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'1F JC: ,d 64 .('- .t R t !S !{ .,.zs,,pp, a .d A`i. ,1. §' „1.➢. 3,1..r°Sv. ,z�.t,..a'4... ¢,.,... ,. ,, ,a1 ,.r.v..,v,,:�q:'.: t . ,': :. l5 m 5,�..,?� a'+'3 Gt..r.. �.,. e.;-.M ,:•r..: „{ F: a.,., ,a:.#,.. ,..r7 1„ ..,-, is r: ,mkF 7 , �. ,.! £.('., ,. !t L;e,. ,d,,.t„�N3S � ,'S„+4.r ,,fi1. liyy.1A y.^zr � �dr�.S,F�kf:' ,is".�.'r1 ,t,u.,::{7A7>`;}u ..arf5,l..?r,,,. 9:et^. ,+. n,5`�,u�.,,,:k? .� fi !. r}•'u�raSd{nu.:.➢f+�^zr / _ ' �� �ii:� L�� � C�e%�� ���f �� �� R qKE r 4 / 7 Application number.......................... Date Issued.......HARNSTABLZ ���(.(. .. ° w A'itiSS � A/o � �. II o�� N o� Building Inspectors Initials.....TO INA/ . �� [ABLF Map/Parcel.........� 8....t�f 7.................................. CD- TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIljWG/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION ION Address of Project: e1l& C ee(r;c- CZ aQ . NUMBER STREET ' VILLAGE Owner's Name: Pe. �/ % Phone Number 7 x/- yo/-or-v z Email Address: gq,XI, 5- ver;zo ,,r)-4 Cell Phone Number Project cast 19, Check one Residential vl Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: 5 e r A-iq z Ana C��,.-{r�-� Date: TYPE OF WORK Sidingi 1 Wind w o s (no header change)# %/ ❑ Insulation/Weatheriz 'g ) atton Doors (no header change)# Commercial Doors require an inspector's review El Roof(not applying more than I layer of shingles) n Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name (�r�Gn `��n.�,'so - SS,, 2�n' Afe.�! �:,,, Iev4 1,fl'n chow S Home Improvement Contractors Registration if applicable) 17 3 Z.Lt.� (attach copy) Construction Supervisor's License# 09 S`7 Q;7 (attach copy) Email of Contractor See- q q5-@ G ; (- C b M Phone number V0/- -, Z R -9 Roo ALL PROPERTIES THAT HAVE STRUCTURES VER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS ltN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUE®. j APPLICATION NUMBER ......•• .................................................... *For 'Tents Only* Date Tent (s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/COAL/EELLE'T STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowners Name: III Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures; specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date PLICANT9S SIGNATURE Signature . Date All permit applications are subject to a building official's approval prior to issuance. Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal By Andersen of Southern New England Heave Peggy y .. Legal Name:Southern New England Windows,LLC. 218 Cedric Rd RI #36079, MA#173245,CT#0634555,Lead Firm#1237. Centerville;MA 02532 wixoow RE cacsMExt 10 Reservoir Rd I.Smifhfield,RI 02917 H:(781)407-08N Phone: 866-563-22351 Fax:401-633-6602 1 sales®renewalsne.com Buyer(s)Name,(Peggy Heavey Contract Date: 05/20/19 Buyer(s)Street Address: 218.Cedrie Rd, Centerville; MA 02632 Primary Telephone Number: (781)401-0802 Secondary.Telephone Number: Primary Email:peggyh5fterizon.6et: Secondary Email: Buyer(s)hereby jointly and.severally agrees to.purchase the products and/or services of Southern New England Windows,LLC d%b/a Renewal'By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions.de'scribed in this Agreement. Document and PaymentTerms,any documents listed in the Table of Contents,and any other rdocument attached to.this Agreement Document, the terms of which are all agreed to b the parties and incorpporated herein by reference(collectively, this "Agreement ) Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under.this Agreement. Total Job Amount: $18,86] Bysigning this Agreement;you acknowledge that,the:.Balance Due,and:.the Amount Financed must be made by personal check,.bank check,credit card orcash . Deposit Received: $9,433 Balance Due: $9,434 Estimated Start: Estimated Completion:, Amount Financed: $18,867 . 6 to.8�.week 6 to 8. eek Method of Payment: Financing : '.We schedule installations based on the date.of the signed contract and secondarily on the date in which we complete the technical measurements:The installation date that we are providing at this time is only an estimate.We will communicate an official date and time-At a later date.,Raiti and extreme.weather are the most common causes for. delay. Notes: Depo paid.gsky/bal gsky;Tax Centerville Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing:or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will,be valid without the signed,:written consent of both the Buyers) and Contractor. Buyer(s)hereby acknowledges that Buyers) 1)has.read this Agreement, understands the terms of this Agreement,and has received a'completed,signed,and dated copy of this Agreement,including the.two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel.this Agreement: .. - •. NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy,of the contract at the time you sign.. YOU,THE BUYER,.MAY CANCEL:THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 05/23/2019 OR THE THIRD BUSINESS;DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER:SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN. EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC dba:Renewal By Andersen of Southern New England Buyers) Signature of Sales Person' . Signature Signature Cory Scanlon Peggy Heavey. Print Name of Sales Person Print Name Print Name . UPDATED: 05/20/19 - Page'2 / 13. I-—I -I `� Iz �1? - t-/ Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card Registration: 173245 SOUTHERN NEW ENGLAND WINDOWS LLC_ - Expiration: 09/18/2020 10 RESERVOIR ROAD SMITHFIELD, RI 02917 -05/17 SC 1 1 0Update Address and Return Card. 20M� ��/CP. �GYJJ/72/.'