Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0078 WATERSIDE DRIVE
- ,. .- ` y 1■Y7P 4 v . - � }.. Q � ., f .. _ _ .. p _ � - ,. o , ... s Town of Barnstable �. w _. r ��� AB ? Post This Card So That it is Visible-From the Street Approved,;Plans Must be Retained on Job and this Card Must be Kept �'^ $ Posted Until Final!Inspection Has Been Made. %asq Where a Certificate of Occupancyas Required,such Building shall Not be Occupied until a.Final Inspection has been made Permit Permit No. B-20-1294 Applicant Name: Patick Clifford Approvals Date issued: 05/26/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 11/26/2020 Foundation: Location: 78 WATERSIDE DRIVE,CENTERVILLE Map/Lot: 227--163 Zoning District: RC Sheathing: Owner on Record: CARLIN,JOHN J&ANN ELIZABETH Contractor Name: ' HYTECH ROOFING.SOLUTIONS Framing: 1 Address: 78 WATERSIDE DRIVE LLC. 2 -.--Contractor License: 184383 CENTERVILLE, MA 02632 Chimney: Description: stripping old shingles, install certainteed landmark pro Est. Project Cost:. $ 17,160.00 Permit Fee: $87.52 Insulation: Project Review Req: Fee Paid $87.52 Final: Date: 5/26/2020 . Plumbing/Gas . ! Rough Plumbing: Final Plumbing: Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas:' ' All work authorized by this permit shall conform to the approved application and the`approved construction.documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-.laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing - _ - —• - - 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected atthe throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: S.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Vy Town of Barnstable Building -� annraarw Post This Card SoTFiat tt is>Visible>From;the Street Approved Plans Must be'Retamed on,Joband•;thisCard Must�be Kept '"" iPosted UnULLFinaI Ins ection Has Been Made s Permit 1639-A� dy., x-' e p y„ 3"''� t = i�: ? ,i ., .k. ? .�sE n. t�> ..`ia Farms+ Where a Certificate of Occupancy�s Required,such Building shall NoLrbe Qccupi d until a Final�lnspectionhas been made ^I Permit No. B-19-3223 Applicant Name: CARLIN,JOHN J&ANN ELIZABETH Approvals Date Issued: 09/30/2019 Current Use: Structure Permit Type: Building-Shed-Residential-200 sf and under Expiration Date: 03/30/2020 Foundation: Location: 78 WATERSIDE DRIVE,CENTERVILLE ,Map/Lot: 227-163 Zoning District: RC Sheathing: k Owner on Record: CARLIN,JOHN 1&ANN ELIZABETH +" Contractor Name: Framing: 1 I Contractor..icense: Address: 78 WATERSI DE-DRIVE ; 2 CENTERVILLE, MA 02632 $ Est Project Cost: $0.00 Chimney: f Description: 10x12 shed Permit'Fee: $35.00 Insulation: Fee Paid $35.00 Project Review Req: shed registration 120 square feet. f 3 `.' Date 9/30/2019 Final: Plumbing/Gas f Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced with insix.months afte' issuance. All work authorized by this permit shall conform to the approved application and theapproved construction documents for+which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures�shall be in compliance with the local zoding by laws and codes. This permit shall be displayed in a location clearly visible from access steeetorroad,and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. V Electrical The Certificate of Occupancy will not be issued until all applicable signaturesiby�the Building and Fire Officials arse provided on this permit. X Minimum of Five Call Inspections Required for All Construction Work: ` h £, s Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: a ..,. 3.All Fireplaces must be inspected at the throat level before firest flue lining is`instaIled 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 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). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: f Town of Barnstable THE rp Building Department Services Brian Florence,CBO Tom OF • BARN sr.E Building Commissioner mks9. 1659. 200 Main Street, Hyannis,MA 02601 If-P� '> .pr�D www.town.barnstable.ma.us w f , g 4: 27 Office: 508-862-4038 F= 508-79.0-6230 r�RM�T# ,C3 i 9- 3 3 FEE: $35.00 SHED REGISTRATION RESMENTIAL ONLY 200 square feet or Iess JZ Location of shed(address) / Village �07 757 Property owner's name Telephone number (D 'x Cu',,c� Z 1163 Size of Shed Map/Parcel 9 Signs Date Hyannis Ma m Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? You must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.- PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST U ACCOMPANIED BY A PLOT PLAN . Q-forms-shedmg REV:08/6/17 - MORTGAGE INSPECTION PLAN DOSTON 12-04519 SURVEY, INC. P.O.Box 290220 Charlestown,MA 02129 (617)242-1313 MAIN (617)242-1616 FAX mpp@bostonsurveyinc.com APPLICANT. JOHN J.&ANN ELIZABETH CARLIN DEED/CERT. CERT#121175 LOCATION: 78 WATERSIDE DRIVE PLAN REF: #32290-E CITY, STATE: CENTERVILLE,MA SCALE: 1 inch=40 feet PREPARED: 05-15-2012 CERTIFIED TO: 1: L=20.00 R-453.07 97.13 — — _ 20'WIDE WAY �9e LOT 18 N DECK su 2 STORY #78 147.77 N �\ lC ty-a 6 • 1 I 1994(c)Bww Survey Solk—i, WATERSIDE DRIVE The permanent structures are approximately located on the According to Federal Emergency Management Agency ground as shown.They either conformed to the setback �P�ZN�F n'L9SS, traps,the major impruvemenL%on this property fall in an requirements of the local zoning ordinances in effect at �t� 6! the time of construction,or are exempt from tiolation GEORGE Gip, area designated as Zone. A I cr, enforcement action under M.G.L.Title Vll,Chapter 40A, o -C. N Community Panel Nu. Z-� .-•r p _ T7 Section 7,and that there are no encroachments of major a COLLINS - Effective Date: �-�-— oz _^-Z improvements either way across property lines except as N0.4178 shown and noted hereon. 9 P Q .r NOTE:Zone C is areas of minimal flooding(no shading). y� of This designation is not based on an elevation certificate. NOTE:This is not a boundary or title insurance survey.This plan e nce to procedural and technical standards for Mortgage Loan Inspeclions as adopted by the Massachusetts Board of Registration of professional engi rs,250 GMR 6.05.and use for any other purpose is prohibited.This plan is not to be used for recording,preparing deed descriptions,or constructio ol 41 N zo, WILLIAM G Ia N Y E ti No. 19334 O GIST - CE.2 T/F/LSO �L0T P��i�c/ I ao suRv ,saC,4 7/0 y.