The URL can be used to link to this page

Home My WebLink About0048 BEARSE'S WAY L... � �-�� -- -------- - -- - - - - - 1 A / �, �v�i BIKE � Town of Barnstable Building Department - 200 Main Street * � * Hyannis, MA 02601 9 MASS ib,3�. . (508) 862-4038 RFD Mp`► A Certificate ofOccupancy Application Number: 201400264 CO Number: 20150233 Parcel ID: 309163 CO Issue Date: 12/09115 Location: 48 BEARSE'S WAY Zoning Classification: RESIDENCE B DISTRICT Proposed Use: SINGLE FAMILY HOME Village: HYANNIS Gen Contractor: WILLIAM WHALEN . Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: Building Department Signature Date Signed ry TOWN OF BARNSTABLE 1 Buhlbing 201400264 �BARNSTABLE, * Issue Date: 01/15/14 Permit y MASS. 16 3.1h Applicant: Permit Number: B 20140079 Proposed Use: SINGLE FAMILY HOME Expiration Date: 07/15/14 o Location 48 BEARSE'S WAY Zoning District RB Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 309163 Permit Fee$ 48.45 Contractor ' WILLIAM WHALEN Village HYANNIS App Fee$ 50.00 License Num 074928 Est Construction Cost$ 9,500 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND REMOVAL OF WATER DAMAGED SHEETROCK,INSULATION,FLO RRjOIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: GREENE,DONNA M BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 48 BEARSES WAY INSPECTION HAS BEEN MADE. HYANNIS,MA 02601 Application Entered by: PF Building Permit Issued By: I THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,-ALLEY OR SIDEWALK OR ANYPART THEREOF,EITHER TEMPORARILY.OkPERMANENTLY..ENCROACHMENTS PUBLIC PROPERTY,NO _ SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED,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 FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). , mat , BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 7 c l_t.�n[{1�/ ,'n QSScvno✓jt; v ��t 2 I 3 1 Heating Inspection Approvals Engineering Dept Fire Dept S1 2 Board of Health ! 2 I� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 0 9 Parcel Application # Health Division Date Issued o7,15-- rq P� Conservation Division Application Fe 1 , " 1 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address LfV' J3 6-AASE S U-)A Village _qJgktj 61ts Owner CAko 1_ k6ft;J Address l I!S G Fn,6R RuAj ORmyinu� &K41 Telephone 3% "?9s s339- QA Permit Request l A1r,6RImVI— REPjIR S osr W Al`S, FGoc%AS Aa(4 ON rat FAST- A&A sC-e4tic4 Fl=n-S Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District c Flood Plain Groundwater Overlay Project Valuation 7�7-®,0® Construction Type Wu� 59AA-� Lot Size ®.SAc Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) t3 4< Age of Existing Structure girt'4S Historic House: ❑Yes )(No On Old King'. ighwaF.,Q Ya ❑ No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other RJBasement Finished Area(sq.ft.) 0 Basement Unfinished Area (sq. ) Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: existing —new 0r Total Room Count (not including baths): existing 7_new First Floor Room Count Q Heat Type and Fuel: '*Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing A_ New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Slp6kS 5AVu1-.L-J Proposed Use SAv APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name U),6*1L4►kAA- AALk-_�w Telephone Number 760 l91f Address 1 aD PONg Tr 90k9v SreK- License # CS ®') g'i 19' WAAJ.w" RffSCU"r,-wti+S =NC. Home Improvement Contractor# Worker's Compensation # I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE U) v-�� — DATE T FOR OFFICIAL USE ONLY APPLICATION# k Y DATE ISSUED - MAP/PARCEL NO. ADDRESS VILLAGE. OWNER t DATE OF INSPECTION: FOUNDATION FRAME E INSULATION t FIREPLACE L: ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL. GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. .ry_� r D of I m OJOW OVINvadgadom N saWW orr,iltA 02111 Worker'Compeusatton':r=mne*AM&vW,gv tetra/Contra�elorslLlectric� Pinmbers ti. tMestse tPrt..�t,.,., Name Whaaen Restoration Services Ad&=: 22 American Way Ci /S South Dennis, MA 02660 508 760 1911 Ari r�iv Phone it Cheek. piab 5oii: 1.( t a em i"w with-„2= COT a �nd I Typ��otpeo�eet("9�: {l61 �od/or F�•time�• 6sve'hired 6. 2.❑ I am a sole � tots ❑New coon ! or P tistert on the alleged'` 1, 7. Q Remodeling strip aad Oe no Tt a yb•��oatea�toes iunre s. p Demoution rue in my collocity• [No 'coM.in�uance gyp.iouaooat 9. ❑Bwi&s sdd don s. p We see: 3.❑ L o °0f p°i�0a�d ns` t O.Q<Ela�rigi repsire orwaim doing aU work f�ken-travie. ttse ' l t•0 Phunbing Mxdn or addidooa mry►�elt»' worlcees'comp. ig� 3a.❑ t, �'' C. t"S2:` 1{a�;sma W have no 12.0 Roof reaie, aorroraetoc(rj; I!lay^e!s�.[No ,. 13.0 Ot6ar Any now aowibsf�oueaaaio.eNo.,yo„ �,1 e �P!�!►e.4a�� ea.; e�ip ,low .tlSol_Who"Grim foiea"bara'cb' aas�at arw aye uwptr�ip A.wi p F t!a aYa�air~ 's�aerp�i'i ,� � -• aussat B b d arPJw /bb SIAU InSUMM COMpWNatm Ace American Insurance Company Policy#or Self iaL tao. IB-5B894542-14 Expiration Date: 4/1/15 Job Site Address:, eg A-Sa-$ y Attsab a copy otlM werlwrs'compesestys C�YlSdtdZip: 9��4rtee,e g Faitrae to secure Seclran Z3Ao ° '1O+a �) fig up to 3i,300.00 t Lorotie- uq R te ofcr"q paesides ofa Of up to M0 00 s da P :ut the lbem'of STOP WORK ORDER and a f. Y dre violator. Be advised;tt�t s comer of a Invest of ttrov DtA for sal!be A -w ded to the OtRce of - P ojPryarrJ►i�lit.` -� . �Psidrnrtt trsir�/�t dV � O,8wd we W* Do,rot . !seal bri'lg►a lower o City or Tows; PermtH[,teease N IUNIai Auft ft(*de on).. t.Bout-of t&itdt 2.BaBdtaf Dep wtwot I 6. Ctymewn Cerk •1, itOther t opsor S.Plumbing toepeetor Cow Ponca: 1:Theresa Cahalane-Norkus To:Kathleen S., Whalen Restor SerY Inc./ Estate of (15087AM%) 12:00 10/03/14 EST Pg 4-4 Ril;httax N3-2 10/3/2014 .10:39:57 AM PACE 2/002 Fax Server ' •'' `o� DATERJIMIODN CERTIFICATE OF LIABILITY INSURANCE VYV) T X-1iTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPONTHE 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.AKIULSIE C TE OLDER. IMPORTANT:It the certlllcate holder Is an ADDITIONAL INSURED,the polley(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this cerllllcate does not confer rights to the certificate holder In Ileu of such endorsements. PRODUCER CONTACT NAME; HUB INTERNATIONAL NEW EN PHONE FAX 265 ORI-FANS RD (AlC,No,Ext): (A/C,No): EMAIL NORTH CHATHAM,MA U2650 ADDRESS: 77GKf INSUREn(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: ACE AML•RICANTNSURANC13COMPANY WHALEN RFSTORATTONSERVICES.INC. INSURER 0: INSURER C: INSURER D: 22 AMERICAN WAY INSURER E: SOUTH DENNIS,NIA 02660 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURA NCE.LISTED BFLOVI HAVE SEEN ISSIIEDTOTHE IHSUnED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTVATHSTANDING ANY REOUIREMEIII.TERIA OR COtIDITMN OF ANYCONTRACT OR OTHER DOCUMENT WITH RESPECT TO YIN CH THIS CERTIFICATE MAYBE LSSUEOOR MAY PERTAN.TIIE INSURANCE AFFOnOED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL 111E 1F/IMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOVIN MAY HAVE 0FEN REDUCED DV PAID CLAI6!0. INSR ADD SUB POLICY FfF DATE POLICY EXP DATE Lill TYPE OF INSURANCE L A POLICY NUMBER (11.611DDIVVVY) (UTADDIYYYV) LV.1R5 GENERAL LIABILITY .ACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 5 C AtMS AU+OEEl OCCUR. PREMISES(Ea occurrence► AEDEXP(Any one palsen) $ PERSONAL L ADV INJURY S GENt AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE S 71 POLICY PROJECT ❑LOC PRODUCTS-COMPIOP AGG S AUTOMOBILE LIABILITY COSABINEDSINGLE S ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY S SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY S {Per accided) NON-0WNEO AUTOS PROPERTYOAMAGE S (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE 8 RETENTION S $ A WORKER'S COMPENSATION AND WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-58894542-14 04/0 /20A 0001015 X LIMITS ANY PROPEnrTo"ARTNERIEHECUTWE a OFFICENMEMBER EXCLUDED? N/A E.LEACH ACCIDENT S 1,000,000 (MandaloryinNH) E.L.DISEASE.EA EMPLOYEE S 1,000.000 R yes.dosuibo under - DESCRIPTION OF OPERATIONS bc4ow E.L.DISEASE-POLICY LIMIT S 1,000.000 DESCRIPTION OF OP ERAT1ONS1LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS RUPLACDS ANY PRIOR CHRITTICATB ISSUITD TOTHII CM'nRCATBROLDBR AFFRCDNG WORKERS COMP COM- AGLL CERTIFICATE HOLDER CANCELLATION ESTATE OF DONNA GREENE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED AS BEARSF.$1VAY BEFORE THE EXPIRATION DATE THEREOF,N0710E WILL B DELIV D IN ACCORDANCE WITH THE POLICY PROV HYANNIS.AAA 02601 AUTHORIZED REPRESENTATIVE q' �.nea��+n. , .......... ACOAD 25(2010lOS) The ACORD name and logo are registered marks of ACORD�m ��1986.2010 ACORD CORP RA��!