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Home My WebLink About0135 WEST MAIN STREET e�s+- -O t Y-L S-V. - - -- - __ wr"r-k ova --Broi 1cern�s i o,¢Ecc©S�.ee ua/ry3 ih i ,ParcekLookup Page 1 of 3 tn Y � r Logged In As: Parcel Lookup Thursday,January 3 2019 Nancy Larned Road Lookup Condo Lookup Multiple Address lookup Reports Search Options Search By IStreet Street# 135 Street Name west main Village I Hyannis Ell ......._.................... Search <PrevNext> Page 1 of 1 Rows/Page: Fq- Parcel Location Owner Village Index Map 290-102- 135 WEST MAIN IORDANOVA, DENITSA HYAN 1813 29010200A OOA STREET UNIT 1 290-102- 135 WEST MAIN GENEROSO, ADRIANO HYAN 1813 29010200B OOB STREET UNIT 2 290-102- 135 WEST MAIN ST COEUR, BRADFORD S & HYAN 1813 29010200C OOC STREET UNIT 3 SPILLANE, D 290-102- 135 WEST MAIN MILTON, JULIA HYAN 1813 29010200D OOD STREET UNIT 4 290-102- 135 WEST MAIN TARR, CARMELLA HYAN 1813 29010200E OOE STREET UNIT 5 290-102- 135 WEST MAIN SOARES, WELLINGTON HYAN 1813 2901020OF OOF STREET UNIT 6 290-102- 135 WEST MAIN DOREY, CRE A HYAN 1813 2901020OG OOG STREET UNIT 7 290-102- 135 WEST MAIN BOWES, DIANE HYAN 1813 29010200H OOH STREET UNIT 8 290-102- 135 WEST MAIN SHEPHERD, BRADLEY P HYAN 1813 290102001 001 STREET UNIT 9 290-102- 135 WEST MAIN BEAL, JOHN SCOTT HYAN 1813 29010200J OOJ STREET UNIT 10 290-102- 135 WEST MAIN DALEY, MYLES J HYAN 1813 29010200K OOK STREET UNIT 11 290-102- 135 WEST MAIN GANNON, ERIC W& KRISTIN C HYAN 1813 29010200L OOL STREET UNIT 12 vl 290-102= 135 WEST MAIN MCCANN, CYNTHIA VELLONE HYAN 1813 29010200M OOM STREET UNIT 13 AND MEDEIROS, CORINNE M HYAN 1813 2901020ON http://issgl2/iiitranet/propdata/lookup.aspx 1/3/2019 'Parcel Lookup Page 2 of 3 290-102- 135 WEST MAIN OON STREET UNIT 14 290-102- 135 WEST MAIN CONTI, JOSEPH T JR & HYAN 1813 290102000 000 STREET UNIT 15 MEREDITH H 290-102- 135 WEST MAIN SUOMALA, JOHN E & DIANE HYAN 1813 29010200P OOP STREET UNIT 16 290-102- 135 WEST MAIN BARNETT, MICHAEL R TR HYAN 1813 29010200Q OOQ STREET UNIT 17 290-102- 135 WEST MAIN KELLY, ERICA HYAN 1813 29010200R OOR STREET UNIT 18 290-102- 135 WEST MAIN TRAUTZ, ZACHARY C HYAN 1813 29010200S OOS STREET UNIT 19 290-102- 135 WEST MAIN BABUSCI, RALPH A JR HYAN 1813 29010200T OT STREET UNIT 20 290-102- 135 WEST MAIN MACDONALD, MICHAEL J HYAN 1813 290102000 00U STREET UNIT 21 290-102- 135 WEST MAIN GONSALVES, MARIO C HYAN 1813 29010200V 00V STREET UNIT 22 290-102- 135 WEST MAIN CREEDON, DANIEL M III HYAN 1813 29010200W OOW STREET UNIT 23 290-102- 135 WEST MAIN PIPER, MICHELE T HYAN 1813 2901020OX OOX STREET UNIT 24 290-102- 135 WEST MAIN THOMAS, TRICIA A HYAN 1813 29010200Y OOY STREET UNIT 25 290-102- 135 WEST MAIN WILLIAMS, MONICA HYAN 1813 290102OOZ OOZ STREET UNIT 26 290-102- 135 WEST MAIN OLIVEIRA, EVERSON & REJANE HYAN 1813 2901020AA OAA STREET UNIT 27 290-102- 135 WEST MAIN SCOTT, SUZANNE TRUSTEE HYAN 1813 2901020AB OAB STREET UNIT 28 290-102- 135 WEST MAIN OAKLEY, PETER J HYAN 1813 2901020AC OAC STREET UNIT 29 290-102- 135 WEST MAIN ARONSON, MARVIN E & HYAN 1813 2901020AD OAD STREET UNIT 30 GOODWIN, SHARON L 290-102- 135 WEST MAIN POLIZZI, LINDA M & DAVOLI, HYAN 1813 2901020AE OAE STREET UNIT 31 JENNIFER L 290-102- 135 WEST MAIN CUMMINGS, CHRISTINE HYAN 1813 2901020AF OAF STREET UNIT 32 290-102- 135 WEST MAIN SALLES, CLEITON M HYAN 1813 2901020AG OAG STREET UNIT 33 290-102- 135 WEST MAIN HANNIFORD, PAULETTE S HYAN 1813 2901020AH OAH STREET UNIT 34 290-102- 135 WEST MAIN BABINEAU, CHARLES &ANITA HYAN 1813 2901020AI OAI STREET UNIT 35 290-102- 135 WEST MAIN TEAM HOUSE LLC HYAN 1813 2901020AJ OAJ STREET UNIT 36 http://issgl2/intranet/propdata/lookup.aspx 1/3/2019 �ParcelLookup Page 3 of 3 290-102- 135 WEST MAIN GONCALVES, VERA C HYAN 1813 2901020AK OAK STREET UNIT 37 290-102- 135 WEST MAIN O'SULLIVAN, DANIEL F TR HYAN 1813 2901020AL OAL STREET UNIT 38 290-102- 135 WEST MAIN JOAQUIM PROPERTIES, INC HYAN 1813 2901020AM OAM STREET UNIT 39 290-102- 135 WEST MAIN SHANNON, MICHAEL S HYAN 1813 2901020AN OAN STREET UNIT 40 290-102- 135 WEST MAIN KNOPOV, LEV & NATALIA HYAN 1813 2901020AO OAO STREET UNIT 41 290-102- 135 WEST MAIN MOREN, PETER J & ELIOT, HYAN 1813 290102OAP OAP STREET UNIT 42 SUSAN J 290-102- 135 WEST MAIN CORREIRA, CYNTHIA HYAN 1813 2901020AQ OAQ STREET UNIT 43 290-102- 135 WEST MAIN BOVAT, CAMILLE HYAN 1813 2901020AR OAR STREET UNIT 44 290-102- 135 WEST MAIN DEOLIVEIRA, JOAO HYAN 1813 2901020AS OAS STREET UNIT 45 290-102- 135 WEST MAIN GRISWOLD, SUSAN E HYAN 1813 2901020AT OAT STREET UNIT 46 http://issgl2/intranet/propdata/lookup.aspx 1/3/2019 Town of Barnstable Building Post This Card So That it is Visible From the Street-ApprovedPlansMustbe Retained on Joband,this Card Must be`Kept rnat�t�rnea c - ,� y�m * Posted Until Final Inspects Has Been Made ,.' � _ 1 llllt Pe a ' W _ _ Certificate of Occupancy Requ ed su h Bu ld g shall Not�be Occ�upied.untit f a„Final.lnspect�ori>has been made Permit No. B-20-364 Applicant Name: CARLOS H FIGUEIROA Approvals Date Issued: 02/06/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 08/06/2020 Foundation: Location: 135 CONDOWORK WEST MAIN STREET, HYANNIS Map/Lot: 290-102-OOA Zoning District: Sheathing: Contractor�_ Owner on Record: & F REMODELING INC Framing: 1 Address: ContractorLicense:` 153,792 2 HYANNIS, MA 02601 'Est, Project Cost: $900.00 Chimney: Description: TRIM WORK BLDG A Permit Fee: $ 160.00 UNITS 1-10 i. Insulation: Fee Paid $ 160.00 Project Review Req: TRIM WORK ONLY. Date 2/6/2020 Final: y Plumbing/Gas T k" � Rough Plumbing: . . . =,Building Official , 3 - Final Plumbing: This permit shall be deemed abandoned and invalid unless the work autQ ized by this permit is commenced within six months aher.issuance. All work authorized by this permit shall conform to the approved appl atiori and thetapproved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structuresrshall be in compliance with the local zoningjby laws and codes. This permit shall be displayed in a location clearly visible from access or road and shall be maintained open for public inspection for the entire duration of the street Final Gas: e/ a work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures liy the Buil"ding�and Fire Officials are`-provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: -_ Service: 1.Foundation or Footing ' Rough: 2.Sheathing Inspection L_ k 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site _ Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Application number .... ... ..0............................ Fee ..................................0....go 9 ........................................ Bw�Ett�tTs►,Bi�. Building Inspectors -,1401k.................... I+f �► g p Date Issued........2, LOU /. ./............................................ l a-� �- Map/Parcel....0".1................................................. TOWN OF BARNSTABLE `'r""y` sir EXPEDITED PERMIT APPLICATION: SCANNED ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION F EB PROPERTY INFORMATION 1. Address of Project: I `)S N-,AA�� k'W"Al 1 S 6L►76 A NUMBER STREET VILLAGE L`"'143 1 " Owner's Name: I.lAru/�✓ WC)Y Ck✓ Phone Number ,SO 0- 17.SC.iPJ 0 ^� Email Address: 1I Gd`AW S (OW"t -AIC Cell Phone Number Project cost$ �00.00 Check one Residential Commercial Y F- OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: z. S �„ 0 TYPE OF WORK Siding E Windows (no header change) # F-1 Insulation/Weatherization Q Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than I layer of shingles) Construction Debris will be going to 1.4A/V\/%- CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# 1 S ry' (attach copy) Construction Supervisor's License# 10� 0 (attach copy) Email of Contractor r cc laP �, Phone number ALL PROPERTIES T AT HA vk STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. j, APPLICATION NUMBER ............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X , X 9 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 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: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date Z &RD All permit applications re subject to a building official's approval prior to issuance. /hlG_ 299 Main Street, West Yarmouth, MA 02673 508-775-6880 Fax: 508-775-6939 E-Mail: horansh@comcast.net February 4, 2020 To: Town of Barnstable Building Dept From: Shawn Horan Re: Hastings Meadow Condominiums To Whom it may concern, Please note that CF Remodeling Inc has been retained to install new fascia board and soffit venting at Hastings Meadow Condominiums, 135 West Main St, Hyannis. Sincerely yours, Shawn Horan Cape Realty Inc Property Manager SALES RENTALS REAL ESTATE MANGEMENT BUYER AGENCY www.caperealtycapecod.com .�za�iz��zeHa�ea�l�Z office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Corporation Remstr`atlon Expiration N �tS3792 01/07/2021 N _e. C&F REMODEUNG 1M0 V-fi, Mr- ,O ayi CARLOS H.FIGUEIRO._Af% N c N `p 20 CAPTAIN NOYES L c0/i a .y S.YARMOUTM MA 02604 — — ,_ M °�'ISt(>,�,. Undersecreta tC J 0f(+ I ,A 7o c Mao o�%� RQ CD C ° c ✓t. W E .y 12 m o . �1 �^ E :�w 41 4 ° U a 0 i Registration valid for-individual use only U O 0 N H } O r..a.Q Z before the expiration date. If found return to:. m it oU C Office of Consumer Affairs and Business Regulation 1060 Washington Street Suite 716 C Boston,MA 02118 Not valid without slgrlature, AC" CERTIFICATE OF LIABILITY INSURANCE TE �� DA05/02/2019rr) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS 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 Deborah Kelly NAME: Leonard Insurance Agency,Inc PHONE (508)428-6921 FAX (508)420-5406 A/C No Ext: AIC No): 683 Main Street E-MAIL s: deborahk@leonardagency.com ADDRE Suite B INSURER(S)AFFORDING COVERAGE NAIC# Osterville MA 02655 INSURERA: Atain Specialty Insurance INSURED INSURER B: The Commerce Ins.Co. 34754 Carlos Figueiroa,DBA:C&F Remodeling Inc. INSURERC: Associated Ind.Of MA-ARWC 26158 INSURER D: 20 Captain Noyes Road INSURERE: South Yarmouth MA 02664 INSURER F: COVERAGES CERTIFICATE NUMBER: CL195203710 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. 1 EXP �TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DDY/YYYY M EFF MIDDY/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000' A CIP383515 04/18/2019 04/18/2020 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY D jECT LOO 2,000,000 PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ 250,000 B OWNED Ix SCHEDULED RVM277 01/18/2019 01/18/2020 BODILYINJURY(Peraccident) $ 500,000 AUTOSONLY AUTOS XHIRED NON-OWNED PROPERTYDAMAGE $ 250,000 AUTOS ONLY AUTOS ONLY Per accident Medical payments $ 10.000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION S $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YN - STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE / E.L.EACH ACCIDENT $ 500,000 C OFFICER/MEMBER EXCLUDED? a NIA WCC-500-5018589-2019A 04/30/2019 04/30/2020 (Mandatory in NH) E.L.DISEASE.EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Mashpee ACCORDANCE WITH THE POLICY PROVISIONS. 16 Great Neck Road AUTHORIZED REPRESENTATIVES Mashpee MA 02649 ©1988--2l0✓16 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 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: Bw7ders/Contractors/Electriciang/Plumbers Applicant Information Please Print Legibly J Name(Business/OrganizadmVIndividual): pp,-- eg,Y C Address: Zri iU City/State/Zip: Phone#: �� 3 7 Are you an employer?Chedc the appropriate box: 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. ElNew construction 2.❑ 1 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.acitY• employees and have workers'[No workers' comp.insurance comp.insurance.: 9. El Building addition 5. We are a corporation and its 10.❑Electrical repairs or additions 3.Elrequired.] officers have exercised their I I. Plumb airs or additions I am a homeowner doing all work h id ❑Plumbing reP • mysel£[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance ]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 most 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-oontractors have employees,they must provide their worker:'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is thepolicy and job site Information. Insurance Company Name: C4-- l✓4 Policy#or Self-ins.Lie.M &"CC 500 S0/,958 f. Expiration Date: -'f 130 -goao Job Site Address: l S 6U-esy City/state/zip: / ice✓` 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 under a pains and penalties of perjury that the information provided above is true_ and correct, 2 Z Signature: Date: D Z Phone#• ��' 3 7 f�; Ojjicurl use only. Do not write in this area,to be completed by city or town of trial 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 M Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to ties 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 groimds 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 constrict 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-cunt wtor(s)name(s),addresses)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 sire 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 Offiicials 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 time 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 bur 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 Dgwtmernt of Industrial Accidents Office of Investigations 600 Washington Street Bastion,MA 02111 - Tel.