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Home My WebLink About0012 ROOSEVELT ROAD �t r Town of Barnstable *Permit# oXQ22Yo23 Expires- months from issue date • Regulatory Services Fee Gjd aaxntsM e. RMmass. I-T Thomas F. Geiler, Director c �, Building Division JUL _ 2 2007 Tom Perry, CBO,Building Commissioner V 0 Main Street Hyannis,MA 02601 o� aARWSTfjBL www.town.bamstable.ma.us Office: 508T2=403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL._ONLY Not Valid without Red X-Press Imprint Map/Parcel Number 039/130 Property Address 12 Roosevelt Rd.'Cotuit,MA 02635 ®Residential Value of Work $10,000.00 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Ralph and Terry Sneep 12 Roosevelt Rd. P.O.Box 642 Cotuit,MA 02635 Contractor's Name Lagadinos Building and Design Inc. Telephone Number 508-428-4097 Home 1�nprovement Contractor License#(if applicable) 104804 Construction Supervisor's License#(if applicable) 012653 ®Workman's Compensation Insurance Check one: I am a sole Proprietor am the Homeowner have Worker's Compensation insurance Insurance Company Name AIG Workman's Comp. Policy# 7483541 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles)All construction debris will be taken toCasella Waste Sandwich Re-roof(not stripping. Going over existing layers of roof) Re-side ® Replacement Windows.U-Value 0.33 (maximum.44) *Where required:Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. * * *N Pro rty w r must sign Property Owner Letter of Permission. o e Improvement License is required SIGNAT E Jun 27 07 02:31 p Terry 508-428-6215 p.1 Town of Barnstable RegWatory Services aASIL ThMM R.Geller,bbvdor $uil&ng DivWou Toms perry, Bmhdwg COMMiammer 200 Mzm S vet. Hyaams.MA 0260i Office: 509-962-4038 Fax: 548-790-6230 Property Comer Must Complete and Sign.This Section If Using A Builder r , as Ommez of the subj=T property hexebp=&aa za to aft cu my brlal j i3 all mat#ers relative to mark authnazed by this btuidmg pe ait apomtioa fq= !L eye r �OTUId,, 06 ar 3s' (Address of Job) . .sivntwe ofawner Date 1 The Commonwealth of Massachusetts 3 t Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumber's Applicant Information - Please Print Legibly Name (Business/Organization/Individual): 051444 =4 C Address: I 1 WI Lk1 Ld9Tlis City/State/Zip: (' )l► YVl I� d Sj�'_ Phone#:_ ,SO Q `�Are you an employer?Check the appropriate box: Type of project(required): 1.( I am a employer with - 4: ❑ I am a general contractor and I : 6 Q New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ P am a sole proprietor or partner- listed on the attached sheet.i 7. Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9, ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its. required.] ;officers have exercised their. 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of.exemption per MGL 11 Plumbing repairs or additions myself. [No workers'comp. C. 152;§1(4),and we have no 12.0 Roof repairs insurance required.]t employees. [No workers' n comp.:insurance required.]_ 13:❑Other •*Any.applicant that checks box#1 must also fill out the section below showing their workers'compensation pohc�!tnfotmation., , t Homeowners who submit this.afftdavit indicating they ate doing all work ind'then hire outside contractors must submit.a new affidavit indicating.such.. *Contractors that check this box must attached an additional shiet-showing the aatne of the sub-cotttractors and their workers'comp:policy information. I am an employer that is providing workers'compensation insurance for my employees. Below.is the policy and job site ,information: r., .. Insurance Company Name: e4[C(_(n 1�rrlM��j, / eb Policy#or Self-ins. Lic.