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HomeMy WebLinkAbout0505 HUCKINS NECK ROAD Nun k-;n. - d,�, .Y .e el JR y 1 >y a a B 4' + L • r , : A, 4 � _ r - a. N i .:. N u. - � n a •. Ay • ^ . � ' , ._ .. ... `.. .. .. _ _. _, ., w. ., .. ., �. 1 � -. ., ' � `� n _ _ _ u, a. .. ... .,. !. 7 :. �% :, ,. - _ _ _ _ �, ,� . � �., .. � .,. - � � -, x .. '. .. _ .. � �" c ,. 'z. .. +„ .. :. - � . r - � a Y `� t ✓ �. �. � n � Y ., - x c .. � � y •r _ j. "_ ,, _ �. '- _ - -,. _ .. .. c .. _ .. �. .. .: �„ �... ,; ,. .�- ... _ u.,:. _:, ., � ,.a, ,. .'. �- ,� ., � v �,, c^.. .. _ , - - - - _ _ a � ,- -. -, :. .. „ . Town of Barnstable BLi11C�lrig Post This Card So That it is Visible.From the Street-Approved Plans:Must be Retained on.Job and,ahis Card Must be Kept. rexvsrae�.E, . _ _ , Posted Until Final Inspection Has Been Made Permit � .. 1 1iJl 1. Where a Certificate`of dccupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made Permit NO. B-19-4151 Applicant Name: OCEAN EDGE CUSTOM HOMES INC. Approvals Date Issued: 12/16/2019 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 06/16/2020 Foundation: Location: 505 HUCKINS NECK ROAD,CENTERVILLE Map/Lot: 233-050 002 Zoning District: RD-1 Sheathing: Owner on Record: SIAGEL,CYNTHIA J&STEVEN A TRS Contractor Name: DAVID CROSBIE Framing: 1 Address: 53 LITTLEFIELD ROAD Con tractor License': CS 109703 2 _, NEWTON, MA 02459 3: �' Est Project Cost: •$2,000.00 Chimney: Description: adding window in closet for light&ventilation Header to be 2x10 to Permit Fee: $85.00 span a 24 window Insulation: Fee Paid:f $85.00 Project Review Req: NEW WINDOW INSTALLED 1N EXISTING CLOSET.. Date: 12/16/2019 Final Plumbing/Gas . Rough Plumbing: _ Building Official . . ... _t _.. Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within'six`months after.issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: I. i. with h local zoning b -laws and codes. All construction,alterations and changes of use of any building and structures-shall be in compliance t the g y v Final Gas: n in d open for,public ins ection for the entire duration of the r"road and shall be mai to e This permit shall be displayed in a location clearly visible from access street o_. p p p P work until the completion of the same. �V -- Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on thispermit. Service: Minimum of Five Call Inspections Required forAll Construction Work: - 1.Foundation or Footing )` Rough: 2.Sheathing Inspection ,. 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund” (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Application Number..........10..... ................... ..... ... ... BAPIMAE&E, XAS& g Permit Fee............. ..................Other Fee........................ 1639. TotalFee Paid................................................................ ...... JTOWN OF BARNSTABLE Permit Approval by.... ................on...!.,z.../(,J/5...... . ............ BUILDING PERMIT Map... ...................Parcel.... ...... APPLICATION Section 1 — Owner's Information and Project Location Project Address !�Q:5" Village—t/7 Owners Name OwnersLegal Address City IJ4W— & (�OA State. #4�A zip Owners Cell # -7 N E-mail (�2 Section 2 —Use of Structureo Use Group E] Commercial Structure over 35,600cubic feet — ❑ Com mercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling co M Section 3 — Type of Permit Fj New Construction ❑ Move/Relocate ❑ Accessory Structure EJ Change of use E3Demo/(entire structure) ucture) 0 Finish Basement ❑ Family/Amnesty El Fire Alarm Rebuild El Deck Apartment ❑ Sprinkler System F� Addition ❑ Retaining wall ❑ Solar 2"Renovation ❑ Pool El Insulation Other—Specify Section 4 - Work Description 1 1 2 k, to 492 S—E L—)J"k) Lpmt undated- 11/15/701 R Application Number..............................................:..... Section 5—Detail Cost of Proposed Construction G Square Footage of Project Age of Structure Dig Safe Number A)14 # Of Bedrooms Existing Total#Of Bedrooms (proposed) r 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑,Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage F� Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom i Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes d No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage # of Dwelling Units (on site) Setbacks Front Yard Required Proposed � P Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No , f Last updated: 11/15/2018 SCANNED s DEC 171019 Z-A S-V 5 t"i v 'A v to$ n-e e v 12-iD Ceink{fvl a e mA- Sei ccljo% r rl co k t�( s y F wyf l ,fle4AI,L_ JL #r tXl� cry Moo Lv 14-,CA .er a Yto ov bte 5tttv s'iu ., w A 11 -t� be irt;ftaoved The Commonwealth of Massachusetts Departurent of Indus Accidents tru�l Office of Investigations 600 Washington Street Boston,MA 02111 ' www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers" ApipUcant Information Please Print Legibly Name(Business/Organization/Ind ividual): < Address:, City/State/Zip: r ' Phone M I R Are you an employer?Check the appropriate box-.