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HomeMy WebLinkAbout0187 OXFORD DRIVE �,i Town of Barnstable Building Post This Card SoTh',at,it„Is:U�sib'IeFrom the Street Approved Plans Must be.Reta�ned on Job.and;this Card Must,be Kept , P163 'osted Until.Final Inspection Has Been Made , Where a Certificate of Occu anc is Re wired,such Bwldm hall Not be Occu1 ied until a Frna1 Ins ection,has been made Per n�lt p. Y. . q, tw..... r. g Permit No. B-18-3586 Applicant Name: CAPIZZI HOME IMPROVEMENT INC. Approvals Date Issued: 10/31/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 04/30/2019 Foundation: Location: 187 OXFORD DRIVE,COTUIT Map/Lot 021-036 Zoning District: RF Sheathing: Owner on Record: WOLFE,JEANNINE C&PATRICIA i ContractoruName CAPIZZI HOME IMPROVEMENT framing: 1 3 INC. Address: 187 OXFORD DR t: 2 raContract�or License 100740 COTUIT, MA 02635 s , Chimney: g i Est Project Cost: $ 12,000.00 Description: siding Permit Fee: $61:20 Insulation: Project:Review Req: Fee Paid $61.20 Final Date 10/31/2018 Plumbing/Gas F Rough Plumbing: R. _ Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authoraed by this permit is commenced within six rrionths after issuance. ,p; Rough Gas: b this permit shall conform to the roved a lication and ti4a roved construction documents�for whi6 this permit has been granted. All work authorizedY P pP pP .z;�. .. pP All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This emit shall be displayed in a location clear) visible from access street or road;and shall be maintained open for.:pu(lic inspection for the entire duration of the pY r � . work until the completion of the same. k Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and,Fite Officials are:provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing " s Rough: h: 2.Sheathing Inspection 3:All Fireplaces must be inspected at the throat level before firest flue lining is installed Final' 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Application number....... Fee...................... ..6............................ BAPMUSM MAn Building Inspectors Initials.......I............................... DateIssued................................................................. OCT ', 0 2 ....... ............. 08 Map/Parcel.......... TO K/Al V T"I fd*v 098VARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/'FEN'rS/STOVES/WEA'rH.ER,IZATION PROPERTY INFORMATION - C OTU Address of Project:,,. Iv 1.. �D x F IDD,V.- I NUMBER- STREET VILLAGE Owner's Name: c 6,tjwWe- C- V-- ?,4 IXi f;f t A/khone Number- K,9t fW-6 y/1 Email Address: u 14 Cell Phone Number AJ14 Project cost 12i000, Od Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property 1.hereby authorize to make application for a building permit in accordance with 780 CMR Owner SiRnature: 165' f 161f t4el- 4 0 THof iM 1-/e/ Date: TYPE OF WORK ;//y(/l 'A jCX0,#jj- eeP4.*, 0" )f4',4/ 7� Siding E-1 Windows no header change')# Insulation/Weatherization I - 3 -D ED Doors (no header change) # Commercial Doors require an inspector's review El Roof(not applying more than 1. layer of shingles) Construction Debris will be going to -10,WAI e)/.zq&,0111-d 1,4mm"// CONTRACTOR'S INFORMATION ' Contractor's name Home Improvement Contractors Registration (if applicable) # I 00-7fO _(attach copy) Construction Supervisor's License# 0 (attach copy) Email of Contractor �Ac4/- L. C is till ApAy,104 Phone number 5a1- ALL PROPERTIES THAT HAVE STRUCTUhES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER .....................................I...................... *For Tents Only* Date Tent (s)will be erecVtched ved on number of tents total Does the tent have sides? (if yes please attach floor plan with exits marked) Dimensions of each TentX X Additional tent dimensioeparate piece of paper. Purpose of Event Check one: this event is a: for p fit non-profit event Check one: Food served Yes No Flame Spread Sheet of each ent must be attached. Provide a site plan with the location(s) of each tent If food is being served t your event please obtain a Health Department approval between the hours of 8:00am -9:30 a or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *kVOOD/CO�g/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from eombus