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0039 HITCHING POST LANE
��' �,{� �►�G.;� i h ©.�� �,.—sac-h��. .: � � �,;. o :, �,� -,r 7 � , w , _ .. .. _ . 'l� r ! �} 4 :. - .. -. v '. .. _ .. �' .. .. J _ - r � � e � � '. � .. e w .._ - � t .. c ., ". a ., .. o .,, 2 .� - ,. �- �.: �. .. k '' i .. .. .. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �01 4 o � Map 3 Parcel d3,3 Application # Health Division Date Issued LCI Conservation Division Application Fee Planning Dept. Permit Fee 3S ' Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 3Q W"I n V QS�- Village l Pl'1tu0 Owner 04f I- G1 &;Lin r1LH Address na 06Sl- a A Q Telephone 1 ^( a ? V `'Permit Request3�S�.�LL°��QR 2,;�3(oS�, - Q,-I�r- a�: (4�# Sc,.�I-� -l�-tea t-10 --� lCC s O 3- 8 Swz o S;_ 3- (L5 mar 1-6urgp s :3 wwPAi m�e,s I c(-ransiJ�z-A0 ;6 awe dot v Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 31- Construction Type Ype Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure «RD 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: J existing _new Total Room Count (no�rLl baths): existing new First Floor R°dpm Count: Heat Type and Fuel: Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ xisting 4j new- size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: " Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name h f P 8 dk&-\ &_r6L1 Telephone Number 65M Address %nd W d License # L 5114-&rd!�. &4N MA- 60-6-3 a— Home Improvement Contractor# 1-7 S A- I Worker's Compensation # �— RES0LBU110N ENERSY INC. ALL CONSTRUCTI DE IS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 49 R E R R I NS f 0 RQ J0 BUZZARDS BAY, MA 01532 SIGNATURE DATE l I LI FOR OFFICIAL USE ONLY -APPLICATION# DATEISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER I DATE OF INSPECTION: -FOUNDATION, FRAME r INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL FINAL BUILDING a } DATE CLOSED OUT -= ASSOCIATION PLAN NO. The Commonwealth of MassachusetUts Department of Industrial Accidents m Office of Investigations ' 1 Congress Street, Suite 100 y Boston,MA 02114-2017 S° y www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Resolution Energy, Inc. Address:49 Herring Pond Road City/State/Zip:Buzzards Bay, MA 02532 Phone#:508 8881740 Are you an employer? Check the appropriate box: - Type of project(required): 1.0 I am a employer with 6 4. ❑ I am a general contractor and I employees(full and/or part-time). have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.: 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.0 Other weatherization employees. (No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $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 isproviding workers'compensation insurance for my employees Below is the policy andjob site information. Insurance Company Name:Continental Indemnity Co. Policy#or Self-ins. Lic.#:46 872479 0102 Expiration Date:06/14/2015 Job Site Address: 59 �ArA�Ch le15 Qo5," Ld(U— City/State/Zip: 6criwV"I a< Alf)- 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 a a' st the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations oft A r insurance coverage verification. I do hereb certify u er the pains and penalties ofperjury that the information provided above is true and correct. Signature: Date: ( l Phone#: 1740 r. Official use only. Do.not write in this area,to be completed by city or town off Zcial. 