• C'EvTrRViZ26f, TA447- Tf�� Cuc �:►F ,fN®�✓�f,�E.2Eo.(/CoM.�L YS. l rj%rH SC.4 L. C— • 0A TE of TN6' 7-,:=) /cam S'VrA&--C- -A,VO /s NU LG T l8 , 0CA 7",E ys/iTy/r�/ TyE .�,LOG� t.kC Y ���A r f�G4141 C - `ARA XTE�26 t,<;/,oT BAS ZA �v,2y�'Y� Qs'T.�2✓%c.C�a MQ3S. D�,�SE7-S.S/�oi✓�V Ss�vtp •t/vT - n^ ... .. 'Np 2061.a.. Permit for 1' S o ........ .....:. -� (:r Single Family Dwelling ............................................. — s Location .....JAt..la.......78..Wat rsida.-Dri-ve u Owner K.. .Bpwes s Type,of,ConstrucT!on Frame V ...... ...... � . t Plot is Lot fig � • _ Permit=!Granted Aril 30i ;...... 19 84 3 Date of;lnspecti ?......� ./.!•.i.J ....:19 41q Date Completed `. . 19,e � � i 4ss ssor's'map'and-lot number..... a..... .. 0 Qyoa ropy Sewage Permit number ...................... . c.... THE /' ..✓�, L�g y,� TABLE House nm ......:. /J: .. ........ s0 'rmn TOWN OF BARNSTABLE BUILDING INSPECTOR' APPLICATION FOR PERMIT TO .......... ...... ►. Gr.. .............. .. ... TYPE.OF CONSTRUCTION .....\ " ...... ... �.. '�. .......... � �. . . ......... ................ .: .... .... .19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according tot the following mformatioric Location ... ................ ........... ...... Proposed Use �.l Lit'.��...'1. �?...15?::.. .\Y _r` ......: ......... ...... ..... Zoning District .............[........:.:...........................................:...:Fire District :...... Name of Owner•.6- .......,:........ ..... .......Address� .L-1' ' r'x{••••...... fl .?..`.••:•••k .... Name of Builder/... ..!ill:`.�.�.... Address ...... 1.`�,.....` .!5� 1� `i.A +.:.. i. `ll 111 Name of Architect .... .................!.`..........:`.....Address ................................. Number of Ro ms . ......................................:.........I.............Fcundatio Exterior ..�Q�... , \ ..... ..:...........Roofing �.:.oq.. .... :... WXID Floors .... .... ` o ....interior .: ...... "Y 4 .......... /J lam/ 1 Heating ".1/.�•1.-Iwo/ �..c .........................................Plumbing_.`...<r... ��1......:.. Fireplace ..0 1........................................ ...............Approximate Cost ... :...:.... Definitive Plan Approved by Planning Board __—_______19 Area . .. 9. d Diagram of Lot and Building with Dimensions Fee ...... ... SUBJECT TO APPROVAL OF BOARD OF.HEALTH /� I 1D :. 7/L y�y OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS . I hereby agree to conform to all the Rules:and Regulations of the Town of Barnstable regarding the above construction. Name ... ..... Construction Supervisor's License .......... BOWES, K. 'Np .20 .. Permit for ................. ................. ._.) !4 4 Single Family Dwelling ............................ ........ — Location .....Z,Qk..a.ft.......78..Waterside..Drzve ......C=terville................. Owner ..K....BCAVEA................ Type•,of Constructiori Frame... i j i :. Plot ..: ................ Lot .... PermVGranted P, ril 30r , 19 84 Date olnspecti ....11•.1.•1........Y9 E Date Completed 19p I i ii r I s .--�^n S:�-•+o <,-„�` �b `' ,�_ -` S _ v c-. -- �" -'-*.E 6.��a m .�� r-n.'sfi S_,§ _, v-�" r5.; I ' s z z �a f TOWN OF�BARNS,TABLE Permit No 25 T t Bu11dfng£=Inspector Ins +Cash: t sra _ ' '� � J Oar Bond -_ E T OCCUPANCY gP RMI Y l I a` � P Issued to � Address _ .,_ .Sys-� r��... T .xRp JiJ tta yi Drive Wising Inspector f C � Inspection date t ' Plumbing Inspector ✓j ri_ '� Inspection date - Gas Inspector �` Inspection date': rt zo Engineering.Department Inspection date Board. of Health ° G� Inspection dates l. THIS PERMIT WILLt NOT. BE VALID,'AND THE BUILDING SHALL NOT,BE OCCUPIED UNTIL r. SIGNED BY' THE BUMMING 'INSPECTOR .UPON ,'SATISFACTORY 'COMPLL+INCE -W1TH TOWN_ REQUIREMENTS,AND.IN ACCORDANCE WITH:SECTION 119.0.OF THE MASSACHUSETTS STATE BUDING IL CODE %l Building Inspector r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1 Parcel Application # Health Division Date Issued Conservation Division Application Fee d Planning Dept. Permit Fee N U J Date Definitive Plan Approved by Planning Historic - OKH _ Preservation/ Hyannis Project Street Address - Village CEAl C-P-V(>-k Owner CA P,LIA . TO 4 AAA) �V gpWPJ Address 36 "N"t^ Ad BIAI60mrol Al Telephone 64 - 7 Sq - z s 2 U i Permit Request ) F(*M E /5 / �1Zr�/1� �J�L� f3ETt, u �ITGt�I�u /�it/� �l^/��✓� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation g OO 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 3 Historic House: ❑Yes 4No On Old King's Highway: ❑Yes 4No Basement Type: ❑ Full ❑ Crawl Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 3 new Half: existing new Number of Bedrooms: 3 existing _new Total Room Count (not including baths): existing r- new First Floor Room Count Heat Type and Fuel: >(Gas ❑ Oil ❑ Electric ❑ Other Central Air: XYes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ,Name. CAP( A5Dc1p7-6'S -�QC Telephone Number Address;P0 S4k 19 o License /) M eAbTAA,'^ ),iqA Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Sty 6c c.o SoLq N -J ewA s SIGNATURE DATE J., FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME C,5 IZ' s-5 0 ` INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL " FINAL BUILDINGI�� DATE CLOSED OUT ASSOCIATION PLAN NO. _ The Ca=w7zwealth ofMassachusef& Department oflndusb"ia[Acc Am& Office of Invesfigadons 600 Washington Street Boston,MA 02111 www.muss go-PI&a Workers' Compensation Insurance Affidavit:Baders/Contractors/Elecfiricians/Plmubers Applicant Information p Please Print Le>s4bl�' Name(Busmcss/orgm alion/Indiv dual): �I C A5-5&GIA 7-ES —f . Address: PO. FO 6 K NJ 6 - City/Statd2 p:NM71V C—ZTdt/444 NA OZ.01 Phone#: JW'2,5'ir—I Are you an employer? Check the appropriate bon Type of project(required): . am contractor.1.� I am a employer with 1� 4 0 I a��contr and I employees(full and/or part time).* have hared the sub contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7.XRemodsling ship and have no employees These sub-conhwtors have g_ .0 Demolition Working for me in any capacity. employees and have workers' 9. 