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HomeMy WebLinkAbout0075 SHELL LANE �� - .. �. .. .. n .. .�, :�• .u ' ,� _� Town of Barnstable _ Building in t 8,rp M ; Post This Card So That it is Visible From the Street ApprovedTyPlans Must'be Retained on Job and this Card Must be Kept', tnnsa IPosted Until Final Inspection Has Been Made. Permit i6�q q� 1 JIJIJI 1 Where a Certificate of Occupancy is-Required,such Building shall Not be Occupied until a Final Inspection has been made: - Permit No. B-19-388 Applicant Name: HALSTED, EUGENE Approvals Date Issued: 02/06/2019 Current Use: Structure Permit Type: Building-Shed - Residential-200 sf and under Expiration Date: 08/06/2019 Foundation.: Location: 75 SHELL LANE,COTUIT Map/Lot 019-096 Zoning District: RF Sheathing: Owner on Record: HALSTED, EUGENE Contractor Name: Framing; 1 Contractor License. �: Address: 15 LYNCH DRIVE2 MANCHESTER, CT 06042 � " '-�� „ Est. Project Cost: $0.00 Chimney: Description: 10X20 shed i . £ Permit Fee: $ 35.00 - Insulation: fee Paid;= $35.00 Project Review Req: 10'x20'shed located as submitted on plot plan Date 2/6/2019 Final: 4 _t 4� ' s Plumbing/Gas l Rough Plumbing: _ .�Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after..,issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road,and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. a' Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the-Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection a e � M .• - Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: i fr I i Town of Barnstable - � Building Department Services Brian Florence,CBO txsrAscE Building Commissioner use. 200Main.Street, Hyannis,MA 02601 www.town barnstable.ma us Office: 508-862-4038 Fax: "508-790-6230 PER IT# ' I - FED, $35.00 SHED REGISTRATION O 0o RESIDENTIAL ONLY 5 -rr 200 square feet or less Irocadon of shed(address) Village G o ff1 ZZ S' LSTUL Prop owner's name Telephone number 10' Y, 2L®� 0-1 et - Og Size of Shed Map/Parcel# i S Signature Date Hyannis Main Street Waterfront Historic District? OldKing's Highway Historic District Commissionjuiisdiction? You must file with Old King's Highway t- Consefuaiion Commission(signature is required) ga-off-haft's fey-Esuser_v :OQ`9:3fi1- 3'3�4::0. PLEASE NOTE:IF YOU ARE W1=THE JU=ICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. (T-HIS-FORM MUST BF ACCO.MPANIEID-13Y-A-7 CPLQ_T_PI�AN ---- =� Q-forms-sbedmg REV:08/6/17 HALSTED - PROPERTY 75 SHELL LANE ,g COTU I T, MA old ce55p00 12 m ------------------------- �-• preSen t propoSed i FU cottage add i t i on fu ' J 27 I ------ -- -------- W 57 I wa ter -� i n e Ul I , 150 one re to bound SHELL LANE �S� ty HALSTED PROPERTY 75 SHELL LANE COTU I T, MA old ce55p00 1 12 cn CD38—� ------------ ------- -----, T pre5en t proposed c o t tape add i t i on j rIv 2 7 .--------' . W 2 8�--------------- 5 7 � ` water � i n e U1 I 150 concrete bound SHELL LANE I a -- A D D I T I 0 N o'THE To TOWN OF BARNSTABLE Permit No. .32723 BUILDING DEPARTMENT I ' j TOWN OFFICE BUILDING Cash .........• . rra ,6T9• Q 'taur HYANNIS,MASS.02601 Bond . CERTIFICATE OF USE AND OCCUPANCY. Issued to Raymond Halsted Address 75 Shell Lane Cotuit, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND,IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. September 14, 19 89 .fit ...... ............. ........... ........ .................... Buildi Inspector R Assessor's office (1st floor): n �� THE T Assessor's map and lot number . . ..01...1. ....:... f Board of Health (3rd floor): 2r Sewage Permit. number . .. �3 :..:. �. �� ' I AHd9TGDL i Engineering Department (3rd'floor): ��Y� rAea • House number. .........................:.......' .... ......................... Definitive Plan Approved by Planning'Bodrd -------------- a APPLICATIONS. PROCESSED 8:30-9:30 AM, and .1:00-.2:00'P,M, only. TOWN . SOF BARN.STABLE BUILDING . -INSPECTOR APPLICATION FOR PERMIT TO ��. .. �V� TYPE OF CONSTRUCTION .............. W.O:vV:...15 rZ4.Al.�...........:..................................................... ...... . . .1 ---------------------19.. . TO THE INSPECTOR OFBUILDINGS: The undersigned hereby applies for a permit according to the' following information: ' Location ... .... ... .............::.... .d ............:........................................................................ t Proposed Use ......... F.- .. ....... ...... ...:..................... .a.` *. . ..............Zoning District .............Fire District .............,... .. . ......................... .... ....... .... .......... C �Y;-c ��QQ , Name of Owner '.JA.. lG�,tOl .+:.1T15TG ....... �:..... k �" !�`ti....... p.... ' �o\Sov .. � .........Address ..... ....-. ............... ..........�.� Name .of Builder L`!4 E' ...... ................Address Name of Architect ..............................:.Address .................................: .......:.....................:.-...............:. Number of Rooms ....... ........Foundation vY7 �L3' !�1 ........... Exlerior ........ i . ,e N ............... .... �. ..... .... ...............:.Roofing .......�-1 ... `�^�. !a' .................... Floors p a,� ' ..........................................................Interior ..:....1�6�. • ��................:..:................'. Heating ..... g l ...................... ` Fireplace ...........'. ........Approximate.Cost • .... ` ... Ems. .... ' � � • � � Area .. .!.?.... .................. dk- Diagram of Lot and Building with Dimensions, Fee ...:. ..' ./..- k. OCCUPANCY-PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulation f the Town of B nstable reg rding the above construction. 11 Name ......... .. f.. ... ..................:.. D 1 Cv �7 Construction Supervisor's License ............ ` HALSTED, RAYMOND T 3 2 723 .... .. _ No ........ ^Permit for Build Addition t. ...:Single_"Fami.1X..Dwe.11.ing.......... Location ..7^ She11 Lane...............p........... _ I . COtuit. ...... ... .... .... . x. .. of •-' +� � ' f" Ownery .....:Raymond Halsted - u " Frame Type of Construction Plot . .. . , t- cPermit Gran.ed ......: March':21.................................19 89 s� %. Date of_Inspection G��?..' .1......19 Date Completed .... ...19 Assessor's office (1st floor): "s"lessor's map and lot number .......0) .g„/a Q o� "E To Board of Health (3rd floor): Sewage Permit number ......... fq......; .....�,1..?��t�....�� i BJHd9'AXLE, J Engineering Department (3rd floor): yL r , �o M"°a House number 's{- . o 1639. \0� ....... .................................7. ..........:...... e war a .Definitive Plan Approved by Planning Board ________________________________19________ . 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 ......��?.w..R.�.�......�..��'....�-„J.,`�.`.'��,7.a`.!....................................�.,...�...?........... TYPE OF CONSTRUCTION � t'- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies jfor a permit according to the following information: Location .... ... ....................�.�.. .