#: eAExpiration Date: Job Site Address: - City/State/Zip: l`r�iil�:r `tlll- OLG3 C" ' Attach a copy of the workers' compensation policy declaration page(showing the policy number and expi`ration 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 S 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 S250.00 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 irlswance coverage verification. it tereb cer y un r th p ns and pen Ities of perjury that.the information provided above is true and correct. Sig*natur - Date: ; .Phone#: d q0f 7 Official itse only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License`# Issuing.Authority(circle one): I.Hoard'of Health 2. Building Department-3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6,Other Contact Person: Phone#• ✓6e �ammw�r.,csecr��ac�ivae� Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration; "104804 Board of Building Regulations and Standards Expiration 7-1'5l2008 One Ashburton Place Rm 1301 Boston,Ma.02108 Frivate Corporation LAGADINOS BUILD!ING&,DESI.GNINC Nicholas Lagadinov,`. _ 13 Thankful Lane Cotuit, MA 02635 -' ______ Deputy Administrator Not vali i ion signa ure � t t# ✓�te Va'/�/noozus Board of Building Regulations and Standards Construction Supervisor License ` License CS 12653 Birthdate 7/16/1954 Expiration 7/16/2009 Tr# 19610 Restrtcfion 00; , NICHOLAS A LAGADINOS 13 THANKFUL COTUIT,MA 02635 "" Commissioner 04/25/07 WED 11:06 FAX 1 .508 420 5406 LEONARD INSUTRANCE.AGENCY Q 002/002 .ACoR—P. CERTIFICATE OF LIABILITY INSURANCE DATE(MMID01YYYY) 04/25/ZO07 04/25/2007 PRODUCER (508)42s-6921 FAX (508)420-5406 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Leonard Insurance Agency Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 7 Wianno Avenue HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P 0 Box 494 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ostervil l e, MA 02655 INSURERS AFFORDING COVERAGE NAIC# INSURED Laga Ines Building & Design. Inc. INWRERA. National Grange Mutual Ins Co. 14788 13 Thankful Lane INSURER A: AIG XSBO09 Cotuit. MA 02635 INSURERc: INSURER D: INSURERS. COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDIN TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY MSB87460 01/01/2007 01/01/2008 EACH OCCURRENCE " S 1 oao.0o X1 CpMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED S 500,000 CLAIMS MADE OCCURPRPMIRF-R MED EXP(Any one person) $ 10,00 A PERSONAL&ADV INJURY 5 11000,000 GENERALAGGREGATE S 21000,000 GEN'LAG ATE LIMIT APPLIES: PRODUCTS-COMWOP AGO $ ' Z a00 000 LA AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY 6 SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY S NON-OWNED AUTOS (Par accldml) PROPEMYDAMAGE E (Per Se6ident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHERTHAN EA ACC S AUTO ONLY: AGO S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AOOREGATE $ S OEDUCT16LE 5 RETENTION S $ WORKERS CpMPENBATION AND WC8934499 01/02/2007 OVO2/2008 we qTU OTH. EMPLOYERS'LIABILITY WR B ANY RROPRIeBER/DARING IE ECUTIVE EL EACH ACCIDENT S 500,000 E.L.OISEA6E-EA EMPLOYE $ bIF PyyeeEssC,describe0 0 IAL PROYISIO1NS below EL DISEASE•POLICY LIMIT S 500,000 OTHER D G LP ION OF OPERATIONS I LOCATIONS F VEHICLES!EXCLUSIONS ADDED BY ENpORSEMENT F SPECIAL p♦ZOVISIONS ulfier on Cape Cod. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CEIMFIcATE HOMER NAMED TO THE LEFT, Town of Barnstable BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 200 Main St. OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Hyannis, MA 02601 AUTHORUEDREPRESENTATNE Stace Spear ACORD 25(2001108) FAX: (SOS)428-7709 VQACOkD CORPORATION 1989 2 sM_,...,.,,............ d,_,,...........,......• ._,, ,,.,.�,.•..•r.._.,..,..,.,r..,...,,.,,,,,,,,,,,,r„n..... .,.,_.,.,,..,..,.,�..................M...,..,r.., ,,,.,,,r,,,,.,,,., ir✓.' "Jr��';�jl�''rA:.r A /P„rl.r.... 7 r/ .,..Alt;,,. ,/r b t; A,l�it ✓ ,r/ ,•' I ts 1� $ 41 of ito oe 1 h ��,y �, ..✓;,.i(':'w"nY.LN----..-._........,....,,,,. A�._. .........................._�rnUnrm 7 qq i r , '�� .•, ^^n"�A----'— ...J� ---'��lamrum ,`i;;,r�w•.. n��i.v� K;�.,. '� � �, r (2 �••4,'��`i � � ram`'.`";,;,a;,r;' � �'�::',t��.:',�' r �,� /� t r"•ti q �/.y q�•,q. 6 y' 1�1 / A.'..f �/ �'':„f. ;.4.f..XLa'4.;(.(i'$ �/!,�,"�r;f.'l'(i rfrl/!,j{,rl .:^r y4.�:1 C) � �� •i i711.J/✓d!'�w'J &.. Y1 ,P •,9r �1,.� ./'e•,fr. ..� I Co. 1nA.1*1 Y .iCT'ttvE YORC �"'"' ,.,_---- •-- ---�, .,., ,.. ,,,..,.:11,,,...'::..,.:;,•..,.........•.•....; i. 346 LONG PONY) � CG G4"G,a -IEl"uO....Al,t/r. ! � G..,{•Jt�nrd'{ccJs'c - 1J.'':,M1 4l,{./A,.A.,%p n, �'I�,.y�r�l,/,•, t PLAN REFERENCE uf/ a I I , ''/,r'! .