?,CC'P,O:GI�G�G'�2vJ!LC/GCGJC`Gs Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:,Suoolement Card before the expiration date. If found return to: Reaisti"ation Expiration Office of Consumer Affairs and Business Regulation 1732.4b- 09/18/2020 1000 Washington Street-Suite 710 SOUTHERN NEW-EN_GLAND WINDOWS,LLC Boston,MA 0211 BRI N A DENNISON \2 _" 10 RESERVOIR ROAD SMITHFIELD,RI 02917 Undersecretary '-!--..--Without signature r Commonwealth.of Massachusetts ;.y Division of Professional Licensure Board of wilding Regulations and Standards Constructt6n Supervisor CS-095707 Ea-p i res: 09/08/2020 BRIAN ® DENNISON 8 BLACKWELL-DRIVE CHARLTON MA-, 507 S1 a •` f i �.i Commissioner The Conunonwealdt'of�Ylassachusetts Department of Industrial Accidents 1 Congress Stree4 Suite 100 Boston,MA 02114--2017 www mass gov/dia «or6•ers'Compensation Insurance Affidavit.Builders/Contractors/Etectricians/Plumbers. TO BE FILED WITH THE PEILNU TI:YG AUTHORITY. Applicant Information ,, !! Please Print Legibly Name(Business/Organization/individual):__— btx'�'h e r 11. Ne u� �i LLnp I ! /A it) Address:-Jo U Se r VDt r Ci /State/Zi : e-jd 7?1 DZ / C) tY P SM �� � 9 7 Phone#: �01-ZZ�— Ara you an employer'Cbeck the appropriate box: L Type of project(required): 1. t am a employer with �7 employees(full and/orpart-time).* -7. New construction 2 am a sole proprietor or partnership and have no employees working forme in $; Remodeling any capacity.(No workers'comp.insurance required] ❑ 3. I am a homeowner do' all work m sei 9• ❑Demolition ❑ � Y [No workers'comp.ir>a��.a��required,]r 4.[]t am a homeowner and will be 10 D Building addition hiring contractors to conduct all work on my property. [wilt ensure that all contractors either have workers'compensation insurance or are sole I L[]Electrical repairs or additions proprietors with no employees. ❑S.[]I am a general contractor and t have hired the sub-contractors listed on the attached sheet 12. Plumbing repairs or additions13.o Roof repairs These sub-contractors have employees and have workers'comp.insurance.t qq ' 6. We ace a co ration and its officers have exercised their ri 14.[tither W i�cee w ❑]A§1(4),and we have no employees.[No workers'comp oinsurance exemption MGL a r *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 suck xContnrctors that check this box must attached an additional sbeecshowing the name of the sub-contractors sad state whether or not Use entities have employees. Ifthe sub-contractors have employees,they must provide their workers'comp.policy number. I ant an enfloyer that is prolridina workers'compensation insurance for my employees. Below is the policy andlob site lafornmaon. � n Insurance Company Name: `I"'!f P;l1�I w t7,swamp— GO . pF W9, Policy#or Self-ins.Lic. -8 /c2 Pp?T— Expiration Date: Job Site Address: City/Stataip: 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. 152,625A is a critnina 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 MOM a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce . under the p ' And penalties of pei jury that the informadion provided above is true and correct: S i re: Date: — — Phone 22:2 9 M Official use only. Do not write in dds 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!/- Aco CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DWYYYY) `� 1 12/28/2018 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 endorsement(s). PRODUCER CONTACT NAME: CoBiZ Insurance, Inc.-CO PHONE FAX 1401 Lawrence St., Ste. 1200 WINE e: 303-988-0446 A/c No:303-988-0804. Denver CO 80202 E-MAIL COMaiI cobizinsurance.com INSURE S AFFORDING COVERAGE NAIC# INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO-01 INSURER.B:Firemens Insurance Company of WA,D.C. 21784 Southern New England Windows, LLC.dba Renewal by Andersen of Southern New England INSURER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: INSURER F. COVERAGES CERTIFICATE NUMBER:787175890 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. ILiRR TYPE OF INSURANCE ADDL SU R . POLICY NUMBER POLICY IDDY� MWODNYYPY LIMITS A X COMMERCIAL GENERAL LIABILITY CPA3158728 1/1/2019 1/112020 EACH OCCURRENCE $1,000,000 DAMAGE TO REN CLAIMS-MADE a OCCUR PREMISES a occurrence $300,000 MED EXP(Any one person) $10'Wo PERSONAL&ADV INJURY $1,O()O,ODO GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2.00W000 X POLICY PRO- LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY CPA3158728 1/112019 1/1/2020 COMBINED SINGLE LIMIT $ a accide�_ 1,000.000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident $ $ A X UMBRELLA LIAR X OCCUR CPA3158728 1/112019 1/1/2020 EACH OCCURRENCE $15,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $15,000,000 DED I X I RETENTION$, $ B WORKERS COMPENSATION WCAM5872924 1/1/2019 1l1/2020 X ST TUTE ER OTH- AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,0oD OFFICERIMEMBER EXCLUDED? N❑N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1.000.000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C. Pollution Liability 7930073340000 1/1/2019 111/2020 Each Occurrence $2,000,000 Claims-Made Policy Aggregate $2,000,000 Retroactive Date 06/20/2013 Deductible $25,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. FOR INFORMATIONAL PURPOSES ONLY AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD � 6C -7U� Town of Barnstable *Permit Expires 6 months jrom issu ate Regulatory Services . Fee vil 9 ..N„639 sue,' Richard V.Scali,Director �-1 Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY a - Not Valid without Red X-Press Imprint Map/parcel Number . / 0 63` ,,-a Property Address_a $ � C't G t Can__k 'C-U I �15 - [Residential Value of Workt— Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address t teen Contractor's Name Baker&Associates, Inc Telephone Number 508-362-2445 Home Improvement Contractor License#(if applicable) 162600 Email: info@bakercape.eom Construction Supervisor's License#(if applicable) 009714 OWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Associated Employers Insurance Workman's Comp.Policy# WGC589a9A24a4291aArti Copy of Insurance Compliance Ceficae m tust 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) ❑ Re-side (Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows_ #of doors: ❑ 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 Improvement Contractors License&Construction Supervisors License is re ire . SIGNATU E' C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOI DHR\EXPRESS.doc Revised 040215 Adhorization Form: as owner of the subject property, hereby autho i.e Baker & Associates to act on my behalf, in all matters relative to work uthorized by this building permit application. for Address of,propr : 218 Cedric Rol. Centerville, T Signature of owner: Print Name. Date: '�_ j �e F , Y T'he Cammanwealth o,f Massackuselts. Department of Industrial Accidents . 