#617-727-4900 ext 406 or 1-877-MASSAM Fax#617-727-7749 Revised 4-24-07 www:mass.gov/din LYNCH & LYNCH Francis J.Lynch,111 Nella M.Lussier Stephen M.A. Woodworth A PROFESSIONAL CORPORATION John F. Gleavy John A.Eklund J. William Chamberlain,Jr. Susan E. Sullivan 45 Bristol Drive Jeanne E.Flynn Stephen J.Duggan South Easton,MA 02375 Benjamin J. Whitney Peter E.Heppner Tel:(508)230-2500 Marina N.Medved Clyde K.Hanyen Fax:(508)230-2510 Thomas A. Murphy Joseph C.Ferreira www.lynchlynch.com Andrew H. Lynch J. Gary Bennett — Sean J.McCarthy Thomas A.Pursley* One Federal Street. 155 South Main Street Teamy Uy Carroll D. Coletti** Suite 2120 Second Floor Nicholas M. Vaz**** Boston, MA 02110 Providence,RI 02903 Kelly J. Wilbur (401)861-0108 Laura T. Daly Milena Y.Ponomareva Francis J.Lynch,11 OF COUNSEL 1967-2001 PLEASE DIRECT ALL CORRESPONDENCE TO SOUTH EASTON ADDRESS Ellen M. Chiocca Carey Also Admitted in Rhode Island Gerard A. Coletta **Also Admitted in New Hampshire ****Also Admitted in Connecticut June 7, 2017 Town of Hyannis BUILDING DEPT, Building Division 200 Main Street JUN 12 2017 Hyannis, MA 02601 k, �3L TOWN OF BA�neS n`r7, .= Re: Souza, Robert v. Hastings Meadow Condominium Trust, et al Barnstable Superior Court Civil Action No.: 1672CV00568 Safety Insurance Company Claim No.: 7500005295 Our File No.: 17.25393 Dear Sir/Madam: Pursuant to General Laws Chapter 66, Section 10, kindly provide this office with copies of all records in your files concerning the following: Hasting Meadow Condominium, 135 West Main Street, Hyannis, MA It is further requested that, if possible, original digital photographs be provided on a cd. If there is a charge for same,please contact my paralegal, Brenda Dinis, at 508 230 2500 X 240. Thank you for your cooperation in this regard. Verylyd Gleavy ,. JFG/lpw cc: Karen Stefanski via Email Town of Barnstable OFtHE Regulatory Services Richard V.Scali,Director Building Division &UMST"LE. BSTLE u�cQhmm�!t•cpnm-WHOs ass. Paul Roma " _ 16gy �0 ) tew ioia iOrEn �°i Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us June 14,2017 I Debra Barrows, Office Manager to the Town of Barnstable Building Department certify this is a True Attested Copy for all copies from the Building Department file for 135 West Main Street, Hyannis Debra Barrows Office Manager Witness i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma �� Parcel ® ® D Application # l -I SP p �pT pp Health Division ZQ Date Issued (Y V � 16 . Conservation Division Application Fe Planning Dept. xir •�TggLE Permit Fee Date Definitive Plan Approved by Planning Board _ I- li Co/3�1 Historic - OKH _ Preservation / Hyannis .y Project Street Address �JcJ l�J �� lk t4,S CCa;Q:te_ LX)cQ6- 'A Village II Ownel,57%N� foul C_ Address 3E::) v� JIS Telephone 50$ 3to1 -6gg1 4.w4 �64K,) 1elc:.D2^2� Permit Req.tjeste ioArSdey��- \"-vto �c`�1�.aJG�i Yx�NlO�6W& Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new ; Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Acre9�'LGV'-4 Lot Size Grandfathered: ❑Yes M9 No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) C© Age of Existing Structure -V % Historic House: ❑Yes dNo . On Old King's Highway: ❑Yes 3 No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ r Oth yp ou e Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new 6 Number of Bedrooms: existing new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other ; Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0 No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing.-U.new size_ Attached garage:❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ " �r Commercial 0 Yes ❑ No If yes, site plan review # Current Use COKIQOS Proposed Use 5AAAC APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name y,eLui V,1Gr (tic, Telephone Number 9byo Address g PgVJ J QDAD License# 0901 I6: ®� Home Improvement Contractor# ,aa96� Email LCLOLZ • 1.A.1/yl Worker's Compensation #66620222 90 1371 Ifo ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO '-SIGNATURE ' DATE � �3� �� " C 0,An";•- .. r FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL :,> a N FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i .the t awwoanreah*qfA&mdruYd& 600 WashhWoxSftet ;.;:;. . . �os&Y4 MA�l� >Trptkmamg�iia WGrlce& Calccspe Iuslsaance Affi&vit BufldersdCnntmztm&l � ers ApartIufur3=f 0U PleaseFrin Nam oksillewoz9atiz Al ens: k-U.uJi~ rt erstt Phone2111-- 60q Arer u an emmpIager?Cheektbe appropriate bay Type of project(regaft%d): I.U I am a employer with_ 4. ❑I am a ge erA confmctor and I 6- New conskocEM employees @6A andfor part-#ime)* bat,*e biredthe mgr-� I❑ I am a sale pn arparluer- Misted .the attached sbee� I ❑Remodeling slip and have no etnplayees These sub-contac4cm butte ❑Demalifioa m Q forme in employees amdhave xgaskess' �� _ 9_ ❑S�uil�tag atfdififln [No 'comp-�saace comp msmat�I 10:❑Electrical repairs Or adCEEGM reTimd] 5. ❑ Weare aaorpomfionand its 3_❑ I am.a homeovmer doing all wodc, offeess have exercised their MEI PM&kgTqMM or aMfia s ngsel€[No wadme camp- rigM of exemptim per MGL 11. Roofrepaics i nsurance reTsi red I i c.152,§1(4• audwe have no employe-[No wotj e& I3❑f?thet cemP-instxame, ] •day spplicmt�atchec7rsbasASlmostalsoffioa�thesecBonbeioarsbs,uiagBieirworkexs'cflmp sipcTs<9iafozm�Pirm� ffnMM vrbo submit fins nftidn4f &gam4nie�sHwaY amdthmbae-"dd—Cattactnrsmnst an7tmitaaew�d:e�mdiahey snrT+ rCanuadors8uj cbecji7ds bus must a3tacbe�as addiBcros]sheet sLao�gagthea Hof the sad statevrbsthe�ornactbose eni bsra eaplayem Tftbesn6-rnatactmLsQ=&Tea%tky lmViethek Md—e—P-PO&Y—ba I am an srrtplaFer flint is prm�durg ioorkers'cotngheresatfon Mmranw or mg earprywes. SE my is tits paffcy and job site ircfurmafian. . . " �� Iasurancecompanpl+Iamne: Paficyor^,�e1€-sns.Li� ��DZ� 2��OtJ II l6 FxpisaEiaaDate.6^ 3Jn Iob&te.Address:_,,,"-2 City/5tate : teach a copy of the workers'comptmsatioaporwy declaration page(Am Ming the poficy member and.expiration date). Fade to seeuce caveor as requiredun&r.section 25A of MGL M 157—can lead to the imposition of crimsaal penalties of a. Sae up to$1,500 OQ m6or one-yesrimprisonInE4 ES well as civil penalties is the&M of a STOP WORK OMEgaad a Sae of up to$250_00 a day aggind&e,viol-far. Be advised gid a copy of this statement snag be forwarded to the Office of Iavestizations ofte DIA for ice coverage vim. I do here'6 ue�r Skepains and ofpffp rp fisatthe igarma€=pm hW abm J:9 bare and furred rate- Phone ik b 0jVkiat nas wed}. Da rust mite in tills urea;to be ovrVWed by tat+arirncn ex,ffldaL Otrj or Town: PerwhMieeme.0 Issuing Audwrky(chide one): L Board of$Ealth I Emg Departm at 3.f igjr m Clerk 4�Ejech ical hmpector S.Phw3bhtg fiLVedrtr 6.der Contact Person: Phone#: 6 �C ® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 05/27/2016 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: Christine Davies DOWLING &O'NEIL INSURANCE AGENCY P"C FAX "o M. (508)775-1620 (A/C A/C No ADDRESS: Cdavles@dolnS.COm 9731YANNOUGH RD. INSURERS AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURER A: ACE AMERICAN INSURANCE CO 22667 INSURED INSURER B KELLY ROOFING INC INSURERC: INSURER D: 8 RHINE ROAD INSURERE: YARMOUTHPORT MA 02675 INSURER F: COVERAGES CERTIFICATE NUMBER: 56798 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 LTR TYPE OF INSURANCE ADDL SWVD UER POLICY NUMBER MM/DDPOLICY/YYYY) (MMIDDfYYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR E PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY a PRO-JECT ❑ LOC PRODUCTS-COMP/OP AGG $ PRO- OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTYDAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ Ll EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 A OFFICER/M EMBER EXCLUDED? I N/A N/A N/A 6S62UB2E90137116 05/06/2016 05/06/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEEI $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for tenefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hastings Meadow Condominiums ACCORDANCE WITH THE POLICY PROVISIONS. 135 West Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 U Daniel M Cro in�y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD Q , 1 0 1/9&0 j Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration - Registration: 128957 Type: Individual Expiration: 6/14/2017 Tr# 266936 Oliver Kelly Oliver Kelly 8 Rhine Rd -- - Yarmouthport, MA 02675 _-_ Update Address and return card.Mark reason for cha sca 1 es 20m•05m Address ❑ Renewal r] Employment ❑ Lost C�%�n, �rrnirrr.•rrraerrl/�,a/�C/l�ni.;nc�r%e(/' _— �' _�.. ~� Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ' (HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: t� FRegistration 1289.57 Type: Office of Consumer Affairs and Business Regulation r 10 Park Plaza-Suite 5170 Expiration 6M4/2017 Individual Boston,MA 02116 Oliver Kelly Oliver Kelly = �. 8 Rhine Rd. Yarmouthport,MA 02675 Undersecretary Not valid without signature Massachusetts Department of Public Safety Board of-Building Regulations and Standards License: CSSL-099167 'Construction'Sup'visor Specialty g _. OLIVER M KELLY_ 8 RHINE ROAD YARMOUTH PORT MA 02675 Expiration: commissioner 0912812017 � 1 W M Cape Really Inc 299 Main St West Yammouth, MA 02673 508-775-6880 Fax: 508-775-6939 E-mail: horansh@wmcasLnet ^ WOOF REPAIRS WORK FOR HIRE AGQeMM This work for hie agreement a made an May 25,2016 between HasaW Meadow Condominhum do Cape Realty Inc,299 Main St,West Yarmouth,MA 02673,the party who will be receiving services(hereinafter referred to as Customer")and KeUy Roofing,the party who will providing the services(herein rethmed to as"Connector')for work to be performed at Hastings Meadow Condaminiums,135 West Main St,Hyannis.Barnstable County.MA.Contractor agrees to perform all work as specified under the following terms and conditions. 1)Contract shoo take down and remove all exterar vinyl sided tone chimneys from exiting roofs.Total of 23 chimneys. Contractor shao protect work area to prevent any damage toads"roofs,guitars,Siding,and shrubs.All debris shall be kl into dump truck arnd properly disposed of off-site. 2)As each chimney is removed,Contract shagWOW5ff exterior grade plywood to.opening and then followed by#15 felt paper.Area to be shingled with wdftd style roof to rratdtadsting roof(Cerlebteed oo(I Landmark shing"year warranty).Each shingle to be fasts 0 with h 6 roof nails.No chimney holes shall be kOht open overnight. 3).As each chimney to a roof section separated by jog is completed,Contractor shall Install 1Y Certainteed Air Vent Shingle II Ridge Vent with hard railed caps on all ridges with ridge cut to 2°gap on either side of king ram.Air Vent Shingle ii Ridge Vent to be secured to roof rafters with 3°roofing nails. 4)Contractor agrees to perform all work in a good workmanlike manner consistent with industry standards and manufacturer's spoons.Promises to be cleaned up of all debris upon completion of ail work as specified. 5)Contractor agrees to furnish and pay for all costs of materials,equipment,permits,disposal costs,and labor in order to complete all work as specified Contractor shoo maintain general tiability($1,000,00=,000,000)and workers compensation insurance.Cettifikeles of Insurance are attached herahk Contractor shall supply generator for III• 6)Contractor agrees to start work on May 31,2016 and complete all work on or before June 16,2016,exceptions being made for wet weather conditions. 7)Notwithstanding any manufacturer's warranties,Contractor shall guarantee al{work to bs tree from any Wm for a period of 24 months from the completion date. 8)The total cost of this work as specified above is$25,480.00.Customer agrees to pay$12,000 as an initial payment prior to the strut of work.$13,460.00 shall be payable upon comPMM of all Work and,final cleanup. 9)ConWCW shoo indemnify and hold Hastings Meadow Condominium,Cape Realty ink,and all unit owners and assigns harmless from any property damage or personal Injury occurring on the premises. 