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#: FDATE 6.ACC MD' CERTIFICATE OF LIABILITY INSURANCE 06/0 °/201' �-�"" 06 03 ao14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: FAX Awlied Risk Insurance Services, Inc. /c°,No,Ext): (877)234-4420 (AI,No): (877)234-4421 10825 Old Mill Rd E-MAIL Otwha, HE 68154 ADDRESS: PRODUCER CUSTOMER ID# (877)a34-44a0 INSURER(S)AFFORDING COVERAGE NAIC INSURED INSURER A: Continental Indemnity Co. 28258 Resolution Enezvy, Inc. INSURER B: dba Resolution Ene%W, nw. INSURER C: 49 herring Pand Rd Buzzards Bay, MA 02532-2226 INSURERD: INSURER E: CTL 1273 880009 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/D MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE Is COMMERCIAL GENERAL LIABILITY ❑ ❑ DAMAGE TO RENTED CLAIMS PREMISES(Ea o=rrence) $ MADE OCCUR MED EXP one emn $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PROJECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO ❑ ❑ (Ea acc dent) $ ALL OWNED AUTOS BODILY INJURY Per enatr $ SCHEDULED AUTOS' BODILY INJURY Peraccident $ PROPERTY DAMAGE HIRED AUTOS Par accident $ NON-OWNED AUTOS $ UMBRELLALJAB OCCUR EACH OCCURRENCE $ EXCESS.LIAB CLAIMS•M OE ❑ ❑ AGGREGATE $ DEDUCTIBLE` $ RETENTION $ Is WORKERS-COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY q/N O LIMIT E NY PR VEOFOR/PAR EMBER N/A E.L.EACH ACCIDENT $ 500,000 A EXCLUDED? a 46-87a479-01-Oa 06/34/a01A 06/14/2015 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 Des describe under IAL PROVISIONS below E.L.DISEASE-POUCYLimrr $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach Acord 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION Rasauticu munw, Mw. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 49 P+� EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH Hw=iWa+zz *+A� �►, NA 02532-2226 THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 00, Attn: PttojWt M=ager V 17 83118 ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD ©1988 2009 ACORD CORPORATION.All rights reserved. . Housing ®. Assistance kin Corporation Cape Cod HOME OWNER WEATHERIZATION WORK PERMIT&FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE THE APPLICANT HOME OWNER. I rrh .d hereby consent to and agree that weatherization work may �by the Weatherization Program of Housing Assistance Corporation ( herein after referred as "Agency" ) on the property located at: The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: . Weather-stripping & caulking of windows and doors, insulation of attics, sidewalls & basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. in consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to the "Agency" its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions of this agreement as listed and freely give my consent. Home Owner: (Signature) e_jj fy-) tit) ;;j Date: ',/ r Agent: (signature) ✓✓�,� Date: I ' B"(/C'j !f'�OC/®9Y/(/'/Vli�Qi�C�r.1®� �j� ��:ij�����K.f/��°"�^/�1�'i%[/u✓ Office of Consumer Affairs and Business Regulation 10 Park Plaza.- suite 5170 � Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 178211 Type: Corporation Tr0 250244 Expiration: 3/26/2016 ! RESOLUTION ENERGY, INC. —" i PHILIP HAGLOF ---- "_ ! 49 HERRING POND RD ------ BUZZARD BAY, MA 02532 Update Address and return curd.Mark reason for change. L^I Address CJ Renewal 0 Employment Lost Card sCA 1 0 2OM-05/11 a oii�uianri�crrll/a�C����mwac ifiel/t ce Linse or registration valid for individul use on y office or&asumer Affairs&Business Regulation before the expiration date, if found return to: ME IMPROVEMENT CONTRACTOR Type. Office of Consumer Affairs and Business Regulation gistration: .;178211 10 Park Plaza-Suite 5170 t piration:.;. 