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0170 CONNERS ROAD
e Y u � . e r , f K Town of Barnstable Building Post`This.Card�So Thatit is Vis�ble;From the Street.A roved Plans Must,be=Retamedon Joband this Card Must:be Ke�fi rARB,tYrw�LC; � €c...H. .,�a�3� ,£> „� ; �5>. `' � ; pp .,��-.' �, � b� '�``�� •� /"2 ::k�' _ � `� v��p:, � � • Posted UUn ai Inspection Hash Been Made x b A z b Permit Where a Certificateryof Occupancy sRequrredvsuch Bu�Idmg�shl Not,be Occup�edrla F nal Inspection has beenoma e Permit No. B-18-1614 Applicant Name:' Carl Rebello Approvals Date Issued: 06/12/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 12/12/2018 Foundation: Location: 170 CONNERS ROAD;CENTERVILLE Map/Lot:. 251-131 Zoning District: RD-1 Sheathing: Owner on Record: WINER,HARRY P&JOYCE S Contractor Name .Carl J Rebello Framing: 1 Address: 170 CONNERS ROAD Contractorlicense CS-084358 2 CENTERVILLE, MA 02632 Est Protect Cost: $2,326.00 Chimney: Description: Insulation,Air Sealing& Door Weatherstripping', It Fee: $85.00 Insulation: Project Review Req: Fee Pald T' $85.00 Date. 6/12/2018 Final t `_E 4 Plumbing/Gas T Rough Plumbing: ` 31 ,,Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within si imnaths after issuance. Rough Gas: All work authorized by this permit shall conform to the approved appl cation and the'approved construction documents for whicli'this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zonmg"by lawvz6d codes. Final Gas This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspect on for the entire duration of the work until the completion of the same. Electrical x Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Offie�als are proviid d", n ihis permit. Minimum of Five Call Inspections Required for All Construction Work Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 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 Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Per tracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c:142A). Fire Department r Building plans are to be available on site Final: ISSUED RECIPIENT All Permit Cards are the property of the APPLICANT- C q �; pFt�row .Town of Barnstable *Permit# Expires 6 mon hs from issue date Building Department Sei es Flee anaxsrAaM Brian Florence,CBO mm(, p q,MUS �� Building Commissioner I •qS TEn �t 200 Main Street,Hyannis,MA 02601 www.town.barnstable.m� cS601 yu, /'� Office: 508-862-4038 8�Q11 Fax:5�8-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTI I _ Not Valid without Red X-Press Imprint Map/parcel Number Property Address i .7 U CUh rl e(-"1-, cY)4-or c., ❑Residential Value of Work$ IcJ 'Co Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address HAC r V s Contractor's Name__3-1 ( I r_I C C I j rP� Telephone Number �G b T?G 7) 7 3 Home Improvement Contractor License#(if applicable) f S 4 -5 Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Ch one: I am a sole ro rietor P P ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Elj�e-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side [] Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows ` #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is { required. SIGNATURE: QAWPFILES\FORMS\building permit forms\EXPRESS.doc 08/16/17 µ T 1 ' r) 77=e Comriromt►eakh t�,j -Waysa iusetts . Deparbnent ofludush at Accidenft 0JFWe Of gations ' 600 Washnrgion Street Boston, !02111 r inumasLgorldia Workers' Campensafien.Insurance Affidavit Builders/ arntracWrsMecticiansd3h=bers Applicant Informal$nn Please Print fe�i�ily Name fAncirr�cclY]haa�� F1'J1C6k ( ) Ac1dresr—rad ,h P Cot S te1 Phone ik G� 7 7G 7 Are you an employer?Check the appropriate b Type of project(required)- 1.ElI am a employer with 4. I oar a general contractor and 1 6. ❑New eamstructic n employees(fish an&oc park-3ime).* Q t have hired the sub-contractors 2.❑ I am a sole proprietu r orpartuer- listed authe attached sheet ❑Remodeag ship and have no.employees. These sab-contractors have g_,Q volition w or men employees and havewadiers' °�� f i �'capacity- $ g_`❑Building addition " o 'comp.insurance comp.Rmurana j 5_ We are a eorporafion and its 14❑Electrical repairs or additions 3_9MM a homeowner doing all wo& of ff=s have exercised their 1 L❑Plumbing repairs or additions o workers' of esemo:ou per MG'I. 12_�Roof repairs. i�,myself T c.152,§1(4k andwehaveno employees-[No wow' �-❑other Cup- ., -j •Arty appticant&ac chedrshax fl most also fm Olt*e secdoaheLawahavoug&ekwuler'camp—sat;aupa&7 iafnzmsEiazL F€omeoera�s who snhmit dais af�da��t in d5catistg r3rey axe doing ag wad sud rhea hoe auBide[p renre Est submit a new affidavit mdic— such_ iCanaacrg6 that 111e1-lr this ba K xaast attached an additional sheet d wwbg the rune of the Mh-caWxXctM and star whether ar nat fhase slides hav emp3oyees.Ifftmb-cantutoeshmempkyee% fiey=nTp=v eYhek warkers'temp.poRcgam lsen lam an ReTaw is thepaUcy and jab rite in,f ormafian. Insurance Company Nam: Policy AL.or Self-ins..ic_ E4.pi iouDate: Job Site Address_- CitylStawzip: A.ftach a copy of the workers'compensation-policy-declaration page(showing the policy number and ezpaation date). Failure to secure coverage as required udder Section 25A of MGL c- IM can lead to the imposition of criminal penalties of a fine up to$1,50a 00 andFor one-y{esr impfisonmeat,as well as civil penalties.in the fona of a STOP WORK ORDERand a Em of up to$250_Da a day against the-violator. Be advised drat a copy of this statement maybe fmwarded to the Office of 1mvestigatiom ofthe DIA for insurame coverage vrerificafioa_ I do hereby cafify render the ' s ands alms o Pat try thatthe ire;for mat�azs prm did abor and correct , SizMature: Date-lop �� f Phase 9- SSG fs `� 173, O,icial arcs only. Do not wrke in this area,to be compUted by tfty artown ofjierat City or Town: Permitll icense I issuing Authority(circle one): 1.Board of Health 3.Building Department 3.CltpTown Clerk 4.Eectrical Iusgector 5.Plumbing 1Empector 6.Other Contact Person Phan 9: Laformation and lastrnction s MassacImseits CT&=-al Laws ffiVtea 152 rmgairw all employees`tO