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0054 LEXINGTON DRIVE
72) :5 Town of Barnstable *Permit#`� oFt�r� Expires 6 months from issue date * Regulatory Services Fee • saxNSTAB E, MASS1 � Thomas F. Geiler,Director prEo��" X-PRESS. PERMK Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.barnstable.ma.us TOWN OF BA.RNSTASLF, Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not.Valid without Red X-Press Imprint Map/parcel Number o?,20 f6/ Uo) Property Address 5! z e X 1 v1 r C'y i O r i 'V&_ Residentia Value of Wor ® Minimum fee of$35.00 for work under$6000.00 Owner's Name& Address f / Mj X Lex /C'i Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance a Check one: V❑ I m a sole proprietor " I am the Homeowner AUG ❑ I have Worker's Compensation Insurance , I� t Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request heck box) Re-roof(stripping old shingles) All construction debris will be taken to fg e, r. ti XX- L+;,I oo;H ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows r *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is require SIGNATURE: Q:\WPFILESTORMS\building permit forms\EXPRESS.doc Revised 070110 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 Please Print Legibly Name (Business/Organization/Individual): ��?te��,I/ /714'440 Address: City/State/Zip: 9 h ^ d 1 Phone #: Are you an employer?Check the appropriate box:, ^ 1.El am a employer with �,❑ L am,a general contractor and I Type of project(required): employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g• ❑ Demolition working for me in any capacity. employees and have workers' . $ 9. ❑Building addition comp.[N workers' comp. insurance P• insurance e- I quired.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3. m a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[2"R' oof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance 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 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 certify under a pains d enald perjury that the information provided above is true and correct. Si ature: C ---Dat� e. •• Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: f. ,i Town of Barnstable �pF SHE Tp�� y�P Regulatory Services t BARNSTABLE, Thomas F.Geiler,Director p MASS. g �,, �639• A,0 Building Division lED � Tom Perry,Building Commissioner 200.Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: L �/ 0 / JOB LOCATION: � i' /J [Q � �tJtO S °Y-2l number / ` / str village ✓ ' / /`"HOMEOWNER': rC G� �� � / �`®�^ 0 7 7 ff 6/. name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip 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 Person(s)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, attached 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 109.1'.1) 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. r Signature of Homeowner- Approval of Building 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 fully 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. Q:forms:homeexempt 4 °FTHET � Town of Barnstable ' Regulatory Services • anxxsTABLE, + r MASS. Thomas F.Geiler,Director 16.79. n;9. Building Division Tom Perry,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 Sign This Section If Us ing A Builder . I I, G Ac, 1, 10 , as Owner of the subject ro e P P rtY hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address f Job) f ignature of Nmer Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �► /> Map Par/ceel/J a7 70 /©/-�,� Permit# (/Health Division f'( 5 W- �, Date Issued 6191a J Conservation Division �'a L�- Application Fee Tax Collector - '� c��o3 Permit Fee_4V D Treasurer o K '- to APPLICANT MUST OBW A SEWER Planning Dept. CONNECTION PERMIT FROM THE ENGINEERING DIVISION PRIOR TO Date Definitive Plan Approved by Planning Board CONSTRUCTION Historic-OKH Preservation/Hyannis Project Street Address 51. ze- xv;?y"0170/- Village Owner a Address1006 y Telephone X 77� '/� Permit Request --to 1/1S O' 0 000 Square feet: 1 st floor: existing proposed 2nd floor: existing A proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation-3.. 