-- Type of project(required): 1.ElI am a employer with- 4. am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction - 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor mein an capacity. employees and have workers' Y aP t3'• t 9. El Building addition [NO WOIkers' Comp.insurance comp.Insurance. required.] . 5. ❑ We are a corporation and its 10-❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions, myself:[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance 1eqtAred.]t C. 152,§1(4),and we have no employees.[No workers' 13.❑Other " comp.insurance required.] •My 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. xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. ' I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Q('7() Expiration Date: ` Job Site Address: _d 2 C.Ln Y S J ed City/State/Zip: mm c� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties ofperjury that the information providOF is true and correct Si Date: t -1 - Phone#• -7-70 Ojftial use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk,4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written.". An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be.deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public-work until acceptable evidence of compliance with the insurance nce requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation inst,m nce. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retuned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for firture permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents (free of Investigations 600 Washington Street Boston,MA 021.11 - Tel.#617-n7-4900 ext 406 or 1-877-MASSAM Revised 4-24-07 Fax#617-727-7749 www:mass.govldia Office of Consumer Affairs 8 Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. It found return to: Registration, Expiration Office of Consumer Affairs and Business Regulation 184418- 01/10/2020 10 Park Plaza-Suite 5170 OCEAN EDGE CUSTOM HOMES INC. Boston,MA 02116 DAVID M.CROSBIEC, -- 481 DEPOT ST. HARWICH,MA 02645 Undersecretary of valid without signature Massachusetts Department of Public Safety" Board of Building Regulations and Standards License. CS 1Q9703 _ ton struction DAVID CROSBIE t 481 DEPOT STREET HARWICH MA 02645 'W' Expiration Commisswer., 06/14/2020 i Homeowner Affidavit for Permitting We, Steven and Cindy Siagel,owner(s)of 505 Huckins Neck Rd Barnstable MA 02632,give David Crosbie of Ocean Edge Custom Homes, Inc. express permission to act on our behalf for all aspects of the building permit process. Sign Sign `' 1 �l � 1 e _k I 89 Share Tweet Shares Custom Search Property Display 4 233 / 050/ 002 - Use Code: 1010 Owner Information r Map/Block/Lot: 233/050/002 Property Address 505 HLICKINS NECK ROAD Village: Centerville Town Sewer At Address: No GIS Zoning Value: RD-1 Owner Name as of 1/1/18: SIAGEL, CYNTHIA J &STEVEN A TRS 53 LITTLEFIELD ROAD NEWTON, MA. 02459 Co-Owner Name £ THE C J SIAGEL REV TR&THE S A SIAGEL R Assessed�Valuesro.m,�� , �,�.�,A,�,,, .. Tax Information. ro.. , ,.. �.�.,,M.,... z .•, �,,., ......�,. � v •_�__ .� ,.. _r..w v, w.._.__._._ ._�w__ r._ ............._ ............. Sales History i ® DATE(MMIDDIYYYY) ACC)R 0 CERTIFICATE OF LIABILITY INSURANCE 11/20/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Christian Barber,CIC NAME: The Oceanside Insurance Group AHc NoA Ext: (508)775-0500 x (508)790-7955 (Al,No E-MAIL .ADDRESS: 52 West Main Street INSURERS)AFFORDING COVERAGE NAIC# Hyannis MA 02601 wsURERA: Mapfre 23876 INSURED INSURER B: Commerce Insurance Ocean Edge Custom Homes Inc INSURER c: Travelers AIR 481 Depot St INSURER D: INSURER E: Harwich MA 02645 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1991707198 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 AIJUL 51JUK POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE �OCCUR PREMISES Ea occurrence) $ 100,000 _ MED EXP(Any one person) $ 5,000 A Y 8008030006080 07/05/2019 07/05/2020 PERSONAL SADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY JECT PRO LOC PRODUCTS-COMPlOPAGG $ 2,000,000 OTHER: SPPCO $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ B OWNED X SCHEDULED Y BCYX45 01/17/2019 01/17/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ Underinsured motorist BI $ 100,000 UMBRELLA LIAB V~ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE X H ER v/N 500,000 ANY PROPRI R/PARTNE DXECUTIVE E.L.EACH ACCIDENT $ C OFFICER/MEMBMBEREXCLUDED7 � NIA 6HUB-8D89001-7-18 11/30/2018 11/30/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsement of the policy. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. Town of Barnstable is an additional insured for Automobile and General Liability if required in a written contract or agreement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 367 Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 4044�__ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD i .