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HomeMy WebLinkAbout0081 MELBOURNE ROAD /✓!rl b ourne J ' �T9 V�oil, REc BV � �OFp®8g, Application numb Date Issued..................... l.t.i.` BARNSTABLE, ...................... •. . ... MASS. Building Inspectors Initials...................................... Map/Parcel......... ....... 1..................... 06 2Zi� WARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY MORMATION Address of Project: S I e o y r✓1 (�Q ` a n n S NUMBER STREET VILLAGE Owner's Name: ?t,o re-;r, . L-�y M 6 P to Phone Number 5 08- 3 6 - ck P L4 3 Email Address: Cell Phone Number Project costs 3 1 8 l Check one Residential V Commercial OWNER'S AUTHORIZATION .FL IO As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CNIR Owner Signature: See f!4ak.-0Q fo1S('ram Date: TYPE OF STORK Ll Siding Windows (Caderange)# 0 Insulation/Weatherization `Z Doors (no header changeCommercial Doors require an inspector's review `J Roof(not applying moreof shingles) Construction Debris will be going to W -I �, _ P ,�7 G�J��o .'1�, M,A CONTRACTOR'S INFORMATION Contractor's name An �e� P o� e l t/� Home Improvement Contractors Registration(if applicable)# //Z 8 S (attach copy) Construction Supervisor's License# 67-�Z 2�I 7 (attach copy) Email of Contractor Swe �/�S C �1Ma • c cs''''` Phone number -,�/o/- 7iV- 6 3`7,9 ALL PROPERTIES THAT HAVE STRUCTURE OVER TS YEARS OLD OR IF THE SUBJECT PROPERTY IS I!U A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN RE ISSUED. APPLICATION NUMBER............................................................ *For Vents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional can a attached on a separate piece of paper. tent dimensions b p p p p Check one:this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require pare Department approva XW®®D/C®A.JPEELET STOVES Y Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:front back left side right side HOMEOWNER'S LICENSE EXEMTTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedurivs, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date 1i1PFLICAN 'S SIGNATURE E Signature Date 2 —( All permit applicatio are subject to a building official's approval prior to issuance. Home Improvement Agreement: Page 1 Home Depot License Number(s): Home Depot license numbers are listed on page 3, and at Homedepot.com/licensenumbers RYCK HOXIE Salesperson Name Registration # (Req. in CA,CT,ME,MD,MI,NJ,DC) Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/or service the equipment listed below at the price, terms and conditions as outlined on this form. Service Provider Contact Information TBD I TBD Authorized Representative Name Service Provider Company Name TBD TBD TBD Phone # Service Provider Email Address Service Provider License #(s) Customer Information PEREIRA HUMBERTO 2612 H2612-104846 Customer Last Name Customer First Name Store #/ Branch Name Customer Lead/ PO# 81 MELBOURNE RD [HYANNIS MA 02601 Customer Address City State Zip 5087718176 5087718176 5087718176 Home Phone# Work Phone# Cell Phone# Customer Email Address #_NOTICE_OF RIGHT TO CANCEL YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY CONTACTING THE SERVICE PROVIDER OR STORE DIRECTLY; EMAILING SERVICE PROVIDER AT: } Contact Store Directly !OR DELIVERING WRITTEN NOTICE TO HOME DEPOT AT:11 ► 2455 PacesFerry Rd SE Atlanta GA 30339 iAddress City State Zip BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. , (YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME I I DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME i DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN ,SHIPMENT AT HOME DEPOT'S EXPENSE. I IfTHE LAW REQUIRES THAT THE HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT }TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL it 'AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL. Acknowledged by: 01/31/2019 f Customer's Signature Date SPECIAL SERVICES CUSTOMER INVOICE Pagel of 10 NO. H2612-104846 ----------------------------------------------- -------, Store 2612 HYANNIS Phone: (508) 778-8948 65 INDEPENDENCE DRIVE Salesperson: JXL0928 HYANNIS, MA 02601 Reviewer: VXG1123 Name Phone 1 PEREIRA HUMBERTO (sos) 771-8176 REPRINT Address 81 MELBOURNE RD Phone2 (508) 364-9843 ; Company Name city HYANNIS Job Description exterior door install 2019-02-01 13:57 state MA Zip 02601 county BARNSTABLE MERCHANDISE AND SERVICE SUMMARY We oldrtoc stomershttofimitthequantitiesofinerchandise REF#W13 SKU#0000-515-664 The items listed in this section will be carried out of the store by the customer at time of sale. STOCK MERCHANDISE CARRIED OUT: REF# SKU QTY I UM DESCRIPTION PI TAX PRICE EACH EXTENSION R12 0000-627-105 1.001 EA SCHLAGE CAM X ACC HANDLESET ABZ/ JA Y $139.00 $139.00 C o $139.00 END OF CARRY OUT MERCHANDISE REF #W13 CUSTOMER PICKUP #1 REF# W11 SKU # 0000-515-664 Customer Pickup/Will Call S.O. MERCHANDISE TO BE PICKED UP: S/O FEATHER RIVER REF# S10 ESTIMATED ARRIVAL DATE: 02/14/2019 P.O. #12535670 DOOR REF# SKU QTY UM DESCRIPTION PI TAX PRICE EACH EXTENSION S1010 0000-803-680 1.00 EA NA/STANDARD ENTRY DOORS ENTRY DOOR 59.5 X 8/ ENTRY A Y $3,181.80 $3,181.80* DOOR59.5 X 81.625STANDARD ENTRY DOORS #1 SCHEDULED PICKUP DATE: Will be scheduled upon arrival of all S/O Merchandise 014, ! o $3,181.80- END OF CUSTOMER PICKUP - REF#W11 INSTALLER DELIVERY #1 REF# 101 ***CONTINUED ON NEXT PAGE*** WILL-CALL MERCHANDISE PICK-UP FOR WILL CALL Wul-Call items will be held in the store for 7 days only. MERCHANDISE PICK-UP Check your current order status online at PROCEED TO WILL CALL OR D SERVICE DESK AREA www.homedepot.com/orderstatus (Pro Customers, Proceed To The Pro_Desk) Indicates item markdown AID. SPECIAL SERVICES CUSTOMER INVOICE - Continued Name: PEREIRA Page 2 of 10 NO. H2612-104846 INSTALLER DELIVERY #1 j (Continued) REF#101 STOCK MERCHANDISE TO BE DELIVERED: REF# SKU QTY UM DESCRIPTION PI TAX PRICE EACH EXTENSION R03 0000-677-401 3.00 EA 3/4"X7-1/4"X8'AZEK S2S TRIM / A Y $42.74 $128.22 R04 0000-682-285 1.00 EA 3/4"X11-1/4"X8'AZEK S2S TRIM / A Y $62.15 $62.15 R05 0000-458-056 24.00 LF 11/16 X3-1/2 PFJ WM444 CASING/ A Y $1.94 $46.56 R06 1002-961-477 1 1.001 EA 6"X50'WINDOW& DOOR SEALING TAPE/ A Y $17.97 $17.97 R07 0000-715-499 1.001 RL MULTI-PURP 16"X48" ROLL INSUL 5.3SF/ A Y $5.48 $5.48 R08 1001-361-475 1.001 EA 1/2"X 4-1/2" 72"WW472 OAK SADDLE/ A Y $23.98 $23.98 l ® $284.36 DELIVERY INFORMATION: DELIVERY DATE: INSTALLER WILL SCHEDULE INSTALLER WILL DELIVER MDSE TO: SITE OF INSTALLATION#101 AT TIME OF INSTALLATION. INSTALLATION #1 REF# 101 ESTIMATED INSTALL BEGIN DATE: 01/31/2019 ESTIMATED INSTALL END DATE: 03/02/2019 MERCHANDISE TO BE INSTALLED: REF# SKU QTY I UM DESCRIPTION R03 0000-677-401 3.00 EA 3/4"X7-1/4"X8'AZEK S2S TRIM R04 0000-682-285 1.00 EA 3/4"X11-1/4"X8'AZEK S2S TRIM R05 0000-458-056 24.00 LF 11/16 X3-1/2 PFJ WM444 CASING R06 1002-961-477 1.00 EA 6"X50'WINDOW& DOOR SEALING TAPE R07 0000-715-499 1.00 RL MULTI-PURP 16"X48" ROLL INSUL 5.3SF R08 1001-361-475 1.00 EA 1/2"X 4-1/2" 72"WW472 OAK SADDLE BASIC INSTALLATION LABOR: SKU DESCRIPTION QTY UM TAX PRICE EACH EXTENSION 0000-898 EXTERIOR DOOR-NAT/PRE-HUNG DOOR UP TO 38X98 1.00 EA N $377.00 $377.00 -501 OPTIONAL LABOR SELECTED INCLUDES: *""CONTINUED ON NEXT PAGE... V M , low kAct. an OZ w ' wuw r^t �-, ,�i.