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Home My WebLink About0109 MARINER CIRCLE /off' � ��,y�- �^ .� �� r '� a i �, �, �, Assessor's offioe (1st floor): �l A Assessor's map and lot number ......R. .3....... q ' .,� ',. �, us`r Br 6oard of Health (3rd floor): k p i�' {] �� WC Sewage Permit number ... .. . r��............................... �2 S ,gqH TFILE 5 Z BAB35TABLE. )Engineering Department (3rd floor): • ruse House number ........................................................................ e.� � WE* X +oo 16}9.6`9 APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1.00-2:00'P.M. only b � o �9��6� Mar TOWN OF -BARNSTABLE BUILDING INSPECTOR ti APPLICATION FOR PERMIT TO .. -f�a!1Sc.�C .......�.� I....X.z. '.......��1 ..... `'J�U.S��!!\...... .... TYPE OF CONSTRUCTION ...iC..Q ..........Q. ' ,.....fin...."1S.4tt��i"!. ... `C, ................................ ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....`.91....... .4C"!�..�.s�.....4�.�.e-�......... ..................e............................................................ pp Proposed Use .... '�1t.C?.t�. ......C�iti:ei ��Cc.K,......................................................................................................... ZoningDistrict ........................................................................Fire District .................................................................. Name of Owner s. ........'��.Tf.1�......1��'e.'� .'�..,. C1� e�1w�•rS ` 6' /•� / Address 1........... .......................:........ �` ................... Name of Builder �.... ..... 8.\a` 4��.......Address �5 ru!9`'�W'�1�....�� ......\,�!:Cl`'�Ov�"tM(apt� Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ........t.i'` r...........................................Foundation !!�\r, ....�?d` .....%5.114e VC ExteriorArJ ...............w` ........ .........`�K ..............Roofing ... ........................................................ Floors ��<'. .............................................................Interior �`N2�.....qkvn� ............................................ Heating .... �,-.....................................................Plumbing .......vvo................................................................ Fireplace ..... ..................................................................Approximate Cost .... C!® ® v..cau ......... .... ............................ . Definitive Plan Approved by Planning Board ------------------ � ....cQ Fo....s --------------19-------- • Area ..... Diagram of Lot and Building with Dimensions. Fee ..........D.................... SUBJECT TO APPROVAL OF BOARD OF HEALTH w A Ml, ? A0 r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the of Barnstable regarding the above construction. Name . ............................................................................. Construction Supervisor's License P.ie3PA.t. virs.Pease, 1 Betty No ..... Permit-for ..... ...s.i.i.nroom...to . .......... .... in le fa mil P- mil dwelli. ............. Location .....1.0.9...Mar.i.iier...C.irc.i.e...................... . . ...... . ...... . ...... . . ......................C.0.t.uit.............................................. . . ...... 1virs. Betty Pease Owner .................................................................. Type of'Construction ..............frame................. ............ ................... Plot ............................ Lot ................................ Permit Granted .......Sp....ptembi�K...2..2.......19—1 87 . ... ........ Date of Inspection 19..................... ..... Date Completed ...... ).................1.19 :-4: Assessor's offioe (1st floor): n n Assessor's map and lot number ...... .c .a.3..._....04q "�' �' �oFTNETo` Board of Health alth (3rd floor): d ewage Permit number ...$b ". .Y�Y Z BARN Sir U. gineering Department (3rd floor): a rasa s House number p �6}q• \0 ........................................................................ 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 .. �. ....Lj K 10, gc, 5.....5 �v.4�'!` .......... TYPE OF CONSTRUCTION ...UC.fa,CJ`.... Q.' ' .1..Q?!r�....�11 ................................ ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....`.o .......M. .`.`!).4`r ..... >.<<-.` - ...............1.......................................................... ProposedUse .... 1.... ..j.. ..l".O.!r........................................................................................................... ZoningDistrict ....................................Fire District .............................................................. .................................................... Name of Owner ��.�.... . ?. .......` �+5.'�.,..........Address �C?. ....Mraj W-R.JS...C..;..0 . .................... Name of Builder ..... tl l�\ O!!�.......Address , ,....��u!!"�lJt��....L��...... Nameof Architect .............�.......................................................Address .................................................................................... Number of Rooms .........