provide wdrI;='coiapensation for their=play=. PursuanttO this stItEn e�Ioyee e,a is defined as. _.every person inthe under es any contract of service of anofh express or implied,Oral or wzittm- An..Moyer is defined as"an individual,partnership,association,corporation or other legal entity,Or any two or more inc the I ezdatives of a deceased employer,or the a joint and biding legal repres of the furegomg enga�d J.. _ . receiver or trr ACM of an individual,per,association Or other Iegal entity,employing employees. However the owner of a dwelling house having not more than tbrw apartments and who resides therein,or the occupant ofthe - dw M g house of another-who employs persons to do mafit=ance,construction nstruction or repair work on such dwelling house or on the grounds or budding appintenanf thereto shall not because of such employment be deemed to be an employer-" MGL chaptnr 152,§25C(6)also St eS that'every state or local licensing agency shall wiihhoId 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 cdmpuan.ce with th-e insurance coverage requ re&" Additionally,MGL chaptrr 152,§25C(7)states"Neither the commouweal&nor aiuy ofits political subdivisions shalt enf�r into any contract for the perform dcance ofpubho wor uatil acceptable evidence of compliance vaffi the insurance.• r li taient s of this chapter have been presented to the contr�aufhOI:ty-" Applicants PIease fill obf the workeas'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), addresses)and Phone numbers)along with their certfficafe(s)of insurance. Limited Liability Companies(LLC)or Limited Liabiity par�ershtps(LLP)with no employees other than the members or partners,are not rbquirrd to carry workers'compensation insurance. If an LT-C or LLP does have empIoyees;, a.policy is required. Be advised-that this a$daykmaybe snbmifted to the Department of Industrial . . Accidents for confnmation of'nsmmce covmmg� Also be sure to sign and date t'he affidavit The affidavit should bezetrmmed to the city or town that the application for the peunit or license is being requested,not.the Department of Edda -a Accidenfs. Should you have any questions regarding the late or if you are required to obtain a workers' compensation policy,Please call the Department at the number listed below. Self-fimurd companies should entpr their s6if-hisurance,license number on the appropriate line. City or Town Officials 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- Pleas t be sure to fill in the pesmit/Iiceuse Mmaber which WM be used as a reference number. In.addition,an applicant that must submit muYTIe pennitlIicense applications in any given year,need only submit one affidavit indicating current policy mfo=mation.(if necessary)and under"Job Site Address"the applicant should write"all locations (cit3'or town)..,A copy of the affidavit that has been officially stamped or maldced by tare city or town may be provided to the applicant as proof that a valid affidavit is on file for fafne'permzts or licenses Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le. a dog license or permit to bum leaves etc-)said person is NOT wed to complete this affidavit The Of of Investigations would like to thank you in advance for your•cooperation and should you have any ques-fions, please do not hesitate to give us a call The Depar[menf 9 address,telephone and fax number: The th Of Massachnseng Department 4f Iii&xstdd Ac euta Offim of kv tio,= S'tf:1-t ROstm�MA 02111. TfI 4 617- -�-�eat 406 or 1��MA SSAFF` _ Fax 617` 27 774 Revised 4-24-07 .gavIdi ACO�® `� CERTIFICATE OF LIABILITY INSURANCE D7/25/20 17 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 terns 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 endomement(s). PRODUCER . CONTACT Joanne Bretton -NAME: Southeastern Insurance Agency, Inc. PHONE (508)997-6061 No:(508)990-2731 439 State Rd. ADORES bretton@southeasternins.com AODRES: P.O. Box 79398 INSURER(S)AFFORDING COVERAGE NAIC# North Dartmouth MA 02747 INSURER A:Arbella Protection Insurance 41360 INSURED INSURER B AEIC All Cape Exterior Remodeling LLC INSURER C: 12 Baldwin Road INSURER D INSURERE• Dennis MA 02638 INSURER F: COVERAGES CERTIFICATE NUMBER:2017 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. INS TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP POLICY NUMBER MIDpffr_M lMmfppIyYM LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A CLAIMS-MADE a OCCUR PREMISES Ea occurrence $ 100,000 9520048113 1/14/2017 1/14/2018 MED EXP(Any are person) $ 5,000 PERSONAL&ADV INJURY $ 11000,000 GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JEa LOC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SI a acadeMNGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY AUTOS AUTOS (Per accidenq $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Peracciderd $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAR Ld CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ r $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ERT ANY PROPRIETORIPARTNERIEXECUTIVE EL EACH ACCIDENT $ 1,000,000 B OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NH) WCC50078962017A 1/9/2017 1/9/2018 EL DISEASE-EA EMPLO $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below' E.L.DISEASE-POLICY LIMIT $k 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached U more space Is required) Project: Gosnold, 1185 Falmouth Road, Centerville, MA Consery Group is listed as additional insured. CERTIFICATE HOLDER CANCELLATION (508)888-6566 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Consery Group THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 278 ACCORDANCE WITH THE POLICY PROVISIONS. Sagamore Beach, MA 02562 AUTHORIZED REPRESENTATIVE Joanne Bretton/JB 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(201401) Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston; Massachusetts 02116 Home Improvement Contractor Registration Registration: 184383 7 Type: LLC Expiration: 1/5/2018 Tr# 274212 HYTECH ROOFING SOLUTIONS LLC-I... r; PATRICK CLIFFORD . 