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0087 OAK STREET
87 OasC Sir�- of r Town of Barnstable *Permit id b 14 d ZSZ Expires 6 months from issue date PERMIT Regulatory Services Fee f * SARNST"LE Richard V.Scali, Director n 3 �•` 1_ 2014 Eo +. Building Division t i 1`�i � ARNSTABLE Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 3/d O� / Property Address Cl-7 QAk esidential Value of Work$ "�D�� Minimum fee of$35.00 for work under$6000.00, Owner's Name&Addresses ' /'�Rf. f�I-Cc't * Gov mil/ Dirt ��l easr N ZaKa? Contractor's Name (/ rP Os�OS C�►�SYn� ,✓v, Telephone Number �r�?8 Home Improvement Contractor License#(if applicable) e!!� l Email: Construction Supervisor's License#(if applicable) m orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ IAM the Homeowner have Worker's Compensation Insurance . Insurance Company Name �'- wi, Workman's Comp.Policy.# d/7/ c✓ sa% 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 r ❑Re-roof(hurricane ailed)(not stripping. Going over existing layers of roof) ❑ Re- ide Ljj placement Windows/doors/sliders.U-Value (maximum.35)#of windows c3 #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. ---- ------ ....._ A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building ermit formsTYPRESS.doc Revised 061313 The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia _ Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organiiation/Individual):' O Pid a ,•.� Address: ��, to&66 City/State/Zip: yr R Phone#: p �6 Are yo an employer?Check the appr priate bog: Type of project(required): 1 I am a employer with_ �� 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2..❑ I am a`sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [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 I I.❑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.❑Other comp:insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'.compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: a Policy#or Self-ins.Lic.#: '/ 1O 1 Expiration Date:__ Job Site Address: ,�i812. Eiue City/State/Zip: // Attach a copy of the workers'compensation policy declaration page(showing the policy num er and expiration date). Failure to secure coverage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year,imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator: Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify underthe pains and penalties of perjury that the information provided above is true and correct: Signature: �/ Date: Phone#: a 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of.a license or permit to operate a business onto construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situationand,if necessary;supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships'(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town.that the.application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to.contact you regarding the applicant. Please be sure to fill in the permit/license number which will be.used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year:Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you.have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www=ass.gov/dia / T ® DATE(MWDD/(YYY) CERTIFICATE OF LIABILITY INSURANCE 09/02/2014 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 NAME: Kristine Fernandez Mark Sylvia Insurance Agency,LLC PH ON o 508 957-2125 aC No: 508 957-2781 404 Main Street Centerville,MA 02632 ADDRESS:kdstine@marksylviainsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Farm Family Casualty Insurance INSURED _ INSURER B: - D&T Construction,Inc. (NSURERC: PO Box 168 Centerville,MA 02632-0168 INSURER D: INSURER E: 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 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 ADDL SUBR POLICY FFF POLICY EXP LIAIRS LTR TYPE OF INSURANCE POLICY NUMBER MWDD MIDD A X COMMERCIAL GENERAL LIABILITY 20OIX0485 7/21/2014 7/21/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE ❑X OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JE O- ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY - - COMBINED SINGLE LIMIT $ a accident) ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS - - Per accident $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS•MADE AGGREGATE- Y:,. $ - DED RETENTION$ _S A WORKERS COMPENSATION � -2001 W7501 - - 7/25/2014 -7/2512015 STATUTE ER AND EMPLOYERS'LIABILITY - ANY PROPRIETORIPARTNER/EXECUTNE YIN N N!A- - - E.L.EACH ACCIDENT $ -1,000,000 