312t12016 Corporation Boston,MA 02116 Ile i RESOLUTION ENERGY,MC PHILIP FIAGLOF 49 HERRING POND RD, � --fir--- BUZZARD BAY,MA 02532 Undersecretary PNot tgna gre Y _ A t Massachusetts -Department of Public Safety Board of Building Regulations and Standards i Construction Super.isor .,r License: CS-107842 pBUD D HAGLOF 56 SUSCONSETDR . SAGAMORE BEACH MA 02562 f , Expiration commissioner 07/26/2017 ! (a) F/VdkSJ41 OFYHE.r, Town of Barnstable *Permit# 'b Expires 6 m ont s from issue date Regulatory Services Fee —� -- - swRrtsrns[.E, Thomas F. Geiler,Director v mass. g �, 1639. Building Division l fd h1P�b f� Tom Perry, CBO, Building Commissioner 3 r0 j,11' fir' 200 Main Street, Hyannis, MA 02601 www:town.bamstab le.ma.us Office: 508-862-4038 Fax: 5087790-6230 •� EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY yy Not Valid without Red X-Press Imprint Map/parcel Number Property Address 4t P, '1('1 Pc " NResidential Value of Work )1 Minimum fee of$25.00 for work under$6000.00 .Owner's Name&Address C Ian Oc�,, L 1 t) rl Contractor's Name U SS�L C • Telephone Number 14 D( Home Improvement Contractor License# (if applicable) ❑Workman's Compensation Insurance -PRESS Pr� Check one: �p2�08 ❑ I am a sole proprietor AUG 2 ❑ I am the Homeowner �Q I have Worker's Compensation Insurance OWN OF BARNSTABLE Insurance✓Company Name 1 J Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. 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 Fa Replacement indows oors/sliders. U-Value U J (maximum..44) *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 is required. SIGNATURE: r, QAWPFILESTORMMuilding permit forms EXPRESS.doc Revise020108 l The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA. 02111 www.muss.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Wormataion (�c Please Print Le 'bl Name(Business/organizariongndividud): ��� �"`� �C l c`�� � a Address: // 3 CI City/State/Zip: uV L)bV\500a f 2.3� Gc� , Phone.#: 6( � `p O Are you an employer? Check the appropriate box: Type of project(required): 1. 1 am a employer with l 4. 0 I am a general contractor and I 6. New construction employees(full and/or part-time).* have hired the stab-cont actors 2-❑ I am a-sole proprietor or partner- on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have 9. Demolition working for me in any capacity. employees and have workers' 9. 0 Building addition [NO workers' eOmp.-mtt errnr_C comp.msura7tce.t required.] 5. We arc a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a Homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions right of exemption per MGL myself [No workers comp. 12.Woof insurance required.]t repairsin. 152, §1(4),and we have no employees. [No workers' 13. ther iAC2r/►1E h comp,insurance required.] r � J *Any applicant that ehecim box#1 must also fU out the section below showing their warkat'compatsation policy inf—ration t Homeowners who submit this affidavit indicating they aro doing all work and than hire outside contractors must submit a new affidavit indicating such. Tcmtracinrs that check this box must attathcd an additional sheet showing the name of the sub-rnntracton and state whctha or not those entities have employers. If the sub-conhwtom have e-nPloyers,.they trout providt their worker='comp.policy ntanbcr. I am an employer that is providing workers'compensaton insurance for my employee,. Below is the policy and job site information. Inn-ranee Company Nm=. 0,C t�"1 �V � S. Policy#or Self-ins.Lic.