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0012 POINT ISABELLA ROAD
� r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 613 Permit# . � '� , • Health Division �"J ��y✓�lt����'� Date Issued 9' Conservation Division Fee, �� �® Tax Collector '`< �sZY� f MUST BE Treaser` s 6 SYSTEM CE IN TILLED IN C®mPLIAN ur WITI�TITLE 5 Planning Dept, ENT�►L CODE ANDENVIRON Date Definitive Plan Approved by Planning Board ` TORN REGULATIONS ` fi Historic-OKH Preservation/Hyannis Project Street Address 4' /��-� at Village , i Owner �� �e�i GI G Address Telephone � �'�� ;c,PO 'Permit Request ove.m6-y� ,A Square feet: 1 st floor: existing proposed 2nd floor:existing " proposed Total new Estimated Project CostDO•, 0d' Zoning District . .Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes 'O No If,yes,attach supporting documentation. Dwelling Type: Single Family ZI Two.Family Q Multi-Family(#units) P Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes 0 No x 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 ❑Oil O Electric 0 Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: O Yes . O No Detached garage:0 existing ❑new size Pool:U existing ❑new size - Barn:O existing 0 new size Attached garage:O existing ❑new size Shed:U existing ❑new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site'plan review# Current Use - Proposed Use BUILDER INFORMATION Name Telephone Number �J��) hLp ep�- d z S Address / -ec c��s /JUr�G� �� License# Home Improvement Contractor# O O 3 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /�2� SIGNATURE _ DATE `� h� t FOR OFFICIAL USE ONLY -PERMIT NO. _ _ DATE ISSUED' MAP/PARCEL NO: ADDRESS VILLAGE OWNER x f` J• ^ - DATE OF INSPECTION"2k. FOUNDATION,- t w FRAME ^ INSULATION FIREPLACE t ELECTRICAL: ROUGH r FINALY PLUMBING: ROUGH-; A'= ± r FINAL t' GAS: ROUGH` FINAL FINAL BUILDING r y DATE CLOSED.OUT ASSOCIATION PLAN NO. , �•""' TOWN OF BARNSTABLE 22297 y � Permit No. --------_—_-- _ I Building Inspector»n.>c Cash � ♦e wa 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 Cotuit Bay Shores Realty Tr. Address lot #11, 12 Point Isabella Drive, t',atuit Wiring Inspector j„/ 1 _ Inspection date Plumbing Inspector Inspection date Gas Inspector ,�-� `� f' Inspection date X 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. h� 19 2 ........ ��'», .__............ Building/Inspector r - 16 N a � c, tF 0 , 3 ce / a . . . NOTE:• = 5yk SCi QL �.. 01 CIO r.rr. -. a. .3C) .5e'`kocf \ 4 v IN k N -' „ fie ©o�. , S. _ � 1 �P�tFI 0 4ss9 Q 9 ,- ~GRETE G r , O. N o " BQHANNON Na ! ` " 2Gf�L. O T- L ArI N f hereby:certrfy that stokes have fan STR been set os:shown on June 24,/980. su and that.. the location conforms >o LOT i ?�- a ahe zoning -By . Lows of the Town of :t� CO TU/T -BAY E SHORES Barnstable. Fo_undotion wall .' ,* . `/ocatron.,.confirmed` July- 2, , t 1980. --- ---,� COIN; BARNST BLE;; MASS. tm :Sc`ct/e / 40' 'Lf Jude 25, /980 =-BONA NNOl1,, LA ND-,SURVEY CO. C07107r. BAY SHORES, INC. West Bridgewater,: MASS. 02379 e :CVO TE S EXI S TIAI C AND F'//VAL GRAD FS SNARL L 13E E S SENT/AL LY } gym fro i a Q37 ln/fJTE/2 z -736 o`? o ,boo -�x . \ Nl1 O� i \ \ .. / F pIASS-4c ttN Of M� H RICNARD. yG 3� GR� c JAMES 3 OHEAP 694N �+ 6�N 6��6 e_� Q 9 4 �w No.1 �o RFGtsc J� NITA /AND L EGEND EXISTING SPOT ELEVATIONS OxO . : EXISTING .CONTOUR---* 0— FINISHED SPOT ELEVATIONS rO.0 FINISHED -CONTOUR _' 0 ------ - - - -. PROPOSED '.PLOT PLAN ` APPROVED=. BOARD OFr HEALTH .:—' MASS DATE AGENT CERTIFY THAT THE PROPOSED R . d.. OWEARN, INC RL S. RS BUILDING SHOWN . ON . THIS PLAN 1348 ROUTE 134 CONFORMS TO THE ZONING LAWS EAST oENNIs, MASS. OF 13A91?iys7;1Qr3LE MASS. DATE r / 80 SCALE' -/ �/5 8oT JOB NO. cRo- 7.?o CLIENT:17.-� 'DATE "REGlSTr RED LAND SURVEYOR DR. 13Y o H SHEET _— OF Z Assselsspr's map and lot number �. INSTALLEQ IN COMPLIANCE r� WITH:TITLE 5 -Sewage Permit number .............. . .. y :..,.. ._. - ENVIRONMENTAL CODE'AND I TOWNXGULATIQNSTNETOWN OF ' BARNSTBL : i BAW STOBU, • . 