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Home My WebLink About0160 MAIN STREET (COTUIT) 1G0 ��a�-ter ACTIVE w r�s. Assessor's Office(1st floor) Maps; a3 Parcel - Permit# Conservation Office(4th floor)(8:30-9:30/1:00-,2:00) � aie Issued ,.`9- Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) Q e � Engineering Dept.(3rd floor) House# 60 P- b SEPTIC SY 0 BE Planning De t.(1st floor/School Admin. Bldg.) i �s�`�`r�L�� 9� T Defin' ive Plaq proved by Planning Board f 19 a AND TOWN OF BARNSTABLE' Building Permit Application Pro ct Street dress / � � iv' S�' b. Village .Owners % a"C�� ,/ Address Telephone ` -- - { �-� �- 9 717 -Permit Request &A7.ti? 4-�X ` ezi: G 1,,07,;1-' ,00U o3'ty' `;,-'mil 7_ 4/,Py1 �rl � owl, �^ , - �i'��r/N"�y✓r "-Lel e 4/ ox/ A-7Z JwtZv- d L ,First Floor square feet Second Floor square feet Estimated Project Cost $ D�a Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway 0 Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other _ _ Builder Information Name /C r7 ��,�/LZi '✓f/e Telephone Number /7 Address License# 05 7 .O 5 A3,�i9 2,/ � »�' iivl/�,�s�? bvj '�` Home Improvement Contractor# /®ci 70"0 _ % �`% Worker's Compensation# D f-Gc/6 AJ 9 3 ,- 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 FOLLOWING REASON(S) FOR OFFICIAL USE ONLY _ PERMIT_ NO. y� -S' _ DATE ISSUED MAP/PARCEL NO. ! ADDRESS _ i' t VILLAGE OWNER DATE OF INSPECTION: FOUNDATION i _ 1 , FRAME INSULATION r ; r FIREPLACE ELECTRICAL: ` ROUGH FINAL t t ' PLUMBING: iROUGH ' FINAL GAS: 'ROUGH FINAL � ti FINAL BUILDING =" IK- ° _ -- t_i ®t-! 04 DATE CLOSED OU P w 1 ASSOCIATION PLAN NO: i , 1 , DG r.` Assessor's map and 'lot tnumber ... ..,: .`!....r.l�...`!�� `� / ! — 74/,_ SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE r Sew!age:`Permit' number .... , „lhZ .. J.�. �........ WITH ARTICLE II STATE �� 0 SAiNlITARY CODE AND TOWN TOWN OF BARNST ErT�� '• iBLE 15 •_ �TODLE;i `5 41 O,o,1bt39• n Ar RUKOING . � INSPECTOR 'Ep pY 3 41 LC 1 -APPLICATION FOR PERMIT TO. ..4.` ............. ..... t,?.! }........ .. '. G. ........................................ aTYPE OF CONSTRUCTION AO..0.M.zN............................................................................................................ ... ....\..................19. 'y� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: r Location ....� ...........,.,, : .iYj.....:C ..:............ C.7.............. .. . ................................................ Sv nJ ProposedUse ......................... . ............................................................................................................................ .....................Fire District •....................Zoning District ..,. ` .............:............................................ �. 6� ..............Address \ �?.`.......... � ..t. 5•.......�� 4,..e': '•" fi?°, Name of Owner s ...... ..�,... ... , . .. ..:..... t i !� Name of Builder4R,:N ..�-1 � .. .h�' .1: � ��ae .�. .ti'Address .� 'L', ,c;.>: �... "lr ..° .). � , Nameof Architect ...............................................:..................Address ..................................................................................... Number of Rooms ...........Foundation ....!! .r::y ,.C} , ....................................................... ...................................................... Exierior1� . ,^,^ '-� ...Roofing . Floors .........................................:.:.....................................Interior ... .i;'a:P-,r ....... * ?.. .................. {" .y '•y Heating ... �.?°�. :�' ................................................ . ...............Plumbing ...... � :-� .......................................................... Fireplace ...............Approximate Cost,!: Q................................................. Definitive Plan Approved by Planning Board -------------------------------19________ Area .a..... .................... ...... ... .Diagram of Lot and Building with Dimensions Fee " ,1..g ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. rName ......................... ................... McCarthy, Helen , 18422 � add porch to No ................. Permit for •.................................... Slagle family~dwd ling • .......................................................................:....... , 160 Main Street+ Location .....................:.......................................... .