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0045 HYDE PARK ROAD
. . : . , .� ,. � � � . : _ _ : o . � e a � ., � � d �I i b Town of Barnstable TOWN Of RARNSTMB tF t� Regulatory Services, 10+1 OCT 17 pR ; a Thomas F.Geiler,Director51 `" g Building Division 16 Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 DIVI, ; _-`�"' . www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT 0 p9®� / FEE: $ SHED REGISTRATION v . 200 square feet or less E , Pin-AY, Z. Location of shed(address) Village _ N�c.-rs a-►�1 �j��3�'N I� Spg -�{2.p � y.�.3� Property owner's name Telephone number I W( I 4� - -M7�4-P r7�L Size of Shed Map/Parcel# Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) r 6C, Sign off hours for Conservation 8:00-9:30&3:304:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE CONBUSSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. TMS FORM MUST BE ACCOMPANIED BY A PLOT PLAN i Q-forms-shedreg REV:05201 { ` .*N i 2 r• ! ' .n �}�' �� ��' �r � . � � �` �. 4, �l .i� ! �r � F `+i � f .. i �`r � / I F. t � �' ,. r . A' 1 00 A= zi.R 4 m i FoVnIDATOIJ r �a.o_ = LoT7 — �, I in =Lo-rS — u LoT 6= d C4156 06 ,�aSED rro.00. -- SttEP — LEMP1 HUHTANEN LANCE AC.ENERNF-`(. . JOB # . 84-198. CERTIFIED. PLOT PLAN PREPARED FOR. LOCATION., LOT 6 HYDE PARK BARNSTABLE SCALE: 1 " =40 DATE: .09/23/.86 REFERENCE: PB 406 PG. e BAYSIDE BUILDING I HEREBY CERTIFY THAT THE BUILDINGS SHOwrJ ON THIS PLAN IS LOCATED ON THE GROUNb. AS SHOWN HEREON. BUILDINGS CONFORM TO SETBACK REGUIREMENTS OF OF THE TOWN WHEN CONSTRUCTED. 'gRNCyG H. do Wn. Cape engineering � OJALA `^ ` .� #26345 CIVIL ENGINEERS �s. cis LAND SURVEYORS ROUTE 6A YARMOUTH MA' DATE REG. LAND SURVEYOR j TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION i• s Map 13 Parcel + / 01 Application # Health Division Date Issued I cf 2- Conservation Division Application Fee Planning Dept. Permit Fee CDC Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address li 5� PA1Z fk_ Village Cekt4—,evub11C ��� �� Jd �n� Ud ss L4 ' y,)it ?4P_eRp Owner 0✓l Address Telephone G d IJ 9_ 33 �'-�l�j, "f!d�/9'A/e f�r 02,13.2 Permit Request BA J e to P/u-" ven aA ion OF e-)(ddr!'°!. j 12 , C X oowul ,,&�)he{ �� y✓•e AJ 'IV4// ?,4 Pi i�/o�s a U Ale al c 1p cle u�1APl� e mid i it y d'74i�(��e . je�a� p191"?Al e.uy Ili-lelli•op 7-/el' y�o oel L lu yP a 1��e d f�-+ o 10151 161AV 9 A O Square feet: 1 st floor: exi tang prop sed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation /a� 0 C Construction Type Wool) Lot Size 0 3�`' Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family W Two Family ❑ Multi-Family(# units) Age of Existing Structure 1 Historic House: ❑Yes pKo On Old King's Highway: ❑Yes 311o1- Basement Type: Q/Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) �4 Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 3 existing 0 new Total Room Count (not including baths): existing new O First Floor Room Count Heat Type and Fuel: 5 Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes o Fireplaces: Existing / New 0 Existing wood/coal stove:'-Ll Yes-,❑ No Detached garage: ing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑new sbze_ Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: € 1 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ` Commercial ❑.Yes 34o If yes, site plan review # Current Use SIIV rIe A�4141Ly /101NE Proposed Use S e Ace�/W//" APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �I�B/-��> �70 � f'�Z 01/?A/&l, �Telephone Number - �R� f S1� Address License # 16VT Al J-Hu/Allei Ho e Improvement Contractor# CO �9 j AW JJ Ol• ��o�/��J /3 -� Workers Compenslation # 3o ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 111414 SIGNATURE DATE 0,13,1.20/2., r FOR OFFICIAL USE ONLY - APPLICATION# DATE ISSUED MAP/PARCEL N0. - `p - , r ! �. ADDRESS VILLAGE OWNER t s ! DATE OF INSPECTION: - r s` FOUNDATION k