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HomeMy WebLinkAbout0236 GLENEAGLE DRIVE .: .. e o �" 4� � �. ,�. ,. of i '` y ° .� 6 . ,. ., - _ ,1 1 ' o�T"E,, Town of Barnstable *Permitt Ae IT Regulatory Services Iw�ere 6mont/rsf�missrredate .t►`�� 1 9 2013 Thomas F.Geiler,Director -Building Division TOWN OF BEARNSTAft Verry,CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barns table.ma.us Office: 508-862-4038 EXPRESS PERMIT APPLICATION Fax: 508-790-6230 - RESIDENTIAL ONLY y Not YaGlI without Red X-Press Imprint Map/parcel Number Pro erry Address ti Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address t Contractor's Name `�,J/}�—_ r +�-�,F Telephone Number t Home Improvement Contractor License#(if applicable) _ // Cons uction Supervisor's License# if applicable) orkman's Compensation Insurance r Check one: ❑ 1 am a sole proprietor RI am the Homeowner I have Worker's Compensation Insurance Insurance Company Name ' Workrnan's Comp.Policy#--562& �-;/ 9'r"��/ Copy of Insurance Compliance ertficate must accompany each permit. Permit Request heck box) } Re-roof(stripping old shingles)'All construction debris will be taken tom/ 'Y� � 1��% ❑Re-roof(not stripping. Going over existing layers of roof) 3 ❑ Re=side #of doors ❑ Replacement Windows/doors/sliders. U-Valuey (maximum .44)#of windows "Where required: Issuance of this permit does not exempt compliance with other town department regulations,'i,e.Historic,Conservation,etc. . ***Note: , Property Owner must sign Property Owner Letter of Permission: A copy of the Home Improvement Contractors License& Construction Supervisors License is required GNATURE: tf^C�p�FC... 2F `• � y tYTE€"�e lv,"JE Y AR t ONt-R x i i la.'� Y'. �*. �ff;':a v�i Si g*,�i$ail i�qf fboo;073 i,,...j:ft r. •. OfT a. �. tx. St+sLYEe,^��iD.rt •F�V[�.1 Fkt Y t � ` ton 4 v Y q ; f�`ce �i,:it`sz,�u t•4-0 '"". ������ x a � e+�w}'7�".�� EfJ -a J` + °�z �s;y�'�• -. +�h t i� 1 ---r.�T� .. i c p r� � 4' 4zi � �_<s:,� r i€zf,,, f ��,s'a i;y,s= �: r � .r�ec rja'�+' ° ��si�•" 3.�..e'` r 6 d. IS OEMmw h � s�, ae ��o-�k �.` `�'1x4 x�r � z � ,�A � s�r`��"�-z, ��t� c���t4 f:•� ]"� t ;�{ ,..�4�.� ,: c � `�R.9�c �Lx, ruf 0. r' RAVELERS J ' WORKERS COMPENSATION :. . AND - EMPLOYERS,LIABILITY.POLICY 1YPE AR INFOR(MaTI®f+l RAG'E WC;OO 0001 ( A) POLICY,NUMBER: (6KUB-4861 P48.-8-1.2) RENEWAL OF (6KUB-4861 P48,=8-.11 ) INSURER: THE TRAVELERS .INDEMNITY COMPANY 1. NCGI CQ:COD.E: 11347 INSURED: PRODUCER DANFORTH, DAMES DBA PAUL PETERS AGENCY INC JAMES DANFORTH REMODELING - '680 FALMOUTH ROAD PO BOX 973 . MASHPEE.:Mq 02649 COTUIT MA 02635 Insured is AN INDIVIDUAL Other work places and identification numbers are shown in the schedule(s) attached. 11 - 2. The policy period is from 09-29-12 to 09729-13 12 01 A M at the insured'smailsng address. 3. A. (WORKERS COMPENSATION INSURANCE t PartOne of the;policy applies to the.-Workers- Compensation Law of the state(s) listed here: MA B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy,applies to work in each state listed in item 3.A. The limits of ourliabiiity under Part Two are: Bodily injury by Accident: $ 100000 Each Accident Bodily Injury. by Disease: $ 500000'Polity,limit; Bodily�lnjury by`Djsease $ 100000Each Ernpic.,aer" , {; = ; .,x� °av a w ' a i A !, .ra � �� � .; ^F�A�, :-5�#"n� ter" '�,;, '� 3�y��^��„s; } .g"'.:-< C. 0" HER STATES INSURANCE: Part Three of the policy applies to the states; if any, listed he COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A D. This policy includes these endorsements and'schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE ' 4. The-premium for this policy,will be.determined by our Manualsof Rules, Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY. - DATE OF ISSUE: 08-23-12 CP ST ASSIGN: MA OF ICE ORLANDO INDUS AFF 161 PRODUCER: PAUL PETERS AGENCY INC 28LBR 68 0 7 F. , t ' . The Commonwealth of Massachusetts ; Department of Industrial Accidents ' Office of Investigations ' 1,1i 1 600 Washington Street ffi -Boston, MA 02111 www.mass ov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors Alicant Informa /Electricians/Plumbers tion Please Print Le ibl Name(Business/Organ-zation/Individual) Address: -- City/State/Zip: �f .