Loading...
HomeMy WebLinkAbout0141 THISTLE DRIVE t y j v r,�-1 �.vS'7;tF �{ 1+ 't: xa� c 4Q'.t � A f r� •^'t1' �.`�.#, � b.•.' ,. .' ''t. �`,�r s+'. ... + ,: �,?,¢:,*. ��1 G+� -r.al.�i-,a,.r ,. � a �e ;�Y��� .•;��,� '� a�, 7�f""� h� r ra• `,d �� A;�'�� ;? ,r ur ,��s M t t • a , b c , 9 } N"n J F , J r t.. l F TOWN OF BARNSTABLE,BUILDING PERMIT APPLICATION,,, Map j, ;63 t :'Application #r /15ih Health Division Date Issued 0 Conservation Division :Apoli.cation' Fee QN Planning;Dept; `Permit Fee Date Definitive t Plan Approved by Planning Board ®� h)6q Historic = OKH Preservation / Hyannis Project Street Address I4 l y iz— Al P-V 1 L-L� Village ►.Ls J=' Owner 21cam^ NON1 Address SA M L Telephone Permit Request TAt_t__ 4c-PLAc1c LxonaG CSC—n�C�r Square feet: 1 st floor: existing_-�aigroposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay -#Project Valuatiora� zsBO Construction Type C /--kA y c Lot Size dPP2ZC /a AtP—tr Grandfathered: ❑Yes ,�'No If yes, attach supporting documentation. Dwelling Type: Single Family - ' Two Family ❑ Multi-Family (# units) Age of Existing Structure <�l"I)U Q Historic House: ❑Yes )kNo On Old King's Highway: ❑Yes N'QNo Basement Type: �Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) 0 Basement Unfinished Area (sq.ft) OQ��,at( Number of Baths: Full: existing a new 1 Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: UGas `❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes Vlo Fireplaces: Existing_1_New Existing wood/coal stove: ❑Yes U160 Detached garage: ❑ existing 0 new size Pool: ❑ existing ❑ new size _ Barn: ❑existing 0 new Z9ze_ Attached garage: U'existing ❑ new size _Shed: ❑ existing ❑ new size _ Other "w j = Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ w 'Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed UseR. a -- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name A61 /C 3, l-_0J,, ,b Q Telephone Number 1-�bua_ cI' Q� Address /4l /g b57-L Iq 4 ICI t= License# d=,Aj7 P-V I i-L AA Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 8A2 !,S,A&e C A X Sf=�=� 5 SIGNATURE % 'DATE O FOR OFFICIAL USE ONLY C t r 2' k `APPLICATION# r DATE ISSUED MAP/PARCELNO. F j ADDRESS VILLAGE P' ri OWNER DATE OF INSPECTION: FOUNDATION FRAME s INSULATION t FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. f The Commonwealth of Massachusetts Department of Industrial Accidents r Office of Investigations- 600 Washington Street Boston, MA 02111 f� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers pplicaut Information Please Print Lel-_iblY Name(Business/Organization/Individual): 1"1'��1Q (1=' 1-4 L=N l-,l Address: City/State/Zip: 1� "il?.�Ilt,l., �?( a Phone.M 5TW- 4&R '7,9,� Are you an employer? Check the appropriate bog: Type of project(required): 4. I am a general contractor and I 1.❑ I am a employer with � 6. []New construction employees (full and/or part-tiin.e).* have hired the sub-contractors , 2.0 I am a'soleproprietor or'partner-' listed on the'attached sheet. T. [J Remodeling ship and have no employees These sub-contractors have 8. 'o Demolition loyees and have workers' working for me in any capacity. emp 9. ❑Building addition [No workers'•comp.-insurance comp• insurance.$ I equired.] 5. 0 We are a corporation and its 10.❑ Electrical repairs or additions 3-N am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.[] Other employees. [No workers' comp.insurance required.) *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy 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 or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: 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 tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigatioas of the DIA for insurance coverage verification I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si ature: Date: — 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. Other Contact Person: Phone#: 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 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, §25C(6)also states that"every state or local Iicensing 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 produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 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 certificates)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 fo 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: Tho Commonwealth of Massachusetts Ueputment of Industrial Accidents Office of IUVestigadans- 600 Washington Street Boston, MA 0211.1 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia i f ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFVICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) Applicant Namd: Site Address: f print Town: Applicant Phone: Applicant Signature: ��Q Date of Application: G NEW CONSTRUCTION: choose ONE of the following two•o Lions 780 CMR TABLE 6107.1 PRESCRIPTIVE EN"'NELOPE COMPONENT CRITERIA FOR ` NEW ONE- AND TWO-FAMILY BUILDINGS M 'MIN]MUM Ceiling or El Option 1: Slab Basement Fenestration exposed Wall Floor grail Perimeter Apt HSPF SEEI U-factor floors R Value R-Value R-Value Land alue R-Value Depth National Appliance-Encrgy .35 R-3 8 R-19 R=19 R-10 R-10, Conscrvaiion Act(NAECA)of 4 ft.