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0621 MAIN STREET (COTUIT)
�a� �� °F�He Town of Barnstable �{. Planning&Development Department Barnstable Historical Commission �u a * BARNSTABLE, * 200 Main Street,Hyannis,Massachusetts 026 z 9 MASS. (508)862-4787 Fax(508)862-4784 BUILDING DER ., Fv .t A��39. erin.loganka,town.barnstable.ma.us p�wbF BAR JUN 2 4 2020 Commission Members TABLE TOWN OF BARNS Nancy Clark,Chair Nancy Shoemaker,Vice Chair Marilyn Fi field,Clerk George Jessop,AIA Elizabeth Mumford Cheryl Powell Frances Parks Jack Kay,Alternate N DECISION �r Summary: Demolition Delay Not Imposed.Pursuant to Chapter 112 Historic Properties -+ Section 112-3 F 1-TI r'�t N Applicant/Property Owner: Peirson Children's Trust,Elizabeth&Nicholas Pierson,Trustees 0 Subject Property: 621 Main Street,Cotuit Assessor's Map/Parcel: 036/062/000 f Hearing Date: June 2,2020 Pursuant to the Barnstable Historical Commission receiving your notice of intent on February 19, 2020, a duly' advertised and noticed public hearing was held on June 2, 2020 to determine whether the significant structure identified as a single family home on this property is a preferably preserved significant.building and whether demolition delay would be imposed for the partial demolition_ of the structure on the parcel addressed as 621 Main Street,Cotuit. ` After review and consideration of public testimony,application and record file,the Commission by a unanimous vote in favor, found that in accordance with Chapter 112F the partial demolition of the single family structure is not a preferably preserved signiftcantbuilding. In accordance with Chapter 112-3 F, the Commission-determined, by unanimous vote in favor, that the partial demolition of the single family structure would not be detrimental to the historical, cultural or architectural heritage or resources of the Town. This decision applies only to the demolition described in the notice of intent submitted on February 19, 2020. No future demolition shall be permitted without application and approval from the Barnstable Historical Commission. . 2� Nancy Clark,C air 0ate cc: Brian Florence,Building Commissioner Ann Quirk,Town Clerk Planning&Development Department-Elizabeth Jenkins,Director;Paul Wackrow,Senior Planner, Erin Logan,Administrative Assistant-200 Main Street,Hyannis,MA 02601 IHe r Town of Barnstable Planning& Development Department u- Barnstable Historical Commission BARNSTABLE, 200 Main Street,Hyannis,Massachusetts 02601 5>. Y 9� 6 9. (508)862-4787 Fax(508)862-4784 'OtEp s erin.loganp_town.barnstable.ma.us - Or,6agast9 Commission Members Nancy Clark,Chair Nancy Shoemaker,Vice Chair Marilyn Fifield,Clerk George Jessop,AIA Elizabeth.Mumford .Cheryl Powell Frances Parks Jack Kay;Alternate kz �4 ram, March 3, 2020R % ?�ZO Ora Re: Notice of Intent to Demolish Structure.&Relocate NET 621 Main Street, Cotuit, Map 036,Parcel 062 qB�� Archi-Tech Associates, Inc. c/o Timothy Luff 6 School Street Cotuit, MA 02635 Ann Quick, Town Clerk 367 Main Street, Hyannis,MA 02601 Brian Florence,Building Commissioner 200 Main Street, Hyannis, MA 02601 Pursuant to the attached decision, please'be advised that the Barnstable Historical Commission will hold a public hearing;on the partial demolition of the single family structure on March 17, 2020 at 4:00pm, Town Hall, 367 Main Street, Hyannis, 2nd Floor, Selectmen's Conference Room. This public hearing will be advertised, notices sent to abutters and a notice form will be.posted on the building or other visible site on the property. Please contact Erin . Logan at 508.862.4787 or erhi.logan@town.barnstable.ma.us for processing information. Sincerely, Nancy Clark, Chair Planning&Development Department-Elizabeth Jenkins,Director;Paul Wackrow,Senior Planner; Erin Logan,Administrative Assistant-200 Main Street,Hyannis,MA 02601 OF THE T,p� Town of Barnstable �E,oPMf q.� Planning&Development Department 2°� Barnstable Historical Commission Z -• * BARNSTABLE, * y � 200 Main Street H annis Massachusetts 02601 5. y 9� MA 163q. �0�' (508)8624787 Fax(508)862-4784 o. iOrED .�s erin.lgan@town.barnstable.ma.us Hor,sAaNStP _ N C'1. Commission Members >.- y>, Nancy Clark,Chair Nancy Shoemaker,vice Chair Marilyn Fifield,Clerk George Jessop,AIA Elizabeth Mumford Cheryl Powell Frances Parks Jack Kay,Alternate 1 j A 4�3 Chapter 112 Historic Properties, Section 112-3 D. DETERMINATION of SIGNIFICANT BUILDING 621 Main Street, Cotuit, Map 036, Parcel 062 Pursuant to Intent to.Demolish Structure The property located at 621 Main Street, Cotuit, Map 03.6, Parcel 062, is associated with the broad architectural and cultural history of this area. In accordance with Chapters 11272 and 112-3 (D),. the Barnstable Historical Commission.Chair has determined that this structure is a significant building. This determination applies only to the demolition described in the i notice of intent submitted on March 17., 2020. Any future demolition shall require a new,determination from the Barnstable Historical Commission. Planning&Development Department-Elizabeth Jenkins;Director;Paul Wackrow,Senior Planner;. Erin Logan,Administrative Assistant-200 Main Street,Hyannis,MA 02601 INS Application number......... ........ ..............�?... a e Date Issued.............. .bt. ha............................... BARN STABLE,MAS& 1639� `0� Building Inspectors ........(9.................... Map/Parcel.......... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/Vi MOWS/DOORS/TENTS/STOVES/WEATHERIZATION ]PROPERTY RVORMATION Address of Project: //oZ ( /`'lay �O r1 u NUMBER STREET VILLAGE Owner's Name:t,117 � �e%�.So n Phone Number 9 SV- 6 g 3 -/ 7o Email Address: Cell Phone Number S o f-z,12 F Project cost$ 36 `7 — Check one Residential V, Commercial OV*rNERIS IAUB'k ORIMTION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR ,, x_. Owner Signature: S e �-{�Q � C' -(� -� Date: : TYPE OF WORKI ❑ Siding ❑ Windows (no header change)# ❑ Insulation/Weatherization Doors (no header change) Commercial Doors require an inspector's Yeview { Roof(not applying more than 1 layer of shingles) I Construction Debris will be going to R —I- CONTRACTOR'S INFORMATION Contractor's name &5(crud! j ct)c ow S ' Home Improvement Contractors Registration(if applicable)# 17 32_K 5 (attach copy) Construction Supervisor's License# bJ S 7 07 (attach copy) Email of Contractor Phone number V0/- Z Z R - 900 ALL(PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS.1N A HISTORIC DISTRICT, YOU MIDST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT C4N BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only. Date Tent(s)will be erected Removed on number of tents total es lease attach floor plan with exits marked) Des the tent have sides?Yes No P o (�Y P Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a: for profit non-profit event Check one:Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. ie S' x WOOD/COAL/�ELLET STAVE � Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:front back left side right side H01MEOwNEWS LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CRRR the Massachusetts State Building Code. I understand the construction inspection procedures;specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date 1ICANT'S SIGNATURE Signature Date (��2-_g All permit applications are subject to a building official's approval prior to issuance. I - renewal Agreement Document and Payment Terms byAndeesen. dba:Renewal By Andersen of Southem New England Susan Peirson ® VLACEMENT Legal Name:Southern New.England Windows;LLC 621 Main St Ri#36079,MA#173245,CT#0634555, Lead Firm#1237. Cotuit,MA 02635 WINDow 10 Reservoir Rd I Smithfield,Rl 02917 - _ H:(508)428-5119 Phone:866-563=2235 I Fax:401-633-6602 1 sales®renevvalsnexom C:(954)683-1706 Buyers)Name: Elizabeth Peirson ContracrDate: 06/07/18 . Buyer(s)Street Address: 621 Main St Cotuit, MA 02635 Primary Telephone Number:.(508)428-5119 Secondary Telephone Number: (954)683-1706 Primary Email: Secondary Email: Buyer(s).hereby jointly.and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of.Contents,and any other document attached to this Agreement. Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement'). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $4,367 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $1;455 Balance Due: $2;912 Estimated Start: Estimated Completion: Amount Financed: $0 7-8 weeks 7-8 weeks Method of Payment: Credit Card We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date:Rain and extreme weather are the most common causes for delay. Notes: 1/3 deposit,1/.3 at.start,1/3 at completion Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the.terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s)and Contractor..Buyer(s)Hereby acknowledges that Buyer(s) 1)has read this Agreement, understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement: NOTICE TO BUYER:Do not sign this contract if blank.You are entitled to a copy of the.contract.at the time you sign. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN.MIDNIGHT OF 06/1 1/2018 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, -WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC dba:Rei yea r Audersei f Southern New England Buyer(s) Signature of Sales Person tgnature Signature Paul Sandrey Elizabeth Peirson. Print Name of Sales Person Print Name Print Name UPDATED: 06/07/18 Page 2 / 9 rl Cyffice of Consumer Affairs and Business Regulation 10 Park Plaza = Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 173245 Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS LL Expiration: 9/19/2018 BRIAN DENNISON 26 ALBION RD LINCOLN, RI 02865 Update Address and return card.Mark reason for change. Address - Renewal — Employment — Lost Card -Office of Consumer Affairs&Business Regulation Registration valid_ b for individual use only before the >-=HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: Office of Consumer Affairs and]Business Regulation Registrations: 1 33245 Type: 10 Park Plaza-Suite 5170 Expiration: 9ilg%2018 Supplement Card Boston,MA 02116 OUTHERN NEW ENGLAND WINDOWS LLC. !ENEWAL BY ANDERSON RIAN DENNISON r ` 6 ALBION RD INCOLN, RI 02865 �zadersecre6ry Not valid without signature S'0arld Bjiidiraa Re'i?a4'o s and ^.vv CS-095707 q _ ;vG i BRIAN D DENNISON LAMBS POND CIRCLE CHARLTON MIA 01607 The Commonwealth ofMassachusetts Department of lndustrial_Accidents 0 1 Congress Street, Suite 100 _ Boston,MA 02114-2017 w s ww.m ass.gov/dia II Workers Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMTITING AUTHORITY. Appheantwo rmation . _ Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: p Phone##: rAre you an employer?Check the appropriate box: Type of project(required): Iam a employer with !ZO11employees.(full and/orpart-time)_; 7..Q New construction I am a sole proprietor or partnership and have no employees working for me in any capacity.(No workers'comp..•insurance required.] ` g• Remodeling 3.01 am a homeowner doing all work myself[No workers'comp.insurance required.l t 9• ❑Demolition 4.[]I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition ensure that all contractors either have workers'compensation insurance or are sol p 11.[]Electrical repairs or additions proprietors with no employees. S.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet 12.❑Plumbing repairs or additions These sub-contractors have employees and have workers'comp.insurance..' 13.❑Roof repairs 6. We are a corporation and its officers have exercised their right of exemption,per MGL c. 14•❑Other_ (o - Z 0 - I S 152•§1(4),and we have no employees.[No workers'comp.insurance required.] Arty applicant that checks box V1 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 entices 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 jab site information. _ Insurance Company Name: Ire met)$ . 60M Policy#or Self-ins.Lic.;r Expiration Date: ® l 1 I Job Site Address: 6 Z l /yzGi)'1 City/State/Zip: M Attach a copy of the workers'compensation policy declaration page(showing the policy number 21id expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation pr3tiishable by 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.A copy of this statement may be forwarded to the Office of Investigations ofthe DIA for insurance coverage verification. I do hereby certify under th ains andpenahies ofperjury that the information provided abovee is true and correct Signature: Nh a D2ie: (p — Phone#: QO 1- 2 Z,e-IT S-cy Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License rr Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector. 3.Plumbing Inspector_ 6.Other Contact Person: Phone#t: t AC��Z® CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT CoBiz Insurance, Inc.-CO NAME: 1401 Lawrence St, Ste. 1200 P"o"E 303-988-0446 Denver CO 80202 EMAIL FAX No:303-988-0804 • COM91 cobizinsurance.com INSURFRIAi AFFORDING COVERAGE NYC N INSURER A:Acadia Insurance Company 31325 INSURED ESLERCo-01 INSURERS:Tremens Insurance Company of WA,D.C. 21784 Southern New England Windows, LLC. dba Renewal by Andersen of Southern New England iNsum c:Homeland Insurance Comoanv of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1252851165 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 ADDL SUBR - LTR TYPE OF INSURANCE FO-UCPOLICY NUMBER MMMDY EYY MMILIDDY EXP YYyj LIMITS A X COMMERCIAL GENERAL LIABILITY CPA3158728 7/1/2018 1/12079 L=LAIMS-MADE �OCCUR DDA h1A�-TUWN E $7,000.000 PREMISES Ea occurrence) $300.000 MED E(P(Any oneperson) $10.000 PERSONAL BADVINJURY $1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2.000,000 X POLICY D JC ❑ LOC PRODUCTS-COMP/OP AGG $2.000.00D OTHER: $ A AUTOMOBILE LIABILITY N CPA3158728 1/12018 1/12019 COMBINED SINGLE LIMB X - Ea aed5 $t 000 000 ALL ANY AUTO I OWNED BODILY INJURY(Per person) $ AUTOSAUTOS BODILY INJURY(Per acci dent) $ X FARED AUTOS E SCHEDULED ANUTO WNED r PROPERTY DAMAGE (Per accident) $ I $ A X UMBRELLA LIAB X OCCUR CPA3158726 1112018 1/1/2019 EXCESS LU1B CLAIMS-MADE EACH OCCURRENCE $1D.0DO.000 AGGREGATE $70.000.000 DED X RETENTION$ S B AND EMPLOYERS' COMPENSATION WCA31587p}20 1112018 1/12019 X PER OTH- AND EMPLOYERS LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNERIE)O=CUTIVE OFFICERIMENBER EXCLUDED? N/A E.L.EACH ACCIDENT $1,00D.00D (Mandatory in NH) Kies describe under E.L.DISEASE-EA EMPLOY $1,00D,D00 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMB $1.000.000 C Pollution LiablTdy 7930073340000 1l12018 U12O 19 Each Occurrence $1.000,000 Claims.Mado Policcyy Retroarbve Date 06202013 ADed b $ le i.OW O DESCRIPTION OF OPERATIONS/LOCATIONS/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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25.(2014101) The ACORD name and logo are registered marks of ACORD a � l � - � 7 1�, Town ®f Barnstable Permit# OFF Expires 6 atouilrs front issue date Regulatory Services Fee a .ARNsrAat.>r, ; D 9 039. 0$ Richard V.Scali,Director FD MAt�` Binding Division�Q Sep 0 , Tom Perry,CBO,Building Commiss' *, t 6'1®, 200 Main Street,Hyannis,MA 02601 /' !/ , www.town.bamstable.ma.us '7��_(t/� Office: 508-862-4038 ® 8-790-6230 ilp EXPRESS PERMIT APPLICATION - R' SIDENTLALL Not Valid without Red X-Press Imprint Map/parcel Number 0 3(,o D& Z 7 4- Property Address 6.2t t�la n Sf residential Value of Work$ 5� 3 3 Z — Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Sv e 72;r MBA 0..?