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HomeMy WebLinkAbout0080 GOAT FIELD LANE ..,�,""�'r.:- .mac �aa�c ! ..��A ;; �. � ���•":^.� ��,, _ � 3 ik::'� y� \�?m# � �•?� S vi � v t"�,}£ � ,�E�,�� �3e Y� 'ski a �� '. - mac NMg €gga�j1�� y � r syo� M€ all all NO 11 "n I ' 4 3 "� v {j 1. f �Yj H 5-ilap US'! f + 4 g 'g� AW 01 No, wk� VON, p RN A T�""n� IN! lie 'g, 19 vie I�a Y hb9 " "•S .. ' -! c TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ` v YApp Z l Health Division Date Issued 7- /l -lq &Z Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 60 �� �- E Village H `i A AJ AJ 1 S (h A , Owner PtFrEk S C H 0 F 1 L L J0 Address ,n „ .. . T C4 A Telephone f4'=Lf® I 5G 7— 30 a? CC—Lc I ,Permit Request _ I� � 0 'Tt H C-7!V A tt),o Square feet: 1 st floor: existing itoo proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 14 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 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: -� 1 C Zoning Board of Appeals Authorization ❑ Appeal # - Recorded ❑ co o Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use . � y v APPLICANT INFORMATION — - - - - (BUILDER OR HOMEOWNER) Name 9A/"IES M®0R C Telephone Number Address 5 CC L ffA Q Q License # ® Et, F- 14 C/v?0t fr N 0 :1 Home Improvement Contractor# f ® S c Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 130 L4 4 AI LAA)D 1=f L SIGNATURE DATE ! / FOR OFFICIAL USE ONLY = r . APPLICATION# �DATE ISSUED MAP/PARCEL NO. �si • . ADDRESS VILLAGE OWNER DATE OF INSPECTION: r r FOUNDATION FRAME INSULATION FIREPLACE r` . ELECTRICAL' ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSO- IATION PLAN NO. t HYe Commonitwakh of Vassachrisets Dep7rhumt of ladusft ial Accidents - O,We ofInvesaga ions 600 Wass &zgtotryc Street Boston,1 02111 wmv rnass<gov1dia Workers' Compensat axtInsatranceAffiidavit.Builders/ContractorsMectricians/Plumbers Applicant Information Please Brig/Legibly Name L 0 PEN P- CiWStateMp:® 3 Phana4: 50 q -57 2 7 - ( ® 3 -. . -:_Are.you an employer: Check the appropriate __.T of o'ect. r - 1_❑ I am a employer with 4. I ante sired the mA-contractor and I ❑ employees{full andlor part-3ime)- * have fired the sub�contracttrrs iS_ L�=Clin�gz on 2._❑ I am a sale proprirztor or partner- listed on the attached sheet` 7- These s aoatxactors have strip mid have no employees ees g_ ❑Demolition worlii.ng for me in any capacitly employees and have workers' ❑Building addition [No.workers'comp.ircru=e comp.n,crvanc 1 rec[nired] 5_ We area corporation and its 10-0 Electrical repairs or additions 3_❑ I am a homeowner doing all work officers Imm exercised their 110 Plumbing repairs or additions, myself[No Workers'comp- right ofexcemption per MGL 110 Roof repairs insurance regnired]i c-152,§1(4),and we have no employees-[No workers' 13_�Other comp-insurance require -J *Any app�that checks boa Wl mist also fill out the section below showing their woocexe minpenssliou policy infinrutiaes 1 Homeownem who submit this of u1zvrt i dkit a dhey are doing s11 woad and then hue outside contactors most submit a new affidasit m£aca w 5uc� Icuattactors that check this bmr must Stub ed as additional sheet dund g the name of the sob-am3k-Acb-s and sbae whether omit those eatities have emp]ayees If the sub-contractors hxm employees,the}must provide tt ex workers'comp.policy n>m her_ lam arz employer thatis prm iddirrg nvrJke-rs'congwmatlon i inrance for my ampLayem Bdaty is the policy and job site intfotma6gn. Insurance CourpmyNams: Policy#or Self-ins Lim �+ ExpintionDate: Job Site Address: � � �=©� l �t e� t4Y 4°��,� Citylst w2r p: Attach a copy of the work m- '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 rrirninal penalties of a fine up to S 1,500.0(3 andlor one-yearimprisonment,as well as civil penalties in the form of a STOP WORK ORDE t and a fine of up to$250.00 a day against the violator_ Be advised that a cppy of this statement may be f6rwarded to the Office of fin-estigatidms of the DIA for Tnnn-ance coverage vedffcatitm. Ida hereby catT6fy rtnder tha plans aiidpenakies ofpedmy thatthe informiu on prodded above is hue and correct signature: Date: 7 Phone#: -:!;73'— V (7jj'zciad use only. Eta not write in this area,to fir completed by c4 or town of ciuL City or Town:. PermidUcense# Issuing Authority(circle one): L Board of Heaton 2.Building Department 3.Cityffown Cleric d_Electrical Inspector 5.Plumbing Inspector 6.Other contact Person: Phone#: 6 Information and Instructions Massachusetts General Laws chapter 152 requires aU employers to provide workers'compensation for their