�' Phone ( 117 Are you an employer?Check the appropriate box: ---- Type of project(required):I.❑ 1 am a employer with I 4. E I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors b ❑New construction 2.❑ I am a sole proprietor or partner-. listed on the attached sheet.`1 7: ❑Remodeling , ship and have no employees These sub-contractors have 8, (] Demolition working for me in any capacity, workers' comp. insurance: [No workers comp. S. 9, ❑Building addition ' p ❑ We are a corporation and its required.] officers havE exercised their' 10•�Electrical repairs or additions 3.0 1 am a homeowner doing all work right of exemption per MGL i I.El Plumbing repairs or additions myself.(No workers' comp. - c. 152, §1(4),and we have no 12oof repairs insurance required.]t employees.[No workers' -- comp, insurance required.] 13.[]Other *Any applicant that checks box#l 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, tContractors that check this box must attached an additional sheet showing the name ofthe sub-contractors and their workers'comp,policy information. 1 am an employer that is providing workers'compensation insurance or f my employees Below is the policy and job site information. Insurance Company Name: j < Policy#or Self-ins. Lic. ;Expiration Date Job Site Address: a!J(� _ ,( / � / ' �L/ City/State/Zip:v 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification, I do hereby ce 'y under, en s and alties of perjury that the information provided above is'true and correct Si attire. 'Date: Phone#:' Official use only. Do not write in this area,to be completed by,city or' own 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 Construction Supervisor Home Improvement License Number#008267 Contractor Registration#114813 OSHA Approved Member of the Better Business Bureau Home Phone#508 420-5131 CELL PHONE#508 280-0802 ESTIMATE JAMES DANFORTH P.O.BOX 973 COTUIT, MA. 02635 Ann Marie 236 Glen Eagle Drive Centerville, MA. August 14, 2013 Work to be completed on the entire house garage and breezeway roofs. Remove the existing roofing shingles. Install 8" aluminum drip edge at the roof eaves. Install ice and water shield 3ft. up onto the roof, and in valleys. Install a 151b. felt paper over the remaining roof sheathing, from the top of the ice and water shield to the roof ridge. Install a 30-year Architectural type roofing shingle, using CertainTeed Landmark, j which are algae resistant shingles. Color Moire Black Shingle weight is 240lbs. per square. The standard wind warranty is 110M.P.H. I will use CertainTeed starter shingles'along the roof eaves and rakes, I will also use CertainTeed shadow ridge for the roof caps, over the.ridge vent. This process will increase the wind warranty to 130M.P.H. Install new aluminum vent pipe flashing. Install a ridge vent on all roof peaks, using Air Vent Shingle Vent 11. House and shrubs to be covered with tarps while work is in progress. Removal of rubbish. Material and labor $5,500.00 This price includes the building permit. Insurance certificate will be issued prior to the start of the job. There is a limited lifetime manufactures warranty on the shingles. I will provide a seven year warranty against any roof leaks. All materials are guaranteed to be as specified.All work to be completed in a workmanlike manner according to standards practice.Any alteration or deviation from above specifications involving extra cost will become an extra charge above the estimate.Our workers are fully covered by Workman's Compensation Insurance. DATE OF ACCEPTANCE / CUSTOMER SIGNATURE,- CONTRACTOR SIGNATURE Efficient Buildings, LLC t October 31, 2011 Town of Barnstable B ;. Attn. Thomas Perry, C O 200 Main Street Hyannis, MA 02601 re: 236 Gleneagle Drive,Centerville, MA '02632_ Dear Mr. Perry: This affidavit is to certify that all work completed at 236 Gleneagle Drive, Centerville, MA 02632;-has been inspected by a certified Building Performance Institute (BPI) inspector. Work included air sealing, weatherstripping, insulation of attic hatch, and 646 sq. ft. of R-30 cellulose blown into attic:'--All =' work performed meets or exceeds Federal and State requirements. Sincerely, Steve C. White Owner/Managing Member. b Efficient Buildings, LLC e 8 Jan Sebastian Drive, Unit 10, Sandwich, MA 02563 Tel: 508-888-1110 Fax: 508-888-1169 i• S � TOWN OF BAR NSTABLE BUILDING PERMIT APPLICATION I ApMap � Parcel— plication # Health Division Date Issued ;1 Conservation Division Application Fee Planning Dept. Permit Fees Date Definitive Plan Approved by Planning Board 0 gI9Il o�� Historic - OKH Preservation/ Hyannis Project Street Address ke- U) Village �.✓( �� id - Owner Address 0Qwc Telephone h Permit Request �r I C c� e oco L'a .s os�i o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation a` S� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family VK Two Family ❑ Multi-Family units) Age of Existing Structure Historic House: ❑Yes H 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 Rim Count`- o Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woodAcoal stov' ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ t isting gFnewsize Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 1`J e--- w M 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 U�e`'� j��fi� k �4C�b�� S Telephone Number `L T(12 � Address 142 0-l"00A� 14 A, License# �d3 ti S 6 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEB R ESULTING FROM THIS PROJECT WILL BE TAKEN TO �rS SIGNATURE DATE 3 -`® l FOR OFFICIAL USE ONLY APPLICATION# ` DATE ISSUED 5 t :MAP/PARCEL NO. r _ • ADDRESS VILLAGE OWNER y • DATE OF INSPECTION: " FOUNDATION a G;.w s t FRAME w :`INSULATION t _ " FIREPLACE ELECTRICAL: ROUGH FINAL .j PLUMBING: ROUGH FINAL GAS--., ROUGH �� .. . v;<. FINAL _t _ 16 .F IN'AL BU#LD.ING ` Y. •aAk.71 r` DATE CLOSEQ OUT t ASSOCIATION PLAN NO.` ,•r T17e-Common wealth-of Massachusetts , ,Department oflndiustrialAccidenfs.r 1 a Office of hiveseigations 600"Washington Street t Boston, 14�A 02111 yy www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 06 c (/ Address: City/St e/Zip: cd-(. Phone #: Off'~^o2 Are u an employer? eck the appropriate box: �. Type of p toroject(required): l. I am a employer with �" 4 ❑ I am a general contractor and I P Y r 6.� New construction ' eiriployees­(full and/or part-time).* hav,e'hued the sub-contractors.. _ 2.ElI 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 ca act ' employees and have workers' Y P h'• 9. Building addition No workers' comp. insurance comp. insurance.1 required.] ,5.^Q'We are a corporation and its "{10 [❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp: s_`;,. right of exemption per MGL 12'[] f repai s. . insurance required.] t c..1.52, §1(4), and we have no employees. (No workers' l3. Other_ (/�$e� GZ comp. imurance,requiredl *Any applicant that checks box#!) must also fill out the section below showing their workcrs'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submil 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: l%iLQ'r — Policy# or Self ins. Lic. # ': 7 7r2 Ezpiration.Date: Job Site Address: a 3 br.+ 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.violatoi, Be-advised that a copy of this statement may be forwarded to the Office,of Investigations of the DIA fo insurance coverage verification. I do hereby certify tin t pains and penalties ofperjury that the information provided above. trite and correct. LS Sigoture: Phone#' _iOco 991' Official ttse only. Do not write in this area to be completed by city or town offciaL . 