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HomeMy WebLinkAbout0062 GLENEAGLE DRIVE Yi 'Y l -t r k o o . u , Application number.............................. ............. 30-19 Date Issued...... ........ BAMNSTABLE, ° 163 �0i' i .r j Building Inspectors Initials.. D...-C-641-4- TOINN °fit bAHN6rABLE Map/Parcel...........1..�'1..�...��0.�............................... TOMW OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: �,,Z � ✓�ea s �r1/2_ �',, ,�;//.� NUMBER STREET VILLAGE Owner's Name: sl-e-/•e, Phone Number_ Email Address: Cell Phone Number Project cost$ E-O,Zcj Check one Residential Commercial O IER'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: 5e,e -4vWQ,P,a 06,414 Date: TYPE OF WOE ❑ iding ❑l Windows (no header change)# ❑ Insulation/Weatherization 21 Doors (no header change)# Commercial Doors require an inspector's review �— 4 P Roof(not applying more than 1 layer of shingles) Construction Debris will be going to o/r 1 1_ CONTRACTOR'S INFOI ATION Contractor's name IF)c an rya/M;-c e✓n - S vAe rn dfe_-mil Fr^l la, JI-n d o,,,w S Home Improvement Contractors Registration(if applicable)# 17 3 L.L[S (attach copy) Construction Supervisor's License# 01 S 7 07 (attach copy) Email of Contractor Q Soea 9 q5(6 6r►1q; I• C t M Phone number L/01- Z 2 R -9 X ao ALL PROPERTIES THAT HAVE STRUCTURES VER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a:for profit non-profit event Check one:Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a health Department approval between the hours of 8:00am-9.30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES x Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:front back left side right side ROMEOWNER,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 PLICAIOTT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. I Renewal Agreement Document and Payment Terms Andersen. dba:Renewal 4 Andersen of Southern New England _ Steve Goveia MI.CE.M Legal Name:Southern New England Windows,LLC 62 Gleneagle Drive RI#36079,MA#173245,CT#06345551 Lead Firm#1237. Centerville;MA 02632 10 Reservoir Rd I Smithfield,RI 02917 H:5087714518 Phone:.866-563-2235 1 Fax:A01-633-6602 I sales®renewalsne.com' Buyer(s) Name: Steve Goveia Contract Date: 01/10/19 Buyer(s) Street Address: 62 Gleneagle Drive,Centerville,MA 02632 : : Primary Telephone, 5087714518 Number: Secondary Telephone Number: Primary Email: Secondary Email; Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a. Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any.documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference,(collectively,this",Agreement"). Buyers)hereby'agrees to sign a completion certificate after'Contractor has completed all work under this Agreement. Total Job Amount: $5,020' By signing this Agreement;you acknowledge that the.Balance Due and:the Amount Financed must be made by personal check,bank check',credit card,or'cash Deposit Received: $1,676 Balance Due: $3,353 Estimated Start: Estimated Completion: Amount Financed: $0 4 to 6 weeks 4 to 6bweeks . Method of Payment: Cash/Check. We schedule installations based on the date of the signed contract and secondarily on the date in which:we complete the technical measurements.The installation date that we.are providing at this time is only an estimate.We will communicate an official date and time at a later date.Rain and eztreme.weather are the most common causes for: delay.. Notes: Deposit of$1676 up front balance due upon install Buyers)agrees and understands that this Agreemett constitutes'the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both'the Buyer(s).and Contractor. Buyer(s)hereby acknowledges that Buyers) 1) has:read this Agreement, understands the terms of this Agreement;and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,:on the date first written above and2)was orally informed of Buyer's right to cancel this Agreement: Y NOTICE TO BUYER: Do not sign this contract if blank.'You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER,.MAY CANCEL THIS TRANSACTION AT ANYTIME NOT LATER THAN MIDNIGHT OF 01/14/2019 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER:DATE IS LATER:SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT." Legal Name:Southern New England Windows,LLC dbai Rene n rsen o£Southern New England '.. Buyer(s) Signature of Sales Person: Signature'. Signature Paul Conboy Steve Goveia Print-Name of Sales Person. Print Name Print Name UPDATED; 01/10/19 Page.2 I Office of Consumer Affairs and Business Regulation 1000 Washington Street -,Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS,LLC Registration: 173245 10 RESERVOIR ROAD Expiration: 09/18/2020 SMITHFIELD, RI 02917 Update Address and Return Card. SCA 20M-05117 ..%/.Fiv;za%�i,u`ea.!l/ Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:SuDelement Card before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business.Regulation 173245 09/18/2020 1000 Washington Street-Suite 710 SOUTHERN NEW ENGLAND WINDOWS.LLC Boston,MA 0211 i 1 v BRIANDENNISON 10 RESERVOIR ROAD U SMITHFIELD,RI 02917 Undersecretary rove d®I with®ut signature y , Commonwealth of Massachuseti.s Division of Professional Licensure Beard of Building Regulations and Standards Construction Supiprvisor CS-095707 _ - E_X i res : 09/08/2020 RIAN D DENNISON 8 BLACKWELL-1 DRIVE CHARLTON MA -01507 Awl A- Commissioner CIL ® 1 1 r The Coinnioi<twealth of Massachusetts �'- Department of Industrial Accidents r. I Con,-,ress Stree4 Suite 100 Boston,MA 07114-2017 www mass.gOVI&A NVorkers'Compensation insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERNIITTLNG AUTHORITY. Applicant Information / Please Print Legibly Name(Business Orr2anizatiorOndividual): �e Jh e r r, Oleo Address: O S UDl r [z>c1 `►— City/State/Zip: m l-f4 eld.R! DZg l] Phone k 410/—ZZ Are yo an employer"Check the appropriate box: � Type of project(required): 1. 1 am a employer with �� mployees(roll and/or part-time).* 7. New Construction 2. 1 am a sole proprietor or partnership and have no employees working for me in ace S: Remodeling any cap acity.ty.[P!o workers'comp.insurance required.] 3.[J 1 am a homeowner doing all work myself.(No workers'comp.insurance required.]T 9• ❑Demolition 4.[]I am a homeowner and will be hiring contractors to conduct all work on m property. 