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HomeMy WebLinkAbout0055 THREE PONDS DRIVE a � ' .;,. y' -' q - ` 5 0 c .. V .. ' C a .. � � � .. �. 6 � .. � .. ... .-. i. � . .. a ° .. _ - � .. � .. ,. ... r. - o c o � o 4G o � .. V � t r. .. ,. ,: S Town'd Barnstable *Permit# / Regulatory Services ., Efee6monthsJro rssgedo;e MASS. Richard V.Scali,Director 1639. . Building Division �s Paul Roma,Building Commissioner `I � ��� 200 Main Street,Hyannis,MA 02601 � ;lf www.town.barnstable.ma.us Office: 508-862-4038 --e Fax- 508=790ri k30 EXPRESS PERMIT APPLICATION - RESIDENTIAL]ONLY Not Valid without Red X-Press Imprint Map/parcel Number /J Property Address � S //,�,W E�Residential Value of Work$ �� O Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Alt. r 4�L*f. i Contractor's Name Telephone Number a V2 Home Improvement Contractor License#(if applicable) / �so Email: Construction Supervisor's License#(if applicable) orkman's Compensation Insurance y Check one: s � ❑ I am a sole proprietor `� ' ❑ 'I am the Homeowner nir­ �iave Worker's Compensation Insurance Jq N 17 ' Insurance Company Name isi irk, Catz - Workman's Comp.Policy# AoW wo,90e 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) [,e-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows- #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note:' Properly Owner must sign Property Owner Letter'of Permission. , A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc F 06/20/16' r , The I;ommorrrreakh orjfMassadr=e s Dep=tmeat&frndkstrial Acdde7M-, 600 Washington kS`lreel BosIon,MA 02111 - - kVFYR43.ilta�£��i�Ili Warke& Comp nsatianlusu auceAffidavit:B giiers/CaIItTdctursXlectiicianrJP x mbers Appil;cxnt Informiatku Please Print Y NatIIH m Citgf el (�.�•. „t W 6 . Phone i - Are you an employer?(Meek the appropriate box: Type of project(require): I.D�I ❑I am a general contractor arc€I employes(an�dibr part-dime).* have Hired.the sclr-conbmctvas 6. [:]New oo oa 2.❑ I am a sole proprietor or partner- listed an the attached sheet. 7. P-�deug. ship and have no employees These stab-contractors have $- ❑Demolition to and have wo6=&' . worl-ing fiurste in any capacity- � � 9..❑S,uildmg addition - required-] - 5. ❑ We are a corpora ion and its 10-❑Electrical repairs or additions 3.❑ I am homeowner doing all work officers have exercised their 1L❑Plumbingrepairs or additions !UzeM[No work='oomg- too§I( �d a rave m per L try❑Roofrepairs in=anrerequired_]i 1;_❑other employees.[No workers' cotrtla_instasnce required j •Any aggIicaat fat d mcIsbox ft1 mast also Moutthe swfionbelaws]wn5ag dmirwockers'comp�m++�pcHrgiafoxmsEiaa &nmematuexs trlm submit Ants sfii Lwd IuTxztWZ they axe damg O oval amd dies bime amtside caatriammost submit a new affidzdt Indicxtno such fCa a:Yfixn ebedY this bax mast etarly as addinim sheet sboRmg the acme cf the sub-cawmKhicr=d state whe4hec ar nm tbnse sities}we • employees.I€tiyeamB-camtaart--hare empIoFers,tFiey asxstp�mvida their wad�s'taaxp.gal9cy amatseL Jam an Eetoiv is fhepvlicy and job site infbrmat&n. Insarance Company Name: rYL /'4rt�, Ctt f . Policy 4.L or Self ins Lic_ e f(�/ �i✓�OS� 1piratiaa Date: Ste'/' �v�,� , Job Metlddressr � tGnv�S �iCt ul F CitylStafrJ�.tp: Attach a-capy of the workers'compensationpolicy declaration page(showing the policy number and expiration(late). Fafl=to secum caverage as required nudes Section 25A of MCL c.157 can lead to the imposytion of criminal penalties of a fine up to$U00 OD muVor or yearimpfismzne t,as well as rivil penalties in the form of a STOP WORK ORDER and a free of up-to$250_00 a dap against the violator. Be whised tam a copy of this sbdement snay,be forwarded to the Office of. Investigations oftfie DIA for insurance coverage tredficaticw- Fdo hereby catffly rmdsr tTfs pa' and pwabirs*'. .pedW7 thatthe ire ortrtafian prm rled abot�s b bzre and cmreat. Sit�ature: Date Ph=lk OJS�id=w aWr. Da not urine in gibaea, be rarrip&tad bg�ot'fatrrn aA dM, ' Cky or TaRn: Permiff.cease Issuing Autharity(d de One): L Board of Hoddt I Ong Department 3.fitpTmrn Caerk -4.Electrical Inspector S.Phumbbg Inspector b.Other Contact Person: Phone#- 6 Taformation, an Mstructions - m&s&w2 seffS Ge=nl Laws cbaptcr I52 requires all employ=to provide worbMs'compensation for f cna employees.. Prn su,M3ttn Ihis sty,an.mercy Is defined as ._every peasan in fhe service of another tinder nay co 'a ofhue, express or implied,oral or writfm." An emplayer is defined as"an mdi�at partnersbxp,asso��, Poration or other legal entity,or�y two or more of the,foregoing=gaged in aJoint ,and inch ding the legal Fepresemf2five s of a deceased employes,or the association or ofherl�enti oymg Moployees. However fhe receiver or txuste�of am m.dividaal,per, fy,� f a. owner o house mot more an th tbree apartments amd vzho resides tharei a,or the occupant of the,- dwe IImg having dwelling house of anodM who employs Pam=im do mainfPmance,conslracti on or repair wod on such dwelling house or cra the grotmds or bur7dmg appu�thereto shall not becanse of such employment be deemed to be an eroploye." MGL chapter 152,§25g6)also states that"every state or local licensing agency shall WMROId$ze issuance or renewal of a license or permit to operate a Tausmess or fa construct btufldings is tfie commonwealth for any f ho has not produced acceptable evidence of compliance with the;,,cara�ce covexage required." $PPIr Dn 1 P P ,,,,,,,rmwea7ti,nor a'ny ofib poIifical snbEVisi=shall Addit3.anaIly,MQ.