employees. Pursuantto this statute, an anployee is defined as"_._every person in the service of another under any contract of hire, express or implied., oral or written_" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone mi nber(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 cant'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. Tine 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. Sells 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/licease number which will be used as a reference number. In addition,an applicant that must submit multiple permMicense 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 lice to drank 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 Commanwealth of Massachusetts Department of hidustial Acaid(� Office ofkvestigatxans 600 Washington St=t Boston,1MA 02111 Te-L A 617-727-49Q0 W 06 or 1-9 MASWE Revised 4-24-07 Fax#617-727-7749 www.inass-gov/dia rj coR CERTIFICATE OF LIABILITY INSURANCE 7/8 14 THS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIF)CAIE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 13Y THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,MiD THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder lF an ADDITIONAL INSURED, the pollcypes) 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 cert(ficato,holder in lieu of such endors_aamen s. PRODUCER NA United Insurance Agency, Inc. PMDNE (508 759-6595 (508) 759-3822 199 Main Street ADD�R�ss: P.O. BOX 1013 INSURERISI AFFORDING COVERAGE NAIC# Buzzards Bay, HA 02532 INSURER A:Acce t;;ce Indemnit INSURED _ I INSURER 6:AZ IC James Moore INSURERG: Moore Carpentry INSURRRD; 15 Gooletta Dr INSURERE; E Falmouth, MA. 02536 INSURERF: 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 REC4UIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY F' FITAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANDCONDITIONS OFSUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIDCLAIMS. LTR TYPEOPIN9URANGE A 'L uBR POLILyNUMBeR PML/oow MMICa LIMITSarl� A GENERAL LIABILITY CLOO196012 6/20/14 6/20/15 EACH OCCURRENCE $ 1,000,000 DAMAGETO RENTED 100,000 X COMMERCIAL GENERAL-L-�IABILITY EMISES a accuM Mge CLAIM54AADE IJ OCCUR MED EXP One ereon) S 5,000 PERSONAL&ADV INJURY $ 00,000 GENERAL AGGREGATE $ 2,000,00 GEN'LAGGREGATELIMITAPPUESPER' PRODUCTS•COMPIOPAGG $ 2,000,000 POLICY PRO- LOC & AUTOMOBILE LIABILITY o occldonl I E I $ ANYAUTO BODILY INJURY(Per pe mon) $ ALLOWNED SCHEDULED SODILY INJURY(Per aawdnnl) 3 AUTOS AUTOS NON OWNED ROPERTY DAMAGE I-IIREDAUTOS AUTOS PnrAccdon� 3 UMBRELLA LIAB OCCUR EACH OCCURRENCE >F EXCESS LIA9 CLAIMS-MADE AGGREGATE $ DED RETENTION S _ S H wORKERSCOMPENSATION WCC50050101242014 6/14/14 6/14/15 X I WCSTnru- oTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTNF YrN Nil �1,�GACHACCIDENT $ 100 000 OFFICERMEMBER ExCLLIDED7 (Mandatory In NH) E.L.DISEASE-F. EMPLOYEE 3 100 000 I(yes descrlbe11 DESCRIPTION OF OPERATIONS below E:L.DISEASE-POLICY LIMIT 500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEMICI_FS (Attach ACORD 101,Addlbonal Rormft Schedule,If Fors spice IA rogui rod) Remodeling contractor CERTIFICATE HOLDER _ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept. Barnstable, ma 02601 AUTHORIZED RE MESENTAfiIE _ Kris Dexter Q 1988-20 10 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: {308) 790-6230 E-Mail: Main Level TOWN OF BARNSTABLE 201u JUL -8 PIN 1 37 ass„ _ _ ---r----- --------i--.__._.__ ,s,o DIVISION oath m etaStr,ee 4cwpt ,�•x in _ ._.-- ry slal LBun�Room _ _ Gg 31tt"..._.�{ N � N �,a•71 Redm4¢,z L 4 dutQtltl o t 74 irw N ——�..._.._. r- - S'ain l.erat SC1-10FIELD_WATER 6/13/2012 Page: 12 . i �._ License or registration valid for�ndi before the expiratio viduT use only n date. .If found'return to: Office of Consumer Affairs and Business Regulation . r 10 Park Plaza-Suite 5170 Boston,MA 02116 Not valid without signatur �. . �e ueaN& r �-� vJi tPo'nUrna�ru � �oacficcoeCr Office of Consumer Affairs&Business Regulation OME IMPROVE MENT.CONTRACTOR Type egistration 120592 DBA Expiration: 2l5( Expira MOORE CARPENTRY g $ JAMES MOORE 02536 1 15;GOELETTA DR EAST FALMOUTH,MA Undersecretary t�7 n 00 o o � .� w c Restricted -One-and two-famiod ly dwellings or any 3 p a a In ccessory building thereto, irrespective of size. N - H ;(l fir'' ,3 - r'o > cXo i Failure to possess a current edition of the Massachusetts < a State Building Code is cause for revocation of this license. I to Q For DPS Licensing information visit: www.Mass.Gov/DPS I � rn -- m 0 .� _. J p.. Tay Town of]Barnstable Regulatory Services swxxsreaLs. 