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0131 SANDALWOOD DRIVE
0 r ~71z ! THE Town of Barnstable *Permit -lb- )a G Expires 6 months from issue date Regulatory Servi -0 Fee * snxxsrnBLE, « NAM A`0� Richard V.Scali,Director Foy Building Divisit � JuZ1 9 201 Tom Perry,CBO,Building Com issione"�/ j 6 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY e ,p , l Not Valid without Red X-Press Imprint Map/parcel Number jU J I' N Property Address 131 1-5'1 NQA l 1d yyj9 P lei dt 60 L' ✓t Residential Value of Work$ *(10` `°0 Minimum fee of$35.00 for work under$6000.00 'Owner s Name&Address /ort z;t 5'(1410 fl e 1 / 3/ J'4"Ott wav>1 P11 l'��t//� /14 ®2l0 3 5' Contractor's Name je11,11 6¢M UM S'le/ L',qY°ZZ° /�d�dte rnTelephone Number sit G V94y�y/ Home Improvement Contractor License#(if applicable) /d 0'ya Email: Construction Supervisor's License#(if applicable) C1 S 0 G / o l l gorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ �&m the Homeowner Whave Worker's Compensation Insurance �+ Insurance Company Name A ti G L1,4 9 D nzds` ` o,*y4Aj Y Workman's Comp.Policy# a W C.5;, V! A 0 6 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) h/Replacement e-side Windows/doors/sliders.U-Value d, 2� (maximum.32)#of windows C-If P Ir L/J-/.(.e_S 0#of doors: 74111v Povpo, eosi'Ll4L j lt<evl ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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 copy of the Home Improve nt Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\Decollik\App ta\Local\Microsofl\Windows\Temporary Internet Files\Content.Outlook\2PIOIDHR\EXPRESS.doc Revised 040215 4 Page 7 of 7 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I/WE, M&VC�pi S J lc et4 OWN THE PROPERTY LOCATED AT C 1N MASSACHUSETTS. -71-7 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: ► OWNER'S ADDRESS: OWNER'S TELEPHONE: 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: a � r%/re.;�•a.urrirenrrte�rll/r c�o:(la.�.t�rc� Massachusetts Department of Public Safety5` Ice of Consumer Affairs&Business Regulation Board"Of Building Regulations and Standards License: CS-064817 'OME IMPROVEMENT CONTRACTOR Construction Supervisor - =/> Registration: 100740 Typ ` - Ex iration:. p 6/23/2018 � .Supplemen JOHN T STRUMSKI CAPIZZI HOME IMPROVEMENT,INC. 18 ALDEN AVE BUZZARDS BAY MA 02532 ; JOHN STRUMSKI 1645 Newton Rd.- 4 l'ti • Cotuit, MA 02635 Undersecretary Expiration: _ coommifnmi ssioner 06/.1812018: itr9C`md-Buil&mgs of any use group which La less flm 35,000 cubic feet(991n?)o 3ed space. to,possess a curren'c edition oft he hUssachuseifs ul lding Code is cause for revocation of this license. Licensing lnformationWert: Ufww.Mass.Covj0PS License or registration valid for individual use only before the expiration date: If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 - Boston,MA 02116 Notvalid without signature De Commonwealth of Massachusetts v Department of lndustrialAccidents a 1 Congress Street,Suite 100 Boston,PM 02114 2017 www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/PIumbers. TO BE FILED WITHTHEPERIOTP INGAUTHORHY ApplicantInformation Please Print Lesiib�I Name(Business/organization/Individual):CAPIZZI HOME IMPROVEMENT INC Address:1645 NEWTOWN ROAD City/State/Zip:COTUIT,MA 02635 Phone#:508 428-9518 Are you an employer?Checkthe appropriate boa: Type of project(required): 1. JQ I am a employer with 40 employees(fulland/or par tune). 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $. F1 Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition IM I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10[]Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.F]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q of rep airs These sub-contractors have employees and have workers'comp.insurance.t 6.Qwe area corporation and its officers have exercised their right of exemption per MOL c. 14' 152,§1(4),and we have no employees.[No worlors comp.insurance required.] *Any applicant that checks box 01 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. Ifthe sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation lnsurance,for my employees. Below is the poly and job site information. Insurance Company Name:AmGUARD INSURANCE COMPANY Policy#or Self ins.Lic.#:R2WC527200 Expiration Date.12125/2016 Job Site Address: '3 <SAM)+ i R1002 ��• City/State/Zip: L Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by 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.A copy ofthis statement may be forwarded to the Office of Investigations ofthe DIA for insurance coverage verification. I do hereby certify t e poi and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#'508 -9518 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#: AC40 CERTIFICATE OF LIABILITY INSURANCEF12/29/2015°A�`MM'°°"Yn'' 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 endorsemen s). PRODUCER CONTACT NAME: ROGERS &GRAY INSURANCE AGENCY, INC. PHONE FAX FNo 434 Route 134 EMAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# South Dennis MA 02660 INSURERA: AfnGUARD Insurance_Company 2390 INSURED INSURER B: CAPIZZI HOME IMPROVEMENT INC wsuRERc: 1645 NEWTOWN ROAD INSURERD: INSURER E: COTUIT MA 02635 INSURERF: COVERAGES CERTIFICATE NUMBER: 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. tLTRR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF MMIDD EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS-MADE "OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE, $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY1-1 PROJEC- LOC - $ AUTOMOBILE LIABILITY COMBINED UrW6Tff_Lr0= Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED P Y(Y INJ URY accident) $ AUTOS AUTOS ) HIREDAUTOS NON-OWNED SWNED Perraoad nOAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC STATU- OR", EMPLOYERS LIABILITY YIN R2WC655250 12/25/2015 12/25/2016 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $ 1,000,000 If yes, scribe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS]VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION Town Of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hyannis, MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORRED C 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD adc���sl of THE r Town of Barnstable *Permit# 0 Expires 6 months from issue date Regulatory Services Fee . HARNSTO MAW $` z Thomas F. Geiler,Director VY .erED Mpy A rw, (� � � Building Division OCT 2 3200S, Tom Perry,CBO, Building Commissioner �Y ro V/lV ®'�z 200 Main Street,Hyannis,MA 02601 gA www.town.barnstable.ma.us Office: 508-862-4038 LE Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid wit/tout Red X-Press Imprint Map/parcel Number J Property Address 131 i! ,2 d 4 L4 IN CCU� i2 G i C� c P-t esidential Value of Work C]�iJ Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �14/C '(4 S e j,L f b Contractor's Name /-17--w poo �7L`}^��j�rjCGG Telephone Number " Home Improvement Contractor License#(if applicable) 7 5 Construction Supervisor's License#(if applicable) ��j ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑yam the Homeowner 2 I have Worker's Compensation Insurance Insurance Company Name p C-T iK } le C J_ I- Workman's Comp.Policy# tj C .Copy of Insurance Compliance Certificate must be on file. 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 Replacement Windo s/doors/ iders.U-Value (maximum.44) *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 the Hofr►provement Contractors License is required. SIGNATURE: � 1 C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\MY7NB4IL\EXPRESS.doc Revised 100608 jE �..