ront back left side right side HOM WNER'S LI NSE EXEMPTION Homeowner's Name: "Telephone Number Cell or Work number I understand my respo abilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR 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 APPLICANT'S SIGNATURE Signat Date 1 O All pe mat applications are subject to a building official's approval prior to issuance. Page 5 of 5 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, PATRICIA WOLF OWN THE PROPERTY LOCATED AT 187 OXFORD DRIVE IN COTUIT, MASSACHUSETTS. l� , _l I HAVE AUTHORIZED ' CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: LA ( OWNER'S ADDRESS: 187 O Z�4-T—MA 02635 OWNER'S TELEPHONE: 508-428-6411 LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: .�.. .. I ~� Commonwealth of Massachusetts Construction Supervisor lug Division of Professional Licensure Unrestricted-Buildings of any use group which contain Board of Building Regulations and Standards less than 35,000 cubic feet(991 cubic meters)of enclosed Constftcti'Ori ISiS'"rvisor space. ;h CS-064817 " ` Expires: 061181202C JOHN T STRUMSKI � .§ a t 18 ALDEN AVE,; V'lop i ` f r i BUZZARDS BAYPMA 026327 o' C>14S:T4L- f Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license A user c�J elation �onimeir° � ��^ � Registrationvelidtor individual use only before the eipiration date. If found return to: jOME IMPROVEMENT CONTRACTOR pa irs and Business Regulation TYPE:Supplement Card Office of Consumer Reaistra lon „aF�et ion One burton Place=Suite 1301 100740 66WJ2020 A 02108 CAPI221 HOME IMPROVEMENT,INC- f ` withou JACK STRUNSKI [dot Val t signature 1645 NEWTON RD. Undersecretary COTUI T,MA 02635 Construction Supervisor Unrestricted-Buildings of any use group which contain less than 38,000 cubic feet(991 cubic meters)of enclosed space. ' I Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this licettse The Co ont�eQltAt t f manwh D � h � uOfflM ofZo 600 Wad*4 mn steer jwto�MA 0211 www-wwwovlax "Workers'Compenwon I iumce Atuaft BaudersiCoi&acwrdElechidAi&Mh=bOn s Tie •9Tt ,�._. Name��� � ��� }; CapbW Home lmprovemOnt '180 Newtown Road C' /Sure/Zi . C� MA 02835 Pbone#: 50&4"18 An you an empbyuj Cheek die ft4M P bos: Type of proyeet(req k 1. 1 am a employer whh �' 4. 1 am a general contwwr and i 6. New cow employ ve$gill andtar gart-ftq}.* be hired the sub-contract 7. V. Remodeft 2.✓ I an a sole proprlet How on the attaeited sheet.or or pasta - There have g, Demolition sty and have no employM - emplayeasandhenvadwe p.' BWlft addition wooing for me in Ew capacity. comp, z [No workerB'comp.insurance S. We ar+e a corporadon and its 10. additions Ievaer '�' offices have exercised their 11. Plmnbing rapaks or 3. addrr'sons WINE,(No warms;�tp. of a1 per ll�[ insurances Z,11(4),aauiwehave n no 13. ✓Offer �!N eanployees.[No workers' ---T' comp.fimum" •�yrlt�tbouc#2i�tat�oBittatttt� �alalw' �$t "eb '.- t HomwwnwwbonbdtpiadOdwh bdogbg ftY IN dftdU vg*sndgnbb QUM&coumm zM submhauwa suL t'Gam�eactora dtetct�aria boa mtwt attar art a�tonai sheet ehowinB Ste mmte at`the sty and site whetbw°or�>itosa base ampioyam iftksub.��/)� "��_�1 �� �9° 'jw..otl ta' toffq=mb/. -r{ j p l d m as rrl&a/J p.v v.'^�.,�" _,,gQmpmw&n kww r��'iW aVio ___' BNf�►'ID����JY4 bfimadm Instn�ance Company Name: AMC�UARD INSURANCE COMPANY . 12=2Q18 Poliay#or Self im.Lic.A.R2WC803728 l7 Job Site Address: l�'I OX Fo12A v e Vt, City/St Zip: CdTU, t- Attach a eopy of the worteers'eompeneat�poft dedasalbe page(d wbg the POft member and OVh't1On }. Faih M to se M coverage asregnhW under Section 25A of MM c.152=lead to the imposWon ofah'&a1penalties of a tine Up to$1,500.00 andlar one-Year nupriSOMM nt,as well as civil penalties in the form of a STOP WORK ORDER and a fine ofup to W0.00 a day against the violator. Be advisedthat a copy of this wumg tm y be f wmW to the OffCe of roves ofthe D Wv VWMCatron. I do hereby ce rhepabs#xdpmWffOfPffjw7 thatthe fi ' npmvideda a rmeand lu / 212018 si DAM 508 428-9518 . Ojw aw„*. Do no wfte in 9W area to be Meted by do m mwst o,�ela1 ChyorTom Permit/Lieense# InabS Aethol*W*ones 1Tawa Clerk 4�E drw r S.Ph®bhtg I r 1.Board dBealtit I fig 3. ' fa Oder Coniiatt person: Phone I " ® DATE WdDD/YYYY) ACC>R© CERTIFICATE OF LIABILITY INSURANCE 12/27/2017 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 CONTACTNAME: . Rogers and Gray Processing ROGERS & GRAY INSURANCE AGENCY INC P"CN.. (508)398-7980 FAX E-MAIL ma1I9ro ers ra .com 434 ROUTE 134 _NAIC R- SOUTH DENNIS MA 02660 INSURERA: AMGUARD INSURANCE CO 42390 INSURED INSURER B CAPIZZI HOME IMPROVEMENT INC INSURERC INSURER D: 1645 NEWTOWN ROAD INSURERE: COTUIT MA 02635 INSURER F: COVERAGES CERTIFICATE NUMBER: 225451 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. IMS-R --_T- — ADDL;;SUBI----. _. .