9 HAss. Richard V.Scali,Director Qj a63¢ `0 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstablema.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, 22r Sc OTtet � as Owner of the subject property herebyauthorize J L 5 M 0 (? 2 C to act on.mybehalf, in all rilatters relative.to work authorized bythis building permit application for. 8 0 G ra f �r A,'MtsP,; , :(Address ofjob) '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 Owner. S tore of Applicant Q ter S� {�o tee , P,MES 'n00 � '.Print Name Print Name Date QXORMS:O WNERPERMISSIONPOOLS TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Applications Health Division Date Issued Conservation Division Application F 5 Planning Dept. Permit Fee 16 COO 4 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 604 Village o1 MA- Owner�� s c4olp; Address AD 4" AS�64 62857 Telephone d Permit Request V2 lOn [��7F�� 11?X 1(0 ivy Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new. Zoning District Flood Plain Groundwater Overlay Project Valuationf-7 &e 0-®0 Construction Type r eAy Lot Size bb Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes XNo On Old KiN's Highw : ❑Yes C, V0 Basement Type: ['Full ❑ Crawl ❑Walkout ❑ Other ! Basement Finished''Area (s �ft.) Basement Unfinished Area LLc .ft) � Number of Baths: Full: existing_cl new Half: existing h "new Number of Bedrooms: 3 existing _new Total Room Count (not including baths): existing new First Floor loorn Coast ' � r Heat Type and Fuel: )XGas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes XNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes/k(No Detached garage::❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:i,�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 T I APPLICANT INFORMATION (BUILDER OR HOMEOWNER) e Name 1 ®�iir�o� Telephone Number �36;0 Address cc r License# 4 85.Z4 Home Improvement Contractor# Em-W I: Worker's Compensation # U6 ALL CONSTRUCTION DEBRIS RU TING FROM THIS PRO CT WILL BE TAKEN TO .�� "s4 5>SIGNATURE ATE ��®�� 3 i FOR OFFICIAL USE ONLY T '� :APPLICATION# i ( !DATE.-ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER !. a ` DATE OF INSPECTION: i)AFOUNDATI.tiN4i).494 ?fjt4C:l=-(jQ'llQAk'R_ FRAME A,INSULATION-11 FIREPLACE - ELECTRICAL:. ROUGH FINAL rt PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING-- _ DATE CLOSED OUT E ASSOCIATION PLAN NO. - 17ie Commonwealth of?6lassachttselts Department of Industrial Accidents Office of InveStlgatTOTtS 600 Washington Street Boston,ALL 02111 11.101%inass.gou/dia Workers' Compensation Insurance.MaNit: Builders/Contractors/ElectriciansMumbers licant Information Please Print Le 'bh Na=(BusinesvOrganindon'Individual): Oe`- C2� ���i� u� j-�G°✓��, Address: J City/StateiZip: Phone ® Are you an employer?Check the appropriat oi: Type o project(required): I am a general contractor and I 1.El I am a employer-with _ � 6_ New canstiuctio employees(full and:'or part-time)-* have hired the sub-contractors tPECO listed on the attached:sheet_ 7- ��°�� .?.❑ I am a sole proprietor ar partner- These sub-contractors have ship and have no employees 8_ ❑Demolition working for mein any capacity_ emplo-yrees and have workers' 9_ ❑Building addition [No workers'comp-insurance comp-insurance required.] 5. ❑ We are a corporation and its 1Q•❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp_ right of exemption per_MGL 12❑Roof repairs d. c 152,§1(4),and we have no insurance required.] 13.0Other ` employees- o worker' camp-insurance required_] 'Tiny app5cant thar checks box=1 must also fill our the section beR showing their workers'compensation policy infor—oa- Homeowners who submit:his affidavit indicating they are doing all wad's and then hire outside contract mist submit a nets affidasit ienattes bI swill =contractors d at chew d s box mast attached an addinomg sheet shower the name of the sub-conmrtors and state whether or sot[tWSe anxst e5]i ce employees. L`the sub-contracm s has a employees,may must pdovide their mro€kris'camp.policy number- I gin an enipinyer Brat is proridfag tt.vrkers'cottgmiisadon insurance for sty'eiitployees. Below is Hie policy'and job site inforsiadion Insurance Company Nance: Policy'+or Self-ins.Lic Expiration Date_ Job Site Address_ City/StatelZip: �.tiach a copy of the work 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 S1,500.00 and/or one-year ianprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a Ere 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 MIA for insurance coverage verification- Ida hereby certify under the pains and penaltie perjiii in,that Hie informs lion provideed�ab , is f and correct Siguatunr Date: d .