10)Designated work hours.Monday-Friday&00 AM-4:30 PM. 11)No alcoholic beverages or work dogs are allowed on the Property at any time.Shirts shall be worn at all times. Any music that nay become a detriment to residents of Hastings Meadow or Interfere with Ow quiet enjoyment stall be promptly turned down or off. T Cape Realty Inc 299 Main St West Yarmouth,MA 02673 508-7754MO Ram 508-775-8939 E-mail: horanshGoomcast.net This agreement contetins the eMtre agreement between the parties,and there are no other promises or conditions in arry other agreement whether oral or written.Any extra work or services shall be mutually agreed upon in waiting. Both, parties represent that they are autit dnd th execute this agreement hereunder. Executed on this Hastings Meadow Condom` By:Cre Dorey,Trustee Contact Person: Shawn Horan Cape Really Inc 5"7-3997 eflY Rooting By;06vw Ksdy,Owner 508-509.4840 MA CLS#099187 j� a a�toud.ocm I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2% Parcel 1®200 Applicatio Health Division Date Issued CO! / �!J /Conservation Division �� e� Application Fe Planning Dept. 401 Permit Fee Date Definitive Plan Approved by Planning Bonk `a �— �� 613X Historic - OKH _ Preservation / Hyan�n`"s•�: :- ' Project Street Address 5� L4 Village Owner lAddress C AAW 02001 Telephone�� c1N G 2 �Q AN Permit Request ruAC� d X \JC- v�'�N� n Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation` `�� Construction Typ tj l Tjoo Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) 2.40 Age of Existing Structure 3S SLS Historic House: ❑Yes dNo On Old King's Highway: 0 Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing_new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# { Current Use Proposed Use APPLICANT INFORMATION - -- ` (BUILDER OR HOMEOWNER) Name 6� C� WC, Telephone Number S5 ;: J Address �I,�V�1� K.Q License#44�GDWZI _� Home Improvement Contractor# 2� Email Worker's Compensation #�S6�Ll� ocslk �6 ALL ONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 1 SIGNATUR L I (,--CCU DATE L �� s k 1 . i FOR OFFICIAL USE ONLY y APPLICATION # F T DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER r' : r DATE OF INSPECTION: FOUNDATION t FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL y GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t C f B'e7rt�&ffal4t afradusbiatAcddads � rye af' gtzons, 600 Washbi<oan Street Baswi4 MA 0-7111 ' vt�mgo�fi7ia , Wkw1wre CGmpe Sa[iim Lmnrmce Af!irlatr f'Bi>ldel-./CnntrachTs/Bedririans/Pl�mnhers ApvIcznt Infori afin—n Ple't.se print Nw= Basillefto. AddFe�s: �uyy� CitwSt-w�--qMMM&w6dq 46qV . Are tau an emprla er?f 7reckthe appropriate bay Type of project(requift4. I. I am a I with 4 ❑I am a general Victor and I 6. ❑New a on P s hav<ehiredf$e sub-coahactoia employees(fill audfar past-#ime)- 2❑ I am a sale pn43 ietor orgartmer- listed oaths aftmhed sheet 7- ❑Rexaodeliag sbip and have no empk gees. . 71ese smh-Lo ctors have $- ❑Demolition Io and wodoers' working far me is any�� 9_ El Building additiore. LNO ttio&eas'comp-Et sumnce comp' 'l 1@ Elecf�ical m atic ass required-]required-] 5.❑ We are acorpomfiam.andits ❑ repairs 3-❑ I am a homeovmw doing aU work o$cers have exercmed their ILE]3jumbingrepaim or additions Mysem tighf per MCL [Nocomp-- of ese�fiouF L_ Roafrepairs insurance required-]I c. ,§I(4h andwe bran no employem[No wodrers' 13.0 0ther comp-inswance reqaftmd.] ;Any appGcan2ff�stcberboz1 Est also ffioufthe se-tioabeiawsheuffig Bie3ced�Pe�PeTeyiafonastiad ameasvnets�cho sabm*d&M&,v*k&cxdng fty uatlamg Ova*sad it mbbe cum&canuamm,st snhmita newsiizdn t indiamino SadL Zbm=ctan*9 A—Ir TIft b=mastattachedamsddid due sUviagdonmeofthesob-cam sadsmievrhmhesaraatfbaseeafftkshsee empbyem Ifthe Lmveemptayea%dw a pmviderheir mnace&=mixroUcy—b- i am an srrtpla sr that fs proczdfrrg workers'comperssahan iU=ranwJbr nT employees: $elow is thepoiicy arrd jab s ke iafarmaliore. '� "hswm2ceC=qmy I�Eame= � Poyicy¢ccSelf-ins.Iic.0:.��fD2c,�2EG01��1l6 6,b ,2o n rob Site Addre= � 8�6 citlrJStafefZrp: N A ach a coyry of the workers'compensa&apolicp dedparation page(shwwisg the porky number and espi mdoa date). Failure to sew coveaaage as requiredunder Section 25A of MGL m 157 can lead fo t ie imposition of criminal penahies oP a fine up to$%500:00 aaWbr one-yearimpdsonmenk as we$as civil penalties m 1he form of a STOP WORK ORDERAnd a fffie o€lipto$250-00 a dap againd the violater. Be advised drat a copy ofthis sta#ememtmaybe fxwarded to the Ofke of Iuvvestistiaus ofthe DIA.for ias»mnce coverage veriffbation. 1 dio her- c uadsr disp�and fi 6fFM1wy t i&;6w ira fonuafimproufiW abem h bare and emrPA Siomat�m+ hate - 20L 10 phone " 0jok ad usa wily. Do not mite in fish area,to be cvrppieted by-clip ertoism gyfdaE City or Thwm: PermbUcewe; Esuing Anthw€ty(carIe one): L Board o#M21th 3. Dcpartmeirt I CiVFown Clerk 4,Electrical h spector S.PhmAh g Inspector *Other conbet Person: Phone#: ACb 05/2727 CERTIFICATE OF LIABILITY INSURANCE °ATE //2016 `,...� 016 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: Christine Davies DOWLING & O'NEIL INSURANCE AGENCY a/CON o Ext• (508)775-1620 1 ac No: E-MAIL ADDRESS: cdavies@doins.com 973IYANNOUGH RD. INSURERS AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURERA: ACE AMERICAN INSURANCE CO 22667 INSURED INSURER B: KELLY ROOFING INC INSURERC: INSURER D: 8 RHINE ROAD INSURERE: YARMOUTHPORT MA 02675 INSURERF: COVERAGES CERTIFICATE NUMBER: 56798 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 LTR TYPE OF INSURANCE ADOL SUBR Y POLICY NUMBER MM/DD/YYYY MM EFF Y DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE RENTED PREMISES Ea occurrence $ C4O MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO ❑ LOC JECT PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBEREXCLUDED? I N/A N/A N/A 6S62UB2E90137116 05/06/2016 05/06/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC.20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Hastings MeadowCondominiums , 135 West Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 Daniel M.Crc v�y,CPCU,Vice President—Residual Market—WCRIBMA C 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01), The ACORD name and logo are registered marks of ACORD a Massachusetts Department of Public,Safety Board of Building Regulations and Standards 3. License: CSSL-099167 Construction Supervisor Specialty . s OLIVER-M KELLY 8 RHINE ROAD 4 YARMOUTH PORT M- -� Expiration: Commissioner 09/284017 /'GQi 11i � ��if2l�i�flP.�iJ� � \_;i�% Cl:� ✓ '�1�2f1.IQ/riU.� �r Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston;Massachusetts 02116 Home Improvement Contractor Registration _ Registration: 128957 Type: Individual - - Expiration: 6/14/2017 Tr# 266936 Oliver Kelly .. Oliver Kelly 8 Rhine Rd = - Yarmouthport, MA 02675 - -- Update Address and return card.Mark reason for change. SCA I 0 2OM-05m L7 Address f-� Renewal C Employment Lost Card Office of Consumer Affairs&Business Regulation License or registration valid for individul use only '#TOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: registration: 128957 Type. Office of Consumer Affairs and Business Regulation `ta Facpiratian:= _6%i412Q17_ Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 Oliver Kelly - Oliver Kelly -_ 8 Rhine Rd. _ LQa J Yarmouthport,MA 02675 undersecretary Not valid without signature. Cape Really Inc 299 Main St West Yarmouth,MA 02673 508-776-6860 Fax: 508-775-6939 E-mail: horansh not ROOF REPAIRS VKIRK FOR HIRE AGREElAE This work for We agreement is made on May 25,2016 between"between"Iend 9 a Meadow Coadomtntiats do Cape Realty Inc,299 Main St,West Yarmouth,MA 02873,the party who will be receiving services(hereinafEer referred to as Customer")and Kelly Roofing,the party who will providing the services(hereinaitsr referred to as°Cor*acbe)for Work to be performed at Hastings Meadow Condominiums,135 UYest Main St,Hyannis,Barnstable County,MA.Contractor agrees fo perform all work as specified under the following terms and conditions. 1)Contractor shall take down and rermove all exterior vinyl sided faucc chimneys from exiting roots.Total of 23 chimneys. Contractor stall probed work area to prevent any dame to e)ds*V mob,gutters,siding,and shrubs.AN debris shall be loaded into dump truck a nd properly disposed of df-site. 2)As each chimney is removed,Contractor shall irk 5W eoderior grade plywood to.opechirg and then tilowed by 615 felt paw.Area to be sf naled with architect style roof shingles b 1118W existing roof(Certekhbeed mod L shin"year varranty).Each shingle to be fastened with 6 roof nails.No chimney holes shaft be kept open overnight 3).As each chimney to a roof section separated by jog is completed.Cantor shall install 12'Certinteed Air Vent Shingle II Ridge Vent with hand nailed caps on all ridges with ridge cut to T gap on either side of Idng ratter.Air Vent Shingle II Ridge vent to be secured to roof rafters with 3°roofing nails. 4)Contractor agrees th perform all wets in a good woriursrdike manner consistent with industry standards an d manubgurses spedficxlions.Premises to be cleaned up of all debris upon completion of all work as sue. 5)Contactor agrees to furnish and pay for all costs of materials.equipirwit pernft disposal Costs,and tabor in order to complete an work as speCified.Contractor shall maintain gsnerai liability($1,000,0001 A0.000)and workers compensation insurance.Cgiotificates of insurance are eft0ed hereto.Con"dw shalt supply generator for mil. 6)Contractor agrees to start work on May 31,2016 and complete all work on or before June 15,2016,exceptions being made tar wet weather conditions, 7)Notwithstanding any manufacturers warranties,contra shall guarantee all work to be free from any leaks for a period of 24 months from the completion date. 8)The total cost of this worts as specified above is$25,460.00.Customer agrees to pay$12,000 as an initial payment prior to the start of work.$13,460.00 shall be payable upon completion of all work and final cleanup. 9)Contractor shall Indemnify and hold Hastings Meadow Condominiums,Cape Realty Inc,and all unit owners and assigns harmless from any property damage or personal injury occurring on the premises. 10)OesigroW work hours:Monday-Friday&00 AM-4:30 PM. 11)No alcoholic beverages or work dogs are allowed on the property at any true.Shirts shall be worn at all times. Any music do may become a detriment to residents of HOO&W Meadow or interfere with their quiet enjoyment shall be promptly turned dawn or off. Cape Realty Inc 299 Main St West Yarmouth, MA 02673 508-775.6880 Fax 508-775-6939 E-mail: hora not This agreement contains the entire agreement between the parties,and there are no other promises or conditions in any other agreement why oral or written.Any extra work or services shall be mutually agreed upon in writing. Both parties reprosent that they are authorized to execute this agreement hereunder. Executed on this _ '2-0 lJo Hastings Meadow Condom' " ms By:Cre Dorey,Trustee Contact Person: Shawn Horan Cape Realty Inc 50$-387-3997 Roofing OI'w Kely Owner 50"09.4640 MA CLS#099167 kebMgftgWoud.com ca Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 021.16 Home Improvement Contractor Registration Registration: 128957 - = Type: Individual Expiration: 6/14/2017 Trf# 266936 Oliver Kelly Oliver Kelly 8 Rhine Rd Yarmouthport, MA 02675 Update Address and return card.Mark reason for cha SCA 1 0 20M•05/11 Address Renewal Employment Lost c_%//,r,�a��areaivalen�l�•a�C?/fl�i;�s«c�a�nitr Office of Consumer Affairs&Business Regulation License or registration valid for individul use only rt� _ AOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: � Office of Consumer Affairs and Business Regulation 128957 Type: g Expiration: Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 Oliver Kelly Oliver Kelly 8 Rhine Rd. - Yermouthport,MA 02675 Undersecretary Not valid without signature Massachusetts Department of Public Safety Board of-Building Regulations and Standards License: CSSL499167 Construction Supervisor Specialty OLIVER M KELLY.: 8 RHINE ROAD , YARMOUT}I PORT MA 0267y6 ' �x t Expiration: Commissioner 0912=017 � w TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel A0l Application —/6_ lDq Health Division Date Issued ` Conservation Division ®EP Application Fee' Planning Dept. J�N �;1 i �� Permit Fee Date Definitive Plan Approved by Planning Board TOWN nrm onn.,� 3 .,.. TABLE ---�- I led r Historic - OKH _ Preservation/ Hyannis e er Project Street Address��` Village Owner �6 &AMZ Address VQ Telephone V VW-40 G ° Permit Request O den C� SZI� Cr ors �sFCIa n ' tS i t�G Uen (0) IC's Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation kLt26 Construction Type Lot Size Grandfathered: ❑Yes /No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) 0 Age of Existing Structure q0S Historic House: ❑Yes No. On Old King's Highway: ❑Yes i No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial W/Yes ❑ No If yes, site plan review# Current Use QES �, Proposed Use 5NLA c. APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name _tlLt xl ,\A _- U' G bks C_ Telephone Number 1qbq 0 A dress C7 � - License #_ OCO I b7 Home Improvement Contractor# k -1 Email VACUA Ob ' (PM Worker's Compensation # 0131 ALL CONSTRUCTION D BRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO AQAQ0W !!