#: J Expiration Date- `2 ; . b Pd C� ery�Ili[M� o�63a lob Site Address: J t� t) � S �. City/5tatdZigr Attach a copy of the workers'compensation policy declaration page(showing the policy number and ezpiratian date). Failure to secure coverage as required Tinder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine lip 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 statcmcrit may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains-and penalties of perjury that the informadon provided above is true i ndreorrect Date: J 2 D©b Phone# "l �� . (0 7 I A y U . Ofj7cW use only. Do not write in this area, tb be completed by city or town officiaL 'City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2:Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I l °,*THE Toy, Town of Barnstable ti Regulatory Services 0L+xxesiENAM � Thomas F. Geiler,Director i639. �� �Fo1rA Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.ba rnsta ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder r �Ie/1d14, nV)`e ( t , as Owner of the subject property hereby authorize ' °\r 'A c"CJ � .o� (q S HOC �' to act on my behalf, in all.matters relative to work authorized by this building permit application for: Pits ee (Address Job) S C Co A f Yticr Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable �pc 1HE rph� Regulatory Services Thomas F.Geiler,Director BARNsrAmg. MASS 0.19. Building Division PTfD �a Tom Perry,Building Commissioner . 200 Main Street, Hyannis,Na 02601 www.town.barnstable.ma.us Office: S08-862-4038 Fax: 508-790-6230 HOMEOWI\'ER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. 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 building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section iog.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 as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2,15) 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, t. 9X, l/07)7//72p�IZL(JC2GC/Z O�✓4LlZd3QClZ(!. License or registration valid.for individul use only Board of Building Regulations and Standards before,the expiration date..If found return tot Board of Building Regulations and Standards — - HOME IMPROVEMENT CONTRACTOR One Ashburton Place Rm 1301 Registration: 119535 Boston,Ma.02108 Expiration: 7/24/2009 Tr# 130185 Type: Private Corporation MOON ASSOC INC JAMES MOON 1137 PARK EAST DR. Not valid ithout signature WOONSOCKET,RI 02895 Administrator Board of Building Regulations and Standards One.Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 119535 Type: Private Corporation Expiration: 7/24/2009 Tr# 130185 MOON ASSOC INC JAMES MOON - 1137 PARK EAST DR. - WOONSOCKET, RI 02895 Update Address and return card.Mark reason for change. DPS-CA1 0, 50M-05i06-PC8490 Address Renewal Ej Employment Lost Car t w Date:9/17107 12:56 PM Page;2 of 3 From:Shaunna Robinson,Hunter Insurance At:Hunter Insurance,Inc. FaXID; To:Denise OP ID 5 DATE(MMIDDIYYYY) ACORt3 CERTIFICATE OF LIABILITY INSURANCE MOOLIA-1 . 09/17/07 PRooucER THIS GER.TIFIGATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON NE CERTIFICATE ter Insurance, Inc. HOLDEf3',THIS.cERT1 FICATE DoEs NOT AMEND.EXTEND OR In old River Road, P.o Sox 1 ALTER TA; COV-ERAGEAFFORDED BY THE POLICIES BELOW. '89 in trtanvill.e RI 02838-0001 Phone: 401-769-9S00 Fax:4'01-769-9502 INSURERS AFFORDING COVERAGE NAIC9 INSURED _ {NSURER A: o.ti—i az.ny- Moon As. Snaurpno. Co __ sociates Inc. INSURER B'. 9.aoon But-1 In....... C.. . DBA Clutter Re3Tnet INSURERC _ DBA ReneWWal b A$id'ersen Of FLI —_._._.. 