FRAME - INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL a GAS: ROUGH r FINAL"' ^ - FINAL BUILDING d o�tS�lz r DATE CLOSED.OUT ' ASSOCIATION PLAN NO. _t • The Commonwealth of Massachusetts ,. Department of Indus.trialAccidents -- -V. Off ce of Investigations - 600-Washington Street - Boston,MA 02111 r www.mass gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name (Business/Organization/Individual): C A P j l f 6 rA6 :rr p eLie rn6AIi X_&C- Address: City/State/Zip. �,t 'U. = Af 0 2� 3� Phone#: G y S Are you an employer? Check the appropriate box: Type of project(required): 1.[�'I am a employer with 4. ❑ I am a general contractor and I 6 ❑New construction employees(full and/or part-time).* : have hired the sub-contractors listed on the'attached sheet. 7. [ ,'Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have g. El Demolition working for me in any capacity. employees and Have workers' g ❑ Building addition [No workers' 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' camp: right of exemption per.MGL 12.❑ Roof repairs insurance required.]t CO. 52, §1(4),and,we have no employees. [No workers 13.[:1.Other. comp. insurance required.] *And%applicant that checks box#1 must also fill out the section below showing their workers'compensatio%rpolicy 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 is providing workers'compensation insurance for my employees Below is the policy andiob site information. Insurance Company Name: A C,`e proffg+t ( 7P C..SVAL41 D C� I/ 5'j �� 16� Expiration Date: Policy#or Self-ins.Lie.#: p Job Site Address: Q 4g �� City/State/Zip; if `e u leyiya/fe R4 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 cis it 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 unde he ns and penalties ofperjury that the information provided above is true and correct 11W2 Si ature: Date: Phone#: Official'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#: r Client#:47298 CAPIHOM ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/28/2011 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 Karen A Walther,CISR - Rogers&Gray Ins.-So. Dennis PHONE 508.760.4630 FAx 877.816.2156 A/C No Ext: A/C No 434 Route 134 E-MAIL ADDRESS: South Dennis,MA 02660-1601 INSURER(S)AFFORDING COVERAGE NAIC# 508 398-7980 INSURER A:Nationalrang Grange Insurance Co. INSURED . INSURER B:Associated Employers Insurance - Capizzi Home Improvement,Inc. . INSURER c:CNA°Insurance Companies Capizzi Enterprises,Inc. INSURER D: r 1645 Newtown Road " INSURER E Cotuit,MA 02635 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDEQ-BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE'3EEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD. POLICY NUMBER MMIDDIYYYY MMIDDIYYYY A GENERAL LIABILITY MPB1075H 06/08/2011 06/0812012 EACH OCCCTURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occur°nae) $500 000 CLAIMS-MADE F x1 OCCUR MED EXP(Any one person) $10 000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: y PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO- JECT LOC - - $ " A AUTOMOBILE LIABILITY - M1 M28044 06/08/2011 06/08/201 COMBINED Ea accident SINGLE LIMIT 500,000. ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY nt DAMAGE $ AUTOS A X UMBRELLA LIAB X OCCUR CUB1076H 06/08/2011 06108/2012 EACH OCCURRENCE s5,060,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5 OQO 000 DED X RETENTION$$1O 000 $ B WORKERS COMPENSATION QQ130221321 12/25/2011 12/25/201 X WC STAT TORY IT OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N - E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Surety Bond 70011607 11/28/2011 11128/2012 $25,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 10li Additional Remarks Schedule,if more space is required) Carpentry. • 1 S CERTIFICATE HOLDER CANCELLATION Town of Barnstable " SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE - { ©198 -2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S75543/M75539 KW Qffice of &Zusinws Regerdativn 14 or relation valid for Judi-vidut use only WE IMPR V'E BEN F'CONTRACTOR before the e#ratign date. If fband return to: office of Consume ors and Enemess Re—ge on- R I tra rsn (14�J Type; 10 rark Plaza-S€ite 5170 ° Sup;alemeotCam Boston,A:02,116 ; CAPIZI.HONIEt 10. . d CARY GLI ST'r�PS 3 . Cotuff,MA 41 a su tt - Departs lent } I sl lic S Ici _ gmard 4 Il iti,;Re ulafitttts Six rd Cars lc ca{ec Isar License Laos CS ? : CARY .GUSTAfSON $ ` 1A NDWIC4-t MA 02563 ry s Page 7 of 7 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I,NELSON BURBANK,OWN THE PROPERTY LOCATED AT 45 HYDE.PARK IN CENTERVILLE,, MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENTIO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. :` I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILD . : PERMIT IN ACCORDANCE WITH'780 CMR,-THE MASSACHUSETTS STATE BUILDIN COIV SIGNATURE OF OWNER: OWNER'S"ADDRESS: 45 HYDE PARK,CENTERVILLE,MA 02632 OWNER'S TELEPHONE: 508-420-4233 LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: s , APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd.; Cotuit, MA 02635 APPLICANT'S TELEPHONE: . 508-428-9518 - RESPONSIBLE OFFICER: i RESPONSIBLE OFFICER ADDRESS: - RESPONSIBLE.OFFICER TELEPHONE: Q A 16aZ pFIKE rqy, Town of Barnstable *Permit C�o t 1 3�J� OExpires n t jr sue date ' Regulatory Services Fee ' ( BAatvssast.e, MASS. �+ 9cb i639, , Thomas F. Geiler,Director Are p Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 _ www.town.barnstab It.ma.us Office; 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number , ��l.��,d Property Address -� �Q a �, + 0016 3J. [residential Value of Work� 9. 6� Minimum fee of$35.00 for work under$6006.00 Owner's Name&Address Mt. �LV14- � Contractor's Name f' Kt_,o 4 ^'�S �5 :. ��.,e Telephone Numberb �� 1d3� Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) �� (j') 21�orkrnan's Compensation Insurance ' . � Check one. S PERA61T ❑ I am a sole proprietor ❑ lam the Homeowner 4 U G 1 ❑ I have Worker's Compensation Insurance TC)WN OF BARN J STAQLE Insurance Company Name Workman's Comp. Policy# IJ61 (,sA�96 Copy-of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) jZ/Re-roof(stripping old shingles) All construction debris will be taken to I ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is required. SIGNATURE: QAWPFILEST0RMSIbuilding permit ormMXP ESS.doc Revised 070110 r 5N The Commonwealth of Massachusetts Department.of Industrial Accidents i x Office of Investigations 1 ►�; i 600 Washington Street Boston, AM 02111 s www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information "Please Print Legibly Name (Business/Organization/Individual): yta4S e / Address: POt City/State/Zip: Ca4. i a -Phone #: 6 Are you an employer?Check the appropriate box: ` Type of project(required): 1. I am a employer with �'" 4. ❑ I am a general contractor and I _ 6. ❑New construction ` employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp.,insurance. j` g, ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation'and its required.] officers have exercised their 10❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Pl//umbing repairs or additions myself. [No workers' comp c.'152, §](4),and we have no 12.F']2oof repairs insurance required.] t employees. [No`workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#I 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. 1Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'.compensation insurance for my.employees. Below is the policy and job site information. Insurance Company Name: / 6 va r Policy#or Self-ins. Lic..#: tj6 �i-L6 Expiration Date Job Site Address: City/State/Zip: ( OV 11 Attach a copy of the workers'compensation:policy declaration page (showing the policy number and expi rat ipn,date).. Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the4imposition 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.his statem_ent may be forwarded to the`Office of ` Investigations of the DIA for insurance coverage verification. " I do hereby certify un the pains and penalties'of perjury that the information provided above'is true and correct' Si ature: .Date: Phone#: U " Official use only. Do not write in thin 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 1 City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other ,- s. Contact Person: Phone#: r 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 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 insurance. If an LLC or LLP does have employees,a policy isTequired. 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 returned 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 future 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: �`� V The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations` 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www.tnass.gov/dia 07/06/2011 15:40 5084209227 MARK W SYLVIA PAGE 01 ACC& CERTIFICATE OF LIABILITY INSURANCE DATSIMMIDD"' f6w� 07M612011 THIS CERTIFICATE IS ISSUED AS A (MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,T CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND.OR ALTER THE COVERAGE AFFORDED BY THE POLIC BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE.ISSUING INSURER(S), AUTHORG REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the cwMcato holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGA110N IS WAIVED,subjee the terns.and Conditions of the policy,certain policies may require an endorsement A statement an this Certificate does not confer rights to certificate holder in lieu of such endortern s. PRODUCER Acr Mark Sylvia Insurance Agency LLC PHONE FAX 771 Main Street je&Nst.F s(5ffi)428-0440 AD Osterviffe,MA 02655 PRODUCER Jnr_ - —_- INSURIM111AFFORDINS COVERAGE __ NAIL INSURED FNy0 A: orni Fa"CAeually Inaumr= Doyle& Thomas Construction,Inc. INsuW PO BOX 1e8 •-• ---•-•- - Centerville,MA 02632-0168 INSURER C; IINSURER D; INSURER E: INBOf�it 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 PERI INDICATED. NOTVwTHSTANDiNG ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH T CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERI EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,L LJIT'S SHOWN MAY HAVE BEEN REDUCED 11Y PAID CLAIMS. ADDL SUM TYPE OF INSURANCE � .NUM�R ULI U EXP LIhRTs A OENERALWA6IUrr 2GOIX0486 712IJ2011 7/21/2012 EACNOCt,URRENCE_ ! 11000. X COMMERCIAL GENERAL LIABILITY p I11 �� S 5O CLAIMS IMDE I x I OCCUR MED EXP am parson l S 5, _..._ ERSONAL.&ADV INJURY $ GENERAL ASSREGATI: i 2,0p0, GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 2,000, X POLICY jr PR LOC g. AUTOMOBILE YADaM COMBINED SINGLE LIMIT 6 ANY AUTO (Ea ewd0rd) •-• ••• A110►NNED AUTOS SODILY INJURY(Per pe so.I $ OODILY INJURY(PeraeeMaM) $ SCHEDULED AUTOS HIRED AUTOS (PROP GE S NON-OWNED AUTOS UMBRELLA LIA4 H OCCUR Excess L EACH OCCURRENCE S. _.. --rAa AGGREGATE s ,..... CLAIMS-MADE OEOUCTIBLE s RETEM ON S A AND NPeLO�sLu etLLIN 20() W839p 711/2011 7/1/2092 STAM x _ ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFMCERIMEMBER EXCLUDED? � N f A E.L.EACH ACCIDENT S (Mandal"In NN) K dekcft{alder E.L.DISEASE•EA$MPCOYE S A Q,( DESCRIPTION OF OPERAT M bok w E.L.DISEASE-POLICY LIMIT S 5001L 0111SM TIDN OP OPM11ONS f LOCATIONS I VEMUM(AHaeRACOgp 101,Add[OMI Rer wft.9"At11e,N n+ers epRee q regltrod) Carpentry CERTIFICATE HOLDIER CANCELLATION (508)420-7989 Doyle&'homes Construction Inc SHOULD ANY OF niE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOF PO Box 1t3B THE EXPIRATION DATE tMEOF, NOTICE UYILL BE DELIVERED Centerville,MA 02632 ACCORDANCE w(TH THE POLICY PROVISIONS. AUTHORIZED