� ...............:..................................................................... .. .. ......... Proposed Use .......... -` !. ?tr�. ......................... ....... } ^a...... ..................................... ...................... Zoning District , ................Fire District . Name of Owner ...... ................ ......................Address .......... Name of Builder .1`!......!.............�........ .� ......':%'..............Address `.` ."T` �s `a„ Ate► G r1." ............ ..................................... Nameof Architect ..................................................................Address .................................................................................... ............ ......... ............................... Po t✓`. ....... '.�`!G'A. Number of Rooms Foundation .......... Exterior .`......�.°'1-> �+��`� Roofing -�� � � a��� ..... ........ ..................... Floors ........ .... ^ Ir ..............................Interior ........ ....!ar A Heating .... "':. `! .....................................................:...Plumbing ........... .srt................"� ti Fireplace ..........................t .. -...............................Approximate Cost .................. ?. .,+.. .......................... Area .�..?�`'...................... Diagram of Lot and Building with Dimensions Fee r J,.............................. L 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. ° tJ Name ...........V.................................................L................... Construction Supervisor's License ......... .. `�+'�.. .... .... HALSTED, RAYMOND A=019-096 0 I- 096 No ..32723 Permit for .....Build Addition. Sincgle Family Dwelling,,,., , Location ....7.5...Shell...Lane...............„.„...... ...................Cotuit Owner ...Raymond Halsted....................... Type of Construction ...F.XaMe.......................... ............................................................................... Plot ............................ Lot ................................. Permit Granted ....March 21 , 19 89 Date of Inspection ....................................19 Date Completed ......................................19 ,, !�U y . r , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map O t 6) - Parcel ©q& Permit# .�9 71,a 71 He - Date Issued `7'-�— G Conservation Division Fee Tax Collector Treasure Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis - Project Street Address `villag ac TLL(T— ' Address 6ff IB/j''(0 An-fl, �0 T 1�L Al Te ephone ( 06 "060(/3 A Permit Request B_PL2 -f- E/rn t EC J�&706V_ boa f -17V STubS I FLtl6X_UAAF'I 44Via / Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost hLr, SDh Zoning District Flood Plain Groundwater Overlay Construction Type ( �Z Lot Size Grandfathered: ❑Yes Wo If yes, attach supporting documentation. Dwelling Type: Single Family d� Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes Wk On Old King's Highway: O Yes IKo 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 g new. First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑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 O Commercial ❑Yes @46 If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name (lA�l7�-/ hi?�/%�'. Telephone Number8 Address 5 )L(P,a.f7a&W act%, License# TU,IT" 4;�(,3 5 Home Improvement Contractor# Worker's Compensation# &A5 &LF ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO - SIGNATURE DATE _ — 9 FOR OFFICIAL USE ONLY - . t + PERMIT NO. DATE ISSUED � s ' - • - - .. •,.