&M Ekiao,) SIGNATUR DATE IKJ l 1 r u� FOR OFFICIAL USE ONLY i APPLICATION # DATE ISSUED MAP/PARCEL NO. t - ADDRESS VILLAGE J OWNER DATE OF INSPECTION: �f '. FOUNDATION FRAME INSULATION '7 tl FIREPLACE • ELECTRICAL: ROUGH FINAL { PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING P ? DATE CLOSED OUT ASSOCIATION PLAN NO. Y � r r - � wa.. ?lie Compiorrivealth o.f Massr€diusetts Dep rr'&nait ofrndhstriai'Acciden& Off rr.�e of 1Fmwfigadons 600 Washington Street y Boston,41A 02111 y st'vY1v:7r a-w.govIdia Mrorkers' Cumpensaf an Insurance Affidavit:Builders(CaniractarsMectricians/Plumbers ApplicantInfatinaf on Pleas e.Fsinf Le.Qr iIX Name Q_QQr_yt,)G- We— AddEess: QQAD City!'statef ip Phony; 6cR q 64-D 1 AFl u an employer?Check-the appropriate bow Type of project(required): . 1. am a employer with 4 ❑I am a general contractor and I 6- ❑New construction employees(full andlor part-time)-* Have hired.the sub-contractors 2.❑ I am a sole propnetor orpartner- listed on the attached sheet, 7• ❑Remodeling slip and have no employees. . These sub-contractors have g- ❑Demolition -wad-zing forma a in any capaci43r employees and have wo&ers' �_ El Building addifiorF [No ty oriaers'camp.insurance comp-insurance-1 required-1 5. ❑ W- a area corporation and its LO_❑Electrical repairs cr additions 3.❑ I am.a homeowner doing all work officers have exercised their 1L VPM umbingrepairs or additions ri t of exemption per MGL myself[No-workers'caarg- � � F . 00frepaiis fim ance required-]T c_152,§1(4h andwe have no employees.[No workers' 13.0 Otfier comp-insurance required.] #tla_y app&zat that checksbox#1 'also M out the section below showing the¢�uo�ieis'ca®pensatiau poTcg iaformsuan Homeawners who submit dtis af5datqu iudi rating tha-y ate doing snwoa}and thenhEm artctsidecontractors nmd sahnut an Ewaffid2vit indicatia;sme-11 rQnt xctorstfist the this box nmst attached as sdditinnsl sheet shoumg de—ne of the sub-coutractors xad state-whether.or not ihose enddeshave employees nrorkers'•tamp.policy number. I am art alaplo}�r fllrrtispratRtirirg n�crkers'cortrpetlsafr'or!irlsrirQlrca jnr myT elrrplo}�ees Beloly is fJlepaticy Qrrd jab arts t: tr formaliom Insurance:Companyl'�am1eIsr, "C'v3 Policy-,4*or Self-ins-Lic.t-u�(�u N 2e Q o 12)q 16 F spiration Date:-sIn Job Addt�ss c"). 1�16S` 8A!A—) S City/Statdz7p:dqAm[ W6q Ada-ch a copy of the workers'compensationpolicy declaration page(showing the policy number and expiration dafe.). Failure to secure coverage as requued.uuder Section 25A of MGL c M can lead to tfie imposition of cri'mi nal penalties of a fine up to$1,50D.OD md'ar one-year imprisonment-as well as civil penalties.in the form of a STOP WORK ORDEKand.a fine of up to$t250-00 a clay against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Imves ga thins oftie DIAL,for insurance coverage verification. I do hereby c natdsr tT2er pQrris and pail vfpedujytj<IQtfllB ltr,fOrA2tFfL0nprm rL€d above Ts fte and C-QIY6Ct Sitnrature Date: 5 Phone A. b Off] d use arify. Da not asvrrte in this area,tG+be cyan et6d by c Qrfown afOWaL Q;f,or Tomm: PermitUcense 9 Issuing Authority(carte one): L Board-of Health 3..Building Department 3.tyjlTown Clerk 4.Electrical.Inspector S.Plumbing Inspector f.Other Contact Person: Phone#: Taformation and lnstruc-ions Massachusetts General Laws chapter 152 req� all empIoyees to provide workers'compensation for their employees. p -D this sue,an n7g7k yee is defned as"_.every person m e service of another under any colIract ofhire, express or I npjied,oral or writtua" An Mayer is defraed as"an.individual,partnership,association,corporation or other Iegzl entity,or any fwo or more of the foregoing engaged in a joint enieiprise,andincln�the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other Iegal entity,employing employees. However the owner of a dweMag house having not more than the apadxueals and who resides therein,or the occupant of the - dw,Iling house of another who employs persons to do maintenance,contraction or repair woric on such dwelling house or on the grounds or building shallnotbecanse of sash employmentbe daemedto be an employer." MGL chapter 152,§25C(17 also sties that."every sfialn or local licensing agency shall withhold the issuance ar renewal of a license or permitto operate a business or to construct bwI ings in the cofnmonvvealth for any applicant who has not produced acceptable evidence of compliance with the,insurance.coverage required." Additionally,MM chapter 152,§25C(7)states"Neither the coTnm®.wealth nor nay ofits poIifical subdivisions shall enter inb any contract for the performance ofpublic work unhI acceptable evidence of compliance with the insurance:_ regtm emeuts of this chapter have been presented in the contracting authority:' Applicants , PIease fill out the worker'compensation aiidavit completely,by checking-Le boxes that apply to your sitaation and,if necessary,supply sab-contactor(s)name(s), addresses)and phone number(s) along with their certifi-cate(s)of n ern an ce. Lmmite-d Liability Companies(LLC)or Lmnited Liabtiity-Parfnesbips(LLP)with no employees other than the members or partners,are not required to canny workers'compensation insurance. Fran L LC'or LLP does have submitted to the De ar[ment of Industrial . employees,a policy is regoited. De advised that this off davit maybe P Accidents for confrimation of insurance coverage. Also Ire sure to sign and date the affidavit The affidavit should be retrmmed to the city or town that the application for the permit or license is being requested,not the Department of IndnstdaI Accidem-ts. Should you have any questions rega-dmg tine law or ifyou are regied to obtain a workers' compensation policy,please call the Department att$enraber listed beIow. Self-fi utdcompaniesshouldentertheir self-m sTrance license zron;ber on the appropriate line. City or Town Of aiciaTs t - Please be sure that the affidavit is complete and printed.Iegihly. Tho Department has provided a space at the bottom of the affidavit for you to fin out in the event the Office of Inv'estigaiions has to contact you regarding the applicant_ Please be sure to fEllinthe peun:llicense ntnnber which will be used as areference nninber. a addition,an applicant . that must submit multiple peimj,VHcanse applications m any givmyear,need only submit one affidavit mdicating cm:mat p olicy.inforr;ration.[if necessary)and under"Job Site Address"the applicant should write"all location ru (ccY or ` ;wn)_'A copy of tlie-affrdavitthaf has been.officially stamped or marked by-Ler city ar town may be,provided to 1Le ' applicant as proof that a valid affidavit is on file for fotm e peuaits or licenses. A new affidavit must be filed out each year.Me=a home owner or citizen is obtaining a license or p=mitnot related to any business or commercial YPnfi� tie. a dog license orpermit to burn Ieaves etc.)saidpmson is NOTregniredto complete this affidavit The Office of IuvestigadOns would EM to thank you in advance for your cooperation and should you have any questions, please do not hesitate to givens a call- The Departm enfs address,telephone and fax number. 'I3�e f:amMCtweajft of Massa.ahuszetts : Departnent ofIaciustzial Acaidentaq Q�t�e 4f�.ve�?g�tiop,� �44�ashin.�tan � - Te,-L 617 727-4900 Qxt 4-06 ar 1477MASRAFE Fax 617` 27 7749 Revised 4-24-07 ma- gckg�c�ia ; Co CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `...►� 05/27/2016 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 CONTACTNAME: Christine Davies DOWLING & O'NEIL INSURANCE AGENCY P"C"o Ell: (508)775-1620 A/C A/C No ADDRESS: Cdavies@doins.COm 973 IYANNOUGH RD. INSURERS AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURERA: ACE AMERICAN INSURANCE CO 22667 INSURED INSURER B: KELLY ROOFING INC INSURERC: INSURER D: 8 RHINE ROAD INSURERE: YARMOUTHPORT MA 02675 INSURER F: COVERAGES CERTIFICATE NUMBER: 56798 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 LTR TYPE OF INSURANCE JU=WVD SUER POLICYNUMBER MM/DDY� MM/DYE LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ —1 -079TA-GE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRO ❑ LOC JECT PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AU TOS AUTOS N/A BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBEREXCLUDED7 N/A N/A N/A 6S62UB2E90137116 05/06/2016 05/06/2017 (Mandatory in NH) E.L.DISEASE--EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below I I DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance Shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Hastings Meadow Condominiums 135 West Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 Daniel:M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD _ Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 128957 Type: Individual kci; —=1 - Expiration: 6/14/2017 Trp 266936 Oliver Kelly Oliver Kelly 8 Rhine Rd Yarmouthport, MA 02675 -, �Update Address and return card.Mark reason for change. scA 1 0 20M-05/11 Address Renewal ❑ Employment Lost Card P��e ((J6977/1724�h1lKCl.�IIL 6��CLJdCtC�lc'JBClJ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only a-- ., (HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Zogistration 128957 Type: Office of Consumer Affairs and Business Regulationxpiration�6/14/2017', Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 Oliver Kelly Oliver Kelly 8 Rhine Rd. >' Yarmouthport,MA 02675 Undersecretary Not valid without signature t Massachusetts Department of Public Safety i Board of-Building Regulations and Standards License: CSSL-099167 Construction Supelvisor Specialty OLIVER M KELLY�`� 8 RHINE ROAD YARM,OUTH PORT MA 02678 ' l/l_— Expiration: Commissioner t 09/28/2017 e r 4 • Cape Realty Inc 299 Main St West Yarmouth, MA 02673 508-7754M Fax. 508-775-6939 E-mail: not This agreement contains the entire agreement between the parties,and there are no other promises or conditions in any other agreement why real or written.Any extra work or services shall be mutually agreed upon in writing. Both patties represent thatt1W are authortmed to execute this agreement hereunder. Executed on this '2-<D Hastings Meadow Condom" tns By.Cre Dorey,Trustee Contact Person: Shawn Horan Cape Realty Inc 50"7-3997 horansh Roofing By;O11w Kelly,Owner 508-509.4640 MA CLS#099167 g"ud.com r Cape Rea Inc . P �Y 299 Main St West Yarmouth, MA 02673 508-775-6680 Fax: 508-775-6939 E-mail: horansh@c omcast.net ROOF REPAIRS WORK FOR HIRE AGREEMENT This work for hire agreement is made on May 25,2016 between Hastings Meadow Condominiums do Cape Realty Inc,299 Main St,West Yarmouth,MA 02673,the party who will be receiving services(hereinafter referred to as Customer°)and Kelly Rooting,the party who will providing the services(hereinafter referred to as°Contractor")for work to be performed at Hastings Meadow Condominiums, 135 West Main St, Hyannis, Barnstable County, MA Contractor agrees to perform all work as specified under the following terms and conditions. 1)Contractor shall take down and remove all exterior vinyl sided faux chimneys from exiting roofs.Total of 23 chimneys. Contractor shall protect work area to prevent any damage to existing roofs,gutters,siding,and shrubs.All debris shall be loaded into dump truck and properly disposed of off4te. 2)As each chimney is removed,Contractor shall install 518 exterior grade plywood to opening and then followed by#15 felt paper.Area to be shingled with architect style roof shingles to match existing roof(Certainteed Birchwood Landmark shingle-a-0 year warranty). Each shingle to be fastened with 6 roof nails.No chimney holes shall be kept open overnight a. 3).As each chimney to a roof section separated by jog is completed,Contractor shall install 12°Certainteed Air Vent Shingle ll Ridge Vent with hand nailed caps on all ridges with ridge cut to 2°gap on either side of king rafter.Air Vent Shingle II Ridge vent to be secured to roof rafters with 3°roofing nails. 4)Contractor agrees to perform all work in a good workmanlike manner consistent with industry standards and manufacturer's specifications. Premises to be cleaned up of all debris upon completion of all work as specified. 5)Contractor agrees to furnish and pay for all costs of materials,equipment,permits,disposal costs,and labor in order to complete all work as specified.Contractor shall maintain general liability($1,000,0001$2,000,000)and workers compensation insurance.Certificates of insurance are attached hereto.Contractor shall supply generator for electricity. 6)Contractor agrees to start work on May 31,2016 and complete all work on or before June 15,2016,exceptions Ming made for wet weather conditions. 7)Notwithstanding any manufacturer's warranties,Contractor shall guarantee all work to be free from any leaks for a period of 24 months from the completion date. 8)The total cost of this work as specified above is$25,460.00. Customer agrees to pay$12,000 as an initial payment prior to the start of work.$13,460.00 shall be payable upon completion of all work and final cleanup. 9)Contractor shall indemnify and hold Hastings Meadow Condominiums,Cape Realty Inc,and all unit owners and assigns harmless from any property damage or personal injury occurring on the premises. 