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I am returning the paperwork that we were holding pending more information. We did not obtain the details needed to process this sign application. The unit involved needed to be identified so that we could process the request for a sign permit. I am including a detailed list of units so that you can resubmit with the corresponding unit identified. We would also need I a new check. Sinc'rely, Sally Shea Town of Barnstable Assistant Zoning Admin/Lead Permit Tech 508-862-4031 Y signs/signrequ&app revised: 9/22/l 7 I Application number ...�.,..I. ................................. .... Z _ Building Inspectors Initials..... .. .. 16 Date Issued.:.... 1.1...................... .......... q �J( Map/Parcel........ ............................................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: V I - A,� Z NUMBER STRE T 0 VILLAGE Owner's Name: VJ Phone Number Email Address: e_�g i �C'O-C7 tiQKell Phone Number 5-0 ,�— 94,� 5t)�5 Project cost$ � t� Check one Residential Commercial X 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: Date: TYPE OF WORK ❑ Siding QR Windows (no header change)# L3 ❑ Insulation/Weatherization ❑ Doors(no header change)# Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name A to �0 B4C Home Improvement Contractors Registration(if applicable)# I9 �? _(attach copy)" Construction Supervisor's License# AOL C5 %0 q Z � (attach copy) Email Contractor a umber ntractor 2 ' Phon n = _=�o ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A 228 r 8%80- vim#8 AA#mr AftnrA uI wrrn928k- A nnnn2 iA i nrrnne A nenAA/r PA AN ne Nee-.8e0n - - 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. Purpose of Event 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 Fuel source being used LP tank 201bs. or> Yes No ,if yes, a gas permit is required. Natural Gas Yes No ,if yes,a gas permit is required. 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/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: 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 APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): ��010 '('� gftd�a 011641 /� Address: f('It J Ac't �c� S k `1 F Le"J-LK Ul City/State/Zip: Phone#: 7� 7X Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑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 working for me in any capacity. employees and have workers 9. ❑Building addition [No workers'comp.insurance comp. insurance. 10. Electrical repairs required.] 5. ❑ We are a corporation and its ❑ p irs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.[:1 Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no 13.❑Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. , I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: , Q_L ` 1 L=o 9 N U u N.a w& `Fs,;4 S w�Zt.W a In Ce 6 _l _ r Policy#or Self-ins.Lie.#: s'o�b(/ ) -- j (� D,�1 S�9 �—�j 0 � Expiration Date'://,A Job Site Address: f `1��e lA4C.�c�'li PC) 4!! n'`el-Vi� City/State/Zip: N( l9,Z 6�.2 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-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify and the pair nd penalties of perjury that the information provided above is true and correct. Signature: Date: 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all.employers to provide workers' compensation for their employees. Pursuant to this statute,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,§25C(6)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,MGL chapter 152,§25C(7)states"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 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their self-insurance 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. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that lias been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new 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 (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. , The Department's address,telephone and•fax.number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia Andrew Mar°Ida Owner of first floor of building F located at 1645 Falmouth Rd, Centerville, MA 02632 United States contracted Vladimir Doklev owner of Cape Cod Renovation LLC to replace; -Two 80 1/2" /62", currently casement style windows to be replaced with new construction "Harvey"three double hang type window units (no grills). -Two large 60"/62", currently casement style windows unit to be replaced with new construction "Harvey"two double hang type windows units (no grills). - Nine windows. First floor left and back side of the building. Curren double hank type window to be replaced with replacement style "Harvey" double hang type window (no grills) Work will be complete as is specified above in the estimate. Total materials, labor$20,270 Total Contract Price and Payment Schedule Proposed Start and Completion Schedule -The following schedule will be adhered to unless circumstances beyond the contractor's control arise. Contractor will begin workin after permit and all materials arrived. Contractor will complete the project in two weeks period from starting day. • Permit fees is not included in the price! *Any additional work not specified above, unexpected hidden damages and defects (termite damages, rotted wood.....)will have additional cost. The Contractor agrees to perform the work, furnish labor and materials specified above for the total sum of: $20,270 Payments will be made according to the following schedule: First deposit of$8,500 have been received. Final payment of$11,770 upon completion of the work and contract, no later then 7 calendar days from completion of the contract. I agree on terms and conditions specified above. Owner.......... Andrew Marolda ............................................. Signature Date Oct 8,zo,s Contractor : Vladimir Doklev Signature Date 10/04/2019 a Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-109726 Construction SupervisorN VLADIMIR DOKLEV P.O.BOX 323 DENNIS PORT MA 02639 1('-j C CA_ Expiration: Commissioner 01/12/2020 f Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvem`nt C°ontractor Registration r Type: LLC Registration: 194808 CAPE COD RENOVATION LLC Expiration: 03/10/2021 PO BOX 1362 19) SOUTH YARMOUTH, MA 02664 t Update Address and Return Card. SCA 1 0 2OM-05/17 a. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:LLC before the expiration date. If found return to: Registititian Expiration Office of Consumer Affairs and Business Regulation #948 03/10/2021 One Ashburton Place-Suite 1301 r,� CAPE COD REN � Boston,MA 02108 J.(3 VATIOiIiC'b <, VLADIMIR DOKLEI 5 MATTACHEE Rl7< SOUTH YARMOUTH;Ana 02664 Not valid without signature Undersecretary f NOTICE N NOTICE TO a TO EMPLOYEES . a �� EMPLOYEES � 0W � r OqM S�6 The Commonwealth -of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress,Street, Suite 100, Boston, Massachusetts 02114 — 2017 617-727-4900 — http://www.state.ma.us/dia As required by Massachusetts General Law, Chapter 152, Sections 21,22&30,this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: HARTFORD UNDERWRITERS INSURANCE COMPANY NAME OF INSURANCE COMPANY P.O. BOX 1450 MIDDLEBORO, MA 02344-1450 ADDRESS OF INSURANCE COMPANY (GS60UB-1 K09595-0-18) 12-18-18 TO 12-18-19 POLICY NUMBER 'EFFECTIVE DATES WM F BORHEK INS AGCY INC 311• PLYMOUTH ST cC HALIFAX MA 02338 NAME OF INSURANCE AGENT ' ADDRESS` PHONE# o� CAPE COD RENOVATION LLC 45 BAKERS PATH S YARMOUTH MA 02664 EMPLOYER ADDRESS m EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) ` DATE o_ MEDICAL TREATMENT ' The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions.of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably •— connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS 007660 W20P1G15 TO BE POSTED BY EMPLOYER Parvin, Lindsay From: Vladi Doklev <capecodpropainting@gmail.com> Sent: Friday, October 11, 2019 2:12 PM To: Parvin, Lindsay Subject: Fwd: Bayberry Centerville Building F dental office windows ---------- Forwarded message --------- From: Vladi Doklev <capecodpropainting�2gmail.com> Date:'Wed, Sep 25, 2019 at 6:29 PM Subject: Re: Bayberry Centerville Building F dental office windows To: Devin Witter<Devin,Lfpmcapecod.com> Great, thanks for the update. On Tue, Sep 24, 2019 at 11:46 AlV1 Devin Witter<Devin ,fpmcapecod.com> wrote: I have submitted this to the Board and will be in touch. i . From: Vladi Doklev <capecodpropainting_(igmail.com> Sent: Monday, September 23, 2019 12:06 PM To: Devin Witter<Devin cr fpmcapecod.com> I Subject: Bayberry Centerville Building F dental office windows Good morning Mr. Witter, - My name is Vladimir Doklev owner of Cape Cod Renovation LLC I am fully licensed and insured. The owners of the dental office at building F contracted me to replace first floor windows front, left'and back side of building F. I attached pdf info for the window. i - I'm proposing. I Front side first floor. -Two large 80 1/2"/ 62", the currently is casement style windows unit i'm.proposing to be replace with new construction "Harvey" two double hang type window units. 1 - - Two large 60"/62", the currently is casement style windows unit I'm proposing to be replace with new construction "Harvey" two double hang type window units. Nine windows. First floor left and back side of the building. Currently have double hank type window. I'm proposing to be replace with replacement style "Harvey" double hang type window units. Please let me know you need.more information. Thank you, E Vladimir. I } CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content'is safe!' r 2 I PICK YOUR GLASS PERFORMANCE . ` � sh � Harvey provides a variety of glass options that meet or exceed Energy Star® requirements. Depending3, r on your climate zone, you can choose the glass ✓ . package that's just right for you and'your home: ♦ a Y r r w 1 2131- N A xr y e t A specialized UV-filtering Low-E glass coating reflects I, � heat back into your home while Argon gas insulates . � . air between the panes, keeping your home's inside temperature consistent, and preventing the effects ofUS outside temperatures, yet still allowing sunshine in. Alt gr ££ M g 4 1, W ax fgr s A s Industry-leading Low-E coating combines with Argon gas for effective insulating properties, Durable, multi-chambered keeping the inside of your home comfortable vinyl frame is fusion welded and assisting.with energy efficiency. for extra strength 0 Both sash tilts in for 5y ' a �r�rn�n��►tli�t �Zc��t� � easy cleaning R-- Metal cam lock.+ limit- latches provide security SunGain utilizes High Solar Heat Gain Coefficient,. and ventilation meaning more of the sun's rays penetrate the glass, - offsetting heating costs in colder climates.SunGain Block and tackle balances also has.our highest Visible Transmittance (VT) rating allow for a lifetime of smooth which means it allows more natural sunlight'in. opening and closing i i r WITH HARVEY,.YOU GET PEACE OF MIND STANDARD* We've got you covered: For over 55years,we've built our reputation on the craftsmanship of our.products and our world-class customer service.You can rest easy knowing that Harvey ` windows are backed by our Clear Confidence Warranty and that our commitment to your home lasts a lifetime. CLEAR: CONVENIENT: Your windows are We make recieving _e far warrantied for life on any replacement parts defects in.structure,parts,, -easy, including full sash and mechanisms,and replacements for glass for 20 years on interior repairs—no professional Ed R&M 2 %j YEARs GLASS SEAL glass seal failures. glass installer needed.. . 1120 YEARS CONFIDENCE: With this kind of TRANSFERABILITY We are confident in the coverage, its easy:to quality of our products,but see why Jib.Power harveybp.com/warranty if something's not quite- ranked Harvey among for full details right,you can count on thetop* manufacturers our highly trained, US= in their customer based.customer support satisfaction study. specialists and field' technicians to solve your issue:over the phone or at your property if needed. �1 h �n� a , 1.800.9.HARVEY I harveybp.com I 1'400 Main St. e Waltham MA -02451 I I�It I'�' y THERMAL PERFORMANCE DATA for WINDOWS&PATIO DOOR3- 0 t� Replacement& New Construction 0Ut1..91N*PRODUCIrS ENERGY STARV version 6.0 WE ..: Blossom VINYL WINDOWS ENERGY STARO Veislon 6.0-Valid JanuarY 1,2010 f -511,11, IF RIP;, R, it tEi:, ThernaLock 3X TG 3x Low EtKrypto+UfOAM 0.11. 0.24 0.44 NC?,t$." 0.18 Q.21 .0.39 NC 5t•�' Tribute Double Hung ThermaLock(ES 6.0)A Low-N gon 0.25 0.29 0,52 NG 0.25 0.26 0A6 X11, SunGaln Nigh Solar Meat Gain Pack a 0.29 .0A8 0.58 0.29 0.43 0.51 9 ThermaGuard(ES 5.0)Low-E1Argon 0,30 0,30 0.$9. K. 0.30 0.2P 0,47 N Thermal-oekUp,.ieoomsriTGaxLow-etKriptUnFOAfA 0,18 _0.25 0.46: NC , r.O,25 0.22 O,441 N T ThermaLock(ES 6.0):2XLow-ElArgon 0,25 �0;30 .0.54 NC,' 0.27 .0.48 N " Classic Double Hung SunGaln High Solar Heat Gain Package 0.29 0.50 .0.60 0.45 0.54. ThermaGuard(ES 5.0)Low-ElArgon 0.29 0.31 0,55 NCB 0.28 0.49 'NCB Low-E 0.33 0.31 0.55. .0.28 0,49 Clear 0•A6 0.59 0.62: 0 53 035: ThermaLock(ES 6.0)2X Low- 0.27 .0,30 0.54 NG: EO;2 0.27 0.48 - Slimiine Double Hung SunGain High Solar Heat Gain Package 0.30 0;56 6.60 0.45 0.54 &Single Hung ThermaGuard(ES 5.0)Low•ElArgon 03.0 0:31 0A NC 0.28 0.56 NCy low-E. 0.33 .0.31 0.56. .0.28 0,50 Cloar 0:46 0:60 0:62 0.54 ..0:56 ThermaLock 3X TG 3x Low-ElKrypton 0.19 0.24, 0.44 NCG [020 0.21 "0.39ThermaLock(ES 6.0)2X Low-ElArgon 0;27 0.29 O;52 0:,F 0.26 0.46 1NC`Tribute Commercial Series SunGain High Solar Heat Gain Patika a 0.30 0.48 0,58 0 43 0.51 Double Hung ThermaGuard(ES,5:0)Low-E/Argon 0.30 0,30 0.53 NCB, 0 27 .0:47 NG Low-E 0.34 0.30 0.53 :0.27 0A7 0:46 0.57` 0.60. 5i 0:53 . LNG d ThermaLock 3X'TG 3x Law-EfKryptan 0.19 0.20 0.36 iNd`� 0.20 0,18 0,32 ThermaLock(ES 6.0)2X Low E1Argon 0.25 0.24 0:43 NG, 5,° 0.25 :0.22 0:38 NC S Casement,Awning SunGain High Solar Heat Gain Package 0.28 0:40 0.48 NC 0.28 !0.36 0.43 N28 NC &Fixed Lite ThermaGuard(ES 5.9)1ow-ElArgori 0.29 0.24 .0441 NG 0.29 022 0.39 NC. Low-E 0.31, 0.25 0.44 0,31 0,22.; 0.39 Clear 0,43. OV O:A9 0:43 0.42 0A4. ThermaLock 3X TG 3x low-EJKrypton 0.19 `0.24 0.45 NC,, 0.19 0,22 0,40 NC G _ ThermaLock(ES 6:0)2X low-VArgon 0.26 0.30 0.54 NG; 0.28 0.27 1 0.48 NC SunGain High Solar Heat Gain Package 0.29 0:49 0,60. 0.29 0.44 0.53 Rolling Window - -_- ThermaGuard(ES 5.0)Low-ElArgon 0.30 0.36 0.56 NG 0.30. 0,27 0.48 :NC. Low-E 0.33 0.31 0,55 0f33 0.28 0.46 Clear 0.46 0.59 0.61 0:46 0.52 0.54 ThermaLock 3X TO 3z Low-ElKrypton 0.15 0 26 0.49; NC` 0.16 0.24: Ot43 NC S, .r ThetgtleGuard(E5 5.0)Low-E/ArgOn 7076 0.32. 0.59 NC 0.26 0.29 0.52 NC• Picture Window SunGain High Solar Heat Gain Package 0.27 0.53 0,64: 0.27 1 0.47 0.57" Low-E 0.30 U3 0 59 NC,: 0 30 ;0 30 0.52 ;NC. Clear O:q5 0.63 6.66; . 0.45 0.56. 0,59 - ENERGY STARO 6.0 Qualification Criteria for WINDOWS Notes: u4amr in accordance with NFRG100 arfd based on whole window Values i eCr 0 27 ANY Performance values shown are for'Single Strongth'glass,unless otherwise noted. Performance with'Oouble Strength'glass,dKerent reinforcement levels,may vary. N2$ r? 3 > 32 Performance with V g ids msY vary, -� Select glass types shown•others are available subject to Special InRrtry. Tempered Low-E and Bronze Tint glass vntl affect U-Fador,SHGc and VT values w 0 S0 0,4A. Obscured glass is treated as pear glass and shares the same.thermal data ✓NbTRh-G@rstral xi. All Patio Door Glaring opgons are Tempered Gass only, 0,30 «0.25 . •-., ca'0.40 ca 0.25 Revised:u14n019 Manufacturing ACKNOWLEDGEMENT o BUILDING PRODUCTS Harvey Industries,Inc. 1400 Main Street.Waltham,MA 02451-1689 (781)999-3500 harveybp,com Hyannis 186 Breeds Hill Road HYANNIS,MA. 02601-1186 Phone:(508)775-7788 Fax:.(508)771-3217 BILL TO: SHIP TO: I l ( ] CAPE COD RENOVATION CAPE COD RENOVATION III�I�IIIIIIII II�ILII�II�II��IIII�iI�I PO BOX 1362 PO BOX 1362 MP30140467e45200 PO BOX 1362 SOUTH YARMOUTH MA 02664-0600 Phone: 774-810-6606 Fax: Phone: 774-810-6606 .Fax: y QYIOTE NBRx GiJST NBR C�51 TQ1V I2 R0� DAT �R`EATE g DATE,QRDER �„ ORDER T PE 4678452 1080796 13/2019 Quote Not Ordered I _ Cash ORDEREDBY �SIA�JIS SH[i?t'VIA EIYER7tAREA � NONE None WAREHOUSE HY VJhse Pickup NNIS nnr s M, a,4 0 A C S CLERK n. ..... ama -Anne-Marie Arsenault 1645 FA.LMOUTH RD C VILL 10000-1 Classic DH , Unit Size 27.25 x 52.5,RO 27.5 x 53 Unit 1, U-Factor=0.25;SHGC=0.30,VT- 0.54,HII-M 31-05358-00001,Size f Options=Custom Size, Replacement,Fully Welded ! Z .Frame Width(Inches)=27.25,Frame Height(Inches)=52.5 Double Glazed,Double Low-E RS,Argon Filled &� Base Color=White,Painted Unit=No,None Single,Sash Limit Devices=Night Latch Half Screen,Fiberglass Mesh 27.2v Head Expander Ro.Z7s• - M Overall Frame Width(Inches)=27.25,Overall Frame Height(.Inches)=52.5, Overall Rough Opening Width(Inches)=27.5,Overall Rough Opening Height (Inches)=53 Clear Opening Width =22,25,Clear Opening Height=21..125,Clear Opening Square Footage=3.24 E.Star Zone:North=Yes,E.Star Zone:North-Central=Yes Room Location: None Assigned Last Update:9113/2019 1:53 PM Page 1 Of 3 Printed:9/16/2019 1 28 PM �.VIE Scan with Smanphone to access installation instructions in HBP's Document.Center 0 1 _ " QU'OTENBR� C[JSTNBR < CU�STOIt DATE�I�ATlJI7�]AMP t�II�ER t' 4678452 1080796. 9/13/2019 1 Quote Not Ordered Cash �O RbEREb;B,Y STATUS �a SH IP . . . ELI<VE2Y AI4 ► 3 �� NONE one se it up HYANNIS WAREHOUSE- CLERK �,: Viz. w.✓, ..Y,':._ .�.:x,.. ,_; ..,z:, .r 4,,,,_, ,,,,a...wng_..d�O�a. `.sa;+....*t� , „• ' . ama -Anne-Marie Arsenault 1645 FA.LMOUTH RD C VILL LINE`#�y, DESCRIi'TIONx"�Y .. . . '. � '., l 1000-1 Classic DH,Unit Size 80 x 61.5,RO 80.5 x 62 2 ( -- = = VT=0.54;HII-M-3`1-05358-00001,Size Unit 1,3: U Factor 0.25, SHGC 0.30, Options=Custom Size,New Construction,Fully Welded ta4 Unit 2: U-Factor=0.25,SHGC=0.30,VT=0.54,HI1-M-31-05358-0000,1,Size E". Options=Custom Size,New Construction,Double Hung,Fully Welded Frame Width(Inches)=27.5,Frame Height(Inches)=61.5 Double Glazed, Double Low-E RS,Argon Filled µ 1 aoV Base Color=White,Painted Unit=No,None Single, Sash Limit Devices=Night Latch _ Half Screen,Fiberglass Mesh,Screen Shipping Separate Integral L Fin,Receiver Pocket Overall Frame Width(Inches)=80,Overall Frame Height(Inches) 6I.5;Overall Rough Opening Width(Inches)=80.5,Overall Rough OpeningMeight(Inches)= 62 Clear Opening Width=22,5,Clear Opening Height=.25.625,Clear Opening Square Footage=4 ° E.Star Zone:North=Yes,E.Star Zone:Nonh-Central=Yes Room Location: None Assigned DFSCRIPTI0,m I2000-1 Classic DH,Unit Size 59.5 x 61.5,RO 60 x 62 .2 IT Unit 1,2:U-Factor=0.25, SHGC=0.30,VT=0.54, HII-M-31-05358=00001,Size ` Options=Custom Size,New Construction,Fully WeldedON Frame Width(Inches)=30.375,Frame Height(Inches)'6L.5: y Double Glazed,Double Low-E RS,Argon Filled g� Base Color=White,Painted Unit=No,None Double,Sash Limit Devices=Night Latch . Half Screen, Fiberglass Mesh = 30375_59.9 3o;3TS— Integral L Fin,Receiver Pocket RO' Overall Frame Width(Inches)=59.5,Overall Frame Height(Inches)=61.5, Overall Rough Opening Width(Inches)=60,Overall Rough Opening Height (Inches)=62 Clear Opening Width=25.375,Clear Opening Height=25.625,.Clear Opening Square Footage=4.52 E.Star Zone:North=Yes,E.Star Zone:North-Central=Yes Room Location: None Assigned Last Update:9l13/2019 1:53 PM Page 2 Of 3 Printed:9116l2019 1:28'PM Scan with Smartphone to access installation instructions in HBP's Document Center i r i f Parvin, Lindsay From: Vladi Doklev <capecodpropainting@gmail.com> Sent: Friday, October 1:1, 2019 2:.12 PM to: Parvin, Lindsay Subject: Fwd: bayberry square s . ---------- Forwarded message --------- From: Vladi Doklev <capecodpropainting@gmail.com> Date: Wed, Oct.2, 2019 at 10:32 AM Subject: Re: bayberry square To: Devin Witter<Devin Upmcapecod.com> CC: Andrew Witter <andy(-&fpmcapecod.com> Great, thank you. On Wed, Oct 2, 2019 at 10:30 AM Devin Witter<Devin@a,fpmcapecod.com> wrote: ,The recent-work yyou_have proposed at Bayberry Sq uare has been_approve Devin Witter CAUTION:This email originated from outside of the Town of BaMstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content is safe!' i First ropei M A N A G E. M : F :N. Y 1046 Main Street Suite 11 Telephone 508.420 0299. Osterville, Ma. 02655 Facsimile 508.420.0789 www.fpmcapecod.com i Torn of Barnstable Building.Department Hyannis, Ma. To Whom it May Concern, Cape Cod Renovations is approved to snake certain repairs to Unit-#1F at The Bayberry.Sq.:Condominiums. 1645 Rte. 28 Centerville,Ma. 02632. Si nceNly, / r r � n An rew J. Witter ARM,AMS,CMCA President,First Property Management OCT/04/2019/FRI 02:20 PM COMM Water Dept FAX No.�5084283508 P-001/001 CENTERVU LE-OSTERVMLE-MARSTONS MILLS WATER DEPARTMENT PO BOX 369-1138 MAIN STREET' OSTERVD.I.E,MA 02655 W W W.COMMWATER.COM OFFICE OF ti O� BOARD OF WATER COMMISSIONERS - WATERSUPERENTENDENT Tel 508-428-6691. ATER FX 508-428-3508 '# DEPT. KS October 4, 2019 e Town of Barnstable Building Division Via Fax-508-790-6230 a RE: 1617 Route 28 Centerville Acct: 3123 To Whom It May Concern: On Friday, October 4, 2019 the water service was disconnected at the imeter pit for the property mentioned above. It is our understanding that the owner plans to demolish it and will install a new water service at a later date. If you have any questions regarding this do not hesitate to contact our office: Monday through Friday, 8:OOAM until 4:30PM at 508-428-6691. Sincerely, e Craig Crocker, Superintendent Centerville-Ostervill.e-Marstons Mills Water Department CC/cvb i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION , Map— ;ZO ( Parcel d M �ppton# 'Health Division �7O� !� Date Issued (� Conservation Division Application Fee Planning Dept. 4 Permit Fee _ VI)k Date Definitive Plan Approved by Planning Board pp Historic - OKH _ Preservation/Hyannis V Project Street Address 105- &fjLmu� &a,4 Village Ceei4e4-Vi/1z . A h Owner DVA LelfslAi;ve. Lets F=oa.mafAJ7;0y!i Address .PQ-WG Telephone Permit Request Remots Mood, d-eioi AqP_ /'nDV2 74u ► /1nli!57'Dt- ahliya,!IS 0A t4"t do t- 0&se4 i dypkWgW /11 Lascphetif Square feet: 1 st floor: existing+�00 proposed 2nd floor: existing �� proposed Total new Zoning District go Flood Plain NA Groundwater Overlay IVA Project Valuation*#W/ 006- Construction Type WpaoL PIV- e. 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: WFull ❑ Crawl ❑Walkout ❑ Other 1 Basement Finished Area (sq.ft.) 106) Basement Unfinished Area (sq.ft) �J 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 S Heat Type and Fuel: 3'Gas ❑ Oil U Electric ❑ Other Central Air: M Yes ❑ No Fireplaces: Existing New Existing woo bal stover❑la ,�No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: L&isting O ne�ize= _n 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 644 theS S 044 ZZS Proposed Use &ks t Aess 04**_'-7"tG,S APPLICANT INFORMATION A (BUILDER OR HOMEOWNER) A Name C. • V 6Acon Telephone Number --t7-4- 1,2-(3 13� Address 1 .SHII gftZ 14 60, .. License # 33 A. Sd to YG1.t"AlpGQ Z(.06-r Home Improvement Contractor# A0 04-45 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /V4,_;e,f SIGNATURE DATE /Vus 1 e F , FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED '- t t MAP/PARCEL NO. ADDRESS .. VILLAGE OWNER i � a DATE OF INSPECTION: 1 'a FOUNDATION 1 FRAME ` INSULATION Y FIREPLACE ` ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL z - GAS: ROUGH FINAL r FINAL BUILDING - DATE CLOSED OUT ASSOCIATION PLAN NO. • -.Department of fniiustriat Acciderzts ... Off ce of Investigations. 600 yPashingtan Street 3 y .Boston;MA 021.11 mass.gov a : Workefs' Compensation-Insurance Affidavit: Builders/Contractors/Electricians/Plu nbers Applicant thforniation _ Please Print Legibly ' Name(Business/OrgmdzationadividuaD: i�.-4. -Address: I.�' V7J! h18 l�rQoC City/State/Zip: s• rQY 1�' . 1t/T 4Z 614 Phone_# 1 "-2/.•� -4 3� Are you an employer? Check.the appropriate bow :Type of project(required):; ' 4. I am a general contractor and I 1.❑ I am a employer with.`. 0 6. ❑New construction . employees (foil and/otpnrt-lime).*. have hired the still-contractors 2:❑ I am a sole proprietor or partner- Iisted.on the'attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working forme.in any capacity. employees and have workers' 9. ❑Betiding addition comp. nsurance.if [No workers comp.insurance 10. Electrical airs or additions = 5. ( VTe area corporation and its ❑ rep. required] X officers have.exercised their 3.ET I am i homeowner•doing all work' l l.�Plumbing repairs or additions right of exemption per MGL myself [No workers' comp. � � 12.E]Roof repairs insurance required.] t c. 152, §1(4),and we have no �,,,�' employees.[No workers' 13.XOther F VOL /r" comp:insurance rcgLred_] - *Any applicant that cb=k:s box#1 must also fiA out the section below showing their workers'compensation policy infomation t Homeowners who submit this affidavit indicating lhey 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-conb=tors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for.my employees. Below is the policy and job site information Insurance Company Name: - = Policy#or Self-ins.Lic.# Expiration Date: Job Site Address: 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 canal penalties of a fine up to$1,500.00 and/or one-year imprisonment;as well as civil penalties in the form of a STOP WORK ORDER and a fine of uP to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to fhe Office of Investigation of the DIA for insurance coyerag-e verification - I do hereby certify under the pours and penalties of perjury that the information provided above is true and correct ' Sienature Date: Phone#' T74—.2/� Official use only. Do not write in this area, to be completed by,city.or town offzciaL , City or,Town: PermibLicense# Issuing Authority(circle one): J.Board of Health 2,Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Inforao :andnrucion S .. Massachnsetts General Laws chapter 152 requires.all employers to provide workers' conhpensation.for their employees. = ._:_ `:e Pursuant to,tbis.stature,an employee is defined as"...every.person in the service of,another under any contract of hae, implied,or e Tess oral or written.,' xp . An emplayer.is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more __.:. of the.fore a ed.in a out enterprise,and including the le r resentatives of&deceased lo. er or-the... -- _._. .. ._... �? ._fig_ ] _. rP.... .. _... .. �.. Y.. ... .. .._. .. ... •.. .. . _. receiver or trustee-of anmdividuual,partnership, association or other le entity,'emp oyng employees. However thD 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-bi repair'work`on such dwelling horse, or on the grounds or building,appurtenant thereto shall not because of such employment be deemed to bean employer. MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to•operate a buisiness or.to construct buildings in the commonwealth for any applicanf who*has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25g7)states"Neither the commonwealthnor any of its political subdivisions shall enter into any contract for.the performance of public work until-acceptable zvidance of compliance with the ins-arance requirements of this chapter have been presented•to the contracting authority." Applicants , Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-conti:actor(s)name(s),address(es) and phone number(s) along with their certificate(s) of insurance.'Limited Liability,.Companies•(LLC)or Limited Liability Partnerships(LLP)with no employees other than the. members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Induustrial 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. Self-insured companies should enter their self-insurance 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 Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/liceme applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city or town)."A copy of the affidavit_that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related io any business or commercial venture i Cie. a dog license or permit to bin leaves etc.)said person is NOT required to complete this affidavit The-Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: O OQMMMWW k Of MassarhUSOM OfRCC Q-_f JUVes 7:gatjoxts 6W.Washing Stma. BADston,ILIA 02111 FW 617-727-7749. Revised 11-22-06 WWWM=gQV/di&L - Town"-of Barnstable t ato S.. rYleces.: Regal q. Thomas F.Geiler;Director _ oAr'` ' Building Division Tom Perry,Building Commissioner. . 