12 BALDWIN RD aZy DENNIS, MA 02638 Update Address and return card.Mark reason for change. SCA 1 C: 20M-05111 Ej Address 0 Renewal Employment Lost Card V�P. (QC77C"7JZ09tCGCCIfCJC C����lJ�CCCILCGiC �\ Office or Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR ! before the expiration date If found return to: istration: 184383 Type: j Office of Consumer Affairs and Business Regulation 7 iration: ;_ 10 Park Plaza-Suite 5170 exp1/512Qf8;:;::: LLC. Boston,MA 02116 HYTECH ROOFING SOLUTIONS:aLC' PATRICK CLIFFORD 12 BALDWIN RD DENNIS,MA 02638 Undersecretary Not valid without signature i Massachusetts Department of Public Safety PF Board of Building Regulations and Standards License: CSSL-105951 Construction Supervisor Specialty PATRICK CLIFFORD 12 BALDWIN ROAD DENNIS MA 02638 IJL� Expiration: Commissioner 06/02/2018 V0_rw7701_i. 5 7 -1, 73 12 Baldwin Rd. Dennis; MA 02638 AZEK TRIM & IIARDI-PLANK SIDING PROPOSAL July 23, 2017 Harry Winer 170 Conners Rd. Tel: 508 725 5259 Centerville,MA. EM hwiner(ahotmail.com HyTech Roofing Solutions hereby proposes to perform the following services in a neat and professional manner and in accordance with the manufacturer's specifications and local building codes. Remove and Haul Away All of the Old, Siding, and rotted Trim from the entire exterior of the House. (2 layers) Inspect and Re-Nail Any loose or,popped plywood or boards on the exterior of the House, and replace any rotten or deteriorated sections as required. Supply and Install New Hardi-Plank"Pearl Grey"fiber cement Select Cedarmill 5% siding on the entire house replacing all of the existing siding.All Hardi-Plank is to be fastened using stainless steel nails. Courses are to be installed with a 4" exposure to match the existing size on the house.All cuts made are to be primed using Hari-Dobbers in"Pearl Grey", and any seams are to be sealed closed using matching Hardi-Caulking in the"pearl grey» � I POSSIBLE EXTRA CARPENTRY: Any rotted or otherwise deteriorated trim boards, plywood sheathing, missing metal flashing, side walling or any other carpentry needing replacement will be done and charged for as an Extra: materials plus labor at the rate of $ 60.00 per hour. PAYMENT SCHEDULE: A deposit of one Half is due at the signing of this roof proposal and the final payment for the balance is due immediately upon completion. WORK SCHEDULE: All roof work is normally scheduled for completion within 30 days of acceptance and receipt of deposit providing the materials are available. Please Make Checks Payable to: HyTech Roofing Solutions HyTech Roofing Solutions warranties the Sbingles, Trim and Labor for 20 years. All materials come backed with a 50 years,"limited lifetime"warranty. HyTech Roofing Solutions Carries Workman's Compensation and Public Liability Insurance on the above work TOTAL INVESTMENT: $24,500.00 DATE OF ACCEPTANCE: /J ACCEPTED BY: SUBMITTED BY: W"W arry Winer PATRICK CLIFFORD HOMEOWNER (Business Owner) MA CSL license 105951 . MA HIC license 184383 C yl►-7h h Building Performance Contracting,LLC Nauset Insulation P.O.Box 1044 N. Eastham,MA 02651 Phone(774)316.4464 Fax(774)316.4462 Date 24_5 RE:Insulation Permits Dear Mr Perry, This affidavit is to certify that all work completed for the insulation work at_ m V l Q� has been inspected by a certified Building Performance Institute(BPI)Inspector.All work performed meets or exceeds Federal and State requirements. Respectfully o mond a-�I 0 P � t') ` 0 t , •- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �`� Parcel Application # a 613 q3 Health Division Date Issued 6 Conservation Division Application Fee J` Planning Dept. Permit Fee _ Date Definitive Plan Approved by Planning Board �6�i3 13 JP_ Historic - OKH _ Preservation / Hyannis Project Street Address leP CD✓e,6 �. �i�''VI!*��. 4. 0X12 Village t�i�h �k , Owner w— Address COht)LyS Xef 06 # h Telephone J "6� G3a Permit Request --�(4 6, sly Alcedsem, r Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District ( Flood Plain Groundwater Overlay Project Valuatior'�(� ffS Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ 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: Zonii g Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use - Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address �� License# :19AT NA-1 Home Improvement Contractor# Worker's Compensation # tA)GU0DL32 /M ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE � � w FOR OFFICIAL USE ONLY «.: f,, APPLICATION# E . DATE ISSUED r 4 MAP/PARCEL NO. 1 L r ADDRESS VILLAGE OWNER L f, Z ' DATE OF INSPECTION: FOUNDATION FRAME INSULATION t rti FIREPLACE E i -ELECTRICAL: : ROUGH FINAL 'r PLUMBING: ROUGH FINAL i } GAS: ROUGH FINAL 4 FINAL BUILDING - 1 , l _ , DATE CLOSED OUT ASSOCIATION PLAN NO. a t OWNER AUTHORIZATION FORM , (Owner's Name) owner of the property located at 70 �o e, (Property Address) (Propert Address) hereby authorize 1 0 C LA-Cl (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's Sign ure WX Date f ' E 4 { 1 The Commonwealth of Massachusetts Print Form Department of Industrial Accidents Office of Investigations ' 1 Cono ess Street,Suite 100 Boston,ALA 02114-2017 M W-V www.massgov/Via `Yorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ApplicantInformation Please Print Ledbly Name(Business/Organization/Individual): 2jLl � Address: City/State/Zip: f Phone#: 7W� C� Aieru an employer?Ch the appropriate box: Type of project(required): 1. am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. Demolition workingforme in an capacity. employees and have workers' y p �'• .. 9. ❑ Building addition [No workers'comp.insurance comp.insurance.* required.] 5. We are a corporation and its 10.E) 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 of exemption per MGL 12. R repairs insurance required.]t c. 152,§1(4),and we have no L1B employees. (No workers' 13. Other 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 anew affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'cDmp.policy number. I am an employer that is providing workers'compensation insurance for my employees, Below is the policy and job site information. f� Insurance Company Name: ��J L G���✓ �C- d�� '� ,, Policy#or Self-ins.Lic.