b arns tab l e.ma.u s Office: 508-862-403 8 r Fax: 508-79M230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject ro e J .P P nY - hereby authorize , ► 1� �-CmZo - CtmS ru��h� �.v� to act on my behalf, in all matters relative to work authorized by this building permit application for: i (Address of rob) - ' 7 1 L/.-• 5ignat= of Owner Date a rt c OYl cLe4g) Print N If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNEPPERMISSION TK�E 'Town of Barnstab.le �46F r�ti - - ti�.�. o Regu atoty-Services L mtAxxsr�sr> 7 - Thomas F. Geiler,Director kussr g - �63� .� Building Division 4rED Tom Perry,Building Commissioner 200 Main-Sfrc: t,_Hyannis,MA 02601 Rrww.to wn.b arnstabl e_ma.us Office: 508-962-403 8 Fax: 508-790-6230 HMMOV NER LICENSE EXEMPTTON Pleare Print DATE JOB LOCATION: number street ' village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or Iess and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEF=. ON OF HOMEOVrNTER ~ Persons)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constrgcts more than one home in a two-year period shall not be considered a bomeowner. Such "homeowner"shall submit to the Building Ofcial on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned`homeowner"assumes responsibility for compliance with the State.Budding Cade and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"cemti$es that-he/she understands the Town of Barnstable Building Department ` mm urium inspection procedures and requirements and that he/she will comply with said'procedtrrc:and.- requirements. Signatiirc of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOwxER'S EXEMPTION -The Code states that "Any bomeovener performing work for which.a building permit is required shall be exeanpt from the provisions of this section.(Section ID9.1.1 -Lic=r:hg of constrvetian Supcvsors),provided that if the homeovmrr engages a pason(s)for hire to do such work,that such Homeowner shall ad as supevisor.^ )ri'any homeowners who use this excrnptiom are unaware that they arc assuring the responsibilities of a supervisor(see Appendix Q. Rv)cs&Regulations for Praising Construction Supervisors,Section 2.15) This lack of awareness ofian results in serious problems,particularly when the homeowner hires unlicensed persons. In.this case,our Board cannot procccd against the unlicensed person as it would with a licensed Supervisor. Tbc homeowner acting as Supervisor is ultimately responsib)e. To ensure that the bnmwwner is fuDy swans of his/her responsibilities,many communities esquire,as part of the permit application, that the homeowner certify thathdshe understands the responsibilities of a Supervisor. On the last page of this issue is a form currsnt)y used by several towns. You may care t amend and adopt such a forrn/ccrtifi&ati.on for use in your community. Q:forms:homw cmpt t . A. zL Fk t /r • -ova } ;� .� p' y a. r kL Ao i S' a '. +Y�� Y-.i 'y "F}' W � V' yit'Y' ::A"S' 3�• f Sc U4 WILUAM C.5 N Y E' 71-I,4T Tf/E�=cz�;�%a�tT/o:. ;CoG.4T/O.c/ �C,,/����/i�L k z `,S'.�/OWit/,yE.2E0.(/Ci�M.dL yS h//Thy, SCE L�- /: ��. 0.4TE r A//!P SETBA Gk �2EQU/.eE�1E�t/TS Off" � Tow�t/�F .L.4�(! E�2E�/G'�' LGG'ATEcv lyiTs,�/Ic/ y G4�YGAiv l—�C�/z / NI c GATE: L`_ C� °:l t✓ ^ '�� ��i ��.< '.J�-#�i. �'9, i°if See r ;BAXT�.2E NyE /it/C :4 r ¢� //T /S P.L4�t//S'�t/oT BA,SEO ON.4�t/, 2EG/STE.2EI> !- /p SU.e1!6'yar� 7'//4.• 0�•45167725r SyaJA/.�/ l%S6p ,7'o OET,��I/.t�� .LOT%N.S � .f�i✓ � � �"��'✓°� �;_�t /C LI ,��:`ter ` ;+ � � ofxtoao �s1 -- r J (� � Pn�> ��•� e ( b `' o , C . J� � � �7cf0 r ^ tj ✓- J Q o � 2 f � a F i qz � Zf b1 , �5 S� � t��i o S fin,• � t-av^k `?,r\1 .4 s � l n D e c t( A 1 /Q �'sord . f sic K Te Bs� '�S .fix 11 ,$1r\�c.� �e r > i 77) 141) Town of Barnstable �o Expires _ Permit# Regulatory Services Fee 6e1O1from issue date f � • R�RN.gT�iti^ f i h e� Thomas F.Geiler,Director 1 Building Division -PRESS PERMIT" Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 J t1 L ? it www.town.barnstable.ma.us c Office: 508-862-4038 7'`� IN yax A5� 62� E EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY Not Yalid without Red X-Press Imprint Map/parcel Number CD l p;� 6 !y Property Address / el r, PH 0 Residential Value of Work f t) r Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address _1U a K M A.