- the Commonwealth of Massachusetts Department of IndustrialAccidents ;;j Office of Investigations I Congress Street, Suite 100 _ Boston,MA 02114 2017 www.mass gov/dia Workers'-Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Informafion Please Print Legibly Name (Business/Orgmization/Individual): Address: j := p" - ��� ll..: l�C•1 City/State/Zip: >:_, Phone#: Are you an employer?_Check the appropriate box: l. tun a employer with 4. ❑ I am a general contractor and I Type of project(required): ❑ I employees(full and/or part-time).* have hired the sub-contractors 6• ❑New construction 2.LJ 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 1 I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] C. 152, §1(4),and we have no employees. [vo workers' 13.0 Other comp.insurance required.] *Any applicant that dri-C _,box rl must also fill out the section below showin_,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 cheek this box must attached an additional sheet sho%adng 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 emploler that is providing workers'compensation insurance for my employees Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.-#: Expiration Date: 9 Job Site Address: City/StbLie/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 %z under the ains and enalties o P P f perjury that the information provided above is true and correct Slanature: Date:. ._........ - - Phone#: s• Offrcial Erse 01141. Do not write in this area,to be completed by city or town-offzciaL City or Town: Permit/License# Issuing Authority(circle one): - 1.Board of Health 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other 'Contact Person: Phone#: I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 Boston,JU4 02114-2017 www massgov/dia Workers'Compensation Insurance 9ffidavit: BuilderslContractors/Electricians/Plumbers Appficant Information `� Please Print Le 'biv Name rDk�essJG oanizatiooiIndiv//dual): O �i J/ b _ Address: Citv'State/Zi : sl sd /� diSY.sr- Phone#: 7 / ��" 7S - o?- Are you an employer?Check the nropriat�e b Type of project(required): � I am a employer with , 4• I 1 am a general contactor and I :mployees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction r' I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have i 8. Demolition wo for me in any cma employees and have workers' o �''• 9. (_j Building addition workers' comp.msurance comp.ira,rance..= i required-] 5. ❑ We are a corporation and its 10.❑Electrical repairs additions 1 .[ 1 am a homeowner doing all wort officers have exercised their I I.[]Plumbing repairs or additions myself T10 workers' comp. right of exemption per 1VIGL L.❑pof repass issuance-equired.]t c_ 152,§1(4),and we have no 1v Other �f' D u employee4. [-No workers j 13.E comp.insurance required.] 1, re 10 At{in,e K-I -Any appiicant La: box a'_must also fill out the section below showing their workers'compensation policy mformatiou. t homeowners who submitthis affidavit indicating they are doing an work and then hue outside contractors must submit a new affidavit indicating sack =Cort -tors that check this box must attached an additional sbeet showing the name of-It sub contractors and state whether or not those entities have =pioyees. s the Sub-conaactors have employees,they mast provide their workers'ramp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job sire information. Lnstrance Company dame: r!<.r Q. bitic�/ (/Nl oa'✓ //`C� �i✓S . C.6. Police ft or Self-ins.Lic.#: x VY d" 7 7 o E Tiration Date: Job Site Address: I Met /1 CitylSrateiZi. .......... ✓Jil t��_ 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 uc to$1,500.00 and/or one-ye mmpr. onment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to50.00 a day st a Tatar. Be advised that a copy ofthis statement may be forwarded to the Office of Investigations of the DLL ce coverage verification. I do hereby certify un the information provided above is true and correct Si attne: Date: Z Co— Phone 4: 0— Official use only. Do not write in this area,to be completed by city or town officiaL Cite or Town: Permitl icense n Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityi Town Clerk 9.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone : -7 'i ff C C'`f•(,f=}'(. ,-,l r V i�f u: .0:"�'f ,("f�i. '��'C:1 -_ Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Type: Supplement Card Registration: 112785 HOME DEPOT USA INC Q 2455 PACES FERRY RD C-11 HSC Expiration: 04/221201„ ATi ANrr.A,GA 30339 Update Address and return card. Mark reason for change. -' ❑ Address ❑ Renewa! ❑ Employment 0 Lost Card —_- Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE Suoelement Card before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation i 12785 04/22/2019 10 Park Plaza-Suite 5170 HOME DEPOT USA INC Boston,MA 02116 i ANDREW SWEET - 2455 PACES FERRY RD G11 HSC ATLAN T A,GA 30339 Undersecretary d ithoU signature I ACC> CERTIFICATE OF LIABILITY INSURANCE Do 122201E 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED,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 endorsoment(s)- CONTACT PRODUCER NAME: FAx MARSH USA.INC. PHONE TWO ALLIANCE CENTER fAFC No rxil, AIc No. 3560 LENOX ROAD.SURE 2400 E4UAIL s: ATLANTA.GA 30326 ADDRE INSURERS AFFORDING COVERAGE I NAIC A CN101642069•HcmeD-GAW-IS-19 INSURER A.Old Rep0c Insurance CO 24147 INSURED THE HOME DEPOT.INC. INSURER S:New H2mDshire Ins Co 23841 HOME DEPOT U.S.A.,INC. INSURER C:HomeRisk C213bve Insurance Carnpany 2455 PACES FERRY ROAD INSURER D: BUILDING C-20 ATLANTA,GA 30339 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004353439-16 REVISION NUMBER: 3 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADD SUER POLICY NUMBER MMID�� 9 aP LIMITS LTRWVn A X JEWERCIALGE"FRALL14BILlry MWZY312717 03101201E 10NIMI EACH OCCURRENCE S 9,000.000 AMA E R NTED I.000,000 CLAIMS-MADE 7 OCCUR PREMISES Ea occurrence