9oo 0 3-9.AV BUILDING, INSPECTOR , APPLICATION' FOR PERMIT TO ........i✓.ozs.tr.ui~.t..a:..dw.elUlag.......................................... . TYPE OF CONSTRUCTION sing..-_? anvil ,,..wood frame , . -- -= i 1<tike...7.7 19. .80 ri TO THE'INSPECTOR ,OF BUILDINGS: The undersigned hereby applies for a permit according to the;;follo*ing information: Location Lot 17 Point Isabella Road, Cotux Ba Shores Cotuit MA ....... .. �;.. s. ...... i Proposed Use ....... single famil ..................reidence l ... .. ................ __.. ...�. . . . Zoning District RF fire-�5istrf t Cottlit .... .; .. . .......... ... .. f 'r. 82 Pt Isabella Road Cotuit Name of Owner CQ. 7.: .:Bd�..5�AQ �S.`..R�.a �i�..:.Address ..,.. a ...... . ... ... ...........a..... ... ..... Name of Builder Cotuia..B.aY...Shores . ... ,�c{dress .....Same....... .. ... ..... ........... . ..... . ... s r . Name of`Architect R9ya1.,Brry,.;Wlls addres$ 6 Newbury Streets Bostona, ;MA Number of Rooms o Poured concrete .:.....7................ F'undation ....P. wood frame :: "- as halt Exterior ;.,.Roofing ::.,........�?..,.... Floors ..WOOd...f , ?OX.S...-..TAaL].II...S Jnl .UiI1Q... r:,: 1 #erior ..:..h�a.�.�,�....- dX' w 11/Skim...co.................. .hot...water.,...o fired .............Pluml2ing'�;: per code Heating .. il _ .............. Fireplace .....:...Y.eS.:......................:....:............ ;% Approximate Cost $...80 000 g... ............. Definitive Plan Approved by Planning Board > e__25_,---------19 3, Area .....c l0j....... Diagram of Lot and Building with Dimensions -'...Fee ....... f............................. _ SUBJECT TO APPROVAL OF BOARD OF .HEALTH V. -k herEby agree--to zarrform to':-a_lr:ChB ules'' ind "Regulations of the of BarggRblq,regardjft_.th- above _constr.uct ion, ! - CO IT BAY S�HZE EALTY TRUST ic`hard L„ De_._pamp i..lis..,.-Trustee.. COTUIT BAY SHORES REALTY TRUST No 22 ..... ....2.97. .... Permit for ...... ......5 in�.I!��...Eamil Dwellin..... ...........y..................... ............... Location ..L.Qt...#17...;L�...Point Isabella Rd. ................................. .................Q'Q tpi t................................... ............ Owner ...Bay..Shores...Re.al.ty.. Trust ..... .... .. Typq� of Construction ....Frame ...................................... ................................................................................ Plot ............................ Lot ................................ Z3 Permit Granted ........... -.19 80 Date of Inspection ................... Date Complete ......................... ....�19 PERMIT REFUSED ................ ............................................... 19 ......... ... ...... ...................... ............ .. ...... ............. .. .................. ..... ..........lot*l- ....................... . ...................... &... .............. /M..... . ................................................... Approved ............................................. 19 . ............................................................................... ..................... /VO Assessor's map and lot number ... ......................................f . Sewage Permit number G"a .r gyp*THE r0� TOWN OF BARNSTABLE Z ,BARNSTABLE ` M6 BVILDING INSPECTOR O�p MFY G 4 t APPLICATION FOR .PERMIT TO .......conatr1xct 3.. .dwea:a.ing............................................................... TYPE OF-CONSTRUCTION ....... single.. ...ly, Wood. frame 7�.7.............. 8 i�� ..19 80. TO THE INSPECTOR OF. BUILDINGS:, The undersigned hereby applies 'for a permit according to the 'following information: Location ....: ...)�o.t 17. Point...Isabel la Road,.-C.otu�a_ Ba.y..Shores., 'Cotuit.,...MA...................... Proposed Use ..sin�le...