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0935 PHINNEY'S LANE
�� �� f �� I J Town of Barnstable s a � , , U11d11V at rtis .sblv' .�omeS e Msst d� U .� FPo , T P on;Job andthis Card.Mus!be Kept 16 a Posted Until vnalelnspectignHasBeen Ratle s x 3 Permit {Where a Certificate of Occupancy3 s Required,such 8uildmg shall Nat be Occupied until a�mnal,lnspection has been made Permit No. B-20-549 Applicant Name: Michael Maher Approvals Date Issued: 02/24/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 08/24/202.0 Foundation: Location: 935 PHINNEY'S LANE, HYANNIS Map/Lot: 252-169 Zoning District: RC-1 Sheathing: Owner on Record: LIRA, MARCELO ContractorName ' MICHAEL MAHER Framing: 1 i Address: 570 WEST MAIN ST UNIT B Contractor license: CS-109089 2 e. HYANNIS, MA 02601 F Est Protect Cost: $4,300.00 Chimney: Description: Air seal and insulate the attic,insulate the knee wall area,,insulate iPermit Fee: $85.00 Insulation: the bulkhead door t Fee Paid.` $85.00 Project Review Req: ZS f ", Date 2/24/2020 Final: s Plumbing/Gas F Rough Plumbing: a fficial This permit shall be deemed abandoned and invalid unless the work au'thonzed;by this permit is commenced'withm six m nths after issuan DU Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which'this permit has been granted. All construction,alterations and changes of use of any building and structures�sha lit e incompliance with the local zoning{by laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access sheet oar ro d nd shall be maintained open for public inspection for the entire duration of the work until the completion of the same. y` Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures bythe Bu-lding and.Fire Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work " 1.Foundation or Footing QService: 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest fluelmmg 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Final: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of Barnstable uildin 9 ' Zfr-°` ;� .0 . : . ,,.*.�4 Gw"�„ ;.�Y �is Y3t ` e.." Mt'' ;' .:Y... S' :: �5 # :• . `... Pbst Tfiis'Card 5o That t isUisible From- he Street A roved.Plans"Must betRetamedaon..Jnb and#his CardM�us b�e�Ke"t i Ag1.B,_• .=" :.;fir �: � �, >'� ' �r � .,� , pp � e � �". r r.,,, ,.` � �`. i� � P W os�te�d``U nt I:Final I?n specti�on'�Ha s Been Made -1 arm it Permit No. B-19-2138 Applicant Name: Jose Pereyra Approvals Date Issued: 07/02/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 01/02/2020 Foundation: Location: 935 PHINNEY'S LANE, HYANNIS Map/Lot 252-169 Zoning District: RC-1 Sheathing: Owner on Record: Jose Pereyraa Contractor�Name: Framing: 1 � eE � Address: 935 Phinneys Lane Contractor License 2 MA Est Protect Cost: $900.00 Chimney: Description: siding Permit Fee: $35.00 i, ,. Insulation: Femme Paid: $35.00 Project Review Req: Date 7/2/2019 Final: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzed by�this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and'Ahe,approved construction documents for which this permit has been granted. `. Rough Gas: All construction,alterations and changes of use of any building and str ures shall be incompliance with the local zomn laws an codes. This permit shall be displayed in a location clearly visible from access street of road and shall be maintained open for public I_ ection for the entire duration of the Final Gas: work until the completion of the same. £. " u idx Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the bui and rive®officials are pr'vedPon�this,;permit. Minimum of Five Call Inspections Required for All Construction Work , .. ; Service: 1.Foundation or Footing Y 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue'lining is installed �` m 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property,of the APPLICANT-ISSUED RECIPIENT Final: Application number................................................ Qa Fee .........�til. A..........:......................................... 6 KAM `p` Building Inspectors Initials...... .......G� 6' .................. '3s` JUL 01 2019 /a.I-/ 9 Date Issued.: Map/Parcel......... ........ .......................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: Y,n e YS �&J e a e n(ef V i I e-j el A 02 IP 3 2 NUMBER STREET VILLAGE Owner's Name: S OS e ReKey'ra Phone Number_ Email Address: e`CeY Y'q\ Z Z Gmal I-C©cam Cell Phone Number Project cost$ Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a b 'ldmg permit in accordance with 780 CMR Owner Signature: Date: 4710(l 20 R TYPE OF WORK Siding ❑ Windows (no header change)# ❑ Insulation/Weatherization ❑ Doors(no header change)# Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THESUBJECT PROPERTY IS IN A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION.NU.MBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total r , Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of'Event 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 Fuel source being used LP tank 20 lbs. or>Yes No ,if yes, a gas permit is required. Natural Gas Yes No ,if yes,a gas permit is required. 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 Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE,EXEMPTION Homeowner's Name: "�\OS-e CxJ e (e y,'rA Telephone Number (o - 3 iS-(�Z _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 procedures,specific inspections and documentation required by 780 CMR and the Town o rnstable. Signature --- - Date (� 01 eG APPLICANT'S SIGNATURE Signature:- Date All permit appl -ons are subject to a building official's approval prior to issuance. i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizatiordlndividual): "�10 Address: a, City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I 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 g, ❑Demolition employees P Y working for me m ees and have workers any capacity. 9. ❑Building addition [No workers' comp. insurance comp. insurance.# e uired. 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions q ] officers have exercised their I I. Plumbing repairs or additions 3. I am a homeowner doing all work ❑ g P 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.