OFFICERIMEMBER EXCLUDE., Y� (Mandatory In NH) - - - I. E.L.DISEASE-EA EMPLOYE $ - - 1,000,000 - If yes,describe under DESCRIPTION OF OPERATIONS below E.LDISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS'/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is_required) Carpentry CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE D&T Construction Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 168 ACCORDANCE WITH THE POLICY PROVISIONS. Centerville,MA 02632 - - - AUTHORIMD REPRESENTATIVE f 1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD u Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialty i License: CSSL-099913 TROY,A THOMA - 499 NOTTINGHAM 13 ` CENTERVILLE CIA 02632 �.�..—11 •" "`. Expiration Commissioner 04/13/2016 Office of Consumer Affairs&Business Regulation License or registrateon valid for mdividul use only ME IMPROVEMENT CONTRACTOR I before the expiration date. If found return to: registration 1-5954 Type: ! Office of Consumer Affairs and Business Regulation ,;Expiration 3t15/2015; Private Corporation: 10 Park Plaza-Suite 5170 =` Boston,MA 02116 DOYLE+THOMAS CONST,INC TROY THOMAS 499 NOTTINGHAM DR CENTERVILLE, MA 02632 -- Undersecretary j N�t v lid without signature i e 506-326-1635 SPECIALIZING. IN ALL FORMS OF ROOFING & SIDING doyleandthomasconstruction.com MENEM . M P.O. BOX 168 eBs_ ` CENTERVILLE, MA 02632 Fully Licensed & Insured Construction Supervisor Lic#99913 Doyle and Thomas Inc. Proposes to perform the following work: Location of proposed work: Mr. & Mrs. Patitucci 87 Oak Street i Hyannis, MA 02601 Date on which construction should begin: Fall/Winter 2014 The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that cannot be avoided by the contractor shall not be considered as a violation of this contract. The contractor agrees that when-such delays become known to the contractor,the contractor will advise the homeowner as soon as possible. The homeowner hereby acknowledges that in certain remodeling work,the demolition process. may reveal defects in the existing structure which must be repaired, creating additional work which may need to be carried out in order to complete the work described in this contract. In such case the homeowner agrees that the duration of the work and the schedule date of completion may differ,and that such variation is not to be considered a violation of this contract. The total cost for labor and materials under this contract: - f - Proposal to install Maibec A white cedar siding shingles on areas: Entire left gable $4,932.55 Entire lower back section of the home(not to include the sun porch) $2,800.00 Entire lower front section of the home(not to include the sun porch) $2,800.00 Install of 3 Harvey tribute triple double hung windows on the back of the home would be an additional . (to include trim inside&out ready for paint) $8,650.00 Thank You For Giving Us The Opportunity To Help You Improve Your Home In the event that while stripping the siding we find rot that needs to be replaced,the homeowner then has to agree and authorize any replacement or restoration. Then in addition to the above contract price,the homeowner agrees to compensate the contractor for any repairs or restoration at the hourly rate of$45.00 for a carpenter and$30.00 for a carpenter's laborer, plus the cost of materials. -Siding to be stripped and cleaned of all old siding&debris -Home to be papered with Typar house wrap -Maibec Grade A white cedar shingles to be used in the installation -All.PVC trim to be.installed with cortex hidden fasteners system -5 Yard dump trailer will be needed on site; and will be removed at completion of the job -Contractor will be responsible for all building permits needed at the property NOTICE REQUIRED BY LAW With the agreement of the.contract$500.00 of estimate is due. Further payments under this contract are as follows: 1/2 of the estimate due at the start; and remainder due at completion of the job. Balance of all materials and labor shall be payable in full upon completion of work described in this contract. Payment as agreed upon shall be made when due. Any payments which are delayed shall be subject to a finance charge of 1.5% per month. The contractor warranties the work com.pleted under this contract for a period of one year from the date of completion. . During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment, but the contractor shall not be responsible for the normal maintenance, repair due