200'Main Street.Hyannis,MA 02601 wwwaown.barnstable.ma.us Office:. 508-862-4038 Fax: 5087-790-6230 Property Owner-Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on nay e bhalf , in all matters relative to work autliotized by this building pemait (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of er Signature of Applicant Lh is o bier Print Name Printarae 9/ILI 3 Date Q:F0RMS:0WNERPERMBS10NP00LS.62012 'I`owR of Barristabie . �* Regulatory:Services . . : ti Thomas F.Geiler,Director. .. Mass. - .' • . . . • . .i659 Building Division: Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 . www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print . DATE: JOB LOCATION: - number street. . village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings'of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. ��4 € ,: DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person.who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable.to the Building Official,=that he/she shall be responsible for all such work performed under tlie'buildine-permit".(ecti'on 109.1.1)., The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other- applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note;.. Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109 1 1'-Licensingof constriction Supervisors);provided thatif the homeowner engages a persori(s)for hire to do such work,that such Homeowner shall act as sppervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, 'Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly Y when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed K w . Supervisor. The homeowner acting as Supervisor is ultimately responsible. } � `- To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,' that the homeowner,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 t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt =. Office of Consumer Affairs&Business Regulation License or registration valid for individul use only _' before the expiration date. If found return to: I`� (�OME IMPROVEMENT CONTRACTOR (Registration: 160948 Type: Office of Consumer Affairs and Business Regulation ,;Expiration: 9/15/2014 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 CHRISTOPHER A VINCENT CHRISTOPHER VINCENT �---� 17 STILL BROOKRD SOUTH YARMOUTH,MA 02664 Undersecretary Not valid without signature s 'Vlassac^ s - U 3car7 _ V `� mild J a - Unrestricted-Buildings of any use group which Construction Supen isor contain less than 35,000 cubic feet(991m)of _ a CS-095633 enclosed space. .,. J CHRISTOPHE A V R INCENT '.:• 17 STILL BROOK ROAD SOUTH YARMOUTH MA 02664 , Failure to possess a current edition of the Massachusetts J,.C,.. JJ/ j _.._ .:.. -. State Building Code is cause for revocation of this-license. 08/20/2014 For DPS Licensing information visit: www.Mass.Gov/DPS Massachusetts Department of Environmental Protection w_ .__. . ■. Bureau of Waste Prevention • Air Quality 100174175 BWP AQ 06 Decal Number :................................................. Notification Prior to Construction or Demolition Important: gout A. Applicability forms on the computer,use only the tab key A Construction or Demolition operation of an industrial, commercial, or institutional building, or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection cursor-do not use the return (DEP), Bureau of Waste Prevention -Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09 (2)ten (10) days prior to any work being performed. The following information is required pursuant to 310 CMR 7.09. D. General Project Description 1. a. Is this facility fee exempt-city, town, district, municipal housing authority, owner-occupied Instructions residence of four units or less? Yes ',✓, No 1.All sections of b. Provide blanket decal number if applicable: blanket - - . ..... ankett Decal Number this form must be completed in order to comply with the 2. F 11 acility Informa 1.tion: Department of Environmental State Legislative Leaders Foundation Protection a Name _, _...._._,. . notification 1645 Falmouth Road, Unit D _, , requirements of b Address ... ...... .... �,.. ._ .I �I 310 CMR 7.09 ....... Centerville .... MA __.. ..w... 02632_, .._ .... .. . .. (508) 827-7233 'finance@sllf.org f_Teleohone,Number,_(area code„and extension)._ qE-mad Address(optional) 3,300 3 h.Size of Facility in Square Feet i.Number of Floors j. Was the facility built prior to 1980? Yes 7 No k. Describe the current or prior use of the facility: _.._,. . .., ... ._.__.. .... _. Business offices I. Is the facility a residential facility? M Yes ✓ No -o m. If yes, how many units? Number of Units 0 3. Facility Owner: �N `State Legislative Leaders Foundation ...... o a Name 0 1645 Falmouth Road, Unit D b.Address Centerville iMA i02632 co c._Citv/Town d State ... ............. ,. e Zi1), ode ® ......... o (508)827-7233...... ... . .. finance@sllf.org _ . r Teo one (area,code,and extension) a.E mail Address(ootiona,l)_ C! _ . ,Steve Lakis _.:. ....... .._.,.. . m.,_.....,_, h.Onsite Manager Name ag06.doc•10/02 BWP AQ 06•Page 1 of 3 f � 4� a Massachusetts Department of Environmental Protection ®; Bureau of Waste Prevention • Air Quality 100174175 BW P AQ 06 Decal Number ........................................... Notification Prior to Construction or Demolition General Statement:If B. General Project Description (Cont. asbestos is found during a 4. General Contractor: Construction or ... ....,,. ...... ....., _... .__... _ ,.,_ Demolition C.A.Vincent, Inc. operation,all responsible parties a Name . ._. _ ,.. . _. must comply with .17 Still Brook Road 310 CMR 7.00, b.Address 7.09,7.15,and _ ._... _ - Chapter 21 E of the South Yarmouth ,MA 02664 _. ...... General Laws of c.Citv/Town d State e Zip Code the Commonwealth. (774)212-0938 ; info@cavincent.com This would include, _.. _ but would not lu f.Telephone Number(area code._and_extension) q,E-mad Address(optiona). __ limited to,fling an Christopher A Vincent asbestos removal h.On site Manager Name notification with the Department and/or a notice of release/threat of C. General Construction or Demolition Description release of a hazardous substance to the 1. Construction or demolition contractor: Department,if _._ ......_ ....... . _._ .. _...._.. ..__. . applicable. C,A.Vincent, Inc. a.Name 17 Still Brook Road b.Address --.-, South Yarmouth ,MA 02664 ..._ _.. c.City/Town: ., d.State ,..m.e Zip Code .,.._ .. (774)212-0938 info@cavincent.com - fTelephone Number(area code and extension) µg E mad Address(opEional) .Christopher A.Vincent h.On-site Manager Name 2. On-Site Supervisor: Christopher A.Vincent On-Site Supervisor Name 3. Is the entire facility to be demolished? . Yes ✓ No N —0 4. Describe the area(s)to be demolished: o Five partition walls ®N 0 5. If this is a construction project, describe the building(s) or addition(s)to be constructed: ..... Four partition walls ag06.doc•10/02 BWP AQ 06-Page 2 of 3 i ro Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality 100174175 .................................... BWP AQ 06 Decal Number Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project, were the structure(s) surveyed for the presence of asbestos containing material (ACM)? I' Yes No If yes, who conducted the survey? b.Survevor Name c.Division of Occupational Safety Certification Number 03/2512013 04/30/2013 7. Construction or Demolition: rt ......... a.Sta Date(mm/ddiyyyy) __. b.End Date(mmlddiyyyyj 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: seeding paving b. If other, please specify: wetting shrouding ✓' covering other 9. For Emergency Demolition Operations, who is the DEP official who evaluated the emergency? a.Name of DEP Official b.Title c Date(mm/dd/yyyy)of Authorization d.DEP Waiver Number D. Certification .... ....... Cl) I certify that I have examined the 'Christopher A Vincent ®o above and that to the best of my a:bent Nam o knowledge it is true and complete. The signature below subjects the b.'Authonzed Signaturee _. -N signer to the general statutes 9 9 ;President o regarding a false and misleading c PosiUonnitle o statement(s). C.A Vincent, Inc d.Representing 03/21/2013 Date(mm/dd/yyyy) 0 ® ag06.doc•10/02 BWP AQ 06•Page 3 of 3 r e;VEP - MassDEP's OnlineFiling System Page 1 of 1 ' MassDEP Home I Contact Feedback I Tour I Privacy Policy MassDEP's Online Filing System Username:CAVINCENT Nickname:CAVINC Receipt J Forms Signature Receipt Summary/Receipt print receipt Exit Your submission is complete. Thank you for using DEP's online reporting system. You can select"My eDEP" to see a list of your transactions. DEP Transaction ID: 550821 Date and Time Submitted: 3/21/2013 1:57:28 PM Other Email Form Name: AQ 06 -Construction/Demolition Notification Payment Information DEP code: 82709 Date: 3/21/2013 1:56:51 PM Amount($): 85 Payment Detail: VINCENT CHRIS --AccountType--AccountNumber****8830 Confirmation Number: Contractor Contractor Number Name Address, , Supervisor Project Monitor Lab My eDEP MassDEP Home Contact Feedback Tour Privacy Policy MassDEP's Online Filing System ver.11.12.0.0©2011 MassDEP 3/21/2013 I • Gregory F. Fater. Attorney at Law 55 Memorial Boulevard Newport, Rhode Island 02840 (401) 848-7777 FAX (401) 848-7733 June 21, 201.9 Building Division Town of Barnstable Attn: Robin Anderson 200 Main Street A Hyannis, MA 02601 F ; ' RE: _1645 Falmouth Rd. Unit.5JD, ,7D and,8D, Centerville, MA. Dear Sir: Enclosed is a check for $225.00 to cover the cost of the letters stating the current zoning use and the zone in which the above parcels are located in, together with a self-addressed stamped envelope. Thank you for your prompt attention in this matter. V truly yours, GREG FATER GFF/j ak COW Town of Barnstable Certificate of Zoning Compliance Certificate 2019-22 Owner Name as of 1/1/18: Map 209 Parcel 086-D08 NEW ENGLAND MANAGEMENT SERVICES INC Address 1645 Falmouth Rd 1 TECHNOLOGY PARK DR SUITE C Village Centerville BOURNE, MA. 02432 Zone HB Highway.Business RC Residential SF Family Overlay None Year Constructed— 1983 Property Use: Commercial Condo Lot Size 0/Condo Cert of Occupancy None on file HB Setbacks: RC Setbacks Front Yard 100 Front Yard 20 Date NA Permit# NA Side Yard 30 Side Yard 10 Rear Yard 20 Rear Yard 10 Open Permits: None Special PermitsNariances None Permits: Building Permit# TOWN OF BARNSTABLE BUILDING DIVISI®N Building Permit# 200 MAIN ST HYANNIS, MA. 02601 Code Violations: Zoning Code No open violations on file Building Code None on file Certificate of Inspection Zoning Violations: No open violations on file. Zoning History: The subject property was developed and constructed in 1983 as a 1-story commercial condominium structure in a commercial condo complex containing several units. Reviewed by Title Date: Robin C. Anderson Chief Zoning Officer 01/2/2019 Town of Barnstable Certificate of Zoning Compliance Certificate 2019-21 Owner Name as of 1/1/18: Map 209 Parcel 086-DO1 NEW ENGLAND MANAGEMENT SERVICES INC Address 1645 Falmouth Rd 1 TECHNOLOGY PARK DR SUITE C Village Centerville BOURNE, MA. 02432 Zone HB Highway Business RC Residential SF Family Overlay None Year Constructed— 1983 Property Use: Commercial Condo Lot Size 0/Condo Cert of Occupancy None on file HB Setbacks: RC Setbacks Front Yard 100 Front Yard 20 Date NA Permit# NA Side Yard 30 Side Yard 10 Rear Yard 20 Rear Yard 10 . Open Permits: None Special PermitsNariances None Permits: Building Permit# Building Permit# TOWN OF BARNSTABLE BUILDING DIVISION Code Violations: 200 MAIN ST. HYANNIS,MA 02601 Zoning Code No open violations on file Building Code None on file Certificate of Inspection Zoning Violations: No open violations on file. Zoning History: The subject property was developed and constructed in 1983 as a 1-story commercial condominium structure in a commercial condo complex containing several units.. Reviewed by Title Date: Robin C. Anderson Chief Zoning Officer 07/2/2019 �3-r5 a (75 Town of Barnstable Certificate of Zoning Compliance Certificate 2019-20 Owner Name as of 1/1/18: Map 209 Parcel 086-D07 NEW ENGLAND MANAGEMENT SERVICES INC Address 1645 Falmouth Rd 1 TECHNOLOGY PARK DR SUITE C Village Centerville BOURNE, MA. 02432 Zone HB Highway Business RC Residential SF Family Overlay None Year Constructed— 1983 Property Use: Commercial Condo Lot Size 0/Condo Cert of Occupancy None on file HB Setbacks: RC Setbacks Front Yard 100 Front Yard 20 Date -NA Permit# NA Side Yard 30 Side Yard 10 Rear Yard 20 Rear Yard 10 Open Permits: None Special Permits/Variances None Permits: Building Permit# TOWN OF ISARNSli isu Building Permit# BUILDING DIVISION 200 MAIN STP C HYANNIS, MA 0260 Code Violations: Zoning Code No open violations on file Building Code None on file Certificate of Inspection Zoning Violations: No open violations on file. Zoning History: The subject property was developed and constructed in 1983 as a 1-story commercial condominium structure in a commercial condo complex containing several units. Reviewed by Title Date: Robin C. Anderson Chief Zoning Officer 07/2/2019 Gregory'F Fater Attorney at Law 55 Memorial Boulevard Newport, Rhode Island 02840 (401) 848-7777 FAX (401) 848-7733 June 21, 2019 Building Division Town of Barnstable nn Attn: Robin Anderson 200 Main Street Hyannis, MA 02601 J w RE: 1645 Falmouth Rd. Units 1D" 7D`and 8L) Centerville, MA Dear Sir: Enclosed is a check for $225.00 to cover the cost of the letters stating the current zoning use and the zone in which the above parcels are located in, together with a self-addressed stamped envelope. Thank you for your prompt attention in this matter. V truly yours, ,,- 6 GREG FATER GFF/j ak at Town of Barnstable . Certificate of Zoning Compliance Certificate 2019-22 Owner Name as of 1/1/18: Map 209 Parcel 086-D08 NEW ENGLAND MANAGEMENT SERVICES INC Address 1645 Falmouth Rd 1 TECHNOLOGY PARK DR SUITE C Village Centerville BOURNE, MA. 0243.2 Zone HB Highway Business RC Residential SF Family Overlay None Year Constructed — 1983 Property Use: Commercial Condo Lot Size 0/Condo Cert of Occupancy None.on file HB Setbacks: RC Setbacks Front Yard 100 Front Yard 20 Date NA Permit# NA Side Yard 30 Side Yard '10 Rear Yard 20 Rear Yard, 10 Open Permits: None Special Permits/Variances . None Permits: . Building Permit# TOWN OF BARNST'ABLU - . . BUILDING DIVISION Building Permit# 200 MAIN ST. HYANNIS,MA. 02601 Code Violations: Zoning Code No open violations on file Building Code None on file Certificate of Inspection Zoning Violations: No open violations on file. Zoning History: The subject property was developed and constructed in 1983 as a 1-story commercial condominium structure in a commercial condo complex containing several units. Reviewed by Title Date: Robin C. Anderson Chief Zoning Officer 07/2/2019 Town of Barnstable Certificate of Zoning-Compliance Certificate 2019-21 Map 209 Owner Name as of 1/1/18: Parcel 086-DO1 NEW ENGLAND MANAGEMENT SERVICES INC Address 1645 Falmouth Rd 1 TECHNOLOGY PARK DR SUITE C Village Centerville BOURNE, MA. 02432 Zone HB Highway Business RC Residential SF Family Overlay None Year Constructed— 1983 Property Use: Commercial Condo Lot Size 0/Condo Cert of Occupancy^ None on file HB Setbacks: RC Setbacks Front Yard 100 Front Yard 20 Date NA Permit# NA Side Yard 30 Side Yard 10 Rear Yard 20 Rear Yard 10 Open Permits: None Special PermitsNariances None Permits: Building Permit # Building Permit# TOWN'OF BARNSTABLE BUILDING DIVISION 200 MAIN ST. Code Violations: HYANNIS,MA 02601 Zoning Code • No open violations on file Building Code None on file Certificate of Inspection Zoning Violations: No open violations on file. Zoning History: The subject property was developed and constructed in 1983 as a 1-story commercial condominium structure in a commercial condo complex containing several units. Reviewed by Title Date: Robin C. Anderson Chief Zoning Officer 07/2/2019 /3 -15 C r Town of Barnstable Certificate of Zoning Compliance Certificate 2019-20 Owner Name as of 1/1/18: Map 209 Parcel 086-D07 NEW ENGLAND MANAGEMENT SERVICES INC Address 1645 Falmouth Rd 1 TECHNOLOGY PARK DR SUITE C Village Centerville BOURNE, MA. 02432 Zone HB Highway Business RC Residential SF Family Overlay None Year Constructed — 1983 Property Use: Commercial Condo. Lot Size 0/Condo Cert of Occupancy None on file HB Setbacks: RC Setbacks Front Yard 100 Front Yard 20 Date NA Permit# NA Side Yard 30 Side Yard 10 Rear Yard 20 Rear Yard 10 Open Permits: None Special Permits/Variances None Permits: Building Permit# � TOWN OF BARIVS'lAbLh Building Permit# BUILDING DIVISION 200 MAIN ST. Code Violations: HYANNIS, MA 0260 Zoning Code No open violations on file Building Code None on file Certificate of Inspection Zoning Violations: No open violations on file. Zoning History: The subject property was developed and constructed in 1983 as a 1-story commercial condominium structure in a commercial condo complex containing several units. Reviewed by Title Date: Robin C. Anderson Chief Zoning Officer 07/2/2019 Gregory F. Fa ter Attorney at Law 55 Memorial Boulevard Newport, Rhode Island 02840 (401) 848-7777 FAX (401) 848-7733 June 21, 201.9 Building Division Town of Barnstable n a Attn: Robin Anderson . 200 Main Street Hyannis, MA 02601 . b w f RE: 1645 Falmouth Rd. Units,ID,h 7D and 8D,`Centerville MA Dear Sir: Enclosed is a check for $225.00 to cover the cost of the letters stating the current zoning use and the zone in which the above parcels are located in, together with a self-addressed stamped envelope. Thank you for your prompt attention in this matter. V truly yours, GREG FATER GFF/j ak Town of Barnstable Certificate of Zoning Compliance Certificate 2019-22 Map 209 Owner Name as of 1/1/18: � . Parcel 086-D08 NEW ENGLAND MANAGEMENT SERVICES INC Address 1645 Falmouth Rd 1 TECHNOLOGY PARK DR SUITE C Village Centerville BOURNE, MA. 02432 Zone HB Highway Business RC Residential SF Family Overlay None Year Constructed — 1983 Property Use: Commercial Condo Lot Size 0/Condo Cert of Occupancy None on file HB Setbacks: RC Setbacks Front Yard 100 Front Yard 20 Date NA Permit# NA Side Yard 30 Side Yard 10 Rear Yard 20 Rear Yard 10 Open Permits: None Special Permits/Variances None Permits: Building Permit# TOWN OF BARNSTABLE B BUILDING DIVISION Building Permit# 200 MAIN ST. HYANNIS,NIA. 02601 Code Violations: Zoning Code No open violations on file Building Code None on file Certificate of Inspection Zoning Violations: No open violations on file. Zoning History: The subject property was developed and constructed in 1983 as a 1-story commercial condominium structure in a commercial condo complex containing several units. Reviewed by Title Date: Robin C. Anderson Chief Zoning Officer 07/2/2019 Town of Barnstable Certif Cate of Zoning Compliance Certificate 2019-21 Owner Name as of 1/1/18: Map 209 Parcel 086-DO1 NEW ENGLAND MANAGEMENT SERVICES INC Address 1645 Falmouth Rd 1 TECHNOLOGY PARK DR SUITE C Village Centerville BOURNE, MA. 02432 Zone HB Highway Business RC Residential SF Family Overlay None Year Constructed— 1983 Property Use: Commercial Condo Lot Size 0/Condo Cert of Occupancy None on file HB Setbacks: RC Setbacks Front Yard 100 Front Yard 20 Date NA Permit# NA Side Yard 30 Side Yard 10 Rear Yard 20 Rear Yard 10 Open Permits: None Special Permits/Variances None Permits: Building Permit # Building Permit # TOWN OF BARNSTABLE BUILDING DIVISION 200 MAIN ST. Code Violations: HYANNIS, MA 02601 Zoning Code No open violations on file Building Code None on file Certificate of Inspection Zoning Violations: No open violations on file. Zoning History: The subject property was developed and constructed in 1983 as a 1-story commercial condominium structure in a commercial condo complex containing several units. Reviewed by Title Date: Robin C. Anderson Chief Zoning Officer 07/2/2019 Town of Barnstable Certificate of Zoning Compliance Certificate 2019-20 Owner Name as of 1/1/18: Map 209 Parcel 086-D07 NEW ENGLAND MANAGEMENT SERVICES INC Address 1645 Falmouth Rd 1 TECHNOLOGY PARK DR SUITE C Village Centerville BOURNE, MA. 02432 Zone HB Highway Business RC Residential SF Family Overlay None Year Constructed — 1983 Property Use: Commercial Condo Lot Size 0/Condo Cert of Occupancy None on file HB Setbacks: RC Setbacks Front Yard 100 Front Yard 20 Date NA Permit# NA Side Yard 30 Side Yard 10 Rear Yard 20 Rear Yard 10 Open Permits: None Special PermitsNariances None Permits: Building Permit# TOW i OF I ARNS fib Building Permit# BUILDING DIVISION 200 MAIN ST. Code Violations: HYANNIS,MA 0260.E Zoning Code No open violations on file Building Code None on file Certificate of Inspection Zoning Violations: No open violations on file. Zoning History: The subject property was developed and constructed in 1983 as a 1-story commercial condominium structure in a commercial condo complex containing several units. Reviewed by Title Date: Robin C. Anderson Chief Zoning Officer 07/2/2019 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION f` Map O 9 Parcel 0.3 Permit# � Health Divisions�" Date Issued Conservation Division Fee 0 o Tax Collector Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address / '� �� ` � �' 74/ lZ D Village Owner Address Telephone -7 7 S `7 7 G Permit Request S-7I�l Square feet: 1 st 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 t ❑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 Ves ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name 4eZ'Z_'1,1 r—a GlC Z!--fy V—T Telephone Number Address Zl4o Z; cez �✓ l�r//.�'� License# ',:�?All AllC S �2.1�= �4416 C Home Improvement Contractor# a -7 7 Worker's Compensation# � ✓ " �Z�� X � �` ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Af 6 b SIGNATURE - `, DATE �a 1ti era r FOR OFFICIAL USE ONLY r PERMIT NO. DATE ISSUED MAP/PARCEL NO. s a� a ADDRESS f' VILLAGE OWNER` DATE OF INSPECTIO i FOUNDATION 's FRAME INSULATION , A. FIREPLACE . ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. I, r _ _ The Commonwealth of Massachusetts 31 -- - Department of Instrial Accidents du :: : .. Office oflonestlgatleas ?� - • - on Street =3 ' 600 Washington Boston,Mass. Oil" Workers' Com ensation Insurance davit rr ririiiii i r //// / �� name: � e � location: r '77 :/ / ✓� lj 7�6,3.2 hone i! �' city C-G L e r ❑ I am a homeowner performing all work myself. ❑ I am a sole •etor and have no one worlds in anv //// %%/ %///////////%/%%//�///////�� on this job. . . uonformyemP.a9ees �� ensa W I arsemployer.P...::.::::.:....:::. y `ni:'.:is^;::.; ............... .:.. .. :.::::.:...i::i::i.:viiiiiii:;:i:�ii}i::C:ii$i:!!.i:::: .::. .:....:.:. .. ..::::.. y�.. .. .....:::.�:..i:ii:ii::::v:ii::.i>ii:i F•i::i•i:::ii-i:ii:.::.iii:•iii:{:vii:::rii:is i:::•:-+;<L•;:•::is i :::::::::: ' any..: . ..:.:. ...... ..'::. :::::is ..... :::...�yM�:�.. 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Failure to secure coverage as required urtder Section 25A of MGL 15Z can lead to the a One of S100.00 a day against me- I miderd that a one years'imprisonment as well as civa penalties in the form of a STOP WORK oItDER a verinci copy of this statement may be forwarded to the onlice of Investigations of the DU for coverage that the information priat4ded above is truce and correct I do hereby c e p signature Print name ite in this area to be completed by city or town of ci • ofncial use only do not wr # ' OBuflding Deparmn e rioft/11c� Board pe ❑I,lcensing city or town. QSciectmen's ofnee nsa is required OSealth Department ra ❑check if immediate p° — (]ether • phone#,, contact person* (>c�t6 05 PJA) HOME. IMPROVEMENT' CONTRACTORS R:-G i_.CIS�R4TIUN oard• of Building Regulations ar,d -'ta.ndards- a� r One Ashburton Place - Room 130' .Boston,• Massachusetts 0210,3 HOME IMPROVEMENT ,CONTRACTOR Registration' 108915 Expiration 06/27,160 —� Type S t rati�r vp THEODORE L . HITCHCOCK � �� Edpii3t.Jd PO BOX. 211/ 55 LISA LN '� i W . BARNSTABLE MA 02668 FC,3'CK 8 TOWN OF•BARNSTABLE permit No.;_14 1 ......... I nil `Inspector B f�1II$ Cash OCCUPANCY ' .PERMITi' s n Bayberry .Squard Realty Trust` Issued to Address - 1645 Route 28,; Ceriterville t J. Wiring Inspector Inspection date Plumbing inspector; r_ l " _ i,- ); Inspection date Gas.Inspector'.' f '• 'w Inspection date ; � W Engineering Department • spection date f.. 7" sPection In 'date��/ o Board of Health ' �/i THIS PERMIT WILL-NOT, BE VALID, AND THE BUILDING SHALL,•NOT BE'!OCCUPIED UNTIL SIG;VED BY THE BUILDING INSPECTOR UPON SATISFACTORY' COMPLIANCE WITH TOWN REQUIREMENTS.AND IN ACCORDANCE WITH SECTION.11s.0 OF THE'MASSACHUSETTS STATE BUILDIING• CODE:'. ` - ^)3uilding Inspector -w ' - ssessor's ma and lot number ' Se wa a Permit number 3 g ..8 .......��..� ................. .:'... ~ �' � 1i. �A g x INSTALLED-IN C01VOLIA, esasTsnt r B E House.number ... � ...............:.............. ..:...... ..... . WITH TITLE 6 "6 �.-.5 ENVIRONMENTAL C IDE ANS; �oyaYa�e�' TOWN ' OF BARNSL 's BUILDING *. INSPECTOR - vit von F(ZAtqu, t6 oi0tw6 r ewtY� _ APPLICATION FOR PERMIT TO ..... ` /.......:.........5/.`:..................................................................................... TYPE OF CONSTRUCTION ......Q) ...Em!Y ................. .. ........ .......19..4..L R TO THE INSPECTOR OF BUILDINGS: The undersigned hereby,applies for a permit according to' the following information: Location K T 2 VIC.L�/:. MA :.................. .. ............................ Proposed Use ......(110M (.OIR_CtA��......:.... :.. 