2®0 Construction Type Lot Size 27 Grandfathered: &Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 11r5 Historic House: ❑Yes IDWo- On Old King's Highway: ❑Yes U-Ne- �- Basement Type: M-F051-1 ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) - f) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing .3 new 10 Total Room Count(not including baths):existing �,� new First Floor Room Count Heat Type and Fuel: was . ❑Oil ❑ Electric ❑Other Central Air: Wes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes �.,1 to d Detached garage:❑existing ❑new size Pool:❑existing U<ew size pil a am:❑existing ❑new size Attached garage:; fisting ❑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 BUILDER INFORMATION Name Su10 POD °`J I't� Telephone Number 5QY- 71, "v?g33 Address License# GS 07�9 / P + a 11Y1-61 l9 C>5L(o O I Home Improvement Contractor# f 3d Cr./v/ Worker's Compensation# C /S3l l ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE q DATE FOR OFFICIAL USE ONLY 4 } PERMIT NO. f J DATE ISSUED MAP/PARCEL NO. r " ..r ADDRESS VILLAGE10 OWNER r —� DATE OF INSPECTION: r FOUNDATION /ly FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL .' f PLUMBING: ROUGH FINAL _ I GAS: ROUGH FINAL FINAL BUILDING °� .3/ 3 �•? i DATE CLOSED OUT10 ASSOCIATION PLAN NO. s r . � I4 . `.. . The Commonwealth of Massachusetts q . Department of Industrial Accidents =` Office ofinyestigations . . , 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insnrance davit . name: V 'd location ,Ti W yk P 2C( q IeM b'1P,.11�- city gsd o o t2 j':i. a & 02 jOQ 4 phone# O f) —rYIa/Z ❑ I am a omeowner performing all work myself. . ❑ I am a sole r r. for and have no one rkin ' an capacity / ❑ I am an employer providing workers' compensation for my employees working on this job. com sn.:name :::;;:...I.::::<.':. .;:.;::.:. ... :.;.;:.. ::a;:a<>: do . ... . ....... ........ ::. I am a sole proprietor,general contractor, r homeowner 'rcle one) and have hired the contractors listed below who have I . . . thefollowing workers'..compensation polices:.:.....::.:.::::.:.::::::::.:::::....::::::::.::.:::::::::::::.:::::::::.:_.:..::::.:.:,:.:......:..:...:.........................................:....:;..:.:..... :»:::<:::::><::::>:«:>::::>::::>:«:«:::>;;::::::::::<;::::::::: :....:::::.....:: ..:::: »:::;:>; aumnanv name a 1� '3 t # E .i � .::.:........ ''::...:;.:;::.s:::::r:.';::':::::':.:':. ..................................... :::::.;:<.::.: :.:... . ::.::. one.#: . «:;<:;:.... .....:. ::::: ::.:::..... . ..:.:... :; :...:.:.....:.....::.:....:.::::.:...:............::... .city: . x. ... .._. l $e::: ..5........ ::>::':> '':%dig:;:::::;:: ?':::::::'::' ::f":2::;:cri'<:::,:'';: ,fie.::: :::.>::::i:::>::::::: ::is2%::': ::: :::::::::5::':2%: ...............................: ::.. :::::::::::.,.....''*:::":::::.::,:: S:�:::::::::::::::::i:::::::::::::::::::%:::::::::::::: .. .....:..........4.. :i::i:::: :i:::•..":.':.:::i::::i:i: ::::i::::i::''.iji:::iii`::::::i' ':i::i:i+i$::::i`'::'::}:::i:: ::";::::isiiii'r:i:;::::ii::::::'rii:#:%'•:::';:'>'^ ii:: :'::...:.••: •. .. .........::.:...:::... ... .......v:v:w:v::�: :...:.. ........ ...:.... ...... !!,, ,�.y :.:::::.::::::::.....:::::.:.::.: :::: .. .......... ..::.::::.::.: ..?:y?:^:i::is r::.:::::v.