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0233 MEGAN ROAD
a `�� �- _ _ _ � �., Town of Barnstable *Permit# -s 3-�?- i y 7wl a�es;6�months from'slue date Regulatory Services Fee 0/, � , a aMAO& � Richard V.Scali,Director ✓� 6s¢ . ` Building Division . ------ ---------Paul-Roma—Building Commissioner----- -- — 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 _ _ Fax:,50. -��T�Q0-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY a y Not Va1fd without Red X-Press Imprint Map/parcel Number Property Address Residential Value of Work$-`Q d.0 e2 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address CaCCOA Contractor's Name Telephone Number - Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance ® 10. Check one: ❑ I am a sole proprietor _:K�eam the Homeowner JUN 22 ❑ I have Worker's Compensation Insurance ro Can P Insurance Company Name Workman's Comp.Policy# 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 f) e-roof(hurricane nailed)(not stripping. Going over existing layers of roo Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Properq<Ywner must sign _operty Owner Letter of Permission. A copy of th Home Imp ov ment Contractors License&Construction Supervisors License is require . SIGNATURE: Q:\WPF'M\FORMS\building permit forms\ RESS.doc 01/25/17 r 690'Wash&Van&rea ' wrvla�m�g�rQ�rfia Warlmre tapensaficn Insar2uce Afdzvit Bmldeim/C•mfimctarsMectdcau&Tlmmbers APPHcant1nfwxwii= PleasePrhd Na= Address phm� fizz- Areyou an emplayer. eckthe apprapriate bare ' Type of project(required): L❑ I azzea e�nplayervziffi 4 ❑I am a geuczdl conizsctm IndI ❑New Caushuctka employee;C Dr pact-�tme).* �hifedi a sub-coa ' 2.�'I am a sole arpartaer- Tined enthe atlarSned sheet. �- sbip and have an employee% �-�ac�nrs hafie 9-,Q Demalifion wozling faf�in any capadty of adhave wos mre 9. ❑Bui1g action jld� ' comg.iss�nce camp-�„�,�# 1 5. ❑ We are a=pozzfi=and its 1@❑Ele�-lsicai repaim or ad�as 3. azaa bomeormner doing all u*wk aim ha4e exw�ed the iL❑P3mabmgrepaim or addifitms. o 1a�s' ofama permaL my�[No ��- c.15Z.§IM andwebaveno 1'❑Roof repairs insaimmemployam[•a wodoe& 1311 other coap-kmm2m zequired-] A,W ff—t&stcbPdsbox#lmascciliasnoartth�se aabe�aars aeQwo�ceis'co�pe�atnspc g go¢t a�swboSIIb-faffii E ant MCTL rCOIISIiCi1iS$R71t d7ECVi%iCbnx 5 rtr-ftrh6d'mLSAA shed �"Mr PCf IbE sul)-C L ad stdB•9�$OfmVtt 3Eenfftkrbn-P m4duyeEs Db.utba -G**+haria Ixva anpigy a s6 I=nsrPm-&d1w 8mdm:e C=mp PGlky II=bw- Iaril art srrrplaysr Slat ispra*Bk,g markers'camper a fan in=r=w jbr ary eugAaP wm Selaw is fha pc&cy rind jab site 'PofiCyA of a�f ir�S.11C IL aD;d£- Job Site Address= Cstp/Stzf:e12 : Aftwh a ropy of the warkere camapensatiaapolic -declarahm page(showing the parity number and expiation date). Fail to semen covmmge as requimdnadr r Sec€i=25A of MM m 157—can lead to the iffipas<.kiaa of mmsmal penalties of a ime ap to$1. OO OD an&o r one-gew imprisosm=#,as well as civil penalties n*e fazm of a STOP WORK OR DER and a:ffae of up to$2fADa a&p aft the violator. Be advised that a capj•off his Weme••%uayIse far wded to the Offim of IQv - $he DIAL cavemp v on- I do hffz y� nurlsr arm gerjut}+ f1Es i far iau prat r d a/b�at�s is bars mtd correct Sina„ Date: at Phone ik O rwwil}% D-a notwrits in ffib mwv,€rt be MmPreted 5y eftp ertOWU vffyciaL City er.awa: P6rmMA-ease;9 T—in Whoridy(kircle ane): L Board of EleaM BmTdmg Deparbmcat S.CRYMOwn dark 4.Electrical hmppednr S.Pinmbi ng Inspector a&W Coaiact Person: Ph4M -- 6' �luformation waid ]Instructions . jbss7/-ITiTf.`Gi 11��Law M��• aU Tmnplay= o �1'� o �"'T C�Gtit��.1�' +� •�I"Jt;, . s �service of suoth�undrr aay f Im e, . m p this ,an e�Iop��s drfined as_ _"eve=ypeassan . eapJess ar finplied'anal or vzdtmf An P&Ym�is ddmed as�individual,pmine�,amafidi�cmparaiian a atheS IegaI e�ty,or any two or turns off c fategyiug=W ged in a Jost mabclodig flie Iegal of a deceased emplaye.or fife r=civw or try of m mdividnA paz[neaslfip,mc)ciaf m or offimIegd cmtdy,employing M=. - Howevez ffia awnrrofadweI3m�'hou=bavmgaotmorei3raatiaeeapatfinea�and who residesfi�reui,mri�eo ofthe- dweTlmg bonne of ano• =Who=plops p===to do mZMknBnc .rs,ncf acts n or repair work on such dweIImg house or on the grm=Oz or borldmg apg ffi=dn ZhRnotb=m=of sarh effiplaymeaftbe deemedtn be an employr," M(SL cbsp�I52.