� Cotuit ......................................................... .................. ` Owner Helen McCarthy ' '• , r ................... --�, frame Type of Construction -,.. `Plot ..................... . Lot ............... `............ _Permit 6ranted .........Jung..1.......''....:.'19 76 Date of Inspection 19 � v _Date Completed .../��`...�./...........19 PERMIT REFUSED .................................................................. 19 ;.. .......................................... t -....:................... /....................... ...................... . � ............-'�.. ..r ....................... ......................:".. ........0.... h r ":..........................r...............................•............... ., Approved ,............................................... 19 ............................................................................. ..................... ..................................................... c Assessor's map and lot number 7 EPTIC SYSTEM MUST BE ........................ .......... INSTALLED IN COMPLIANCE n WITH ARTICLE II STATE Sewage Permit number ... .. ..t�-.................................... SANITARY CO DE ODE AND TOWN REGULATIONS, yoFTNET,�° TOWN OF BARNSTABLE • BABB9TADUS, i "6 �Y a BUILDING . INSPECTOR Opp PY APPLICATION FOR PERMIT TO .. .,Y-�..v ./ .... .......`P ?�`'��.................. . . ... . ...... ... . . TYPE OF CONSTRUCTION /.:�i :`'"`'' ............S .. ......... ... ......................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the .following information: Locationll.�...` z.....N!/�i e�....s!—:....S�1��. ...!........ ............................................................. ................................... ProposedUse ..... n.,t�.l.<.lk................................................................................................................................... ZoningDistrict ........................................................................Fire District .................. .......................................................... Name of Owner /1?i552-6 41-1....�?..`..14':e .`,/............Address .. .....�L�fTli....... �.......cS�a�.� .. .SJ.......... Name of Builder !P��.C,i—%y a� .�/e......�... ........Address .. sA civ.c.c;,� ... cd. f_ lw��.-/ia... ........... ............. ........................................................... . ri-� Name of Architect .. .,Tf� . '�....................................Address .................................................................................... .............. Numberof Rooms Y Foundation C �...... ........................................................... .................... ............................... Exterior Cg�i�t� J�/i ride Roofing ....a� 3 /�.�/4 t? ..................................................... Floors �� i Lc�E�<i� �� GY/�� ..................................................................Interior ..............y................................................................... Heating e ie iI?le g ........... ..................................................................Plumbing Fireplace ....... 6:...................................................................Approximate Cost ........... .00. !.......................................... Definitive Plan Approved by Planning Board ________________________________19--------. Area /c a - (;;�1-7 - Diagram of Lot and Building with Dimensions .1 Fee ....... .... .............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH r 4� Vs � 6 Ity A I hereby agree to conform to all the Rules and Regulations of a To of Barnstable regarding the above construction. . .No .......... ................:4 . ....................................... J &Garthy, leis s Helen No ...:1628.... Permit for .....onA.....tox'y........... ........single.family.4wT11ing...................... , Location ... ... Main Street............................... ...... ... .. ............ i Santuit ........................ass Helen McCart................. Owner .................................................�?.y............. Type of Construction .........................frame.......•.,_„ k ................................................................................ s Plot ........................ Lot .......... ................. June r.;,� Permit Granted ...................�......:...........19 73 i S Date of Inspection .... :......::19 6) Date Completed ... .....:...19 ¢ I e PERMIT REFUSED ................................................................ 19 b ............................................................... ... .......... T f S d ............................................................................... Approved i ............................................................................... I P. i ............................................................................... TOW ��RNSTABLE BUILDING PERMIT APPLICATION Map '22 r roc - r - 2�,,J " Parcel J Permit# Health Division - /�� 2061 { Date Issued MAY 3"° r9-� Conservation Division T�-�Z�lo 1 ��- �;�;-"•��-` .//;"'-"' Fee Tax Collector �� SEPTIC SYSTEM MUST�� Treasurer s GJ -t-c-< �171?,a D INSTALLED IN COMPLIAt i:u Planning Dept. A WITH TITLE 5 ENVIRONMENTAL CODE A," Date Definitive Plan Approved by Planning Board TOWN REGULATION Historic-OKH Preservation/Hyannis Project Street Address �a Village Owner Address Telephone Permit Request , S j Square feet: l st floor: existing2lJD proposed Q 2nd floor: existing proposed to Total new Valuatit _ ��d . Zoning District Flood Plain Groundwater Overlay Construction Type -e- Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family a Two Family ❑ Multi-Family(#units) Age of Existing Structure d 4- Historic House: ❑Yes ULNo'- On Old King's Highway: ❑Yes Ul.Ale--� Basement Type: G1Ft l ❑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 Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other 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:Cl existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number 4C 1 4/C20 739 Address License# ( J C a 1a � �i`��c� �"/f9 Home Improvement Contractor# d ! (0 Worker's Compensation# / OO -3 25� /�, ALL CONSTRUCTION DEBRIS TING FROM THIS PROJECT WILL BE TAKEN TO P�1P cl SIGNATURE DATE Ty• FOR OFFICIAL USE ONLY t 1 PERMIT NO. DATE ISSUED.- MAP/PARCEL NO. ' RESS VILLAGE NER - r DATE OF INSPECTION:j r { FOUNDATION FRAME .All INSULATION FIREPLACE ' r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH- = i'' FINAL GAS: ROUGH' _ '' FINAL FINAL BUILDING , k .., � Sava �Ns_.P • DATE CLOSED OUT ; ASSOCIATION PLAN NO. 3 f, The Town of Barnstable $ Regulatory Services Thomas F. Geiler,Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMMgT TO PERMIT APPLICATION f ' 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 struca M which are adjacent to such residence or building be done by registered contractors,with certain exceptions.along with other requirements. Type of Work: Estimated Cost Q Address of Work- 5Z- r Owner's Name: v Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1.000 QBuilding 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 for amermit as the a f the owner. Date Contractor Name Registration No. OR Date Owner's Name g1omis Affidav . ?lie Commanweaidi o�',llassacizusens Department of'Indtrstrial Accidents �" � 01�Icro�lapestl�sllo�s 600Washington Street Boston,Mass 02111 Woricera' Compensation Iasarance davit mill 77/577/77777,7T, IL name' V location Y -f ❑ I ata abcmeo'waerp�iag ail waiiC�eif ❑ I am a sole aroariesa '=d have no a=vuAd=in=7 an emaiover .. CMMM=sadrm for=y empioyees wan=g an thzs jo ...... ft,....:....... .::... M.. :., ...::.: :J.v.• •:•:i':C•:'-••�}. 4 is�i�t•?C;::isikXjn<C;�:?v:�:;:;: ::in;::::yti� :;:s>j�-': t��pat1Y.'ltEZaC"''•. ' ?<>f :.,. .fi:•, :• .`�t - .{:c`}r %, .,.•, :..Tyr%+�6eno� .,ad, Nall :}, ttJc:'... ,}.,..... .:.''fir a.ON. =aa ....°`'J �a:3c�;•:Y;�:#cw�..w>"?�:�?.a'"�1�v,;`5::.�:'.•'v;:•x:;a`:�^�::... r•:: . ... y : r . 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I• ••qIY. « •• 1 w•r.1 u11 • U .0 • •re••1 • 10 • u •• ••n1 r...• v •I•••• •-. a rt I • IL..• �••wr• •lone •... f• ••• • IL Its. ' • •• • • Its. •1 N• ...v, •11•-. .tot=•• y_•u_•u ere • • • w.