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I� � , .:� 1 `�2�_,, i�:,�,;�,,4, ��� ),- ,, �,�_:, �,fi - , , � , -W-- _Q 1, !, �: : '11 " , "I'll���,, I '. , , Z0411 .", : i��,,;,.�,�,�",�,,,,,,,",.�i',,.;,,,,�-,..',,��,��",��", __�,,�,_,,,��,,�� - - "',"'l-, . ,,;.,� _". - 9 F Town of Barnstable *PermitOO 6�1 Expires 6 months from issue date Regulatory Services Fee s"� Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner _ PERMIT 200 Main Street,Hyannis,MA 02601 w'� s www.town.barnstable.ma.us Office: 508-862-4038 0 CF1x25%8*6230 EXPRESS PERMIT APPLICATION - RESIDENTIA DONL(V BARNSTABLE Not Valid without Red X-Press Imprint Map/parcel Number . Property Address •M Residential Value of Work /.5 �Q, ---- Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address ti t-1/I V, r Cc rn�-Cc , 1I Vh Contractor's Name i ..1.IRG. Telephone Number!%&,: a - Home Improvement Contractor License#(if applicable) k 1 s 4q4 Construction Supervisor's License#(if applicable)_ EiWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner (�I have Worker's Compensation Insurance Insurance Company Name oC Workman's Comp.Policy Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side eplacement Windows. U-Value (maximum.44) *Where required: lssuancc of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property. caner must sign Property Owner Letter of Permission. Hom rov nt ontractors License is required. SIGNATURE: Q:Forrns:expmtrg Revise071405 `"mac Department of Industrial Accidents Office.of Investigations 600 Washington Street Boston,MA 02111' lip www.mas&gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name (Busmess/Orga=ation/Individual): �eC'- STOra kom% (l �' V►�/1 1�1 . Address: `R_�60X Qa3 :. City/State/Zip:l �t�1e. I'VK Oo1lo�a► Phone#: S*Wba- a44 J Aree ou an employer? Check the-appropriate box:. Type of project(required): 1.[YJ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New constmction * _ have hired the sub employees(full and/or part-time). coutractOrs . 2.❑ I am a sole proprietor or partner- listed on the attached sheet# 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working forme in any capacity. workers' comp. insurance. 9. ❑ 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 I •❑ Plumbing repairs or additions myself:[No workers' comp. c. 152,§1(4),and we have no 12.ElRoof repairs insurance required.]t employees.[No workers' 134 Other.Q yr comp.insurance required.] rage fr]L_.-__ +Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they an doing all work and then hire outside contractors must submit anew affidavit indicating such Tcontractors 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-Comp any Name: ` &C 1 GL� 'E� YYl QI11. Policy#or Self-ins.Lic #: 5tbo�ASA6 I a0Q rJ Expiration Date:• �" a �O Job Site Ad&ess:-j City/State/Zip: .16�2&' Attach a copy of the workers' compensation p cp 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 pengties 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 u.p 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 c.e u ' s and penalties of perjury that the information provided abov Is true d correct. Si ature: Date: Phone#:,�M__( ?LQ-aY4� Official use only. Do not write in this area,to be completed by city or town offu;iai 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 Town of Barnstable Regulatory Services Thomas F.Gefler,Director , ;6 3 g Building Division Tom Perry, Building Commissioner 200 Main street, Hyannis,MA 02601 www.town.barnstable.maxs office: 508-862-403 8 - Fax: 508-790-6230 Property O�Amer Must Complete and Sign This Section If Using A Builder I ( � as Owner of the subject property to act on my behalf; hereby authorize r in all raatlE rs relative to work authorized by this building permit application for: vv� l I� (Address ofjob) qSiga,atu)redOwner Date Print Name Q:FORMS:O�J]1ERPERML55ION = = Board of Building Regulations and Standards License or registration valid for individul use only _ HOME IMPROVEMENT CONTRACTOR before the expir4on date. If found return to: Board of Building Regulations and