�'', .,on/�' 9 / �i l�{.• •Y M1 h�M1uYy"�'4/ r�:�.i.1/l.�'l• % r' r ?• a•. •�µ 4�.�3 'f�;>,5.,/)./�'�'�,,J•'•�;f'��".%'�i', a!'"• ` 'ry /"',j'.J.Y��t:� •ll,,r;4 p!� ,,1'.��.• f \sue!Sys y � C.7N 'Y'd- M 4�J1_AN { i LDC�;JED Gi^•7 'Yi• E C:'R r+ �;lc:;y 1.[''Y7<,I; 6; � AS SHOWN N H Zfk`.ON F,04D"fPirfi(y��'+, fey nl I y/r .t. S., , 5!V Y!'O' Ji'4J `l �4.f...i.a st "'4'l;�F,r " 7 q.l y:.' �'.r,,,I ! 2•• ;l " '.V" O F' "(' - lE " 9�� 5� /rye +I,, `) ,;r(�r{//, ',• 6 {'Q:)JirT l'•r1 (;>t'•' f I,l`'f' 1�'rl1,�„f„s Massachusetts { •.F.,l•l i.i.•I.I.Y I..J f.``{'%"�I,�,,.r,�J• ry 6al•rsY 4 .n'!S:•' •'1'Ari.TA ��,.•� f �r_ ' - . ,��'. � ...... off}- i'c <'� - -s` - 7S- Assessor's map and lot number .:,...,.�................. ....... Sewage Permit number ` .lJ ................ 6,7HE?��yn TOWN OF BARNSTABLE EAW ST"LL "6 9 BUILDING INSPECTOR OM a' APPLICATION FOR PERMIT TO COPS / A !� � T ��I`, �'�� 4 Us C i ..................... ........................................... ..... ...... TYPE OF CONSTRUCTION (,tJ n d I�) � aA. .................................................................. ..f •hf�.e?i'....3 ........19....J. TO THE INSPECTOR OF BUILDINGS: ; 41- I_ Thg undersigned hereby applies for a permit according to the following information: Location4..OT r 6 C7 S t �� / A a ( l �l'l /• ••............... ._ ........................................... ../.............,. . ....�.....`.../.. _ ................. Proposed Use .....rl.!��.r.1. '.........!...: ...!.. ..... /•L;li'//l/.. ?... ....................................................... T� i-� / T Zoning District `�` 1..................................................Fire District ... U.,! 11 / Name of Owner .r.,!p,j i,i.n.YH.... ..... i9C, �1 . 12:....Address ... ;...1��!�.../ 'l J`�l,n►A� :......i.. ,.. Nameof Builder .................:..................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .......:..........................................................Foundation ................. .......,......,. Exlerior .. !1 � .;'Tr ..--' ..� _' !.........................Roofing ...... � ... /] �.... .......I. ...V............................................. v Floors ?J4. +.:,..................................................................Interior .....r�........... rA—r^--,k (�- .t. .................................. Heating r/., 1` f k)...................................Plumbing Fireplace ..:� ..1........................................... .........Approximate Cost .`.. ... f7t�!/.. .. Definitive Plan Approved by Planning Board _____4= _________19 7 . Area Diagram of Lot and Building with Dimensions Fee .................... .4........�................ SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .....! r............. .................................. r t . Dacey, William E. r. , A=39-130 17927 one story Permit for Not................ ......................... .......... c • single family dwelling ........................................................... Roosevelt Road Location . .. .......................................................... Cotuit.................... . ............... Owner ...........William E. Dace , Jr. ............................... frame Type of Construction ........................................... .................................................. ........................... Plot ............................ Lot ..........28............ Permit Granted .......Sept ber 5 19 75 Date of Inspection .......... .........................19 Date Completed ......... .............................19 PER IT REFUSED .......................... ................................. 19 ........................ ..................................................... ) � 7 & @ t-n-F Approved ................................................ 19 ............................................................................... ............................................................................... As ssor's map and lot number / s ....:......i' of C 4V — 7s SEPTIC SYgT �. !J °y INSTALLED IN t�l IW dST.13E Sewa a Permit number :5......................... � 1.A�4:C`E. . 