REPREWNTAIM ®ISM-2009 ACORD CORPORATION. All rights resew ACORD 25(2009109) The ACORD name and logo are reglstered marks of ACORD • FH 506-326-1635 SPECIALIZING IN ALL FORMS OF ROOFING & SIDING doyleandthomasconstruction.com P.O. BOX 168 � eBa CENTERVILLE, MA 02632 Fully Licensed & Insured Construction Supervisor Lic# 99913 Doyle and Thomas Inc. Proposes to perform the following work: Location of proposed work: Mr. Nelson Burbank 45 Hyde Park Road Centerville, Ma 02632 Date on which construction should begin: August 2011 The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that cannot be avoided by the contractor shall not be considered as a violation of this contract. The contractor agrees that when such delays become known to the contractor,the contractor will advise the homeowner as soon as possible. The homeowner hereby acknowledges that in certain remodeling work,the demolition process may reveal defects in the existing structure which must be repaired, creating additional work which may need to be carried out in order to complete the work described in this contract. In such case the homeowner agrees that the duration of the work and the schedule date of completion may differ, and that such variation is not to be considered a violation of this contract. The total cost for labor and materials under this contract: $8,489.68 30 yr. GAF/Elk Timberline architectural shingles The price to install 4 new rake bards will be an additional $438.00 In the event that while stripping the roof we find rot that needs to be replaced,the homeowner then has to agree and authorize any replacement or restoration. Then in addition to the above contract price,the homeowner agrees to compensate the contractor for any repairs or restoration at the hourly rate of$45.00 for a carpenter and$30.00 for a carpenters laborer, plus the cost of materials. Thank You For Giving Us The Opportunity To Help You Improve Office of Consumer Affairs&Business Regulation License or registration valid for individuFuse only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration -')45954 Type: Office of Consumer Affairs.and Business Regulation Expiration .3AW013 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 DOYLE+THOMAS CONST INC TROY THOMAS 499 NOTTINGHAM DR CENTERVILLE,MA 02632r =:';; UndersecretaryOE ' Not v id w' out signature Nlassachusetts- Department of Public Safety Board of Build'rm, Regulations Ff , ulations and Standards Construction Supervisor Spec.ialty-ticense License: CS-St- 99913 Restricted to:, RF,WS TROY THOMAS ti 499 NOTTINGHAM DRIVE CENTERyILI_E, MA 02632 Expiration: 4/13/201,2 ( mnni�si mcr Tr#i 99913 a -Roof to be stripped and cleaned of all old shingles and debris -Roof to be papered with weather watch leak barrier and synthetic roof underlayment, installed with Timberline architectural shingles using.galvanized nails. (Storm nailed) -All new 8 inch drip edge and pipe flanges to be installed -Cobra ridge vent to be installed on all ridges -Timberetex premium ridge cap to be installed E -10 yard dump trailer will be needed on site; and will be removed at completion of the job. -All gutters will be cleaned at completion of the job -Contractor will be responsible for all building permits needed at the property NOTICE REQUIRED BY LAW With the agreement of the contract$500.00 of estimate is due. Further payments under this contract are as follows: 1/2 of the estimate due at the start; and remainder due at completion of the job. Balance of all materials and labor shall be payable in full upon completion of work described in this contract. Payment as agreed upon shall be made when due. Any payments which are . delayed shall be subject to a finance charge of 1.5% per month. The contractor warranties the work completed under this contract for a period of one year from the date of