3 t777ffice of Investigations' s 604 Wi>'shingtoir Street Boston,MA 42111 stiviv.mass govldia Workers' Compensation Insurance-Affidavit- Builders/Contractors/EIectricians/Piwnbers Applicant Information Please Print Legibly Name des{ lioii�b&iduaD- Baker&Associates Inc Ad&m: 521 Shootflying Hill Road City/State/Zip:Centerville MA 02632 Phone 508-362-2445 Are you an employer?Check the appropriate boa: Type of project(required): 1.9 I am a employer with 1 4. ❑ I am a general contractor and I 6. .❑New construction employees(full andtor part-time)." have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet_ 7. ❑Remodeling ship and have no employees These sub-contractors hat a g_ ❑Demolition. working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.itmxanre comp.msurance_- rewired.] 5_ ❑ R'e area corporation and its 10.❑Electrical repairs or additions 3:❑ I am a homeowner doing all work officers have exercised their 11_❑Plumbing repairs or additions myself.[No workers'COMP- right ofexemption per MGL 12.❑Roof repairs. insurance requimd.]t c.152,§1(4)-and wee have no employees.[No workers' 13.0 Other comp.insurance required.] *Any applicant that checks bra*I must also till out the section below 3hmme their workers:compensation policy information. T Homeowners who submit dm affidavit indicating they are doing all walk and then hire outride contractors ma submit anew affidavit indicating such- Godactors that check Shin bass mug attached an additional sheet showing the name of the mar-canuxtors and state whether or not those entities have employees. If the sttb-connttactois have employees,they must provade their workers'cornp.policy number. I am an employyer that h providing workers'compensadfon insurance for iriv empiojves. Below is the policy end job site information. Insurance.Company Name.Assocuated Employees Policy,*"or Self-ins-Lic_9:wcc50050024542015a Expiration Date_ l Job Site Addtess: City/State/Zip- 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 can lead to the imposition of criminal penalties of a fine up to S1,500,00 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 fiorwarded to the Office of . Investigations of the DIA for mi surmce coverage verification. I do hereby certify)u�nde®r the pains and penalties of perjuty that the information provided above is true and correct Simature'. ZZ Date' /a Phone Q f€ciat use only. Do not write in this area,to be completed by cite,or town official City or Toter PermitUcense it Issuing kuthority(circle one): 1.Board of Health 2.Building Department 3.CityiTown Clerk 4.Electrical Inspector 5.Plumbing Iaspector 6.Other Contact Person: Phone#: 6 3i�lE i3 iai rl fit},>i•s..:4 .:,.. CS-009714 . RICHARD P.GAR,NEAU Jet PO BOX 476 West Barnstable MA 026i6t; a 04/04/2016 Office of Consumer Affairs a d Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 0211.6 Home Improvement Contractor Registration ......... Registration: 162600 Type: Supplement Card 'Expiration: 3/26/2017 BAKER &ASSOCIATES INC. RICHARD G'ARNEAU -___.... ._. __.........._._ P.O. BOX 923 ...---_ __ -........:..........._._ _......: _......_.....--- CENTERVILLE, MA 02632 Update Address and return card.Mark reason for.change. Sc,n 1 0 zone-05/11 E Address � Renewal � Employment E.I. Gast Card dTAI ney�a xu+rral� r' C?�F2�izJacxc �are<i { cc of Consumer Affairs 8c Business Regulation License or registration valid for individul use only E IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation egistration 1 .2604} Type: 10 Park Plaza-Suite 5170 Expiration 3/26/2017` Supplement Card Boston,MA 0211E BAKER&ASSOCIATES CNG.'; RICHARD GARNEAU' 521 SHOOTFLYING HILL RD - .... _........ .....-- _ CENTERVILLE,IiAA 02632 Undersecretary Not valid without signatur f _ t } Client#:9742 2BAKERAS ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE(MMMD/YYM 04/22/2015 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,sublect 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 endorsement(s). PRODUCER iCONTACT i NAME: Dowling&O'Neil PHONE - Insurance Agency E CV Ext:508 775-1620 A/C,No): 5087781218 973 lyannough Rd., PO Box 1990 ADDREss: � INSURER(S)AFFORDING COVERAGE NAIC 0 Hyannis,MA 02601 !INSURER A:National Grange Mutual Insuranc INSURED Baker&Associates,inc. INSURER B:Associated Employers Insurance P 0 BOX 923 INSURER c Centerville,MA 02632-0071 INSURER D i INSURER E: INSURER F: 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 CONTRACTOR 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. LI pR TYPE OF INSURANCE ADDL UBR POLICY EFF POLCY EXP INSR WVD POLICY NUMBER MMIDD MM/DD LIMITS A GENERAL LABILITY MPJ7223M 4/19/2015 04/19/2016 PEACH OCCURRENCE $1 00O 000 X:COMMERCIAL GENERAL LIABILITY PREMisT Eaoaurrence $500000 CLAIMS-MADE 1 L X OCCUR MED EXP(Any one person) $10,000 _ ` I I PERSONAL&ADV INJURY $1,000 000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMB APPLIES PER:PROPRODUCTS-COMP/OP AGG $2,000,000 POLICY JEC LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT h-- Ea accident ANY