HomeMy WebLinkAbout0093 HARBOR HILLS ROAD ti
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�pIME r Town of Barnstable *Permit#
Expires 6 mont 'ron .11ue date
RN7 Regulatory Services Fe
sAM'S'Tnsne, ►
9� 16g9� ,�$ Richard V.Scali,Director ^
ArFD MA'1'p it/
OF BARNSTABLE Building Division 0
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 PE T APPLICATION - RESIDENTIAL ONLY
9C ✓� �r Not Valid_without Red X-Press Imprint
Map/parcel Number I Property Address k o r L a - /I A p o,�-U rc-e t;, Y I/
0
Residential Value of Work$ C'�7 2DU Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address t�12 d0 Cj,CJ e d/p S
Contractor's Name 15(Lo-S �D( - S 4C�- Zc` Telephone Number "�� -3 G L/6 l
Home Improvement Contractor License#(if applicable) 10 OG S j Email: 9/la c, d c 50t/2 61, 4
Construction Supervisor's License#(if applicable) C G 54 1I
❑Workman's Compensation Insurance,
Ch ck one: -
91 am a sole proprietor`
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy# -
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Reg st(check box)
[( Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to lc�,_h hC,
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ,
❑ Re-side
❑ Replacement Windows/doors/sliders:U-Value (maximum 32)#of windows'
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red Sand inspections required.
Separate Electrical&Fire Permits required.
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required.
SIGNATURE: i
Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc
Revised 040215
r 1 Massachusetts -Department of Public Safety
Board of Buiiding.Regulations and Standards
Conitruction Supers isor Specialh
License: CSSL-106031
SILAS DESOUZA
20 COOK CIRCLE ";
Hyannis MA 02661 >
Expiration,
Commissioner 10/05/2618
'Restricted To: CSSL-RF-Roofing
I
• Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
• i For DPS Licensing information visit: www.Mass.Gov/DPS
I __ � _ ��e�arr�rizoatcaeaCC�d�C��lcmaac�uaet� II,�
Ofrice of Consumer Affarirs&Bosmess;Regulation
OME IMPROVEMENT CONTRACTOR y,I
�I a egistratlow A00651. TYPe f�
:Exprationt-2Ft6 Individual
SILAS ME OUZA
• I i
�. SILASs DESOUZA
20 COOK CIRCLE
f. HYAN A 026 NIS M0:1 Undersecretary
` i -
f
the Corastrronivealtli of massack"setft
Dt'Wft wit oflndusti'ial Acciden '
IIflice ofInm6gations
3 600 Wash nglan Street
Boston,MA 02111
YV'miz mas&gvv1di a
Workers' Compensation InsuranceAffidavit: Btdlders/Conti-ctorsAElectriccians/Phm Hers
Applicant Information Please.Print Legibly
Name(Rudme m=,+andh&vidual): -� J�/P_�i J��Cif�!/ �C(_
Address: 2 o CAD C i'. -
Cityls'tate/zip: 0 2 01 Phone oX 6 G 1 11 S ( 15
Are you an employer?Check the appropriate boa; Type of project r
4. I am a contractor and
(required):
1. I am a employer with 1 . � 6_ ❑1+teur cxuisttanctioit
employees(full an&or part-time).* have hired the sub-contracturs
2,0I ant.a sale proprietor or partner- listed on the attached sheet. 7..❑Remodeling
strap and have no employees These sub-contractors have g, ❑Demolition
working, Rw me in any capacity_ employees and have workers'
[No worloars'comp.insurance comp-insurance.$ 9_ ❑Building addition
required.] . ❑ We we a corporation and its 10❑Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have esercisecd their 11.❑Plumbing repairs or additions
myself [No workers'comp- right of exemption per MGL 12.❑Roof repairs
insurance required.]l c..152, §1(4�and we have:na
employees_[No workers' 13.❑Other
comp;insurance required.]
• ,appBicamm tat checks box#1 must also fill out the section below show mg their wu&ere compensation palmy iafbnnstimL
4^Fgamnemvners I.submit this affidavit ind
icating they are doing all,work and then hire ouW&contractors oust sob=anew affidsait indicatimg such.
ZCGntr&ctors that check this box must stuched an add timnsl sweet thawing the r2me of the sub-camtractm and.state whether or not those entities hsee
employees. ifthesub<*nUactarshaveempIcyee%IkT=rstprovidetheir worlters'comp.p€siicynumber.