£ama.ly resi.dence...:.::. ......... .:.... ......................................................:........... Zoning District .............. ... .................................................... Fire District ... .cOtttlt Tz. Name of Owner CA.t;7Ai.t.ay...Shore ....Address .....82..Pt,*_„Isabella Road, Cotuit Cotuit B Shores same Name of Builder ...........................?Y...................................:Address .............................................................................:...... Name of Architect a- A ...Address .. ..Newbury, Number of Rooms' ..........Foundation ....P9ured,,,GOACre..t.e...................... Exlerior WOOd..fraItt ............................................e Roofing .......aS Ylsla..:...................................................:... ... . Floors ..WO00..f.1Q.4.r.S...^ Main....awellxng............Interior .....Tn a.1.119... ...EOat Heating ...hat water.v...°.il fired Plumbing per code .. ...................:............... Fireplace .........YPS.................................................................Approximate Cost ..........$..802000.... ............................... Definitive Plan Approved by Planning Board ___J_Lk1'1_e___��_�_____.__19.7��__. Area.. .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH , r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. COTUIT BAY SHORES-REALTY TRUST Name 'L �!,.. %.,sft:,. �, �•(1ct �_ R 'cfiar'd L. .�5e"'L�'ampi'iTis TruslreF " =74-13 COTU AY SHORES RE TY TR ST_/ ," No 22297 Permit for ..l 1l2 Storms ..........S ngle,,,Fam ly,,,Dw line.,,,,,.,,, Location Lot 17...#12 Point Isabella Rd. . .................................... ,,,,,,,,,,,,,,,,Co to i t Owner Cotuit.....Bay,... hores.........Realty,,,Trust Type of Construction ...FZaMe.......................... Plot ........................ ... at ................................ Permit Granted .............June 2 3 f......19 80 Date of Inspection .A.............................. ....19 Date Completed ......19 ............... PERMIT REFUSED ..................................................... ...... 19 ... ,'e�'f - -(. .�.. .; e.......... Cie ...... ......... .............r............ 5........................ • ........................C�10 -•. "•..... ... A...................... .... F r Y T Approved .............................F................. 19 ............................................................................... ............................................................................... �pFTHETp The Town- of Barnstable BARE.MASS. Department of Health Safety and Environmental Services 9 $. 039. �0 pTEDMA+A Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location /� �,r/T /a&eeufl Permit Number /V oAJ E Owner Builder One notice to remain on job site,one notice on file in Building Department. The following items need correcting: Esc i°� W/aib©ca! -- W-&cc, 15 AIC-e-J dQt-fi-g �)riy b ow s 4 *6 o dn- y1le /Ue--w NC—w u Please call: 508-862-4038 for re-inspection. Inspected by Date �pp(HE1p��� The Town of Barnstable BARE. 'MASS. Department Deartment of Health Safety and Environmental Services 9 � rn 163q. �0 prFOMA�a� - -- Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: r 508-790-6230 Inspection Correction Notice Type of Inspections S r E Location �Z Oa 1-wr 10 rr-c& Permit Number /y o N ': Owner Builder One notice to remain on job site,one notice on file in Building Department. The following items need correcting: 0 Esc�hc G-IAJ,` c)cd -+ Cu c-c- Al�c�J (A-) J o cv s 4 �)0 dPz- A)C-(aJ t, 1 0 r� T� u Please call: 508-862-4038 for re-inspection. Inspected by 7�?YP C�� Date 4 � I �" °� "� } � � h Tad C- �" Y� '*�1"'�+a§r x ,xw•y��k.: .g,,.� � 3 e t 1 6 r d .' It Aflwt 4 WON W 1110p ik A4A ni f i �- M lq- a stage d ar " r. i. *LM T '5erg 07,4 T#4v,wtf , �YI. 'w . y'"a�•w' a � yu'. V eAl VT 7� m t*-t � !4 V32 Aw f-T n,-rre xrK >r"a°s.' ,��; ," --3 4^:. i✓-'xb .r ^4,.. 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'S„S'. eA',Y+p'� .�,�� :s- � w- `�.`: Y A i} "+.r �^rr.