S LIMITS OF POLICY XS i � MED EXP(Any one person) �S EX..LUD ED OF SIR:S1 M PER OCC PERSONAL&ADV INJURY S 9.00A,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 9•0�'0� X POLICY❑PRO LOC PRODUCTS•COMPfOP AGG S 9,00C.000 JECT 5 OTHER: AUTOMOBILE LIABILITY MWTB312718 031012018 03/012019 aB.INNED SING=LIMIT S 1.000.000 (EaX ANY AUTO BODILY INJURY(Per person) S OWNED ^�SCHEDULED SELF INSURED AUTO PHY DMG BODILY INJURY(Per acciderd) S AUTOS ONLY AUTOS i HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY i Per acadent � S UMBRELLA a LIAR HOCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTIDN 5 S B WORKERS COMPENSATION WC014122577(AK,NH,NJ,VT) 031012018 031012019 X STATUTE ER B AND EMPLOYERS LJABLLITY Y 1 N WC 014122578(WI) 03101201E 03/012019 5,000,000 ANYPROPRIETOR/PARTNE[EXECLfrNE E.L.EACH ACCIDENT S OFFICERfMEMBEREXCLUDED� NrA $000om (Mandatary in NH) E.L.DISEASE-EA EMPLOYE S 0 yes.ttesaibe under Continued an Additional Page F- DISEASE-POLICY LIMIT S 5,000.000 DESCRIPTION OF OPERATIONS below C Excess Auto 297-1-10011-002018 03101201E 031012019 Urtdt: 4,000.000 DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,may be anached if more space is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING C-20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA,GA 30339 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee �LaKNao'= I ©19B8-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo arc registered marks of ACORD I r AGENCY CUSTOMER ID: CN101642069 LOC#: Atlanta ACORN® ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY MARSH USA,INC. NAMED INSURED THE HO"IE DEPOT,Ir1C POLICY NUMBER HOME DEPOT U.SA.,IrIC. 2455 PACES FERRY ROAD BUILDING C-20 CaRRtER ATLANTA.GA 30339 l NAIL CODE i ADDITIONAL REMARKS EFFECTIVE DATE THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liabili Insurance Workers Compensation Continued Carrier.Indemnity Insurance Company of North Amenca I'dicy idumber WLR C64783191(AL,AR.FL,ID,IA nS.KY,LA.tiS,MO,Nl;NFa.ND,OK.SC.SD.TPJ,WV.Nf) Effective Date:0=12018 Expiration Data:031D72019 (EL)Limit S 1,000,000 Camer Now Hampshire Insurance Company Pdicy Number.INC 014122576(DC.DE,HI,IN,tiD,MN.MT,NY,RI) Effective Date:03/012018 Expiration Dale:031012019 fEL)Lunt:S1.000.000 Carrier ACE American Insurance Company Policy Number.WCU C64783221(OSI)(AZ.CA,IL.NC.OR,VA,WA) Effective Date:03/0112018 Expiration Date:03/012019 (EL;Limit:S1,000,000 SIR S1.000.000 SIR for the states of AZ.CA,IL.NC,OR!JA,'NA Lanier.National Union Fire Insurance Company policy Number.XWC 4595580(OSI)(CO,CT.GAAiE,111,NV,0H,PA.UT) Effective Date 03/01f2018 ExPrahon Date:0310112019 (EL)Umil:St•000,000 S7,00D•000 SIR for the states of CO,1IE,NVAI,OH,PA.UT _750.000 SIR for the state Of GA S350.000 SIR for the slate of CT Camer.NabDft Union fire Insurance Company Policy Number.X WC 4595581(O$I)(.MA) Effective Date:031012018 A p ExPinilion Date:03/012019 (EL)Limit S1,000,000 �Il SIR:S500,000 TX Employers XS Indemnity. Carrierplinios Union Insurance Company Policy Number.TNS C4916693A(TX) Effective Date:03101,7018 &puation Date.03f012019 (EU Limit7 S 10.00D.000 SIR:S1 D00,C00 I ACORD 101 (2008/01) 2008 CORD CORPORATION.- All rights reserved. The ACORD name and logo are registered marks o ACORD Town of Barnstable *Permit Expires 6 mont/ rev ate X-PRESS PERA ulatory Services Fee s F.Geiler,Director AUG 14 2006 Building Division TOWN Tom Perry,CBO, Building Commissioner Q f OF BARNSTASEein Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �j �} Not Valid without Red X-Press Imprint -0 Map/parcel Number © D D � J Property Address C> I mi - . [Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Py1-1D. A1_A_ 76 l YV _0 b cr,� a � Contractor's Name — �e�.« (�.,�, Telephone Number Home Improvement Contractor License#(if applicable)_ Construction Supervisor's License#(if applicable) E�pdorkman's Compensation Insurance Check one: ❑ I am a sole proprietor } ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# `"] y / 0 Copy of Insurance Compliance Certificate must be on file T Permit Request(check box) ' n D5 Re-roof(stripping old shingles) All construction debris will be taken to /"l t C XA ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Pro erty Owner must sign Pro Owner Letter of Permission. A cop f t e I vem ontractors License is required. SIGNATURE: Q:Forms:expmtrg Revise061306 PERMIT PAYMENT HLCFIPT TOWN OF BARNSIABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 08/14/06 TIME: 09:56 PERMIT $ PAID 25.00 i AM] TENDERED: 25.00 AMT APPLIED: 25.00 CHANGE: .00 APPLICATION NUMBER: 20062465 PAYMENT METH: CHECK PAYMENT REF: 11441 a CERT ICAT O/ LIAB TY INSURANCE SU NCE DaTe(MM/DDrvYYY) PRODUCER (508)58$-1250 t FAX (308�588-7236 , s�+-as Y 09122/2005 1 THIS CEp, IFICATE IS ISSUED AS A MATTER OF INFORMATION Wise & Quinn Insurance Agency Inc, ONLY AN{;CONFERS NO RIGHTS UPON THE CERTIFICATE 449 Pleasant 5t. I HOLOMR, I iylS CERTIFICATE DOES NOT AMEND,EXTEND OR Brockton, MA 02302 ` ALTER rF COVERAGE AFFORDED 13Y THE POLICIES BELOW- CISR, Paul Crawley INSURERS AFFORDING COVERAGE NAIC 4 ,INSURED Dean Fraser - IINSURsRA: Hartford Insurance Company DBA: Fraser Construction Co. INSURERS: 71 Tarragon Circle I cNsu�R B. s C. Cotuit, MA 0263E-2443 j rNsURERD: I INSURER E: C0VE13AGES ~ --- THE POLICIES OF INSURANCE LISTED BZELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 1NDICA T ED.NOTVVITHSTANOIN( 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 18 SUBJECT TO ALL THE T ERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. �1SR DD' TYPE OF INSURANCE Pr LtG EFFEC !VIE (IQU Y EXP;RATION L POLICY NUMBER IMITS GENERAL LABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY { DAMAGE TO RENTED $ CLAIMS MADE OCCUR } MED EXP(Any one person) $ PERSONAL BADVINJURY $ GENERAL AGGREGATE S rGEN' GREGATE LIMIT APPLIES PER: PRD- PRODUCTS-COMP!OP AGG S ICY JECT LOC AUTOMOBILE LIABILITY ANY AUTO ? COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS ( I SCHEDULEDAUTOS ( BODILY INJURY $ (Per person) HIRED ALTOS NON-OWNED AUTOS BODILY INJURY ' (Per accident) $ ( PROPERTY DAF4AGE (PeracGdent) $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S I AUTO ONLY: AGG S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE r AGGREGATE: DEDUCTIBLE RETENTION $ WORE(ERSCOMPENSATIONAND 6%0faB-794X619-1-05 09/26/2005 ' 09/26/2006 X $EMPLOYERS'LIABILITY WC STATU- OTH- ANY PROPRIETORIPARTNERIEXECUTIVF E.L.EACH ACCIDENT $ yQQ QQ© OFFICERIMEMSER EXCLUDED? I(yes,describe under • �' E.L.DISEASE.EA EMPLOYE $ 500,00 0 SPECIAL PROVISIONS�elovr E.L.DISEASE-POLICY LI c!1T -$ So ^ " OTHER _�...rj't�Q U! CRPTION OF OPERATIONS 1 LOCATIONS!VE19CLES 1 EXCLUSIONS ADDED BY ENDOR8EMFcNT!SPEC IAL PRO'13SIONS the operations usual to carpentry, r� IFIC TEHOLDER- SHOULD i ARI L'Tt �; I I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 13EFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TD MAIL 10 D 1YS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, � Fraser Construction Co. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 71 Tarragon Ci rc7 a OF ANT'KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES, Cotuit, MA 02635 AUTHORIZED IyE RD25(2001108) FAX. (508)428-0123 CACORD CORPORATION 1988 f _ 4 �le �arrNnarecuea ��/ eae�udelta Board of Building Regulations and Standards License or registration valid for individul use only IM�i?OVEMENT CONTRACTOR befor i the expiration date. If found return to: HOME { Bear of Building Regulations and Standards `� Registrafron:z 112536 One Ashburton Place Rm 1301 lug rra tong-3/2007 Boston,Ma.02108 FRASER CONSIhRJ DEAN FRASER � y,r' 71 TARRAGON CIR f -� — Not valid wi±hout signature COTUIT,MA 02635 Administrator r' Fraser Construction Roofing & Siding Specialists Possible Extra -After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation be not up against the Plywood sheathing, preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$4.00 per panel including Materials & Labor. There are 6 panels per sheet of plywood. Possible Extra -Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$45.00 per hour, plus materials, plus 20% overhead mark-up on total extras. FRASER CONSTRUCTION Warranties the labor for 10 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% for the first 10 years, and then on a pro rated basis for the Lifetime of the warranty chosen if the shingles become defective. CERTAINTEED Warranties the shingles to be ALGAE resistant for a full 10 years. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION: Carries Workman's Compensation and Public Liability Insurance on the above work. DATE OF ACCEPTANCE: SUBMITTED BY: f A Homeowner Fraser Construction r - 4 t ne t.ommonweacrn of lvluziYuenua&euni Department of Industrial Accidents Office of Investigations d 600 Washington Street Boston, MA 02111 www.mas&gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organizationadividual): Address: 8 J> $ City/State/Zip: Phone#: Lf2�4�S" �- Are you an employer? Check the appropriate box: Type of project(required): 1.2�+am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet $ 7 ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical r airs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.] t . employees. [No workers' comp.insurance required.] 13.❑ Other *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. tcontracton;that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name; Policy#or Self-ins.Lie. #: j IYX (2/g7 Expiration Date: l0 XG G Job Site Address: X,1�r City/State/Zip: i9�rdc. i Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,.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 hereb :fy unde t �enas of perjury that the information provided above is true and correct Si afore: Date: Phone#: — �S 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 Eealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbiea lraspector 6. Other Contact Person: Phone#: f` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel o?y Permit# Health Division �?P - 03P��0 Date Issued ©?, Conservation Division ' wo);�/eFee S Tax Collector Collector o2 -c o� "0 A' SEP X-WOMMUST OF- Treasurer 6Z — 07 —0 INSTj g,L; 1N COMPUANCE Planning Dept. UVITH TITLE 6 c: EWRONIgENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address Village Owner Ber-l- ere I f-a, Address X/ Telephone ��� � ��/-c`�/ 7� } SOY 76v -8357 Permit Request « Square feet: 1st floor: existing proposed /60 2nd floor: existing proposed Total new Valuation t �` ��-�-- 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 0 �1T,,2�� Historic House: ❑Yes )(No On Old King's Highway: Li Yes 4No 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 13 new Total Room Count(not including baths): existing 46 new First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes *0 Fireplaces: Existing � New Existing wood/coal stove: ❑Yes 6-I o� Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size f Attached garage: existing Cl new sized .2,/ Shed:❑existing ®'new size /0 X/& Other: Zoning Board of Appeals Authorization Ell Appeal# Recorded❑ Commercial ❑Yes ®'No If yes, site plan review# Current Use Proposed Use BUIL ER INFORMATION Name f �OS% � � � �'f Telephone Number 91 �00 T Address 34/el l/Cct�o�Y� © License# C S 079 %1,5 N e_/Q,nn /y/h' 0,2ExD Home Improvement Contractor# Worker's Compensation# � /7 03 0/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i SIGNATURE DATE S I FOR OFFICIAL USE ONLY 1 PERMIT NO. DATE ISSUED MAP/PARCEL NO: h i r 1 ADDRESS VILLAGE OWNER r � a , DATE OF INSPECTION: - t FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH ., FINAL { PLUMBING: ROUGH FINAL GAS: ROUGH 7 R Y; FINAL ` FINAL BUILDING 00 DATE CLOSED OUT t» �' A; ASSOCIATION PLAN NO. f RESIDENTIAL: SHEDS - POOLS -DECKS-OPEN PORCHES- GAZEBOS DETACHED GARAGES FEE VALUE WORKSHEET ACCESSORY STRUCTURES >120 sq.ft. (Sheds,detached garages,gazebos,etc.) >120 sf-500 sf $35.00 $ 3`� 0 >500 sf-750 sf 50.00 $ >750 sf- 1000 sf 75.00 $ >1000 sf- 1500 sf 100.00 $ >1500 sf—USE NEW BUILDING PERMIT APPLICATION DECKS x$30.00= $ (Number) PORCHES x$30.00= $ (Number) IN GROUND SWIMMING POOL $60.00 $ ABOVE GROUND SWIMMING POOL $25.00 $ RELOCATION/MOVING $150.00 $ (Plus above fee if applicable) PERMIT FEE $ ' Ob I Q:forms:dkcost eff:0823.01 S Y..9 0 ' S v Y ! 1 11 1 d Mim 1 1 �• • 11 1 �rll / \ .1 • \ 1 1 1 •, �1 •\ 111•.11 .11 • 1 • 11 •�/111\ • ' 1 i 1 1 i n e 1 11 \ 1 \ • • \ :11 1 fit 1 • 1 1 11 1 I Y I I\ I 1 �1 1 Y• 1 \ • �/ • \ ••I\ 111 1 1 1 II H ��,i13Dd•C� � ,� G �. .,F ��,.0'��..IR - X 1 1 1 i n r In 1 i 1 1 riiii/i� %;'//„arl{�•Ur/rat/o/�iiii�i/iai����������������� �����������������������������������������������/��/�%�/�������������������������� •I. - - - 177r.rT7,=. - 1 1 i i - • 11 _ 1 ME plf� Is •11 1 11 1.il ■ ■ 1 1 1 11 1 1 1 1 1 1 1 1 • - • �•a 1 I .1 r •1• • / e -. 1 =•••u • • • • • - • •u1•.ItLt.0 •u • • " • • • �• \ •111 // • 1/ / o r11rm-1 -1 a :1 • 1• \�• ell •�1 • •1.1• . • \ IL• / II • • • t/ / • •« r •1• •A•• rse a/ • •) of • • •f II 11 Meteil. 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I Ul•1 L• r• /1 MI •I • •• 1 11 .1 to .11 • V61r •11 Iklolqhfo •.•/•Itll q4I lobw1 -• 1 w. 1_t 1 1 li , • .1 toI w11 •1 1 0ll \• « 1 w/ll lI • 1 • • • I 1 .le ' 1 1 w, • •II w•Y.1 • u • u • • _• / 1 -• • t 1 Y. 11 ' •I•.