to abuse, misuse, and or normal wear and tear,which shall be the responsibility of the homeowner. . All warranties for the materials supplied by the contractor shall be passed directly to the homeowner. The homeowner may be-required to register or mail in such warranty card or evidence of ownership in order to activate such warranties. Homeowner failure shall not create any responsibility for the contractor under the warranty provisions;the choice of repair of replacement shall be at the discretion of the contractor. The homeowner acknowledges that the form, content, and notices contained in this contract are intended to comply with the applicable portions of the Mass. General Law Chapter 142A, and regulations promulgated there under. In the event of any instance of non-compliance,only such portion shall be invalid and the remainder of this contract shall be in full force effect. In addition, any such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and regulation. Signed as a sealed instrument on this date:-- Date:, Homeowner Contractor z _ �y Town of Barnstable C73��Z Expires 6 months from issue date "7 Regulatory Services Fee • BMMSrnsi.E, MA & $ Richard V.Scali,Director 1639. AlED�(A Building Division , Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY � �ot Valid without Red X-Press Imprint Map/parcel Number Property Address Ak � 2-1 residential Value of Work$ 3� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address / �• �' �. �i4��T�Cttu Contractor's Name e!� e j�o e Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) 07'M/ [gWorkman's Compensation Insurance �� Check one: ❑ I am a sole proprietor MAY 2 7 ❑ I am the Homeowner 2014 [ have Worker's Compensation Insurance Insurance Company Name /�v✓a 74 Ali G, �f v�l�: S Tormy OF BARNSTABLE Workman's Comp. Policy# J; c/ 4.) Copy of Insurance Compliance Certificate must accompany each permit. Permit a check box) roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to e-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ElSmoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 Hie Corr mozatwalth of lMassachusefts Deparhuent o,f Iirdrashid Accidents OJTWe o,f-Investigations 600 Washington Street Boston,,M,l 02111 YVtF'mmassgovIdia Workers' Compensation Insurance Alliidavit:Builders/ContractorslMectricianslPlumbers Applicant Information Please Print Leeibly Name Oksme�Organizatioa&dividnao: 1-1)6� 1-' Address.-- 0.1 /6 d CitylStatt:lZip: vc Phone 4- Are you an employer?Check the appropriate box: Type of project r ,�,/ 3'Pe lam' I (,rgnu-ed}: 1.k 1 am a employer with �-Z- 4. ❑ I am a general contractor and I employees(full and/or gaiY-#ime)- * have fired.the sub-contractors 6_ ❑New oomstnrc#sou 2-❑ I am a sole proprietor or partner- listed on the attached sheet 7- ❑Remodeling ship and have no employees These sub-oontractors have g- ❑Demolition. working for me in any capacity employees and have workers' 9_ ❑Building addition [No workers' comp:insurance comp-insurance I required_] 5 ❑ We area corporation and its 10_❑Electrical repairs or additions 3-❑ I am a homeommer doing all work office>:s ham exercised their 1 L.❑Plumbing repairs or additions myself [No workers'romp- right of exemption per MGL 12Zal;C�of repairs insurance required-]1 c. 152, §1(4,and we haNIe no employees-[No workers' 13_0 Other Comp-insurance required.]! #may Pti�t that checks boa#1 mmst also fill out the:section below showing their woAer:'compensation policy infnLmatiom Ti..S.��nm� eowners who submit this affidavit indicating they ue doing all nook and then hire outside contractors must sL�it a ncw:a�dwit indicating such- lContractors that cliga this box must attached an additional sheet shotcmg the name of the sure-CantlaCtm and State whether tar not those eatilks have employees. If the sub-contractors hale employees,they must pruvide their workers'comp.policy number. I am an employer that isprmidurg it orke-rs'compeiLvation insurance for my employees: Below is Ste poUcy and job site information. / Insurance Company Name: Policy g or Self-ins_IncA� ram'/ a1 j— Expiration Date: Job Site Address: City)'StatelZip: LTI�W/ Attach a cop} of the workers'compensation policy declaration page(showing the policy aura er and Ilpultion date). Failure to secure coverage as regturedunder Section 25A of MGL c. 152 Can lead to the imposition ofcriminal penalties of a fine up to$1,500-00 andlor one-year imprisonment,as well as civil penalties in the fo m of a STOP WORK:ORDER