HomeMy WebLinkAbout0325 POPONESSETT ROAD 3�� ��� Oti ass �it �zcj
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10/25/2019 Citizen Web Request
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Citizen Request Management - Internal Use
a Request ID: 70321 Created: 10/25/2019 1:10:13 PM
Status: Assigned To Staff Assigned To: Parziale, Jim
j Health Office
Anonymous: Yes Category: Chapter 108 : Hazardous
Materials
E.C. Date: 11/8/2019 fl
Created By: Tripp,Vanessa Citations:
fF Health Office
Time Worked: 0.00 Response Time: - 0.00
Requestor Details:
Email:
Request Location:.
325 POPONESSETT ROAD
Cotuit, Ma 02635 -
Parcel Number: Map: 019 Block: 113 Lot: 000
Request:
Says home is operating a swimming pool business named "Souza Pools." Says they do sell
products to pool customers. Also, pool chemicals are stored in house #325 in the back shed.
Is location as Been In poolBusiness or a long time. See no e below.
Request Work History:
Internal Note History:
Entered on 10/25/2019 1:10:13 PM
by Tripp,Vanessa
Anonymous caller says House#333 is part of the pool business. The name of the owner is
Leslie Sousa Oakley. The owner of house #325 is Carol Sousa. Copy of report given to Zoning in
Building Division.
System entry on 10/25/2019 1:10:13 PM:
Assigned to Parziale, Jim
https://itsgldb.town.barnstable.ma.us/C.itizenRequest/WRequestPrint.aspx?ID=70321 1/2
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Engineering Dept. (3rd floor) Map Parcel GJ ermit# , u
House# ,5�069c_ _ Date Issued
Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30)J?7- ee
r� '(4th floor)(8:30.-9:30/1:00-2:00)
4 floor/School Admin. Bldg.)
fl PTI SY$TE
oved anning Board 19 $TA E
TOWN OF BARNSTAM �a - ND
6 Building Permit Application TOWN REGULATIONS
Project Street Address a, ,Sf.� --
Village
Owner . �d�i� L . -� ��G�J �8 y Address -3 Co 7Z,
Telephone
Permit Request
i
First Floor : // square feet Second Floor pJ square feet
Construction Type
Estimated Project Cost $
Zoning District _��.� ' Flood Plain Water Protection
Lot Size j Grandfathered ❑Yes ❑No
Dwelling Type: Single Family U11" Two Family ❑ Multi-Family(#units)
Age of Existing Structure S Historic House ❑Yes Q o On Old King's Highway ❑Yes EJ-No
Basement Type: ❑Full [drawl ❑Walkout W�dther PA �,,,;Q. /j 57
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Nujnber of Baths: Full: Existing f New Half: Existing New
No.of Bedrooms: Existing 3 New
Total Room Count(not including baths): Existing New First Floor Room Count
Heat Type and Fuel: Oas ❑Oil ❑Electric ❑Other
Central Air ❑Yes p'o Fireplaces: Existing ( New Existing wood/coal stove ❑Yes ❑No -
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ( ,3
❑Attached(size) ❑Barn(size)
p None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review# -
Current Use Proposed Use
Builder Information
Name Telephone Number
Address License# -
Home Improvement Contractor#
Worker's Compensation#
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE D /3 /97
BUILDING PER ENIE FOR THE FOLLOWI G REASON(Sgal
Et
FOR OFFICIAL USE ONLY x
(;r
PERMIT NO.
DATE ISSUE 4
MAP/PARCEL NO: '
ADDRESS VILLAGEf
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME/
ram-
. — t:
INSULATION
4
FIREPLACE
ELECTRICAL: 41-1 li FINAL .