___-_._.—.�'_ '_ POIiCY EFF POLICY EXPT-� ^�— L TYPE OF INSURANCE I POLICY NUMBER IDDNYY MM1DD/YYY LIMITS COMMERCIAL GENERAL LIABILITY t EACH OCCURRENCE LS— __._._... DAMAGE TORENID I CLAIMS-MADE OCCUR ;OCCUR PREMIS1.5-Eaaccurrence� i MED EXP(Anyone person) IS N/A g i PERSONAL&ADV INJURY I8_ s GEN'L AGGREGATE LIMIT APPLIES PER: 'GENERALAGGREGATE }S POLICY PRO- LOC PRODUCTS-COMPIOP AGG S PRO- JECT I IS OTHER: AUTOMOBILE LIABILITY j CO MBcid DtSINGLE LIMITtEi S f ! BODILY INJURY(Per person) i S ANY AUTOALL AUTOS OWNED i AUTOSULEO N/A BODILY INJURY(Per accident) S NON-OWNED 'PROPERTY DAMAGE HIRED AUTOS t AUTOS S UMBRELLA LIAS OCCUR EACH OCCURRENCE 1 5 EXCESS LIAB CLAIMS-MADE NIA AGGREGATE i5 ----. _ - --_ D DED I RETENTION S S WORKERS COMPENSATION i I AND EMPLOYERS'LIABILITY /�'STATUTE ER I Y/N; ANYPROPRIETORlPARTNER/EXECUTIVE E.L.EACH ACCIDENT s 1,000,000 A :OFFICERfMEMBEREXCLUDED? N!A,NIA NIA; R2WC863728 �12/25/2017 12/25/2018 (Mandatory In NM r E.L.DISEASE-EA EMPLOYEE!8 1,000,000 if yyes.describe under 2 _ =OESCRIPTIONOF OPERATIONS below E.L.DISEASE-POLICYLIMIT ES 1,000,000 E d N/A 1 �d DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage Coverage Verification Search tool at www.mass.govAwd/workers-compensationfnvestigations/. A CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601-0000 Daniel M.Cr , y,CPCU,Vice President-Residual Market-WCRIBMA 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD I Town of Barnstable *Permit# . F.zpir m 61aorrthsJ, issue date _ Regulatory Services FeeNAM • Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner $ - 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint . Map/parcel Number oo G Property Address sidential Value of Work ��5 ?0 M((i�n__imum fee of$35.00 for work under$6000.00 Owner's Name&Addresser c!� (.gyp(k-L Contractor's Name Sprinkle Home Improvement Telephone Number,508 775-1778 Home Improvement Contractor License#(if applicable) 103757 Construction Supervisor's License#(if applicable). C�5 hp y 3 ZWorlmtan's Compensation Insurance X-PRESS PERMIT Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 5 P s 3 2010 I have Worker's Compensation Insurance TOWN OF BARNS T ABL Insurance Company NameAssnCiated InrltlstriPs of MA Workman's Comp.Policy#AWC 700494,1019011 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) w �e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken toy" dcr S�"l1k� ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A co of th qoM&Improvement Contractors License&'Construction Supervisors License is SIGNATURE: � C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Oudook\DDV87AAZ\EXPRESS.dw Revised 072110 The Commonwealth of Massachusetts Department of Industrial Accidents Qffce of Investigations 600 Washington Street Boston,Mass 02111 www.massgov/dia Workers' Compensation Insurance davit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Businmworganin ion/lndivid w): Sprinkle Home Improvement Address: 199 Barnstable Road City/State/Zip:HYannis, MA02601 Phone#. 508 775-1778 Are you an employer?Check the appropriate box: Type of project(required): 1. CK I am an employer with 9 4. ❑ I am a general contractor and I 6. ❑New constriction employees(full and/or part time).* have hired the sub-contractors 2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance. $ 9. ❑Building addition required] 5.❑ We are a corporation and its 10. 0 Electrical repairs or additions 3. ❑ 1 am a homeowner doing all work officers have exercised their myself [No workers'comp. right of exemption perm MGL 11. ❑Plumbing repairs or additions insurance required]t c. 152,§ 1(4),and we have no 12. ❑Roof repairs employees.[no workers' comp.inm„anCe required.] 