✓ AO I VA A) �TPhN f ANC lP-��?P►1 y� I} Contractor's Name Telephone Number S'a Home Improvement Contractor License#(if applicable)_ l'U l "g Construction Supervisor's License#(if applicable) 2 ❑Workman's Compensation Insurance Chec e: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# �opy of Insurance Compliance Certificate must accompany each permit. 'ermit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roofl ll ❑ Re-side f 2 Replacement Windows/doors/sliders. U-Value �'f�S�)t #of doors e� CP (maximum .44)#ofwmdows�_ *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Co required. nstruction Supervisors License is GNATURE: i iVPFILESTORMMbuilding permit formslEXPRESS.doc vised 070110 i i ' Niass.ichu�ctts, Board of Department of Pu'bli-c Buildin�.Rel ulations Safeh Construction Su and Standards License: CS 58266 Pervisor License Restricted to: 1 G MICHAEL.3 387 PHINNEYS LNI CENTERVILLE, MA 02632 tl �_ ('ummisgiimer Expiration: 1/30/2012 Tr#: 13520 Office of Consumer Affairs&Bdsiuess Regula ry /1ze �anirnaozurealCl /�aaagula. 6 ! License or registration valid for individul use only i HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration »1:,11859 Type: Office of Consumer Affairs and Business Regulation ; Expiration 2%412Q13 DBA 10 Park Plaza-$uite 5170 Boston,MA 02116 MI EL RENZI CONSTRUCTION i `J MICHAEL RENZI\ ,E 387 PHINNEYS LNG,, I CENTERVILLE,MA 02632 ✓ Not val' thout signature_ Undersecretary J . The Commonwealth of Massach usefts, Department of Industrial Accidents Office of Invesfigadons 600 Washington Street Boston, MA 02111 e- www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual) /fit 1 �f IC.P.u2 I��� Ai 01A..) CT1 Oti Address: t7 F�tti.c�P y•/ ��of City/State/Zip:a4tt </ l t O—L >v ?1 Phone #: !F9 6 Are you an employer?Check the appropriate b : Type of project(required): 1.❑ I am a employer with 4. 61 am'a general contractor and I 6 New construction iployees(full and/or part-time).* have hired the sub-Contractors ction 2.E, Lam a sole proprietor or partner- listed on the attached sheet. t ❑Remodeling ship and have no employees These sub-contractors have S. El Demolition working for me in any capacity. workers' comp. insurance. 9. Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions myself.[No workers' comp. C. 152, §1(4), and we have no I2.❑ Roof repairs insurance required' t employees.[No workers' comp. insurance required.] 13.❑ Other b•0 t.r o o W J t w *Any applicant that checks box 11 must also fill out the section below showing their workers'compensation policy information. t.Homeowner;who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. #Contraciars that check this box must attached an additional sheet showing the name of the sub-contracton and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for irry employees Below is the policy and jnb site information. Insurance Company Name: .Policy#or Self-ins.Lic.#: Expiration Date: . Job Site Address: City/State/Zip: 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 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 S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby 1ce Vl�r,�AA 0u/\l l ti under Athee pains and penalties of perjury that the information provided above is true and correct V 'Sianature: Date: c Phone 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 one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Dther J Information and Instructions 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 is defined as"an individual,partnership, association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the Iegal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees_ However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction°or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to.operate;a business or•to construct.liuildings in the coaiinonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C()states"Neither the commonwealth nor any of its political subdivisions shell enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements.of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is Tequired. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of'insurance coverage. Also be sure to sign and date the affidavit The affidavit should be retnpned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to'obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the-affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out iii the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. . f The Department's address,telephone and fax number. . ' " ;,, .. 1• The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations' ' 600 Washington Street Boston,-MA 02111 Tel. # 617-727-4900 ext406 or 1-877-MA-SSAFE Fax# 617-727-7749 oFT ,� Town of.Barnstable ' o Regulatory'Services v 141 AlJ1.T3 RT-� i )d Aa.q g Thomas F. Geiler,Director Building.Division Tom Perry,Building Commissioner 200 Main Strcet,Hyammis,MA 02601 www.town.barnstab le.ma.us Office: 508-862-403 8 Fax: 508-790-6230 �. Property' C:wrier Mus t Complete and.Sign This Section If ussJng`A Builder r ; as Owner of tb.e subjectproperty here by authorize I(••Q. ' I Z �-e►� -kv 'rrvl <' to act on my behalf, is all matters relative to.work authorized by this'budding permit application for. M A (Address of job) �, „� o Owner Date t. Nokm If Prop erty Owner is applying forpe mitplease complete.the Homeowners License Exemption .Form on :the reverse side. r , Town of Barnstable o . Regulatory Services Tbomas F. GeErr,Director s43¢ •b BnUding Division Tom Perry,Building Commissioner 200 Main-Street; Ayannis, MA 02601 WWW.to wmb am stable.ma.us Off-Je: 508-862-403 8 Fax: 508-790-6230 777 int DATE JOB IACAnox: number street village '7-10MFAWNER": name bane p e t# work phone# CURRENT kfArLIIdQ:ADDRESS: ettyhown state zip code ' Tke current ex=aption for"homeowners"was ded include owner-occupied dwellings of six mats or less and to allow homeowners to engage an individual f lure who oes not possess a license,provided tb.at the owner acts as stmca-yisor. ON OF OMEOWh7:R Pcrson(s) who owns a parcel of land on w he/she resides r intends to reside, on-% ich.thcre is, cr is mtcndod to- be, a one or two-fuanly dwelling, attached or detached strut accessory to such use and/or farm strucftnu. A person who constrgcts more than tine home in a two-year perio not be considered a homeowner. Such "homeowner"shall submit to the Bmltiing OfEcial on a form acc table to tfic Building Officia..l, that he/she shall be- rcstogisibIc for all such work erformed-under the bunldin etmit (Section 109.1.1) Th,c undersigned`homeowner"assumes responsibility for compam with the State Building Code and other• applicable codes, bylaws,rules and regalafions. The tmdcrsigned"homeowners'certifits that,helshe understands the Town of Barnstable Building Department r,rn,i,,,nr,msptiction procedures ana requirements and that he/she.will comply with said procedures and requirements. t. Signature of Homw"cr Approval ofBurldmg•O 5cial ' :.�-.. .+..`,•- :}; ! ry'1 •fir ;i',9 .t , Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the, ' State Building Code Section 127.0 Construction Control. ' H014�O WKER'S ExEMP'IION The Code stairs that: "Any homeowner part=ing work for which a bmldatg permit is required shaD be exempt]Torn the provisions of this=dqn(Section l D9.1.1-Licasiag of construction Supervisors);provided that if the bomeovmcr engages a pasoa(s)for hire to do such work,that such Homeowner ri shall Adis supervisor.,• 7=1y bomc:owncrs who use this nczmption 31C tmaware that they are U nrung the responsibilities of a supervisor(sec Appendix Q R.ulcs&R.cgulations for 1jccnring ConstrvcSon Supc ysoa,Section 2-15) This lack ofawarc cm bfkm rmulrs