__. 7 37, 1rS S I T E?i'il `iCcLa .� y _! \C.> ` , t !.. ER 7 M �2 5° t^JR Dr kE..-!REI�1_N M O'r r�;F:,JC&,C' Aif CDI >x OF L'T�, G r�- .u i i_ ^_._�..LL....A..: d ..ONJI,.^a,,_F F°kT WH 7-4E IKSURaN':J ;.tC In H'- t B ci: n- _ I -:.? •- FOLi0.° .A@3k cGr'cLlfilrT^_ .-- aGLL - N '!.4-��a .:175 !_ra r r —_ ( I 'TP I1 r. C;,' 8S8=S?�' '2/":i/Cvv8 1 f—c rEtc &Nll h — — -- Z `.'O C VA i I u { I _a I EHCESSP-n,-EL4TL�.cILm Cil �i81S'8 12i31jZDO2 12 31itC�D=' l -L.� ' 5_Q`0,C•J�1 f I A'. r. L EC Iu E,LL S SET,- n�_w T. i_-0,DDi} �. .. l4C8 51O1;ZODG N'ORKERSCCISF NSPTONAND _a...•i �E,�, SOG,OJOi EMPLtiYEx'L'ABi,Ti r ..._ E - JUG IA T m�9 E t U ti t SCD,>1CCl D IHER UES. FTION CF GF'E�LT.DNS:iDf-i;T101J5IVEHCLES)E%CWSICWS.NDDEL B\ Sfn5[41 NT15P-CIpL PROV15I0r:P• { i-1 ATl4N - ��+�II,CIS-!aT V LIIJLD,NY OF THE AL+`/E DEF"RIS`-D F'U�-G25 3F:CAN"=1,LFC PEFORE THE W Egpjk--4�:t_N GATE THEFEDF 7H 1 1 1- INE F '' EN V P Tr:"L -- 11 DAIS YJRt-tEN 4CTICE 0 HE ER:fIC T I Di-cF .y CD TO�!E'- 2�!=alLlf2E'0 NnIL U_H Nu'CE SHA...tst Ja P+C DSLMAT•.N,,R..'ACILrtt ` I- DF Wti k:NO iIFGN THE!I'iiURa:F.,ItS nu-:J.TS_R REPPESE?1TAT'Ii-cS—_--�:_; _ II,4:THO�aEPRE4E�'?TVE Timothy25 >,• , FAX: (oi?j838-3D9n 1 I � ��ie�ammriuueaLCf a� �i!aadac�i��aee� Board of Building Regulations and Standards License or registration valid for individul use.ott'y. - __ HOME IMPROVEMENT CONTRACTOR before the expiration date. Iffound return t ,. Registration .146589 Board of Building Regulations and Standards ` _ Expiration "5/5/2011 One Ashburton Place Rm 1301 Tppe Supplement Card So is t Jfa..02108 NEWPRO OPERATING LLC TOM PEACOCK 26 CEDAR ST. f t WOBURN',MA 01801 :1dmi6isti,itor fi '' :::utva]... ithoutsigr:iurc . �# z �saissuuwo� - EGLZtTVV'I�kNQ7�S i'i i e9stsale suis�� gr#o pnio 4=i Eger � L 7� 7 7-l 2,- !T, _I 711 Z��, j _L1 am- n 7- Addr--Ssz: 7 D City/State/'Lilp. 7 Are you sn ern-o]Dyzar? Chzck-the Epproprizile box- Type of P r oje c i (n 9 12,1 r ie • am a qimeral co•ntractOr and'.1 bave 61. Coristru L.' 1. 1 am a e-finployer with employees�'fiull and/or part-Cime).* hired the sub-contractors listed on 7. RemodehnQr t attached sheet.he o 2. 1 am a solle proprietor or paartnership ThcEe suib-contractorsl ive Dennolitio. g� . employees and have workers' comp. 9., ED Building addition and have no employees working BUIE m + e in any capacity. [No work insurance. u. Electrical repairs or adiditio comp insurance required.] 5.17 We are a corporation and its I-. -Plumbing repair"Oradditic officers have exercised their right of 3. T am a homeowner doifta all work exemption perlWIGL c. 1152 § (4),and 12. Roof repairs -myself. [No workers' comp. mehivi-,n6e,�,nployees. [No workel3 13. E] Other insurance required 1.] t comp.insurance re,I quired.] "Any applicant that checks box#1 must also fill out the section below showing their workers' compensation policy information. -i Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affiddvit indicating such. +.Contractors that check this box must attach an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation i?jsurance for rny employees.Below is the policy and job site information. Insurance Company Name: kc— Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address, a City/Stte/zip: Attach a copy of the workers';compensation policy declaration page(showing the policy nuinber 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/al one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up tci$250.00 a day against the violator.Be advis that a copy of this statement may be-forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c L under th,pans a pe, ties of perjury that the information provided above is true and correct. Si gnature: Date Phone#. Official use only.Do not write in this area, to be completed b 'city or town ojP)7cial. City or Town: Perm t/LicenZe# Issuing Authority(circle one): nbmg Enspector 1.Board of Hea.1th 2.Building De�artmen.-1. 3.City/Town Clerk 4.Electrical Hnspecto. 5.Plul; 6.Other Contact Person: Phone 10-19-`09 15,09 FROM-Newpro-UlheelingAve 1-781-932-0860 T-056 P002/002 F-176 • ,�.�.��YII'�„/\may R,'tVeN,,J _ , uuu,u. ,u+r ev e.vs-a.,e..+ �( °- CT Reg#0605216 57627 RI Reg#26463 Wi'rJ**i Si ft end More Corporate Headquarters,26 Cedar St,Woburn,MA,(P)800-342-2211(F)781-933-9626,www.nawpro.com 1' THIS CONTRACT MADE THE day of v L4, 20 ®4 between 6- rl (Home Owners) (Home hone) (Bus/Cel one) tot I n � . of 1 9,C."JI40 WOT) L,�- AA 0a &*_Z-I (Address) (City) e (state) (zip) the"Owner"and NEWPRO Operating, LLC,"NEWPRO"- ❑ The job address is a condominium. NEWPRO hereby agrees that it will for the consideration hereinafter mentioned,furnish all labor and material necessary to install the following described work at the premises located at (Job Address E-Mall for proprietary use only TOTAL Additional Model TOTAL Windows Purchased NEWPRO Work Number .0ty CASH 0 Window Color In: Out: Slidinq Glass Door PRICE Capping Color Steel Security Door Ooor oior In: ut: DEPOSIT _ Model Name Model Numbers Oty Sidelites Fe. jiv)MLWITH Ll 6)tC)(;;I " Double Hung New Construction Unit ORDER Picture Window torm Door BALANCE Casement Obscure Glass TOP BOTTOM DUE AT . ��O 2 Lite/3 Lite Slider Screens HALF FULL INSTALL Bay I Bow Frame Please Initial: Roof.- ❑ Soffit: ❑ Customer understands that NEWPRO®does not CASH �0 Garden Window do any painting or staining. (e:when removing Balance paid to inswier at Instwatlon Awning or replacing interior stops or trim) Hopper NEWPROS is not responsible for conditions or Shaped circumstances beyond its control including con, INgN Other densation resulting from or due to pre-existing Bank completion form signed at installation GRIDS Colonial SOL Euro 1congitions. DESC IBE WORK: 6f of- d4AM 32 C& alleo Fst,Start Date:�Vjao O Customer understands this is an"estimated date" Est. Comp.Date: U Pn,.. Initials Vcustomer understands all steel security doors will have a 3/4"aluminum threshold installed over existing hreshold. It shall be the obligation of NEWPRO to obtain any and all permits necessary under this agreement,as the Owner's Agent. The Owners who secure their own construction-related permits,or deal with unregistered Contractors will be excluded from the guaranty fund provisions of MGLC,142A, All Home Improvement Contractors and Subcontractors shall be registered by the Director and any inquiries about a Contractor or Subcontractor relating to a registration should be directed to: Director,Home Improvement Contractor Registration,One Ashburton PI,Room 1301,Boston,MA 02108,(617)727-8598. If the Owner Is obtaining financing by way of a Retail Installment Sales Agreement,such Agreement shall include a time schedule of payments to be made under said contract and the amount of each payment stated in dollars,in all finance charges. The Retail Installment Sales Agreement shall be incorporated herein by reference. If the Owner is obtaining a revolving credit line to pay,in whole or in part,for the contract amount herein,the terms of the revolving line of credit including interest rate and payment terms,shall be clearly set out on the credit application. The portion of the credit application referencing a time schedule of payment,to be made under this contract,and the amount of each payment stated in dollars,including all finance charges,shall be incorporated herein by reference. NEWPRO represents that it