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0265 MEGAN ROAD
c��v 171 e a r _ _ _ 1 r BU1�D�NG DEPT. MASSACHUSETTS PROPERTY]NSU RANCE UNDERWRITING ASSOCIATION pE� 13 2019 Two Center Plaza Boston,Massachusetts 02108-1904 T01�111� OF BARNSTAg�E (617)723-3800 Ma Only(800)392.6108,FAX(800)851-8424 12/11/2019 Form of Notice of Casualty Loss to Building - Under Mass.Gen.Laws,Ch.139,Sec.36 BARNSTABLE BUILDING DIVISION 200 MAIN ST r HYANNIS MA 02601 Re: Insured: LAWRENCE M NOTARANGELO Property Address: 284 MEGAN ROAD,HYANNIS, MA 02647 Policy Number: 0955031 Type Loss: Fire(including Fire caused by Lightning Date of Loss: 12/09/2019 Claim Number: 444711 Claim has been made involving loss,damage or destruction of the above captioned property,which may either exceed$1000.00 or cause Massachusetts General Laws,Chapter 143,section 6 to be applicable. If any notice under Massachusetts General Laws,Chapter 139,Section 3B is appropriate,please direct it to the attention of the writer and include a reference to the captioned insured,location,policy number,date of loss and claim or file number. MPIUA Claims Division I CMA00021 k l �t�r� Town of Barnstable- � *Permit#off/® 00W93 '4p Expires 6 3XIS om issue ate Regulatory Services Feee * BARNSTABLE, v� MASS, `0 Thomas F.Geiler,Director QED MA'I A Building Division Tom Perry,CBO, Building Commissioner l 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address 12 U/51, �C � a PA? om U&/esidential Value of Work ol� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 06 1y i)G '4_ ¢ 014-Awe N n7 4 lr/,P 1 Contractor's Name ��'! Telephone Number Home Improvement Contractor License#(if applicable) I oe'3 y0 m Construction Supervisor's License#(if applicable) S �' Ekorkmah's Compensation Insurance Check one: ® El am a sole proprietor EC 19 ❑ I am the Homeowner 20�? [�] I have Worker's Compensation Insurance ro Insurance Company Name, 4 JS0 L/4-'e"rf` E& 1p ef kC j_AcAft 4 k) c G �61� �Vj 6 f a�, RNSTgB� Workman's Comp.Policy# F 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 #of doors Replacement Window door /sliders.U-Value d' 6 (maximum.35)#of windows "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 required. SIGNATURE.. C:\Users\decollik\AppD \Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 Page 7 of 7 Capizzi Home Improvement Inca .Specifications and Estimates STATE OF MASSACHUSETTS :LETTER OF AUTHORIZATION TO APPLY:FOR A BUILDING PERMIT I, OWN THE PROPERTY LOCATED AT S �� IN MASSACHUSETTS.. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO.ACT AS MY AGENT`TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE:WITH 780 CMR,THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FORA BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS.STATE BUILDING CODE: SIGNATURE'OF OWNER'S ADDRESS:. _ . OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: µ SIGNATURE: . APPLICANT'S ADDRESS: 1645 Newtown Rd._, Cotuit, MA 02635 APPLICANT'S TELEPHONE: 508,428-9518 - -- RESPONSIBLE OFFICER`. RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: f AA Massachuse! s -Department of Public Sa" Board of SuOding Reg-Wnttora,and stanB wds. Coattructuon Sperms or i Lg_—es s C 6M7 t$AFN AVE � s &txzoacts Rai�1�0 ; Expsrion `• Cnra as�a ate. 11&J2014 Umee or L•oasat¢er Asters nassness rtgwautm LtCeitSC or rts�[aEtuu Yalu ter.unasriuut uoc only C1"E IMP ROVE tEWCANTRACTOJt before the exoration date. If found return to: F egfstration;0(' -. _ . . Office.of Consumer Affaf s and Business,. Type- 10 Para R�Wal, a-'Suite 5170 l r� =S,► ;Supplement Card Boston,MA 02,16 CAPI72!HOB * P' vt E JOHN STRUMS V .-r---'� 1645 Newten Rd. - ' COW,MA Undersecretary— Notat sigaatnre. i = I The Commonwealth of Massachusetts Department of Industrial Accidents = Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):Capizzi Home Improvement Address:1645 Newtown Road City/State/Zip:Cotuit, MA 02648 Phone#:508-428-9518 Are you an employer? Check the appropriate bog: Type of project(required): 1. ✓❑ I am a employer with 40+ 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.ElI 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.❑ R of repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13 Other' (J� comp. insurance required.] .eXf lie Any applicant that check box#I 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 is providing workers'compensation insurance for my employees Below is the policy and Job site information. Insurance Company Name:Associated Employers Insurance Company Policy#or Self-ins. Lic.