in serious problcras,particularly when the homeowner hirrs unlicensed personm In this case,our Board cannot proceed against the unlicensed person as it would with}lieascd ;trpervisor. The had=vm er acting as Supervisor is ultimately rrspon.nbla To ensure that the bomcawner is f dly awar=of histhcrnsponnb m ire, ilidas,many communities requ as part of the permit ipplieadon, )at the homeowner gutty that bdshe understands the msp='btlities of a Supervisor. On the last page cf this issue is a•form currently used by :vcra]towns. You may care t ar=d and adopt such a fannkerdfieation for use in Your community. i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ppp r / ` F Map ��� Parcel � / 7" Permit# Health Division Date Issued " Conservation Division Fee 06�- 00 Tax Collector r Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board /1 Historic-OKH Preservation/Hyannis Project Street Address Village C> Owner . o A /0 Address 134 Telephone S¢ r 7 7 1 -z Permit Request -Si i�o �,,y J ,2�� �ltc�� ,,�oo,Y s�i ✓�/�r Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new . Estimated Project Cost73 ®0 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On 0ld King's Highway: ❑Yes ❑No Basement Type: ❑Full &C-rawl ❑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 C new First Floor Room Count Heat Type and Fuel: ❑Gasz" O'6ill ❑ Electric ❑Other Central Air: ❑Yes Ro . Fireplaces: Existing / New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:O"'existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name . . fit! Telephone Number Address License# ��% �� //>✓ ` _ Home Improvement Contractor# fY), Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 7-ow .4, d SIGNATURE o?�rt � DATE /1 —FOR OFFICIAL USE ONLY t PLRMIT NO. DATE ISSUED " MAP/PARCEL NO: �= ADDRESS - VILLAGE 7 OWNER- 1 } DATE OF INSPECTION `' r FOUNDATION ' FRAME "' f INSULATION FIREPLACE v ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL r . GAS: ROUGH FINAL s FINAL BUILDING t DATE CLOSED OUT ASSOCIATION PLAN NO. ; r . 4 Office: 508-862-4033 Ralph Crossen Fax: 509-790-6230 HuiIding Commis: HOMEOWNER LICENSE EXEMrrION Please Print DATE: �/ •�'� JOB LOCATION: /34 ��"� .� ✓ �£<�v._0 A.wJll atnnher saes -HOMEOWNER": /�/ ,/e 4! Ji'x! /0�0,9i 7 / -Z.L amine home phone># work phone s CURRENT MAILING ADDRESS: /3 -C J��'✓ � ��f ��,�3"•�ez y��/ s✓ mil,¢ ��-� � � gt},itown state ap code Thermo 1 exemption for mhomeamMefe was extended to include rnxn n-nc=ied dwellings of six units and to allow homeowners to engage as individual for hire who does not possess a license,ivi_� or less l� . that the iowner acts ere tnncrvisrOT. DEFINMON OFHOMEOWNM Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or . farm strums A person who cmnstrntxs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Biulding Offatdal an a form acceptable to the Building Off trial,that he/she Shall be=onsi'ble for all such.,.m*•,••fot**±ed under the buildin��it. (Section 109.1.1) The undersigned"homeowner'assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws;tales and regulations. ertfiett hesieThe undersigned"homeowner' understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. � Slgaatttse of Homeowner Apptovai of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the Stare Building Code Section 127.0 Constriction Control. HOMEOWNER'S EXEMPT10N The Code stases that: "Any homeowner vafonamg work for which a building Dana is requited shall be exempt from the ptovisiops of thfs section(Section l09.1.1•l.TeMing of txas=ruon Supo:vtsorsl.Fr°w�that if the homeowner engages a person(s)for him to do such worm that such Homeowner shall ant as supervisor." the responsibilities of a su ervisor(see Many horo�smes=who use this exemption am tmawa:e that they are assortingrasp° p Appendix Q,Rules&Regulations for llcat:iag Consnuction Supervisors.Secdo Lls) i7ds lade of awats:tess often ttsttits in serious pmblcmL pwicuiarty when the homeowner him uaiicensed person. his this cases our Board cannot