�.l� s S�' ° . a �e ND r � r +A a M. f i ' , s m z,. x ro n ° Y 12 Point Isabella Rd . , Cotuit 9/15/06 �t r ,o + IV jac ;; �r�. a s m fiu �dM � , `p�a'Rt'&Mmg 4`e° wdg .; �.�� `� �, es`� � � 3$ r,+ �} d�.y`.• �� Rip WJUTPRI�',� R 1 a� �e t^t, m o- w a ',,� r s ,_,a+' - y" �s t„ig- +a .y :� "'>ks•. T a"" ,53 g„gpv 97 i F r �3` r r 12 Point Isabella Rd . , Cotuit 9/15/06 pia "moo camp 70,7 k s c � a at fur, M ' { ;� r�. P O 4l of a` r r! mu IF"4 e g Fri r y , ,.w jj -IA ;^3y8AA y *. _ t x �i"r ^c�, yrLiyx '�a'i ET411 e F,x a ? xu �y F r � awn— w , „ d' a " x_ x 'fl w z m a 12 PointIsabella Rd . , Cotuit 9/15/06 \J oFt r Town of Barnstable *Permit# ayti Expires 6 months rom iss ate Regulatory Services Fee M Y * tiAxrtsrast E, Thomas F.Geiler,Director y MASS. 039• ,off g Buildin Division AjE p�,t A . Tom Perry,CBO, Building Commissioner �l 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY II - Not Valid without Red X-Press Imprint Map/parcel Number O 77 rr`-I 0 F3 Property e Address r ❑-Residential Value of Work<f39bO' Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address PQ CrMrci Contractor's Name I �C ���'�J t„�� Telephone Number_ '��� --✓-(,��� Home Improvement Contractor License#(if applicable) ❑Workman's Compensation Insurance tT Check one: X-PRESS PE EdA—am a sole proprietor JAN 2 1 Z�a� I am the Homeowner D-- have Worker's Compensation Insurance TOWN OF BARNSI-A8LE Insurance Company Name nn h!t"-&S,rj at A Z f-7 sib S `ids Workman's Comp.Policy# ay-—S,-)0�A (e�w Qoofp Copy of°Insurance Compliance Certificate must be on file. Permit Request(check box) \ i ❑ Re-roof(stripping old shingles) All construction debris will be taken to .d•�t (�(� ��Nr6, 1'i�� ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ C= Re-side Replacement Windows/doors/sliders.U-Value (maximum.44) _ ' _ r; tv �s *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Hista"i ConservaTlon,etc.3x C5 a7 ***Note: Property Owner must sign Property Owner Letter of Permission. ' A copy of the Home Improvement Contractors License is required. ti0 � G+J M SIGNATUR �C --- —t Q:\WPF[LES\FORMS\building permit forms\EXPRESS.doe p Revise020108 f License or before the registration _ 1 .8Oardof expiration valid for in Buildi date. If dividul '. Bo a of ng Regu/ati f°uad ret use only st°n,nIa h Place g ons and sta urn to; 02108 m 13o1 ndards ". ,..:. Not valid kitboutsi n ;+ g at4te , n r + s 4 ` a ,per 711. &.moouueadd a�/ �ucliuee�a \ Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registr 101149 E ani, 5/2010 Tr# 267680 ' 1mi dual '. JOHN P.DUNN i John Dunn x , � 80 MARIE ANN TEy f • } CENTERVILLE;MA 0262 Admmistrator } I 01t � � 1a f , a{ Boar o u�, m u aho s and Standards l Construction Supervisor license !! Lice�>5 a CS 14007 Expi " n L$5/2010 T# 23257 JOHN P DUNN t 41= BOX 924/80 MARIE CENTERVILL-E,MA 0 a82 Commissioner t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address:_ d V-ALte,_ i r- -V.2 4- — 'l`',O �c � City/State/Zip: �1 �Z y,`�� . ; 0 -Phone.#: � Are you an employer?Check the appropriate box: Type of project(required): L❑ I am a employer with . � 4. ❑ I am a general contractor and I ��yees(full and/or part-time). * have hired the sub-contractors 6. New construction 2: I am a sole proprietor or partner- listed on the attached sheet. 7. .❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' , # 9. ❑Building addition [No workers'comp.insurance comp. insurance. 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ P 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs \ insurance required.] t c. 152, §1(4),and we have no 13. er�i <+-Cl ��o��L employees. [No workers' comp.insurance required.] Any applicant.that checks box#1 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. tContractors 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.Lic.#: 1(d(0_, � (D ) L (o Expiration Date: Job Site Address: ���Ay.;e[ k City/State/Zipel, , A. o4r,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 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 her y certify under the pains and penalties of perjury that the information provided above is true and correct � i�1 Si ature:�. 