[1 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un r the pains and penalties of perjury that the information provided above is true and correct Si ature: Date: n 2 Phone#: Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r 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 or to 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 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 partners,are not required to cant'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 Revised 4-24-07 Fax#617-727-7749 www.mom.gov/dia Town of Barnstable Certificate of Zoning Compliance Certificate 2018-53 Map 252 Record Owner: Parcel 169 Address 935 Phinney's Lane Onewest Bank NA Village Hyannis 2900 Esperanza Crossing Austin, Texas 78758 Zone RC-1 Single-family Overlay Ground WaterProtection Year Constructed— 1979 Lot Size 0.28 Property Use: Single-family dwelling Setbacks: Front Yard 30 Cert of Occupancy Issued: Yes No Side Yard 15 Rear Yard 15 Date Feb. 29, 1980 Permit#21500 Open Permits: Yes Building Permit# B2015-00972 Insulation Electrical Plumbing Code Violations: None: Zoning Violations: None Reviewed by Title Date: Robin C. Anderson Chief Zoning Officer 8/08/2018 TOWN OF BARNSTABLE BUILDING DIVISION 200 FAIN ST. HYANNIS, MA 02601 Town of Barnstable Certificate of Zoning Compliance Certificate 2018-53 Map 252 Record Owner: Parcel 169 Address 935 Phinney's Lane Onewest Bank NA Village Hyannis 2900 Esperanza Crossing Austin, Texas 78758 Zone RC-1 Single-family Overlay Ground WaterProtection Year Constructed— 1979 Lot Size 0.28 Property Use: Single-family dwelling Setbacks: Front Yard 30 Cert of Occupancy Issued: Yes No Side Yard 15 Rear Yard 15 Date Feb. 29, 1980 Permit#21500 Open Permits: Yes Building Permit# B2015-00972 Insulation Electrical Plumbing Code Violations: None: Zoning Violations: None Reviewed by Title Date: Robin C. Anderson Chief Zoning Officer 8/08/2018 I TOWN OF BARNST ABLE BUILDING DIVISION 200 MAIN ST. HYANNIS, MA 02601 I Em P E M C 0 L I M I T E D PEMCO-Limited 4600 South Ulster Street, Suite 530 Denver,CO 80237 Town of Barnstable—ATTN: Robin Anderson 200 Main St <: Hyannis, MA 02601 O t Date: 7/19/18 v _ a ' RE: Code Violations Search cs� Dear Zoning Dept, v rn Please see attached check for the $5 search fee required by your municipal. PEMCO Limited represents Fannie Mae,the owner of record of the property located at: 935 PHINNEYS LN,Centerville, MA 02632 PARCEL#252-169-000 We would like to request a zoning compliance letter pertaining to the below: 1) Copies of open code violations and summons(if applicable) attached to the property. 2) If there are open invoices or past due liens pertaining to the code violations, please send copies along with the fee breakdown. 3) Send copies of open code violation notices/letters attached to the open lien. Please email or fax your return reply if possible.Thank you for your time! Danielle Vandyke Pr rt Specialists Direct: ( 2 ) 50 -3243 Fax: (303) 284-8026 Danielle.Vandyke@pemco-limited.com PEMCO-Limited,4600 S.ULSTER ST,STE 530,DELVER,CO 80237 Official Website of The Town of Barnstable - Property Lookup Page 1 of 4 Select Language Assessing Division Property Lookup Results - 2018 367 Main Street,Hyannis,MA.02601 <<BACK TO SEARCH<< Print Owner Information-Map/Block/Lot:252/169/-Use Code:1010 Owner Owner Name as of ONEWEST BANK N.A. Map/Block/Lot G/S MAPS 1/1/17 2900 ESPERANZA 252/169/ CROSSING Property Address 935 PHINNEY'S LANE AUSTIN,TX.78758 Co-Owner Name 1 Town Sewe Address:N GIS ton g Value:RC-1 Assessed Values 2018-Map/Block/Lot:252/169/-Use Code:1 0 2018 Appraised Value 2018 Assessed ValuePast Comparisons Building $111,200 $111,200 Year Assessed Value Value: Extra $19,300 $19,300 2017-$232,600 Features: 2016-$233,300 2015-$229,100 2014-$229,200 Outbuildings:$2.100 $2,100 2013-$229,200 2012-$230,800 2011-$229,000 Land Value: $106,300 $106,300 2010-$228,600 2009-$254,000 2018 Totals $238,900 $238,900 2008-$259,900 2007-$259,500 Tax Information 2018-Map/Block/Lot:252/169/-Use Code:1010 Taxes Hyannis FD Tax(Commercial) $0 Hyannis FD Tax(Residential) $642.64 Fiscal Year 2018 TAX RATES HERE Community Preservation Act Tax $68.87 Town Tax(Commercial) $0 Town Tax(Residential) $2,295.83 $3,007.34 Sales History-Map/Block/Lot:252/169/-Use Code:1010 http://www.townofbamstable.us/Assessing/propertydisplayscreen 18.asp?ap=... 8/8/2018 Official Website of The Town of Barnstable - Property Lookup Page 2 of 4 History: Owner: Sale Date Book/Page: Sale Price: ONEWEST BANK N.A. 2015-05-20 D1270492 $384000 DUGENER,JOAN ESTATE OF 2015-04-26 D1299548 $0 DUGENER,JOAN 1999-03-25 #D760462 $0 DUGENER,WAYNE L&JOAN C1980-03-17 C81215 $0 Photos 252/1691-Use Code:1010 k Sketches-Map/Block/Lot:252 1 169/-Use Code:1010 x K a As Built Cafds:cfickcard#to view:card#1 Constructions Details-Map/Block/Lot:252/1691-Use Code:1010 Building Details Land Building value $111,200 Bedrooms 3 Bedrooms USE CODE 1010 Replacement Cost $140,819 Bathrooms 1 Full-0 Half Lot Slz Acres) 0.28 Model Residential Total Rooms 5 Rooms Appraise 106,300 Value Style Cape Cod Heat Fuel Gas Assessed Value $ 106,300 Grade = Averag Heat Type Hot Air Year Built �! 1979 AC Type None Effective 1 Interior Floors Carpet depreciation Stories Interior Walls Drywall Living Area sq/ft 1,219 Exterior Walls Wood Shingle Gross Area sq/ft 2,792 Roof Gable/Hip Structure Roof Cover Asph/F GIs/Cmp http://www.townofbamstable.us/Assessing/Propertydisplayscreenl 8.asp?ap=... 8/8/2018 Official Website of The Town of Barnstable - Property Lookup Page 3 of 4 Outbuildings&Extra Features-Map/Block/Lot:252/169/-Use Code:1010 Code Description Units/SQ ft Appraised Value Assessed Value BMT Basement- 768 $17,500 $17,500 Unfinished WDCK Wood Decking 120 $2,100 $2,100 w/railings FOP Open Porch-roof- 32 $1,800 $1,800 ceiling Sketch Legend Property Sketch Legend 62N Bam-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor,Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished)FUS Second Story Living Area SPE Pool Enclosure (Finished) BRN Barn GAR Garage TQS Three Quarters Story(Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLIP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UST Utility Area(Unfinished) FCP Carport KEN Kennel UTQ Three Quarters Story (Unfinished) FEP Enclosed Porch MZ1 Mezzanine,Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story (Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio Print contact Director Edward F.O'Neil,MAA P 508-862-4022 F 508-862-4722 i . 367 Main Street I Hyannis,MA.02601 Public Records Ann Quirk Public Records Request http://www.townofbarnstable.us/Assessing/propertydisplayscreen 18.asp?ap=... 8/8/2018 Official Website of The Town of Barnstable - Property Lookup Page 4 of 4 !Helpful Links to Downloads Abatements SALES LISTINGS 111 Barnstable FD Residential C.O.M.M FD Residential Commercial-Industrial- Mixed Use Cotuit FD Residential Hyannis FD Residential Townwide Condominium E W.Barnstable FD I i Residential Exemptions Parcel Consolidation Questions about values FY18 Combined Tax Rates! Town Land Use Codes ! I Helpful Maps All Town Maps Flood Insurance Maps A Property Maps FY18 Tax Maps Owned and Operated by The Town of Barnstable-Information Technology Home Departments&Services I Boards&Committees I Residents&Visitors I Doing Business I Town Calendar I Phone Directory I Employment I Email Town Hall http://www.townofbamstable.us/Assessing/propertydisplayscreen 18.asp?ap=... 8/8/2018 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 6 Applica ion # Health Division Date Issued Z-26-/S Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 9 ��� i h v S L&A Village Ail Owner T)��a o fj— Address A.M Telephone ' S 08 7-9- 1 �a S' Permit Request ft91 U1 r:9 d R' 0 c A R. ` r .7,x c4L. 11 r se 'c e L P�7� 1 �� 4 m Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation a b 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's,Highway: O Yes.❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement,Unfinished Area (sq.ft} r = Number of Baths: Full: existing new Half: existing r new _ Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Roorrl Count F_ 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 X'N o If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) U11111AM Name # �ti cS �. Telephone Number �'Q -9 V Address , 1t, 04 Arge, License # S' Y,r fhA 0 M 14 al Home Improvement Contractor# f 8 b Email Worker's Compensation # W W f 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO t, SIGNATURE DATE I A FOR OFFICIAL USE ONLY -c• APPLICATION# DATE ISSUED MAP/PARCEL NO. a ADDRESS VILLAGE OWNER ; F DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. I The Commonwealth of Massachusetts Departitzent of Industrial Accidents ° F Office of Investigations I Congress Street, Snite 100 ' r Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): -.Cape Save inc. Address: 7D Huntingto'n Ave City/State/Zap; South Yarmouth, MA 02664 . Phone#: 508-398-0398 Are you an employer?Check the appropriate box: Type of project(required): 4. , 1 am a:g"eneral contractor and 1 1, ✓�`1 am a employer with _ ❑ 6. New construction employees(full andlor part-time),. have hired the sub-contractors 2.❑ la a.sole proprietor or partner listed on,the attached sheet. 7. n Remodeling ship and have no employees These sub-contractors.have g, ( Demolitioli workingfor me in ail ca acit- employees and have`workers' g y P Y f 9. Building.addition [No workers' comp.insurance- comp.insurance .required.] 5. We are a corporation and its 10.(] Electrical repairs or:additions 0. 3.(❑ 1.am a homeowner doing all work officers have exercised their I Ln Plumbing repairs or additions 'co right of exemption per.MGL myself. o workers.' m o f s y [Np- 12.❑ Roof repair insurance required.]? c. 152, �l(4),and we have no e .ployees..[No workers' 13.�Other Insulation: conlp, insurance required.] VArty applicant that checks box#1 must also Fil out the section below showing their.workers'coinpensation policy information. Homeowners who submit this affidavit indicating,they at 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 naive of the sub-contractors and state.wbaher or:uot those entities have einpioyces. If the sub-contractors have employees,they must provide their workers'comp:policy number. I aon an employer that is peovidjh workers'.compensation insurance for nry.e►nplojiees. Below is the policy and jo.h site infort►uction. Insurance CompanyName. Wesco Insurance Company Policy#or Self ins..Lic.# WWC30$5:633 _. Expiration'Date: 04/09/2015 , p r Job Site Address: 1 � Tole Lai (% City/State/Zip: GallAttach a copy of the workers'compensation py declaration page(showing the,policy numb :and expiration date):. Failure to secure coverage,as required under Section 25A of MGL c. 15'2 can lead to the imposition of criminal penalties of`a fine np to$1,500.00 and/or one-year inipriwtimei t,as well as civil penalties in the form of a STOP WORK ORDER.and aline of up to$250.00 a day against theviolator. Be advised that a copy of this statement maybe forwuded to the,'Office:of. Investigations of the DlA for insurance coverage verification. I do hereby certia cinder the pains and penalfies ofper' that the in orniation provided dbov is true and correct i 'nature: _ Date U` [ S _ . Phone#: 509-39$-8398 Official use only. Do not write in this area,to be completed.,by city or town official. City or Towns _ _ Permit/License# Issuing Authority(circle one): .1 Board,:of Health 2.Building Department 3.City/Town'Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact:Person; _ _._ Phone#i . ACC>Rp CERTIFICATE OF LIABILITY INSURANCE CATE(MMIDDIWYY) 11/L/20.14 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 pol)cy(les)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require anendorsement. A.statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. :PRODUCER co NAME:CT Colleen Crowley Risk Strategies Company PHONE , (781)986-4400 FlcNo..ITe )9s3-aa20 15 Patella Park Drive ccrowley@risk-strategies.com Suite 240 f INS s AFFORDING COVERAGE_. NAIC'f Randolph MA 02368' INSURERA:Selective Ias. or America INSURED INSURERS Allmerica Financial Alliance 10212 Cape Save, Inc iNsuRERc Wesco InsuranceComany 7 D Huntingtol�.Ve INSURER i INSURER E;: South Yarmouth MA <02664 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1.4111085532 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. MTSRR - TYPE OF QJSURANCE POLICY.E POLICY,EXP POLICY NUMBER M10 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENT X COMMERCIAL GENERAL LIABILITY EMISES Ee o rren $ 160,000 �ADE 10,000A CLAIMS 0/16/2014 6/2015 PERSONAL 8 ADV INJURY $ 11600,000 GENERAL AGGREGATE $ 2,000,000 GENIL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 2,000,000 POLICY X' PRO- X FLOCXCT $ AUTOMOBILE LIABILITY Ea accident _ 1,000 000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED 6796600 1/6/2014 1/6/2015 AUTOS X' .BODILY INJURY(Per accident) $ X HIRED AUTOS X N AUAUOTTOS OSWE6 P 80 E�RdT YDAMAGE $ X. UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000. A146ED EXCESS LIAB CLAIMS-MADE AGGREGATE. $ 11 OOO,OOO I.. RETENTION Hil _ 1994480 0/16/2014 0/1.6/2015 $ C WORKERS COMPENSATION Dfficer6 Included for VvCSTATU O7H- AND EMPLOYERS'LIABILITY X. IMT ANY PROPRIETORIPARTNERIEXECUTIVE YIN overage. E.L.EACH'ACCIDENT $ 500 000 OFFICER/MEMBER EXCLUDED9 NIA 3085633 (Mandatory In /9/2015 NH) /9/2014 E.L.DISEASE-EA EMPLOYE $ y 500 000 If yyees,describe Under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $. 500 000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule;if more space is required) Issued as evidence of insurance. Issued as evidende of insurance. Thielsch Engineering, Inc: is listed as additional insured as respects General Liability as required by written contract. r CERTIFICATE HOLDER CANCELLATION msong@capelightcompact.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Light Compact ACCORDANCE WITH THE POLICY PROVISIONS. Attn Margaret song PO 'Box 427/SCH AUTHORIZEDREPRESEMATIVE 3195 'Hain--Street Barnstable, HA 02630 "chael Christian/CLC ACORD 26(2010f05) w O 19882010 ACORD CORPORATION. All rights reserved. INS025(201005101 The ACORD name and logo are registered marks of ACORD i do Housing /' sun Assistance Corporation Cape Cod HOME OWNER WEATHERIZATION WORK PERMIT&FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE THE APPLICANT HOME OWNER. I �'; �.