�►Co® CERTIFICATE OF LIABILITY INSURANCE DATEIYYYY) �i 11/27/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Next Insurance,Inc. PHONN Ex ;(855)222-5919 AlC No PO Box 60787 E-MAIL Palo Alto,CA 94306 ADDRESS: support@next-insurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: State National insurance Company,Inc. 12831 INSURED INSURER B Scott Shields Tri-s Development Corp INSURER C: 72 Briar Patch Rd INSURER D Osterville,MA 02655 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:7277135 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER Y LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000.00 DAMAGE TO RENTED CLAIMS-MADE I-XI OCCUR PREMISES Ea occurrence $100,000.00 MED EXP(Any one person) $15,000.00 A X X NXTULB6XBR-00-GL 11/27/2019 11/27/2020 PERSONAL&ADV INJURY $1,000,000.00 M'OTHER: L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000.00 POLICY❑JECT LOC PRODUCTS-COMP/OPAGG $2,000,000.00 $ AUTOMOBILE LIABILITY COMEaaccidentBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ .DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ _ Each Occurrence: $25,000.00 A Contractors Errors and Omissions X NXTULB6XBR-00-GL 11/27/2019 11/27/2020 Aggregate: $50,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is,required) Ocean Edge Customs Homes Inc is an Additional Insured on the General Liability policy,per the Additional Insured Automatic Status Endorsement.A General Liability Waiver of Subrogation applies in favor of this Additional Insured if required by written agreement with the insured. CERTIFICATE HOLDER CANCELLATION Ocean Edge Customs Homes Inc SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 481 Depot St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Harwich,MA 02W ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE n 'n @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD c , IN3►URA�ICE ! oe1olzol9 �k CEFTIFIC ` "B`OF LIABILI'i`Y �r �} 'n FORa ray THE ppu,, <-THIS CER`T ,, , , 133<I "I3 -F,tkNilTi1►j?YEOR NEQAT11f Y Aj japYEX;T$NG OIZE ALTE�R� EE IINEi IN#Ut1 R�1)," 0 CERTIFICATE GOES NOT AF B CONSTITUTE A CONTRAC BEL'OtlY TN19 CERTI M.ATEs•OF INSURANCE r „n v 'rr/ � r REPRESENTATIVE Of ANO THE;CERTIFICATE NOLtIEft' m / � 4 pq NPO is must tNave ADINTIONAL�IBt1i D pt�� tNU►ORTANT: itfhe�jrtlNeata'11190 la sn ITIONAI INSt1RED� I Yt �ceAaln pollee- man endorsGnent A'atet rat tt SUBROQAR01M,jS,yVANEG;,mubj ;J>Jo:tho t m�0 end c_',,,hiona of the poiN:y, % !Ma cMttkolte dons not cantor Me to tlo cadiflcato hoiet m ilau of such endotaemem e r 2 6 's3 13 vaoouc0► ' i 472 09rt7� ,. Y blBERK S sS biBERK— M I P.O.Sox 113247 Statnr6rd,°CT'06911' '': iiasiirtERiJ" "oR RAoe el r 911aeR u"µst{On01 uaW�ty b Flf tnourelfr ��. NAKS ass T04ncn 8 71m Rule 19uIR c 3539 MAIN 57 ----^', """" r ro rr /F m.'"/ "' ✓ �'`'Breier;MA'p2631 / '� INauRER o ~° INauaertei "° , ,. ✓ a /,�,. r y,,,;- l r ':rr.: ✓ ✓2 „p .,. .„ 'a, SURERF r,, r,: w„ v !,„ R r;COVERAGE$/.':; „n:,w CERTIFICATE NUAABER; . EV1810H NUMBER THIS IS TO CERTIFY THAT THE;P QLIGES OF INSILRANCE ISTEO BELOW HAVE BEEN ISSUED T. Thy INSUI D NAMED A9GVj;tt$ Tt Tl POLICY PERIODf NT 1MTH SPECr TO H TH►S It tCATED:'NOTMATHSfiA1�lPKi";ANYrREOIHREMENT�TERM t COt�ITiOiJ OF,ANY CQN,"' ,, #OT R CM �, m p, CERTffiCATE,AAAY BE ISSUED OR MAY PERTAIN f7iE INSURANGE AFFORDED BY THE POLICIES INSCRIBED HEREI)V 1S$t�JECTy TO ACL TIC TERMS " „.r.."EXCtUSKNVS 'GOl71TIONS''OF SCJCW:PQL1CItSl11MNTS SH01MN MAYwHAVE BEEN REDIJCED,BY PAIQ Ci AIM:!: s; � >. •T*m R45URANf3E µ, r r, L 'r DE W/k coMMERcaALOENALLueSrcY w ', EACH & 5/ g M -:/ �6 Ig n "W rrrr k ° _ ° Q CWMFSOAADE OCCUR r ,/ ✓ (} a s r�- r e - a „d r MED Exf„ .. tM 9` 99MM NAL8ADYINJURY s 0 ° a ,a. a, Q•m ✓ f - ,✓, ✓ ro n i l " iEN1 AGGREGATE tiNNT APPtlES PER GENERAL AGGREGATE p / " p fl Cn kd" r 2¢/ N rr a ,t' a PlC1' c,,; LOC r r pROttSCOMls+JOPAGO E a Q. f „,, OTHER SI E IJMtf �, / AUTO ELY1a1UTY 4;r �:, s r 1 ' ,r h� r 00L'i,l"RY lam!Pam) s sy., U r,r, :ANY AUT4f' i. ;v m r d z ,4 .: OVNiEO SCHEDULED 80DfLY:INNRV(P!t eCClds S > AULti90►r ,," ; AUTOS ' v .., , PRO D AGE G 't!g MIRED NONCWNED AUl' cmLY AUTOS ONLY J r a ,_r r r r s , f ✓ ri" ^�&,yryr z ✓ z e IMN1RP1t:AUA® 'QCCUR,"„ $EACHOCCAJRRENCE r : AGGREGATE a rs- EXCE8B LIAR ,' CUtIM4 MADE ` , ; w S rr / OED,,,, ,, a� RETEf N 5 , r�^ OTH•�. r ' ` "'^ " NIORNERSCOMPEN ' AND EMPLIGM LIA&LrrY Y!N Wf ROPRIETO"ARTNERIDtECiR1YE N N!A N9W0009aC�G OH/OS/ZO19a O�OS/Z�ZO ELEACNACCkOENT A,"I OFFICER/NEMBEREXCLUDED9 Q, °EL:DISFAgE rEA r ist"'b O (Ma'ndaLory,tnNN)' „, t� nrr q, ;deaetiEolindar a EL.'DiSFABE POLICY LIN�L;r Y� r' i yyppss „, ' r ,.. ..,, x`. Geu `i DESCRIPTJONOF t)PERAT�ONS below t)0 QQ Professional Uabiilty r(Errors& I Per O�wCcurrenee! r °e °<OmtSSlons ,'C n -Made ppAA �` „.... ,- ,., f 1*Ei1lCLEB D 1Dt Addltfgmel Remarks Scb9AuE6 m g)t by atfaehod E rtlaa Is eoquueaj' " ' „ x I ; r"F are ;< OESCRIPTIQPIOFOPERATIONSIL"OCATt�IS G e arr„ A,z, a „/ „s ,:r '%,,, f /r „m.3: r ✓v ' m t ,,," ,:5 ,, �"r,,.: " y,,"'�° ,eF. 