and a fine of up to$250.00 a.clay against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIET for incarrrornce:coverage verification - I do hereby certify under thepains andpenalties ofperjury that the information prosided aboue is true and correct Sisuature _, 1 `� Date: ,--,e—c9O/y Phone# >6 ?r Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: PerrmtUcense# Lssuing Authority(circle one): 1.Board of Health 2.Binding Department 3.City1rown Clerk 4.Electrical inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 r4 Information and Instruction Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an err3Ployee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written" An enTloyer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for aizy applicant who has not produced acceptable evidence of compliance with the insurance.coverage required.'' Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants — Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partnars,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit 'll e affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Deparment of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at:the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permitllicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations i-a (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be idled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents €}ffim ofJnvestigations 600 Washington Street Boston,IAA 02111 Tel.A 617-727-4900 w 406 or 1-977-MASSAFE Revised 4-24-07 Fax# 617-727-7749 www.mass-gov/dia Aco CERTIFICATE OF LIABILITY INSURANCE °ATE`MM,°°"Y"Y' 10/07/2013 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 IN$URER(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 NAME: Debbie Mark Sylvia Insurance Agency,LLC PHONE FAX 404 Main Street a/c No 508 957-2125 ac No:508 957-2781 E-MAIL ADDRESS:mark@marksylviainsurance.com Centerville,MA 02632 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Farm Family Casualty Insurance INSURED INSURER B D&T Construction,Inc. PO BOX 168 INSURER C: Centerville,MA 02632-01.68 INSURER D: INSURER E: 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 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 ADDL SUER POLICY NUMBER POLICY EFF MMIDD EXP LIMITS LTR 7/21/2013 7/21/2014 A GENERAL LIABILITY 20O1X0485 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 50,000 CLAIMS-MADE FX OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ Included GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMPIOP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR EACH OCCURRENCE $ EXCESS LIAR HC0L;AC'AMJR_MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION 2001 W7501 7/25/2013 7/25/2014 7OC LA IT X OETH R AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDEb9 N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEd$ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORb 101,Additional Remarks Schedule,if more'space is required) Carpentry The workers compensation does not provide coverage for Troy A Thomas and Shawn M Doyle: CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE D&T Construction Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 168 st ACCORDANCE WITH THE POLICY PROVISIONS. Centerville,MA 02632 AUTHORIZED REPRESENTATIVE .:_..._ ......... ..........___.....,, r � ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD .�polnvnzoaxcoecrCG�a�C�/l/�i�Jaaccata 6 Office of Consumer Affairs&Business Regulation License or registration valid foi individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: - egistration 145954 Type: Office:of Consumer Affairs and Business Regulation xpiration 3/45/2015 Private Corporation 10 Park Plaza-Suite 5170 . Boston,MA 02116 DOYLE+THOMAS C©fyST,.INCs TROY THOMAS 499 NOTTINGHAM DR CENTERVILLE, MA 02632' Undersecretary N t v lid without signature u . IBM Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction SupervisorSpecialty License: CSSL-099913N TROY A THOMAO�`� -, ''•� f 499 NOTTINGHA CENTERVILLE RA 632 Expiration Commissioner 04/13/2016 _ o . 506-326-1635 SPECIALIZING IN ALL FORMS OF ROOFING & SIDING doyleandthomasconstruction.com P.O. BOX 168 BBB_ CENTERVILLE, MA 02632 Fully Licensed & Insured Construction Supervisor Lic# 99913 Doyle and Thomas Inc. Proposes to perform the following work: Location of proposed work: Mr.