AUTO BODILY INJURY(Per person) :$ALL OWNED SCHEDULED _-_AUTOS _AUTOS BODILY INJURY(Per accident) $ i NON-OWNED P HIR ROPERTY DAMAGE ---- --ED AUTOS AUTOS $ -- Per accident $ UMBRELLA UAB OCCUR -- — }--- EACH OCCURRENCE I$ EXCESS LU\B CLAIMS-MADE ----- AGGREGATE $ DED RETENTION$ T_ ---- --- WORKERS COMPENSATION WC STATU- OTH- $B I WCC50050024542015A 4/23/2015 04/23/201 X AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE i OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT %500 OOO_ I(Mandatory in N M yes,describe under E:L.DISEASE-EA EMPLOYEE $500 000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $4OO,000 i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. „ CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE 01988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S149786/M149785 MER A,ssessofs Office(1st floor) Map Parcel ® �' Permit#` / _ Date Issued Tan. A Fee /&V Engineering Dept. (3rd floor) House# J BARNSTABU. 19 MA a ,� TOWN OF BARNSTABLE ; Building Permit Application oject.Stre ddress / C C Village.e-In J e'r i Owner/'I rs Ren AV Address �.l � C���t�� P.ql { .Telephone F Permit Request �'� Gt a O `� h 1 N1 Q'I PL s r V crF C©h L 10 A e l-A ie r V-F e�i 54 i p►g s h', es o a wi e reseeti !:1: kJs_�-Qll so ve�J-L C( VVd r,*,dc vex ®h eils4l'hiL hot" e First Floor square feet Second Floor square feet . Estimated Project Cost $ , Zoning District Flood Plain Water Protection Lot Size Grandfathered ? (Zoning Board of Appeals Authorization Recorded Current Use Jc/o G �� �,1�Y 046 P Proposed Use 5 i12j 1e 4C,,,;_"Z �c, Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure rev_f Basement Type: Finished Historic House O Unfinished Old King's Highway ki �/ Number of Baths ` '�� No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel l L Central Air (/(, Fireplaces f Garage: Detached Other Detached Structures: Pool Attached f Barn None Sheds Other Builder Information Name q L t L� !it Telephone Number © Address n e_ R License# , 60 !?- 4 dM4� b Home Improvement Contractor# 0 D Worker's Compensation# S e/ 2 hip/cP� NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO v Vh 6 sie—r SIGNATURE DATE O Za-3 ZI BUILDING PERMIT DENIED FOR T E FOLLOWING REASON(S) FOR OFFICIAL USE ONLY ,^ - :• PERM N... DATE:SSU D _ MAP/; AR EL NO. t ADDR SS ° , VILLAGE i OWN DATE F I SPECTI I t FOUNDATION FRAME t _ r INSULATION FIREPLACE r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH ` FINAL •, r '• 7 GAS: ROUGH b FINAL FINAL BUILDING � t DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Alassachusetts Department of Industrial Accidents 8 ccBURFOsl/got loffs :��•\ :;#.:.__r,: 600 !1<uslrt►tgtun Street Boston,Alas. (12111 `- Workers' Compensation Insurance Affidavit �,�phcant rotormation• _ _ Please PR11VTlebtbl�=� name• /r�,JQ t/ 1"J Ll:k a� L locition- k, e c citvV l 6? e 1 am a bomeowner performing all work myself. am a sole proprietor and have no one working in any capacity i tstw-•f�rw..f�'.•-..c-...--r.7.-�.. ,,. __ MpA°s�,��•w` _.,,�.. - --- t '''_" ZC..::i.""e""""'""..""".""�-""` 1 am an emplover providing workers' compensation for my employees working on this job. compiny name. �sldreee• _ may nhone#• insurance co nolicy# am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comijany nnmc• a(ldress: City. nhone#: insurance co oli •# �.'�•.st.. .�:•-.-r.: __ .... Kn•:/-.y,:Tl�es"r�'y�'�1'��ti��fi-.��''sr+P= "�'7CG�F'l�''R1�rR�'T.�r7era7F"!^T4"..*'_'4S '*4MCT�'.'�":^�J' comanv name: address- city nhone#: insurance co nolicy# ::Attach additional shcJ t if oec �� :•�7 <.w�s: ^.�t` r +arm ;:•;,;,;*'*=`_ "te" — .rs..�. Fuilurc to secure coverage as required under Section 25A of I11CL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or One Fears'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of SI00.00 a day against me. 1 understand that a cop-.'of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby cerrifj under the p ins and p aloes of perjury that the information provided above is true and c rrecL/ Si=nature l Date Print name- '"Dal rp (ae L Phone# -/74 �p - .moo. -�• official use onh• do not write in this area to be completed by city or town official city or town: permit/license# rnBuilding Department E3Licensing Board. check if immediate response is required C3Scleetmen's Once �licalth Department ' COMM person* phone#;. nOther ! ;. iC -a.— ,...-.-.�.►-r _,..�..-..rr...-� .r Imised 3/45 PJA) . The Town of Barnstable �S Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Ralph C.rossen Office: 508 790-6227 Building Commissions Fax: 508 775.3344 For office use only Permit no. Date AFFIDAVIT HOME V"ROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the-reconstruction,alterations,renovation,repair,modernization,conversion, improvement,•mmo%al, demolition, or construction of an addition to any pre-existing owner occupied led building containing at least one but not more than four dwelling units or to suucmm which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work:'' D o °.I� Est. Cost LA��_ Address of Work: l endir i C _�z57( i� 't tc �� e Oaner.Name: 64 / Date of Permit Application: J I herein,certify that: Registration-is not required for the following reason(s): Work excluded by law Job under S1,000 Building not owner-occupied Owner pulling own permit Notice is herebv given that: CONTRACTORS MP NOT OWNERS PULLING THEIR OWN PERMIT OR DEALINGCG DSO LjNF u LESS TO THE FOR APPLICABLE HOME IROVEMENT 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 ov►-ner. a Date Contract r name Registration No. OR nest Owner's name . i Z, COMMONWEALTH ;I,DEPARTMENT OF PUBLIC SAFETY -• i• OF -ONE ASHBORTON PLACE ; MASSACHUSETTS f BOSTON,MA 02108 LICENSE " CAUTION EXPIRATION DATE 18414 `.CONSTR. SUPERVISOR 06/22/ 996 EFFECTIVE DATE LIC-NO. l FOR PROTECTION AGAINST RESTRICTIONS p THEFT, PUT RIGHT THUMB 1 S 03/31 /1994 •050096 PRBOX ON IN -1 9 2 FAIMILY HOME DAVID 6 HUFNAGEL Ir? t c 38 JONES RD BLA INGOP€RATIO MASHPEE PIA 02649r . Mt NCI P}3Dj .