19 .'f... `:...................................:.. Zoning District ....... .........................................................Fire District CD Name of Owner ddres's / T..ZP1....C Name of Builder' .. -: �(7�. i � �Vl� u ldress 1� +:!<<...G,EJ�� JU�� MST........tj Name of Architect ..PM�..�14iG��...� <i�:..O� .. .. ....................... ...........Address .........:.. ' Number of Rooms ....:..0......................................................Foundation �c9LITE. Exterior p. � .. .!/V►lt't..sft? �...Roofing ....Itt..... .... ��,. ,{.......... Floors C�T�. ....................'.......................................Interior ... .....k . ��7. ......................... .......... � y g� conn� Heating ..�{.R .......�3`J..... :5 ................................Plumbing ........................4� ...�:+'3�aT:G/�s }.W7 Fireplace . b1. ......................................................................:Approximate Cost �2(�� Uo - Definitive Plan Approved by Planning Board -----------_______-----------19 . Area ..s;2W ..0.. . ................ Diagram of Lot and Building with Dimensions Fee 1 .F.!'.`�. SUBJECT TO APPROVAL OF BOARD'OF HEALTH ��%Y ' C CC PANCY PERMITS REQUIRED FORDWELLINGS ' O NEW D EL N U W GS W LI I hereby agree to conform to all the Rules and Regulations of the ow o nst bl rega ding the above construction. Name .. ...... .......................... i BAYBERRY SQUARE REALTY TRUST 24532 Build ............;... Permit for .................................... CommercHal...Bu 1 ing..................... ..........I........................ ...........d... Location ....16.4.5....Rou.te.... .... .. . ....... .... ..................... -�Centervil:Lp Ile ........................................... ........................... Bayberr S Owner...........A...........y......q�A4;re r ......Re-alty...T r"L st 91 Typetof Construction .....F);IaMe........................ ................................................................................ .............. Plot .... Lot ................................ Peirmit Granted ..,..Nov.emb.er....10,......19 82 ....... ....... .... ..... Date of Inspection .....................................19 A Date Completed ..-19 191--2 Assessor's map-and lot number . ........ yoFTNETo ' Sewage Permit number ...e.�.......-...S ..:.......... 7......................... SS i B)SIISTAELB i House, number ...�.... ........................................... '� rb 9 . e 'EonAYa`� y: TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....1,QQ 2...... ......E�. �......FRAP4� ....... t TYPE OF CONSTRUCTION .....1.V,. 1' ...EgAkF..... .................... ............................. ....................... ; TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......................................... .........Gi l�l:`.�:: ..1i� ;'i........� .. �2. .: ........... •; Proposed Use %�? ......... ..................... .................................................................................................................................. Zoning District ....... .r. .................. ...................................Fire District C:0 ..........: .. Name of Owner I.'j.. !!� .`j .- ��.. ......................� dress ...�r;`��".• �7 �?...�. � � ��? ....'.jllt l fir... .��: Name of Builder' ... ...Tr. .::t�... j�`rC L�:....,�C�...3�'Li�. 'Address ../b .2A` .:( z z vl �e � I"......:.... Name of Architect ...� . .. �:k �. :.. ( l�r�`�:Address ........ Number of Rooms 11 Foundation �' � Exierior .( ...... T .�.1/ t::..5!:I.ltl� '...Roofing .... .�i ............................................. .......... Floors >�.t. � �...... ......................................................Interior ��I L� � ?V157. .... n Heating . .... .. .� ........y?`#...................................................r Plumbing ...... ... . .. .' fl 'C,�.1 .'.. t? t r;�cA:....... Fireplace 7* (�(�# ................................ .......................... .Approximate Cost ........1000,0 ... w ~ "Definitive Plan Approved by Planning Board _ _________ ____-________-19 _______. Area .�?�' .. .... ..... Diagram of Lot and Building with Dimensions Fee C � " .... I....` . SUBJECT'TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 4WJ I hereby agree to conform to all the Rules and Reg 6 lotions.of.the'Town-of-Barnstable y arding the above construction. a Name ... : .... �.. BAYBERRY SQUARE >EALTY TRUST A=209-36 No.............24532..... Permit for .................Build................. ;t"0mmerci&l Building 1645...... : , ��,u, , . r Location .............. 2.............................. Centerville 5�2 G Owner ,,,,Bayberry Square Realty Tr,.ast ............................. .... 11A 60et Frame -� Type of Construction ¢ � .......................................... r Plot ............................ Lot ................................ November 10, 19 82 Permit Granted .................................. Date of Inspection ....................................19 r 1 Date Completed 14 O o 0,13 73 6-7 a .�..4 -7 Town of Barnstable Building Department"` Brian.Florence, CB Building Commissioner 200 Main Street,Hyannis,MA 02601 www.towm barnstable.ma us Pre-application for.Business Certificate Date bw MaJ Parcel Applicant Information Applicants Name " A plicants Address4an Email Address C� -�Z)o x 3 5 C0t+eA ,i I lZ , /A- QPro 3;1, cvnq Telephone Number Listed ❑ Unlisted J � c - 14 oZ Business Information New Business? No ---------------------------------------- Business is aregistered corporation? --------------- -----• Yes No If yes Name of Corporation f Does business operate under the registered corporate name? Yes No Is the business a sole proprietorship or home occupation? _------- Yes No If yes then a Home Occupation Registration is required—See Building Division Staff Name of Business (1)KC)(0- Business Address L'J )lX- Type k!Z Buil ' g- ornmi stoner Office Use Only C ]aditions �d � Building Commissioner Date '.cP f Clerk Office Use Only YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. a$ 4F L 1„FSal� k fG � (� DATE: S C L T Fill in please: pia + APPLICANT'S YOUR NAME/S: S r BUSINESS YOUR HOME ADDRESS: 6q IP ' TELEPHONE # Home Telephone Number I\-o 9'- --I-z - a 3 i 39.4 t ,32; NAME OF CORPORATION: o. -Z c NAME OF NEW BUSINESS TYPE OF BUSINESSrf.r ✓Lk,nc,eexen'�'" IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS t(,oqS MAP/PARCEL NUMBER (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM SIO ER'S OFEC E This individu ha n�+#or e f a y p rmit requjrembpts that pertain to this type of business. Aut orized.Signatu COMMENTS: 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: YOU WISH TO OPEN A•BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years]. A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does-.not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's„Office, 1 st FI., 367 Main St., Hyannis, MA 02601. (Town Hall) and get the Business Certificate.that is 'required by law. ' DATE: b F'I in please: ;•'ii>';; {�+ ]I'i=' ''�))i "APPLICANT'S YOUR.NAME/S: YOUR HOME ADDR SS: ^:.I,::a ;zy'>:•i�- +i7 . _,,i, BUSINESS `>>.i^i • l�ul,�,. 9iuiiiy:;.i{�j' Li. rl Jul;i� - °ys TELEPHONE # Home Telephone Number E-MAIL: lam' NAME OF CORPORATION: NAME OF•NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION? . E NLj ADDRESS OF BUSINESS. . MAP/"PARCEL NUMBER " [Assessing) When starting a new business there are several things you most do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining tho information you may need. You MUST GO TO 200 Main St. -(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. 'BUILDING COM SSION R'S OFFIGE This individua he b n •rffo- d f n er requireme "ts that ertain to this type of business. Auth rized Signature COMMENTS: 2. BOARD OF HEALTH _ This individual has been informed of the permit requirements that pei tain'to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: YOU WIS1 TO.OPEN A BUSINESS? For Your Information: Business certificates[cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you f must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the.completed form to the Town Clerk's Office, 1st FI.; 367 Main St., Hyannis, MA 02601. (Town Hall) and get the Business Certificate that is required by law. DATE: _ Z Fill in please: t J ' "! "'•-' Niz 9� +. APPLICANT'S YOUR NAME/S: (2�sse tl J a YOUR HOME ADDRESS: 1n r��fn (f of- ¢'�:i��r��,•,;' 'f.�, BUSINESS , TELEPHONE # Home Telephone Number 7 1 0 — ,. f NAME OF CORPORATION: 1z a opcb C- bF-NEW BUSINESS C F G L�� '✓,iteS_TYPE OF BUSINESS f--,r�a�c IS THIS A HOME OCCUPATION? YES NO > O�[Assessing) ADDRESS OF BUSINESS. 1(P4.1s- •a.,f�+ 3v;1 r 17- -1 MAP/PARCEL NUMBER 17 = cer, l-er'-,;1 e rv\A- 0 06 3a When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the.Town of Barnstable. This form is intended to assistyou in.obtaining the information you may need. You MUST GO TO 200 Main St. —(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM SSIO ER'S OFFIJQF This individu I h s e infer d ooner require erns that rtain to this type of business. ut orized Si tC MMEN S: tA 2. LARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS [LICENSING AUTHORITY] This individual has. been informed of the licensing requirements that pertain to this type of-business. Authorized Signature** COMMENTS: TOWN OF BARNSTABLE. MASSACHUSETTS _ BUSINESS CERTIFICATE i DATE ISSUED: 07/15/2013 DATE RENEWED: 07/21/2017 BOOK:200 RENEWAL BOOK: 205 RENEWAL PAGE: 18-051 ; AGE 13-193 DATE DISCONTINUED: CERTIFICATE EXPIRES: 08/21/2021 DISCONTINUED BOOK: DISCONTINUED PAGE: In conformity with the provisions of Chapter One Hundred and Ten(110), Section Five(5)of the General Laws, as amended,the undersigned hereby declare(s)that a business is conducted under the title below, located as shown,by the following named person,'persons or corporation: fiPLEASE NOTE A BUSINESS CERTIFICATE INDICATES THAT THE NAMED PERSON(S)IS(ARE)DOING BUSINESS UNDER A,NAME -,' r _ x -� D FFERENT THANHIS/HER PERSONAL NA_ME(S) SIT DOES NOT IMPLYTHAT THE APPLICANTS)HAS(HAVE)MET ALL�LIC.ENSE PERMIT--AND OTHER PERMISSIONS REQUIRED BY THE TOWN OF BARNSTABLE.BUILDING;HEALTH AND CONSUMER AEFyA'IRS X DEPARTMENTS FORTHE LEGAL OPERATION OF THIS BUSINESS AT THE-STATED-LOCATION �,ems'` �� "" � -� �i"5` - �Y: B P CE ING SS: 1645 FALMOUTH RD BLDG F, D-4 CENTERVILLE, MA 02655 RUSSEL J CO N 116 WINTERGREEN CIRCLE OSTERVILLE,MA 02655 Si THE ABOVE NAMED PERSON(S)PERSONALLY APPEARED BEFORE T THE FOREGOING STATEMENT IS TRUE. TITL Identification Presented: D< u t 21, 2017 CONDITIONS: NEEDS SIGN PERMIT IF PROPOSED. In accordance with the provisions of Chapter 337 of the Acts.of 1985 and Chapter 110, Section 5 of the Mass General Laws, Business Certificates shall be in effect for four years from the date of issue and shall be renewed each four years thereafter. A statement under oath must be filed with the city clerk upon discontinuing, retiring or withdrawing from such business or partnership. Copies of such certificates shall be available at the address at which such business is conducted and shall be furnished on request during regular business hours any per n who has purchased goods or services from such business. Viol sublect. a fin of not more than three hundred dollars($300)for each month during which such violation continues. J RTIFI N C USE i nder a pen lt' of erju that I, to the best of my knowledge and belief, have filed all.state tax returns and paid all.state taxes r r la * Signature of IndivT tporporate Name(Mandatory) By: Corporate Officer(Mandatory if applicable) ** or Federal ID Number * This license.will not be.issued unless this certification clause is signed by the applicant. ** Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or revocation. This reouest is made under the authoritv of Mass: G.L. Cha 62C, S. 49A. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map [_ 09 I Parcel O Application # Health Division 7J "� Date Issued LYI,s Conservation Division ,® �j� Application Fee Planning Dept. ��✓® � , Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis ?. .�� C,it'd Project Street Address Village G�t'r� vv�`��,(m a Owner �t-, 1� Q��G� Address Telephone I Permit Request `�n. -! �r Ell 4' 4-r<< C Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 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 y-APPLICANT INFORMATION. (BUILDER OR HOMEOWNER) Name Telephone Number 776 S 3 e� Address 149�(n ��.. C�� License (/ r L/ �l �.� Home Improvement Contractor# q In Email 4C4kPhJ r'014A C 5 ✓y / d-WWorker s Compensation #ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED .: MAP/ PARCEL NO. f, 4 ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATIONY FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' r ` r I Y v; Y { ` QFFER�TO�PURCHASE REAL ESTATE "THIS�IS A LEGALLY BINDING CpNTRrACT. CIF NQT.UNDERSTp�OA,-,SEEK COMPETENT AD'UTCE" TQ: KSAL LLC DATE: 6/6/2417 �clo Commercial Realty Adv%sors,;Inc. : FRAM:�'osh Kouri<or nominee. .I .Hereby offer to buy the :property herein referred to and identified asarfollows 'Unit E2 of ttie Bayberry Condominiums located at 1�645 Route"28 Centerville,'MA, and as shown on the attached plan �lFoz Title see- v .� x` 1, n � 4K-, t �� ,Book Page at the Barnstable CotuiCy`Registry ofrl�eeds a (1} I will pay,�therefore Seventy�Five Thousand dollars,ofxwhich is paid herewith as a de osit�to bind this Offer 00 : is to be paid as�ankadditional�deposit upon execution�of Purchase and Sale Agreement as provided forYbeiow. 'T0;040'00 is to.,be paid;i�i�casl',cered check or3bank draft at the time of theFdeliverynof the�deed' , a5,000 00 is the Total purchase price 5 This() Qffer �s good until 4 00 P'lei on 6i8l2017, at or before which ttme a copy hereof shall be signed by you,=thesSeller, signxfyirig acceptance of this�Offer, �nd`returned to merfor forthwith oth�rwtse this:Offer .' 'shall be cgnsldererl'�as r`e3ected and , and maney;d eposited herewith shall be returned togme forthwith (6) lBttyer & Seller shall, on or before 4 P on 6i14/17; execute,arid deliver a iurchase an`d Sale Agreenien�,M which,shali be of standard form.and shall be consistent:with the ternxsand conditions contained in this Qffer ��} Seller shall deliver`a good and sufficient Deed, con�reyu}g a good, record to;:Buyer fat 10 the second Wednesd follawuig Sealer noti in Buyer that S.etler's Alki lender hasappra�ed the release of Sellersporkion- ibutedto this�unit,at the Office - ofe Buyers Attorneys,unless some other time and place are mutually agreed.upon This is not to be construed7as a mortgage contingency however (8) Tlis Offer pis subject to"Buyer ha�uig 14�day Inspection,penod, from;the full execution.of this5Offer Agreement, to evaluate `tlie.condition of the'unit, 'evaluate the condominium documents and review the f nancial condition of the:Condominium Association {9) This Offer; ssubject to the buildtrig bean service b a ro erl fiirictioniri Title 5 septic-system: {io) This Offer is subject to;the>Buyer being able°to receive an occupancy permit for the use of a Chuopra�tic Office (it) Seller hereby agrees to reasonably�cooperate with Buyer inrts efforts to;effectuate the acquisition of said property (t2} If Buyer,does not<fulfill sits obligattonsunder this offerzthe deposits;mentioned above shall,become Seller's property as liquidated damagesxwithautzrecourse to eitherpparty cc 11 pp;; . •�ti+►� T r 9ryW'�. ( y e r es t it i ig w s er"' edwth ,.remedy., pia) Time is of the essence of this agreement (iS7 The Seller#shallfpay Cammerc al Realtor Ad risars Inc a fee t(�3004.OQ ,at the tame ofthexclosu�g:! {t6) Buyer shall be responsible for the replacement ofthe heating and air conditioning system for"the unit: {i�) Seller hereby notifies Buyer that°tlie has and-Electric service for the unitare,shared withzthe tinit.across the shall and the edrrinon-area'"of theFbuiIding and'"not billed separately,Each tenant pays"its appropriate share: hwlrNEss my(o ........ SIGNED '" Jos ' .uyer: This Offer is accepted upon'theforegoingaterms and coi%ciitions at 100 p M on June 7 ,t2`Ul? Receipt ofthe dep„osit of$1000 00 is',hereby acknowledged WITNESS my(our)hands)and seal(s) SIGNED Seller *-Phone S48 862=�44(1 `Fax 508=862-92U0'* s q :. ij ... .. .. AC" CERTIFICATE OF LIABILITY INSURANCE F°ATE`MM/°°"""' �� 5/14/2017 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 have ADDITIONAL INSURED provisions or 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 FRANK L HORGAN INSURANCE AGENCY INC CONTACT 44 BARNSTABLE ROAD PHONE FAX PO BOX 250 LAIC, C o Ext A/C No): HYANNIS, MA 02601 AD RIESS: INSURERS AFFORDING COVERAGE NAIC 9 INSURERA: LM Insurance Corporation 33600 INSURED INSURERS: CAPE & ISLANDS CONSTRUCTION COMPANY INC PO BOX 210 INSURERC: CENTERVILLE MA 02632 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 35624081 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. INSR ICY EXP LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM DPOLIDY/YYYY MM EFF LDD//YYYY LIMITS COMMERCIALGENERALLIABILITY _ EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAM O RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 0 PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED - PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR 1 'EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION WC5-31S-377540-017 5/7/2017 5/7/2018 /JPER STATUTE EORH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN N E.L.EACH ACCIDENT $ 100000 OFFICERIMEMBEREXCLUDED? ❑N NIA - (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100000 if yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 MAIN ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN HYANNIS MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE LM Insurance Corporation ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 35624081 1, 1-377540 1 17-18 WC 1 n0270258 1 5/14/2017 11:09:46 PM (PDT) I Page 1 of 1 t i _ cpanvnxonc�ecr,�a�C�aczc�u�eCto Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration: ' .1'65936---- Type: Expiratio Private Corporation i..ii CAPE&ISLAND C0;5 INC. F JOSHUA•-KOURI = i V 55 ELM AVE. HYANNIS,MA 02601 c Undersecretary Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-074660 Construction Supervisor JOSHUA X KOURI r 2¢ PO BOX 210 CENTERVILLE MA 02' 32' 00 31 Commissioher Expiration: 02/12/2019 Anderson, Robin a 571 �A.rx)a; i6 u To: Josh Kouri iJo Subject: RE: Chiropractors office Hi Josh, I pulled the street file and found that the project was constructed circa 1989. I found the original permit for Buildings C and E. I checked both because you indicated that the deed sates one building and the listing sheet identifies another. The permit for Building C declared the use to be office/retail and Building E was identified as office. The zoning was identified as HB during that time. The zoning _subsequently changed to include the HO as well. Since, it appears that the facility was constructed with the purpose of inviting the public into the units and since the E' construction date is prior to any HC requirement under the building code, there is no" trigger to update it accordingly. It may be your advantage to consider this since the chiropractic use may indeed involve clients that have difficulty walking unassisted. Should you proceed with securing this location, you will need a tenant fit-out building permit to officially change the use (from its previous office use to chiropractic) as .well as. a sign permit. A permit application may be submitted with a copy of your P&S agreement but cannot be issued to you until after the conveyance. Please. let me know if you require additional information or clarification. Robin R8bin. 1C. Anderson Zoning Enforcement Officer 200 .Main Street Hyannis MA 02601 508-862-4027 = iginal Message----- From,:.. Jo.sh Kouri (mailto:josh@capeandislandsconstruction.com] Sent'- 'Friday, June 09, 2017 9:19 AM o Anderson, Robin Sub�gct, `Ch.iropractors office Helh'cf Robin c Per your request I` am sending this email to confirm the permissibility for our proposed use,,,gf; a,.chiropractor's office at unit 2E, 1645 Route 28 Centerville. In bayberry pl.ac,e. Thaks again for your help. Josh '� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Q Application # �OJ PP Health Division ®�� Date Issued ;l- z_17 fir,. Conservation Division ��0 Application Fee I, Planning Dept. Qe��,, Permit Fee BUD.Q0 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address l 6 S' Fa1 m:aotA% Off:c Village Ceeo VP Ile-, Owner ? laee-<` ocu a.! CAN a Address Telephone n Permit Request r < © /v I C I s cc../,e C e�C CW_1 e �,C( Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 2��C'�G� Construction Type LIcA 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: JELFull ❑ 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ------ Name Cf ` Telephone Number SG?— n— CS,09 Address 1 �, Jcscc 1 `c .S/ L�� License # CS— Q�J R-5�� G-) y'l'leI el"`'mo t 0 Home Improvement Contractor# 133 "S � Cr Email i'Ocr C Cs 1C `� c_tl A1 e7 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 4IL4 DATE / A7 c� - 1 FOR OFFICIAL USE ONLY APPLICATION # s C .z ri DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r - . Tie Couzraromveakth qf3&iwrdruseffs DvarinTent of rirdus-bid Acculei r#s Ohre of rMw_Vd9GfiG=. 600 Wasliurgiort j6t wt jr Boston,MA M i wiv�ricrs govAdia Workers' Campemi afmmlusu ceAffrdavit BlEdIdex-dC aniractarsJEl ers Applic2m#InfcninatEau �-7-� Please Flint y. -Nam(.g ): po 4�_C,/' ess. Qr S ci 74 cG st .t" cty/Statm�_ /"/S S, 0 JPhone t. Are you an employer?Checkthe app apriate bona T of project r I.❑ I am a to vffi 4. 0 I am a gea eral confractor anc€I Type P ] ( e '= �P 6. ❑New canstrmctica eraFloyees Ch 1.an&ot:part-lime).* 1mve hued the sub_cosakeacfvss 2.$tl am a sole propsietof arpartaer Fisted anttle a4 ched;beet` 7. ❑Remodeling slip and 1mves no emplcyees These sub--ca afractass have g_ ❑Demolition: working fhF�e in many capa cafl`- employees afldha a workers 9. ElEnildmg addition VN'o wod mrs'camp.insurance camp_iasurau�� reclaired-] 5..❑ We are a corporati an.and its 16- EleEtdcal repairs cr adaicm 3.❑ Iam.ahzmeouner doing all wa�dt officers have esrrcisedtheir 1L❑Hurl s grepaissoradditiom, Myz 1€[No Vimikers'camp- rim of exemption per 1irIGL 1?❑Rflofrepais insurance reqairecl]1 � c.152,§1(4)aadwe.hawena employees.[No wormers' 13.0.Otfier, comp-i surance mqu-e&] •�ayspp��stcbe�Uos�ltma�alsafiIlanEthese�oabeIawshasdagt-6e's�o3texs'compessafi�Pe�F��II� ffameonra�rsuhosah�tthis>d�daruin�rafmgtBvyaxgtlniagsdE�oQicsadtheahiieau5idecoatmctnrsamstsuhmitanewaffidaeiti 6.ti g=dL fCautRs bMV3xtf`haAiW bmcmustattarh ffi.sdditianslsheetshawingthen2aeoftbgsu7 11ATe . ��lo}ees.I€ihesvhteatradv�sb�ce emFloSe�s,ifieYmustgmri3e th.enr srork�,'Comp.galic3�•a>m�reL . I am ara employer that is prm-idirtg narkers'eaugvusrdi4m iimirauce for uW earpLoywer. $e£ow is Mo po cy and joh site iru,forazatiom Insurance Company'Naum: •Policy,41,or f--ins_Iic. 1=xpimtionDate: Job Titantlddte= Citg15tafe ziP: Attach a copy of the w&rkere compensationpolicy declaration page((showing the policy number and espu ation date). Failure to secum coverage as required under Section:25A of MGL c.I52 can lead to the imposition of crimixnal penalties of a fine up to$L,54QOa andfor one-year imprison as tin&as civil penalties is the fomx of a STOP WORK ORDE1Rand a fne - of up to 50-M a day a gaiust the violator. Be adiised that a copy of this statement maybe forwarded to the Office of Investegatiom of the DJA for insurance,coverage ve€iffcation I rya Itereiiy c the psis dpsr:afti�s a.fFer �}'ffaaf Efts irafaratioragrmided aTia��s i� s arsd rarreGt Date- tr3,Ukhd uw anl. ,Da nat write in tfas irreQ,6a be wimp£eteed by c#arton7l o,Ticia£ City or T'owm Perrmffff,icense f Lmr6 zg JAM&Grity(fie One): L Sward of Health 2.I3nTTmg Department 3.CitylTown.Clerk 4.Electrical hmpector S.Phunbing Inspector b.Other , Contact Person: Phone 9: THE Town of Barnstable Regulatory Services ` MASS. Richard V.Scall,Director �,,�+► Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section �tkv� If Using A Builder ' 0O as Owner of the subject property- hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) 'k'kPool fences and alarms are the responsibility of:the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant " ` a Print Name Print Name Date Q:F0RMS:0WNERPERMISSI0NP00I S r a F1 It r r 1046 Main Street Suite 11 Telephone 508.420.0299 Osterville, Ma. 02655 Facsimile 508.420.0789 www.fomcapecod.com A January 4, 2017 To Whom It May Concern: This letter is to inform you that I, Devin Witter acting as agent for Bayberry Square Condominium Association located at 1645 Falmouth Road, Centerville, MA 02632, and with the power given to me by the Board of Trustees have contracted Roger T. Cox to perform work on the siding of the Bayberry Square Condominiums. In order to perform this work I authorize him to pull any and all permits needed for the completion of the contract. If you have any further questions feel free to contact me. Sincerely, Devin Witter CMCA, AMS First Property Management devin@fpmcapecod.com 77 77 V/ze.ipo�runronvveall�o/� et Cie46-1 J ry s, Office of Consumer Affairs&Badness Regutahoul ,-, bi6n a or registration:vafit�f9j4h:dividui use only v R u`��" •o _(;,H,0ME IMPROVEMENT CONTRACTOR' before the expi'rat�on date ff6uhd retyrlj ttl: 1 o o N. _ registration 33j75 Type Office of Consumer Anal nil"d.l3tfii.h 1 egulatioft cca tT a : — Expiration 8/7/2017, JndividualYY 10 PgrT: lza°:Smte 5170. x t -Btston-M 021161 • i � � ,. �°-r �: RogerT:Cox'. - o_ m o to c. Roder Cox 4 c O 19 SoutheN Lane v s A Centerville,MA 02.632 Uudersecreta M. ,O U) N' �Y 5., .. ot'va6d.w..ithout signature a g,' ,o 00 I, v 4 m J a Lo' v — m a V c XOW - 5 E m 0 oa .. J U O w U' N 2 � F-m � O �. WU V! W c�a O J c a y Z O 0 W , m .0 V Aip ,\ 'A l\ r YOU WISH TO OPEN A BUSINESS? For Your Information' Business certificates(cost$4o.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. -it does not give you permission to operate.) You must fist obtain the necessary signatures on this'form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601 (Town.Hall) and get the Business Certificate that is required by law. DATE:_ 1 T7 1 _ '1 / Fill in please: APPLICANT'S YOUR NAME/S' BUSINESS sin YOUR HOME ADDRESS: a� TELEPHONE # Home Telephone Number . qa ��(+' •.•:+ :'�U"!:iNl C:4 •T q';) E I N #: E-MAIL: v ` NAME OF CORPORATION: NAME OF NEW BUSINESS vL' TYPE OF BUSINESS Exrlb �CQi IS THIS A HOME OCCUPATION? YES NO 0Q ADDRESS OF BUSINESS. 7 a. V MAP/PARCEL NUMBER (Assessing) m 0a6 3;-' When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your•business in this town. - 1. BUILDING COMMISSIONS '&Ied CE This individual has ee o of any it requirements that pertain to this type of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business.~ Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: c I 4 - TO ALL NEW BUSINESS OWNERS DATE: !