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THE✓EXPIRATION DATE THERETO ,x NClTtC Tlm Role ACCORDANCE WITH TJIE PAY I'RC1VI � , r z an,✓✓✓ r 4rJ4// / m /""1 r/ , G; ri% r r 'riJ^f /r ✓ ✓- Jr'., / 2 rJ,,, ,5% G.s v✓ x c E m / ,: pr/' 6 sr`✓ir✓. ;Y"rNKi d� 38g'MAIN�5 f �... ., ,,✓ ,BreVJ er�u��:O26'�1>e"r ! - a i✓ro/rft q ✓D - " rGF/r-✓ r ,m rE f.J� urati A e C r yF✓ !� ""y ry/✓s! J" 3Yr: ro!f✓'G,�/ p -. II r r r / a r J r , r G a r✓! ✓dzk ✓„r �, m Gam.., r✓3; ,, a,,.„ �;. s ,x, uG.: r..C.. rG� a f G v r,�r"r v'wtly✓r ,5,»5u."'u,d '✓"f ,6 ✓ ,3 s >>,,,J r r r�'"L'„ ;3 r/ r/r r r ,; /k z ,`'�x ,,/ . v 9V l988 2Q13i/,GORY COR�!,.RATtQN� AOEti�hts toal� t ?.s z' ACOFtI?2b(2016lOS)� ThesAGORq name and logo>IEre registered ntlwr✓ks of ACORD�j / ��,�,s.....„. �u��"4�,,,, y� M �' �. 'w /r J" a /)/; �r ��a r F" .r d J rr„m „r ✓G r �,^r �'. �".. � '^fir -. � -:/^ a ',. �mrr°, ur ✓ : ✓ r f ✓rri:f i , - J. ! n r,r✓ S G'P�, rw YY m �m� ,ter m,, rr� � '��rd.�s„�y�C,✓:.:ro iHNx^mr^ s➢,s n�- u, ,,,` r✓rr,,,Z. v rG/✓ a„dl r y ✓ %/ s ,r r?� r ra"'✓ f rJ R fr rr� '; ,✓, - m ,,i t d v ce of.gym ^y �. '/ram. ,/2, .'�✓ Photos r Sketches ,w, mn �,N„ �,x� m �► S u s�njd" ( i il f G AR As Built Cards:Click card#to view:Card #1 (HMdisplay.asp?mappar-233050002&seq=1) 132N Barn-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor,Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished)FUS Second Story Living Area SPE Pool Enclosure (Finished) (' BRN Barn GAR Garage TQS Three Quarters Story(Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLP Loading Platform GRIN Greenhouse UHS Half Story(Unfinished) s FAT Attic Area(Finished) GXT Garage Extension Front UST Utility Area(Unfinished) FCP Carport KEN Kennel UTQ Three Quarters Story (Unfinished) FEP Enclosed Porch MZ1 Mezzanine,Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story (Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio I ` Construction Details r Outbuildings and Extra Features �► Town of Barnstable 2019 (/index.asp). Town Records Access Officer Ann Quirk Public Records Request Form (Mapartments/TownClerk/R9eview.asp?file=Office Information/Public- Records-Request html&title=Public%20Records%20Reauest&exn=Office Information), P 508-862-4044 F 508-790-6326 Contact Town Hall 367 Main Street Hyannis MA 02601 508-862-4956 M-F 8:30 a.m. to 4:30 p.m. Email Us(hops://tobweb.town.barnstable.ma.us/townmeganet/telephone-directory.aspx) Social Media 10 Facebook(hftps://www.facebook.com/townofbarnstable/?fref=ts), DjWifter(httttDs://twifer.com/BamstableMA) Quick Links Departments(Lpartments.asp) Boards and Committees (/BoardsCommittees.asp) Calendar(/calendar.asp) Property Look up_(�partments/Assessing/Property_Values/Property-Look-Up.asp). Employment(/Departments/HumanResources/pageview.asp?file=Employ ment/Barnstable-Employment- Opportunities.html&title=Barnstable%20Employment%20Opportunities&exp=Employment), Contact Us (hops•//tobweb.town.barnstable.ma.us/townmeganet/telephone-directory.aspx) Application Number.............. .....................`...... Section 9 Construction Supervisor b Name K, J L C Z Telephone Number ' l Y Address i City ((J; State 1 Zip (_2�(pq S� License Number Licease,Type � Expiration Date Contractors Email n:- 06 C o (iS- w Cell# '77L ' 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 b 780 CMR and the Town of Barnstable.Attach a copy of your license. F` Signature Date Section 10—Home Improvement Contractor Name <0I W� e_' Telephone Number 2 — — �; Address _ City State _Zip : � C„ Y< Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required b 80 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners 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 78.0 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signatur Date / Print Name Telephone Number '77c( E-mail permit to: Tact nnrintrri• 11/1,;noi R Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ - I Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13 — Owner's Authorization i i as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name Last updated: 11/15/2018 r00 `Assessor's Office(1st floor) Map 2. 33 Lot :=M ' Permit# Conservation Office(4th floor) - U Date Issued12 Board of Health(3rd floor)(8:30-9:30/1:00- 2:00) ��J" / 77;1 � e go Engineering Dept.(3rd.floor) House#1 ,,1`(� LZ t a- Planning Dept. (1st floor/School Admin.Bldg.) INSTAUE LIVICE Definitive Plan Approve-&bx Planning Board 19 ENVIR N ME AND TOWN OF BARNSTABLE Building Permit Application ✓Project Street Address a �y c-r/ S /V L= A- /t Q. ,/Village d14F GU V I z-e ✓Owner 1 t9 H ,S' PO 6 A) t : Address !v 1_W 7c Si Dk7 0 /Telephone 7 J7S- V I/S-0 /ermit Request 11 o D L t Total 1 Story Area(include 1 story garages& ecks) 3 3 of �J square feet Total 2 Story Area(total of 1st&2nd stories) 2 cl 8 R- $ I b quare feet . ,/Estimated Project Cost $ _ 3 1)o L9 - Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Z.S z <--Q Proposed Use Construction Type Commercial U O Residential Dwelling Type: Single Family V Two Family Multi-Family Age of Existing Structure 3.0 Basement Type: Finished Historic House / ""(�0 Unfinished Ck*AA- Old King's Highway /� V9 Number