��I52,§25C(7)states fiTeifhcr fhe� . . an into any contract for the perfxmanc,ofpnblio wmk ur�tl acceptable evidence of compliance wish the msm-ao-ce:.. regan-Mments of this rbapter have been.presenfeti m the contracting authority_" Applicants , Please fla 0-at the wotixeas' compensation affidavit completely,by checking the boxes!hatapply to pots situation and,if recess snb�ontractor(s)name(s), address(es)andphnne— er(s) alongwiththeir certificate(s)of a'L�PIy insurance_ Limited.Liability Companies(LLC)or Ladted Liability Pmt a=ships(LLP)wi$E.no employ=ofber fhan.the members or P a b=s,ate not rued to carry workers'mnpensafion fiance. If an LLC or LLP does have empIoyees,a.poIicy isregnftt4 Be advised that this a$idayrt may ba sabmit t i--dto the Depa-Iment of Indasfrial Accidents fior confmnaiion offiLmumce coverage Also be sure to sign and date the affidavit The affidavit should be retumeti to!he city or town that the application for the permit or license is being mque not the Department of ; Iz>dustrial Acciden-L-- Should you have any questions regatdmg the Iaw or ifyon ai a regmred to obtam a workers' compensation policy,please call fhe Department at the=nber listed below. Self-bsm-ed companies should enter their s elf iusur� ce license number an the approprlain line City or Town Officials Please be sale that the aTadavit is complete and prntted.legibly. The Department has provided a space at the bottom of the affidavit for you tr fill out in.the event the Office ofluvestigafio has to cordajct you regarding the applicant Please be sure to fill in the pen�L>tllicense nwnber which w7I be used as a refere nce mrmber. Iu addition,an appliaant that must submit multiple pen it/Ecen se applibatioms in.aaty even year',need.only submit one affidavit indicating current policy information if necessary)and under"Job Site Add rss"the applicant should wt�"aII locations m (�Y or: p C town)-"A copy of the-afftdavif that has becu.officially stamped or mazlxed by Ii the city or tovm maybe provided t,the applicant as-�roo­fthat a valid affidavit is on file for fudrse permits ar cevse� A new affidavit must be filled ovt each year.Where a home owner or citizen is obtaining a license or peamitnot related to any businrss or commercial venfise (Le-a dog licenses orpeonit to bttm leaves etc_)said person.is NOT=T*rdto cOnpleft this affidavit The OfficeofIu iomswouldItketothankyouimadvanceforyourcoopea�ionandsbovldyouhaveanyquestions, please do not hesifafe to give us a caIL The Depsrt nmfs atidrSS telephone and fax nIImzbea: - dam c&Ydmtdal AoDidant% Tar 4 617' --950 Q�t 4€6 or 1- 77 MA GAFF' Fax 9 617` 27'749 Revised424 07 WW �v Idia fT, OMAS HOME IMPROVEMENTS PH. 508.328.1635 owl Exterior Remodeling Experts BBEL f- r eb: www.thomashomeimprovements.het r Fully Licensed & Insured 3. Box 177 Construction Supervisor Lic#99913 �nterville, P'IA 02632 .- Thomas Home Improvements Proposes to perform the following work: Location of proposed work: Mr.&Mrs. Beauchainey 55 Three Ponds Drive Centerville, MA 02632 �a Date on which construction should begin: The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that cannot be avoided by the contractor shall not be considered as a violation of this contract. The contractor agrees that when such delays become known to the contractor,the contractor - will advise the homeowner as soon as possible: The homeowner hereby acknowledges that in certain remodeling work,the demolition process may reveal defects in the existing structure which`must be repaired,creating additional work which may need to be carried out in order to complete the work described in this contract. In such case the homeowner agrees that the duration,of the work and the schedule date of completion may differ,and that such variation is not to be considered.a violation of this contract. The total cost for labor and materials under this contract: Proposal'to install Maibec grade A white cedar shingles on entire back of home&botl y gables as discussed would be $10,830.00 - Proposal to install Azek PVC trim on entire home that is not already PVC as discussed would be $6,550.00 Proposal+to install Waterfall Gutter Guard System on entire home would be When I receive the quote for gutters I will forward to your email address Thank You for Giving Us the Opportunity to Help You Improve Your Project In the event that while stripping the siding we find rot that needs to be replaced,the homeowner then has to agree and authorize any replacement or restoration. Then in addition to the above contract price,the homeowner agrees to compensate the contractor for any repairs or restoration at the hourly rate of$45.00 for a carpenter and$30.00 for a carpenter's laborer, plus the cost of materials. -Siding to be stripped and cleaned of all old siding&debris -Home to be papered with Typar house wrap -Azek PVC trim to be fastened with Cortex screws &plugs as discussed -10 Yard dump trailer will be needed on site; and will be removed at completion of the job -Contractor will be responsible for all building permits needed at the property NOTICE REQUIRED By