10 Date: -_)An� I C _ Phone"#: 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#: T 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 ---ofthatoregoing-engage m-a-jointente prase;afid=inZuddiag=the legal=repr-esenmtive*-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-contractors)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 home owner or citizen is obtaining a license or permit not related io 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 Dtepartment of ladustri.al Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-977-MASSAFE - Fax#617-727-7749 Revised l i-22-06 wwwrnass.gov/dia 'j+'vr.4.NHg,C r _ L },�.�r• q', s>..r p �, }''p' t fi �:• ,- ,r•' .�:i h\�`i„t>'. ct �%u t,: ' 7'� S .•Z ,r ,,''`_S•--"'�••'{.3.i :,F pq`�g•'' 3 1!R[ {°.,� kT�0�i.. �13�X1s� 'h.SYfi''.'.3"�ye.L� }'�l 4 r� �/ ✓ 667 ,. tfa- R'1'.•.µ : S i(� 7: 'a. � '�' x1..A31 M'4". .y.• 1z,i' .p1 i'4" 5„ .+. JOHN:P. DUNN �., -..; �:• - ., � Aluminum'& Vinyl'N'Products; �y q4 J� P.O. Box 924 a .` CENTERVILLE, MA 02632-;)-, .r } A (508) 771 4585 7 PHONE '»f DATE Patricia Godfrey JOB NAME/LOCATION y12* Pt. ,Isabella Rd iame +- Cottiit,' Ma. 02635 L• Attn. -Tom''Bprrows 508-68175810/ 508-428A-2805 ` W . + JOB NUMBER - JOB PHONE axe+- _ r •` We hereby submit specifications and estimates for: -Storm-,-'Windows/Storm. Doors 8 ' .a �'-' Storm Windows: 3. Supply and install (17) 'Harvey Tru-channel white storm windows with Triple Channel Design, . Rigid Bar -Double Interlock, and •Fiberglass Screen. Remove existing aluminum#,Pstorm' windows—take all debris to landfill- Clean and-_Caulk new units prior°;to., installation, remove'all .rubbish. Total.. . (17) Units Installed $ 2, 635.00 Storm..DQors: Supply and install (2) Aluminum Storm Doors-. (.1) Harvey Hi-lite .White Aluminum Storm Door with both Safety Glass and Screens._` (Side Door) (1) Anderson 4000. Series Full view door with, Brass Hardware- Safety Glass and Screen. Total. . . (2) Storm Doors 'Installed. : .$875.0.0 . Sliding Glass Door Replacement: Supply and install (2) Anderson PS510 High Performance =6•x6'8" .White Gliding -Doors w/Screens Replacement size to .replace existing aluminum sliders. Remove all debris._.,,., ` Totalw (2) Sliding-Doors Installed _$'. 3,250-.QO . _ -- - --- — We Propose hereby to furnish material and labor—complete in accordance with the above specifications,for the sum Six Thousand Seven Hundred Sixty and 00/100 Dollars dollars($ 6,760.00 ) Payment to be made as follows: $3380.00 Down to Order (special Order Items); Bal. .Upon. In5ta'llation All material is guaranteed`to be as.specified.All;work to be completed in a professional manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon:wriften orders, and will become an extra Signatu _ charge over and above the estimate.All agreements contingent upon strikes,accidents or ; delays beyond our control.Owner to carry fire,tomado,and other necessary insurance.Our -Note:Thi 'proposal may be workers are fully covered by Workers Compensation insurance. w withdf n by us'if of accepted within 30 days. Acceptance of Proposal—The above prices,specifications and con- ditions are satisfactory and are hereby accepted.You are authorized to do the work as Signature l 1 specified.Payment will be made as outlined above. Sign%ture Date of Acceptance: PRODUCT 13128M USE WITH 771 ENVELOPE NEBS To Reorder:1-800-225-6380 Or www.nebs.com PRINTED IN U.S;A. B f oFtME Town of Barnstable Regulatory Services BARNSTABLE, . MASS, Thomas F. Geiler,Director - Fo;A�0. 