#:WCC5010 547012011 Expiration Date: 12/25/2012 Job Site Address: C�d �j'�'� City/State/Zip: 2#vwlmi-1 Attach a copy of the workers' compensation policy declaration page(showing the policy numbe 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 DI r insurance coverage verification. I do hereby certify nder he pains and enalties of per'ur ' formation provided above is true and correct Simature: Date:_____ L ZO z Phone#. 508-4. -9518 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#: i Client#:47298 CAPIHOM DATE(MMIDDIYYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 6/08/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the.certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Karen Walther, NAME: Rogers 8r GrayIns.-So.Dennis PHONE aC No; 877-816-2156 g AIC No Ext 434 Route 134 E-MAIL ADDRESS: South Dennis,MA 02660-1601 INSURER(S)AFFORDING COVERAGE NAIC# 508 398-7980 INSURER A:National Grange Insurance Co. INSURED INSURER B:Associated Employers Insurance - Capizzi Home Improvement,Inc. INSURER C: Capizzi Enterprises,Inc. INSURER D: 1645 Newtown Road INSURER E: Cotuit,MA 02635 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN-IS SUBJECT TO ALL THE TERMS,. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AT L SUBR POLICY EFF POLICY EXP LIMITS INSR LTR TYPE OF INSURANCE A WVD POLICY NUMBER MMIDDIYYYY MM/DD/YYYY —INA GENERAL LIABILITY MPB1075H 6/08/2012 06/08/2013 EACH OCCURRENCE $1,000 000 X COMMERCIAL GENERAL LIABILITY - - PREMISES Ea o.ur en. $500,000 CLAIMS-MADE Fi OCCUR- - MED EXP(Any one person) $1 O 000 . - PERSONAL&ADV INJURY $1,000,000 . - GENERAL AGGREGATE $2,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY JE C LOC - COMBINED SINGLE LIMIT $ A AUTOMOBILE LIABILITY M1 M28044 6/08/2012 06/08/201 Ea accident $500,000 BODILY INJURY(Per person) $ ANY AUTO ALL OWNED rx SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTYDAMAGE $ NON-OWNED- PerccdenX HIRED AUTOS AUTOS - X rive Oth Car $ A X UMBRELLA LIAR OCCUR CUB1076H - 6/O8I2O12 06/08/201 EACH OCCURRENCE s5,000,000 FEXCESS LIAB CLAIMS-MADE AGGREGATES $S 000 000 _ DED X RETENTION$10000 $ B RKERS COMPENSATION WCC5010547012011 12/2S/2011 12/25/201 X WC srATu- orH- EMPLOYERS'LIABILITY PROPRIETOR/PARTNER/EXECUTIVE Y/" E.L.EACH ACCIDENT $1000 000 ICER/MEMBER EXCLUDED? � N/A ( andatory in NH) E.L.DISEASE-EA EMPLOYEE $1 000 000- If yes,describe under E.L.DISEASE-POLICY LIMIT $1,000,000. DESCRIPTION OF OPERATIONS below - - - - x DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Workers Comp Information Included Officers or Proprietors CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE .WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE I ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD TLH #S82889/M82857 f C) ( 00 1 °FIKE Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fee - 9 A lrnss. ♦� Thomas F.Geller,Director 2010 ro Building Division BARNS -ABC 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 Not Valid without Red X-Press Imprint Map/parcel Number 9LC7 / /d, Property Address ;). `-� a44 0 Residential Value'of Wor Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address CV l-e A7446 OA (v Contractor's Name r10Y Ll 2 L)j Telephone Number Home Improvement Contractor License#(if applicable)_ Construction Supervisor's License#(if applicable) ck t0_ orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner �I have Worker's Compensation Insurance Insurance Company Name Lj Q/ laxp Workman's Comp.Policy# `"l- g- -! Copy of Insurance Compliance Certificate must accompany each permit. I� Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors replacement Windows/doors/sliders.U-Value ' (maximum.44)#of windows _ *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Pr perty Own must sign Property Owner Letter of Permission. opy of t me Improvement Contractors License&Construction Supervisors License is re uire SIGNATURE: Q:\WPFaES\FORMS\buildingpermi fo \EXPRESS.doc Revised 090809 CAPIZZI HOME IMPROVEMENT INC. Page 7 of 7 SPECIFICATIONS AND ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT /6CffoL OWN PERTY LOCATED AT o� IN THE RO MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS STATE BUILDING CODE. V SIGNATURE OF OWNER: OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT.'