carries Workmen's Compensation and Public Liability Insurance in the amount of$100,000-$300,000. If the Owner refuses to permit NEWPRO to proceed with the work herein,or in the event of any breach of the Owner of this agreement,for any reason whatsoever shall cause the owner to pay NEWPRO a sum of money equal to thirty-three and one-third percent of the price agreed to be paid,as fixed, liquidated and ascertained damages,and not as a penalty,without further proof of loss or damage. NEWPRO shall not be held liable in damages for delays in the performance of this contract due to causes beyond its reasonable control. Owner warrants that he is the owner of the property on which the work is to be performed or that he is otherwise authorized on behalf of the owners to enter into this agreement. This contract represents the entire agreement between Owner and NEWPRO and cannot be changed except in writing signed by both the Owner and NEWPRO. You are entitled to a copy of the Contract at the time you sign, Keep it to protect your legal rights. We,the aforesaid owners, certify that immediately after the signing of the aforesaid agreement,a copy was furnished to us. You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller,which may be his main office, or branch thereof, provided you notify seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. (Saturday is a legal business day). See the attached notice of cancellation form for an explanation of this right. - - ,- Pal Whe owner has seen"sample"warranties that will be provided by NEWPRO upon installation. Sample warranties rovided t ^� DO NOT SIGN THIS_CONTRA IF _HERE,ARE ANY BLA_ K SPACES. . _ p � p opOwnsr. IN WITNESS WHEREOF,the parties have hereunto signed their names this day Of 20 '9 EINit Signed Marketing Representat/P4' ,. ame Owner Accepted: NEWPRO O LLC By 4i' Signed _-- Owner CORPORATE OFFff SHREWSBURY BRANCH OFFICE WARWICK BRANCH OFFICE 26 Cedar St 151.153 Memorial Drive Business Pk 24 Minnesota Ave Woburn,MA 01801 Suite B-C Warwick.RI 02888 (P)800-242-9974(From NE) Shrewsbury,MA 01545 (P)800-356-3312(From NE) (F)781-933-0717 (P)800.456-0555(From NE) (F)401-732-1371 (F)508-842-9248 WHITE: Branch Copy YELLOW: Customer's Copy PINK: File Copy GOLD: Finance Copy us-is R0508 1' aF ZrIF.rah Town of Barnstable *Permit#, L 6d6Vq� S Expires 6 trionth8from issu a[ Regulatory Services . Fee . anxxsraar�; Thomas F. Geiler, Director Y MASS m Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.to wn,b arnstab l e.ma,us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid withoia Red X-Press Imprint Map/parcel Number 0 (o 0 tom( Property Addressv2>A XResidential Value of Work E)& Minimum fee of$25.00 for work under $6000.00 Owner's Name&Address CI- Contractor's Name _Telephone Number C �6- tS["�6 Home Improvement Contractor License# (if applicable) 0-� Hc) _ Nworkman's Compensation Insurance Check one: ❑ I am a sole proprietor - E PERMIT ❑ I am the Homeowner I have Worker's Compensation Insurance SEP _ 8 2008 Insurance Company Name 0Q M -rtl%lntoi OF QR�ISTA6i — I ��—B «� Workman's Comp. Policy#� Copy of Insurance Compliance Certificate must be- on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) .All construction debris will be taken to ❑ Re-roof(not stripping. .Going over existing layers of roof) Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum..44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e. Historic,,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: (1\U✓PFii FC\F(1R A�f CIh ;ti;-,o.,F,-,-..;t fn rm c\FYPR FCC rinr The Cornrnonwealfh cf Massacftusetfs Department of Indr�sfrial Ac_ri.deicts Office of rnvesfiga-ions 600 ff"ayhingtori Street Bostorx, AIM 02111 www.rnass.gov/di-a Workers' Compensation Xnsnrance Affida-rit: Build el-s/ContractorS1ElectTic).ansfrIumbers Applicant Information Please Print LeeiUly Name usincss/ izaiionllndi� ----------------.-.-- City/��tatelLip c7 - - Axe you a.n employer? Cherk the a.ppr-opriatc bl:lr: ---.----- ------- Typc of project(required): `] I am a crnploycr�vitli - ..._ `l- F] l am a general rontractorand I 0. - Ilrw r..otlstrucfinr.� employees (full and/or part-titnc). liavc nixed dic. svb-cnnt actors 2.❑ Zama-sole proprietor or partiicr- listrti on t3ae a:ctached sher..t '1. Rcmodrling ship and have no empinycrs l llcse sub-contractors have g, ��llcn�ol.iUpn rmployecs and havr. vTDr)::c;rs' working ftY m -i a r e bny capacity: 9. [�Btuldm9 addition. [No worictn' utmli. in to ancc cnrrrp•insu.tancc.$ Cgitirr�] 5. N azn a corporation a.nd.ita 1.0.❑ E-1-fiical rcpaa.rs or r add t;r �-� VC 3.❑ I am a bomcoa ncr doing all wnrk officers bavc cxcrciscd their 11.❑Plmxbing repairs oi: uzysclf [No workers' rnnnir_ ri tit of exetnpl.ion per M.(_TL 17 Roof repairs insnr�.ncr r.e timci t r.. 152, §1(4), and we have na q' ] cmployecs. [No workers' 13.[_] Ot}�rr — ----___._-- corxp_msurancr rcqu.irr ] -- — — ---------_...------,---- 'Any applicant tha.t C11.';:tS bDx.i(1.InUt a150 rill DUt the zmti l be w shc)wh-kg thCiT wm-ka3,cDrr pauzzEDn policy infM-n2ticM. �)��� f 1'IO"i=wnaS who sublrnt this HTd3lrit i-n6c- iAg f)JCy l M--dDing a woi :Tad thm 1TiTC D11t_66c can trEz oTs nnist rubTTit Rncw zffi ivitindidting r:tich. ?Colitraeta s tli.at tll k Phis box rrnist a.tfachtd an additiDrx.]chctt showing the nanw Df the svb-cantmArirs and stair_whctha Dr not tilD<<rnli$cs have aTyloycrs. if the sub-crjnhr,tare have an4)loyr_^s,they must Mz%r d,their wen i:cs'c mj3_poficy ntnnbcr_— ----- --_ — ram aft emplaycr that is prciridin.g work.er.s'rompers catinn Fn.crrrancc,for irry errepin}Jer_,c R'elatTJ is(Ile pori.ry and jor in farm alion h.,mr, ancc CourYany I irafion Dale: j.t __-_ _ Policy#or Srl.f--ins.Lic_#:�C, �,-�1� ------__._.._..-------_--.__--. City/5 - Job Sitc Address: _``= `` z----._....---------"-- �—� Attach a copy of the workers' compensation policy detIaradon page(shoving the policy nninber and erpira.ti.ou dal. Failure to secure coverage as required undo Sectson 2 5A of MGI.,C. 1.52 can lead to the istposition of criminal pena_ltirs o: Eno tip to S 1,S00.00 and/or one-ycaz imprisonment, as well as c!viiI penalties in thr form of a STOP WORK ORDER anti a of to$250.00 a day against the violator. Be advised that a copy of this statrrnctit may be forwarded to the Office of Inyestig&tians of the D A_for ianu ncc coverage ycziHcation._ __ - —--- Ida,hereby certify ander the pelns-id pen ry that the informaticri provided ribove a true and correct_ "4i abircl Date;-----------------—-- O jidal use only. Do not write in this area, eb be compt�Ced by city or town o�r[H City or Town: — Permit/Lieense# —_____ — Isstdng Authority (circle one): 1. Board of Health ?.Puilding Department 3. CityffoF rm C9erk 4.Electrical ILlspector S. PItz.mbing Inspeefor 6. Othe.r --------- ---- Board o ui �n t laans and g tan ards One Ashburton Place - Room 1301 4~ Boston, Massachusetts 02108 Construction'Supervisor License License CS: 57032 Restriction: 00 Birthdate: 9/26/1963 Expiration: 9/26/2009 Tr# 3801 THOMAS X CAPIZZI JR ---_...__.__..__..---.___.