PLUMBING: FINAL �
e
GAS: • FINAL ..ai'� s
F
• s
FINAL BUILDING � .1 _ s
Q
a�
DATE CLOSED OU n, -
ASSOCIATION PLAN NO. + -
' r
j` The Commonwealth oj.1fassuc•huscttt
,
Dcpurtmutt njltrdustrialAccrdcnts
8Meol1nveS#9J11ooS
600 «ltShtttgtott Street
�. Boston, Ma.yx 02111
Workers' Compensation Insurance Affidavit
Applicant information: �lPlease PRIIVTIe�j$j� -..,-,._, -"� �name: S��l �. 'CN (I
r✓ location:
city V hon•# Z'S 2� Z—
I am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity
I am an emplover providing workers' compensation for my employees working on this job.
conalaanv name:
address:
city: [►hone#•
insurance co. Police#
I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have
the following workers' compensation polices:
companv name:
address:
city: nhonc#•
insurance co. nolicv#
a
companv nainc:
address:
city: nhonc#:
insurance co. nolicy#
titnal sheet if tieccssary, _. __ _ �"�'� ''^�T• '��'--'T �'�
Attach addi ' .. ,_ :_ :J,. ..< .- --'__ _-._. .L.-_ .r.. ..... •,,.,,....::�',�,t:.,...�::Z'�• r....•. �.,..._ _.
Failure to secure coverage as required under Section 25A of A1GL 152 can lead to the imposition of criminal penalties of a line up to 51,500.00 andiur
one Ncars imprisonment:as well:as civil penalties in the form of a STOP NyORK ORDER and a fine of 5100.00 a day against me. I understand that a
cope of this statement miA be forwarded to the Office of Investigations of the DIA for coverage verification.
I do herehr c/ertift•tender the pains and penalties of perju that the information provided above is true and correct
Sicnatur Date IL3�
Print name Phone#
:. �of6cial use only do not write in this area to be completed by city or town official
city or u»vn: permit/license# riBuilding Department. .::
C3Licensing Board ,..
C3 check if immediate response is required selectmen's Office t-
[311catth Department
contac[person: phone#; flUther �.: ,
r
information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all empfovers 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 emplt rer 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 emplover, or the
receiver or trustee of an individual , partnership. association or other legal entity, employing employees. However the
owner of a dwellings house having not more than three apartments and who resides therein, or the occupant of the
d\ clling 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 even,state or local licensing agency shall withhold the issuance o►-
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.
Additionallv. neither the commonwealth nor any of its political subdivisions shall enter into anv 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 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 cite 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.
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of
tite affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to
the Department by mail or FAX unless other arrangements have been made.
Tile Office of Investigations would like to thank you in advance for;you cooperation and should you have any questions.
please do not hesitate to give us a call.
The Department's address. telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 «'ashington Street
Boston,Ma. 02111
fax#: (617) 727-7749
phone #: (617) 727-4900 est. 406, 409 or 375
The Town of Barnstable
Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Off=' SOSMO-6227 Ralph Cressen
F= 508-775 3344 Building Commissioner
For office use only
permit no.
Date -
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c 142A requires that the"reconstruction,alterations,renovation,fair,modernization,conversion,
imprvvezae ,.rcmo%-4 demolition, or construction of an addition to any pre-existing owner ooazQied
building containing at least one but not more than four dwelling units or to s=cM=which are adlM
to such residence or building be done by registered contractors,with certain emeptions, along with Other
t
Type of Work: n !;( C ��ts -� +� St.cost �6
Address of Work: ' 6
O%mer.Name:
Date of Permit Application:
I hereby certify that:
Registration is not required for the following rrason(s):
Work excluded by law
Job under S1,000
Building not owner-occupied
Owner pulling own permit
Notice is hereby gh-en that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITTIDNRECiiST> ED 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
�� ; 3 16W,jexo
� 3
r
j
TOWN OF BARNSTABLE
.BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
--------------------------------
Please print.
DATE 3 y n
/ 7
ppoyj Awl/
JOB LOCATION
v.�
Number Street address Section of town
'HOMEOWNER" s t
Name Home phone Work phone -
PRESENT MAILING ADDRESS ' •
City 7 town State Zip code
The current exemption for "homeowners" was extended to include owner-occupied
dwellings of six units or less and to allow such homeowners to engage an in-
dividual for hire who does not possess a license, provided that the owner
acts as supervisor.
DEFINITION OF HOMEOWNER:
Persons) who owns a parcel of land on which he/she resides or intends to re-
side, on which there is, or is intended to be, a one or two family dwelling,
attached or detached structures accessory to such use and/or farm structures.