Standards Registration: 118494 a}? OowAshburton Place Rm 1301 y Expiration: 2/1/2007 Boston,Ma.02108 Type: DBA BAKER CUSTOM ALUM&VINYL INC. MARK BAKER 521 SHOOTFLYING HILL'RD. �� :�, ENTtRVILLE,MA 02632 Administrator Not valid w4hout signature �F. r , S Date: 6/12/2006 Time: 2:29 PM To: S 7,16083626115 Dowling & O'Neil Page: 002-002 ;7 Client#-9742 2BAKERCU ACORD,>, CERTIFICATE OF LIABILITY INSURANCE 0612o DlYYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Agency ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 222 West Main St.PO Box 1990 Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Harleysville Worcester Insurance Co. Baker Custom Aluminum&Vinyl,Inc. INSURER B: Associated Employers Insurance Compa P O Box 923 INSURER C: Centerville,MA 02632-0071 INSURER D: INSURER E: COVERAGES 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 RESPECTTO 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF MIHIRJINCE POLICY NUMBER P Y EFFECTNE PODLAJCY EXPRATION LIMITS A GENERAL LIABILITY . CB831748 04/19/06 04/19/07 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1 OO OOO CLAIMS MADE 51 OCCUR - . MED EXP(Any one person) $5 000 X PC Ded:250 PERSONAL&ADV INJURY $1 00O 000 GENERAL AGGREGATE $2 000 000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2 000 000 POLICY PRO LOC AUTOMOBILE LYUlBJTY COMBINED SINGLE LIMIT $ ANY AUTO (Es accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS ' - BODILY INJURY NON-OWND AUTOS (Per accidem) $ E PROPERTY DAMAGE $ (Peracadem) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ 11 ' AUTO ONLY: AGG $ EXCESSAIMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE - $ RETENTION $ $ B WORKERS COMPENSATION AND WCC5002454012006 04/23/06 04/23/07 X we STATu- O R EMPLOYERS LIABILITY ` E.L.EACH ACCIDENT $100 000 ANY PROPRIETOR/PARTNERIEXECUTIVE OFF ICERIIdEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $100 000 I'"" deacnbe un�r E PROVI I NSbelow E.L.DISEASE-POLICY LIMIT $500 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/V EIBCLES 1 EXCLUSIONS ADDED BY ENDORSEMENT/SPECYIL PROVISIONS Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable-Bldg.Dept. DATE THEREOF,THE ISSUING INSURER WI L ENDEAVOR TO MAIL I_ DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 80 SHALL Hyannis,MA:02601 PAPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE SURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED RfPRESENTATWE ACORD 2S(2001/08)1 of-2 *43183 LS1 O ACORD CORPORATION 1988 j - oFE r Towm of Bar nstable *permit# Expires 6 months from issue date Regulatory Services Fee- 9 ninss $ Thomas F.Geiler,Director rFc i e+ �m A A ... • • • - e 9 �rr-9 _,. Bu�llding Division �_._;` 4 - w Perry, Building Commissioner L - 200 Main Street; Hyannis,MA 02601 )- 2004 Office: 508-862-4038 C = A N,S TA GL br Fax: 508-790-6230 EXPRES$,PERMIT APPLICATION - RESIDENTIAL ONLY. Not Valid without Red X-Press Imprint Map/parcel Number _6�0 Property Address A [4( ) � Residential Value of Work 6 o Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name Tele hone Number �� +-�^ p Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) + (3 Worlmian's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on ile. Permit Request(check box) " ® Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. 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: Pro erty ust sign Pro Owner Letter of Permission. Ho pro eme t cease is required. Signature QTormsiezpmtrg Revise063004 i Fraser Construction Roofing & Siding Specialists immediately u completion Payable immed y on p NO MONEY DOWN - NO Payment at the start or partway thru Payments accepted are: 1 CASH -CHECK- MASTERCARD -VISA-AMERICAN EXPRESS *Any payments not made within 30 days of completion will be charged 1 '/Z%for every 30,days the payment is late. Possible Extra-After the shingles are removed from the roof,we will lift one sheet of plywood to make sure that the insulation be not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$4.00 per panel including Materials&Labor. There are 6 Panels per sheet of plywood. Possible