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#¢ hformation and fnStructions 3 Massachusetts General Laws chapter 152 requires a)) employers to provide workers' cornpe.nsation for their employees. Pursuant to this statute, an employlee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An emplDyer is defined as "an individual, partnership, association, corporation or other legal entity, or any eT oor ore of the foregoing engaged in ajoint enterprise, and including the legal represenlaLives of a deceased employ r 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 Lhe grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also slates 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 perforihance of public-4ork until acceptable evidence of compliance with the ins�>rance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out.the workers' compensation affdavit completely, by checking the boxes that apply to your situation and, if necessary,supply sub-conLraetor(s) name(s), addresses)and phone numbers)along with their cerlificate(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, e 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 th-e aff-idavit. The affidavit should be returned to the city or [own Lhat•ihe 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 e,work s' er compensation policy,please call the Department at the number listed beloW. Self-insLued 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 Deparlmenl 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 yoti regarding the applicant. Please be sure to fill in the permit/hcense number which will be used as a•reference number. Ln addition,an applicant that must submit multiple permitllicense applications in any given year, need only submit one affidavit indicating current policy information(if necessary)abd under"Job Site Address" the applicant should write"a]) locations in _(city or town)."'A copy of the affidavit that has been officially stamped or marked by the city or town niay be provided to the applicant as proof Thai a valid affidavit is on file for future permits or licenses. A new affidavit:Snust be fJled DLit each year. Where a home owner or citizen is obtaining a license or permit not related to any business�or commerei a] venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavil. The Office of lnves(ig.at�ons wog t e o , nkyotirimco�pPratinn and shou➢d youhaye any questions, please do not besitate'to give us a call. The Department's address, te)epbone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents office of Investigations 600 Washington Street Boston, MA 021 l 1 Tel. # 617-727-4900 ext 406'or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia s � , . Massachusetts- Department of Public Safet% Board of Building Regulations and Standards Construction Supervisor License License: CS 95038 Restricted to: 00 i STEVEN WHITE j 147 RIDGEWOOD AVENUE HYANNIS, MA 02801 Expiration: 2/2&M12 ('nnmi��i rocr Tr-": 19311 ✓fe 1°omvrizarz(aealll� �aaaaC�tuGeka Board of Banding Regulation§§and`Standards HOME IMPROVEMENT CONTRACTOR Re9Wtra en.154359 ,1 8/2011 . TO 280764 Tj L-tdlL:�bility;Cor�ratien { CALIBER BUILDIt :RdEUNG;LLC. STEVEN WHITE t 147 RIDGEIINOOD AV1= Gt•� j HYANNIS,MA 02601 Administrator II License or registration vah_dd•for, mdividal_use only ' W%Ire the expiration'date. u found return to: Board of Building Regulations and Standards One Ashburton-Place.Rm 1301 x: Boston;Ma:'02108` Not ia6dwithout signature L as owner(s) of the subject property at: 2-S C9 6 hereby authorize Steve White of Caliber Building And Remodeling, LLC (contractor) to act on my behalf in all matters relative to the building permit application. ID signature o ner date signature of owner date it v ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD�Y) 03/30/2010 PRODUCER 508.945.0393 FAX 508.945.4048 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eldredge & Lumpkin Ins. Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS TEND OR 697 Main Street ALTER THE COVERAGE AFFORD D ES BY THE POLICIES BELOW. Chatham, MA 02633 INSURERS AFFORDING COVERAGE NAIC# INSURED Caliber Building and Remodeling LLC INSURERA: National Grange Mutual Ins Co— 4788 INSURER B: Commerce Group CIG001 147 Ridgewood Ave INSURERC: Granite State Ins. Co.