10 Building,addition Y P Pent. [will ensure that all contractors either have workers'compensation insurance or are sole I I.[]Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.01 am a general contractor and I have hired the sub-contractors listed on the attached sheet These sub-contractors have employees and have workers'comp.insurance.* 13.Q Roof repairs 6Q We are a corporation and its officers have exercised their right of exemption per NIGG c. 14. Other �i 1 Qp r 152,§1(4),and we have no employees.(No workers'comp.insurance required.] r42 01 *Any applicant that checks box 41 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•conautors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providin;workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: � 5_ (� l.W'Ct/L °� CO • O� �, /�. (i . Policy#or Self-ins.Lic.#:—N/C R l ,r 7 2 S L Expiration Date: Job Site Address: 41 C le i ea _1p 6 City/State/Zip: MA Attach a copy of the workers'compensation policy declaration page(showing the policy number and expire 'on date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A_copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certi under the poi penalties of perjury that the information provided above is true and correct Sianature: Date: Phone#: 4 n 1 T2� 9O Official use only. Do not write in this arery to be completed by city or town ojflciat City or Town: PermitMeense# 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#: i ac�� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 1 212 8/201 8 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 CoBiz Insurance, Inc.-CO NAME: 1401 Lawrence St., Ste. 1200 IAIC. o E t: 303-988-0446 IX No:303-988-0804 Denver CO 80202 E-MAIL ADDRESS: COMail@cobizinsurance.com INSURERS)AFFORDING COVERAGE NAIC# INSURERA:Acadia Insurance Company 31325 INSURED ESLERCO-01 Southern New England Windows, LLC. -INSURERS:Firemens Insurance Company of WA,D.C. 21784 dba Renewal by Andersen of Southern New England INSURER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER 0: Smithfield RI 02917 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:787175890 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE NSR1ADDL SUBR . POLICY EFF POLICY EXP INSn POLICY NUMBER MM/DD/YYYY MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CPA31SB728 1/1/2019 1/1/2020 EACH OCCURRENCE $1,ODO,000 CLAIMS-MADE a OCCUR DAMAGE TO RENTEU-- PREM SES Ea occurrence $300,ODO IVIED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000' GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY❑ $2,000,000 X JE T LOC • PRODUCTS•COMPIOP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY CPA3158728 1/1/2019 1/1/2020 COMBINED SINGLE LIMIT Ea accident $1 000 000 X ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per person) $ , AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ A X UMBRELLA LIAB X OCCUR CPA3158728 1/1/2019 1/1/2020 EACH OCCURRENCE $15,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $15,000.000 DED I X I RETENTION$ $ B WORKERS COMPENSATION WCA315872924 1/1/2019 1/1/2020 AND EMPLOYERS'LIABILITY YIN X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? FN] E.L.EACH ACCIDENT NIA $1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Pollution Liability 7930073340000 1/1/2019 1/1/2020 Each Occurrence, $2,DOD,000 Claims-Made Policy Aggregate - $2,000,000 Retroactive Date 06/20/2013 Deductible $25,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. FOR INFORMATIONAL PURPOSES ONLY AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD WE Town of Barn *Permit# 30 lY ti� 8 ntordhs froiu issue dote he Regulatory Servicesa uanntsMULF, ; SEP o Richard V.Scali,Director 2017 i639- � BuNillg MASI� Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 0260I S www_town.bamstable.ma.us �r r O 6 Office: 508-862-4038 ®w�7 Q�r� Fax: 508-790-6230 �7APArn— EXPRESS PER112IT APPLICATION - RESIDENTIAI. ® NEV.- Not Valid without Red X-Press Imprint Map/parcel Number /r// 4/o l Property Address 1 GIPn P�<l �Oit �l✓� �Izesidential Value of Work$ ? -2j Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address S4c✓e Go ✓e a 6 2- 61e1 ea g�� �P�TP�✓r./�e7 6 3 Z ( r' le h ne Number O 1 2 Contractor's Name 'n�c7,,1 2?/1 // so/( Te p o �� Home Improvement Contractor License#(if applicable) 3 Z L( S Email: Construction Supervisor's License#(if applicable) 06T 7 D OaWorkman's Compensation Insurance - - Check one: ❑ I am a sole proprietor ❑ m the Homeowner I have Worker's Compensation Insurance Insurance Company Name ; P aM fl.� Workman's Comp.Policy# W C 8 *3 1,5"8 7 2.9 2 D Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) side ❑ Replacement Windows/doors/sliders:U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: issuance of this permit does not exempt compliance«ith other town department regulations,i.e.Historic.Conservation,etc. ***Note: Property _wner must sign Property Owner Letter of Permission. A copy the Home Improvement Contractors License&Construction Supervisors License is require SIGNATURE: C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.0utlook\2P101 DHR\EXPRESS.doc (J [revised 040215 �/ `ieriewal Agreement-Document.and Payment Terms bAtldelSeCl. dba:Renewal By Andersen of Southern New England'. Stephen Goveia Legal Name:Southern New England Windows,.LLC 62 Gleneagle Dr RI#36079,MA'#173245,CT#0634555, Lead Firm#1237: Centerville,MA 02•632 WIDOW 8r ....... 26 Albion Rd I Lincoln,RI 02865 - - -' H:(508)771=4518 Phone:866-563-2235 1 Fax:401-633-6602 1 sales®reriewalsne.com Buyer(s)Name: Stephen Govela Contract Date: 08/24/17 Buyer(s)Street Address: 62 Gleneagle Dr; Centerville; MA 02632. Primary Telephone Number:'(508)771=4518: Secondary Telephone Number:.'. Primary Email: . Secondary Email; Buyer(s)hereby jointly and severally agrees to purchase the products•and/or.services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorpporated herein by reference(collectively,this"Agreement'). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under•this Agreement. Total Job Amount: . ' $7,391.. By signing this Agreement;you:acknowledge that the Balance Due;and the Amount Financed must be made.by personal"check;bank check;credit card,or cash.. Deposit Received: : $21`463 Balance Due: $4,92$ Estimated Start: Estimated Completion: Amount Financed:.. $0 6 to 8 weeks 6 to 8 weeks Method of Payment. Cash/Check We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical'measurements.The installation date that' ' weave providing at this time is only an estimate.We.wily communicate an official date and.time at a later date..Rain.and extreme"weather are.the'most common causes for delay. Notes: Deposit of $2463 up front balance due upon. install" Buyer(s)agrees and understands that this Agreement constitutes.the entire understandings between the-parties and that.there are no verbal.. understandings changing or modifying any of the terms of thisAgr&rnent.No alterations to or deviations froth this Agreement will be valid without.the signed,.written consent of both the Buyers)and Contractor.Buyers)hereby acknowledges that Buyer(s)-1'):has read this Agreement,understands the terms of this Agreement;and has received a completed,signed,and dated "copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and2)was orally informed of Buyer's right to cancel this Agreement: NOTICE TO BUYER:Do.not sign this contract if blank.'You are entitled to a copy of the.contract at the time you sign. YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANYTIME NOT:LATER THAN MIDNIGHT'- OF 08/28/2017 OR THE THIRD BUSINESS DAY AFTER THE.DATE OF THIS TRANSACTION, WHICHEVER'DATE IS LATER:SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN. EXPLANATION OF THIS RIGHT..* Legal Name:Southern.New England Windows,.LLC. . dba:Rene}v A ersen of uthern New England Buyet(s) - Signature of Sales Person Signature Signature Paul Conboy Stephen Goveia Prinr Name of Sales Person Print Name Print Name UPDATED: 08/24/17 Page'2./ 11 f Massachusetts Department of Public Safet,i Board of Building Regulations and Standar s License-. CS-095707 BRIAN D DENNISON 7 LAMBS POND CIRCLE �. CHARLTON MA 01507 =- =x r3ticn: �OfnCltSSlOner O8i08i2018 7a,ii ~ ula0 — � aLustness � Q . � Bi,)stori, NlassacctLseus _. T�cL,z Tr,prcvement rcrtractor ReCrisLatio Aegistrabon: 173245 Type: Supplement Card _ _ = =--Oration: 909/20iE SOUTHERN INIEVV ENGLAND WINDOWS-LL BRIAN DENNISON 26 ALSION RD _-------- LINCOLN, RI P2869 -------------— Uudnte.iddr-ss:md return'arti . - — of i.Asi Card `= (Gce of Cnosvmer Atfays s 8asiuess +mL�dnn- Nwistmtion-talid for indn idual ase uni;'ue`nre dte' . _,: :.. ., s�piration:late if fo®d:etum tu. .'OME IMPROVEMENT CCNTRACTCR 'Jfrc gP,ausumcr.-,,Tair-aad 3winus.3e'ga dine Registradon i?3245 T'.tpe: t0Par[:Pl:rct-SWM51;0 r .. c-,piratlon._9f1912013 Supplement Gard $mtun.%L\9211S SOUT,HERN NE'N ENGL\ND'N_INDOINS L LC. _ 9ENEWAL 3y ANDERSON _ BRIAN DENNISON - uNCOLN.RI 02865 '-UnderseME31ry Not v atone i .. The Commonwealth of jllassachusetts Department of Industrial_Accidents 1 Congress Street, Suite 100 I1� c O Boston,:VIA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/ElectriciansiTiumbers. TO BE FILED WITH THE PERNUTTLNG AUTHORITY. Applicant Information Please Print Legibly Name. 'Nam (Business/OrganizatiorvIndividual): E e� Address: 2& AL- uakp City/State/Zip: N Phone #: O� Are you an employer'Check the appropriate box: Type of project(required): II am a employer with Zo temployees(full and/or part-time).` New construction 2.17 I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity. [No workers'comp.insurance required.; 9. ❑Demolition 3.[]l am a homeowner doing all work myself. [No workers'comp. insurance required.! ]0 F1 Building addition 4.[_�I am a homeowner and g will be hiring contractors to conduct all work on my property. I will either have workers'coin ensation insurance or are sole 11.Q Electrical repairs or additions ensure that all contractors p proprietors with no employees. 12.❑Plumbing repairs or additions i 5.❑i am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.' /J j 14. Other 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. r 1527 61 C4),and we have no employees.[No workers'comp.insurance r equired.) P�R Cd►'�Bn S li 'Any applicant that checks box g! must also fill out he section below showing their workers compensation policy information. 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: Fire me S Ips. / — Policy#Or Self-ins.Lic.#: ,3t 7 Z'q — i 0 Expiration Date: ! f Job Site Address: 4 2 Gee e a r• City/State/Zip: T,mvi l to HA Attach a copy of the workers' compensa ion police declaration page(showing the policy number and expi tion date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a aninct e virator.A co of this statement ma be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certify under the ains and penalties of perjury that the information provided above is true and correct. Si atum oe Date: 5 Phone#: 2-2. 6?__ Wy Official use only. Do not write in this area, to be completed by city or town official. Citv or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r ESLERCO-01 SANDERSO DATE JMM/07120/7 T) CERTIFICATE OF LIABILITY INSURANCE or�o71017 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). PRODACT UCER COME_ AX CoBiz Insurance,Inc.-CO PHONE 303 988-0446 (,C,No):(303)9t3�13 804 1401 Lawrence St,Ste.1200 late,No,6d):( ) Denver,CO 80202 EDDR COMail@cobizinsurance.com ADDRESS: INSURERS AFFORDING COVERAGE AIC 9 INSURERA:Acadia Insurance Company 5 INSURED INSURER B:Firemens Insurance Company of WA D.C. 21784 Southern New England Windows,LLC.dba Renewal by INSURER C:Libert_ySurplus Insurance 10725 Andersen of Southern New England 26 Albion Road,Suite 1 INSURER D: Lincoln,RI 02865 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO INDICATED. NOTWITHSTANDINGTIFY ANT THE Y REQUIREMENT, TERM LISTEDIES OF INSURANCE OR CONDITION OF ANY CON ISSUED THE OTHER DOCUMENT ABOVE POLICY 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 NCE INSD ADDLSUBR POLICY NUMBER POLICY EFF Mao EXP LIMITS L TYPE OF INSURANCE INSD WVD 1,000,000 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 CLAIMS MADE ❑X OCCUR CPA3158728 01/01/2017 01/01/2018 PREMIDA SES E TO RENTED 300,000 PREMI E Ea acanence $ - MEDEXP An one erson 5 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 PR�- PRODUCTS-COMP/OP AGG S 2,000,000 X POLICY❑JECT ED LOC 2,DOQ;000 EBL AGGREGATE 5 OTHER: COMBINED SINGLE LIMIT S 110W 000 A AUTOMOBILE LIABILITY