A person who constructs more than one home in a two-year period shall not be
considered a homeowner. Such "homeowner" shall submit to the Building Officia.
on a form acceptable to the Building Official, that he/she shall be responsibly
for all such work performed under the building permit. (Section 109. 1. 1)
The undersigned "homeowner" assumes .,responsibility for compliance with the Sta-
Building Code and other applicable codes, by-laws, rules and regulations.
The undersigned "homeowner" certifies that he/she understands ..the Town of
Barnstable Building Department minimum inspection procedures and requirements
and that he/she will com ly with said procedure and requirements.
HOMEOWNER'S SIGNATURE � Q
APPROVAL OF BUILDING OFFIC21AL
Note: Three family dwellings 35, 000 cubic feet, or larger, will be required
to comply with State Building Code Section 127. 0, Construction Control.
i ..
HOME OWNER'S EXEMPTION .,
The code state that: "Any Home Owner performing work for which a building
permit is required shall be exempt from the provisions of this section
(Section 109.1. 1 - Licensing of Construction Supervisors) ; provided that if
Home Owner engages a person(s) for hire to do such work`, that such Home Owner
shall act as supervisor. "
Many Home Owners who use this exemption are unaware that they are assuming
the responsibilities of a supervisor (see Appendix Q, Rules and Regulations
for .licensing Construction Supervisors, Section 2. 15) . This lack of awarenes
often results in serious problems, particularly when the Home Owner hires
unlicensed persons. In this case our Board cannot proceed against the
inlicensed person as it would with licensed Supervisor. The Home "Owner actin
as supervisor is ultimately responsible.
To ensure that the Home Owner is fully aware of his/her responsibilities, man
communities require, as part of the permit application, that the Home Owner
certify that he/she understands the responsibilities of a supervisor. On the
last page of this issue is a form currently used by several towns. You may
care to amend and adopt such a form/certification for use in your community.
Assessor's Office(Ist floor) Map Lot � Permit# - "� ��'g
Conservation Office Oth floor �+�- 1- �--� 30 oN* ` Date Issued 9�
Board of Health Ord floor
dP»�
Engineering Dept. Ord floor House# ` �'Ea"W MUST BE
); IN COMPLIANCE
ENV TLE 5
(Applications processed 8:30-9:30 a.m. & 1:00-2:00 p.m.) AL CODE AND
TOWN REGULAMNS
TOWN O BARNSTABLE
Building Permit Application.
Project Street Address
Village COko'k Fire District n
Owner `.�����. �-��'"'y ��(JJ U Z4 Address 7`1� Orp(2 ear i`CS57 f
Telephone S-22-a;'
Permit Request: j"--o!a �.j W dV,.'Yv►v" �� \ /�� ?�- '-/
i
Zoning District l Flood Plain Water Protection 1�
Lot Size Grandfathered
Zoning Board of Appeals Authorization Recorded
Current Use Proposed Use
Construction Type
Existing Information
Dwelling Type: Single Family Two family Multi-family
Age of structure Basement type
Historic House Finished
Old Kings High�yav Unfinished
Number of Baths No. of Bedrooms
Total Room Count(not including baths) First Floor
Heat Type and Fuel Central Air Fireplaces
Garage: Detached Other Detached Structures: Pool 1 2if
Attached Barn
None Sheds
Other
Builder Information
fName G. �` i °V F�� \ Telephone number 'C) C,
I-Address License# 0
Home Improvement Contractor# G ® k S�
Worker's Compensation # c �O�«ZO 4
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS TING FROM THIS PROJECT WILL BE TAKEN TO
Project Cost 0)•t1Z1T ) ' cre
Fee 'Y�'�
SIGNATURE c�IYvl DATE �ci
BUILDING PERMIT ENIED FOR THE FOLL WIN REAS (S)
BPERM T
{
FOR OFFICE USE ONLY
ADDRESS a VILLAGE �-7A , <
OWNER
s� 1
i = IV
DATE OF INSPECTI d I'll"
FOUNDATIONiC
FRAME {1 J a
INSULATION
FIREPLACE j^
ELECTRICAL: ROUGH FINAL
,
PLUMBING: ROUG1 FINAL_
n
GAS: ROUGH FINAL
. � - It
FINAL BUILDING: „_• :� �
DATE CLOSED,Obfi:
ASSOCIATE PLAN Np f A '
• y ems+' JTr� ... :...