• x••eau •• I • �.� I• •• -•• • I ee • • .n .• I.1 • I •••• u •e u • • -eat• 1• • • I - i 1 11 11 1 1 1 � s •, 1 • ease 1 1 1 1 • • s off • Its - of i 1 of I v .. r✓�L!' -V/O"JJEIJGd7Y"L!J(2Lt!fG O�✓��11;f./7.LlJP.�d �' - .. .. - ` . Hoard of� Buildirg liegu,'360as and Slandaras r r�. ye:. i .••, °•Bali:l_`r' .,ivrdn • HOME hUPROVEMENT CONTRACTOR �,iur 'ate. 1f .nd reii r h to: egstration: 127 ' Ri v 24,, gP atior �xNcatic. : 09i2i/2002 �..�c 03l r Type: iP:'JI'ti/IDUAL 1-',R1.A11 DiJFFY 41R! dl DU FY TV hltlD PATH' ►d:ni.ri177.rtcr 1 ,(J�Z6 -CIJO�IYG77L(Y/LCU4�L(U7- !��[CJ<JJCLC//[IJPIGJ� . DEPARTHENI OF PUOLTC SAfE CONST RUG ION NPERVISOR LIC.,61, Nu ber: Expires: Rests ,;. BRIAN Py OUFfY , 1 LEET W000 PATH 133 MARSTON'S HILLS, HA 02648 6 p fig I a A o`er °°'��C � � " � r f., a , p m { 04� ti, Ahd<r,t iCapoco a. ' p. 6*IL NA tit , p p-- A x , r 4 t x i n " � • C^ ,. ♦ ,i • .. ° . .. .. - .,• Spy �V P4- r I gig do— Orr J STANDARD LEGEND NOTE:not all symbols will appear on a map GOLF COURSE FAIRWAY �=•'c— EDGE OF DECIDUOUS TREES a MAP 1/'1P 23 =�`rry-•x.� EDGE OF BRUSH A^n 'I /� ORCHARD OR NURSERY I^ V-v-7?-V EDGE OF CONIFEROUS TREES _ 6 6 MARSH AREA # 148 . - -... . EDGE OF WATER DIRT ROAD DRIVEWAY PARKING LOT Imo_PAVED ROAD DRAINAGE DITCH � MAP �� - - - - - PATH/TRAIL M A PARCEL LINE 1� 7 MAPtta E—MAP# Y�Jl •21 E PARCEL NUMBER #1860 E HOUSE NUMBER \ # 160 2 FOOT CONTOUR LINE t® 10 FOOT CONTOUR LINE Elevation based on NGVD29 4.9 SPOT ELEVATION I cco STONE WALL ------ -X—X- FENCE RETAINING WALL • MAPA�P �� -}-1-I-f- RAIL ROAD TRACK M - STONE JETTY 2,9 SWIMMING POOL ------- # ^ PORCH/DECK lXJ ] BUILDING/STRUCTURE DOCK/PIER � HYDRANT '"MAP 2 3 e VALVE O MANHOLE \ / / 0 POST OF' FLAG POLE T O W N O F B A R N S T A B L E O E O O R A P H I C I N F Q R M A. T 1 O N S Y S T E M S U N 1 T O SIGN ® STORM DRAIN N PRINTED SCALE:IN FEET *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetrics(man-made features)were interpreted from 1995 aerial photographs by The James 1"=100'scale map and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD a UTILITY POLE TOWER w e 0 20 40 National Map Accuracy Standards at this do not represent actual relationships to physical objects Corporation. Planimetria,topography,and vegetation were mapped to meet National Map Accuracy Standards enlarged scale. on the ma at a scale of 1"=100'. Parcel lines were digitized from 2000 Town of Barnstable Assessors tax maps. LIGHT POLE O ELECTRIC BOX s I INCH=40 FEET* g P• g p Assessors. map and lot number ......... Sewage*Permit number ...../. 7ME.l°�° TOWN OF BARNSTABLE Z BAHBSTeDLE, i ° MAM 0 9 DUI-LDING INSPECTOR o war 7, APPLICATION FOR PERMIT TO .... ...........................:...... ...... ....................................... t TYPE OF CONSTRUCTION .\AD.e-.At............................................................................................................ J ..... ::..:-.........................19 j TO THE INSPECTOR OF BUILDINGS: V The undersigned hereby applies for a permit according to the following information: Location .......fk?..c'.................................( ' ` �,.r�...... ........................ ..!........:...............!..i....0...................................................... ProposedUse ........'7-........................................................................................................................................................................ ZoningDistrict ........................................................................Fire District .............................................................................. Name of OwnerA:tJ!q.ms.A.....M. t�..-.C'T;�,�� . ; , ................Address ..............�f`a ..........................................t... Name of Builder �A��.� .o��o.•: 1 sa t6K,T(ter� ..t• 'r....... �Gx tJ :............... Address ........... ................. t Nameof Architect ..................................................................Address ...._............................................................................... Numb ......................... er of Rooms ..................................................................Foundation .... .f^,^ D ..