(..)"\Q............................................Foundation s\.b...dr.....�t,?4C................................ . Exterior .. .....CjG.< ..... �.�cJV ...............Roofing ... C.'� r Floors. ..`.............I.................................................Interior .. ....CV,<L�W�•.....��St... . ............................................... Heating ....Q.M.C....�.`�—.....................................................Plumbing ....... ............................................................... Fireplace O .........Approximate Cost �5 90 ., w� Definitive Plan Approved by Planning Board --------------------------------19________ . Area .... � ....a ,.... O� Diagram of Lot and Building with Dimensions Fee ...... ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH CA 4Nk< , 2n O a 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 .....::E` '................................................................ Construction Supervisor's License d C) d Pease, Mrs. Bettyl/// A=023-049 '"31218 add sunroom to No ................. Permit for .................................... single family dwelling .......................................................................... Location .......109 Mariner Circle ........................................................ Cotuit y ............................................................................... Owner Mrs. Betty Pease + ................................................................. Type of Construction ........... frame ............................................................................... Plot ............................ Lot ................................ Permit Granted .......September 22.......19 87 Date of Inspection ....................................19 Date Completed ......................................19 ssessor's map and lot number .....Al.-!� ��K:.......... D CF THE t0 Sewage Permit number :...... ............................................. SE P7IC'SYSTEM MU INSTAL ST aEb9TanLE, House number q /6..��....................................... LED IN COMPLIA "b WITH TITLE 5 1 39 �•c waY a' ' TOWN OF B A R l ` ° ' � (CODE AND TIONS BUILDING I}NSPEDTOR , APPLICATION 'FOR PERMIT TO ..................... ........w.............................................................................. TYPE OF CONSTRUCTION ...Cl ... r'Z !.... . ... .. .......... ...........:..........19 � TO THE INSPECTOR OF BUILDINGS: . The undersigned hereby applies for a permit according to the following information: Location ... ..�......... !...... .......... . .. i6G Proposed Use ............. .................... ................................................................ .. .................. ......................... .. ..... ..,.. ZoningDistrict ........................................................................Fire District .........,.. . ... ....:..................................................... Name of Owner ...Address Nameof Builder ...... .... ...:. .... ................................Address .................................................................................... Name of Architect ..................................................................Address Numberof Rooms ..................... .......................................Foundation .,�... .......................................................... Exterior ......................Roofing .. . /CG ......... ....... . .............................. Floors ....10, 40.... .. .................................Interior ... .. .. , /�, f Heating /..:.................. ... .......�lJ.............................Plumbing ............. . . ..... .................................... Fireplace ..:................ ............................................................Approximate Cost ...C.) .......... y.................... CG O D.. .f� . . pp Y g ---- -----??-- - 197�-. Areas ..............ZS................ Definitive Plan Approved b Planning BoarVhs _ _ �J ___ `Diagram of Lot and Building with Dimens Fee ��' SUBJECT TO APPROVAL OF BOARD OF HEALTH r del�aa J � . I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. e Name ........ .... .......... ............. ............................ Theo Construction Co. *' 22931 one story �i• _ . ,',4Na ................. Permit for .......a............................. single family dwelling r 109 Mariner Circle Location .............................................................. :. COtuit Y Y I + ............................................................................... Theo Construction Co. Owner .................................................................. , Type'of Construction frame .......................................... ....................................................... ....., .......... - 'Plot ............................ Lot ............. !-i3..... ... r Permit Granted .....r...MkrCb...Z0............19 $j ' Date of Inspection .....................................19 Date Completed -j ... � 19 S !J;ERMIT REFUSED tU .......... .1r..... ............ 