------- 1645 NEWTOWN RD COTU IT, MA 02635 Update Address and return card. 1llark reason for change Address Renewal lost Card oPs-Cnt Co :iOM-OSl06-PC8490 � Board of It Iding Regutatiud.:urd Standards, Construction Supervisor License License. CS W032 Y Birthdate: t1/:(;/1963 Expuafton: 9/26/200g Tr# 3Fi01 1 ' Restriction: 00 'I FIOMAS x CAPIZZf 1641iNl--WTOWN RE). CC)I I)ff, MA'2635 Commissioner !per ✓Xe (r-o�ir-�iuouuenll�i o� lZawtcc�aiae/lr 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: 100740 Board of Building Regulations and Standards Expiration: 6/23/2010 Tr# 267955 One Ashburton Place Rm 1.301 Type: Private Corporation Boston, Ma. 02108 CAPIZZI HOME IMPROVEMENT, INC. _ Thomas'Capizzi,jr. 1645 Newton Rd. � Cotuit, MA 02635 Administrator Not valid without signature Client#:47298 CAPIHOM A60RU. CERTIFICATE OF LIABILITY INSURANCE 06112/2008 Y' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers&Gray Ins.-So.Dennis ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 434 Route 134 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O.Box 1601 South Dennis,MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: NGM Insurance Company Capizzi Home Improvement, Inc. INSURERB: American Home Assurance Capizzi Enterprises, Inc. INSURER C: 1645 Newtown Road INSURER D: Cotult,MA 02635 INSURER E: 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. NSRDDPOLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE EFFECTIVE DATE MM/DD/YY A I GENERAL LIABILITY MPB1075H 06/08/08 06/08/09 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE ( RENTED PREMISES S ocgu $500 000 CLAIMS MADE 17X OCCUR MED EXP(Any one person) $10 000 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY PRO- JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO - (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESS/UMBRELLA LIABILITY CUB1076H 06/08/08 06/08/09 EACH OCCURRENCE s5,000,000 X OCCUR CLAIMS MADE AGGREGATE $5 000 000 DEDUCTIBLE - $ X RETENTION $10000 $ B WORKERS COMPENSATION AND WC6716562 - 12/25/07 12/25/08 X TWC STLIMATT• OER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT s500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE - OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE s500,000 If yes,describe under SPECIAL PROVISIONS below I E.L.DISEASE-POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Carpentry CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 n DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis, MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001108)1 of 2 #S36540/M36539 KW 0 ACORD CORPORATION 1988 ' Page 7 of 7 CAPIZZI HOME IMPROVEMENT INC. SPECIFICATIONS AND ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, OWN THE PROPERTY LOCATED AT IN , MASSACHUSETTS. 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: �" C3-" OWNER'S ADDRESS: OWNER'S TELEPHONE: 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� 1"Elm Town of Barnstable *Permit# �"Cj jsf 2 BARNSTABLE : Expires 6 mouths from issue date y MASS. Regulatory Services �t p o $iOrEo ;�a'� Thomas F.Geiler,Director Qe • Building Division f r Tom Perry, ]Building Commissioner � l Office: 508-862-4038 200 Main Street, Hyannis,MA 02601 ]'Qw 2005 Fax: 508-790-6230 IV OF 8ARNS7AS ,EXPRESS PERMIT APPLICATION LE Not Valid witlioutRed X-Press bnpErcnt SIDENTYAi, ONLY Map/parcel Number o Property Address Residential Value of Work {{�) UV� Minimum fee of$25.00 for Owner's Name&Address work under$6000.00 Contractor's Name l / j Telephone Number —9 Home Improvement Contractor License#(if applicable) D D _______j vConstruction Supervisor's License#(if applicable) workman's Compensation Insurance Check one: ❑ I am a sole proprietor ■ I am the Homeowner I have Worker's Compensation Insurance. isurance Company Name �-1�j, ell orkman s Comp.Policy# opy of Insurance Compliance.Certificate must be on file, ,mrit Request(check box) ,. Ai ✓ ❑ Re-roof(stripping Old.shingles) All construction debris will be.... Re-roof{not stripping. Going over ,existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) "where-required: Issuance of this permit does not exempt compliance with other town.departrnent regulations,i.e.Historic,Consery ***Note: Pro a anon,etc. P rty Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License.is required. ature ms:expmtrg ;063004 S'ck7l CAPIZZI HOME IMPROVEMENT INC . SPECIFICATIONS AND ESTIMATES PA GE 6 OF 6 STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, ( 1 1 / OWN THE PROPER `T LOCATED AT IN MASSACHUSETTS. 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: OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: w LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 NEWTOWN RD. , OCR TUTT, MA 02635 APPLICANT'S TELEPHONE: 5081428-9518 RESPONSIBLE OFFICER RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: Jd�ACCEPTED BY /<< DATE THIS PAGE IS PART OF AND IN CONFORMANCE WITH PROPOSAL # YS J.1s.�r3�c; 113��7rc,�-����e�13� ;(l���r��(.�.�( ►r ��('r�,:i�1.r-v���l�� Rupistiaiinn: I ON-40 :' •• -Iyl.�c:: }•'rivals Gorhuraiiarr Expii 6/23/20D6 CAPIZZI HOME IMPROVEMENT, INC_ .` Thomas Capizzi, jr. 1645 Newton Rd. -- C of u ii, IAA 02635 Upd2lc Address 9nd return card. Marl{ reason for changt pp E] Address E) Rtncm,nl F—I Employmcnf [j— Losi C: ✓�u• Z�it»nmw�zcuetr�.��'�/�,�ficcoe(.7.c ^ 4 lluard of Buildin Rca,ulatims and Standards Licensc or reggistration Valid for individul use only HOME IMPROVEMENT CONTRACTOR before tl)ceapiration date. if found return to: i3egisirai:ion: 10D740 Board ofTluildino Regulations end Standards One AShhrion AhccRrn 1301 Expiration: b/2312DD6 Type: Privaie Corporation Bosion,Ma.02108 CAPI2L1i:-SOME lhrjPROVEIdIEidT,I 't'ciomas Capri,jr. 964514ev%4on Rd. ! COluit,MA 02635 - Administrator Not v2lid withou b reto"r �1 ✓lie iDanMlw_wea 0zuGelx6 , UVIS BOARD OF BUILDING REGULATIOLicense:'CONSTRUCTION S Number::•CS, 057032 I� Brrthdate t39/26/_1963 tExprres 6/2007 Restricted t)0 '' THOMAS X CAPI7rZiJ{� - - CO UIT,TO 02635� Commissioner TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map _Parcel W� Permit# IM 019 Health Division � � �!" Date Issued S t o 0 S Conservation Division C1 0'!K K r MA Y —9 A M 9: 2 0 Application Fee i Taz"Collector Permit Fee , S,o Treasurer �M Ii`%dSBQ ! . `6T BE Planning Dept. 6416TAL L-D III CrE WITH TITLE 5 Date Definitive Plan Approved by Planning Board CODE X-"I Historic-OKH Preservation/Hyannis TOWN IR9 ULAi Ifs S' Project Street Address 1 I A nda I VV O DA b N(I Village 1 . Owner �C'� U �/� �D Address Aht 66 kk,t [wok 4 - Telephone 'lU® 4A' . Io j IM W6 Permit Request I o VAu Iny, i W rob 1t& b he�v yrr filArrv . 0) ojac_Li" W10joyi Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation b j Construction_ Type ww bamL or Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation..• '` Dwelling Type: Single Family 3/ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes IINo On Old King's Highway: ❑Yes UNo 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 ❑ Electric O Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# Current Use Proposed Use - _ T BUILDER INFORMATION = -- - Name U�S I 'f jl V Telephone Number Address , License# Home Improvement Contractor# �U Worker's Compensation#ALL CONSTRUCTION CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE 1 l DATE ` FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE K' OWNER DATE OF INSPECTION: ' FOUNDATION FRAME INSULATION ; FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. g/� />O��7� .Z-t"�•�?. ��f?�:�f��� 0���.f�1!1f,1�C.�?