I am an e►rtplaiw that isprovitUng workers'cattrymmwden insurance far my amgdoyrees. Blow is timeprrlicy andiab site
infornzadon.
Insurance CompanyName:
-Policy 4 or Mf=irns_Lic.4: Expiration Date:
Job Site Address: t itylStatelzip.
Attach a copy of the wGrkers'compensation policy declaration page(showing the policy number and expiration date).
Failure to sectors coverage as required.under Section 2.5A of MGL c- 152 can lead to the imposittomt of criminal penalties of a
fine up to$1,500- 0 and/or one-yea-imprisorimerut,as wet!as civil penalties in the fora of a STOP WORK ORDER and a fine
of up to$250.00 a,day against the wolator. Be.advised that a copy of this statement may be forwarded to the Office of
Investigations of the MA.for nstnrance coverage verification-
.
I do Tteratryl c f1' trtder tie rs and ponabies of perjury that the inn•f btmati n.provided above is.Erase and correct ,
sure: U hate: d (4 L -7. 20
p
Phone#:
Official c al use only. Do not write in this area,to be completed by city or town offf"� -
City or Town: Perrnitucense 9
Fssuing Authority(drde one):
1.Board of Health 2.Ru ling Department 3.Cityffown Clerk 4.Electrical Inspecto-r 5.Plumbing Inspector
d.Other
Contact Person: Phone#:
BARMARL&
65
I9. Town of Barnstable
Regulatory Services
Richard V.Scali,Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Mairi Street, Hyannis,MA 02601'
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I, y y �/� ® �,as Owner of the subject property
hereby authorize ��f / -c to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job) i
Signature of Ownel Date
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
C:\UsersU)ecollik\AppData\L;ocal\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOIDHR\EXPRESS.doc
Revised 040215 l
� t
CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DO/YYYY)
F
/27/2015
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, 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 TACT PAUL SCHLEGEL
NAME:
SCHLEGEL INSURANCE BROKERS INC PHONE FAX
(A/c,No,E>d): 508-771-8381 (A/c,No)508-771-0663
34 MAIN STREET AIL
ADDRESS: SCHLEGELINSURANCE@GMAIL.COM
WEST YARMOUTH MA 02673 INSURERS)AFFORDING COVERAGE NAIC#
INSURERA:NGM INSURANCE COMPANY 14788
INSURED INSURER B:
Silas Desouza Dba Silas Desouza
INSURER C
20 Cook Circle
INSURER D
INSURER E:
Hyannis, MA 02 601 INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT -TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR AUUL bUtM POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
A GENERAL LIABILITY MPT1035P 06/20/2014 06/20/2015 EACH OCCURRENCE s 2,000,000
DAMAGE-'U'IENtU
N
COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 500,000
CLAIMS-MADE Fx I OCCUR MED EXP(Any one person) $ 10,000
PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s,2,000,000
1-1 POLICY PRO LOC
JECT
AUTOMOBILE LIABILITY COMBINED SINGLE:LIMIT
(Ea accident) $
ANY AUTO - BODILY INJURY(Per person) $
ALL OWNED SCHEDULED -AUTOS AUTOS BODILY INJURY(Per accident) $
NON-OWNED PROPERTY DAMAGE - $
HIRED AUTOS AUTOS (Per accident)
F I $
UMBRELLA LIAR OCCUR - EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DE D RETENTION $ $
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS'LIABILITY ,r/N , TORY LIMITS ER
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A '
(Mandatory in NH) - E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required)
,
CERTIFICATE HOLDER CANCELLATION
THEODORE C SPINOS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
93 HARBOR HILL ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
WEST HAYNNISPORT MA - ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
IN HAND
All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACOR 0198 -201 ACORD CORPORATION.D
,. .. _„ Pi S �J^. .. .. ...,. .. ... ♦ ran r r .... K
TOWN OF BARNSTABLE
Permit No. ..3.68.1.I.......
BUILDING DEPARTMENT
TOWN OFFICE BUILDING Cash
'Y9
D�a67Y V
HYANNIS,MASS.02601 Bond ................
CERTIFICATE OF USE AND OCCUPANCY
Issued to Theodore C. & Mary E. Spinos
Address 93 Harbor Hill Road
Centerville
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE. ` i
I
December 8, 94
19................. ....... .....
, ............