-& s' Contractor's Name nctvuJ r,�/► / //r:59/7 Telephone Number N-2( 2. Home Improvement Contractor License#(if applicable) 73 Email: Construction Supervisor's License#(if applicable) nl c7 [3Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ m the Homeowner [�'I have Worker's Compensation Insurance Insurance Company Name F_ f° Workman's Comp.Policy# i_5 9 72 9 2 O Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ate-side 3 ["Replacement Windows/doors/sliders.U-Value 30 _(maximum 32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 Moor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit.does not e-xempt compliance with other town department regulations,i.e.Historic,Conservation,ctc. ***Note: Property wner must sign Property Owner_Letter of Permission. - P _ - . .. p r copy the Home Improvement Contractors License&Construction Supervisors License is require SIGNATURE: C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.0utlook\2P101 DHR\EXPRESS.doc Revised 040213 Ren,ewal Agreement Document and. Payment Terms �lll lde�$en' dba:Renewal By Andersen of Southern-New England Susan Peirson MRELACEMENT Legal Name:Southern New'England Windows LLC. 621 Main St RI#36079, MA#173245,CT#0634555, Lead Firm#1237 Cotuit,MA 02635 WI 26 Albion Rd.I Lincoln,:RI 02865 H:(954)683=1706 . .. - - - Phone:866-563-2235 1 Fax:401-633-6602 1 sales@renewalsne.com C:(508)428-5119 Buyer(s)Name: Susan Peirson Contract Date: 08/22/17 Buyer(s)Street Address: 621.Main.St, Cotuit,:MA 02635 Primary Telephone Number: (954)683=1706: Secondary Telephone Number:_(508)428-51.19 Primary Email: . p : : Secondary Email: • sue iersonC�aol.com Buyer(s)hereby.jointly and'severally agrees to purchase the products and/or services of Southern.New England Windows,LLC d/b/a " Renewal By Andersen of Southern-New En land("Contractor"g ),'in accordance with the terms and conditions described in this Agreement Docutitent and Payment Terms;any.documents-listed in the Table of Contents,and any.other document attached to this•Agreement Document,the ternis.of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement.). Buyers).hereby agrees to sign a completion certificate after Contractor has completed.all work under this Agreement. Total Job.Amount: : $5,332 By signing this'Agreement;you"acknowledge t kt the Balance Due;and the Amount: Financed.must a made,by personal check,. an "check,credit card,or cash. Deposit Received: . . P $2,666 Balance Due $2,666 Estimated Start: Estimated Completion: 6-9 weeks 6-9 weeks Amount Financed:" $5,332 Method of Payment. Financing We schedule'installations based on the date of the signed contract and secondarily on the date in which we complete the'technical measurements:The installation date that weare providing at this time is only an estimate:.We will communicate an official date _ and,tithe at a later date. Rain andextremeweather are.the most common causes for'. delay .• ... Notes:. 500% deposit by bank,balance on completion by bank Buyer(s)agrees and understands-that this Agreement,constitutes:the entire understandings between the parties and that there are no verbal . understandings changing or modifying any:of the terms of this Agreement.No alterations to or deviations from this Agreement will be . valid without.the signed,.written consent of both the Buyer(s)and Contractor.Buyers)"hereby acknowledges that Buyer(s) T).has.read this Agreement, understands-the terms of-this Agreement;and has received a"completed,signed,and dated copy of this Agreemeni,including the two attached Notices of Cancellation,on the date fitst written above and2)was orally informed of Buyer's right to cancel this Agreement: NOTICE TO BUYER: Do:'not sign this contract:if blank:'You are entided.to a-copy-of the:contract at the time you sign. YOU,THE BUYER,'MAY.CANCEL THIS TRANSACTION AT ANYTIME NOT:LATER THAN MIDNIGHT: = OF 08/25/2017 OR THE THIRD BUSINESS DAY AFTER THE DATE OF:THIS TRANSACTION, WHICHEVER DATE IS LATER'SEETHE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC Rene', ndersen' .. uihern N' Engh' ' :. Buyei(s) Signature of Sales Person. :. : Signature. :: . Signature Paul Sandre y :Susan Peirsori. Print.Name of.Sales Person Print Name: Print Name UPDATED: 08/22/17 Page 2 / 10 Massachusetts.Department of ?uk;iic Safat t Board of Building Regulations and Standars icehse-. CS-095707 i BRIAN D DENNISON 7 LAMBS POND CIRCLE CHARLTON MA 01507 .-. ..ten l,A, xpiraticI: Commissioner 09f0812018 - J � ?.1-•a�IlSllTeL .� ��rS�Zd gUSi:IL'SS <.�aU �iiG UC oo;ton, ;tissachusel,s T o-Ine irrtprovemtent r or:LT,',- R,.o-iS�;lClcr= - _---_ Registradon: 173245 _ - Type: Supplement Carta - E:cpirauan: 9!?9I20t8 SOUTI TERN NEEU7 ENGUkND WINDOWS LL BRAN DENNISON, 25 ALBION RD ----- LINCOLN, RI 928,35 --- _------— daw.addr=Ss and teL�ifi I rv.i�[ar:;:,soa"oc,:naoq[, —gMWaylWgL 7. Last Card _=-. mce of(:nnsvmer:Vrair�•1 3asiurs "'°udnn j•: . Regisizution 7 Hlid far iIIdivid»�l 75e onl,'oei-are ike ' esniratian clan, If faand return?o: ,y HOME IMPROVEMENT CC14TRACTOR 'Jitic ai con:armc:.arTai,:.and 3,^in,ss.3e_�istinc -"- Registration:,732a5 Type: to Par!c PL•rn-score 511a ^. c-Xpiratioo:.-gj.19/2A73 Supplement Card SmYon,�Gl!i311ti - - SOUPHERN NEW ENGLAND WINDOWS lLG- RENE4HAL By ANDERSON 3RIAN DENNISON UNCOLN.RI 02865 '-Undersecreiarp `lot v azure ' 4 . =� The Commonwealth of Massachusetts iawl r ? Department of Industrial Accidents f I I Congress Street Suite 100 �� 10 Boston, ALL 02114-201 i www.mass.gov/dia u/dia «orkers' Compensation Insurance Affidavit: Builders/Contrac tors/ElectriciausiPlumbers. TO BE FILED WITH THE PERNUTTING AUTHORITY. Applicant Information Please Print Le 'blv 'dame (Business/Organizaiion/Individual): E e Address: ,?f'o A RIDS City.'State/Zip: LIIJAJP Phone 4: Are you an employer?Check the appropriate box: Type of project(required): I XI am a employer with Zo employees(full and/or part-time).` 7. New construction I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.; 9. Demolition 3.a I am a homeowner doing all work myself. R to workers'comp insurance required.]` 10 Building addition 4. I am a homeowner and will be hiring contractors to conduct all work on my property. I will 11.0 Electrical repairs or additions ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 12.❑Plumbing repairs or additions s.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.oRoof repairs These sub-contractors have employees and have workers'comp.insurance. // 6.7 We are a corporation and its officers have exercised their right of exemption per MGL c. „?§i(4,,and we have no employees.(No workers'comp.insurance required.; j ne�'�}ce',el,_pS `Any applicant that checks box 91 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 is providing workers.'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 1!� I►IQ Is / C� Expiration Date: / l Policy#or Self-ins.Lic.#: n / 1 Job Site Address: & A �� City 5tatelZip: L'ory� 7. Attach a copy of the workers' compensation police declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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 at r.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the ains and penalties of perjury that the information provided above is true and correct. Date: Si ature: Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: PermitiLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Phone#: Contact Person: I ESLERCO-01 SANDERSO F�DATM(MMIDDIYYYY) R CERTIFICATE OF LIABILITY INSURANCE s10712017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE.OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. f e policy,certain policies may require an endorsement A statement on TION IS WAIVED su bject to the terms and conditions o the p y, P If SUBROGATION , J this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER ME CoBiz Insurance,Inc.-CO PHONE 1401 Lawrence St,Ste.1200 (ac.No,Erd:(303)988-0446 FiuAXc,NoI:(303)988-0804 Denver,CO 80202 E-MAIL COMail@cobiz-insurance.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Acadia Insurance Company 31325 INSURED INSURER B:Firemens Insurance Company of WA D.C. 21784 Southern New England Windows,LLC.dba Renewal by INSURER c:Liberty Surplus Insurance 10725 Andersen of Southern New England 26 Albion Road,Suite 1 wsulaERD: Lincoln,RI 02865 INSURERE: 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE INSD 1NVD POLICY NUMBER M D MM/DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1'0�'000 CLAIMS-MADE ❑X OCCUR CPA3158728 01/01/2017 0110112018 DAMAGE TO RENTED 300,000 PREMI E Ea ocanence S MED EXP An one erson S 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 0p 2,000,000 X POLICY❑jR8f LOC PRODUCTS-COMP/OP AGG S EBL AGGREGATE S 2,00Q;000 OTHER: COMBINED SINGLE LIMIT S 1IWO 000 A AUTOMOBILE LIABILITY - Ea accident) X ANY AUTO CPA3158728 01/0112017 01/01/2018 BODILY INJURY Per erson S . OWNED SCHEDULED BODILY INJURY Perac Went S AUTOS ONLY AUTOS PROPERTY DAMAGE HIRED NON-0WNED Per dent S AUTOS ONLY AUTOS ONLY , S A X UMBRELLA X OCCUR EACH OCCURRENCE S 1,000,000 EXCESS LIAB CLAIMS-MADE CPA3158728 01/01/2017 01/01/2018 AGGREGATE S DED X RETENTIONS 0 Aggregate S 1,000,000 PER g WORKERS COMPENSATION X STATUTE ERH 1,000,000 AND EMPLOYERS'LIABILITY YIN WCA3158729-20 01/0112017 01101/2018 ANY PROPRIETORIPARTNERIEXECUTIVE ❑ E.L.EA ACCIDENT S %FICER/MEMBER F>(CLUDED? N/A 1,000,000 (Mandatory m NH) E.L.DISEASE-EA