�fld '�[Q '+ }_3()ard o -is a RCT,111, �Jol One Ashbi)jf'm J)j,,-jcc, Roon 1301 l3osi.03L M;us 02108 30T) RE-PiStlaliD11 100740 ype: Private Corporation CAPIZZ) HOME IMPROVEMENT, INC. Expiration: 6/23/20DG Thomas Capizzi, jr. 1645'Nevtdor) Rd. Cotuil, MA 02635 Updiile Address and return card.Alnrh reason for c)llinf Address [] Renewal E] Empioyment Los, C pp 921 Board of j3jjjjdjj)p 3tCgUj2ji ons:Hrid Standards License or registr2tion valid for individul use on)), HOME IMPROVEMENT CONTRACTOR beforethe expiration date. If found return to: Registration: 100740 Board ofBuj)dij)gRcgIJ12fiOns and Standards Expiration: 6123120C)G One Ashburton 1`12ce Rm 1301 Type: Private Corporation BDSiOn,3�52.02 108 CAPIZ71 HOME IMPROVEMENT, I %onlas Capizzi,jr. 1645 l4evlon Rd. COtuil, 14A 02635 Adminisirmor N Nol ),21id without tar�ol,,Iid�wifl,,.j BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 057032 Birthdate: 09/26/1963 Expires: 09/2612005 Tr. no: 7171.0 Restricted: 00 THOMAS X CAPIZZI JR 1645 NEWTOWN RD COTUIT, MA 02635 Administrator f[� . " _ The Commonwealth of Massachusetts . 19 _( Department of Industrial Accidents ti I Office of investigations r 600 Washington Street, 7rh Floor '< Boston Mass. 02111 _ Workers'Corn ensation Insurance Affidavitt:gBuildin lumbin /Electrical Contractors A D 1Il -1�OTIIII1D .. 3 : a1�111 1 t V` �wsiti m wzr r�" s '" Ca 1( name: address udh, rLV i city state: zip: hone#' �` t`J l work site location(full address): �� 2 b df l W Doi bV NIL `' ❑ performingl y Project"type ❑New Construction Remode lain a homeownerall work myself ❑ am a sole�ropnetor and have no one working m any capacity ❑Building Addition I am an employer pro/vliing wnorkers'.compensati�o�n,,f/or my epmpllooypees working on this job. company name: Cf I I �(/i _ I V 1I ��1 1 U address: l,Y AAA city: 4 �. \V�, ' 1 r t', ` phone#: � ,D insurance co. policy# ❑ 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: , company name: _ address: t, city: _ phone#: insurance co. policy# ' t��..� -.. .'-_.mow: . - .� .' -' .,.'�r'..�m�'`���f'�r.� :'�.�`' �Y .°. ys'.'.aJ' "µ�'"ds'T3!§.d. .. :�'.w?e••�..x'X'�sw.'..�.�.'�i�:t'-ie��d` company name: address: city: i phone#: - - t insurance co. oli 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 years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification: :. I do hereby certify under the pains bnd penalties of perjury that the information provided above is true and correct' Signaturemum �� 1 ' Date Print name ` V' Phone# ` ff official use only do not write in this area to be completed by city or town official , , � city or town:' permit/license# ❑Building Department Licensing Board ❑ P 9 ❑Selectmen's Office check it immediate res onse is re uved DAealth Department ". r contact person: phone#; w ❑Other „,�,• (revised Sept.2003)' - -. 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:tbe 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. " 1211 Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name,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 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 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 returned to the Department by mail or FAX unless other arrangements have been made. The 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. .. t° The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,71"Floor Boston,Ma. 02111. fax#.: (617)727-7749 phone #: (617) 727-4900 ext. 406 1 oe-le CAPIZZI HOME_ IMPROVEMENT INCa� �S0 SPECIFICATIONS AND ESTIMATES PAGE 6 OF 6 /) y tA�• STATE OF MASSACHUSETTS LETTER OF, AUTHORIZATION TO APPLY FOR A BUILDING PERMIT:`: u^ ' OWN THE PROPERTY LOCATED .AT. IN . MASSACHUSETTS I HAVE AUTHORIZED CAP17ZT HOME TMPROV MPNT INC TO ACT AS MY AGENT TO APPLY-FOR:: .A BUILDING PERMIT IN ACCORDANCE WITH 780:`CMR,.: THE MASSACHUSETTS STATE. BUILDIN'd CMDE. I GIVE MY PERMISSION TO LESSEE TO APPLY FORA BUILDING;PERMIT IN ACCORDANCE WITH;:780,CMR, -;THE MASSACHUSETTS STATE BUILDING,.CODE: : SIGNATURE OF OWNER: OWNER'S ADDRESS: a OWNER'S TELEPHONE: . LESSEE'S SIGNATURE: LESSEE'S ADDRESS: ,LESSEE'S TELEPHONE: . APLLICANT'S SIGNATURE: �� n APPLICANT'S ADDRESS: 1645 NEWTOWN RD COTUIT MA 02635 APPLICANT'S TELEPHONE: 508/428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER •TELEPHONE: ACCEPTED BY DATE THIS PAGE IS PART OF AND IN CONFORMANCE WITH PROPOSAL # I I , 27 Harvey Industries I A Proud ENERGY STAR Pa1111er jll\I \\ilulc,\\s;lrc• 1`11 I';RM, yI;llili(•cl (lu(ul,tlu ill Owl :.�. \\jlll,l ,\�' I';%:1r,lnl l'Llr.jll" I;�'I;I�(;l' ,�'Ii11Z cllcllilic cl \\ill(lu\\s ;Ire• 10% Imwc• (•Ili( hilt Ili;lll \\jll(I(Ms Ill;il III.cc-l'lnnsl u;lliciil;l1 Inljl(lill", ( culc.s. II' ;111 1m)(Im Is Ill Ili(- U.-S. \\c•rc• FNI';R(;Y STAR (III;Ililic•(l, I ` 10 I)IIII(m ill ('us(s MVI' III(• I)(•xl I't \r;Irs. FAI';IZ(;Y �;TAIZ \\I ;u( u()(l lin (li( c il\ irunuu il(, usill 1(•ss li)ssil lil(•Is Mild) ( ;lose ;III p)IIIIII( l), sm( ), ;I11(1 (dukll \\;II.ImII0 Cuun r: l!..ti. I)cl)�nn nrn(of I:n,'r;?��. M I(.\(t(.\c'1.O1r-I:/Ar•�c n I Ir)urhic'a t 1;NI�:I�(;1'ti�l%11�t ruit 1 r U and K Values U-\aluc: .\ nu:lsurc of kcal unusnlis.i(n1. 'I he km r III( l , Il,r Icss It,;tl Ins . IZ-Value: :\ nu•:1�urc()I :I \\inclotc.n,i l.lnrl (n hc:n condnrtion. l hr hi!g11cr Il,( R'\alrl(:Ihr I,(11) •1 \610(m is:Ihh i() in>ulnlr. 1,VIW I u.h. (I „ -I „ „i,,, ,.I Clear Insulalim" Lo\s-[? Low-F/Argun" Air Inlill-alion VINYL\A/IND( \\/S ti-Valcce R-V:rluc li-\':clue It-\'aloe l -\9clue It-Value. ci'n1/Il' (:LissicU(n1ldclluu�(1\I((It:111ic,tlj 0-1)O 12.00 O.'i% 270 (:Llssic Umll)Ir Hun.(\V'ciciccl.,�ati11 c\ FlmllO (L If) 2.OI 0.:9)l1 . 11?{:(;:i 0.9)l 2.961 I0 C:Iosxi( :\c(ulstic;Il 1)c,ul lc Huth ti:6(:.141 11.:'ia (1.2, 1.00 R21 1.1 7 (IS) tii n;1(urc llcu11)Ic l ion (\Iccll:ulical) 0.50 2.00 Il.17 %(1 (L:iI '>.')I O'I' 51ill1111Ic Uuul)I( Hung(\\(I(Ic d Sash R I'i',11nc'i (1, l) 2.00 0.37 _?.70 -O.:i3 3.(I:i .0) SIinllinc Sin lc Him (\\cl(Iccl Sash c` I r:utu) 0..)II 2.00 O.:i7 7(I O.i:i :i.Oa O(i Vim (:;I11'lll('lll/.'\\\nine (1..17 �.I.`i O.i(i /"�! (1 ,3 L. i ' (Il VIII\i C;Isc mc•nl/A\\116w & Thi•rnr11 I'mid (L:i2 :1).13 0.26 i.li') I).2 i 100 .0 I VHINII)c:sig-nc).)JI:Ipcs (LIST 2.0_1 0.31 11 0.30 :i.>i ---- Vmyl Ho ppc•r OA7 2.13 0.3.) 2.ii(i 0.32 :i.l:i IUi Vin\I I'ic'ttn'( \\inclu\c R-IG 2.17 0.31 :i.23 0.2}l, a.:)7 .01 \'it1 I Rollcr-2 Imc• 'i I.i(c• 0.50 2.00 0.ii 2.6:i 0.1V) 2.86 .(ICI . VINYL NEW CONSTRUCTION A\/INDO\A/S \ ic()lI I)(mb)c Horn)(\\•rlciccl Sash& lame) R.5 2MO 0.i7 '?.70 R,i:i- VI(()I -sing 1c I I(u, (\\'(l(lccl ti:tsll& Fr:lnu•) (l.:iO .(III U.9)7 >.jll Il.i:i a.O i l(1 \ ic(m C:I,Issi(.I)uul)Ic l luu Ml_.I (.d tinslt fi l r;'Ill ) U.Ifl 2.0 1 (l.ali 2.78' R:.')'1: a.0:i IO ` Vh(m(:�Iscmcnt/Aw]III g, 0.17 :>.Ia O::iP 11 (l.:il a.2.`; 111 Viccnl PI(lum W111 l m 0.17 2.13 R32 ;.1:1. 0.28 3.57 01 VW(m I h si1ncr Slr:tl)(s 0.111 2.OfI O.:i2 a.13 0 2`) a.I.', 01 Low-E/Argon** Low-IS/Kr�'plon:: Air Infiltration WOOD WINDOWSr;_valuc IZ-\aloe I)-Vahw R-Value 1\lajcsl\ Ihull)Ic HunI N/A )N/A O.:i i 2.1i1i I:i \Injcst\ FixctlCascntctlt (MV) 0.:i(i 1J8 N/A N/A (F1 \lajcsl\ (:ascnunl/;\\\nine 0.11 2.11 N/A VA .02 f\Ltjcsl) Picluli.Willdmv IM 1) R')1 2.(.).i N/A N/A I ' 'Icmpered Tempered I'empered Dbl.7cmp. Air Inlillralion ('lean Lu\w I': Low-t?/Ark Low-K/An, crm/rr PATIO DOOR l'-Value R-\4(lue l -Value IZ-\'aloe III-Value R-\'aloe 11-V:due I2-V. I I:uvr\ Solid Vilt\I I',Ilic1 1)uul' - R 19 2.0.1 0.10 2_50 0.i7 2.70 O.:i.`, 2.8G 11(1 All vinyl wilidows with LOW-F/Argon qualify for the P;NLRGY STAR I\rograill lhroughoul the U.S. *I`I'hr nu-(,f lcn11n ed leI(c-I;til,iss-nr1\ rllc(l FNFR(;l ';AAR, glI,Ilil;(alion in voiwlcgion. 