10)Designated work hours:Monday-Friday 8:00 AM-4:30 PM.- 11)No alcoholic beverages or work dogs are allowed on the property at any time.Shirts shall be wom at all times. Any music that may become a detriment to residents of Hastings Meadow or interfere with their quiet enjoyment shall be promptly turned down or off. BIKE Sign TOWN OF BARNSTABLE Permit * BARNSTABLE, • MASS. i6 a� Permit Number. Application Ref: 201205375 201205375 Issue Date: 08/31/12 Applicant: Proposed Use: Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 135 WEST MAIN SREET Map Parcel 290102 Town HYANNIS Zoning District Contractor PROPERTY OWNER Remarks 135 HASTING MEADOWS - REPLACE CONDO FREESTNG SITE ID SIGN REDUCE EXISTING 14 SQ FREESTND SIGN TO 12 SQ Owner: CONDO WORK Address: HYANNIS, MA 02601 r-- Issued By: (PC POST THIS CARD S.. THAT IS VISIBLE FROM THE S REET TIOWIN OF Town of Barnstable , tf- — P Regulatory Services 7rj? q ") T BAMSrABLE, MASS. Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 D I V 1 a 10 �o www.town.barnstable.ma.US Office: 508-862-4038 Fax: 508-790-6230 Permit Building Official approving------- Application for Sign Permit __ _ AssessorsNo.__C -- kbq0— 2_---- Doing Business As:— ---Telephone No. Sign Location co ZA Street/Road:Zoning District: tA—'F) —Old Kings Highway? Yes/(No) Hyannis Historic District? Ye Property Owner Name 00,Af-fv�'f�\(QK Telephone: J Address:_1 Village Sign Contrac Name:-- -------------------Telephone:(j Cc), Mailing Addi,Lss:- z- ------ rl Description -1 Please follow the cover directions..You.must have an accurate rendition of sign with dimensions and location. IstliLsigntobe-clectriliedi) Yes& I recluliv(1) Width of building face __fL x 10- _X.10=__ Check one Reface existing sign_.I�' or New Total Sq.Ft of proposed sign(s) If-YOU halve'ad(hij,01alsigns J.-Vease allach il'42cet each("Ile Pkith If refacing an existing sign please provide a pictuie of the.existing sign with dimensions. I hereby certify that I am the owner or that.I have the authority of the owner to make this application, that the information is correct and that.the use and construction shall conform to the provisions of §240-59 through§240-89 of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized Agent: Date dA SIGNS/SIGNREQU revised 12110 �v MISR 930 CIA RIM VIA, PP IYI [� I\\tti N ♦4y MI I J'ra �yS ` a$ uki ti=r 135 gM NSF 01 10 Al 01 , ��S ,,�'� '✓' � .r.= �.� .by ►- ` � ,U..�y,4t^ .G - � r- `!�a-✓' �r,�:; th ' gam+a��"�',J -�'� :e�ti _�_ ram.. Ills [If 4 Wit,:• "� � �, 4 �j! `i�l� �;', � � ��. � e� h- �c;o- y �., .ay.:� ,�w.:+�.s`.'^'S.�'•:s, �;�. ��. --•;ir.•.. 3 .�r ar_r�: z`.: `r, �Y �'` t�t >A� �-�* 4 y'�r"y�"'r f � 1. ...a�. :.��• ,:'� ., �'£ nG��,.�' ,.•-�,�- �yi-:'x .�� .a s .K{'�,,.-�%'��` �'::.ry rt�.. s.,,,��111 `�_��' -i" '��.•, .} hs}x`+','�+gg �exl}s�,�'.F i - `�.. r u -..�.. 5 n, � .\ u' - �' i-� �� •Y S F:� "'4 � Z A.. i��,h= i�� - - ,"� =A xC ..-, �� '�, 'w:-r- � ^r �' � " vn4. '_ ....j�. .- Y ✓...��+� is � ::.� ,1�'"3i "'t FC' ; - T� Ry.*�^'. „,.� " �•. ;fir.,, r: s� '�° k� >. o s' l ys # �•...��a ✓, wa 3�1a�j?I fig' �,�''. 7 in fe All AW 014 p3 r,• g, 7r �r, •s f ff 3��f i v :3 t: riTi. �F'�,�'� rb�F��Sf r i.�,"` ✓.,F^-4t`+�+� vF.,,'i,�y` �.s�'c"' � � _. :_'"� 1. 1. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel o c L 1'2 Co Application# Health Division Conservation'Division Permit# Tax Collector Date Issued Treasurer �31v Application Fee �Q OL �7 Planning Dept. Permit Fee /e L Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis LTewllrephone Street Address f3S weS} rnGl� Sl�c��+ its NY" ti � No s-�i nci s nu ct Lj Cn L A i�v u m Address iru i 4 h �D� 7 7,r '� 11 )) .Y ' Request J 7'r� 2 k Q� v� S h ` Uh ` /- eS oir S��`hs if, , (0 3 xluctrt Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio 176,060,DO Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑No,, Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other • Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count b i 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 Altached 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 Nic BUILDER INFORMATION Name n Son rhe_ TY I , Telephone Number J60k-o?96-3� Address PO 80C 0)1-/26 License# i't44 G 2 6 S 3 Home Improvement Contractor# 33�5"l Worker's Compensation# QK off'3 1- D kJG d-G ll CALL-CONSTf1RUCTION-DEBRIS-RESULTING"FROM-THIS-PROJECT WILL BE TAKEN--TO Z�4hi-e j Peticf'hs Viol J SIGNATUR — DATE FOR OFFICIAL USE ONLY PERMIT NO. — — DATE ISSUED MAP/PARCEL NO. ` c ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION - FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT - ASSOCIATION PLAN NO. — ' r n_ Town of Barnstable L Regulatory Services a ear Thomas F.GeRmi Director Bnfldb ig Division. Tom Perry. Building comudssisucr 200 Main Street. Hymm*MA 02601 www.tewn barnatab] Office: 5.08462-4038 Fax: 5084901230 property Owner Must Cossaplac and Sign This Section If Using A Builder r C� no of the subject PmPenY y authorize to act oa lay behalf, in all n=mrs rrlafwe w work authmiztd bytbis binding permit application for: (Addmss of jobY/ ran 4-� Vwmr !Co r o Print Name Q:F0NM:0wrWMemcssZN �a 1 %nCiu "A71IA nn n-7 no i T'd L0TSSS280SZ:01 SSt?6SLL 80S ONI NOSNHOf 9Idd0:W08J SZ:02 9002-L2-83d f e ✓lf.@ �IY)!fi!/LlYJ2G.CCG�C/L- O�%l��J:1CCCi7CLtfB� i Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 133851 Board of Building Regulations and Standards Expiration: 8/17/2007 One Ashburton Place Rm 1301 Boston,Ma.02108 Type: Private Corporation NICKERSON HOME IMPROVEMENT MARK NICKERSON 12 COMMERE DRIVE. Gayer �� ORLEANS,MA 02653 Administrator Not valid without signature TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION / U0 t4ap . a �_Parcel Permit# Health Division Date Issued Conservation Division Application Fee R,.5 0 O0 Tax Collector Z�RO(�oZ — ® It b n (0 U_h4s-�` /111.,'` Permit Fee 6 d0 Treasurer (O k Planning Dept. /rt o Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address (" C-C VL L s� Village H`1_ a- �--a`— Me-, 1�?R Owner rwv-abr AddressS' Telephone l t�C Permit Request C �v� ft.- a—n�t��__. tl r CO 27 Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay o Project Valuation Construction Type w c Lot Size Grandfathered: ❑Yes ❑No If yes, attach supportiBg documentation.' . O u) Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) E5 Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Hi hway: ;Yes rn❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) _ Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count not including baths):existing( y ) y new First Floor Room Count 2 Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other �O Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage: ❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION /-7 Name Telephone Number &� / 7 — & 7 Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURES--` DATE ®,� FOR OFFICIAL USE ONLY ! t PERMIT NO. DATE ISSUED 1 MAP/PARCEL NO. 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Fxu=v to seems ooraert as regofeed 6idar 8eetiaa M of MQ.14 cm alead to the hugs laastesdaiai penold a of a Baa.np to S3,So0-Ua Mawor ow ymn,tmprh�::wee a c"penalties fs3 the form of a t'i�P WOES OgDggsada�a Genoa"a dq ataimd mt.Itmde��thata MV of this statementmq be forwsaded to tha Oaks of Inteatl;atlom of DlAtor R I do hereby canfy pours mtd paudda ofpaJ"tlt�th��abaae is t�iatd eorred Date Ale Pzmt name U'e-t Ph®t: (Me 7 ofndal an ontf do not writs in this am to be enmpleted by city or tower o1Fda1 P s OBofldla f DeP� cHyortown: - ❑� tB-a Ogdeconea's OM= ❑cbmkif ttamediste fOPonse is nquired ❑HeslthDepsroses� contact person• P�k; �Other (lerr�a 9/93 P1A1 e Information and Instructions as sachusetts General Laws chapter 152 section 25 requires an employers to provide workers' compensation for th::r M — anv °' person m the service of another under ,quoted the law as em la ee is defined employees. As qu P Y ��' of hire, impress 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, orthe rec- er trustee of as individual,partnership, association or other legal ent employing employees. However the owner of a dwelling house having not more than three apaitcaL and who resides therein, or the occupant of the dwelling house of m another who employs persons to do maim a=, cons ruction or repair wm:k=S{n&dwelling house or a a the grotmis cr building appurtenant thereto shall not because of such employmeat be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local.licenung agency shall withhold-the issuance or renewal of a license or permit to operate a business or to constrict buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the fi^S*MM^ce coverage required. 'Additionally,nettherthe commonwealth nor any of its political subdivisions shall cite=into any contract for the performance of public work unril acceptable evidence of compliance with the iasuraace requirementscf this chapter have been presented ed to the cct R- authority.-. - 'Applicants Please fill in the workers' compensation affidavit campieteiy,by dwkm8 the.box that applies to your supplying company names,address and phone numbers along wish a cmtif c=-of iamrance as all affidavits may be submitted to the Department of Industrial Accidents for rm of insiraace coverage. Also be sure to sign and date the affidavit. The affidavit should be.returned to the city artownthat the application for the permit or iic�se is being requested,not the Departmeaz of Industrial Accidents. Should ycn have any questions regarding the"law"or if you are requircd to obtain a workers'compcasatioa policy,please ei1T the Departtacat at the number listed below. . - ,try,,,,.• City or Towns _ _... ._. .e Please be sure that the affidavit is complete and pr inted legibly. The Departnicat has provided a sp au.atthc��botto Please' m of tl; affidavit for you to fM out in the event the Office of has to contact you regarding the app be sure to fill in the peiik icense=unbet which will be used as a reference number. 'The affidavits may be refined t^ the Department by mail or FAX unless other airange=C=have bemmade. - The Office of Investigations would Ike to thank you in advance for you cooperation and should you have any questons- please do not hesitate to give us a call. The Depazunent's address,telephone and fax number. The Commonwealt�Of Massachusetts Department of Industrial Accidents office of imtesduations 600 Washington street Boston,Ma. 02111 far#: (617) 727-7749 phone #: (617) 727-4900 erL 406, 409 or 375 Town of Barnstable Regulatory Services vBA MASSS.. Thomas F.Geiler,Director ArEo;9;. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1C I, A-rle'ln 4 Z-� f' � �- ,as Grier of the subject property herebyauthorize 0 e O-e., ��t 1] to act on m behalf, Y in all matters relative to work luthoxized by this building permit application for(address of r job) IV gnatT o er Date Print Name TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION MapParcel,! .�;Applicatibn # �90. Y Health'b ivisi6n i Date Issued AC : 'Job Conservation Division Application (,Jl Planning'Dept'. Permit Fee Date Definitive Plan Approved by Planning Board Historic OKH Preservation Hyannis Project Street Address 13S i�Je 14 04:n Y-f Village Owner Address Telephone Permit Request .5t,JC tti Square feet: 1 st floor: existing proposed .2nd floor: existing—proposed --.L—_.Total new Zo, ning District: Flood Plain Groundwater Overlay Project Valuation Construction Type Lot, Size Grandfathered: LJ Yes LJ No If yes, attach supporting documentation. Dwelling Type: Single Family .Ll Two Family LJ Multi-Family (# units) Age of Existing Structure Historic House: 0 Yes L3 No On Old King's Highway L]Yes LJ No Basement Type: Ll Full LJ Crawl Ll Walkout Ll Other CE M -P Basement Finished Area(sq.ft.) Basement Unfinished Area(smft) ' w.. Z — Number of Baths: Full: existing. new Half: existing v> &QN 3> Number of Bedrooms: existing —new X. P.Total Room Count (not including baths): existing new First Floor Roo COU14- C:) M, Heat Type and Fuel: LJ Gas LJ Oil U Electric Ll Other Central Air: LJ Yes Ll No Fireplaces: Existing New Existing wood/coal stove: Ll Yes Ll No Detached garage: LJ existing Ll new size—Pool: L1 existing L1 new size Barn: LJ existing Ll new size Attached garage: LJ existing U' new size —Shed: L3 existing LJ new size Other: Zoning Board of Appeals Authorization Q Appeal # Recorded L3 Commercial L1 Yes Ll No 11 yes, site plan review# )Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 'CA7q[�dres'S,3t/, L&Mef &VII License # SI) va,00� y2 GGy Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 1t... ,DATE r')6'11 -(10 FOR OFFICIAL USE ONLY ' APPLICATION# I6 DATE ISSUED MAP/PARCEL NO. s ADDRESS VILLAGE it OWNER .DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL { PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING c - r c' } DATE CLOSED OUT t - ASSOCIATION PLAN NO. } s 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/Organization/Individual): T;M e^�r✓1{ Address: . Ldcjer Srejt' �Z City/State/Zip:= ark;gfw 04 Phone#: .Sda ?60—2202 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 �— have hired the sub-contractors 6. ❑New construction employees(full and/or part-time).