19 F . 'color�,. i n .............22. 6 i` ...................................... ............ •�.� ................................................. . Q , Approve ............................... 19 ........................... .................................................. L`� t Mj •aa s try,.r ... i :d.i, r .�' K•=4g.• t Sirs i lab n 's OG Lm m PLAN SHOWING r ^ c > FOUNDATION LOCATION " � ➢' � d N tqA v COTUI Te MASSACHUSETT S OWNED BY _r, r7�_r7%0 RV 0 V i 'i SCALE : / "= 4ea ' DATE: �y,,4,'Z y9S/ � NORMAN GROSSMAN----- - REGISTERED LAND SURVEYOR T C � D C +{ I HEREBY CERTIFY THAT THIS FOUNDATION IS LOCATED d �- ON TINE LOT AS SHOWN AND CONFORMS TO THE TOWN o i j OF BARNSTABLE ZONING REGULATIONS REGARDING ' SETBACKS FROM STREET LINES AND LOT LINES . NORfJAN GROSSMAN R.L. S. DATE Ftt;v+'Y y' 1 May 15, 1981 RE: lot #43 109 Mariner Circle Cotuit . Building Permit #22931 I hereby certify that the basement insulation will be completed in the above dwelling. c� �• lc b'yO` •� TOWN OF BARNSTABLE Permit No. ----------_------ t �� Building Inspector Cash --------------— ee OCCUPANCY PERMIT Bond "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ...................................................... 19......_ . ...................................................................................................... . Building Inspector Assessor's map and lot number ...........:................................ �pf THE TOE .Sewage Permit number ...................::................................... row Z EA"S'TABLE, i House number :o NAO& O 39- �0 'EQ YPY a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPEOF CONSTRUCTION ............................................:........................................................................................ ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................................................. .......................'....................................................................................................... ProposedUse ............................................................................................................................................................................. ZoningDistrict ............................... ........................................Fire District .............................................................................. Nameof Owner ......................................................................Address ...........4............ ..............................:......................... r Nameof Builder .........:...................:.............:.........................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..................................................................Foundation ......CLKL�:.. ................................. Exierior ..............:...........................................�:,.......................Roofing ...... ................... . ............................... Floors ......................... .......................:.................................Interior ..................................................... Heating ..................................................................................Plumbing ...................... .1..............:........................................... Fireplace ..................................................................................Approximate Cost ...... .�'.......................................................... Definitive Plan Approved by Planning Board ---------------_----_--------19__=_____. Area ......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH f V)7j, r 1.�3t I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....... .......................................................................... Theo Construct io Co. o . 22931 one story No ................. Permit for .................................... single family dwelling ............................................................................... 109 Mariner Circle Location ................................................................ Cotuit ............................................................................... Owner Theo Construction Co. .................................................................. Type of Construction frame ................................................................................ Plot ............................ Lot .. ..........#43................... i Permit Granted .............14ar..Ch... .........19 81 Date of Inspection .......`"'......... ..............19 9 Date Completed .................... .................19 f PERMIT REFUSED ............. ............................... 19 ... Q.. ............�// ......................... ................................................................................ ..............................:................................................ ............................................................................... Approved ................................................ 