� f Phone' b y cl�7 FFOfflc,al iise only. Do not write in this area,to be completed by city or town o frcial. Town• PermiVUcensessung Authority(circle one): 1.Board of Health 2.Building Department 3.CitylToam Clerk.4.Electrical Inspector 5.Plumbing Inspector 6.Other Phone#: Contact Person: - -- - t; Rightfax C1-1 7/1/2013 5:37:40 AM PAGE 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE DATE(MMrDD111 /YYYY1 T TIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEER. TM 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 RODUCER AND THE CERTIFICATE HOLDER. IMPORTAN T: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 endorsement(s). PRODUCER CONTACT NAME* HUB INTBRNATIONAL NE LLC PHONE FAX 125 ROUTE 6A (AIC,No,Ezt); {AIC,No): E4YlAiL SANDWICH,MA 02563 ADDRESS: 78CNTB INSURE R(S)AFFORDING COVERAGE NAIC III INSURED INSURER A: TRAVELHRSINDEvMTY COMPANY OFAMERICA HODGKNS,BENNETT INSURER B; INSURER C: INSURER D: 31 AUDREYS LANE INSURER E MARSTONS MILLS,MA 02648 INSURER F- COVERAGES CERTIFICATE NUMBER; REVISION NUMBER: THIS 13 10 CERTIFY POLICIES OrINSURA CE LISTED BELOW HAVE BEIER ISSUED TO THE INSURED ABOVE FOR THE POLICY PTIUDD INDICATED. NOTYATHSTANDINO ANY REQUIREMENT,TEAM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THEP DUCHIES DESCRIBED HEREIN IS SUBJECT TO ALL THETIERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LINUTS3HOWNMAY HAVE BEEN REDUCED BY PAD CLAIMS. - INSR ADD SUB POLICY EFF'DATE POLICY DIP DATE LTR TYPE OF INSURANCE L R POLICY NUIMER (MMDIYYYY) (MM MYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE g COMMERCIAL GENERAL LIABILITY $ CLAIMS MADE ❑ DAMAGE TO RENTED OCCUR. :'REMISES(Ea occurrence) ED EXP(Any one person) $ EENt AGGREGATE LIMIT APPLIES PER: RSONAL&ADV INJURY $ENERAL AGGREGATE $ POLICY ❑PROJECT❑LOC ODUCTS-COVPIOP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per axidenq UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION$ $ A WORKERS COMPENSATION AND i WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-5B889439-13 0326f2013 032821Y14 LIMITS ANY PRCPERMOMPARTNER/EXECUTIVE NIA LEACH ACCIDENT $ OFF10ERrMEMBEREXCLUDEDa ❑ 11000,000 (Mandatory In N14 L DISEASE-FA EMPLOYEE $ 1,000,000 r yes.describe Under DESCRIPTION OF OPERATIONSbetow EL DISEASE-POLICY UMTT $ 1,000,000 DESCRIPTION OF OPERATIONSILOCATIONSJVEHICLESIRESTRICT(ONSJSPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. THE WORIMRS'COMPENSATION POLICY DOES NOT PROVIDE COVHRAOR FOR HODGKINS,BENNETT. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED NORTH ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REP RESENTIVE HYANNIS,MA 02601 Ar-non�c ron��r,(u, r,^ernop., .,?^a a•^^'-'^'^'i marks of ACORD 4988-2010 CORD CORPO TIO 1 r is reserve . D d l .Me 1.,1 1 '1�'9 L. �lhA� LI 1A(C g i CF IKE OT tARNSTABI�, L659: ,� Town of Barnstable AlFp�p Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnsta bl e.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I. R42r SC (.cry as Owner of the subject property Q� C hereby authorize '\ C�c� �' J ti!� to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) l Signature of dwrier Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\deco]U\AppData\Local\:\4icrosofi\Windows\Temporary Internet Files\Content.Outlook\8R76BDVA\EXPRESS.doc Revised 061313 N K �a f l Z-o -r Z Lb Y z / b% �O O LOT N i � Z 3 Dr. � IX �o-o . 70. l� P,-��• v If Of CERTIFtE(? PLOT PLAN RQB�'EtT �, LlJT r y yel /j'1E/�DOGJS ' a ucE 6411E3 T <7 f�o2r" $ RLOR IN ~ s �a ut�. SCALE, / `�3o DATE S ��( DRQGE ENOlNffRlNO COt IN v ak.IBNT flYSIAC 1 CERTLFY THAT THE "--" aMOWN ON - TH19 PLAN 13 LOC T �EQ19T�RED� AE019TERE0 ��' - - . JOB NO• ?' : ON' THE GROUND AS INUICATD' CIVIL. LAND. CONFORMS. TO THE YONIMA L ENGINEER SURVEYOR ON BY# �.— OF BARNSTABLE MAS ., 712 M Al N S 'R E E T _ i -: • :NVA.Ntl (C MA.S4 ,;. k ,,,.:. . wua�*'' ;1. A�.:.. / .r _.•.._ .,:..Y:..... License or registration valid for individul use only l before the expiration date. If found return to: Office of Consumer Affairs and Business Re 10 Park Plaza-Suite 5170 gulation Boston,MA 02116 Not valid without signature 0 R Massachusetts -Department of Public Safety Board of Building Regulations and Standards' Construction Superiisor License: CS-086267 ,f RICHARD D SOA)RES '? 18 SPRUCE ST W BARTNSTABEE J I Expiration 02/221201& .,Commissioner i f : ... �Z6�6�I9YI720i/ZU/�QA�2 o�(J(JGCLQdQ,Cfzt�e�' i u �, .