.S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit,MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: . The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' a 600 Washington Street Boston,MA 02111 sJ www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name(Business/Organization/Individual): �: t !�`Z� Address: A -�2w,4 (t1Zf2-✓ City/State/Zip: , Phone.#: ,50 Are ou an employer? Check theTaprpriate box: Type of project(required):. 1. a employer with 4. � I am a general contractor and I employees(full and/or p -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 [No workers' 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 M❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no ' � employees. [No workers' 13.V6ther rAim V ?l►'0 C)C J�S 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. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. 1J Insurance Company Name: LI'6 . Policy#or Self-ins. Lic.#: � .10,47 Expiration Date: - N WWJ� Job Site Address: V o [ City/State/Zip: L 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 ' ance coverage verification. 1 do-hereby—cer-d - depth ins and- enaltie&ofperjury-that-the-information-pravide4-abave-is-true-an /correct. Si ature: Date: L-L r _ 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#: i �• . r Y Y • ✓/ia �o_m.� a�✓vcaaeczc�u�eeli<a uildiii Re and Standards . Board of I3 g g uletions License or registration valid for individ.u1.use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return.to: Board of Building Regulations and Standards 9 ` : Re litAo str t,:100740,. ,. WIE 1TR�koio One Ashburton;I'.lace Rm 130E : 7 Boston,M a 02108 M1U Plement Caro, Z. CAPIZZ{HOME _ �1': ' NO 01 �, t; RY GUSTAFS©Nr 1645 Newton Rd Cotuit,MA 02635 __. _ . .._ _... .._ . Administrator No vali ttho,t nature ~ D:i�.+.rttZu±.t3ts 3T I)i�ttst►iiti of I ubfic Safec� -- — Bir rtl rji Br:iiittn�� i ,trt.rtit3s:. tnj1,,Standarms Cons#ruct�os.Supervisor LicPpse License; CS 74640.4 1 {� Restricted a. 00 .YES , _ GARY GUSTAFSON 3F 8 SHORT WAY SANDWICH MA 02563 11/29/2010 Tr#: 7755. Client#:47298 CAPIHOM ACORD- CERTIFICATE OF LIABILITY INSURANCE 01/05/0DNYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers&Gray Ins.-So.Dennis ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O.Box 1601 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. South Dennis,MA 02660-1601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Nat'l Grange Mutual Insurance Co. Capizzi Home Improvement,Inc. INSURER B: ACE Property&Casualty Ins.Co. Capizzi Enterprises,Inc.1645 Newtown Road INSURERC: INSURER D: COtUIt,MA 02635 INSURERE: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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 CLAIMS. S POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD DATE MM/DD LIMITS A GENERAL LIABILITY MPB1075H 06/08/09 06/08/10 EACH OCCURRENCE $1 00O 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES E u n $500 000 CLAIMS MADE OCCUR MED EXP(Any one person) $1 O O00 PERSONAL&ADV INJURY $1.000 000 GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY jE d LOC A AUTOMOBILE LIABILITY M1 M28044 06/08/09 06/08/10 COMBINED SINGLE LIMIT ANYAUTO (Ea accident) $500,000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) X Drive Other Car PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN. EA ACC $ AUTO ONLY: AGG $ A EXCESSIUMBRELLA LIABILITY CUB1076H 06/08/09 06/08/10 EACH OCCURRENCE s5,000,000 X OCCUR CLAIMS MADE AGGREGATE s5,000,000 DEDUCTIBLE $ X RETENTION $10 000 $ B WORKERS COMPENSATION AND NWCC45843208 12/25/09 12/25/10 X WC STATU- OTH- EMPLOYERS'LIABILITY - R I T ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000 000 OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1,000 000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Carpentry CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001108)1 of 2 #S48108/M48107 KW 0 ACORD CORPORATION 1988 11�A a a y/ o r- . Assessor's map and lot number ....... ............................... Sewage Permit number ' T"ET°�° w - TOWN OF BARNSTABLE Z BARISTABLE, i 039. BUILDING + INSPECTOR .g APPLICATION FOR PERMIT TO .:....N Q.1 ;°� l/ T`....................f! .................................................' / �. �r ............ ,T. TYPE OF CONSTRUCTION ys .................................................................................:.......,............................:............... .................................. .. ...19.7�-. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............It- ..........................y t : J. + +i % ... :.......................... ProposedUse s? G.............................................................................................................................................. Zoning District ................................Fire District Name of Owner .................Address ..... 1/� ... � fr4a /44t,�'i .ria Tdi��'770/v Name of Builder .....:..... .................... ._......:.....................Address ........ . ........ s .......... ......... . . .... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..........:.......................................................Foundation .............................................................................. Exterior �Rr? f% 11Sc T ....................................... Roofing .............. ..................................................................... f'/�i�t—A 1a .Interior ` Floors ...�..:..:............................................................ ......................................................................:............. Heating ..................................Plumbing u �/� r.........:...................................................... Fireplace ..........................................Approximate Cost ..........�` 0�......................-.................... Definitive Plan Approved by Planning Board ________________________________19--------. Area ...... .. : � .......`.'................ Diagram of Lot and Building with Dimensions Fee /' ............................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH } I .9 I C� A, V -- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .........................(.....l ,....:...................................... Charles - ~^, l ^ ' .........��������.� , ' . ... .... .........................---, ` Location ........... . ' . — — ' — --. \ / —^---------'--^—'----'�—'f/--'— _ Owner .........Char:Iva.Auaxa I---- ----' ' Frame Type of Construction -------------... . . ' —^---'-----------------^---'' Pk 29� 248 Plot -----.---_ Lot ............ ' . . . ' Permit Granted ' Date of Inspection . ~~'~ Completed - _ ' ~ .E~~~ — —.-----.---.. ' . ` . . � .............r'' ]r __ ................................ .—. � --. ~~ . ' Approved ................................................ 19 ' -------------.--.---------.. ' -----------'---------~~---^' Assessor's map.and lot number .......................................... _ �,�i 7� �L _ /ae �v�i� ok -jt� �� "pp�iPII BE ANCE v NSTAt-L _ 11 ,f STA ... ITH �,�TI6�� TOWS -a C� Sewage Permit number _ ......... ... . .....' ' ����� CODF �ofTHEro� TOWN OF ;BAR `` A Z 89HHSTODLE, • �: "AM DU11DINGf INSPECTOR zi APPLICATION FOR PERMIT TO .. .Q ..'.................I!.L7 .......... Sr ........ TYPE OF CONSTRUCTION' .. ..•�..r �L�.. ..... ............... ............. ..................................................... v � ................................./-/...... . �. TO THE INSPECTOR OF. BUILDINGS: The undersigned hereby applies for a permit 'according to the following information: . Location ..........a��. ...../.�!.�GQ -41 !t¢ ... P.. �..f...; ./�j/9�'!a!/��.. .�l� ....................... :....................... Proposed Use .:............ �Pe /9f�r. / Zoning District ............ � /J t!?1!....................................Fire District .................................... . .. Name of Owner ...CAW/- .5........�}IYl�1���i.................Address r..... J Name of Builder .........Address A;�.AdA`'/. ! ......... Name of Architect ......... ................................................ ........�-.....................:..................Address ............... ...............:Number of Rooms ..................................................................Foundation ...... ...pl!e '' .,.................................................... Exterior ...........�.ri3 .......�(H .........................Roofing ..........ff�'&Ie.r Floors ..Interior Heating /�� .......Plumbing .,N .................. ..... .................... Fireplace Approximate Cost'......................................p............................... Definitive Plan Approved by Planning Board ---------------1_----------__--19--------. Area ....... ................. Diagram of Lot and Building with Dimensions Fee Z ..........(<J.............