�. }iu ea� � hereby consent to and agree that weatherizatio work may be done by the Weatherization Program of Housing Assistance Corporation ( herein after referred as "Agency" ) on the property located at: The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather-stripping & caulking of windows and doors, insulation of attics, sidewalls & basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to the "'Agency" its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2 . The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for. the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions of this agreement as listed and freely give MY consent. ;1 '"Xem,e Owner: (Signature) :3?. Date. 2,, 051 l 5 Agent: (signature) AA I Date: ,• Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171380 Type: Corporation fi t Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. ' .. _ � M WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE ; � s SOUTH YARMOUTH, MA 02664 ---- -' ' -- '---- q,-:v Update Address and return card.Mark reason for change. SCA 1 C. 20M-05nt E] Address 0 Renewal Employment 0 Lost Card Office of Consumer Affairs& Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 171380 Type: Office of Consumer Affairs and Business Regulation Y�.Expiration�8 W2016: Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE SAVE INC. v 1 WILLIAM McCLUSKEX.$<: 7-D HUNTINGTON SOUTH YARMOUTH,MA 02664 Undersecretary Not vali tthout signature Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specials License: CSSL-102776 t WILLIAM J MC 4 3LUS_ �Y r 37 NAUSET ROAD 11 West Yarmouth AIA 026 : 'u Expiration Commissioner 06/28/2015 1� Town of Barnstable *Permit# (� Expires 6 months from issue date . Regulatory Services Fee — * NAM Thomas Thomas F. Geiler,Director 39 A� f 0 pM� ; :. £ �, i Building Division ;Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: -08-862-4038' `� ..< Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number o2 �;Q /6 Property Address m n .t i C [Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address b u Q p m e r Telephone Contractor's Nam e��P��!SG'1l/1�.5' � Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 74 7'//7 7 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Namec�s Workman's Comp.Policy# (,�� (.(ffzy &7 5 l a 6 0 Copy of Insurance.Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris.will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors_ Replacement Windows/doors/sliders.U-Valut% (maximum.35)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note:' Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement.Contractors License&Construction Supervisors License is requir SIGNATURE: C:\Users\decollik\A Data\Local crosoft\Windows\Temporary'Intemet Files\ContentOutlook\DDV 87AAZ\EXPRES S.doe Revised 072110 12/07/2010 14:36 5083626115 BAKER: PAGE 02 C17 Board of Bui.ldin Re ula g g ions and Standards One Ashburton Place - Room .1.301. Boston, Massachusetts 02108 -HOMe Improvement:C.ontractor Regristratiozi Registration: 162000 -hype. Private Corporation Expiration, /26(2011 TO 28,71 u BAKER & ASSOCIATES INC. MARK BAKER P.O. BOX 023 CENTERVILLE, MA 02632 Update Address and return card. Mark rosim For c6aurt• 0-'y, n susint�a.:y�n�.ct: Addrem Renewal �;sn ►Inymen 1 A.,,.,.. "3�Ai�w'Ri'.Ib���►t��1:� - I.� 1 s � -� t•r r.l' I;a. ��� ._...�..._..?,1�,._, r � I x � 9rd _�� is . ;ry� . •�r:' . � �$t��.t9't� i��' f�i.��#t'lia.�„� ��a:;:�t��3$lt8t't� �0>►z.f '">;., �';a ;i :i>� " i�:.emse- CS 74477 Rk'St0f'ied to: 00 BRETT J .BUSSIERF- 1 11 WAREHAM LAKE SHORE Q EAST WAREHAM, MA 02538 , 1/6/2011 8715 �X/w 6mmowwea&J?1 Board of Building Regulations and Standards. N. '. One Ashburton Place - Room 1301 Boston. Massachusetts 02108 I-lome Improvement Contractor Registration Registration; 162600 Type: Supplement Card Expiration, 3/26/2011 BAKER & ASSOCIATES INC. BRETT BUSSIERE 521 SHOOTFLY}NG HILL RD CENTERVILLE, MA 02632 update Address and return card. Mark reltsntl for uhangr. u,:, �� ,onn,.naua,caruta.,t� Address Renewal Finpltwment Lint Card The Commonwealth of Massachusetts William Francis Galvin -Publ; Browse and Search Page I of 2 1 The Commonwealth of Massachusetts William Francis Galvin J Secretary of the Commonwealth,Corporations Division One Ashburton Place, 17th floor Boston,MA 02108-1512 Telephone: (617)727-9640 BAKER & ASSOCIATES, INC. Summary Screen Hein with'hrs`:rrnl Request a Certificate The exact name of the Domestic Profit Corporation: BAKER&ASSOCIATES,INC. The name was changed from: BAKER CUSTOM ALUMINUM&VINYL COMPANY,INC. on 1/8/2004 Entity Type: Domestic Profit Corporation Identification Number: 000522085 Old Federal Employer Identification Number(Old FEIN): 000000000 Date of Organization in Massachusetts: 01/01/1996 Current Fiscal Month I Day: 12/31 Previous Fiscal Month I Day:00/00 The location of Its principal office: No. and Street: 521 SHOOTFLYING HILL RD. City or Town: CENTERVILLE State: MA Zip: 02632 Country: USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: City or Town: State: Zip: Country: Name and address of the Registered Agent: Name: No. and Street: City or Town: State: Zip: Country: The officers and all of the directors of the corporation: Title Individual Name Address(no Po Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT MARK BAKER 521 SHOOT FLYING HILL CENTERVILLE,MA 02632 US TREASURER CAROL BAKER MRS. 521 SHOOTFLYINGHILL ROAD CENTERVILLE,MA 02632 US SECRETARY BRETT BUSSIERE MR. 521 SHOOTFLYINGHILL ROAD CENTERVILLE,MA 026323 US DIRECTOR MARK BAKER MR. 521 SHOOTFLYINGHILL ROAD CENTERVILLE,MA 02632 US http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 3/25/2009 The Commonwealth of Massachusetts Department of industrial Accidents Office of Investigations i l0 600 Washington Street " — Boston, MA 02111 �.� w}vw.jnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information AA Please Print Legibly Name (Business/Organization/Individual): 5aAe—r � i4Se,0(o S �7�_C� Address:_ City/State/Zip: & (Jt��.� /�Q Phone.#: U`-©l� Are you an employer? Check the appropriate box: YType of project(required): 4. I am a general contractor and I am a employer with I 6 New construction employees (full and/or part-time).* have hired the sub-contractors .❑ 1 ani a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. F Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers' comp. insurance comp. insurance.$ required.] req ] 5. 0 We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 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. ICont aors 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. _-T Insurance Company Name: Q Cl ale Of Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: t City/State/Zip: e� Attach a copy of the workers' com ensation 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 imprisorunent, 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 corn under the ains and penalties of perjury that the information provided above is true land correct. CSianamre:_ Date: l—)�r Phone Official use only. Do not write in this area, to be completed by city or town officiaG. 