�� e ,'*. tity Office of Consumer'Affairs&Business Regulation y ;ryry; r ME IMPROVEMENT CONTRACTOR E egistiation 164040 Type: ' icpiration c.8/14/2015 Individual j EP t RICHARD SOARES d 1 is eta RICHARD SOARES ix3} 18 SPRUCE ST W. BARNSTABLE, MA'02668 Undersecreta 8266& 54 t r•. .._.--„ •, _:L..3r.�ie}1,ja',r1�.,i*�6.#'`s.,,x..+ups..... 3..�sik ' I ' I k t:! ._._..__..._._..._...mow ! S�.`iO�, ws.•w.-..+�..�,..a......�..,.......e•u... w.. " .�,(3) Pars' �q ' ' PoulaZi Cogti�ITIE CaGv�i.b' !, ate.� .�,.�..� ......... w ..M, It 410' 3014"T I .SQL 4D J + .1 �• . x CAR JAGE boL;rS r l t:� frY ao !I 1 ff > : w _ N Y SIA10 owsfb ■/•{{ ■�/Ln— ply SCALE: APPROVED BY: DRAWN By _ DATE: 77" ,'� ,..REVISED � atia { 6t ' �al�''T�lri',�',�1D I•, �� �`l� d'�0�: IN1'� b2.Ga4n'I' R BIER �'D AWING NUM ..,. ."..,; ._. ... .....:-... .. ........, ,�,MSS 8%a X 11 PRINTED ONE-NO.1000H CLEARPRINT® r :u j `' .. : ..,u. .v..rerin':+rvoiwm.a.�nan ..W+.wnr+M... .s..m�mme•Fanao..n+.r-ww � �O r sl � jr 17 17 ryiIN ... ,::ti5.w:,.+.w•n>..,.,,......,.».,w..«::..e.eww.w.«urw 's&W�..�,. '......e..w-... .wan.�.i>A ` ..::,� �.... 'ia�•.mn..�imrN�.w�i+aea.v+mraaa�ar.�inxdns�r�-mcwxs*L4glWetS.MN�➢i»aaiw+tn.rn. 0 °$ r«.++.n'o:,�..im:.ar..a.r1.r..wear,..i+...•...»..:.y��aeew+.�w.,e�naf+.:ekn�katilarrvnnw.,>.�,.,.a,oi,.e�a..,:s�.�.ev�.�+,w � '�►` ' v ' • p4oPo , IL x ru° XT'1 6 CITCYAM c . . SCALE: 4.-- �r�0e1 APPROVED BY: DRAVNN BY DATE: ��' �!t7" REVISED Z :b Q Cob A ' I L a 1.-m„ tN r 5► M 2 �, ,� Plu"ViS V2 Jo HIM101 D Cif PL OO K P1-4 DRAWING NUMBER cjCC TIC N� �U�i��t�in� �� off' Z 81A X 11 PRINTED ON NO.1000H CLEARPRINT a' r 7-C 9f ® 13 c -q,5-Q 6 Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fee ,g-71, s � • iARNSfASIE. MAW 1619. Thomas F.Geller,Director A�� �Ep Mfd Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY ft Neap/parcel Number ® Not Valid without Red X-Press Imprint (� ,nn Property Address aQ G -e(� L� C^�- _�n i5 YV 1 01—( O ' - gResidential Value of Work$ 1 f 1 3©6 . 0 °' Minimum fee of$35.00 for work under$6000.00 1 Owner's Name&Address c�cr S tt'r �, Lip�N �0 �e� ��� fir• n 5 �24 G i_ R` i S 6 G..�S 50 g,�- 36 Q- 014 7 Contractor's Name t G Gr Telephone Number Home Improvement Contractor License#(if applicable) 0 y b Email:-'env I rof,S+h k41 c,:, I C 0 Construction Supervisor's License#(if applicable) CS— ®8 52 (o-7 ❑Workman's Compensation Insurance - Check one:❑ I am a sole proprietor X•PRGBC SS PERMIT ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance JUL 0 9 2013 Insurance Company Name Workman's Comp.Policy# NSTABLE Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to [�Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ® Re-side Replacement Windows/doors/sliders.U-Value ° (maximum.35)#of windows ) #of doors: _ ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A co oni Impro m nt Contractors License&Construction Supervisors License is \ wired. SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\Windo emporary Internet Files\Content.Outlook\8R76BDVA\EXPRESS.doc Revised 061313 3 t The Coninionsvealth of Massad iusetts Depar'tinent of Industrial Acciderds Office ofInl�est gadvns Wi- 600 Washbigton Street Boston,AL4 02111 1M,11'.Riass gov/dia Workers' Compensation Insurance Affidavit:BuildersfContractors/Electricians/Plumbers Applicant Information n Please Print Le 'bI Name(Boasinesslorganimtion&dividwal): 0 s Address: 14 City/State/Zip: Phone# 5,0 $ b` ,1_ Are you an employer?Check the approptiatos: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I 6. F1 New construction employee--(full and/or part-time).* have hied the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ?. Remodeling: ship and have no employees Theme sub-contactors hacre 8_ ❑Demolition. working for me in any capacity. employees and have workers' 9. ❑Building addition [No workm'comp.insurance comp.insurance., required-] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LD Plumbing repairs or additions myself.[No workers'comp right of exemption per MGL I2.❑Roof repairs insurance required.]i c.152,§1(4),and we have no employees.[No workers' 13.❑other d comp.insurance required.] *Any applitant that checks bw#1 must also fill out the section below showing their workers'compumn oa policy infotr tioa. i Homeowners who submit this affidavit indicating they are doing all work and then lure autidde contractors must submit a new affidavit indicating side_ tContmctors abet check this box must attachM an additional sheet showing,the mme of the sub•cont ectors end state whether or am those entities have employees. If the sub-coatmctots hm-e ernplDyees,they must provide their workers'camp.policy number- lain an ainployer iliat isprmi&Rg workers'corngwisataon insurance for€cry erlrployees_ Belotw is thepolict�nand job sate information. IImurance.Company Name: Policy#or Self-ins.Lic.