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TOWN OF BARNSTABLE
CERTIFICATE OF OCCUPANCY
PARCEL ID 024 159 GEOBASE ID 35246
ADDRESS 100 CURLEW WAY PHONE
Santui.t ZIP -
LOT 3 BLOCK LOT SIZE
DBA DEVELOPMENT � DISTRICT CT.
PERMIT 24321 DESCRIPTION SINGLE FAMILY DWELLING {PMT.#368 j
PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY 1
CONTRACTORS: Department of Health, Safety
ARCHITECTS: and Environmental Services
TOTAL FEES: INE
BOND $.00 ox
CONSTRUCTION COSTS $.00
756 CERTIFICATE OF OCCUPANCY
* BARN3TABLE. ;
MA83.
OWNER DACEYt BRIAN-. T TR ,s63
ADDRESS SANDALWOOD DEVEL TRUST E�M1�►I
PO BOX 95
CENTERVILLE MA BUILDIN %bI I..
BY
DATE ISSUED 07/10/1997 EXPIRATION DATE
1� I E
'1N;,�9Wp OF BARNSTABLE, MASSACHUSETTS• D
"A-Q24.159 " • December. 20 94 Q +` _19 "ws�1`, ZM.I:T NO.
rlatthew Aacey" > P.O. Box 155B $u�zards Ba t.
APPLICANT ADDRESS f y.
4'- (NO.) (STREET) (CONTR'S UI ENSE1 -
-Bi3IF.D DWELLING2 r $i 11 j NUMBER OF 1 t
PERMIT TO ( ) STORY ngle Family Dwelling � DWELLING UNITS 1 �
(TYPE OF IMPROVEMENT) ,p NO. '(PROPOSED USE)
AT (LOCATION) �100_Curlew'RQSd, COtuit (Lot ZONING
�� DISTRICT
(NO.) - (STREET)
rT
BETWEEN AND
(CROSS STREET) (CROSS STREET)
' - LOT
SUBDIVISION LOT BLOCK .SIZE
. '
BUILDING IS TO BE FT. WIDE BY -.FT..LONG BY: - FT1.91N HEIGHT.-AND SHALL CONFORM IN CONSTRUCTION
•
TO TYPE USE GROUP _ - BASEMENT WALLS OR FOUNDATION
(TYPE)
REMA RKS: Sewage .#94-213
fig: Ovr, T
AREA OR-* Ll3L.vV.. sq. tt. - I*q Ann A!3
VOLUME- ' ESTIMATED COST, "arDO., FEE
(CUBIC/SOU,ARE FEET) I
OWNER
Ctt Dion Builders, Inc.
UVLDING DE
w Liu, ate B
..� Unit A, buzzards f9ay, MA y,�DING
ADDRESS
t •
;THIS PERMIT CONVEYS NO RIGHT ,TO OCCUPY ANY STREET, ALLEY OR,SIDEWALK OR ANY PART THEREOF. EITHER T-EMPQR,ARILY OR
-PERMANENTLY. ENCROACHMENTS ON PUBLI,C PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE ,MUST.BE AP-
PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES,AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED
.-,.FROM THE DEPARTMENT OF PUBLIC'WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
"`OF ANY APPLICABLE SUB.DIVISION'RESTRICTIO.NS.
MINIMUM OF THREE CALL -APPROVED PLANS MUST:BE RETAINED INSPECTIONS REQUIRED FOR ON JOB AND THIS WHERE APPLICABLE SEPARATE
' CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED- FOR -
ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND
I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING_S-T-RU-C-T-GR-AS QUIRED,SUCH BUILDING,SHALL NOT BE OCCUPIED"UNTIL
MEMBERS(READY TO LATH). FINAL INSPECTION HAS BEEN MADE.
3. FINAL INSPECTION BEFORE
OCCUPANCY. '
POST CTHIS CARD SO SIT IS,, VISIBLE FROM STREET
B ILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
JA
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A a }
2 3 z G J,r 2 e2
(RICtiR L -7 i9197. 11 P�)
3 I HEATING I ECTION APPROVALS ENGAJEERING DEPARTMENT
? 97 g/ L B 0 'HE LTH
,7 /J�
r
OTHER SITE N R IEW APPROVAL
' WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!L L BECOME NULL AND V01 D'1 F CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE
TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN
CONSTRUCTION. (I PERMIT iS ISSUED AS'NOTED ABOVE. NOTIFICATION.