�:::::'.::::;v:•::::.�:.:�:::.y.::::::•:::::::. :: :::.:�.�:: " .. Ri::?::: ??',/: :i,:n;(�':'r?:tii?i:: v:::::::.:::: :.v:•::.�:: ?. ::::::.:�:.�:::::::::::::.�::.::::::::::.:�:..... ...... :::: ::::.:�::: \:.�::::•.: .:n: :: .: v:: .::.::.L :::::::-':::::::::::.:.:.:,:F. : :: ii:r:.::: r�;jl1...,.,.Jf�,:•,.,.,:,Yi r�,:::::: :. ?[ IlrA11Ce.:COa?;? '. : t ..c::: �0:::::::.,:......:::.:..:...::::.:::.::..:. 0)9 .#....... >;::p:r,;; ::a::::• '-���allles'2G '::::::: :: ?' ' 2 ' �G :? k ' ? ' < ><`•�:'''::: `' icy : :?;:;: : ?t ?' 5 > < < ''% ?: ? r; : . % :;:::;:>::>an .n .gM ....... ::•.::...:::::::::::... .:.:. ::::.;:.:.. :::..::.::: :•...:..:. <: :address >::::::::::';: ::: .. :.::.::..:::::.::..:.:,m.:::.::.. XXX nsnra %. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains andpenalties of perjury that the information provided above is true and correct SignatureJ44A Date �Z69` � _ Print name Phone# 7 2 O -r�&I-.� official use only do not write in this area to be completed by city or town official . city or town: permit/license# ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised 9195 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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 aii 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 section 25 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. Tlie 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. City or Towns 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. The affidavits may be rertvoned-in- the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. FEEZjjjjjjj/jjj/jjjjjj��jjj��jjjjjjjjjjjj/jjj��jjjj��j The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Me 01 inllestigatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 i �P�oFIME, Town of Barnstable y Regulatory Services BARNSfABLE ' Thomas F.Geiler,Director as,►ss. 1639.�A � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. / p Type.of Work:- �lro C, /"®t�ego T C� Estimated Cost Address of Work: 01 Le c n`re, (/o., zrs Owner's Name: /71 110— ln /'".l "1l /C Date of Application: 0 0_3 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. r Date Owner' �oETHElpk, Town of Barnstable Regulatory Services HAMM'ABLE, ' Thomas F.Geiler,Director 9 HAM. g �pTf1639.IA Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I a , as Owner of the subject property hereby authoHze 7 p %�`/Q��g l S,02 6f(Y-t 1 to act on my behalf, in all matters relative to work autho ' ed by this building permit application for (address of job) vrq Y—' t A` Signature of Owner Date r� t Print Name t QTORMS:O WNERPERMISS ION The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION jn / Please Print DATE: �C� 6 0 / - 70B LOCATION: number s '�iOMEOWNER M 0/ �V� al � name L� home phone# -work phone# CURRENTMAn1NGADDRESS: city/tolkw r state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellin-gs 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. . DEF=ON OF HOMEOWNER Person(s)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, attached 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 109.1.1) 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 omomeowner . • Approval of Building.01ficial 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. 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":tx t'?�'* � •:�n, ,?a,�.,�._, �. �,`s,�, .�'Te;: ..a RUFFCOATE AX MILATNO-52 3Ep iiot i �I� Ste < .. . : „ Ac�uAsP®RTS POOLS geed ARE EETTEARH Structural Engineering&Superior Distinctive Designer Styling Embossed:Do Not Jump, .".t 2 Piece contour Engineered Do Not Dive,4 Feet Deep, t B z =� Wrap Aroung Locking Seat 8 d a Clamps,Polymer Resin Do Not Stand,Do Not walk urled Returns oS°Ruffcoate w Extra Wide Patterned wail r lop Seat I E'bi # IX@ YI s t t4 t sC Rugged Ribbed xMV a Upright .' 