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HomeMy WebLinkAbout0016 JACQUELINE COURT - ,, �. - 4 ,. .. ,�¢ - , � o 0 d � • .. � - G ' - .: U 1 o �.. �. .. .: ,. � o � _ o. Y �� �. � �c _ .. � _ a .. „G a a �. - .. � G ,. .. .. I � o ,.- _ 6 o° _ .. ., ° �. � a . ,. � a e - , � o u Town of Barnstable Building - a 4 ,,.3.;:u .,i•`u" '""'. rvn ... `' * =',t ...ti• •. R •..3:5' : .. s 'z., .;:',�.• ,s �..... „ . �.'�',.?� E'" 1 Post TCard So That it'isVisible�From;th`e5treetA froued'Plans Must.be:R'etamed on�J`oband this Card Must be Ke t 6A&NtTCABLC,. C a .`, 's prs .c •s :•. - .+ �. .� P, ;.. 6 �Posted,Unti1:Final Inspection Has Been Made i,< zx _ � � +° Where a Certificate`of Occu anc is`Re `u�red such>;Bulld�n shall Not be:Occu ied until a Final.,ins ,ection has been made Permit Permit No. 13-20443 Applicant Name% SWEET,ANDREW Approvals Date Issued: 02/14/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 08/14/2020 Foundation: Location: 16 JACQUELINE COURT,CENTERVILLE Map/Lot 210-178 Zoning District: RC Sheathing: . Owner on Record: NASTASI, DAVID&ANNE B Contractor Name: ,SWEET,ANDREW Framing: 1 A: =Address: 16 JACQUfLINE COURT Co 2 ntractor license i-1�2785 CENTERVILLE, MA 02632 Est Project Cost: $2,647.00 Chimney: 5 Y : Description: 1 Door xPermrt Fee: $35.00 Insulation: Project Review Req: i , FeePaid S 35.00 Date 2/14/2020 Final i F 3 ' yz Plumbing/Gas r ✓-" Rough Plumbing: Building Official 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 theeapproved construction docum �,ents fo�r hick this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zo61ng1by laws and,codes. This permit shall be displayed in a location clearly visible from access street oar road and shall be maintained open for public inspection for.the entire duration of the Final Gas: work until the completion of the same. A, Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials4re provided on thas permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 3 1.Foundation or Footing F' a, V, 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 y 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 cting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL'c.142A). Fire Department CC Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: f Off , Application number ........� Date Issued. ...... ... /� .Z............................ BUILDING DEPT .. .. . ...... sTAg abg9. 1�� Building Inspectors Initials...... to FEB 1 3 2020 .......................... TOWN Map/Parcel.......�i l-E-7(.�...................... OF BARNSTABLE 44- TOWN OF BARNSTABLE 435'00 EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATIERIZATION PROPERTY MORMATION Address of Project: j l}('�(J e�l r�p� (i1 f�jr k0- C� NUMBER STREET VILLAGE Owner's Name: 4P 0 < Phone Number 54&' 7 76' 666 7 Email Address: Cell Phone Number Project cost Check one Residential Commercial OV NEWS AUTHORUATIOI, As owner of the above property I hereby authorize FEB 1.4 2020 to make application for a building permit in accordance with 780 CMR Owner Signature: See A-tt'ack, C Date: TYPE OF WORK Siding Windows (no header change)# 0 Insulation/Weatherization Doors (no header change) Commercial Doors require an inspector's review — Roof(not applying more than 1 layer of shingles) Construction Debris will be going to Was4 CONTRACTOR'S INFORMATION Contractor's name l e oar e l V� � J Home Improvement Contractors Registration(if applicable)# 112—-7 F- (attach copy) Construction Supervisor's License# -0-71217 (attach copy) Email of Contractor Swe�f/2 5 e 5L1 a I' • C CT''z X Phone number �o/- 7/V- 6 3 7 9 ALL PROPERTIES THAT HAVE STRUCTURE OVER TS YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a:for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:front back left side right side HOMEOWNEWS LICENSE EXENTTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CNM the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permit applicatio are subject to a building official's approval prior to issuance. Home Improvement Agreement: Page 1 Home Depot License Number(s): Home Depot license numbers are listed on page 3,and at www.Homedepot.com/LicenseNumbers DONALD STARR Salesperson Name Registration No.(if applicable) Home Depot U.S.A.,Inc.("Home Depot")or Service Provider named below will furnish, install and/or service the equipment listed below at the price,terms and conditions as outlined on this form: Service Provider Contact Information _ t �TBD - - TBD Authorized Representative Name Service Provider Company Name TBD I JTBD TBD Phone# Service Provider Email Address Service Provider License#(s) Customer Information NASTASI_. _ Y+ANNE -- 2612 H2612-147825a + Customer Last Name Customer First Name Store#/Branch Name Customer Lead/PO# 16 JACQUELINE CT CENTERVILLE MA 02632 Customer Address City State Zip 5087718715 5087718715 5087718715 A.NASTASI(cDCOMCAST.NET Home Phone# Work Phone# Cell Phone# Customer Email Address NOTICE_OF RIGHT TO CANCEL YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY CONTACTING THE SERVICE ° PROVIDER OR STORE DIRECTLY;EMAILING SERVICE PROVIDER AT: Contact Store Directly OR DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: ' 1 i 2455 PacesFerry Rd SE Atlanta GA 30339 Address City State Zip s BY MIDNIGHT ON THE THIRD.BUSINESS DAY AFTER SIGNING,UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD.THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS s SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE.YOUR PAYMENT(S)WILL BE RETURNED WITHIN TEN(10) '' BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE.YOU MUST MAKE AVAILABLE FOR PICKUP I BY HOME DEPOT OR SERVICE PROVIDER,AT YOUR SERVICE ADDRESS,AND IN SUBSTANTIALLY THE SAME 6 CONDITION AS WHEN DELIVERED,ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU.OR YOU MAY ' CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. } THE LAW REQUIRES THAT THE HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL, I PLEASE SIGN BELOW TO ACKNOWLE E THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL. e ' Acknowledged by: Phone Sale 02/01/2020�� Customer's Signature , Date • • . Home Improvement Agreement: Page 2 Description of Work to be Performed A detailed description of the work to be performed is included in the paragraph entitled Scope of Work or Specification which is included in this Agreement. Anticipated Delivery Date/Installation Schedule Approximate Start Date: TBD Approximate Finish Date: TBD All dates are approximate and subject to change based on unforeseen events including inclement weather,permitting delays,and delays in confirming insurance coverage of Your claim for any repair,if applicable. Electronic Records Authorization You are entitled to a paper copy of this Agreement if you choose.If you consent to an e-mailed copy,your consent applies to this Agreement and all subsequent documents and written communications related to this Agreement.By contacting your E Service Provider,you may update your email address,withdraw your consent,or obtain a paper copy of the Agreement or f . related documents at no charge.By providing your consent and verifying your email address above,you confirm that you have access to a computer that can receive and open emails and PDF documents. 1 do❑do not❑consent to receive only electronic records related to this transaction. A Contract Price and Payment Schedule Payment of the Contract Price is due upon signing unless a different payment schedule is required by law,specified below or in a payment addendum. 5 jContract Price: $ 12647.94 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 126.93 (If applicable,total amount of taxes included in Contract Price) *Maximum deposit ONLY applicable in MD,MA,ME(33%),NJ,WI(99%) f Deposit% Deposit Amount $ Remaining Balance $ i ° i Finance Charges _. Any interest payments or other finance charges will be determined by Customers separate cardholder or loan agreement,to jwhich Home Depot is NOT a party,and will be in addition to Customer's payment under this Agreement.Customer is subject 'to the terms and conditions of the cardholder or loan agreement,as applicable.No funds should be made payable to Services Provider;however,Service Provider may collect Customer's payments made payable to Home Depot. 11insurance proceeds will Q will not❑be used to pay some or all of the total amount of sale. Acceptance and Authorization By signing below,you authorize Home Depot to:(a)arrange for Service Provider to perform any Services or(b)order and arrange for the delivery of special order merchandise,including special order merchandise that may be custom made,as specified in this Agreement.Do not sign if blank or incomplete.(Service Provider's or permitting information may need to be provided to You later.)By signing,you acknowledge that:(i)You have read,understand,and accept this Agreement in ' its entirety,including the General Conditions and State Supplement,if any;(ii)You are receiving a complete copy of this Agreement;(III)all rights and interests under this Agreement are solely vested in the person listed as"Customer"above;and (iv)Electronic signatures will be deemed originals for all purposes: X I Phone Sale 02/01/2020 Customer's Signature Date X /s/The Home Depot 02/01/2020 The Home Depot Digital Signature Date Call The Home Depot at 1-800-466-3337 for help. - I ` Commonwealth of Massachusetts Division of Professional Licensure f Board of Building Regulations and Standards CS 074247 spires 04104/2021 PAUL M DOWNING a 25 ALCOTT CIR 02780 TAUNTON MA > Commissioner , • 1 = ^ a The Commonwealth of Massachusetts Department of Industrial Accidents ==�,�r. �— _►� Office of Investigations I Congress Street, Suite 100. , 7 Boston,MA 02114-2017 y www.massgov/dia . ; Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): T�Uu—, Address:- � S�t✓1CKc City/State/Zip: j' ;,�. e�o� �r r��3v - Phone#: Z- 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 employees(full and/or,part-time).-, have hired the sub-contractors 6. ❑New construction e 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 Working for me in any capacity: . employees and have workers' comp..insurance. 9. ❑Building addition [No workers' comp. insurance P- - required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I. Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t C. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also till out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. . ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees Below is thepolicy and job site information. Insurance Company Name: ` Policy#or Self-ins.Lic.•#: Expiration Date: _ A p Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. p do hereby certi y under the pains and penalties ofperjury that the information provided a ov i is true and correct Si'gnature:` I 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#: The Common'Wealth ofMassachusetts .D:l epartment of Industrial Accidents 1 Congress Street,Suite 100 Boston,M4 02114-2017 www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information I Please Print Legibly Name(Business/Organization/Individual): Address: 01 0`d +>os hn Tt,rn p;K 2_� City/State/Zip: MA Of 5-4 S- Phone#: -7 7 q -.2 l 5 - L 1 5 S Are you an employer?Check the appropriate boa: Type of project(required): L you- am a employerwith 20 Q+employees(full and/or part-time):' 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $. Remodeling any capacity.Wo workers'comp.insurance required.] 9. El Demolition 3.®I am a homeowner doing all work myself(No workers'comp.insurance required.]t 10 0 Building addition 4.F11 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are solo I L❑Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.®I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.x 6.❑We are a corporation and its officers have exercised their right of exemption per MGL a 14. Other 152,§1(4),and we have no employees.[No workers comp.insurance required.] "Any applicant that checks box 01 must also fin out the section below showing their workers'compensation po'cy' ormation i 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 ofthe sub-contractors and state whether or not those entities have employees. Ifthe sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. _ '// i Insurance CompaayName: a/(dt6�u I (JniQ,1 . t -e Imo)g ara/teLa— ir,a7 ) Policy#or Self-ins.Lie.#: X WC 5S (o S 5 1 -7 Expiration Date: - Job Site Address: ((0 U�lal rw l/l City/State/Zip: l 1 Attach a copy of the workers'compensation-policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprison as ell as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. py this statement may be.forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify tin an enalties o information provided ove i true and correct. Si'mature: Date: �3 Official use only. Do not write in this area,to be completed by city or tmun 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 A. Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement_Contractor Registration Type: Supplement Card Registration: 112785 HOME DEPOT USA INC Expiration: 04/22/2021 P O BOX 105451 — = ATTN: LICENSE MGMT TEAM ATLANTA,GA 30348 = Update Address and Return Card. SCA 1 0 20M-05/17 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE.`Supplement Card before the expiration date. If found return to: Reoish-11Hem Expiration Office of Consumer Affairs and Business Regulation --04/22/2021 1000 Washingto41t 10 HOME DEPOT 1 J Boston,MA 021 ANDREW SWEET-..,, ; 2455 PACES FERR°Y-.FoC fi HSC ATLANTA,GA 30339 Undersecretary No I nature DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 02/0612019 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 , MARSH USA,INC. NAME: TWO ALLIANCE CENTER ' PHONE WC.No 3560 LENOX ROAD,SUITE 2400 E-MAIL ATLANTA.GA 30326 ADDRESS: INSURERS AFFORDING COVERAGE NAIC M CN101642069-HomeD-GAW-19-20 _ INSURER A:Old Republic Insurance Co 24147 INSURED INSURERS:New Hampshire Ins Co 23841 THE HOME DEPOT,INC. HOME DEPOT U.S.A.,INC. INSURER C:HomeRisk Captive Insurance Company 2455 PACES FERRY ROAD BUILDING C-20 INSURER D ATLANTA.GA 30339 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004353439-28 REVISION NUMBER: 21 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 VVITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE'POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR' TYPE OF INSURANCE AODLISUBR POLICY EFF POLICY EXP ! LIMITS LTR' POLICY NUMBER MM/DDIYYYY I MMIDDIYYYY i A X !COMMERCIAL GENERAL LIABILITY MWZY 314574 03101019 03/0112022 EACH OCCURRENCE SDAMAGE TO RENTED 1.000.000 CLAIMS-MADE -FX !OCCUR j PREMISES Ea occurrence) !s 1.000,000 X !SIR:$1,000.000 MED EXP(Any one person) s EXCLUDED _ PERSONAL&ADV INJURY s 1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 1,000,000 X POLICY PRO- LOC JECT I� PRODUCTS-COMP/OP AGO 3 1,000,000 OTHER: s A +AUTOMOBILE LIABILITY MWTB314573 i 03I0112019 03101i2022 !COMBINED SINGLE LIMIT ; 1.000.000 _ (Ea accident) X :.ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED SELF INSURED AUTO PHY DMG BODILY INJURY(Per accident);s AUTOS ONLY : AUTOS HIRED NON-OWNED ;PROPERTY DAMAGE i _ AUTOS ONLY ^AUTOS ONLY Per accident 77 UMBRELLA LIAR OCCUR EACH OCCURRENCE S —~EXCESS LIAR CLAIMS-MADE: AGGREGATE s DIED RETENTION S l S B i WORKERS COMPENSATION NC 012717099(AK,NHJVJ,VT) I I 0310112020 X PER ( orH-. AND EMPLOYERS'LIABILITY I :STATUTE ER Y—NN ' 'WC 012717100(WI) i O3IO112O19 031O1I2O2O B IANYPROPRIETOR/PARTNER/EXECUTIVE . E.L.EACH ACCIDENT ; 5.000.000 'OFFICER/MEMBEREXCLUDED7 N NIA' (Mandatory in NH) i E.L.DISEASE-EA EMPLOYEEI s 5A00,000 If yes 9 ,describe under Continued on Additional Page DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT!3 5.000,000 C Excess Auto 297110011002019 03/0112019 03101/2020 I:Limit: 4,000,000 A Excess General Liability MWZX 314580 03/0112019 03I0112022 Limit: 8.