'Building addition .. [No workers'comp.insurance comp.insurance" ❑ reqW A l 5. We are a`corporation and its 10.0 Electrical repairs•or additions 3.❑ I am a homeowner doing all work a officers have exercised their 11.0 Plumbing repairs or additions myself [90 Workers'comp. . . right of exemption per MGL 12.0 Roof repairs insurance required.]t c.152, §1(4),and we have no employees.[No workers' 13.❑Offer colup.inerrrancerequired-) *Any applicant that checks box 41 mnst also fill ondthe section below showing their workers'compensation policy mfornntion.. t Homeowners who submit this affidavit indicating they are doing 0 work and then him outside contractors nmd submit a new affidavit indicating such. $Contractors that check this box mast attached an additional shed showing the name of the s¢b-contractors and state whetba or not those entities have • employees.If the soh-contractors have employc=.they must provide their woriccrs'comp.policy mnnbcr, lam an employer that is pravkgng workers'compemation insurance far my employees,Below is the policy and joh site information. Insurance Company Name: ►�K(! �l Policy#or Self-ins.Lic.#: 1?6 7 A ExpirationDade: OA�lf .rob Site Address: /g W l M51 DC Ql VC- City/StatelTp�t�t , gm t,)26 32,-- Attach a copy of the workers' compensation policy declaration page(showing the policy number and e3Timtion date). Failtrre to secure coverage as required.under Section 25A of MGL c. 152 can lead to the imposition of crhninal 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 Investigations of the DIA for inmrance coverage veufrcation I do hereby certify penalties ofperjury that the informaiian provided ahov is fnze and correct Fod Si Date:V Nk is Phone# OTxid use only. Do not write in this area,to be eonTkted by city or town oolciaL City or Town: PermiMcense# Issuing Anthoritp(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector • tS.Other Contact Person: Phone#: i Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Parsuautto this scat te,an employee is defined as"_..every person in.the service of another under any contract of hire, express or implied,oral or writinn_" • An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged is 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 oa 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 buildings iu 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 perfounance ofpublic wont until acceptable evidence of compliance with the ffis ranc0. requirements of this chapter have been presented to the contracting au tliority." Applicants Please fill out the wodcers'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 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 conformation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be retnmed 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 ifyou 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 ce 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 pemiitllicense number which will be used as a reference number. 7n 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 bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would lice 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. 'Ile Commonwealth of Massachusetts Il-pa-d ment of 1�dustdal Accidents office of bivesugatiom 600 washirzgton t Bastou,MA f1�111 Td,#617-727-4900 cot 406 or IM-MASSAFE • Fax 9 617-727-7749 Revised 4-24-07 • vnvw.mas.5_gov/dia � T Town of Barnstable Regulatory Services • MAIM Richard V.Scaly Director Building Division Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 ww mtown.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder h CA-f ,as Owner of the subject property hereby authorize C P<— Q O(Ji to act on my behalf; in all matters relative to work authorized by this building permit application for. 7,9 (Address of job) ""'Pool fences and alazms are the responsibility of the applicant. Pools are not to be filled or ut7ized before fence is installed and.all final inspections are performed and accepted. a S4 m of Owner S' of Applicant Print Name Print Name 3/31120o Date • Q:FORMS:OWNERPERMISSIONPOOLS CAPEASS-01 THORNE CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYI) 1/612015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ELOW. 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 CONTACT NAME: Rogers&Gray Insurance Agency,Inc. PHONE FAX /877 $1t)-2156 434 Rte 134 A/C No Ext: A/C No):\ ) South Dennis,MA 02660 E-MAIL-ADDRE s: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:NGM Insurance Company INSURED INSURER B.:ARROW MUTUAL Cape Associates,Inc. INSURER C: P.0.BOX 1858 INSURER D: North Eastham,MA 02651 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS I WVD POLICY NUMBER MM/DD MMIDDIYYW A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR MSO41163 01/01I2015 01/01I2016 pREMISEs Ea occurrence $ 50,000 MED EXP(Anyone person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JEC LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea a.!den,) $ 1,000,000 ANY AUTO M9641163 01/01/2015 01/01/2016 BODILY INJURY(Per person). $ ALLOWNED X SCHEDULED BODILY INJURY(Per $ A UTOS AUTOS ( er accient) X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per.adcident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE CU041163 01/01/2015 01/01/2016 AGGREGATE $ 5,000,000 DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATION X SPER TATUTE ERH AND EMPLOYERS'LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 1767A - 08/24/2014 08/24/2015 E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? N❑N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Office ®f Consumer Affai and �uslness ]�egula�fl®n 10 Park Plaza e Suite 5170. Boston, Massachusetts 02116 Home Improve m- 6-nt Contractor Registration Registration: 100110 Type: Supplement Card, Expiration: 6/9/2016 CAPE ASSOCIATES, INC. -- - RICHARD BRYAN I - ___ _ 345 Massasoit Rd N. Eastham, MA 02651 Update Address and return card.Marls reason for change. ❑ Address ❑ Renewal ❑ Employment ]Lost Card 3-CA1 0 50M-04/04-GG1/0/12166 ✓IZ2 -V047N77.6?ZCU2[ZGG1L 4�iG�dClCf2fLQ��6 Office of Consumer Affairs&Business Regulation License or registration valid for individu➢use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 'J Office of Consumer Affairs and Business Regulation Registration.:100110 Type: 10 Park Plaza-Suite 15170 Expirafi.an 912'6-1 Supplement Card Boston,IC1A 02116 CAPE ASSOCIAT 'INC:.:;= ; = RICHARD PO Box 1858 N. Eastham,MA 02651 Undersecretary N t v\id ithout signature . • 1 1 Massachusetts -Department of Public Safety — Board of Building Regulations and Standards Construction Supevisor r License: cS-082435 RICHARD M BSRYANT 125 KETTLE HOLE RD` EASTHAM MA 0264 �• ��` ��'�ti�`' Expiration 05/08/2016 commissioner .._ _.ALA�00 ip-) 'Z-2Cfo � W SUM , i 1 I 1 i . iSEA& 14): _ -- --- pF MAC . t q �44 E GAF GODI O pL u ........... _. 