�.� V aU110-4♦`✓.It all • • I v ✓. 1 tl 1 for. to-11 .1 •1 111111 1.� 1-• a • MAN a is ask I /t[ i• 1 ' 1 V61111/ .'1 .11 0 • IU/-o w•• I 1 1V, oll .Itl 1 I • •-• • « .1 /I • • t em • e " 11 • el 1 •1y • • / 11 /1 .•ol e1 1 i/ . • 1 .� • 'Y.1■ •11 1 /• M•111 Y. « • 1 .••I: t1e1 • el • r •%Itl I to i11 II 11 • \1111 Vw• IIIIf1 • .1 ' 1 1 I I _• -/1-I wt 111111 t.1 1 ■I • 1•. 11 • ••let_• a eel-11 • • 11 •1 IIt •/1.I • ,t1 ' w1•w11• 1 - •-�'1 11✓• ee • 1 r to •le '• I to 11 .II • 11 I • .11 V • • 1 V•• •-/ .1\ •11 1 e 1 • • • 1 •11 • • w e •a • too-to /• w v. • 1 •11 .e1 a Y••' I I 1 1 1 1 1 1 • � 1 e 1 1 e / e i t 1 1 1 1 I 1111 - 1 111 11 11 1 °dine rpm ti �. . ° The Town of Barnstable �'$ Regulatory Services Thomas F. Geiler, Director Building Division Peter F. DiMatteo,Building Commissioner 367 Main Street,Hyannis MA 02601 :e: 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.. Type of Work: iai �cy �J� s � - Estimated Cost 5o �0y Address of Work: Owner's Name: 7 Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law 0Job Under$1,000 ilding 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. OR ` Date Owner's Name a:forms:A ffi da v:rev-070601 1: 1doe � u-"�-�c • '�Gt�UO� Vj I , of M qjP1-- ��,. . A YNLk.MM ;�. '• =L L D.GA -� .Lyi 15P0 Y t C) H A,T . �MYE . FQ► TE �"�4 E�EcZE :iGE sO`��+ � `pL A ti► R �� *TV d A.f. T 1 �� ,5 y �-1FR �K EQ 115. - aik�o t ---• - — SIOiNG I � �� I - ' I I p vIMENSioN►atr IJir.,F- I ' - A s E Ds N-,q vE i G At3cE' END LOU vi�as a'X y �,LLA-a. n E s I LNor- SF DVJN� 'f Xy TvA PLar� , q x y 6LOLKI y I I � iI i 12,yu el 2 (." Ioo�C Joist 111P i I I I i loxI � �rTC14 - _- 51oiN6 I a Ll fur c �;< Pi uv ,�c; l I 6 y 2x14' &rTEplS DIMENS1p�JN1. �iNE - ALL s HE Ds r+A vE j G I teCW EN o Lou v' as a x y G a LL�"R- 11 E s LN br s WD w N, Ll Y 4 Top PL f?T� i lyy i! (jLOCKI►� G /30 5 i i P,y,U,,6 0 � A IOx1 (o - _ Board of Bid4n gulations -_ One Ashburton PTac�e, Rm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Bitthdate: 03/14/1970 'Number CS 073855. Expires:0311412002 Restricted To: 1G JAMES R MCGRAITI 50 WINTL'RkiREF.N LANE BREWSTER. MA 0263I - - -- Tr.na: �"3855 Keep top fw and'dtsnge of address notification. Board of Building Regina ions and Standards 4 One Ashburton Place -Room 1301 ti- Boston, Massachusetts 02108- Home ImProvexnent Contractor Registration Registration: 1'32935 Type: Private Co poration ' Expiration: :0/31/2002 MCGRATH POST & BEAM CO. JAMES MCGRATH 259 QUEEN ANNE RD. - ---- - -�. HARWtCH, MA 02645 Update Address and return card.}lark reason for chance Address Renewal Employment ." Lost Car BmMbf Bulling Reolshti0as and Sgndards License or registration valid for individul use oniv e ti: IiOME AiAPROVEM0IT CONTRACTOR before thepspiration date. If found return to: Reg--stration: 132935 Board of Building Regulations and Standards Expiration: 10131/2002 One Ashbnrtoa Place Rm 130t Type: Boston,Md.02108. �. MCGRATit POST&BEAM CO. JAMES MCCRATH 259 QUEEN ANNE RD_ lfARlMt,ti IAA 02645 Admiuistrater L Not valid without signature '+� I The.Commonwealth of Massachusetts 414-1 Department of Industrial,accidents %1�1 0 i�fIICSOJ/BY6SabOf�(t/i 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance.Affidavit Annlicant information: P[easePRIlQ'TT h'bTir name:" location: city phone# 0 1 am a homeowner performing all work myself. am a sole proprietor and have no one working in any capacity, 0 1 am an employer pro,.iding.workers' compensation for my employees working on this job. Company name: C Ar or-at � � / t 6 V+ CJA - NarbO F address: rn .` ci n**')q phone#• 17 I �CJt Jl1 insurance co. 1J 1 / I e, UQ 1 Of V ®O policy# H17056le " 0 1 am a sole proprietor. general contractor.or homeowner(circle onel and have hired the.contractors listed below«ho have the following worker-; compensation polices: company name: address: City: phone#• insurance co. policy# company name: address: city: phone#• insurance co. porey# Nil' Is 81 Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a But up to$1,4"and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of SIODAfl a day.against me. F understand that a `.copy of this statement may be forwarded to the Office of Investigations of the DU for coverage verification. l do hereby rt* der the pains a ies ry'ury that a information provided above is true and correct Signature Print name Lb ono# —�� —.s..�►-- OfMcial use only do not%rite in this area to be completed"by city or town oflieial city or town: YAR14OUTIL _ permitAicense# riBuilding Department pLicensiug Board o check if immediate response is required 261 Oseleetmen's Office 0Healtb Department contact person: phone#;_ (508) 398-=2231 ext. raOther CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: DATE JOB LOCATION PROPERTY OWNER CONSTRUCTION SUPERVISOR LICENSE NUMBER . PHONE ADDRESS ��9 � . LICENSED DESIGNEE (IF ANY) 2 . 15 Responsibility of each license holder: 2 . 15 . 1 The license holder shall be responsible for all work for which he is suner fully and completely responsible for seeing _ icing. He shall be Building Code and he h dr ings as s approved suant to the State Of by the Building 2 . 15 . 2 The license holder shall be responsible to su L construction, reconstruction perv_se ', alte_anon $1 `---e de:�ol-t-on involvi _ repair, removal or structures only put u pursuant tothe State elements ild n Code s of or a,, l Other acolicable Laws of the Commonwealth even th ugrh he and the lli cnn ho-der, is not the pe=nit holder but onlya sub y _se contractor to the permit holder. contractor or 2 . 15 . 3 The license holder shall immediately notify the ; i official in writing of the discovery of any violation y bu__a�ng covered by the building permit . ns which are 2 . 15 . 4 Any licensee who shall willfullyv' 2 . 15 . 1, 2 . 15 :2 or 2 . 15 . 3 or any other violate Subsections reTsiations and an off, her suctions of theses rules and revocation or Suspensioncof1the license res as nb amended, shallbe subjec� to Y Board. 2 . 16 All building er:�i sicnature and licensee uumbertofDtheccons ruations �hall contain the name, to supervise those 4" ' on supervisor who is a'teration engaced in construction, reconstruct_ an, repair, removal or demol `t_on as r 109 . 1 . 1 of the Code an these rules an egulated by Sec�ion t:lat such licensee a regulations . In the event is no longer supervising sai persons.,shall immediate) d e..sons., the wor.1 y cease until a successor license holder is substituted on the records .of the buildingdepartment. - rtment. I have read and understand my responsibilities under the reculat-ohs for 1-ceasing consLrsct= r•, rules and wit? Sect- _on suDe� ri sots i n accorcance on I09 . 