13. ❑Other *Any applicant that cheeks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tCothe n an t c this box mast attach an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. if must Provide their workers comp,poft number. I am an employer that is providing workers'contpemanon insurmce for my employees.Below is die policy and job site injorntadon. Insurance Company Name:Associated Industries of MA Policy#or Self-ins.Lic.#: AWCr7004943012011 Expiration Date: 01-01-2012 Job Site Address: ( x-Mi�1 �Q P eity/State/Zip: n t t,��) �� (�— 3 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 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 $250.00 a day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herb ce r th n y and pft tip of perjury that the information provided above is true and correct Siture. Date: Print Name: Brad Sprinkle Phone#.- 508 775-1778 Ext.10 OJj'icial use only Do not write in this area to be completed by city or town off City or Town: Permit/Ilcense#• Issuing Authority(circle one): I-Board of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#• CERTIFICATE OF LIABILITY INSURANCE DATE11/24/2010 _ I1/24/2010 HIS 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). PRODUM CONTACT Bryden & Sullivan Ins Agency NAME: PHONE PAE Inc Ra. s=t): E-WAIL 88 Falmouth Road ADDRESS: Hyannis, MA 02 601 CUSTOWM IDS. INSURED INSURED(81 AYI'ORDING COVBRAOE NAIC 1 Sprinkle Home Improvement Inc INSURER A: A.I.M. mutual Insurance Co C 199 Barnstable Road I9SURERER IN : VR : Hyannis, MA 02601 INSURER D: YNSUMM E: INaoaeR r: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BEIgW 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. wr w TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS (roUro/Ym) (wUOa/rrtY: GENERAL LIABILITY g COMMERCIAL GENERAL LIABILITY EACH OCCURANCE Okbom TO1:1 RBRT® 0 ❑CLAIMS MADE ❑OCCUR PREWI888(Ea.oaoarranaa) ❑ WED MG? (Any oaa Parson) 8 ❑ PERBORAL i ADV INJURY Z GEN'L AGGREGATE LIMIT APPLIES ER: G=43ULL AOGREGATE y ❑POLICY [:]PROJECT [:]LOC PRODUCTS-CCw/OP AGO AUTOMpBILB LIABILITY 8 COWBINBD BINOIZ LIMIT MANY AUTO (aa aaaidant) 0 ALL OWNED AUTOS BODILY INJURY (Par Parson) 8 ❑SCHEDULED AUTOS BODILY INJURY(par entl aaaid 8 ❑HIRED AUTOS PROPERTY DAIOWE ❑NON-OWNED AUTOS (Par aaoidmt) 8 8 8 UMBRELLA LIAR ❑ OCCUR BACK OCCVRAENCB Z OEXCE99 LIAR ❑ CLAIMS MADE AGGREGATE DEDUCTIBLE 9 RETENTION 6 WORKERS COMPENSATION 8 MC KAiY- AND EMPLOYEES LLABILITY OTN- rent tIMIa RATHE PROPRIETOR/PARTNERS/ Lai A EXECUTIVE OFFICERS ARE B.L. EACH ACCIDENT a 500,000 ® incl ❑ excl 7004943012011 Y.L. DISEASE-POLICY LIMIT a 500,000 01/01/2011 01/01/2012 B.L. DIeEAeE -Ei1 BWPLOY88 8 500,000 COMaD7Te DESCRIPTIoa 01 OPERATioNe OR LOGTIORB: WORKERS' COM+IPENSATION COVERAGE APPLIES TO b=SACHUSETTS EMPLOYEES CERTIFICATE HOLDER CANCELLATION PROOF OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. /\J AUTHORIZED RznRRZNTATYVBG- _\ 13u:trrl „f 13uildin_ fZr ulali n• .rnil �t;rnrf;t. '', Officeo onsumer airs smess a ulahmt I-✓ construction Su'perv,sor Licens:a HOME IMPROVEMENT CONTRACTOR f� _ - R tstration: 103757 Type: :-.-i rise: :'S 6643 Registration: Expiration: 7/9/2012 Private Corporatic Rcstr!.:ed to. 00 S NKLE HOME IMPROVEMENT,INC. BRAD K SPRINKLE 190 LOTHROPS LANE Brad Sprinkle W BARNSTABLE, MA 02668 199 Barnstable Rd. Hyannis, MA 02601 Undersecretary 10/8/2011 — n......m r T r- 5478 Restricted to: 00 License or registration valid for individul use only 00- Unrestricted before the expiration date. If found return to: 1G 1 2 Family Homes Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: WWW.Mass.Gov/DPS Not valid without sign Lure • Town of Barnstable Regulatory Services Uwass F.C.Mer,Dhvebr BuRdift DiVWOII MMM"Perry,CIO BWld ft Commissloam 200 Main Street. Hyannis,MA 02601 www.to O>lim 5084h624M8 Fax: 508-7904M Property Owner Must Complete and Sign This Section If Using A Builder L e"n �&L Wo ,as Ownm of the subject MPM9 hezeby a.d dZe Sprinkle Home Improvement to:aa on my in all matters relative to wank authorized by this building permit aPP&Mdon fox (A&hm of labs bwatuit o .