* 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. m 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 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 13.❑Other 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. $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: Policy#or Self-ins.Lic.#: 73,0 51¢-; 07 Expiration Date: 3/S/O S Job Site Address:13f �✓P1>t me n St J�vc-,t;r Pff 026cq City/State/Zip: 6060/ ` 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 under the pains and penahies ofperjury that the information provided above is true and correct Si attire: Date: t'd 4q�U Phone#: Syk 7e0- 2 202 , 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#: 1 y f ACORD_,. CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDYYYY) 03/04/2008 PRODS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SCHLEGEL INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 34 MAIN ST HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. WEST. YARMIOUTH, MA 02673 INSURERS AFFORDING COVERAGE NAIC# INSURED Timothy.Keating Dba Keating Construction INSURER A: COLONY INSURANCE INSURER B: CNA INSURANCE 54 Lower Brook Rd INSURER C: - INSURER D: South Yarmouth, MA 02664 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. OLICY MMRAnON LTR BiSRD TYPE OF INSURANCE POLICY NIA POLICY EFFECTIVE P IBER DATE 110111i'DO/M DATE(MWDDIM LIMITS A GMERALLIABILITY GL3326876 03/06/2008 03/06/2009 EACH OCCURRENCE f 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE 10 NItU PREMISES(Ea ee) f 100,OOO CLAIMS MADE OCCUR MED EXP(Any mro person) $5,000 PERSONAL&ADV INJURY f 1,000,000 GENERAL AGGREGATE f 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPA)P AGO s2,000,000 POLICY FACT LOC . AUTOMOBILE UABILITY COMBINED SINGLE LIMIT ANY AUTO (Ee accident) f ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY f (Per Peron) HIRED AUTOS - NON40 MED AUTOS BODILY acci erd) f (Per aedderd) PROPERTY DAMAGE f (Per accident) OARIWELIABILITf AUTO ONLY-EA ACCIDENT f ANY AUTO p ___ OTHER THAN EA ACC f AUTO ONLY: AGG f ... E71C11199{YBRFLLA UABILITY EACH OCCURRENCE f .. )9CCUR CLAIMS MADE . . AGGREGATE f s DEDUCTIBLE f RETENTION f. f V11ORKERS COMPENSATION AND X WC*LIMITS ER B EMPLOYEW LlamLm 7305A— — ANYPROPRIETORIPARTNERA7(EIXlI1VE 6 07 03/09/2008 03/09/2009 E.L.EACH ACCIDENT $lOO,000 OFFICERIMEMBER EXCLUDED? - E.L.DISEASE-EA EMPLOYEE f 100,000 SPECItl Yee.AL PROA under YES - OTHER ROVISIONS bebw E.L.DISEASE-POLICY LIMIT f 500,000 OTHER DESCRIPRON OF OPERATIONS I L='n=I VEHICLES I E70 =OW ADDED BY ENDORSEMENT I SPECIAL PROVISIONS THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE WOKERS COMPENSATION INSURANCE FOR TIMOTHY KEATING CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DUE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 21 DAYS WIBTT91 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO Do SD SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY IOND THE INSURER, ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPR TIVE ACORD 26(2Wl=) ©ACORD CORPORATION 19� �HET°wti Town of Barnstable Regulatory Services &ARNMBr MAM t E 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 J as Owner of the subject property hereby authorize �e'laf to act on my behalf, m all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner D to Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side: Q:FORMS:O WNERPERMISSION --s �oF zne r�� Town of Barnstable „�P o Regulatory Services BARNSTABLE, : Thomas F.Geiler,Director atAss. 0.19. A.O� Building Division rfD � Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 vs'ww.town.b arnstable.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 on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The 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-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that 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 forr/certification.for use in your community. Q:fornu:homeexempt TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel `' Application ©o`�6�� Health Division Date Issued Conservation Division Application F Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address I S 5 IAJOsf Mg n St U�1 c nn;r N1.A Village I 05[M f Owner G) 6(4;& 'Fphn , Address Telephone 569- 6k0- 6 Z kk Permit Request S*`�Sa Sl g I r„ ! i�o. 6 i 3fef 16 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed .,A Total nqw Zoning District Flood Plain Groundwater Overlay Project Valuation 11,04 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting docur�rt,�ntatloh. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION ,� (BUILDER OR HOMEOWNER) Name t ; , Telephone Number SDS-'760` 27d z Address 51 L ok)u bfoa I✓ . P� License # �Iq 3 S 1 �l�f 32 Sv4/"CO A, 1114 O?W Home Improvement Contractor# f,y 3,o 53 Worker's Compensation # _7 3 ,�- 6 d� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Yys-l&�t �A SIGNATURE `"�� DATE 12 h Jd g ar FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: - FOUNDATION FRAME INSULATION FIREPLACE .Y ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING !a DATE CLOSED OUT ASSOCIATION PLAN NO. i �, • :ram The Commonwealth ofAfassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 °� s�•�`, www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Les?ibly Name(Business/Organization/Individual):r! ;ty) k-et, '' Address: S•N L o u✓er or"- City/State/Zip: -5 q4/,"oj i, M4 OZ66y Phone.#: Stir 7 6*,'-Z-2 Are you an employer? Check the appropriate box: Type of project(required): 1.® I am a employer with 4. ❑ 1 am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors .2.0 I am a sole proprietor or partner listed on the attached sheet. T. ❑Remodeling ship and have no employees These sub-contractors have g. '❑ Demolition workingfor me in an capacity. employees and have workers' Y P tY• $ 9. ❑Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.0 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. 1Contractors 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. f am an employer that is providing workers'compensation insurance,for my employees. Below is the policy and job site information. . Insurance Company Name: ('1VA Policy#or Self-ins.Lie.#: 7 3-0 /4-4�-d 7 Expiration Date: Job Site Address: 13S ttJPJ f pl e,"n Sf, City/State/Zip:�y�,nv� /� c) 2 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 tip 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 under the pains andpenalties ofperjury that the information provided above is true and correct Signature: o Date: 1 Z 1 710 _ Phone#: .S'y f- 7 6u- 2 2C)Z 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 S.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 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), addiess(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 Df 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 Investigatlans, 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-NIASSAFE Fax# 617427-7749 Revised 11-22-06 www.mass.gov/dia I T VEr� ' own of Barnstable Regulatory Services hN. Thomas F Geiler,Director 16�, Fn ate% Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02.601 www.town_barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Trust Complete and Sign This Section If Using A Builder L , as Owner of the subject.property , hereby authorize �w{i r� C ns+-rvtj-i M to act on my behalf, ¢,r in all matters relative to work authorized by this building permit application for. 133 l de-4 Mz-m s i, (Address of Job) Signature of Owner Da 14 . l� Pent Name . If Property Owner is applying for.permit please complete the Homeowners License Exemption Form on the reverse side. . l,.rnn..o.ntn.rcooc�>„rccin�.r Town of Barnstable o Regulatory Services RAms-asp Thomas F. Geiler,Director Building ]division Pr"D µAl a Tom Perry,Building Commissioner 200 Maiu Street, Hyannis,MA 02601 _ www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HONMOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village _ "HOMEOWNER": name home phone# work,.pbonc# CURRENT MAILING ADDRESS: city/town state rip 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 Persons)who owns a parcel of land on which he/she resides or intends to reside, on which there-is, or is intended to be,.a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The 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-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this scction.(Scctian 109.I.1 -Licensing of construction Supervisors);provided that if the homeowner engages a pcnon(s)for hire to do such work.,that such Homeowner shall act as supervisor.,. Many homeowners who use this exemption are unaware.that they are assuring 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/hrr 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/ccrtification for use in your community. Q:forms:homccxcmpt. r Vassachusctts- Dcplu-tmcnt.of Public S.rfctv Board of Buildin-� Rogulandns and Stand a dti., Construction Supervisor J Specialty License, License: CS SL 99351 Restricted to: RF TIMOTHY KEATING 54 LOWER BROOK ROAD SOUTH YARMOUTH, MA 02664 S Expiration: 5/11/2012 A 'til,tss Tr#:99351 i 80.1 d 0 f tts -0 But l.tr t nstructl - Ctce": op SU .,UI„tl Res trtc nse: CSS Aerv/sor Ops tnt/ S`tl�h �>ie �omm �2zcraa� ,. ted to: RF 9g351 SPeclaltytS�`tn��tr ds 13oai a e�BuiNilig k, �idatioi s aul:;tlEiC��ds r, T/ ease 4i, HOME IMPR0VElt9ENTCOiITF:ACTOR ° M 54 LQw Y.KI�AT/NG . ., �� Registr��c N 143053 SOUTH ER BRQp Exp1ro-KI _6/n4/2010 q i - Ti. rY 268376 Y�RN1p(ITHRo E _ �TYpebBd f NIq 02664 r, KEATING CONSTt J� TIMOTHY KEATING +'rrer t 54 LOW BROOK RDj� FXPira n: 5/1ji2 p 2 t .:F SO.YARMOUTH,MA'(" 1 Klass tch r#• 99351 " A it inisti userts De 1d w. , ... ._. onst uct>ontl Iny Reb�, t�on0f Public Satet� L`tc Supewasor i all Stand use:'cs SL o 4 Spectalt' trds Restricte 9 832; Y License d to: WS TI �I�ulsorre�ls[i"7' M. KEATINNG t, �.4 i '` "-b` orc tlle:e s: `t�rarh�� it1 gal uidl ,dllt us ap�raU�n rti e :.jr found rcturnult} p ; 54 LpWER:BROQ Boar d of Btulcfiin Re i SOUTH YgRMO K ROAD 0ae ASIlbt rt011 dace 1' t130I�nd'S�wdards UTH`M;4'02664" 'dos*on;�1a.021�8 . t'um,nissioner sq Ezpiratron: s/11/2012 r rr#: 1 No valid It signature u. CERTIFICATE OF LIABILITY INSURANCE DATE"'DO!YY ' _ru 05/21/2009 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SCHLEGEL INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 34 MAIN Se HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER TPF r•nvr-n•C-r ::�.vniie.LJ of I IHE YVLICICS BELOW. I f WEST. YARMOUTH, MA 02673 INSURERS AFFORDING COVERAGE NAIC# INSURED - Timothy Keating Dba Keating Construction INSURER COLONY INSURANCE )INSURERS: CNA INSURANCE 54 Lower Brook Rd j INSURER C. T I INSURER South Yarmouth, MA 02664 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMFD ARIIVc cno Tuc nn�!nv _..._ '-—"' ,�.a..�vr+,ev. iiv i YW I HO h liN UINI! CUi U111UN OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO uWHICH 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 I POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR ;INSRD) TYPE OF INSURANCE I POUCY NUMBER _POLICY EFFECTIVE �POUCY EXPIRATION 1 DATE(MMlDD1W) I GATE IMM/DDM') LIMITS A GENERAL LIABILITY I I GL3326876 r-- 03/10/2009 03/10/2010 I EACH OCCURRENCE }E 1,OOO,OOO PREMISES(Ea xcuTnce) SZOO,000 - -I-_ I CIAIMS MARE !){ j OCCUR } I MED EXP fAny one person) I E 5,000 PERSONAL Ji ADV INJURY }151,000,000 GENERAL AGGREGATE %S2,000,000 G GEPJ'L AGGREGATE UfAi APPLIES PER , � nnn POLICY JECT i LOC AUTOMOBILE LIABILITY } % I !COMBINED SINGLE LIMIT ANY AUTO S !Ea amden) i I A.LI OWNED AUTOS i t } w SCHEDULED At ITns i 8001LY INJURY I HIRED A.V i05 i NON-OWNED - l BODILY INJURY E I � WNED AUTOS ` I(Per accident) PROPERTY DAMAGE I j (Per accident) E VAKA61!LIABILITY - -� - i ' - I `AUTO ONLY.EA ACCIDENT IS ! ANY AUTO .. . . I OTHER THAN EA ACC ,E AUTO ONLY. <GG f; ... I EXCESSIUMBRELLA LIABILITY I r- EACH OCCURRENCE E OCCUR I CLAIMS MADE � I ALiCiREGATE $ 1 E IE r RETENTION S ! 1S WORKERS COMPENSATION AND I i IX I r C `�V- { i EMPLOYERS'LIABILITY I I Rv :SIT. 9 n i3,UJA-6—V'/ 03/09/2009 03/09/2010 EL EACH ACCIDENT ANY PROPRIETQP,�pARTMER/E:KECUTIVI' f I E 100,O00 OFFICER/MEMBER EXCLUDED? (it yes.describe urinal YES , ! E L.DISEASE-`ca EMPL7YEE____II E 1 OO 000 SP CIA,L PROVISIONS below I E.L.DISEASE POLICY LIMIT 1 E 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS PHE WORKERS COMPENSATION POLICY DOES NOT PROVIDE WOKERS COMPENSATION INSURANCE FOR TIMOTHY KEATING CERTIFICATE HOLDER CANCELLATION VO CERTIFICATE HOLDER ON FILE SHOUI.n ANY OF •.••��„_.._ L - 1"-.� �'"^':^=ems..