��1 r�g�lts reserved, Massachusetts -Department of Public Safety Board of Building Regulations and'Standards __ � ffice of Consumer Affairs&Business Regulation Construction Supervisor !f ME IMPROVEMENT CONTRACTOR License: CS-074928 r 3, registration: 129244 Type: � , xpiration: 7/30/2015 Private Corporatio WILLIAM WHAL�N = Whalen Restoration Services Inc. 122 POND STRUT �j7C BREWSTER MA=02631 William Whalen 22 American Way Expiration South Dennis,MA 02660 Undersecretary Commissioner 08/10/2016 Unrestricted-Buildings of any use group which License or registration valid for individul use only contain less than 35,000 cubic feet(991m)of before the expiration date. If found return to: enclosed space. Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 Failure to possess a current edition of the Massachusetts — State Building Code is cause for revocation of this license. Not valid without signature For DPS licensing information visit: www.Mass.Gov/DPS a. r Dec 301'3 09:47a E Ilucian 1-386-256-7744 p.1 1 , Dec 30 2013 10: 45RM Whalen Restorations_ 508-760-9995 page 2 Restoration Services Inc. =iic,Smoke,Soot,Water&Mold Remediation Services Cleaning . Deodmrhation;, Reconstruction Specii alms In Fire ttestoratbn -.An Work Guaranteed Access$ Authoirizatio n and Oiroot Payment R*gU*St Ferns (we)authorize WHALEN RESTORATION SERVICES to perform work as oer estimate at property located at 48 Bearses Way, Hyannis, MA 02601 to repair damage caused by water. As owner(s)of this property, i (we) understand that I (we)must authorize thiswork.l (we)hereby authorize WHALEN RESTORATION SERVICES to perform this work and for paymera•upon completion. -? %%4 eS fit. ..s:1t be w'po��.Ltc (we)authorize and direct my Insurance Company, Mass Prop Ins Und Assoc, Policy #0968963, to make payments directly to WHALEN RESTORATION SERVICES, Insurance Claim Specialists,for doing this work and to that extent 1 (we)assign the benefits applicable to this loss to WHALEN RESTORATION SERVICES. I (we)acknowledge receipt of a copy hereof: MATED GWNER_ 5[G OWNER WHALEN RESMIKA'TION REP. SIQN£J 22 American way,South Dcaniz.MA 02660 phone:(5o8)760-l9t 1 Fax:(501)7W-4995 t-SM-244-2598 E-Mail:ks1Kt a hsleaeeAorations&'-M W6 Page:hnp://www.whaknrestmal:aas.com Oct Q6 14 00:30a Ellucian 1-386-256-7744 p,1 DECREE AND ORDER ON 1 Docket No. commonwealth of Massachusetts The Trial Court PETITION FOR Probate and Family Court FOR MAL ADJUDIGAT.I ON ;Estate of: Barnstable Divlsion Donna Greene 3196 Main Street ` irsi ame i e ame ast, ame P.O.Box 346 i Also Known As: Barnstable, NIA 02630 Date of Death: December 18,2013 (508) 375-660D After a hearing or on the uncontested Petition for Formal Adjudication filed on January 7,2014 (aate THE COURT FINDS: 1. The Petitioner is an interested person and has filed a complete and verified Petition. 2. The Decedent died on December 18,2013 (dale) ® domiciled in the abcve named County. j� a nonresident of Massachusetts,but leaving an estate in the above named County. 3. Any required notices have been given or waived by all the interested persons. 4. Venue is proper. 5. The Petition was filed tvithin the time period permitted by law. 6. ❑ The VkfiII dated wth codicil(s)dated ate a e(s referred to as the Will,is valid and unrevoked. There are no known Wills that haue not been expressly revoked by a later instrument. The Will is the Decedent's fast will and is admitted to formal probate. Z There is no valid Will. ❑ The prior informal finding as to testacy is set aside. iL] The Will dated with codicil(s)dated (date) ate s) referred to as the Will,has been lost,destroyed or is otherwise unavailable. The above-referenced Petition states the contents of the Will. The VVRI as stated in the Petition is valid and is the Decedents last Will. The instrument dared with codicils)dated is not a valid Will. sate Ca[e(sJ ❑ The duly authenticated copy of the foreign VM11 dated ( a[s with codicil(s)dated along with the duly authenticated certificate of its legal dale(s) custodian are true copies and the fore gn Will has become operative under the law of 7. ❑ Otner 8. The heirs of the decedent are as stated in theetiiion. '' QR ❑`P as follow : e roi nnoy Name and Address of Heir -" keojp[ship to Decedent t I. iJsat MFG 755(3!19112) page REG1 STEER 3 Oct 06140Q:31a Ellucian 1-386-256-7744 p.2 Docket No. Estate of: Donna Greene -first Name !d a Name 1-as! amei 9, ❑ Any blfill to which the requested appointment relates is or has been previously formally or informally probated. 10. 1] The person whose appointment is sought has priority entitling that person for appointment. OR The Court finds that those perscns having priority for appointment are not qualified to serve or,although given notice of the proceedings,have failed to request appointment or nominate another for appointment,and that administration is necessary. The following person(s)islare qualified to serve. Carol C. Hogan First Name mil`- ast ame first Name `RCS Last Name 1113 Glengad Run ress Apl, ni, o.etc. ( ress pt.J al, a.etc.) Ormond Beach FL 32174 ( ry own) ate — t� ty sown tale Primary Phone#: (386)672-7899 Primary Phone#: THE COURT DECREES AND ORDERS: TESTACY DETERMINATION 1. Q The Will is admitted to probate. The Decedent died intestate. The instrument is not admitted to probate. 2. The Decedent's heirs are as found above. APPOINTMENT OF PERSONALREPRESENTATIVE 3. The fZ aforementioned OR following person(s) islare appointed or confirmed as Personal Representative(s) ;hereafter"Personal Representative"): mt Nam> Last Name 4. The Personal Representative shall serve: in unsupervised administration. 71 The Will directs unsupervised administration. ❑ The Will directs supervised administration,but the Court finds that circumstances bearing on the reed for supervised administration have changed since the execution of the Will and there is no necessity for supervised administration because: _rU 1� •'• �., "A TRUE COPY - -.m r. JATTEST '�6'9' •" �° REGISTER 2 of 3 IJPC 755(3119l12) > j(� 't page Oct(1614 06:31 a Ellucian 1-386-256-7744 p.3 Docket No. Estate CA: Donna Greene us? ame d—f�v TeNime �v(;�,i Fj in supervised administration because: ED Decedent`s Will directs supervised administration. The Will directs unsupervised administration,but the Court finds that supervised administration is necessary for protection of persons interested in the estate because: The Court finds that supervised administration is necessary under the circumstances,speciflcalPr Unless further restricted below,the Supervised Personal Representative may exercise all of the powers of Personal Representatives except the power to make any distribution of the estate without prior order of the Court 5. The Personal Representative shall serve: ❑ Without a surety on the bond because' ❑ The Will waives the requirement of a surety bond. ❑ All of the heirs or all of the devisees have fled a written waiver of sureties on the bond. The Personal Representative is a bank or trust company_ The Court finds that sureties are not in the best interest of the estate. ® with D personal ® corporate sureties on the bond. ❑ A Demand for Sureties (MPC 360)has been filed. ❑ The Personal Representative's prior bond is re-examined and approved. 6. ® Letters of Authority for Personal Representative shall be issued. ❑ ?reviously issued Letters of Authority for Personal Representative are confirmed. 