Building Inspector
MIT
i TOWN OF BARNSTABLE, MASSACHUSETTS B U DING I
A-247 055 DATE Jung: 2.1 � 94 _ P F3 �. O. N® 3681i
Silvia « Silvia Associates, inc31b931
AbDRE55
APPLICANT 1 (N0.4) R3 RE^ G 5 "F5'L" t1lP TR'S LICENSE]
PERMIT TO Build dwelling & garc2 f'_Il TORY Single family dwelling NUMBER r
DWELLING
UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
lot #38 93 Harbor Hill Road, Centerville ZONING "RB
AT (LOCATION) DISTRICT—
! (NO.) (STREET) - -
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
i I
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
! TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
f
REMARKS: Sewage #94-254
. - BOND
AREA OR 2054 8Q. 'i tt t. -' 118,000 PERMIT 164.00
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET)
-Theodore C. & Mary E. Spinos
OWNER
Z RutgersRoad, -Andover, BUILDING DE PT.
, •' ADDRESS BY
j
M THE DEPARTMENT OF PUBLIC WORKS. I ME U NC F THIS ERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED- FOR
ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND
I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.-
2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MEMBERS(READY TO LATH). FINAL INSPECTION HAS BEEN MADE.
3. FINAL INSPECTION BEFORE -
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
z z ,�,e:Gi�e Z
� z 7
HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT
Od S
BG'RD OF HEALTH
OTHER SITE PLAN REVIEW APPROVAL
GOU-AV-4� '
V40RK SHALL NOT PROCEED UNTIL THE INSPEC- "ERMIT 'W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE
i TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN
CONSTRUCTION. (I PERMIT iS ISSUED AS NOTED ABOVE. NOTIFICATION
Ar
BU DINIS P R.`IIT r
NO.
T
ASSESSORS PARCEL NO. j
CONTINUATION OF ROAD BOND
The undersigned owner/contractor he=ebv agree to mai:.tain their roar bond it
rforce until the following war', items are co=leted to the sat-suction of the
E nginesr-_mg 'Section of the Derar=ent of Public wor'_tis:
Ica-- and saed shoulders as soar. as
wzacner per—;ts:
otHer (ey_?lain)
LCCAT=O.,: dry-
(G:Y►;- C:;T^r .C-z-) (pr=nt naWe
. Y v ;�;� •,. x.- ..:, ,.,.. ...._.. ...,.�r rya w+..,
a -a"A�' ;i�� , 'o
°i OWl�_OF BARNSTABLE, MASSACHUSETTS G UiDI
L NG PE R M 1 T
A=24i 055 June 21 94
DATE ® e�s�'1 _ ,Fi 17�1.0.
11
APPLICANT S.)_iyia & S1.iv—Li I. %".ssociB'..zc, in ADDRESS -
016932
IN .N -1-i(�S FRE i'C^'kTR'S LICENSE)
J +
i'.u" i�'`,;"c1..::.Jli.:. "ar.-i,.r.r> .._. ` (c 31Il1.�.y USJE�.2.11.'i g, NUMBER OF !_
PERMIT TO - ('_)i STORY �''� DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT(LOCATION) lot #38 93 tiarlbor Hill [Goad, Centerville ZONING RB
DISTRICT—
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
y LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
i
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: Sewage #94-254
BOND
AREA
VOLUME 2054 sq. ft. ESTIMATED COST S 118,000 FEE MIT 164.00
(CUBIC/SQUARE FEET)
OWNER. -Theodore C. & Mary E. Spinos
t�itgers Road. -Andover,
BUILDING DEPT.
ADDRESS BY
NLI-LAbE THE APPLICANT FROM THE CONDITIONS
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN
ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND
I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
FINAL I S(RE INSPECTION
TO B LATHE FINAL INSPECTION HAS BEEN MADE.
3. FINAL INSPECTION BEFORE
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
( i
2 2 2 --
HEATING INSPECTION APPROVALS ENGINEERING DEFARiMENI
i
BOARD OF EAU
OTHER. SITE PLAN REVIEW APPROVAL
WORK SHALL NOT PROCEED UNTIL THE INSPEC- i PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE
TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN
CONSTRUCTION. l PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION.
•«ice TOWN OF BARNSTABLE
BUILDING DEPARTMENT
�2TA TOWN OFFICE BUILDING
� ouua.
v639,
3 HYANNIS, MASS. 02601
MEMO TO: Town Clerk
FROM: Building Department
DATE:
An Occupancy Permit has been issued for the buildingauthorized b
P Y �j Y
Building Permi # v ��
issued to _
Please release the performance bend.