---=•- -- ELLc'v oEFunE Inc earlHaTION EPRESENTA HE/ISSUING INSURER WILL ENDEAVOR TO MAIL 21 DAYS WRITTEN NOTICE TORTIFICATEHgLDER NA�EO TO THE LEFT, BUT FAILURE TO DO 50 SHALL TION OR LIJBIE!Y' 6F ANY KIND UPON THE INSURER, ITS AGENTS OR ti CORD 5(2001108}' k / ©ACORD C(1RPnR6T1/1ti 1000 PROJECT NAME: ;--7 Iwn � ADDRESS: Z-9, (/U�?�r/6�gi� S,/ PERMIT# PERMIT DATE: M/P: LARGE ROLLED PLANS ARE IN.- BOX SLOT Data entered in MAPS program on: /I BY: q/wpfiles/archive 5 A"sses or's map and lot number .........29.Q ..1D.2... �� . % ,3- S': ��., /�i us _ cow�c �T �o l�,u,... _ s�u-c Prof roe` I THE ewage Permit number .......................................................: i BARISTAXE. i 35...W.est...Main.; St.,... �i House number .........1. Op 1639• TOWN OF B.ARNSTABLE BIURDING INSPECTOR APPLICATION 'FOR PERMIT TO ...G•ora6•tr-uct:•46•••twa•••bed•raom...town—hou&es••••••••••••••.••..•........ TYPE 011 "CONSTRUCTION .....Woodl...fr.................................m .......... .............. ........ .....:................... ......................Marsh......2...;:19..81,. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a.permit according to the following information: Location ......13.5...Wes.t..l ain:..�.t�eOt,..:I33��n�i s.,..:.p��.,...................................::................................................... Proposed Use .......Resid antal...................... Zoning District .:Business...&...Resildp-np-e...B.............Fire District ....Hya nii ss........................................................ Name of Owner ...James... .....T akl.o.r............................Address .....9.5.-Stan-16y..W- y.j...Cen-te•rv.i•IIe. ....Ka. Nameof Builder ......S,ame....................................................Address ................................................:................................... Name of Architect ....M.••.Iaa.-.MaCkay............................Address ..DUXbur• Maw................................................... Number of Rooms ....5...80•oms...ec`iah...=it..................Foundation Gono-re-te......................................................... Exterior ...Zhingla..............................................................Roofing ,...As•phalt............................................................. Floors ........Goncxat.e...&...w.00d........:..............................Interior ..She•etroe.k.......:................................................... d _ HeatingEl.e•¢tr•id.:........:........ g �,....:.-.Plumbin Fireplace .........Np..ne.....................I..........................................Approximate Cost ....2.;.000.j . . . .+.GG................................. Definitive Plan Approved by Planning Board -----------_______-----------19_______ . Area 133 70G Sq Ft Diagram of Lot and Building with Dimensions tl ' SUBJECT .TO APPROVAL OARD OF HEALTH ram. �13 S I hereby agree to conform to all the Rules and Regulations of the Town of stabl errding 7abe construction. Na `... .. ...... ..... TAYLOR, JAMES J. 22950 Build Two Story - t�lo ................. Permit for .................................... Y " Town Houses ............................................................... Location .......... / .................ly.ean i s........................................... Owner ..J.4116P5..J.?....'g.4Y.IQr....... ........ ....... � Type of Construction k�XAMe............. .. ......... ................................................................................ Plot ............................ Lot ................................ I ? � d O Permit Granted ......,March 27 , .......19 81 .................. Date of Inspection ........................./...........,19 Date Compl a .................... 9g'o" PERMIT REFUSED /.�.............................................................. 19 , .... .......Z/N 17-S ./.-/ ................... �rdy.... ......... +!i7�5.......��- fie?............... /�d e &/v/Ts S .....%7/..-43.70 Approved ............................ .................. 19 �... .. ... ' �� Assessor's map and lot number ........... THE Sewage Permit number ......................................................... Z 9AR33TADLE, i House number ......... .. .t. .n ; rho Mb 9 .-. s, .E TOWN OF BARNSTABLE 0 MO a* BUILDING INSPECTOR APPLICATION FOR PERMIT TO .........................:.. TYPE OF CONSTRUCTION ......food frame ............................................ ......................Nla rt'ti?..... .....19.s:�... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... t �= off# ?; n �2- —n.^i1. PN, nnj ^R ....... _. _ �_ ProposedUse ...... .............................................................................................................. Zoning District ............Fire District ... :r Name of Owner ... r+r ..............Address Name of BuilJ'er amo ........Address r;. Name of Architect T n r Address Number of Rooms ....F...k.^. :" ...P'^h „n�+....................Foundation ,+ ........................................................ Exterior " "^ ' P ...Roofing n c r nn�ro+o x• n^� ......................................Interior Floors ,.,......•._........................_....... ,,..,.. .............................................I................ Heating ....................Plumbing ^ -r Fireplace ......... .. .............................................................Approximate Cost .. .0. ni1r� n^^ ?r ................................ .... ..:.. Definitive Plan Approved by Planning Board ________________________________19________. Area .....1.....33 ,70G S.......... .......a Ft . ,........... .F'ee. .......:Dia ram of Lot and Building with Dimensions :. -(! ..............Y.................... SUBJECT TO APPROVAL 00�13OARD OF HEALTH V' )1 I hereby agree to conform to all the Rules and Regulations ofthe Town of,Barnstable.regarding-the. above construction. Name .....u. . 'ti!G'� ..�..�....... �...!. �.'' ....:.: ...... ll 00 reC f)'"C{ TAYLOR,JAMES J. A=290-102 No 22950 permit for ,Build Two Story Town Houses . ............................................................................... Location .135. . ...West. . ...Ma. ... in Street. . ............. . .. ..... . .. ..... ..... ....... .... .. Hyannis ............................................................................... _ Owner Ja.mes. ...J......Taylor. . . ............................ .. .... ... . .... .. .... .. Type of Construction Frame .............................. ................................................................................ Plot ........................... ot ................................ March 27, 81 Permit Granted .. .... -.............................19 Date of Inspection .............. .................19 Date Completed ............:..........................19 PERMIT REFUSED . ........................................................... 19 ......................................................... ............... C ....................... 1.. r ...... Approved ......................... .... ............................................................................... ............................................................................... TOWN OF BARNSTABLE Permit No. _______ 295` p____ Building Inspector case OCCUPANCY PERMIT Bond V/A_=___- "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 `` Jmes ` . Taylor- Address Centerville unit #2, 135 Flest Main Street, Ryarnis Wiring Inspector � c 'Inspection date//,>_/_ ar Plumbing InspectorCs{ Inspection date Gas Inspector Inspection date Engineering Department ` Inspection date r' 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. ...............................................3.1a 19 __................. _ .......___ . /' Building Inspector J.�` ,_•e TOWN OF BARNSTABLE 22950 Permit No. ------ 50 Building Inspector ■ 11AE17AU Cash 63 OCCUPANCY PERMIT Bond __ Pd/A___ 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 James J. .Taylor Address Danterville Unit #5 135 West fKain Street, I1varmis Wiring Inspector � ,� Inspection date Plumbing Inspector r/'4 �' Inspection date Gas Inspector Inspection date Engineering Department ' Inspection date 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. .. ..., .....w,... �... .... BuildingAnspector .�`""'• TOWN OF BARNSTABLE �� Permit No. ______•---__—__-- t sMnm a Building Inspector .ML � Cash --------0 No __—- 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 James J• Taylor ",Address Centerville Unit #7 135 West Main Street, Hyallt is �� _ Wiring Inspector 6 � Inspection date Plumbing Inspector''—,,� 1 Inspection date Gas Inspector tJ Inspection date Engineering Department Inspection date 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. / l Rik 19. `� %f/. GIG '... .....G Building `Inspector t. „�•"" . TOWN OF BARNSTABLE 22950 Permit No. ---------- Building Inspector s""*'n Cash OCCUPANCY PERMIT Bond 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 Jams J,• Taylor. Address Centerville Unit #8 135 west Main street, flyamis Wiring Inspector Inspection date,// Plumbing Inspector '.. Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. ; 19. _ Building/Inspector _ TOWN OF BARNSTABLE 22950 ��. ,�,•., , Permit No. ---------------------- i DAUSTLU Building Inspector �! cash ----------- - 679• p �O Val�` OCCUPANCY PERMIT Bond -- NIA _---_ "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 Jams J. Taylor Address rmtervi-IZe ITnr i.t: �41' i -LI5 EJegt Moiri 0,t-rr.--t- TTvarat„c Wiring Inspector � Inspection dater, �.s.°V Plumbing Inspector . - t _ Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREME,N�TS. Building,Inspector TOWN OF BARNSTABLE Permit No. ________22950 t "AUSTAU r Building Inspector line. Cash ---------- - � ,e,q• � OCCUPANCY PERMIT Bond ____-NfA "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 .lames J.. Taylor Address GmiterV2.11C' Unit 11 135 West Main Street„ Hyamis Wiring Inspector / Inspection date Plumbing Easpectoz (_ Inspection date v' Gas Inspector Inspection date Engineering Department Inspection date 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., ........ ....... ........ Building`Inspector z TOWN OF BARNSTABLE Permit No. `90 { 11AUSTAU ; Building Inspector ■..� Cash _----_-_--- �o �e■ar► OCCUPANCY PERMIT Bond "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 Jades J. Taylor Address Centerville Unit: 14 135 West ��in Street, Hyamis � r Wiring Inspector /' Inspection date Plumbing Easpector", \ Inspection date Gas Inspector �� Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID,°SAND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. f T................................................................... .... . .._M Building Inspector „�•""'• TOWN OF BARNSTABLE permit No. ---_--- 22450 •�' �� 1 »n� Building Inspector Cash OCCUPANCY PERMIT Bond 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 Jos J' 'Taylor Address Centerville Lh-dt 15 135 West Main Street, 1Iyanrus f Wiring Inspector '�� Inspection date Plumbing Inspecto Inspection date Gas Inspector Y �j/ Inspection date Engineering Department Inspection date 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. F/,4 *7/-J-,Of ` .. Building/Inspector „�•"”' TOWN OF BARNSTABLE s 22950 Permit No. _________ IIAUSTM Building Inspector cash _-- OCCUPANCY PERMIT Bond 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 James J. Taylor Address Centerville Unit 18 L15 West Main Street, Hyannis Wiring Inspector (�� r Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. x/�7,t r ................................... 4----—--....... Building/Inspector TOWN OF BARNSTABLE Permit No. --------_-22950____ Building Inspector .�� Cash _---____— OCCUPANCY PERMIT Bond "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 Jam-J. Taylor Address Centerville- Unit 19 135 West Main Street, H-yatmis Wiring Inspector �� i�/. Inspection date Plumbing Inspector �' / Inspection date v Gas Inspector Inspection date Engineering Department Inspection date 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. k �j 19........2/..!...�. .............................. , .., _. ....�,. .....�,....Buildin.....In...._..........__..............._..........» .. ...,..... . .. . g Spector TOWN OF BARNSTABLE Permit No. 2295C I nYr>r.,� Building Inspector Cash ---- __— OCCUPANCY PERMIT Bond "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 Jams J. Taylor Address Centerville ilni.t 22 135 West Main. Street, Hyannis Wiring Inspector , Inspection date Plumbing 1bspY toi �� Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. `, is 197 BuildinglInspector TOWN OF BARNSTABLE 22950 Permit No. ----------- 11,Y1fT.YL Building Inspector Cash _-------------- OCCUPANCY PERMIT Bond "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 Jmeg J-., Taylpr Address Centerville thit 23 135 hest Main Street, Hyarmis Wiring Inspector J, Inspection date Plumbing mspector � "� Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE 4VALID,3 AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING'INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. _.. ......... 