completion. During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment, but the contractor shall not be responsible for the normal maintenance, repair due to abuse, misuse, and or normal wear and tear,which shall be the responsibility of the homeowner. All warranties for the materials supplied by the contractor shall be passed directly to the homeowner. The homeowner may be required to register or mail in such warranty card or evidence of ownership in order to activate such warranties. Homeowner failure shall not create any responsibility for the contractor under the warranty provisions;the choice of repair of replacement shall be at the discretion of the contractor. The homeowner acknowledges that the form, content, and notices contained in this contract are intended to comply with the applicable portions of the Mass. General Law Chapter 142A, and regulations promulgated there under. In the event of any instance of non-compliance, only such portion shall be invalid and the remainder of this contract shall be in full force effect. In addition, any such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and regulation. Signed as a sealed instrument on this date: Dat ,vim i J Home ner Contractor Assessor's mgpan . d"c1.ot number�..r'� .�..... ;! ...!� T . THE Sewage Permit, number ......................................................... A - �._Ci. BAR33TAXLE, i House number .................. ........ ......... MA4& 1679• �0�9 SEC YPY Ar, - TOWN OF BARNSTABLE BUILDING INSPECTOR f APPLICATION FOR PERMIT TO ....f a:T-L.'x..../Z ..... ?ter 7.. ... ... f?'l.r..:1 .... .'.{Tf c J �- i.. u TYPE OF CONSTRUCTION ......... i)k"a:-el.. z.,4.4,aa...t .............................................................................:. �s ..............19...4:... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...........fit`1........ ...........t`r�c� i:�Y' .....1!.:a:ZGG.................... .............. ................................................ ProposedUse ........fr�(t�t`!!!L.C.. `! ......................................... ............................. . . ........ . ............................... Zoning District .......... ............. ..............: ..........Fire District .........L� .y�$� . . ?. .................................. Name of Owner !✓.yi�'j..�G Address .............t � ........................................ Nameof Builder .........: (!�l' .. .......................................Address ............... F S.,%A..................................................... ,+ Name of Architect .�:,�:....:�vG � .Address 0.5t Number of Rooms ................... .............................................Foundation .. .s{............... Exierior ......-......!'.(. .. ���.�:� 1 ��r _.... ...............Roofing ..A1.'`,,. .6� aj..1................... .. ......................................... f Floors i r !�.. 'j ............... �< �,.:(?. ......�.I.!, .. IntenorA yC.t l��-�� �l ?!? �.,.......... �5 rl . Heating 1. t........`.............I mb ng Fireplace ...............���.C�..1��1�.... .. .................Approximate Cost ......... ........................... Definitive Plan Approved by Planning Board -----4il _____/ ________19 4 s: Area � Diagram of Lot and Building with Dimensions Fee ' SUBJECT TO APPROVAL OF BOARD OF HEALTH i 1 - I ; OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS -1 hereby- agree to conform to all .the Rules and Regulations of the Town of Barnstable regarding the above construction. !` � i= ......1....� ......................... Name ....•J Construction Supervisor's License ......�» .. .2.�ti,......... BAYSIDE BUILDING CO. A=173-16 No M9 -. Permit for ,,,Two Story ....... .......... Single Family Dwelling .... .... .............. Location ,.,,Lot #6, 45 Hyde P k ; Centerville ............................................................................... s Owner ..Bayside Building Co.. .. ..................... Type of Construction ....Frame ................................ .................r............................................................. , Plot ............................ Lot ............................... Sept.' 25, 86 Permit Granted P .........19 Date of Inspection......................................19 Date Completed ......................................19 `-f (cf a6 TOWN OF BARNSTABLE Permit No. ..?.964...... 4 BUILDING DEPARTMENT B"g;w TOWN OFFICE BUILDING Cash ................ 7 i679 ` °�aur► HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to BAYSIDE BUILDING CO. Address lot #6 45 Hyde Park, Centerville USE GROUP FIRE GRADING OCCUPANCY LOAD i THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL , SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. December 4 19......86....... G !'.� ......•...•.....,...•,•..• ••..• •...• .Building Inspector 1 TOWN OF BARNSTABLE BUILDING DEPARTMENT S asaaSTAU TOWN OFFICE BUILDING g i6J9. �� HYANNIS, MASS. 02601 r MEMO TO: Town Clerk , FROM: Building Department DATE: An Occupancy Permit has;� Q �2...7been issued for the building authorized by $�Building Permit ...... . ,,6 ......_........................................................................................................._........»....... . ......._.._. issued to ............ � ,�....../J.... ... .....� ... .. ........- --�..------- Please release the performance bond. . p BUILDING PERMIT 'TOWN OF BARNSTABLE, MASSACHUSETTS DATE 19 PERMIT I��i +Pi7�l� APPLICANT .-.!'1S'i:.1r' ADDRESS i -'.r i + (NO.) (STREET) (C ONi R'S I_i cr,,5F� PERMIT TO Iioi ` " �!L+.� ': i ( ) STORY I NUMBER OF ' _ DWELLING UNITS (TYPE OF IMPROVEMENT_ NO. (PF OPO S ED AT (LOCATION) .l )r ./•',.L, ZONING I. DISTRICT (NO.) (STR ET) BETWEEN AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOT _,... LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GRCUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: AREA OR ..1�i; :_. j I_• - PERMIT VOLUME ESTIMATED COST $ `� I•`'(' FEE (CUBIC/SQUARE FEET) OWNER BUILDING DEPT. ADDRESS. i.V �. -... BY ® THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FO CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN P. ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL Q-UIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL M fRE TO LATH`. FINAL INSPECTION HAS BEEN MADE. 3. FINAL L INNSPECTTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 2 2 � /� � 2 3 HEATING INS4CTIQA APPROVALS GINEERING DEPAR1MENl 1 ----- 00, OTHER Z x 7 e-ft b eY ge(p BOARD OF HEALTH a, o r WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN RE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR By TELEPHONE ofs :^."I':TE'l CONSTRUCTION PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. ,w R` A'3o s.� A Zi.gy N M M Co 4C FO �AT�oN = LoT 7 — r �3.a_ =Lo-r S — =LoT 6= m -- flo-oo -- — LEMP` HUHTANEN : L-ANGE A . I-\AC.ENERt,4F y JOB # 84-198 CERTIFIED PLOT PLAN PREPARED FOR: LOCATION: LOT 6 HYDE PARK BARNSTABLE SCALE: I "=40 ' DATE: 09/23/86 REFERENCE: PB 406 PG 8 BAYSIDE BUILDING I HEREBY CERTIFY THAT THE BUILDINGS SHOWN ON THIS PLAN IS LOCATED ON THE 4 GROUND AS SHOWN HEREON. BUILDINGS CONFORM TO SETBACK REQUIREMENTS OF THE TOWN WHEN CONSTRUCTED. ARNE G down cape engineering 2648 N CIVIL ENGINEERS fr CIS LAND SURVEYORS A0 ROUTE 6A YARMOUTH MA' DATE REG. LAND SURVEYOR " j J - / ok L 4ses.� `jmap,and lot number. ::. 7......�U, you T e rod '76 4 -1 P Sewage Permit number ........ ............................................... . A-,::;- SEPTIC SYSTEM MUS T fO� MAS9TS 33TALEy, Houte number ..................... T ...�. : .......................... STALLED IN C 03 .AVE e0� WITH TITLES ��MAYa� TOWN OF BA ` *, AND S BUILDING INSPECTOR cr Ln APPLICATION FOR PERMIT V .. �`Y6F. .. �............... u .a TYPE OF CONSTRUCTION �).a. ?!. ..... ,/�.