9 ..... WITH A TICI E t i STATE SANITARY C. THE?C TOWN OF B A R T1TaL ` ' " y�F 13ARNSTAI1LE, i "6 9 am BUILDING INSPECTOR. ' � AY a' fAPPLICATION FOR PERMIT TO ......\ .4C./Y4?...1/.K.. .�:...1:.... . ....!..'..�: cl ................ TYPEOF CONSTRUCTION ............. ....... ��. .�x.✓-7............................. ...:..........:..........:............ TO THE INSPECTOR OF BUILDINGS: , The undersigned hereby applies for permit according to the following information: �s� / Location ko..1.......,?O.:; .......1.094..e..U.6).T... o-a 4J........ .f ./...J....y. ................. Proposed Use ..... 'l.n�.G..�.IG'.... ..et.... .�...[... ..... . ��/� ..�... ........:...... ................................... Zoning District ............®........................................................Fire District ...eq../.6..c.7.................................................. a.l(..�. C � . : . Address .. / ` j J Name of Owner y. d. ...V�I.:. / j. .t�. :...../!!.�A .f.: l/ Fj Nameof Builder ....................................................................Address ...................................................................................... it Nameof Architect.....:.............:...............................................Address ...............................................:..................................... Number of Rooms ..... ..........................................................Foundation ../0......... ... . Exterior .. .. ......` �/:•"�•^.... . . Roofing ..... ...: ... ... Q.................................................................:..Interior ....�......... ............ ..... . . Floors �.lJ�l?r ........................:....... Heating . . ............ ....................................Plumbing ....:...........::. .. ........ ............................................... Fireplace .V1--1 -..I........................................... Approximate Cost �S�.tflfJ(Jv............ �6V0.......`...... Definitive Plan Approved by Planning Board _______ 1_�___1--o_________19 __ Area .... '. � Diagram of Lot and Building with Dimensions Fee �- SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam ................. Dacey, William E. Jr. 1 k N ...17927... Permit for ......one story, sin le famil dwelling Location 12 Roosevelt Road ................................................................ Cotuit ............................................................................... Owner .....Wi.l.l.iam...E.....D.a.ceY.�. Jr.................. . . ...... .. .. .... ....� ` } Type'of Construction ........frame 617 28S Plot ...t....................... Lot ................................ ail' t Permit Granted September .. 19 75 � , 07�.. ` Date of Inspection ........ Date Completed .10..�l.�....5 19 y4 PERMIT REFUSED :f .. ........................................................... 19 r^............................................................................... +` V^ + ............................................... ........................... ' '............................................................................ ................................................................ 6+ Approved ................................................ 19 ............................................................................... ,� pA 7j- SS1J 0 97 7,, R' min .5 'T��OMAaS E. �,:&'sL•LEY CO. t'i��%S�3%.X7R /��'n.(rE?�l� � 20,0C,0 A (;.fl,, LAND SURVEYORS �.•n n.:a'n4w,n. m�„�,,, CERTIFIED PLOT PLAN 346 LONG POND DRIVE SOUTH YAl4�vYO3YiH, MASS. LOCATION SCALE ., 'E rpI1 y. DATE '�:r(�., �n ¢ .,, ,••/9'�. �g�lh.,d4„y ✓� 11i MA tl I,L, �„a�. ,!fb✓i.��. 1, �'•••" �'�•,.q1 PLAN /p�psi �q ry��?�•p�^ram,rye•�pn p g�•• 'j �p� �,^•�•5� fi'"P P•q.l'9 B'L S:.Y"ERENC14. •.fie•wp J� �^^•'^.i. dHOl�•f(�.+� A Land. y��,�,7}} Court. urt '{ g ,,f�f��[��{'� ,,;{ q,' � .&.w ild. .1/WeW+a.•5,�Y• rL'�e0. e..• /l"'✓:"�°�`✓8 •6R cA�V,;(.md, I CERTIFY THAT THE %,,OWN L^J ';� PQ ON T'a41.°�,'r f'l.AN IS LOCATED ON THE Cit'Tan1,JNDI 1 AS SHOWN HEREON AND THAT IT CONFORMS To 570 6�e MainStreet �s� `,: WS' of THE TOWN OF DATE. 25 X . BEG. AN4� aU&��/�1OFt q,•.