-: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 2.SA 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 chril 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 cerh;y curler the pains and penntia pedury that the ir�orrcretion provided a68, as and correct Si Olt[ Date: �7 Z ZZZ Phone 4: 6 8 y Z�7 Official use onl1: Do not write in this area,to be completed by city or town odiciaL City or Town: PermitUcense 9 L g Authority(circle one): ard of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector her act Person: Phone M f � , List ®f subcontractors Bennett S. Hodgkins Custom Building & Remodeling 31 Audreys In. Marstons Mills, MA 02648 508-648-6362 Fax. 508-420-0424 bennetthodgkins@comcast.net r ... ..:;::. .:ii.�.� :.,:Y:...•.'.�/......nn ncnrc LInC ..aty_IJl) iU11UC1 GXCi nv + i - THE COMMONWEALTH OI+ MASSACHUSETTS Registration: 164040 Orrice or Consumer Affairs and Business Regulation Expiration: 8/14/2013 Home improvement Contractor Registration Program 10 Park Plaza.Suite 5170 e Boston. MA 02116 a 'a V APPLICATION FOR RENEWAL OF RF,GISTRATIO ED J� ,.W Home Improvement Contractor or Subcontractor MG 2013 Chapter 142A,201 CMR 18 OFFICE OF CONSUMER AFFAIRS RICHARO SOARES RIGHA'0 SOARES 1&SPRUCE ST W. 8ARNSTASLE, MA 02668 NEY,ORDEItS,CA,,N BE ACCEPTED � .. TIF;➢�D C',�FCKS,OR,M. MassacP setts.-Department of Public Safety Board of Building Regulations and Standards' Construction Supervisor � � z License: CS-085267 - �` ti RICHARD D SOAJIES " s 18 SPRUCE ST ; W BARTNSTABEE 8 ✓.G,. �/5t�jc- +t '��' CExpiration -_Commissioner 02/22/2015, w _ k + d Kt e A �s I — 51, b C �D Smyle or comb�at�on vah�le riot Class A B;or C � , �o����� t ®R�s � 9n? .;- �1IIICII�IIII�1111��1�1111�11III�II11 l IN a +: _}k �� awomaracwrm � Place change of address label here 77 L ) Unrestricted Buildings of any use group which 9 c�ontam leis than 35,000 cubic feet(991rn3)of enclosed space:., a Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS 77ae Coniniornmalth of Massa&usetts _-- Depmhnent ofIndus&ial Accidents Office ofIm=estigadons 600(Washington Street - Boston,ALA 02111 wmtunass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electticians/Plumbers Applicant Information n Please Print Le. N Name(Bag[mm/Organizationqadivndaal): .� S. ( -��L ��-S ¢� f (4-%o1 Address.- 31 4,J4,jS City/Stat&Zip_ 144 C.5St 0^S VN I S MG` Phone-# Got - re v Y 0 9 (2 Are you an employer?Check the appropriate bog: Type of project(required): d 1_ I am a employer urith 1 4. ❑ 1 am a general contractor and I loyees(full and/or par#-time). a have hired the sub-contractors 6- New instruction 2.❑ I am a sole proprietor or partner- listed on the attached sheet_ 7. [)Remodeling ship and have no employees These sub-contractors have S. ❑❑,Demolition wodring for me in any capacity- employees and have wogs' [No workers'comp_insurance comp.insurance-19_ ❑Building addition required-] 5. ❑ We are a corporation and its 10.❑Electrical repairs or - 3_❑ I am a homeowner doing all uwk officers have exercised their l LF]Plumbing repairs or-aMfions myself[No workers'comp- right of exemption per MGL 12_❑hoof repairs insurance required]1 c. 152,§1(4k and we have no employees.[No workers' 13.0 Other comp.insurane required-] Any applicant that checks box#1 also fill out the sKtion below showing their woxkets'compensation policy mfortns iob i Homeowners who submit this affidavit inditatiag they are doing all we&and then]rite outside contractors must submit a new affidavit indicating sudL *COntracmrs tbat check this box trust attached an additional skeet showing the name of she sub-conwzcturs=md state whedw or not those entities have employees. I€the sub-conuu mas have employees,they must punzde their workers'o mp.policy number_ I orn an employer that isprov&TbW ivorkers'conqwasation itisuralice,for rrtw eaziphTeex Below is thepal cy crud job stile inform albiL _ (( I Insurance Company Name: � �G ire Gr, 1 �� I h�(tt1 C�:d^G N� UZ Policy 4 or self-ins.Lic_#: J 5 ' 301— I Expiration Date: 3'02 6, i ]fob Site Address: loo COG �(U LA Citylstate/Zsp: �-(I-I&S of 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 2.5A 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 fame ' 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 DLL for insurance covers a verification. I do hereby cerd ra er the pri and penelh of gegyi that the inforatafionproWded