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 i Contact Person: Phone #: _— I ToWn of Barnstable r Regulatory Services nANABS.mErrAkE, Thomas F. Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, ✓' , as Owner of the subject property hereby authorize to act on my behalf, 7 ,950"1 e24 in all matters relative to work authorized byte building permit application for. (A dres>or j ou �--�-- 1d Sig afore of-Dvker Date -Print Name If.Pro e—. Owner is applying forpen-nit please complete the . Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMIS SION i¢ Town of Barnstable T11E Tp� Regulatory Services "+ Thomas F. Geiler,Director iARNSTABLE, Mass. 9� ,659. ,�� Building Division ATfD I��A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official onra form acceptable to the Building Official, that he/she shall be responsible for all such work performed under thebuilding permit4(Section 109.1.1) r The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-fanuly dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing:of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supgrvisor." Many homeowners who use this'exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC 'I Date, 8/19/2010 Time: 1:29 PM To: M 9,15083626115 Page: 002 Client#:9742 2BAKERAS ACORM CERTIFICATE OF LIABILITY INSURANCE oei912010 PRODUCER THUS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 9731yannough Rd., PO Box 1990 Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIL# INSURED INSURER A: National Grange Mutual Insuranc P 0 Box 923 Associates,lnc. INSURERB Associated Employers Insurance Bo INSURER C: Centerville,MA 02632-0071 INSURER 0: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER DATE MN�jO NY) DATE(MMICOffln EXPIRATION UMrTS A GENERAL LIABILITY MPJ7223M 04/19/10 04/19/11 EACH OCCURRENCE $1 000 000 DAMAGE X COMRENTED MERCIAL GENERAL LIABILITY TO $SOOLOOO _ CLAIMS MADE a OCCUR MED EXP y one person) $1 O 000 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s2.000.00 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2 00O 000 POLICY J� LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea aocident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Par person) $ I HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS - (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT_ $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ B woRUERs com ENSATWN AND WCCSW2454012010 04/23/10 04/23/11 X D W ST2 oER TLR- EMPLOYE RS'LABILITY E.L.EACH ACCIDENT $500,000 ANY PROPRIETOPJPARTNERIEXECUTWE OFFICERIMEMBER EXCLUDED? NO E.L.DISEASE-FA EMPLOYEE $500 000 If yes,describe under SPECIAL PROVISIONS belay E.L.DISEASE-POLICY LIMIT $500 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAL 1f)_ DAYS WRITTEN 200 Main Street NOTICE TOTHE CERTFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRFSENTATIVES. AUTHORIZEe PRES 01 c.4EW � ACORD 25(2001108)1 of 2 #S71887/M68180 LS1 0 ACORD CORPORATION 1988 C Town of Barnstable _ mit ' Erpires 6 monlh.cf run issue do ' Regulatory Services Fee l;nxlvsrnsLE. v� �9. ,�$ Thomas F.Geiler, Director '°rEo Mac Building Division fL—f Tom Perry,CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us C)i'fice: S09-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address-- `� Al ki I'tiKI Residential Value of Work ,S7_7 pZ Minimum fee of$25.00 for work under$6000.00 Owner's Name& Address Contractor's Name_. -- . Telephone Number_15?9) Home Improvement Contractor License#(if applicable) o I Construction Supervisor's License#(if applicable) Workman's Compensation Insurance Check one: ❑ I am a sole proprietor vX- E S PERMIT❑ I am the Homeowner (t�v( I have Worker's Compensation Insurance Insurance Company Name 5soexQt10Gz-11 �O emc ._.1-III /_/II-If k Workm OWN OF BARNSTABLEan's Comp. Policy#���.° l� Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) J ❑ Re-side 9 of doors Replacement Winduws/doors/sliders. 11-Value_ >� (maximum .44)#of windows 63 *Where requircd. 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 req u i red. SIGNATURE: f (."UsersldecnlliklAppl)art\LocaflMicm oft\Windows Femporary Internet Files\Content.Outlook\4S'1'(illiOO\FXPRFSS.doc Revised 090909 f r FI ME aAMWABLE i639.39, � Town of Barnstable �� Regulatory Services Thomas F.Ceiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4018 Fax: 508-790-6210 Property Owner Must Complete and Sign This Section If Using A Builder 1, S64Vv' NA'f ,lo✓ as Owner of the subject property ltcreby authorize & Pt' to act on my behalf, in all matters relative to work authorized by this building permit application for: Qc? -mob!ti M(i �!✓� (Address of Job) Signslure of Owner Date n baa en e Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:AUsers\dccollik\Apf)ata\l.oca1\Microsoft\Windrnvs\Temporary Intemet Files\Content.Outlook\4STGl15QO\F.XPRF,SS.doe Revised 090809 � 1 The Conintonrrpealth of Massaehnsetts Department of Industrial Accidents Offtee of Iwesligalions 600 Washington Street Boston M4 02111 `��J�� �=' n�►t�rtntnss.gm�elirr Workers' Compensation Insurance Affida-vit:Builders/Contractors/Electricians/Plumbers Apphcant Information Please Print Lepibh Natiie f-3=nes&Org=ation`Indieiduai)_ 14.c, Address._Q�W AkH V—P City.istate-.Zig_ t 0?21� Phone k d a d Are you an employer". Check the appropriate boz: Type of project(required): 1.eI am a employw with 4. ❑ I am a general contractor and I —F_ 6. ❑Neu constructiort employees(full and`or part-tazue).* hai.�e hued the sub-contractors listed on the attached sheet. T ❑Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have g. ❑Demolition working for me in an capacity ernplo�rees and have workers' Y 9. ❑Building addition [No workers'comp.insurance comp-Msurance.j 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 I1.❑Plumbing repairs or additions myself[No workers'comp. right:of exemption per 144GL 12-0 Roof repairs insurance required]" c. 1527 y l(4).and we have no -/ employees.[No workers' 13.[9 Other W1 {ieloct s comp.insurance required] •.kny applicant that c4ter_ks bm#1 mxtsi also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidamit indicating they are doing all work and theta hire outside contractors must submit a new affsdwit indicating such- Contrac;ors that cheer rhm box must attached an additional sheet showing the time of the sub-contractors and state whether or not those entities once. employees. If the sub coavactors have employees,then,must pmv-ide their workers'camp.policy number. 1 ant an employer that is providi* g*twrkers'conipensatron insurance for PRy emplaateem Betora,is the po hi y and job site infvr»tatiott. Insurance Company Name_ Q am � J ? �U elrS . ;44�� .,,/ /, 0 Policy�or Serf-ins.Lic.m: w C t"_ h-6 o��r7 Y���d�l/ Expiration Date: Job Site Address- a ` City;'StateiZip_ v t1 Attach a copy of the workers'cam nsation 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 an&or one-gear 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. 