�i-/1-6 Fill in please: ° APPLICANT'S YOUR NAME: BUSINESS E YOUR HOME ADDRESS: ow-4f Ad .5r TELEPHONE Telephone Number Home NAME tF NE1N BUSINESS ; " , GYP �FUSIlS5' f �� -� IsI�sc� OCuIA�rrONa Yes N raval.:fra # e br,ild,wt rr� tt'� YIDS IVY (i Hive youe , p . I ADM O..... S a •..d;� I✓? ll 11PA t I L NU I When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor- Town Hall) or if you get the,business certificate first you MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St. — (cor f Yarmouth Rd. &)Wain Street) and you will find the following offices: 1. BUILDING C MIS IONS, 'S OF This individual s b e infor od of any i equire ents that pertain to this type of business. o iz Signa a*" - COMMENTS: 2. BOARD OF HEALTH This individual een i for eq of th=it requirements that pertain to this type of business,` A orized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual t b� een inff thlic si requirements that pertain to this type of business. Authorized Signature**� COMMENTS: Business certificates (cost $30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. - it does not give you permission to operate -you must get that through completion of the processes from the various departments involved. **SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY. Bayside Building, Inc. P.O.Box 95 • Square BayberryS uare • 1645 Route 28 • Centerville MA02632 ""QualityTo Live By 508 771-1040 • Fax:508 775-0155 • www.baysidebuilding.com July 11,2016 Paul Roma Building Commissioner Barnstable Building Division 200 Main Street - Hyannis, MA 02601 �- Dear Mr. Roma, I am the current owner of Units 3,4, 5 & 6 at Centerville Plaza on Falmouth Road. I have anew.tenant for Unit 5 who would like to have some modif cations made to the unit. As you know, work was stopped on the previous,plumbing changes, and a new plan is being made. Unit 5 will be completely separate from Unit 6, and will.consist of approximately 1,178 sq. ft. The tie4n to the septic system will come directly from Unit 5, and will not pass through Unit 6.New plans and the necessary permit applications will be submitted as soon as they are ready. I can be reached in my office at(508) 771-1040, or on my cell at(508) 221-1041. Thank you for your time and consideration. -n Sincerely, -mow an T. a ey President Bayside Building, Inc. ' TO ALL NEW BUSINESS OWNERS: • Fill in below: NAME OF NEW BUSINESS: �T c Le - Et e�Jil-,(u � TYPE OF BUSINESS IS THIS A HOME OCCUPATION? ADDRESS OF BUSINESS r I 4 S �' '�� r` -l�MAP/PARCEL NUMBER P` a J 06& Z 6 7 If you are starting a new business there are quite a few things you need to do in order to be in compliance with all rules and retulations of the Town of Barnstable. Once you have been checked off on this sheet you may apply for a business certificate at the Town Clerk's office(Ist floor-Town Hall). 1. TO BUILDING IN PECTOR'S OFFICE(4TH FLOOR TOWN HALL) Th' individ s iR comp lance has been explained the procedures needed to start a busines - . uilding Inspe&or_'s Signature 2. GO TO BOARD OF WLTH(3RD FLOOR TOWN HALL) This individual has be i ormed of any per 't re i ments that pertain7tothis of business. � CLL1 Health Inspector gnat C/ 3. GO TO CONSUMER AFFAIRS (LICENSING AUTHORITY)-(3RD FL SCHOOL ADMINISTRATION BUILDING. This individual has been informed of any licensing requirements that will pertain to this type of business �, � . 1.censing Authority Signature . After being checked off by all of the above-remember to return to the Town Clerk's office to actually obtain your business certificate. ��I _ L 4i�-v� E 7 J � .� 0 13 TOWN OF BARNSTABLE STATEMENT OF DISCONTINUANCE, CHANGE OF RESIDENCE, CHANGE. OF LOCATION OF BUSINESS, WITHDRAWAL, OR DECEASED FROM BUSINESS OR PARTNERSHIP 1) In conformity with the provisions of Chapter 110, Section 5 of the Mass. General Laws, the undersigned hereby declare(s) that we(I) have. this day ❑ Discontinued ❑ Withdrawn from the business known as conducted at I .��D—`j5�� o �(1 L°. Q#•-7— as set forth in the certificate filed on CAk C;k d NAME ADDRESS 2) The location of the business ❑ my residence as it appears on the business certificate of filed on ►1'l QC 00< < S Z_ has been changed to �j?� GJi► 7E7'Z-. f i"-- ►'jj L. ''7! 3) As Executor or Administrator for the Estate of who died on I hereby request a re � R ❑ oti ::'w Discontinuance of the business1certificate. Withdrawal of his/her name from the business certifiLlAte ' „M filed on in the name of V SIGNATURE(S) : ON THE ABOVE NAMED PERSON(S) APPEARED BEFORE ME AND MADE OATH THAT THE FOREGOING STATEMENT IS TRUE. TITLE 1 �r IDENTIFICATION PRESENTED: Flue# (74 P&#,93 OTHER keiF z ,iv 1 %`�r Western Surety Company c, A Subsidiary.of CNA Surety Corporation: September 10, 11998 Agent,.,Code: 20-01508 TOWN OF BARNSTABLE BUILDING INSPECTOR 367 MAIN ST. HYANNIS, MA 02601 Re: Bond No. 23323170 Penalty $1,000 PRESTIGE PROPERTIES, INC. 1645 FALMOUTH RD. , STE. E-1 CENTERVILLE, MA 02632 GENERAL CONTRACTOR TOWN OF BARNSTABLE We-have ,received-,a request to cancel or nonrenew this bond. We wish to comply with the principal' s request by taking advantage of the cancellation provision pertaining to this bond. You are hereby notified that this bond is cancelled and voided as of December 23, 1998, or the earliest time permitted by applicable law, whichever is later. Thank you for your attention to this matter. cc: PRESTIGE PROPERTIES, INC. OLDE CAPE COD INSURANCE AGENCY, INC. 435 MAIN STREET HYANNIS, MA 02601-3905 Underwriting Services SINCE 1900 ■ 1-800-331-6053 P.0.Box 5077 FAX 1-605-335-0357 Sioux Falls,South Dakota 57117-5077 http://www.westernsurety.com i, 71 TOWN OF BARNSTABLE BUILDING INSPECTOR 367 MAIN ST. HYANNIS, MA 02601 °Fri+e The Town of Barnstable 9� 1 Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner June 16, 1999 First Property Management 832 Main Street Osterville,MA 02655 Re: Bayberry Square,1645 Route 28,Centerville Dear Sirs: On inspection of the above referenced property,I noticed you have the following violation(s)of the Town of Barnstable's General Ordinances,Article XLIII PARKING FOR HANDICAPPED PERSONS, Section 2 Sign Requirements for and Location of Handicapped Parking: _ The handicapped parking signs do not meet the requirements of the Town of Barnstable's General Ordinances ___X_Faded/missing pavement striping and handicapped logo in your parking lot Please see that these violations are brought into compliance by July 12,1999. Call for a reinspection when this has been done. If this is not brought into compliance by the above date, a fine of$200.00 per day will result. Enclosed,please find a copy of the"Handicapped Parking Signs Key"as well as a copy of the appropriate section of the Ordinances to use as a guide and for your file. Sincerely, VIOLATION G44� Unit 1-A--Faded sign,no logo Ralph L.Jones Unit 1-B—No pavement logo Deputy Building Inspector Unit C through 7C--no sign,faded logo Unit 10E--No pavement logo RLJ/Ib enclosures(2) FORMS Q990615a Assessor's offioe"(1st floor):' § ® r pp// YF. r �' THE t Assessor's map and lot number ...0..o9'..Q P..�or::�.nK,A r,� � � Board of Health (3rd floor): ii ' LL Se°nrage Permit number (,,. ... - -5.. . ...:. ......... WITH TITLE 5 2 INAUSTAILL Engineering Department (3rd floor) „O� , ,CNMENTAL CODE Ak-7� +oo t63 ....:...�y..�rP. . ...�f F'ouse number ..:............. � •. 9 a` APPLICATIONS PROCESSED'.8:30'--9:30 A.M. and 1:00•-2:00 P.M. onlyM TOWN OF RARNSTABLE BUILDING . INSPECTOR .il APPLICATION 'FOR PERMIT TO .'..W. :. .0 TYPE OF CONSTRUCTION .. 1 ....:................... n ........ TO THE INSPECTOR OF' BUILDINGS: - The undersigned hereby applies for a permit according to the following information: Location 85J•l(_DiJU..D.. �� ... ........ U.�Cj ...uG��.rf :.�. ..l. f0. ...... � cJIC Proposed Use .. ..-. .t. t►••6 1 ................::...............:.. ...... .............................................. Zoning 'District ............. ...................'............................Fire District ...,'. •........ � :.... Name of Owner .... .:Address .1...�,,...�.6..-�.yei� iC• _Y SS0Q, � _ (, C.' Gvl� Name of Builder r ). .. .�� ... adress r. Name of Architect ... ..... .:................................................Address ..............................:.........:.......................................... . Number of Rooms .............Foundation ...e7k,-t5j..l.�J.lo....................... ...........:............. Exterior .....a.k5...... ....... ...... ....Roofing ......� ._ '....................... Floors ,��YI. ...Interior ..... Heating ...Plumbin ....--'4�2- • ' Fireplace ...... ....Approximate Cost ..: ' Definitive'Plan Approved 'by Planning Board ________________________________19-------- , Area .,..t�......�Q................ Diagram of Lot and Building with Dimensions Fee, -�........ .......... SUBJECT TO APPROVAL OF 'BOARD OF HEALTH � tip' • F , 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 . -`t� .....,,•.. k CENTERVI"LLE DENTAL ASSOC.. No. 3e886 Permit for Move Bathroom & Replace ;w/H/cay�J�Jed bathroom s y ; Ck - 4. " ��.s}...•,•......,....•...4.h...,....... .............. fY` R � l• ' rs.-. _f, `' � .. � - » h ','y. .4� Location$ d - r UnYt 1, i645 F3avberry Sq. ..................Centerville................................ I Owner .,,Centerville Dental Assoc ' R Type of Construction .sFr . .... ............... ti w �. c Plot .....".'.... :^............. Lot , ~z 8 7 Permit Granted ........June: 2 ....... �.�............19 Date of Inspection ...... ........... ........19 ._ —Date Completed .................19� - t iI r Assessor's offioe (1st floor): p/ Assessor's map and lot number" �.c7 f o U Board of Health Ord floor): S4wage Permit number ......rr.rn... .....`.��..,....:....,................. 2 HesasrsntL S Engineering Department (3rd floor): 'o MA'L Pause number � y F-,U - 0 0 MIN APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING I INSPECTOR M'A . �M�uort APPLICATION FOR PERMIT TO b •.. �fs 4,z '. �..R OC, ar ,..�t,L/F� P(7C�M..�lfc TYPE OF CONSTRUCTIONM� .. ................................................................................................. Y . t ................................................19........ TO THE INSPECTOR OF 'BUILDINGS: The undersi'gne`I8 hereby applies for a permit according to the following information: Location ......� 1 ( 1CC ... t�?TC, ;.. Proposed se ........7 C '- �-� ZoningD.is_,frict ............. ....:.............�..............................Fire District .............................................................................. Name of Owner t_ ...?� 1�• AQ............Address )l�Y�(!�1 .. ...�),►�T . , Name of Builder K .. .�.J P..�C?��`n' A. Eldress t • Name of .Architect .... Address .................................................................................... j........................................................ Numberof Rooms ........I..........................................................Foundation ... !_ ke................................................ Exterior .... ..............................................................Roofing ...... ? ............................................................. Floors X.(. .f:........: .Interior ..... . '�-' ... ,......................................... ................................ .......... .. Mb� E-"(( Cart( f.)�� c ► j i�C ' ,xI �T (�. -R.-SAP -;. Heating ........_....... ..................................................................Plumbing ...................... .................,............ ........................... Fireplace ......N) . .................................................................Approximate Cost .....cl ................ . Definitive Plan Approved by Planning Board --------------_-----------------19-------- . Area Q.. �. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH Ott 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 ....... .................................................... Q.449.0 ' 4 Construction Supervisor's License ... ............. .........:.... CENTERVILLE DENTAL ASSOC. A-209-086-00K /7v ch No 30886 Permit for ...Moveathroom & Replace„w/H/Capped„bathroom 6/r10uk Location .....Un t,,.#,1.,.,_,16,45. q. t ..................Cente,.:.V.: 1 Q................................. Owner ..Centery l.le„pe.n.tal,,,AsAgq.. Type of Construction ErIaMe........................... ...................:........................................................... Plot ............................ Lot ................................ Permit Granted ......JgmA...22..............19 87 Date of Inspection ....................................19 Date Completed ......................................19 k_ TOWN OF BARN 1'xALL%' .R BUILDING PEMIIT PARCEL ID 209 086 B01 GEOBASE ID 12877 ADDRESS 1645 FALMOUTH ROAD (ROUTE PHONE CENTERVILLE ZIP LOT BLDG B BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CO PERMIT 61390 DESCRIPTION REROOF COMMERCIAL BLDG PERMIT TYPE BROOF TITLE BUILDING PERMIT ROOFING CONTRACTORS: PROPERTY OWNER Department of Health Safety ARCHITECTS: P � Y and Environmental Services TOTAL FEES: $50.00 �tME BOND $_00 CONSTRUCTION COSTS $3,413.00 750 ROOFING AND SIDING 1 PRIVATE "P, Pam' * BARNSTABLE, * C 111/ . BUIL N DIVISION l BY DATL ISSUED 05/29/2002 EXPIRATION DATE �---� � r y tTOWN OF BARNSTABLE. -q , � 1 ,}. k,:. • BUILDING PERMIT PARCEL. IDp 209 0$6 B0.1� GEOBA E ID 12877 ADDRESS . tt1645 FALMOUTH ROAD (ROUTE PHONE T j CENTERVILLE ZIP . LOT' _. BLDG B BLOCK - ,.�: �J :::° LOT SIZE DEVELOPMENT DISTRICT CO I" PERMIT 61390 DESCRIPTION;P-EROOF COMMERCIAL BLDG PERMIT TYPE • BROOF TITLE �. . BUILDING PERMIT ROOFING ,-CONTRACTORS PROPERTY OWNER Department artment I Health Safet I ARCHITECTS: �.A.. . y Y I and Environmental Services_ i TOTAL, FEES: $50-00 N BOND `�. $_00 O .CONSTRUCTION: COSTS $3,413.00 750�. ` ROOFING AND SIDING ] PAIVATE R BAR�NS�!p'ApBM 1p I . _ ti 1111 BULL DIVISIO ' DATk) ISSUED 05/29/2002 EXPIRATION DATE _, THIS PERMIT CONVEYS NO RIGHT TO OCCUPY`ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY-EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR I ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- PERMITS ARE REQUIRED FOR (READY TO LATH). PANCY IS REQUIRED, SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- ANICAL3:INSULATION.' OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. s � Lim� 1 BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 I I I I ,I ,I 2 c 2 2 =I I .I .I 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 'I 1 2 BOARD OF HEALTH' OTHER: SITE PLAN REVIEW APPROVAL I I WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. I I I . . . . . . . . . . . . . . . . . . . . . . _. . . . . . _ . . . r , � , . w . � . : � . � � / � � � ` � f � � � . . \ � / f � . \ / y . > v . . » / � / } / � � � _ / ? « � ` s : . 2 ° y . e � . v . . » »w«y. », © © « .: . ` . �« »� > w». «&�e / y «< < . . � » :�� : - 1 y \ Z. \ � � � \ j. > . s . � f , . . : \>�: �v»« �4�\ f r f \ 2 . . / . / � \\�m. \ � \ �� \ / / � | � � � | � . � | TOWN OF BARNSTABLE - !� µ J = SIGN PERMIT ( PARCEL ID 209 086. GEOBASE ID 2R462 ADDRESS 1645 FALMOUTH ROAD (ROUTE PHONE CENTERVILLE ZIP LOT BLOCK LO`].' SIZE . DBA DEVELOPMENT DISTRICT CO PERMIT 24852 DESCRIPTION IMMIGRATION COUNCIL (5 SQ.FT. ) PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $10.00 BOND $.00 OxIm CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE + • * BARNSTABM 1 MASS. OWNER NOWAK, STANLEY P i639 ADDRESS P DAIGLE & M CROUGHWELL TRS ED MA'S 1639 FALMOUTH RD i w CENTERVILLE MA B/ ILDING DIVII0 , DATE ISSUED 08/06/1997 EXPIRATION DATE V k The Town of Barnstable = Departure of Health,nt Safe and Environmental Services - _ 7 t3' Building Division ill 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Cmssen Fax: 508-790-6230 Building Commissioner Application for Sign Permit Applicant: n�a�i ,� 1.1 Z Assessors No. cZ 09 .0 � 6 Doing:Business As: j rY\ n, i &kA T 1 o nJ Go L)-VA C'+ L Telephone N o. Sign Location Street/Road: 1 &qS al o� � aI kk+ �_S Gem- ✓�i LL2 Zoning District: Old Kings Highway? Ye Property Owner Name: Telephone: Address: Village: Sign Contractor Telephone: Name. Address: Village: Description Please draw a diagram of lot showing location of buildings and a:dsting signs with dimensions, location and size of the new sign. This should be drawn on the rLn,erse side of this application. i Is the sign to be electrified? I : o (yore:IFjmr, a rnuingpermiris requiredl I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of Section 4 3 of the Town of B le Zoning Ordinance. 7 Signature of Owner/Authorized Agent: Date: - 66 Size: Permit Fee: A- Sign Permit was approved Disapproved: Signature of Building 0 4aC, .. / - Daze: .. a ti 11 L_ �MM� �• rc�T�� ,J � ©��; � _- �� r -.- ��s . ',� ^s p I TOWN OF BARNSTABLE ` SIGN PERMIT , PARCEL ID 209086 GE09ASE ID 25462 ADDRESS' 1.645 ROUTE 28 PHONE "Centerville J zip;' - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CO I PERMIT 9716 DESCRIPTION BAYSIDE ELECTRICAL CONTRACTORS PERMIT TYPE BSIGN TITLE SIGN PERMIT Department of Health, Safety CONTRACTORS: and Environmental Services ARCHITECTS: TOTAL FEES: $50.00 THE BOND $.00 , CONSTRUCTION COSTS f $.00 Q� 1 * BAMWABM f MASS.' OWNFR NOWAK STANLEY P - 1639. Al®� ADDRESS P DAIGLE & M CROUGHWELL TRS D .1639 FALMOUTH RD - CENTERVILLE MA y _,B I ILDI NG DIVISION DATE ISSUED 08/15/1995 EXPIRATION - E.B . DIVISION APPROVALS FOR CERTIFICATE OF OCCUPANCY + TO BE SIGNED BY EACH DIVISION HEAD UPON COMPLETION BUILDING:'' •L-"`a• �` DATE: COMMENTS: = ' 31 , PLUMBING: DATE: COMMENTS: i T } ---ELECTRICAL: ' DATE: COMMENTS: GAS: DATE: COMMENTS: CONSERVATION: DATE: COMMENTS: OKH: DATE: COMMENTS: HISTORIC: DATE: COMMENTS: .FIRE DEPT.: DATE: COMMENTS: OTHER: DATE: COMMENTS: TURN THIS IN TO THE BUILDING COMMISSIONER AFTER ALL SIGN-OFFS ARE COMPLETED.A CERTIFICATE OF OCCUPANCY WILL BE ISSUED AT THAT TIME. TOWN OF BARNSTABLE ' SIGN PERMIT PARCEL ID 20:3 .'086 GROBASE ID 25402 I ADDRESS 1645 ROUTE 23. PHONE Ceti tervi,j le ZIP LOT BLOCK LOT SIZE � DBA DEVELOPMENT DISTRICT CO PERMIT - 9710 DESCRIPTION BAY81DE ELECTRICALS CONTRACTORS � PERMIT TYPE BSIGN TITLE SIGN PERMIT Department of Health, Safety CONTRACTORS: -.; and Environmental Services ARCHITECTS � TOTAL FEES $50.0.0 ENE BOND $,00 CONSTRUCTION. COSTS $.00 BARNSTABLE, s MASS. , OWNER NOWAK:, STANLRY P Ep A �ti r ADDRESS, P DAIGLE & M 09OUGHWELL TRS 1639 FALMOUTH RD CENTERVILLE MA B ILDING DIVISION r DATE ISSUED 08/15/1995 `EXPIRATION P R Y THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED-ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH, OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON= INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA-, TION. NOTED ABOVE. TION. 508-790-6227 BUILDING PERMIT i The Town of Barnstable permit no.17 .� Department of Health, Safety and Environmental Services NA M � Building Division date S u 367 Main Street,Hyannis MA 02601 � fee Application for Sign Permit Applicaf. Assessor's no. c _ Doing Business As: J040 DO�Iq H U �- Telephone Sign Locatio street/road: I-T 1@ 1.IC0114 QQ A D --0 SU 0 I �- 6A C6 Wl Er VL C-LL Zoning District Old King's Highway District? yes no Property Owner Name: Telephone Address: i N L Ty Village Sign Contractor Name: - ��a w 44)VL Telephone � � [ cl Address: QouT� lsi2�N�D W I N Village Description Diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign to be drawn on the reverse side of this application. Is the sign to be electrified? yes no (Note: if yes, a wiring permit is required) I hereby certify that I am the owner or that I have the authority of the owner to make application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinances. L/ Date V Signature of Owner/Aut o�j d Agent Size (sq. ft.) � Permit Fee Sign Permit was approved: di pproved: a Date / Signature of Building Official YSIDE ELECTRICAL CONTRACTORS INC. -R - - its s 4 6 P'.)L A I'D(F,;3 TOWN'OF BARNSTABLE BUILDING PERMIT APPLICATION ' ^� Wq . Map Z0Paree Permit# Health Division -Date Issued " Conservation Division 7 k Fee - D� Tax Collector ' �� 17/�'j - Treasurer Planning Dept. F t Date Definitive Plan Approved by Planning Board > Historic-OKH Preservation/Hyannis Project Street Address Ste, Village _ -J in ILL C a-4-0 V6577064T—Mb57- Owner Address //A cl S r- Q1t M Rh l E•. a r Clt Her Telephone rl rl f! - 3 qa D ' Permit Request 2UL,LJ) X j& b t C_&W . i - Square feet: 1 st floor: existing proposed Xl L¢ q g p p �a �_ 2nd floor: existing proposed Total new Estimated Project Cost 1 w Zoning District Flood Plain Groundwater Overlay Construction Type W b F2 Lot Size Grandfathered: ❑Yes P�No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family 0 Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ANo On Old King's Highway: ❑Yes Lilo 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 r Number of Bedrooms: existing new T Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: 0-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:O existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial kYes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name ! 7_ ,1 Hi ME Telephone Number 67 F Address r-WIMAd l��. License# Q_S acru: T lm ft l)a 3_5 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO' (24 pi J eZ _,by1t b SIGNATURE DATE,= c , FOR OFFICIAL USE ONLY - t PERMIT NO. D'ATE•ISSUED _ ' � t ' l .� • •^: - ,' •- _ a g ��` •'J ; - • ... MAP/•PARCEL NO..— ADDRESS VILLAGE +' ' OWNERr DATE•OF INSPECTIONS FOUNDATION r Y� FRAME � ' � r' � � g - .J T, J � ,,+ Y J- _ H• ', lt t INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 17 C r „ , PLUMBING: ROUGH FINAL .. ' GAS: ROUGH FINAL. ; FINAL BUILDING s DATE CLOSED OUT ASSOCIATION PLAN NO. t # t " - - - -- The Commonwealth of Massachusetts -" Department of Indtarrial Accidents 1600 Washington Sired Boston,Mass 02111 Workers' Compensation Insurance Affidavit ca �WKr VIMMIM, M,/ ,Mon�.,6,"'""... name: location: city vhone# J 3 ❑ I am a homeowner performing all work myself. ❑ 1 am a sole =n*etor and have no one worldn in any ca acity 9111110 9� I am an employer providing workers*compensation for my employees working on this job. company name: 1/'r—W address: Ito llleiyn.g,y ..R�. city: 0 TZt l r Aa fe 3—T phone 9S18 insurance co. olicv INW C ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name- address: ;,:•:: :..:. dtv phone*.- -... :.. sa insurance cn. olicvtY 117 company name: address. city- ... phone 0. Insurance co. olicv 0 Fallure to secure coverage as required tinder Section 25A of MGL 152 can lead to the Imposition of criminal penalties of a One tip to S 1.500.00 and/or one wean'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a One of$100.00 a day against me. I mtdetstand that a copy of"statement may be forwarded to the OMce of Investigations of the DIA for coverage verittc:tion I do hereby certify under the palm and penaltieslaftedury that the information protdded above is trn•and eorred Date -'7 - / LI —g 9 _ Print nine r0 Ed at It. PA S C H_I T r�%n cmpizz-; Phone g q�37—9 S/8- otncial use only do not write in this area to be completed by city or town oOlcial city or town• permitlllcense 0 ❑BuildiJD - - ❑Licen checki[fmtnedLts rn nee b tiled--- ---— ------..-._--- -- _.--- --------------_____-- po req -0SdectOHealth contact person phone ti; ❑Other (rmua 9,95 P1A1 ��r�o � . . .. . • . ' The Town of Barnstable �� of Health Safety and Environmental Services 9 ��¢ �mg Department Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-790-6227 Building Commissicre: Fax: 508-790-6230 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: q �0 st. Cost RI - Address of Work: �� of u lrpm�-rh 409 � Owner's Name q i'S1JiT7 ftsr Date of Permit Application: —� ! I hereby certify that: Registration is not required for the following reason(s): Work excluded by law _Job under S1,000. Building not owner-occupied j Owner pulling own permit i Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED ABLE HOME T HVE CONTRACTORS FOR APPLICOR GUARANTY FUND UNDER MGLO 142A ACCESS TO THE ARBITRATION PROGZAh SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: D Contractor Name Registration No. Date -z �a P l z �rl OR nwner s `lame �e Lai�vnzan�ue� o`er llauac�r�dell� u`PAKMCNI.T .. PuB_.. TRU!TIDi1 ,'1PERV SO .''tN:._ INju_be4' fii q7. P,y�.•n-,t ,i „was o r HOME IMPROVEMENT CONTRACTOR d�MA> CA,.tn Registration 100740 - =6'` NEWTOWN': -r Type - PRIVATE CORPORATION rpr;.T MA Expiration;'Ob/23/00 CAPIZZI HOME IMPROVEMENT, INC as Capizzi, Sr. ADMINISTRATOR 145 Newton Rd. , Cotuit MA 02635 ^ .. ---- ��re �nn:.nro��uoe�rl� o`:.•l`tr��ac%u�eG`(i DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE i Number: Expires: RestritTed%To: BB THOMAS X.-t'APIZZI JR '280 PERCIVAL OR W BARNSTABLE.,»MA 02668 s; DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Humber: zpires: Restricted To: 00 _ FREDERICK V RASH iIi BOURNE RD PLYMOUTH MA 02360 F � ,� . ' � - .. } •s � fir {� s x �� Y , - wo � V ;Z 117 :i RAav /6=coNa aww. ° L _DQoP of./5 t OUeB L p t P i • y 0 Z 1 © _ T i� �`•cL `Pp 1 Z ' .. 9 a> 4 �+ � li tie F a Lill p'4 . •F � C .. A i w s n ' 1 5y A RAMP 14'LOle wuwa4 ° T L _p Q M P Z L �+ O • M 2 ' II ` Sr via �JET I c c z Miss �Y 4O`4 .. ar .a. O ez . t nz TOWN OF BARNSTABLE STATEMENT OF DISCONTINUANCE, CHANGE OF RESIDENCE, CHANGE OF LOCATION OF BUSINESS, WITHDRAWAL, OR DECEASED FROM BUSINESS OR PARTNERSHIP 1) In conformity with the provisions of Chapter 110, Section 5 of the Mass. General Laws, the undersigned hereby declare(s) that we(I) have. this day Discontinued ❑ Withdrawn from the business known as calf C A+iy L E-79-1> conducted at as set forth in the certificate filed on r9R- o1a + t yq - NAME ADDRESS 2) The location of the business ❑ my residence as it appears on the business certificate of 4(n cQ I C 4-pJ Z- /�3 f-Z=-rn &VT _r7VO filed on I'1'1 6R C f� �[S Z- has been changed to '3"n n1 �- ,� > 3) As Executor or Administrator for the Estate of .who died on I hereby request a a R i ❑ Discontinuance of the business certificate. ❑ Withdrawal of his/her name from the business certifi�!ite :.;.._�. O n filed on in the name of V SIGNATURE(S) : ON THE ABOVE NAMED PERSON(S) APPEARED BEFORE ME AND MADE OATH THAT THE FOREGOING STATEMENT IS TRUE. TITLE IDENTIFICATION PRESENTED: Flue A (N P64 93 OTHER TO ALL NEW BUSINESS OWNERS ��7v ,�, �, S� DATE: gl--lz,- OS Fill in please: :44 APPLICANT'S !. YOUR NAME: -'At BUSINESS YOUR HOME ADDRESS: - �eou- -e4 p YCo .- TELEPHONE Telephone Numbe I�1A_: :. � ;! lls �IIS :HOm c� u� �rNOnlgr No Heve. au;been even ep ravel Born ikh;e burld1 dlvs(an YE510 .;!. :. ter. .:.. : .. . AC�C?RES$ OF C3M. �5�IIESS 1t �iRLri .:::.:��':t?t 4 ; .: : .:. .:.:. 3 IIII ?►I /PIdkE1 �. 