§25CC6)also sf es that¢eve9ry state Qr TocaT Ticeusmg agency sl;all Wrtiihold Sze issues„ or renevt-al of a Hcease or perms to operate m T}ugiaess or to inns act buadings in the commonweal$z for any applicantwlzo bas notprod=ed acceptable evideum of cdmpfiav=wn ffm ksmanmr-ovetagerequirmd-7 dffi,t-�r ,aIbr,MC=L cbapirt I52,§25dM SW=-Nc&L sr fbe nor gay off POMIcal subcTisians , shaI1 eater into any cqntcadfor-ffimperffi=MnCd ofpnbliowDikuntilarcepfableevidenceofcompiian=wnthere >nsm� . Mffs ofthis a pfiEsbavet;a pimae rdto life cmtadmg:a3tTioity AgpIicafzts Please fill oi± the worlo;es'=np=L�zeon affidavit compylety.by checWhg fhebm=that apply to your Oman md,if n=msg,Y,amply sub lrador{s)nm e(s), des)and phone,rmmberCs)slangwxhffi it ems)of ice. L=ntedLiabMjy compmmes(SC)orLmntedLmbility Part=hips(LU)•vi&na =qpIoy=oIL=f m the m n,h,=or pazfnexs,arenotrbqoired fn carry camPensalion finmim a. If an I LC or ILP dDesbane employees,apolicyisr=pfted- BeadvisedfifatfhisafEdeNtmaybesabmiiDdtothoDepaLtneutoflm&stdd Accidm s for coffin of nice covmmge Alm bo sire to sig m and dafe are afSdayit Tba affidavit should be�tnmed to$e city ortivym >atfhe app�aa forthepa-4 or licease is beingrequested,notthe Depatimeaf of • ' hdast i .A=id=t5- gmuldyou b m=Ly qaesdans r6gmiliog the Iaw or ifyou are reed fn obtain a worlkrs' czzapmsatim poficy,please ca a the Depatfm eut at tba amber 1 step below Self-i==d companies shouId euzr .their ce Howse inmber aa.fhe Ime City or Town Officials Please be so¢e fat the Efadwitis"let-.andprtntedlegibly- The Departmenthms provided a space at fife both= ofthe affidavit for youto fill Dot in the evert the Office ofhMmfig-atioas has to codai-tyonregm-amglie apPhcant. Pleascbesmet,,fMi f..putt/IiceaseamnbmwhichvMbeused.asaimax=m =bm Inaddaion,aa.agpltcaat flfai:mast sabrait mu410 pemtT-,ram+.=spphtans m my gives.year,need only s-abit=affidavit kAicatiag cm=t policy mf m at m Cif ne�ry)and mid="T �Aob d( s 13±e applic�should v�-all'GMfi=s in Cry or town):'A copy of the-affdr&ffiathas bca ofdd&By stamped ormm3mdbythe city or to Mc ay beprovided in the applicant as proof that a 4affd affidavit is on file for foix¢e'p®ifs or 1icerses- A n6w af2dmvkMML t be fide aiot earJi notTelmindin b year.V1lieae alfome owneg ar cifizra is obtaining aTicense or permit say nc;T,es or cotama�a.c Ttzt= " Ci m.a dog Hccose orpcmit to bum leavrs eft-)saidp�an is 110T r d to Mete tTfis affidavit Tho Office ofTnveSfig1dim WOudlflo',to fl'=kponmadrmcc for your coopma ion and sbaaldyonhave any gmcstims• please do noth=&ftto givens a call" The De pmtnmes address, and Dmmt afliftEfdal A T�L 617-727-4 czxt4.06 or 1-9 IMSATE Fax#617 72"-'74 Revised¢24-07 II . f Town of Barnstable L'? Regulatory Services pIP Richard V.Scali,Director Building Division t Paul Roma,Building Commissioner MAM 639• �� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax7 508-790-6230 HOMEOWNER LICENSE EXE1Vff'I'ION DATE: Please Print /mil�0 'l 1 / JOB LOCATION: _ �p��/)�/_S A O ZiSo l umber JJ (sheet village "HOMEOWNER": name /y me 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 buildingpermit (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 ersigned"ho caner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection pro ores and re ents and ffip He/she will comply with said procedures and requirements. goffiaue of Homeo er 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 helshe understands the responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. QWPFLL.ES\FORMS\budding permit fonns\EXPRESS.doc 06/20/16 ToWn of Barnstable Regulatory Services M ` Richard V. Scali,Director. Building Division. Paul Roma,Bnilding Commissioner 200 M&Sheet,Hyannis,MA 02601 www.towmbarnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 tt Property Owner Must Complete-and Sign4This Section, •r \' , If Using A Builder C T ,as Owner of the subject property hereby authorize to act on,ray behalf in all matters relative to work authorized by this building permit application for: (Address of Job) "Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized befort fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMWWNE"MZNWSIONPWIS t++e rq . Town of Barnstable Build° i i <„,. gym '!' '� ri` .> Reta�nedonSL b:a dth�s Ca,rd-Muste:,Ke t •. �.' = .- .,_: _Fr rn th .Street,..A roved,Plans IVlust ,,e,, .. ,. n;,. ,, �<, . P Tht3 rd S .T.ha rt�su s ble ,, - E .. �. h.o,, pp rAFt2�I8tA(�3.'�:'::: .�,. ,. ..., '. ,,.., .._.,. ,.,.,... ,... .�., ,.,, .,,... • H,.r.. ,,,. ::-: .., ..,. � v,... ..,.,+ , ,.',. '..