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) EVIDENCE OF INSURANCE - CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN BUILDING C-20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA,GA 30339 AUTHORIZED REPRESENTATIVE -of Marsh USA Inc. Manashi Mukherjee �Cauran ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101642069 ' LOC>f: Atlanta _ _ _ ACO ADDITIONAL REMARKS SCHEDULE . Page _2 _ of 3 AGENCY 'NAMED INSURED MARSH USA.INC. THE HOME DEPOT.INC. HOME DEPOT U.S.A..INC. POLICY NUMBER 2455 PACES FERRY ROAD BUILDING C-20 _— ATLANTA.GA 30339 CARRIER NAIC CODE EFFECTIVE DATE: " ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation Continued: e Carrier:Indemnity Insurance Company of North America +. Policy Number:WLR C65890549(AL.AR,FL.ID.IA.KS.KY.LA.MS.MO.NE,NM.NO,OK,SC.SD.TN,WV.WY) Effective Dale:0310112019 Expiration Date:0310112020 s _ (EL)limit:$5,000,000 ' Cartier:New Hampshire Insurance Company Policy Number:INC 012717098 (OC.DE.HLINADANATAYAI) Effective Date:03101i2019 Expiration Date:03101/2020 . y (EL)Limit:$5.000.000 + Carrier:ACE American Insurance Company Policy Number:,NCU C65890586(OSI) (AZ.CA.IL.NC.0R,1/A,'NA) Effective Date:0310112019 Expiration Date:0310112020 (EL)Limit:$4.000,000 SIR:31 A00.000 SIR for the states of AZ,CA,IL.NC.0R,11A,1NA r Carrier:National Union Fire Insurance Company Policy Number:XWC 5565596(OS0(CO,CT.GA,ME,MI.NV.OH,PA.UT) Effective Date:03/01/2019 Expiration Date:03/0112020 (EL)Limit:84,000,000 S1.000,000 SIR for the stales of CO.ME,NV,MI.OH,P.A.UT $750,000 SIR for the state dt GA $350,000 SIR for the state of CT Carrier National Union Fire Insurance Company Policy Number:XWC 5565597(OSI)(MA) ! Effective Date:03101/2019 Expiration Date:03/0112020 (EL)limit:34,500.000 SIR:3500.000 v TX Employers XS Indemnity: Camerallinios Union Insurance Company Policy Number.TNS C65221019 iTX) Effective Date:03101/2019 - Expiration Date:03/0112020 (EL)Limit:310,000,000 SIR:31.000.000 a ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Town f *Permit# � Z� . o Barnstable Permit# � 7 Expires 6 months from issue date Regulatory Services Fee---,"-z '-` -7 -P Thomas F.Geiler,Director �EnA41 Building Division ���Y 70 Tom Perry,CBO, Building Commissioner -10V 200 Main Street,Hyannis,MA 02601 �� B�( nj`5��8� www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint parcel Number .4 rty Address 6A��,L.4'�1 GC C:v,NJ iesidential Value of Work '�e��y Minimum fee of$25.00 for work under$6000.00 Al ger's Name&Address intractor's Name ��:'� �}.. '�"'� Telephone Number Srv% .8G Ci )me Improvement Contractor License#(if applicable) d Z%'R G- 1M=tMrSqErvisorls-License-#-(fapplicable-) lWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ZI have Worker's Compensation Insurance urance Company Name LL -'n't qti )rkman's Comp.Policy#_ L-L_S i -py of Insurance Compliance Certificate must be on file. :mit Request(check box) dRe-roof(stripping old shingles) All construction debris will be taken to -4+:r t�^ `i ❑Re-roof(not stripping, Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Im vement Contractors License is required. =NATURE: IDC W )rms:expmtrg ise061306 \ !!!yyy///, Board of Building Regulations and Standards ` One Ashburton Place - Room 1301 T_ Boston, Massachusetts 02108 Home Improvement Contractor Registration Reg{stration: 128957 Type:. individual •Expiration: 6/14/2009 Tr# 131109 Oliver Kelly- Oliver Kelly 9 Peregrine lane S. Yarmouth, MA 02664 Update Address and return card.Mark reason for change. DPS•CA1 €, SOM-05'06-PCe490 F] Address Ej Renewal n Employment n Lost Card ✓/LC �097N.)tG'7L[IfBILG[OL C�v'G"�d3CLC'llLDr!/.d - y .. .. ..__.. j _ - _- - Board of Building Regulations and Standards License or registration valid for individul use only Hj OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Regstrration. 128957 Board of Building Regulations and Standards Expiration: 6/ One Ashburton Place Rm 130114/2009 Tr# 131109 Boston,Ma.02108 Type: Individual Oliver Kelly Oliver Kelly �^ 9 Peregrine lane South Yarmouth,MA 02664 Administrator Not valid without signature - 11a <<itittt�cti�- 1)i{i.u-tmctil rrt latti-.i�� 4,tt`t:;� � liti u d �1t Swl+tlm Rc�uiahonv tnd tit tnt{,l.t t{� q License: CS SL 99167 Restricted to: RF,V`3 OLIVER KELLY 9 PEREGRINE.LANE SOUTH YARMOUTH?MA 02664 Ex piraticrr:,9(28/2011 i lunnsanniv T .: 99167.' ' The Commonwealth of Massachusetts Department of IndusWal Accidents Ofj9ce of Invesdgations 600 Washington Street Boston,AM 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers pyticant Information _ Please Print Legibly NaMe(Business/organizedoNlndividual):. Ll V e�Q k c A4 ddress:Cl CityiState/Zip:9o. `'t40_AAja i\k, �A WPhone#: vG% —ISO0l Lkt 04/0 AWu an employer?Check the appropriate box: Type of project(required): 1. am a e la er with 3 4. Q I am a general contractor and I y • have hired the sub-contractors 6. ❑New construction employees(full and/or part-time). 