proceed against the ualicased persou as itwould with a licensed Supervisor. The homeowner=tint as Supervisor is ultimately responsible. To eastae that the homeowner is fully aware of his/her responsibilities.many communities mNim as part of the permit application.that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a fort currently used by several towns. You may care to amend and adopt such a fotm/cemftcation for use in your community MEYE AM Q:FORb • 9BA� Department of Health Safety and Environmental Services a61q. �0 Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Cressen Fax: 508-790-6230 BuiIding'Commissione Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: �i�/y'�� � Estimated Cost Address of Work: / 3 4 '<xLAl /—,4.A/ t, Girl rl� A vy C Owner's Name: /10/2- 44 4-'y 4 9,A) Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under S1,000 Building not owner-occupied 00wner pulling own permit Notice is hereby given that: - OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MOROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR 2 Ae 4--o 14 YC,,,9,A) Date Owner's Name q:fomu:Affidav . The Commonwealth of Massachusetts 3r z Department of Industrial Accidents '' `�`°• •• Ot�ceol/asesit�gat�oos 600 Washington Street +3 Boston,Mass. 02111 Workers' Compensation Insurance Affidavit narne �1/D'/� Ii�'✓�/ /� r-l4-.y1/ location: city NT�i'C °� ✓l �. phone# S d Q'I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in any achy � i///�0 '////,d///%/� i ❑ I am an employer providing workers'compensation for my employees working on this job. ..:..... :: �.::......:...::::::.::.:.;.:� :<;;:::>::::<;:;;:::::»>�<:>:<::::>> :. . ............ s 8ress-: .. .. ._ ..... .......... . ... .:.:::::.: .:...........:...:. ::...... ...................... ..... ......:. :: nh :..:.::..................... insurance co. cv : ... ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: +:cx`e z2',<'' ii <5['>sijt`i'i:``:i"?< ?:asi:i'isii }ii ;i:_ ;:`i.y;i;> >iy:::asisi:. »c, i;<i.i%;Li%<?ii::%�<?:: xx- ::nam COmD anv S: a >:s a re . ....::..... ........ ........................... ........ ..... :>::::.................................... ..... ................ ::::.:::.::.::.::::......:....... .::..v..:. ::::................................, ...........:......:..........................:::.:.-:::::.:.........................::.::.:<.::::.::. ::::::::.:::.::::.................?.:?�.... .. :.......................:.......>........................................::....:.::................................. ....:.............:......................................... <.:............ v:::.,.: ,.:::: .....................::•....................................::•::::••.....................:.....,....................:<....,:.:......::r............................................. :..,....v.�:::.:.:., •::::.w. ....................... .........................................................................................:.........s::.�:.......:...............>...+ ................................ ........................................:::::: :•::::::•: ::•:::::•::::•:::::::::.:::::::::::::::.:.�.:::::•:. :::::::.......:::.::::: : ::.....: :.::,::::,..............: :::::::...:.................................:..::,:::::::::..:::•. ._::.�:.. .�....:.�.........•......::::�:>:>::•:... A/llt..:::.:::;.:.::::::.>.>::..::::::::.::::.::.:.::::.:>::.::•:rr:•::•:::;:.•.h•::.r>;:::;;:i::::.::.:<i'::; tiff*... :.. ..::.... :.::.:.:........................:. ...... ...::..:.:::.: ........... ............... phone i.;.... ..... .........h<...n....vw.x:•:.:•...........................ten.+........w..,........:..:::v.. y.......................... ............ nsntance�ctx,,,:..,:;:.:<<�>�:�:�:::::.;:�;:.::.K:.:.:;.�<.;:�;;;:.;:.;;::.;;�:::;.;:.:::.>:::; :>:. ;::.:,....,,.;..,:,:.<.::.;:::.:<..