��;. . ..ram• ... ,e Lb �#��' , J`F.
1 � f
BUILDING
PERMIT
Assessor's office(1st Fl)or): r *3�
Assessor's map and lot number � a i �'S ��+' _JET BE of TNc>o
Conservation(4th Floor): `"' 3Ai
e � v w
Board'of Health(3rd floor): t3 LE5 •
Sewage Permit number �`"/ •�.. � 1s9RONc + ''`L C01)E AND ssaay.ntt
Engineering Department(3rd floor): ' 70WN fir_DWI LATOONS °° o670'
House number « /00 'tp
Definitive Plan.Approved by Planning Board — 0 19 �'
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only
�{ TOWN ; OF BARNSTABLE
f . 'BUILDING INSPECTOR
' APPLICATION FOR PERMIT TO
TYPE OF CONSTRUCTION
19
- e
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby
applies for a permit according to the following information:
Location
Proposed Use
Zoning District / Fire District .1.[
Name of Owner . Address
Name of Builder Address U
Name of Architect �� Address L
Number of Rooms Foundation AZZ411'/'
Exterior c4w Roofing
Floors I/
L Interior (� 1,_� 44-
Heating Ha Plumbing �V
Fireplace d/�'� t-`�` /J����(�'� Approximate Cost 5
Area �a
Diagram of Lot and Building with Dimensions Fee
G
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 Siipervisor's License [f� -'5_6 V
No Permit For
Location �6a
a
Type of Construction r `
T T _
Plot Lot
Permit Granted 19
Date of Inspection:
Frame 19
nsuion 19
19
Date Completed 21 ✓� 19
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Date?15 Time ✓/
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TELEPHONED PLEASE CALL
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WANTS TO SEE YOU URGENT
RETURNED YOUR CALL
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AMPAD 23-021-200 SETS
�� EFFICIENCYe 23-421-400 SETS CARBONLESS
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P!TER
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KNOWN HEZW14. C'0M'PL S witµ THE 51�LIME LoT'
1' C?_EQ, (� `1DjN1J D�' �A2nIS1-pg I?6A14 Tom -aAZLC-AF-
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pa-r� $e x`r�rz NYE f NC,
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APPLICANT; tl3>1$.
., r 6177277122 DEPT IND ACCID
(forruno,uueaCt{i o f Wajjac4u6etb
_. _ aUaparfirtenE o�J'.ndudtria�✓flcciden,fd
600 ! -sAington Stmet
James J.Campbell &ton, 1//am.AwRttd 02111
Commissioner
Workers' Compensation insurance Affidavit
11 C7l fq M &3 � c�,—s �j L
with a principal place of business at:
�- (Gcy�searelziv)
do hereby certify under the pains and penalties of perjury, that:
O I am an employer providing workers' compensation coverage for my employees working on
this job.
Insurance Company Policy Number
O I am a sole proprietor and have no one working for me in any capacity
() I am a sole proprietor, general contractor or homeowner (circle one) and have hired the
contractors listed below who have the following workers' compensation policies:
Insurance Company/Polity Number
Contractor
Co
Insurance Company/Policy Number
ntractor
Insurance pan Policy Number
Contractor
O I am a homeowner performing all the work myself.
I understand that a copy of[his statement will be forwarded to the Office of InvestiPtians of the DIA for coverage verification and that failure to secure
coi erage as rewired under Section 25A of MGL 152 can lead to the imposition of criminal penalties consisting of a fine of up ttoinsE rs i,500.00 and/or one
years' imprisonment a well as civil penalties in the form of a STOP WORK ORDER and a fine of S 100.00 a day ap
e.
Signed this
'Z � S-C day of
Licensee a Building Department
Licensing Board
Selectmens office
Health Department
TO VERIFY COVERAGE INFORMATION CALL: 617-727-490n
� 0 X4�, 404, 405, 409, 375
TOWN OF BARNSTABLE BUILDING PERMIT 1 ,
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ISSUE DATE(MM/DD/YY)
07/01/1994
}:•::
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PRoliucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
D.J.Rielly Insurance Agency,Inc. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
243 ChufCh Street DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
Pembroke, MA 02359 POLICIES BELOW.