`. FEB 1 6 194 PHOTO(BLASTING OPR ONLY( Fib � i ^ ! Q.00 NOT VALID UNTIL SIGNED BY LICENSEEAND OFFICIALLY '« HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER 1959p . L.—0 THIS'DOCUMENT MUST Di � I•; SIG r CARPIEDON THE PERSON SIGNATURE OF LICENSEE THE HOLDER WHEN Et, OTHERS-RIGHT THUMB PRINT GAGED IN THIS OCCUPATIOt t; COM IONER e< z;w t k; DME�INPROVEME r��,• _ Regll r lion } ` TYPe a' � 1088 1 ATE CORD ON '" CUSTOM50 REMODEltN6 NC 3 {t N . ,. HUFN•0 E „ F ADMINISTRATOR a R - r _ � �,h�� MASHPEENgg0264'4 r. j s R Assessor's map and lot numb r .. l � 87� �Q�O TN Er Sewait number ... ,� _p• � BABHASeTdDLE, i House number .........................:. I.O... :. ........: ....;i.. M a YPY a' TOWN OF BARNSTABLE AUILDING "-INSPECTOR APPLICATION FOR PERMIT TO ........... ..... . ... ........ ........ ..................................... TYPEOF CONSTRUCTION. .... ...... .............. IJ ................ :.:.......................................................... :. ....... ...........................19�ir•• TO THE INSPECTOR OF BUILDINGS: The undersigned hereby plie for a permit accord' to he followin information: Location .... `. .................... :....:g ..... �?.1.. ............... ProposedUse .......41C 4?... .. ..... ...................................................... ..................................... ............. ZoningDistrict ................:.. .........................................Fire District ..:.. .. .. ........................................ . .................... LK.Name of Owner` ........... 147dclress .... ................ Nameof Builder ..r... .s............. .. ..... ..............Address .�1.1............... .......... .. .... .............. .................. Nameof Archi ect ../.'.4 �............................................Address .................................................................................... m4nAlITI& Number of Rooms .....lJ Foundation ....................................... ..... . Exterior �!�u' �t"' -Y.... .......... .. .. .. ...................Roofing ........... ...... ....... ..............::......::................................ p w Floors . ... . .. ...... ...........................................................Interior ... .....� ................. Heatin ......Plumbing ............... Fireplace ...................................................Approximate Cost ..............................ol/............ 11-1, .Definitive Plan Approved by Planning Board -------------------_-----------19________R Area . ..... .............. Diagram of Lot and Building with Dimensions", Fee ...:........ l....:-_.-.. SUBJECT TO APPROVAL OF BOARD OF HEALTH ti VI�'1 ASio S Ida-® GW� L-A/fCl� ` /Tep` T O-z' e1157-/ILC- (? To ro0� o +fie &_,CCoS k'p ' w r 7-W401, 4r �e -AR G1£ H005)z a, f - OCCUPANCY PERMITS REQUIRED FOR NEW D MGS 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 .... .q23..2 F MUIZVERY, EI=N & MARG RET F No .. ... Permit for PORCH......... Single Family Dwelling f / of N Location 213 Cedric Road . ... ...............Centerville........................................ Hearvey, Eileen & Mar aret Owner .. .. .... k � ,•i:�~ �:�; Frame. .�. .� .... f Type of Construction < 73, Plot ...... Lot -' L 4-2 Permit.Granted ....Tay 1.' 9 84 -V t D,ate'of I spectio /` .....r...... 19� Date Completed .: �...r.�<. r9 - .� .� F-r ` r% >4 p j o jj,` - /�• Q ., �r.r1 "' ~• , '"' 'cam" ' 's •-''. - _ ,,�5 `�`� � � '- _ .�_ `•'�,,,_._._....fir 1��,1�� _ IV 1 Assessor's map and lot number f� " .r1: •.k':.... ,�" : �oFTNE Toy ..:.............. � Permit number .�...� ...!!Y..:..<.<,...............::wcg ....... ...... Z BABHSTABLE, i House number /// ""8a O t 63 q. `e0 TORN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO (���� 2 .c.t,.�t � / T 1� e� *;a ...... .......... ........ .........................`........................... TYPE OF CONSTRUCTION .... ..�................................. ........... .........................191� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby plies for a permit according to the following information: Location ..,......�.Q�r .... ..................... +................... ..............................................s........................................ ........... ............. ProposedUse ......:�;u.IL1 ,A.....&14i�A................................................................................................................ ZoningDistrict ................... .........................................Fire District .....` .. 0....................................................... 0- 4 Nameof Owner ................... Address .. .,.,.•........................................................ aaName of Builder ...... . ...... .!... ..... ... ......... ..............Address ..................................Af..... ............................� Nameof Architect .. ............................................Address .................................................................................... Number of Rooms .....0:9!?.•""....................................... Foundation .... ...................... Q. Exterior ................`.. ......,...:.....................Roofing ........... ....... ............................... ............................... Floors ..... /.!!.... l............................................................Interior ....C ..... ... ................7W41... ...................... ................. .............. � Heating �..............................................Plumbing ..... �>..................................................... //�,.