1137 Park Eas Dt ve INSURERD: _ Woonsocket RI 0289'S INSURER E: COVERAGES ITE_POLICIES OF INSuR NCE11I TED BELOW HAVE8EEN-(6SUED TO THE INSUREQ wjjeD ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENi,TERM OR CONDITION OF ANY COMRACT OR OTHER DOCUMENT WITH RESPECT TO'NHICH PHIS E"ER'TIFICATE MAY BE IS5UEU OR I,V,Y PERTAIN,THE INSURANCE AFFORDED B:Y TT4E:POLICIES�OE6CRIBED HEREIN IS SUBJECT TO ALL THE TERkIS,EXC'LUSIGWS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY NAVE,BEEN REDUCED BY PAID CLAIMS. INS POUCY NUMBER DATE:(DA'i WDO/1'YI .DA Ejh4A1DD/YY LIMITS LTR NSR TYPE OF INSURA14C6 EACH OCCURRENCE $ 1o0oaoo GENERAL LIABILITY ES(R A X COMMERCIAL GENERAL LWBILRY MPS26619 09./16/09 09/1fi/08 PREMIREM SES(Ee.occurence) $500000 CLAIMS MADE Fx]OCCUR MED EXP lorry�pwson) $10000 — - PERSONAL&AnVINJURY- $ 1000000 GENERAL AGGREGATE $2000000 GENL AGGREGATE LIMIT APPLIES PER:PR PRODUCTS-co%ipiOP:.GG $2 0 0 0 0 0 0 POLICY Dlecoi M LOC AUTOMOBILE LIABILITY COkIDINED SINGLE UMR $10 0 0 0 0 0 A X ANY AUTO BIS26619 09/16/07 09/16/08 (Eao dd-tj —.._----' ALL OWNED AUTOS 80DILY INJURY $ (Per person) SCHEDUL ED AUTOS- -HIRED AUTOS BODILY IN.rURY $ (Per accidenl) ,NON-OWNED AUTOS — PROPERTY LW4AGE $ . (Per eacWett) AUTO ONLY-EA ACCIDENT $ GARAGE LIABILITY - - ANY AUTOOTIIER THAN EA ACC $ AUTO ONLY AGG $ 6%CESSNMBRECLA'LUU31LnY EACH OCCURRENCE $1000000 A X DcoJR Q.cwMS MADE CUS26'619 09/16/07 O'9/16/08 AGGREGATE $ $ DEDUCTIBLE }{ RETENTION W10000 $ I WORICERS COMPENSAITINd AND - - TORYLIMITS EMPLOYERS'LUIBILITY 28S86 10/01/07 10/01/08 EI. EACH ACCIDENT $ 500000 _ B .ANY PROPRIETORNPARTNER/EXEC-UTIVE ' OFFICERNMEMBER EXCLUDED? E.L.Op3EASE-EA EMPLOYEE $500000 It yes,I.scnb.under - E.L.DISEASE-POLICY LIMIT $S 0 0 0 0 0 S4&-I.PROVISIONS below OTHER DESCRIP ON OF OPER TIONS I LOCATIONS'!VEHICLES/.EXCLUSIONS ADDED BY NDO SEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION' MOONAS S SHOULD ANY OF THE ABOVE DrSGRISED POL16ES BE CANCELLED BEFORE THE EXPIRATION Moon ASSCiCt18 es,T Inc DATE THEREOF,THB*IiUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTEN dba Gutter @61Tne.t NOMI~TIDTT*OEATEICA-M HOLDER NAMED TO THE LEFT.BUT FAILURE TO DD SO SHALL dba ReneWal by Andersen IMPOGE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 113-1 Sark East nrive PRE9E�J1AiTVEB. Woonsocket RI OaLH9S :A REPRESENTATP-19 i 7A�✓1. ®ACORD CORPORATION 1999 ACORD 25(2001/09) �'^_� lWl°Il6ut' t 4 "t`77-r ? ti d d EW" G 1, �L �: r• •• V1. i'j '��rfa.u=•�"4� k .l.�I��.�i�, I�y4y ..'�'r'.E� r � _-'-�'�;'�, Iii .'"'�°r.-0�pl , .y•: ..�� $�. ,kg �. ,a�r.:• ._ �;��,t,•, w i ace..n. IA:`I �,.�....rF; a t - Year hams was ovilEw.: E p Phone-H ABdi@"ss Phony-work. ...n..,.,-............... ,....-ao -- ---- 3 - - -•D State ZIP , I-��SGYZ�J�$f3YI Specifications,r,00F.11,Color, Prici, Qi-V. Weight Style Type ZY t r J f rI, it �t it • A@Fl@iivali by ANtIePF@fi'ProgO8d1 Y'Y.Y.....T„_. f All ot'du 5Ei6vE iep)Ao¢iui7it ivttldmvs artd dontn to be pmvid for Qsc sum sAtal the,utwunt stared in this Agfecncnt. L�-9P�. ,a;�CIR.§ •fhis Eihopdsal Will t27iM4!!1 mu'd fiit 30 slays, p So*[ x {/ o — � y�f+.+' VU9Fk Permit cot _ 460t, AgIft-Dnir �rnrrcttl6j R„dr,r� nlrF rxrhnt.l'rxrw+n?r / .� 'Fatal nynt pf Agre@M@PI, You are hore6y autYtaHW to WrxiA all repist&awtit windows And&ors retluire,4 to complete this;tgntrucvi for iWiidi ffie diiilMigued tlgieft to pay the amnunt incutiuned in this Agmcment and A4covLug m the CCftrid hucof. - - � �u_�.��nap I e. you)the h�A tmy mcel this mnsacdon at any time prior to midni t of Else tip hwiti day after the dtatc of this transaction.Please see attached @@bane@ D9@ on�atnpl@tied idth of ecllation fi r!n fo an explan oio oft right. host of WPrfnf@§een RoWr§ . ' — - I4no ' :mroe i 9Rprdtstl:Si lrr„ _ Aj(rinling rpultl!!g&tarylhea/nelig tcGrch ntaX/!f nrtxfed it not i;7G�it rd rq R I!g rtgrdc.l�rr l?rr>/rr>rpgnfi v�y rruterl r:lmw. R@ft@wii by Acid&wn'Areeptance - - !'Ltarp!lurr IfinY.A.gr art pAnE,(e fR h!r{pn rr unen rFr7 NASCCA rlmt79 Elounrr>; if•troy inrut,rlgm«�it!