Ea a.dem X ANY AUTO CPA3158728 01/01/2017 01/01/2018 BODILY INJURY Per person) 5 OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS PROPERTY DAMAGE HIRED NON-OWNED Per accident 5 AUTOS ONLY AUTOS ONLY S I 1,000,000 A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE CPA3158728 01/01/2017 01/01/2018 AGGREGATE S 0 Aggregate 5 1,000,000 DEC) X RETENTIONS PER OTH- B WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY Y/N WCA3158729-20 01/0112017 01/01/2018 1,000,000 ANY PROPRIETORIPARTNER/EXECUTIVE E.L EA ACCIDENT S %F.RCER/MEMBER EXCLUDED? NIA 1,000,000 IMandatory m NH) E.L.DISEASE-EA EMPLOYE 5 If yes,describe untler ,000,000 DESCRIPTION OF OPERATIONS below E.L.EL DISEASE-POLICY LIMIT S CA3158730-20 01/01/2017 01/0112018 1,000,000 B Worker's Compensabo 1,000,000 0110112017 01/0112018 DESCRIPTION 7 SC Workers OPERATIONS ERATIO S I LO ncludes-All spates ORexcept NDdiOH WA a�S�ule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLAE'Y PROVISIONS. AUTHORIZED REPRESENTATIVE I F R IntormafinlPr ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Town of Barnstable Expires 6 nwnths fr (n issue(late Regulatory Services Fee = snaxsTnBM MASS.t6 9. Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,.Hyannis,MA 02601 www.town.Barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Q t Not Valid without Red X-Press Imprint Map/parcel Number 1 .� Property Address G��n ec� �l`1 f`�- Ce r kryi f e .M6, Residential Value of Work y , 4-�-V•00 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address _C+(14,n C bo ye-(`Gl Contractor's Name Telephone.Number�/�- Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable)-- �­ ❑Workman'sCompensationInsurance ®PRESSPERMIT Check one: ❑ I, �lna -mole proprietor D E C .1 d 2009 LL`fam the Homeowner ❑ I have Worker's Compensation Insurance TOWN.OF gARIVSTAB .E Insurance Company Name Workman's Comp.Policy#. Copy of Insurance Compliance tertificate,must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors Replacement Windows/doors/sliders.U-Value `,1.33 (maximum.44)#of windows r *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Cont c ors License&Construction Supervisors License is require SIGNATURE: C:\Usersklecollik\AppData\Local\M erosoft\Windows\Temporary Internet Files\Content.Outlook\4STGU5QO\EXPRESS.doc Revised 090809 Zhe Commonweakh of Mkssadnia etzs Deparhume of lndusdrid Acddenis O&e.of Investigations 600 Washington Street Boston,MA 02111 M"Rutas-govlditr Workers' Compensatioulnurance,Affidavits Bu deis/ContractorstElectrician/Plumbers Aumiicant Information ( Please Print Lesiblu Name(e,�sraess/organ zatianlla�vidnat}: %'/%�' P4,r+ c Fie Address: City/Sta /Zip: Fh�l�a�`}'�1 /l^c: O�S-qd Phone# Aree you an employer?Checkthe appropriate box: Type of project(required):1.❑ i am a employer with 4. I am a general and I b: E]New construction employees(full and/or pact-time).* have hired the sub-cont:actols 2.❑ I am a sole proprietor or partner listed on the attached sheet. 7 Remodeling These sab4mnt actors have ship and have no employees S_ ❑Demolition working for me is any capacity- employees and have wo ' [No worirers'comp_insurance comp.insvragoe.1. 9. ❑Budding addition 5. 0 We we a corporation and its 10•❑Electrical repmirs.or additions 3.[� I nd a homeowner doing all work officers have exercised their I Ln Plumbing,repairs or additions s'comp. ri myself[No workers of exemption per MGL 12 insurance y c. 152,§1(4),and'sehaveno ❑Poofrepaits employe.[No viorl�' 1-3.0 Other comp.insurance required.] ` Y apP that checks boa#I nag also till oat the section below shoeing their lwaeterV campensatim policy bdon�stica T Aomeowaers wbo submit this affidavit inilkating0ey are doing all work and then Lire outside co"mrs M submit a new afdwit mikCating such. ;Cant<araoas that check this box must attached nu additional dim shoving the nsme of Poo sub-coutmcian and sta6e robed er OF not those eniit@es have employees. If the sub-contmctors bate employees,they must provide their wakers'comp.policy autnber_ I ant an employer that is proWd ug workers'con gr madon insurance for my entployeet.:Below is die policy ald job site information. Insurance Company Name: /A Policy#or Self-ins.I.ic.# N//}- Expiration Date: r Job Site Address:- City/State/Zip-- Attach a copy of the workers'compensation policy declaration page(showing the policy number andvxpirationdate). 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 aL STOP WORK ORDERand a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to f}le-Office of Investigations of the.DIA for in a ra ce coverage verification I do here cirri ender s and onalfies %' ,qyLahe in orntation rodrided above is hue and correctby fy > I p Si Bate. a Phone# Qa'idal usa only. Do not write in thisarea,to be completed by city or town officiaL City or Torun: PeramitUcense# Issuing Authority(circle one); L Board of Health Z.Building Department.3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: a - Imp- Town of Barnstable, Regulatory Services t AIMBARM REAM ' Thomas F.Geiler,Director ,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 HOMEOWNER LICENSE'EXEMPTION 1 \^ Please Print d'0 DATE: l�1 g I 0 JOB LOCATION: U G I /1 Cic\�1� 6r11 V _ Cep i'1n'i') number /' stree village "HOMEOWNER": S k-p]`en 6oV p ex —7 "I]:SI T name // home phone# work phone# CURRENT MAILING ADDRESS: CD I"P.Y1 P.e s Le- 2 n 0 a 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. 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 the buildingpermit (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 Barnstable Building Department minimum inspection procedures require ants d ft h he will comply with said procedures and requirements. SignaKv of H eowner 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-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act gs 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) This 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 a 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. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\4STGU5QO\MWRESS.doc Revised 090809 ° THE TOwti Town of Barnstable Regulatory Services BAMSrABLL ' Thomas F.Geller,Director Muss. 9�AT i639. a`e� Building Division Ep '� MA Ralph Crossen,Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 SHED REGISTRATION Location of shed(addr ss) Village S e R, 6D8 - 77/ Propefty owner's name Telephone number Size of Shed Map/Parcel# eg Signature Date Hyannis Main Street Waterfront Historic District? /y Old King's Highway Historic District Commission jurisdiction? Vd Conservation Commission(signature required) 0 s- 0 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg C_ ___._ 1 � � ----------------- - __ -- ---------- jf -- STANDARD LEGEND NOTE:rant all symbols will appear``on o map ------ - _ _ I .=4 GOLF COURSE FAIRWAY EDGE OF D€CiDUOUSsFR EES ' EDGE OF BRUSH P19 60 I i j 1` if r' ORCHARD OR NURSERY l EDGE OF CONIFEROUS TREES 72 MARSH AREA J ' ' EDGE OF WATER 11191 - - 4_ DIRT ROAD IV' •` —OR EWAY -1 KING LOT V_r - = PAVED ROAD DRAINAGE DITCH PATH/TRAM. r--- - -- C PA L LINE #RE $ na s------MAP# 2 E---PARCEL NUN EtER i �" '�' �. �T '. •! HOUSE NUMBER r 10 All a�P 2 FOOT CONTOUR LINE i l ^M i �11 f \�1 ^t i r. — — 10 FOOT CONTOUR LINE E a� /// Elevation based on NGVO29 l 4.9 SPOT ELEVATION 11 STONE WAII FENCE . ! ' ---------- RETAININ6 WALL I r RAiL ROAD TRACK jSTONE JETTY 42 �411 j 1 1 SWIMM NG POOL PORCH/DECK BUILDING/STRUCTURE DOCK/PIER ( HYDRANT J AP 19 lP E? VALVE 0 NrtiMNOtE i 1 I2'1 o POST pR FIAS PDIE T O W M 0 6 B A R db E T A ! l 9- O f O O R A P N I C 1 M S O a M A T 1 O N S V S T E M S O M I T o SKit1 Sim DRAIN r PRMWED ME:t%R(T *NOTE:This map is on enler9e ow of a **NOTE: DATA SOURCES:PlMm nvo(maa-made owum)were O WW here 1995 aerial Fiwto 1*6 by The tomes i"=MY stale map ad may NOT rtrmet W.S"d Compmry.TopWgN oad vapetotioo ware Wap M bow 1989 aerial pb000pphs by 6E01) 0 ffDUIY POLE m TOWER " ` 0 10 QO Nmioeol Alap ACCaofy 9ndads Dt ft dD rro±repowt ooml reEationsteps to physiml objects Cmpomtian.Mniv lria,EOFography,and mars-- -k-— _ v eat b ara9 Naliooeidap pttaaatyStandards - —----- i t It10i=e0 FEET* enka�d ws a+pie map. at o stale of i`=IOIi'.Patai Emes via digitiRd hem 200D Term of Aomst�e Assessa's tac maps. d U&IEE POLE o ELECTRIC 80% _J j HAg80 344 Yarmouth Rd. 259 Queen Anne Rd.' Hyannis, MA 02601 Harwich, MA 02645 r �o �y (508) 771-5007 (508) 430-2800 01)PROVio 1-800-368-SHED SOLD BY DATE NAME n1 - f19 aL ADDRESS CITY � BUILT BY lz� A.,,Ag o,)6 :?2, C O:Q _ PAtOQUi-. DE). ACCT DESCRIPTION AMOUNT SIZE 0 ` �-- STYLE LEFT GABLE RIGHT GABLE SHINGLE fyJ� i r-A . 'OPTIONS / w w FRONT DELIVERY . DIRECTIONS TAX BACK CUSTOMER SIGNATURE TOTALS CHECK# if TOWN-OF BARNSTABLE BUILDING�PERMIT APPLICATION Map 9 1 Parcel A Permit# Health Division LM 2c �1_yam.. it 10- NOV 6 Z001 Date Issued Conservation Division 1 , Fee 2• 33- Tax Coll as r Treure � t t Jn SEPTJC YS�E � ,�ti 'NISTALLED IN CCd�pLI Planning ept. IWITH TiTLF Date Definitive Plan Approved by Planning Board $' ^.°" I t l FINAL ; Historic-OKH• Preservation/Hyannis Project Street Address (n C� ax-\ Village Owner Address 'Qb a Telephone S©,g -9f-4-1 =1--I�j/g Permit Request � �o ,._O ! X ) e sL�ck1 C\��car_ Square feet: 1st floor: existing � proposed 2nd floor: existing proposed Total new 1-7 6 Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type C->- Lot Size 5 � Grandfathered:1 ❑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 °1p new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other 1 F • Central Air: ❑Yes VNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes (XNo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size k Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ •x Commercial ❑Yes ❑No If yes,site plan review# Current Use ` - - Proposed Use SL R CLL I - BUILDER INFORMATION Name p+T1C�x_T kk(X Q C0,9L Telephone Number �O? -0 L4 o6 Address License# �)c�,L C ")•,�� 0 C_4-(00 Home Improvement Contractor# Worker's Compensation#3t)W1RCGV:T_ lsC1a� ALL CONSTRUCTION DEBRIS RESULTINQ FRO THIS PROJECT WILL BETAKEN TO A C_—, ( QcJ E'� t - ;a1 5 Ail) SIGNATURE DATE /d .ZI/ d� FOR OFFICIAL USE ONLY v PERMIT NO. DATE ISSUED t _ MAP/PARCEL NO. , y E _ • - i VILLAGE yr` • 't � . � t ADDRESS OWNER DATE OF INSPECTIORfi FOUNDATION FRAME , INSOLATION , FIREPLACE, ry a ELECTRICAL_ : ROUGH FINAL , PLUMBING: _"'ROUGH .' FINAL GAS: _ ROUGH. y- FINAL FINAL BUILDING DATE CLOSED OUT } r ASSOCIATION PLAN NO. s ` The Commonwealth of Massachusetts Department of Industrial Accidents { = 0 greollatresu�at�oas 6 Washington Street 00 -s` •�'� _"=�.-- Boston,Mass. 02111 € _ t keys' Com ensation Insurance davit �� //� ,,,••••� ation' r (� a lv 3 hone ����. 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As quoted or written. •:ire, express or implied, two or more of co oration or other legal entity, or any �, BSSOCi3Li0II, rP � �^� A� ,?nployer is defined as an individual,p the legal representatives of a deceased employer, or the rec-elve or ed in a joint enterprise, and including } emp}ogees. However the owner of a foregoing engaged 1 entity, employing house of asso and�=sideS tbereu1,or the occupant of the dwelling ;tee of an individual,partnership, house or on the grounds or -Ming house having not more than three apartmentscc or repair work an such dwelling �taer who emPloy�persons to do maintenance, be deemed to bean employer. 1�g app��t thereto Shall not because�such e�npl� a issuance or renewal ;. . ,. ..,. a. a en shall withhold the "state or locid licensing g c9 Iicant who has 1L chapter 152 section 25 also states•that o construct bwldin&s in the commonwealth for a PIIe e a license or permit to operate a harm ce coverage requesed. Additionally, produced acceptable evidence of compliance with any cosmact forthe p�rmance of public work until of its political subdivisions shall U of this have been presented to the con=--=g :;;monwealth nos'any presen zrotable evidence of compliance with the insurance req horny. �%z ��%z/ ; is an �pIican Gplctcly�by chsclang the.box that applies to your sitzsaa inky be ease fill in the workers' campeasanoa hers along with a certificate of insurance as all affidavits ma• .ppiy�many names,address and phone Also be sure to sign and of Indus-ialAcc canfi � application for the permit or license is omitted to the Department to the city or toara that the aPP m the affidavit The affidavit should be rem Mmuld 9�have MY =regarding the "law"or if you m,requested,not the Depar neat of b&suW Ac dam' caIl the Departsneat at the mmnber listed below. required to obtain aasatiaap /, ;;; a workers camp / /���;, /! 