19......_. V ..•,•.� �� ` BuildingInspector ......�.�. _ TOWN OF BARNSTABLE Permit No. ________-2?050 Building Inspector Cash - OCCUPANCY PERMIT Bond 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 James J. Taylor Address Centerville T it 25 1.35 West; Main Street, Hyalmis Wiring Inspector �;�/ �% Inspection date Plumbing Inspector- Inspection date v Gas Inspector C, ' Inspection date Engineering Department Inspection date 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. �` Building/Inspector �µ �� ". TOWN OF BARNSTABLE Permit No. _22950 .... Building Inspector sia■nut Cash ------- 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 James J. Jaylor Address C.eT1tenr2lle Unit 29 135 West plain Street. Hya mis Wiring Inspector f` Inspection date Plumbing Inspector's Inspection date t Gas Inspector f,�/ Inspection date Engineering Department Inspection date 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. ... ..r.. ............ ........._ -- Building Inspector TOWN OF BARNSTABLE 22950 Permit No. ---------------------- I s Building Inspector Cash — YPY OCCUPANCY PERMIT Bond ----______________ "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 t;. 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 Jssms Js Taylor Address Centerville Thit 30 • 135 West Main Street. Hyamis Wiring Inspector � �� Inspection date Plumbing Inspector � � Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. 19 � �� - Building Inspector L ".e TOWN OF BARNSTABLE 22950 Permit No. ----------------------- 1 Building Inspector »n.0 Cash a: ■... ----------------- t OCCUPANCY PERMIT Bond 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 James J• .Taylor Address Centerville unit 31 135 West Main Street. Hyannis Wiring Inspector ;� �� Inspection date Plumbing raspectorl L--� Inspection date Gas Inspector1 Inspection date Engineering Department Inspection date 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. f 19 Building/Inspector _ __ TOWN OF BARNSTABLE 27954 Permit No. _-------_----- 1 VAUSTAu Building Inspector Cash ---------•---- 'Oo �e�o OCCUPANCY PERMIT Bond "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 James J, Taylor Address Centerville Unit 33 135 West Maim Streit- Evam-lis Wiring Inspector / Inspection date Plumbing Easpector/-X ^ A �.r�� Inspection date Gas Inspector µ w Inspection date Engineering Department Inspection date 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. BuiI din g1Inspector TOWN OF BARNSTABLE Permit No. _________22950 Building Inspector cash --___--- 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 Jades J. Taylor Address Centerville Unit 34 13115 gent t'aln Street, Isis Wiring Inspector `' L/ / „f Inspection date Plumbing Inspector � Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. 19 2� ..... ._................... ,��' ` Buildingr'Inspector „�•"”'• TOWN OF BARNSTABLE Permit No. 419 sAUITA , a Building Inspector Cash OOP YPY Y'`� 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 Jwnes J. Taylor Address Centerville 'unit 36 135 test Main Street, Hyannis Wiring Inspector ' Inspection date Plumbing Inspectwe Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREME/�N�TS. Al,�Wvw ........ ... Building Inspector TOWN OF BARNSTABLE Permit No. _______22950 i »TrAM Building Inspector Casa -___--- •moo "o � .0 OCCUPANCY PERMIT Bond 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 James J. Taylor Address Centerville Unit 37 135 West Main Street, Hv is Wiring Inspector 1i2�� Inspection date Plumbing hmeotor . x� Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. Building Inspector ,o�"'�'♦ TOWN OF BARNSTABLE Permit No. 22950 _________—.__ __ rJ s Building Inspector cash -----_—_--- � rua OCCUPANCY PERMIT Bond "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 Jos J. Taylor Address Centerville Lhit 38 135 West Mzin Street, Hyarmis Wiring Inspector �.-- i � Inspection date Plumbing Inspector �� Inspection date Gas Inspector / Inspection date Engineering Department Inspection date 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. C ��.. .....�.....f�,%� Building Inspector TOWN OF BARNSTABLE Permit No. ---------22950 I DAUSTAU�!s Building Inspector Cash ------- ' OCCUPANCY PERMIT Bond ...—__.... "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 James J. Taylor . Address Centerville Unit 40 135 West Main Street, HYarmis Wiring Inspector li��/� �% Inspection date Plumbing Inspector � J ^ Inspection date Gas Inspector 4 Inspection date Engineering Department Inspection date 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. 19 " ./ Building(Inspector „•�"” • TOWN OF BARNSTABLE Permit No. ___ 22950 »n..r Building Inspector Cash _-----_---- '� 039 OCCUPANCY PERMIT Bond "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 James J.. Taylor Address Centerville Unit 41 135 West Main Street, Hyarmis Wiring Inspector .� Inspection date Plumbing Easpector � � Inspection date Ga's Inspector Inspection date Engineering Department Inspection date 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. /r BuildingAnspector TOWN OF BARNSTABLE Permit No. ---------?�QKfI sMWAU BuildingInspector Cash --------------- 'Oo 0e o �a URI OCCUPANCY PERMIT Bond 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 JameS J. TaylO r' Address Centerville 17nit; 42 115 West ;mian Street:. Rvatmis Wiring Inspector / Inspection date Plumbing inspector (' _R Inspection date Gas Inspector ~' V �N` F Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALIDO-AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. �/ Building/Inspector TOWN OF BARNSTABLE Permit No. --------22950--_- a . Building Inspector sanrraX Cash OCCUPANCY PERMIT Bond "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 Jams J^ .Taylor Address Centerville =Jnst 44 135 Vest Main Street, Hyannis '7 Wiring Inspector �� Inspection date Plumbing Inspector � '' Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. ....... ....... . ........ ....... Building,`Inspector �„��""'• TOWN OF BARNSTABLE Permit No. -----22950 1 )PY777►tL 's Building Inspector - - — -- Cash '�OYPY Y' 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 James J. Taylor Address Centerville Unit 45 135 West Main Streat, xyamlis Wiring Inspector t,/ice Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID,1AND THE.BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. / 22950 �„o�""'• TOWN OF BARNSTABLE Permit No. ww .{ ya e 1 )wrrw i Building Inspector Cash --____-- ''r0Y0.Y� OCCUPANCY PERMIT Bond 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 James J. Taylor Address Centerville Unit 46 135 West fain Street, Hyami s Wiring Inspector �` / ll' -c'st. Inspection date Plumbing hispeetorx ��.., �� _ Inspection date Gas Inspector Ir Inspection date Engineering Department Inspection date 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. e"z1 ,/—,5 ....... ....... /F Building,Inspector „'""'• _ TOWN OF BARNSTABLE Permit No. Building Inspector Cash OCCUPANCY PERMIT Bond ii/A 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 Jams J. Taylor: Address Centerville Tln,it 7 135 West Main Street;. Ilv,•amii a Wiring Inspector �f T% Inspection date Plumbing Inspector _N �"^� _ Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. ........ .._ ............... ,.../,Bilildirig�Inspector __ -TOWN OF BARNSTABLE `Permit No. _______a ---- 4 s 1 7�E1f7.YL Building Inspector s ■STA - Cash --------- '�rO OCCUPANCY PERMIT Bond ____`3� "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 James CS J. Taylor Address Centerville Uftit #26 1.35 Vest Z ain 5tree!�. H�mmi s Wiring Inspector �� Inspection date Plumbing Irispector4 � Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. .... , ..:. ............ 19.9 .................. 7Building..In4ec6r Assessor's Office(1st floor) Map * 2%4 -Parcel O Permit#A a- - - ) Date Issued . `5) Fee .~ • Engineering Dept.(3rd floor) House# . : BARNSTABU. MA96. TOWN OF BARNSTABLE ,Buuilding Permit Application 9 Pro3jece ss Village Owner ' �SA� �_ P.I.eE y Address �T,lJo'e_1"e J i /[J Telephone Permit Request /Ndi79ZG, �, 7//dl�/L K/fsl?T�;EjE�LL�AGIAaI/1►17T'/.t//rJN�J'f .First Floor square feet Second Floor square feet ' Estimated Project Cost $ ZX606 ` Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use. Proposed Use Construction Type �q Commercial Residential t/ Dwelling Type: Single Family ✓ Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House /V/o Unfinished Old King's Highway ,J v Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone Number 1�Z QS`l Address 16 OW r i> License# pS"703 Z 2s 1:1 � �9�%rl6rih "— Home Improvement Contractor# 1007 y0 i '�Ayc Worker's Compensation# Q9 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO dG� SIGNATURE DATE 9 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED � �� ^:' ^, '' ' '.� � • " • e_ � - � MAP/PARCEL NO. , t° l ADDRESS - VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME, — E INSULATION f FIREPLACE + ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH S FINAL r F GAS: ROUGH -FINAL _ z ' FINAL BUILDING DATE CLOSED OUT �+U" "I r✓" J a ! ; t _ 7 ` ASSOCIATION PLAN NO. _The Town of Barnstable eP Department of Health Safety and Environmental Sernces Building Division 367 Main Street,Hyannis MA 02601 Ralph Crosses Office Sob-79o-6227 Building Commissione: Fay 508-775-3344 ' For office use only - Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"recanstraction,alterations;renavation,repair,tnoderntzatton.won+ improvement.mmMML demolition, or construction of an addition to'way pre- owner owed building containing at least one but not more than four dwelling units or to strncum which am ad*m to such residence or building be done by registered contracx M with certain C=Tdons, along with other requirements. � r_ Type of Work: . 1//N�yG lie/i n/.7D� Est Cost Address of Work: s O�i 9 Owaer.Name: Date of Permit Application: S Z I hereby certify that: Registration is not required for the following rtason(s): _Work esduded by law Job under SI,000 Building not owmr-0ocupied Owner puftg awn permit Notice is hereby gives that: OWNERS PULLING THEIR OWN P OW RKG_DO NOT HAME ACCESS TO ME TIE FOR APPLICABLE HOME IIAPR ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: ero 7 V-o Registration No. Date OR ' Owner's name 1 r-- fiat 7 IM HOME IMPROVEMENT CONTRACTORS REGISTRATION .,. � .. oard of Building Regulations and. Standards •One Ashburton Place - Room .1301 66oston, Massachusetts :021.QS }:HOME}''IMPROVEMENT 'CONTRACTOR ________________________ ..__ K Revla.ttation-'100740 Expiration 06/23/96 • r Type - `PRIVATE CORPORATION I •HOME IWOVENENT.CONIAUTOR...,. I ..lto0ltttotiol i100)/0 '= t Capizzi Home-Improvement , Inc . I Typo -PRIVATE CORPORATION- Thomas •Capizzi , Sr . I Eopltotloa 06/23/96 1645 Newton Rd I ' Cotuit •MA 02636•.' I I Coplul None Upcovooeot, loc a is i Th000e Coplul, 5r. `�rx��`�� a - ' I •Cotult MA 02675 ' t J ' _ r _ ' Fi4ofW-01 tiw rr �� rJ r4 14 DEPARTMENT sy r 7 r ONE ASN13UR D0S'(UN tr5y , I UCY ftN,iSUPERVISUR LICENSE e lV r, ; Expires: . 61cted�,Tu 'UU ; t . ;_.;t' TVs fit £ �.� _, i �Yr r ASU ^ CAFVirvs JR fi tROVAL NSJJ BILE,,, '0266t3 NA`GiTL .i y k ) L M ryM,Y t r d. vi" .The Commonwealth of Massachusetts �r ' Department ojlndustrtalAccidents OfllcsiJ/orest/�sdi�s 600 Washineo r Street Boston,Mass 02111 Workers'Compensation Insurance Affidavit . .-- ... -. Applicant *11f0rol2tiOn! name kxation- 3 Lit. t�i`rtJl7� i!i'/ QZ 6� phone I am a homeowner performing all work myself. I ani a sole proprietor anJ ha%e no one %%orking in any capacin r I am an employer prop iding workets compensation for m% employees working on this job. _ company name: address: .� p. . insurance co l' policy# -27 I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below %+ho.have the following workers' compensation polices: company name: address: i n n a: q insurance co policy - . ��..... .._.._ ter .. _ ._ _ i..._ :V-� • _ corriv an in rant [0 D011[Y if Failure to secure coverage as required under;Section 25A of MCL 152 can lead to the imposition of criminal penalties of a line.ap to SI.S00.00 and/or one years'imprisonment as well as civil penalties in,the form of a STOP WORK ORDER and a not of S191.00 a day against me. I■aderstaad tint■ copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. /do hereb}'certify under t s and penalties per uty that the information provided above is true and correct c Signature atc Print name �� Phone t Z -9.s'l Sl '�� Mr f oMCial use"onh do not write in this area to be completed by city or town official + City or town: _ _ _ permit/license p nBuildiog Department oticensing Board j OScicctmen's Office check if immediate responx is required oHcaltb Department eoatact person phone q _ _ nOtber fi �i. �`a�..K3*.< .,.,..�v' „mow`,!•. r ! ..<.v..,�4. .i:a .• �'