{r+. ,t�rr/r{y7tAg r�FN,(�?6iury,rnr ry,rdl rotnpG'rr,�rcl 'Nil, ,4nrtm,lly.l;rd>!n M„n.rtrr'1ipMrun,• rlrngryurrfyrr/>r.r(,..,rr.,rgtuAiq?4r�//lrncyrL/Irr{rrrr!#nft{>,t�q(;xl( ,um7nrrrin!?Jel r eaillA r?grureanyd rn r,<allrlrrslyuArrrn�+t rlr�:u nr<l NUt @INIDING ON RENEWAL 9Y ANGERSEN"WITHOUT MANAGEMENT ACCEPTANCE. rb a,Grllgtinri y ,r. 1 Drill jlruiligiiuti 4t%!n!t'-lir•irt'f{.till iTl+Andersm, YWlnw hnialki itur,Pink ("Inior,r Q�dNO���l�lti ; W yi7 WF�tifi sS0 800 9 -'•[�t 9STU t?680S : 'ON 9NOHd • }, -- Town of Barnstable *Permit# 1 1� S 6 Expires 6 months from date _ sAnivsrn" Regulatory Services Fee • Usse. 1639• ,0g Thomas F.Geller,Director b,�ED ,, Building Division Tom Perry, Building Commissioner X-PRES °� L. 200 Main Street,.Hyannis,MA 02601 J U L 1 Office: 508-862-4038 8 2005 Fax; 508-790-6230 TOWN OF g�RNST,gBL6 EXPRESS PERMrr APPLICATION - RESIDENTIAL ONLY Not Valid without Red .Press Imprint Map/parcel Number 17 503 Property Address ❑Residential Value of Work Minimum fee of•$25.00 for work under$6000.00 Owner's Name&Address Co e2%7 S " L Tel hone Number Z- 5`Z_ Contractors-Name nc aT /0— Sr ---- Home Improvement Contractor. License#(if applicable) Construction Supervisor's License.#(if applicable) [ UVorkman's Compensation Insurance Check one: ❑ I am a sole proprietor I an the Homeowner I have Worker's Compensation Insurance Instrance Company Name Workman's Comp.Policy# -2 Z, Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑-Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side c Replacement Windows. U Value 3/ (maximum.44) *where required: Issuance of this permit does not exempt compliance with other tows department regulations,i.e.Historic,Conservation,etc. ***Note: Properly Own3pnlist sip Property Owner Letter of Permission. Ho ement Contractors License is required. Signature QForms:expmtrg Revisc063004 �SFIE rqy� Town of Barnstable °^ Regulatory Services &MMSTABLEvMAM '$ Thomas F.Geiler,Director 0 ..�6. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder j as Owner of the subject property hereby authorize ;4U- = to act on my behalf, in all matters relative to work authorized by this building permit application for. (Addres of Job) 7-f —05� Signature of Owner Date (Olve-/S Print Name QTORM&OWNERPERMISSION i 9 CM Double Hung - Vinyl A eon/brAw E 4r So RefD Cmd No Grids 1-800-746-66tj,5 NFRC 2001 ENERGY PERFORMANCE RATINGS U-Factor(U.&A-P) Solar Heat Gain Coefficient 0 .34 0 . 29 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0 . 49 M eMilkhQersupulapatwthese ratings conform to applicable NFRC procedures for determining whole product performance.NFAC ratings are determined fora famd set of environmental conditions and a specifiMducts¢e.Consult manufac mes literahae for Other product perrormance information. www.ftorg ...., bib— lr;v'�f�31'STAR IInit qualifies foe Sner93' Star via 9 on(s): Northern, North Central, South Central, -„ Southern . D DPs I ih: tt Ihr t?0/U'�IsS3 BS�H-R30 `, 'Pest Size: 44 x 60 Order #.3930873030001 40313 HS ,f Board of BMllding Regotatieas and Standards HOME IMPROVEMENT CONTRACTOR Reetatraftw: 126W3 Exoirmtkw ttt3raw type: Supplement Card THE Home DO W At-Home Slavic R"K AUVETTE 3200 COBB GALLEMA PKWY ti20 ALTAt+ITA,GA 3o339 Adr�alstrator^ a a Lkease or rs a valid for Mdivldal at�Y bden the ettpirsom dolf, If found retard w. Board d Bnildind'Reg¢hd0w and Standards One Asbbw'M Plaoe Rm 1301 Beater,Ma•t210B -. --let valid wit0�ut�Brr�re . ti f TOWN OF BARNSTABLE .`� •" Permit No- --------------------------------- I ; Building Inspector 1 ► ."L Cash 1639 ?