19 ............................................................................... .h y11-7lIN t91 Building Performance Contracting,LLC Nauset Insulation P.O.Box 1044 N. Eastham,MA 02651 Phone(774)316.4464 Fax(774)316.4462 Date RE:Insulation Permits Dear Mr Perry, This affidavit is to certify that all work completed for the insulation work at has been inspected by a certified Building Performance Institute(BPI)Inspector.All work performed meets or exceeds Federal and State requirements. Respectfully, Emon µ� Co 0 R . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 623 Parcel O q9 Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board bk Ci 3 Historic - OKH _ Preservation / Hyannis Project Street Address 10 f i-r n fr Grck- 6hAjV_ /*/I, 05Zk_:?s-.X6b Village C-CT(.Li .S--,2,6 O-D Owner Ell, /ZZ4 6 Address 0 5 Gi/�G/�_ Telephone Permit Request �Y G�to r Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District 4Q Flood Plain Groundwater Overlay Project Valuation . OeConstruction 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 ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) � —� wZE Number of Baths: Full: existing new Half: existing new c.a Number of Bedrooms: existing —new r3 CD Total Room Count (not including baths): existing new First Floor Room Count _ z Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other I �, Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal Love: ❑Yes Lf to Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑ Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �{��(, Telephone Number Address License #�Pa3� Home Improvement Contractor# 2T; Worker's Compensation # Wc,V9f ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO I-M ncczl)&,sa_5-a SIGNATURE DATE h 1 P FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP/PARCEL NO. ' ADDRESS VILLAGE 4 OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' 1 r PLUMBING: ROUGH FINAL 1 GAS: ROUGH FINAL ,f FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ,; r `T/ze Comin6nwealtli"pf Massachusetts F Print Form'' ---1 DepartmetZt of Industrial Accidents 'Office of Investigations 1 Congress Street, Suite 100 s � -' 4 Boston,MA'02114-2017 { www.mass.gov/dia Workers' Compensation_Insurance AffidavitBuilders/Contractors/Electriciaris/lPlumbers Applicant Information Please'Print Legibly Name (Business/OrganizatiotAndividual); Address: Y,l{J W r . . City/State/Zip; rLt r D hone#. VZO Are an employer?Checkahe appropriate box: Type of project(required): 1. I am a employer with,` "64. ❑ I am a general contractor and I employees(full and/or part-ti e).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner liked:on the attached sheet. 7. ❑ Remodeling l These sub contractors have ship and have no employees 8. ❑Demolition working,for me in an capacity. employees and have workers' g' Y P 9. Building'addition [No workers' comp.-insurance comp:msurance$ ❑ Building'addition required.] f 5. ❑,We are a corporattonand its ""l0.❑ Electrical repairs or additions 3.❑ I am a homeowner,doing all work. officers haverexerci" their 11.❑Plumbing repairs or additions myself. [No workers' comp.s right of exemption per per MGL 12 ❑ Roof"epairs; insurance requiied.]'.T " ' c. 152, §1(4),;andwe have no employees. [No workers' 13 ther 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 and job site information. Insurance Company Name: Policy.#or Self-ins,Ltc # ` 1�� Expiration Date: w Job Site Address:_ ci► clt - 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 criminalpenalties 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 j of up to$250.00 a day,against the.violator. Be advised that a copy of this�statement may be forwardedio the Office of Investigations of the DIA�for insurance coverage verification. I do hereby certify under`the parrs and penalti s q/per- ry tliat the unformation provided above is true and correct Signature. ICT _ o� Ati_. . Date. Phone# ZL 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 # � �`✓;. � a�ti ate,.. ..� nqi� _ � w a _ _ x Inforr a tio '`arid' I s'tr cti®ns ` P ° , Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for theirgemployees f Pursuant to this.statute;an employee}is defined as` every person m the service of another under any contract of hire, express or implied,oral'or written " An employer is defined'as `an mdwidual,partnership,'association;corporation or other legal entity,or any_twoor more of the foregoing engagedin a joint enterprise;and including the legal r'epresentatives'of a deceased employer,or the receiver or trustee of an individual,partnership,-association or other legal entity;einploying 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;`consiruction 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." i ` f `MGL chapter 152,.