1 do tterebt certr r.. 111.ender the paitt.s Writ/penalties of perjiityr that the information provided above is tries and correct. Si tune: Date: f✓ v Phone.30_ Official rase ants'. Do not write in this area,to be completed by'city,or town official. City or Town: PermitaAcense it Issuing Authority(circle one): 1.Board of Hearth 2.Building Department 3.City frown Clerk 4.Electrical Inspector 5.Plumang Inspector 6.Other Contact Person: Phone# 6 Dater 9/19/2010 Time, 1r29 PM To, @ 9,15083626115 Page; 002 Client#:9742 28AKERAS DATE DO ACORD,. CERTIFICATE OF LIABILITY INSURANCE 0811 010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES , OR Agency ALTER THE COVERAGE AFFORD D BYT HEEND POLICIESEND BE OW. 973 lyannough Rd., PO Box 1990 Hyannis,MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: National Grange Mutual Insuranc Baker 8 Associates,lnc. INSURER B Associated Employers Insurance P O BOX 923 INSURER C: Centerville,MA 02632-0071 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER DATE EFFECTIVE DATE(MMfrn OLLY EXPIRATIONLIMITS A GENERAL LIABILITY MPJ7223M 04/19/10 04/19/11 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL00 I�LIABILITY DAMAGE TO RENTED $SOD O CLAIMS MADE r ^,OCCUR MED EXP y one parson $10 000 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE $2 000 000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s2,000,00 POLICY n JE LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Eaactldert) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Par person) $ ers HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per acddent) PROPERTY DAMAGE $ (Per acddenq GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC b AUTO ONLY: AGO $ EXCESSAIMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR a CLAIMS MADE AGGREGATE S S DEDUCTIBLE $ RETENTION t $ B WORKERS coMPENsAT*H AND WCC5002454012010 04/23/10 04/23/11 X I 1WR)STA - oTH- EMPLOYERS'LIABRITY E.L.EACH ACCIDENT $500 000 ANY PROPRIETOWPARTNEWEXECUTWE OFFICERMEMBER EXCLUDED? NO E.L.DISEASE-EA EMPLOYEE $500 000 If yes,desWbe under SPECIAL PROVISIONS bebw E.L.DISEASE-POLICY LIMIT t500 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSKM ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Insurance coverage is limited to the terms,conditions,excursions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAL _An_ DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRE5E NTATIVES. AUTHORIZED 1PRESENTATIVE --` .� ACORD 25(2001/08)1 of 2 #S71887/M68180 LS1 ® ACORD CORPORATION 1988 /�n i V I W -Commowweald I' = Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement:Contractor Registration Reqistration: 162600 Type: Private Corporation Expiration: 3/26/2011 Tr# 282115 BAKER & ASSOCIATES INC. MARK BAKER P.O. BOX 923 .. ---- CENTERVILLE, MA 02632 Update.Address and return card. Mark reason for change. DPS-CAI 0 50M-04l04-G101276 --; Address �__'i Renewal Employment _', Lost Card Massachusetts - Dcpat-tment of Ptjb c ',,, af t Boat of Building Regulations and `�tandat-d'. Construction Supervisor License License: CS 74477 Restricted to: 00u BRETT J BUSSIERE � . 111 WAREHAM LAKE SHORE D EAST WAREHAM, NIA 02538 �-- - -- ' -�- Expiration: 1/6/2011 c.a;,..VM.. T r#: 8715 Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 .Home Improvements.C.ontractor Registration - Registration: 162600 Type: Supplement Card Expiration: 3/26/2011 BAKER & ASSOCIATES INC. BRETT BUSSIERE 521 SHOOTFLYING HILL RD v CENTERVILLE, MA 02632 F Update Address and return card.Mark reason for change. DPS-CAI 0 50M-04104-G101216 Address Renewal !-_l Employment I Lost Card The.63mmonwealth of Massachusetts William Francis Galvin -Pub]; Browse and Search Page 1 of 2 ay`' - io� - x d, The Commonwealth of Massachusetts William Francis Galvin r 1 _ Secretary of the Commonwealth,Corporations Division One Ashburton Place, l7th floor Boston,MA 02108-1512 Telephone: (617)727-9640 0 BAKER & ASSOCIATES, INC. Summary Screen Request a Certificate The exact name of the Domestic Profit Corporation: BAKER&ASSOCIATES,INC. The name was changed from: BAKER CUSTOM ALUMINUM&VINYL COMPANY,INC. on 1/8/2004 Entity Type: Domestic Profit Corporation Identification Number: 000522085 Old Federal Employer Identification Number(Old FEIN): 000000000 Date of Organization in Massachusetts: 01/01/1996 Current Fiscal Month I Day: 12/31 Previous Fiscal Month/Day:00 100 The location of its principal office: No. and Street: 521 SHOOTFLYING HILL RD. City or Town: CENTERVILLE State: MA Zip: 02632 Country: USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: City or Town: State: Zip: Country: Name and address of the Registered Agent: Name: No. and Street: City or Town: State: Zip: Country: The officers and all of the directors of the corporation: Titre Individual Name Address(no PO Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT MARK BAKER 521 SHOOT FLYING HILL CENTERVILLE,MA 02632 US TREASURER CAROL BAKER MRS. 521 SHOOTFLYINGHILL ROAD CENTERVILLE,MA 02632 US SECRETARY BRETT BUSSIERE MR. 521 SHOOTFLYINGHILL ROAD CENTERVILLE,MA 026323 US DIRECTOR MARK BAKER MR. 521 SHOOTFLYINGHILL ROAD CENTERVILLE,MA 02632 US http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 3/25/2009 Town of Barnstable *Permit R �p WETp� Expires 6 mondrs jrom istr�re dale Regulatory Services Fee d� ►ss '� Thomas F.Geiler,Director 9�'°TFo►ra.+.,,� Building Division X-PRESS PI Peter F.Dillatteo, Building Commissioner 367 Main Street, Hyannis,MA 02601w. 0 C T 1 8 2001 Office: 508-862--038 TOWN OF BARNSTABLE Fax: 508-,90-6230 _ RESIDENTIAL ONLY EXPRESS PERMIT r valid wIrhosaAcdX raxlmprint Map,parcel Number 2 16 Property Address G Value of Work (Residential Owners Name&Address ' G � Telephone Number Contractor's Name Home Improvement Contractor License (if applicable) Construction Supervisors License=(if applicable) t r ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner (�I have Worker's Compensation Insurance Insurance Company games �� J 6T Workman's Comp. Policy- Permit Request(check box) J �Re-roof(stripping old shingles) �d .�-roof(not stripping. Going over existing layers of roof). �__ mpp _ ❑ Re-side ❑ �� Replacement Windows. U-Value � '44) ❑ Other(specify) sired: Issuance of this ettnit does not exe t compliance with other town departtnent iegulations.i.e.Historic.---------- Conservation.::c. Where req p mP Signature Q:Forrns:esprntrc:rct170601 Assessor's map and lot number ........................................ ,O L7f) Sewage Permit number ........................................................... ��Qy�FTNETD�y� TOWN OF BARNSTABLE • • It BABBSTABLB, i 639. N {r• BUILDING INSPECTOR PY APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION ...U ,•.-Y,! F, .,r..... ......................................................................................... :...................19 74. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......................... .w. .C.... ..a:-.....................................�.` ........