-- L- � ,_ � ' MAP/PARCEL'NO. j i . , • w ADDRESS - ''VILLAGE OWNER DATE OF INSPECTI FOUNDATION , FRAME INSULATION - ' FIREPLACE ELECTRICAL: ROUGH FINAL + - PLUMBING: ROUGH FINAL ` - GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT i ASSOCIATION PLAN NO.-- - ' t _ The Town of Barnstable 9 Department of Health Safety and Environmental Services � Ear Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Building,Commissione: Fax: 508-790-6230 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, 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 Aone by registered contractors, with certain exceptions,along with other requirements. GJ ln/D0u) ' Type of Work: - 1 �. 4 P Est. Cost Address of Work: Owner's Name �I�GM �,o l/v►�hA1 l /4JL i Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law, Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name - -. The Commonwealth of Massachusetts Department of Industrial Accidents Olfrce of117Yes9gations 600 Washington Street Boston,Mass. 02111 Workers' Comj/ensation Insurann/ce Affidavit ���� ��������� ",..... name: S/� L location a/ll city �_6_Z4.I phone# a�" �� ✓ ❑ I am a homeowner performing all work myself. ❑ I am a sole oraDrietor and have no one workin in any capacity %/%////////%//%%%%%%%%���/%//%/%%//%/%%%%%/%%%%%%%%%%%/%%/%%%/%%/��%%%%/%�/%/%%%/%//%//%/////.�',;';;: �Q I am an employer providing workers' compensation for my employees working on this job. comonny name: � / � P-6—ME =tGl.?XQ ViS MIAA1 ll0 5 A1eiJ7 WAJ 9d. address: r city: Co dato 3s phone' * C.�Da') �a�g- 991 insurance cn. / /'TG noiicv# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the folloning workers' compensation polices: comoanv name- address- . city phone#: insurance cn. camnanv name: address: city • phone#' inuurance co. > 4 Failure to secure coverage as required under Section 25A of b1GL 152 can lead to the imposition of criminal penalties of a tine up to S1.500.00 and/or on;years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a line of 3100.00 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. 1 do hereby certify under the pars anddppennalties perjury that the information provided above is true and correct Si>ma G Date % Print name r/Q Et)Frei cY_ A S C H.J—ir Phone —Cl-5'1e ofacial use only do not write in this area to be completed by city or town otlleial city or town: permit/iicense# ❑Building Department ❑Licensing Board ❑ check if immediate response is rei'red ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (tum,sM*95 PIA) DEPARTMENT OF PUBLIC SAFETY HOME IMPROVEMENT CONTRACTOR Registration 100740 CONSTRUCTION SUPERVISOR Type - PRIVATE CORPORATION Number,:,"L. Expi; Expiration 06/23/00 CS 007454 02/2412096 1'2 4.19 4 4 CAPIZZI HOME IMPROVEMENT; INC as Capizzi, Sr. ar"O"T"H 0 PIZZ, ADMINISTRATOR �145 Newton on Rd. 1645 NEWTOWN RD Cotuit MA 02635 COTUIT, NA 02635 DEPARTMENT OF PUBLIC SAFETY CONSTRYCTJOMSUPERVISOR LICENSE Number Expires: C ........... ei7933 6126/1999 0912611963 i� -a R id' I�s�f 0 7 1,7 1 T H 0 K JR 28 @ PERCIVAL'OR W BARNSTABLE, MA 02668 DEPARTMENT Of PUBLIC SAFETY CONSTRUC40N SUPERVISOR LICENSE Number:- Expires: 8 i kh d a t e CS. `472 7 4 9 02/04/2002 Restricted o 00 FREDERIGK Ve RASCH III PLYMOUTH, NA 02360 co ic CAPIZZI HOME IMPROVEMENT INC . �- SPECIFICATIONS AND ESTIMATES 1 OF 411 5 CAPIZZI HOME IMPROVEMENT PROPOSAL —� Established 1976 , Serving the Cape for 23 Years 1645 Newtown Road Cotuit, Massachusetts 02635 FILE COPY D'�{�'%fig 508-428-9518 1-800-262-5060 Fax 508-428-1547 Date: /���p r t iS. �/� S fie., ■ %� F-6 