� Exterior �13 t'. — ...............................Roofing ................ s \ Floors i Intenor �c�-,rc�; . ...... ''n: . .......................... v ` ... .................. Heating � ...........................Plumbing ...... ............................................................. Fireplace ..................................................................................Approxima-e Cost ....f..`'�!"►r., ................... Definitive Plan Approved by Planning Board ----------------------_---------19________. Area ./. .................. Diagram of Lot and Building with Dimensions Fee ' SUBJECT TO APPROVAL OF BOARD OF HEALTH r C, I i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... ... ................... ' McCarthy, Helen A=23~67 � 18422 add porch to } No ................. Permit for .................................... ` single fami I y dmwsll1no \ ---..��------��-----------. . ^ - ' 6O x&a�o 3tree� ' � Lu`"/ux. ' . | Cotuit . ' ' Owner ~=^=~ ' �} . ' . ' � . � frame Type of Constr ctio /.......................................... ..............................7............................................. r/cv ' ' - rumv vn=.e" Dateof --,__� - . . . Date . .... PERL REFUSED ' ` . . ' . . 19 — ................... ' . - . --r' '— ....................................... — ��' .......... ----...— �� T�� —' —' ' . .------� --.—.—.~.—....�.--..----... ^ Approved ,''�-------------- lA . ' ^ . --------'----'--~^^'------'--' ------ ........................................................... ^ � U, - [ ' ' . . i 2A S" DER' Town Of Barnstable *Permit# 2a Expires tonths front�Pe date SEP' 1 9 2008 Regulatory SCI'V1Ce5 Fe TOWN OF BARNSTABLE Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner dV 200 Main Street,Hyannis;MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIA.L ONLY 2 Not Valid without Red X-Press Imprint 3 Map/parcel Number 0 Property Address ( , residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address ax-n t' Contractor's Name F J► G�A l (7�/J l�u c-ce ems. Telephone Number Home Improvement Contractor License#(if applicable) 5 3(o Construction Supervisor's License#(if applicable) C S (o 9 Oworkman's Compensation Insurance Ched one: ❑ I am a sole proprietor ❑ I am the Homeowner (,I have Worker's Compensation Insurance ) Insurance Company Name T� EL,^ t; Workman's Comp Policy# G 0 J O L 3, 6 0 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) [&Re-roof(stripping old shingles) All construction debris will be taken to C ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: i Q:Forms:expmtrg Revise061306 The Common wealth of Massachusetts -- Department of Industrial Accidents _ Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): /1)-,-,T LU—C--f- I d A-) Address: 'Po City/State/Zip: C O-t(� 1' �- f A 6Z,3_�Phone#: vr'� — `�� --o�2 6 q� Are you an employer?Check the appropriate box: 1.01 am a employer with 4• ❑ I am a general contractor and I Type of project(required): employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for mein any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.$ 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.,<Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box 41 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: `LJ F_ 4P-R� Py Policy#or Self-ins.Lic. gS O L S 5,j O�- Expiration Date: (7 , �2 G Q g Job Site Address:_ [ Cp� r� Is 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 Investigations of the DIA for insurance coverage verification. I do hereby certi er the ams and Ides of perjury that the information provided above is true and correct Si ature: Date: ' Phone#: J� Z �oZ 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#: ,f LAY Regwafjo °� ®r.� FRAS OEM �"-.rI® Ragfstratton: z 12ess j Ca 8 MA 0263a T27920 AddrM ligard return and Hogs UNPAl" cm and i� -- ❑ �� 0 $ ,a��. Smr� ❑ Lost Crd ° � ER the f 6 JndfW � use Cho AAbb ®��®$aate. 7f$bg$d�g � idge$ugn o. TV 127920 r�uc�fey ZMTM� and0 1� � g!