<.,.:<:::?:::;.:;<..:.: oIi iii _ . . :::.: address. ..... ,. ,....:,;. city- ;:nh on e ............. ............................... X. nsarance�co:::..:....,.,.;»::.... ;;:.:.:.:<:.;:.:<...:<.:;.;:;.:.;.:.:....:,..,:.::.:,:,.....:::.,.::::.....,.......,...:.:.... .... . ..... . .... oiicv# Failure to secure coverage as required under Section 28A of MGL 152 can Ind to the imposition of crkni ai penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as dva penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a Copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pane and penalties of perjury that the information provided above is& .and correct Signature ��°'► — Date Print name ✓SSG �'d a7l✓ /�L �'d3""'� Phone# 7 7/ —2'e!.Z ------------ official use only do not write in this area to be completed by city or town otllcisl city or town: petndtilicense# (]Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Orlice ❑Health Department contact person: phone#, ❑ r�� Uemed 9195 PJA) R „o• TOWN OF BARNSTABLE Permit No. 28075_ _ = Building Inspector cash -- 1639. — �o rat►� Bond OCCUPANCY PERMIT Issued to Norman D. McLean Address �.: #49C 136 Tern Lane, Centerville `. Wiring Inspector Inspection date ! 1 Plumbing Inspector Inspection date jr ��•. Gas Inspector i j Inspection date Engineering Department Inspection date Board of Health `� Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. . 19� Building Inspector -77";'. x€.ay';ay� n(r,'.,: ar�. ,,r�'.11. �W: fk t a.n...� •N. ;r,�ai ,.A' " TOWN OF BARNSTABLE BUILDING DEPARTMENT = 'saa$TAU TOWN OFFICE BUILDING nua Mgr 1639. HYANNIS, MASS. 02601 �I MEMO TO: down Clerk FROM: Building Department DATE': An .Occupancy Permit has been issued for; the building authorized by Building. Permit #..................... ......... ,...... ... ».... issued. to .,e! `Ch �r IJ , lr .. ? � Please release the performance bond.. J r- /o 41 i7o V r.ao• �.Sa NJ T VE cE.e7-i.�/Eo O,L�OT oL4�c/ S.yDWit/f�E,2EO.f/COti/OL YS W/Tf/ SCA L.Z - / �� j OATS 3/ P TNT SI D,,! .0/ic/E A1/0 SETBA Ck �CEQU/.2E�lE�/rS OF T,�/6' 7`owNOF' Lcrr s(-9 � b, 17, OATE'• ;BAXT.E.,2E Al,yE TiS�/S A14,41//S IVoT B.4S, '" a v Apt/ �2EG/STE.2E1� L ip sU.eI�EY�t� 0�.4SETS Syol,�/.1/.51-0411-2:> .V,07- Z7,f-- 1 Assessors map,. lot numbe'r.�..../`.�. .... E. .....De o�T ETo P: r,4 IALL Sewa a Permit-number•• ..... l r �pp� c yyl pi�pf, d� • / � �" 9 � y. J'r' 9T/1DLE, i d louse number .... ......... ! .... roVi 'NI-A� 90 f MAO& .-�'. C•- , MAY L TOWN ' ,. OF BARN STNBLE .� BUILDIHG .IHSPECTORP h fi r v 4 .APPLICATION FOR PERMIT TO ' TYPE OF CONSTRUCTION .......0 .......:.. ...................................................... ......: . . . � ..7.....................19. .. TO THE INSPECTOR.'OF BUILDINGS: } The undersigned hereby applies-for a-`permit according too�the � following information: ; Location .....- ?. .......'- q:1 .... .. WAY..... ........... ? �9� -��.��`C;.. .......................................................... ...`................ ........ ......... ........ ,Proposed Use ...� . ..... 4: .................................... ...................... . ..... ............ . Zoning District ....:..� �. � .�. Fire District'.... . L .40T.... Name of Owner . .. 4 .1"`<i�!"n�!................Address ............. V..L. .I�r.�. 'n�?. - � ...: Name of Builder M ... 6A ,4 1 4C, Address lXl:�c/....1 1� ..vl ...j }. . . ... Name of Architect rt�..... "s1.�1 L ;_,.. . :,.qaciclress Number of Rooms ....,,%:)k .....................................................Foundation . .....11 ....................................................... `r� y Exterior ,. ....................................................:......... :Roofing .... .r....rat' . . .�� !C ........................ 4 x , Floors Interior .`� - C- -�. .:. ►�.1. ................... Heating '°..": ` ................................................Plumbing .li.. ....................... ................. ._. .• Approximate Cost .� Fireplace .... ,.; .... ...... _. ....... .//. . .. .. .... ...:. .... .Definitive Plan Approved by:Planning Board�____�_�______ Area ,! /.