& Mrs. Patitucci 87 Oak Street Hyannis, MA 02601 Date on which construction should begin: May/June 2014 The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that cannot be avoided by the contractor shall not be considered as a violation of this contract. The contractor agrees that when such delays become known to the contractor,the contractor will advise the homeowner as soon as possible. The homeowner hereby acknowledges that in certain remodeling work,the demolition process may reveal defects in the existing structure which must be repaired, creating additional work which may . need to be carried out in order to complete the work described in this contract. In such case the homeowner agrees that-the duration of the work and the schedule date of completion may differ,and that such variation is not to be considered a violation of this contract. The total cost for labor and materials under this contract: $6,626.30 30.yr.GAF/Elk Timberline HD Architectural shingle(Life Time Limited Warranty) Proposal to install white cedar siding on upper sections only $3,250.00 In the event that while stripping the roof or siding we find rot that needs to be replaced,the homeowner then has to agree and authorize any replacement or restoration. Then in addition to the above contract price,the homeowner agrees to compensate the contractor for any repairs or Thank You For Giving Us The Opportunity To Help You Improve Your Home I restoration at the hourly rate of$45.00 for a carpenter and $30.00 for a carpenters laborer, plus the cost of materials. -Roof to be stripped and cleaned of all old shingles and debris -Roof to be papered with weather watch leak barrier, Synthetic roof underlayment, and installed with Timberline architectural shingles using galvanized nails. (Storm nailed) -All new 8 " drip edge and pipe flanges to be installed -Cobra ridge vent to be installed on all ridges Timberetex premium ridge cap to be installed -A 5 yard dump trailer will be needed on site;and will be removed at completion of the job -Contractor will be responsible for all building permits needed at the property NOTICE REQUIRED BY LAW With the agreement of the contract$500.00 of estimate is due. Further payments under this contract are as follows: 1/2 of the estimate due at the start; and remainder due at completion of the job. Balance of all materials and labor shall be payable in full upon completion of work described in this contract. Payment as agreed upon shall be made when due. Any payments which are delayed shall be subject to a finance charge of 1.5%per month. The contractor warranties the workmanship completed under this contract for a period of ten years from the date of completion. During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment, but the contractor shall not be responsible for the normal maintenance, repair due to abuse, misuse,and or normal wear and tear,which shall be the responsibility of the homeowner. All warranties for the materials supplied by the contractor shall be passed directly to the homeowner. The homeowner may be required to register or mail in such warranty card or evidence of ownership in order to activate such warranties. Homeowner failure shall not create any responsibility for the contractor under the warranty provisions;the choice of repair of replacement shall be at the discretion of the contractor. The homeowner acknowledges that the form, content, and notices contained in this contract are intended to comply with the applicable portions of the Mass. General Law Chapter 142A, and regulations promulgated there under. In the event of any instance of non-compliance,only such portion shall be invalid and the remainder of this contract shall be in full force effect. In addition,any such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and regulation. Signed as a sealed instrument on this dater Date: Homeowner Contractor TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma m-1/17 Parcel —7 'Applicatio n # Health Division Date Issued 1 ' Conservation Division ( Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address / 0A e S Village1-16 Owner I NOE 10,4 If I Wee, Telephone � Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation. q 19 7v' Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) . C7 Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's I-Li;y way: ❑ s e o Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other � Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)-F — 2 Number of Baths: Full: existing new Half: existing ne s� Number of Bedrooms: existing —new LV w Total Room Count (not including baths): existing new First Floor Room Count' Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed-Use - - - - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name AI it ✓I ca Telephone Number ky�Address b cense# C.)6 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ` SIGNATURE DATE ' FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ' MAP/PARCEL NO. a ADDRESS VILLAGE OWNER V DATE OF INSPECTION: FRAME F _INSULATION:. i4 FIREPLACE ELECTRICAL:.'—, ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL .d I FINAL BUILDING- Y: —DATE CLOSED OUT ASSOCIATION PLAN NO. ' Die f ouantonwealth of Massachusetts epartinent of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 11%8114.masx gmfdia . . Workers'Compensation.Insurance Affidavit:Builders/Conn-actors/ElectricianslPlumbers Applicant Information _ _ __ IR CHIMNEY E . Please Print Legibh= Name(Busineworgaaizatiowindividnal): P.O.BOX T-T TEATICKET, MA 02536 Address-. (508) 540-OM City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. 0? 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 gsrtner- listed on the attached sheet 7. Remodeling strip and have no employees These sub-contractors have g- ❑Demolition workingfor me in an capacity. employees and have workers` y � �'- 4_ ❑Building addition [No workers'comp.insurance comp.inswance.a required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.[1 I am a homeowner doing all work officers have exercised their I I E1 Plumbing repairs or additions myself(No workers'comp- right of exemption per MGL 12.❑Roof repairs insurance required]t c. 152,31(4),and we have no employees.(No workers' 13.❑Other comp.insurance required.] •Any applicant that checks box#1 mast also fill out the section below showing their workers:'compenution policy infotmatim 1 Homeowners wbo submit this affidavit indicating they are doing all work and then hue outside contractor must submit a new affidavit indicating such. Contactors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether at 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 employem Beloit'is the policy and job site information Insurance Company Name: Policy 4 or Self-ins-Lic.#: � j, �'�� ��"� Expiration Date: Job Site Address: �/� ' S i'♦ CitytState/Zip- J A � � f 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 S 1,500.00 and/or one-year imprisonment,as well as ci%ril 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. 1 do hereby certify under the pains andpenalyis of pednty that the information provided abotre is trife and correct Sianature: Date: Phone#: Official use only. Do not write in this area,to be completed by cite or town official. City or Town: Permit/License# Issuing Authority(circle one) 1.Board of Health 2.Building Department 3.City/Tomm Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact.Person: Phone#: RigbtfaX C3-2 9/4l2013 4:39:20 AN PAGE 21002 Fax Server CERTIFICATE OF LIABIUTY INSURANCE DATE(ti m orYym is IWtM ASA 011TE3t OF iit33RAltATION ONLY AND CONFERS RtS NO FUGH=tFPON THE CER I WICA Wwwma Ct ITIFtCg7e DOES NOT AFFIItiMATiVELY OR NEGATWELY AMEND.EKTeHD OR ALTER THE COVE3b%8E AF1-7RDED BY THE POLICIES BELOW. &"�twmam;d: iT �tTGtC471E OF INSURANCE DOES NOT CORSTITLVM A CONTRACT BEiWEEN THE ISSUING 11 SURER(S),AUTHORIZ D TrAZ P TE 11Ilthe tsokrer Is an ADDIiTOi1A!D1611R�,Stft palicy( tn�t be en4of3�. tT SUBROGATION 15 tWAtVED,sub#M to conditions at Ure policy.certain policies may require and endorsement. A statement on this e:xtMpte does not confer rights to Ute oeTUflcaffi hoMw In Neu of such eadon nlis). p CONTACT tQAEi� :_:CROSS lrFSULANM-PHABODY PHONE FAa1 -139 LYIANIFIKM ST IAC^No.E* tAR'..em7: SUITS 210 Swim PEABODY.MA 019M ADr�ItSss: 2.27?M1ir D�I i ARFORte cousaAGE t rAMC O tip OWNER A: TRAVELPM DFDE3 VWV CMDANY Off A&mw^ #47�L�C Q�►�B1EY tNC = irSURM lk tNStJRt3t o:' 75 XCRIH MADr STRHHT#109 game, MA 02363 lummut F: ClER71FtCA7ENu?0BE-R: REMOON Nt1iVi at iml Dip-, O VG W THE TEA MmamArwomm�IOf 7�08aF/inYCflNTAACTOIr4TI1StOOLl11/8N'ri1NTBA�ECT70fIR�11T11GCE3TIRCATE1rAY8&ISfittEO WtN0.V 8"MFULWHESDROCNISMIMUM B 8t mwr TO0"Tim TEAr%S mUisom mm commu sop SUCH Pal I= tum omm my *Comm" ce PY VMC9AWS, Ask FOLLY F.PF GATE Fourxiwimm g stTSOe t a moucvxut>erm t t LMwwrl"i" um" UANLUT OCCURRENCE S 00at6'd:fiQALCENNERAlUABIRY FUNTED CLANS MAM �OCCL � $ +' [Uti't/rnYardparsal S RSOIVlaf. ENE AGbRE0ATEUtdtTAPPf.EB PER: A ADV 84AMY S EilAi AGME'sATE § ,POLICY QPROAM 0 LCC OIJUCT3. A[3O