- 1997 as amcndcd,minimums or catcr as applicabIr Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: REScheck Version 4.1.2 or later variant software analysis must be completed 780 CMR 6107.3.2 REScheck--Web which can be accessed at http•//www.energycodes.goy/rfscheck/ ADDZT ON OR•;AT�T'E4aTXONS.T0 EXISTINGBUrLDl1v S.OVER5 'EARS OLD* *13uildings under 5 years old must use option#1 or 42 in New Construction section above. Complete the following formula to determine the %o of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b_ a) SF 100 x - _ % of glazing (b) Glazing area equals SF 6 a If glazing is<:40%.u' 8e the chart beloW. If gla±ing is > 40 % rocc6d to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTL4,L BUILDINGS MAXIMUM . MINMTM Ceiling and Slab Perimeter Fenestration Wall Floor Basement Wall R-Value U-factor Exposed floors R-Value R-value R-Value R-Value and Depth .39 R-37 •a R-13 , R-19 R-10 R-10, 4 feet EL R-30 ceiling insulation may be used in place of R-3.7 if the insulation achieves the full R-value over the entire ceiling area(i.e. not com ressed over exterior walls, and including any access openings). ' SUNROOM—An addition or alteration to an existing building/dwelling unit where the total glazing area of said addition exceeds 40% of the combined gross wall and,ceiling area of the addition. Note: Owner to fill out Consumer Information.Form found in Appendix 120.P Town of Barnstable -. o Regulatory Services RMWSrABLE Thomas F.Geiler,Director MAss. 1639 ,��' Building Division ATf0 Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 �^ HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: [ (-k 1�!l.li �' �Ic1-�T�Q-V 1 l l_l'- number Q street (�p p�7 village "HOMEOWNER": Mkt ya +J 1c l.� ���" `-c - gC3.1 1 t-k j A 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 less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)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 constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official 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 Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that be/she will comply with said procedures and req%,reents. , Signature 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. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed _ Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,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 form currently used by several towns. You may care t amend and adopt such a form/certifrcation for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC r� �IKEr � Town of Barnstable Regulatory Services. " sn MAMes Thomas F. Geiler,Director- . i6�¢�'. 1�� 039 ► Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the . Homeowners License Exemption Form on the reverse side. QTORMS:OWNERPERMISSION 0- 1 f Iy �L I q � , CION- APPac4- 46 Lj 7 0 FLOE - r r :/ Ve a C -\L`-eF .:�� 1����u� �� Cam. W�.�.���,��.� �rr2�P�� «11`h tdok- �lime„ Town of Barnstable Permit# Expires 6 months from issue date { Regulatory Services Fee_ ` a r &MMSTABM • 1659. Thomas F.Geiler,Director Building Division PREE-SS PERMIT Tom Perry,CBO, Building Commissioner 200 Main Street;Hyannis,MA 02601 .; h www.town.bamstable.ma.us NO V I V 2011 Office:'508-862-4038 TOWN QF> *FW619,, 09K0 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number J 7 ,k36©c .3 Property Address ' Residential Value of Work 6 bQQ • U U Minimum fee of$35.00 for work under$6009.00 Owner's Name&Address Q J CL �s� I nc\,, �� Cep-�e�UC\11 � Irn CA Contractor's Name c�k,( c �J jm cj n Telephone Number. Home Improvement Contractor License#(if applicable) �� � �j Construction Supervisor's License#(if applicable) oo [/Workman's Compensation Insurance Ch one: (�I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy#� � Copy of Insurance Compliance Certificate must accompany each permit. Permit Request check box) 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) ❑ Re-.side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE; C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Oudook\DDV87AAZ\E3<PRESS.doc . Revised 072110 i pace of HOME 1 RegIs�Mtio�pVEa1ElUT Cp B sFness Regnla trio _ 'Expiration. a_361g0 RACTpR License or Y 4 K! N --=61?8i�2012 1 TYPe: before the�g gistration valid.for' EMO r �; ndiv' O Piiatio end' a l _ idual lopOffice of Consurn date. If found return idol use only PITCNERN ff,L ' Bo on,M p Plaz,116i 5 airs and Fusin_ essRegulatio S Wqy ` °' A n NM1S, X Mg 02� Undersecretary Not valid without � - Signature .tchusc tts .