7. Tne Court further orders: 17 9 Date Justice ❑Vag istrate + •1',,. .. ATRUE COPY ATTEST REGISTER MPC 755(3119/12) page 3 of 3 First Floor at 48 Bearses Way 17'5" OCT 16 9" r � � v o Dining Room Smoke detectors= o N 3 CA" '4' 16'7" a 00 17 2" N Co Bathroom- Den ` ,-A 8 _ 4'7" Kitchen Area b o ---6' 11"— tj 3'9„ 3, 17' N I, 911 o ta' rn 0' Living Room °O Bedroom 20'4" 34'5 Repairs to the walls,flooring and ceilings in all areas on the floor Scale:1/8" = 1'0" ,S Second Floor 8' t-----13'9" -T 4„ - 13'6" N 13'5" Bathroom 60 13'2 o Hal a 0 4"1 `" `O Bedroom - Bedroom °°2' -3,9" 3 3 2' ! T C air C i�_ 10' 10" I F -14' 1 17 5" Repairs to the walls and flooring on this level ,Scale:1/8" = 1'0" , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �10 Parcel ^' Application #C�?OJC160 i Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ., Historic - OKH _ Preservation/Hyannis Project Street Address �t�' �S u�E4 Village A�N cS Owner t ON EC- 6 APAO L 1161>AN Address 5CA f2 S C wA Telephone 3 a' '� POA] Permit Request vv%Qc L( `K',o r"J n t: Wt4 --5_YL 1i4w-AG578 S ae,&- UdZOc.L< i/US VL,�I ,� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay d� Project Valuation 9J�C_00 Construction Type 6-40b � Lot Size 3 a Cy TF-r- Grandfathered: ❑Yes " ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family V Two Family ❑ Multi-Family (# units) Age of Existing Structure -5'3 -f2 Historic House: ❑Yes XNo On Old King's Highway: 0 Yes *0 Basement Type: )(Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) b Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 13 existing —new Total Room Count (not including baths): existing -7 new First Floor Room Count Heat Type and Fuel: Ji Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes J� o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use _ a APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1/l)D A vw U-3 Telephone Number :d 0' -7(0Q� Address I 'A'a kotiA sT- %3 =vl._ License# 6.S 6 7 V 2 Q R- ��fv �i 'C"or t'�c�sv S�2terc Home Improvement Contractor# 139' 01 qq Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PRO ECT WILL BE TAKEN TO 't-OWN or cA C A✓L ! G 9, L.D S. D t,.Vgo S t e SIGNATURE S-J � DATE H\ d I y r FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED t MAP/PARCEL NO. . ADDRESS VILLAGE OWNER ' P L- 1s 1 DATE OF INSPECTION: 3 % FOUNDATION k FRAME S INSULATION f. x FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH,.. . ;. . ; 5. FINAL .;FINAL BUILDING DATE CLOSED OUT op A ASSOCIATION PLAN NO. �\ The (•untmun►e•ealth of.11a.kisaii-huseirk Department of Industrial Accidents Office of bi►'e'ste,• rion.f 600 1'!uslti,tl;tnn. . •.Peet Kvstuu, :11-1 02 t 1! ►.•► iv.inass.govIthc. �%orkers' Compensation Insurance :Affidavit: Builders/( .\ntr;ii tors/[,.Icctricians/Plumbers Applicant Information Please Print Legibly \,un�' .i+l.•,t::,.' ) /.:u.Vt It•.!:'.;..•... • _whajgg._&s oration Services _ _-- American Way ('iE\ State' /iP: South enais. MA 02660 Pliot)c• 508 760 1911 :%rc%ou an employer"Check the appropriate hog: 1'vpc of project (required) -: n I .::n .. _.n..:.• ;, .rla�ltu,lull 1 1 . l cinpio\er \\ith 25 �—• (1 �L\\ lltil,,tl'llCtllln CI11plJ\:., I I'tlil anti of part-ttntd: Il.t\i !ill':,a (tk' ' 7— ,,l\• ! . .. the I\C;11ild,hil`_' l 1 l ::tu i ,ttic proprlctor ar part;ll:! 11C�: ,ilh-�onlraitvr, ;1:1\C i El I)cttt,lltU,�r1 ;Jill):ui,? ha\C no crtlplo\cc, clt•!�L,\Ci'. Jllu II:1\: \\t,rl,Cl', \\orhin_ fur Me In an\ capaclt\ t j v D Buddin.-, addition. ,t,11tp I1t\ttl'alliC � I 1\t)rKer,, :,mill It stlrall�� tt--11 t t Itl I Iel:tncal repair,or a,lJllltt;lam i rCt.lU!rCJ �1 \1: .:rC :orpor.ln ti .w,. I:, . ' ,_,; 1 :Ii?t a litlllico\\tier .11,ln_ .ill \l trr 1, t!ttlt.t.'!, h.,\C C\:i�,i,:t: iht:R � i ! i,� I'lUlllhlll,' I'Cp:Ill', Ur.1JJIl;Ul1, ll ;i_Ill t,t :\CI111111Un her rl 1 nl\,Cli' j\t, \1llrAer,' iCU11p I !-2 Cj I<ttt,t r:llatr\ ItUUraildl.' '.'t.'glllrCtl.! � �,, li-li, a!i,: \\C It.t\: ftt' ! i lltt:s :Illritl\VL" �,i \\or).er, Ii I C , ) ! I ;tmlp ,n,urancc require\! i '.rn :,;t,L:ans the:_hca.,n.,\=1 rnl,:.ill++::!!,.,.,the,.,..+�r.n:i+�••+t ,II..\ting rhea t+.,ri,cr, d,+nlpen,.d„w r,�l,,, :nitau:.,wn: •iL;:,a\\uc!, ,till,,un11,1!;hl,allWat:l :nJt.:dull'vw% a:c Jn:n all t\,,;�JUJ Ihelt i:ur,tu: :J._.'uua:t,a,mC;.t,unnu;.,r,:tt atti .tt :u1Jt:at 'l.•:11r'J:1.•t,IIIJI:t1c,:k(tit,h.:\nlu,t J;IJ:I1C.!.111 J.Su,it'!liaf.41eCI,tiv\\lil_Ills IlLio C i;, Ito:-,ut,-. I11tracti,h 311J,I:IIC t\;iCU::'.„r:Wl;C+•,:t.'RIIItC+itJt. empt„)tr. it the>ut+-:,mug ur.ha\c cmpio\cc,•thr\ mull prot.ide their %%or►.er, ,t'nip pttl,,\ numhcr I um apt entplgt•er that is providinig workers'runtpensatiuti insurance fur tnY entplu►•ee.%. Belun-is ilte police•and juh sitr information. lil,urdnct:C��llllpan,, \anic Ace American Insurance Company 5B894542 ! \l,rr.,uun I salt; 4/1/14 Job Site Addret.,. 7 (?._.tJ �✓�S �� 1 --- _ t. ,t\ ,tatr llll `�� CS Attach a cups of the worker.' compensation polic\ declaration page(sho%%ing the policy number and e\piration data. I allure to secure coverage a, required! under Section 25A of.�Nvtui. c In Icad to the unposttion of crunnlal pcnaluc,of .: klh.7 up to S I.?UU.UI/and or one-\car unprnonrlicm. a,\\cl'. .1,cl\11 ; • ri. ,: -n the iorm lit ;, ti'I i)I' MORK ORDER anu a lint al`it,S2-;0.t)t)a loll a�_lalllit the \I01Jl01 lir .:i\!,C4 !tai hC I0M.IrI.jCdj It)the t lllit'i tl: Imc,tt`atluns ol,the DIA for insurance ce1\crat-,c \erlt`!catlot 1 du hereht•certify under lite pains utld pena/tie. of perjur►'that the infurrnatir prrn•idcd uhnre is true and currecir. 1 4 Pllt'ne 508 760 1911 Official u%e unh'. Da not►►vide in this area. nr he completed M'rip'or town official it 0tsorTo%%n: Issuing AuthoritN (circle onc): ' 1. Board of Health 2. Building Departrucnt 3. ( It.,.'I ovi o ( lerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone r lLlbil L.1 QA VL 1 1/ J/ LV1'S Z JJVJ AL'1 rAl.,l L. L/ VVL 1-QA LJG1 VGL r�- CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) TWS.QERTIFICATE 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 and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME: HUB.INTERNATIONAL NEW EN PHONE FAX -65 ORLEANS RD (A/C,No,Ext): (A/C,No): E-MAIL NORTH CHATHAM,MA 02650 ADDRESS: 77G1eE INSURER(S)AFFORDING COVERAGE NAIC d INSURED INSURER A: ACE AMERICAN INSURANCE COMPANY WHALEN RESTORATION SERVICES,INC. INSURER B: i INSURER C: INSURER D: t 22 A VIMCAN WAY INSURER E: M t SOUTH DENNIS, A 02660 INSURER F: I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS ISTO CERTIFY THAT THE POLICIESOF IFMPDW GSTE LOW RAVE BEEN IM115 T TH E INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATEQ NOTNITHSTANDING ANY REQUI REMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLIOESDESCPoBEDHERETNISSUBJECTTOALLTHETERMS,EKCLUSIDNSANDCONDITIONSOFSUCHPOLICIE& LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR ADD SUB POLICY ETF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MM DMYYYY) (NUDD\YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TORENTED $ CLAIMS MADE ❑OCCUR. PREMISES(Ea occurrence) MED EXP(Any one person) $ ff:: PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 7 PROJECT ❑LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea acciderrl) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accideir) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND x WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-513894542-13 04/01/2013 04/01/2014 LIMITS h ANY PRCPERITOP/PARTNERID(ECUTIVE NIA E.L.EACH ACCIDENT $ 1,000,000 OFFICE MEMBER EXCLUDED? El (Mandatory inNH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe OF er OPERATIONS below OF DESCRI PT1CN E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE-ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE, CERTIFICATE HOLDER CANCELLATION DONNA GREENE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 4S BEARSES WAY BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL B DELIV D IN ACCORDANCE WITH THE POLICY PROV AUTHORIZED REPRESENTATIVE HYANNIS,MA 02601 I ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORP R ��f A(I ngllts reserved. rc..mmmteuwl/ Massachusetts-Department of P4blic Safety v fGce of Consumer Affairs 3c Business Regulation Board of Building`Regulations and Standards. ME IMPROVEMENT CONTRACTOR ' ,Gonstruchon Super isor " 1• , traEion i129244 Type: Licensex CS-0T49M. p piration:Ey7130 0'-i5 _ Private Corporatio: Whalen Restoration &'- WQ.I:JAM e'Sei{v+ces I , �F POND _ William Whalen �' BEVYSit'LR IJrIAr r 7 + ; 22AmericanWay _� w �, South Dennis.AAA O'660 "�; e I , e..• r+v 73 ;,s�' �EXpi ration! f; Undersecretary Commissioner 08MOM14 Unrestricted= IOdings of any use group which License or registration valid Wr mdividui use on js than 35000 cuibic feet(991m3j-of is before the expiration date. �f found-koro to: •, I Office of ConsumerAffairs`and Busieess Regulation enclosed ' I0 Park Plsza Suite 5170` ' -Boston,MA 02116 ' t .Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this lice se:; ., ,„ : _ . Not valid without signature ` f For M l,tensing information WAt*. www.Mass.Gov/DPS _ - z > a ♦i _ Sri z a +r a A i �, � .__.,__�,.., __•__ _._.._,...3�..�l:a,.., ,moo._...-. .�... — ----..._... .