1111UIIB ..:.. When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall) or if you get the,business certificate first you MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St. -(cor r of Yarmouth d. & Main Street) and you will find the following offices: _1. BUILDING C M SSI NERR'',S F I This individual sn i ormed rmit r quirements that pertain to this type of business. /na" >i 6 1 ed Signature** COMMENTS: 2. BOARD OF HE, LTH This individual as eenUr�ta of th mit requirements that pertain to this type of business. thorized Signature* • _ COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual quirements that pertain to this type of business-. Authorized Signature*' COMMENTS: Business certificates (cost $30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. - it does not give you permission to operate you must get that through completion of the processes from the various departments involved. **SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Qq Parcel D 1 Permit# � Health Division Date Issued Conservation Division Fee Tax Collector Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address "— C 7 Village l/� Owner 4 u t, C'�.�-t,. -r.,s-r Address ��Z t^,�-L,� �r� C)S;1LIA, lilt Telephone Permit Request 3 I M Square feet: 1st floor: existing proposed 2nd floor: existing proposed Totfiew cz cnp Valuation a �( , "� Zoning District Flood Plain GroL9 Nater O\te;lay ' Construction Type oo�•� 5 51> C" �Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting do umentat� r. rn Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes drNo On Old King's Highway: ❑Yes -11tTio »s Basement Type: ❑Full O 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 Cl Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0 No Detached garage: 0 existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:O 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 Name Co Telephone Number o Address `l 10 License# C W\-e 1�� ` Home Improvement Contractor# I Is ) �— Worker's Compensation# La2ap,�-2AOX 2- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO V0 SIGNATURE DATE { FOR OFFICIAL USE ONLY P l' PERMIT NO. DATE ISSUED MAP/PARCEL NO. t - ADDRESS VILLAGE OWNER s . DATE OF,INSPECTION: t FOUNDATION FRAME INSULATION + I FIREPLACE i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL , FINAL BUILDING - DATE CLOSED OUT ASSOCIATION PLAN NO. ,F l� The Commonwealth of Massachusetts Department of Industrial Accidents rid ', , : 0117croflararll0atfoaS 600 Washington Street Boston,Mass O2111 Workers' Com ensation Insurance ATIdavif / / %%// n , 11117 city ❑ I am a hameawner pafa¢miag all tovxic n�o�rif ' . •; • . ❑ Iamasolewup etor and have.no one in aav wowas for�Y �8 arhu job. "...X�....w>..!!-� ..... ...::•:^vn:•e:nv.::rniv:;?_3:\...4:!`:nxr:n;y..�,w�},}}w,w3;.,v,.,wrw;ys{.v:.,}wwv. ....:•. -.... �. ....... ..: - .. ...:...... ...-:.:......::.::n.......,x.v �?�fJtCQ',LEd•..:.. .x ...:..v.• ......... .... ... -. 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CATAUMET MA 02543 .. , COMPANY D ' >.[•:',,:;.:::::;:;F:: trf;'� x:JiL'�;,,. e<,e,)':;:::ii:>:>S:x�i'•x {:i:f> NOW�[ i ') tll. .<):,::,: „1e J '.:K,•` �:<.. 'i) .[' ) q vi[:4f :#:,:x:. i,{.,=z:>r:):r)is" THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEPxN 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 CuuMS- coPQucY EFr'F�T111E POUCV 19XPIRATM LIMITS 4 o TYFE OF INSURANCE POLICY NUMBER DATE(MIpIDOjYV) DATE(MM IDIVY) GENERAL.LIABLITY GENERAL AGGREGATE i COMNEROIAL OCNERAL LIABILITY - PRODUCT6-COMPlOP AGO 1 CLAIMS MADE F7 OCCUR PERSONAL 6 ADV INJURY S OWNER'S S CONTRACT01*5 FAOT " _ _ ._ EACH 00GURR®4CL 8 ' FIRE DAMAflE(Any oM Rom} $ Mm EXP(Arty one Person) S AUTOMOBILE LIABILITY - COMBINED SINdIE LIMIT $ ANY AUTO y ALL OWNED AUTOS BODILY INN MY nw SCHEDULED AUTO& (Per DOl ;SIRED AUTOS - 1300ILY INJURY E NON-OWNED AUTOS (Per m1derd) PROPERTY DAMAGE E GARAGE LIABILITY AUTO ONLY-EA AQCIDENT III ;xa ANY AUTO OTHER THAN AUTO ONLY: } EACH ACCIDENT i . - AQQFI90ATE 14 .EXCUSE LIABILITY .. EACH OCCURRENCE S UMBRELLA FORM - AGGREGATE $ CrtHER THAN.UMBRELLA FORM ¢ WC STATU- WORKERS COMPENSATION AND 6 R2 3 UB 7 4 3 X 2 7 9 4 0 5 f 13 01 5/13 0 2 X TORY LIMIT E1 r: EMPLOYERS'LIABILITY M EACH ACCIDENT 11 100,0 G 0 THE PROPRIETOR! 1 !INCL - EL DISEASE-POLICY LIMIT 500, 000 PARTNERSIEXECUTWE r— 1 Q Q 0 0 0 OFFLOERB AHE:. EXOL EL I PLOYEE S s OTWR _ DESCRIPTION OF OPEkAIiON&LOOATIONSIVEHIGLEQ/SPE(iAL"EMS t ,.i, 9. :S. ,•3•: t:.2.. %Sp •:a„i.y,1l:;ki: iY,l• i > Y.i x. Xta,X) a: ,`•2!.ii�f.;•;.p}:){:;:e<:!}i<s :Y^z%, c�gys•:••.>. ;s�i: Sys SNOUW ANY OF THE ABOVE DEGUNIII 0 POLICIES 40 CANFELLED BEFORE IN"- TOWN OF FALMOUTH F7(PIRATON DATE THEREOF, TNR iSWNQ COMPANY WILL ENDEAVOR TO MAIL 10 DATE WRnTvm NOTICE TO THE CERTIFICATE HOLDER VAMED TO TM LEFT, 5 G 6—5 6 3-6 G 9 2 MUT FAILURE TO MAIL SUCH NOTICE SHALL IMP04G NO OWOA710M OR Lmmm ' OF ANY AHD UPON THE COMPANY, ITS AGENTS OR REPRBBBNT TiVES. .. AUTHOARED REPAESENTATIVE Bob A1lietta BA B MAN; ...L .... a'. t, £.,..L}..?:.> ) 5::: S ..i:Si:io-.tl.3f:::r, , •: :',f,, .y. _::. . .yy. .:... m (�...�:. "�itl�l ..'•{ :<�k.p;r. s.'::.�. .. i...v#•Y+0:7:,•.{z•s::.L:.:>asa .:.:. W.. .'i:�4 amid ...�,.3--�'M.., ....�.i...+s,..�.�A�..+e `irs'- s.—_ .w. .�..- a .. .,_}.--_. f ::l.v+..c=>.�_?-e« ,�-... . .a c..=..,.�� b:s'F°-'•'�i"etta^""""`� ..s...�_ i i, ar ° TOWN OF B ARNSTABLE Permit No. __27039 Building Inspector 1 Cash -------------9 a. OCCUPANCY PERMIT Bond Issued to Bayberry Square Realty Address 1645 .Rout,9 28, Falmouth+Road ^Building E1, Centerville Wiring Inspector . q,+ b,. Inspection date Plumbing Inspect�or� 9 Inspection date f l Gas Inspector a Inspection date Engineering Department Inspection date Board of health AN Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ....................................................... 19.. ............................. 17C;;........ 5? . rr i Building Inspector /asses! s ma and lot number l� p • - Sewc � Permit number .. -/.00.�...le: .. **THE Ero ,� � i 4,,.j' d v e{.I."i,. BdHII9TlDLL, i J d 114l6 Hour umber ........................ ,.Y , ' e� TOWN OF BAIN "'TAB LE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...Construct New Building TYPE OF CONSTRUCTION ............69.oad...x.z,ame............................................................................................... .....November 3. ...............19.83.. ..................... JJ TO THE INSPECTOR OF BUILDINGS: I The undersigned hereby applies for a permit according to the following information: Location .1.6,45. Route„28, .... lmouth Rd.._.....Centery,ille,,MA JBuilding„E,,,-, F)..................... .... ProposedUse Office...Space.............................................................................................................................................. Zoning District Highway Business C 0 ....... . .................................fire District ........ ..................................................................... Name of Owner Bayberry..Sguare,,,Realty„rg)gAtdress ,1,64,S,,,Routtr...U... ...... Name of Builder Pe.ter.,Dai,gle..,Builder,s..............Address .1.64.S...Rout;Q...2,8,,, Name of Architect PQ.tQ ...P.A.icjl.(�... ...........Address .1.6.4.5...PQtlt.Q...z.8...0Q1:ter.v.ilI.e.... kiA...... Number of Rooms .......1.Q......................................................Foundation 1?.aur.ed...Qorxcx.Qt.(�...................................... Exterior ..............................Roofing Red FloorsCaroQ.t......................................................................Interior .Shoe.tr.QGk,............................................................ Heating .......E.lzatric......................................................Plumbing .Co.ppe.r................................................................. Fireplace .......N/A...................................................................Approximate. Cost ...$....17.5•,•0.04—oa................................. _ Definitive Plan Approved by Planning Board ________________________________19_______ . Area ..... ..........t..��l��Y. Diagram of Lot and Building with Dimensions Fee 1..1.(.. SUBJECT TO APPROVAL OF BOARD OF HEALTH T am aware of the moritorium article-to be acted upon at the Town Meetin as advertised. �,o4jz,(/.,'L Y OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the To n of Barnsta a re rding the above construction. Name ....4. G..... . .... .... . .............................................. Construction Supervisor's License ..... ...�.�` �40 . ................. JFFRTBrRRY S01.7,izE REALTY No ...27039 for ... UILD...................... BLDG./ OFFICE SPACE .........................:..................................................... Location 1645 Route 28, Falnmouth Road a....................................................... Centerville ............................................................................... Owner Bayberry Square Realty .... .................................I............................ Type of Construction .......................................... ................................................................................ Plot ............................ Lot ................................ October 1, 84 Permit Granted .......................................19 Date bf Inspection ....................................19 Date Completed ........./4,7e�/4-/7e�r............. d0 S 7/l°l J 3CaIfE1 z FL 711,1P-s '9tds F r`fL Asses' ° map and lot number .. .. .... o .. .�. C . M U r^ OFTHETpf` / Sewa; `Permit number ..�l':!.642...la:r.�t:............1 --'. �. w�Q� ♦� �± Z HAUSTULE • House- iJmb4er ..................................................:........ 1i 9�o M6 9- \0� •a Yr' 0 YPY a TOWN OF BARNSTABLE BUILDING INSPECTOR t APPLICATION FOR PERMIT TO ...Construct New Building ?, i ................................... ...................... TYPE OF CONSTRUCTION ............W.0041FAIPMe................:. November 3, 19 8 3 ................................ ...r ... TO THE INSPECTOR OF BUILDINGS: 1 ti The undersigned hereby applies for a permit according to the following information: Location 1645 Route 28, Falmouth Rd. , Centery lleaMA.....,�Buildinq E -...11..... ? Proposed Use Office...S. ...ace................................ . .......................................................a...............................;- ........ ;; Zoning District Hl 1Wc3y...BUS1neS.I................................Fire District .....C/0......................................................... ....... Name of Owner Bayberry Square...ReAlty... r -Atclress 1645 Route 28„Centerville., Peter Daicrle Builders 1645 Route 2>3 Ceinterville , r�� Name of Builder .... ....Address .1..... ... . ......... .. ...... .... Name of Architect Pcetet Daigle... uilders,.„.,,,,,.Address .164,5,..Route 28... entexy,,� 1,le.R,?s,NL fit, Number of Rooms .......10„ .., ......... Poured„CAncreire, _. %.., .................. Foundation Exterior .White..cedar S.hln.9.1e.S..............................Roofing Red..C�dar...�h.?finales....................................` Floors Carpet Sh e:tn? k .......................................................................................Interior ... .e...........�..................................................,........... Heating .......E.. .QC.t...<iC................................................... g. Fireplaces .....ALA.A.......................................... ........ .........Approximate.Cost ... . ..1.? .,:.0.�?f?-.0.17..... .... .... . . ...... 't Definitive Plan Approved by Planning Board --------------------------------19--------. Area .... Diagram of Lot and Building with Dimensions � T/ g 9 Fee ........... ................ -............ SUBJECT TO APPROVAL OF BOARD OF HEALTH I am aware of the moritorium article. to be acted upon at the Town Meetin as advertised. 1 r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town wn of Barnstable regarding the above- construction. t Name . -. ....�.� .f'................................................ ;f r Construction Supervisor's License # 024940 L` ...................... BAYBERRY SQPARE REALTY A=209-086 A c No f,27039 . or ..BUILD...................... ',j BLDG./ OFFICE SPACE ....................... ...................................................... Location .... ...45 R ute 28, Falmouth Road Centerville .. ............................................................................... Owner ......)��.Square .Realty .................... ............. Type of Construction ....... rame F.r.aT.m........................ ................................................................................ Plot ............................ Lot ................................ October 1, 84 Permit Granted ............... ....... ............19 Date of Inspection ....................................19 Date Completed ......................................19 r ' ��. mow[..•mw4S2tYs�Yra.� i .��., �,.,+^vu2n---">'i'-rle� ?' �;�ar - ��- ---.....—q. .�.. ...•w,.,::1n+:•r'va�,.^w�nPr+��_ __Y�..,v-.:r:.c.i i • • 27039 TOWN OF BARNSTABLE Permit No. ---- t Building Inspector Cash .�' 2 as OCCUPANCY ''• PERMIT- Bondy Issued to:,,,"Bayberry Square Realty\ Addre.sz. i Building F. 1645 Falmouth R89d, •C,4nterVille Wiring Inspector � � ri Inspection date Plumbing Inspector C ;1-- Inspection date Gas Inspector, �a ��•.,l tri la..�•a Inspection date.2 2 F&A.RS J t •Engineering Department= Tr�.yJ �r� � J�� Inspection date Board of Health �• i ! n^\1° Inspection date THIS PERMIT WILL, NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN ,y REQtIREMENTB AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE , BUILDING CODE. v ................................................. ..........................................�. Building Inspector, _ _ lyyy„y •,a,,.r-,��_:FCyw«`�?'-�..Yw,.;. .� R y.yr .aSx^'^wy�":;t...,,.1;=A v' .W*! ,qK^!„ -' .. 2'.>i 'C:.�Cr�^a.`..Wlen v�+,�.,••.••,.•.a.....rVic- Fivr1:a..w. TOWN OF BARNSTABLE Permit No. _27.00.......__.... . t >*� Building Inspector cash 1 x 'e + OCCUPANCY �FERMIT Bond Issued;o Bavberrv\Square Realty Address Build-inh E2/ 1645 Routre) 28, Centerville Wiring Inspector ]Y . nspection.date 1 � :r _ Plumbing InspectorC � Yn Inspection date / S t i 4. Gas Inspector q! v p Inspection date d 40-A . 9 w,. Qa,� c _ 3 o A u co- As r Engineering Department, k/A f Jnspection date�yd Board of Health �f (Y� 1 yi Inspection date QLl 30,1485' .. .. ! \. THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED' UNTIL SIGNED BY THE BUILDING INSPECTOR ',UPON",SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING'CODE. 1 3 0 1s G� �!_ .... �, � U "t Building Inspector. y x\ ,��'�+; �� a :a:.y.._i.:�Y4•r�+ '_i�L^ +F>rJ��..-��fi�yf•.� �'�� 1�`��°�^�ay.r"f•«'F` x,j.(:'.K'R•/��.�'° �' � ��`�'.rra::_..,Sy.c,ccy.:..y;;r..y, f ♦ R , t 1. • TOWN OF BABNBTABLE ' 27039� o Permit No __ _ -_---.- t- 1 nua F Building°Inspector cash --- _ -- '"'� OCCUPANCY PERMIT. Bond Issued to Bayberry Square Realty Address / 645 Route 28, Centerville C Build na F lataf7nnr /MnrTnnal.i little ASs'� y ' r Wiring Inspector ld Inspection date Plumbing Inspector ' Inspection date,• Gas.Inspector, � GSi ' Inspection dale Z/ g..Q ., , ,�3 �, r 1 .,� n' a .,... , t�• V" Engineeringi:Department v .�, N/ti; . +, '}�7^+xx„ in1.� �vd1�jE1,Inspection date Board of Health R t < -- �'. ; ^° `i Inspection date « d-s,,6'. THIS PERMIT WILL NOT,BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL;, E SIGNED BY THE BUILDING INSPECTOR UPON4 SATISFACTORY COMPLIANCE WITH TOWN'"'.. REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE i BUILDING CODE. ' } ..........•... ........ ......... -•... D ' r / •. Building Inspector . 4 P '' ' '• !A • ^�', 1.1 �4wl��i 1 I,'..? }� "'•"zc'�Y')'.i�'1,`{ ,di" y..�'Y y� ..... Y?:Slt"'tY'sa't¢/i✓. .a,; c..,.;✓+k+F+•M' �kL•3'KifiyF"::Z`: Il V `BA i� 4 WN 0FRN8T"I /Permit No. ---"-"----27039 Building.-Inspector Y cast, - - -=-- — !• Y Y ' OCCUPANCY f PERMIT Bond _ N/A � i� ~ "/" F f ��• '�' /jam Issued to Bayberry Square Realty ' 1nddress, a " Building E2 2nd floor 1645'Route 28; Cent1rvi�JAe 41 ��Viriyr Inspector � � -�, Inspection d to "r; 14 —, - ' . - Plumbing-IIaspector Ins ection'date Gas..Inspector n �• c�-e�vi� vL .:.J,' �spection datey7, IC7,0 (9_ Q.A`, f. li -'Engirieeng�Depaitmerit �' t, N' � i-i �~InsP_action date 'z Board.of Health ,r Inspection dateG.-.�G / a THIS PERMIT. WILLf,,NOT BE VALID, AND THE BUILDING;eSHALL NOT BE OCCUPIED UNTIL SIGNED BY THE,4BUILDING INSPECTOR,,.UPON SATISF_ ACTORY COMPLIANCE WITH TOWN. REQUIREMENTSE'�AND IN ACCORDANCE WITH SECTION 119.0.OF THE MASSACHUSETTS STATE ""`%BUILDING CODE. v+. ( % _ .-Building Jnspectoi ve ' ..�.. J: " • i,� r• %TOWN OF BARNSTABLE permit No:' _..25893 , ( r Braiding .Inspector _ ., t n"��°m. F :d wV� .,'•1 wx lei r �- !t r,ir. f 1� �.�y 'Cash ....... .... t-j- OCCUPANCYi` PERMI-fw Bond .._........ a ¢•. �,� ill .^ i[•, >` � r ` Issued to Bc1V YV .wluc[L' Re alYty ,T Trust Ad_drte'ss. a, 4dUdiL CT' 13 1 45'.F`a7s Wth.Fta;">tre�app r yam„. }Insp ector e�for �!�--- J g P C, (`'' (urn f iA Inspection date Plumbing Inspector f Ily " Inspectlon`date Gas Inspector Inspection date.' ..• }[ Engineering Department` �f� ! ' i/�� .yr/lI`:� +� t'Inspection date "'4 Board of Health '"" �:• .� /`� Inspection date THIS PERMIT WILL'NOT BE VALID, AND THE BUILDING"'SHALL NOT 'BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN' . REQUIREMENTS AND IN ACCORDANCE WITH SECTION, 119.0 OF THE MASSACHUSETTS STATE B�UILLDING CODE. �! ............ //! [V� . K............................................ , .� .. .. .. ........... ...... .................... ........... .................. Building Inspector , a�}-,r.�i+i{Ls.cawxwL ,yy:.Y. vT-•+r-..a�, �t.,....w-: n...:.:rrz.+vn.rryaa:+r:1�.....+.....,..iuy.v.;�:+w:�aLm..✓+.:.. n..c+-vr+�..8::�y,:.wxavw+.+:•v;,F..r.rw�ae.'rs' . fir , • _ -• TOWN OF B ARNSTABLE permit No. 27039 Building Inspector cash fl " ----—----- ------ '" OCCUPANCY PERMIT Bond i Issued to Bayberry Square Realty Address . 1645 .Routg 28, FalmouthiRoad Building E1, Centerville Wiring Inspector �� , J Inspection date Plumbing lYLspector`/ ' - 9 '' Inspection date ///P' • Gas Inspector Uv Inspection-date Engineering.Department Inspection date Board of Health x ¢ .'ti t�'J a {ns- J ,...• Inspection date THIS PERMIT WILL'f NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL-1 SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BBUUI^LDING CODE. ............l........... I � �s � r ........,\�.v. _. .. Building Inspector �� W a.o .�assessor's map and lot 'number t Sewage .Permit number .................... .. .....:?l4:.1�/ t HABISTn LE House number ....16.4.5...i ....... ....... TOWN OF ' BARNSTABLE � BUILDING INS:PECTO.R: `. APPLICATION FOR PERMIT TO. Add... ••• •••••ir t"ol 1) TYPE OF,. CONSTRUCTION .......... ..Wood .....i.......................... .................. ......... ......... July 5 83 I ' ...................._ ...... .......19.......: TO THE INSPECTOR OF ,BUILDINGS: j The undersigned hereby applies for a permit according to the t Ilowing information: „ tI . Location . 1.645•• almouth••Road•;•••Rte•. ••28•,••.Centervalle;--M4 ProposedUse ,.:..:..offfce••eoehos...................................:.....................:.................... ....................................... ............. . Zoning District ' Highway business . ,,,,,Fire District Cente'rvj.j. ,e-QS.t�X�L� 1�.. ..................... .............. Name of, Owner ...$maybexry••Square•••Rea•1•ty•.T•r'ust•"•'Address ...:..,3"'Raybe'rry--&q:; Rte':•:'2.8•;• C'enteTvil-le Name. of Builder .peter..Daigle..&"Go':';"'Suild'er .. ,Address .3..gagk�enr}* 5q: ; Rte: 28•;•••eentervi1-1-e•••• Name of Architect ':....:......... Address .......................................................... same...:................................ Number of Rooms .. ....................Foundation'. . ..L.:'..::.:.... .. g........:...........:....................... Exterior :.. ..clapboard imont; white cedar' shingl gofings. :-:,:red...cedwr-siiingles.......j.......... .1 remaining Floors. ....:...Interior -....... ................:................. carpet................................................... sheetro+c.k............... . .. , , electric Plumbin Heating .............. ..................................................4.._.. g .:........:.........:..:...............................................:.:..c:.r.: Fireplace .................DJA-.:........:..........................................:...Approximate. Cost ..:.........$6 ,D.0.0AD....................:............,. - .,' Definitive Plan Approved,by Planning Board __,________ __.-_.____:__19_______. ~ Area •:. Didgram of Lot and Building with Dimensions Fee .. .......:...'7.' r 'SUBJECT TO APPROVAL OF BOARD OF HEALTH ��6 �' OCCUPANCY• PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform.to all the-Rules and Regulations of the To Barnstab regarding•the above construction. . Name .. .. ....... 02494.. Construction Supervisor's License �.R. YBERRY SQUARE REALTY TRUST ; z • 25293 . ADD 2ND FLOOR - No ..4c ........ Permit for:................................... COMMERCIAL BUILDING- ............................................................................. - Location 1645 Falmouth Road (Rte 28) • , Centerville - - ..... ....... ......................... ............... c. Owner Bayberry Square Realty Trust 1 , - Type-of Construction ,•Frame - .......... .....•..............•...... ......... •.•. .......... • - ` - - _ Plot ............................ Lot Permit Granted .._:Ju y...8.[.........:........19 83 `! Date of Inspection _ �• t DatelG leted ........... .a. 19 }sue" ........ •, ... �: ._ .. _ - � � "- - `' ,� . y�' � y , • ' I - - '. �..� .��, T ice..- - �1._._ -�--- 1� (-� � �JJ�- __ _. _ ��- ♦ .- � _- �"T'�' "_- � �-. .... _�.. Y •Ff r - - �'.��/"• CF Al rim U I I DfU(o FIT ( oP TA,+Jk 6Y1`�T►+�G ��S' EX Orl0& _ Tr-- 5 50o X-Ols ° 2( i - _ I 6A TANK_. bk- ►`:K IS'C i1�.Cam. i . I �.. e . �:w w t� LY I ST1� co 7B Assessor's map and lot number ..... .L� �i ,/. PLO*THE T0� SevJa a Permit number O 1�✓ .g ............................................ Z BABB9TAII L House number ....1.6.4..5........................................................... 'oo MM 2639. 0� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .................add..�:.......� ...`�•:....................� `..all"................:.......... TYPE OF CONSTRUCTION .............Wood y ................................................................................................................. .........Julys.......................................19..8.... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according othe following information: Location ......1645..Ealmautah••R.esads...Rye.,. . .S..Een iva.1.i sq'..rt�. ...................................... ................................... ProposedUse .......Off . ..................................................................................................................................... Zoning District ••Highway business •••Fire District ..eentery lle Ostervile.e....,••••„•,;......,•„••• Name of Owner ... a••�?e�^•1t3�...T.ru.st.....Address ..... ..I.Bayberry..,c.q.o..g...11te.a• •Zg•q••�c Name of Builder .pa.re,r...Daigl@..&..C-© ...Buii4dr.......Address .3..Bayberr-f ...Ceft-eryille ... Nameof Architect ...............rc,;�..........................................Address .................................................................................... Number of Rooms 3 ¢ =2 exdstin _. Foundation ................................$............................................ Exterior ......e•larboard• font.j...white--ee-d-ar••e :i`gl8gofing .......reed...oedar••ship:gle-9..................................... �. remaining , Floors ...............�.arp,at..........................................................Interior '.:^`- sth+atroe-k......................................................... Heating electric ...................................................... plumbing .................................................................... ............. Fireplace .................1 hk..........................................................Approximate Cost ........... SN.O.O.N.O. .................................... Definitive Plan Approved by Planning Board -------------------------- I �D ------19--------. Area ...................... ................... 27 Diagram of Lot and Building with Dimensions Fee ................ . .. .... . " ................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstablregarding the above construction. Name ,. ........ �.... . '.............................. i 024940 Construction Supervisor's License BAYBERRY SQUARE REALTY TRUST I A=209-86 25•293 ADD 2ND FLOOR No �............. Permit for .................................... COMMERCIAL BUILDING .................................................... .$ ....................... r Location ...1 .... 645 Falmouth Road (Rte 2':3) ................................ Centerville ............................................................................... Owner ... Square Realty Trust ...... 1 Type of Construction Frame ................................................................................ Plot ............................ Lot ................................ f I Permit Granted ..July. 8.....................19 83 Date of Inspection ....................................19 t Date Completed ......................................19 i /U u 1 I 1 � o• TOWN OF BAILNSTABLE Permit No. 2.5293 Building Inspector Cash +wm TEMPORARY Doi OCCUPANCY PERMIT Bond ---__--------- ,r. Issued to 13ayberry Square Realty BruslAddress _ Building E-2 1645 Falmouth Road, Rte 28, Centerville wiring Inspector y ; f Inspection date Plumbing Tnspector4 �,,�,� ��4 A F Inspection date �.�� Gas Inspector Inspection datef� x , * Engineering Department Inspection date Board'of Health �..._..—,_ � Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ....................................................... 19 • y.........K/ ...................... (/ Building Inspector TOWN OF BARNSTABLE Permit No. - 27571_---------------------------- . . .i Building Inspector cash ---------------------- ,OCCUPANCY PERMIT Bond --_-_ - u issued to Bayberry Square Trust Address y Building A, 1645 Falmouth Road, CenterviAe Wiring Inspector �i� /,f �� i Inspection date . Plumbing Inspector l� �'r� ,-,. Inspection date4 Gas Inspector c /A � � Inspection date A u Se Engineering Department ��•f (' ;r,r Inspection date ( - j Board of Health r. vt i ✓h Inspection date ~ . - THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. A if y:.... r Building Inspector Assessor's map and lot number ............................................ TIN E SEPTIC SYSTEM MUST Sewage Permit number ...... ................................ INSTALLED IN COMIMLIA WITH TITLIE 5 ZMAR33TABLE, House number .................... a. ......................................... mum CNVMONME�NTAL C t639. 0 MAY TOWN. OF BARNSTABLE BUILDING (INSPECTOR I ODr)Cref APPLICATION FOR PERMIT TO I................ L...k. !)dA TYPE OF CONSTRUCTION ................................................................ —J#,0 72 1925 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location & ID 4-5 ��Qufe ..0 _U. .enie_cy�.dle................... .................... ....f ProposedUse .�cnl- -.,!� I al.w ........................................................................I..........I............... -a--yak ffuj. , 1 *4 fS........................................Fire re District Zoning DO....................................................... VUSIAdclress IIP45...................i............ C Name of Owner LO-c cQ 3. ... ...... ....Name of Builder ............1.91........ ........Address "JQ4...1'�a.�.()... app-3 .....................Address 1?-ID a_k 1�:� H Name of Architect ............. ................................... .........j0.n 0uls............. Number of Rooms ....M......r.4 Ilk..............................Foundation .................................... Exterior ....... ..............I.......... 9�e ............. .. . CI oarfQ6L.Ce_d. ...... o0d, s4b Floors ..................... .. ... ..Interior ................ g .Cc Sqs Fv-4(2) .�- ' u... .....L P\/C- - .....p IP ...........Heating ............................... .. ...........C lumbing .............. .................................... Fireplace ......... ...........................................................Approximate Cost Definitive Plan Approved by Planning Board ------4. Area 1.9QU....... - Building with Dimensions Diagram of Lot and Fee ......... ....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS )T *j e(2bo I hereby agree to conform to all the Rules and Regulations of th B able re i bove construction. Name e ................ D-q L A 0 Construction Supervisor's License .................................... Y SQUARE TRUST 2-7571 ,� ADDITION TO No ............ Permit for .................................... I No Building ...........I..................................................................... 1645 Route 28, Location ................................................................ Centerville ............................................................................... Byr Owner ......a.......be....r...y Square Trust.............................................. Type of Construction ................Frame.......................... ................................................................................ -plot ............................. Lot .... ........ ............ Permit Granted 9 85 Date of Inspection....................................j 9 Date Completed 6.-.C.7.......... q�& 0, 10/ , Assessors map and lot number....:............. ........... l........,; _ r THE Sewage' Permit number?"�' f:..... ` i /( �, 1 Z 33ARNSTSIILE, i House'" number ..ry. -: .;. 'o YAGIL ........................•. 039. p'• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ,O,S�.O.A l...o nC r 6p...rot.A,nt a bon, .�C.'.,�I10CJ C F„��c j an ...... ..... TYPE OF CONSTRUCTION (PE.... .)A h„W �.c ................................................. TO THE INSPECTOR OF BUILDINGS: j The undersigned hereby applies for a permit according to the following information: Location &.�hPr t1col� .r.. C4T1 . ...,..`........ .............................. ........... ... . . ProposedUse .C( r1 t, -,(Yl 1 (� U.m... ( ....................................... ......................... ..:.:.................... Zoning District ...�`. ...1�.................................................Fire District !.J.. .. . .. ...1................:"':..�................. Name of Owner � ..k hPf �..(:A .��„d I„� �F...�{,1 ..i.Address V!2A5..l?t.L,l f...� Name of Builder Q.1.� ......(,ln a.. .�..�. ..Address `� ! . .. �. ..o-)..;...j .... �P............................Y1 r Name of Architect :.. .....!...�P.r`?.4. ............... :..Address ......_ t��.ti rl l l ............. Number of Rooms ... ......!SLR �.. ..............................FoundationA .(9.) . ` -).n..................................... Exterior �U ...Sh inn�o F C1u&�1.((ROofing fp(A..Ce.�C rV�J�✓(�(.... ................ ........................:........... i ............................................ t Floors t `� �. l l l,�. I- I�rl � �C. ...interior ..I:JY..�,..��„��lJ.�.I... ...Pei �r1±r r.......... i. ............................................... Heating ��I��00-'P.d...C'.�: ... tv. .....� / -L.Plumbing . .....:.:�.r�: C f. ...........'................ Fireplace .........N.J.!...l..........................................................Approximate. Cost .. � : :!,� ..................`................. Definitive Plan Approved by Planning Board 171 P-------d_,_19 Area .L...!Q(..t......... !:...r.T Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ram, t ,t 1 t �- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all,-the Rules and Regulations of the Town- f Barn§table reg,ginLg t'he above construction. .�� V l l.r o . Name P r+ ICI ` Construction Supervisors License va 0 U .................................. 1 BAYBERRY SQUARE TRUST A--209-86 No Permit for ....ADDITION TO ................................ ....IdiL Co .. A�q?PLIJ51-u .. Ig........................... Location ...1.6,45...RQUte-..2K.............................. ...................aerl .................................... tetL Owner ......Bayberry...Square. . ..Trust........................ ...... . ...... .... ........... Type of Construction ......Frame.................................... ................................................................................ Plot ............................ Lot ................................ March 1, 85 Permit Grarpd ........................................19 Date of Ins ection ....................................19 Date Completed ..................19 Assessors map, and lot numbe ' v..... ` - SEPTIC SYSTEM MUST BE INSTALLED. IN COMPLIANCE { i < .... ( G vio Seviage;.Permit' number .. ... ��.t.b f. ,�/I,y/ /' �/l..it� .: WITH ARTICLE II STATE ` , + SANITARY CODE AND TOWN L �pFTNE TOWN OF B1-1�� TI��LE Z B)H.B57ADLE, � C', � 1NASIL 639 mal11 ING INSPECTOR Apo,i639• \00 .:�, BP-4 r• •-I cc ' APPLICATION FOR PERMIT TO .. 'y........ ... ....................... TYPE.OF CONSTRUCTION ............................... .....t�!!' l: ................................. v .......... ...............�.f ..19 rf4. 4^ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .................� .... ............................................................................................................. ProposedUse ..G 'r................................................................'.... Zoning District ........7..............................................................Fire District ... .................... Name of Owner ...................................................... .............Address .,�..�... ....:�t�wc..... ............ ...: ..,5.:��2d'/t t� Name of Builder ..... . .. ............ .. ........................................Address ....I�/yl �'' ....f.`-f!!:.... Nameof Architect ...............................................................:..Address .................................................................................... Numberof Rooms ..............................................................Foundation .............................................................................. Exierior. .....- ...........................................................Roofing .................................................................................... Floors ....................Interior .................................................................................... �. .rtNeating . i'+r" Plumbing ...... '. s........................................................ Fireplace 6 'C- ........................Approximate Cost .... ...,c® Q Definitive Plan Approved by Planning Board --------------------------------19--------. Area ` .....C'�............. Diagram of Lot and Building with Dimensions Fee �" SUBJECT TO APPROVAL OF BOARD OF HEALTH n I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . .. .............................................. ' Sims, Norma i rF t 18594 R remodel to medical No`..................`Permit'for .................................... office- ................................. ...... ....... ...................... `Falmouth Road Location ................................................................ Centerville Owner Norma Sims frame" F Type of Construction .......................................... .... .............................................................. _ Plot ...... ............... . Lot ................................ Permit Granted .........August ..........19 76 Date of Inspection ......... ........ .................19 Date,Completed ..1�.� ..... ...........19 PERMIT REFUSED ............................................ .................. 19 ............................................................................... ............................................................................... ............................................................................... f • Approved ................................................. 19 ............................................................................... ............................................................................... Assessor's map and lot number ..r....................................... Sewage Permit number �- +.-rJ: !! ..!^. ?. �� ZVI, . �OF7NEr��y TOWN OF BARNSTABLE i • t. B9SHSTODLE, i M 9 6 ,� BUILDING INSPECTOR am a' APPLICATION FOR ,PERMIT TO 0en?4:. `............................................^ ' ' '........................................................ TYPE OF CONSTRUCTION . " j ............. .....:... ..........................t.....19.I('.. JO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: . ./L:. Location .................. ............................................/...................... . ... . ... ... `... ProposedUse /1� L i'� %141-1....1................................................................................I......................... Zoning District .......,`, ..........................................................Fire District ../'` ...................................- L. ........... :�-''' . ..................... Name of Owner ... 1, _r...z`".'.'.............` .y1:..............Address .. �....�......`./�......-w`..! : .....L' 'f ,%'............... r Name of Builder w� . ... ..x r� ....� ....Address f • • f `..� '. "`��.....'f..f'....-".........`-..:.:.....''................. ....... .... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ....... ?.......................................................Foundation .............................................................................. Exterior ......: :. .. : ...Roofing / .....................Interior ............................... Floors Heating . _.'................................................................Plumbing ............. .......................................................... Fireplace i .. ..........................................................Approximate Cost .. Definitive Plan Approved by Planning Board ________________________________19________ . Area .... ........... f i r •'i,J p/ 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 Town of Barnstable regarding the above construction. Name .... ." 7...:fp,... L .... :L. +...`.:.......:............. r Sims, Norma . A=209-86 / _ v' 18594 remodel to No ................. Permit for ------------ ' medical office ---------.:'�--. � . � '[---' -------- Falmouth Road ' Location --__—________________. . . . Centerville ' --------------------------' Norma Sims ' [�vnar .................................................... ' frame Type of Construction .......................................... �----.—^--------------------' � ' Plot ............................ Lot ----------'' . . Aouoot 17 ' 76 Permit Granted ---.--....------.lg , Date of Inspection ..................................... ' ' � . ^ . Dote Completed ------'------lV ^ ` � . . . � � PERMIT REFUSED ' ` f �. �� . `��~ /h �/ ' � - --------''---''^^---/' -----'' ' � ` ............................................ . ` . � .- ......................... . ....................... . -------... --....----. lA - . ' ^ ' ............................. ^ . ---------------------.~....— TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. D p� � 77C Map 2 Parcel � - : Application # Health Division r`i P Date Issued Z d Conservation Division f Application Planning Dept. F Permit Fee ?� Date Definitive Plan Approved by Planning Board _ Historic;- OKH Preservation/Hyannis — Y Project Street Address VillageN�� Owner 'V �- Z:0 T a Address' /YY�R C Telephone Permit Request __ �� C�c�'L O 1 l e 42L C(-01 ("4- �J Square feet: 1 st floor: existing_400proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 201010 0 Construction Type a CD Lot Size Grandfathered: WYes ❑ No If yes, attach supporting docurrientation. Dwelling Type: Single Family 0 Two Family ❑ Multi-Family(# units) Age of Existing Structure . g J Historic House: ❑Yes U No On Old King's Highway, Y s IWNo Basement Type: ❑ Full WCrawl ❑Walkout ❑ Other • Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft') a Number of Baths: Full: existing new Half: existing A new Oe Number of Bedrooms: existing _new Total Room Count (not inc ding baths): existing 2 _new First Floor Room Count Heat Type and Fuel: .(Gas ❑Oil ❑ Electric ❑Other Central Air: WYes ❑ No Fireplaces: Existing 70—New Existing wood/coal stove: ❑Yes irNo Detached garage: ❑existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size— Attached garage: ❑existing U new size _Shed: ❑ existing ❑ new size — Other:,,'.:=-•°; --d U Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ r Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use y 4 P' APPLICANT INFORMATION ti (BUILDER OR HOMEOWNER) Name rz(A C_W L(Q C t-"-j f G,V1?VT t c)�i� Telephone Number eLs Address �C 0� Z V License# 9®( � 3 O I y t -r Home Improvement Contractor# i q 3 .3 sy Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE j 2l { FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL N0. - ADDRESS VILLAGE ` OWNERr ,k DATE OF INSPECTION: FOUNDATION ILI FRAME „ INSULATION FIREPLACE a ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ' :4 GAS: ROUGH FINAL FINAL BUILDING r DATE CLOSED OUT ASSOCIATION PLAN NO. ` s Vie Commonwealth of Massachusetts ,Department of Industrial Accidents Office of Investigations 60 Washington Street Boston, MA 0.2111 www.mass.gov/dia Workers' Compensation Insurance Affida'vi.t: :Bul�ders/Contractors/Electriicians/Pltlmberg A licant Information Please Print Le I' Name(susincss/org�izari divi an/lndual): C E� 0 Address: i City/State/Zip �V l ) PhoneA a,PQ T ) Are you ani employer? Check the appropriate box Type of project(required): 1.M-"1 atn a cmploycr with 4. ❑ I am a general contractor and I 6 New eonstr=tion employees(full and/or 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 pn employees: These"sub-contractors have 8. []Demolition employees and have workers' working for ma.in any ctpa6ty. 9. []Building edition [ND Workers' comp.•innancc comp.insur-ante$ rr Mp&rAl 5. ❑ We are a corparation`ant3 ❑$l its l0: cctrical repairs or additions 3.❑ 1 am a homeownrx doing all work office rs bave exorcised their I1.❑-Plumbing repairer or additions mysd£[No workers' comp. right of exemption per MGL 12 ❑Roof rep " inm=cr 1equired.]t c. 152, §1(4),and we have no employees. [No workers' 13.�Othcr G .�f comp.insurance required.] •Any applicant that checla box#1 wort also M out the=r-60a blow sbowing their workcxV corapcosFADn policy infounzEm-L t Homcodmas who rubrdt this affidavit indicating tbey an doing aII work and than hire outsido contractors must rubrmt a new affidavit indicating rueh. TCantmctors 0h 1r-beck this box mint affichcd as additional rbect cbowing the name of the sub-contractors and mate wbathcr err not those entities haver earployom If the subtontractorr have czvployccr,they nnirt pro-idb Thar workers'•comp.policy number. I am an employer dud is providing workers'compensation insurance for eery employees. Below is the polity and jab site information. Insurance Company Name: l ✓`} �U C� U S v't (/'v S vl�L� Policy#or Self-ins. Lic.#: l 2-- Expiration Date: ® Job Site Address: ) (0 4 _City/StatclZip: ��-� Gam• ) ( LC C Attach a copy of the workers' compensation policy derlaratiDn page(showing the policy number and expiration date). Failure to scctn a coverage as requirod under Section ZSA of MGL c. 152 can lead to the imposition of crimTrial penalties of a fine tip 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$250.00 a against the violator. Be advised that a copy of this statcmriA may be forwarded to the Office of 1UVr,Nti9RtiM19 of IA for insurance coverage verification. I do hereby ce under the payrs•and penaLdzy of perjury that the information provided a/bLO av is true correct. Si alutc: Date: / ; �. Phone •. Of e only. Do not write in this area, tb be completed by city or town offtclaL City or Town: Permit/Liceme# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City(Towu Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: �_Phone#: •• �..• r..�., .ry �<ua vvvarvvoc.0 �.c�rattlun f�l]-�91L:001 r ' Town of'Bar�,Stable Regulati)ry Servxces Thomas Z Gefler,Dire' Building Divispn Tom-Terry', Building Comminfonet, 200 Main Str* Hyannis,MA 02601 www.town.ba rnsta bte.ma,as 'Qf cg: 508-862-403$ Fax. 508=79076230 Proverty Own er Must, CoM fete a -1 d Sign.Thus'Sect�ozx If Using—A Builder as,( ex'ofthe'subject pxoPert 7 �:� �hetc•by, uthonza --�:�A� �fik1�.:��yC C.�V� � =- --- ._... to act oa may behalf, is sil.zx�ttexs z'elati a to work authorized by this buiidin eunit a Best oa for. g P PP (Address ofjob) / 7, 7, S Uztmc Of Own= ate tJ (� c .Print ` atae If Property owacr is appl,x' ;-fox perm t please Complete the Homcowaets License Exemption Form on the reverse side. AC -. CERTIFICATE OF LIABILITY INSURANCE 04115120 PRODUCER (800)752-0251 FAX (781)261-2099 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC - Commercial ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE E HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND ppR 77 Accord Park, Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELIOW. Unit Bl Norwell, MA 02061: INSURERS AFFORDING COVERAGE NAIC# INSURED Capewide Enterprises LLC INSURER A: Hanover Insurance Co. 22292 PO BOX 763 INSURER B: ACE USA Centerville, MA 02632 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY LBN5336555 041,3012009 0413012010 EACH OCCURRENCE $ 1,000,00C COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ -300,OO CLAIMS MADE Fx_1 OCCUR MED EXP(Any one person) $ 10,00( A PERSONAL&AQV INJURY $ 1,600,001 GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE,LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY PRO- F_jLOC JECT AUTOMOBILE LIABILITY TBD AUTO 0412012009 0412012010 COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO 1,000,006 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) A X HIREDAUTOS BODILY INJURY (Per accident) $ X NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELA LIABILITY UHNS336545 0412012009 0412012010 EACH OCCURRENCE $ 2,000,OO OCCUR CLAIMS MADE AGGREGATE $ A 2,000,000 $ 2,000,00 DEDUCTIBLE $ X RETENTION $ 10,OO $ WORKERS COMPENSATION AND C45761472 04114/2009 0411412010 1 WC STATU- I OTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 500,00( B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ 500,OO If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,006 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, q BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. ��..�.�Ru�onaZ �REREVSEN�Ej' > ACORD 25(2001/08) ©ACORD CORPORATION 1988 c llassachusttt• Dq)a1-intcnl in i'liblic Bnartl ul IW Idin_ Rc,,tikiliun, mid dtmltkmk _ Construction Supervisor License Ucense: CS 89273 qn— Restricted to: 00 t RICHARD M CAPEN 122 WHITMAR RD COTU IT, MA 02635 Expiration: 11/27/2011 c nunii..i ncr Try: 9638 Restricted to: 00 00- Unrestricted 1G-1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: WWW.Mass.Gov/DPS �O%9?!I9LlYl2lli8(.7.GLlZ Board of Building Regula-ti'ons and Standards HOME'1'MPROVEMENT CONTRACTOR ` Regis.tratfon: 1,43358 Expiration Ti•# 272627 Type: :LtdiLiab'ility Co'rpor CAPEWIDE='ENTERPRISES L?L. AFOARDI CAPEN 450.7R RT'E.28 COTOIT Mk02635 Atlministrat'o`r+ License or registration valid for ind'ividul use only before the expiration date. if found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,Ma.02108 valid wfhout''igmature III __ • a R p \ I N tln` 1Sa1 1 ny 111 16 r{ O ,e , (,M()Lk f TOWN OF BARNSTABLE Permit No. 2453 t�,.. = Building Inspector :r cash rya f / OCCUPANCY PERMIT Bond ----- __l�' t �_';+ Issued to Address Cen 'Wiring Inspector Inspection date j ; Plumbing Inspector: V r 1 Inspection date Gas Inspector Inspection Inspection date Engineering Department �_Y ra Inspection date ;b , `•.- - r Board of Health - Inspection. date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE i BUILDING CODE. r ' Building -Inspector _ A i =5 TOWN OF BARNSTABLE BUILDING PERMIT_APPLICATION..- 1 ap Parcel. :Application # a Health Division Date Issued Z� Conservation Division Application Fee Planning:Dept: Permit Fee Date Definitive'Plan Approved by Planning Board 11211114 Historic ' OKH Preservation/Hyannis Project Street Address Village �'i'A\r_ Owner S5A MgLN2W tnll� Address N16c"42 N` i Telephone Permit Request eA �7_ '— i 'S '1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new ` Zoning District' Flood Plain Groundwater:Overlay Project Valuatiork_ Oct ' 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 4�q ct Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)l Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new 7Z Total Room Count (not including baths): existing new First Floor Roo Count V i i Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other co 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name � �� Telephone Number Address ks cit License # CS `7"�z$ Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ZI l 0� I f f i 4Y. FOR OFFICIAL USE ONLY `APPLICATION# DATE ISSUED MAP/PARCEL NO. t ADDRESS VILLAGE OWNER i } DATE OF INSPECTION: FOUNDATION _ FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL x PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 4 FINAL BUILDING 4 f s F I DATE CLOSED.OUT i ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street 4 Boston, MA 02111 Y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers Applicant Information G r Please Print LeLribly Name(Business/Organization/Individual): Address: �c h CZ City/State/Zip: kj M\, Phone.#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑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 g• ❑Demolition workingfor me in an capacity. employees and have workers' Y P tY• $ 9. ❑Building addition [No workers'comp. insurance insurance. 10. Electrical repairs or additions required.] 5. Vw::e a corporation and its. ❑ P 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.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 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 a new affidavit indicating such. (Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 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 tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under thq pains and penalties of perjury that the information provided above is true and correct �— -a I Signafore: Date: 3 (J Phone#: Official use.only. Do not write in this area,to be completed by city or town offWaL .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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined'as"...every per!76n 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 anotlier 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, §25C(6)also states that"every ystate or local licensing agency shall withhold the issuance or renewal of a license or permit to operate Atisiness or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall . enter into any contract fm 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 out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and.phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their self-insurance 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 sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant Please be p m>, . that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town),".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e.a dog license of permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations, 600 Washington Street Boston, MA 02111 TO. #617-727-4900 ext 4-06 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia 1 ii ii . ..i.LVVJ 1L•VV: 1 1 Lill\I 1J 11"ILLL LJVMJ\l .JI 11Lr%-i f-1 I Ti.GJl r.G/G Town of Barnstable Regulatory Services Thomas F.Geller,Director VAM Building DivislOn Tom rerry,Building GonUTdSOaaer 200 Main strect Hyaaais,MA 02601 www.town.barnstable,ma,us Office 509-962-4038 )~arc; 508-790�6230 Property Owter Must Complete and Sign This Section If Using A Builder as Ovfflrof the subject,propexty hereby authasize COI- to act 0a my behalf, is all matters relative to work authorized by this bw7t ng permit appkztion for; rJ' (Address of job) 33 y Joi Si nature of Owner Da ta If Pfopertv Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. .z VORWS:OWNLttP UISSION + 4 -� x 4 � ` i t 4 5 ` � M1 S Nla"sachusctts - Department of Public Safety Board rrl'Buildim, Rc�guladons and Standards Construction Supervisor License License: CS 75281 Restricted to: 00 TODD J CANTARA 10 ECHO RD W YARMOUTH, MA 02673 Expiration: 3/121201.1 ('nnrnissioncr' Tr7#: 12753 Board of suflatng Regulations and standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR ' before the expiration date. If found return to:- Registration:, 159211 Board of Building Regulations and StaudArds Expiration:.4/10/2010 Tr# 266397 One Ashburton,Place Rm 1301 Type: Partnership Boston,.Ma.02108 ECHO CUSTOM CARPENTRY TODD CANTARA 10 ECHO RD. W.YARMOUTH.MA 02673 -- Administrator Not valid without signature TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application Health Division Date Issued A e Conservation Division Application Fee r` Planning Dept. ;.'Permit Fee Date Definitive Plan Approved by Planning Board Historic = OKH Preservation / Hyannis Project Street Address FVI L M O`. T Village C_d_)7_C_a 0 (C C C_ Owner �3 B C 1-1 OL f~ l�� Address Telephone SOS `"l -0.C)2q q Permit Request Square feet: 1st floor: existin proposed 2nd floor: existing�G' proposed otal new F—IT Zoning District Flood Plain Groundwater Overlay Project Valuation ©Q-dO Construction Type W Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family -❑ Two Family ❑ Multi-Family(# units) C01Yln 1?1CC'*f ( Wirt/17 Age of Existing Structure R6 3 Historic House: ❑Yes XNo On Old King's Highway: ❑Yes L)No Basement Type: ❑ Full aCrawl r1kout ❑ Other �/ Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 't 3 Number of Baths: Full: existing new Half: existing newSIR C) Number of Bedrooms: existing new a C) Total Room Count (not inclu ing baths): existing new First Floor Roon Count Heat Type and Fuel: WLGas ❑Oil ❑ Electric ❑ Other CD Central Air: A_Ye ves ❑ No Fireplaces: Existing New Existing wood/coal sto zu Yet TN k Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑ existing (4 new Mize_ 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 APPLICANT INFORMATION - - - -�-- ___(BUILDER OR HOMEOWNER) Name C�'-11C(Lx'� l� �C- Telephone Number Address C�XY1�YtC��C L Sl License# Home Improvement Contractor# Worker's Compensation # W )_ 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO t�IV t'�AU43i (- SIGNATURE DATE Xx i rr 3 �. FOR OFFICIAL USE ONLY ` APPLICATION# DATE ISSUED MAP/PARCEL NO.. f ADDRESS VILLAGE OWNER DATE OF INSPECTION: 4'FOUNDATION. x FRAME INSULATION_= FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL :GAS': (71, ROUGH ?a-� FINAL ',FINAL BUILDING'!!