LAW With the agreement of the contract$500.00 of estimate is due. Further payments under this contract are as follows: 1/2 of the estimate due at the start; and remainder due at completion of the job. Balance of all materials and labor shall be payable in full upon completion of work described in this contract. Payment as agreed upon shall be made when due. Any payments which are delayed shall be subject to a finance charge of 1.5%per month. The contractor warranties the work completed under this contract for a period of one year from the date of completion. During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment, but the contractor shall not be responsible for the normal maintenance, repai o r due to abuse, misuse,and or normal wear and tear,which shall be the responsibility of the homewner. All warranties for the materials supplied by the contractor shall be passed directly to the homeowner. The homeowner may be required to register or mail in such warranty card or evidence of ownership in order to activate such warranties. Homeowner failure shall not create any responsibility for the contractor under the warranty provisions;the choice of repair of replacement shall be at the discretion of the contractor. The homeowner acknowledges that the form,content,and notices contained in this contract are intended to comply with the applicable portions of the Mass. General Law Chapter 142A, and regulations promulgated there under. In the event of any instance of non-compliance, only such ----_---portion shah be ir+valid and tine-remainder-of this cot�ract-shall be in full•-force effee :Irradditian;anp -- such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and regulation. Signed as a sealed instrument on this date: Date: / "�� Homeowner Contracto �, AC® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 05/03/2016 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 ISSU NG INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)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 ark endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such.endorsement(s). PRODUCER CONTACT NAME: Kris K0 reski' Mark Sylvia Insurance Agency,LLC PHONE FAX 404 Main Street t 508 957-2125 AIc'No: 508 957-2781 E-MAIL ADDRESS:mark marks Iviainsurance.com Centerville,.MA 02632 INSURERS AFFORDING COVERAGE NAIC 9 INSURER A 'Farm Family Casualty Insurance INSURED INSURER B _ Thomas Home Improvements LLC { f PO BOX 177 INSURER C Centerville,MA 02632 INSURER°: 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 NAMEDIABOVE 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.` IL7R TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP MMI.DDIYYYY MMIDDIYYYY • J LIMITS A X COMMERCIAL GENERAL UABILITY 2001X1416 5/1/2016 5/1/2017 EACH OCCI JRRENCE $ 1,000,000 DAMAGET RENTED CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 100,000 MED EXP( ny one person) $ 5,000 PERSONAL,&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,DOO,D00 X POLICY❑PRO- _LOC - PRODUCT-COMP/OP AGG $ 2,000,000 OTHER: ., $ AUTOMO6ILEUA8ILITY CO eBcaideD SINGLE OMIT $ y ANY AUTO BODILY IN URY(Per person) $ OWNED SCHEDULED BODILY IN URY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPER DAMAGE $ AUTOS ONLY AUTOS ONLY, Per eccide t UMBRELLA UAB` OCCUR EACH OCC RRENCE" $ EXCESS LIAS CLAIMS-MADE I A' AGGREGA E' $ DED RETENTION$ A WORKERS COMPENSATION 200IW8053 5/1/2016 5/1/2017 PER CITE ERN AND EMPLOYERS'LIABILITY II ANYPROPRIETORIPARTNERIEXECUTIVE YIN NIA ' EL.EACH ACCIDENT $ 1.,000,000 OFFICERIM EMBER EXCLUC ❑Y El.DISEA E-EA EMPLOYEE $ 1,000,000' (Mandatory In NH) If yes,describe under E.L.DISEA E-POLICY LIMIT $ 1,000,000 ' DESCRIPTION OF OPERATIONS below ' ^ - DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Carpentry I ,, ' Insurance coverage is limited to the terms,conditions,exclusions,other limitations`and endorsements. Nothing contained i the certificate of insurance shall be deemed to have altered,waived or extended the coverage provided by the policy,provisions. e CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBE POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, OTICE WILL BE DELIVERED IN Troy Thomas ACCORDANCE WITH THE POLICY PROVISIONS. 499 Nottingham Drive Centerville,MA 02632 AUTHORIZED REPRESENTATIVE 01988-2015 ACORD CO RPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD' ` 1 ry , Massach . . . ' Board of us �e art 'rv; Id_ nt Co .. Lice se'C ui ng Regu t- f Public Safet nstructio 99 y n Su ervi 13 and Standards pen'isor SPe6alt TROY AT Y y.. 499 NOTT 'v[AS Ga CEN.T.ERVILLE Mq U� Comm � •�',1; . . . ,, � ssioner Expiration.. 