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling ship and have no employees These sulks-contractors have g, Q Demolition workingfor me in an capacity. employees and have workers' Y aP tY t 9. ❑Building addition (No workers'comp. insurance comp.insurance. required.] 5. Q We are a corporation and its ME]Electrical repairs or additions. 3.❑ I am a homeowner doing all work officers have exercised their I LE] ing repairs or additions myself. (No workers'comp. right of exemption per MGL 12.[?koaf repairs pairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.0 Other comp.insurance required.] Any applicant that checks box#t 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. tContrsctors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. if the subcontractors have employees.they must provide their worker'comp.policy number. I am an employer that is providing workkers'compensation Insurance for my employees Below Is the policy and fob site . information. A Insurance Company Name:U Policy#or Self-ins. Lic.#: (N G2 l 3_606 cS CH 019� Expiration Date: 2-q Oq Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and eipiradon 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 S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a finer of up to S250.00 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 cce^erdfyfy under the pains and penalties of perjury that the information provided above Is true and correct Signature: �:�1� -� Date: Phone Uf clal use only. Do not write in this area,to be completed y city or town of vial. City or Town: Permit/Llcense Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 1-Plumbing Inspector 6.Other Contact Person: Phone#: THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) i m F /Fl, G"- L DATA 'I!ED 1 :2b F.4T 508 I78 1. IB DOW'LANG & 0XT1 INa 001%001 .1/14/2009 9:59 PAGE 0021002 LMG t Lib"mutual Group amutua. P.O.Box 9090 Borer.NH 031 -1.9090 T cIcohonc(BW)653-7i, Fax(M3)-245-5330 Ir �� 14,2009 ''-•Xw OF F-U2vfOLrrH •l•j 'N I-L�LLSQU�4RE _ , L-W. MA 025 y: i`rtiffeste of Workers C-nmpen-S204"ZnxurAncc OI.I Ta KFT.T Y n PEREGRINE Lam:. SOU-;4 YARM0uj- , Mfi 026(,4 -ELT-Number: WC2••31S 338804-026 Erieeri 12/28/2008 Fzpieaaon: .12/28/Z(RU9 ...oeLr,a afforded under Workers corrjp en.Rtion Law of tee fo:lowirg state(s): lc 7.i��bilit;�T imits). I Ctr�IC'f fYFtOfi?;,r C' vrr-• Fle�iio r icy un,By-Accident $?00,00EI Eueb Accident ' "he-a orken'co npm3sa on ii r!n u b Dist ast ?. poky does not provide 1 ry y $10010W ...z+ch Parson Svc ge for: .- 'Ritary by Disease: S 500,Ipp Policy Limits OLI ER"t TELLY 1 !his dxe,the 6ove-referenced pol4cyhoicler:s insured by Liberry'Munu2a Fire Insurance Co we policy listed above. n:sutmce allirded by the Iisted policy a :object to slI the terns,exclusions and conditions,.nd is not ,:-Icl br•cozy requirement,tear_or condition,of ary o--other dccuntents with respect to which this ':ftcate,may be issued. .EV,acate is issued as 211-attec of infom-ation! �Iy and co���rs:zo ri�,t upon goof the eert>ficate 1ILs certificate is trot 9ra ins:a:ance policuuid does not emend,er.teh 9,or slte�the coverage ::_d.:i by the policy lis tod abcsrc. us poky is catncclkd befo.e the stated expiratiar-kt�,Liberty Mutual vi11 en dezvct to notify you o: �h c�tcxilatian. A'CITHORIM PEPP,S3Et3'PATry-- LMFIRTY MUTUAL R.iU."WE GROUP .::.'ctiGcste if cueve�t+y LiDERTYMIlfCA;..T.1�St1RAVCE GRUL't�as mxpten soh lttddaeaoea 9s L sl�bed by:l�osa co�alea. F !'II511i8d: Producer Of Record t I.I�7EA TC T LY SA9bPIPRk NSURANCa AGEhI_CY INC ->FP.EG :vE LANE 12 ENTFRPRISE ROAD :a i,'1'H Y""ARMCaU IT3, IVIrI 026i HYNIWTNTS, MA 02WI 1. - �°��+ Town of Barnstable ti P Regulatory Services �B^RaM MAM Thomas F.Geller,Director `Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 )ffice: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I as Owner of the subject l property. hereby authorize �t.iy �%Ct-�.`� to act on my behalf, in all matters relative to work authorized by this building permit application for: 110 �ACrc;ZJ:r,- (Address of Job) Signature of Owner bate Print Name Q:FORMS:OWNERPERMISSION � f THE TOWN OF BARNSTABLE i sARNST"L 'oo e 9 � MASSACHUSETTS O Y�Y Solid Fuel Stove Permit DATE OF APPLICATION ..: ..��.....c ., �,....�:..4...4:: ..... F NAME (owner) ... ..V..I.L ....... .S.T .1............................. NAME (Installer) 5. ..�.IKr......P.4.44--k.... .......................... ADDRESS & C—t'�c iADDRESS S.. A.&... ....... ......../7� ..�i. -!..4!�.����I STOVE TYPE ... .d... ..L.................................................................................... CHIMNEY: NEW ...................... EXISTING dL................ Manufacturer ........ .. ./! ...4. ...r-J11.............................................. CHIMNEY: Masonry ............................................................................. ........ Mass. Approval JgA.S.i/? .m.......... ............................................. CHIMNEY: Metal ..................................................................:.................._............ This is to certify that the above installer has permission to install a solid fuel burning appliance at the listed address in accordance with an application on file with the ..:................................................................................................ t, and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made under the authority thereof. 1&4 IssuedBy: :... . ,....................................................Title .. �` "'�............ .�. Date vZ ....................... ... Permit to install expires 60 days after issue date Stove <.. .. ../!.�!.d.v.�..�... ........................................................................................................................................ ............................................................... StoveClearance ........,l ..r ..... .. ......F.lR.4..!` .........I .r.. 7.....11..E. ................................................................................................................. Floor ............ .s ..... ..t..!g. ...........:'...11....E&a� .........--....... ........................................................................................................................... SmokePipe ...... .................................................................................................................................................................................................................................................................................... SmokePipe Clearance ......: .... ......................................................................................................................................................................................................................................... Chimney .. ... .......... �.. .. Q ;�,............................................................................................................................................................................................................. SmokeDetector ..............' f=... ............................................................................................................................................................................................................................. .............. The undersigned hereby certifies that the installation of solid fuel burning stove and equipment made under au- thority of permit dated ...... �...Ll................ has been made in accordance with provisions oft C monwealth of Massachusetts State Building Code now currently in effect and pertaining thereto Installer v e INSTALLATION APPROVED ............a .. 4'�`............... . .. , /// d ...... By:.......... ..... ..... ,...................... Title .................... `... WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT e v , s � . ssor s map and lot number ......... SEPTIC SYSTEM MUP 9;.oF THE t01� Sewage Permit number INSTALLED IN COMOU o 8.�. ...�..o` _5f......0<<�...2 W730 �� 0/dam U« Vf1!f'F7T�TLE �� STAl1LE.House number .......... ....... .. NMENTAL C® M3a 039 T®MAI PFGt,l.rATION oo aMpx.a`0m TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........Build...Single...Family..D ella.ng........................................... TYPE OF CONSTRUCTION Mood frame Sept. 18 ............ ..................................198Q... TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby applies for a permit according to the following information: Location .............Lot...14...J.aaqueUne...Cour-t.,...Gent.eruille.......................................................................... Proposed Use ...Single...F3II ily..Mcelling. ............................................................................................................. Zoning District .Residential.........................................Fire District .......Gent.er.yi11.e?n0St.e=. .i11e............. Name of Owner .....Jamez..K.....Smith....... .................Address .............Brmstable............................................. Name of Builder ...James...K......Smith............................Address .............Barns.table.............................................. .Name of Architect ..................................................................Address .........:.....................................................................:.... Number of Rooms 4 Poured Concrete .................................................................Foundation .............................................................................. Exterior Clapboard & T113 ...Roofing Asphalt Singles .............................................................. ....................................................................... Floors Wall t0 Wall .......Interior .............DY�TWall.................................................... ,.,,...Fieating­t� GAS .................................................Plumbing .............. ij�-..baths.................................................. Fireplace .................One.........................................................Approximate Cost .......