Assessor's office(1st flQor):
• Assessor's map and lot numbs r`= E �o�-THE to`
Conservation(4th Floor): — _ � , °•• , � °w
Board of Health(3rd floor L " `r t' sass Manta !
Sewage Permit number
Engineering Department(3rd floor): t �,�^ y � & ��
House number ����"� ° ,
Definitive Plan Approved by Planning Board 19 a a nd �OD A la
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only f s R " 7
TOWN OF BARNSTAB=LE
k BUILDING INSPECTOR -'
APPLICATION FOR PERMIT TO U U
'TYPE OF CONSTRUCTION , �a �� � 4�E
19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location
c �
Proposed Use ✓IP6 C C Pw 1CC /?°Q
Zoning District `J Fire District `GP
Name of Owner lg-L7 C,- �2 1 tt Qdress 1 e �rs � 0+ D 1 Dv ve b
c� 77�
Name of Builder , Address
s Jv,v,/T-e-p>D(el)
t o I
�(L S/lave A SSCC. I ,
dj
Name of Architect /' Cr Aj C_ Address 1AM
r
Number of Rooms Foundation !r�Lj
Exterior 6 Roofingf�
Floors Interior 0 g
Heating < '` X Plumbing S
Fireplace Approximate Cost —-
-77
Area 1�?t --41 /:
Diagram of Lot and Building with Dimensions Fee
VV
N�
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above constructio
Name
Construction Si/rvisor's License
S INOS, THEODORE C. & MARE Ej ® �
No. 3 6 81 1 Permit For BUILD DWFTJ ING
& GARAGE 1; story
Location 93 Harbor Hill Rd.
' Centerville
.,owner' Theodore & Mary Sni nnsq
Type of Construction
Y , c
Plot Lot
Permit Granted June 21 1994
Date of Inspection: f` `
o"Frame 19
Insulation 19
Fireplace `19
Date Completed . 19
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-v70)UCC16' COMPJNSATION 1NSUI1ANCLAFI=IDAVIT
I Silvia & Silvia Associates , INc . COWAN. BUILDING PERMIT
(licensee/permiacc)
with .2 principal place of business/residutee sc
619 Main Street Centerville , MA 02632
(City/St:tc17_ils)
do hereby ccrlify, under the pains and pcnalrics of perjury, that
1 ] I rm an cmplovcr providing rlsc following workcrs' compensation coverage for mycmployccs --orking on this
lob
Fidelity & Casualty Co . of NY 28C8148787931) (04-01-93-04-01.--9/1 )
Insur2ncc Company Policy Numbcr _-
j ] 12m 2 sole proprietor and 112ve no one working for me_
O l 2m 2 sole proprietor,gcncrzl conmaor or homcovrncr (cirdc onc) and hive hired the contnaois Iistcd 66c )1-.-
wbo hzvc the following workers'compcnnuon insurance policies:
Name ofConmccor Insurzncc Company/Polia.Numbcr. -
N2mc of Contractor Insurance Company/Policy Numbcr
F-2mc of Conmaor Insurance Company/Policy Numbcr
0 1 2m 2 1101`171cowncr performing 211 the work rnyselC
NOTE:`-I'Ic:sc be ate.-uc tbitw-ilc Loraco"n<r:v bo employ fcrcon: to 'do mii0tcnincc,co0rtnj4n;00 Orr<p1if rlc on a
2.-cil ng of not ruorc tbin thfcc uolu rn wbtc�&borocowncr 2Jro rcttdcl or on the Crouo6 Ippuruo:ot dc(cto Arc Dot E<9:)<r11I)-
<onricr<rcJ to b<employers t!-n&r the Go0:cri Compcas:tion Act(GI-�C 152, rcct__ 1(5)),:ppGc11;00 by I bofacowncr for a Nccnr<
or permit r-:y'evideoee the IcEJ sums eft crployct uoder Ut a VJo(l err*Cornpeot:tion Act
i cnccrs(anc tact a copy of ti,is.st:tcmcnt-IL*a lor,vdcd to tr,c t)cp:::ncnt of Industfia Acadcnu'Ofrt c<orinrc::nu for.cn�<rsic
�rnfieaion_nd tli_t failure to s<eutc co,crz�c a rcSuircd under S<etion 25 f MGL 152 c-m 1c:d to the imposition of�tjmin:I pcnJeics
consisting of a tint of vp to S1500.00 enefor impri:onrncnt of up to one yc-u and civil pcss:Iri<s in the form ore Scop Worl:Ordcr end : I
fine of S 100.00 a day against r
Sisncd tlri d2y of 490 _ . 19 ---
Liecmcc/Permitice Licensor/Pcrmietor
Note
1)Property lines shown hereon were compiled
from a plan recorded at the Barnstable County
Registry Of Deeds In plan book 103 page 127 Lot and do not represent an actual survey on the
ground. Parcel 56
N Harbor
Cb
Hills
ZONE RB �-+-
" '100.OU� W g Road
Minimum Setbacks. 00'
Front 20'
Side 10' Z a I n
Rear 10' o�
N
15.10 Owlo W. Hyann isport
("'
Asbunt Foundation L.— 20.43' m
Q M A
in rn Garage I r porch
Parcel 54 10 1P m I Prepared For.