t# p I,r ,
t
pp 4
�.'f. :t ., ,1 � t.. 3 t� t•� �.. . F. .. is
F�.d • tart %: r .}� t -. .:: Y is ,.... .. ,�� I �r�tf r
' "COMMONWEALTKrf-,m F DEPARTMENT OF PUBLIC.SAFETY
OF s' 8' , 'ONE ASHBORTON PLACE '0�
ASSACHUSETTS ; BOSTON,MA.02108
' PIRATION DATE LICENSE CAUTION
a a 04i 22/f 95)`7 CODS I R. . c lJf FF2V I5[JR �
FOR PROTECTION AGAINST~
I V, RESTRICTIONS EFFECTIVE DATE LIC
RI
r THEFT, PUT RIGHT THUMB
c ,:r PRINT IN APPROPRIATE
LAB* 0�/ i 4/t'39�� ' �fr�'(Q!5 � BOX ON LICENSE ry,'ki '. ,r
MARK _! CItL.Et�tAN BLASTING OPERATORS
MUST INCLUDE PHOTO
�9 # 24-,C:HERI]K,EE ::Rr m i._..
4PNOTO(BLASTING OFF!ONLY) - ,FEE:, 'HARWICH , hIA 0;::-645 3
NOT VALID UNTIL,SIpNED BY LICENSEEAfdb OFFIDUILLVF c fdln/s to posasas s corrals
$ HEIGHT: t?,��R `Tt' °ti"� ' 10"�" ;I YasaaoA�rsstts3tatoBr/ld1s�I' i
w q�- ^Fae. < STAMP a
,ti{ja*ul**a@ Code Is osnso rornvooation
r D06 !�yl%lm' hoi MIS lloob
r� THIS DOCUMENT MUST-BE- SIGN NAME IN F�YLL,ABOVE SIGNATURELINE �^�` �.
CARRIEDONTHEPERSONOF SIGNATURE OF LICENSEE' 1 -
' THE HOLDER WHEN,EN..+.RIGHT THUMB PRINT GAGEDINTHISOCCUPATION
,d.
Y7' .I
�g� I
r
o
r� t lit;
,x
F Rf
1
Ae �ar�,o�uue.z. o��/Gl Qaac�ivaea i
RE HI:. ME IMPROVEMEN i CON (RAC i"<<(:`� t3I3TR A.T L01`i
E3o rc! of Cu.i]'clinq Regular ions and 5tandarc�: l
'. One Ashburton Place ... F:oom 1301 �
Bostom, Massac�iuwr:tt 02108 I
a;
HOME IMPR •/EMENT CONTRACTOR
I -.---- -- -- ,-----------
3 Registrat 112070 ak ExPirat, .7.o11 02/22/97
T - PR"i
YPe�_ f ! E CORPORATION I
�y HOME IMPROVEMENT (ONTRAC
Registration 112070
ME ANCI+.., 1 E)ESIGN &:`POOL CORD � Type - .PRIVATE CORPORA!
SCAN il . i�Il"TRTCM Expiration 02/22/97
ht 1[4? r I: R COUI'4Y RD
I.)ENN c RT MA 02639 I ANCHOR DESIGN & POOL COF'
t,§EAN M. DITTRICH
143 UPPER COWiTY RD
ADMINISTRATOR.
s'` 0 DENN SPORT MA ii'
e
t
',1.'0' c; 17: n2 Z�51;T 2f 12L' DEFT IIKD 'ACC1D Chi
-
1� «0�;7WL0J7 •Fat ill. o i
, �a��czc/u6et �
oUvParin:ent o��ndu�tria(�cctdeRLj
fi00 UVa�l�ton�t�ef
James J.Campbell Uolton, "/a�a ;:�al.. 02f f f
Commissioner
•;•:• .�'�� �.::. :l. ci::,::<ivsc Fiij:SE-_;:psi; i'tiriFC4�V1Z
0l�, x
with a principal place of business at: _
' ._
(Gty/StstcJl#yj
do hereby certify under the pains and penalties of perjury, that;
C) I am an employer providing workers' compensation coverage for my employees working on
this job.