=., Date Print Name lfftvawoww is amft far pwmk,*M CMpWb tM B=wwners Lkease ffaMpti"Form M toe . Revised 072110 1Loa11Nimao�Wiodowd?empoeary low"Filedcaameoeoutlootc�DDve7 r Town of Barnstable *Permit ea Expires 6 month from issue date r Regulatory, Services Fee IL MASS.1639. Thomas F.Geiler,Director ,�� ,erED MA'I Building Division Tom Perry,CBO, Building Commissioner (( 1 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number at Property Address %l X � �ft�,�T l' NA Residential Value of Work a C) ._ Minimum fee of$35.00 four work under$6000.00 Owner's Name&Address iP1v�i fl r� Loo l 1 7 06" br. S ` _ vrr ��i �6C- Contractor'shame ��c I��C..l-@ � Telephone Number :Sb%` 7_1��"(.'j")1- �,�-f-- �e Home Improvement Contractor License#(if applicable) j®3 75 Construction Supervisor's License#(if applicable) C o 4 *orkman's Compensation Insurance -PRESS PERMIT Check one: ❑ I am a sole proprietor n ❑ I am the Homeowner Al)G :- ❑ I have Worker's Compensat__ioln Insurance TOWN F yRNSTABLE Insurance Company Name PtSSc�C-t�l9-� Workman's Comp.Policy# Ate -7m,+9 4 IC UC� Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) r ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) Re-side — �Q�Cii� (jd1�V Lkv�Lf' / #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc: ***Note: Property Owner must sign Property Owner Letter of Permission. of he mpr vement Contractors License& Construction Supervisors License is gyred. SIGNATURE. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doC Revised 070110 The Commonwealth of Massachusetts Department of Indust► al Accidents . Office of InvestigaiUns - 600 Washington Street Boston,Mass. 02111 www mass gov/d a Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Bus andotganizatiow/Individual) Sprinkle Home Improvement Address: 199 Barnstable Road City/State/Zip:Hyannis, MA 02601 Phone#. 508 775-1778 Are you an employer?Check the appropriate box: Type of project(required): 1. CK I am an employer with 9 4. ❑ 1-am,a general contractor and 1 6. 0 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. ?• ❑Remodeling ship and have no employees ,These sub-contractors have 8. D Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance.t 9.D Building addition 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 myself [No workers'comp. right of exemption 11. 0 Plumbing repairs or additions emp � perm MGL� insurance required]t c:152,§ 1(4),and we have no 12. ❑Roof repairs employees.[no workers' 13.0 Other'5t �P-Uo t�t Re y' comp.insurance required.] • ,opplbant that cheeb boa 81 mmrt ahw tlID oat the section below showing their workers',compeongdon policy intormsMon, tHonmwmn who wbmk ahh a®d"indicating they are doing all work and men hire oatide contractors mast submit a aew affidavit indicating such. 2Coatuton that check this box mart attach an additional sleet mowing the name of the spb•ooatnxbon and state whether or not those entities have employees. If tbe�ntraeton have tier mart provide their workers'comp,noftY numbs law an employer cent Is providing worlters'coaspensadon a'iuMnce for.my employees Below is the policy and fob site Infor ntadon. Insurance Company Name:Associated Industries of MA Policy#or,Self-ins.Lic.#: AWC 7004943012011 A r Expiration Date:, 01-01-2012 .f Job Site Address•_ `j � C,r� rt�fp city/Stoe/ZiP'- cdqx,�T Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration(date). Failure to secure coverage as required Iunder Section 25a of MGL 152 can lead to the imposition of criminal penalties of a fine u U a 00 and/or one year imprisoinment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $25y against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. q _ - I do herby and of pedury that the information prvvi"above.is drae and-correct Si Date: Print Name: Brad Sprinkle Phone# 508 775-1778 Ext.1 O O id d use only Do not write in this area to be completed by city or'town offWad City or Town: Permit/Iicense#: Inning Authority(circle one); 1.Other of]Heath 2. Building pepart ra 3.City/Town Clerk 4.Electrical r S.Plumb 6,Other I,nspecto ing Inspector. r Contact person: Phone#: CERTIFICATE OF LIABILITY INSURANCE DATE`�D,YYY) 11/24/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFWMTION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AM=, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITOTS A CONTRACT BETWEEN THE ISSUING INSVRER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFIC ATE 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). COWSACT