2 c �xagyr�"y�i�� �r�► * � � � �' ..�5�d lie; ��> '� ��*s �� ;,a z4�'�tfa!����r `rX, '���•-�� WARRANTY gpgM { reI zt ,.p' .pill ({jj5 3rioF s#L' i fj�s fi M W nal . ntniur°ate anrl �;.itttl . ,� �• �., � ��., � a limited 30 yr.warranty and customer � s service policy an pool wall and frame i V 61 - �� Distributorfsgt, s ° raEprijpu�s r r ,, �. � n• � s: � , �, w m ,q�'(}'>* P�gINAtl�bTR+USINY P Failure to comply with all safety - � signs and all pool safety rulesl �, ,, w ". 4. may result In serious permanent body Injury Product Safety is the Joint responsibility of Jx I 4 the Manufacturer and End User(Con- sumer).Failure to comply with all caution signs and all pool safety rules may result In serious permanent body Injury.These products are In conformance with the r dr Voluntary approver!Standards for fiFf L+IQ .� Aboveground/On Ground Residential h#r�° . Swimming Pools.ANSI/NSPI-41999 or r latest revision. 01r!.K--H'-'!r!�mp BTS 'INC. ,�e" ►PO P.O. Box 7283, North Brunswick, N.J. 08902(732) 247-6134 i EXPLODED VIEW .►µ,•w.sty+ tw—lf OVAL MCAOGLAMP SCRtft f wLVwJJWIUJ�MALt (TV. ewfP K S/6 I:CnMJ 4'1OP yy +^reN'� • 7 LJNL11 VTOPSTRAMTfvAI� , J 3 -� 1 MALL NAIL 7 tMJ+VIfJSA110wE1► r __ ]&tpfsrwA�Gftt i WAIL L AA1L ••'•f` fG 81IrTJTESi 'y: ' �\ 12 Bono"stAw/' J7 ZMAP StfPRICKT COKJKGYOA /�� ff UAriVEASAL CWfV 0 �{rrALL, 1�."'FF •, • ` WALL APfL '10811T'fRE;� TQNACIV 15 .tOLO J. OOTWOM SOUAA[ 17UNIVERSAL L�. 196VT'TACSSSOPPORT 22110170M imam I. . WALLRNT 15 strrr�►p ANOLF BRACKET wAu Raa tlt•or. 30 yr.wsrraffr RUB onsf"mw 4...0• seance peNcy on pool wall mfd llelate. ........ rw•rwh ..•l��.' ��»,,11��.....!V T{j."wr..'��.+ ..+.f•. FwrN::ff....��..r!r.•. - '- , : •�r j i:.... .�r:d!•Y...l....•M�•'.r:..:.. mow.M'Mr .....• P.O-Box 7283, I North Brunswick.N.J-08902~(908)247-6134 I �1JGa .. loo.00 �I r 7�b 2�-x- 3`96 {Z 7- Of } JOHN�8 �= 2S _s LAURETANI A Y 34311� T01.! s �7---� Z4 ozzl Scale: JOHN S. LAURETAN 4 PROFESSIONAL LAND SURVEYOR, )O HEREBY CERTIFY THAT THE AMERICAN SURVEYING COMPANY 4BOVE MORTGAGE INSPFCTION ...... --- . ... .._ - Q , o , 0 0 0 0 0 o • 0 0 C 0 0 p iinard of I1nilding Ringpilntions and Staurt:.rds L1cr sr or rcfistration.'xiid for adividui tsc only O i HOME IMPROVEME bClor v the exl>it ution d%:tc. If found retur to: Rogistr+:tion: t3i1:;68 Boar!t of Buil.iiug Rcgu.tatlans a' !Stand.rile One lishhm•ten.Place Um 1301 t3xpirntlott; 41ii%04 p Bost:un,it•Ia.0::I08 o ryp�, DBA a , 0 p The Scairn foal Spit Sal:.& O O O 435 bvaquolt Uwy O _ O E.f;:irnouth, +A 02536 pdn tulstrat��: _ Not vslid witl out sigma a!re O O O O O O O M _ tU . O O � , N - tV N i ACQRD CERTIFICATE OF LIABILITY INSURANCE P7 �03 14 03 PRODttcER THIS CERTIFICATE Is ISSUED AS A mATIER OF INFORMATION $ A TO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CO. R.I.,INC_ HOLDER.THIS CERTHWATE DOES NOT AMEND,EXTEND OR P O BOX 14190 BAST PROVIDELdCE RI 02914-0190 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone:401-431-9883 Paa:401-431-9889 DISURERSAFFORDINGCOVERAGE INSURED NAIC u a MWIWE IM5URANCS CO�BNY SWIIRUNG POOE�L/�6��$$Spa GROOP, R 0: 435 STWJz3� Kfa% 7 EAST F M& 02536 INSLREltD: L E COVERAGES TILE POUCES OF Q MURANCE LLSTED SEWW IIAVE WMv tSSUW T07HE UM*MD NALI6DABDVE FOR THE POUt7y/.PEOW MICATED,NOTWRNMTANOtMG AM REQUtRMWT.TERM OR COMMON OF ANY WINTIMACT OR OTHER 0OCUJWNT VJTH RESPECT To WGM IM CERTNICAM MAY BE MSUM OR W►Y PERTA N T1M DM UPAUM AWMDED IIY TILE POU MS DESCRY HMM M M MB=T TO ALL TIE TAM$,_EXC AMONSAND CONDITIONS OF SUCH POUCMS.AGGREGATE LBWS SHOM MAY HAVE MWA REDIRED BY PAN)CIA9LS LTR TYPE OFMMURAHCE PDLlCYNUMBETL pA� DA M Ulm GENERAL LUUMLTTY EAa+occsReRe+oE S1,000,000 A X COMMERCKLGENBRALLMORM MC190022 06/24/02 06/24/03 PRDAMEs Ea $50 000 CLAM MMW ®OCCUR UMEWcAro—vim $1 000 PtRSC*ML.