° •.arc .: ;: s. :Made. ,, , ..r �.,�3.,, ,, � .,, ,.,. .,.. ... � ,_ osted..Until:,Flnal-,.Ins ectlon,Has Been. nm R ° here a,Gert�f cate�of=.Occu a�ic is;,Re wired such�Build�n shall Nit be Occupied ur�t�t�;E{nal In pec�ton'has bee,, ade �:; ; Permit NO. B-17-1533 Applicant Name: Elwell Perry Approvals Date Issued: 06/05/2017 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 12/05/2017 Foundation: Location: 233 MEGAN ROAD,HYANNIS Map/Lot 291 244 Zoning District: RB Sheathing: ��. Owner on Record: MORELL,LORAINE L&MARTINEZ,JONATHA 4 Contractor Name. Elwell H Perry,Jr. Framing: 1 Address: 233 MEGAN ROAD r Contractor Ucense CS-104088 2 HYANNIS, MA 02601Est Project Cost: $3,773.00 Chimney: Description: AIR SEALING. INSTALL 14"CELLULOSE TO 11Z6'OPEN ATTIC. INSTALL Per 1 Fee: $85.00 1 BATH FAN HOSE W/ROOF MOUNTED FLAPPERFNSTALL 64 PROP-R- Insulation: VENTS. INSTALL(10)4"X16"SOFFIT VENTS Fee Paid: $85.00 Final: Date 6/5/2017 Project Review Req: AIR SEALING. INSTALL 14"CELLULOSE TO 1176'OPEN ATTIC ` - INSTALL 1 BATH FAN HOSE W/ROOF MOUNTED FLAPPER �. �, E r GG� y- - Plumbing/Gas INSTALL 64 PROP-R-VENTS. INSTALL(10)4"X1'6"SOFFIT VENTS vf�� Rough Plumbing: s51 3 l Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work a6fh6hzed b this permit is commenced within six months after'issuance. P Y P Rough Gas: All work authorized by this permit shall conform to the approved application and theapproved construction documents for which this permit has been granted. and changes of use of an building and structures shall be in compliance with the local zoning by l' d codes. All construction,alterationsg y g P .; _ Final Gas: from access sYreut or,roa::and shall be maintained open for` ublic ins j ction for the entire duration of the This permit shall be displayed in a location clearly visible P p P,,,. Pi �>. work until the completion of the same. w P : f ��. � Electrical illThe Certificate of Occupancy will not be issued until all applicable signatures by theBu Idmg a Fire Off icials are proviil ded onth `permit. Service: Minimum of Five Call Inspections Required for All Construction Work: ' 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: .: .. : . ':'Persons contracting with unregistered,contractors-do,:not.have'access to.the,guaranty fund",(as set,forth in:MGL c142A). Fire Department Y Building:plans are.to be available on-site Final: All Permit Cards are the property of the APPLICANT ISSUED RECIPIENT Town of Barnstable F. z �� N 200 Main Street, Hyannis MA 02601 508-862-4038' ; Application for Building Permit Application No: TB-17-1533 Date Recieved: 5/17/2017 ' Job Location: 233 MEGAN ROAD,HYANNIS � W r Permit For: Building-Insulation-Residential Contractor's Name: Elwell H Perry,Jr. State Lic. No: CS-104088 Address: Acushnet, MA 02743 Applicant Phone: (508)992-5770 (Home)Owner's Name: MORELL,LORAINE L& MARTINEZ, Phone: (508)360-8038 JONATHAN M (Home)Owner's Address: 233 MEGAN ROAD, HYANNIS,MA 02601 Work Description: AIR SEALING. INSTALL 14" CELLULOSE TO 1176' OPEN ATTIC. INSTALL 1 BATH FAN HOSE W/ROOF MOUNTED FLAPPER. INSTALL 64 PROP-R-VENTS. INSTALL(10)4"X16" SOFFIT VENTS. Total Value Of Work To Be Performed: $3,773.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Elwell Perry 5/17/2017 (508)992-5770 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $3,773.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 5/17/2017 $85.00 XXXX-XXXX-XXXX- Credit Card 4419 :.............................................................................................................................................................................................................................................................................................................................. Total Permit Fee Paid: $85.00 Town T B L of Barnstable a Bull ding F'r;.. f ,��: _ 1 From-th tr t�-_A r ved Plans-.Must,be Ret med o,n,=Job�and this Gard....ust be,-... .. .. ., .PostThls Card�So�That rt is Visib e S ,eg _-. o ,_ s a M, ..... t in Pvn3 osted Until F nal Ins ection.Has B, en,.Made..,. w.. a i� . p e s6 u s «„ w.Rr 'ateof:Oc a ane, �s e.'u�re ch 6. ldEn shall Notbe1Oc u'1 d u:n al;a'Final Ins AV M�Ilullll .ection ha �.1 1 Permit No. B-17-1543 Applicant Name: Carl Rebello Approvals Date Issued: 06/05/2017 Current Use: Structure Permit Type:, Building-Insulation-Residential Expiration Date: 12/05/2017 Foundation: Location: 14 MARSH LANE,HYANNIS Map/Lot 324 013 Zoning District: RB Sheathing: Owner on Record: DAVIS, LYDIA J TR �$ Contractor Name Carl J Rebello Framing: 1 Address: 14 MARSH LANE Gontra'ctor Lice se ._CS-084358 HYANNIS, MA 02601 . Est ProJectCost: $3,084.00 Chimney: Description: Attic insulation and air sealing. �., Permit Fee: $85.00 Insulation: Project Review Req: Attic insulation and air sealing. Fee Paid: $85.00 6/5/2017 Final: s py Plumbing/Gas RouglRough Plumbing: it l Buildin Official g Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorlied]byythis permit is commenced within s1%months of erlissuance. Rough Gas: All work authorized by this permit shall conform to the approved appl caLon and thelapproved construction documents:f& Jich this permit has been granted. i All construction,alterations and changes of use of any building and structures shall%be in compliance with the local zoning by lawsand codes. Final Gas: This permit shall be displayed in a location clearly visible from access street� a rX,od and shall be maintained open for p IIc ni spection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatur'es by ihi'�.i'gbildi'hgiiiia;Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work } ; 1.Foundation or Footing ���° Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting:with;unregistered.contractors do not`have access to,the guaranty fund" (as set forth,in MG c:142A): . Fire'Depar'tment ' Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT I,f .