-ARWC 3102 Hyannis, MA 02601 INSURER0: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITH ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUE MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD, - POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YYYY DATE MM/DDIYYYY LIMITS GENERAL LIABILITY - MP027360 09/15/2009 09/15/2010 EACH OCCURRENCE $ 500 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 500 CLAIMS MADE OCCUR MED EXP(Any one person) $ 10,00 A PERSONAL&ADV INJURY $ 500 GENERAL AGGREGATE $ ] 000 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1.000. ON POLICY JPE O- LOC AUTOMOBILE LIABILITY < BBNVCS 02/16/2010 02/16/2011 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $ X SCHEDULEDAUTOS (Per person) B 250, HIRED AUTOS - BODILY INJURY $ NON-OWNEDAUTOS _ _ (Per accident) 500 OO PROPERTY DAMAGE $ (Per accident) 100,OO GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTOONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ DEDUCTIBLE - $ RETENTION $ - $ WORKERS COMPENSATION WC7425405 03/02/2010 03/02/2011 TO Y LIMITS OERH AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE r E.L.EACH ACCIDENT $ 100 C OFFICER/MEMBER EXCLUDED? (Mandatory in NH) - E.L.DISEASE-EA EMPLOYEE $ - 100 OD If yes.describe under ' SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - Carpentry P , CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town of Barnstable IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Att: Bldg Dept. REPRESENTATIVES. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis, MA 02601 Alan R. Long. President ACORD 25(2009101) ©1988-2009 ACORD CORPORATION..All rights reserved. The ACORD name and logo are registered marks of ACORD Assessor's map and lot number ....... ................ .� j_L Sewage Permit number .... ........ ..................• 1 ............... .. .. 4'If NETp TOWN OF BA.R NS UBME MASIL ro +� s � ZBoA�Hb9TADL$ i '£26 9.a\ U I L D I I S E T O NP d . . ..:::^.J..APPLICATION FOR PERMIT TO ..........t �.. ............... S •• TYPE OF CONSTRUCTION to coo`�- ................:..Y....................19Zr TO THE INSPECTOR OF BUILDINGS: The undersigned ereby applies for a permit according to •th following in or tion �'�� �'.L:.. �c erg. .�4� ` ...�. `..._ ... ... ... Location ........ ...� ...... .r.. ..... ................................... '• Proposed Use ........ .......................... Zoning District ........ ..Q-7a....................Fire District ......... ................................ Name of Owner -- .e:S? ? °`'.......Address 2 Z .. ...................... ct� 4r................ Nameof Builder ........ .....................................::...................Address .................................................................................... Nameof Architect ..................................................................Address .......................... .................................................... Number of Rooms (. .............. Foundation .... .... ................................................... Exterior ...: c .........Roofing ......... .... Gr ........ ..................... ........... Floors .C�:!t . ......................................Interior CL�L c� ........ .................. .. t;'. .r. Heating .....In....V......i V............................................... Plumbing ........ ............... Fireplace ..........a.�cjt.r..................................................Approximate Cost ............Z .. ...� ci E� ... ............. ��s• t—�-�-/ '/a spa y Definitive Plan Approved by Planning Board ---------_______-----------19______. /p� Area .34. ...� 41A2 r.......... Diagram of lot and Building with Dimensions �� Fee ........ . .�............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH f-� 4 1 hereby agree to' conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........ a. Breen, Joseph A=192-151 ,-- Permit #17953 Build 1 1/2 ory, single family dwelling Gleneagle Drive Centerville Lot #34 September 23, 1 75 1 t I I i U r Y' tM .ssesscr's map and lot number . .. ............ ... ........... SEPTIC E INSTALLED I�4 COA4KIANCE ............ ,, �.................... WITH Ar-, T,-jSewa a Permit number .... ........ CCI I .. R-EGMA yofTHE r TOWN OF BARNS9r BLE } BARNSTABLE. i 1639. O•Ep YI►Y a .e� BUILDING INSPECTOR i .. 1.. .