04/13/2018 �/e�pavnirr�a�rcaeccll�d�vaLt�;rac�t�eC�i ,• Office of Consumer Affairs&Business Regulation License or registration,valid for individual use only HOME IMPROVEMENT CONTRACTOR _-before the expiration date.4f found return'to:';E Registration j'g 22 Type:, Office oft onsumer Affairs and Business Regulation ka Expiration 619%2098 LLC 10 Park Plaza Suite 5170 " �.. « ; Boston;MA 02116 TROY THOMAS HOME-,- fMENTS,LLC 1 y� TROY THOMAS 499 NOTTINGHAM DR CENTERVILLE,MA 02632 Undersecretary Not valid w- ut signature Massach Board us 9 yr+ Id- nt De ar Const�gene fCgSL ng Re9u tionS anablic Safety action SUpervi o 9g13 Standards TRO Speglty vV 499 Npr NGMAS d CE .TERVI�LE qM ORNE M'4 02B32a "Co Commissioner — Expiration; 04/13/2018 c—L Office of Consumer,Affairs&Busio"ess Regulation e� License ` -- - or regtstrati,on valid for individual use only' HOME IMPROVEMENT CONTRACTOR -before the expiration date.,If found return,to*lv<.. Registration 1822 Type: Office of Consumer Affairs and Business Regulation Expiration 6t79/201& LLC 10 Park Plaza-Suite 5170 Boston,MA 02116 TROY THOMAS HOME IMPROVEMENTS, LLC TROY THOMAS 499 NOTTINGHAM DR—,= CENTERVILLE, MA 02632 Undersecretary Not valid w' ut signature ! lc ` Town'of Barnstable *Permito,��, 66 ,70_1;1-0`( Expires 6 months from Issue date Regulatory Services Fee - Thomas F.Geiler,Director Building Division l 11>4�oZ Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable ma.us ' Office: 508-862-4038 Fax: 508-796-6230 EXPRESS PERIM APPLICATION - RESIDENTIAL ONLY �] Not Valid without Red X Press Imprint o Map/parcel Number ` i Property Address 1 IJ�-e ot�St�� �Q�-�evv�� Ui A,j� ®ZCc'3z Residential Value of Work�P'Z-0q7 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address jj jj(1A,( I U Lp S T hre-e LkA k- cam y Contractor's Name 1��%co � I/lCl� Telephone Number 6-0 b ali$ t 5 11. Home Improvement Contractor License#(if applicable) /Z 4 7 5 3 Construction Supervisor's License#(if applicable) (g b G1(o A U ❑Wo0onan's Com pens ation In s ura nce S e �1�� � one: 1 I am a sole proprietor NOVNO V I � 2001 ❑ I am the Homeowner ❑ I have worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name t\jaSLL�k ,� �ICJvt,l,�i td(,-��1 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ' ❑ Re-roof(stripping old shingles) "All construction debris will be taken to - 6-wo" -y1 lv-1 G.,q TCA( Re-roof not.stripping. Goias over layers of roo ❑ ( PPS g existing y f) ❑-Re-side J� Replacement Windows. U-Value L, 31 (maximum.44) - /.*Where requhd: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic.Conservation,etc. ***Note: Property Owner mast sign Property Owner Letter of Permis' on, Home Imp; vement Contractors License is required. SIGNATURE: '" L 1 '3 U Q.Forms.expmtrg Revise071405 Department of lndastiW Accidents LA O,f,juice of Investigations 600 Was Boston,MA 02111 r,ww.mass gov/din Workers'Compensation Insurance Affidavit: Builders/Contractors/]Elect idans/Plumbers Aw :cant Information Please Print Le�bly Name(sus,'mess�Organization/Iadividnan: V c:o -1 j,:X QZ,;`"' C Cc,, - Address• ` 4 `Vl��"\K�`l �V , 4,t r 4 T .,Y � � •1_ T .. City/State/Zip. -6o :( nkS I►l • O toO -Phone#: 5�'�3 31�L9 (S-1 1 Are you ari:employ&f Chick the appropriate box:! , Lw,�..:� ,� :Type of project(regatred).- 1.❑ 1 am a employer with W. 4. ❑ I am a general contmctor and I 6. ❑New co7nsitaction employees(finll'and/or art time * ' • Have hired ffie'siib-comractors�: t �- 2. I am a sole prop detar orpaitaea•) y' Es'�on the attached sheet t 7 .❑ Remodeling ship and have no employees# ' ; These sub-contractors have 8.:❑Demolition .Working formeinm,capacitY , :R ,workers' comp insurance: . + 9: ❑ Buildmg.addition c e:f (No workers'. m eozap. sorance `` 5 '❑ We area aoiporation and its co- . .-required.] officers have exercised their 10.❑Blectricai repairs or.additions 3.❑ I am a homeowner doi�hg aIl vwrk ' r fi' -' of exemption per MGL I1.❑Plumbing repairs or additions myself Wo workers' comp. ` - c.352,'§1(4),and we ha�re act ..a 12:❑•Roof repairs r /.y' insurance reglwred.]t pmY ;[No worlcerss' cMV-insurance required.] "Any ePPhceatthat chtftboa#1 mast also ffi_outate section below showing tL*workers'Wmpansati m polieybfotmotion: 1, t Homeowners who snbmitt6 d5&V tindiceifiag 9hey she doing Ovork endfhmbim outside his must subunt anew affidavit indceting.such -:- - tr-amkwtm ihd checkt&boa mum aft&ed ua additioaat sheaf shdwing*e name of the sub-contractors i m ihek workers'comp•policy itrfoxmmdon. infOrtnatmli b nrance•CompaW Name rl,U ;4,� J i Policy#or elf ins. a#• (2� 2� -ZCj Z''r f -13xpiratwn Date L 0 Sob Site Address• �`�� Q� P •: { . �hT .:! ` ,#"' , -;City/StatielZlp: ozk Attach a copy of the workers'compensation pollcy declaration page(showing the policy number and'eapiration date). FaRwe{to.secure coverage as required mhder Section 25A of MGL e. 152 Bari lead to She imposition of ariminalpenalties of a fine up to$1A00,0Q and/or one- ear'. y msprisammelh�as well as.civzY penalties in flte form ofa'STOFWORK ORDER and a fine_ of up to$250.00 a day agaiust.t, violstdr. $e advised that a copy of this stateramf may te,forwarded to the Office of Investigations of the DIA for'insuranee coverage verification L t. : r t f .r•r. .P i+ •f I do hereby ce fy under the atns and penat#es bt perjur y that the`in,�ormadin provided above is true and correct 7 Z' SigmaNYV. w.—V� r 1;. ...i.r,..it. ",$x P '• v .S b r f r T- Q i c Phone#: ., .=r, •u' � =s �� / /�.,. 0 r 1d use-onl ;Do not write i n thts:area,to be coin feted c .or town o 4City or Town :' P {ermitlLlcense#r .� Issulag Anthority(circl'e one): 1:Board of Health 2.Building Department 3.ChyPFown Clerk 4.Electrical Inspector S.Plumbing Inspector _6.0ther ContactPerson: Phone • _ ;4. � .