Insurance Compa;ty '
Polity Humber ,
{�! I am a sole proprietor and have no one working for me in any capacity.
i am a sole proprietor, general contractor or homeowner tcirde one) and Lave hired the
contractors listed below who have the following workers' compensation policies:
�'►'"�,�,v2-`ems��,-v �-��a � � �s"�-�-�"�-� �' �� w.1�,.�"'�•I
Contractor
lasurance CimpanylPolicy Number
Contractors
Insurahce Company/Policy Number
Contractor Insurance CompanylPolicy dumber
() I am a homEOWner performing 2II the work Myself.
^r:crccc iC ".G.,1ce cf��;E:`il;c.,:f<;of cx Ol �C::f
• < r �for Co\'ffagE VEri(Ca.�Cr:cnC L.h2' f Lc
cc.r�Ec iEC:::EC l'nCcr Sc��cr.2:f,cf NCL i S2 car.k2C rQ Z!SC 1f���SitiGr CI C if 1fA� Fcf.<<,i�<or'6istnc o1:Lr.E c- up to S 1,5L''.C-0 znC"Cr cn_
)f2 _ L.--rL'�--En xE'.I cS C::d pprt21,• j❑ ! _ _
—day o; ,Crc� 19 91
Building Department
Licensing Board
Selectmens Office
Health Depamment
TO VERIFY COVERAGE It41FORMAT1011(l CALL: 617-727-4500 X403, 404, 405, 409, �7c,
-:BLE BUILD,G PEIMIT .'.'
dF�
. The Town of Barnstable
BAMSTABM
tee$ Department of Health Safety and Environmental Services
3� Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-775-3344 Building Commissioner
For office use only
Permit no.
Date -3
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT 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.
Type of Work: J-,�� ao�-9d° Est.Cost
Address of Work:
OlAmer Name: o ��-' cq lLA v-,l --
Date of Permit Application:
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under S1,000
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WTI'H 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:
( �f
Date Contractor name agistration No.
OR
Date Owner's name
. .
.... ::::::.:,:::: pA: 95
UD
DATE( / /YY)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Dowling & 0' Neil Insurance , ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Agency, Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
g y, ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
222 West Main St. PO BOX 1990 COMPANIES AFFORDING COVERAGE
Hyannis, MA 02601 COMPANY
ATravelers. Insurance Company
INSURED COMPANY
Anchor Design & Pool Inc . BInsurance Company of North America
143 Upper County Road
Dennisport, MA 02639 COMPANY
COMPANY
D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICYNUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MM/DD/YY) DATE(MM/DD/YY)
A GENERAL LIABILITY 660365KO042IND94 04/09/94 04/09/95 GENERALAGGREGATE $1 000 000
X COMMERCIALGENERAL LIABILITY PRODUCTS-COMP/OPAGG$1 OOO 000
CLAIMS MADE❑X OCCUR PERSONAL&ADV INJURY $500 000
—OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $5 0 O O O O
FIRE DAMAGE(Any one fire)$5O 000
M ED EXP(Any one person) $5 000
AUTOMOBILE LIABILITY
' `= •� ^'- � COMBINED SINGLE LIMIT $::.
ANYAUTO .
ALLOWNED'AUTOS.y '1 ' BODILY INJURY
SCHEDULEDAUTOS (Per person) $
x k, s _.
HIRED AUTOS BODILY INJURY
(PeraccidenQ $
NON-OWNEDAUTOS
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANYAUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
B WORKERS COMPENSATION AND C 4 0 815 2 OA 0 4 15 9 4 0 4 15 9 5 STATUTORY LIMITS
EMPLOYERS'LIABILITY EACH ACCIDENT $100 ...00.0•••..