�._� .,. - Dec 301309:47a Ellucian 1-386-256-7744 PA Dec 30 2013 10: 45k9M Whalen Restorations 508-760-9995 page 2 Restoration Services Inc. Fire,Smoke,Soot,Water&Mold Remodiation Services Cleaning . Deodorization , Reconstruction Specializing In Fire Restoration -All Work Guaranteed Access, Authorization and Direct Payment Request Form (we)authorize WHALEN RESTORATION SERVICES to perform work as per estimate at property located at 48 8earses Way, Hyannis, MA 026D1 to repair damage caused by water. As owner(s)of this property, I (we) understand that I (we)must authorize tNswork.I (we) hereby authorize WHALEN RESTORATION SERVICES to perform this work and .. far payment-upon completion. (we)authorize and direct my Insurance Company, Mass Prop Ina Und Assoc, Policy #0968963, to make payments directly to WHALEN RESTORATION SERVICES, Insurance Claim Specialists,for doing this work and to that extent I (we)assign the benefits applicable to this loss to WHALEN RESTORATION SERVICES. I (we)acknowledge receipt of a copy hereof; .a1ao1/ 3 e DATED OWNER SIGNED OWNER WFLU"RESTORATION REP, SIGNED 22 American Way.South Dennis,MA 02660 Phone:(509)760-191 l Fax:(508)760.9995 . I-800-244-2598 E-Mail:kSnelmaefalwhalenresford'ons.00m Wei Page:hitp:l/www.whalenresiorstion&cotn Jan 141406:05p Ellucian 1-386-256-7744 p.1 4 • Durable Power of Attorney July 31, 2312 1, Donna M. Greene aik/a Donna Greene, of 48 Bearses Way, Massachusetts 02601 being a competent adult, eighteen years of age or older. of sound mind and under no undue influence nerebv appoint the ollowing person to be my Attorney-ir_-fact under the terms of this aocument: Attorney-in-Fact dame: Carol Cotmar. Hogan R.elaL;ot;.Ship: Cousin Address; l 1 13 Glengad Run Ormond Beach,FL 32174 I hereby constitute and appoint the individual(s) named above io serve (hereinafter wher t..1e context so permits the one serving, being referred to as my "Attorney", and if more than one, il;hcther acting together or separately) to be my true and lawful attorney-in-fact, for me and in my name and stead to have; in complete and uncontrolled discretion; the possession, care, management and control of all my property and all my business and affairs, personal and othewise. I authorize my said Attorney to take action :in behalf of we personally, to undertake am, (Ibiigations and to do and transact all business and other matters of every kind and nature with.respect to any of my said.property; business and affairs, and execute any and all documents or instruments pertaining thereto for me and in my name or behalf as fully as I might or could do if I N ere personally present. I particularly authorize my Attorney,without in any way limiting the generality of the foregoing, from time to time for me and in my name and stead: t) To demand, recover, receive and collect all surns G-F money, debts, dividends, rents, pro5ts, income, annuities, securities, gifts, bequests, devises, and all property of every nature. hots �•eal and personal, which may now or hereafter be due, belonging or coming to me, by airy ineans whatsoever,and to give due discharge for the same; I Tc) defend, resist, extend, comproLn.ise, adjust or submit to arbitration any claim by or against mc.. including claims for taxes, or any other matter; 3) To invest and reinvest, manage, control, sell, exchange, assign, transfer, lease, let, mortgage, encumber, pledge, surrender, terminate, give, contribute, convey, release, use and occupy all or any property, real or personal, or any custody, possession, interest or right therein, belonging to me or to which I am now or may hereafter become entitled, at such times and in such manner,to such persons, including :ny Attorney, for such consideration, and upon such tcnns in respect of ime and manner of payment as to my ,Attorney shall seem judicious, and no other person or persons shall be responsible for the application of any purchase money; and; without in any way limiting the generaiity- of the foregoing, from time to time for mc, and in my name and stead.,to assign or sell to such person or persons, including my Attorney as my Attorney deems wise, or otherwise to dispose of any and all .registered United Stites securities or securities for which th.e Treasuc}` Department el' United Mates acts as transfer agency now or hereafter Ovned by nie; an.d, i.n connec.iion therewith; to endorse ,�r. f Jan 141406:,06p Ellucian 1-386-256-7744 p.2 '6 transfer or otherwise any stock certificates or other securities and to sign, seal, acknowledge and deliver. in m.y name and behalf one or snore deeds, mortgages, leases and other instruments of transfer, conveyance, release, notice or contract as may be necessary or convenient therefor; 4) To enter into contracts or agreements with respect to any of my property or affairs; 5) To employ, retain; and discharge agents, contractors, employees, accountants, investment counsel,and attorneys-at-law.for any purpose and to pay tilem compensation, 6) To pay, perform, or otherwise discharge, upon suc11 evidence as my attorney may deem sufficient, all my obligations and liabilities now existing or hereafter incurred by me or by my attorney; 7) To make, accept, endorse and negotiate checks,notes and other evidences of indebtedness; to pay to or deposit with any bank, corporation; fin7n or person any money or property that may belong to me or be due to me; to go to,enter and access any safe deposit box to which I have access and to place in or take fxom it any property or papers; 8) To appear for me and represent me before tb.e United States Treasury Department or any other taxing authority, Federal, State or local, either personally or through a duly authorized agent, in connection with any matter involving taxes in which I am a party; to prepare and execute any tax returns, including, without limitation, Federal Income and Gift Tax Returns and .Declarations of Estimated Tay:, State Income Tax Returns, Social Security and Unemployment Tax Returns and Information Returns, Federal, State and local; to execute any claims for refund, protests, applications for abatement, petitions to the Tax Court of the tlnited States or any other Board or Court, Federal, State or local; consents and waivers to determination, re.lvn.d or abatement of any tax imposed by the foregoing taxing authorities; to receive and to endorse and collect any checks in settlement of any refunds of taxes,penalties or interest; to execute closing agreements relative to tax liability; to examine and to request and receive copies of any tax .returns, reports and other information from the United States -Treasury Department of any other taxing authority, Federal, State or local,in connection Nviih anv of the foregoing matters; 9) `Co transfer assets of any kind, real or personal, to any trust created by me or others,without application to any court for permission to do so; and generally to take such action as my attorney may deem best, in my-behalf, in any matter whatsoever. whether or not herein specifically mentioned. 10)To sign, execute, acknowledge, and deliver on my behalf any deed or other document of transfer or conveyance covering any or all of my personal or real property in which l may from time to time have an interest, including,-.without limitation,the following actions: (a)to b-ansfer by gift including advancement of bequests or devises to beneficiaries under my will or in the absence of a will to my descendants of whatever degree and other donees or beneficiaries; (b) release any life interest, or waiver,renunciation, or declination of any gift to me by will or deed; and(c) transfer ownership of irrevocably assign (be income of or change the beneficiary of any individual retirement account owned by me. Jan 14 14 06406p Ellucian 1-386-256-7744 p,3 1 hereby grant my Attorney full power and authority to take and use all means and processes of law or equity that may seem desirable to carry out any matters entrusted to my Attorney, and to represent we at all times, in all places and before all courts, commissions, councils and persons in authority, and I hereby covenant for myself,my heirs and personal representatives that any and all persons dealing in any way with my attorney may rely on a copy of this instrument certified as true and complete copy of dic original by a notary public to the same extent as upon the original, and may rely upon the statements of my Attorney as to the validity and continuance in force of this instrument. This power of attorney shall take effect immediately and shall remain in effect and shall not be affected by my subsequent disability or incapacity. if Protective proceedings withrespect to my person or my estate be hereafter commenced.. I nominate as conservator of my property or guardian of my estate andlor my person, as the case may be,the individuals named above as my Attorney and as Alternates under this Durable Power of Attorney,in the order of preference listed. IN WITNESS WHEREOF, I hereunto set rnv hand and seal on the day and year first above wri tten.. Ja M. Greene onna Greene Commonwealth of Massachusetts Barnstable, ss. July 31_ 2012 Before me, the undersigned notary public, personally appeared Dorma, M. Greene a/k/a Donna Greene, %Nbo proved to me through satisfactory evidence of identification, consisti»g of r , to be the person whose name is sinned on the preceding or attached document, and acknowledged to me that she signed it voluntarily for its stated purpose. NN ota ry Publ 1 My Commission Lxpires: S AIRYN,.