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Home My WebLink About0524 SANTUIT ROAD r � i Town of Barnstable *Permit# VoSZ/� Expires 6 months front issue date BARMADUrftRegulatory.Services f � . ray ,0� Thomas F.Geller,Director Fee _ '°rFo►�+" Building Division Tom Perry, Building Commissioner -: E 200 Main Street, Hyannis,MA 02601 Fffice: 508.-8624038 - - ax: 508-790-6230 EXPRESS PERMIT APPLICATION - -RESIDENTIAL ONLY Not Valid without Red X-Press Imprint parcel Number 6 -.rty Address ( -�~ esidential Value of Work Nnuimum fee of.$25.00 for work under$6000.00 er's Name&Address Y-K ) Q A Q � 1 �0 � t �� ractor's Name Telephone Number( a� , l t-1 1 ie Improvement Contractor License#(if applicable)_ -truction Supervisor's License#(if applicable) 9j'a5 lorkman's Compensation Insurance Check one: ®P F S toE ❑ I am a sole proprietor ` ❑ I am the Homeowner 2004 have Worker's Compensation Insurance ranee Company Name C)64A) i ? �� `�� 1 VAlv TOWN OF BARNSTABL : kman's Comp.Policy# L�2 0) '—C y C;5-(1 CO H y of Insurance Compliance Certificate must be on file. nit Request(check box) Nll�e-roof(shipping old shingles) All construction debris will be taken to (�Y . � ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) 'Where required: Issuance of this permit dots not exempt compliance with other.town department regulations,i.e.Historic.Conservation,etc. ***Note: Property Owner must sigaProperty'Owner Letter of Permission. H me Improvement Contractors License is required. iature nns=pmtrg se063004 i �pTME, Town of Barnstable P� ~C ' Regulatory Services r i sa M s MASS. Thomas F.Geiler,Director nss. 0.39. .a�"�e� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office:. 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder L mw?21c Cf as Owner of the subject property hereby authorize ��,��,;��— to act on my behalf, in all matters relative to work authorized by this building permit application for: -6-2-V 16aal 6(k-� (Address of Job) > igna e of Owner Date . ,�� C• Tren na, �rint ame QTORM&OWNERPERMISSION f .ACO-RD-. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYY),4/2 0 0 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Mc Shea Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 Main Street, Suite#H ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Osterville, Ma. 02655 508-420-9011 INSURERS AFFORDING COVERAGE INSURED Paul J Cazeault & Sons INSURER A: Lloyd's Roofing Inc. 4 INSURERB: TraVeler,S 1031 Main Street wsURERC: Osterville, Ma 02655 INSURERD:. — — 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. INSR POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE - POLICY NUMBER DATE MM/DD/YY. DATE(MM/DD/YYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ CLAIMS MADE ®OCCUR MED EXP(Any one person) $ A LGL034776 04/30/04 04/30/05 PERSONAL&ADV INJURY $1 ,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1 ,000,000 POLICY JE PROCT LOC 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 $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND W TATU- TH- EMPLOYERS'LIABILITY TORY LIMITSI I ER 7PJUB-0095864AO4 08/13/04 08/10/05 E.L.EACH ACCIDENT $100 ,000 B E.L.DISEASE-EA EMPLOYEE $100,000 OTHER E.L.DISEASE-POLICY LIMIT $500 ,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED RE �A I ACORD 25-9(7197) I= 0 ACORD CORPORATION 1988 e ulat'ons an tan�arsad Board of Building R g One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement i Contractor Registration Registration: 103714 Type: Private Corporation l; Expiration: 7/9/2006 PAUL J. CAZEAULT & SONS, INC.'',` Paul Cazeault 1031 MAIN ST OSTERVILLE, MA 02658 Update Address and return card.Mark reason for chang Address Renewal Employment Lost Card OPS•GAt Co SOM•04104•G101216 ,� ✓�LC U/00lNltO�UIM.CLCCIL O�✓[�laN,fdP.�6 hoard of Building Regulations and Standards License or registration valid fur indivi11'11 use uulN HOME IMPROVEMENT CONTRACTOR Rogistration:. 103714 before the expiration dale. II*found rcluru to: Board of Building Regulatiuu r s and Standads Exptratlon`;10371 06 Uuc i\sliburton Place Rin 1301 =_';Type:'Private Corporation Boston,Ala.02108 PAUL J.CAZEAULT;B..SONS,INC. Paul Cazeault `'' '-:`. 1031 MAIN ST , OSTERVILLE,MA 02658 ✓�u; �oai�rxosc.ue��. o,� Administrator Nu BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 026325 Birthdate: 10/20/1959 Expires: 10/20/2005 Tr.no: 8603.0 Restricted: 00 PAUL J CAZEAULT 1031 MAIN ST s OSTERVILLE, MA 02655 Administrator 07-7 Board of Building Regulations = One Ashburton Place, Rm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 10/20/1959 Number: CS 026325 Expires:10/20/2005 Restricted To: 00 PAUL J CAZEAULT . 1031 MAIN ST OSTERVILLE, MA 02655 . Tr.no: 8603.0. Keep top for receipt and change of address notification.