above is tare and correct si tire:. l Date: Phone#: O,,(fncial Use onk. Do not write in this area,to be completed by city or town©fficgcrl City or Town: Permit/License N Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector a.Phumbing Inspector 6.Other Contact Person: phone#: Rightfax 131-1 7/1/2013 5:37:40 AM PAGE 2/002 Fax Server rERFCERTIFICATE OF LIABILITY INSURANCE ATE(MWAzInjDDIYYYYI TIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. MEATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, TIFICATE OF INSURANCE DOES NOT CONSTITUTEA CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED TNEO ODUCER ANDT CERTIFICATE HOLDER. NT:If the certificate holder is an ADDITIONAL INSURED,the policyjies)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 NE LLC PHONE aFAX 125 ROUTE 6A (AIC,No,�I: C,ND). EMAIL SANDWICH,MA 02563 ADDRESS: 78CNB INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: TRAVELERS INDEWRTY COMPANY OF ANJ3RICA HODGIITS,BENNETT INSURER B; INSURER C: INSURER D: 31 AUDREYS LANE INSURER E: MARSTONS MILLS,MA 02648 INSURER F: COVERAGES CERTIFICATE NUMBER; REVISION NUMBER: THIS 15 TO CERTIFY POLICIES O TO THE UISU O OR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OVARY 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. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLABIS. - I NSR ADD SUB POLICY EFF'DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICYRUMBER "ADOXYYYY) (VM1DD1YYYY) LINTS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY ' DAMAGE TO RENTED $ CLAIMS MADE [:]OCCUR. ;'REMISES(Ea occurrence) ED EXP(Any one person) $ RSONAL 9 ADV INJURY $ GENt AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ POLICY PROJECT a LOC ODUCTS-COMPIOP AGO $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS ' (Perperson) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) 71 UMBRELLA LIAR MOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION$ $ A WORKER'S COMPENSATION AND WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-5B889439-13 0328/2013 03/28/2014 LIMITS ANY PRCPETRMORIPARTNERPEXECUTIVE LEACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? 10 NIA 1000 000 (Mandatory In NH) ALL.DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERA71ONSILOCATIONSNEHICLESIRESTRLCTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THH CERTIRCATE HOLDER AFFECTING WORKERS COMP COVERAGE. THE WORKERS'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR HODGKINS,BENNETT. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLB SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED NORTH ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZE)REPRESENT HIVE HYANMS,MA 02601 �. .,..a+�:mi. �n I ?„at CORD 9 rgis reservA/on oi•^ o ' marks 88 2010 ACORDORPOTIO e . V•� Q f � BAaNSrABL • 5 9. Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Si This Section � If Using A Builder I /�P`� G^a ` U"'e (� s Owner of the subjectproperty ( ' 1p pm' hereby authorize f to act on my behalf, . IG�r in all matters relative to work authorized by this building permit application for: (7 1' r1to L�. �11, �1 Ira A A,� OI V�.� �2 G 7e2 04 (' 1 (Address of Job) 7A-43 Signature of Owner Date � M--Q-r- sCU�Lkc Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microso8\Windows\Temporary Intemet Files\Content.Outlook\8R76BDVA\EXPRESS.doc Revised 061313 Office of Consumer Affairs &Business Regulation-Mass.Gov Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Consumer Affairs and Business Regulation Home Consumer Home Improvement Contracting HIC Registration Complaints Registration # 164040 Home Improvement Contractor Registrant Registration Home Page Name RICHARD SOARES Address 18 SPRUCE ST City, State Zip W. BARNSTABLE, MA 02668 Expiration Date 08/14/2013 Complaints Details No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Back To Search http://services.oca.state.ma.us/hic/licdetails.aspx?txtSearchLN=65832 7/9/2013 Assessor's map and lot'°number .: ��. ..... � �B O .... ..........: pp oo r ypF IN E?��♦ Sewage Permit number ..........V.... v�l '�?�1` ��. d� o,► Z BAWSTABLE, • House number .................. ......RR..... .. rasa . �� t639- ' t 'Ea YPY a. TOWN ' OF '.BAR BE . y� r..N�S�TA` ` L`MMP �� N1 i!l TITLE 5 4 .� a BUILDING [INSPECTOR C ODE AND .� Q v �{ ! .�C N APPLICATION FOR PERMIT TO .... .. .... .:...<!1.... :.. ...... ... ...... .......................... TYPE OF CONSTRUCTION �/d d, T x ..... '.... ................... ......... - ....13.............9S3 . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby app' for a permit accordi t .th ollowin in mation: F Location ....... �.. ProposedUsec)p.