+° M� 7 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application Health Division Date Issued r Conservation Division `� Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address W ay 0 1_�0 0 Village 2 Owner-Do n nGq M a 6 r e,—e_n t. Address wCI'Q Telephone Permit Request W he�ej ChCLi f^ ra.rn IJ 0Ccv _F(aw"-L .- a.,.. ! 1(")�Kyrx.q GU Hsu - 140 SzL Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning.District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting d®curo%tation. Dwelling Type: Single Family uV Iwo Family ❑ Multi-Family (# units) '.Z� Age of Existing Structure Historic House: ❑Yes UfNo On Old King's HighwayOU Yes ❑ No Basement Type: �] Full ❑ Crawl ❑Walkout ❑ Other =» Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ij) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new, size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes O/No If yes, site plan review# Current Use Proposed Use s J- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) p, Nar ie M ✓� LAPi t f Telephone Number Address 4`frr Rond License # I lHome Improvement Contractor# EM9fl° ` 0'0. Worker's Compensation #`j(Cq)p9q 7 I©(, ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOD ►�n� �G Gi♦1 k SIGNATURE DATE i FOR OFFICIAL USE ONLY -APPLICATION# - DATE ISSUED MAP/PARCEL NO. � 1 is ADDRESS VILLAGE y � , OWNER i i DATE OF INSPECTION: i 0AFOUND AT,ION � FRAME F • dNSULATION ji .,t FIREPLACE ELECTRICAL: ROUGH FINAL ' '. PLUMBING:. ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ` DATE CLOSED OUT ASSOCIATION PLAN NO. 3 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA. 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information r Please Print Legibly Name(Business/Organirdtion/fndividual): e, l Address: 9 dEr-r-T City/State/Zip:P i VinQLAh MA MA Phone#: b%< o r'0 g Are you an employer?theck the appropriate box: �� am a general contractor and I Type of project(required): 1.lad 1 am a employer with S 4, � I g New construction employees(full and/or part-time).* have hired the sub-contractors 6. 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling ship and have no employees 'These sub-contractors have g, []Demolition working. for me in any capacity. employees and have workers' 9 Building addition [No workers'comp.insurance comp.insurance.: required] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp, right of exemption per MGL 12.❑Roof repairs insurance required.]t c.152, §1(4),and we have no 13 ��Q�i'(; employees. [No workers' comp.insurance required.] Cl *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. �Contrartors 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 sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is the po&y and job site information. Insurance Company Name: Sen e eG_ l n S u rn ace, Policy#or Self-ins.Lic.#:IA) LCJ Q 09—1 _T10110 1 a` Expiration Date: Job Site Address: `1 1'<✓So �/ay City/State✓ZipA\/of ( M� 0�0 I 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$1,50.0.00 and/or one-year imprisonment,as-well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the paiaijns and penalises of perjury that the information provided above is true and correct Signature: /�V�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.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6,Other Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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-contractor(s)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 is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance Coverage. Also be sure to sign and date the affidavit The affidavit should be 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 bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Comm(mvm lth of Massachusetts Department of Industrial Accidents Office of kvestigatiGns 600 Washington Street Boston,MA 02111 Tel.#617-727-49W ext4Q6 or 1-877 MASSAFE Fax#617-727-7749 WWW.masS.gov/dia . Town of Barnstable 0 Regalatory Services r R1A717CP�RTR t BUM g Thomas F.Geiler,Director �6D 16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnst6le.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, as Qwnet of the subject propett7 hereby authorize IG 1J�� to act on my behal� in all matters relative to work authorized by this bmlding permit 4 wo ww�s WU- (Address of Job) *Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature_of Ownet of Applicant Print Name Print Name Date QFORM3:OWNERPERIMSIONPOOL•S 62012 1 % Town of Barnstable Regulatory Services Thomas F.Gefler,Director `g Building Division Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 www.town barustable.ma.us Office: 508-862-4038 Fax: 508-790-6230 H0MM0w7ER UCENSE ExEMM0N Please Print DATE: JOB LOCATION: number sty vMa;e "ROMEOWNER7: name home phone# work phone� CURREISf MAajNGADDRFss: city/town state rip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,affached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval ofBwldmg Official Note: Three family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fatly aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\dmonk\AppData\L.oca112v5crosoftlWmdowslTemporary Inhxnot Files\ContmtoutIDoklQRF6LUBN\EXYRFSS.doc 953012 MAYBHOM-01 DGREENAWAY A�Ro CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD 9J23/2013 IYYM/) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE FCERTIFICATE 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 H.J.Knight International NAME: PHONE ac No:(781)966-3701 30 Braintree Hill Office Park ac No Ell:(781)966-3700 3705 Braintree,MA 02184 L MAIIEss: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:Rockhill Insurance Company INSURER B:Associated Employers Insurance Company Maybruck Home Improvement INSURERC: 9 Herring Pond Road INSURERD: Plymouth,MA 02360 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRsun LTR TYPE OF INSURANCE POLICY NUMBER FOLIC EF MP DCY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000 A X COMMERCIAL GENERAL LIABILITY BINDERJTBD 9/22/2013 9/22/2014 PREMISES IEa occurrence $ 100,000 CLAIMS-MADE 'I—X-1 OCCUR MED EXP(Any one person) S Excluded PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE S 2,000,000 qGEN-L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG 5 2,000,000 POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SIN LE LIMIT $ Ea accident)5 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) S NON-OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE 5 Per accident I — S UMBRELLALUIB OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE 5 DED RETENTION S B IWORKERS COMPENSATION WC STATU- OTH- S AND EMPLOYERS'LIABILITY X T Y I S ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N yes'd and If yes,describe under IWCC5009477012012 9J22/2013 9/22/2014 E.L.EACH ACCIDENT S 500,000 OFFICERIMEMBER EXCLUDED? N/A (Mandatory In E.L.DISEASE-EA EMPLOYEE S 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 t DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Certificate holder is included as Additional Insured for General Liability if required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I - ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/06) The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 175338 Type: Corporation Expiration: 5/8/2015 Trk 239956 MAYBRUCK HOME IMPROVEMENT, LLC. MARK BUELL 9 HERRING POND RD. - - PLYMOUTH, MA 02360 - - Update Address and return card.Mark reason for change. sCA I Ca 20M-05/11 i-i Address j„ Renewal F--1 Employment E] Lost Card �'"�1L8 (!'crpt��ta�zcGPallJz c�l'.-l'(r�.i3llrlt c<�c/fJ qi@ sumer Affairs&Business Regulation License or registration valid for individul use only before the expiration date. If found return to: CONTRACTORType: Office of Consumer Affairs and Business Regulation 5/8/201b Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 MAYBRUCK HOME IMPROVEMENT,LLC. MARK BUELL 9 HERRING POND RD. PLYMOUTH, MA 02360 Undersecreta—ry d without signature 'IxSa3;tti i is — [) d .£5 iat n P l x .