1 . 1 of the State Budding Code . understand construction instection procedures and the spe ; I unde_s��nc ca'led for by the building official : - `'yf-c ispect;:ons as LICENSED CONSTRUCTION SUPERVISOR Suggested Affidavit for Home Improvement Contractor Permit Application For Office Use Only NAME OF CITY/rOWN Permit No. Date AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL e.142A requires that the"reconstruction.alteration.renovation,repair,modernvation,conversion,inprovement,removal,demolition. oeconstruction of an addition to any pre-existing owner-occupied building mntaininzat least one but not more than fourdwellin¢units-».or to structures which are adjacent to such residence or building"be done by registered contractom with certain exceptions,along with other requirements. ` Type of Work: �t�SfrvCfiOn o-(Poshr 64 y Est. Cost Address of Work/ Owner Name'✓ Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law Job under S1,000 _Building not owner-occupied _Owner pulling own permit _Other (specify) 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 age t t n r:1109,37V Date tractoor1�a e Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name I PLOT PLAN FOR LOT # Indicate location of garage or accessory building Additions with dashed lines ----- -------------- Sewerage disposal (cesspool) Well 0 I (lot.... ...... .... ..ft. rear) uttor's Abuttor' me Name t # Lot # REAR YARD this is a if this mer lot, ........�....ft. corner ite in name write street. �. name of A, other 4ZI, a°Ji street. a b SIDE YARD SIDE YARD • HOUSE ; • FT • �]--- �- -FT=- �j--- - -- O ; SET BACK 19 (lot..................ft. frontage) \ / (NAME OF STREET) / Information Supplied by lime Town of Barnstable *Permit# Expires 6 months from issue date BARNWABM 's Regulatory Services Fee ;MASS. F7 s� 1 �e� Thomas F.Geiler,Director 3 � Building Division Elbert C Ulshoeffer,Jr. Building Commissioner X®P 1 367 Main Street, Hyannis,MA 02601w ��°S - Office: 508-862-4038 Fax: 508-790-6230 MAY 3 ZOO EXPRESS ERA Red�PPLI APPLICATION TOWN OF a,�RNST� - r' p Map/parcel Number 100 q7 y p N / r Property Address U /)e G� 1A4/)_t)r) Q�z residential OR ❑Commercial Value of Work O f ?0 , On Owner's Name&Address o f A Q e r Ie 0— Contractor's Name 1 � Lze gm�elephone Number !% D -gSl k Home Improvement Contractor License#(if applicable) 0 O-7-4/0 Construction Supervisor's License#(if applicable) Ccs U 72 7"7 fjW-orkman's Compensation Insurance Check one: I am a sole proprietor I am the Homeowner [ have Worker's Compensation Insurance Insurance Company Name 2 o r C',h /7!1 I Cr I CQ t*1 Workman's Comp.Policy# tUC 3 / - o2-7 T9 6 CYO Permit Request(check box) Re-roof(stripping old shingles) Re-roof(not stripping. Going over existing layers of roofl Re-side ❑ Replacement Windows. U-Value (maximum.44) Other(specify) aLk_m I�ls� *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signatury expmtrg CAPIZZI HOME IMPROVEMENT INC . SPECIFICATIONS AND ESTIMATES PAGE 1 OF 3 CAPIZZI HOME IMPROVEMENT PROPOSAL Established 1976 , Serving the Cape for 25 Years 1645 Newtown Road Cotuit , MA 02635 REVISED 508-428-9518 1-800-262-5060 Fax 508-428-1547 Date: 4/17/2001 Name : BERT PEREIRA Job Address : 81 MELBOURNE RD. Address : 81 MELBOURNE RD . Town: HYANNIS City : HYANNIS , MA 02601 Home Phone : 508/771-8176 Other Phone: Estimator : 2/MH Job No . : 22063 We hereby submit specifications and estimates for the following work: SECTION 1 . Furnish and install aluminum trim coverage on the following trim: fascia , vented vinyl soffit , frieze , rake boards , rake tips , window sills ( full ) , window casings , door casings , corner boards , ear boards , garage door casing , new stops and [ 1 ] one louver . All trim will be bent in a manner to cover all wood trim and edges with aluminum trim nails 1 1/4" hidden as allowed without scratches or buckles on entire house . Not including basement windows . USING SINGLE-COAT , BAKED-ON ENAMEL ALUMINUM TRIM ALCOA , COLOR = WHITE LABOR & MATERIALS $ 9 , 224 .00 SECTION 2 . Furnish and install [ 2 ] two dead light panels . LABOR & MATERIALS $ 191 .00 SECTION 3 . o=i rot on trim boards on the following areas : a) Front -- E_- .L� -iert corner (bottom) , front door kickplate , front right corner (bottom) , b) Left -- middle slider casing , and c) Back -- far left rake tip. LABOR & MATERIALS $ 245 .00 SECTION 4 . Front door to be fluted casings . LABOR & MATERIALS $ 205 . 00 SUBTOTAL $ 9 , 865 .00 LESS SCSP -$ 987 .00 JOB TOTAL $ 8 , 878 . 00 NOTE : Homeowner to remove back canopy . ACCEPTED BY (� 1 DATE 9 2 THIS PAGE IS PART OF AND IN CONFORMANCE WITH PROPOSAL #22063 Assessor's-map and lot number ...'.'..( .� ...Ar'a.7 Q o Sewage Permit number ......: SEPTIC SYS�TEM'MUST........�:3�.6.�r.�.................... INSTALLED IN C®MPLIA House number .......:.... .$. / WITH TITLE 5 t BABK"& LE. 9� M6 6 0 46C ENVIRONMENTAL C0�� f�..°mac eaY ' TOWN OF BARNSTA:jL ¢� ' BUILDING INSPECTOR z APPLICATION FOR PERMIT TO .. .:...... .. .. .. ........ ..... .... TYPE OF CONSTRUCTION ....��J O v. .......... G`:4.0...................................................................:..:...:....} � ...�..:......2.c� ..19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following informatio Location .. .........J�. ...........1...1.. L.130 4( ?/n ........ ............. .1.. �� .'.1./11 J.. � V................ ProposedUse ...� ./../.V.1 .. ................ ........................................... .......................................................... Zoning District .........k .:...................................................Fire District ........... ... . A..IIv/.s .................................................... Name of Owner ./ !J. .�4 ...... I�I e .....Address Z 7.... t4��r � .. 1�.,`�.....1.. Name of Builder l/.. V4.6. ........ Address V �QC_. I! N.11J. u� ../.......... .. - Nameof Architect ......... .......................................................Address ....................................................:............................... Number of Rooms .....Y.........................................................Foundation ��� G2G......... .4J!/C.�G G'............. (ill Exterior ..... ..A.4 .......... 11� }ill .............................Roofing .......�s..P.w&c..i ................................................ Floors ........ L .L'.V.c�......... :.. �4 .1/..............Interior ...- G. (T�rf�. 