of Baths + - No.of Bedrooms Total Room Count(not including baths) CT First Floor Heat Type and Fuel (OA-5 Central Air ��o Fireplaces Garage: Detached, Other Detached Structures: Pool Attached Barn None Sheds OAICS- ther �/ Builder Information "2_15 AIA,5L NameP& v 010 Telephone Number -7 2, -7 Address 1 L)! l,D-b- ,/ License# (,ts�37t✓/cif/ � ~ D�Ur Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CON TRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �s7 _ t-)I) pYL-1P q SIGNATURE 0 Lti—,` DATE ✓��— /� BUILDING PERMIYDENIED FOR THE FOLLOWING REASON(S) t ( FOR OFFICIAL USE ONLY PERMIT NO. L `J DATE ISSUED MAP/PARCEL NO. _ ADDRESS VILLAGE - i OWNER ' , DATE OF INSPECTION: FOUNDATION FRAME. i �� �� ✓ �� INSULATION / , /'G� FIREPLACE' 1, ELECTRICAL: ROUGH FINAL PLUMBING: ;. ;, =:ROUGH FINAL GAS: ``" %-ROUGH FINAL ' FINAL BUILDING.: DATE CLOSED ;x ASSOCIATION PLAN: NO.r; $817 i 2i i 122. DEYT il�y �►V�j+' y , ugt ' I�OIfZIiZO1ZWP.QL�fL- O� I�1Q�QCJZLL6l��, .y jjjM��(t•: 1 tn:aRl Q 600 James J.Campbed CprrtmrssiMff Workers' Compensadon ftw=nce Affidavit tj (ffoe�edpam�es► with a principal place of-mess at: (Qt�dSta�ZEv� i f do hereby cerdfy°under the pains and penalties of perjury, that: () [ an an employer providing workers' ootnpeasa dan coverage for my employees wd this job. t , Insurance Company Policy Number () [ am a sole propriesor and have no one wo or 'n any tapacky. () I am a sole proprietor, general ooauaccor h omeowner elide one) and have Idt contractors Qsced below who have the foliovrnag ootaPeasaIIoa poltdes: Coy/Poficy Contractor C�� / [ostaanoe Conuaaor [nsucance Ccmpnwipoficy . ntr r Idsuraaae Company/Policy I am a homeowner performing all the work myself. i�ad��cno��at s ct�f of rtiu srte+nem vn11 be fo.ended M d'.e OMM of invedpdota of cite t7U1 for aoaeca;e v and chat I u c:(e 1s reG:•-ed seder Satson ZSA of MGL l:Z we ivad m tM fi=Gs�it M of CMvh t v� of a tme of uo!o 51,5 ire�-s' ttnprico:.r..anc as well as ctWI venalto in the tom:of a STOP WORIC ORDM and a tine of 5100.00 a day Mina mr- Signed this, ti vl. day of k Cicen Perrnittee Buctdbg Depatmtene . Ucensing Board Sete Office : The Town of Barnstable NAM�S Department of Health Safety and Environmental Services °- P Building Division 367 Main Street,,Hyannis MA 02601 Ralph Crosson Office: 508 790�227 Building Commissioner Fare 508 775-33" For office use only Permit no. Date AFFIDAVIT HOME n"ROVEMENT 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 opted building containing at least one but not mom 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. Typeof Work: E-e emu. J d-e Est Cost L Grs� Address of Work: S� S �f v e GC `, Ouner.Name: Date of Permit Application: I hereby certify that: Registration is not required for the follo%%ing reason(s): Work excluded by law Job under S1,000 'Iding not owner-occupied Owner pulling own permit Notice is hereby given that: CONTRACTORS OWNERS PULLING THEIR OWN PERMIT OR DEALING WTrH t1NRECIS'TERFD FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: �i9 � � s �� c� dy c�•�t G � k Date Contractor name Registration No OR Date Owners name • TOWN OF BARNSTABLE' BUILDING DEPARTMENT .HOMEOWNER LICENSE EXEMPTION Please ' Print. ...... JOB LOCATION •w �C'IAIs � . V ,, .. . ,b "" -Number Street address Section of town "HOMEOWNER" . bow -) Name Home phone Work phone PRESENT MAILING ADDRESS �7s/IJ - �'•: ._ .. 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor.*. DEFINITION OF HOMEOWNER: Person(sy who owns a parcel ofland on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six 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 Officia. on a form acceptable to the Building Official, that he/.she shall be responsibly for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes-.responsibility for compliance with the Star, Building. Code -and other applicable codes, by-laws,. 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. . - HOMEOWNER'S SIGNATURE W�4 APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State .Building' Code Section .127, 0, Construction Control. r - HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which a-Milding permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that..if Home Owner engages a person(s) for hire to do such work, that such Home Owne shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a 'supervisor (see Appendix 0, Rules and Regulations for .licensing Construction' Supervisors, Section 2.15) . This lack of awarene often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor: The Home"Oianer: acti as supervisor is ultimately responsible. :. ,;: To ensure that the Home Owner is fully aware of his/her responsibilities,. ma- communities require, as part of the permit application, that the Home 'Owner certify that he/she understands the responsibilities of a supervisor. On th, last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. j .,/ f.'y:*kk*hkk*Yp YNNN'rt*rtrtrt**k****yt>t YN'7.'NYC Yc***K**Yc StrtA*soN*Stx;s;**YYIC YC St YC YcNN'N7k***1r i;*N*/t