` £sn_ ts €t €t �aai car Irc�t��e � a ' License: CS 104344 MARK BUELL PO BOX 453 MONUMENT BEACH, MA 02553' i Expiration: 4/2/2014 ( aanii�.i,scr Tr=: 104344' L Q C Y i i� o' k 00 1IG ! b 111V 6<; i j Elul glo"11g SV JG NAA01 1 -- �-- 1 3/4, rG p r�i �'i�L•r ! PC, s �K 4� a x 2 �<IGStcr �! S e1Xb'��` oZ X 4S TarSr t vi •. Y.l3tPVL7 jo �p�tJ1 r Town of Barnstable Geographic Information System September 12,2013 0 N 309159 309167 #14 #19 309165 #52 ) 309166 #44 309161 #90 309162 ,` 309163 #84 #48 A. 309164 ".t § � #60 4, } ... S' �yR xO3o 23118 Feet DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:309 Parcel:163 boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:GREENE,DONNA M Total Assessed Value:$202000 Selected Parcel 1'=100'may not meet established map accuracy standards. The parcel lines on this mapW+ are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: Acreage:0.50 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:48 BEARSE'S WAY such as building locations. Buffer � F iff. r Town of Barnstable *Permit# 6 lC��v Z�S Expires 6 months from issue date Regulatory Services Fee Thomas F.Geiler,Director 3Ug�' Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 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 Map/parcel Number Property Address [residential Value of Work S ! S Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name F_A 6_v� Telephone Number-,50 Home Improvement Contractor License#(if applicable) j 953(5, Construction Supervisor's License#(if applicable)- C S (p [OWorkman's Compensation insurance X-PRESS PERMIT Ched one: ❑ I am a sole proprietor 4 U G 1 9 ZOO' ❑ I am the Homeowner 3,I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name 01,0 Q Workman's Comp.Policy# _ L.f v — 0 3 q 1 T)1 ,5,5 Copy of Insurance Compliance Certificate must be on file. r Permit Request(check box) Z-Re-roof(stripping old shingles) All construction debris will be taken to 0—ytiLL0 Limit ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side - I ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. I ***Note: Property Owner must sign Property Owner Letter of Permission. I A copy of the Home Improvement Contractors License is required. SIGNATURE: Q:Forms:expmtrg �= evise061306 E- The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers AAvpGcant Information ,Please Print LeEibly Name (Business/Organization/Individual): TAL LC, Address: (�u� City/State/Zip: C )b_u t oa63s Phone#: `jQ9S—YO-9 Are you an employer?Check the appropriate box: Type of project(required): I Z-1 am a employer with _ 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.$ 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I 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 13.❑ Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: U f,j — 0 3 q I M 5,56 — Q d Expiration Date: Job Site Address: lam✓ City/State/Zip: Y Q!�Lt�u� 0;xe Attach a copy of the workers' compensation policy declaration page(showing the policy nu er and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi he nd pe [ties of perjury that the information provided above is true and correct Signature: CC p Date: ` Phone#: UQ Yoeb ' o2 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#: f RightFax C2-2 10/1/2008 1 : 00:56 PM PAGE 2/002 Fax Server ?' {:v'-}{{:•;:{••:'r:?{=i:i:•:-:vi:-Y.•' tier' :.tiff{ti;'r,'i::}}:•:-:::•:=r}:•:•:--:-:•i:•:�:•:•?: 753UE DATE :::J::rr:::•Vl:rr::.:{•:{V:�:•f`.•:{{•f:{LL}:•:•:.... ..._ ...r:..:•: :Vr J h... :.L�•:•�:f::•:: J•:{:...:-:•:•.�;•V! 10/01/08 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY PRODUCER AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. WISE&QUINN INSURANCE AGENCY COMPANIES AFFORDING COVERAGE 449 PLEASANT ST BROCKTON MA 02301 ICOMP NY A HARTFORD UNDERWRITERS INSURANCE CO INSURED COMPANY FRASER CONSTRUCTION LLC "'� PO BOX 1845 �ARNY C COTUI T MA 02635 MANY D tiL:tVAL{1l{•::V:•:Vlti{•.L•l::r:t•Ih{VX::_{lJr:•lh:llY:{{{•.{L{•ham' COMPANY .•r,'::=r::••:.L•::-•::ri��:•:::L:•r='{•'•.:{•'r-:{.;:.::•••r:••r•'i.{;:;} r �'1 _ •.;r.:�;{..t r ..L�,{.;}t::i_{ti`:.:_{t:f-:•{{::i�ti}~_'.~': LbTJER THUS IS TO CERTDTY THAT THE POLICIES OEINSURANCB LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDINO ANY REQUIItEbiEIVC,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE,ISSUED OR MAY PERTAIN,THE INSURANCE AFEORDR D BY THE POLICIBS DESCRIBED HEREIN IS SUBIBCT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEBN REDUCED BY PAID CLAIMS CO TYPE OF INSURANCE POLICY NUMBER POLICY POLICY LIMITS LTR EFFECTIVE DATE EXPIRATION DATE (bIMIDD (MM/DDNY) GENERAL LIABILITY GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGO. $ ❑COMMERCIAL GEN13tAL LIABILITY $ ❑ CLAIMS MADE ❑ OCCUR. PERSONAL&ADV.INIURY $ ❑OWNERS&CONTRACTOR'S PROP. EACH OCCURRENCE ❑ FIRE DAMAGE(Any One Fire) $ MED.EXPENSE(Any om person $ AUTOMOBILE LIABDdTY COMBINED SINGLE LIMIT $ ❑ ANY AUTO ❑ ALL OWNED AUTOS BODILY n)URY $ (Pa Person ❑ SCHEDULED AUTOS ❑ HIRIDAUTOS BODILY INJURY $ (Per Acchicni) ❑ NON-OWNEDAUTOS ❑ GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY ❑ UMBRELLA FORM EACH OCCURRENCE $ ❑ OTHER THAN UMBRELLA DORM AGGREGATE $ STATUTORY LOWS X A WORHER'S COMPENSATION EACH AGENT $500,000 AND UB- 09/26/08 09/26/09 DISEASE-POLICY LIMIT $500,000 0341M556-08 EMPLOYER'SLIABILITY DISEAS&EACHEMPLAYEE $500,000 OTHERTHE PROPRIETOR1PARTNH(SIEXECUM V E OFFICERS ARE INCLUDED DESCRIPTION OF OPERAT ION811.00AITON91YEHBC M/SPECIAL ITEMS THE INSURED'S MA WORRIKIN COMPIMATEON POLICY AND ITS LIMITS)OTHER STATES INSURANCE ENWRSE ENT ALPTHOWOM THE PAYMENT OFBENBFTIS FOR CLAMIS MADE BY THE INSURED'S MAENPLOYEES IN STATES OTHER THAN NIA.NO AUTHORIZATION 18 GIM TO PAY CLAIMS FOR BENB1 M IN ANY STATE OTHER THAN MA IF THE INSURED MIRES,OR HAS HIRED,WAPIMMIS OUTSIDE OF NIA.TM POLICY DOES NOT PROVIDE COVERAGE FOR ANY STATE OTHER THAN MA. THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HDIJM AFFECTING WORKERS COMP COVERAGE l•::::{L:r.:1:{LV:1•.1V.•{:-•V• {i:•.{L•:.•:::•.1.V:r.S.•fLV.S{ {'r•.REM N l lrt{-.•:•J{V:.`.rY:{•r:ti{•.V:.LL\•.••�{Y1::{•.{{•:L•�itil.•.L:::::VX:.�•.� ti. : •:::{ :l'h''l:lh :-::LLi:-:i h{i:t :-:::�ti:'i•}1:::-':':::•:::1::i:-::--L.-::• 1V:JL:•:•Jr.V.I•::LLL:LL•_LLLLLL•�.r{JI!Xr.:V{ALLS:JL J.L•..L.:. FRASMENTMTERPRISFSLLC SHOULD ANYOFTM- ABOVE DFBCRDIRD POLICIES BE CANCELLED BBiORSTTIN PO BOX 1945 EXFMA77ON DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL COTUITMA02635 ID DAYS WB1TmNOTICETO THE CRRTIFTCATEH unR NAMED TO Tim JmT, BUT FADDRETOMAHLSUCHNOTECESHALL IMPOSENOOBLBIATMOR LIABIIITYOFANYK@IDUPON THE COMPANY,ITS AGEMORREPREiENPATRTS AOIBORL7mI1;IRESEV1'ATIM MA MU G4s7trz-dwi-EN • .•.•.•..••-.yL...•.rr... .. -. -.". .:h•• '•. ... ...•.S':: ;.- LULL..•• ti.�..:::{ {:�:::• ' ;r,.:{{xr.;:r{y.•r;7t{::�.::��{{V.•lLY�}.k:•511:'{f.W-•{.LL-•;{1.1.4''.�•:L.`:}.V:'l:Y{:L. �L..{r}:L .L:{{•;•.Lr{•:1::�L:-x.V:�.�L�'i: l �'!ze �am�nw�zcaea o�✓ aeac�u�eelld Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registra't* 112536 Board of Building Regulations and Standards lug p Expiration:V23/2011 Tr# 281021 One Ashburton Place Rm 1301 Type: DBA Boston,Ma.02108 FRASER CONSTRUCTION C.O. DEAN FRASER 104 TWINN VIEW LANE ' E FALMOUTH,MA 02536 Administrator Not re Boaaoi in e lad g gu ons an tan ar s One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 112536 Type: DBA FRASER CONSTRUCTION CO. Expiration: 3/23/2011 Tr# 281021 DEAN FRASER P.O. BOX 1345 COTUIT, MA 02635 Update Address and return card.Marls reason for change. Al 0 40M-08/08-DBSLIFORMCA108212008 ❑ Address Renewal Employment Lost Card t e� f7 , . i � . � - � i _ . P '- ),� i � � t.:.. t5� ; �n� ,�,-�.:�a��f jj �: �., J E --- �--- -. - — - . + �; - - � � . 1� �„t.� T ' � :g 'II ' f f I ' Fraser Construction, LLC VCONSTRUCTION P.O. Box 1845, Cotuit MA. 02635 ROOFING S ' Email: fraser_constructiongverizon.net SPECIALISTS www.fraserroofing.com FAX 1-508-428-0123 508-428-2292 MCL#112536 CS#97668 RE-ROOFING PROPOSAL DATE: June 15, 2009 PHONE: 508-775-2298 NAME: Donna Greene MAIL ADDRESS: same JOB ADDRESS: 48 Bearses Way Hyannis, MA 02601 FRASER CONSTRUCTION hereby proposes to perform the following services in a neat and professional like manner and in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Supply and Install - CERTAINTEED LANDMARK /WOODSCAPE AR 30: 30 -Year Warranty, 5 year Sure Start Protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10 Year Warranty against ALGAE Containment. 