1.C............................................. Heating < I .. .. ..............L..................................Plumbing / .. .... r CC {{ Fireplace ........ ... ..1.............................................................Approximate Cost .....v.. .. •• �.Lam'. ......... ............................. -Definitive Plan Approved by Planning Board ____ l_______ ___,� 7 19__��. Area .../ .o........... a.'.... Diagram of Lot and Building with Dimensions ` Fee �1.'. SUBJECT TO APPROVAL OF BOARD OF HEALTH j�.57 � 08 k t I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re rding the above construction. ) / � I Name . . !� ... R.?�..... .. .. ✓ . .. ? . ................. Construction Supervisor's License .... ..L�f. l. cf.Y - r�J PEhEIRA, HUMBERTO 25620 One Story No ................. Permit for .................................... ' Sin le Family... .........- .............. .................. ..... ..... , r Location ..Lot 51 cl�ouria.e...Rpad .................w�...HY.annis.P4r:.......................... Owner •Humberto Pereira••.••••,•............. - F r ame -. Type of Construction / ........ .....`: .................... ...................... ..... t Plot ........................... Lot ....................:........... Permit Granted October- 7,,r- 19 83 ............................. ...... Date of Inspection ...:................................19 < Date Completed ../. ........ : ' ...19 t17 � : - yo�TMt TOWN .OF BARNSTABLE - 'Permit No. _25 5�fl Building Inspector cash �r __-L// _ -- � �, mix r• OCCUPANCY PERMIT Bond ____x_-__ ------------ r fl � Issued to Address [ i✓Ta�z�aka�rt-,n� P�+rai ray x T^Jr �Pf'ftr, .. TAT �7�44Pr1lnY ..5°,��3 Wiring Inspector v -' �/ Inspection date Plumbing Inspector/ � Wit... w Inspection date r A f. Pas Inspector "2, a Inspection date ,9 7 A r 7 4 R4' )Engineering Department Inspection date Board of Health S -�° r Inspection date 4p 7-7.- r THIS PERMIT WILL NOT BE VALID,N""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. ....................................................... 19..........� ....................................................................... .......,............_..................... r Building Inspector .. - FROM -� TOWN OF BARNSTABLE BUILDING DEWTUENT. 1- 367 MAIN .STREET HYANNIS, MA 028E ;. ' Phone: 775-1120 17 SUBJECT: FOLD HERE - DATE - - AIAU 27 19 MESSAGE �4 ' SIGN D - '� .. DATE ' w REPLY ' • SIGN D _ i _W—.,r _.__ _fir°f_ - _ �.. i"�4. .. r�Y. .. •.,. - a;.?� .... _ t �• 4 ,,ta` i - _ Lo _ tt Y t Al it l.t '� �• =- cEQ.T1FIED pt_or,, pt--41013 I : MYE � . No. 19334 S ��pISTEN�OQ• 1..QC./aT_ I�)--1, i �� `I � ptA�1 �•RYEFEcZE►JGE t j, C,6RTIFY : .T>•-IAT THE. CvuC FbuU0 5uo-V Q ::1-IEQ�c►�1 Go�MPL�(S WITH TNE : 51QE.l.I►-�& c,-�` Auv 5E1' GK �ZEQU1czEME:wT5 OF -rNE To w u off, eRNS vY�-8[..�� A.►.�� �s ►-'��' (��I C.Y 2 u - P 13 F11�1 LoGAT'i=� WI T�-t l F'L.00/v� 1 g a XTG.tiZ (... J REGIStc-JZt=D 1�►.1� SU�Vt`(o1ZS `dAT� Iy�S•� � -. ♦ OSTE2V1�. o MASS, :IS S l oT BAS E 014 A �..� tl.ly^rr�cJMF-wr Su Ttaa UFPS =rS 5i1o"w QPP1_.1C.A.p�IT -�t`V '�: ". `• � � LI We , S I 5�t� �! ' u v�SPoSAL PIT U;� BOTTOM AQea- 1►3 5F x� .01 i ToTA," 4 PEY.c-��•s'r t ou P�T�= l t u 2 kvu oQ Lr�,S �s I G I is I I :.. . . . .. i ZI o • �4•�•�OF ED WILLIANI G: '. :.Sr` •I ,n ?'�'' L..+ Imo- G. N Y E p No. 19334 �� � _P ;,.� _ !r• 7 I U�! 4••PPF- A. r L u `15u� Sic -� a.� . f Bo IW X. �U W_ ' C I boo 5 iU Wv. N. -1 b . � (yam• �,Z. . 9&'`j L.EAC r+ U u11T►a I , waSu� CTD N� 1 J C EtZ T 1 F 1 E D �-10 LC-- � ' t \� ID AT�. PL 11 I 1 2(=F=E1L C-sJ C.E= I C�r-Ti F:- THAT T"• F- tom. �K�rZL!UC 5 �� ►-�E2E.o►-� ' GoMP�-Y S WITH T"Gr_ AhtD SL-�E3AGK. RE!?v12�M�►.tTS OF l'�1E Tewk4 OF �us�x�.ADD i s•►•-��7- c...,�:�J ��=y'c�G�•-,. ?.::: �� ��C,�. 1 d LoC-_4-CE3Z:� V`/I l"l N TNT F•Loot� PLAtti.l, ' �A-c� �5.1� • � ^ \ $Ax-rer� e, ucE lu•C. 't 2 ►sT� u� Faun �,c�evcYoCG T"I4 ?L&d J 14 f OT USED OU Au W4T ME�4T OtT�VtL l � mA.C,S TOQ oFFscT; •5"DuLU WOT ZfiE USeO r i To "D cT r_Zm I w E LOT LI u Eg, ------=r.. � , _. •�J, 1 , s�� �� � � � � �� AA 9/1 IOU Assessor's map and lot number "... CF TN E Tp� Sewage Permit number ...............! ................... BABBSTA►DLE. i House number ...............................� �... : ro NAM . ........................... 16C p 1639. \0 o MAY a' TOWN OF BARNSTABLE f BUILDING INSPECTOR APPLICATION FOR PERMIT TO i 4U Ir" ............................................................................................................................. .— TYPE OF CONSTRUCTION Lo2D ��/`f�� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... ..........`-:S-/............/ I.-/ L���)U.���/..G ........ ................../� �fl�f��/l!„�/1��.�...... ProposedUse ....:/.J,�cJ�` C. .:../,J�/(�,-- ................................................................... .......................................................... Zoning District ......... ...................... . ............................Fire District ........... ..JtiJ. ........................................ Name of Owner l.�.Gt /ZlI T�iT ..... Re://2/�......Address .�l�....�..��t�/1/Gf�,� ..��.`�.....191 !`i�!�'//11)"J /W Name of Builder (.......( u—!l -s........�.e..:_!//!M1/®i!/i�....Address (�...����J�,%'��.�II1,C/�i��......�� �.....�.�/��1�//� Name of Architect ............Address Number of Rooms ..�:....................... Foundation �C?cf 1�2L�........�.0/��C 2�T G.............. t Exierior ...../,h,).OP.......... r ��..L .............................Roofing ....... ................................................ c� i Floors r.�-t. f.��i 6�a �. .���'� ..........Interiorf ............................................. Heating......... �a ..!.........6..�.4 ..................................Plumbing ........... .......���� �.................................... .. Kftt Fireplace .:....� F Approximate Cost `- F ................................................. Definitive Plan Approved by Planning Board __ _t __ _ __19 Area .......................................... Diagram of Lot and Building with Dimensions U Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . .. i(/...: �..........a Vie !.. ................... Construction Supervisor's License ....Q/.Lf..C.'?.. ../.... PEREIRA, HEMBERTO A=268-249 9 25620 One Story No ................. Permit for .................................... Single Family.. Location ••Lot... 1 ........81• Melbourne...Rpad ................. Hyannispor ......................... Owner ...Humberto Pereira ;•„• ......................................... Type of Construction .Fret?1P............................ ................................................................................ Plot. .........:.................. Lot Permit Granted ..Qctober.,_7,,............19 83 Date of Inspection......................................19 Date Completed 1 1 f� Assessor's office,(lst floor): '` /l� _ OFTMEt� Assessor's map and lot number : .: s .'.:.a.. 9 .. �♦ Board of Health:(3rd floor): �! ` Sew ag a ' it number .....��'1"... �... � ?" ....� C QN r . Z BARNSTADLE. Engine Department (3rd floor): a ' +o NAM � psi 1639• \00 Housem. . ..........................................................I............. �f0 MPS a' Definitive Plan Approved by Planning Board`_______________________________19__:_-___- APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00.2:00 P.M. only TOWN OF -BARNS'TABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO- ... or 4. , N TYPE OF CONSTRUCTION ..... i:r ... ...................................:........:..:........ .. ... .........19 TO THE INSPECTOR OF BUILDINGS: .The undersigned hereby. applies for a permit according to the,following information: Location ....... �.....'/..� %UGC �/�'L�!... � ...........?�/ LJ:....................:...... 4 Proposed Use ...... l-.::.. �:.iV ..................`...................:......... Wing District .................:......:.......,...:,............ .::.................:Fire District ................. .............................................................. ' Name '.of Owner .��!/1.4f'. %`!/lIJ. O/l?.!/LQ...,.......:.......Address ... ............. ................. Name of Builder ..:.:.(-. 0 G .. /��,�.........Address V Nameof Architect .... ...Address ...............................:..:.......................................:......... Number of Rooms ............4. �/ C ....Foundation ...... .. ... ..y.. Exterior ........ ..........................:.............Roofing .... . . .. ... .............................. �j Floors /(,IQP .... / Z CS ............Interior .. . .................................................... gHeatin .:. .Plumbing , b Fireplace .............% 1 .................................;........:...........Approximate Cos .. . ..................... .....,........... Area ..... ........... Diagram of Lot and Building with Dimensions Fee .. :�........................... OCCUPANCY PERMITS' REQUIRED FOR NEW DWELLINGS ' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 'Name .... ......................... Construction Supervisor's License - PEREIRA, MR. & MRS. REBUILD GARAGE/ � :32703 f No .................. ,Permit for FAMILY ROOM ; <Sin amily Dwelling - `- . ...."......... ....................... Location r8lrMelbourne Rd. :.................... _• ... . ........ Hyannis ............. ;- / .� ;/� •. �' ��� •• i � , .... ....P.. ............ Mr. & Mrs. Pereira - Owner r .................................................................. i -Wood Frame r Type of.Construction ...................... ... .................................... !"41 4 "' .6, r i J. f" - f.. f • - ( - Plot .. _4 ........ Lot~... .... .. March 14 1 f' 89 f Permits Granted .... ..: _ '.. " .19 � .:� Date of Inspection .............................. Date;C6mpleted ...... k ... . ."... '19 I7. I •s ,, t , a •s� r< S • f r• <. Aw ram. - t' t ,, ��• 3• �" ~x J ,r.`�,- .. � «. A + � r�_.r� •L Ar— J' 1 - ', _ wo-er. ... ty..ty ,].imF(+ara -. ,.�,x. ..+ ...+ et'•..^x �.a�».. ..v:T;7�F:+ a..+r`tW.'�'.4°•w•s:;i.:r. r .. ..rry .::4 Qv .,R...e.',ram-r+.y�',.,..�.e• Assessor's office (1st floor): �� ' Assessor's map and lot number v�s '.'.. ........ A Q�oF THE toy♦ Board of Health (3rd floor): �L � ,�� QNaY�t J Sewage Pe snit number ....................................................... i Baea9TGDLE, S Engineerin Department (3rd floor): 'moo r639 House cumber .................. s, �Fa d� Definitive Plan Approved by Planning Board ________________________________19-------- - APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN 'OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION ..... .. 4,4_- .................................................................................... .3/. `..... •. ..............19.b Y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......� �.... � (n!' ,{...� ` ........ ?� �. ,./ /!'1. ..................... Proposed Use ...... !..!�C.ti� - '..:..�� !1��!/X . '......................!d ?s "'�'1..,�w��? 7�f.. �Q/1 . .............................................. ZoningDistrict ........................................................................Fire District .............................................................................. / n/� � 4 ' Name of Owner . .....Q. _,..a. ./d.:.................Address ... �............. Name of Builder ......(' Y ld 1�..4 .�.-�/�. . .........Address ....a..� � e. e��..... ...... + GC ` Name of Architect .../ r( .... � �� ...Address .................................................................................... Number of Rooms ............ .....'Z..�, ..Foundation + Exterior ........ � .'-L....C1.4/44-......................................Roofing .. ......... ...........Q!1.. ... ..... Floors \..:: ! �.....:� .1!? ....�/ ! ' ...........I n ie r i or .�d_&� . ................................................... HeatingA .... .. .............................Plumbing ... J / .. !..................................... G� �v Fireplace ............ f��?. .....................................................Approximate Cos ���..1.... a.�J..0......................................... r . Area ffi................... Diagram of Lot and Building with Dimensions e Fe r �1 ... ?. ........................... OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to oil the Rules and Regulations of the Town of Barnstable regarding the above construction. ��& 1Name ......... �_ Construction Supervisor's License ...00.e 5...1,,,J„ I 1 PEREIRA, MR. & MRYBUILD 268-249 GARAGE/ 32703 LY ROOM No ................. Permit ........................... Single 'Family Dwelling .........J�.......................................................... Location ....81 Melbourne Rd. ........................................................... Hyannis ............................................................................... Owner Mr. & Mrs. Pereira .................................................................. Type of Construction Wood Frame :......................................... ............................................................................... Plot ............................ Lot ................................ March 14 89 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19