140 " ��FGISSE�C>� RESIDENCE MODIFICATIONS MICHELE CUDILO, PE. 3� `5' Consulting Structural Engineer Centerville, Massachusetts 02632-1979. (508)771-7601 Drawn By: MC Date: 3/23/15 Drawing u 78 WATERSIDE DR. Scaler d=AS��u.ED Rev. 0 CENTERVILLE, MA S K— 1 File Name:HAVENcopea Project No.:2015-53 'i `fix st Ltd l < I 0 _. . o C OF MAC cy t q TPAL..(It9,Pt1..._ S, io 34114 REGlst� yC�� BSI a f RESIDENCE MODIFICATIONS MICHELE C.UDILO; P.E. Consulting Structural Engineer Centerville, Massachusetts 02632-1979 (508)771—.7601 Drawn By: MC Date: 3/23/15 Drawing 78 WATERSIDE DR. scale:�+!Alf;�EDog.Rev. 0 CENTERVILLE, MA S K_ 1 File Name:HAVENcapea Project No.2015-53 I Ta a7 .1�s Cape Associates, Inc. BUILDERS e5t.197t 2013: AUG 14 Pik �� �4 PROPERTY MANAGEMENT II SERVICES II PAINTING Dtl�' ' : Jeff, . . .. . I have attached the building permit with the fire department sign off and pictures of the top and bottom.handrail returns for 78 Waterside Drive in Centerville. Maybe these will. be sufficient,and therefore will save you from a return inspection visit. Please let me know. My phone is 774-994-0673 Regards, Brad Haven; Cape Associates COMMITMENT II QUALITY II INTEGRITY P.O.Box 1858 North Eastham,MA 02651 II 508.255.1770 II 508.240.1473 FAX 203 Willow Street,Suite B Yarmouthport,MA 02675 II 508.362.9770 II 508.362.4600 FAX 782 Main Street,Chatham,MA 02633 II 508.945.1010 II 508.348.1047 FAX www.CapeAssociates.com ya;A M1,x,l;r a .d w' cT ,rc .. .. .. to .F.x�a ,. .£�`#.;. ':,, er.+ e. ,p y :� { t .� �1 d s:d � T > f• r � r.,f ��,t7 0"` rf t���S7 0 � .. - a. r_. +..M a".' .y '.;aP a» ,`f _..{� � rc'' ��N, �.. •� �� hs. " ' .., (,/�•l� .�7c. ter c +d u++'. -r e ' .,Iµ `.• _ { S rt;:, k ` 4 pr 'dk 4r . 7'... { •+Ai�'!fg i 4 4t .•• � _. N x;?� �, .. t�r'oe' t� w ',n ei �, rF r t r•°•� �, •-..>�� r {� ,��' r`. + i,c�F R'r r • f, V*�.T��,r� . 40- y , v R* t��e :� 3y. �,tar.... r �„ �*sY�,� �" '�'`�'�,,.�.'• `v��a ,.l r�rau t� ',�y� � i. J� ���S rah 4 '* 1. Lks + + S f 17 t ar�•�4 g t 1j � E![` �� ,vbk- "n. 41-Rt+ Lx' X w tffl- ., i az t „• a- E�„. ;T�. �-� '"' �' s��r •P �' +. <.�n ��* � *: .i , .{ R���-ids T. m .F ' - fie• 5v"' " _ � 't• ." ,y�„� 1 3� } - r�X 'f r ' Y� a i}r - T _v S+_ d,�3 r1 H %r ems} i qy � � t#y` A Y" - ;. w. �; � �•. .�"_ •k �^.` " �; fir. u �_ •a �� k�'{ � 2^5 t.» +.. .. y Qr,�;'x• it I • A��,. Y- r�'�'iB'+.X' -� ��`3✓x. Th'�e �i... �i :: 1^V' yam+ tc w� $ ��y'�� w'{ All - �k'�<•s Lv�i'��.;*� �" �,w✓.ems. r >��'��r.. a ty '' Ai f , cfl M ' 0 v r n dr 10 c rH� c � �T �6 • tY r p 1 "ub" y • ef AI Y - a _ _ ,��' � .ram �' 'ty'� • m.�. .. 4 >. o c � i. � °` � t7 - �•5y � ".,"�i �` �d 'A � � �c ,.r, sS � �� *� .. ;zl y It tid:'... s _ � tv � +- -$ 'y- # r# _' � o • - � ray ,,„y � ' 5� '. r x � � .. � ... `.` � �`tiMi•. III » r i v'• w n e, s a r f, TOWN OF BARNSTABLE Building. . . 201303342 * BARNSTABLE, + Issue Date: 06/07/13 Permit 9 MAS& i639• �� Applicant: CAPE ASSOCIATES Permit Number: B 20131324 RFD MA't a Proposed Use: SINGLE FAMILY HOME Expiration Date: 12/05/13 [Location 78 WATERSIDE DRIVE Zoning District RC Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 227163 Permit Fee$ 94.35 Contractor CAPE ASSOCIATES Village , CENTERVILLE App Fee$ 50.00 License Num 14985 Est Construction Cost$ 18,500 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND FINISH ROOM ABOVE GARAGE,NEW 4'KNEEWALL UNDER SKYLI 7jHTrHIS CARD MUST BE KEPT POSTED UNTIL FINAL STAIRWAY WALL TO EXT TO ROOF,CATH CEIL FOR OFFICE USE-INTINSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: CARLIN,JOHN J&ANN ELIZABETH BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 36 LAUREL AVENUE INSPECTION HAS BEEN MADE. BINGHAMTON,NY 13905 Application Entered by: JL Building Permit Issued By: THIS PERMrr:CONVEYS N0 RIGHT TO OCCUPY.ANY STREET ALLEY OR SIDEWALK OR ANY PART THFREOF;.EITHER nVORARILY O Y.'::ENCROACHMENTS ON PUBLIC PROPERTY;NO SPECIFICALLY PERMITTED UNDER THE BUIIDtNG CODE,.MUST BB"APPROVED BY THE JURISDICTION: sTRuf oR ALLEY.GRADES AS WELL AS.DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE'"; OBTAINED FROM THE,DEPARTMENT OF PUBLIC WORKS';TTIE ISSUANCE OF THIS PERMIT.DOES NOT RELEASE THE'APPLICANT,FROM THE CONDITIONSOF'ANY APPLICABLE SUBDIVISION RE3T1tICTIONS ` MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE'PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). Po • RD RO BUILDING INSPECTION APPROVALS PLUMBING,INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS Dip 2 2 ?( c 3YP 3 1 Heating Inspection Approvals Engineering Dept Fir g _ t 2 Board of Health � c TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a 1 Parcel Application # Health Division Date Issued 17113 Conservation Division Application Fee S Planning Dept. Permit Fee Date Definitive Plan Approved-by Planning Board G17�13 Historic - OKH Preservation/Hyannis Project Street Address /8 INATICKS 1 blE by_-I y<, Village C"TERV f I_L� Owner CA UV. 11094 J t AW Address 4 I,AuREL, A✓OIA4C DAIN- 140A) Telephone - N l3 per' Permit Request FINtSlI Room qGnRpGE ,vac,) jbC SKYu646 S`AA)R..t✓p Y' WALL- TO Q-00Ftt ill E CA t l)EDkA C. Cat i-1�lJ O�fC� SPACE Z t6S�- O,NC.Y Square feet: 1 st floor: existing proposed 2nd floor: existing proposed 3�2 Total new 31 L Zoning District Flood Plain Groundwater Overlay Project Valuation I8,5oo 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 of (5 Historic House: ❑Yes XNo On Old King's Highway: ❑Yes,No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count _ p Q Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: N Yes ❑ No Fireplaces: Existing New Existing wood .al stove❑Yeq ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: LIS sting mew �ize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: can w a� Coning Board of Appeals Authorization ❑ Appeal # Recorded ❑ 00 rn (Commercial ❑Yes ❑ No If yes, site plan review# Current Use - =- —__—__ - - _ Proposed.