EMPLOYE S If yes,desaioe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S g Worker's Compensatio WCA3158730-20 01/01/2017 01/0112018 1,000,000 117 01/01/2017 01/0112018 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space is required) 17-18 Workers Compesnation Includes-All states except ND,OH,WA,WV,WY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELJVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ' AUTHORIZED REPRESENTATIVE IFOR liAmnational Pr ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel (j 6 Z Application # CX Health Division Date Issued t'J Conservation Division Application Fee Planning Dept. Permit Fee �g Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address C d, Sfr-m+ Village Owner kll Z,_rl /� �'��$'° Address 0 l cvv Telephone Permit Request r-(<d'A�j ���✓a�v�` Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 7r&y?), vfl 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 Historic House: ❑Yes VNo 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 Heat Type and Fuel: ❑ Gas UfOil ❑ Electric ❑ Other / EB Central Air: ❑Yes O No Fireplaces: Existing New Existing wood/coal stove❑Yes ❑ No o Detached garage: dexisting ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑7exsting 0 new maize_ .Attached garage: iexisting ❑ 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) n� / q Name /_)ou �o� Buj,ld,/y Ca Telephone Number SQ© - 3/9 ' 3a f I Address-26 046 Ag,r Sf%e License# ' A Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �� DATE Z- lwy ` FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ` MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: E FOUNDATION FRAME �� � � RllWly i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING le,,AWC- DATE CLOSED OUT ;3 ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents m . 1 Office of Investigations 600 Washington Street c F.r Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): ✓1 �/ ' 6 Address: St City/State/Zip: ��.�-e-'A 1�4 0,21 bf Phone#: 5"0f TV 9749 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. VI am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors 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 workingfor me in an capacity. employees and have workers' Y9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ 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 1 I.❑ 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#I 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 is providing workers'compensation insurance for my.employees. Below is the policy andjob site information.Insurance Company Name: Amerl,c o,— zdrt ck Cob Policy#or Self-ins. Lie,#: W C 8 t 9 6 Qa.y Expiration Date:_ �o10 8 Job Site Address: 611 / 1 MI"^ sfr+r+ City/State/Zip: ��tli'�, A-A Q � 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 ` rtify under the pains and penalties of perjury that the information provide above is true and correct Si na re: Date: Phone#: 50 -3 cl v aaci 3 Official use only. Do not write in this„area, to be completed by city or town off ciaL 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 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-contractor(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. Y g Y g g PP 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.Wherebusiness a homeowner or citizen is obtaining a license or permit not related to any 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 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877=MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia 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-contractor(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 homeowner or citizen is obtaining a license or permit not related to 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 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877=MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia ,. 4 Y r Town of BarnUstab4e. `R:egul:atory Vices r is _ t IAA?lSTABL.E, ;• -•` Thomas r - ThbmasF Geiler,FDirector• • t 6 q tee, s o A Buildiug Division Toni Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstabie.ma,us Office: 508-862-4039 Fax: 508-790-62 Property OwierMust Complete and Sign This Section If Usina ABuilder I, �i 7 G►6 �,��.' � S ar , as Owner of die subtect•.property hereby authorize �e.. /���/ry"� to.act on M7 beb_alf, in all matters relative to work authorized bythis building perriut application fox: J qA (Address of job) : _ r Onw Signature of Owner Date Print Name If Property Owner is applying.for permit please complete the Hormeowne�s License Exemption Form on the reverse -side. • � I�ti �x,c`. '� �t cal. o Jt c7�`Rr' S c D�� _, • Town of Barnstable �oF Y�ray o� Regulatory Services H ,. g Y Thomas F. Geiler Director RARNSrABLF_ Building Division rEo l,,u,t k • Tom Perry,Building Commissioner 200 Mairi•Street, Hyannis,MA 026.01 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 509-790-6230 . HONMOw•NER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street . villa'gc -^'HOMP_OWNER': name home phone.# work-phone# CURRENT MAILING ADDRESS: cityhown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellint=s of six units or less and to allow huzneowners to engage an individual for hire who does'not possess a license;provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there•is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Btu7ding Official on a form acceptable to the Building Official, that he/she shall be responsible:for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner'assumes responsibility for compliance,with the State Building Code and other applicable codes, bylaws,Hiles and regulations. + '" ._ _.. _ .a+ �_.y r_,_aL_.t_/. ..._'_-,.�-__.f,.t_ _ .... -rt'�-_.-.,tab 1c Build:.-. D r/-„ nt ,T'IIC-LrnderSTgneQ T1u111cu'tYllc ��ciu.�iw WLc„aiu� G uiluct�m.uuawu -u'vru-ui ucuuau<u.....�.aa�.�...tY .=-.L". - minimum inspection procedures,and requirements and that be/she will comply with said procedures and requirements. Signatirrc of Homcowncr Approval of Building Official Note: Three-famly dwellings containing 35,000 cubic feet or larger will be required to courply with the State Building Code Section 127.0 Construction Control. HOhfEOWNER'S EXEMPTION ' .The Code states that: "Any homeowner performing work for which a building pernvt is required shall be exempt from the provisions of this sccdon.(Seeticn I o9.I.I -Licerrsing of construction Supervisors);provided that if the homcowncr argagcs a person(s)for hire to do such work,that such Homcowncr shall act as supervisor." Many horimeownas who use this exemption arc unaware that they are assurrring the responsibilities of a supervisor(sec Appendix Q. RuIcs&Regulations for Liecnsin Construction Supayisors,Section 2.1.5) This lack of awarrncss oftrn results in serious problems,particularly when the homeowner hires unlicensed persons. In this ease,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homcovrna acting zs Supervisor is ultimately responsible- TO ensure that the homeowner is fully aware of his/her rasponnblZitics,many communities require,as part of the permit application, that the homeowner certify that lydshe understands the responsibilities of a Superyisor. On the last page of this issue is a_form currently used by several towns.'You may care t amend and adopt such a form/ccTtification for use in your couUnunity. Q:forrrs:homccx crept ACORD DAV CERTIFICATE OF LIABILITY INSURANCE OEN-1 P ID J DATE(MMJDD/YY 04 06 09 9 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Addis Group, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 2500 Renaissance Blvd. Ste 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. King of Prussia PA 19406-2772 Phone: 610-279-8550 Fax:610-279-8543 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Am-ric— Zurich I-sur--e-co. 40142 INSURER B: Z—ieh Am-sic—X--Co. 16535 Davenport Realty Trust Stephen Aschetta.no INSURER C: 20 North Main St. INSURER D: South Yarmouth, MA 02664 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REGUIREM,ENT,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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .Nbm Avu� POLICY EFFECTIVE POLICY EXPIRATION LTR INSR TYPE OF INSURANCE POLICYNUMBER DATE MWDD DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 B X COMMERCIAL GENERAL LIABILITY GL08196255 03/01/09 03/01/10 PREMISES Eaoccurence) $500,OOO CLAIMS MADE X❑OCCUR MED EXP(Anyone person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO- LOC - JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,OOO,OOO B ANYAUTO BAP8196256 03/01/09 03/01/10 (Ea accident) X ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS - .(Per person) X HIRED AUTOS _ BODILY INJURY X NON-OWNED AUTOS - (Per accident) $ 250 Comp PROPERTY DAMAGE $ 500 Coll (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC S OTHER THAN AUTO ONLY: AGG S EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ ' OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ - $ WC WORKERS COMPENSATION AND X TORY LIMITS ER A EMPLOYERS'LIABILITY WC8196024 03/01/09 03/01/10 E.L.EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? E.L.DISEASE.EA EMPLOYEE $1.,000,000 II yyes,describe under — SP EC, AL PROVISIONS below - - E.L.DISEASE-POLICY LIMIT $1,000,000 ` OTHER - - DESCRIPTION OF OPERATIONS!LOCATIONS 1 VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Building Permit Dept IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. - - AU TH SENTATIV 4 ACORD 25(2001/08) ©ACORD CORPORATION 1988 r i -tll�rrMdofVuil=g�ReguIallion'ris"";aii5 Stan aids One Ashburton Place --Room 1301 Boston, Mass- chusetts 02108 Home lrnprovem : C. tractor Registration Registration: 106024 Type: Trust z I r Expiration: 7/21/2010 Tr# 271689, DAVENPORT BUILDING COMP Dewitt Davenport _ a 20 North Main Street = South Yarmouth, MA 02664 SN 6 4\�4 Update Address and return card.Mark reason for change. DPs-CAI CO soon-07107-PC8490 - � Address ❑ Renewal Employment [_� Lost Card - ------------------------------ lie �om�mwnulealli a�✓�czcluceea� ----------------- Board of Building Regulations and Standards License or registration valid for individul use only HOME IMP„i2OVEMENT CONTRACTOR before the expiration date. If found return to: Registry .one, 101i024 Board of Building Regulations and.Standards xpi a.0 t�'� 21/2010 Tr# 271689 One Ashburton Place Rm 1301 Boston Ma.02108. . DAVENPORT B I � � � ANY TRUST Dewitt Davenport 20 North Main Stree a, /'_6s South Yarmouth,MA 02 B" Administrator- Not vali with t signature 1. Massachusetts-Department of public Safeh Board of Building Regulations and Standards C.bn'-s'U tibmSupervisor License --License: GS 12060 Resfrictedto.�OQ _0 DEWITT, DAVENPORT' 20.N MAIN-SS S_YARMOUT /IA 2664 - Expiration: 11/24/2011 Commissioners Tr#: 8392 SdQ/eo�sseyQ AAAAM :o;is;ag asuaag siq;;o uo moAaa.[o;asnea si apoj 2u.ppng a;e;g sjjasngaessuIq ;o uowpa;uw-m a ssassod o;a mpe3 sau[og SIPURA Z I-9I p3;3u;53azu11 -pp 00.:o;PaPPIsab --------------- 1 y i RES-7 5 0 Residential Elevator Entrance (314" setback) Designed for the residential market, the RES-750 series entrance includes a concealed interlock and comes prepped for any standard door latch hardware. This product is recommended for use only on lifts.egiipped with a car gate. 3/4" t Standard Features g, g 3—, 1 ,� % "c ., ' • 16 Gauge Frame 61/8" Jamb depth, galvanneal & paint ready) • 18 Gauge. Door (H/C core, galvanneal & paint ready) NIAG "RA �BEI;aC�O� Blank:hollow metal.door �a W • UL Listed 2 speed door closer with adjustable backcheck 4� � � . h I cushioning (Meets ADA requirements) Wherlyou cllooseNlagara Belco, " n n icon. w n 'x's`, .ts 3 e'r:� �. „� • 161 x 23/4 Setback (Std. Cylindrical prep) your choosequahtyNiagaraBelco's� ri ar ��y d'S� r� � s't Y '.�c�r-�w,�ir� - • 3 41/2 x 4 Ball bearing hinges US26D �� � � r ( ) g g ( ) � produ,C-S N built�Fby 1, ator • GAL type "N" interlock c/w beak � �� � ��' • Removable checker late sill peoplefor-eleuatoMMMUrpeople u ire�.�,rt `5i �ax� t ,�e^}�-x*" • 1=��2�Fiou�B�fire�l.abel Diu°XW �� . t n . G�`. ..�' '1��k Aa.fis` i.a`S. arv- B1sz Adjustable drywall or masonry anchors supplied tCornmlttedto�proMM dng �hlgh • Completely assembled and ready for installations a � � -YAW glallty,4productstoNorthAmMGM, Options Ar�.0,ouer 25 years, we guarantee,� xl- Hall station prep in Pre frame r you H satisfaction • Custom hardware to match customer's d6cor N, ? 4" • Various jamb depths • Concealed door closer experience;rcommrtment • Splayed frame d wltoexcellenceand hands onprolect • Electric strike prep• ' management 4frhom-start to�inish, • Power door operations certaln N j ` � were ro you 11 be pudto • EMA prep in frame T� ��� 4 g .ar. " sr� aA +'M:� • Exterior package (Includes; m Styrene core door, akeNag 1ara�BE co�door pr-oducts a = weather-stripping on frame and door sweep) 5 & � � � . • Heavier a door & frame s�uccessful part of yourn�ext pro� ct au 991 j Ilk • Various wood doorsyad%IN �� � � rr ' • 6 Panel metal door (as shown in picture) �NlagaraBelco�ls aernember�ofthe x • #304SS or #316SS Stainless steel (2B or #4 finish) ��� Natlonal �Assoclation, of� Eleuator Stock saes �3 w4 x h w <. �U Contractors (N A E Cam) x andh the • Custom sizes only Canadian rt Elevator1Contractors° • 6 Panel metal door offered onlyin 36" x,80" 36" x 84" WIA k ssociatlon (,CAE CAA ),since�19;84 0- - �+€ , rt?' a ,•, -ra.�l� w,.p,� xEaS�'" " ^riw�+4>� "'r�w. � EIkMc w, - m , i r -� s r � S iV. � ASSOCIATED ELEVATOR COMPANIES, INC. 5 E Boston•Providence•Springfield•Worcester Hyannis ZBUILDINGS ' 1-8007828-5151 MA:•1-800-422-4922 RI ;{ p (568)760-3875•(508)760-2809 Fax a z fa J .�G.x W W W.associatedelevator.com \a i BELCO 1.A' G-A�,, R. . North America's, Lift & Door Solution � a e # 4 v } 1 ,t S North America's premier manufacturer and distributor of quality accessibility lifts and elevator swing door assemblies for over 25 years! P ► Jjf� Assessors office(1st Floor): ? SEPTIC SYSTEM, WkWST BE Assessor's map and lot number �J INSTALLED IN COMPLIANCE Board of Health(3rd floor): WITH TITLE 5 sewage Permit number � � �� .�� ENVIRONMENTAL CODE AND = Dsaa9T11DLL Engineering neering Department(3rd floor): House number _ . TOWN REGULATIONS • Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN - OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO D� MLnPA t`Q TYPE OF CONSTRUCTION woo ( pry me- 19 . O TO THE INSPECTOR OF BUILDINGS: . The undersigned hereby applies fora permit according to the following information: Location I r, Shy er C 0 +y e f q Proposed Use G Zoning bistric� `- �� ";.`•" � Fire District Name of Owner LoA Qn, P-6 ialcoin Address 69,1 0-\w�V\ SAP C-&A C t)+U o4 \ MA 1- t388-LRl6 Name of Builder +euetn S a W to Address 1 G l cl CcZ i A u WG �Qqk dl1 MN, ytnCA Name of Architect Address A. Ljit Number of Rooms Foundation ��sR esk ErQ& L\-nk, S1ct� Exterior GI b0CT1 v S' ° Roofing A-S �} F►� �wS ��"n���s Floors 4\1 F'bieg Iymeh c la eiA DA (QV)[P--k Interior 5 �.� is� I t1b Tl n&QICL. i L-jlc� Heating nevi e Plumbing hd Fireplace r)bt k Approximate Cost 000-00 Area a jp�2 . Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re arding the above construction. r Name. �v Construction Supervisor's License -09A09 r,N - 4 PEIRSON, EDWARD & SUSAN f Na• 33904 Permit For Build Detached Garage k ` Accessory to Dwelling Location 621 -Main Street c t` CotuitIp Owner'. Edward & -Susan Peirson Type of Construction Frame r r Plot ~ s ! Lot ` , Permit Granted August 9 C „19 90 0 Date of Inspectiori , Date Co pleted y 19 i �r , . I — 4 M t 3: C-T00 ffj a 011 r M - �v r ' : Lr i T a. y n � III 11� n1RSonR� `tlu. - PooR '� Qpenin9 v FORI out I la Ids r, FOR Poc+ Foo�'in95 p«.IkCta Slob GF}RAGE 94' Fouv),DA, PIRN Frnc- 4't Fi lkold bca rncs� slab (3ewn (he+ gol+�) �IeQGd R" To From w e 11 +o be. l{I FRost wFKI getow ph t ' 33- SCA1E 'I4''=l' S Stile tEE\p- ton . 2�8 fl;d9e Beam o•L'• . lo/I , I. ?x3al lb." LDR (IooF r• Whit Stic.a�'h;n9 i J �� RspMIF�F(bcr�ItSS J'4�inq�c5 j �en+ed ' y� SofF�il , Iq� cet . + t6" O.L. '(])7yt� 6Han�E 000R (1) to"rn;c.aoLRtnS 1ti6 RRkc H sail oR _ Vcn+ed So ff;1t -Cal 7r81+e4dc 0. T PT I yX4. R-3w s° _ T44 e-k o.c.. rq post 7' � o - - — GRADE Fp,osM. PC°tl.-.