1 ;It)(] R-\';Ilnr`.1rr>ulljc(I (u(1rn1 r(cilhllu( un(i((. WIA) il1l ----------- i ox I I I I I i � I , iI I I i/0 r (I.i . G(PN-�0A) Fiji/'9/I )✓lm Auq'i'v. z cc�, PZ yU)o&A ::sic ir y a _I: . � �. --�--------- j t � ' � � Zit'/D �lr�,'f"D/1 •�D�F ��4f��Tfl� �r�� ,3ox ;�e� E J ; s h i I r t >3 1�5/9 JO'I L W o,(m pie. 4)� ' a ors roe Town of Barnstable h Regulatory Services l ]DAMSTMA Thomas F.Geiler,Director ss. 9 Ma sb39 1�� - �AIEn Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 - Fax: 508-790-6230 Office: 508-862-4038 Permit no` Date 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: &A&—Estimated Cost Address of Work: .79 Owner's Name: Date of Application: v I hereby certify that: Registration is not required for the following reason(s): MWork excluded by law ❑Jab Under$1,000 {]Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERNIIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDERMGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: " Date Registration No. Date Contractor Name Q9 -- OR Owner's Name Q:famis:homeaffidav i 9114� �pFVE rpk� Town of Barnstable *Permit# Expires 6 months from Issue date IARAtSTAELE, : Regulatory Services Fee 00 s63939. Thomas F.Geiler,Director Building Division Xpiiess Tom Perry, Building Commissioner . sEP �T 200 Maui Sheet, Hyannis,MA 02601 � 20 Office: 508-862-4038 T®�I/�/OF BA �4 Fax: 508-790 6230EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY R�STABC� Not Valid without Red X-Press Imprint Map/parcel Nurnber 10 0 I Pro erty Address Residential Value of Work !, Owner's Name&Address 1 ' t� Contractor's Name A 0111,1 1 Telephone Number ►�1 D ���'� - cCC�T Home Improvement Contractor License#(if applicable) Construction Superviso?s License#(if applicable) VO ❑Workman's Compensation Insurance- Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance C+ , Insurance Company Nameryj� I t u (664, Workman's Comp.Policy# Permit Request(check box) ❑ Re-roof(stripping old shingles) " ❑Re-roof(not stripping. Going over existing layers of roof) ,r"� S/Re-side Y I'Ulll) °� t�T I �a b�• y ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) 14 11A IM.1 nVl m ' r M *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature °I Y IS C&O V. Q:Forms:expmtrg r Reviscd121901 x, - t SQ k Ioeez CAPIZZI HOME IMPROVEMENT INC . �Sd SPECIFICATIONS AND ESTIMATES PAGE 6 OF 6 cl STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT Ao I, W K/ 4'vh 10t�� OWN THE PROPERTY LOCATED AT � ' Lj(/L��(it UVOV� t►X I Vl IN r(� � MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT INC. 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: yet. [�0 OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: I f APPLICANT'S ADDRESS: 1645 NEWTOWN RD. , COTUIT. MA 02635 APPLICANT'S TELEPHONE: 508/428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: ACCEPTED BY DATE Q"1 THIS PAGE IS PART OF AND IN CONFORMANCE WITH PROPOSAL #_l ►OJ The a Conutron weall/r of Massachusetts R _ Department of Industrial Accidents Office ollncesdgaUoos 600 Washington Street .3 Boston,Mass. 02111 Workers' Compensation Insurance Affidavit 1111111 location: city _ tahone 4 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. compa a .. 33 � stty, � phone N: �R imp I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who hi,.: the following workers' compensation polices: somnanv name-, address*. phones.'. insarance;eor., policy N 4. company-name• City.. - phone insnranccso. policy t! >, Failure to secure coverage as required under Section 25A of h1GL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 andim one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. t do hereby certify undei the pains and penalties of perjury that the information provided above is true and correct. Signature Date ' Pont name ` Phone# official use only do not write in this area to be completed by city or town official city or town: permitAicense q riBuildin Department I g P h; immediate response is required QLicensing Board check if F: _0 p q OSelectmen's Office contactp non: Y ., ., ...... ..�.. ....._.. ... _ ..._.._...... _.,.... . :. .�. _ _ ._.• ---. . .__.._.,__.�.--� ..._�. ._.._. ,._. oHealth Department t, phone q; mother . S Jrr=ised 3195 PIA) From:Maurabeth Chilsm CIC At The McCarthy Companies FaxID:07898OW38 To:Capizzi Home Improvement Date: tY/1U/tuu0 I t:it rm reyo. — YYM a o v_ CERTIFICATE OF LIABILITY INSURANCE DATE @eAfDD1 12 10/0 C7f�IL 1 3 FRODUCI R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Norcross i Leighton Cape Loc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE C.J.Macarthy Ins.Agency,Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 437 Station Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. So.Yaruouth Na 02664 Phone:509-394-0946 rax:509-160-1407 INSURERS AFFORDING COVERAGE NAtCM INSURED INSURER A: National Grange Mutual Ins. Co INSURER B: ' Safet_y Insurance Company Cavisai Home aprovement =nc Ir+s c Guard iasusaace"asoup Cotuit INL 02636d NsuRERD: INSURER E:. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMF ff.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCLNIENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR .. M RM AY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TES.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. " LTR TY/E OF INSURANCE POLICY NUMBER DATE 1111W DATE LSWTE G LIABLnY - EACH OCCURRENCE 11000000 A X CO#&RCAL GENERAL LIABILITY 14PS02733 04/01/03 04/01/04 PREMISES(Es occurence 1500000 CLAIMS MADE FY 1 OCCUR +. MED EXP(MY one person) $100 00 -- PERSONAL&ADVINJURY 11000000 GENERAL AGGREGATE a 12000000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPlOpAGG S 2000000 i POLICY ,(';T F Loc AUTOMOBILE L IABLM - COMBINED SINGLE LIMIT 1 g ANYAUTO 1601064 04/01/03 04/01/04 (Esaccldeli) AIL OWNED AMOS BODILY INJURY. 41000000 IPer person). X SCHEDULED AUTOS X HIRED AUTOS - BODILY INJURY $1000000 (Per ecciderl) NON- X ONTED AUTOS " PROPERTY DAMAGE $500000 . •. - ,.. (Per accident) GARAGE LIABILITY AUTO ONLY-EAACCIDENf ANY AUTO OTHER THAN FA ACC >< AUTO ONLY' - AG 1 , EXCESSAIMBRELLA LIABYITY EACH OCCURRENCE t - OCCUR El CLAIMS MADE AGGREGATE : DEDUCTIBLE 1 RETENTION 1.. Im - WDM(ERS COMPENSATION AND X TORY LIMITS I R _ C EAPLOYERrLIABLITY CAM401043 01/01/04 01/01/05 E.L.EACH ACCIDENT $100000 ANY PROPRIETORIPARTNEMXECUTIVE -OFFICERMENBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE 1 100000 I yes,describe under E.L.DISEASE-POLICY LIMIT 1500000 SPECIAL PROVISIONS below OTHER - DESCRrnON OF OPA I LOCH I CL ES I EXCLU610NS ADDED BY RSEMENT I SPECULL FROVISIU ER CERTIFICATE HOLDER CANCELLATION _1 SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCEI LFD BEFORE THE E%PIRATIDN DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL ' 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE L EIrT BUT FAILURE TO DO SO SHALL • WOSE NO OBLIGATION OR LABILITY OF.ANY KIND UPON THE INSURER,In AtiOM OR REPRESENTATIVES. , AUTHORIZED RES ATAIE l ACORD 25(2001109) CORD C RPORATION 1989 - � ✓��� 0 I111 � �I113�OnS and �zandar�t • . One Ashburton Place- Room 1302 Boston.IVlas usetts 02208 . _ Home Improvemen a:tvactor Relation Repistration: 10074D ?ype: Private Corporation E=iration: 6,2312DD6 CAPiZZI HOME IMPROVEEMENT, INC. .:: Thomas Capi=i, jr. - - 1645 Newton Rd. - CotuPi, IJiA 02636 'Update Address and return card.Mark reason for change. j; Address 7 Renewal :; Employment -' Los:Card ✓ne'oas,H.caruuP.alG.' oF./�iaaoaa � ' Board of Building Rquiations and Standaras License or registration valid for individul use only s HOME IMPROV=M_N'T CON Tr ACTOR before the expiration date. If found return to: —� Board of Buildinr.Regulations and Standards Regisnation• 100 4C - _xpimbm TDDE One Ashburton?lace Rm 1303 _ Boston,M2. 