`... . .. . ....... APPLICATION FOR PERMIT TO ........... Q TYPE OF CONSTRUCTION .Ch`�-� . ...................................................................................................,..//................................ ................ ...................19Zr TO THE INSPECTOR OF BUILDINGS: The undersigned ereby applies for a permit according to . following infor .tion: Location f � ................. .... .... 4: ProposedUse .... .1. .................... ........................ .................................................................................................. ZoningDistrict ....... .. .......... .........................Fire District ............ ....... ............•............................................ Name of Owner .... ..........................Address .Z...L .V�6CC. li? �...` '0/:` a` Q c l c e Nameof Builder ....... ........................................................Address .................................................................................... Nameof Architect ..................................................................Address .......................... ......................................................... Numberof Rooms .................:........7.... ...............................Foundation .......... ... .......... . .................................................. Exlerior ............. . o. .. ..Q..:......................... . ....L�' c .........Roofing ......... .. . ................................. Floors ......................................Interior ..............I.. . .... ........ .......... Heating .....r-.!.V.......'!V........................................................Plumbing ....................... ..Z......... .... ................... Fireplace ..........Cy � ..................................................Approximate Cost ............g. .y..� Definitive Plan Approved by Planning Board ---------------____-----------19_______. �p�� Area ... a.1t .......... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH g a I hereby agree toy conform to all the Rules and Regulations of the Town of Barnstable regarding the above -construction. I 7i?� Name ........ ........y`: ..... Breen, Joseph 17953 1 1/2 story, f No Permit for siJugle family dwelling .................................................:............................. Location G.leneagle. . . . ...Drive. ....................... .. . .... . . ...... ........ . Centerville t ............................................................................... Owner ...........J......os.eph. . ..Breen.. . .. .. ..................................... Type of Construction frame ......... .................................................................. 1 ' Plot ........................ Lot ........��. .34.................. ' r Permit Granted .,,. September 23 19 75 !, Date of Inspection .................. . Date Completed .l .. l?. ...............19 1 PERMIT REFUSED . . .............................................................. 19 ............................................................................... ............................................................................... 1 ............................................................................... r .............................................................................. f Approved ................................................. 19 I ............................................................................... A ..................... ......................................................... i } R r / . iew • �3. .0 5r 1 C [3 � Car � 4 r• �� �` J IAI ,e 1 +? /�r! .✓ 4,J xJ, / �, J � f .S 1/tl'YT c ,� t7 �'b'1 t® e''' • via , �� /J r 1 CERTIFY THAT THIS PLAN SHOWS THE ACTUAL. LOCATION OF THE STRUCTURE ON THE LAND AND - - — - - THAT IT CONFORMS WITH THE - r - BY-LAWS OF THE TOWN PLAN of LAND �N 0� Ai7 R vi4� MA C. y�sfcy P� pr'. 'ss*' OWNED BY --;' rC L- ! !/ FRANK FRANK CONERY FRANK CONERY 5 TREN1ON 51. ,A Me. 6232 0 NON`R3 4 HYANNIS, MASS. 02601 Q'1STOI FG�S TE!`F' ReoIe'MMo¢HGnkiiew s LAMD SVFkVWvnrs �._._r SCALE t 1N -2o FT. ✓«Ly /5TJ