°Mob. OCCUPANCY PERMIT Bond ------------------- No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date \v Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ...................................................... 19......_ _ ................................................................................._................_._.._...._ Building Inspector I ,'. _� fly',��.� t" .,�. '� ", -t 1. � , ;4 . , - . , - - �4 , ,, ',��g .lel ,_�11 1`11 - 1�vl",� T i . -1 ;I.U,!. ." %�I�j'�,,,�,`�*�' - , �4�i�" " -� -I ��,-�,_".��, ll I.. �,I,-� �,;�.-, _- � ..� I , - ,V� e. .. . . �. - 4. ,r I, I - , `�; '!�.�"".',-'_,, ,.4j_'_1.1 ,_;..-, ��:,I 9 4 " '" z,� 4, .4, ') , ,.i,,-Z,4,1 .- �;-��ll;�?�4�- .:1 , . " , , . . ,� Z, ���%I"', 4. 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L ,Q3k-A�AOtW�?i*�--,__ - I - I.-I I ,"z-_____ -_x.lz�,"z__, L I 1'5 I Apse: map and lot nu r OF TH E TO Sewage Permit number .......... ............................................ w MUSTADLE, i Housenumber ....1 ....��i....C .............................. , '" _A O 6 UU �A�0 i �'Q NPY tr TOWN OF BAR °ONSND BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..................... . ..... ... ..... . ... ............ TYPE OF CONSTRUCTION ..... .... ........ ... ... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �L j-11f- Location ... 'C1.. .C�.... �.`. ...�� 1` A... ......................... ProposedUse .............. ........ .......". ... ..A-.1......................................................................................... Zoning District .... .... .....................................................Fire District ... !.i ::'��s `�. ., Name of Owner(NA............ ....`.J..�. .��✓1.?��i�,:-.. .. .:.:.................Address ... ..��.../�:�`•'�•�z...�. .P.1r. .ctdk�� / Name of Builder, 'Z� ..L. -a/a .....Address .1�7 .... f Name of Architect ��"1 ....1�`.. v�?.?....... .............AddressA�v. ... �f, �.....,. •� G tr \ Number of Rooms .............'L .................................................Foundation Exieriorl.�R. CaZ•r�cr✓f.... .�.a't��. t`' ` S �RG!f ti..Roofin !aL.(r.Q h......... .....!YS�. ....... ....y .... Floors..: 0� ...1 ...7.8'..k.!! / !"��...............Interior/�...6Z�,jJJll�f.�?.P`r�.....�?��.:.::�...va�L�4i✓ Heating /� .... ... ..!� ...........................Plumbing Fireplace .....................................................Approximate Cost r ` Definitive Plan Approved by Planning Board ---------------—_—-----------19________ . Area ........ ............ ....... ... .. ... Diagram of Lot and Building with Dimensions Fee ............ /Z................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH �O�D O I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .......`-- L .. .......... ........ ...... 1 l 1 Linnell, Curtis H. Jr. No 22115 permit for ...... ... 1 1/2. . ..Story. ... . . .. .. . ............ single family dwelling ....................................................................... Location ............39 Hitching Post Lane Centerville ............................................................................... Owner ............Curtis. ..H....Linnell. . ... , Jr........ ...... ...... .... ............. . . .... . Type of Construction ........frame .............................. .. ............................................................................... Plot ............................ Lot ........... 29.............. Permit Granted April 15 19 80 Date of Inspection ....................................19 Date Completed ......................................19 RMIT REFUSED ....... ... 