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH --------------------------------- +A j=f�u1 1.2to I � •� ._...� fir'� , I hereby agree to conform to all the Rules and Regulations of the Town of Barnstabl4rearding the above construction. Name... ... ........... Charles Amaral 291 248 t 1881 Gara e - - { No ............. ....Permit for..............P....:................ - . ..................................;.:....... ............................... , Location ......26�..M:�E�gh;> '.Rd. ,Hgannis...... , ........... ........................................ .................. f } Owner ........Charles..Amaxal ..... .. ^ .......... Type'of Construction ....Y.tam.e:................... Plot ........291.................... Lot .... .248 'Permit Granted ......... OY.....12.............. .1976 Date of Inspection ..,..................................19 .Date Completed ...... ............ .19 PERMIT REFUSED ....................................... 1.9 ,y ............... ............... .. ................................. r ............................ ................................ ................... • • • t• ............................................................................... • '. . y '�t� . � Approved ...................:......................:..... 19 . .................... .......................................................:. i " -+.. .. _ �,q.1/•sue-` ,.:/:�/y/� _ .. _ .... w,.. .... Ay sesser•s map and lot number ............I. ......................... Sewage Permit number ..... .y�........................................ �pF THE t04 TOWN OF BARNSTABLE • H9B139TADLE, i �6 BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ...................................... .................................................................. TYPE OF CONSTRUCTION ...... ..... t!L...::........................................................................ �t 2 ..................19.�%'l TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ��...... �.. .... ...... �� :............................................................... Proposed Use . ......... f..... c���; 2 r� .....................�........................................ . (/ Zoning District % ..Fire District ...... �..? ��� ........ ..,......`............................................... �...../..................... .... Name of Owner .,..:........ / t/ ...Y..Address ........................................... t�� Name of Builder Name of Architect Address .................................................................. ......................................................................................... Number of Rooms ....... .....................................................Foundation � /�r.... . //�1�' I'G ................... ......... ..... ..................... r Exterior liL .� Roofing !„..!f.; ......................................................... /t�A �i• �`r-�' ).......... Interior ..........�Z: 1! �G ti d-!/�^: Floors .................,...............:......::..............................f. .. ..............:................. .-.................................. I Heatin � - ........................Plumbing Fireplace .......... ...................................................................Approximate Costa i .................................................................... ,v Definitive Plan Approved by Planning Boards_/_�____��_---------19_:�` Area '�...... ..................... Diagram of Lot and Building with Dimensions Fee ................. c .. ..... �� . ....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name 7 . Dacey, William E. Jr. 17410 one story, i 1Vo ................. Permit for .................................... t single family dwelling F Location SMegan Road ... Hyannis ............................................................................... Owner W.illi. . am..E.....Dacey. .,'..Jr....... .. . . ......... .. . ........ . .. .... . Type of Construction frame , ............................................................................... Plot ............................ Lot ................................ Permit Granted October 31 .19 74 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ..............................................................................: a i 80. 0 8 17 HI) 80. 00 i " (::5; C E R T I FIE ® PLOT FLAN LOC AT I O N' �y� SCALE. � _30 � DATE -�z R E P E R E N C E : 7—/� �9 5 _5/-/o 444 o^i ,dG�, '� ���y�.