�3.5.s.qpp....................... ........... ........ S:f- Definitive Plan Approved by Planning Board -----------____---------------19________. Area ................... ...................... Diagram of Lot and Building with Dimensions Fee 2� SUBJECT TO APPROVAL OF BOARD OF HEALTH 41 o I hereby agree to .conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . !C�..., ................. a SMITH, JAMES •K. I ..2.252.4.. Permit for Que...Star. ......S.ingle...F.amily....Dwe.11ing .......... ... Location .LQ.t...#.14....16...Jac.q e 7�x1. ..Court f Centerville 1 .......................................................... ............ - James K. Smith , Owner ............................................................. �: n Type of Construction `Frame ` ................................................................................ - tPlot ......................... . Lot ................................ } Permit Granted 3..`^r..19 80 Date of Inspection ~` Date Completed �. Q" .19 ' t . O � tv..�l��d i' PERMIT REFUSED tv '....... ............................. . 19 ; z i , .........................S. ........................................ 4:................... ..5 a:: ...... ..................... .............................�.. - .i ..�-..:. ....t ............................................................. it rh t Y , r Approved ................................................. 19 t - F .q........ ............. ............. As ssors map and lot number ...`....................................... /� F THE T Pao o� Sewage Permit number �� - 4 C� �x� 9A / ~ o g ..................:................1'.:...-:............. ,9v ro w BARNSTADLE, i House number r 9 MAGa •........................................................... 0 p 1639. \�0 ��YPY Or• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........:9- 7t?1A g a� „k�am 1? f �c f 1 i r rr....................................... TYPE OF CONSTRUCTION Wood -"ra e ...................................................................................................................................... 1? 18.....................19�� ... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................n+....1.. ,..... i..al,? !?!' f`ra1�rF::...! F?x}f n'` .t. . ?.......................................................................... Proposed Use ...... .._~.,.,,rp7 n Pprni I tT =real Zoning District .........................................Fire District ....... Name of Owner .....:3R?n r u <;r,i th...........................Address Name of Builder ....T:sran TC . ............................Address R. mn5.1:t . 2? e .Name of Architect ..................................................................Address .................................................................................... Number of Rooms .............Foundation ...........a�...'�Cl Concrete Clapboard & Tlll Asphalt aingles Exterior ....................................................................................Roofing ..................................................................................... Floors ..tall 0 WaE .Interior Drywall .... .................................................... Heating GAS.........................................................Plumbing ...........1-k-...`�1-k-baths.................................................. .... b v�� '>Fireplace ..:..................tt 8:............................................. Approximate Cost ...........•......................................................... Definitive Plan Approved by Planning Board ________________________________19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ^........^.................. SMITH, JAMES K. A=210-178 N� 2 2 5 2 4 Permit's for .,, One t o r y Single Family Dwelling .................................................... Location Lot 16 Jacqueline Court .......................................... Centerville ............................................................................... Owner James K. Smith .................................................................. Type of Construction „Frame Plot ......................... . ot ................................ Permit Granted ! ember 23 , 19 80 �. ....... Date of Inspection .......... .........................19 Date Completed ............1.........................19 PERMIT REFUSED ..........�...'� ... ......�.................. 19 .± .....�..... .... ....... ; ............... o. ....... ............................................................................... Approved ................................................ 19 ............................................................................... >1L t�IT.. �PA,A.tt -,' - �at`_I7Tc1JC>•'4'� �.rGt�rc� sz. — /Z 9, z9 ;C'?00 G4,t_. os 51UGU/ALt. Atza=AA10#4 OX � T s.p v. TOTAL T V--S16Q = 42S G.P.D. •u 32t _ 1 --oT,&L bA.t c - 1=LZIw = . 330 6.P► . � r1GDl.pTtOtJ QI�T<r (��t� Z h�ttJ J2 L>rSS. v !S—+ T . 0�Mkt nr jifh A. d AS' _ FV:1 1 T15T ,p 4. 1 smc -�;� .aiir. tuv• q 7.m 4o.9M µ t IOcq�> t1M' .4 sUB�soiL 4'�9& tuv ' T.c�lK !e`' QG 61-19 v�L,' I Laa,c N - — _ i PIT t •'' - WAsa�lL�• 5ii'o+.iE, qO.o c3 /•oaf - MEO/UMC_1✓2TIFICC7 PL.L'T' QrOsTo N.