(617)826-0123 COMPANIES AFFORDING COVERAGE
:..............................................................................................................................................
.......................
CO
MPANY A WCAR/Cigna Insurance Co.
.....................................................................................................................................................................
COMPANY B
INSURE.p..................................................................... LETTER
.............................................................................:......................................................................................
COMPANY C
Champion Builders,Inc. LETTER
P.O. Box 1558 .....................................................................................................................................................................
Buzzards Bay,MA 02532COMPNY
LETTER D
:.....................................................................................................................................................................
COMPANY E
LETTER
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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.
............................................................................ .....
CO: ;POLICY EFFECTIVE [POLICY EXPIRATION LIMITS
TYPE OF INSURANCE POLICY NUMBER
LTR DATE(MM/D0/Y1) ; DATE(MM/DDlY1)
GENERAL LIABILITY GENERAL AGGREGATE :S
............
COMMERCIAL GENFI2AL LIABILITY :PRODUCTS COMP/OP AGG. S
.,.r::.........
................................................GG.
.................
f{y? PERSONAL 3 ADV.INJURY S
.?•:::: CLAIMS
•OCCUR. ,
.
..............................
;OWNER'S 8 CONTRACTOR'S PROT. :EACH OCCURRENCE :$
.............................. ..................
:FIRE DAMAGE(Any one fire) S
......... ...................................................... ;................................................:.....................................
i MED.EXPENSE(Any one persons$
:AUTOMOBILE LIABILITY
.......... :COMBINED SINGLE
;ANY AUTO .S
:LIMIT
........................................................................................
,.•.....:ALL OWNED AUTOS
:SCHEDULED AUTOS :BODILY INJURY
(Per person) $
HIREDAUTOS :................................................:............................
;NON-OWNED AUTOS (PeDlaccident)INJURY
$
................................................
GARAGE LABILITY .i.....
.................................
.•���•�
:PROPERTY DAMAGE $
i EXCESS LIABILITY EACH OCCURRENCE i$
UMBRELLA FORM
:AGGREGATE.............._..........?.$.._......_.
;........
:OTHER THAN E UMBRELLA FORM U BRE L
.......... ..........................
X 'STATUTORY LIMITS
.........:::::::::::..
f.:::.:::::::::::::::::::::::::::.::::
WORKER'S COMPENSATION ;........:......................................:...........;:.:
:EACHACCIDENT S 100,000
A AND WOCC41002463 06/27/1994 06/27/1995 '•'•"""......""'''
..............
DISEASE--POLICY LIMIT :$ 500,000
: EMPLOYERS'LIABILITY ........................ >
................................
:DISEASE--EACH EMPLOYEE :S 100,000
:OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESISPECIAL ITEMS
C A OL '
....E H... ;:.;:.:.:;:.;:.;:.;:.;:.;:.;:.;:<.;:.;:.;:.;;:;.;:-:.;>:.;:.;:.;;;;:.:;.;:.;:.;;;:.;>;:.;;;;:. <.>:.;:.::.;;:.;:.;:.;:.;;;:_;;:.::.;;;:::;> .;::>:.;:;:.
........................ .............................. ANC ::<;:.;:.;:.;:.;:.:;.;:.;:.;:;.;;:;. ;:;;:.;;' . ::::.:::.::.:.:::::::.:..: ::::
ELT,A.::.:..............::::::::::::::::::::::::::::::....................:::.::::::::::::::::::-::.........................................