THEPROPRT INCL DISEASE-POLICY LIMIT $500 OOO
PARTNERS/EIEXECUOR/TIVE
OFFICERSARE: EXCL DISEASE-EACH EMPLOYEE $Z00 000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
RE: Job for Ed Caldwell
Operations performed by the named insured as provided for by -the policies
and their conditions . I
SHOULD ANYOFTHEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Town of -Barnstable EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Town Hall .10_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAM EDTO THE LEFT.
Hyannis, MA 02601 BUT FAILURE TO MAIL SUCH NOTICE SHALL IM SE NO OBLI ION OR LIABILITY
OF ANY KIND UPON THE COMPANY AGENT EP ENTATIVES.
AUTHORIZED REPRESENTATIVE
...............................:............................:..................:..::::::::::.:.:::.::.::::.:::::::::.::.::::::::::::::::::;:::::::.:.......::::::::. :;:. ::.:.is .:: ;:.;;:. ::.:>.:....
:..::: .......... .:. a ..
::::::::::::::::.::::,:::::::::::::::.::::::::::::::::::::::::::..:....:..::.:..::::::::::::::.::::::::::::::::::.
CERTIFICATE OF INSURANCE
v
ill
l
7i,
GENERAL AGENT ISSUE DATE(MM/DDI,YY) I ` 1/ 4 j
Ag °' R e t-ts] '° jes
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
n E 71 l vc r ' r U NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND
u x t i d g e W. 01 5 v y EXTEND OR ALTER.THE COVERAGE AFFORDED BY THE POLICIES BELOW.
i% e as c.y COMPANY AFFORDING COVERAGE
AGENCY NO. v U Z
caaut1 iuS
INSURED
t11 - i Co j .n 'laa
15a center :)treaL �SIDE�N
Ya r : uuth o L NA
38 9 1'
te'-f3
Senn Mil hu38fts302
COVERAGES
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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 REDU'CED BY PAID CLAIMS.
POLICY EFFECTIVE POLICY EFFECTIVE
TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) ALL LIMITS IN THOUSANDS
GENERAL LIABILITY GENERAL AGGREGATE $
:J
GOMMERCIAL GENERAL LIABILITY r} PRODUCTS-COMP/OPS AGGREGATE $
:;; t)42I. 11 r 7 J EiI a CbX--
PROFESSIONAL LIABILITY END.
OTHER PERSONAL&ADVERTISING INJURY S
EACH OCCURRENCE $
i
FIRE DAMAGE(Any one Ore) E
('. MEDICAL EXPENSE(Any one person) S
EXCESS LIABILITY X EACH AGGREGATE
-5i OCCURRENCE
8 O HER THAN UMBRELLA FORM 'v. $ E
OTHER 1
F
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DESCRIPTION OF OPERATIONS/LOCATIONS/RESTRICTIONS/SPECIAL ITEMS
F
swjru"-, I,ny Poc_aI installation
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CERTIFICATE HOLDER CANCELLATION
tl C h.v a S l i t; ': Pool V O; �ry, SHOULD ANY OF THEIABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
I EXPIRA• I N DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO
14 3 t ' e r C t' :c u a d MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Den a t.)r is 'r°3/` c,i 2 6'3� LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
a, LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES.
it
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AUTHORIZED REPRESENTATIVE
Si
S 948 (1/92)
.. .. ....
.... ....... ...... .......................... ..........
.............
..................................
...........
. ...... ............. ..........
..... ...............
. . .. .. ..........
"T 1 F! A E
ISSUE DATE(MMIODNY)
MORS.'
.........
7/18/94
......... ",";,
.........................I F1
I.............11.........
........... ...................
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
PRESIDENTIAL ENTIAL INSI-ANCE AGENCY CONFERS NO RIGHTSiUPON THE CERTIFICATE HOLDER.THIS CERTIFICATE
DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
1368 FQUTE 134 POLICIES BELOW.
DRAWEF.-�K
EAST VENNIS MA 2641
COMPANIES AFFORDING COVERAGE
)
COMPANY
A
LETTER ROYAL INSURANCE COMPANY OF AMERICA
COMPANY
B
INSURED LETTER
MARK J. COLEMAN COMPANY c
154 CENTER STREET LETTER
YARMOUTHPORT MA 02675 COMPANY
D
LETTER
COMPANY
E
LETTER
. . .......