'ity or Towns e of the TI>t Department provided a space at vrt is casnpleoe and hlY to contact you regarding the applies Please :rase be sure that m�eveaithe Off=of abet. The affidavits may be rid io Ydavrt for You a mmnber which w�be used as a�� sure to fill in the p have been.i3 h w Department by mafi or FAX unless other m3ngcm Office of Inyestigati°us would Ike to thank you is advance for You cooperation and should you have any questions. :esse do not hesitate to give a caII. MORONI ; rum, 0111 jg��� tel and fax msmber: a Departinces address, ePw The Commonwealth OstMal Accidents assachusetts Department ofIur UMCIS of UNDS lDaUoas • 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 ext 406, 409 or 375 . The Town of Barnstable UgrISiABI.E. ' $ Health Safety and Eo v><ronmental Services Department of s639• Building Division lED MA'S 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-862-4038 Building Commissioner Fax: 508-790-6230 Permit no. Date-.,, AFTMAVIT 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: � ���''C 0 c\s C� Estimated Cost Address of Work:(D a Gr Owner's Name: A' Date of Application: A2 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law r3ob Under$1.000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH NR DO NOT HAVE CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK c. 142A. ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UND R SIGNED UNDER PENAL F I hereby a ply for a permit as the agent of the owner. ZI Registration No. Date Contractor Name OR Date Owner's Name a:forms:Affidav k r.���:1. D 01�"� : id v rasur_�c..J•:... �......_.._.J.r.��.r r....rw:.l J� _ [.Y../: ._rL_� _ .'�.'l�•..G�G+d�Z:A-�i r. � 4ss��enuset� 5fare3uildr��T'Gaffe (iO`C T -� ec m T: . -----__ �...._= __..._..•..-...:- '-'- en S Tne Ma3sac}iu3 —L,3 Stu:-'` ?uildinff CDd /780 Ctf?l ; iD °' }�1.� i lC L 'eS P!Y' s t"J nsur 0 li: 'OTi o' and nOtise additions -meet tnt erilcien Sianalards. T "S' 5L to :31 COi�)V'l�r:� It:C��alC� ?} =� �F), Ile.. i C M iS i0 De :Iled as Dom! C i?e DLiIdiP.Q fit-' it a ?llCai:C .T,' a v:_'lCe'%0. u^`Cr Q,' I _JicCvYr:z3r tons-muC'-in z/i n.st Ilirt� a Ilouse aCCiiilOil :"'Till t'eiy lame Uei e77i2?- OI a!?SS to CD'aCllle wall, SCCI S t0 Li111Ze a D cIal 0rle-?Y consB t'aiiO m-p' txe io QQ?IQI1 TOi li]-OO T1 vGli' Appt�ldiY T, SaCiiorl Jl.l_?.3.I}. This CP,.'f iS not Ii_ .l ad iC 7rCYvz!n a^hO;jieC i�t�r - __ iro i seI�ciing a r:jtOQt.:tT CZ °'V SiZ COi tlt_- `1Qn Cllf„I✓:_ a << _ _ e or i C_s% Oi co—, t_C__'On C- D'tC rit Ala :- 7T_, ra`njp IS r,�}•.r - .�?l, �t a,mot C)n' .(. _ti .'.3 1_�1 J��7`+'__ _.a_ u_....._.I :g a .lun J^i( a'`.11 �_,L��Si-�c 'tC1 _,."I 'f .�I :i::)�;L va �.tI'V% l�iv_;�'>i ii}il;�!_. _.3i ci ii V:.'.e�JY'�:��L ___1�• __. _ �;1 ..._....�. ��_�. _ ..v:uLL '7. Cri: "iC- is�iIns a:1enD a yti i•:J,�titt i; �..�,_t-IT .�:j'.I�;I l,.at C^: tr-� t[� h L S" L. LJ C '%LIt 4% eC-r jC.ja OO IOt S T't j ��'` ✓` IIY O_j _,t,�ju! ,�7 TJC Cr CC - ) Ore- `C -rni; �_a.` s v aj .aCLCj, __ _ .. _.' P'v. L!tial _ -��' �.c._ 1 _ uiscomLojl iS 2CS•. i l 3f1QILIO 1T LL2C rliali ICa'fOi?S an. -' DuiaiIOI] CT h Cmmp'any of ;-dividu lc -'r eir d a-!5 I 1poiiamt Coil SidCratiOr1S_ PRODUCT AND .DES'"GN.C.QNSrDEx2A�.T ONTQ I u T A•ru D n "S C07� S>' Solar Orlcntafio.I itud Na4ural shadily , ZT.%cr GnZ1=,. d �i t�`c�- r ri r., :j' i nr '3 1ng' an. asketi 1: ii..a iI`a s/seal .1 t-n.D;.,ity 8u�_�.. pit°'SS oI,Ele Sim ri F'C1G "I - aQE 2iZ''r ijiii2CIQ 1 - CI)C-'lil` WIIICIOWS and taps a insulation 1--vel EP, i-1 orSt walls, and CCilb%?aS " _ S .., ... iJ'Jiil2J_t_~r, __ >e _a? __ , u �i t x n'z1 drzli`ci c.o= ar s Iid-_ '-ibme wnCr h.ck-r-1 1-11 in— Ti' MaSSRr-huSC ._ S'Lai? Buiidii- CCdC, S�c6o-n-.1:_1.23.1, C'. itGi :iiC ,r-jcr'S �g?r.t or r� ,res n a i��j aC.,-,o� i, <irC IL) oI U. �C(DIN.SUI« x: Cx C'-'? C �Vi�riQr .Q issuanC� 02 a Jli11CiiI?? P Crnlii for, a p-Oj'c.,: 'l;at j:nCIUrC " " Cif` `in? -J S St_iliOOil7 a ILIOL S O'.._II CX:S. CSiQ-Si:_;al jt_ti 1I �_ it accord'an 'r'_iil. il2ls i'C'111rC71Ci] iC '?il l-SiSI��Cl IiC.'Cj}% 3Cr'v 0+'JIC��CS l2` i-iC iC ti=S ; d3 1n� =^._`1,'T;a`t•,j1 t `}]i j'�^�.i"?`_'_:+ �vT.�C-'': �� ..r''^i... _.....✓rt Si?ila u, t A tuaJ:3--, i-1J %ii i D;- r rTi.^.: t%` AdrJt �io� --SS Oi�ermn: 0 rz:1�1114c'xro, oc? oC 32— 77115-1 - Ov IPr t'':.Q—3S fif ;I?Iv-�i t _ii 1171,i'O}C i 'OCc ii•Cii) CY'flvl `elCp C 1�. ltl: :jai ki'f�Y�AiiALL�lA[ L�Ffa� uli�IIII'CJO.ZIls£i't!.rys:,a.,`.,'� .... Lam+ ... .. Except€o' Sunroorrz dd fi.ons_/_C.o.nstiiiiei'.N,oti cationT;:Sunrooms, as deigned in 780.CMR . hppsii3l.x 12:o I I"IrQi I'JG72��, 1.��t1 t is exur� ryf itcai:i7 t a col, m-nts setfo,dq in igo CIVIL J1.I:.Z.3[l and J1.1,3 thai.tl.e actual. xoi?erty ovmeer (not.tie owner's agent or represer!tative) of the Structure onto V il:Ch-u'le SunrooJm additioA 15 beL-g made, provides 3 SlgIIed copy o�the S=oorti "CONSliN—' RTINTOR.IvLA iION FORIM" (fou-nd in 780 CMR, Appendix B) to the Building J7epar`i~n nt. T his si-ri-d "CONSU vi-'R'i KFORMAT£ON FOFLM'' shall be S?�liliried to the UL'iiding oiiicial aS a req'iiir=.?tnt of buif ding pt, :?it SSLanc- and Si_11 re_ua 11 as f�- rl"l? ��'1Ci^i'7 Cl'Y /lil^'�?1� fC p -- - a`,vallj1and are condition,-d spaces, ti-Itin a rCadil j' aCCCSSi7iC rnazival or aut-m-latic i%�aIIS Sha !De �i'JVEt.la Lv ✓ ' i.=11+ i�J!..a.�'L. �i. s" ut of 1IP:2,'.�t nz A7? t t-'T' _!% Y_??r i:! _Z 61�i `�I����./y1i!'i Q;7?.^.QQYTS _ M2_ _ mot: e'.. a. r.r _,_ ��1- ._ __�f.., „ l .1.�. l i!iL Dili Li oLi o1 u •..-..J. i.l.1C�'.1.J:�✓:-,=L''� _ ..Ju.i fi ve i+ .--__ ,___ __...___ _... _. _.ice ,..__ ; -n��li V t. _I I� 'f I _�__�_`� :...+_ '.)1 1'}•_ _ JLI C_J _.i ._.__'JV ... I.v1 1 ._.l a._.., �a.iC ui+ ^ V� 7 7„ ....: 'mil �.i'V� -,.f"'1'"/'/1 i't-•��i lei '_7`"___✓� �� _,..LL - ..�... VL __✓ _v1... _._,.-t-"' _L .. .. 1C";D_ _)_. ��_ mil. �V�F�� � F � i tr C YF 1.5,.. C � J CSG LIS_L.'4 �"i✓.l �L.T '�'Y�ti". �'1r,'-�', ? �> ..�. ::.� •__..j 1^s, ..- .ti-'_...._.. _..._.._.._._.____''_ .ram_.__.,.....i_ 3�C TT / .J A_ .Z .' >U1vROOryl: P,_ ` i ;.I i„7loi%Jetii_ L ll vJl,czt thti total a Eta (rG" i o�v . (7�J.G_'T1iJi1 i.o ZIl c`'Ii� !P� DU _ or taut dimemsions) Of 21%�d fci?