$r 28 CdTU17,IWA 02MB N® alit i 5 I ATE :tAM V) 1D t ►. ::: ::. ............. -15-07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE WISE & QUINN INS AGCY HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR 449 PLEASANT ST ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. BROCKTON MA 02301 COMPANIES AFFORDING COVERAGE COMPANY 24WCB A HARTFORD UNDERWRITERS INSURANCE COMPANY INSURED COMPANY FRASER CONSTRUCTION LLC B PO BOX 1845 COMPANY COTUIT MA 02635 C COMPANY D 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 TYPE OF INSURANCE POLICY EFFECTIVE POLICY EKPIRATION LTR POLICY NUMBER DATE(MMWD\YV) DATE(MMU)D\YV) OMITS GENERAL UABWTY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ CLAIMS MADE F OCCUR. PERSONAL&ADV.INJURY $ OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED.EXPENSE(Any one person) $ AUTOMOBILE LU►BILITV ANY AUTO COMBINED SINGLE $ LIMIT ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) $ HIRED AUTOS NON-OWNED AUTOS BODILY INJURY $ (Per Accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: ................................. EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND A EMPLOYER'S LIABWTY (6S000B-085OL35-5-07) 09-26-07 09-26-08 STATUTORY LIMITS ::>` '?<:>%«':'»::: .................................... THE PROPRIETOR/ EACH ACCIDENT $ PARTNERS/EXECUTIVE INCL -ion Ono DISEASE—POLICY OMIT $ OFFICERS ARE: X EXCL OTHER DISEASE—EACH EMPLOYEE s 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS i THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. + FtTlallT ::ll #LDI=.'::::::::::::::::::::::::::::.::::::::::::::::::::::::....:.:.............................................. ....... 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 FRASER ENTERPRISES LLC LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR PO BOX 1845 COTU I T MA 02635 LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATNES. AUTHORIZED REPRESENTATI ►T' ::;%:;<'<;:�i :::: ,:;:::•'.>'::.::.:;::: ..........:4::!..... ...............:.:.:::.:.:::.:::::y::::y:::. :::::::::::.:::::::::::::.::.::.:i..:.::::::::::::::::::::::::::::::::::::::::::::::::::::: y� 00.,0 .........................................................:.. isviiiiiiiiiiiiiiiiiiiiii:;•;i:•:;:;::::::<Y:;:;::::;::i::::::::::,.��,..:M..M��YY';.�M:�.J[i'MilT1;�;AR✓IY:::7:�„�,.�,.,fi::i P. 9- l �' Fraser Construction, LLC CONSTRUCTION P.O. Box 1845, Cotuit MA. 02635 ROOFING ' Email:fraser constructionnven'zon.net SPECIALISTS www.fraserroofiag.com FAX 1-508-428-0123 508-428-2292 HICL#112536 CS#97668 RE-ROOFING PROPOSAL PARTIAL PORCH ROOF ONLY PATE: September 13, 2008 PRONE: 781-307-2527 3NAME: David Mccarthy WAIL ADDRESS: 99 Whitman Ave Melrose Ma 02176 j9MAIL: davem43@?verizon.net JOB ADDRESS: 160 Main St Cotuit, MA 02635 ]FRASER CONSTRUCTION hereby proposes to perform the following services in a neat and professional like manner and in accordance with the manufacturer's Specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Supply and Install - CERTAINTEED WOODSCAPE AR 30: 30 -Year Warranty, 5 year Sure Start Protection, CLASS A FIRE RATED, ALGAZ Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Fill 10 Year Warranty against ALQA_1F'_, Containment. 5 year 110 mph wind-resistance warranty with six nails in common bond area, Fraser construction includes six nails in common bond area at NO additional cost. See actual warranty for specific details and limitations. Color: Color to match existing 3-Tab in an Architectural Style Shingle Color: Birchwood Porch roof Only PRICE- $975 Initial Supply & Install- CertainTeed Winter - Guard: (ice & water shield) Waterproof Underlayment System (3ft. on eves and valleys, 18" on rakes, walls, and skylights) Supply & Install- Roofer's Select Underlayment Paper (as recommended by CertainTeed) Supply & Install- Hick's Ventilated Drip Edge or 8" Aluminum Drip Edge Supply & Install-Aluminum & Neoprene Soil Pipe Flashing Supply & Install-Air Vent Ridge Vent (as recommended by CertainTeed) p. 2 .n a NO MONEY DOWN -NO Payment at the start or part way thru Payments accepted are: CASH - CHECK - MASTERCARD -VISA-AMERICAN EXPRESS *Any payments not made within 30 days of completion will be charged 1.5%for every 30 days the payment is late. Possible Extra-After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$6.00 per panel including Materials &Labor. There are 6 Panels per sheet of plywood. Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$55.00 per hour, plus materials, plus 15% overhead mark-up on total extras. FRASER CONSTRUCTION Warranties the labor for 12 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. CERTAINTEED Warranties the shingles to be A.GJA_E resistant for the duration of the Sure Start Warranty depending on the shingle that was purchased. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: 7 /1 $ o IT oMeovmer Fraser Constr 'on, LLC CAPIZZI HOME IMPROVEMENT, INC. SPECIFICATIONS AND ESTIMATE PAGE 1 OF 1 CAPIZZI HOME IMPROVEMENT PROPOSAL 1645 Newtown Road r n Cotuit, Massachusetts 02635 j 508-428-9518 , 1.-800-262-5060 Fax 428-1.547 Date: q /q� Q / Name:' /�J�/eh � �'L�-y't J� ; Job Address Address:/ ' / Town: City: rtcy-< n - s� 1 Home Phone:. _. .. _ Other Phone: cl Estimator: � Job No Furnish and install new extra clear white cedar shingles on of building only in the following manner: 67PI a . Strip existing siding and remove debris � Y� b. Check all boarding and nail as necessary r.. c. Install all new window and door drip cap flashing d . Install Tyvek housewrap e. Install extra clear white cedar shingles to match existing courses. Labor & materials Cc Vie � pry ,sc<� �-aC�,�7 ccu"f I& r-5- J' fly J-:ps tL .,d �.,s 4 a}C!�c?r-f Cbkm �C�f oe �� ,--may- r�� •�f � � �'�. h ►r To l E o� SIG:�ATi'RE y C,-)V d 7 CTI THIS PAGE BECOMES PART OF AND IN CONFORMANCE WITH pRnvc�sxA ,�[�. ACCEPTED DATE z -J CAPIZZI HOME IMPROVEMENT, INC. SPECIFICATIONS AND ESTIMATE PAGE 1 OF 1 PIZZI HOME IMPROVEMENT PROPOSAL 1645 Newtown Road Cotuit, Massachusetts 02635 Date: 508-428-9518 1-800-262-5060 Fax 428-1547 p/ Name: Job Address : Address: I Town: City: l /"t a/u S� Home Phone: 1 Other Phone: _- Estimator: Job No. : 1 . Furnish and install solid vinyl white replaceme.nt .windows with 7/8" insulated glass, 1/2 screen- using the Harvey Leif S-sgn at 1�- P�w e4_cl P rl a h w i n dam. ( tt�Gt CO i-/ Dou le h 'ng Pict re unit V��i6� � n� fvtsTg� / fTe-c/. 6'/co sing l casement Doubl casement - Tr. ipl casement 9 7 - dt,L e�7�e-,'�o!� �� vv 2 liz e�lider �f - 3 lite glider Labor & Material0 73 . 2 . Labor & Materials pt- us i-gn--th e—p- -rh-e"epa ne-�S3-i-m 1 i n e-r egla-e�e�► n t �3. A Q-.m o a .. - window. Labor and Materials OPTIONS: b C. Gelel Tce $ lease call. I hope this will help you, however if you have any questions P Thank y Si el.y,� - Capiz 3 Home rovements 1645 Newtown Road Cotuit, MA. 02635 (508) 428-9518 t 4iOME .IMPROVEMENT CONTRACTORS REGISTRATION j /' Board of Building Regulations and Standards s •One Ashburton Place - Room 1301 t Boston , Massachusetts 02106 HOME IMPROVEMENT CONTRACTOR "L--- "-----"----- Registration 100740 Expiration 06/23/98 Type — PRIVATE CORPORATION HOME IMPROVEMENT CONTRACTOR t Registration 100740 CAPIZZI HOME IMPROVEMENT, INC. I Type - PRIVATE CORPORATION Thomas Capizzi , Sr . Expiration 06/23/98 1645 Newton Rd . I e Cotuit MA 02635 t CAPIZZI HOME IMPROVEMENT, INC t Tboaas Capizzi, Sr. Newtea Rd. t ADMINIs7AATOR Cotult MA 02635 I DEPARTMENT (,},`' •'"•.J._ ..�.'4' ONE A31413UR DOSTUN 'kUC-T-1'0 -SUPERVISOR LICENSE 1 6 -—t =Expires: . 4. . icted: 1U:' U0 -- , ►S�'-4,kGAPIZU*j*JR •.`. ?�RCIVAI�b ��`r "• • •� WtABLE;, ' A` 0266a v The Commonwealth ofAfassac•husetts Departnieut of Inditstrial Accidents Office ol/westigations 600 liitchier;;ton Street Boston,Afa.u. 02111 ` Workers' Compensation Insurance Affidavit o PI'ase PR 1 �i it -"' name: location: 'I.,�---cs—�Zmwv city7?//® Phone# I am a homeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity . :..Srsrwrra ""�lr.-.. { '7:T• s� }�'•-- Stc�esr,:-sus,.: .. _ +x.,rm.?H. r c :-, r.,•.t .�a.da •.......aay,....m�:ai...a �a.+�'s+'i�sa�---¢�^-D'e.- "ie.fsuuu�., is e.: '•;�?'�1.zs�..,sus........:; .sz� fi,n<:r...a.,..::.:n..:.._.....:,._._� I am an employer providing workers' compensation for my employees working o t this job. company name: address: city - phone 4- insurance co.--,� ;` � 2� Policy# 408 A45Z svwiu.,w.:z___•• ..�y. -. Y Y.. . i.. .Y.= K. F .:�,�nrt�♦ . .xy..ry Y�^'.�Gad.'IT'� '.C+.............a I am a sole proprietor,general contractor,or homeowner(circle one)and hav:hired the contractors listed below who have the following workers' compensation polices: company name address phone#: insurance co. policy# _._ .. - _.titer_. :ati•:iar 3:a:......u�....:.a'C..