#: Information and Instructions _. , . anon for . . em Massachusetts General Laws chapter 152 tequmres all emiployers to provide workers compere �P�Y Parsumt tom , an employee is defined as"...every person in the service of another under any contract of hire, express Or.ianphed,oral or written.» . f. f •f ' a ership association, rporatio odier legal entity,r any two or more em 1 q is defined aS" d .P n or _ to er or the Ali p oY. .. of>$e foregoes'�g�'in a joint enterprise,and including the legal representatives of a deceas emP. Y � , arts ,association or other legal entity,employing employees. HoWover:tbe receiver or trustee of an individual,P �P '' house haviisg.notmarethanthree-apar"c is abd who resides fherein,oxthe occupant of the owner of a dwelling horse of anotherwho employs_personsato do maintonance,construction or repair worY•on such dwelling horse dwelling or burg appurtenant ttereto Shan not because of inch employment be deemed to be as employer." = - oi•on the grounds en w . 15Z,§25C(�also stag that"every state or local liceimsing'ag cy shall withhold the issuance or MGL chapter ' to operate a business or to construct buildings in thecommonweaith for any or, ,-m P 4 ewal.of a licens .. P� :. ... � � • rem the insurance coverage required. E Ifaace with _. a.cce le eYfdence•of comp • , applicant who has not lrsiicei . MGL chaPtez 152,§ZSC(7)states"Neither"die commonwealth not'any of itwpolitical subdivisions shall:. Additionally, for the p ace of public work. acceptable evidence of compliance with the insurance enter into any eseated to�the contracting i irements oft&chapter isft eenpr ` f Appli .cants , t, .° .b .. <;r •' 4. ' -Please fM out,the workess'w4ensation.afdavit completely,by the the Boxes that apply tb your situation•and,if sub-cOnlrac*s)name(s),addresses)and phone n miber(s)along with then cettzficite(s)Of. " necessary,supplymil s with no employees other t3�the • �aance. Limited Liability Companies(I,LG').or Limited Liabi'li'by Partnership (LLP) 'are not required tb carry members or partners, workers' aompensat�on insurance. If an Td;C or LIl'does have -y Be advised that this affidavit may be submitted to the Department-of Industrial employees,a policy,is requned• o be sere to sign and date the affidavit, 'Ihe affidavit should Accidents for cmft stun of insurance coverage' Als be returned the city of town that me application for flee permit or iicease.is being requested,not the Depaztimeut of r;, _ Indaitrid Accidents• Shouldy'on have any questions egarding ffie law or if you are requaed to obtain a workers' y _, x w lease call the Department:atfe imumber listed below, Self-insured compa nies should enter then .. Pcnsatio_n p_ohc36.p — — -- _ =-—• --...--— --— .: ; : ,��_..—- — -self-insurance lieense tm>ber an flee appropria#e-Iine� � . City or Town officials please be sure that the affidavit is complete and prmted'legibV. :The Department has,provided a space at the bottom , y for on to fill out in the event the Office of Investigations has to contact you iegarding.l}►e applicant. •of iliaaffidavit . Please be swre'to fill in f�i per�a /license number which WM be used as a reference r nmber. In additi m an applicant. ear need submit one affidavitin& thatmust submitmnliiplepermit/license applications in any given yen. only � g courant sf necessary)and ender"Job Site Address"the applicant should write"a111ocatlons in • '-''' (city or i policy iafotmalwa:( or town may be provided`to 9ie town)."A copy o€fie' '� thatbas been officially stamped or•tax - by the city -applicant as proof that-a valid affidavit is•on file for;futiue permits or lases..A new affidavits be,fa71e� out Bach year., here a home ownei or citizen is obtaining a license or pixmh not related to any business or commercial vbntare license. pemsit to-burn leaves etc.)said person is NOT regnrted tD complete Bus affidavit: (i.e:a dog -; . {- The O of Investigations would lice to thank you in advance for your cooperation and should you have any questions, a call. give us _ w . Please do not hesitate Tb �. ........„ s address,telephone and.fax member The Depazim�t' . • .' r.. _ _ _.._ ne;Caminonwed&of Massachusetts " Uepaxtment of In dostia Accidents _ _ _ :._ . • ' , �.. _ : : 1 Office 9, Investigations a •�' r.. .�.r: �.,. -640 Washington Street... `� � ,► -F _ Boston,MA Q211L ' `Tel.#617-727-4904 ext 406 o -•1477 MASSAFE _A -#ax#617=727-7749 ,Revised-5-26-05 �� www.IIlasS.gOv/ THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I M AC(:7 L DATA "VASCO NUNEZ CARPENTRY 79'Mayfaif Rd. _SOUTH DENNIS, MA 02660': MA Lic.40696$101 H.I.C. #124793 =' 866) 398-1511 • Toll Free (508) 398-1511 • Dennis, MA PHONE: DATE TO: , t;, Ja to ruir_e 508-420 JOB:NAME/LOCATION Drive r r? 32 Andersen 'Windows ylurtinum Storm'Door ' ryL.2ricr'.'T'riT .:for xte3.0+`.-:UOo JOB NUMBER JOB.PHONE ' 51 30/2G 7 SA X-- We hereby submit specifications and estimates for. - _. G..,oaei double nut tnl nC1ovis tr G_T:�1"ia5eii'te"1L '�.eVei� ( OPe in garage anc, r ... fi.ni,shea a _ 1 asement Rhepiace/7PSLa _ w,tl E� .ree Pd4rsen rrn�ltwaSnrr Clog, .c., un.g : th._nucws l._ s aticns. wlnocG�s �lll i1aV� a bdi•lite V1 n Ji Clad' ext.eri r wit_2.a [. 11te p e F _._s_rleu =r or, = CcrdNare, f —l-screens., c,-;.3 +rart_Le i7^1�1Ca �O :ate re?IOTaDI.e •.grill i•ci. c!':7 -.tie•i .dcws 41z._.:!: ha= e .a z1lLwaS!7" b1 it v Gra l ':�'_a.Ve:.Low-E4 argon eras 'ed .. i_SuIa-ems. C_ -., _ir._ the ci:-er -w ndows .it -your h6 use .. .. 