-stratiori pJ-odUCts of 3 a,id addii'ioi' .CeadS 0% Of the COutb1 ed ,oSS J ail a rk C�liiI?.� aXca ri 1ic c7r�ii t Ji7. ��¢*tl-r L'�C'S-�L`C� �J•t"ji >S k�C.F.E:�.xn.�ti.*�t.'i e�c_.t F.�— U@'�. € r%::_�.:..._��!,�.�1`Z,..x Q 5'C'o_' d�.'���"t�.e r`a.,..Y,>�` �:L.�� ..,zap �''� ��. ,,,_, �r [:`"�c.m {,...t< h' �. - --n.�'-, ".�Y,,:�[,..ti �. ..'Tit'F..�•zu'-��X.l-rwYfc'7�-�r..h�..a�cn.'�'�C.^�'C'_!_� �n w�'.-+.4� L t � cLt�..�CL�_� �Rf �i 1YTt"'r)P•r1P4�F+CC."T� �''?�1:_G 4FOL A•�_tir•Ll' �'f`3 `�eI�iL�e.F��;��_C �:E f�.��`�� R&5�i0���.-� '5.17�"� TY�-s_r� n_n�f'�,,r...5.,t^-tu�-^- t�r•"_z�5..',.�'a`L�""��''�'e3o-`,. 1 A ifdard of Building Regulations and.Fta, wrys =,'t` License or registration valid for inaividul use only €,` =) HOME IMPROVEMENT COiiTie<C T OR bEhUre the expiration date. r xp a.tion d f.3uno re uri.ta: Pegistration 125168 Board of Building�RegulatAors and St_r dGrds Expiration '1,0/2.1/03 Or.eAshburton Place lFn 107!. Type Private Corporation ' Boston,Ma.021,08E PATIO ROOMS Or-.BO.STON.IN.0 ANDREWS MALONE- -'' 100 OTIS ST NORTHBOROUGH, MA 01532 — - -- Adarini9t,atar Not valid without signature — p l 3 BOARc O BUILDING REGULATION License: CONS;-RUCTION SUPERVISOR Number: CS 070998 n�i €i�967 G ,.,�, -- oir st 02120/2003 .Tr.no: 7227 Restricted To 1.G ANDREWT MALONE 41 WASHINGTON S T-#2 � NATICK, MA 101763 Administrator .�� Atli-31'40»E 1 p5 00, MAP 191, PARC 161 62 GLENEAGLE D I VE h SHED .N h DECK / �• EX, HOME N 4.9 CO 0 2974 cQ of N 1V 11;31.40On G�ENEq 1 os o0 GCE OR/V E CER TIFIED PL 0 T PLAN GOVEIA RESIDENCE I CERTIFY THAT THE IMPROVEMENTS SHOWN of w 62 GLENEAGLE DRIVE HAVE BEEN LOCATED WITH AN INSTRUMENT �P�t� Assoc CENTERVILLE, MA t� tiG DATE. OCT 26, 2001 DRAWN: RBS SURVEY. i ROBB JOB # E00215 o SYKES SCALE 1"=30' No. 35418 ti EASTBOUND LAND SURVEYING, INC. �ss� IL LAND 5 ' P.O. Box 1836 ROBB SYKES, RLS. DATE 41 Meetinghouse Lane Sagamore Beach, MA 02562 EXI5fl C4 61 Poce From NOUSE P , MOP05W NEW P7 CK 16'0'(AMOX) I6' I,2X8 PT MAME @ 16"O.C. 2.LWaP,6afW I/2"X5"LACE-52"O,C, 3,J015f I•IA CU5 @ LE UP, 4,(2) 2X8 PT TIM LtAM5 5,WI,J015T5 AT Wa OF ROOM 6,178L 5IM J015f5 �,5/4"X 6"Pf MCKING 8,(8) 12"O X 48"WV FIC6 W/ANCNGZ5 9,3/4"f&G PLY OVEI:LAY OB" 10 6X6 P05T5 16 k----11'-2" II.STABS PPOP05W 3 W,50N VCVCN II'X 16'0WFP.OX) 5TUn10 5111.E ENCL051., 6"EP5+ N POOF 5MM (16 5PAN) NEW 6' VOT From POPICN (NOf 5N0WN IN - TNI5VIEW) P NEW 6'DOGf: From POPICN =I I� _I � I �� I I I I—I I—I — � � � •" ' _—I� —I I� ICI I�I T�I I—I—I I I I I� II kll ll�ll cll�ll � II E I I 1 1�11111 1 IIfs IIII I Ir�� III r— I In ICI I I 'I I� II II I�II_II� � II J� rill, I 11, III I 7 —II III II ,Fir STApS& LJ LJ LJ LJ LJ LJ - - FAILING NOC 5HOM FOf2 . CLAPIIY. STAIp&PAIL ; A ® 36"NIGH PAIL O I I"•11?EAI� t all pa 4"IWU5fM 5PACE - Project; Scale:1/8"=11 -0" 17rawing etterl iving 60VNA F�51PFNCF 62 GIENMGLE WK A- BPATIO ROOMS CENTVVILLE,MA02652 100 Otis Street Nothboro,MA 01532 Phone(508)393 0400 Fax(508)393 0340 bate:10/30/01 Sleet I of I .r LAYOUT f LANS WALL SECTIONS EXISTING BUILDING 96.75" F 96.75" e re, •,t- (MAX) .3 (MAX) .-. r —57" 63" inz y „ Z `} (51 o � T 5TUD10 51DE WALL(A) STUDIO 51DE WALL(C) p a I- - ASSEMBLY DETAILS s E 4`. ALUM.PANEL,HANGER 6i e s CONNECTS TO WALL STUDS OR ROOF RAFTERS a 96.75" SEE ALLOWABLE LOAD-1.{' +f ' e, UM DM (MAX) 0 TABLE FOR PANEL SIZES 63"x78"D 57"x78"D 63"x78"DIc "-- " B WALL MINIMUM SLOPE 1.12 � �z �� GC —� 16'2"— I GUT(ER FASCIA— STUDIO FLOOR PLAN HE<ADEK SUPPORT BEAM NOT TO SCALE - ( ) STUDIO FRONT WALL(B) TRANSOM(OPTIONAL) ALUM.SLIDING ALLOWABLE LIVE LOAD TABLE FOR 17 FT. PANEL. WITH 16 OR 55 51'AN DOOR OR WINDOWI---- 20 P5F 25 P5F 30 PSF 35 i'5F 40 P5F 45 PSF 50 FSF 55 PSF 60 P5F 6 4.5"HC 4.5"HG 45"HC{ fi 4: 11 t-H 4.5"HC+H 6"HCl H 6"HC+H 6"HC TEMPEREDGLA5S +H SLIDING DOOR ON 511- 's 4 I 4.5 EP5+I I •545 EP51LI,., 6"EP50-1 6"EI'5+I-I 6"EP5-rl 6"EPSi-li +�"°�ij1311f�1j' r„ SECTION WffH DOOR -- V£ �o>'• F Ile W flq, Pop, STUDIO CONSTRUCTION ' ,*o�•" y FLOOR CHANNEL 4 t 10.ABBREVIATIONS ?hv CAAIG p 0 1.STRUCTURAL MEMBER5'SMALL COMPRISE 4.WIND LOADS=20 P5F =v 1 dOt1M m c — 6063 T6ALUMINUM EXI'RU510N5 PROVIDED FOR 80 MPH EXPOSURE A,B,C D DOOP e•, a cross DECK/SLAB-- -- Dlvl=DOOR MUI LION No 9551 r. 4 4 , 5.DEAD LOADS=5 P5F TYPICAL S I UDIO SECTION BY CRAFT Bll;f MANUFACTURING COMPANY. 6.DOOR AND WINDOW LOCATIONS W WINDOW,., 30�'�,c ,SE° 2.ALLOWABLEL'OA05 ARE BA5EO.UPON WM WINDOW MULLION P .Fu NOT TO.5CALE THE LESSOR.OF THE ULTIMATE LOAD/2.5 ARE INTERCHANGEABLE. U' lJ CHANNEL ��'' SS OMfIA ';<<`' 'N OR THE LOAD AT SPAN/120. 7.GLASS KNEE WALLS ARE I IC=FIONEYCOMfi PANELS , f — ZN OF M1tq� t PPOJECT: CONTRACTOR: FIC/EP5 REFERS TO CRAFT-BIL'f 5'fRUCTURAI- INTERCHANGEABLE WITH PANELS. EP5=POLYSTYRENE PANELS PANELS WITH ALUMINUM SKINS BONDED TO 8.WIDTH OF B-WALL MAY VARY PEP, H=;THERMALLY-BROKEN CTIAIG J. f 16-0ff X 1(5 -nn I IONEYGOMB/POLYSTYRENE COPES(3 4/z" DOOR/WINDOW LAYOUT UPTO 24FT. ALUM FI-STIFFENER doss ;,I' L 0/H=OVERHANG �a �7RUCNRAL AND6"THICKNESSES.. 9.AUTFIORIZEDFORBETTERLIVING 40324 h, STUDIO ENCL SURE t : PSF=POUNDS/5Q.FOOT DWG NO.: DEALER USE ONLY. q Pie yF DRAWIJ BY:CJJ GENERAL LAYOUT ADJACENT PANELS ARE CONNECTED USING P=PANEL 'o�F sC(STrF/<; g em50 16x16.dwg FT=FEET y' yoy±i,.. VINYL CLEATS OR Hs. SCALE:1"=50" PATE:11/27/2000 ALUM.=ALUMINUM riF't S 7� e t N11 v13¢O.,E 4 105 00, L( i \ t( MAP 191, PARCEL 161 ' 62 GLENEAGLE DRIVE '<o ISHED N h DEC —y 24.96 EX, HOME N N C t 29.74 cp / I ' Al 1 31 g00 145.00. 'I VIE GOVEIA RESIDENCE I CERTIFY THAT THE IMPROVEMENTS SHOWN of w4 62 GLENEAGLE DRIVE HAVE BEEN LOCATED WITH AN INSTRUMENT ��P s194, CENTERVILLE,. MA SURVEY. DATE: OCT 26, 20011 DRAWiv: RBS ROBE SCALE. 1"=30 JOB * E00215 o SYKES ; ' No. 35418 "' a EASTBOUND *LAND SURVEYING, INC. 40-2�"d `�ssioy�STS LA o s P.O. Box 1836 ROBB SYKES, RLS. DATE 41 Meetinghouse Lane Sagamore Beach, MA 02562 EXISTING 61 POOH ` FROM 0115� PI21GPG5fPNEW PECf 16.0,(AP'Wx) 16' 1,2X8 PT FP,AME 16"O.C. 2,LEPGE210LTEP I/2"X5"Lf�32"O.C. 3.J015TVNG °5 Co I.EPo 4.(2) 2X8 PT TVIPLE 1EAM5 all5,111.J015T5 AT EPC Gr 10010 ! 6,211.512E-Vi5T5 T 5/G"X 6"Pt IrGJNG 8,<8) I Z"pl PEEP NC6 W/AN0'&vK5 �� 9.3/4"T&G PLY OVE AY "- _S -CB 10,6X6 P05T5 � 11, 9:,2�� i I PI:OP05EP 3 5EA50N PCFGj I I'X 16'(AM,0)( 5MPI0 STYLE ENCLCIU°E 6"E1`5+ N PGO"r 5Y51Em �6'SP,�IJ1 NEW 6'POGP_ n �I \ FpOM P02CN (NOf 5HOVVN IN THIS VIEW) - FrOM POM-1 -ml � I I f -!