�:rf.'dza. [^" Yti r r .y. •y w: '.X•: Y.J..�.A:?.1.�l• •�3•.-h.a ....i�d..0 'Kia.yi�•'r'.a•C�.t4i.LJ a.L'l��C.)S :iY'G�.£www.L - ...4..4`+il:•.. company name: address city: phone 9- insurance co. d Policy# Attach additional sti--cat if rieccssa �;r � i�"`_'�f�• �,�;�r;."";�"w,s•> �-.-_"z tr - �• a;..- ��-� 6 +x -�:r�_,��:>xr..�_..��.r` Failure to secure coverage as required under Section 25A of MCL 152 can lead to the imposition c`criminal penalties of a fine up to S1.500.00 and/or . one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fire of S100.00 a day against me. I understand that a cope of this statement may he forwarded to the omcc of Investigations of the DIA for co,.•cragc yc-ification. l do hereht•certify t der pains and pe !ties of perjwy that the information provided a5ove is true and correct . Signature Date Print name_ /'C � ��- Phone# official use only do not write in this area to he completed by city or town official cih or town: permit/license# n►3uilding.Department OLicensing Board i-- check if immediate response is required _- oSclectmen's Office ,. C3I1calth Department �contact person: phone#. rlOther T...._ .. ,_. �'"�,:..ti.oi."'". •^L ._ ... .. ...-•.—•-�' ^'-sr�' _ r_-.r�.c-r.^., ^nf„-.. sue••, r. ,...,r. J,: i Informatititi and -Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an emplr�ree is defined as every person in the service of another under any contract of hire, expr:ss or implied, oral or written. _ \ An entploVer is defired as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing enga,_ed 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 dwellin,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 renewal of a license or permit to operate a business.or to construct buildings in the commonwealth for any applicant,rho has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor ally 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. � •.c � 't.:.�:'M ' .:.i . j"'_"�•� fia..,'..---• >.*"�"^- 1'�'_'.rT^t"f :.z++� ��'r�' �� ..c-*-yam�,p Lwg.. .7P^+?. 5 Applicants Please fill,in the Nvorkers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidentz 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. r -r :�r.+r ir..Y�1w.S.y E fi"M_ 7 fi i!K - „t`•r�A°ier .t.zr✓1Eesr.,. ,tA :.... �3 K .Yr^ 1Fv v 1r City or Towns . Please be sure that fhe affidavit is complete and printed legibly.'-Tile 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`teference number. The affidavits may be returned to . 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. yC,paF,v.M,,.,t.-a'_s•�e.._.re^+r- xrgy'w+_+!n.7wa�...' 'an 'a.' ,. .-. „"'^' f yr,9 i 7n ^T,NP'�.,+.z+na �a..'�_ :+ .}y, eYfcel7:'mm+.auen• .r•�.. .(+..' __ �+ ^.) .J�:�= �-_ !i oY ',.+ 'A3i[- -..q+� �'�+,,,,_ 5�,,,1.,,�+ d. -a.;i. �:�. t _ .mac mac'.'-;c7i-� F�dn a%. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 �. The Town of Barnstab ' . S x+►� Department of Health Safety and Environmental *�- Binding Division 367 Main Street,HYaamis MA 02601 Ralph Crosse= �� Sp8-'Tg0�Z27 Bml Caroni-monc Fat 308-775-3344 - For office use only permit no. Date 7—�7— �� AFFMAVrr HOME IlViPROVEMENTC TO CATIONrOR S SUppIMwE 1T TO M that cdo alterations,renovation,=pair, °� oocnzFte3 GL c. 142A a"tecotts� n, improvement..r�� demolttron. Or cortstruarof of an ��o t �v, are bumin containing at least one but not more than four dwelling ad}aft g be done ered contractors,with eextain==ptio� along with other to such residence or building by� � Type of Work: Est.Cost 7r 6 Address of Work: Owner.Name: � � ��'✓ /�' ��- r °l Date of Permit I herein certify that: f , j. Registration is not required for the following reason(s): 1 Work ccdnded by law Job tmrl SI1000 Building not cwmes cd ow=puu=g own permit . Notice is hereby gh-ea that: OWNERS PULLING TH M OWN PERMIT OR DEALING�NMqI�OT ELVE C CESS .�CME FOR APPLICABLE HOME IMPROVEMENT WORK ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A SIGNED UNDER PENALTIES OF PERSURY t I h=rby apply for a permit as the agent of the oauer: ®f 74' 71Regstration No. Date aarae OR t