#:_ U�V����/ �[(1U Expiration Date: Job Site Address: a�.5 Xorlg� City/StateMp: ey&U;Ae hsa32 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$1,500.00 and/or one-yeaf imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under the pains and penalties!Zee 'ury that the information provided above is true and correct. Signature: -- Phone#: - Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r Oi$ee of Coowmer Affairs&Be aess Rwkfion License or ration valid for in&Wdut use only WMEIMPROVEMENT CONTRACTOR Were the expiration date. If found return to: n Type: OfBoe of Consumer Affairs andBusinessRegnlatia LLC !8 Fark Plara-Suite 5178 = Boston,MA 02116 BUILDMIG PERFO [C11NG,L,LC. ,.. _ JOSH'EDMOND - = r 8 KINNlrjNNICK RO - TRURO,MA 02566 Umkrftnv to y valid without signature Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor - License'CS-078845' JOM P.MONID �/y b��s Lys PO BOX 633 T Truro MA 02666 Expiration Commissioner 0312512015 06/03/2013 23:26 9787778415 PAGE 01 1 Ref' CERTIFICATE OF LIABILITY DATE(MWDUT" INSURANCE 16 CERTIFICAT! IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS .:lRTIFPCA'TE'bOhS NOT AFFIRMATIVELY OR NEOATIVELY AMEND, EXTEND OR ALTER THE COVERAOE 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: M the gAiBoWe holder is an ADDITIONAL INSURED,the PoNCOes)must be andorsad. If SUBROOAitON IS WAIVED,sub)W to the terms end Conditions of the policy,eartain policies may requke an andoreement, A statement an Oft Gartlflcate done not center rights to the cenMkaa holder In lieu of such endorseme4a). PRODUCER COUNTY INSURANCE AGENCY INC NAM` PVT 123 Sylvan St w 62 gw: (978) 774-2463 ac N :(978)777-8415 Danvers, MA 01923 :G 04WR S) AFFORDeIe C0V9%AU well INSURER A:Commerce Ins. Co. NSURED Building PsrfOrmancs COnt ranting, LLC INSURER B:EsseX Ins. CO. INSURER C,Atl,antic Charter P.O. Box 633 INSURER D:RB Jones Truro, Ma 02666 INSURERE: INSURER F: OVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. r11 TYPE OF INSURANCE IL POLICY NUMBER Four Y nx LIMITS LIABILITY EACH OCCURRENCE 3 1 000,000 $ COMMERCIAL GENERAL UABILRY DAMAGE (Ea RTE15occurr nee 3 50 000 CLAIMS-MADE �X OCCUR PREMISES MEDUP(My one person) a 1,000 B 3DE9441 11/19/1211/19/13 PERSONAL&ADV INJURY $ 1 000,000 GENERAL AGGRIZOATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO g 1,OOO 000 POLICY PRO LOC g AUTOMOBILE LIABILITY EA BINErd y .1 000 000 ANVAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED LQ3983 A AUTOS X AUTOS BODILY INJURY(Per sceldenl) S HIRED ALTOS NON-OWNED 2/2/13 2/2/14 UTOS Per S X UMBRELLA UAB OCCUR • GxcEss Lv a CUBW3 90 4112 5/1/13 5/1/14 EACH OCCURRENCE S 2 0 0 0 0 0 0 CLAIMS-MADE AOOREQATE S 2,000,000 DEDI RETENTION 3 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y IT NV P AROPRIETOMPARTNERIEKECUnVE YIN T11/23/12 11/23/13 E.L.EACHACCIDEKT a 5OO OOO OFFICER GNIDPA EXCLUDED? ❑Y NIA (M-dawy In NN) WCV00939900 EL.DISEASE-EA EMPLOYEE$ 500,000 V yea describe under DESCRIPTION OF OPERATIONS bWow EL DISEASE-POLICY LIMIT S 500,000 _BCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Aced+ACORD 101,AddlOonal Remarks Schedula,'If more apace is required) RTIFICATE HOLDER, CANCELLATION °" " Town of Barnstable � Barnstable, Ma SHOULD ANY OF THE ABOVE DESCRIBED"PDIJCIES BEMICELI_EP BEFORE THE EXPIRATION DATE THEREOF, NOTIr`E WILL q'E Da-- ED IN ACCORDANCE WITH THE POLICY PROVIS)OF1S. AUTHORIZED EKTArnE s 01 2010 ACORD CORPOkKnON. 111-'q"ghts r-erved, ;ORD25(2010/05) The ACORD name and logo are reglStered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION , Map 2-6 I Parcel 13 { Permit# Health,Division' Date Issued (0/ D.3 4 Conservation Division Fee ��s r� Tax Collector ` Treasurer Planning Dept r Date Definitive Plan Approved by Planning Board ' Historic-OKH Preservation/Hyannis Project Street Address / / V �Q��)Em R Village l..' Die&U1 Owner (�-f /(� l))6- Address `.5� 1l1 fir✓ Telephone Permit Request RE"UF- =1s'kWd PO4- `2t&60j - Square feet: 1st floor:existing 'proposed 2nd floor: existing proposed Total new Estimated Project Cost Zoning District Flood Plain . Groundwater Overlay Construction Type , Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑. Multi-Family(#units) Age of Existing Structure Historic,House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths:, Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other ' Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing •❑new size: Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes. ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Q Name lephone Number. p Address V3 License# � Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNAT DATE FOR OFFICIAL USE ONLY PERMIT NO. zo DATE ISSUED MAP/PARCEL NO. ADDRESS ! ' VILLAGE 1 E OWNER a 1 r + yr ! f p y DATE OF INSPECTION i FOUNDATION ✓' FRAME INSULATION, FIREPLACE f , Yf ELECTRICAL: ROUGH FINALt - + PLUMBING: ROUGH FINAL - - • , + GAS: ROUGH r FINAL' FINAL BUILDING j� DATE CLOSED-OUT ' ASSOCIATIONTLAN NO." f The Town of Barnstable Department of Health Safety and Environmental Services ,�o�► Building Division - 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner . 1 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERWr APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. E/ Type of Work: - Estimated Cost 46`J Address of Work: /�/f1 (131,) m cP kd Owner's Name: Date of Application: h /U 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 h y apply for a permit as the agent of the owner. / od Date Contractor ame Registration No. - OR Date Owner's Name q:forms:Affidav The Commonwealth of Massachusetts �==- Department of Industrial Accidents 600 Washington Street , cG Boston,Mass. 02111 Workers' Compensation Insurance Affidavit r / name: location: city 0E/J�_ phone# 4-- 3L� ❑ I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one working in any capacity am an employer ding workers' ensation for my employees working on this job. . ...........::......... .::::........... com any name:.. ::><: :>:. ;. .......... ::.................: ddcess: :.::. - >: h;::•.;::::::;;>::;<:::>:::: one# .:..:........ .:.::::::::: Olt insurance co:: ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the follamaim pensation polices: :. ............ ...:,.,.....,.,:,.:::•::::;;::.:::-::::.;::::::.;:.. ::;:.;'.;::.::..::: ...... ..................... ........................ ....................... ...... .........:............ .........:.::.:::::.:.............. ..................... .::...... c any:name• '<::>::>:::<:>:::;<:>:>:;;.;;;' :; :. addiess- . :::.. 't..... ll.'i . 4 ?:i:riii:is::ii?r;::J:::�::::irrii::i:f:::v:'`?::iiii.::i::i::.i:.:::iiJi::4ii ii.:�r:!'r:f:•ii:.:;:::::'.,`::;{i}nir:•:::{;:iti' i:�:::::::} j:' i: t?•r:;:iry:%;'.;;i iii�:'i:::(:.isylii::::<i:::i::i:::::>:::>iti'v: n�urance:co :. .... ,...............:.:...:... poll P nil R Failure to secure coverage as required under Section 25A of MGL 152 can lead to the im osdioa of crlmiosl enalties of a Sae to 51,500 00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Sae of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. I do hereby certify the pains enalties of perjury that the information provided above is truo a r►eat sigaa14 Date l Print name 0� U ihirLk Phone# L4 official use only do not write in this area to be completed by city or town offidal city or town: permtNcense# � ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑selectmen's O!$ce ❑Health Department contact person: phone#; ❑der _ (4=iscd 9/95 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 tooperate 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 along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the`9aw"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be redirneA 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. N HN/ The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents 0MCe of inllestigau ns 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 :.�.� ✓12G �OO� L �� I F IMPROVEMENT CONTRACTORS REGISTRATION j HOME RoOulations and Standards _ Board of Building Room 1301 1 pig© Ashburton place 1 Boston , Massachusetts 02108 --------------------------- -- OME IMPROVEMENT CONTRACTOR I ,,,,� ©Oistration 103714 Expiration 07/09/00 1 1 _ --- HOME IMPROVEMENT CONTRACTOR y p© - PARTNERSHIP I Registration 103714 1 = Type - PARTNERSHIP PAUL J . CAZEAULT & SONS ROOFING Expiration 07/09/00 Paul J . Cazeault 1 2 G i d d i a l t R d . P .O•- B o x 2781 I PAUL J. CAIEAULT 3 SONS ROOF! 2 1 Paul J. Cazeault Orleans MA 02653 I � I ��2kG>.ddialt Rd. P.O. Box 2 78 IAto" Orleans MA 02653 Board of Building Regulations Place, Rm 1301 One Ashburton -1618 Boston, Ma 02108 c_7 Birthdate: 10/20/1959 License: CONSTRUCTION SUPERVISOR LICENSE Restricted To: 00 Number: CS 026325 Expires: 10120/2001 PAULJ CAZEAULT 1585 MAIN ST OSTERVILLE, MA 02655 7665 Tr.no: d change of address notification. Keep top for receipt an ACORD.. CERTIFICATE OF LIABILITY INSURANCE oaiiii� PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Md story & Servant, Ltd- ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 5700 Post Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 1158 Gast Greenwich, RI 02818 INSURERS AFFORDING COVERAGE INSURED INSUREHA:Transcontinental Ins. Co. (CNA) Paul J. Cazeault & Sons Roofing -- ...- - --_ -----.._........_..__..._.. ...-_...... _ INSURER R: _- INSURER 0: I NSUH I-H 0: INSURER F: COVERAGES TI IE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICY PERIOD INDICATED. NOTWITFISTAIDING ANY REQUIREMENT. TERM CR 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. INF�j( POLjf.YFFFEC7IVE PC1L17;Y EXPIRAiI(/N CIM115 _ LTn TYPE OF INSURANCE POLIICYNUMBEFI ATE MM DO (M DATE MM DO A GLNL•RALLIABILITY C180024822 04/30/99 04/30/00 EACHUGCUHHENCE - S ,.O-O0,000 X f:(1M MEHC;IAI.(.:EN EHAI LIA NILIIY FIRE LIA MA( F(Any unelre) S1OO. OOO. . ._-. _._...._._ ._.._...- .. .. ...,..... . .... ... -_--,I CL AIM,S)MAUF I-XJ 6CCUR MFO EXP(Anyunepe(sun) s5 X PD Dell . 1 , OOO PFRSDNAI AAOVINJURY Si—, 000 (,iENEHAIACiGHE(iAIE S2,0001-0010 C:FN"I ACi(iHECiAII:IIMIIAPPIIF:i PFH: PHOI)11C 1%-COMP/011 A(i(i L2 OOO -1-000 PHO. PUI ICY X .IFCI LOC AUTOMOBILE LIABILITY (;OMHINFUSIN(91.E LIMI 1 S (En eu:eidenl) ANY AUTO A1( OWNEI)Ali 105 BODILY INJUHY S (Per person) SCHFOII I.F D A II I OS IIIHFI)AtJIO;i RODILYINJURY S NUN-OWN ED AUT05 (Per mddenl) --- PH0FFHIYIIAMA(iF. S - .. ........_................._ . ` (Permudeni) UAIIAGL-LIABILITY ALIIOUNIY EAAGGIgEN) S - ANY All ID (III IER TI IAN FA AGG S AUIOONLY: AGG S EXCESS LIABILITY EACHOCCOIIHFNCE S ClGGl1H —1 CI.AIMS MAOF AGGRFGATF S S FIFDO(.IIHI F - S S HFIMN IIDN S p WORKERS COMPENSATION AND WC 199413744 08/09/99 OV/O9/OO X iyRY�Mt15 1H EMPLOYERS'LIABILITY F.I..FACH ACCIOFN) S100 OOO E.L.OISEASE EAEMpLOYEF S100,-000 E.L.EIISF.ASE POLICYLIMIT s500 OOO OTHLII - DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULDANYOF THEASOVE DESCR I DEDFOLICIES B ECANCELLEO BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR 10MAIL3a DAYS WRITTEN NOTICE70 THE CERTIFICATE HOLDERNAMEDTOTHELEFT,BUTFAILURE TODO50SHALL IMPOSE NO OBLIGATION OR LIABILITYOF ANYKIND UPON THEINSURERAS AGENTS Oil REPRESENTATIVES. AUTHORIZED REPRESENTA Ive /) ACORO 25-S(7/97) D S 8 2 8 9 4/M8 2 8 9 3 ( BAM 0 ACORD CORPORATION 1908 Nsessor's map' and lot number ................................�........ %ewage Permit number ..:............ ..............:.......................... 7"ET°�y TOWN OF BARNSTABLE j ,MS LE. : 039. BMILDIHG INSPECTOR - APPLICATIONFOR. PERMIT TO ...................................................... ........................................:................. T �'/ �` TYPE OF CONSTRUCTION ...jf...r�...._................. �..!'��..•!;1;,�`�•...........................�..j................................................. • .... .........�9. � e TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................ ..................................... .. .....:.....................................................................,........................:.............:... ProposedUse ................................................................................................................................................................... Zoning District ......'