8�91-ct r�r' Name : ;� /%1 ■ Job Address : 7r s h�j h Address : g- �� rc �, -- �- exT■ Town: City: ■ Home Phone: C'v ■ Other Phone: M M7 ■ r ■ Estimator: // ■ Job No. : l 7 / 7�O /�7 We hereby submit sp cifications and es imates for ng Item 1 . SITE ovi e ons . Builder to provide permit . - Builder to protect existing during construction. - Owner to move all personal objects , furniture , etc. , from work area. Item 2 . DEMOLITION �,, 5'i ,-e- ;ti TEr-ivr- Builder to remove S Tvvs Snob `/aor' T_ Builder to provide clean up on a continued basis AND al debris to be removed from site. • Item 3 . EXCAVATION All excav tion, trenching an backfill necessary for poured concret footings, foundati and slab. Item 4 . FOUNDATIO - Footin s : 8" x 16" cont ' uous poured concrete. - Walls 8" x poured oncrete. -. Sla . " poured co rete dust cap. - Co lete waterproofs Ve t: - Access: Item 5 . FRAME TIGHT . -shiez*h i-ng_ . o collar t ' 1/2" ULC plywood underlayment. �A�Xrj� nvpr _ 5 � ACCEPTED BY DATE �/ f THIS PAGE I PART OF AND IN CONFORMANCE WITH PROPOSAL # t TME r Town of Barnstable *Permit# 7- 9 Fxptres 6 months from issue date uAwmAmr, Regulatory ServicesXAM Feer— s639. 10�' Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner XoP ES S P ERIMIT 200 Main Street, Hyannis,MA 02601 Office: 508.-862-4038 OCT 2005 Fax! 508-790-6230 EXPRESS PERM_IT APPLICATION - RESIDg2We g- & LISTABLE Not Valid without Be,(X--Press Imprint [ap/parcel Number 19 qco roperty Address I c Residential Value of Work l r Minimum fee of$25.00 for work under$6000.00 ►wner's Name&Address jam' i38 r 461 �l r. E4�L, Lwno* C-1- NIOCN0 :ontractor's Name h u L C l �- i) I Telephone Number g , come Improvement Contractor License#(if applicable)_ :onstruction Supervisor's License#(if applicable) VWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance nsurance Company Name_ I [-/I \/ e) -e --17fV Vorkman's Comp.Policy# 1) (b obq 5 b `p(4 A-0-S :opy of Insurance Compliance Certificate must be on file. - 'ermit 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. 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. Home Improvement Contractors License is required >ignature 2:Forms:expmtr8 Levisc063004 w� �1 /f \ 1/1Q: Li.QyYBsfY8a16a I'b•iG wY.�hs ..� iguwJ'✓tad e.dwo-.u-..44v . `oL'T Department of Industrial Accidents - ' Office of Investigations a 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Orpnizatiowludividual): 1 lo �C— Address: � City/State/Zip: ( Q�(`J�1�.Q W+ Phone#: Are you an employer? Check the-appropriate box: . Type of project(required): 1 I am a employer with is 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ` ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. g. ❑ Building addition ' comp..insurance 5. ❑ We are a corporation and its o workers . additions [N10. Electrical repairs or required.] officers have exercised their ❑ � 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' 13` C Other �P r COMP.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and 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. Insurance Company Name: Policy#or Self-ins.Lic. #: ��qrJ `PULP /emu S Expiration Date: n CP Job Site Address � �n City/State/ZipO ��MR O&U.35 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 cari lead to the imposition of criminal penalties of a fine up to$1,500;00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the.DIA for insurance coverage verification. I do hereby ce i under t pains and penalties of perjury that the information provided above is