S DMPutF.U8tNGlE S AtTTO BbNT tEa ecgUes�li ALL0Va4W AUTOS LY sumv ti SAE AUt05 ra+sorll F6R lAdRGS YINJURY 3 ecj "Y RTY DA MAGE S - acddetfp a: lAUAB Otx.1rR A-W� S t E7B�11A8 CJ 1tilAS-Ir1ADE S •Z DsmicnmzS Lt9 ICON S N A'IIMAND x WCSFAMMY OTI" LO�YE3TSItp 17Y ym UB-7S9dA5dt 73 Q$rt)I11013 pH1011�54 it�llTB tMOPROPORNMPARTHUMNEUTM Nip E-L EACH ACCd EKr S 5ti0.00D tn�laalf E.L.0*84W•EAEMOYM ,3 500,000 �B 0FOF9RATWWbdbff E.L.DISEASE-PO=UiWi S 50D.000 D QFcratAYioNaLOF.YmurymcLs REFrwnomwwECIALnwas wNYP2=42RIUtCATE tSKM T/]TfM CERTHI+CATR IOMEta AFFECrM VMRR7RS Ott COVWtA0E ATE HOLDER CANCELLATtON- FALI ITH tati�lAtEY SHOU�AW OF IMAROVEDESCRISED PCg�SUE CANCELLED ilf WW MWMTMN DATE Tit RWF.iNOTICEt LL SElRLYEM ATTN: JDE BENTO INAC6ORDAMMWFIH7MPOLICYPROVIUML PO 13137E T. 230 JONES RD AUTOO ---A . �� TSATZCKET MA 02356 gm� Tho ACOM name and liji am m ulstered nmft olXMW lBHXM0 ACORD CORP Hilm resl:iNed. •�I T 'd 9009-986-TSL ROuwlg3 314ueT4a *0:8 6102 ibt] des KAMToms-n of Barnstable Regulator- Services Thomas F.Geiler,Director Btrilding Dlvision Thomas PerrT.CBO Building Commissioner 200 Alain Street, HyMmis,ALA 02601 www.town.barnstabie ma us Office: ;0S-S62-L033 Fxx: S0S-790-6230 Property frvvner Must Complete and Sign This Section If Using A Builder Ms. `Dianne' Patitucc L ,as 07%mer of she subject propertr herebe authorize F a l mn u t h s h i m_ S wp to act on my behalfs in all rna—fters relative to worh.authorized by this building pernit application for. 87 Oak. St. -Hys. MA. 02601 (Address of Job) - Signature of Owner Date .Dianne Patitucci Print\amine *Y, If Property Owner is applcing for permit,please complete the Homeowners License Exemption Form on the reverse side. C:1UsersldecolliklAppData\LocaIMcrosofttWmdows\Temporary InternetFileslContent.Outlook18R76BDVAlE"RESS.doc Revised 061313 :. ._ ##361 ? Massachusetts-Department of Public Safety cEano Board of Building Regulations and Standards swr Thlru Construction Supervisor .' License: CS-024158 [/ December m t 3 JOSEPH BENT PO BOX T rXA TEATICIKE'�MA 025M i *` Expiration Commissioner 01/01/2014 Falmouth Chimney Sweep Teaticket, MA Y GOMMONWEALTH OF MASSACHUSEITS - - - ! • . • nJ/�c• Tf>are[-��Lc>a�aPca.ap�C�/�ti::Juc�ulel, I • • • •-• Office of onsamer airs 6c Kasmess Regalahon SHEET METALWORKERS — ME IMPROVEMENT CONTRACTOR AsTAN`�STER NRESTRI�TED . ._ egistration: 167149 Type: xF ISSUES THE' LICENSE TO piration 8/17/2014 DBA d' FAL TH CHIMNEY SWEEP JOSEPH BEHT =JR p t _ JOSEPH BENTOJR 440 LOCUSTFIELD RD. M A 0 2 5 36 0 2 0 0 1' E.FALMOUTH,MA 02536`' Undersecretary 90 7 :7 01/28/15 321433Tz Td �MO0M6imes Along Perforations Before DetachingT —f— Assessor's offioe (1st floor): ! �+ _ o`TwETo� Assessor's map and lot number ...... .......Z3.................... Q� ` Board of Health (3rd floor): Sewage ;Permit number ........:....... ... (-,...... C�AJL� i t B9Ss9roDLL, Engineering Department (3rd floor): �- 1 �o rb 9 House number ....................................... ...:..................... i �OYPYa' APPLICATIONS PROCESSED 8:30-9:30 A.M. and. 1:00-2:00 P.M. only ti TOWN OF BARNSTABLE BUILDING INSPECTOR ) APPLICATION FOR PERMIT TO .... .,.,...�......�..�.� ..................................................................... TYPE OF CONSTRUCTION ASS.. .... Eg? .....W: ................................................ ............... TO THE INSPECTOR OF BUILDINGS: ,. f / The undersigned hereby applies for a permit according to the following information: Location 1 `�/few!�l!-�5....................:................:.......................................................... �......0.!9.........s7"...... .. Proposed Use s.. ., ...................... .. ' . ...... . .dw Fire District ......: ................................................... Zoning District ::.:.:. T Name_ of Owners16./i!'^f'✓.l'`)�it �q'P'}�o`,. J (� ��ty '� may`I�/vn .............................................. t � ' Name of Builder .-....Address ....,>:.. .......... ...,.' '"''...............3................... 1 ........:f......:.................:,... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....:.........' ...... -............................................foundation .... ... �'... .................................... Exterior ......... ..........................................................................Roofing ............................