2. erc.Gve one, ._t T.i:k r storm. door, and exte or zr from`garage`exterior doer Replace a`urn1nun, s-' toot c a.nC4 2xt2riOr L.rirr: 11 3aII:v L- Cai s -o top ...nte: c- anyea 18 g`as:, /screen pane 1. with. a glass bo+.tO:i•. 1 7. - ; �_.. ,r- I n prl"eo Pine stock I e new screen- for,r one window in garage . acing.. the S c r.e8t. e or r Zi 'and framing _:tateri.cl5 w lerC Zeedeci: . S_ 3_"- ns+d? e building TJC_T_ :E a' c ^et nor de_L Terv,,of. new do and r iidGY75. s ._ :._ :<oes not. include anv psi., ng.; s�airt'rig, or '.o.Lher repairs. .de a . a_ m_ =;m products .desoriced move will be prepaid :by. nose c _er. .y.,„ T= 'll:s ,::�:iS•a,i is- Sat:i-rdCtOZ'V, Tease 'sign the. YE-u�Cii�T 'copy -and re'�urn r+iic..'� pa47rte'it. -asc _ e _ -avable ' o Vasco unz ez Carpentry e_:tr'v in he'.a,molYnt i✓? : _U ._ � cr Z%C' _ -.tee SCr' r`c`1 vT7 } ...- -. ..__ ...._e.._...,....... . ... � _::..._.. ... Pu.-LId� 'F"'1:._5 C"1Ck IAT C .., L _. _ r7e2r'.s _ de 3 -very. We Propose hereby to furnish material and labor-complete in accordance with the above specifications,for the sum of: T^o 3a 10 ?_� .,_ee 1_re tj S2ven and 30/'1=00 Dollars dollars($ 2,297 :_ ). Payment to be made as follows: ? .,. _ . . '1 T1e t C start at time G start. . . . . . . . . . . . . . . . . . . . . . Y :rJJ, iJ �_itDleL-Lon at Lime of com.,le .:n. R. . . . . . . . . . J - — v All material is guaranteed to be as specified.All work to be completed in a professional manner according to standard practices.Any alteration or deviation from above specifications Authorized !I involving extra costs will be executed only upon written orders,and will become an extra; Signature e- charge over and above the estimate.All agreements contingent-upon strikes,accidents or' delays beyond our control.Owner to carry fire,tomado,and other necessary insurance Our Note:This prop sal`may be workers are fully covered by Worker's Compensation insurance. withdrawn by us if not accepted within ., -:0 days. Acceptance of-Proposal—The aboye prices,specifications and con- ditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.Paymen will be made as outlined above. # Sign S. ure"/ Date of Accep nce: PRODUCT 13128G ;USE WITH 771C ENVELOPE NEBS-TO Reorder:1-800-225-6380 or www.nebS.colri PRINTED IN U.SA. A s - ; iO WMB�YI REGULATIONS License: CONSTRUCTION SUPERVISOR Number CS 069680 q i9 Birthdate 10L031.4948;' a �, Expires 101A3/2008 Tr.no: 2714.0: i _ _ y Restrfctbd 1 G VASC • O E NUNEZ4I1, S DENNIS, MA 0202141 commissioner .. 'i ✓/ie '�aisvnxon+.ueal� a��/�aa<sacdiudeCl3 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR a Registration 124793 Expiration'. 8/'25/2009 Tr# 1'32409 . Y � Typei Intlividual Vasco E.Nunez 1.1 Vasco Nunez, j . 79 Mayfair Rd. r-� S.Dennis,MA 02660 Administrator i The Town of Barnstable Department of Health, Safety and Environmental Services LAWWAB & : Building Division HAM 367 Main Street,Hyannis MA 02601 • Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration Date: Name: �,f/t�`' .S <� E'f?i�c,t-�/,�1 6' Phone#: .S"U 3'' •1! 3 0 Address Type of Business: Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling-which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree-with the above restrictions for my home occupation I am registering. i 7 _ J Applicant;. r� - Date: A or) Map 3 Parcel Permit House#= Date I �— t, Board of Health(3rd floor)(8:15`-9:30/1:00-� "' Fee ssue 98 ar. Conservation Office(4th floor)(8:30- 9:30%1:00 :2:00) Planning Dept.(1st floor/School Admin. Bldg.) $ s111E Definitive PI pp ve y Planning Board . i. BARNSTABLE.MARSL . 6 TOWN OF BARNSTABLE _<f _ Building.Perm itA plicati P et ddress Village Owner P_�. ��(lJ�i P' I ,Address aL Telephone Permit Request r t t • -First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes p No , Dwelling Type: Single Family ❑ Two Family .❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full O Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths):Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ,'❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes p No k Garage: ❑Detached(size) Other Detached Structures: p.Pool(size) ❑Attached(size) ❑Barn(size) ❑None p Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use i o n e,0 I n 1Rilder Information Name Y )l 6 u � Telephone Numbers Address `License# 9� (+ _ Home Improvement Contractor# old Worker's Compensation# �Q .h NEW.CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE F LOWIN EASON(S) FOR OFFICIAL USE ONLY _ ma's � '. ' _- - :, :, ,• • _ . _ PERMIT NO. 17 DATE ISSUED `. Itc MAP/PARCEL NO. ADDRESS -. :VILLAGES OWNER 1 e, DATE OF INSPECTION: FOUNDATION FRAME , j _ • y INSULATION FIREPLACE ( t t + , 3 F• ,f t h - fi ELECTRICAL: ROUGH i FINAL PLUMBING:. ROUGH FINAL GAS: ROUGH : FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. L , T he Town of Barnstable- . : 9 N Department of Health Safety and Environmental Services �°r� •`° Building Division 367 Main Street,Hyannis MA 02601 mp h crossen Building Office: 508-790-6227 B Fax: 508-790-6230 Buing Commissione om For office use only 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: '�� Est. Cost Inn Address of Work• op Owner's Name Date of Permit 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 Owner pulling own permit Notice is hereby given that: OWNERS .PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL C. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply fora, ermit as the a en of the owner. . Date Registration No. OR Date Owner's Name 1 1l � �J The Commonwealth of Massachusetts 1 °=__ Department of Industrial Accidents a^ = ; yy t Office oflnFestfgatfons 600 Washington Street "• Boston,Mass. 02111 Workers' Compensation Insurance ffi Affidavit � t7D�rII r%�ri Y.� name: location: city hone# ❑ I am a homeowner performing all work myself. ❑ [am a sole proprietor and hav no one working in any capacity ❑ I am an employer providing workers' compensation for my employees working on this job. com nnv name: address: city phone#: insurance cn. poll cv # I am a sole propriet eneral contractor. or ho eowner(circle one)and have hired the contractors listed below who have the following work sat'on polices: company name: addressr L� hone#� do tv / insornnce CO. camranv name: address. .. phone#r city- :: insurance co . olicy# Fafiure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one veers'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a ante of S100.00 a day against me. I understand that a copy of this Statement may be forwarded to the Omce of Investigations of the DIA for coverage verification. I do herebv certify under the p and pen es of perjury that the information provided above is tru.-and correct sigstature —Date e/—' Print name Phone# FC3 y do not write in this area to be completed by city or town official. permit/Ilcense# a d1n4 Deparnnettt etsing Board once is required ❑Selectmen's Otflce mediate reap 4 E3HealthDeparttment phone#• ❑Other�� lmym 9,95 PJAI Information and Instructions 1 Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any cunt w 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 c 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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewE of a license or permit to operate a business or to construct buildings in the commonwealth for any applicarii"who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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 in the workers'compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns 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 pi cerise number which will be used as a reference number. The affidavits may be reduned ib the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. 4 The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Iwesuga"Ons _ 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 la' phone#: (617) 727-4900 eat. 406, 409 or 375 r. y I !NT OF PUBLIC SAFETY NSTiQCT%N SUPERVISOR LICENSE 47 s. I I YARNOUTHPORT, 1 j AN a u 1 *14 + ey 'fit .x_,>�...:3�°:..ww...c....,a-'_ c:s�:-�_ a....:...�,�:.,�.. - ....:. tee:. _. aa�ez.-: r;�„ a.�;rYt':,e�.kaN� �•-�—.._«r+�s:��. ., �.�aadyk :moe� �iia�.afri#�'w`a.$a�,�I°-�'`'4i I'I RE-ROOFING If located in OKH or Hyannis Historic District-Certificate of Appropriateness required unless same color/same materials specified on application Map/parcel number / J Sign-offs from , Tax Collector #of squares of shingles or square footage of roof to be shingled specify stripping old shingles or going over old roof. ` If going over how many roof layers existing now what size are rafters? What is span? Complete dwelling information for the Assessor's Dept.-if known ✓ Workerman's Comp.form Home Improvement Contractor Affidavit(RESIDENTIAL ONLY) ' Home Improvement Contractor's License OR Homeowner's License Exemption(RESIDENTIAL ONLY) COMME AL WORK-No License is required. Fee q-forms-PERMITS 1 Rev 2/10/98 Lf TOWN OF BARNSTABLE 20499 r` .w Permit No. --------------------- Building Inspector »nam. Cash -------!tsgp_no -- 'Ob OCCUPANCY PERMIT Bond ----__--------- "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Suffolk Realty Trust Address Box 308, Centerville lot 4#42 55 Three Ponds Drive;, Centerville Wiring Inspector � � Inspection date Plumbing Insp cto f Inspection date Gas Inspector _ Inspection date y'Engineering Department P1ff.��it�,!��./.L Inspection date 7 e 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. 91( 02 f C ..............�..� ......_.... ............................, 19 .............................. .............................. BuiTding'Inspeetor .v Assessors map and lot numbe ........................ 7 SEPTIC SYSTEM MUST B �ofTNETo� Sewage Permit number °"( INSTALLED IN COMPLIANCE g ........:......... ....... .............. ARTICLE II STATE WITH • House number ....... ... CODE AND TO B�aasTsnrB, ........................:...... SANITARY. rasa 0 . REGULATIONS.. r"-" '°�aU13 TOWN OF BARN-STABLE BUILDING IN,SPECTOR APPLICATION FOR PERMIT TO ...........Suffolk Realty Trust,,,,,,,,,,,,,,;,,,,•,,,,,,,,,•,,,;,,,,,,,,,,,,,,, ,•„•••:„ TYPE OF CONSTRUCTION ...........Single family residential ... Au_qust 11 , 1978 19........ TO__THE jNSPECTOR OF BUILDINGS: The undersigned- hereby applies for a permit according to the following information: Location ...Lot„ #••42„Three Drive. C,entervill�,,,,, ,,,,, ,:Q' 3.z,,,,,, Proposed Use .........Single„family....rest.,denta,qL.j.................................. ............. Zoning District .....single• faml�r•,resident•i��,,Fire District ..... .�X��.�zV.7.�7..