'Building Division Thomas Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 RE: 12 POINT ISABELLA RD. COTUIT OUR RECORDS THE FOLLOWING ELECTRICAL PERMITS DOES NOT HAVE A FINAL INSPECTION #20062801 l ELECTRICAL PERMIT EXPIRED FOR WIRING OF BASEMENT - RECESSED LIGHTS & OUTLETS IN BASEMENT OFWE . . �; The Town of Barnstable M PLUR Department of Health Safety and Environmental Services Building Division - 367 Main Street,Hyannis MA 02601 Office: 509-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW 'SUPPLEMENT TO PERNUT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. I Type of Work: Estimated Cost' a-0 4. 06 Address of Work: �� �� n sc` 11 Cv 0_6A.21 214 Owner's Name: Date of Application:_ /a , /��l I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name q:fb ms:Aff day r _"� The Commonwealth of Massachusetts a =-^ Department of Industrial Accidents , = = Office offaresti98deos 600 Washington Street ...... Boston,Mass. 02111 -- Workers' Compensation Insurance Affidavit i location. k, city phone# ❑ I am a homeowner performing all work myself. �I am a sole r rietor and have no one workin in ca acity I am an employer providing workers' compensation for my employees working on this.job. .:..:. .....:.....;:..;.: ;: ii'i+i.<> �<::::<:>J :><:<r'::`:i.isisy :»:'<: ::>z:::>:<>::>i<:<:; >:«i:;::«:>:::>::::>:::::;:::;>z:::;: :::z::::%%%;i; ar an neat ;:::.:. . shone#.. ::. Crty' :::::::..........:::::::;::::::;: :: : insurance co.. ;<:;:•;x;S:':r::;a:;'»:<::Y:<... ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the wntractors listed below who .have the following workers'compensation polices: name :::::>:::.;:;: >;:; wm env .... .... .:. .:.. _::::....::..::...:..........:...... . < '<> adr ...::: :::.::.......:::.:. .......:>::.: .................. ..................................................... x<..:.... f opi �.:. ::::. :.::.............:.::.:.:..:::::......::::...:...................:::::::::::::::.:::.::.::::.::::::::::::::::::::::::..:................::.::::::: address; . ....:..:::::......................... ...........................:..::::::: W. ...................;:.:.;:.;;.::......:. :::::i:: >::::::::::::: :: : ::: ::::5: .. t': ;: it i;i 3i < <i::; `y,•;......?:r;;+i`^'3:%«2:i::: a�nranceco. � .. .. :. :: t►li Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal pensWes of a 6ne up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fhne of$100.00 a day against me. I understand U a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above is trrw and correct, Y Signature Date Print name Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# • ❑Bonding Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (raised 9/95 PIA) 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 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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant 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 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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance 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 yaa are required to obtain a workers' compensation policy,please call the Department at the number listed below. City 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 reduned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you m 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 imlesdua0003 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 s. OEPARTNENT OF PUBLIC SAFETY CONSTRIICTIDH SUPERVISOR LICENSE I Number, Expires: 6 — Res#r#cted To R06ER8'...RBIDr PO BQX.IWI �...+w 7r�M✓ COTUIT, NA 02635 -#•v 4�k:tii-:'K'Ys CONTRACTOR { HAME IMPROVEMENT, '`Registration �;100035 � { Type DBA > W' � �Ezpiration�06/08/00 a ilR06ER B REID CARPENTRY Z y v }£ Roger 8 Reid f� Lewis Pond::Rd/ BOX 145 mNisTRATOR COtUit MA 02635 } THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) IM A DATA V/-1 V U K/K L h � (�.6 Za 41� Ol_D +•t.r,�;:; , ...,. ,. - ... . r•i.'.:�;,: i�F21J?.9 is•:CJ"11•• �rYrvr ri? ,c;n.ticlr•Iw n.ac MADE F CSi .•'�' •: .. - ..�. ..� .::� '::Yd!.''r. UNGi::•'.� NA iicny CIRpf�::7. 5..:,..... . •. ..: -... I. ::Ic.i'iAl•1.CL ril SI-1 w" Tf ��n r1'1+ Y),,►. 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