Yt*1t Yf*t4**R PRODUCER NAME COMPANIES AFFORDING COVERAGE Fredericks Ins. Agency, Inc. CO: LETTER A: Travelers.Insurrance Company P. 0. Box 427 CO. LETTER B: Eastern Casualty Ins. Co. INSURED NAME _tnlct CO. LETTER C: G atxel'is Bros. ConsIor) CO. LETTER D: 105`Cape Drive CO. LETTER E: ------------------WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY-------------------- CO TYPE OF INSURANCE POLICY NUMBER : EFFECTIVE EXPIRATION LTR DATE DATE B WORKERS' COMPENSATION WCP0008522_ 11/05/94 11/05/95 AND EMPLOYERS' LIABILITY LIMITS OF LIABILITY IN THOUSANDS STATUTORY EACH ACCIDENT $ 100 DISEASE-POLICY LIMIT, $500 DISEASE-EACH EMPLOYEE $100 --------------------------------------OTHER--------------------------------------- CO TYPE OF INSURANCE POLICY NIMSER EFFECTIVE EXPIRATION L'TR DATE DATE LIMITS OF LIABILITY IN THOUSANDS ---DESCRIPTION OF OPERATIONS/LOCATIONS/t?EHICLES/RESTRICTIONS/SPECIAL ITEMS------ OPER/LOCATION/VER/RESTRTCTION/SPECIAL ITEM: Carpentry, residential and light commercial. =====-CERTIFICATE HOLDER"=----------------- -------Town of Barnstable SHOULD A�VX OF THE`ABO�TE DESCRIBED POLICIES Building Inspector BE CANCELLED BEFORE THE EXPIRATION DATE South Street 'THEREOF, THE ISSUING COMPANY WILL ENDEAVOR FAX 790-6230 TO MAIL 10 DAYS WkITrEN NOTICE M THE Hyannis MA CERTIFICATE HOLDER NAMED TO THE LEFT, BUT 02601 HOLDER-ID 005 FAILURE TO MAIL SUCH NOTICE SHALL, :IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. UTHORZZED REPR TATIV TOTHL P.01. <� OCT-1B-1995 11:37 FROM FREDERICKS INSURANCE TO 7906230 P.01 *****ACORD-ID***An*A CERTIF'ICATE''OF INSURANCE "**** DATE xr.r*x 00091 x *,t** +**,tx 10/18/95 xxn�tYc xYttYTkxNrYtxY<wxxxN'YcxYCY�7C:txxlK>tx7K*rtR'xYcYc�7Yx9t�tYtYrYtkYtYrv,YrtYr>tYcv*?ksk�xt3rxtiFasr*tt�*4tc9ticthltittYt***Y[kfk PRODUCER NAME & ADDRESS THIS CERTIFICATE 15 ISSUED AS A MATTER OF Fredericks Ins. Agency, Inc. INFORMATION ONLY AND CONFERS NO RIGHTS UPON P. 0. BOX 427 THE CERTIFICATE HOLDER. THIS CERTIFICATE 1046 Main Street DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Osterville MA 02655 AFFORDED BY THE POLICIES BELOW. INSURED NAME & ADDRESS COMPANIES AFFORDING COVERAGE Giatrelis Bros. Construction CO. LETTER A: Travelers Insurance Company 106 Cape Drive CO. LETTER B: Easter-n CasualtyIns. Co. CO.. LETTER C: Mashpee MA 02649 NCO. LETTER D: CO. LETTER E: _________________________ _ ____COVERP,GES--- __-_--_-.�-_--_-_-_- -_ .�---_______ THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIRE- MENT, TERM OF 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. ------------------------------GENERAL LIABILITY COVERAGE------------•-----...----------- CO TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION LTR . DATE DATE COMMERCIAL GENERAL LIABILITY , CLAIMS MADE OCCURRENCE OWNER'S & CONTRACTORS PROTECTIVE A X Comm Package 680-363K9399 03/09/95 03/09/96 LIMITS OF LIABILITY IN THOUSANDS C ENER,AL AGGREGATE $ 2000 EACH OCCURRENCE $ 1000 k;RODUCTS-COMP/OPS AGGREGATE $ 2000 FIRE DAMAGE(ANY ONE FIRE) $ 50 'ERSONAL & ADVERTISING INJURY $ 1000 MEDICAL EXPENSE(ANY ONE PERSON) $ 5 ---------------------------------AUTOMOBILE LIABILITY------------------------------_-- CO TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION LTR DATE DATE ANY AUTO ALL OWNED AUTOS SCHEDULED ,AUTOS HIRED-AUTOS NON-OWNED AUTOS GARAGE-LIABILITY y. . LIMITS OF LIABILITY IN THOUSANDS .: BODILY INJURY (PER PERSON) $ PROPERTY DAMAGE $ BODILY INJURY .(PER ACCIDENT) $ CSL $ ----------------------------------EXCESS LIABILM--------------------------------- CO TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION LTR DATE LATE UMBRELLA FORM OTHER THAN UMBRELLA FORM ` EXCESS APPLIES TO: LIMITS OF LIABILITY IN THOUSANDS EACH OCCURRENCE $ AGGREGATE $ EACH OCCURRENCE S . AGGREGATE ACORD i5-S 11 85 ( . /._..._� _ . .._. ... _...._PAGE....:1..OF 2 CERTIFICATE OF.INSIJRANCF *w*'t DATE ***xn *x*xh 00091 *x**x*x x**** 1!li1R/qF ***** P. 02 I, ; 110MI" IMPROVEMENT CONTRACTORS REGISTRATXQN Board of Building Regulations and Standards One Ashburton Place - Room 1301 i Boston . Massachusetts 0210$ i i HOME; IMPROVEMENT CONTRACTOR Registration 115020 Expiration 41/23/97 . Type - PARTNERSHIP � J�I�olnlwcx.enQ{ fGnu��4.�tsl NONE IMPROVEMENT CONTRACTOR Registration 115020 GIATRELIS CONSTRUCTION TYPO - PARTNERSHIP STEPHEN J . GIATRELIS Expiration 11/23/97 106 CAPE DR MASHPEE MA 02649 I GIATRELIS CONSTRUCTION STEPHEN 3. GIATRELIS l ssle�.m 7y ,1,106 CAPE DR ADMIN*TRATOR NASHDEE NA 02b49 1 i D. COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY t ' OF ONE AEHBOFITON PLACE { I.. �Fe!lwrs to c•^•"..