5 year 110 mph wind- resistance warranty with six nails in common bond area, Fraser construction includes six nails in common bond area at NO additional cost. See actual warranty for specific details and limitations. Color: All sections except rear right PRICE- $5,475 Initial o Includes re-siding with white cedar & re-flash on rear dormer left side cheek rear facing section only o Includes replacing rotted trim only on dormer SupplY & Install - CertainTeed Winter - Guard: (ice 8v water shield) Waterproof Underlayment System (3ft. on eves and valleys, 18" on rakes, walls, and skylights) SupplY & Install- Roofer's Select Underlayment Paper (as recommended by CertainTeed) "Wl 8a Install - Hick's Ventilated Drip Edge or 8" Aluminum Drip Edge Sta 1 86 Install -A 1 uminum & Neoprene Soil Pipe Flashing gttip' 8s Install-Air Vent Ridge Vent (as reco mmended by CertainTeed) Cican 8s Remove - Debris from work area daily. "4 Star Warranty Upgrade will be applied if proposal is signed returned within 10 days. (see enclosed brochure) and Payable immediately upon completion NO MONEY DOWN-NO Payment a art or part way thru Payments are CASH- CHECK- MASTERCARD - VISA -AMERICAN EXPRESS * Payments not made within 30 days of completion will be charged 1.5%for Payment is late. every 30 days the Possible Extra-After the shingles are removed from the roof, we plywood to make sure that the insulation is not u will lift one sheet of preventing ventilation from the eaves to the ridge.P against the Plywood sheathing installed by; removing the plywood sheathing If it is, ventilation panels will be plywood over and then re- stallin ' 'nstallmg the Panels, turning the as an extra at the rate of$6.00 g the Plywood. If needed, this would be charged for Panels per sheet of l per panel including Materials 8& Labor. There are 6 Plywood. possible Extra-Any rotted or oche other careen otherwise deteriorated trim boards 1 try needing replacement will be done and charged forth as lead flashing, a an extra at the rate of$60.00 per hour, plus 15% mark-up materials FRASER CONSTRUCTION Warranties the labor for 12 years FRASER CONSTRUCTION Warranties the shingles against glow-Offs for CERTAINTEED Warranties the shingles 10 Years. Warranty duration. and labor 100% through the Sure Start CERTAINTEED Warranties the shingles to be ALGAE resistant for the d Sure Start Warranty depending on the shingle that was purchased. uration of the Ally deviation or alteration from above specification will be executed u orders and will become an extra charge over and above the es ent upon strikes, accidents or delays are beyond our co Pon written contingent P control. All agreements carry fire, tornado and other necessaryntrol. accepted within thirty days may insurance upon the above work.wner should .�- Y Y withdraw this proposal. We, if not FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: eowner Fraser Co struction, LLC i 1 B' E F f Town of Barnstable E Regulatory Services �oF THEfO�. �t. Thomas F.Geiler,Director Building Division RARNSrABM MASS. g Tom Perry,Building Commissioner iOrFo ,t► 200 Main Street, Hyannis,MA 02601 Office: 508-862-4039 Fax: 508-790-6230 Approved: Fee: P'ermit#: ( 3 U HOME OCCUPATION REGISTRATION Date: Name:• Phone#: C.� r Address v WC'4 Village: C* Its Name of Business: �rp Type of Business: �C 'K` ►� i�C. Map/Lot: / (• O INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within, that dwelling unit. • Such use occupies no more than 400 square feet of space: • There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or.other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. o There is no-storage'or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met.on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • .There is no commercial vehicles related to the Customary Home Occupation, other than one van or one pickup-guck-not to•exceed,one ton:capacity,and one ,trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwell' unit I,the undersign a e read and agree with the above restrictions for my home occupation I am registering. Applicant' —Date: la—rjt_�47_ YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates COST.$30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAM E in.the Town (WHICH... OU M ,...Y UST DO BY M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures y gatur es on this form at 200 Main C--St., Hyannis. Take the completed form to the Town Clerk's Office, 1" FI., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Busine"- t-i$ificate that is required by law. > r Pg�s b DATE: Fill in please: o-: APPLICANT'S YOUR NAME: ✓-Z, BUSINESS YOUR HOME ADDRESS: Gf" C(- TELEPHONE # Home Telephone Number: •-7 -' NAME OF NEW BUSINESS cis--A `J.1CL(' t"1 �4 (�r-a .. TYPE OF BUSINESS: � CI IS THIS A HOME OCCUPATION? YES f�O A / J Have you been given approval from the building division? YES NO V ADDRESS OF.BUSINESS . Y[—C--01. s ( � , MAP/PARCEL NUMBER When-starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street}to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMINISSIO�4ERIS OFFI� This individual sheen inform dl f a rp(�rmit requirements that pertain to this type of business. MUST COMPLY WITH HOME OCCUPATION Authorized SignatureRULES AND REGULATIONS. FAILURE TO COMMENT MA Y-RF-SI IIJ I EINJES 2. BOARD OF HEALTH This individual h s b n in,ormed f the p rm' requirements that pertain to this type of business. t CD n `horized Signature* COMMENTS: N n -------------------------- 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) _- This individual h s ren infoV of the li n in, requirements that pertain to this t CO p k j's p type of business. _ M Authorized Signature** COMMENTS: .s f , 1'own of Barnstable oFTWE rqE, Regulatory Services o Thomas F.Geiler,Director Building Division i �p BARMSTAULFE . v MASS, Tom Perry,Building Commissioner fo .t 1. 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Approved: Pee: _ Permit#: HOME OCCUPATION REGISTRATION Date: Aca Name: ]aYll!-E,4 Phone#: Address: Oi aA-1 Village: ova Name of Business: Type of Business: �r Map/Lot T�-�rn�. INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carved on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space: - �� N' • There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of.such use. gY • No traffic will be generated in excess of normal residential volumes: • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,' odors,electrical disturbance,heat,glare,humidity or other objectionable effects, :--C �, o There is no-storage or use of toxic or-hazardou$materials,or flammable or explosive materials,in excess of normal household quantities. �(f • Any need for parking generated by such use shall be met.on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials o" equipment. • There is no commercial vehicles related to the Customary Home Occupation, other than one van or one pick-up-t uek-not#o=exceed-one ton:capacity,and one trailer not to exceed 20 feet in length and.not to �C exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwellin 't . I,the undersigne read and agree with the above restrictions'for my home occupation I am registering. Applicant Date: YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates COST $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU MUST DO BY M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 151 FI., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. DATE: - k Fill in please: AM C APPLICANTS YOUR NAME: CJIr'C� �*�Q�� B SINESS r YOUR HOME ADDRESS:Sc TELEPHONE # Home Telephone Number: '1_7 j c� 3`� NAME OF NEW BUSINESSjr TYPE OF BUSINESS '•Cry� IS THIS A HOME OCCUPATION? V YES NO �t rvt Have you been given approval from the buildinoivisi.on? YES NO ADDRESS OF BUSINESS MAP/PARCEL NUMBER When starting a new business there are several things you must do in order to be regulations Iiance with the rules and of the Town of p Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — corner of Y g Y Y Yarmouth Rd. & Main Street) to make sure.you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COM ISSIO ER'S OFFIj -C This individu I h` b e in r - d&f 'ny pe�rmit.require"ments that pertain to this type of business. Y, MUST COHOME OCCUPATION u -rize Signatur'' RULES AND REGULATIONS. FAILURE TO OM ECTSI;- A! d� (,k( COMPLY MAY RESULT IN FINES. x — ¢ cD 2. BOARD OF HEALTH any C^_j �C This individual has,.iee info Ted of the pe mi requirements that pertain to this type of business. ;'] PQ Aug rized Signature** / v r �� =: COMMENTS: / M 3. CONSUMER-AFFAIRS (LICENSING AUTHORITY�jg�i This individual ha Ike n inform d..of the licements that pertain to this type of business. �J Authorized Signature** F��COMMENTS: The Town of Barnstable Department of Health , Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration Date: Name: GPhone#: ` ^ Address: `'t :arl-WU wc- Village- ±� L Name of Business: warl Type of Business: �' r��•LQ Map/Lot: �09 I (_0� INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings, subject to the provisions of Section 4-1.4 of the Zoning ordinance, provided that the activity shall not be discernible from outside the-dwelling: there shall be no increase in noise or odor; no visual alteration to the premises which would suggest anything other than a residential use; no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector, a customary home occupation shall be permitted as of right subject to the following conditions: U The activity is carried on by the permanent resident of a single family residential dwelling unit, located within that dwelling unit. U Such use occupies no more than 400 square feet of space. U There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. 