PRaoocaA Bryden & Sullivan Ins Agency PH PAX ONE wC. No. zt:a: (A/C. NO): E-INIL 88 Falmouth Road + a•I Hyannis, MA 02601 PRooDaR Lv.soo7l wa. INSURED INSURZO(S) AFFORDING CONSRAM NAIC a Sprinkle Home Improvement Inc nRUAnA A, A.I.M. mutual Insurance Co. 199 Barnstable Road INS B, =Sam C: Hyannis, MA 02601 nORmxR D: Into=EI ffi1mRR P, COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:' / THIS I8 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIRIMENT, 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 CCNIDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVQ BEEN REDUCED BY PAID CLAIMS. Derr TYPE Of INSURANCE POLICY NUMBER POLICY EFF POLICY EXP - LIMITS awtomm� awmimn GENERAL LIABILITY SACK Ott9AANCt a OCOMMERCIAL GENERAL LIABILITY DAWAn To RAID OOCLAIMa MADE OCCUR PRncen(a4.eew:s.ne.) a - - WED ffi (Any ow Pagan) a ❑ PERSONAL i ADV.IIWUAY 0 GEN'L AGGREGATE LIMIT APPLIES ER: ORNRWI.AOGRSGATS a POLICY OPRDJECT OLOC PRODUCTS-COW/oP we a a AUTOMOBILE LL#BILITY ooM4a®sum s LWT OANY AUTO (aa aaOldaat) 0 GALL OWNED AUTOS BODILY INJDRY (par Patron) a OSCHEDULED AUTOS _ BODILY IWORI(F-roaidmt) a - ONIRED AUTOS PROPzwr DANUM ONO--OWNED AUTOS Ow aootdaot) a Oa UMBRELLA LIAR OCCUR EACH OCCURRENCE a OEXCESS LIAB O CLAIMS MADE AOWROATB a DEDUCTISLE a ❑Bete-rxoN s a WORKERS ODMPENSATIOLI ® �.AIL• reAn► - AND EMPLOYEES LIABILIT7 � rm Lnarr THE PROPRIETOR/PARTNERS/ >n A AR EXECUTIVE OFFICERS E X.L. YACRACCxVzwT a 500,000 ® incl ❑ excl 7004943012011 01/01/2011 01/01/2012 L D SSAs-POIJO'N LIMIT a 500,000 B.L: DIUASS-BA EMPLOYEE a 500,000 COISm}YS D=ft92PlION OF OPS71ATYdU pt IOCATid41 WORKERS CCNPENSATION COVERAGE APPLIES TO MASSACHUSETTS ENMWYEES CERTIFICATE HOLDER CANCELLATION PROOF OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL 8E DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AvnmmBBD RRPR IMMATIVS �i.n.a�lru•:•II. O •�,.;r'trll�•rrt .Il'trlrli. `.:'i'tti .. ` . o t%ume .._ f lr "uulati n t3":rr,l ,1' t3rrilrliri_ ft� 'uLttr„n .tn�l �I;urrl rr '• Office o onsumertarrsrBusrnessgulahon Construction Suoer.,+so _!tens�,. HOME IMPROVEMENT CONTRACTOR "t =" Registration: 103757 Type .. „. S 6643 Expiration: 7/9/2012 Private Corporatic kr5tr t.d tu:' 00 , rp :• . SPRINKLE HOME IMPROVEMENT,INC. BRAD K SPRINKLE 190 LOTHROPS LANE Brad Sprinkle W BARNSTABLE, MA 02668 199 Barnstable Rd. Hyannis, MA 02601 Undersecretary 10/8/2011 5478 Restricted to: 00 License or registration valid for individul use only 00- Unrestricted before the expiration date.'If found return to: IG-1 2 Family Homes Office of Consumer Affairs and Business Regulation 10 Park Plaza-,Suite 5170 Boston,MA 02116 Failure to possess a current edition of the Mr. Massachusetts State Building Code i is cause for revocation of this license. Refer to: WWW.Mass.Gov/DPS Not valid without sign Lure Town of Barnstable Regulatory Services "an=F.Cxter,Dh+ Wr BURMBg Division Thomas Perry,cw Baitdiod commissioner 2W Main Street. Hyannis,MA 02601 www = Office: SOS-W2-4M Fax: SM79"230 Properly Owner Must Complete and Sign This Section If Using A Builder L 3P"(JjY%iL PM� y,)O� _____,as Owner of the subject Property hereby authorize Sprinkle Home Improvement to act on my behal f in adl matters relative to cvorlc authorized by this building permit application for. (Address of Tab) Signature Date Print Name U Y Owner b%WbiUg fOr Pam.PWM Complete the homeowners License Exemption Forman the reverse dde. 1L.oaM�ow�lWiodowd?m�powty law=FilmlCo�at 0utlooklDDV87 Revised 072110 �oF�tqy� Town of Barnstable *Permit# Ror7 4 o Fspires 6 months from issue date sARtvsresr.s, 3 Regulatory Services Fee *Z- ' v� asass �'s63 Thomas F.Geller'Director q. �� A'ED"AD�� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 XSEDRESS PERM. IT Office. 508-862 4038 Fax: 508-790-6230 6 2004 EXPRESS PERNHT APPLICATION - RESIDENTIAL d Y Not Valid without Red gPressImprint TOWN OF BARNSTABLE Map/parcel Number Property Address 1,761 o)(4,j It ` 4E_ [residential Value of Work � � 3 Owner's Name&Address Contractor's Name 'c Telephone Number�(4- 775-`17 7� Home Improvement Contractor License#(if applicable) b3 ' Construction Supervisor's License#(if applicable) c3 no`6 4 3 p6orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 9311 have Worker's/Compensation Insurance Insurance Company Name Workmen's Comp.Policy Permit Request(check box) ❑,Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side' placement Windows. U-Value o (maximum.44) *where required: issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property 0 er must sign Property Owner Letter of Permission. rovement Contractors License is required. Signature Qxorms:expmtrg R evi aefl51003 Y_.'