-I �� i-{ rill lull i t i! Ili I_I I i I� I;I I I II I' =1 ±!-III=III=III=I i 1=I l=1 i :I I= ,Till I l t is a rl l I �I I -IIL- kill II=III II�111� III-III !III rim cll��l l IL i!illl I III IF I i If-11N ( -il�II�III-� ;'�=null'=IIN Fiji!Ililllllil�,����I �I_�I • II ��ir- II :�=1 � 11-IL�.II ,IIEI �!: LJ LJ LJ .LJ 51AIP.5& LJ LJ PAILING NON 51.10VV I FM aAPITY 5f,qir o 36"'NIGNP AIL �! . II"tPEAP 8"n15E 4"1ALU5V\5PACE Project: 5cale:1/8"-1'-0" Prawina: e r i i BPAt -H® ROOMS 62 GIENEAGLE PPNE I 1 CENTE'P,VILLc,!v>r102632 , 100 Otis Street Nothboro,MA 01532 Phone(508)393 G400 Fax(508)393 0340 Pat 10/30/01 51 ee 1 of I 1 - - > I _ i\ .; n �> XN C r O� 7. oCU> c> Qp- n � c j> vn O S �G Off' r l - r n 0 >I lc \ C V cC c'n cSi S a J >T"OJ�' � v > O I IGIICi� M O 117�iIICil - - O� � C� ��OGi C11 I � Iz � !� rn J - r Cn sn z pI�ISIC S= Ill =7' p Ip's q -< N _ Z.0-r CDt'i Gl n II =n�c cJ Cz_D `-m�Ga S y J>> m c- C .r. �.IN Z — M. s a I�i o jI Ifl III o II I ICI ill of ! \21 �` III i IIJ >III _.-'I'oA I if i �I� II p n II v: �. :t! Off•_ ��' �C c _ {� m o c co 1� - G z T _ Z T. o s > 713 ,i,� I > Zx S W'v I i aII p•ESA,N �\�_ _ - !II � III : i�I i JUN-04-20 1 11:34 EL HAPUEY AND SONS IP,JC 1 800 212 C1300 P.r2 AFrIMVZT acc0r-da-ce with t=cla ? SeLticn '_ . 1.3 0= e -.�._.'tet 5-i^ s ��'�='s'_A. fapP'"_ ,._ sir:.3=?Y a '- _ _ w.1 n b.V _roper.iv ail S�osad c- N 1 = s d! Ti;a- - "...:.9T1 S=n -Rrij?4� �5 o5 J �_ �"tr r�t=T. 1` _ _ 7 S L_Jil } RR Q • L lqA t3q PV I N T M P ri �rd t --M- oy _p .�l it -zT F w I I i id M �A w (R �E 135) 1 _it �v 5�4 _ f i a1ilG 1?T iy Pr vi -=S Lt t�v T ✓+ i'I r 12, IS9 '-tipi?-: th ICade _0rce_ zm_ acting lu-zde= Chat_w Y4art clr' 73 J to i85 YVOrC�SL? Kev Asa t 0a:d ae-.ri S g-anerated, as a :c7asu t of F�i's p e=i L-_ The�nroof fro2!11c' l.Z.C2="�S 9� sY�asal racility `ontain_ng be z©llowirzg �prmat_on. esc*_ tiC�u o= the debris, t-.he wsi get =��� veWu�te of the e :-?is o.sa= =a. vy PCa1`J`_ l,FLSL a Isc) na-2 a' sig-na`.ure 0i the ©WTi the disposals .facil?ty` ail--re to CCai lyr W-I la tl�a =S I�rho 1_c a 4 5 �= 1i1 T Ce nn by TOTAL P.02 4 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 4`0, 00 N g � Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE _��square feet x$96/sq.foot_ x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x W/sq.foot= x.0031= plus from below(if applicable) r ACCESSORY STRUCTURE>120 sq.ftj >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 r >750 sf-1000 sf 75.00 E >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= 30 , D (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee projcost 10/( C P6 ���V k 3 1 Assessor's map and lot number . . /......... SEPTIC SYSTEM M S B INSTALLED IN COMPLIANCE � � �g WITH ARTICLE 11 STATE Sewage Permit number [ SANITARY CODE AND. TOWN. REGULATIONS, .`"_. - °Ft"Er° TOWN OF BARNSTABLE i BARNSTABLE• i r 9� OyYa`�� �t.: RU;IL®,ING INSPECTOR APPLICATION FOR PERMIT TO .cM. � ... ... ... ..... .! ........... TYPE OF CONSTRUCTION .4 ,,! . ... ..' ..�. .. ... ... ....�............ 1...........................19`�, . a TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fo p rmit according t e following infor ion: Location ..........ZO.T ..06. ........ ........ JILJ...V „r..................................... .... ................................. ProposedUse .... .... .... . ` ....... . ... . ....................................................................................... ZoningDistrict ...... .................................................................Fire District ...........,................. .......=11D............................ Name of Owner .. ��` �°�- `�°�'�` ."�'t° . ""9t Address ........................... .................. Nameof Builder ..........`.................................. .....................Address .................................................................................... Nameof Architect ..................................................................Address ................ .......................................,....................... Numberof Rooms ...........................��..... ............... .............Foundation ....... .. . . ........................................... Exierior .............. �.t?.,C�... ..................Roofing .......... . . .. . .. .. ........................................ Floorss�/. . .....................................Interior ............... 1. I�.1. .................................. Heating ...............4..f:........... ........................Plumbing ..........................0 ...... ut5 Fireplace .................... . ... ,>............................................ Approximate Cost ........... ........................ Definitive Plan Approved by Planning Board ___________�=_LC______19_`l Z, Area ...../.!t..(;Y. .................. Diagram of Lot and Building with Dimensions F `S ee -......... ...... ................ SUBJECT TO APPROVAL OF BOARD OF HEALTH l � xzz. = C;2v I 3Y t I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... ..... ............ ....... .... ..................... Breen, Joseph No .1 .... Permit for 1 1/2 s ry ..... ............ single family dwelling r ............�................................................ ................. Location Gleneagle Dx-lve .................................... .................... Centerville Owner Joseph Breen Type of Construction frame ................................................................................ 4 'Plot ......................... . Lot ...............bp.......... + Permit Granted .......... .g:5t..9... ..........19 73 Date of Inspection ... y AAb *1,7 7, Date Completed ............ ............'.............19 E r, PERMIT REFUSED f� ................................................................. 19 T ............. .................................. ......................... e ............................................................................... v Approved ................................................ 19 ............................................................................... .................... ......................................................... i r