19 i.�.. . ........ ............ • 0 �--- i 10. ................................................ sa �: Approved.............................................. 19 ............................................................................... Assessor's map and lot number THE Sewage Permit number ........................................................ S BA"STABLE, i Housenumber ........................................................................ v Maas g i639• 90 i 'E1 MAY a TOWN OF BAR.NSTABLE BUILDING INSPECTOR ,w►' APPLICATION FOR PERMIT TO ............................................................................................................................. TYPE OF CONSTRUCTION .....k z':o�Tr!.....%.. ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ............:... Location ......... ....... ProposedUse .:........... ...-.�-............................................................ ZoningDistrict ......... .. .r.. .../.......................�.. Fire District ......9.........�.................... ............................................................ Name of Owner ................................ Address .../(f....: :::....�..........�1... �).......� .....:.. ....... v - Name of Builder ...........:c /rn�lJ�4/1t1! �./y�....Address ...li�:............................................................................ Name of Architect f: ........ ,? T. .G ......Address .. /1.... ..'".`r:".`:....................................................I...... f Rooms ........ ... .........Foundation .... r/�..a.. ,t............::??�Z.a.................................... Number o 0o s .... .......... ....... ........................ Exierior ....................................................................................Roofing ii......a k......:: .... fsw; /...................................... FIaars���?... ... .: ....cs/......7�1...................................................Interior ........ ............................................... Heating !`�... .....:...... -................. .........Plumbing .........::.,.........../'.................................................. ..............................Approximate Cost - Fireplace i 3�.... :................................................. Definitive Plan Approved by Planning Board ________________________________19-------- . Area Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. r- r Name ......... ...:................................................................... Linnell, Curtis H. Jr. A=173-33 22115 1 l/2' sto No ................. Permit for ............... ... ......... s iq-,4e family dwe 1 in Location 39 Hitching Po ne Centerville ............................................................................... Owner ...Curtis H. Linnellz.Jr. ...................................... ..................... Type of Construction .........frame ............................. .. .......................................... .................................... Plot ............................ of .........#29................ Permit Granted April 15 19 80 Date of Inspection ... ...............................19 Date Completed .... .. 19 ............................... PE IT; REFUSED ... ... ........ .. .. .. .. .. . . 19 ..... .T" . .... ... .................. ....................................... ....................................... Approved ................................................ 19 ............................................................................... ...............................................................................