0.108 Type: Private Cor?omiior: C,<;==!LAN:=It✓?RO1':1J;=N i, 1 novas Caa` I 'Nemor Kam. otut,IJit.02c'35 snminist-.ator riot valid without signature --- -- - - . - - - - f � - • I �,. � ✓�s �nmmon�iicall�c �i��iieerxcv�iie� ` f BOARD OF BUILDINd REOULATIONS j License: CONSTRUCTION SUPERVISOR Number; GS 057032 4 Birthdale: 09/26/1963 Expires: 09/2WO05' Tr.no: 7171.0 Restricted: 00 i 1110MAS X CAPIZZ_I JR + 1645 NEWTOWN RD _ COTUIT, MA 02635 � � �� � , Adm1histrator i 9,� G - �1 Assessor's offioe (1st floor): / -- Assessor's map and lot number Q of TNe to Board of Health (3rd floor): 7 3 �' Sewage Permit number i BASd9TADLE, ................................................ NAG +t� Engineering Department (3rd floor):' moo 030• a h House number .......................:........;�? ........... ..�-,-^-! i°�Fo r a� YP APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR *PERMIT TO ........`.......°`^......a.... w.ueJ !rt�ow. • ....... TYPE OF CONSTRUCTION ..... ?. ............................................................................................................... ...............c�... q.....................19.....h TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: .......... M ............................................................................Proposed Use ... 4. .!.`�K. ...... ................................................................................................................................. Zoning District ..................................................Fire District ' .!........................................................... Name of Owner? .oha�. ..tlh?.a,rc.� ..... c\„loer U......Address .�3.�........�a. 4..�.1 4?c?cc�Q..... .. ...:.�04 t, Ali. Name of Builder n........Address .. G J. ) . ... ...Sf.....,. �s .c.�r.c._ .......................... _J C` .r.�Y_��........o!?. .. ......�cs �tcn� G ,..Address ............ ..Name of Architect � �`...A...... ...... .• ..................................................................... �y .. ` n ure ~..................... . .k ........... f`t b� Number of Rooms, .............?5...................................................Foundation .`7p GQ. • I Exlerior .G?.h..a...... Roofing ........`� . Floors ...1_: 1 ..................................................................Interior ...S,kneeA....Xc 5Mc Heating .. .................................................................Plumbing ...e 6. �..�.....�?.: R................................................ Fireplace ...:'....6n .........................................Approximate Cost .....=�.�.,:..4.�?..c�............ Definitive Plan Approved by Planning Board ________________________________19________ . Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 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//� t . Construction Supervisor's License ... .................. SCHLOERB, RONALD & MARCIA A=10-14 b No ...298.��... Permit for ADDITION ................. Single Family Dwelling .......................................................................... Location .....131 Sandalwood Drive .......................................................... Cotuit ............................................................................... Owner Ronald & Marcia Schloerb .................................................................. Type of Construction Frame .. .......................................... ............................................................................... Plot ............................ Lot ................................ Permit Granted ...........September„5.,,..19 86 . Date of Inspection ....................................19 Date Completed y Cop-It 11, 1�7 r - TOWN OF BARNSTABLE Permit No. -- — - { Building Inspector 1 7i7D)Tw. . Cash OCCUPANCY PERMIT Bond ------------------ 4 � 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 Kevin O'Neil & James RiCh Address 491 Main St. , Hyannis 131 Sandalwood Drive, Cotuit Wiring Inspector rT ` Inspection date Plumbing Inspector �, Inspection date Gas Inspector Inspection date Engineering Department , f` ,.. / Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ....................................................... 19.........._ ..................................................a............................................................ Building Inspector T J i 150 I cvs �rt k T i�—� i-i�i�l:c;i.► Gcyr+ihLY`� W i i i-1 Tt-IG 5i DE L1"�-- /S.iv� SCTk3hL1C �'C-�uiiZ�,Vtc►,,jS GF= Ti-+C � C)1�t ��c.J Ci�'TEIZ�'%L-LG �ASti, A P P L i GAS T LG'T' �tt.1(=� `";-',' 0 n . AA//� f' /pG At,sess& map and lot num r NP..YO..i...64...�. Gam' �� l/`�~ / MUST E� *THE roe Sewage. Permit number ............ w +► ,`� g i �.jf. SEPTIC SYSTEM Q�'d'LIANCE 1 ......................... �> INSTALLED1N 11 STATE g / ARTICLE TOWN 9E ASH9TeI1LE, i HOUse number ..;....... R• MAea WIT4� n CODE -rr' `:.� . e � ? SANITARY ANDo''�.o wnY REGULATIONS.. + TOWN -OF BARNSTABLE •, r}'yv� f Cj BUILDING INSPECTOR APPLICATION FOO PERMIT TO ✓. ....0.4.1/....� . �' ......................................... Tj CJ .... .. .... TYPE OF CONSTRUCTION .......�/'.!� '�Y ty ..... ... ............ ................................................ w. ......... 3/.................19.2. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to th_eQ,following_iinformation: /k Location ....!4.�1.. ....fP.....�. q ..10...1-0!.!Y)......�! !ULhf�./k�QC�fA..... j:. l .. �f ./ ..... .. . . ProposedUse ...............&.%. ... 1h1. �.��, . .......................... ......................................................... Zoning District ........pp. .....................................Fire District .. . . Name of Owner u�11�...�,�.1.!1 1h.'. �1 .. :.. Address ... ........I. . ... . .. .............. Name of Builder ..�!. ., .�.��!� 4►�..Address ..T...l r.....MAW. ..�.1!............. . .11}�}.�................ Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ....... ......................................................Foundation .............................................................................. // /(f �� ...Roofin Exterior �$I(1."1.(/....�....��!4�?7.t.'!:r!!.................................. g ..4ra� ..a'41 ...................................... Floors ......................................................................................Interior ........................................:............................................ 1' ` Heating �ts7�RC.R...Li�6 .. ..................................Plumbing ........ . .. .........................................0.. .................. Cot ............Fireplace .5...................................... Approximates ..... .QQ ......... Definitive Plan Approved by Planning Board ' 19�81__. AreaQ.. ..5� ....:........ ... Diagram of Lot and Building with Dimensions Fee / 7S SUBJECT TO APPROVAL OF BOARD OF HEALTH a t0 34 al tb+ I hereby agree to conform to all the Rules and Regulations of the njofBtable regarding the above construction. Name ................................................... _ _ J O'Neil, Kevin & James Rich 20413 1 1/2 story No ................. Permit for .................................... ,I single family dwelling ............................................................................... 131 Sandalwood Dri ve Location ................................................................ Cotuit ............................................................................... Owner .....Kevin...0I.N.e.il..