` .... . d oj,Bur .Cp-i►-ttnc n '"` ^- u C 1din., t of P its/r Stipp Su Rc..ul uhlic.atton� S.dctrw License: -'Visor Fnd St. Restricts tat).�nt/ard` - d to: CS S� 10020� Y Liceps 1 MARK RF�yS a . , P LEMON. p 6ox .:: r WEST Hy 23 s M iftpoRT, Mq' 267 nn.vio , ner Expirati n: 4`.10p7 a f INE MAW Town of Barnstable FD MA'S� Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section - - If Using A Builder —,as Owner of the'subject property hereby authorize m c 1k Lo 1 f `cn to act on my behalf, in all matters relative to work authorized by this building permit application for: l l ( � (Address of Job); Signature of Owner Date ' Ne ty N ., Print Name If Property Owner is applying for permit,please complete,the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\.ocal\Mic osoft\Windows\Temporary Internet Files\Content.Oudook\DDV87AAZ\EXPRESS.doc Revised 072110 . • The Commonwealth of Massachusetts Department of Industrial Accidents - - Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): mcVa,(Yn�- LQ mc/n Address:_go City/State/Zip: w,� (� n iS Phone#: Are yo an employer?Check the appropriate box: Type of project(required): I.Er I am a employer with k 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. employees and have workers' y p �'• • ❑ [No workers'comp.insurance comp. insurance.$ 9. Building addition required.] 5. ❑ We are a corporation and its' 10.❑Electrical repairs or additions 3.❑ f am as homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no 13.�er employees. [No workers' comp. insurance required.) Any applicant that checks box#I must also fill out the section below.showing their workers'compensation policy information. fi Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew 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 site information. Insurance Company Name: Policy#or Self-ins.Lic.#: \ � a ) 5 90 Expiration Date: I Job Site Address: Q_ 06 U-C 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 head to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisomnent,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of , Investigations of the DIA for insurance coverage verification: I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. —� Signature: 2 - ' Date: l/ —� 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. Other Contact Person: Phone#: To: Page 5 of 9 2011-11-08 08:41:10 GMT-05:00 16175880432 From:Cristina Medeiros A�'� DATE(MMIDD1W W) t� CERTIFICATE OF LIABILITY INSURANCE 11/7/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN ,THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER N0AN1E7Cr Cristina T. Edmund Garrity & Co. , Inc. HONo Ext: (617)354-4640 X No:(617)354-5e2e LAIC,545 Concord Ave. A-MAIL :cristina@garrity-insurance.com PRODUCER 00005330 Cambridge MA 02138 INSURERS AFFORDING COVERAGE NAIC 9 INSURED INSURERA:Scottsdale Insurance INSURER B.CitatiOn Insurance 40274 Mark Lemon, DBB: ML and Son Construction INSURERC-.The Hartford 490 Pitchers Way INSURERD: PO BOX 423 INSURERE: West Hyannisport MA 02672 INSURERF: COVERAGES CERTIFICATE NUMBER MASTER 2011 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR TYPE OF INSURANCEADDLSUBR POLICY EFF POLICY EXP LIMITS LTR I D POLICYNUMBER MMIDDIYW MMIDDIY GENERAL LIABILITY - EACHOCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES fEa occurrence $ 50,000 A CLAIMS-MADE ®OCCUR PS1399527 /7/2011 /7/2012 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,.000 ANY AUTO B ALL OWNED AUTOS BSTLT /14/2011 /14/2012 BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE $ . X HIRED AUTOS (Per accident) X NON-OWNED AUTOS $ UMBRELLALIA11 HOCCUR EACHOCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION C WORKERS COMPENSATION- - X WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETORIPARTNEWEXECUTNE E.L.EACH ACCIDENT $ 100,000 OFFICER(MEMBER EXCLUDED? © NIA gO515N280 /18/2011 /18/2012 (Mandatoryln NH) E.L.DISEASE-EA EMPLOYE $ 100 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORD"101,Additional Remarks Schedule,If more space Is required) - - CERTIFICATE HOLDER CANCELLATION (508)862-4784 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Barnstable, ACCORDANCE WRH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Garrity/KATHYi — ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200909) The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE Permit No. -----------_-------------------- Building Inspector cash eO'r'639VIR•\� OCCUPANCY PERMIT Bond ---- _--_-----`J "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to ('nriyno.ri7i a2 Pron--�rty Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. /f P ................................................ 