�a �. �o�s1i7 �/►�� S G•JT Town of Barnstable 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-17-1543 Date Recieved: 5/18/2017 Job Location: 14 MARSH LANE,HYANNIS Permit For: Building-Insulation-Residential Contractor's Name: 'Carl J Rebello State Lic. No: CS-084358 Address: Swansea, MA 02777 Applicant Phone: (508) 567-4109 (Home)Owner's Name: DAVIS,LYDIA J TR Phone: (508)957-2167 (Home)Owner's Address: 14 MARSH LANE, HYANNIS,MA 02601 Work Description: Attic insulation and air sealing. Total Value Of Work To Be Performed: $3,084.00 t Structure Size: 0.00 0.00 0.00 Width Depth Total Area 'I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the,Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Carl Rebello 5/18/2017 (508)567-4109 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $3,084.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 5/18/2017 $85.00 Paypal _ Paypat ...................................................................................................................................................................................................................................................................................................:...................... Total Permit Fee Paid: $85.00 i z -/t o/LTG �,. .�v-.....-..r.-�.�•._...-�.�._..-.�....�-..�..,.-.......'_•�-•yam .r-^-•-_�_�.r..ti .., ti......,,a-�..,. -.�.....--�.,... �..,+"'�-...-.�•�•..••.--..-r- ,...._•<-� �... .� -y_. .�_�,.1,....,� Assessor's map and lot 'number I }ST BE sa COMPLIANCE Se Sewage.Permit number ... ..... ...................................... .. :.. �e'1TI AST;CAE 18 �S ATE. a , ` SANITARY CODE AND TOWN Tf oF QyOfTHETp�y TOWN OF., BAR \ STAN i BAHH9.TADLE - 9 YA86 •�` r2 r� , •1 * t ° oapYae� DUILDING INSPECTOR ff: f APPLICATION'FOR�;PERMIT TO .......... .. ... . . �................. ��..... , i. TYPE OF :CONSTRUCTION .. . .. ........ ........................... ................. 7 ` ..... ..........................19...... . TO THE INSPECTOR OF BUILDINGS: The undersigned •hereby appli s for a permi according to`the following information: Location ....... .............. .. .......................................... Proposed Use - .......... z ... . ........ ......... ... .......................I.................... ..... Zoning District .1..`.........C,..... ................... .. ..................Fire District ... . ... . ..1 �1��`�'......................... 4aw4 Name of Owner (� ............... ....... ....Address ly �-....................................e ... n .................... 9 ...............4 Name of Builder ................................ ................Address ........................................... ..................^.... Nameof Architect .......'..........................................................Address .....`............................................................................... f/ Number of Rooms ....... ...................................:... .............Foundation e.0. ........... . ....... ,�..c . .. . ...... Exterior .. ............ !......................Roofing .....10-4.0..........a..... .. . . ...... ....................... Floors //.....................................................................Interior ......... .. - Heating ......../..........i9 r.��..............................................Plumbing ......../........................................................................ Fireplace ......... .......................................................Approximate Cost ..r�. 7.�/ ........................... Definitive Plan Approved by Planning Board _ ----- ------------19-- Area ..............�72— /� 4..... ...: ...... ------.� .. Diagram of Lot and Building with Dimensions Fee C�-`?.. ............... SUBJECT TO APPROVAL OF BOARD OF HEALTH t ©(� � Esc N 9 L.0 N Joo I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable rewarding the above construction. Nam ........................ ................... ...................... Dacey, William E. No ....17232... Permit for ....one story, ......................... single family dwelling ............................................................................... 7 4�I Megan Road f Location ................................................................ Hyannis ... ......................................... Owner .............Willi.......... am ........E...... Dacey............................ frame �``►, -- c Type of Construction .......................................... .......................................................... .................. • Plot ..........................<. Lot .......#18 ......................... • Permit Granted ........Tu1y..26. �. 74 O +••'" ' Date of Inspection ..... ..1 .. .....� � Date Completed s PERMIT REFUSED "t ,! ....................................... f ,e ��,• ..... ............................................ ......... . x ......................................................... ..... - ., ....`................................................ ..•• .......... . •�T} Approved ................................................. 19 ............................................................................... .......................................................................... i� Assessor's map ,and lot number ......... ..........................1—�.. -• C8 3TBE INSTALLED IN COMPLIANCE ;Sewage .Permit number ..... ......:.... X -sr�r, WITH AR 8� .E II STATE SANITARY CCbE AA O-TO ", •. Y{ - �QyOFTMEt��o TOWN OF BARNS ' E r SBBA ,9TADLE. Q M�a BUItD:IHG INSPECTOR �p z639. 00 �MPYa\ Y: ID APPLICATION`FOR'PERMIT TO � ... ................... r TYPE OF CONSTRUCTION ... `... .......... �J'K ........:..................(. .. .��.. . .. /...�.. `. ......?!. ...........19....... TO THE INSPECTOR OF BUILDINGS: The undersigned ereb applies for a permit according to the following information: Location ..... ....... ....................... . . ......... ............... ....... :....... .. ... .. �.i..... ... ..���..................... ProposedUse :. n ....... .................................................... ZoningDistrict ......... .. ........... . ..............Fire District ......... �' .................... y. . ....... . Name of Owner ...:..........`.. :. .. ..... . dress ��...................... ......... .. r. Name of Builder r................ ......Address .................................................................................... Name of Architect ..:...0....... f .Address . Number of Rooms ..............45................................................Foundation Exterior .. . .......Roofing .... �/ ........ .... .............................................. Floors .......... ............C .............j.........Interior .. ...... ........ Heating .....,(. / /1 .........Plumbing Fireplace ........................................................Approximate Cost .....iO�- ..�................................... Definitive Plan Approved by Planning Board __________________ ___________19 Area fi..!.. s ......................... Diagram of Lot and.Building with Dimensions / ..................................... SUBJECT TO APPROVAL OF BOARD OF �EALTH � 3 � IN • . CIUr. . I hereby agree to conform t a all the Rules and" Regulations of the Town of Barnstabl r garding the above ! ' construction. Name .. .. ......1.......... ..... Dacey, William E. 17234 one stor No ................. Permit for ......................Y..*.......... 1 sin le famil dwellin ' Location .......Megan„Road.................................. ... Fi annis , Y................. f ` William E. Dace~ • Owner .................................... ....Y................... f� h � f ' f f Type of Construction ...........fr...........ame.................... ................................................................................ t r.. %j%s 4 Plot ............................ Lot .....#2.0........ ........... elf '''�'� ►�"' �� ,l"� 1� j r Permit Granted ...........July aV �19 74 Date of Inspection ' Date Completed /�&Zex 99" " PERMIT REFUSED :• # t` ...................................................... . 9 a ,X 10 ..... . ..................................... ..f!'!............ tyx y ' t1 . i ` , Approved ..,.......................................r....... 19 .......'............ ......................................................... .................... ................................................ ....... e 3 ' � .t... ..e ...!Rio-- ..- .« J . r .,..r. ..... ... ... ... .. • . .. Assessor's map and lot number ....21 /" `'v/�t — / .21................................. %. Sewage Permit number .................?... ......................... °fT"ET° TOWN OF BARNSTABLE Z BARBSTOBLE, i "b 9 D NPY p' BUILDING INSPECTOR � ' APPLICATION FOR PERMIT TO ........... .......... .......................... �.p�.!ll..... ....... .... ................................. TYPE OF CONSTRUCTION ........./ ......... -r- .�i? ...::........_.............................................. aC.. .... ...........19.. 7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby/, applies for a permit according to the following information: Location ..... .. ( ...................... ....... G?