�/Yf ............................................................................... U--J T© THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according/to the following information: Location ............ .................1 . .Wif...... 1 ..................� .............. ......... ................................. ProposedUse �e ( dll. .` ..........................................:....................................................................................... ....................:.....Zoning District .......... ....................Fire District .........(.. ...ID ............. �.....4.T Nameof Owner ...........E.1. .--s-.4 ..................................Address ......... ... .................................................... Name of Builder .......... / .......................................Address ...............C ....................... ... ....................... Name of Architect .......... .: :.... < .. .....................Address ............... ...................................................... Number of Rooms ..................(.................:............................Foundation .........`..O.:c ?-Q :....� .. ,-............ Exterior ............. ,Q �.��I,..�?........,rs...�'k1..�.�/.�-K�...�...:...........Roofing ...............✓..1:s�.CL.4 t......................................... tl �! .Interior S ,I� ............. ...(.lam:-... ...... .. .. ......... ...................... Floors ................�•�. . ............ .l. ..... ... ....................... I Heating' ...........G45........'.t`:— .................................Plumbing .........k..V..c..-..... ...... t s Fireplace ...............0.Q_.� .......�......R.[?)ct�...............Approximate Cost ...........�.�4.�......���� ,....... �. ....... Definitive Plan Approved by Planning Board -----l`#.//ff v_ _____ ________19 Area �1�... ..................... Diagram of Lot and Building with Dimensions Fee ......... . ............5 ............. SUBJECT TO APPROVAL OF BOARD OF HEALTH - �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 ...... lrs... 3 Construction Supervisor's License ......�.�Lj � BFSIDE BUILDING CO. J9 Two Story ,294Pe,mh for --N6 ''-- -----.� ---. ' � . ��'y Dwelling — . -----.:.—.------.-----. ~� �^ , ^ �o� #6, �� Hyde Par ^ � � �`"."". ------------^--�-----. ` ^ Centerville ~ ---�---~------------'-----'' ^ 8 oide Duil�io Co. , Owner --..���--------'�-------. . ` Frumee - ^ Type of Construction .......................................... ----'---'------------------ . . ~ Plot Lot � ----'.----' ----.`-----. ' - ' �e�cSe � '25 86 Pe,mh�G,on�d ^ _" lg ' --- _ Inspect / - vn ' o _ . � . . � . . . | � . _ r iAl ` E Q E existing ( I - °� N bulkhead I I pg E 3 o V N existing l-�G ye 140P�.e'`' cu � N N.N - - - - _NVIA/DOw gLn a 3� .77,77 i EA u 10, b — V, existing closet NEW 5-0,`;BIFOLD m > I" o �� ; 1°1 �''� @ existing opening I I o Iv NEW 2-6 DOOR NE1N 3-0 DOOR @ I I o QL EXISTING OPENING� TING O � V I L a o 8'-0' E S — — existing unfinished area ( ( L,, ADD PARTITION AND 2-b i to remain as is DOOR FOR STORAGE ex. closet to UNDER STAIR remain as is ° I — ALL NEW DOORS TO BE HOLLOW-GORE � N RA15ED 6 PANEL-. TILE FLOORING I :� I � - �- w L � ALL NEW BASEBD @ FINISHED ( I z ;� - - - - - - I AREAS TO BEAZEK I I o � = m 16-4 31b . s +` AT GEILING: HUMIDISTAT I I �'°' 2'x 2'SUSPENDED TILES I I - W/NEW FRAME A5 NEEDED . I I . , ii _ _ I I • _l } Q Date: L — - - - - - - - - - - - "-- - - - - - - - - - - - - - - - 5-22-12 A Revisions: Final Plans: PLAN OF Br�aEMENT . scale: 1/4=1-0 BUILDER TO CONFIRM ALL CONDITIONS i AND DIMENSIONS ON 51TE Accepted by: Date: Note: These plans are for the sole purpose and use of Gapizzi Home Improvement and are not } to be distributed or used for construction other accepted by: Date: .. - than by Gapizzi Home Improvement.