19...... ................................................................................................................_ Building Inspector cG ►. G; ------ S6't Al f Ll .; uU OF t r C 5. N r E r C1=IZ`C'1F 1CU pl.bT' No 19334 `Y --- PL.h�I_ r RTE�� 4 ,-x LbUaT'l0f�l P" ?�;� y�1 �t�},'(, .tiny• A•��,�,_��""� 1�••�`Y''�.�..� ( �� lb ( � CG1:TIr- -M(AT TI-1CC tout rluwp. 5"O, ww Pt41J 1`�.i=E�c►JGC. t-1[['Ec�tJ 'G�wIPL.�IS W I T1-A TI-iC. .� A1.1L7 SLT>3ACIC K'C-Qvt�EMtcu�-S bF= T�-1f:� ��`r ' ( . ?d w w of ►)SrA 15L:i-�, a Q KTcQ-- -�t, _- �EG15 tz��:.0 1..A1.1p 5U1?v`YotLS TI-(l`S PLAN !S UOT B Se-' +-S AiJ OSTE�vtt_l.G o /tx/��,�j, t.,, £lt_ uSLo i-o oa:rc- _AiiwL:. Lor LliJeS APPt_lGb.1�1T C�k� ��Llcc�� 1�'! '�S Assessors. m lyy. .. �..:.. ,� ' map and IoC: numk3er ... ....... .. ... oFTNeto SEPTIC SYSTEM MUST BE Sewage Permit numb �.. ...� zt!...�.�`........................... �. 1 INSTALLED IN COMPLIANCE Z BAIMSSTADLE, : i House number ......:.......:................ ..T.1........................ ..... E5. WITH TITLE r uo i63 • ENVIRONMENTAL CEDE ANC ��owara. TOWN 'OF BAR"'MAMILMNs DUILDIKG.: - INSPECTOR APPLICATION ;FOR PERMIT TO ......... . • ! ........CJ.1.by. ...... �...../......:. � LLI`�c} TYPE OF CONSTRUCTION .....'....................'.�F :IM. ............................................:............................................ TO THE' 1NSPECTOR­OF BUILDINGS:' i The undersigned hereby applies for a permit according to the following information: j J Location .......... .`�...k .l v � �xlt!.``.. ProposedUse ............ ..W.IP74. 1..� 1.. ...........................:....:.............................................................................:... Zoning District Q ..Fire District (��.�.1."� .�� i ..,.1.. ...... .F.. ....... .i...... P rv\ Name of Owner :.............��lG(. �<.........:.... � 44Address .... ......... .......... U....... ��� . Name of Builder ...1. .!." ..........0 10...i�'gI.S KX � ����. �G��............. c %. Address ......................................... Name of Architect ..............................:...................................Address. Number of 'Rooms .............. ..............................................Foundation ...........65 Aj C_0—6__T_IZ5 Exterior �" `t G .f........Roofing ' "t . . Floors ... v4� ......:,., .......v� ?�1.�............................Interior .......... am.[/.............. ............................................ Heating ,J. .....:.:.V..1iC1 ..... ....:.......Plumbing ,tom:-..�� ........�5.��.....�I?.�C�Zl2 Fireplace. ......... ..L4r'':(�.................I`� ��.................Approximate Cost L�.......�„� �....f�CJ..... Definitive Plan Approved by Planning Board ________________________________19________. Area ...... ?..r............ Diagram-of Lot and Building with Dimensions Fee O a SUBJECT TO APPROVAL OF BOARD OF .HEALTH 30 a • I p I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . . ................ . .......... ..................... i r F COMMERCIAL PROPERTY a One St r 22815 ,1 No Permit for .................4..Y............ Sing7, ..Fsl7.ly...Dws1]irag. .� ....... . ............. {¢ Location ••Lot#1 141 Thistle...Dr. X . r Centerville . ' Owner Commercial Property„ t a Frame T�pe of Construction .......................................... rPlot ........................ Lot ................................ Permit Granted January .14.., 19 $1 Date of Inspection ................ .19 a _ Date Complete . ................. .. :.:19 LL t /~ =PERMIT REFUSED r 1 ..... . j....................................... 19 ....... .yam. ................................................. „^ _.. .-+..` _e._ ^ �, r l • . ........................................................... - .; ................... ... �f ...... .� ..�^-.. ............................................................. Approved ... ....................................... 19 ....................:...................... a C ..L4lCG ...... ...............r... _ .y _ �Zl _ - - -- _- ---__._- __.�. ��. -'�•` _ a- —ter---.' - - 70 LN VAN+�y i WALK IN 10-p e J w ty 10 Al 1 ru _ !. i .. b !r- - I - . - - — -1•� �y' - --- ti x, Rminky . i • s. wr.e.Js , L Q I Y ::Ft f c4 a 5 :• i I\ I �. tz- r pJ�Y. i I �. - I r 4 z R 28 ' ll —24 p / tJl. ,e ilII 1�1, a po + I , 3�p-. f I r , 1 �g ALL lq;NV.w 19K2o bAT-,4 Z`Ixl& M