N
to f Theodore C. Spinos
Assessors Map 247 Parcel 55 4b^ 911 Mafn Strout
m k• ,� Ostrnlle, MA
�, �6. .......:- ....., 02655
80.90'
I HEREBY CERTIFY THAT THE LOT CORNERS, S 6435'10' E
DIMENSIONS, AND SETBACKS TO THE FOUN—
DATION AS SHOWN ON THIS PLAN ARE
CORRECT AND THAT THE FOUNDATION CON— A. M. Wilson Associates Inc.
FORMS TO THE ZONING REGULATIONS.
Harbor Hills Road 508 426 1450 FAX 420 1856
OF 4f4S (40' Wide) Scale: 1'—20'
C
RALPH y�\E 0 20 40 50 FEET
1` 4ARLOW
COLE 40.2 � ate: June 13, 1994 Dwg No:
so9 Field: J.V.B. C.P.J.
'EG ST 4�° c Check: R.H.C.
y��7 94 Drawn: J.V.B.
Professional Land Surveyor T— ob No:2.0720.0 Sheet 1 of 1
r
r ,
-. ,_..._ ._.,. . Fallureto
posaassaosrront
Afassaossstts8tatoBsNdlgo
COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY Coda/scarso/orr#Mglion
OF ONE ASHBORTON PLACE o/tAlslls"".
MASSACHUSETTS C Q; '5 BOSTON,MA 02108
CAUTION
EXPIRATION DATE
FOR PROTECTION AGAINST
EFFECTIVE DATE LIC-NO- THEFT,PUT RIGHT THUMB
RESTRICTIONS PRINT IN APPROPRIATE
BOX ON LICENSE
r
T zBLASTING OPERATORS
z MUST INCLUDE PHOTO.
PHOTO @LASTING OPR ONLY) FEE: ,� .d :�,,,+'
r NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY 1•.' }•-
STAMPED-OR-SIGNATURE OF THE COMMISSIONER
{ HEIGHT:
DOB:
SIGN NAME IN FULL ABOVE SIGNATURE LINE
<' THIS DOCUMENT MUST BE
SIGNATURE OF LICENSEE
CARRIEDON THE PERSON OF N W
THE HOLDER WHEN EN-
[;OTHERS-RIGHT THUMB PRINT GAGED INTHIS OCCUPATION.
CA'1["lH[1LERIN w A. Mc DOW ELL
ATTORNEY AT LAW
P.O. Box 334
BARNSTABL-E,MASSACHUSETTS 02630,
TELEPHONE: (508)420-0244 -
May 24, 1994
Alfred E. Martin,
Building ` Inspector
Town. of Barnstable
367 Main Street -
Hyannis, Massachusetts 02601-
Re: Mr. Theodore C. Spinos
93 Harbor Hills Road, Centerville, Massachusetts
Dear Mr. Martin:
I have run-down the title to. Lot 38, 93 Harbor Hills Road, Centerville;
Massachusetts, along with the title to the two abutting Lots 52 and 39. I
hereby certify that, .neither, Lot 52 and' Lot -39 have been held in common
ownership with the owner of Lot 38. The Subdivision Plan was dated
August 24,. 11951 and is duly, recorded in the Barnstable County Registry 'of
Deeds Plan Book 103 'Page 127. Lot 38 contains approximately 7,500
square feet.
I hope that this ' information- is sufficient to allow the issuance of a
Building Permit .for Lot 38: _
Should you have any questions or 'concerns', please do , not hesitate to
contact the office.
Very trul yours,
Catherine A. McDowell
CAM/.pm