-,' DATE CLOSED OUT ASSOCIATION.PLAN NO. 'f t a' The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations A' d 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information p Please Print Legibly Name(Business/Organization/Individual): CA E'V t��r C Vt C'0- (kI % C") -Address: l eornrnC-P_r_t 4L . S City/State/Zip: 6 ��'``� ��l` Phone.#: S03 q 1rb5,_k+ Are you an employer?Check the appropriate bog: a of io ect(required).. C? 4. I am a general contractor and I P ] 1.[ .I am a employer with g 6. ❑New construction . employees(full and/or part;dme).* 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 have g. Demolition workingfor me in any capacity. employees and have workers' Y P tY $. 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. We are a 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 df exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no 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 a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance far my employees. Below is.the policy and job site information. Insurance Company Name: kl VCC_ A Policy#or Self-ins.Lic.#: 3 Expiration Date: f lob Site Address: 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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the h IA for insurance coverage verification. I do hereby ce nd he painted ef� 'ury that the information provided above is it a an correct: 111� Si ature: Date; Phone#: l V Official Ze only. Do not write in thts area,to be completed by city or town officiaL City or Town: Permit(License# Issuing Authority(circle one): A.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ACORO� CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDIYYYY) 5/2/2011 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: Rogers & Gray Ins. Plymouth PHONE FAX 341 Court Street A/c No Ext: - - A/C No: E-MAIL P. O. BOX 3700 ADDRESS: Plymouth MA 02361-3700 PRODUCER cLISTOMER ID#:CAPEENT INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA:Arbella Protection Cc 17000 Capewide Enterprises LLC J.P.Macomber & Sons INSURERS: PO BOX 763 INSURERC: Centerville MA 02632 INSURERD: INSURER E: _ INSURER F:. COVERAGES CERTIFICATE NUMBER:599145344 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. INSR TYPE OF INSURANCE ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR INS D POLICY NUMBER MM/DDfYYYY MMIDD/YYYY A GENERAL LIABILITY 8500050813 4/30/2011 4/30/2012 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE 0 RENTED 250,000 PREMISES Ea occurrence $ CLAIMS-MADE FTI OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY F7 PRO- LOC $ A AUTOMOBILE LIABILITY 58944400004 4/20/2011 4/20/2012 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULED AUTOS X PROPERTY DAMAGE $ HIRED AUTOS (Per accident) X NON-OWNED AUTOS $ A X UMBRELLA LIAB OCCUR 4600050814 4/30/2011 4/30/2012 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000.,000 DEDUCTIBLE $ X RETENTION $10,000 - $ A WORKERS COMPENSATION 005437 4/14/2011 4/14/2012 WC DRY LIMIT' O R AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? a NI A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $500,000 If YYes,describe under DESCRIPTIONOF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Joao Junqueira Richard Capen CERTIFICATE HOLDER CANCELLATION to SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE = ©1988 2009 ACORD;�CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks ofA..CORD 't I 89273 00 RICHARD M CAPEN 122 WHITMAR RD `,li •; COTUIT, MA 02635 c 11/27/2011 9638 Office of Consumer %n';ors C ftu:iiie < Rcuul.rtion HOME IMPROVEMENT CONTRACTOR Registration: 143358 Type: Expiration: 7/8/2012 Ltd Liability Corpo CAPEWIDE ENTERPRISES L.L.0 RICHARD CAPEN 4507 R RTE 28 s „ COTUIT, MA 02635 l'ndcrsccrct�n Restricted to: 00 ---- 00- Unrestricted 1G- 1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: WWW.Mass.Gov/DPS License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation r 10 Park Plaza-Suite 5170 Boston,MA 02116 &Rlid with tt signature f lg]001/001 T'oWn of-Bakistable Regula:Ory Services bun Thomas P. Geiler,Director t6� Building Division Tom'Perr)' Building Commissioner 200 Main Str* Hyannis,MA 02601 w".towu-barnstable.ma,us Office: 508-862-4038 Pax: 508-790-6230 Property Owner Must Complete az�d Sign T Ws•Sectxozx If Using A Builder i (ji 117A z , as Comex of the'subject property ' 'hereby autho,=-c . �A-0C-cV W9 c— �C � t C� to act oa toy,behalf , in all matters relative to work authorized by this building p=nit apphgatioa for. 1 LACI-ho'l" n %, h, (Address of job) SignAture of Owner D e 7 Uj TT �ta= If Pro perty Qwndr is appIing fox permit please complete the Homeowxitrs XRicense Exemption Porm on the revessc side. i _ _ YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4.years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permissidh-'tiFdp` e. Business Certificates are available at the Town Clerk's Office, 1'FL., 367 Main Street, Hyannis, MA..02601 (Town Hall) DATE: 11 go O 6 Z M � 3 ' Fill in please: APPLICANT'S YOUR NAME: Son 1 o- . Olt,. BUSINESS YO R HOME AD RESS:OP TELEPHONE # Home Telephone Number _ o 7 NAME OF NEW BUSINESS i eS „1 IS THIS A WO ME OCCUPATION? YES NO P BUSINESS ch- / TYPE "( E OF BU N SS een gi. .: . . al from the building ADDRESS OF BWSI'NESS ice;. . _ -E' MAP/PARCEL NUMBER When starting anew business there are several things you must do in order.to be in comp iance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Ma.i - corner of Yaf( mouth Rd. & Main Street) to make sure you have the appropriate permits and licenses.required to legally o era o r usmess in this town. 1. BUILDING COM SIO ER'S OFFICE This individu I ha' in d o a y permit requireme at pertain to this type of business. Au rize urn* r COMMENTS:0� -- 2. BOARD OF HEALTH This individual has been infor d o th per it requirements that pertain to this type of business. a' Authorized tignature** COMMENTS: . 3. CONSUMER AFFAIRS (LICENSING AUTHO TY) This individual hasVrized rmed of he`Ice s' re ements that pertain to this type of business. Signature. COMMENTS: YOU WISH TO OPEN A BUSINESS? For Your, Information: Business certificates (cost'$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by.M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this forni at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601 (Town Hall)and get the Business Certificate that is required by law. _ DATE: ?/�5 r 3 - R� �W � Fill in please. APPLICANT'S YOUR NAME/S: Ftt' P g�m Zrr yON-te r F BUSINESS YOUR HOME ADDRESS: 116 e4-)/I e,t o/c 0 SIt'rvi//c' 1N 02GS3 TELEPHONE # Home Telephone Number ,/'7 S/0 a Q 09 :NA ME;OF CORPORATION:'' NAME OF NEW BUSINESS ran m, S�:rcnc� TYPE;OF BUSINESS'! ,c'✓r's✓✓ r,z . IS THIS A HOME OCCUPAT,ION� YES: :`NO ADDRESS OF:BUSINESS„ Y �Q . . •YID. F v�,f; � MAP%PARCEL NUIVIBE (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING C MMIS ONER'S O CE This indi idual s b era+rafp m f an per it re uirements that pertain to this type of business. thoriz d S+gnatur COMMENTS: Q� 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: YOU.WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office,.1'FL., 367.' Main Street, Hyannis, MA 02601 (Town Hall) :r ..(�� r{ ' DATE: (� Fill in please: , F� ?' APPLICANT'S YOUR NAME/S: Y - �e BUSINESS YOUR HOME ADDRESS: _ r £` �k TELEPHONE # Home Telephone Number 5 C': 7 '2--� Il NAME OF CORPORATION: NAME OF NEW BUSINESS CJ% .� � -t4PE OF BUSINESS IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS ✓�� car/ "/ MAP/PARCEL NUMBER %O [Assessing) When starting a new business there are several things you must do in order to be in compliance with.the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate,your business in this town. 1. BUILDING COMMI ON R'S OFFICE 5 This individual as n nfopm f ny er it requirements that pertain to this type of business: s Ali Authorized Signatu e COMMENTS: } 2. BOAR OF HEALTH ;MUST WITH AM W AM This individual has bee r ii�� /IRRf the permit requirements that pertain to this type of business. IHAMMUS MATERIALS REGULATIONS. Authorized Signature** - COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. KU t s? n Authorized Si nature** COMMENTS: NO Cf,b(1 W00 ULU. - { YOU WISH TO OPEN A► BUSINESS? For Your information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town [which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available.at the Town Cleric's Office, 1`FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: /L Fill in please: { APPLICANT'S YOUR NAME/S: T yy�sg aH 11 1 cN ,� ti�3ii� sir ` ""r'j°I +�' ia �ntfa3 BUSINESS YOUR HOME ADDRESS: C 12 C�t^a,, IG�rnl rr f��5y lr , r "3 - - l�-(il r�l/1 1�— �r f=-4t2-(�Lr y„M If 'G rrf,;� r�c1 ;, �J /Q 1" �'k °' �,� � v✓�' TELEPHONE # Home Telephone Number NAME OF CORPORATION: ✓ ✓1 . /N' TYPE OF BUSINESS NAME OF NEW BUSINESS �5 IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS KoL Cq I 3 L .MAP/PARCEL NUMBER —Ob W�Q Duo (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to malce sure you have the appropriate permits and licenses required to legally operate your business in this town. 1.. BUILDING COMMISSIONE FFICE This individual has be i rmed of an ermit requirements that pertain to this type of business. Auf rized Signature** COMMENTS: r 2. BOARD OF HEALTH This individual ha en informed p rmit e uiEement that pertain to this type of business: x > f Authorized Signa e* COMMENTS: �r ',�t.x3 CONSUMER AFFAIRS ( CENSING AUTHORITY) This individual hen ' o f I' si e ui me is that pertain to this type of business. Authorized Signatu 'a .COMMENTS. Duct Leakage Test Form Customer Information: Test Conditions: Name: Bayside Building Date: 10/10/2013 Address: 1645 Route 28 Bayberry Square rime: City: Centerville Indoor Temperature(F): State/Zip: MA 02632 Outdoor Temperature(F): Phone: Floor Area(ft2): 1398 Email: System Airflow(cfm): 1400 Cooling Size(tons): N/A Heating Size(btu): 60,000 Building Address:(if different from above) Primary Location of Street: 22 Pheasant Hill Circle Supply Ductwork: Basement City/State: Cotuit, MA 02635 Primary Location of Return Ductwork: Basement Comments: System serving first and second floor on one zone.Second floor supplied and returned by duct risers in interior and exterior walls.All duct joints seams and connections sealed with 3"venture mastik tape. System tested after rough install with equipment attached. System tested with Minneapolis duct blaster.All duct work and flex runs insulated with r-6 foil face insulation.All duct work in cold spaces insulated with r-8 foil faced insulation. Total Leakage Test Depress Press Outside.Leakage Test Depress Press i Test Pressure: (Pa) Test Pressure: (Pa) Baseline Duct Pressure(optional): (Pa) Duct Press. Flow Ring Fan Press Duct Press. Flow Ring Fan Press(Pa) Installed (Pa) Flow(cfm) (Pa) Installed (Pa) Flow(cfm) 25 3 73 Fan Model/SN: Results: Outside Leakage(cfm): Fan Model/SN: Outside Leakage as% System Airflow: Results: Outside Leakage as Total Leakage(cfm): 73 Floor Area: Total Leakage as% System Airflow: Eric Whiteley Toal Leakage as% W,V RN. N eric@wvwhiteley.com Floor Area: 5.2 i . .+ 28 Village Landing }+i�.yy�/�. P.O.Box 1266 tt1S3.:.ki 34 fWc i AK .SmW I W.Chatham,MA 02669 Plumbing• Heating T 508-945-1100 Air Conditioning F 508-945-5549 Since 1952 www.wvwhiteley.com l �I � �e2 � YOU WISH TO OPEN A-BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME.in town (which you, must do by M.G.L.-it does not give you permission to operate.) You mustfirst obtain the necessary signatures on this format 200 Main St:, Hyannis, Take the completed form to the Town Clerk's Office;:1st FL, 367 Main St., Hyannis, MA 02601 (Town Hall) and get the.Business Certificate that is required by law_ DATE: 10-- �� Fill in'please•' , • riai�. g; •;� ;ev;,• : ;�,, d Vbs APPLICANT'S YOUR'NAMEJS: 1 �b „�.5t€Li �r<tj :• " 'r BUSINESS YOUR HOME ADDRESS:AMA ut TELEPHONE # Home Telephone Number �-n F? �3(e n - r� f 02 N ME O .O ATI iJ N US ESS, , •• Tl(PE-OF`rBUSINESS:: S` NAME�OFNEW B IN � - . 0 =Y N �•�,,ES O. 5Y IS'A.H ' .' .:`.I M ,• �.. +.. A[]DRESS:.OF IVI CEL•.N•UMBER � �s .g) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town,of Barns you.may need.. You MUST GO TO 200 Main St. - (corner of Yarmouth table. This form is intended to assist you in obtaining the information Rd. &Main Street) to.make sure you have the appropriate permits and licenses required to legally operate your business in this town. I., BUILDING COMMISSIONER'S OFFICE This individual ha wee ' formed ny permit requirements that pertain to this type of business: . . Authorized Si9 natdre COMMENTS: 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature COMMENTS: S. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: : YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.007for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L. it does_ not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. r r < t DATE: I �b Fill in please: . APPLICANT'S .: YOUR NAME/ S: n h' M a �r k t $U,SINESS YOUR HOME ADDRESS: D r- z , 6 -v.-`r [� S / k.4 Q 2 4y,4 f � �, �;h`• oe= M' TELEPHONE # Home Telephone Number 29T-1`fo 1 NAME OF CORPORATION: c c. NAME OF NEW BUSINESS ,,.-n Sc [ v 1 - TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES N CQ�-��ee.��nn(Q RA ADDRESS OF BUSINESS S rn c.� o c.r+e`18 o�b 3a MAP/PARCEL NUMBER 'v� (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1., ,BUILDING COMMISSIONWinfed ICE .. . This individual has bee an r i equirements that pertain to this type of business. Ij jj Aut rize n ture COMMENTS: 2. BOARD OF HEALTH This individual has been informed of the er�mi p t re uirements that pertain to this type of business. q P YP Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: a f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel . — U Application # � ! Health Division s~ C6 Date Issued Conservation Division ;Appli"cation Fee : Planning.Dept. d� Permit Fee' Date Definitive,Plan Appr ved by Planning Board - Historic = OKH Preservation/ Hyannis Project Street Address 2 A: : Btee.r�J� Village 02632_ Owner Address `�� Telephone �r09 3 6 7. F-3 05, ermit Request ��zc�. .-r� <i and, 6"W'61042/n e 2,-4 d e C/ -5 f4 40 c r,,, Square feet: 1 st floor: existing proposed ;2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �Q Construction Type I Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family -0 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: ❑existi g ❑ n,ew size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: ' - Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ o c Commercial ❑Yes ❑ No If yes, site plan review # _ v„ Current Use, Proposed-Use - Ch APPLICANT INFORMATION (BUILDER OR HOMEOWNER) w Q �- — �.-- L `Par=r-•-.'-,1eA��A��_ - - - Telephone�Number_-_.._ Address `-4- 5 �enee_-zo,5 - � License # Home Improvement Contractor# 026 73 . Worker's Compensation # ALA L CONSTRUCTION DEBRIS RESULTLNG FROM THIS PROJECT WILL BETAKEN TO SIGNATURE.- �� i a �-DATE� FOR OFFICIAL USE ONLY APPLICATION# - e DATE ISSUED r MAP/PARCEL NO. y ADDRESS VILLAGE OWNER Y 3 .. 7 DATE OF INSPECTION: b FOUNDATION R FRAME 7 G loci INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLU MBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING "'Z! DATE CLOSED OUT `( ASSOCIATION PLAN NO. The Commonwealth of Massachusetts �. Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA02111 kMw. i www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name-(Business%Oga-----------nization/Individual): C ty;F t�ate/Z p 1�� `�`• �' �✓i Phone.#: SO %— IM6 . Are you an employer? Check the appropriate bog: Type of project(required): tEl I am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. 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 workingfor me in an capacity. employees and have workers' Y P h'• $ 9. ❑Building addition [No workers'•comp.-insurance comp. insurance. 10. Electrical repairs or additions required.] ' 5. ❑ We are a corporation and its ❑ P 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.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no 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. tcontm aors 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'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.M Expiration Date: Job Site Address: 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$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy-of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi `u�er�t(h�e pains andpeijauks of perjury that the information provided above is true and correct Si afore: IJ�.JV��•o.►�-- � •2.1,c�„ .. 5...".""""'.'"w'`'`Dat-�e:�,._-,—.Jy�/c- .T`, c�� _ Phone#: Official use.only. Do not write in this area,to be completed by city or town offcclat 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,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 tiustee 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, §25C(6)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,MGL contr chapter 152, §25C(7)states"Neither the Commonwealth nor any of its political subdivisions shall . enter into any act 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 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-contcactor(s)name(s),.address(es)and.phone number(s)along with their certificate(s)of insurance. Limited Liability Companies*(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their self-insurance 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. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"I.he applicant should write"all locations in (city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commonwealth of Massachusetts Department of ladustri,al Accidents Office of Investigations, 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia Town of Barnstable Regulatory Services. M'sr�Ay$t'E Thomas F.Geiler,Director �Eo.Ig6 16�� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must , Complete and Sign This Section If Using A Builder of the"subject property hereby authorize'+ iL�`�` � __ to—act on my behalf, .. in all matters relative to work authorized by this building permit application for. (Address of Job) fi�Pc ✓iLi 02-Cj 2. Signature-of Owner E5ate ar Ole- Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:FO RMS:O WNF RPERM IS S ION Town of Barnstable " mop tHE Tp�� . Regulatory Services Thomas F.Geller,Director MAss Building Division rfD MA'1 Tom Perry,Building Commissioner 200 Mairi•S.reet,._Hyannis,MA.02601 Yrww.to wn.b arnstable.ma.us Office: 508 86 2-4038 Fax: S08-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER!" name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINMON OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that.he/she understands the Town of Bamstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 1 D9.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) Ibis lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with p licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner 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 t amend and adopt such a form/certification for use in your community. Q:fonms:homcexempt �w � ��ze "t�ana.naooacueal� a�✓�izodczc�ia�ap,�6 Board of Building Regulations and Standards w:J. Construction Supervisor License l a;' License: CS 66751 ` +. Expiation 10/4/20pg Tr# 7254 Restriction 00: WILLIAM G PEIRCE JR { PO BOX 1304 DENNISPORT, MA 02639 Commissioner f V 00-35,000 cf enclosed space IA-Masonry only 1G- 1_2 Family Homes a ' i Failure to possess a current edition of the j Massachusetts.State Building Code iscause for revocation of this license.. 1 i i (P / '�— Ln •. Of —0 IN wONR 04 L Ln ru Postage $ $0.61 CAA rR Certified Fee $2.80 10 R ostm C3 RReturnReceipt Fee a C M (Endorsement Required) $2.30 Lc) Here C3 P17 Restricted Delivery Fee E3 (Endorsement Required) $0■00 ru cO Total Postage&Fees $ $5.71 "9 A 0 O E. Sent To ------------- ------------------------------------------------------------------------ - p Street,Apt.No.; 1� N or PO Box No. /W)� S e,- ................. ------ - ---------------- -------------------------------- City,State,Z/P+4 �05� QZ/U� Certified Mail Provides: o A mailing receipt a A unique identifier for your mailpiece e A record of delivery kept by the Postal Service for two years Y Important Reminders: o Certified Mail may ONLY be combined with First-Class Male r Pi ority Maile. o Certified Mail is nat,vailable for anyLclass of international mail. a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please. o der Insured-on Registered Mail. o For an additional'fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt,service,please complete and attach a Return Receipt(PS Form 3811)to the artide.and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested'.To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. hipeo e For an additional,fee,,,,delivery.,may,�,be restricted to the addressee or addressee's iai tti'orliedta ant.Advis6the clerk or mark the mailpiece with the endorsement"Restricteft livery° e If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an Inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 Massachusetts Department of Environmental Protection Bureau of Waste Prevention . Air Quality Please Enter Decal# ----------------------------------- Ll BWP AQ 06 Notification Prior to Construction or Demolition Affix Notification Decal Here ---------------------------------- A. Applicability Important: s When filling out A Construction or Demolition operation of an industrial, commercial, or institutional building, or forms on the residential building with 20 or more units is regulated by the Department of Environmental Protection computer,use (DEP), Bureau of Waste Prevention-Air Quality Division, under Regulations 310 CMR 7.09. only the tab key to move your Notification of Construction or Demolition operations is required under 310 CMR 7.09 (2)ten (10) cursor-do not days prior to any work being performed.The following information is required pursuant to 310 CMR use the return 7.09. keys nl�l B. General Project Description p 1. Facility Information: Bayberry Square (one small 600 sq. unit) _ Name 1645 Falmouth Rd. Address Instructions Centerville, MA 02632 City/Town State Zip Code 1.All sections of 508-790_10 0 _chart e this form must be 5 SCaG —r(d�rahnn cnm completed in order Telephone Number E-mail Address(optional) to comply with the Size: Department of Environmental Entire building is 4300 sq. ft. 3 Protection notification Square Feet Number of Floors requirements of 310 CMR 7.09 Was the facility built prior to 1980? ❑ Yes B No 2.Submit Original Describe the current or prior use of the facility: Form To: Commonwealth of office working unit (3 employees — no customers) Massachusetts Asbestos Program P.O.Box 120087 Is the facility a residential facility? ❑ Yes No Boston,MA 02112-0087 If yes, how many units? N/A 2. Facility Owner: B. Lori Case — Trustee of '_the LORI CASE INVESTMENT TRUST Name 49 Beldan Lane / Centerville, MA 02632 Address Centerville MA 02632 City/Town State Zip Code (508) 771-6449 hloricaseOyahoo.com Telephone Number(include area code and extension) E-mail Address(optional) And)r Witter (First Property Management) 508-420-0299 On-site Manager ag06app•6/04 BWP AQ 06•Page 1 of 3 Massachusetts Department of Environmental Protection r'1 Bureau of Waste Prevention • Air Quality Please Enter Decal# BWP AQ 06 Notification Prior to Construction or Demolition B. General Project Description (cont.) 3. General Contractor: Ericsson Torre Name —l6 unn17Pr Rd_ Address ao�t hA 508-360-9221 State Zip Code Telephone Number(include area code and extension) E-mail Address(optional) Same On-site Manager C. General Construction or Demolition Description General Statement:If 1. Construction or demolition contractor: asbestos is found during a SAME as GC Construction or Name Demolition operation,all Address responsible parties must comply with 310 Telephone Number(include area code and extension) E-mail Address(optional) l CMR 7.00,7.09, 7.15,and Chapter I 21 E of the On-site Manager General Laws of the 2. On-Site Supervisor: Commonwealth. This would include,but would Name not be limited to, r filing an asbestos 3. Is the entire.facilityto be demolished? Yes N/A' — no 'demolition removal ❑ No notification with the Department 4. Describe the area(s)to be demolished: . and/or a notice of NONE release/threat of release of a hazardous substance to the Department,if applicable. 5. If this is a construction project, describe the building(s) or addition(s)to be constructed: No buildliag constructi Q - or addition Simply building 3 walls for division-of office working space for employees 'in small office unit • ag06app•6/04 I- BWP AQ 06•Page 2 of 3 I I Massachusetts Department of Environmental Protection 1 Bureau of Waste Prevention • Air Quality Please Enter Decal# BWP AQ 06 Notification Prior to Construction or Demolition C. General Construction or Demolition Description (cont.) 6. If this is a demolition project,were the structure(s)surveyed for the presence of asbestos containing- material (ACM)? ❑ Yes ❑ No /X/ None — not applicable If yes,who conducted the survey? Name Division of Occupational Safety Certification Number 7. Construction or Demolition End of June 2009 mid—July 2009 Start Date End bate 8. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving El wetting ❑ shrouding If other, please specify: ❑ covering ❑ other Any wood/sheet rock dust will be minimal, and totally contained because office door to e kept 9. For Emergency Demolition Operations,who is the DEP official who evaluated the emergency? shut NOT APPLICABLE Name of DEP official Title Date of Authorization DEP Waiver# D. Certification certify that I have examined the C— �� above and that to the best of my Print Name knowledge it is true and compt—:__—�utho�dz6d' The signature below subjectsnature signer to the general statutes —_' regarding a false and misleading Position/Title statement(s). Irze ' Representing Date P.E.