��............................................. r ..... ProposedUse .... ! r r� ........ .......................................................................................................................... Zoning District ....eO..... ..... ...... .... ...`..........................Fire District .... Name of Owner � ...,•� /!J/ � �nA^i... ter.,-r i/� ,.., .,..... r. ........... Address .................... ..........-........................................... Name of Builder ................ .., e,--. ........Address .................................................................................... Nameof Architect .............:....................................................Address ..................................................................:............:.... Number of Rooms } :r '.'...........................................Foundation Exterior ..... �.r.' :.'�^ .... � �r... .........Roofing ....•?�* ?L *?�............................................ Floors ..... ..........................................- .`� 2 ..........»�' .Interior .......�?� k ............................... Heating .. , /� 1 f „- g �� .Jp z"'., ....................................... ............... . ....... ...... .............................Plumbin ........... ........ Fireplace ....=:-......�a ��^�-:.^/ ' ✓.-r. .Approximate Cost ..... ................. .0 .. Definitive Plan Approved by Planning Board ________________________________19________. Area ..�`` '`'=._'�► ... . Diagram of Lot and Building with Dimensions Fee - ~ I SUBJECT TO APPROVAL OF BOARD OF HEALTH �10 1 � � t- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . .-........ lf' ..1 fl�. �r -',r " `:.,. ........ J Williams, B. Arthur Inc. &=252-169 No ''215O0..... Permit for o�.p.:otuxy..dwelling _ , � —~......................................................................... � . . \ Location . . �! , ~_.~. R....1irthur-Wd-Iliams................... Type of Constriction ...........f.r.am'2'*....... ...................../..................................................... Plot ......../.............. Lot ................................ PERMIT REFUSED 19 ' � ` . � � -'`' ---- � '...''.................'...'............' Approved y ` . � ' ................................................ lA � -------'------'--^—^--^'—^^`^—' -----^-------------^~^~^^^~^'' �„o• TOWN OF BARNSTABLE Permit No. _____21500 # ��n.q Building Inspector Cash - — MAN _ OCCUPANCY, PERMIT Bona "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a` Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to R. Arthur Williams, Inc, Address lof #IQ$; . Q Ir) Phinnev's t anp, Cf-ntervilAt- Wiring Inspector ! C-/ ,<�.� ,�� Inspection date,,.2 Plumbing IIispec�to% .� F`` 2 __ e Inspection date ~ Gras Inspector � nt �,M1, � Inspection date 15& J An- Engineering Department���l�� Inspection date / l) f THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY.THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ............... 19f1 �! tf\ iaCfll „. _ ( /Building Inspector T ' Full Capet with ell "k s �� fix, a,a ;�._t �°...; �--•"'. ^^"�..-�""� .f 4* 'T - taw } ; t� Ij -j PZ - 7 A r I Standard Features • 2 Bedrooms - 1 Bath • Unfinished upper level. • G.E.Dishwasher,Range,and Hood with Fan -all with G.E. Factory Service. • Custom pine kitchen cabinets with BUILDER choice of color and hardware. R.ARTHUR WILLIAMS,INC. s Breakfast bar. P.O. Box 55 • Stainless steel sink with spray. Marstons Mills,Mass. 02648 • Forced warm-air heat. SECOND FLOOR PLAN Telephone 428-5717 • Wall to wall carpeting - choice of i j �.' colors. • Deck. • Landscaping. o o :_ • Storm windows and screens. • Combination storm and screen I a. doors. < do • Shutters - choice of color. u4. CL _ • Aluminum gutter. • White cedar shingles. eeor�n • Full basement with bulkhead. • Washer and dryer connections. • One piece fiberglass tub-shower S combination. • One piece sink with vanity. FIRST FLOOR PLAN Options 32' x 24' Cape w/12' ell • Full shed dormer - unfinished. t569 M L€�€Nc, Pooh • Completed upper level with two II'■tl° €� 14°t tl' bedrooms and full bath. • Fireplace. _ I 1 a (-,nrnna dj ILJ J f!1 3 '� e -3 U.J Q ILA o p L,LD `` IJ Vz -` kp NIN- 2 V% J Q + 713 d � o R J NPOL i W0 J_ F 9 r 1p •(� L f� w� psi _ r V 1{ .� f ,n u Q1, �� ^ W f.Y'�Y i - r `` � � �N I l � �- ,. U J � V — 5 3 - 1- {f .� 4 ( ,`,� i' t �»�a co 11J Q ' V� w � Q Q s In `Z • 1 C I- ►li "� �S i i A%sessor's,� map and lot number ....... a'rBT M MUST BE J - G "WALLED IN COMPUANCE Sewage Permit number ........................................................... W1TM T CFTHETO N ITIE ®fir a„ TOWN i EASBSTADL$ : ► �.n ° "6 a' BUILDING ,�' INSPECTOR CEO MPY . . � .� APPLICATION FOR PERMIT TO ...hse!Lid.............': ............................:...................................................y^. TYPE OF CONSTRUCTION ...l- 0. ...&12e.."..(e,. ....................................................................................9-3 ... ..................197.;t.' The undersigned hereby applies for a permit according to the following information- ................................. Location / p ....................... I.eG�/ —' '..a....B.�,..4rr................. /.0.. ..................:........................... ProposedUse .....1/C� l.. ....... r ./y....................................................................... ... ..................................... Zoning District .........Fire District f Name of Owner ,�7 !1. ../ ..Address ........... ..414;744 a.- . ..tf,6•4.................................. Nameof Builder .............-5-1 ..................................Address ..................................................................................... Nameof Architect ............./Ira7Pfr' -i..................................Address ..............................................................................:..... Number of Rooms ..........h .✓!t. .......................................Foundation ......�dE� ...C» Exterior ...f���1+ .... �t .. r�.,r�. fi� .........Roofing .... 4?. ~¢.�. . , 7.krao ./r...............................�` Floors ..... :,r/.....f�...h! .f1....G � ..............Interior .......�.-01..�.., ��� ��-�1.................................. Heating•� .... ca. :.... . err.K!�...:: ,( .!r......................PI"umbing ..:..4�ir�P.... .I�'�f.`t...................:.....:..........:...a:. Fireplace 4&.,�4vt�p .,c<!meft..•................. �Approximate Cost .... �J. t!"f ........ .Ut .......... Definitive Plan Approved by Planning Board ________________________________19________. Area ...>..... .. . . .......... Diagram of Lot and Building with Dimensions Fee cc� SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 nL I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. P)074., Name . ... . ......... Williams, R. Arthur Inc. No ....2.�5.QQ.. Peimit for One—%tory..dwell•ing ,l ........................................................ 