true and correct: Si afore Dater )D,:-7b Phone it: 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 r Contact Person: v Phone#: Town of Barnstalble P °^. Regulatory Services sAxIvsrnBLE• ' Thomas F.Geiler,Director %6 9. N Building Division Tom Perry, Building Commissioner 200 Main Street, Flyannis,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 as Owner of the subject property hereby authorize. (,' a-Z -p— to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) 00 Signature of Owner; ate 0 . :Print I`Tame • F - • `Q:FORMS;OWNE UNUSSI021 Board of Building Regulat'ons an =an �ars One Ashburton Place - Room 1301 Boston. Massachusetts 02108' Home Improvement-Contractor Registration Reqistration: 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 DP8-CAI G SOM-04104-GIOIZIG � ItC �V 1..1tQ'!tl!/ea&1, 00✓VLQddCLI/f.UdP.�4 _.,5Z� hoard or Building Regulations and Standards - -- HOME IMPROVEMENT CONTRACTOR License or registration valid for individpIl use ouh. Rogistr'..4" before UIe expiration date. If found rclw'u to: . 1 1037103714 06 lioard of Building Regulations:uul St:n:d:u(is Expiration one \shhurion I Lace Iron 13.01 Private Corporation Boston, Ala.02108 PAUL J.CAZEAU•LT,&.SONS,INC. Paul Cazeault ; 1031 MAIN ST ': <:''�` C.G—r.�r rs�'✓ OSTERVILLE,MA 02658. Administrator �4- 60'1e"'nonfvnrz�' Na. 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 OSTERVILLE, MA 02655 Administrator i 7zle =_ Board of Building egulations One Ashburton Place, Rm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 10/2011959 Number: CS 026325 Expires: 1012012005 Restricted To: 00 PAUL) CAZEAULT 1031 MAIN ST OSTERVILLE, MA 02655 Tr.no: 8603.0 Keep top for receint and rhanna„r—1,4-- e� .s .� W �.� •UI1T..�. D Y t � e: D1'iz l ,'SSi z . :..tea:. ... ......:,.;...:...+;.,.,,::o - j PRODUCER ONLY CE IRCA E IS ISWED AS A i ►TTEEi 61F 4 0Ni80RRia STWBI f S`` a-DOWLINc'i'✓ o NEIL INS°AGC '}' Y. AND' CONFERS: O RIGHTS PON"THE •CERTIFICATEr , HOLDER. THIS'CERTIFICATE DOES NOT AMEND'•EXTEND•AR +. 222 WEST° HAIN,.STc.EET•„ ALTER THE COVERAGE AFFORDED BY THE P,OLICIE BELQViL".:' PO.BO{,1990 _. i g `'HYANNIS'` "" s` MA 02601 COMPANIES AFFORDING COVERAGE:,` =w ' COMPANY. U2LGR A TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA I INSURED COMPANY PAUL"J CAZEAULT 6 SONS INC. B ! 1031'MAIN STREET' II OSTERVIzLLE 14A•02655 COMPANY n«t COMPANY D S F t JQu;S�n s.` t... rrHis`� Tar ERTIFY.� o::• I T.: s,. 7H~ a E-P r OLI CIES" a.OFa Y fr If �.�NSUR•ANC E CISTEO BELOW HAVE BEEN ISSUED TO'THE'INSUREQ NAMED'ABOVE FOR THE POLICY, PER)OU; <.. ' INDICATED,'NOTWITHSTANDING'ANY REOUIREMENT,TERM-OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS!: ' it :,:INDICATE CERTIFICATE MAY•BE'ISSUED'OR MAY PERTAIN,TkANSURANCE AFFORDED BY THE POLICIES DESCRIBED,HEREIN IS SUBJECT'TO,ALL,THE TERMS, II � �. ti OPSUCHPOLICIES.l.IMITS'SHOVVNMAY'HAVEBEENREDUCEDBYPAIDGL'AIMS.'•'' .`' ��:4:-;-.� � 1� f� E s.� EXCLUSIONS AND-CONDITIONS.... ..,_. .,.. •,..,...,_ ..r._.,..�w.. ..............• CO f 4TR 'Tr• : TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS I DATE(f=O➢\YY) . DATE(MIZODWY). GENERAL UABILITY ' . . , GENERAL AGGREGATE gt '_ K, COMMtH({AL t tNtHAI tIAHIL111 ' MHUUUCI`J f(N�IF/UP AUG CLAIMS MADE F7OCCUR. PERSONAL A AOV:INJURY g OWNEt'S a GONiRAt TiiRS PROT. EACIf OCCURRENCE 'r... . g . -#. ' .:. - F FIRE DAMAGE(Any one fire) MED..EXPENSE.