.,-.,:i::.. ._•_.��. ..-r;.._ �'CT?'g?'��-c�F';a r7-..,...p..,,�� .r..+r+.-•..�.7. -..rn<'°��.�sn:..zys. __ Yf '_,"�`�'�.r.:F'..-_.° .- �-,�a .-. � .- - �_ -. ;7 l � , � " Ito b pe Ica Jpwfi a. 5 { HOMEOWNER ADO NOT SffGN THIS CONTRACT IDFTHERE ARE ANY BLANK SPACES P c / er signatasre. Contractor Signa ure Date Date k' �,�e Vrimmoruue�z�iaz. [�i.l'�.Q�.C4zLlU�S .. BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number:.CS 006643 Brtfaiiate: 10/08/1-955 Expites 10 0812005 Tr.no: 5711 Restett-W .:AO- BRAD K SPRINKLE.. p 190 LOTI3ROPS LAME W BARNSTABLE, MA 02668 Admir'istrafor �%/e 1°arnnwozusea�/ o�✓�aooc>�auaaCla ug Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registral oW 103757 Expi aBbn 7-19/2006 Typs: Private Corporation SPRINKLE HOME to-.09 MENT,INC. Brad .Sprinkle 199 Barnstable Rd. LG j �- Hyannis,MA 02601 Administrator ----------------- 00-35,00o cf enclosed space k (MGL C.112 S.60L) 1A-Masonry only 1 G-1&2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DIG SAFE CALL CENTER: (888)344-7233 � F �a License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,Ma.02108 Not valid without signat re Assessor'-.. map and lot nu o .... .C............. "� a rSEPTIC SYSTEM MUST- BE <. z INSTALLED IN COMPLIANCE Sewage Permit number .......................... ......... t V°`'!1 M.A`�TICLE 1! STATE SA N(d TARY CODE AIVD TO C r= �THE TOWN OF �BARNQ; ''uA-ff`h y . 039- . . . - BUILDING INSPECTOR APPLICATION FOR PERMITJO Ll Aq. ....... ........................................................ • TYPE OF CONSTRUCTION ........ L .:e...................................................................................... .............................................. .19........ TO THE INSPECTOR OF BUILDINGS: The undersigned. hereby applies for a/pe,,Mit according to the following information: Location .... / ....}....... / ............................ ProposedUse. :�' /.f:`�� ............ .......... ......./................. .......................................................................... ZoningDistrict ..................:................................../...........:.......Fire District .........1......�................................................... . Name of Owner ..AA �1 L�... (,/ �1..1..6.�if............Address � 1 Name'of Builder . .. Q.. Lf IYa........Address �Q�...�,�%... G��1�/�1� . .:���................... Name of Architect "` .........Address Number of Rooms .....1`/�'✓�..............................................Foundation ...1...11.........E t�1p� ..........:...................... �A / .... / .... . Exterior ....."/�..��,�!�5. ��(iXp/�:...Roofing S��l."l��T...... ... ........ ........................ Floors .......�,1 .�..�.....4��P:. ......................................Interior ...�?'(. �' G'.. ....................................... Heating /...° �' /�07` �!!!f c`?�� �3,...01....................Plumbing lr/.l��f� , 4f�G.:..., .....6'1�/1f9 ................... Fireplace Azz.........................................:..............................,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 2ot-o23 1I 02051 zo N ZO,2 d� 4 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........ S L - Duncklee, George 19296 one story ................ Permit for -----------... � v w��ole family- dwelling / � �~ . 'v----------'--'---' 0 K�..« ........................................... �— r - . ____.____C�to�t . _____________. George �m���lee Owner ---,----'^.------------.. ' frame ' Typo.of Construction ---------.�---.— ' ^ ' . ----'—^—'r---------............................. #23 ^ '_ ............................ Lot -------.--' . - ' June 15 - ' 77 Permit G,onns6 ......... - lP ' ' Cate of Inspection Date Comolete6 �,���./�---,�.�lP ' . . . ^. . . PERMIT �REFUSED ' ' � . . . '--~—.,_-----~---^.�-----.. 1-9. ^ .-------.—..---------,-----,.— —,—.—.