5 Location 10t..Jka.95... Owner ... ...R...Ax thin •.W1]• .arxi-%.................... �� , �,.. � " # '' ,� ,• " Type of Construction ...... raine. ....................... ..................................................................... ...... {r Plot ............................ Lot ...... ..........:..... ;� y Permit Granted .........July.....26. .19 79 Date of Inspection ;19 Date Completed ............................ ..... .19 : PERMIT 'REFUSED ....................ff,............... .. ........... 19 ... .. .I. 1....�`/ ............. �� �/} ✓-/ f F ' . ' � r 1 tip. !.................. Yet; y .. .............................. * .... .� ......................................................... ro L Ap ................................................ 19 1' ...... ............... ................................ ...... �t +,..-� - .n .1 - - '•-•/ - .. .. .. .,.i....... .....Y:...... i 1+Assessor's,offioe -(1st floor): /e� OFfNE Assessor'sk map and lot number .......................... TO ... . ........... Q.. 1' �♦ BoaM of AIth (3rd floor): Sewage Permit number `... .......................... '...! ,(..r.......��....: t; BASd9T11DLE. i rasa Engineering Department (3rd floor): * q ` 6. KJ moo +639 ♦� House number...................................d..-�................./.... ........ ''�O�pYh` APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00=�2:00 P.M. only TOWN OF BARNSTABLE = ' BUILDING INSPECTOR C O,�/V APPLICATION FOR PERMIT TO ....................� �..�fJ •,;,.�.T�,,:D;t............................................... TYPE OF CONSTRUCTION ... ' 1�'a ............................................................................................................... ..................... . ......... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....3....... �A�✓ ! ...'r- .!! .... '.E!! .........................................................f _ ProposedUse ........ .. .. . ....< ............. ....:.. /... ..... .............. .t,-.o ...... .. .......................... Zoning District ........� .. I ��M � r ;� ; ��, "-h�/�l- Fire Distract ............ .. ....d: .<, ...•...... ....:.........._,......... Name of Owner W. A Y��...4, 5.V.G;,.!�e`d�°,.................Address .....,, Nameof Builder :........ .. .......: ......................................Address ..... ................................. .e `.......:...:........,... Name of Architect ......-- �., .-� _-�..............."........Address .....................................:.............. .............. ............ :.. Number of Rooms ...............CO,.,.,,......................................Foundation ... ?.(.. l,/� r................................... Exterior ..,................ ;.; .......... ......................................Roofing ............. .. ,��. 4��'•��.................................. Floors ............. ........ ..... .......... //J Heating .... .......................:..............:.:....: Plumbing a - ................. .. ......i............`......:..::............ .................`: - t Fireplace ..........Approximate Cost ...f.. . .................................................... .Definitive Plan Approved by Planning Board ________________________________19 Diagram of Lot and Building with Dimensions Fee < ' d SUBJECT TO APPROVAL OF BOARD OF HEALTH F 7 4 r i OCCUPANCY PERMITS .REQUIRED FOR NEW DWELLINGS f 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 .... ..'.... ,,KQ i p I Dugener, Wayne L. A=252-169 No ""31236 Permit for ......remodel garage ` -: to den Location .935 Phinney's Lane ............ .. ............. all h a - A, Owner Wayne L. Dugener Type of Construction .frame . ................................ ..............................................................I............ .... Plot ............................ Lot ................................ i Permit Granted ....September 28 .19 87 Date of Inspection ....................................19 ' Date Completed ......................................19 5'�'Assessor's, offioe (1st floor): .g _ / Q Assessor's:map and lot number "..� ..... //./ �R, �8�° ""fir, ��np����e.ST �� �oF ?off` �tj�lwN�i.�A� r' THE Board of Health (3rd floor): c� / ����� ��_.T J C� WQ o Sewage Permit number ...�.9.,,..�`'`06 .. u E 5 f Engineering Department (3rd floor): — L ®� �0 0 a9 a`m' House number `5 'b e 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 ..COV_VIR-r.•4f/JR�GF //trm .DE'J ,.•....................................... ..... ........................ TYPEOF CONSTRUCTION ...f ................................................................................................................ ....................91 44...........19.07 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .93 izo l. .... RV ...............................................................Proposed Use ........ ..... .. ..... .. .... .. ..... C. Q�.....l. S. .................... C.Zoning District ......... ...I.................................... ......Fire District C....!V�T.V/..X.l...f67��!.V1 1 Name of Owner WAYAl ...4 D.Q.G.eW9' .................Address .....s*AKV................................................................ Name of Builder ......... ..............Address ..... ....................... Nameof Architect ......... Address .................................................................................... Number of Rooms .. ............. �...........................................Foundation ...��G. sr( .................................. Exterior ... .. ..... ..... ........... ........... ......................................Roofing ...................................... 12, Floors :..................................................Interior ......... Heating ..... ..... .... .. .............................................................Plumbing ............ ........................................... Fireplace .... /`� 0.......................................................Approximate Cost ... .. Definitive Plan Approved by Planning Board ----------------------------- 19-------- • Area . / ............... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 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. ��l Y--_Name .K/.. . . Construction Supervisor's License """ I Diigener,- Wayne L. No" ... Permit for .......Kf�TR9�4�1...Ma T 4 9�- .................................................................. to- den Location ......:...9 i5...Phin.n.e.v.'..s...Lane....................... . . .. . ...... . . . ........................................ ....... Owner Wayne L....pu...........gi�ner................... .. Type d frame f,"Construction .......................................... ................................................................ ...... Plot ............................ Lot ................................ Permit Granted ..... q .19 87 Date of Inspection ...... ....I. .........19 Date Compl6ted .............................. ..190'/ th 7� 0 17