Extra-Any rotted or otherwise deteriorated trim boards,plywood sheathing, lead flashing, or other carpentry needing replacement will be done } and charged for as an extra at the rate of$45.00 per hour,plus materials,plus 20%overhead mark-up on total extras. FRASER CONSTRUCTION Warranties the labor for 10 years. FRASER CONSTRUCTION Warranties the shingles against Blow-offs for 10 years. CERTAINTEED Warranties the shingles and labor 1000%for the first 5 years, and then on a pro rated basis for 30 years total if the shingles become defective. CERTAINTEED Warranties the shingles to be ALGAE resistant for a full 10 years. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We,if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION: Carries Workman's Compensation and Public Liability Insurance on the above work. DATE OF ACCEPTANCE: _ 16115404, SUBMITTED BY: (I"CAIV Home caner IT asse on uct10n f THE tp�y TOWN OF BARNSTABLE i 8ASB9TOIiL&, i M639 a' BUILDING INSPECTOR °�O YPY � • APPLICATION FOR PERMIT TO .... .........I..... 2 I x ZZ ....................... ............. TYPE OF CONSTRUCTION ...................................................... r TO THE -INSPECTOR OF BUILDINGS: r / The undersigned hereby applies for a permit according to the following information: CC� � Location r SR! bPP ( U�� �..a` 5................^^.......................................��........1 ................. ......................... ®T............. ...... ProposedUse .......1....... ...................................................................................................... ZoningDistrict...�...................................................................Fire District .C............................................................................ 13 Name of Ownerl..!�,/'></U.K... Ll�},IU C.�................Address .5.5. ...S. O�T ��- �! .��... .l.L L... �J Name of Builder M......( !.U. -.1....�o�.....:� �N�. ..5.......Address ®x....S ....... b....Pk ,'1bk).L Nameof Architect ..................................................................Address ................................................... ............................... Number of Rooms ..........................Foundation N C.!�,... ,� .............................................. ExteriorECE�r n5, ...Roofng ApH A L7- S tj /�U a� LS.... . IUG� • .... ... ........ ....... Floors ...U.u.cP'.C.. ...........................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..............................11,.................................................Approximate Cost .....I.. . .............................................. Difinitive Plan Approved by Planning Board --------------------------------19________. T Diagram of Lot and Building with Dimensions £ 0 FOR _j E. l �,i y SE!' AGE DIS OSAL. DRAINA(�L ►S �-[►::tc�.�3ti "s`LD �®�' Ilt T a � 'ARNS ADL,F::, O`'VN OF D- _ BOARD. OF. HEAL, H -9 (�� �.�xt�tilt-7ykCikz M..:..1� .:.-•. �� ��"C,f At tr 7. o 1 I�wA� '420K ,r • � o C I�►�Ih►11t� � � —- 9 .o I herebyagree to conform to all the Rules and Regulations f t g g o he Town of Barnstable re arding the a ove construction. - Na1...... . ..... . .. .... ........ � Blanche, Frank l ' �a�a�m l���o ^— ~~.�~� No ................. Permit for ------------ ................................... . ^ Location — 555 Shoot l�l] Rd. —���--_---���...................---..'' ~ Centerville .----------.--.---.--------- Frank Blanche Owner -------'..............__._______' Type of Construction .............frame ............................. ' [ __---^-------_------------.^ P|c» �» ---------' ----------' �, D < i ~ \ � Permit Granted �� . —..�������------]g '—�� ' Date of Inspection ------.. --]9 v. � | Date Completed — ��.'����.--]q / ' ' ' \ PERMIT REFUSED � .-------.------------- lV ' --------~-----------------' | � i —_—~----..--------~-----~,,{ ` ^ ` ~ ' '—''—'--'—`-----~`~^^—^^''—'----'` � ----^----------~—^'^^---'—~''^^' / / ' Approved ................................................ 19 ' ' . � ^ -------------.—.—.----.-----. . ------.—,'------.-----,....—..— . / | � | �