&...Jame.s...Rich..... ........... ... .. . .... .. ........ . ......... Typd',of Construction .........................frame.....:........... ..................................................................... Plot Lot #6 ......................... ................................ July 24 .19 78 Permit Granted ...... 19 �-�� bate of Inspection .... �.1...... Date Completed .............. _19 PERMIT REFUSED --- ..................................................................c- 19 ............... ........................................................................ ........ ................................................................................ .............................................................................0. Approved"....................................... .19 ..................I ..................................................... .................................................................. Assessor's mop and �t �\ n \r1 . � J_/4 ,�^� � �' ^0�' _ ' . If Er + Sewage Permit number .................................................. . House 'number ---- ....................................................... MASL - . ���� �� � �� �J�� r�� � ��-� �� | -.TOWN � �]� �� /� N� �� �� �� �� ������ | ` | �� N0 �� 0�� INSPECTOR �� �� ��� NN � 0 �N� N ���� 0� � NN �� �� ~pm ���� � w��� wm���m ���� � �� �� . �� �-�l / ' APPLICATION FOR PERMIT TO ./Y� — ' ' - _ TYPE OF --.������`! L�0i��:t�.' —.—...-------.____._. ' ' ~ ~ ................................................ .J l��x:.L/ TO THE INSPECTOR OF BUILDINGS: � The pn6emigna6 hereby applies for o permit according to the following information: � '^ r`' Location ... /;� u //� 2�f /y � �� ^ � ' `�:' ------~—^~—~r— —'—^-- --- --^'------^-- -----'' 'y'^ -------'^'^�—^ Proposed Use Use .............. -------.--.-------..---.------.—.- | ' . �� �� / � � Zoning District --.J.\�../.;..—.......---.------.—.�na District .....1/����\--..-------.-------,..,_ � N-omo of Owner � � >^j../\ --..A66 . .�� | _ ---__.. .—. ... .—. Name of Builder � /� ]\ 4—[� ^ ��./\ A66reu ./��./—. N�^�t>..(-]..................... v8!�!L —.---, Nome of Architect ----------.-----------.Ad6rao ---------.--.—...----_---.----. Number of Rooms --���------------------Foon6otion ------------------.----.—__. /� Ex�ehor 'r[���!—��—.. ---.--------RooGng ..�/�����@�y�—.��������--.-------_—~.� ' / ' Floors ----------------------------.]»teriur ---_-----------------------, Heating ....... ... —.. v /'�.�.---..—.---.-------.----. . Fireplace '--. ...---------------------ApproximoteCox ..................��. ,.].J...).,..',,_,. ......... / Definitive Plan Approved 6v Planning Board /��-lQ . Area —.... ............../............ � Diagram of Lon and Building with Dimensions Fee ................... ........................ SUBJECT TO APPROVAL Of BOARD OF HEALTH � �' �i��lA %r 6�/Cn/u,Wr4 -_-'-- _-__- | ' L _ L" �(Vf . / . 4b , , L . \ | ' � ' | hereby agree to conform to all the Rules and Regulations regarding the above construction. ^ � momop —.—......—.—.----_.. 8 | O'Neil, Kevin & James Rich A=10-14 20413 1 1%2 story No ................. Permit for ........................ single family dwelling ............................................................................... Location 131 Sandalwood Drive ................................................................ Cotuit ............................................................................... Kevin O'Neil & James Rich Owner .................................................................. Type of Construction .............frame Plot Lot ........ 6................... Ju 24, 78 Permit Granted ................�`.....................19 Date of Inspection ....... .......................19 Date Completed .......................................19 PERMIT REFUSED .............. .................... 19 .. ......... ................................................ . ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... AP-Assessor'soffioe-(lst floor):•, G K` SYSTEM MUST r Assessor's ma and lot number ........................... ...... .......... SEPTIC E oard of Health �(3rd floor): ` WSTALLED IN COMP Sewage Permit. number ........:��..............�............17.... WM TM S a Engineering Department (3rd floor ENVIRONMENTALC639. House number ........................... � �++ TOWN REGUTATI OMON APPLICATIONS PROCESSED 8:30-9:30 A.M. and. 1:00-2:00 P.M., only- .. .•a TOWN, 'OF BARNSTABLE BU.1 LD I NG'1µ�INSRECTOR APPLICATION FOR PERMIT TO .°`^...Q .d:... .......a.....�.�twri�la�..r..a.car! .. ..!n���..!n?4! .......................... TYPE OF CONSTRUCTION ......UO oA............. :....................................:.................................... � . ... TO THE INSPECTOR OF BUILDINGS: ` The undersigned hereby applies for a permit according to the following information: Location 13) .SCl►l-c:.a..t,WR!PA...... c... <QA��� (ti�ss ProposedUse ... fk.w�i.1�Sc ......r.ron.1� ..................................................................:....................................I......................... Zoning District ..........!�. r"..:...............................:................Fire District � �`!}=.......................................................... o .4 Sc�nloer(� �3 c:�h Name of Owner 0Y�4`�!1. a-�c.l.... ..Address ........�. . � d..... Y,t�'o !a.,.� lr�. Name of Builder �rw „ {� r — c,.......Address '...........��....��.1. e..........�-rnr.r._.J ...�.4�.0�..ets.7...��'....y S�.�n r. ........................... Name of Architect .: QY..y. . .. aiJZ.C,--... .X �'IS G ..Address ..............:...................................................... ....... .. J pcecc�C \,-eUjbe- . Number of Rooms .............b....................................................Foundation .k"r.-efQ......7........Sm La. �.k Exterior ...............................................................Roofing .or...... .............................................. Floors, ..: p.©. ................................................'......:.........Interior ....S. eC�.f1....T.o.C. ................................................. Heating 11U..."..........................: ........:..........'...Plumbing ...C.o.P . .. ,p.;.�e... . ......:................................. Fireplace ..�`r;.�.S.��. ...-.:..�?y.ic.k .....................................Approximate Cost ..... .©. o c) ©.............. Definitive Plan Approved by, Planning Board ----------------- /f 9 Area .....`'.. C/.. .. . Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH a , gob, V4 lib a - OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction_. Name ........ .:................... ... .. ....................................... Construction Supervisor's License ............. SCHLOERB, RONALD & MARCIA No...29877 Permit for .,ADDITION - Single Family Dwelling . ... ...................................................... Location ..••131 Sandalwood. . Drive . .......................................... Cotuit .... .................. ................................................ ` Owner Ronald & Marcia Schloerb ` .............................................................. - Frame Type of Construction ....:.....................................' Plot ... .................. Lot ................. ........... Permit Granted September..,5,......•...19 86 - 4 • l I Date of Inspection lF 74" 7t!�................19 —Date Completed . ...:..... ...cc Q M r 1 aEC I� { i