�-Q���xV.11 � ............... r Suffolk Re t Tru t Name of Owner .............................. ..Y..........A5t..............Address ... ..Geate..ZZTillp.................. Name of Builder .Suffolk Red,:�Y...' rt?St..............Address ........ aU7 ................................................................. Nameof Architect ..................................................................Address .......................................................:............................ Number of Rooms .........8......................................................Foundation ..........po.ur.ed...concr Pate............................ Exterior .........C2dar...S.b. R92,e.,9......................................Roofing ...asphalt..shinglPas....................................... skim—coat laster Floors a .p��.7.XiS ..O�LeX..L11�der 7 aSCL2T�t.........lnterior ..............................P........................................ .; . Heating Forced hot water.. ...oil ... P ....................Plumbing .............. ?Y.�............................................................ Fireplace brick and...bloCk.......................:................Approximate Cost ........ r? .QQQ.r.QQ.................................. Definitive Plan Approved by Planning Board ________________________________19 . Area ......15 l..5.9.2......................... // a© Diagram of Lot and Building with Dimensions Fee �.............(n...............................j SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 / S5V1 0 1yly • 9 ,; ys Ifi 'rX�s¢ .................................... I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ....22,5.Z.4 ...... .. . ............... ................. Suffolk Realty Trust "No .....204.99. Permit for ...one..Pto1?x............. single„family„dwell g..................... Location ......... .`..Tree.. Oz�d ..Ax�.Y�........... .......................... .I� tlua ll.e........:..................... Owner ......`....$uffolk„Realty,,,Trut . Type of Construction .....................f.ra O.e........... .................. ...................................................... Plot ............................ Lot ...........#42............... Permit Granted August..17............19 78 Date of Inspection ....................................19 _ Date Completed ....................19 r a �12_8LW — PERMIT REFUSED .... . ^ ..... ............. .1..... ..... 19 n ..... ... / .. . .. .. ................ ........ Approved ................................................ 19 ..................................................................... ...................................................................... Assessors map and lot number_ / �- �_jy- J� ypi TM E Sewage Permit number ........................................................ i BABB9TOIILE, i House number .# .IrS........................................................... '�o M63s 0� 01110 l►� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........... ;i �fnl. ?r'?7_t-.v Trtagt .......................................................................................................... TYPE OF CONSTRUCTION ........... !ncrl,P f ami l,v rAci dtznt-_i a1. ................................................................................................................... f?sur-rust II . 1�7�...19........ .... ..... ..... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......Lt........�? r711rrp..F.onds...Dr'i.vo.........r?t r'rvi ].�.p.:... accar,h- Got-.t � .......n9F'i9...... Proposed Use .........:' .ng:�.P...F..ami.?:v......��i,clF...... ;a1:..........................................................................................:...... Zoning District ....", ncrle fami7:v rasi.donti Al.Fire District ....r'ent-er . ..�p.-r;...+-. 1.1P.............. Name of Owner ... :'.ealty Tria-t..............Address ...VS ,.....Rca?x...�0, .n................. Y FA Name of Builder f off- `�.p Z•.�v Tr13 f camp.�u .................Address........................ ........... .................................................................. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ............................Foundation rtnat--curl a Exierior cE d it 4;hirarrl.ra......................................Roofing ... Floors r r. tincr nVP? ttnrlP^1_wmpni. Interior ...skin—Coat n1aste� Heating ........r...c...c..d.....I...r.a..t.....W...a....."...C.....by...o.iI....................Plumbing ............ v ............................................................... .. ..Fireplace .b...lo}`:.. .... .. .sloe},.........................................Approximate Cost ........$.IS nQ4,. .................................. Definitive Plan Approved by Planning Board _______________________________19________. Area 592 .......................................... Diagram of Lot and Building with Dimensions Fee ........`-? '.... ......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH A'• � �?y. 1 a 4i I � I I r Yr I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ..........::<.:....:..:...........�-r......c::t.................... � 13-53 � No —..2O4gg. Permit for . . ----.������'��gg=��[.g����J���L. —. Location ---5�..�b�e��.��P��.�c���_-- / ............................----~^~~ ............................ 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