(Any one person) g AUTOMOBILE LIABILITY + M COMBINED SINGLE ] ANY gl)70 LIMB g J ALL OWNED AUTOS I 0001I Y INJURY z. SCHEDULED AUTOS (Per Person) g 1 HIRED AUTOS NON -OWN AUTOS BODILY INJURY 3 a+ (Per Accident) PROPERTY DAMAGE g �.0 1 GARAGE LIABILITY 'AUTOONLY_'EA ACCIDENT g { t ANY AUTO OTHER THAN AUTO ONLY—EACH ACCIDENT S w i ,AGGREGATE ' � r r EXCESS LIABILITY - ,.• g s EACH OCCURRENCE._ try ". f UMORELLAFORM AGGREGATE OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND a .� y A EMPLOYER'S LIABILITY I (UB-0095B64-A.05) 08-10-05 08-10-06 STATUTORYL9ARS tsss s at ! THE PROPRIETOR/ EACH ACCIDENT g 10 0 O IM W PARTNERS/EXECUTIVE X INCL DISEASE—POLICY LIMIT g 500 000 , OFFICERS ARE: EXCL ~_ __ — DISEASE—EACH g "T ' 100,000 w t - cif, ..5, i, zi ir.' r r {•t J D. r+ `�1 THIS REPLACES ANY PRIOR CuLTIFICATE IwUED T04TtIE CERTIFICATE HOLDER AFFECTING VIORP.ER.'a COMP COVERAGE. y` G FAG Qt; ft....,•:ay:..•: , :<.,. - .:... :..::. x e SHOULD D OULD ANY OF THE ABOVE-DESCRIBED POLICIE9UBE CANCELLED BEFORE THE ,ti i I EXPIRATION. DATE THEREOF,`THE°ISSUING COMPANY WILL,ENDEAVOR TO MAIL PauIJ.Cazeault 8�Sons '' 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDERNAMED.TO THE r Roofing,lnc. , y' w .~ LEFT, BUT FAILURE TO MAIL SUCH,NOTICE SMALL IMPOSE NO OBUGATION OR LW` 1031'Mai 1 Street LIADILITYOFAWYwN¢uPuciTllEcar�PrJiyAGOOS-awRFIiRES�itr.TlriEs. a i- m w. ..,M,,..O a1 ;4 a'r Osterv)Ilc, MA 02655 x,.:�� �'�� 4'fi T ^ '^: ' *".•" u i :t"`7+w o,a, r ti w,. s rxr :v <i AUTHORIZED REPRESENTATIVE- 7u r �. F ` s' `l• x � .P 3w, ) _ ` i s!. 1 •.e:° ry„1s:i:' +.+ ?fi ,��•<-dam°��'F 4 t d,,.,��4�Y�� k 7tv i�c:P . ' :: +^-a:,.m. _�'. ti..� .,.ux--ux•Mx4•.p-tw sr,:.,, *.ia-..^i.,+`?. It'd � t .a3•, Ghent#: 199tf9 2GAZEAULTPA ACORDTM CERTIFICATE OF LIABILITY INSURANCE OdIJE(MM/OD/YYYY) 05/0"J/Q5 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION`, Dowling &O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 222 West Main St.PO Box 1990 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED Paul J. Cazeault&Sons Roofing, Inc. INSURER A: Western World 1031 Main Street INSURER B: Osterville, MA 02655 INSURER C: INSURER D: 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. MwAun LTR INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE MMIDDITY DATE MM/DD LIMITS A GENERAL LIABILITY NPP925580 04/30/05 04/30/06 EACH OCCURRENCE $1 OOO 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDMIS $50 OOO CLAIMS MADE a OCCUR MED EXP(Any one person) $2 5500 X BI/PD Ded:1,000 PERSONAL&ADV INJURY $1 00O 000 GENERAL AGGREGATE $2 000 00O GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- PRODUCTS-COMP/OP AGG $1 OOO OOO JECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ (Ea accident) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) HIRED AUTOS NON-OWNED AUTOS BODILY INJURY(Per (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY ANY AUTO AUTO ONLY-EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND WC STATU- I OTH- EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? If yes,describe under E.L.DISEASE-EA EMPLOYEE $ SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Operations performed by the named insured subject to policy conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Paul J.Cazeault&Sons DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Roofing,Inc. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 1031 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Osterville, MA 02655 REPRESENTATIVES. AUTHORIZED REPRESENTATIVES ` L C ■i,�w�.� ACORD 25(2001/08)1 of 2 #M38166 LS1 © ACORD CORPORATION 1988 e THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) m A �C(L� IL DATA