~------~----.---~----..�. ' .-----...-.---..—..,...--.--.—...—... _ � ._--.----.—.—.---~.—..—.----,.— - - , . . ' . . Approved ---------------' lA � � -------.-------.~--...---~---. . --------------------------.. ^ . ' - •..r.-..:. ..rr. -•--': -':.n.r..-.., ..- � ,.. �� � � -. y�'` � .Lr;s",.�..c:.^n..�::>•,....t,'�•tti.lww�-^r'...-lr a.-•-r a... -��, - 1 �`f (r t f r Assessor's map and lot number .... ..... .^ ......... Sewage!Permit number ..........................:............................... y�FTMET��y ; TOWN OF BARNSTABLE Z BASH9T�DLE, i - 9°° "b BUILDING INSPECTOR a M4,°'' APPLICATIONFOR PERMIT TO .............................................................................................................................. TYPEOF CONSTRUCTION ............1A ;?'.............. P....................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit.according to the following information: / .r r Location .........L_.1��. c?1 ......... Tc:...:....�r....c�r�c.1... C. .........::`� ........�Ss.... ................................... 2 �.5��J F'n1/ /.0 ........ .. .......... ... .. ........................................ Proposed Use .... ...................:..............:...: ..... ................ .......... .......... ....................... ZoningDistrict ......................................................:.................Fire District .............................................................................. Nameof Owner ......... Address ...,.....-.:..... 1.:. ......... ......,.......... . Name of Builder AAYAX41', //!..:/,.,;(1,;5; 1`t�(1.........Address G' .....ti�9� e4w� ................... Nameof Architect ....:.............................................................Address .................................................................................... Number of Rooms ...................v...im................,...................................Foundation ... ••••• ••• ..... a 7.Exterior 1'�E •. Roofng .....�5 �� ........�..�... ... �................................... ............. 1 � XC .G............` �/ / �T Interior / C ,�P� �� Floors 1,4/� S� f/>l�✓a Via.....:�?'�............�� .............................................. Heating ...�� /�� k � �'.1�✓:..............Plumbing /s'/!. }r?....... :../!�!a. ................... g .....: ........................... Fireplace ......................................................................Approximate,Cost ..... � n Definitive Plan Approved by Planning Board ________________________________19_______. Area �"'�.. S'� ...................... ................ Diagram of Lot and Building with Dimensions Fee '�� , . ......... ............... SUBJECT TO APPROVAL OF BOARD OF HEALTH �l� y F/,. t L � U I hereby agree to conform to'all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................. .. ....... ................... No —l9./96— 'Permit for .....�e_story ___. ' . single family dwelling ` '—'---^----'—~---'----'----^—'' � Location 1.Y'1—.Oxford..Dr1�e_______`. . Cotolt ---------'~^----'----------- ,/ Qeo Dmocklae � ~~... .-----,=--------.------. - ' `- ' � Type of Const,uchon ..........frame..................... . � —...----~-----.-------------- . . ^ � Plot ---------. �� ___..#22_ p . ^ . ' ' . � re/vx' Granted � ~~'~ of Inspection^ Date com PE REFUSED ` ' -- ' � — .............. —a .................. . �' ------. ---. ............................... , ............... ........................................... .~� � � Approved ---------------- lV ' � ` � ..................... � ----------------------.....— � ` Al -WAZa& I / Zor i4 L0T_._ > 5 r h( N � 6x& ,ter. /ooa G.gc 7Zi0� �'CTUE _. liV T XJ�i9NS/ON 14 Box s_-n Tic s V - OX FORD L�RI V� 4 0' !NH V �P�t 41 OF lAgS ��V OF/,. — - S RICHARD �- or L� JAMES v �� RICHARD G O'HEARN Va JAMES M No. y V O'HEARN o ,, �F No. 694 ,J y CERTIFIED PLOT PLAN IN /STEQ .a,0� BARN ST„ 6L F !�'/�AA SS, SU rE ; SnY►Tr l�� LCT' �� - OXFO1,-L7 DP.-'IVF- .T CERTIFY T1-1,A T THE RI CHARD L/ O'l-lEARN, R.L.S. R. S. a;fOWN ON TN/S PLA/V IS LOCATED -/9/ MAIN ST- �RTE. 28) ON THE GROUND AS INDICATED AND WEST DENN/S , MAS-5 CONFORMS TO 7WE ZOMING LAWS MASS. DATE: �� ri SCALE: i - 'VOB NO. i) 7/ CL IE'NT.' DA re REG. LAND s uR vE-rOR DR.-B Y: .`�%� SHEE"T_ OF