_� ..... .�.��-�jE'�1'��................... - Proposed Use .... .......:.. .......��!�.f/L ..:�. 1......... ...................................... Zoning District ......... . ......��:7...... ............ ................Fire District ........o..j. .. � - .... Name of Owne`��v� ^� " .:.. . .u° .... ...jddress �1��1.................... ............:..y.�;".. i � Nameof Builder / ....................................�............. ................Address ................................................................ Nameof Architect K' Address........................................................... .............................................................................. . Number of Rooms (' ................................................Foundation ./ ........... w..V......................................... ��'� Exterior .....<�.................... �.........:.......................... .........Roofing .....,. -?/� �/t..��:� Floors / ............ .................... Interior .................... Heating ...... ..........Plumbing ........ .................................................................... Fireplace .........................................................Approximate Cost ..... v...... ................................... / —7/ Definitive Plan Approved by Planning Board -`__ ---------19 - Area ............................ Diagram of Lot and Building with Dimensions d Eee............ ............................................. IN SUBJECT TO APPROVAL OF BOARD OF 1EALTH It r-2X _ I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable-'regarding the above construction. 4 � Name .. ......... .................... ........... / ................................. Dacey, William E. 17234 one story No ................. Permit for .................................... single family dwelling ............................................................................... Locati ?JJMegan Road ................................................................ Hyannis ............................................................................... William E. Dacey Owner .................................................................. frame Type of Construction .......................................... .............:.................................................................. #20 Plot ............................ Lot ................................ Permit Granted .........July..25...............19 74 S Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... Town of Barnstable Regulatory Services o Thomas F. Geiler, Director T Building Division LAANSTA13M + q 1MASS. m� Tom perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862--4038 Fax: 50 9 - 30 Approve , . Fee: Permit#: 0 . D ,._ HOME OCCUPATION REGISTRATION D ate: t U 0 C Name:. 1— -4 ywm au 7i Phone lt: J `f -(.J3 Address: G C✓�_ Village Name of Business:_�Imb R� - TE U 1/i_��,� L�e C + G L:r_cT&o-nLc9 14-�J D `1'ype of Business: C � '_��fLMap/Lot: 1N III': It is the intent of this section to allow the resid(,nts.of the Town of Bamstable 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 tamed on by the permanent resident of a single family residentia1dweRing 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 xrbt involve the production of offensive noise, vibration,smoke,dust or other particular matter,' odors, electrical disturbance,heat,glare,humidity or other objectionable effects, •' There is no-storage`or:use of toxic or-hazardou$materials, or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be mc1o' n 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•aot�ta•exceed•out,tonzapacity, and one trailer not to exceed 20 feet in length and not to exc�d 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, have read and agree with the above restrictions for my home occupation I am registering. 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 firstobtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office the Business Certificate that is required by,law. , 1'' FI., 367 Main St., Hyannis, MA 02b01(Totivn Hall) and -et b eri Fill in please: DATE: G / APPLICANT'S ,/��� YOUR NAME: (U `TJ" w, r W BUSINESS r r YOUR HOME ADDRESS: e TELEPHONE # Home Telephone Number: r� NAME OF NEW BUSINESS /VI -r CC L GCS �L TYPE OF BUSINESS \� IS THIS A HOME OCCUPATION? Have you been given a V YES NO Y g approval from the building division? YES NO ,,(( ADDRESS OF BUSINESS 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 li town. censes required to legally operate your business in this 1. BUILDING COM ISSIO R'S OFFIC This individ dal h s b i,Rfor e of an p rmit requirements that pertain to this type of business MUST COMPLY WITH HOME OCCUPATION Aut ized Sign a**COMMENT RULES AND REGULATIONS. FAILURE TO COMPLY MAY RESULT IN FINS: 2. BOARD OF HEALTH This individual ha n i rmed of th�/C it r ents that ertain to this type of business. Authorized Sig ture** COMMENTS: 3., CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual ha infor the lice in re ire � ts that pertain to this type of business. Aut rized S' nature— CO MMENTS: Town of Barnstable Regulatory Services �THETp�O - 43V41'S B k!N Thomas F. Geller,Director s]'AB€.E Building Division ZQppNSTAB BAR v MASS, g Tom Perry,Building Commissioner s6Jq. .m QED MA'S 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us �`"'`----_. Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: 5— Permit#: r;?Gb�d�34o� — HOME OCCUPATION REGISTRATION Date: O( O q � d Name: F Jae lV (W Q"C) I V-` CZU hone#(sz . ) 2`t'6^6 9,4_3 Address: 1 V`P C(.VL Village: Name of Business: Type of Business: +t,t ►'1 +I D5�v Map/Lot:_ l 7 G/ INTENT: It is the intent of this section to allow the residents of the Tonarim of Barnstable to operate a home occupation v«thin 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 d«•elling: 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 um traffic above normal residential volumes; and no increase un 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 writhin 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. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,um 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 Arithin the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one v:um or one pick-up truck not to exceed one ton capacity, mid one trailer not to exceed 20 feet in length mid not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicatung 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 wdno„is not a permanent resident of the dwelling unit. I,the undersigned have read and agree with the above restrictions for my home occupation I an registering. Applicant: X1(/W)X Date: ® 6. 0 Homeoc.doc Rev.01/3/08 YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS THE BUSINESS NAME in 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, 15Y FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by.law. . Fill in please: Date: Q whtgg�,,r APPLICANT'S NAME: i�%' C,�C -- Y UR HOME ADDRESS: 01 'C - 1503 P� USINESS TELEPHONE # HOME -El ELPHONE #: �a,,tsar i 3 04 NAME OF CORPORATION: NAME OF NEW BUSINESS �.; TYPE OF BUSINESS IS THIS A HOME OCCUPATION?_�!� YES NO ADDRESS OF BUSINESS P 3a ML 0-frt3 ' r—bAD .- WjAP N LS MAP/PARCEL NUMBERAI (Assessing) When starting a new business there are several things you must do to be in compliance with the rules and regulations of the Town of Barnstable. This form is 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 town. 1. BUILDING CO ONER'S OFFICE This individ al en-inf d any permit requirements that pertain to this type 91WO IPLY WITH HOME OCCUPATION ,,,WXu orized Sin rej A COMPLY MAY RESULT IN FINES. COMM NTS: 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature"' COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature" COMMENTS: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# �y0 Sc� Health Division Date Issued Zy Lo o _ Conservation Division Fee '��, -D—o Tax Collector '"` Treasurer WA A I �too Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address k ?3 f r— 1�,Q A) / 4, (C�c�y � �ZO Village )QLlh Owner lk CIE d� Address �AWL Telephone " 71— 096& Permit Requestf�'Y)(Z(/F A re G) A � �— Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost Q06 Zoning District Flood Plain Groundwater Overlay 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: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION C Name Telephone Number Address 66 License# ���3c� re � Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE J DATE f r FOR.OFFICIAL USE ONLY , PbRMIT ISO. F DATE ISSUED , MAP/PARCEL NO. ADDRESS z VILLAGE ; OWNER= i DATE OF INSPE N: FOUNDATION «FRAME t INSULATION FIREPLACE + ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT .. ASSOCIATION PLAN NO. ? f —_ r/YtG UJ [►lU.)�u�r�ta�t a�► Department of Industrial Accidents ?� -= Office olfolyM911005 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: �l7 CZE—Ai AoIr S7/s3D/y(�z-. location: Cu Z3 /0 LOIA AJ kd city / `t /J A)/yJ\S nhone# ❑ I am a homeown r performing all work myself. ❑ I am a sole rietor and have no one working in anv capacity /%O/%////ME, I am an employer providing workers' compensation for my employees working on this job /'� , ....Q company name: V ( .......7r (�/E` o address.. ,::� cites f1D!) /I�( nhone#. t.{"'f < r insurance co. � olicv 1 1 IM ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name: address. .:. . . _. .... . .. . ... .:.:. . ..::::: city . ,:. <phone#:: .:.:.. ...........:.::.:.. . X. _._....................................._...........::::..:::. ;:.;;: ....... .:... ....