&JWVMJURY S1,000 000 GENERAL.AGGREGATE 31,000.000 CAWL AGGREGATE� CTM NWLIESPEk PRODU -COMPIOPAGG 31,000,000 POLICY SECT LAC EMP AUTt>Mt>EM,E L1AB47Tlf Ben. excluded ANYAUTO COdI = 94GLELWT Ir as ALL OIMIED AUTOS SCHEDU160AUTO8 ( Y s HRWAUTOS NON-OWNED AUTOS PROPERTY!DAMAGE s GARAGE L.IASnM ANYAUiO AUTO ONLY-EAACCIOENT S OTHER THAN EAACC s AUTO ONLY: AGG S EXC U MEL LA LTA8ILRY EACH OBE a OCCUR El CLAIMS MADE AGGREGATE $ oEDUCTMW Ss RETENTION S - IAr RKERSCQi LTiONAND s EMPLOYS"L"DiTY TOMLfN" ER ANY PROPRUETOWPARTARVIECUTIVE ELEACNACCIDENT S OFFICE EXCLUDED? 6�yess,,r�aibewidet ELO -EA : S7ECVIL PROVISIONS LeICMr E L OLSr�SE POLICY UWr S OTIiER - DESCRVgMOFOPE7MlUM/LOCATIONSIVEMCLESIE)OUJ JMApDEDtry fiISPBdi{LPROYISip� Swimming P0028 - installation, servicing or repair - above g sound CERT�7CATE HOLDER CANCEU ATM T0Wg0FB MOULOAm0FTftAWWE8 Pot[ McECANCELL��eFOLLgTNEL7IPYEq DA.M T"Bt6pF,TLm LMSU mv&LL L3LDEAYORTO MAIL 10 DAYs wwru J NOTICE TOTNEC8RT6TCATENOLa6t WmW TO Tt¢LEFT.LOUT FARAW TO DO SO SHALL TOM OF BARUSTABLIC RDPOSENOOIKJGATLDNORLLWUV,YOFANYtOND UPON 7WMOURETt,MAGEMOft r 367 MAIN STRL6T REPpFSENTWOML 47AMIS b% ROMESENT&TWE ACORO 25(201=) 0 ACORD CORPORATION 1969 Mar 27 03 10:23a 0000000000000000000000000 0000000000000 p.3 rn' dreh qrr--.•:n:Yi�ss of. b trrS.•�.ii::-�f.: 4� OOAM OF 8URX s RGGBfATKM • . lloee CONSTRUE"SUPERWOR J5..0. osmilsss :g Eqvirea:O&OVA 5 7r.nm 78934 Resbie9eATat OD KEM F CgWRAUGti E FAUAOUTH, MA 02MG Pe 1301 One�► � 9698 goat, Ma 02108- ne�s CONSTRUCTIM SUPS Toc 1 'CS 07W406�01tZ�i6 t KEV94 F CAVMAUM 435 WAQUOfl'HOW E FALMOUM MA.425M n�: T89C�4• i -==�z2��:r='ems_:_.-__. .'._ ........— ._ __ .r _ .. ,=Fw� --3.-r-;ems-=?--:=��•�_. _ _ -_ __.; =- .. _ PRODUCER THIS CERTIFICATE IS-ISSUED AS-/MATTER OF INFOR14fATiON ONLY AND CONFERS NO_RIGHTS UPON-THE CERTIFICATE Antonio F A�erto_Insurarsce Agency HOLDER-T}{IS CERTIFICATE-90E"d AMEND.EXTEND OR ago ssatlont Road , _ ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Fall River,M A 02721 - ---- __- COANPAMMSAFFORWNG INSURANCE.__- COMPANY A GRANITE STATE INSURANCE COMPANY INSURED Steve Senn 435 Waquok H4hway _ ___ E Falmouth.MA 0253&0000 TH13 IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN tSSIiED TO THE INSURED NAMED ABOVE FOR --- THE POLICY 1'EIt10D INDICATED._NOT WITHSTANDING ANY RE(m3EMENT.TERM OR CONDITION OF ANY CONTRACTOR OTHER - - - -- DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE WWRANCE AFFORDED THE --_ _.__-DESCRIBED-_ HEREIN IS SUBJECT TO ALL THE TERMS,OCCLUSIONS APID CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LjiMfqZ0PmR1Eropj *A _-_ = POL1CrNIAI�Bt VOUCYEFiFC7ryEDATE POLR.Yl t IDATE T LIMM -- OMITS WE � w - --- - - - -... a CCL a 320213-8 12/02/2002 12/02/20D3- ACCIDENT- POUCYLtwr $ Soo. RIPTtOH OF O TIONS/VEHICLEWSPECIAL NEW C EmpLoYEE $ 100, CERTIFICATE HOLDER CANCELLAT TOWN OF BARNSTABlE -- .. - - " - -- - - ------ -- - -- - SHWLDMYOF7iiEAsaaDgScmmpoLreggEcAnceLLWgEFopzTmF - EPRT1 OAiEIRMW ME OMMG COLMAY Wtl&MEA%RaTo MRR toI -"-E-T,-' HYANNIS,mAo261 DAYS WWMNNGVMToTMCBMWATEWXDM rO"IF LEFr.VJr FAUMETADMACSUCHHOTMSK*,LL MOSUGAT"oR_uNBUTYOF AWX!DLWMTMCOMpMy."SAGEMORt4B4MSBffAWAS. AUTHORIZED REPRESENTATIVE Assessor's ma and lot number ............. i� cF to on K ?"O THE /T,�/ IWA)t` age Permit number ....... .(llll;/� .. S ^� d �r V . MUST CT-'TO T 1 B,ARNST4DLE, i House number ......: .""""""('..............................:...... 