-Use - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ( �,t AS5570 A77C5 Z"A)C. Telephone Number Address3f 5_ M 'Sb)-r License # C5 052f / OVtrA ST l4,a rl'1 O ,74b 1 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RE TTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE `S .� FOR OFFICIAL USE ONLY M1 APPLICATION# E ,t DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: r —>FOUNDATION FRAME -ok ('1 LA13 f 4ow% INSULATION OK FIREPLACE ELECTRICAL: ROUGH FINAL •r PLUMBING: ROUGH FINAL a GAS: ROUGH FINAL y�1 FINAL BUILDING 37) /3 I 3 s } DATE CLOSED OUT ASSOCIATION PLAN NO. i' , ` .A�3ay SMOKE DETECTORS�REVIE _ e w�� WED •- -X r . 1' . 7113, S C UILQIN DEPT. T. DAT-yr �� E uA FIRE DEPARTMENT I ATE BOM SIGNATURES ARE REQUIRED FOR PER D 3251 ZI (3-7, P 360 IV )-0 x ` b 4 i. = The Commonwealth of Massachusetts Department of Indust7vialAccidents Office of Investigations y . 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le;oibly Name (Business/organi�tion/IndividuaI): 1 F N✓SAS Address: J CitySs to/Zip:.,✓ ( AST-P h MA 0 Z6S Phone k S48 '.7D o Are n an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 10 4. 0 I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. Now 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 g. Demolition. working for me in any capacity. employees and have workers' insurance.$ 9.. 0 Building addition [No Workers -comp, inSrTrance comp. required] 5. We are a corporation and its .10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.7 Roof repairs insurance required.]t ' c. 152, §1(4), and we have no : . employees. [No workers' 13.❑ Other . comp. insurance required.] *Any applicant that checks box#l•must also till 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 1contractors that check this box must attached an additional sheet showing the name of the sub wntractors 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. ,n, Insurance Company Name: ATM M V► uT uAL , .Policy#or Self.ins.Lic. F,43Oo6,V 7661 ZQ Z Expiration Date: Z¢ 13 Job Site Address: �it �R-. �. City/Siate/Zip:C�' J Yyl+d 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 weIl as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day-against the violatot. Be advised that a copy of this statement may be forwarded to the Office of Investigations ok the DI f r incrman coverage verification. I do hereby:c u e and penalties of perjury that the information provided above is true and correct -Signafore: Date: S 2" Phone#: �!� o �� d 7 7 l5 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.Snilding Department 3. City/Town Clerk 4.Electrical Inspector 5..Plumbing Inspector 6..Other Contact Person: ti. 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 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 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-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 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 entertheir self ingrrance license number on the appropriate he. —ity or Town Officials ?lease 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 ouf 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 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Iuvestigations 600 Washington Street Bastoii, MA 02111 Tel. #617-727-4900 ext 406 or 1-977-MASSAFE Fax# 617-727-7749 .evised 4-24-07 W www.mass.gov/dia . Client#:43203 CAPEASS A�;ORDTM CERTIFICATE�OF� L" IABILITY, INSURANCE DATDD/YYYY) 1/22122/2013 . 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 THEPOLICIES 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' CONTACT- NAME: Donna White Rogers&Gray Ins. -So. Dennis PHONE FAX 877_816-2156 434 Route 134 E M I�� EXc: A/c.No E-MAIL s: mail@rogersgray.com South Dennis, MA 02660-1601 ADDRE 508 398-7980 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:NGM Insurance Company 14788 INSURED INSURER B:A.LM: NlUtual InSUranCe 33758 Cape Associates, Inc. _ P.O. Box 1858 INSURER C INSURER D: North Eastham,MA 02651 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 CONTRACTOR OTHER DOCUMENT WITH.RESPECT TO WHICH THIS CERTIFICATE MAY BE-ISSUED OR MAY PERTAIN. THONSURANCE 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 SUBR POLICY EFF POLICY EXP' LIMITS LTR INSR WVD POLICY.NUMBER MM/DD/YYYY YYY MM/DD/ Y -_- A GENERAL LIABILITY MSO41163 1/01/2013 01/0112614 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE REM SESOERENTED nce $50,000 CLAIMS-MADE- OCCUR 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 $2,0061000 X PRO- POLICY $ JECT LOC, AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A M9041163 1/01/2013 01/01/261, Ea accident $1,000000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED. BODILY INJURY(Per accident) $.. AUTOS AUTOS X HIRED AUTOS X NON-OWNED'• PROPERTY DAMAGE $ AUTOS Per accident A X UMBRELLA LIA6 OCCUR,.. . CU041163 1/01/2013 01/0,1/201 EACH OCCURRENCE $5 000 000 EXCESS-LIAB CLAIMS-MADE AGGREGATE $5 OOO 000 ' DIED X RETENTION$10000 $ B WORKERS COMPENSATION WMZ8006570012012 8/24/2012 08/24/2013 X`WC STATU oTH- AND EMPLOYERS'LIABILITY 'Y'/N TORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT. $500 000 OFFICER/MEMBER EXCLUDED? N%A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE s500,000 ' If yes;describe under DESCRIPTION OF OPERATIONS below E.LDISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION' Town of Barnstable SHOULD ANY�OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE:'EXPIRATION, DATE THEREOF, NOTICE .WILL BE•DELIVERED IN 200 Main Street ACCORDANCE'WITH THE POLICY PROVISIONS. Hyannis,`MA 02601 AUTHORIZED REPRESENTATIVE ©:198 -2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) :;, 1 of'I The ACORD name and logo are registered marks of ACORD flCQZd1 r,IMQ9R9R, TI,H Page 1 of 2 Pages = PROPOSAL Cape Associates,Inc. All home improvement contractors and subcontractors engaged BUIrDERS ta.io:t is nnoaerry MANAGEMt i SERVICES s ftr 'o in home improvement contracting,unless specifically exempt MA LICENSE k100110 from registration by Provisions of Chapter 142A of the general P.O.Box 1858,N.Eastham,MA 02651 laws,must be registered with the Commonwealth of Massachusetts. 