`:T,eBrrpeE MA33ACHUSETT8 BOSTON,MA 02105 ►I�Y.1 bf hrr kF1'flolag LICENSE Ec OAUTIONAFIBn �L�E .Ad p�fMflK EXPIRATION DATE I CONSTRf, SUPERVISOR IljJR �� 496 EFFECTIVE DATE LIC-N0, �; FOR PRbTECTION AGAINST RE51 5 THEFT,PUT RIGHT THUMB 18 � 1213111993 049915 �'' PRINT IN APPROPRIATE 1 & 2 FA M I LV NONE I� 3' BOX ON LICENSE. STEPHEN J GIATRELIS 06 CAP DR BLASTING OPERATORS SS 578-68-2211 ��MASH PF.E 02649 � . MUST INCLUDE PHOTO. oM010IBU9T140 OPff ONLYI F10af,00 NOTVAUDUNTIL SIGNED B+L+OENSE•E ANLOFFICIALLY L ' HEIGHT: ; STAMPED•OF•$PNATURE OF T&11111NER DOB: _ 07/21/1962 TTOS WCVMENT MUST BE 1 SION NAME IN FULL ABOvE Sf(NAl UnE VNE CARRIFDONTt1E oER90NOF 1I 8lGWATURE OIL ,EF THE MOLDER WMEN EN- � 1, 1 OWFR9-RIOM THUMB 04INT OAGEDINTH'SOCG4DATION. —16 `�tHElp,-O� The Town of Barnstable BARE.p- Department of Health Safety and Environmental Services 7 MASS. 0 prFDMP�� Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location l CV vry S t-' ?r(,u'-,Permit Number Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: Please call: 508-790-6227 for reeinspection. , � u ' Inspected by Date �` �� `OFINE TO The Town -of Barnstable BARE. Department of Health Safety and Environmental Services 9 MASS. 0 t6}q. �0 pTED r�An+°� Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location ( - )c, I/u KJ � Permit Number Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following iiitems need correcting: \j to � C V0 bs - e_�, iC�) A~DO Y -W P i2V, 4 �n ��-�fii�, 0 . '�-C c'`>\ D'�./\ ctA +-tee �����ti &'ti C 0on t e,. �.ur r2t Please call: 508-790-622`7� for reeinspection. Inspected by Date i p I 41 I\ju PAI 'I � I j 'IMF'. s/ I j , s l iiiiii,12`1 ill I Lill, � ..�. ( � /,,'' �� ��� .... I _ •off . fi _ JiC R; 7L1 dg • � . DAM: : _ — ocf ra,wro EIw1icYK - ---NOH'IIISIUE Wo: aE 1 provat ons e �UESICN ET N a 0 ASSOCIATES oaA» Pooh Residence D ,M.�,„ 506 V}tekl YlS hlGck Rc�d,CG'I}<NIIIC,Na w..�e ,..�...... DA TE NENSIONS aEO�CDi - �aa�Y��B�� • 0'Pain, Off ffb nakh I hit F . ! $ R f alb" makh�xi�rt pl. I fi � S F0 ° -71M oi Elif ( 6 III OEM - .d r Uf . lP', i i• -- ! � ' ��,- � !l it ii, � 1P , � � pp a0 �_$ _ r3 ,r•► makn�x!-,1 pa hl 6. .i v"c{y.H+- pVe3� PP Fo � 3 WE: NORTIISIDE oovmmn, o i 15,1�5 EIeVa+iov�S DESIGN °EgO renova ASSOCIATES Uc • 91EET M0. OE 1O✓IS to e pccm Res'Id erv-e, m wwa.u voumu.cau�cul.avcx x,v xa,xm� �Nuc.kins N I���I�G�•v�Ile,N a. cREaeo ' DATE REMSION5 - G— r d II I%L.ZTT.ZZGlTl t�i. I I F.o.a. Z'• Id ON mow 7 1- •'s 1 1- _ IT I d 7-1 ip rig .L � ���� � l ::I, .. - •a+szi . c-ir. yam, � "� 1 : _. III •'� �H YI ' y )Y' IJDH III.'t t ' a s 1pp¢¢$g3g3 4 ..m+ 4�9 renoFva+ast�+he F, - _ —a m— — ❑ IDE smma ,r ASSOCIATES DNiv ORTIIS ESIGN Gc Ie pcn z�z H��ckir Neck Noad,ee l�erville,Ma. - ,-... OATE nen90n5 O1COtm_rae,s ri I r aN yN r u y , 8 .. gg E CL II , L.. 1f_ • \7 "6S_ 3 qa I" l a v a`T�. / •M .LL+... El.w s`x mix ___ _ .,. 4'_.��q' d Ii 1.�c� (.ne shc.l roaFx• • _ _ IN _ 9 08 pAI WET NO, Of tl)JUl IAI h ti m i.-.:h.�,[t,ie'vlllc p1.1 _ •- aco:co -o- �cs II�cF��rs-Nte�l _ o�lc *.nevlsloNs �— L� e Q r)r r.— I 41 I I Itu, 1—_— .; yy Yu RlEt � I hJ➢' >.�.. � .i,•iv � � (11 III 8�� .7-1 _ a_ IV , 11Ii I-1�" �4IL <�.�iSf ti ar�� CI .f•:t� 9 i •. IA III Q I ;C I � r r a P '� �W it C � v •, p � tl y, ail 1 ,. °la' F��It,l )tl� tiIII tiU1 (tfl � rr,: a' = All Fc:ouodai _f .1-rlJn PI(11tI IL`ilUl — _ — x:Da sNEEr�o. a< repovd}im I-itie DESIGN u ASSOCIATES A�J 7 Pooh es id en c sos HUckins Neckttoad,r32vnytEfble - - DATE flEN510N$' OiECxLD_�4{�_. s Y; �C k�k q =a..iah�i7: o NO v� N{:D x NrCM . • ;r�a� v�S •O •O O I_� 5 0 . o S: L. p. p - �. 3• 4:f' �,' 1�IA�I ��d �pp;, :�.' `J .4, .. .P' � DATE. a+ 1D 119$ WINI n)�Cz.Lh 1lEixil_E -- NOHIIISIDI — -- �"' wnrvaH r, tr,.1Ne OBICN S EEr D a ASSOCIATES- i�ooN' Resi�ENCe A �171 UKIq IM PfSP1uY Y uu(NW i W . / l�G 1 SCfi NUcI.:/1��N�Ck Cb3cI,Ct:/1�OrN�IIC,M3 •- ro r• '•n•w� "'o C DAIE 'REVISIDN$ U:ECk CD .�ciT,: r a� �� N E-` iv o N I ,11 ��� � sl • �a I ' E 11 Fgl I I � d I a+ ,.Ul 3 : u El CL Fil ; ya ����� do N. p ((�� � 't�9_. 4o'nu+ :. ; ��. � � �i-E •e C o � ao�,hoc - � mac`I-is"i'Hlru eylF, NORIIISIOE - cct ie,ims Misce ll2n is 'f-� - — - --- ----eo Ue all; DESIGN 9,EET N0. K renovations the - ASSOCIATES h S ' A� P��rJI�E�ID�i\ICE asunrte[vanw un, a.w,.x ww T sos Nueh;ns'I�eek Road,4nicwilla M� �^,r^v'° ��-r'-' OA IE FE�I]IOhs - aIaLD .,G } p_T 3 i L _ ,x q8R �� ��`� - ✓q�� Till ��� ; . i. lyyR I --II #md,. I) I III ` I -rl_ .ifl I -n =+1 I� nE� I t 3 CIS` Z Ile I I r' It G;, III . Its F� t 5 DATE: —4-ro,m„z E I e va t E ✓IS' NOItIIISIUG — I --- DELU st Emr NO a reErove l�-,ns to Ole, OFSIG N FFa ASSOCIATES E S oa» rF D' 1 4 P v� I�esidel�ce s qS�M EM MSgEx W A< q: i s tx 506 Hvcktns iJcck Road,Mary-Oable ••��• o DATE' RE14SIONS Y ba , I 4' IIIIh I . F9e. I ' .FV1 pay z ° — u i ///III II . as - -- =-- I i S d I: I 41 _� I d --j1 i r7 U I F- n •� III __ "-i1 F1_��; II � I I c II , OA ma" o IIII r III I ., u _ _ � � .yY.-f �1 I Wig• y I I � 14• ,i � F 1.3 .. F ac+.rolrns EA e_vd 131DESIGN A550CI,IhS �c�WETRO. Or rebovat,onsfo}L�, __ b•2 4 �L1 r �. .�`Ic1�..1�v1J�C;L g11,xCIn1 FISw..W C 1 DATE REMS10115 OfCCF[Ui "C _ ---- 11 I E - p r It -- --- • pIt f =Ti --- $.: IQ 1ti71 r l fi" - RI 6,Lit Pli la • *marl€ I- .v, arz: aE.I,,rws Fir,} Floor FIev1 o NONTHSIULVA T o 0 0B/ renovafions�"o a DESIGN It— ❑ASSOCIATES - Pcx-,n Re sIdevice •r a,,: .E�Y�EXCW of{. o".,. ..;ti DATE. PENSIONS. �EptE��-•3�� I_ A.7, i III �� a•' � a _ n i III a hY I� 1� k i -IL I Id�r p - j o n 'Ya � �`� o � twy, N 0 t• tt �'Olt (I$y.gppg OAT[: .. c FIcL,r Plan NORI'IISWE -9 Et Ro. « � hr _ +Ic DESIGN FMASSOCIATES p:4R T P D•4 i� `- n �Ec IdL'11CC u gaxnn[41w[xlw O ro [ecw a w. ,nrwM�E scs Muckmc� k.Road Bdvrr.