-knee 3° (g{}ndeRSon >,83a 0 ooe 341(4 x 4�`�4 t. R 3°° 36)(82 - 4X4 TR.QoS+ 4i4 T4 Pos+ i C, R GF- Flood Plan (3) $kg GH0.R&FE 00®R oPenin�$ i j 69I m i G(ARAc� > 0}'� o36-obi FRonT �IEhRTioN -------------- Uint.)L GIRPSoPR') F' GENERAL' CONTRACTOR Steven Shakin 18 Old County Way 45 Assessor's office(1st Floor): A Assessor's map and lot number � THE � �o o� Conservation j F C h A 01 G ��D t r , .Board of Health(3rd floor): I °� � 3� Sewage Permit number sssa3rtnta Engineering Department(3rd fT 1� ����� 7 aye, ; ° 2639. �'-�' "�� � W ��S�'9 ! `"1 �0 Y�Y►. Definitive PlHouse �r proved by Planning Board '. b w i�w� .. 9 APPLIC 10 ROCESSED 8:30-9:30 A.M.and 1:00-2-00 P.M.only TOWN OF BANSTABLE BUILDING DIVISION A (CATION FOR PERMIT TO (3()I L� ) PJ Gr R 6 U P S I J)M I4 I it1& IP®O L TYPE OF CONSTRUCTION 5 TE E L U_1 Q_, L k_ , VINYL L I PJ EP2 19 % TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location (6 A 1 H A I A3 S ER ET-_-F C 6TU oT "A 62.6 3 6' Proposed Use Ia_3 l M M i IU C• P®® 1- Zoning District r! Fire DistrictI�— Name of Owner EDWARD L.;SoM,,J P. PemmoA! Address (o*JL f M'9/tU 87, e-0-Tu vT, 01 A 6260 Name of Builder �-.U a t E'T'T f. /� Address•766- R®U te- G3 a kYhMA113, &4 a 2W I Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fr Fireplace vk o imate Cost oc d� Area- Diagram of Lot and Building with Dimensions Fee � � 0--Z) v • 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 Home lmrpovement Contractor Registration# 108138 Construction Supervisor's License# f - No— - Permit For Location Owner . Type of Construction - r < Plot Lot Permit Granted 19 f Date of Inspection y' 19 : Date Completed �o� 0 19 ` INEW4' DEPARTMENT .OF PUBLIC SAFETY Al D ONE ASHBURTON PLACE, RM 1301 95 BOSTON`I'MA 02108-1618 I 27 CONSTRUCTION SUPERVISOR LICENSE mm D P Sy Number: Expires: ' Restricted To: 00 4 TIMOTHY R LUZIETTI ,. Detach bottom; fold , "sign on 79 ARBOR WAY . , ', �T ;� M� back', and ,laminate license card. HYANNIS, MA . 02601 `;, Keep top for receipt and change f address notification. \ C - .. .'�-•"fir.'4�1.. i J.,r• - ✓�e �oaz�rzdazu�eull� o�✓��,a�t�ueelC_ _ Restricted To: 00 DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE 00 None Number.: Expires: 1G - 1 8 2 Family Hoaes Restricted To; 00 Fcilare to�� rn n r�mr�rrQnt pQanE�6d ', a , ` TIM0IHY R lU2IETTI' ,! Cxrl,�1ta >"; rzrvae:r�fEon �} 19 ARBOR NRY os Qat�rrc, VO HYANNIS, MA 02601 HOME IMPROVEMENT CONTRACTORS REGISTRATION 'Board of Building Regulations and Standards Room 1301 One Ashburton Place i Ba ''ton , Hassachuset is 02108 ! I HOME IMPROVEMENT CONTRACTOR' 96 1- ' Expiration 08/14/96 Registration 108238 l ! .y�✓t %, ° Type -- PRIVATE' CORPORATION ! HOME IMPROVEMENT CONTRACTOR Registration 108238 / Type i= PRIVATE CORPORATION Luzietti ; . Inc • ) Expiration _ 08/14/96 Timothy. R . Luziett"i 955 Rt . 132 Luz ietti, Inc:• `# Hyannis .MA._02601 ) Timothy R Luzietti G� &row Rt. 132 i cep c o ; t e ADMINISTRATOR Hyannis MA 02601 i j The Town of Barnstable ,$ Department of Health Safety and Environmental Services ` BuiIding Division 367 Main Street,Hyannis MA 0Z601 Office: 508-790-6227 Ralph Crcs= Faye 508 775-3344 Budding Commis For office use only Permit no. Date AFFIDAVIT HOME DwROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the-reconstruction,aitemtions,renovation,repair,modemizat an,eomemon, improvement,.nmtto%mL demolition. or construction of an addition to any pre-cdSting owner occupied building containing at least one but not morn than four dwelling units or to sauctures Much are adjacent to such residence or building be done by registered oonuaUors,with certain=cgdOus,along with other requirements- Type of Work:_ wJ 0% Vo0 Est Cost d--6 o 0o 2. Address of Work: Ow•rter.Name:c5�se4N� �:�� ��l r 5® ►'� Date of Permit Application: A 19 T 11 166 t qcf - I hereby certify that: Registration is not required for the following reason(s): Work excluded by law _ _ob under S1,000 Building not owner-ooeupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING T1�iR OWN PERMIT OR DEALING WfIAI1NREGI�fF3IED 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 a permit as the a ent of the ow•ne 00 chi APR\L k L 1 q ?iMua Y R, Date Ontractor name Registration No. OR ' n�.A Owners name w The Commonwealth of Massachusetts Department of Industrial Accidents ;L _ � OJlfceollm�esl/galloas =r;a` 600 {1'mithigton Street B000n,111uss. 02111 r Workers' Compensation insurance.Atftdavit Pletse PRINT lely � "".�.,""' nntne 1pc•Jtion• city nhone# 1 am a homeowner performing all work myself. II am a sole proprietor and have no one working in any capacity �' s 1 am an employer providing workers' compensation for my employees working on this job. comilanyname• address• - ' cety: nhnne#: ineurwn�w nn poliev# V.... wr.. r.•.::w�...-......:.y.r ..�s...r.....+,'w�!�'++sl:._, __ _:_..E....,.� • :- ._ .. _-_ _.. 'ram:- i•:o.-...r.e--.,,._--..ram.. 1 am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: r comnan •n insurancephone 1 a .�.---f::-•- -- xa.-e•.e•y-•- • •�•, _ _ •T�RF�4•J�Q,�:�;?.•,••t7 �►?"�T_•-9:9�43*�!�^--"-":-�f etimnam•name• address: city: phone# insurnnce co Rey# :Attach additional'sheet if neeessa _••�Y •ram -;_f` a�'+�""`"'S"`�`'' " d...••+�� Failure to secure coverage as required under Section 2SA of hlGL 152 can lead to the imposition of criminal penalties of a fine up to SIS00.00 sad/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and aline of S100.00 a day agttian me. 1 understand that a copy of this statement may be forwarded to the Once of lavestigntioas of the DIA for coverage verification._ 1 do hereht•cerdfj•under die pains and enal es of peduq•that the infotmmion pnnided above is true and conea Signature - res J D Print name 0 71ev M 2 to#1 1412lef li /NC- '-77f Y/ Y Z of6ciai use only do not write in this area to be completed by city or town oIDcial city or town• permitfilcense# riBuilding Department Licensing Board 0 cheek if immediate response is required DSeleetmea's Omcc E3111e2ltb Department contact person: phone#;. nOther (mvsed V95 PJA) • information 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 employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An empoyer is defined as an individual, partnership,association.corporation or other :cgal entity,or any two or more o± the fore=oin 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 1'S2 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 commonwvealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally.neither the commonwealth nor any of its political subdivisions shall enter into any contract for the evidence of compliance with the insurance requirements of this chapter hav f public work until table evrde acce p q performance o p P been presented to the contracting authority. - - - - (°•�^"r."^.e+��'��R...'- :�: _ ���./a..- .. r. y yq uyrrS.aAr ^F'- Applicants Please fill in the workers' compensation affidavit completely, by checking the boa that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also'be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. •;�:." _•r•.. t..-:n..ri..:+.;-Y'^� _ }«` r•r:.0i'� �►•,. .+Wr,•r', ,+. Cite or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference 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. 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) 7274900 ext. 406, 409 or 375 ISSUE DATE (MM/DD/YY) C E R T I F I C A T E O F I N S U R A N C E 04/12/96 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, Arthur D. Calfee EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Insurance Agency, Inc. 336 Gifford Street COMPANIES AFFORDING COVERAGE Falmouth, MA 02540-2967 (508) 540-2601 COMPANY TRANSPORTATION INSURANCE COMPANY LETTER A INSURED COMPANY LETTER B LUZIETTI INC COMPANY TIMOTHY R. LUZIETTI LETTER C 955 ROUTE 132 COMPANY HYANNIS, MA 02601 LETTER D COMPANY LETTER E COVERAGES 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 CONTACT 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 POLICY LTR . - TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION LIMITS DATE DATE GENERAL LIABILITY GENERAL AGGREGATE S 2,000,000 A TO BE DETERMINED 02/01/96 02/01/97 PRODUCTS-COMP/OPS AGGREGATE $ 2 000 000 [X] COMMERCIAL GENERAL LIABILITY PERSONAL & ADVERTISING INJURY 00 00 [ I CLAIMS MADE [Xl OCCUR. EACH OCCURRENCE $ 1 000,000 [ ] OWNER'S & CONTRACTOR'S PROT. FIRE DAMAGE (Any one fire) $ 50,000 [ ] MEDICAL EXPENSE(Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ [ l ANY AUTO [ ] ALL OWNED AUTOS BODILY INJURY [ I SCHEDULED AUTOS - (Per person) $ [ I HIRED AUTOS [ ] NON-OWNED AUTOS BODILY INJURY [ ] GARAGE LIABILITY (Per accident) $ PROPERTY DAMAGE EXCESS LIABILITY EACH OCCURENCE $ [ ]Umbrella Form AGGREGATE $ [ ]Other Than Umbrella Form A WORKER'S COMPENSATION WCC 145033120 02/01/96 02/01/97 STATUTORY LIMITS AND EACH ACCIDENT $ 500,000 EMPLOYERS' LIABILITY DISEASE POLICY LIMIT $ 500,000 DISEASE EACH EMPLOYEE 5UU,UU0 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE TOWN OF BARNSTABLE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO SOUTH STREET MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED .TO THE HYANNIS, MA 02601 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS -AGENTS,qF REPRESENTATIVES. A AUTHORIZED REPRESENTATIVE g � l v C 1fr1har 0. Calfee INSURANCE AGENCY,INC. a r rl,qlr-APR 11996 .............. ........ ............................... ............................. . ........ ................. ......X.X........................ ...................X.: ............................... ............................ .................................................... ............... ............................ ... ..... .................... DATE(MM/DONY) ... ...................................... ................................... ... ................. ............... .. .............. ........... ....... A Homo. 1�1�111 1 UIR N .......... ........................... ......................... ........ 04/15/96.................. .............................. ............. .................................... PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE OLDS CAPE COD INS AGENCY, INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW. 435 MAIN STREET COMPANIES AFFORDING COVERAGE HYANNIS MA 02601 COMPANY A COMMERCIAL UNION INS COS INSURED COMPANY LUZIETTI INC B COMPANY 955 RTE 132 C HYANNIS MA 02601 COMPANY I I D ............................ ............... ................................ ...... ................... ............ ............... ...................... ........ .............. ............... ...... .................... ....... ........... ...... V .................. ....... ........ ... ......... ......... ........ ......... ....... . ............................... ......... .......................... ' .......................................... .......... 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 NUMBER POLICY EFFEC77VE POLICY EXPIRATION LTR DATE(MM/DD/YY) DATE(MM/DDIYY) UNITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ CLAIMS MADE OCCUR PERSONAL&ADV INJURY $ F OWNERS&CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED EXP(Any one person) $ AUTOMOBILE LIABILITY CBXB14303 02/01/96 02/01/97 ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ 250, 000 x HIRED AUTOS BODILY INJURY $ x NON-OWNED AUTOS (Per accident) 500, 000 PROPERTY DAMAGE $ 100, 000 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 $ ............... ... ....................... .11 1............... WORKERS COMPENSATION AND STATUTORY LIMITS ....... .... EMPLOYERS'LIABILITY EACH ACCIDENT $ THE PROPRIETOR/ INCL DISEASE-POLICY LIMIT $ PARTNERS/EXECUTIVE OFFICERS ARE: EXCL DISEASE-EACH EMPLOYEE,$ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS 0. .... ................... . ....... .............. ............................................................... ............ ............. .................... .............. ....... ........ ...... .. ................. ........................... , .............................................................. ....... ............. ....... . ...... ......................... ............................... .... ............. . ..............***.......... ::::::::::::::::::. ........... ....... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE TOWN OF BARNSTA13LE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, SOUTH ST BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY HYANNIS, MA 02601 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTOO MED REPRESENTATIVE MB A ... .................. ............ ........!I.................... ........................................................ ......................................................... ................................................................ ......................................................... ........................................................................ ......................I......................................� . .................................................................. .................................................... .................................. ..... ...................................... ...... .. ............. .1 Of .9 AP MY: 0000 ..... .... M _ a RELIANCE BRACE TYP. WHERE SHOWN , a�f i� 1�.,rMc Y7;�:s:•$f!#r#iffc rf .. .. - 't£c•.C,fu•fi< 'EMw'`a i;.i^"€.'`.-ll�fi•,, _ _ . . , < c;'x.};#:�':.�c�;�Sr�rEYtrrt ct ��i%t:•'. •�x •- f «:Sf:TiJShs;(f o-dcf`Zicifc <ff..v.•rtk -'gt: •:;: r;c:: - L ..f;..:..fJ.�.(o.i f ,c.� t t f t £ •?: 1- 1 - ?Ep?_c_Vi'S law•f?F,sd't`,���f%2�3ff';k'{s�3S�f?•E` •;'r '1r�f 4r,c t < <r:'f::r�G.%F;>rY;iS><ift%'< t� •'�•;'rf`fsf 3 ,•,�5<[+`i. f t•f„>, 2.A:<2$.cf<rc'Qrcrgif �. _ " ,. . .. L L>•�t'c}c 's,�� <t frs.f>j._;;..r<,'":.tll;: r, , - t,rS°.:;Sf:£c<aZStsffr::j>.�j r3.r - � , 3 STAIRS ARE OPTIONAL CD m Ix OIGHT NAND) 633 S.F. SURF. AREA 20,134 GAL. CAP. _ I AO LBTMI!VT PIN N y' A ai EiEVAT10N B. iANCE BRACE DETAIL � 2 i; °raelNwlt e k s iano wwr. , _ ► IMM COPING � •t ry .r.0 M -•- .' �. :• � NAILRAL 6RAGE ' . I • RELIANCE SPACE Z. eCIND• • ooNdlr�fz�,tt8» BANG Wh=AV&CR IOU SAM.LW No EDPApaft � . ..�} x __.MA3=ALpm ------ - -� ---- • 13tACE 1r Vfi q t i e �RBCXiim IN C�TAW STATES 0 Y OM 0R ADASTM59PW Q1 dr D5n4 I'=? tD . r. PROD. NO. ` Lim IN OONTnimis m 88102 PiduL D p1jahLrmIN now BEAMNAWN M JPDM - SHEET TYPICAL WALL SECTION E BRACE COMPUTER ' 10-1996 09:15 : P.02 „ °.: - I v ' t ..Yx �•:;•'�;��.Aryv t�.r.i x��,k ti�.:�:ra , �•t;L :Rt�y. V'i- .-t.."' �yr"iry�^:�w',T�•.� .+fn•_,�17. �y,.'{'SivN �. ,. „•CC" _ �^.ti JL` w. v7i+-, r r REPRESENTS �' Q f• -AT AREA r„t`.«..;�v, 1^;v� :•:^r."+,;-ti.v'�•• Y.>�. O w-A�+• ti . fAw n S�RON,4f_E a r . q , 81ZE-S—IOWN -020 P X'46' X 30 -{LEFT Rll N NAND) 1086 S.F. SURF:AREA`>r 33,iO4 GAL CAP.'fl ALSO AVA1LAg� I 18 X 43 X 28i (d_EF7 RIGHT HAND) 94 a x#16 X 41 X'24 , {11, 7 -� RIGHT k-1A O S F SURF. ARE v.28,096 GAL, CAR"' ',. "y I ND) 770 SP. $ iF APEA C ZZ714 GAL. CAP. u 4� RADJUJS � ,TRUW, ,y r _ S 4 • r SCALE : 95 -.,R_ , MRS• SLED o viRs4N Luzir rrl hao L s S , M/1 .-0 -1 -71 - NlYZ SCALF; 4001 ,. I DONALD J. 8 IC. W1LLIAM C. .a VIR 32" 0. ASH..EY ROBlNSC1V 8K. 1445 M 40 ZK4038 PG 51 TOWN OF SARMSTAS COTUIT EUWUTAM 5 - 4 Y G0*25'00"E s, N B.R.B. . 150.00 ,.f A A= 31.42 ,. J��25'00"E R= 20.00 • 17.3.39 '" . - - - - A= 3L42 R= :20= - _ . � LOT NCr ® O TOTAL S = - � F, LET .. .R 4 C.B. . 1 4 t5 57-7.p� ILI LLJ * • III .i 7753 '' t ;�d EXISTING Assessor's map and lot number ................. SEPTIC SYSTEM MUST BE yo* oa ..........................• THE p Q 4 Sewage Permit number ...........................N.(.. ....:......... INSTALLED IN COMPLIANC WITH TITLE 5 g B9HB9TADLE, s House number � �..... ENVIRON1 RENTAL C07" C �.......................... ., f, , f� aaea ... TON R� ., p� 079. \00 'OWN OF IDDAIR.NSTAIBILIE NUMB ROPECUOR; APPLICATION FOR PERMIT TO 400............ ....... 4f' . TYPEOF CONSTRUCTION ............ ........................................................... ........................................... ..... ._ M. .....�J�....19.. .? TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: s Location ................... .. ..........!! ...................................................................................................... Proposed Use ... .. ` `9......re ....... ..e--., ! f...f14J..... �!!!�.� .. .......... Zoning District ..........� ....:...............................................Fire District .... ... ....`' ` .r'` ..i .1...`:�.. ............ le Name of Owner ......................Address ................. .. .. ................. o Name of Builder �:..'..... lq,yC...!