� Fireplace ...........................................................Approximate. Cost "7Y/©Q �r� ....................... Definitive Plan Approved by Planning Board -----------_______-----------19________. Area .........................:..... .......... 00 - Diagram of Lot and Building with Dimensions Fee ............ `� �....................... SUBJECT rTO APPROVAL-OF BOARD OF HEALTH ` r_ �L I�im�N5i0�S /dao �j� �IVGLoSC-�,p a i i �AR{�Gli HUv`�0� S�f " ao ' OCCUPANCY PERMITS REQUIRED FOR NEW DW GS I hereby agree to conform to all 'the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...I ..�1:.�,.- . . ..a.... L.. .......... ............... Construction Supervisor's License ....f.�.... Q (� �....... ..s'.....C3 HEAtRVEY, EI=- i & -MARGUE-E A=148-087 1�411909'7 26366 ADD PORCH No .....:z�......... Permit for .................................... Single Family Dwelling................. ......... ................................. Location 218...Cedri...c..Rpad.............................. .......... ... ..... Centerville ............................................................................... Owner ....... .. .... ........ Type of Construction' Fram..................... ................................................. ............................. Plot ............. Lot ................................. Permit Granted .........May 11................. ....... ... ..1984 Date of Inspection .....................................1 9 Date Completed ......................................19 16 1 y� oFz Toyy Town of Barnstable *Permit# 0 Expires 6 months from issue dote uu >�SUMM = Regulatory Services Fee 9 1639 `0� Thomas F.Geller,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 ` '~ Fax: 508-790-6230 , EXPRESS PERAUT APPLICATION - RESIDENTIAT Not Valid without Red%Press Imprint TOV y,,, Map/parcel Number i q &d l� I C,O+ e a= t YN 'Property Address MA -�o residential Value of Work 00D Owner's Name&Address Jam WQ-&4rQ- uC Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) 10,3757 Construction Supervisor's License#(if applicable) S 61)toCO'Y 3 orlcman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance y /p Insurance Company Name & /t Z& L.rm�- Workman's Comp.Policy# boo L/17 V30 to?CO2 3 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.' eplacement Windows. U-Value 9 3 g (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 Qontractors icense is required. Signature Q:Forms:expmtrg Revise(15�f10� Approximate Start D i Approximate Compl is I accept the work indicated above. /O c;� aO 43 Customer's Signature ate y JO Con actor's-signatuit Date The Commonwealth of Massachusetts - Department of Industrial Accidents — office otIONS 089oas 600 Washington Street . Boston,Mass. 02111 Workers' Compensation Insurance Affidavit EL name: location• � city phone# ® I am a homeowner performing all work myself. ® 1 am a sole proprietor and have no one working in any capacity am an employer providing workers' compensation for my employees working on this job. . co R>I11Y . . .�';Ile . ttame�' � fi6'u �'t�.%i'Y�� .L' (�i"ti�tt'•�rYl'Li�A addeesss>:_ 9 Rc,rn c k ,lam. .. ciln.*: A h 5 ran A c a l,901 phone# 5 6zl ')"t.�—..l instiraeeeeo P laQ�— t �a .: 1 am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who hu the following workers''compensation polices address:.. Iaegraaee:•sdr:.:... ;;:. .::: ; : .. . . .. R compan�stame:' : •:.... . . phoneA insareeee��a p�Y# ' Failure to aeeure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 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. do hereby eerto under! pains and pgltallies of per)ury that the information provided above is true and correct. Signature l Date Print name2fc d k- SA r4nid—e— Phone# z 7 S t 7 I omcial use only do not write in this area to be completed by city or town official city or town: permidiicense# nBuilding Department OLicensing Board ❑check if immediate response is required oSelectmen's Office ❑Health Department contact person: phone#;_ nOther (Mviue V95 PJA) 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 the 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. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names,address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the 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 permittlicense number which will be used as a reference number. The affidavits may be Eturned 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. The Department's address,telephone and fax n—am' .,i:___. .. .. .. . The difice of fnvestleauolls 600 Washington Street Boston,Ma. 02111 fa.x#: (617)727-7749 Y%hrunc.i. r4t'71 '717_eonn av+ An4 AM TIC 00 3'S,000 cf enc[oset space (MGL CA12 S SO:L) 1A'- Masonry only f h Family Horne Farlure to,possess a current edr# of he 1VIas_sachsetts State Bra�itling Code k is cause_for relocation-of this-incense. DIG SAFFE CALL CENTER: �88,8) 344= .y r� .^OL a'a75 ,a . ` License or reg strat5iorn valid fog- inddi, -use only befor Pe the ex: iraton date: If found return to ' Board of Buildi=n Regu�latons and Sxanda-rds a One Ashhurton Place Rm 1301 y . Boston, Ma. 02108 tih F .. J ,.•H F Not valid withon"t si ature 1 -� BUNA!RD O BU-I�LDINGREG +►TIOMS License: CONS °�R;UCTIONx S PE'Ra IS R � � w E Number: CS 0066�43 , d tie � t _ 1, E_ e�: /08/2905 Trno: 571:1 IRsrtct B RR JI�VK hSPRItVlo LE 1r94�L�THROPS � N r r;� Adrn,nistrator- .t a �,g '^ y _�� � n:r �vt�k�i...'"•z�� „�. __ l _ ^�N�f�?�s �,* �a �.�,+Qvr�"�°2a�,, `�' ��`����� �', ri� R %!�'�__. -__-____. ..._.._-.�. _�_-`_-_--�T_-._-.��...v.f�-___ �_�_.___.cam-_....._...m_.».- -•_.-_ -�. -:-.=z v_ ._____---_-__- -�.•. _,.. a Board of, Bult-dig Re lat ons and tandard , x . ' NOME IIVr IE WT` se Reistraxa�; ` 1U3757 . xplrion: 79/ 00`4 �`yp�e Prt atte Corpora n I�NIKLE HOM IMPR�JVEIV1yEI1T i Brad Spra�kte 1"99 Bars#aba.e Rd. H, s: hllAMSG d N ., Amyns�rao°r w 4` CERTIFICATE OF INSURANCE =(MWDDNY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE Bryden&Sullivan Ins Agency DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE Inc POLICIES BELOW. 