� �.. :.. Diagram of Lot and Building with Dimensions Fee,. .,....:, SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1 hereby agree to conform to all the,Rules and Regulations of the Town of Barnstable regarding the above ` construction. j Name...... ...... .... ...... Construction Supervisor's License .. '�1.E3 �.............. MCLEAN, NORMAN D. F!No ...28015;. Permit for 1 ,•Story................. y Single Family.'Dwelling ...... ..................... ........ 7. Lot 49C,` 136 ,Tern Lane `t ., -• - ' r3 Location ..................... .... ......... y t, Centerville =�: c h 's f i�; t .......... ...... ..... . ......... -- r^ e •. Norman- D. McLean , ,` ✓ o �'� Owner 17 Type of IConstruction Frame P 4 is Plot .:........................... Lot ................................. Permit Granted .' ;June..12'" .19 85 Date of Inspection ......... `719 _ Date+ Completed ��..�.......: `tom ��` �s ,� � � r' ;,,.h � � t•��y,1 . �/� .. _ CT IN .`�� ., �{;'• �,,.,...�, �r�.,,'�"' �.�-,_ram-1�- .�'} j""'. `^• � � r - ,,--�< 1•a jam. �ry_ l.. • r'�5 " 4'� t �ir"1. .f v � � !/�--"/'cj F / r , -{} �`�+ 1 t•. '�J• ju .l - - Assessors map and lot number. THE �.... .�. .....o.(3.:.... �t+ toy Sewage Permit: number `--� d / 33AUSTADLE, i House number ................. ✓✓....................................._ r rasa . 00 9� m i63q. ` r `� ,�� .s 'FOMPYtr� 4 TOWN OF BARNSTABLE ___ BUILDING INSPECTOR i APPLICATIONFOR PERMIT TO .....I.......... ...................................................................................... TYPE OF CONSTRUCTION .............:..................c s...............t7fl.,A-M. .':�............................................................ ...........1.:.[°.. .7......................105... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: jjam�; ' A_ ....... d� t' -. .1.'�T�.................................................................. Location ....gT....."�"1..4....... :"� ..... - Proposed Use ...� ..... . ,. ..... . ,�-.1 N�- . ................................ . ......................................... .. ......... f Zoning District .......... ... .g.Q.1..................................Fire District ..... .,(zj;Fe.&Kj .41 4�-T................................. ........... Name of Owner \ 14....D,... !................Address ......... C -4.1-. .... Name of Builder Name of Architect � .... T�tl' .kl�t�r. .Address Tl� -1GR .VR . Iql�ddress .7.. ...��''ff ��IPT. ..... .Ati�..�. Number of Rooms *........... .. ..................................................Foundation b S. i Exlerior ................................................................Roofing ....! L^• ....r .���!�j '........................ Floors .... ...... ..interior .. ..............-_ 6�d� }. .................. _Heating ..... '".................................................................Plumbing r�::7 � �1..........................................:.. .... .... ... _ Fireplace ...�i�!.. . �' ......Approximate Cost .......` ' � s - r— Definitive Plan Approved by Planning Board __________�_�__________19��1_./ Area ................. . Diagram of Lot and Building with Dimensions Fee .................................. r SUBJECT TO APPROVAL OF BOARD OF HEALTH t OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..... � A..... �� ....................... 1,. . 4 Construction Supervisor's License ...00.1.... ............... MCLEAN, NORMAN D. A=212-013 is-0t 7 28015 lZ S�:Ory 3. s� No ................. Permit for ............. . ..... ...........Sing................l y..i7Wel ling. .... ....... Location ...LQ:G..49C.,..:..13b...Te .......... kexva,J 1e............ .............. r Owner .......NQZ7=..D....MClaan........................ r Type of Construction ....FFrame........................... .........I.................. ....^........................................... - Plot ............ ............ Lot.............`..................... Permit Granted ......June 12r.................19 85 Date of Inspection .....19 {............................... Date Completed ......................................19