�LI� '" DATEaraEn _ ec t- c 1. A5sess9r's offioe .(1st floor): �G ,: Assessor's magi ,and, lot number ..a @ L S l "(A) Q cF THE to d ..................................... .. d "'Board of Healath (3rd floor): Sewage .P,. Smit dumber .......~.. ..!...!.. ................... w' Z 11AH39TADLE. MAl6 Engineen�n'' apt�nr►t (3rd floor): / �C�(� '°o 1639• e� House nYjr r� i'::................... `.............. ............................... orAr° L�APPLICATI011'i'*I+fOCESSED 8:30 9:30 A.M. and 1:00 2:00 P.M. only TOWN OF BARNSTABLE ;/,;,%B 0 1,.L D I N G INSPECTOR APPLICATION FOR PERMIT TO — .S/yf p ,wl�.. ..v.......................... H............. ............. TYPE OF CONSTRUCTION ........r'!,.d. p......... �P1. .......................................................:::.................. TO THE INSPECTOR OF BUILDINGS: j The undersigned hereby applies for a permit according to the following information: / Location .....�. P .....L....�..../.�..5......�....�-..*...i.... .. ............... ........... ....1.�...v....a...J..l............................. Proposed Use '� �.!'?.r/..�`e........ a.f-t'A'�../�............. !.E'.f.�!.k.. ......................,................................................. ................. Zoning District ........1!1....D..'.1..................^..........................Fire District .....�41 .�1. l�(�l ....." .... .`g..!...f'h Name of Owner .... ../y ,S L L. .?L..D..Address 4OSUc ... r'.G ....orLv/i'l�° ................... .,,.,,.,.,........ .... Nameof Builder ............................... .-, ..............................Address .................................................................................... Name of Architect A!a#r......�3W p..4W. r...... L. 'yS..$ A�dd s ................ L , !!-D . ...�.?......!..�..C.....C....O...K. ......... Number of Rooms ...................©©............................................Foundation .................U4,'f..j........Exterior .......... ....... .. .................................. .Roofing ti�....�t....�.............. Floors :.................. ....�!.�1-............,...................................Interior ..... .... s y `P . .. cC / _ Heating 3..........�!� ' .. .. .....:..............4Plumbiri9 :...:." C.L,. `p ('...... .f���r�� .... ! _ . ..,.............5�0.. ...UFirepla{e ............. ....) ..........................................Approximate Cost .......... ............... . ......... r Definitive Plan Approved by Planning Board ------ ------------------------19---4r Area ..... ................ Diagra of Lot and Building with Dimensions Fee .. /U �!�� . ....................... SUBJECT 'TO APPROVAL OF BOARD OF HEALTH .............."` �DL/ 2 A 3 3 «h ' , i i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of'Barnstable regarding the above construction. Name .... .. ..... ......................... . ................ Construction Supervisor's-License ................�................... i ELDRED-GE, JAMES A=233--50 N, 31.7.6.6.*' Permit for .....1. Story ........... Single Family Dwelling ..... ....... ....I...............r............ 1W ............ --got Location' ................................. Centerville ............................................................................... Owner ....,James....Eldredge .. ...................... .... .. . .. Type-of Construction ......Frame.. ............ ............ ....... ............................t.............................. ...... ............ Plot ............................. Lot ............... . .............. Permit Granted .....April 1 , 88..............................19 Date of Inspection ....................................19 Date Completed ......................................19 p-A-e ) r-3jmi <r 7 / ,?>5? 1£_ i 1 TOWN OF BARNSTABLE BABISTOLE APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION TO THE INSPECTOR OF BUILDINGS: -The understgned-hereby appllesJ[or a permit according to the following information: Location ... BUILDING INSPECTOR 7<U ll^lCkiif^I Wl V*VJII IW MJC IVIIWVVMI^11 I <I I J IW I I Wf I i , Proposed Use Zoning District Fire District Nome of Owner^"^^^.Address Nome of ...Address Nome of Architect Address Number of Rooms ;....Foundation Exlerior Roofing (:2^^rpl^i Floors Interior Heating Plumbing ,-../^f~CP ^O^Fireplace /.Approximate Cost l..)..^ DIfinitlve Plan Approved by Planning Board 'Diagram of Lot and Building with Dimensions z'f I hereby agree tp conform to all the Rules and Regulations ojf the Town of Barnstable regarding the above construction. Nam PSi Eldredge,Dr*James No Permit for single family dwellina ^/ •; Centei^llfi Owner .. Type of Construction Xrame Plot Lot Permit Gronted 19 66 Date of Inspection C Dote Completed 19 PERMIT REFUSED 19 Approved 19