�R�!. '� L Q%.........................:.................... ...:.................................................................. Zoning District ..... ..... ... ...........Fire District ... ./.'��. .... .............. Name of Owner .. �.!f�..,.�,1 !(�.. �-:. .Address q.0. � w..!! ... Nameof Builder' ...... 1-57A:n z...... ...........................Address .rJ ......................................................... Name of Architect. ......... � Address .......... ....... .C.7..�N... — Numberof Rooms ....................., .....................Foundation ......:. ....................................... Ezierior ...................�..N..� ...... .... .. ...,........Roofing ....� �............. Floors A\ o ...!! .:.4� r.. i'✓. Interior ....... '.1... .! ..`. ... Heating . ......................: ...........Plumbin gP g ............&.�/..�./J. V�F Fireplace ... ..... . ............................. . ....................Approximate Cost Definitive Plan Approved by Planning Board ------- - - ----------19 -• Area �7`�32`r� Diagram of Lot and-,Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTHY N E • OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the T wn of Barnst b egar ' g the above construction. ��l Name17 t YSIDE BUILDING CO. .41 No 26478.... Permit for ..One..St° .............. Single Famirly IEW11 ng` -( .............................................................. Location Lot..10,. 80 Goatfield..Lane...... West Hyannisport r ...... .... .... . ...... . ...... ................ r Owner ...........Bayside Buildi.ng,CO:.:.......... J . Type of Construction . Fra /..........................:....:. xy - Plot ............................ Lot ................................ aPerm t Granted .May..23..................' ....19 84 if /� + Date of,In for ..................... 4.,'..19e- Date Completedf/ : .vim..... .19 ( F e 7 Ile d _ i z DAT Ny �. -v .41 lop }i WOO- -+ r� .03 c � r OD ® fir3�� Z a � FROM- ,i TOM OF EtRSTABLE BUILDING DEPARTMENT tom. Francis iah Town Clerk � .�.r ����. 067 MAN STPEET HYANNIS, MA 02601 Phone. 775-1420 SUBJECT:, . FOLD HERE • { _ ._,DATE AAESSAGE . 'n�k � r 3.etec3 Pe #26478 ( i. tx lclirsc f 'lease release Bmd. � • SIGNED - S 7 DATE REPLY SIGNED rveT,ami RECIPIENT:RETAIN.WHITE COPY,RETURN PINK COPY + - - - - PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW-COPY ONLY.SEND'WHITE AND PINK COPIES WITH CARBON INTACT.. TOWN OF BARNSTABLE Permit No. _---20478 I . �. Building Inspector Cash ` - ---,63 xOCCUPANCY PERMIT Bond Issued to Bays de Sui-Jana ro. Address Lot 1.0, 89 tfield Tar+ ?,. ` u?pst-. 9winni_S1nc►r# Wiring Inspector y, /: Inspection date Plumbing Inspector/ � Inspection date V y j Gas Inspector Inspection date ( ff11� L{ XEngineering Department `'r� ��// Inspection date 7 � Board of Health � .� ` cyc_ Inspection date `. R THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. d Building Inspector I i00, I i � I r I r i I i ,�•a�►' I ' 1 I rr I ., . 1 i I ' 141 , } I I ' I I I j � , ► 1 I � t I � ` ► t I � ; I ► ; ► � i ; � 1 j j � ljj , � j , j i j ►. � i t I I � i I 1 � 1 �, � � I t � I � � i ( 'lot l I I I ! I I L I I ' + � I I � � ! i i i � i l { i l i l I I ► 1 1 j IIII , 5' Assessor's officmap n st Floor): �6 G,� SyS ` ' Assessor's ma and lot number O� ' � ��° o THE o INSTALLED 1 Co ���' � � Conservation /� l:l�IWPLiAlyr, �� w Board of Health(3r loor): q Mf ff TITLE 5 ,`J = DIfl��T�Dt� Sewage Permit number — 6 ���t �� � ��L��®� o rua Engineering Department(3rd floor): f RkfN f AN-1-�s o s639. \�d° House number L �' �„ 7to rrr Definitive Plan Approved by Planning Board �g 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 TYPE OF CONSTRUCTION 19 `-3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby appli for a permit according JA the following in ormation: Location `Q Proposed Use Zoning District Fire District Name of Owner ArJ A ewoS Address c — •— 1e �..� Name of Builder .!Y-1-ra' CL-1 Address o2 t�w/rl�l d S ll f.L�r, ( ('U(tee. ` U ff Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost Area Diagram of Lot and 'ilding with Dimensions Fee 00 r 1 36 , OD -f-IP 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 4.L41 Construction Supervisor's Licej� t9�zq Z C •-y"`-� �,dt k HEEPS, RICHARD No 35912 Permit For REPLACE DECK. Single Family Dwelling Location. Lot #10, 80 Goat Field Road Hyannis j ;I Owner. Richard Heeps _ Type of Construction Frame Plot ' x Lot Permit Granted June 'l , 19 93 Date of inspection 119 Date Completed 19 f raj x_ n