345 Massasoit Road,Eastham,MA 02642 Inquiries about registration and status should be made to the Submitted To: John&Betsy Carlin Director,Home Improvement Contract Registration,One Ashburton 78 Waterside Dr. Place,Room 1301,Boston,MA 02108(617)727-8598 Centerville,MA 02632 JOB NAME/NO. finish room above garage PHONE (607)724-2648 JDATE 5/7/13 JOB LOCATION 78 Waterside Dr.,Centerville,MA ARCHITECT DATE OF PLANS n/a n/a We hereby submit specifications and estimates for work to be performed and materials to be used: See attached specification sheet Construction related permits: By builder WORK SCHEDULE / Contractor will not begin the work or order the materials before the third day following the signing of this Agreement,unless specified here in writing. Contractor will begin the wotk�on or about TBD Barring delay caused by circumstances beyond Contractor's control,the work will be completed by 5-6 weeks The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not be considered as violations of this Agreement. WARRANTY The Contractor warrants that thew k furnished hereunder shall be free from defects in materials and workmanship for a period of one year following completion an shall comply with the requirements of this Agreement. In the event any defects in workmanship or materials,or d rage caused by the Contractor,his subcontractors,employees,or agents,is discovered within one year after completion of any jo including cleanup,the Contractor shall,at his own expense,forthwith remedy,repair,correct,replace, or cause to be remedied,re a' ed,or replaced,such damage or defect in materials or workmanship. The foregoing warranties shall survive any inspection per ed in connection with the agreed-upon work. We Propose hereby tVsh material and labor-complete in accordance with the above specifications,for the sum of:Nineteen thousand fondred twenty dollars ( $19,420.00 ) Payment to be made as fo ows: Cape Associates,Inc. 20 % ($3,884.00 )upon signing Contract Name of Contractor/Designated Registrant 35 % ($6,797.00 )upon completion of framing,electrical rough 345 Massasoit Road 35 % ($6,797.00 )upon completion of heating,insulation,drywall Eastham,MA 02642 10 % ($ 1,942.00 )shall be made forewith upon 100100 04-2476237 completion of work under this contract Registration No. Federal Tax ID Notice:No agreement for home improvement contracting work shall require a down payment Brad Haven (advance deposit)of more than one-third of the total contract price or the total amount of all Nome ofsewmen deposits or payments which the contractor must make,in advance,to order and/or otherwise obtain delivery of special order materials and equipment whichever amount is greater. Payments due 14 Awt ized Sign— days after invoice received.Late payment interest at 1%per month. Note:This proposal may be withdrawn by us if not accepted within 15 days Acceptance of Proposal -I have read all pages of this document and accept the prices,specifications and conditions stated. I understand that upon signing,this proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above. You,the Buyer,may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. Cancellation ust be done in writing. O N THIS CONTRACT IF HERE ARE ANY BLANK SPACES. Signature Date Signature Date NOTICE OF SCHEDULE CHANGES ;4r 41, x' Office'of Consumer Affai and Business Regulation 10-aPark Plaza - Suite 5170 Boston, Massachusetts 02116" Home Improve menCContractor Registration Registration: .100110 r Type: supplement Card' CAPE ASSOCIATES, INC. M �f I= Expiration: 6%9/2014 RICHARD BRYANT --- > 345 Massasoit Rd V N. Eastham, MA 02651 f� zi Update Address and return card'.Mark reason'for change ^f 'E] Address Renewal Employment. Lost Card IS-CA1 Co 50M-04/04-G101216 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.. P. Office of Consumer Affairs and Business Regulation', Registration:2A 00110 Type: 10 Park Plaza--Suite 5170 r Expiration-09/2014:: Supplement Card Boston MA 0 16 s' CAPE ASSOCIATES,INC �11 t . RICHARD BRYANTr y/ PO Box 1858 �. .� N.Eastham MA 02651 Undersecretary _ Not lid without s► nature , Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-082435 RICHARD M BRYANT 125 KETTLE HOLE RD EASTHAM MA 02642 IIX IN Expiration Commissioner 05/08/2014 �oFTHE Tpk� Town of Barnstable BARNSTABLE. • Regulatory Services MASS. ,b,q. Building Division AlEO MPS a• 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection �— Location 7 W K S:s-D E I� Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: R�Ei ue..wt\) T� t�Hti�ePdST PT 7D PT ? Please call: 508-862-4038 for re-inspection. Inspected by L Date 1/4 _. ._ .... ._. ._..&6') w A C-X�STIlU(a a �� X � 3(-o s� Cal ulu�;f 216 —� i` I�y3T� L�AKjiji n1 , ifv6o 3z s� �S Zf 5, t� A~ r R.7 � P1 a. I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel I �� Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address /� &/1 S Village P//E- Owner DAMES C'��FSS�" , ��r�jo, Address AdfryJ Q-040, WALL aasn.!;:4=0, tJl_ Telephone Permit Request i-� 6 C t e � 646Z 330A,eQ/y-_0rLno&,2�;z. .1 �' . Asa Aa'�1��G ,� v� ,A,l7, �;l�-�'�,� �oS�,f�—�a,� `�'; "��}����, R 6-' G��et �rf�" i ys���►c,a N n t s ��' Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay RrojectTValuation y-�. AW Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family W Two Family ❑ Multi-Family (# units) Age of Existing Structure _?0 Y/L S Historic House: ❑Yes 21 No On Old Kings Highway: ❑Yes W No Basement Type: A Full ❑ Crawl ❑Walkout ❑ Other 41 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 R6,om Count (not including baths): existing new First FloorWR om Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other - - Yp Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) CName ® �` Telephone Number �cddress � hb SSGt4146,42_ 1 C A lyfft— Home Improvement Contractor# / 19 rWor-ker°s Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE r----YDATE� [� / FOR OFFICIAL USE ONLY APPLICATION# r DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING t DATE CLOSED OUT' s ? ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.massgov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl . r ... - e r NaIrie-(Business/Organization/Individual): . ;j ",�k Address: City/State/Zip: 9&/ Phone.#: Are you an employer?Check the appropriate box: Type of project(required):. . -w 4: I am a 1:❑tI_am a employer with �`=�- - :: general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction.. a sole proprietor or partner- listed on the attached sheet:_ 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity.. employees and have workers' [No workers' comp.insurance. comp.insurance. 9. ❑Building addition required.] M.--t5"F1 We are a corporation and its 10.❑Electrical repairs or additions �" 3.❑a I am a homeowner doing all workv officers have exercised their 11.El 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 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. $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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: ' r 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of d Investigations of the DIA for insurance coverage verification: . I do hereby ceply der the pains7an :pen ties of rjury that the information'provided above is true and correct j. Si R'ature --= ► Date:=(d , �'./ ✓ 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 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 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-anti!acceptable evidence of compliance with the insurance requirements of this chapter have been presentedto 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-con6actor(s)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 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 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. The Department's address,telephone-and fax number: ..The Commonwealth of Massachusetts . Depaxtment of industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. ##617-727-490.0 ext 406 or 1-877-MASSAFE Revised 11-22-06 Fax##617-727-774 w .mass.gov/din -L Town of Barnstable i fill Regulatory Services HAS L I Building Division TOM Pam,nuadbg cower MWA Stwg,Hitmis, A 026Di P Owner Must Complete and Sign This Section N Mar Ovum of the ? In auucls xdz; -c to wodc mUhPxi%*d by this bWdLv6 peanit P & La- AX-v ( rs of Pool ene an4 alarMs are fhertspomibiury of the p ..=. . Pools not to be Rued beforefence iS i Wled and pook max:not to be , utilized until W inspwionq perfoed and accepted, mar Prima Name at Ae n 21 12 09:02a Vaughn Homebuilders Inc, 508428 3186 P.1 MaNsachusctts- Dcpartnient or Public s-Lfetv Board ()I*Building Regulations and Standards THE COMMONWEALTH OF MASSACHUSETTc !'%1W, DEPARTMENT OF PUBLIC SAFETY License: cs 46236 I ASHBURTON PLACE-ROOM 1301 BOSTON.MASSACHUSETTS 02108-1618 JOSEPH C VAUGHN 34 GREAT HILL RD SANDWICH, MA 02563 Expiration: 212312013 Tr;7. 10012 g w P Office of Consumer Affairs and usiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Qqntrac.tor Registration Registration: 100513 Type: Private Corporation . ..... Expiration: 6/19/2014 Tr# 224908 VAUGHN HOMEBUILDERS, INC Joseph Vaughn 34 GREAT HILL RD. SANDWICH, MA 02563 Update Address and return card.Mark reason for change, E] Address Renewal Ej Employment 0 Last Card TS-CA1 0 50M-04104-6101216 License or registration valid for individul.use only Office or Consumer Affairs&Business Regulation 64HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:, 100513 Type: Office of Consumer Affairs and Business Regulation -Suite5170 -6/19/2014 Private Corporation 10 Park Plaza Expiration.:... .............. .......... Boston,MA 02116 VA GHN HOMEBLIILDERSJNC*�'.' Joseph Vaughn 34 GREAT HILL RD:,. SANDWICH,MA 02563 Unders"retary , valid without'K' ture T C" Z INA 1, Z Ht 7 .W 6`1Z .&E El AS a:S .9bS re .aut{rz{ a b.ce9{ v3av 9NL4 - .ts+t.rez I H030 Uri WJ30 se r.t-z{ NO3 t3 Q - .9t�{o-a9 f P.O.Box 290220 Charlestown MA 02129 (617)242-1313 MAIN (617)242-1616 FAX mpp@bostonsurveyinc.com APPLICANT: JOHN J. 8 ANN ELIZABETH CARLIN DEED/CERT.• CERT#121175 LOCATION: 78 WATERSIDE DRIVE PLAN REF: #32290-E CITY, STATE: CENTERVILLE, MA SCALE. 1 inch=40 feet PREPARED. 05-15-2012 CERTIFIED TO: 1: La 20.W R=463.07 97.13 20'WIDE WAY LOT 18 DECK xis 2 STORY -- rrit 147.77 N r994(c)aortal Survey,SaRware WATERSIDE DRIVE The permanent structures are approximately located on the , According to Federal Emergency Management Agemy 1/Lv%6'CARRIAGE BOLTS 32'O.C. ROLL FLASHING GALV.HANGER 2X10 P.T.JOIST 3/4'PLYWOOD SPACER FINISHED PINE EXTERIOR DECK CONNECTION SCALE:1'=I'0' ;..< •' �. -� '`,fir, y t rt�' �' i � .. ' -- - TOWN OF BARNSTABLE <= 2636T Permit.No. -------------------- Building Inspector s°usr 1 Cash ------------_----------------- e <- OCCUPANCY PERMIT Bond __.:__ .X - Issued to K. Bqeies 'Address ` inspection date Inspector dz5;/- L f r� Plumbing Inspector�, f T � i # ' Inspection date Gas Inspector Inspection data ^±� r ,XEngineering Department �_F �,� �,� / Inspection date -- �_ Board of'Health Inspection date , f THIS PERMIT WILLGNOT 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 MASSACHUSETT19 STATE BUILDING CODE. f ...'� ..,-��, ......;E`..... ..f:�......... 19« j f �2 .. ............. ........... c ... ...............-- J - r Buildin.- Inspector / FROM j- TOWN OF BARNSTABLE BUILDING DEPARTMENT Mr. Francis Lahteine . 