/M...i...............................Address 31.q.Pd. ... . l.4:!G U .................. ...... Name of Architect �..tC.. -LAi4 �4 ?..............:.........Address .......................... � .............................................. Number of Rooms ..................................................................Foundation ..{ l1!'P. .. ...:....... .................... Exierior .....v �. .... ..........................................Roofing ....�n ... ....................:.................. Floors ................................................Interior ......... Heating 'llf1ad....1191....60& -�4...,.............:...........Plumbing ........... .�.���-- .... ...... ....................................... 'Fireplace .... ..(Zo4J..........Approximate Cost ................................ Definitive Plan Approved by Planning Board ________________________________19_______. Area ..... ..S.c .s Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH nK 0 ` lbY ; ? >� f I � t OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS , I hereby agree to conform to all the Rules and Regulations of the Town of Bar lable regar a above construction. Name ............. .. .c.:........... ..............................I.......... �3d�.. Construction Supervisor's License .................................... �PIERSON, EDWARD T No .2.7.9.7.8.... Permit for ...Addition........... Single. . ...Fami.ly....Dwe;l l ing........... Location 6,21„Main...Street... .................C4 .0 tr...................... Owner .. dwar ,.Piers,on............ :.. Type of Construction .....Frame......................... Plot ............................ Lot ........... ................ Permit Granted ....June.. 6..:..................19 85 Date of Inspection .................................... ` ' Date Completed ..........., ............................19 3 . Assessor's map and lot number ............................................ �oFT ETo� Q Sewage Permit number ..................... .............. Z BAHBSTODLE, i House number ..........:-:............................................................... SAM + �p t 63 9. `00 TOWN OF BARNSTABLE y BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... rt d 1.X........ . '!...Cy ..................................... /.. �. TYPEOF CONSTRUCTION ............f.!.a``:a:"!......................................................................................................... ...................... r ...............19. :y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...................!................I..........3 °°':? .............f.........:......................................................................................................... ProposedUse .......:`.....`'�..... :{:.x,�r :. ............... .. :............:: .............................................I. . ........................................... ZoningDistrict ..........0. .......................................................Fire District ....!...! .it.+.. ....................................................... Name of Owner r' < f4'i s Address f + 1 delf�•r r'r.4, r c l ............. ..................... ................. ............ ...•................................... `N Name of Builder . ....:1 J,_1 v j+x7`;`r ............................Address '.: /I?a?; Ip 3 �1s 1 e ............ ............... ............................. Name of Architect ./ ..... .......................Address ...f ........................................... ...?..................... Number of Rooms Foundation ...t.f..f.,f{" ........................................................ . ...... .................................................. ( �j /�l! .....?frm-rr (.(dl:��Ir t/�.....X �f '; !1-4 Exterior ..... - ..........................................Roofing ......... -� Floors ......................................................................................Interior ..........:,............ ........ ................................................ Heating ...r t..... ....r..-...............................Plumbing ............'!..!`; ` ?I:r :? ....................................... Fireplace .....' ... ... !;!; '/ .../'/d r.,r;'.....'s�,! .........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 ! l'U t� t } — I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding-fh—e above construction. Name ........... f............ ............................. Construction Supervisor's License *f' ` ?`'•-a-� / PIERSON, EDWARD A=36-62 No Permit for ...A.ddition .........;3.ingle Family in ..,. j Location Street........................ .................. Ot.ui.t.............................................. Owner .....Edwar�l...Piers:on........................ Type of Construction .::.F x1 ........................ ................................................................................ Plot ............................ Lot ................................ Permit Granted .......June 6, 19 85 d Date of Inspection ....................................19 Date Completed ......................................19 b Assessor's office(1 st Floor): ��� Zy Assessor's map and lot number _ e�Q�o�t�f_>o�,`w Board of Health(3rd floor): Sewage Permit number r q/ /� .�� • Engineering Department(3rd floor): ±ssaasr nu a' ; ' House number i6}9' Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only i TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO U j 14 D f +CkLh e TYPE OF CONSTRUCTION e, TO THE INSPECTOR OF BUILDINGS: b The undersigned hereby applies for a permit according to the following information: Locati ii on a; m a 1 h S� - Pf'"Tdi C O +L) ;T Proposed Use G-n rYt e -- -- -. Zoning District A,.-,�� � � '."��-� � Fire District J � A Name of Owner fee (A Ro 4- S US Q v\ P-6 0l o r\ Address 6 9-l 0-�Lk r\ ��s c r�A L u�-A t iv\� Name of Builder S+glu PvN S k-)a W;t\ Address C t,t,nA Q W(a re.. Sao A idk VVX c` Name of Architect Address Number of Rooms Foundation 8° Po,)9,Pd FCc Ki 1.XJ 51�� Exterior C 10 QbUu€' U i h V S Roofing Pr so � 11 4 Floors LJ c iv,-MCTD� C01()ci-AyO. Interior Siu� t�`ct�� , tlu InS,u�tct, aV�\ Heating now Plumbing In Fireplace no Approximate Cost �4 S , 0ou- oc, Area q 2 Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS .J I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re Jarding the above construction. Name �-- . Construction Supervisor's License 0 �� PIERSON, EDWARD .& SUSAN A-036-062 03b-o�� No 33904 permit For build Detached Garage Accessory to Dwelling Location 621 Main Street cotuit Owner Edward & Susan Piersca I Type of Construction Frame c � C� Plot Lot r Permit Granted August 9 , 19 90 Date of Inspection 19 Date Completed 19 PERMIT COMPLETED 1/1/- t. �� a� 1 , OA .N 1N •� S OYSOdO(/d O r-750dO&C/ I L_'L- b l �s P P� ' J Q oc �� ar �i- COTUII my '* LOCUS MAP SCALE 1 : 25.000 MAP 36 PARCEL 61 ZONE RF 8 WP DOiN&D J. 5 AM K. ' W LLIAM C. 6 VIRGIMA D. ASWLEROONSON &K. Im PY wo NK.4038AI6 51 TOWN OF &4"T"Aj !a .... .. N60.25'00"E `F.R..S. -• �M`i0"2i'Q®`1E ��� � 30Qi.G�O y -. A= 31.42 � - 73.39 Its 20.00 R= 24= LOT A icr All - TOW, ► s IN A&= 9 LOT /B M2 S.F. S63•15'47"W 3 .00 ,5 C.B. Z FAD. � 1 � . ' 66 7 ` • -J 41 /� 31.1 S -71 1 ` i STOW u N • pfjwpw io 1 re EXISTWG i DWELLNG O -♦ 1 � DECK 1 / � 1 ww.w....l 1 � 1 1 ' C.B. 1 / FND. FDWARD L. 8 SUSAN R. PEIRSON 8K. 3639 PG. 238 NOTE LO r 0 IS TO BE L60 IN CONJUNCTION INT}I 0100016 LAAV OF ED+N W L, 4- SIN R. PEA i PLAN OF LAND i BARNSTABLE =UIT ) MASS . FOR ARTS W. HUGHES ET AL. TRUSTEES SCALE : I" = 40' JANUARY 16, 1990 REV. MARCH 16. 1990 BAXTER & NYE, INC. REGISTERED LAND SURVEYORS a CIVIL ENGINEERS OSTERVILLE, MASS. I CERTIFY THAT THIS PLAN HAS BEEN PREPARED IN CONFORMITY WITH c, THE RULES ANDPEGuLAT10NS OF THE REGISTERS OF DEEDS. �- BARNSTABLE PLANNING BOARD cr c. Kr [ N ift" APPROVAL UNDER THE SUBDIVISION tiTE L CONTROL LAW NOT REQUIRED, GRAPHIC SC LE DATE : ". DEED REF. - BOOK 3639 PAGE 237 .,�� PLAN REF. - PLAN BOOK 339 PAGE 81 4.0 20 0 40 ' I � i Z I I ' T W a 1 —_._ _ ... ..i,b• 2- rj �' 'y-a►! j 1 Ll �' ✓�8 (�ta'C3 0 ! � .. „ +S- h ,..`ry _.. ���►- - Ili+�----- I t r .M IIX tics� � � •�.� i a 4�2 I -j, I M _ LL ff 07, I U i }y; 41A •-I I _l v o F1 a A 52 1 't m c-42r `I `t !-�,I�•. �( ( DONALD I. MEYER PmfssionQl Building Designer AD" 56 N a - 1 u 6-c-s P.O. Box S32 L, So.Ya,nnouth,MA 02664 _ Ilk a1 ' 4 e,•t - ' . �... fir._. (509)394-s296 _ ° ,