88 Falmouth Road , COMPANIES AFFORDING COVERAGE Hyannis, MA 02601 INSURED Sprinkle Home Improvement Inc COMPANY A.I.M. Mutual Insurance Co 199 Barnstable Road LETTER A Hyannis, MA 02601 � 1 COVERAGES _ ThlS IS'1 U CEk'!!fY':e itA'1 THE 1vJ.Clka O1 INSUk"a LNUL)BECUW HAVE BEEN:SSUEV TO THE li:f;URED FAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECTTO 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. , t CO TYPE OF INSURANCE POLICY NUMBER P L'CY EFFECTIVE POLICY EXPIRATI 0.0 L DdTE(MMJDD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ ME RCIAL GENERAL.LIABILrTY PRODUCTS-COMP/OP AGG. S r- 'LAIMS MAUEI .O000R PERSONAL R ADV.INJURY $ • WNER'S R CONTRA(-r0R:S PROT. EACH OCCURRENCE S FIRE DAMAGE(Any one fire) f MED.EXPENSE(Airy one peraoo) S AUTOMOBILE LIABILITY I COMBINED SINGLE f ANY AUTO I LIMIT j ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS Per pecan) HIRED AIjIUS ' BODILY INJURY I S NON-OWNED AUTOS Per awkiem) GARAGE LIABILITY PROPERTY DAMAGE S LESS LIABILrrY EACH OCCURRENCE S R BRELLA FORM AGGREGATE S HER THAN UMBRELLA FORM WORKER'S COMPENSATION AND X WC STATU- OTH- EMPLOYERS'LIABILITY 7004943012003 05/13/2003 05/13/2004 EL EACH ACCIDUM f .� A THE PROPRIETOR/ PARTNERS/EXECUTIVE INCL E DISEASE- ICY LIMIT S 500 000 OFFICERS ARE: EL DISEASE-EA EMPLOYEE $ 100 0w R DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS - CERTIFICATE HOLDER CANCELLATION _� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE PIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO III. 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE FT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR WILI'Y OF ANY KIND UPON THE COMPANY. ITS AGENTS OR PRESENTATIVES. THORIZED REPRESENTATIVE /J ............. . ................. Ass�ssor's map' and lot number Se ge Permit number ...�Lt............../............. *'THE TOWN OF BARNSTABLE . 3AW 639.AMLE. N a. BUILDING INSPECTOR 1 go?N Or APPLICATION FOR PERMIT TO .................................. .......................................................................................... TYPEOF CONSTRUCTION ................... .......... ...............................................................I....................................... 71 .......................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for permit according to the following information: Location ................................................. .......................................................................................... 44..... ............................................................... Proposed Use ........................................................... ........... ZoningDistrict ........................................................................Fire District ................................................................................ Name, Of Owner/"� ............................Address............... ..................... ............... ......................................... It e tt I f Nameof Builder ....................................................................Address .................................................................................... 1 . Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ...... (I /o .,-),c .............................................................Foundation ................;.............................................................. Exterior i ............. ...................................Roofing ,k-1 P) ( 1-(J - ...................................................................................... .... ..................................................................:................. Floors ....... ............ ................................................Interior Heating ........... Af ........................................................................Plumbing .................................................................................. .............................................. Approximate C .................................................... Fireplace ............... ..................... Cost ......:ql.C-0-C-1 /Vj—z-- Definitive Plan Approved by Planning Board 3 /----------------9 Area ... ...................................... Diagram of Lot and Building with Dimensions Fee .............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 49 I hereby agree to conform to all the Rules and Regulations of the��own of Barnstable reg arding the above construction. / / - A X/ Name ... .. ................................................. . ............... Capewide Development A=148-87 0.. ................ Permit,for .......one story,............................. single family dwelling ................................................................................ J.g.Cedric Road LocationA.. ................................ ....................... Centerville ............................................ .................................. Owner Capewi.a.e..Development ....................... . .. .................................... Type of Construction ..........................................! fram ............................................................. ........... Plot ............................/L. .......... ti (Apr` 076 Permit Granted ........r.................N................19 Date of Inspection ...................)...............19 Date, Completed .......................................19 PERMIT/EFUSED .................................................................. 19 ................................./......................... ................. ....... ........................ .......... ........................... ................................................... ............................................................................... Approved ................................................ 19 ................................................................................ ................... ........................................................... ks ♦ t: ,Y{'1 LPN: �M�k JJ} 1) r r,. -?+c•£._ .r. to e7 �t, fin..•' a !a-. r ,t T3 � �/ � f', ,/ .. '" 7�37. _ �•',�"��� t-, e ry a t � i i �;� ga �t ��it�l `b -_.t� ., - :.+ i it ,i �4 ; •N z�,y��f" r3'_ .. D J.. I i,._ .. , f. ! 'i., I� � "i i C,k l✓B:Afl 41k`I� ! g4- s � r t7 �, .f., �5 x_: ,f' ' � -r'• _3.t x s/A :f / @s n L Y +'i �t� vi Yt t i d! !a ,� ,R. Y. Tom_ i ,g;•.. s/ L t # ,:k f£ '�' r•4Z 1 P''� h::t iY { . O ' �� ./h /� T 171d 1 fit ' t .: j f•' .`� 3 5�, T ,$+f 61t5�./ �� t' � ��� ,O _ _../J ��• . � 4 { ;5i �� ' s!� �#'/r "3f+��� ��•,Y �v l O I j. (•�p 1\., I ,� s ,,� y3f� 4 r,�i(�-r- � y � � vP - � -) � gi.�„`) t � e a r.I°A si•$ dr"�g r i'3 y�ryal'11 � t '9 i.. ? - .F//. a iC.q1,61 E��Ot�i ,;: 66ff -� r • - u �2 e M �„ `_..Frr t �ls! Via) j >s ry,, { 1 Ysd .i .I ' ( � .r, : d •� i 4� ly♦ ,I'� ' �Y P� j. !' '7` �.. �e�• � r, A 3 �C ,i 7� ;r f iY "^' �:14�F r +�» -W Y'i �r*, r n V. y'> ' C..:. 't' ✓ �yo",.-P e/✓ATE ,q / u b; •�� ., �e�`'�9��'*' '?'i�A/�d /G/,� /l/�i�a �'S. _ 4• ..� /OCD ,(�.' ..'.'9'��`i�"/�,� �`"? �"�v� Q r- 4. ^ ^ f.WYrY�.�i/ �.I�I • �•�{. �I {�'C1{�,ds //�/+,. V/I9,M•�.In I'. x 3 , e6iC�s: F'i T Tom;:/"(/rvi,c/�vtI } x r6°E,✓�c/Ca► G©7'~. ®Lg1it/ 4300AIZJAI . y A eOAVrONO y TiMoaT 7 W4P 49WJ/6PPA,0d6- q'ad10 av6.AMAP. /99 L.0Ci09rPV OAP 7W& -Offa/OWA-1/p�•lVAV',V,=sU�V.�iLla"* 9'f� Mr /7' ep�- a a �4 LRII�t',.•.rr«, r.¢o r�r• C®.tPe ®4CA-- /0 7WAP ���P� y �•\� OF l"QA ( ` r -', *.. C @Ce rArG/C 71W D. o�' A'RNE e h M. OJAI.A H, 0# I� ifo° �'�T9/�..�♦'iP7� "' #?634�4 n a fin �'. �cy� � �q r{,/O �4'6/da�/®1o�0®3 ' , i!9�t_ 7, k�d.n• yr wk,9�t C ' t:p Assessor's'.map an lot rnumber .............. ...........:........*..... ,�� NSTgLLEY ENj MUST S ` _ :r f J BE - P WITH q��-ICLN COP LIgNC f / t % = , l Sew ge Permit number .. ..�.... 76 N® t ^; UL4� 1l _N = � G !®NS• _TOWN Py�`TNET`�♦. TOWN OF; BARNSTABLE . HASHSTA.BLE; . "6 9 =} B;UIL?DING I; INSPECTOR Lj C Gti4,� APPLICATIONJOR PERMIT TO ..... ........................................................:..... .. ........................... ..I........ TYPE OF CONSTRUCTION .................. ............................ ..... € s...... ...., TO •THE INSPECTOR OF BUILDINGS: The undersig ed hereby applies for a permit according to the following inform Location .... .......................................... ............................................ ... ........................................ C��-.....t.................��.:L........ ......... . ...................Proposed Use ......... ....... .... ..... .... ............................................. Zoning District ��........�.�:....................................................Fire District .......: .. �,.,.... .........................................._............ Name of Owner `e !` ....(N .."'.................Address .c : .......... .. t...... �............... Nameof Builder ....................................................................Address .............................................................:...................... lI e�.............f! << Nameof Architect ..................... .............................Address ...................:............................................................... Number of Rooms ........ ...........Foundation C�-� T Exterior .. ....... ............ ......... .....................:.............Roofing .... �..... .....i..........�............................................... �'�+ Floors .'... ... .. .. : .. .......�.................................................Interior .................................................................................... Heating - .G ...................:...........................................Plumbing ........�.................................................................... _ . Fireplace .................. ... ................................................ Approximate Cost. ..... ...�57� ............................... 2 C,/ Definitive Plan Approved by Planning Board ___J____ __________________19 Area ...`../...� �:.............. III Diagram of Lot and Building with Dimensions Fee :.................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Jwn of Barnstable garding the above construction. Name ... ..................... ............. ........... K Capewide DevelopmetLfi No'":::18327..'Pe'rmit;Yfbr .....one storY..a......... - s1n le famil dwellin .............. Cocatio�.........Cedric:Road _ t{ J ... .... .................. ......... ................................. . f Owner ' Ca ewide DevelAoment r ✓� �- Type of Construction .........ft.ame...................... ^+ - .. . .................................................... ................. •1, Plot ............................ Lot ...........k7.................. Permit Granted Apx�l 20 �.. ..:.............. .............. 6 nspection �. Date of.I ...�. :. /.... I?,.... .19 r Date Com lefed . . /..7 :............... " ` .19 .� tr p "PERMIT'REFUSED ........................ i ......... .......1............ -19 ......................... ..�,............ ................ .......... ........,....... ....... ....... r .......... .... .... ..................._ .................................................. ................. :: ...... .. ....... ..•............ '• w J'h' • .. '. .3 d" 1 Approved'................................................ 19 ; .. ......i....................................... . ........... ... .... . ............ .....................'...................