!....!27 ,...�..........................................Fire District .......... '`�..l..f......:................................... Name of Owner .^!../ 1��........�� ......................Address ..... 1.V.G';' '�? /Y/1 ..... ..., "� .. ... .,.. J — { Name of Builder rx � `��.................Address �` a`�" �'"r Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .....................'�..........................................Foundation .... ` . ................................................ ... Exterior / a� � �✓1 y /Y�.l° c ...............................Roofing u Floors fee'+ .Interior F' 0 'e �`✓........ ........ ....:�:.. :'............,................ Heating ..................................................................Plumbing .......... .'.'!...... ............... ./ 7 Fireplace ...................AI,.''.�......................................................Approximate Cost ..............�''^..`�c '?.. .:i......................... 4,1. Definitive Plan Approved by Planning Board _________________________ .' T- -t9 - - Area .c. ..:. . � ..............�.. r, Diagram of Lot and Building with Dimensions Fee .......... ...r�'`r........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH s I hereby agree to' conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name, :...................::..............!�^'............. ................. King, Glen A=251-131 17991 enclose porch No ................. Permit for .................................... .............................. ................... Location ..j VTOConnors Road . ...................................... ................. Centerville ........................................................ ...................... Glen King Owner ....................................... .......................... frame Type of Construction ........... .............................. . .............................................. ................................. Plot ............... ............ t ................................. Kin g ..:" .. .......... t .......... Permit Granted ........ .ctober 15 .........19 75 I....... ...................... Date of Inspection . ..................................19 .......... ti Date Completed .....................................19 PERMIT REFUSED ................................................................ . 19 ............../,..................... ..................... • ............ .................................................................. ......... ............................................. ....................... .......... ..... .................................... .......... Approved ................................................ 19 ........................................................ ...................... ............................................................................... s /jssessor's map!and lot number �,,�r ^.� ..� :.... ' i, r , r w; 10-ewage Petmit number .. .......... FTNEt� � :- TOWN OF' . BARNSTABLE " ARIFSTADLE 9 " 1639. 4zBUILDING ' INSPECTOR ', \0 o war a• Zo n, r' �.. APPLICATION FOR PERMIT TO ..........UV /G t7� • ............................. .........................:... .... ..... . ............... _:. �J c TYPE OF ,CONSTRUCTION ..'WO.Q .... 1.6..F�/7....I ........ .. .................................................................. ! .... ................../ .......192h/ TO THE INSPECTOR OF BUILDINGS:, _ The undersigned hereby applies for a permit according to the following information: �, � r...............Location ....... Zl.. ............................................................... ProposedUse ......................................................................................................./..................::........................,............ .......... Zoning District ...... �....:.....................................Fire District ...... ............ ............................. Name of Owner .*...��J:....:.. ,......................Address ..:...o�..X.. .!.�./...... � �`..�rc.. Name of Builder '... U� � `�� .....Address / /�`N .. .................`� . .............................. Nameof Architect ...:......................:..:...........................:..:....Address .................../............................................................... Number of Rooms ....... .. ,"Foundation ................®....... ................................................ �� ........s����f./. >�Exterior ...................Roofing � r✓ rile Interior /!C t' 7Ir0�ii,,,• Floors .............y .............................. .......................................... .... ............................. Heating :............../v. ........................................................Plumbing ........../.Y.. ......:................................................ Fireplace ................../ . ®................................................. Approximate Cost ......../........©....c.�... o�. ............ Definitive Pldn Approved by Planning--Board -------------------_-----------1.9________. Area .C , Diagram of Lot and Building with Dimensions Fee ` SUBJECT-TO APPROVAL OF BOARD OF HEALTH y . t • hereby agree to conform to all the Rules and Regulations of the Town of Barnstable garding the above - construction. Nam �... King, Glen 17991 enclose porch �• ` No ................. .Permit,:for ............... - ' ..................... .............. Connors Road Location Centerville . ........................................................... ................... Glen King Owner .................................................... ............. i Type of Construction frame `r........................... Aid '.Plot ..e`...................... Lot ..........r...... '.Permit, Granted .........October..15,.,,,•„•1975 ` {{ e Date of Inspection .............. ......19 " Date Completed ......................................19 _. PERMIT REFUSED' .......................... ............ J ................. 19 ............................... .................................. ................................................... ......... ............................................................................ - - .......................... ................................................... Approved ................................................ 19 � a ........................................................... ............... ................ ......................................................... - 1 ' ' Assessor's office(1st Floor): SEPTIC: /r Assessor's map and lot number �.� � ;'� 7.- _ �STE��s iST ' Board of Health(3rd floor): S�qLL CAI CO '� o Sewage•Permit number 1"9 Epp WITH-nTL { NVIROPNI E$ DARISTADLL i Engineering Department(3rd floor): EN-rMAIL House number G 2 .�2!1?�1� TOWN RE ,yLg ®�/4 � or Y•6`�$' Definitive Plan Approved by Planning Board i 19 ° �� APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-i00 P.M.only s TOWN ; OF , BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION !/ 19 F TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location / '70 Proposed Use Zoning District �` — Fire District Name of Owner /.%lam /� l/LL,t. Address f 76 6 Name of Builder ��-�0.�� Address ?S' Name of Architect / Address Number of Rooms ! Foundation _ Exterior - A Roofing r Floors .� Interior �--�Heating � Plumbing Fireplace — Approximate Cost Area Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License F,. KING, MR. & MRS . s 3•4198 Build Addition No Permit For Single. Family Dwelling M ,:•` t . � ; i' 'fit _ Location. 170 ,Connors Road ?' ' o +.. Centerville a Owner ; Mr. &� Mrs King- Type of`Constrnction_ Frame f . Plot i r Lots Permit Granted: �`Marche 7 , 19 91 Date of Inspection 19 ' Date Completed ZZ?/ 19 ; �. kit r fhJG� T/GAf r r ri e V ' ! _ 3.� 0_ � ' i / -� � ` } � fit• ' � T 77 '•r .fir r , + r ,a. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt from the ;provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person,(s) for hire to do such work, that such Home Ownei shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are. assumin the responsibilities of a supervisor (see Appendix g ons for licensing Construction Supervisors, Section 2. 15) .RuThisa lack eoflawarene: often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against'.the •.• inlicensed person as it would with licensed Supervisor. The Home- Owner actir as supervisor is ultimately responsible. • v To ensure that the Home Owner is fully aware of his/her responsibilities man communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. . You may care to amend and adopt such a form/certification for use in your community. TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION =oaaeavommmeamaaaaaa=== saaaaa=aaaaaaaaaaaaaammaaaaaa�=== Please print. .: DATE JOB LOCATION Number Street address Section o•f� •.v�, • ' "HER" t•OWlL. Name ls. ... , Home, phone w ork phone , PRESENT MAILIN G ADDRESS •.t' ity town State The current exemption for "homeowners" was extended Zip Code dwellings of six units or less and to allow such homeowners to include owner-occupied dividual for hire who does not to engage an in- acts as supervisor Possess a license, provided that the owner DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which he/she resides side, on which there is, or is intend a or intends to re- ed to be o attached or detached structures accessory to such usetosix family dwelling, A person who constructs more than one home in a two-year considered a homeowner. farm structures. on a form ac e. Such homeowner" shall submit top the oBuilding d shall nOfficial for all suchgworkblerformed under the that he/she shall be res onsibl ermit. (Section 109. 1. 1) e The undersigned "homeowner" assumes responsibility for Building Code and other a compliance with the Stat applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she and Barnstable Building Department minimum inspection roc and that he/she will Department complyprocedures d requirements and em with saidprocedures P equire and requirements procedure�- nd requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0 Construction Control. 49"�� ._ I 41 w 11�k v. BY' (o° fie, l.tiY 4+1 - 11i c r4.j ;44— �6p.)(t 1.D rX- 4-)I - SCALE: f. APPROVED BY: DRAWN BY • • DATE: REVISED DRAWING NUMBER r - Mcf I o v r • �/ ° YLl wv SCALE: APPROVED BY: DRAWN-BY: 5EV19ED . DRAWING NUMBER _ IT - l; , 1 I t _ r g Ito -,<I u Fl o • - SCALE:I AVPROVED BYi -0RAWN BY: y(rJ - .DATE:'2 I' - FEVISED RAW N UMBER ' r D iv'^^.ts....,,y r ,+pi.....,s'',..'•..... ..,,�ar'.�..+. eti�.^+`,.v.�+�VY[1r *i.u�r,!,�..v J`�v4a•^ ��,r Assessor's office(1st Floor): /? / _Assessori map and lot number o. / J Board of Health 3rd floor), "` G�' '° ` �QS ♦� Sewage Permit number ��'•� � ��( ,: >:^� AUSTULZ i Engineering Department(3rd floor): MAO& House,n /umber d Z2 ��✓l�_. g moo' 1639. \��'' Definitive Plan Approved by Planning Board 19 0 MCI a' (�_ APPLICATIONS PROCESSED 8:30 430 A.M.and 1:00-200 P.M.only, s TOWN OF BARNSTABLE � ' 1 9#ILD I N INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION 19 4j , TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location r Proposed Use 1 Zoning District Fire District Name of Owner y _ , /% l/Ll Address / 76 Name of Builder_� �� — Address 7 r �� �-u /f.✓`� Name of Architect Address r Number of Rooms Foundation �L c.Jl c_ Exterior �� % Roofing /�—t1-'U IV Floors Interior Heating Plumbing Fireplace Approximate Cost Dc>U Area � I Diagram of Lot and Building with Dimensions Fee ti w 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. cl Name. Construction Supervisor's License w 7 KING, MR. & MRS. A=251-131 t ►y No . 34198 Permit For Build Addition Single Family dwelling Location 170 Connors Road Centerville Owner Mr. & Mrs. King Type of Construction Frame Plot Lot Permit Granted March 7, 19 91 Date of Inspection 19 Date Completed 19 ` 1 IMIT COMPLETED Assessor's map and lot number .f��r /.......X 131-- . ,. .. ..... . . .. . ...