8 Q,rjY SEWS rp „s M a, C- i„ � 'EO MAY.a• TOWN 'OF BA�RNSTABLE BUILDING INSPECTOR F ..............................................................Construct Single Famil Dwell y ing APPLICATION -FOR PERMIT TOS✓ O .• ....... .. Wood Frame ' TYPE OF CONSTRUCTION ............................:...... ......... ........ ....:.:..................:....: :,.. - r September 26, 84 19. f N TO THE INSPECTOR OF BUILDINGS: The"'under_sign:ed hereby applies for a permit according.to the following information: •ISO t # 3 2 Location .:.... :........ exin ,ton Drive .......... ............................................... Proposed. Use ....... ........ .... ........................ ........:................ ::.,.............. . .. ..... ... . .... . R. Be , Zoning District .....: ;.,:Fire District'.... ....... .... Hti}Tan21i8 : 6 Falmouth Road, H anni `Name of;Owner" Capricorn Realty �.. ...... Y 8, MasB� :......................................... °Address ... 1Vame of BuildeFranco. Rea. , Est.DeV,Co. yIn(3Address .:...,.....................................ame .. ....... ......... .... t i Name of Architect ........: ... ................. ......_......................Address ........: ..................................... ..... Six I Number 'of ,Rooms ...............Foundation ............................... P.C. Clapboard and/or Shingles Asphalt Shingles Exterior ...:. ........ .. ... Roofing . .. ... .. ... ....... Floors Carpet S @ troC I Interior .................h.. ......... ...... ......::.. .... GaB F.W.A. TwoHeating Plumbing :. Coffer Non@, A roxim Fireplace ..: :... . ...... ..: ... PP ate. Cost ...... � 404.40 ... Definitive Plan Approved''by Planning Board __ __________________ ____19__-_____. Area 40 n, ft. Diagram,,of Lot and- Building with Dimensions Fee .. _ t SUBJECT ,TO APPROVAL.OF BOARD ,OF HEALTH ' OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I I hereby agree to co6form to all the Rules and Regulations of the Town of Barnstable regardi g the above f construction. Name ... ............. .... .. ..... . . ........ ........ S.f. Construction Supervisor's License ...0.009.8.9................. i!ftRYCORN REALTY TRUST i 27052 No ........... Permit for ..O....... ne.Story........ .............. 1 .. ::Single Family Dwelling Locbt'ron Lot 32.:....54 Lexington Drive �•if' Hyannis ... ........................................ ...... . ...... 1. Owner ...Capricorn..Realty. Trust ; r' .......... . .... .................................... t n n Frame • Type"of• Construction • .. .... .................................................. .................. Plot Lot ................................ j Permit Granted ....October.:4c..............19 84 le Date%f Inspection .. ................................19 Date Completed .. .............190 ' 1 10T 3 / o S S •7�3 a.s 4 C y 1 �o ¢s L a -r- 3 z- � //� S.S4 s,F• it :.0 Z N L U T" 3 3 - , .. ,.. •. ..tel: w _ gz CERTIFIED PLOT PLAN �JZ. L�Xi/T/GToA/. Dl2ivG / ROBERT IRUCE X id /y /S NEW CONSTRUCTION ONLY t ��;�`�r eHuce +�^ TOP OF FOUNDATION IS, FEET- ELDRE IN ABOVE LOW POINT-. OF ADJACENT �' ! �o A9hS AjlLjGMAS , RAD* NO sv��' SCALE, /''=4 v 'DATEt D Of ENQ! EE /NG I CERTIFY 'THAT THE FOUi✓D64T/O/�/ cuEN� saowN 9GISTERED REGISTERED —"'�" ON THIS PLAN 19 LOCATEp CIVIL LAND JOB No 82 4-_ ON THE GROUND A9 INDICATED A" ENGINEER SURVEYORS . DR,Sys „�„-.�4 CONFORMS TO THE ZONING LAWS OF sA NSTA9LE MASS. 712. M A i N -S`f R E.r.T _. C)L AY' Z c' H Y A N td t S, MASS. y' SHEET _ A E REG. LAND SURVEYOR TOWN OF BARNSTABLE 270a2 PermitNo. -----•-°------------------------ ]PAUn.,z Building Inspector cash ------------------- — .e o OCCUPANCY PERMIT Bond ---------�--- Z__ E Issued to Capricar'n Realty Trust Address i.cpt 32, 54 Iexingrton Drive, Wann'i,s _ Wiring Inspector A Inspection date Plumbing Inspector - i\ 6 Inspection date Gas Inspector : !1f 's . *A �.T�— r Inspection date Engineering Department �':+ i�•da: 1.t7/ Inspection date Board.