§25C(6)also'states thatr`every'state'or local licensing agency shall withhold the issuanceor inthe commonwealth for an renewal of a license or permit to operate a business or o construct-buildings,_ y "applicant who has not produced acceptable evidence of compliance with the insurance coverage required." a Additionally,MGL-chapter 152„-§25C(7)states"Neitherethe'commonwealth nor any of it`political subdivisions shall enter into any contract for the performance of public work until acceptable evidence ofcompliance with the insurance requirements of this chapter have been presented to the contracting authority" ", *' Applicants" " ', •? l Please fill`out the worker's'compensation affidavit come`letely,'by checking the boxes that appI to your situation'and,.if " necessary,supply sub-contractor(s)name(s),addre'ss(es)and phone numbers}along with'their.'certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships( -LP)with no employees other than the members or partners,are not required to carry workers' compensation insurance.*If an.LLC or LP 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.bemg requested,not the'Department of Industrial Accidents. Should you have an uestions regarding the! a*w or if you are required to obtain a workers' Y Yq compensation policy,'ple'ase`' all the Department at the number fisted below._Self-insured'coinpanies should enter their self-insurance license number on the appropriate line: ' ;. City or Town Officials. :f 2 u r« Please be sure that the.affidavit.is complete and printed legibly: The Department has pr`ovided`a space at the bottom of the affidavit for you to fill out in the eventthe.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 theaffidavit that has been officially stamped or marked by the city or town may provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A pew,affidavit must be filled out each .year. Where a home owner or citizen is obtaining a license or permit not related to any business'or'commercial venture ' (i.e a do&-license or permit to burn leaves etc.)said person,isNOT,re �uired,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 fi Department of Industrial•Accidents ' Office,of,Investigations t ai r 1 Congress Street,.Suite 1a00 9 ,Boston 'NIA 02114=2017 Tel. # 617-727-4900Jext 406 or l-*877-MASSAFE .r ' Fax# 617-727 7749 i Y Revised 7-2010 ' www.mass.gov/dia °„ . 1 p� ® PAfliICSPAftRO mass saved COCA $V•MSlHauyS s^M•9:NiKVFnSy ,. PERMIT AUTHORIZATION FORM owner of the property located at: (Owner's Name,printed) c S Lam/ Cd�' -c. (Property Street Address) (City/Town) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Q—�Je-q—'t P0-4 Owner's Sign ture Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass.Save Home Energy Services Participating Contractor to the above referenced project: Participating Cont a for Date Rev.12132011 I .....,................. ..,..�Y J•Y a. .via... ri•wz Lit CERTIFICATE OF LIABIL17Y INSURANCE 16/4/2013' ' CEIt11P1CItTE N AS A MATF®t OF iV IAT�II OIIE.Y Ao GONF)Bt$NO ONETS UPON T E CEIDNCATE MOLDER,Tm • A7E Dsk'.ti Mr AFFNIMM7IYELT OR NEGATrALT ARMW 00 ALIM IM OOAIERAAE A AY THE POIdCM BELCM TM CMUFMATE CF MoinM= DOES Nor Of>Ili MMM A CMTRAGT 6E7W� IM10sume VIBUROM mrn uxam RM WM CM PRODUCRk ARID IM CUTRl6ATe HOLPM muORTANh woo or NBC hoMw so 00949*aMM 20 IF M ORMAIM 0 WAIV6 EW*W no aid d B"P *awwo sold=earl►-roM& m A m sls ow§ftdv do not eambr ripu to it -RP-M hddar In ONE of such , COUNTY sraOlx:6a 12 Sylvan at �t c (979)774-2463 (979)777=8415 Danvers, M 01923 aAa�AR�aI o NNC! oulm SBi•1 ding Q A:Ca�ree Ins. Co. -� Pa azmaao. Cantraetiag. I,LC .e:Essm Ins. Co. VMwRM a:A antic Q><artor P.O. Boz 633 DMAM D:gg CM* Truro, Ma. 026" swumm E: OVERAGES C ERTWCATE I UMOM `THIS IS TO CERMY nKT 1M POLKZM OF QMRAKM LMM BELOW PAVE BEEN ISSM TO TIE DM RM HAMED ABOW FOR 7tE POLICY PEMM NDICATEM N0IWMWrAHDM AHY fH9MMG3GKr.7E3iM OR 00NO iON OF ANY OOMiRACr OR OTHM DOC MEMr WRH ACT TO VOWN THE C ERnF=TE MAY BE MSM OR MAY PgirM THE WMANC:ARVMXD BY THE POLICES MECREW H8MN IS SUUW TO ALL TM TERMS, EXCLUMMAND COMOMOM OF SUCH per.LWM SKXM MAY PAVE OEM REDUOWUrPMCLAAW 11 TYPH OF Roup*vcz PO<1CY LMsiB GENOW UAGVJn VM 00CURRdNM S1,000,000 UAW"" Imam s $0,000 - anaoe-M�oE a°� wE�etP{Nry«waraoN S 1 000 �. . 3 3DE9441 1/19/12 XV/23 Ate, s 1 000 000 ►. + L AcaasAte s 2,000,000 GMft A ORWATE UMr APPM FVt PRMUM-OOOPW AM s 1,000 O 00 P = � Luc : UASK v a 1,000,000 AWAM AUGWWM L43983AMM eo�.rw,l r�poo� s MOM /2/13 /2/14 er�ararR�reeeesq s s "ks o : 2 do0 0oo vases Lis aoE C089P3904112 5/1/13 S/i/14 Aa7E s 2r000,000 o� € AM erPvoraW LIABalfY rrr 23/12 /23/3 3 EL.�AC=Mr s 500,000 ® arA 1�CV00939900 o =r�►p: b00 000 ° 0'f°� ei o -PoL�CYLAsi r 300 000 rKm of opmTxm r LCCKnG8I V9=M(Ao.di A�AAp tpf,AddlOaw Rpemala 8ctrmoo,d awe epaw m teatae0 R77FICATE HOLDER CANCEUATM w ci Tons of Barnstable ` c- -SHOW ANY OF THE ABOVE BE BEFOIN Barnstable, ]I" THE EWWATIOH DATE 1 WSJ. Ud ACCORDAN"MMTHE POLICY - %-J3 q AUTHOV49M11VE l O �• �19B&2010 At�RD TI�I. eared. ORD25(2010It15�- The AGE name sad logo are tamed nwM OT AGDRD t>le �� vat des t gnu* CountACTOR _ 6ef ethe daA~ ram toe Tylm 'OfE=QfCuwmmffAffhks=d LLC u 10 Pat Pka-Salb 5198 ,a MGM -JOSH � 8 KIi�Ki[��C RD -TRURO.RA Q7B66 = * I IMlassa* -Dept of Public Swilay Board of'Smlcftg Regulate and Sbmdwds ComuvcfLon sapenisor1151, Tmm MA 8 s 7j - Coenissioner � f Y