........... .... ...
si
s i
............ .................. .........
THIS JS 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*,,,!NSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO -Ji POLICYEFFECTIVE POLICY EXPIRATION
LTR ji TYPE OF IN!,URANCE POLICTNLIMBER DATE(MM/DD/YY) DbTE(MM/DDfYY) LIMITS
GENE14AL LIABILITY GENERAL AGGREGATE $
COMMERCIAL 1 NERAL LIABILITY PRODUCTS-COMP/OP AGG. $
CLAIMS tv,VDE OCCUR. f PERSONAL&ADV.INJURY
OWNER'S&CO-!1 RACTOR'S PROT. r. EACH OCCURRENCE $
�t FIRE DAMAGE(Any one fire) $
MED.EXPENSE(Anyoneperson) $
i AUTOMOBILE LIABILI-Y
COMBINED SINGLE $
ANY AUTO LIMIT
-%LL OWNED AU OS
BODILY INJURY
SCHEDULED At 10S I (Per person)
HIRED AUTOS
BODILY INJURY
NON-OWNED AUTOS (Per accident)
uARAGE LIABILI FY
PROPERTY DAMAGE $
EXCESS LIABILITY it EACH OCCURRENCE $
jMBREU_A FOF A AGGREGATE $
..........
............. ....
jTHER THAN UMBRELLA FORM
...........
A WORKER'S COIAPENSATION
AN' STATUTORY LIMITS
BUREAU FILE #109577R 7/07/94 ,p7/07/95 EACH ACCIDENT $ 100,060
l
DISEASE--POLICY LIMIT $ 500,o6o
EMPLOYERF UABILITY
DISEASE--EACH EMPLOYEE $ 100,000
OTH
DESCRIPTION OF OPERA, INS/LOCATIONSNEHICLES/SPECIAL ITEMS
SWIIIMING POOL ONSTRUCTION
.. ........ :x!
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVORsTO
ANCHOR DESIGN & Pr CORP.
MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TQTHE
143 UPPER COUNTY F)AD LEFT, BUT FAILURE TO' MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATIOWOR
DENNISPORT MA 0; ,19
LIABILITY OF ANY KIND:�UPON THE COMPA14Y, ITS AGENTS OR REPRESENTATIVES.
AUTkfORIZED REPRESENTATIVE
!tit ............
..........
TOWN OF BAR CTABLE
i
LOCATION a y S r on 12 f 5 Sp iyl2alsEWAGE # � /s
c
VILLAGE ����L ASSESSORS MAP LOT I?07Y`-` o o�
_ y
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(tVpe) � (iize))� fLS Dl�
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER 1B c� �i l 0 ` d
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:''
VARIANCE GRANTED: Yes No
e,
Assessor's map-and lot number .........� THE
�Qypf Tp�o
Sewage Permit number ....:
Z BARNSTADLE, i
House number ..............:I...................................................... ' rasa
�p 1639.
D OR a
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ........... ...... 1.rate.. ..c..... .Q......................................
TYPE OF CONSTRUCTION . Gx..1 QrJ ......( : . .
.....:. . ... .�.._.......a... ..19..
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit accor�dingg to the following information: `,
Location .................C�JU��U.n�e ��-` ......1.. .........................' ..... z................
r. . .. . ........................ - .
Proposed Use ............ .. ........ .......... ..:....................
Zoning District .......... �•...................................................:Fire District .... . ..
Name of Owner ...... C�.J�....es,'p. .......GCr.... .4�.?in—Address 3���.. (.�y�./? 5 ..... .:......................
Nameof Builder ................................Address ...................................................................................
Nam_e of Architect ..................................................................Address ....................................................................................
Number of Rooms ..................................................................Foundation .........�1Q ............:......................... .
Exterior .......... l�.......... .(.(..............................................Roofing ...... .........
Floors ............ .........................................Interior ....................................................................................