�` T z_ a sc.a;Ltr- S C.n! r" NO A/19Ira At CajZ'rtJ ! Tt-1A'r T{-1.G FOUNbP�TFC3r^3.'Silac/►J 1-lE:i:C:L]t.:l GC:vVtPt_�(�i' W t7'I i Tt-1 �I D .I.tt�E: L� -�- Autb SE:'T I?•hCtC ; lti C0UtQEAAc t-tTy. T!1 TO W W pr '�I�R.l�1 T L-E P Cam, :,5"7io . c2eGts rr_t��t� tom.-h,l� 3u2virYot~S -rt-tls c�c_nti, t +�oT ��7co CA-4 pN , cTP�mEs 1K. 5M IT 14 i t�.l�T' C�_ U�'>L.� �'u • lj�`1'C:F�iklt►�l": l..U"C' t_It:l�•:� — — - TOWN OF BARNSTABLE Permit No. _______-__�.__ O { Building Inspector �.v�T.,� ...� Cash ----------- 00 �OYP'(�� OCCUPANCY PERMIT Bond No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Janes K. Swim Address Hari6 arJie Wiring Inspector Inspection date Plumbing Inspector f Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. .....................................................1 19_.... ...............................................................................__........................._._ Building Inspector r♦ t f — C;Q U L.1 .tit S Rom," tiM .X L N va e .. r 1 ,r ':f '.{ ,+;i�, pll���1�1F i�ue�i�il t � • SSW G� �•I�s.. ` f i MAP 21p PAZu� 1-t8 LOG (� RiCHARD C v^ BAXTER � ay 24048 ' CEQTIFIED PLO`(" Pt_.�a�l t OCATI O C E NT tZ.\/ L_ . , I C_dizttt rT$4- AT T14G_ VW�u�-� N65t-Ov PLA�1 RE�EtzE�.lc� N6Q6iOti1 CCMPLYS WITH TWE -SIUrm.Ll► C—_ �- A�.tt�?,St=Yit GK rKEQUtcZE�cEt.�TS OP T PC— To w W ;'o�F- $A--t✓N,ST�:.8 LjE- A.I,t� . i s ►.�o i TV L..A K � K, z 5 U �� . S ? •'LoGAT t> Wl T1-1 t 4�1 'TZ-l� l.00 PLAI ki t7AT7 A1�.II,1�` .'1"-' ReGISC�Z>✓D 1-.�1�1� SUevcYoZs T ev U�1 A�•J G. 1�.1SeJMEt•l_TQvcY ¢Tsac UFc:SirTs Si 1oe�W ARP L.t Cl�.►`1 T LA ! i P i f\rk �, t k;� psC' US`C'c�'To D`et'c Pmt N tinT Li titA=S — �S 1 1 , t1m It)MA .: s {r �'• ICI ., ,� ����al t3Z at �-- - ,� ` t a•� 9 ! EEX'M. eL r , W.c.-ct;lqI Lmw/ca"FvcIr : Y Fs a 3 T $ pp r it — -- _.I 'I _ I! ,. _. • � � �,N� E 1 .FcKI..tziEt_c�H/B;I".r�4O6' 'I "•NOTE:PRIOR mUSTVTRUCT( d i CCONTRACTORM1f175T VERIP'YALL DIMENSIONS ?LL��jj 11 e C.Uti t b!� pllr wjy'l r r nssurrre he respon•+Yrlry Jp rury dtc�npaneies d Inrorutxan i,,w bmugh{tp the allmfi011 of thi rksigner. d 1 l --- - �.-�• T ixi ��r d`• : I L_ - T !1 .-. wgnx r+ic,He valet r PMrieic&3.. X6.P'K+'6CIA. IWO.a�v IN f•link P F! I 7 . 7 r U11,11:� 11 W3 .. ,Y I I .. YII,./�..r"•�� ^ ry 1' Si 7{ .s, 1 f W�I i, W ` . h WWW �..... ...« �,�„_._..,,.... ._......w.w.:.,.... »......»... y."__,...,�.,... _._.. . o,.r+�ry.a•w+.i+. �' _ ...,.�..,,..r+-.�.,.a.-..a. � ....�. .++-+.r..., ,y.,�..,,wr'u'-+rvt "w I , � �_. _.. i • ....CV� � 3 r i.*- �Fl�i�, N aid i� YA tltl r,ern/ REra � • r ;,� ;� : e f.at '-C9TBIi 1N1.R•1 - .. _ ._. ... �n.�lW I 1 yy .._^ _s._� N - < _ M1 MEAnM,E F%Yigr t,9p9v, • 'B e� �.rcxb C o c i .fir° � f�H•iie •�. W g —.FICA .9Q I 1 1 G .e' —:. t 91p1IE6176n1_.u.r�.K.. _ t �• J.i ^td+gx40r�S._I rs .I ti l { I { ) ; {y❑J I . Ivr-o , I 1�ccr+aefT'yloglT"�' � \ , Ll m Ir. & ".Fli!IVtJ;L YAWL t .2948tW6ai6 5tl.l9 AAID T(.'Nd'O.G. 6X®KILYIC.7 W,W.A:/ 97 ' OtA3 C 12�eC _ PIM � 1 6M.T�:'� sr j lt.n Wii.o�+m x.e.0l"k / II , yu.a,l+� a}�� .e��` •Rllitc it2 NJG114i l' 1 f{�" Z 1 !n t rOt-*,IC—SLAB F .INTn KztV:1W+LL,' .I 7 P IA{ty ,f t . . . ; ••r J,- ir S n s..:. .; 0 i � h I a 7 NOTE PRIOR TO CONSTRUCI7c A�r CONTRACTOR MUST VERIFYALL D/MENSION3 �, •�• ptr rr+Yramt • ,' i ..rhe (hl7iry nn M's rckr r'�II, s h r mincontlnenc(ee nd Drw ro She rt q _� �. ..V'�� 1-!�i!�.. c . •� 1 w � w11a` Ott p � :tr� 'aaenAnn oJ,rke du(pne+ , , `F` t�{,�1 '� dPo ram' � � _' _ "A - Assessor's-6fice(1 st Floor):>- J�_ / Mays Assessor's map and lot numb / INSTALLED IN OOm Conservation(4th Floor) WITH TITL �w Board of Health(3rd flo � = ENVIRONMENTAL C� Sewage Permit numbs F `. TOWNE��Q„� 6)0• \��' Engineering Department(3rd floor): ` House number Definitive Plan Approved by Planning Board .19 APPLICATIONS PROCESSED 8:30-9:36 A.M'and 1:00-2:00 P.M.only TOWN . OF =BARNSTABLE BUILDING -JINSPECTOR APPLICATION FOR PERMIT TO con4ruc.+ I Ali, �on TYPE OF CONSTRUCTION _ woo tzFri /S 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ,q L-or I Location 1 GEC u i h � I /'jaG�roa� G✓er' 0± Proposed Use �� i Lam i e— Zoning District Fire District Name of Owner �lV', G �ln� 1Y / TES Address Name of Builder Q ���\ f`����°`�� ���Address w ..d 6 Vy• Y�/� �� Name of Architect eJ j/(,/Y Address Tj/�_ J�/t Afiflf44 Number of Rooms C�_ Foundation +bu rc, Cooc Exterior Woo _-a; L Roofing ° /oil Floors I- c)1' 1Ct`� &Vxr� �^� li1(1�l Interior Heating I C- Plumbing /►/a,L)E Fireplace 1NQ��� lre c //CtJ a h rc C Approximate Cost UvU Area71 O W , oD Diagram of Lot and Building with Dimensions Fee J N� Pkch�- 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 ell Construction Si ipervisor's License _ 19 t4v' rr'PV' L(c . -tt 100 3Y3 7 NASTASI , DAVID & ANN ! No 36622 Permit For BUILD ADDITION S ',- Single Family Dwelling ' Location 16 Jacqueline Ct'. . -Centerville Owner' _• David & Ann Nastasi Type of Construction ' Frame ; Plot S Lot - "" _a • � �� Permit Granted -Apri 1 15 , ; , 19 94 , Date of Inspection: -, Frame - r Insulation �e 19 -. Fireplace 19 Date Completed --' 19 vow ' tc 0 CJ 5 l f EMT M� �" ' w • •. � , �,a• � , '