^. ................................................. Floors ......................................................................................Interior ......................... ... ..................................................... 16 Heating.,.,..:.: .... .. . ............. .....Pjumbing ........ Fireplace ............................................ .. ...........................Approximate Cost ...... ... ......... .. ....... ......... ..�/......... Definitive Plan Approved by Planning,"Board _________________________ / - ------19-------- . Area .. ca`-�-`:..S- _ Diagram of Lot and Building with Dimensions Fee ...©.................... SUBJECT TO APPROVAL OF BOARD OF HEALTH .4 'T a 4 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. { ✓ � ,e, ,�,• Name .... •' ! e? !.............................. Construction Supervisor's License`........................:::..:...... ' r BARROWS, JOHN J. & MARIE I . A==310-231 3 1 i) No 30634 Permit for ,Add Deck t Single Family Dwelling Location ....87:. ... Oak Street. . . . ............. .. .. .... .. .. .............. Hyanni.s.......................................... Owner ...John J......&....Marie. ....I......Ba.rrows... . . ....... .... .. . .... .. .... Type of Construction Frame ............................................................................... Plot ............................ Lot ................................ Permit Granted .......April 16 , 19 8 t� Date of Inspection ....................................19 •s Date Completed ......................................19 Assessor's offioe (1st floor): Assessor's map and lot number. .. lo..`.0�.3.1....... l r �� F� Q 0*THE t0` SEPT1C SYSTEM MUST BE e��&��o Board of Health (3rd floor): . - � �5TALLED Q� �®��������� � � Sewage Permit number ......1�l ..C!` (J...Q......�?,& y >; H6H39T1►DLL. . Engineering Department (3rd floor): PTH TITr� 'oo 1639 House number ... �. :i�r P �,n , �0 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 .... . � ...5 �!.� .�f� .................................................................. TYPE OF CONSTRUCTION ........ ................................................ ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location `� ProposedUse .............................................................................................................................................:............................... /-.7: .Zoning District Fire District .......... Name of Owner Off�Yn/-'1 '?I!9�4 `�.°..� �0u-)-s......Address ............................. /,�, iT' Name of Builder .. `.....................o..�...................Address Nameof Architect ..................................................................Address .................................................................................... 62.A)Ck.C"-74Number of Rooms ..................................................................Foundation ......... ..............:.................... I Exierior .................. .................................................................Roofing ..................................................................... Floors .......W4....4.......,O.....................................................Interior .................................................................................... .Heating.. ..._......................................................--__. ......Plumbing Fireplace ..................................................................................Approximate Cost p1S(/!7 Definitive Plan Approved by Planning Board _______________________________19________ . Area .. ..5-......'........ Diagram of Lot and Building with Dimensions Fee r SUBJECT TO APPROVAL OF BOARD OF HEALTH ' D� 1 I 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 .................................... BARROWS, JOHN j. & MARIE I . .... N6 Permit for ...ADDDECK ..... ....................... S-iiigie Fami1v Dwellina ............:... .......................e;,�......................;,f....... Location 87 Oak Street .................Hyannis............................................. Owner ................................................. ..............John i. & Marie ie I .....Barrows Type of Construction .......Frame...................... ..................................................................... Plot ..........�::............... Lot ................................ r. 16 , 87-' Permit Granted ...............April........................19 Date of Inspection .....................................19 Date Completed ......................................19