Heating ..................................................................................Plumbing ...........................................................................;......_
Fireplace ..................................................................................Approximate Cost ...... ...9.. .:.......................... ................
Definitive Plan Approved by Planning Board -------------------_-----------19________. Area ..........................
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
toC-"Z`�
L6
.Yo �iZ S 1F�o E' 02a
`U _
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 ........ . . .....
Construction Supervisor's License .. 4..f'r ..........
SOUZA, JOSEPH R.
No ... ... Permit for ...Buil.d...Shed...........
Accessory to Dwelling
..........................................................................
Location .....325 P2pp2onessett Road
.................................
Cotuit
............................................................ ..................
Owner ...... ......................
Type of Construction .....F.Tlame..........................
................................................................................
Plot ............................ Lot .................................
Permit Granted .....September. 2.5.........19 85
Date of,Inspection, ......0.............................19
Date Completed .............. ...19
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Assessor's mop and lot number ---...^�-',����'��--����_ �` /�
Sewage Permit number -./R&. - '
| �
[ '
House number -----------------------'` .
-
� r���l���77l�T �`�0� ��� � ��o7�T�Zr�� � �� ]� �7
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`
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. �
BUILDING
� NN 0 N �� N �� INSPECTOR
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�� �� � ���� � °� �� '
APPLICATION FOR PERMIT TO ---.. L/! __ r~&�..fr...... �./Y� ...................................... �
TYPE OF CONSTRUCTION .............................
-
.............. I-.�.�..-l��.u�.. �
y .
TO THE INSPECTOR OF BUILDINGS: ' |
The undersigned hereby applies for o permit according to the following information:
- �� �� / `�-
Locohon ------/-~�/f~t����7�'c7�� .�.�__~�:���.^^______,L'�T�(/�.�_ ............ ..... ,, . '
�
' Use ----��./ /l/r� !�� .�-.. -.--------..-_- ______-_.-------------
Proposed -' '_--/ __ --_-._� ..
' .
Zoning District .............. ---------------.Rre District ---( m �\1/-�'--.~-------.----..
�� � r�~ �
Name of Owner .�- --�� Address^-��U1��o_-� u:.1-! /%����.��-.,���.'-.---.-. �
'
None of Builder' ---------_------------..A66rex -----------------.------..--..
/ Name of Architect -----.---'----------'--'Ad6res ............ .......................................................................
` Number of Rooms ----------_-_-----------Foun6otion --'! /A,~L�1g - ........................................
. �
Exterior ---'�±�`/ --. ///---..---'-.~..^..—koo�ng _-� -----------------.�
,
Floors ____( .........................................Interior -'--------._- ..........................., . '
Heating --'.--------------' ------.--�F1u rbing/ i...�..........
-.. ..........................................................
Fireplace ---------.-----------------..Approximo/eCoo ..............Y`0�
...................... --
�
. �
Definitive Plan by Planning 800nJ l�-__- . Area -'�* ......................
. / Diagram of Lot and Building with Dimensions Fee ...... .���-------� |
*
` SUBJECT TO APPROVAL OF BOARD OF HEALTH �
\
�u �
� -�
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` �o ~ -
. `
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ~
^
| hereby agree to conform. to all the' Rules and Regulations of the Town of Barnstable regarding the above
construction.
`
Nome` -' ` -'= --''~
'
Construction Supervisor's Uoonse '/ /.P---
� .
s ' '
SOUZA, JOSEPH R. A=19-113
No 28466 permit for ,.,,Build Shed
Accessory to Dwelling
...............................................................................
Location .. 325 Popponessett Road
Cotuit
...............................................................................
Owner ...JoseP.h..Rr....Souza..............................
Type of Construction ..........FXA.Mg.....................
................................................................................
Plot ............................ Lot ................................
ti
Permit Granted ..,. September 25, 19 85
Date of Inspection ....................................19
Date Completed ......................................19
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TYPICAL BAR LAP DETAIL "`..'r.wr.,xrw4,"•r,...w. "'"
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SECTION17
TYPICAL PILASTER AT SKIMMER
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TYPICAL INTERNAL PILASTER
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