<.... ...., .. nsnrance co:.:.;: ,. ,.:... :.: ll�i///i cbmnan name .. address. ity phone#: :::.:.:. . ... ... :.. nsnrance co:.;: . ollcv ; Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to 51,500.00 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 Investigation of the DIA for coverage verification. I do hereby certify under the pains mid penalties of perjury that the information provided above is trw and correct Signature Date Print name L. Phone# oiHcial use only do not write in this area to be completed by city or town official city or town: permit/license# • ❑Bufiding Department ing ❑checkif immediate response is required ❑Sele tut Board ❑Selectrnen's Office _ ❑Health Depuilneat contact person: phone#; ❑Other (rmW 9/95 PLU Or The Town of Barnstable srABM A.XAB Department of Health Safety and Environmental Services rED MA'S Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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. Type of Work: "� — Estimated Cost J Address of Work: O�I, �q) /i d y� 0/0 )01U Owner's Name: XY L/ eM S'LPp,�)�_',� Date of Application: Jz� 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 „E]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 age of the owner: Date Contractor ame Registration No, OR Date Owner's Name q:forms:Affidav .. CERTIFICATE OF LIABILITY INSURANCE 0B/I1/� PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Me71;tOrS b Servant, Ltd. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 5700 Post Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 1158 East Greenwich, RI 02818 INSURERS AFFOFiDINGCOVERAGE INSURED INSURERA:Transcontinental Ins. Co. (CAA} Paul J. Cazeault & Sons Roofing _ ._._.__------•----...----._ ----_--_-.-_-•--.-------......._...---...__.__ ......._. _.._. INSURER B: _. INSURER C: _ IN(i 11HFH O: INSURER F: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTH[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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. INSN POLICY KFF FCiIVE POl17;V E7(KK"1ON LIMITS _ LTR TYPE OFINSURANGE POLICYNUMDER ATE MM 00 DAtE[MMIDONYI A GENERAL LIABILITY C180024822 04/30/99 04/30/00 tACHO(-,CUHNFNGt Sl,.QOO,000 X (:()M MtN(:IA 1.(:tN FHAL I_IANILIIY FIRE UAMA! t(Any unehre) S1OO, OOO -_---I CLAIM ,S 7 MAOEI_?(j OGCUR MFO FXP(Anyunepem-) S5 0—OO X PD Deli: 1 , OOO PFRSONAI AADV IN.IIIRY S1_L000� 000 (i ENEHALACiGHE(;AiE 12,000,OOO [iFN'1 A(i(iHF(iA117IIMIIAPPIIFSPI-H: PHOOl1GIS•COMP/OPAlifi 121.0001_.0.0.0„ PRO.. Vol ICY X ,IFCI __ LOC AUTOMOBILE LIABILITY (;OMHINN)SIN61.FLIMII S (Fn ecciden I) ANY AUTO At OWNH)AU105 HOUILYINJUHY S (Per person) SG/IFI)ll I,F.-I)AU IOS ---- IIIHF.DAUIO;i HUOIIYIN.IIIHY S (Per scddeni) NON-OWNED AUT03 -- PHOPFHIY DAMAGE S _._...._..................--- (Per aGadenq liAllAli L-LIAUIIITY AU IO ONLY-FA AGGIDFNI S ANY AU IO - OTIIFR TI IAA FA AGO; S Al11OONLY: Arita S EXCESS LIABILITY EACH OCClIH11ENCE S - OGGUR l GI.AIMS MADE AGGRFCiATF S S S OFOUGTIHIF ...._....__.........._.__..._._._.... __._...._._. . ...... _ . . x HFIk-NIION S A WOHKER9C0MPENSATIONANO WC199413744 08/09/99 08/09/00 X iylCivTMii, �U EMPLUYEn5•LIABILITY F.L.FACHACGIDF.NI SlOO OOO E.L.013EASE EAEMI>LOYEE S10O O00 FA.DISFASE POLICYLIMIT 600,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BYENOORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOU LOANYOF THE ABOVE DESCRI BED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR 10 MAIL3- DAYSWRITTEN NOTICETO THE CERTIFICATE HOLDERNAMED TO THE LEFT.BUT FAILURE WDOSOSHALL IMPOSE NO O B LIGATION OR LIA BILITY OF ANY KIND UPON TH E INSURETIAS AGENTS OH REPRESENTATIVES. AUTHORIZED R EPR ES ENTAIIVE ACORD 25-S(7197) N S 8 2 8 9 4/M8 2 8 9 3 BAM 0 ACORD CORPORATION 1900 I I HOME IMPROVEMENT CONTRACTORS REGISTRATION I Board of Building Regulations and Standards One Ashburton Place — Room 1301 Boston , Massachusetts 02108 I ----------------------------- HOME IMPROVEMENT CONTRACTOR I 07. �,� Registration 103714 Expiration 07/09/00 Type — PARTNERSHIP I HOME IMPROVEMENT CONTRACTOR I Registration 103714 I Type - PARTNERSHIP PAUL J . CAZEAULT & SONS ROOFING I Expiration 07/09/00 I Paul J . Cazeault 22 Giddialt Rd . p.a. Box 2781 I PAUL J. CAZEAULT 5 SONS ROOFI Orleans MA 026S3 I Paul J. Cazeault q liddialt Rd. P.O. Box 279 ,,,,,sTRnTOR Orleans MA 02653 AIM Board of Building Regulations F - One Ashburton Place, Rm 1301 Boston, Ma 02103-161 R License: CONSTRUCTION SUPERVISOR LICENSE ✓ � � °��' `d1bC°e Number: CS 026325 Expires: 10/20/2001 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 026325 Birthdate: 10/20/1959 PAUL J CAZEAULT Expires: 10/20/2001 Tr.no: 7665 1585 MAIN ST OSTERVILLE, MA 02655 Restricted To: 00 PAUL J CAZEAULT 1585 MAIN ST (� OSTERVILLE, MA 02655 Administrator