•.iN/.S /jam/L L O YYS i9-,�x0. DATE d I HEREBY CERTIFY THAT THE BUILDING - RE LAND SURVEY R S H O W N O N T H IS P L A N 15 L O C AT E D O N THE GROUND AS SHOWN HEREON AND THAT 1r '00�5 000THEOTO WN T >= E gNOFb9 7 ZONING BY LA 5 ti : �STi'9BLE WHEN CONSTRU C T E D. cr c� n JOSEPH M. .• o MONAHAN,JR. N BARNSTABLE SURVEY CONSULTANTS, INC . � �Foj e�il�� � �+ w C S T YARMOUTH, MASS . DSU�f.R j FI .. r i i f '1 i I O• 'III, llql , 1.k j N o \ y .38.5 •.. - . f' C7:o-O ..y coo C E R T I FI E D P.LO: T PLA•.N L O C AT I O N SCALE DATE ��o/z ,7 R E F- E..R.-E-.N-C.E.,.-e,./; D A�T�E / ` 1 HEREBY CERTIFY THAT THE BUILDING RE LAND 5URVEr R~ S H 0 W N O N T H I S .P L A N I S L O THE GROUND AS. S HOW HEREON ANDh T H AT 1 T .00 4S C O`,N. 'F O..R M T 0 T H E N Z 0 N I N G BY L A W-S O F THE TOWN;,, ,0 F ,�A��/.STi9BGE W"H E N C 0 N 5 T R U C T �..D $ JOSEPH M. • i MONAHAN,JR. N BAR 'NS 'ABLE, ' SURVEY CONSULTANTS, INC �F WEST YARM0U 'rV- MASS . + w�'oSU�i Assessor's map and lot number .. �.....Q?.�� .•• A` �,,, v„s ,, .'tfi�t° O nt Sewage Permit numb! � ;111.gko-�b:7,. yoFT"ET°�� TOWN OF BARNSTABLE i 897�9TLDLE, S 9� "6 .e� BULL"DING INSPECTOR APPLICATION FOR PERMIT TO.......6.......... TYPE OF CONSTRUCTION .... .. ...... .. . ........ .......................................................................... .. r��a........ ......19 7 TO THE INSPECTOR OF BUILDINGS: The undersign! "hereby applies for a permit according to the following information: Lo cation `- /...../. .... /.. - ......... Proposed Use . .........d �.... •.. ...... .:..... / ...................... .Fire District .. .. �.... ......... ..... Zoning- District ..,��� . ......:................ .. .. ..... . ........:.�.... � Name of Owne� � .... . .......Address � I .. Grir 2 ..... .. . ......... �'N„ AE�� - /r- /. a r. A. Nameof Builder ....................................................................Address .................................................................................... Name of Architect ...........................................................'tAddress ...... ............... ................................................... ............... ...........Foundation ®.. ...........:.: .. ..: Number of Rooms ...................... ................................ Exierior .........,............. ....................:.............Roofing .....�� G 4� - ............................................... _ � ti / ............Interior / Floors. ..G.. .0 ......... .. ... ...... ..................... . ................................... � il. 4-- ..pal.......................Plumbing ..........�.........................................................Heating ................................. ........... /' 3,,� Fireplace ...............................................Approximate Cost ...,........... . ................................... ......,.........................,................. n Q ' Definitive Plan Approved by Planning Boardl�- ----------191 Area ..... .......................... Diagram of Lot and Building with Dimensions Fee ....... ................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby 'agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. oe�` s me l ... G... .. . . .. ........ Na ....... Dac;ev, Williat- E. Jr ?M( No .... Permit for .... .......... .................................... Megan Road Location ................................................................ .......................�y�nnis ................................................. Owner ..........Wi.I.1.i.am..E Dac.e.y J.r............ .... .. . . .... .. . ...... . .. Type of Construction .......f.r P m.e......................... .................................................................................. Plot ............................ Lot ........ 16 ...................... Permit Granted ........0a.-tnbe.x�-3.1.,....... 19 74 Date of Inspection ...... 9 . .......... mpleted Date Coi ................... PERMIT REFUSED ................................................................ 19 ......................................... ....................................... ............................................................................... . ............................................................................... Approved ................................................ 19 ............... ........................................................