367 MAIN STREET HYANNIS, MA QM Town Clerk Phone: 776-1120 SUBJECT: FOIDHERE P DATE- - - September 11, 1984 MESSAGE Work has been completed under Building Permit # ,6 6l {K. Bowes}, Please rel6ase'Bond.' ` t e - SI DATE µ REPLY • SIGNED. - .NeT.RMt - RECIPIENT: RETAIN WHITE COPY,RETURNPINK COPY i•' - - - t �' r. " l- PRINTED IN U.S.A. SENDER SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. A s4ssor s�'map'and lot number- . 7 k `............... 7u , { I t Sewage Permit number .. . \/vu�?Lcy ..... FINE Z..,BABBSTABLE, • House number .... .. .:.... �� ��.t ...... ` 9. 'Wrrq�n TITLE 5900. :M6 �� { a 0MAI O 'TOWN OF• B.:ARNST�A-BA - f .. . BUILQIHG tIHSPECTOR ` - APPLICATION,F'OR 'PERMIT TO ........... ,'r.l.!JI. ............................. ... r`, TYPE OF CONSTRUCTION;.................... .�•� 'r Y . .................................. v.............19 ..1 TO THE INSPECTOR OF BUILDINGS: t-:. The undersigned hereby applies for a permit according to the following information: . ? .................................. Location ... ` � .. Proposed Use .1�i t. .:.'1. !7...1�. .. ...... .. ........................•.... ................ Zoning District ........................ 're District Name of Owner ����. \X Address�� c•-x•t...........�"1.' .1:�...`..�..��:...... Name of"Build er .::.... .:1`{ ......Address 1 .. 1 1 .... .... . .. ..... .... . t l � a Name of Architect .. ..l ........................ ......... ....:.,.Address .h'.S ....................................... .............: { Numberof Ro ms .....................................� ...... .....t,:............Foundatio .. .J .....:......................................... :Roofing �<..�. ..Exterior ..... ......... .. .................................................. l Floors 2`.. ...... ..Interior �.......................................... ... ..... .. 1............ . Heating .►.-Iw� � Plumbing_ l� t�l S . .... .. ... .. . Fireplace f �1 ..................... ..::...:. approximate.`Cost ../& .2.fl.(�.(<'.. . -Definitive Plan Approved 'by' Planning Board, --- ---------------------------19---- -_'. Area .....P 9.?�- . .... Diagram of Lot and Building with Dimensions - Fee r .!: r' .......... ..... SUBJECT TO APPROVAL OF"BOA RD.OF HEALTH 64 OCCUPANCY PERMITS :REQUIRED FOR NEW DWELLINGS I hereby. agree�.to conform ,to all the' Rules and Regulations of the Town of Barnstable. regarding the above construction. s • T Name'.... ...... ... ............. .f ' ; Construction Supervisor's License .......... .. ...... BOWES, K. • f .26.361. ^ Permit for 12 S O '`, -. _.• .. ................. Single Family Dwelling :.!............................ ................. .... Location ..Wt..Ia.......7.8..Wa;lu--rAde•'Dr-i- e • ......................�.�teizvllle.............. ................. �.. Owner .....K.,..B4We ............................................ Type i of: Construction ....... � ....3? .......... c + _ t r• ................................... .......................... kt.. • - .. •, 1 t,,5. `:, , ..� S } _ . Plot ..................... Lott. ........` ` A , ' Permit:Granted ... ril30 19 84 ........ ....... ...... Date of Inspecti �� ....7 . .:19 ri Date Completed 19p 9 f r Assessor's map and lot number . .................... .......... aL I - . TH E Sewage Permit number ... EARISTABLE, House number ................................�EJ� .....................* NAG& 1639- 0 MA-4 6'. TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...ke;.C.2.s. \.................................................................................. TYPE OF CONSTRUCTION ...... ........1.4!0te/<%..................................... .............19 ..t TO THE INSPECTOR OF BUILDINGS: The undersigned hereby,opplies for a permit according to thelfollowing information: Location .......................................................................................(I ........I................. .. -........................................................ lk ProposedUse' ..................... ...... ........ ................- ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner,�X...f `( C.. ..............................Address................. s......`.... .........:............. Name of .......Address ....... ........................... ............................ Nameof Architect ....................................Address ...................................................... Number of Rooms A/ ..........................................................Foundation' ............................................................ ......... Exterior ................................... ...............................Roofing ................. .................................................................. Floors .....A�� . ...................................1.interior ..............I............................................. ......................................... u HeatingA�A.A (z�..(...:...........................................Plumbing .................... ........... .................................................. Fireplace .................................. .......................Approximate Cost ...... ..... ........................................... Definitive Plan Approved by Planning Board ------------------------------19--------- Area ........................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 6?............Name ......... ..... . .... .. .............. ........... .... . Construction Supervisor's License ...................................... BOWES, K. A=227-163 26361 v-, story No ................. Permit for .................................... Single Family Dwelling ............................................................................... Location ...Wt..0...... ..................centexMille.................................... K. Bowes Owner .................................................................. . Frc-uTk-- Type of Construction .......................................... ............................................................................... Plot ............................ Lot .............................. Permit Granted .....TQK4.39.1................19 84 Date of Inspection ....................................19 Date Completed ......................................19