`. ; ART"" _ 4•�-•_gd ,. COMPLIANCE Sewage Permit number SANITARY CODE MID *THE•T TOWN OF BAR ff"LE i BASBSTADLE, i mum DUILDI.HG INSPECTOR 'Fp ypY a• AAPPLICATION FOR PERMIT TO ....... ........ ..... ......e.......................................................... TYPE OF CONSTRUCTION .......:: ......... 1.Q.............................................................................. .P .....�........:...19.. T TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies form permit according gt the IT'flowing information: Location ...C�'t .!�' ...... 4!..................r........0 �r :..................... ....................................... ,, ........................ ProposedUse .....4.e4�.:....... ........................................................................................................ Zoning District ...4*.. ,...�........................:.....Fire District ... :: .......................................... Nameof Owner ....... ...........:..................Address .. ......:................................. Name of Builde ..... � .... .. . .......... ...................................:.......Address ........:.......... .r...... '%ro .......... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ... ....................................:.........................Foundation ...................................................... Exterior �� .................................Roofing ... ... .. ?- ........................... .......................� �/� ..�.. 4. �.-R .............Interior .:: /•• �'.C..-t�`? Floors ........................... ................ .................. •` •_ � ._P. ............... ... .......................................... Heating � GG` .......:.....Plumbing ...............�' �...................................................... ............................................ Fireplace ...............l.Y.A.........................................................Approximate Cost .............. •..... ....... ............................. Definitive Plan Approved by Planning Board ________________________________19________, Area .. O ® ........ .. Diagram of Lot and Building with Dimensions Fee .i .. ................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH i I hereby agree to conform to all the Rules and Regulations of the Town of Barns a regardi the above construction. Na ...... ... King, Alan ` No — Permit for --reTodel garage ........ 9...lot' ............................................. , w Location --C�p���:t�q...Rmad................................ . .......................... ............................. Ovvne, .............AlAI!_Ktoz___________ Type ofConstruction ---' XX49------.. ` ( — / --------------------------. | / Plot ............................ Lot ----------' ` ' ~ , September 2� 74 � Permit G,onxa6 ---- . ' � » Dote of Inspection Dote Completed / . . � PERMIT REFUSED ----------.----------. lQ � --------.---------.�--------� / ` ^—_—~--..----------.-------.. � ' �.---..—.----------..----.----.. � �. ----.----------.-----~----- �. � ` , Approved ................................................. lV ^ -----------------.---.—~---. ' ..................— ........................................................ Al ............ 1 F � _ � � .... . cy ` Assessor's number ^ ,.�/ors map and l �{Sewage Permit number .:.. ''!. ?.�....Y.:! r✓�.� � 7... o 'IN ET°�°,� TOWN OF BARNSTABLE Z SAIMSTADLE, i MABEL q w BUILDING INSPECTOR �o ar°'• APPLICATION FOR PERMIT TO .;. .................................................. ......................................................... i TYPEOF CONSTRUCTION .........t. f.................... r` 1. '............................................................................. ..............................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... ......f.y.'........................... ......Alt c'- •• '. ( ............................................................. Proposed Use r. ert .. . ,� _�.... ....................... ........................................................................... . ......................... . Zoning District D7.r..............................Fire District ....................r•���f lam'f' :��••��-�'s .,1 ,............................................ Name of Owner,. ................. . ,. Address . . ........................................ Name of Builder ..�...::.>� °'.�... �'' ............................Address ...... . Name of Architect _ ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. 57/ Exterior ... .. ..... `�............•tl�t+J l"..................................Roofing ........� /� ..f.i�" ... '.F'.r. ........................... Floors ...�' � 4� �. ��' •- �-,�'f �............Interior- .....•...... . .......�......... � �.i..................................... ` v� : : Heating .......:....... . ................:.............�....:a...... r .............Plumbing .... ............ ............................................................... Fireplace ................/V/u..........................................................Approximate Cost ..... d........................................... . _ Definitive Plan Approved by Planning Board ________________________________19________. Area f !.. L.. g C....... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL CiF BOARD OF HEALTH r f I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �.. .Name ........ .... ... ............................................... King, Alan No ..17326.... Permit for .......remodel garage ...........to„ls,t„floor............. Location n o Road . .. ........onnors................................................... ........................Centervi l le ..................................... Owner Alan King.................................... Type of Construction ....................frame ...................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ,.. Septem.b. ... er 20. . 19 74 . .... . . Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................. 19 ...............................................................................