0 No traffic will be generated in excess of normal residential volumes. u The use does not involve the production of offensive noise, vibration, smoke, dust or other particular matter, odors, electrical disturbance, heat, glare,humidity or other objectionable effects. O There is no storage or use of toxic or hazardous materials, or flammable or explosive materials, in excess of normal household quantities. u Any need for parking generated,by such use shall be met on the same lot containing the Customary Home Occupation, and not within the required front yard. • There is no exterior.storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation, other than one van or one pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to exceed 4 tires, parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. If the Customary Home Occupation is listed or advertised as a business, the street address shall not be included. No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I, the undersigned ave red and agree with the above restrictions for my home occupation I am registering. 1 Applicant: Date: Homeoc.doc TO ALL NEW BUSINESS OWNERS Fill in please: APPLICANT'S I A I VA I YOUR NAME: BUSINESS YOUR DOME ADDRESS: n 15-�- F—IYOLn r ►_S m - TELEPHONE Telephone Number (Home) ('Sins ) P7-1 !:3-�d-q� NAME OF NEW BUSINESS ' TYPE OF BUSINESS IS THIS A HOME OCCUPATION? f?S ADDRESS OF BUSINESS. . MANPARCEL NUMBER 09 When starting a new business there are several,things you must do in order to be in compliance with the rules andregulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor- Town Hall). # T.- GO TO'BUILDING INSPECTOR'S OFFICE (4TH FLOOR TOWN HALL) this Individual h s b A informed of any permit requirements that pertain to this type of business. Authorized ignature COMMENTS: 2. .GO TO BOARD OF HEALTH (3RD FLOOR TOWN HALL) This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature COMMENTS: 3. GO TO CONSUMER AFFAIRS (LICENSING AUTHORITY) - (3RD FLOOR SCHOOL ADMI ISTRATION BUILDING) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature COMMENTS: Aft.or'obtaining the required signatures you must return to the Town Clerk's Office to obtain your business certificate (cost $20.00 .,,....,.� n 6iscineseQ rArf;fir- ,fP nN1 Y REGISTERS Yni iR 111n 1141= in the town (which you must do by M.G.L. - It does not give you pie >l it jAssessods off ioe.Ost floor): ° OF THE To Assessor's .map and lot number ...<,1.�. ."...�:. ..�............. Board of Health (3rd floor): `,j Sewage Permit number .:.............�.on.. .. i B6Hd9TGDLE. Engineering Department (3rd floor): MA°d s House number �0 1639 \0� aWc APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 -P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... d TYPE OF CONSTRUCTION .............C�!/..�,V,.�..`� L ..................................... ................................... .............................19. G TO THE INSPECTOR OF BUILDINGS: The undersigned hereby aVplies for permit according to the followTing Sinfor tion: /l Location ...�� ....... ....Qs... . /.-C�.�/L. .. .. .. ........................ ProposedUse ...... .. .... ....................... .. ........................................... ...... . ..................................................... t ZoningDistri t ........... ................................. .... ..... ............Fire District ................ .................... ...................................... . l—� Name of Owner ............ .. ddress .............. ................................ ................................... Name of Builder ......... .. ..... ..............��...G..... - ..�.�t4�/G�G�. .. ... . . / G Name of Architect ................. ....... .......................................Address ...........:... ...... .. --------- ............................... Number of Rooms ....... .............................................Foundation ....... .. ................................................... Exterior �..... ....... ........................Roofing ........ ....... . .................................... Al— Floors ..VV. .........................................Interior .......... Heating .......................................Plumbing ...... Fireplace ...................... .......................................................Approximate Cost .�5/..C/'� v ........................ Definitive Plan Approved by Planning Board --------------------------------19-------- . Area ` ...S...............`... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH r l 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 . ?� / ee .................................. Construction Supervisor's License ............. 4 A� db GREEN, DAVID 7 30532 BUILD ADDITION No Permit for .................................... -Single Family Dwelling ....................... ........................... a We Location ..4....8................................ d.... ........ Hyannis . ............................................................................... David Green Owner .................................................................. Type of Construction ...................Frame........................ ............................................................................... Plot.............................. Lot ................................ March 20............19 87 q ti Permit Granted ............................. FDate of Inspection ....... 7'..........19 Date Completed ............. ....................19' Board of Health (3rd floor): L- Engineering Department (3rd floor): NAB& uxt APPLICATIONS PROCESSED 8:30--9:30 A.M. and 1:00-2,bO P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR TYPE OF CONSTRUCTION 06, - L ^ ` .........--------- � . -��'�/.�---------l9�. /' / / - TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according. to the following information:/ Name of Owner6.'. ,.—..................... ........2. ......................... ...Address ........... 0".. a.........a Name of Builder -----..-.........-�-�-------- -- ` - .......... Name of Architect --. !�-��------A6J,e,, -- Number --.�� Foundation --�/� �� `�^c-��--------~-, Ex/e,ior ---.�� ------�RooOng -- F|oo,s ---- -................'�-........------'|nte,ior --' Heating ---------------------------.P|um6ing -... ................................... '/ Fireplace -----_-/�-------'`'�----------Approximate Cost /. . ___________. Definitive Plan Approved by Planning°Board lV-_-' ' - �_ Diagram of Lot and Building with Dimeniions Fee - ~ ________ ' SUBJECT TO APPROVAL OF BOARD-OF HEALTH V1 It"., � 1' ^ ' / . / ' . � ' | | \ ` y � / N ` ' ` \ OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS - - / | heneb/ ognee to conform to all the Rubs and Regulations oftheTown of Barnstable regarding the above construction, Nome -�f��....'....-��----------.- �Y\ Construction Supervisor's License -' ................. _ ` ^ GREEN, DAVID A=309-163 No 30532 permit for ,,,Build Addition ......... Single Family Dwelling ` .. 48 �n,Tect RarnGtahl P-'Rnad Location ................................ ................. Hyannis ........................................................................... Owner ............David........................Green.............................. Type of Construction Frame Plot ............................ Lot ................................ Permit Granted ...March 20 , 8 7 ' ....................................19 Date of Inspection ....................................19 Date Completed ......................................19 e