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Town of Sandwich LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
145 Main Street LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES.
Sandwich, MA 02563
AUTHOR D PRESENTATIVE
1 v
;CO}ZO Cf7RPORATLgN1999,
M. POLICY NUMBER
WOC C4 10 02 46 3 .INSURANCE COMPANY -OF NORTH AMERICA
❑ New; ® Renewal; El Rewrite of; NCCI CARRIER CODE: 14486
SYM PREVIOUS POLICY N0. �
IWOC11 C40046343
WORKERS COMPENSATION AND EMPLOYERS INFORMATION PAGE
LIABILITY INSURANCE POLICY
Item 1. I CHAMPION BUILDERS INC f Inter/Intrastate Identification No.:
The P 0 BOX 1558
Insured BUZZARDS BAY MA 02532
DIRECT BILLED
Mailing ❑ Individual ❑Partnership
Address L ®Corporation ❑
Employer's Identification No.: FE I N # : 043145058
Other workplaces not shown above: STATE OF MASSACHUSETTS
Item 2. Policy period from 06-27-94 to ''06-27-95 12:01 A.M., standard time at the insured's mailing address.
Item 3. A.Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here:
MASSACHUSETTS
B. Employers Liability Insurance: Part Two of the policy applies to work in each'state listed in Item 3.A.
The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident
Bodily Injury by Disease $ 500,000 policy limit
Bodily Injury by Disease $ 100, 000 each employee
C. Other States Insurance: Part Three of the, policy applies to the states, if any; listed here:
SEE ENDORSEMENT WC 20 03 06
Item 4. The premium for this policy will be determined by our Manual of Rules, Classifications, Rates and Rating Plans. All information
required below is subject to verification and change by audit.
Classifications Premium Basis Rate
Code Estimated Total Per $100 of Estimated
No. Annual Remuneration Remuneration Annual Premium
CLERICAL OFFICE EMPLOYEES NOC 8810 45000. . 33 149.
LOSS CONSTANT ( $10. .A F APPLICABLE ) 10.
ESTIMATED STANDARD POLICY PREMIUM 159.
( INCLUDED IN POLICY PREMIUM OF $32 )
MASSACHUSETTS D. I .A. ASSESSMENT 3. 2° 5.
EXPENSE CONSTANT 0900 160.
s +
Minimum Premium $ 102. Total Estimated Annual Premium $ 324.
If Indicated here, interim adjust— ( PAGE 1 LAST PAGE
4
ments of premium will be made: ❑ Serni—Annually ❑ Quarterly ❑ Monthly Deposit Premium $
This policy includes these endorsements and schedules: WC 200306 000414 200301 200302 200303
200401 200601
AGENCY NO. 984020 04-2793460 BOS 1 1
J RIELLY INS AGENCY Countersigned By
243 CHURCH STREET (AuThorized Agent)
PEMBROKE MA 02359 MARKETING OFFICE:
N TIONAL WC RE POOL 94186 DOC 6176A WCY
CKE-4266a Ptd. in U.S.A. Copyright 1987 National Council on Compensation Insurance a INSURED'S COPY INC 00 00 01/
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"Expect the Best"
CHAMPION
a B U I L D E R S , I N C.
Jay W. Briggs
(617)826-3800 FAX:(617)829-0000
Corporate Park
300 Oak Street • Suite 155
Pembroke, Massachusetts 02359
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A- "Expect the Best"
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CHAMPION Builders • Developers • Contractors
B U I L D E R S , I N C. (617) 826-3800 FAX: (6171 829-0000
June 3, 1996
Mr. Ralph Crossen; Commissioner
Barnstable Building Department
367 Main Street
Hyannis , MA 02601
Re: Request; Building Permit Extension
Lot 3 & Lot 5 Curlew Way, Cotuit, MA
Dear Mr. Crossen;
We respectfully request an extension on ther building permits issued for#100
and#128 Curlew Way, Cotuit,MA. These permits were issued to Bayside
Building Co. and identified as 54-213 and 94-215 respectively:.
Work on these lots, started under the original foundation permits, included:
-Staking of lot boundaries, house, and septic locations.
-Clearing of selected trees and shrubs.
-General maintainence. (To promote interest from potential home buyers
It has been several months, potential buyers are on board, and we now notice
our permits have lapsed. We need:to renew them promptly and.ask for your
assistance.
Any questions please call me at 800 784 7400. Thanks for your cooperation on
this matter.
Sincerely,
bol
Jay W. Briggs
Specializing in Affordable Single Family Custom Homes
Corporate Park • 300 Oak Street • Suite 155 • Pembroke, Massachusetts 02359
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