# ag06app•6/04 BWP AQ 06•Page 3 of 3 I" v The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street - Boston, MA 02111 s www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name(Business/Organization/Individual): Address: /6 Llapve:t 1� City/State/Zip: Wc5r 4%g� 1✓1,4 026%3 Phone.#: ��R c122 t Are you an employer? Check the appropriate box: Type of project(required): 1. I am a employer with _ 4. ❑ 1 am a general contractor and I : employees(full and/or part-time).*. have hired the sub-contractors 6. ❑New construction 2:❑ I am a sole proprietor or partner listed on the attached sheet. T. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an capacity. employees and have workers' Y P ty• 9. ❑Building addition [No workers'comp. insurance comp.insurance.* 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ P , 3.❑ I am a homeowner doing all work officers have exercised their I I.El Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no, employees. [No workers' 13.0 Other Comp.insurance required.] G*any applicant-that checks box#I`must also fill out the`section below-showing thei, rkers—compensation_policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Icontractors 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'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company~Name:-IP.�✓Gi�L�. P60 `r' W'- 1-Y , ir`ation_Date: ��r 22-�2�0 do tom. Job-Site Ad"-dress:��i►��.1}1�� . llrj�f ��' C�:�i�_. � ,,�i. �,/�--., �2��. City/State/Zip: ��` Attach a copy of the workers'compensation policy declaration page("sing 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-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ida hereby certify under the Penalties of perjury that the information provided above is true and correct Sip-nature: 'f l:G Date: Phone M 598":3Zo`7721 Official use only. Do not write in this area,to be completed by city or town of-ciaL 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#: f - RightFax N2-1 6/1/2009 9: 15 :51 AM PAGE 3/003 Fax Server COOK! n .� rr WINE �l a.. j F5 0"I-2009 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY PRODUCER AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. BRYDEN&SULLIVAN INSURANCE AGENCY INC COMPANIES AFFORDING COVERAGE 88 FALMOUTH RD HYANNIS MA 02601 c A TRAVELERS PROPERTY CASUALTY CO OF TTE-R LE TTER AMERICA =0 TY B LETTER . INSURED COMPANY I=-R C TORRES,ERICSSON DBA HOME IMPROVEMENT COMPANY D 16 HOOVER RD WEST YARMOUTH MA 02673 COMPANY E Na�.� �llfla�h - 'i� [�n>•rnuc=�ni¢sUiliti . THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BL•LOW 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 HIItE1N IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS- CO TYPE OF INSURANCE POLICY NUMBER POLICY POLICY LIMITS LTR EFFECTIVE DATE EXPIRATION DATE MM/DD/YY M/DD/YY GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OPAGO. S PERSONAL&ADV.INJURY $ CLAIMS MADE OCCUR. OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE(Any One Pi¢) $ MED.EXPENSE(Anyoueperwu $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per Person) SCHEDULFD AUTOS BODILY INJURY $ HIRED AUTOS (Per Accident) NON.OWNED AUTOS GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY UMBRE•II AFORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $. STATUTORY LIMITS X A WORKER'S COMPENSATION EACH ACCIDENT $100000 AND TBD 05-22-2009 05-22-20I0 DISEASGPOLICYLIMIT $500,000 EMPLOYER'S LIABILITY DISEAS&EACH EMPLOYEE mom OTHER THE SOLE PROPRIETOR/PARTNER(S)ARE INCLUDED EXCLUDED X DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLFS(SPECIAL ITEMS THE INSURED'S IVIA WORKERS COMPENSATION POLICY AND ITS UNITED OTHER STATES INSURANCE ENDORSEMENT AUTHORIZES THE PAYMENT OF BENEFITS FOR CLAIMS MADE BY THE INSUREDS NIA EMPLOYEES IN STATES OTHER THAN MA.NO AUTHORIZATION IS GIVEN TO PAY CLAIMS FOR BENEFITS IN ANY STATE OTHER THAN MA W THE INSURED HIRES,OR HAS HIRED,EMPLOYEES OUTSIDE OF MA.THIS POLICY DOES NOT PROVIDE COVERAGE FOR ANY STATE OTHER THAN MA. THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE loom TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL LMEAVOR TO MAIL 10 200 MAIN Sr DAXS WRITTEN NOTICE TO THE CERTIFICATE HOLIER NAMED TO THE I&FT, HYANNIS MA O2GO1 BUT FAR.URE TO MAIL SUCH NOTICE SHALL AD'OSE NO OBLIGATION OR LABILITY OF ANY KIND UPON THE COMPANY TTS AGENTS OR REPRFSENTATIVE,4 ADIHOREW REPRESENTATIVE , ,�jV,SI-,s,�G � O'NSJ"YIGL�,f1 ivEev �,i✓�No�w+ 3 IN _. 3` LO-C-1%e- � r p l so E' ..r-� ��E�d!� e� .� t�4iw,Cj�I'C•�S. �� `/�f`��fl�i E��. CJB�f l��f ��1��fJ�i,� > k z { xw6 � I ti 4 I CIN Chi 1 N Assessor's map and: lot number .............................:............ sTHE Sewage Permit number;21-a r �^''�'.. T...........T..: INSTALLED 6N CO WITH TITL B House numbers ��1�� aea LE, • a ENTAL TO EGULATI �a TOWN DF BAR.NSTAB BUILDING INSPECTOR • N U APPLICATION FOR :PERMIT TO Renovate and,•A1teX'...P.YiS.tirig. buildings........ r.........:.:.. TYPEOF CONSTRUCTION .......00d...£rame........................................................................................................ .........AIX.il..2.$a...................19.... z TO THE INSPECTOR The undersigned hereby applies for a permit according to the following information: Loca&tr-, .................:......... ProposedUse ..... 71C2..... ..................................................................................................................................... Zoning 'District ...... ..............................................Fire District ....� i�ll !2V[C C .. T2..v1� .:........ Name of Owner B4xb.1PxxY..Sq....Realty..T ust............Address ..1.6.4l..8t_..2$,...Canter.v.ille............................. Name of Bui1derPPte.r...1)4! 1p:,&..GQ...,...liuiJder ,...Ir>'¢Idress ..2.4.2..Dau •••••:......•••• Nameof Architect ..............................Address ...................................................... ............................. Number of Rooms .15.............. ........Foundation 'pouxed•.canoret®................... Exierior .zed..cedax..clapboard/white..cedax:..shingMwfing ...........red-cedar••sl?•ingles..:.............................. -Floors ...carpst...:..................................................Interior ............sheetrock...................................................... Heating .....FHW,/.o.il..............................................................Plumbing .............5..baths...................................................... Fireplace ..........noc..e................................................................Approximate Cost ............$7.5y004t-00................................... Definitive Plan Approved by Planning Board .AP A(-_______19 Area ..... .. .................... .......... Diagram of Loft and Building with Dimensions PrPR�L 18� ......... SUBJECT TO. APPROVAL OF BOARD OF HEALTH �� . Y y OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS hereby agree to,conform to all the Rules and Regulations of the T table regar g the above construction. r Name .. . .............��., � W�:,AYBERRY SQUARE REALTY TRUST 24029 Addition No ................. Permit for ...... ............ ............ Afterations to Commercial Bldg, Rte 28 Location ................................................................ . Centerville ............................................................................... Owner ...BAYbarxy. ..Squar.(a...R-ea-T-ty...T-rus"'t Frame Type of Construction ............................. ............ ................................................................................ Plot ............................ Lot ................................ Mav r .........................Permit Gtdntecl ...... .........19 82 Date of Ihsppction ....................................19 Date Completed .......................................19 /jC Gi/Ci �/ Assessor's map and 'lot number�.�.....:.........; � J ......,.............1 CF THE t0 Sewage Permit number,�?- '.,,... W� d f4 r'U _ t 1 V Z BARASTSDLE, i House number. �.'.:a.........:..'tx�t.f ,C`i., �� ro Mnea . j . .. ........ s6 0� 39 a�9 0 ypY TOWN ,OF B.ARNSTABL BUILDING INSPECTOR APPLICATION FOR PERMIT TO $pnovateod alter ex,3stt.in.ct h„iiAinoa ................................................................................................�............ TYPEOF CONSTRUCTION ...... f: .T ........................................................................................................ .........Anz 1.1.. '.A......................19.... ::? TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according,(� to he following -formation: Location ..2.`?........anti.rvi1..:°........ ........ ..��.(.� .... ...... .................. ................................... Proposed Use ...... Zoning District F ', f t ........................................Fire District ( F 1*,T f't v it-i t- i ........................................................................ Name of Owner ..,!,avhPxry Sn...... ....... Address . A/0. At ')Q r „+-411„ ... � „ .. ... ................................................... Name of Builder-Peter Dni of F X no •_ R„i i rlprc T Address ... a n�,__._.. Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms . .............................................................Foundation ............. ^. .. . . ................................. Y�tl rf+r��r ni flr.F�narri/rt}+itC+ np�nr Qlt Pn-.'Roofing Exterior ................: ....:.:.. ......... ,...... .................................. Floors '''""n° r .Interior ^'!% ^n - Heating �• �.. i ........................Plumbing � ..,-._ Fireplace . .n...............................................................Approximate Cost �,� ,,,.. Definitive Plan Approved by Planning Board ____r_,r W'~_(___ -_'� *- Area ` -�------- -- 1 - - .. ..................::.:::.:..... Diagram of Lot and Building with Dimensions t% �, i ? T-Fee:.......... Jt............................... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .........y......................I... f.:f...`........................ ' 1 BAYBERRY SQUARE REALTY TRUP A=209-86-91 U 2 No ..............4029... Permit for ....NN.i.te4iQ.11.......... .......Al.t.er.ati.on...To....Cmme. .Q oK ;L.aj..B Id ..... .. .... ....... ..... .... ............ Location ........Route...2Q.................... ..... ....... ... ............... ...............C.e.nt.e.rvij%je................................... Owner ..Bavb.err..v...S.qAAq .al:tv...Tx Type of Construction ..ZralM........................... ................................................................................ Plot ............................ Lot ................................ Permit G�6nted ...May...1.1.1...................19 R2 Date of inspection ....................................19 Date Completed ......................................19 w TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION (� E03 �0 Map V Parcel Application # /c� Health-Division Date Issued Z.. Conservation Division Application Fee fo Planning Dept. 7 Permit Fee Date Definitive Plan Approved by Planning Board pl $I Lh 2- Historic - OKH _Preservation / Hyannis Project Street Address Village c- Owner tc2g/ Cf-Abc- Address_/613-. 7-�+/fnw2i 45J Telephone °70,f 3 Z 32Z Permit RequestZ� /�dJ%�9ZL �- �z✓ ��uy-c� rory y� w,��y u� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio <QQ Construction Type n 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: O"'existing a new W,size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:a> �' Zoning Board of Appeals Authorization ❑ Appeal.# Recorded ❑ 4 Commercial ❑Yes ❑ No If yes, site plan review # Current.Use _ - _-Proposed Use _ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �� 14-/C Telephone Number f 360 Z?22/ Address /6 / tz, . 14d' License # Home Improvement Contractor# Worker's Compensation # ��J � �2�i -�'-/2• ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 171T7_2 t_-)o L-77-7 . SIGNATURE DATE / � �9 a` FOR OFFICIAL USE ONLY r, APPLICATION# DATE ISSUED :o: .t- r r MAP/PARCEL NO. t x ri ADDRESS VILLAGE OWNER DATE OF INSPECTION: -FOUNDATION FRAME INSULATION.= "z F' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL :GAS: ROUGH FINAL FINAL BUILDING Ott .DATE CLOSED OUT ij ASSOCIATION PLAN NO. S — ZAe Commonweakk of Massachusettrs _ 4 Department ofingiustrzal tceide�sts �w , y Qifice of fmveskgaiioirs -600 Washington Street Bostan,MA O2III X"mass gop/dia Workers' Compensation 14911tAn.ce Affidavit: Builders/Coati-actors/FIecfricians/Plumbers Amlicant Information Please Print Legibly -Name(Butt s;r/0rgauizadmVjn&vidvai):. D2,c�r ` City/State/Tip: 'PhoneA, _ TD/ a:> 9 Are you an employer?Check the appropriate bar: �,,L t -4. I am a : Type of project(required)::. J, 1 am a employer with ❑ general contractor and I, �,: . employees(M and/or part-time).*: have hired fe gut=cold actors b ❑New construction . 2.❑ I am a'sole proprietor or partner- d an the'attached sheet 7.! ❑RemDdeltng' ship and have no employees . These sub-coub actors have 0 Demnlifion working for me in:any capacity. moployees and have woriners' [No workers' comp.inamt nce comp,insurance.$ 9 ,❑ addition required.] 5.❑'We area cmParation and its I0:[]:Electrical repazrs or additions er 3.❑ I am a homeowner doing aIl.work officers have exercised their 11.❑Plumb*repairs or additions �ysel£[No workers'comp. right bf exemption per 1�lCI, iIIsyssnce required.]t c. 152,'§I(4),and we have no 12.0 Roofr' airs :.. employees.[No workers' 13 — D/e9 comp.insurance required] r Any applicant that checks biz#1 must also fill out the section below showing their worksrs'oompensation policy information t Homeowners who submit this affidavit indicating they ate doing all work and than hire outside contractors must submit a new of davitindicahng such. #Contractors that cberk this box most attached as additional sheet showing the name of the sub contractms mad state whether ornot those entities have ¢aployees. rf the sub-conto�Fs have employees,they mustprovidt their �wrlo rs'oov>p.polipynumber: I-am an employer that isproviding marker's'compensation insurance for my,employees. Belem is thepolicy and job site informaliorr, Insurance Company Name Policy#or Self ins.Lic.# /P�U[ 1� - _ 2'ri — rr� Job Site Address- ) S vytc�. ( }�� v Lriy/St Lwap � y!f�C,_ Attach a copy of the 777 workers'compensation policy declaration page'(showing the pnItcy:¢vvnber and tritium,date), Fathme to secm-e coves as re `coverage gutted under Section 25A ofNICiI c. 152 can lead to the iaiosiion of criminal p�altles'of a . fine tip.m$1,500.00 and/or one-year inzprisamnem,as.well as cin7 penalties in the farm of a STC3P WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statemezit may be forwarded to the Ofiice of Iuvesti Lions of the WA for insurance covers e verification .. of p Ida hereby certify under the pains•and penalties o er'u that the information raUided above is true'aad correct Si tar € Date_ZL �� Phone Offccial use only. Do not write in this Fe to be co leted mp by city or.town afjiciaL City orTowa: r' Per�%tll.icense#`' f` Issuing Authority ezccie one I.Board of Health 2.Building Department A.`Cit n ypn Clerk 4.Electrieal Inspector S.P1u ng Inspector; :>,< 6: Other Contact Person: • •'Phone#: � • , . I vi �"E Town of Barnstable Regulatory Services BARNIMMIM * Thomas F.Geiler,Director. �EpMp(A` Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,NM 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A.Builder I, 6, as Owner of the subject property hereby authorize 45✓1 c S.ren TY'/es to act on my behalf, in all matters relative to work authorized by this building permit.. , /b ySlmyu-I�iC �2�{ Suii� 3 C (Address of Job) **Pool fences and alarms are the responsibility of the.applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name 7.:Z3—/2- - Date Q:FORMS:OWNERPERMISSIONPOOLS . Restndted to. CSSl-11►S .Winfows ahid Sfdfng Massachusetts'-Department of PdbW S'afetY Board of Building Regulations and tanc4a�ds Construction Supervisor Speci:ltp License: C88L-100546 ERICSSON TORRkS 16 HOOVER ROAD 12 Failure to possess a current edition of the Massachusetts WEST YARMOiTH 02` 76 State Buiiding Code is cause for revocation of this license For DPs Licensing information visit: www:Mass.Gov/DPS J Expiration Commissioner 06/16/2014 u s: Dense or rbgists on al ar 2WE"lul u e o � E ` beforFatheexao �t �� 1ati�a` k�sifiessI�e t � ,k,,�p^r`v' . � '� t 'i '� t ✓�t`ra�'tx-TbYf�.ragr,��to�..S � �� L}fof L�opsum rltrs&B iness�ki guia x �7MErrtP OV'E€ T GO1TiGTORAN t g guy Flegistratto. ;�1 33 Sir TYe t t � y ; � k ,� i Ja7�} ivl's,T.iH1$' 'T'� 3� }.p * �•K"�" '. r `A'} 9 ^,kd'9 f3ehvfK ! { � � � ((( � N'ottva�l►d 'w`iou�'s►�ta�ttr� = ..pg .y�: IGSsO -e- M...h � RV E Ui F<s R1�IOU H YE}Z�3 —� � AL OA --7 (- NOTICE V H NOTICE n TO � TO O EMPLOYEES EMPLOYEES O,�M Svc The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 — http://www.mass.gov/dia As required by Massachusetts General Law, Chapter 152, Sections 21,22&30, this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY P.O. BOX 1450 MIDDLEBORO MA 02344-1450 ADDRESS OF INSURANCE COMPANY (7PJUB-4433P24-8-11 ) 11 -09-11 TO 11 -09-12 POLICY NUMBER EFFECTIVE DATES BRYDEN & SULLIVAN INS AG 88 FALMOUTH ROAD HYANNI S MA 02601 — NAME OF INSURANCE AGENT ADDRESS PHONE# op TORRES, -ERICSSON DBA 16 HOOVER ROAD ERICSSON HOME IMPROVEMENT 0= WEST YARMOUTH �— MA 02673 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE ^ MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER 002886 W20P1G02 YOU WISH TO OPEN A BUSINESS? V For Your Information: Business Certificates COST $30.00 for 4 years. A Business Certificate ONLY REGISTERS (WHICH YOU MUST DO BY M.G.L. - it does not give you permission to operate). You.must first obtain the YOUR NAME in the Town at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1'` FI.,.3b7 Main St., Hyannis, es 0260 necessary signatures on this form the Business Certificate that is required bylaw. 1(Town Hall) and get a'l,I-17GL e i C(s�/f/16 /L. Fill in please: APPLICANT'S DATE: NT'S YOUR NAME: YR � -es 011 BUSINESS YOUR HOME ADDRESS: o - I GS-9 NAME OF NEW BUSINESS TELEPHONE # Home Telephone Number: IS THIS A HOME OCCUPATION? � ' - TYPE OF BUSINESS f =' YES NO 1t�O Have you been given a _- / g approval from the building division? YES '/C NO ADDRESS OF BUSINESS kLICC1� �� 4'l� C �� MAP/PARCEL NUMBERaC)'LIC)� When starting a new business there are several things you must do in order to be in compliance with the rules Barnstable. This form is intended to assist you in obtaining the information you may need. ' You MUSTGO TO 2 g0ulations of the Town of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally Main St. — (corner of town. g ly operate your business in this 1. BUILDING COM ER'S OFFICE This individ al as n irR. r e of ny er it requirements that pertain to this type of business. Aut or�ed Signature* COMMENTS: �1� � 2. BOARD OF HEALTH This individual has en infor o the p rmit requirements that pertain to this type of business. COMMENTS: Authorized ignature** 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has e inform of e icensing requirements that pertain to this type of business. Aut orized Signature** COMMENTS: f Town of Barnstable °fI"E'0'Yti° Regulatory Services Thomas F.Geiler,Director lAxxSrASLE, 9q, '� �0g Building Division iOrEn MAC° Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 COMPLAINVINOUIRY REPORT Date: '7 — /s—dam- Rec'd by:_ Complaint Name: G�a�� LIi��GG Map/Parcel Location Address:. /J ! 6eW—Z L Originator Name: / Street: Village: State: Zip: Telephone: Complaint Description: FOR OFFICE USE ONLY Inspector's Action/Comments Dater G Z, Inspector: 41, Additional Info.Attached Q:forms:complaint JUL. ;5: 2002 WON) 13: 15 CENTERYILLE FIRE , 50879023R5 FACE. 1 I � ''i 'i IfVii, r. CENTERVILLI+,-OSTE.RVILLL-MARST®NS MILLS .FIRE DISTPJCI' DEPARTMENT OF FIRE-RESCUE&EMERGENCY SERVICES 1875 raimou.th Road,Rte,18 Centerville,MA 02532-3 i 1.7 Emergency Number: Business:(508)790-7-3So Facsimile: (508)790-2385 Glen S. Wilcox Fire Prevention Officer FAX COMMUNICATION MESSAGE DATE: July 15, 2002 TO: T.U.B. Building.Department PHONE: 508-790-6230 ATTN: FROM: FPO Glen S. WilCox COMMENTS: l ani forvmardi.ug alon his correspondrance T received today concerning the potential ptoblern that exists in Building of Bayberry Square Gundominiums, WE ARE SENDING PAGES,INCLUDING THIS COVER.SHEET, PLEASE CALL(508)790.2380 IF YOU DO NOT RECEIVE THE TOTAL NJJMI3BR OF PAGES. CONl+IDENTYALiTY NOTICE': 'This fax transmission may contain confidential infonnation belonging to the sender and such information is Iegally privileged and is intended only.for the use of the individual or entity mused above. Any copying,disclosure,distribution or dissemination Of"this infonnation or the taking of any action based m the contents of this cotTurminication is strictly prohibited. If you leave received this transmission in error,please notify us immediately by telephone and return the original transmission to us by rail or delivery at our address cbave. We shall cover the cost of.retum snail, Thank your JUL. 15. 2002 (VON) 13:16 CENT'ERVILLE FIRE 5087902385 PAGE. Q i First Property Management 892 Mai.ti Street,suite F Usterville, MA 02655 Telepllon,e 508-420-0299 Fax 508-420-0789 July 9, 2002 Mr. Allen White Bayberry Investors P,0- Box 979 Hyannis, MA G,2601 Dear Allen: As a follow up to my phone message of a few weeks ago, I am writing to again let you know that we are having problems with the tenants in Building E across from Tangles, The number of tenants in the unit exceeds capacity. They are working in the hallways and bathroom in the evenings. an at least one occasion,this prevented the cleaning people from doing their job and it has caused several of the other tenants in the building to become upset. In addition, there was a large amount of construction debris that was left behind the alit which we've cleansed up. Although we are not certain, we suspect this debris is from the unit. 1 suggest you reevaluate this tenancy it,order to come into compliance with the health and building codes. - Thank you for yc,ur cooperation. ere, 1 Andy Witter, ARM cc: Charles Case Brian Dac:ey Ga:-y Glafki Kath)een 'Vendola 10 6 THE TOWN OF BARNSTABLE MARNSTAELL O6 WL ' 3 9- 0M BUILDING INSPECTOR APPLICATION FOR PERMIT TO LIP& ................ .............................. TYPE OF CONSTRUCTION ........ P..... A..................................................... ......... 0........ .........19.73. TO THE INSPECTOR OF BUILDINGS: The undersigned'hereby applies for a permit according to the following information: ��..................................................................................................... Location . ..........e4v. ProposedUse ....C..... . .. ...... ...... 7................................................................ . .......... ........ Zoning District r....... ...... . ... ..5................. ............................Fire District .... Name of Owner . ........ .... a. ........ ...................................Address, ...2_.:�.... ... . ..... Name of Builder/)/( 4 ... ...... . .... ...Arl- .. :...............Address . . . . ........ ............. Name of Architect ...........................Address /W- Number of Rooms .......;F...................................................... Foundation �„/�A.r..Vtoms4v . ......... .... Exterior ..... ..........Roofing ......A/. .... .. ....... . . ............................... ............................................ Floors ......................................................................................Interior .... Heating ...4!51.. I....................................... ................Plumbing ........11.11F...... ... z..........a /0 71 ...........4..... .......................... Fireplace .....................................................................Approximate Cost .... o ................... ...... Definitive Plan Approved by Planning Board --------------------------------1'-' a 9 -------- Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH -V W Z , CO ®W U) 0 a < n Uj W z UA C) 0 U) L) LlF p 0-1 < CL LL1 C nz UR' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ..... ...... ....1. .................................. ' ^ , / � �. . / ./ | � . � / ' - � ` Sims, Robert F. commercial building Route 28 Centerville Owner Robert F. Sims ' 3 ' _ � . | � PERMIT. REFUSED ^ ` -------.--,----------- 1p � ~-------^-----------------'' ' ' . ' . _.-----~..----..----.---~----. . ' '--------------~----------'' \ � ' ---------------------.----. ' ' Approved ,'--------------- lQ ^ ---------------.--.----..---. - ` ---------------------'---^—` | PJ ' F m z 0 a V I r--- -- ---------------- I' r--- -- --------------- z B H 8 H - 1 4'Z' S'1" HA I - ... LL i HALL II 4._3..x 10._3.. i I I 4'-3"x 10'-3.. --=----------_ I ---------------J I o r-- ---- I BAT OFFICE BAT OFFICE - I_ ----------- 4._Z.x4._11.. 14._8..x 15-0.. J +J ——— J 14'8"x 15'4" ( P'-•,�.,. -------------- 4'7'x 4'-11' I� � zz Q I w O o--, It F LL to Y I� r 1� I 14 70 Sw 1 Mech. - II Mech.. - - STORAGE STORAGE 4. ;y 11'F'x 21'-Z' I 11'-5"x 21'2" HALL -•'' I` HALL 4'-11.1 x 19'-11" O E c OFFICE• 4 I I KITCHEN I K ILL. I 13'-1a'x 14'-11"- I I 06 �11'b x 14'-11" I. .I II UN ,I o m I UP .I o �I -: Mech. Mech. I Ik ¢ Mech777771 . Mech. I '. L_---------------� :I ---f-----i -------� t .FI Z i Wo LIVING AREA - - 'LIVING AREA - 1143 sq ft 1144 sq ft f Z Vm Existing Foundation Proposed Foundation DATE: 3/19/2013 SCALE: t SHEET: A-1 a� 0 z ' K L d 7 -7 OFFICE - ! OFFICE OFFICE - 14'-10"x 16-1" ! 8'-10"x 10'-9" 14'-10"x 16'1" O CLOSET L.L N CLOSET ^ CLOSET L - 2'S"x 4.-5" 2'b"x 4'-5" LL OFFICE OFFICE ! 14'-i 1"x 10'-101' 14'-11"x 10'-10" HALL HALL - 8'-10r'x 31,-T' 4'-T'x 20'-T' O O ++ 0 OFFICE �I - OFFICE U-) 14'-9"x 15'-Y 14'-9"x 15'-3' - V w OFFICE - UP �. OFFICE - UP G Cfl 14'-11"x 1 T-3" - 14'-11"x 11'-3' O z V d LIVING AREA f - - LIVING AREA - 1104 sq R _ 1104 sq R Z O 1st Floor Proposed 1st Floor DATE: 3/19/2013 SCALE: S"� SHEET: Ft � 9 F a o y m 0 V I � I _ I O - z y UTILITY - OFFICE L to'-8'•xtr-r. - OFFICE f 1o•-9•x11'-V OFFICE O . - 12'-t t"x 15, (( 12'-11"x 15'-01, - O LL O Y U EN EN m 4• 4'-a 111 4 4•-a 1 HALL 6'-1"x 8•-5" r1 DN 1 DN O OFFICE OFFICE 14•-11"x 22'-4" f 14'-11"x 22'-0" Q HALL _- - OPEN BELO 6'-1"x20'-2• OPEN BELO E - o (B STORAGE OFFICE - 6'-1"x1T-s' 1 OFFICE E LA ILL 1 z'a r'x 1s'a'; F u u f � � STORAGE STORAGE STORAGE STORAGE -. s�'xz-1a s-9 x2-1o" STORAGE STORAGE s 4 x2-1o" 5'-9'x2-1a STORAGE STORAGE 6'1"x 3'11'• - 6.$..x 3,_1 t.. 6'-1.,x 3.-11" 6B•'x 3'-11" Z LIVING AREA _ LIVING AREA - - ME1089 sq ft 1089 sq ft Z V m Existing 2nd Floor Proposed 2nd Floor DATE: 4 3/19/2013 f SCALE: I, y SHEET: r, A-3 .i I ; 4 3'Ks' r r � 4 u OFF 1 9� Gl x I Ll-O" �� a �hr11. T21v\, � i� 44 �t - OIL-DECAL.. 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