-of-Health��� r f -,a _ Inspection date 2, 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. ..... ... ...,... f......... .........................._................... .... ..... BuildingIns ector -r::.> ♦:. .:-,1` �. r,� JL�`•+��.,r..ti Y�rj ax f�r,:;..,,, �^F:.� ..-j�: } w r�-A^' a.. weK,Y �,..+. r �'["a 7'r�h:.. ,.sy �. .�i.:-yt:r ' lr. �".?`' ; , •,. r�A ... .% . f yy , Assessor's map and lot number :. Qyp*THE Pewage✓t�?e�r{iD^umboe�r�vE� c?r�as�M °A� J.,�, </f�8........ J/ ' Z 33AUSTADLE, i House number ......:....` ....... .�..� ..'...... k ........ .:......, 9� M6& O 39• �0 is TOWN . OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......................................Construct Single Fa.mil Dwell ng / .sir .. ..... . . . ... ........ . TYPE- OF CONSTRUCTION .........,Woad Frame ..........................................................................:................................... September 961 ............. ... TO THE. INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....Lot..:�.�..32............. .Asr .n�b'tn.r?.. ,�;•�,�,y„ u��,� .. .�n nR.,. .. :. .::........ Proposed Use ZoningDistrict ..R......B...........................................................Fire District ........Hygmii ............................::_ :a..........:...:,.... S C Name of Owner. .....P._...XA ...4T?..RR. a. f...Trust...........Address ..765...},' .II1Q.lid'ih..RQ.1di...$}T831rif.FJ.�...Zia BS• Name of BuildeVm.n.co...Real. EBt.D V.-CQ.t.y.ITAQAddress ..............,SiF�me...............:.... Nameof Architect .........................:...............:...................:....Address ...................................:.:..:.:...............:::......:................ S Number of Rooms ........... X Foundation ........P...C.s........................:..:.... . Exterior ...Clapboard..:and ;'..Shingl.e.f$..............Roofing ..............A&ph31.t...Shingles. .. ...................... Floors .....Carp@'t.................................................................Interior ..............She@'t-r4Dck.............. ..... Heating Ga.s *.......F.W.A. .........................Plumbing ............T.WD.......% ......Coppar................................. Fireplace None ......•.....Approximate. Cost $..�'Q..QOA Q.0..................................................................... ,�. ...... . i Definitive Plan Approved by Planning Board _______________________________19________. Area ..1056... .......... Diagram..of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH i - I ' I I i e OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS l I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name !r....................:. �J..• ........./� @$.• F � i Construction Supervisor's License ...pp 9.89,................. CAPPJCORM MPM,,TY TRUST A=270-101 No Fe,,,O for SM.At9rv,............... i ........................ .......S....Aq 1q.. ly.. Location ...L�t..R,.....54..X4xington.Drive. ..................BY ann is.............................................. Owner ...Q.aPKiqorn..P-ea1 F- ....... .........ty..rrust .......................... Type of Construction ...FXaM........................... ................................................................................. Plot ............................ Lot ................................ Permit Granted !? tob.er..4.....................19 84 ...... .... Date of Inspection ....................................19 Date Completed ......................................19 Es , e.