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0135 WEST MAIN STREET (17)
f 35 - C�qo -- to R _001 \ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 16 QL b® plication..# Health Division Date Issued Conservation Division Application Fee ab Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Stree Address Village Srt Owner M e Address Telephone Permit Request A) o� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ® Construction Type Patti o Lot Size Grandfathered: ❑Yes ❑ No If yes, attach stf�porting documtation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) - Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's ighway:,.;1 Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other a 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 J C 1 60 Q-h Q Telephone Number Address License # -SA96: Home Improvement Contractor# 0Awn I Mail a ca u orker s Compensation # f a djeK% 4s t uP, Y I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO S SIGNATURE DATE , C dt� FOR OFFICIAL USE ONLY APPLICATION# u DATE ISSUED } 1 ,. MAP/PARCEL NO. t, ADDRESS VILLAGE } OWNER DATE OF INSPECTION: 4 — FRAME — s si IINSULATION., s <,f- ;�,.L: : f FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL a GAS: ROUGH FINAL - ti FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i He CommomseaM of Hassuchusefts Departnsnt off`bzdks&id Accidents - ( e of nvesAkattionrs ' 600 Washiiigton Street Boston,M 02LI1 YVmv.1na—,ego 1dia Workers' Compensation Insurance Affidavit:Bi ilders/C-anti-actors/EiectriciansTlum6ers Applieant Information Please Print LcTibTy Name Address:- X, CityiSta&Zip- • mo OA Phone47 Are you an employer?Check the appropriate box: Type of project x uire _ 4-. I am a contractor and i J� �• 1 ��� '�" I.❑ I am a employer with ❑ 6_ ❑New consEc� employees(full andlorpart time).* have bred the sub-ccnhwtars. 2_❑ I am a sole proprietor orpartner- listed on the attached sheet 7- ❑Remodeling slnp and have no employees These sub-contractors have g_ ❑Demolition working for me in any capacity employees and have workers' g. ❑Building addition [No workers' comp.insurance p insuaantce 5. VJe are a corporationand its 10..❑Electrical repairs or additions 3-❑ I am a homerrwner doing all work offtecs have exercised their 11_0 Plumbing repairs or additions my-self-[No workers'comp- right of exemption per MGL 12-❑Rnofrepairs insurance required]1 c-152,§1(4),and we have no employees [No workers' 13-0 Other V�1'�►a�.r1�,t►C comp.insurance squired-] *Airy agpiicat that checks boa#I mast also fill out the section below showing they worriers'coIIfpPncnii ear policy iuFrrmaeime T Hameawners who submit this affidavit iafficatmg they.um doing all trade and then hue outside contractors t submit a ww affidavit indicating sarh- LContotctors that check this boos mmt attached an additional sheet showing the name of the sub sand stste whether ornot those Mies have empkayees. If the sob-contuicramhire employees,theyrmtst provide their workers'comp.policy,nimber- I rim an employer thatisprmid&g workers'comperz wdan imairance for my employeas Before is fliepoiicy and job site informadon- Inssa ance Company Name: Policy#or Self-ins-Lic. Expiration Date: Job Site:Address: City/State/Zip: Attach a copy of the zsarkers'compensation policy declaration page(shoving the policy number and motion date). Failure to secure coverage as requireduuder Section 25A of MGL c 152 can lead to the imposition of criminal penalties of a fine up to$1.500.Oa and/or one-yearimprisosment,as well as civil penalties in the form of a STOP WORK ORDERand a fine ofup 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 t#te DIA liar insurance coverage vacation. I do hereby cerfi order thepains aiid pen aRias o�f'pedury thatdre irc{orrrtafian provided uMy bmre is Eros unrl correct Simature: Bate: U/3 Phone 9- Qjkiffl use only. Do not write in figs area,to be completed by city or fawn official City or Town- Permit License# Issuing Authority,(idrele one): 1.Board of Health 2.Building Department 3.Cityfrowa Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,-or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants — Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their ceri.:ficatc(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 Depai�ment of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be retuned to the city or town that the application for the permit or license is being requested,not the Depariznent 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 are that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant_ Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permitllicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations 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 idled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would 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 Comrmanwealth of Massachusetts Depaitment of Industdal Accidents Office Qf Tnivest gattiom 640 Washingtan Street Rostou2 MA 02111 TeL A 617,727-4900 W 406 or 1-977-MASS-4FE Revised 4-24-07 Fax#617-727-7749, www.massRov/dia oFE Teti . Town of Barnstable Regulatory Services t sasivszesr.E, •' r MASS. g Thomas F.Geiler,Director i639. �E16.19. A Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize : Se.��e C\Mho to act on my behalf, in all matters relative to work authorized by this building permit I3� less- Mr-x\� S � , (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. SW, attire of Owner Signature of.Applicant Print Name Print Name Date Q:FORMS:OVJNERPERMISSIONPOOLS 6/2012 THE , Town of Barnstable Regulatory Services '"R' M Thomas F.Geiler,Director c- 16 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 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. DEFWITION 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 workperformed 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 car,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used.by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decoUUc\AppData\Local\Microsoft\Windows\Temporuy Internet Files\Content.Outiook\QRE6ZUBN\EXPRFSS.doc Revised 053012 6 Massachusetts 7,Department of Public Safety. Board of Building Regulations and Standards' - Construction Supc.-,0sor License: CS-042,957 a :, J SCOTT CBMNQ` PO BOX 564 SAGAMORB MA 02516 I Expiraticn Commissioner 09/20/2014 License or registration valid for indivtdul use only before the expiration.date. If found;,return to: I- Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5176 Boston,MA•02116 of valid without signature { Massachusetts Department of Public Safety. Board of BuildingRegulations and Standards S Construction Supervisor €:- License: CS-042.957 J SCOTT CBHNO` ° PO BOX 564 SAGAMORP M.IF 02 1 ,I is, Expiration Commissioner 09/20/2014' - I . j emu: � -� � �/�raeac�u�aella l Office ofonsumer ffairs&.BuSiuess Regulation 6 HOME_IMPROVEMENT CONTRACTOR Registration161550 Type: Expiration 101271�014 DBA i. _ I Cl O CONSTFJIe—�ON y;y; J:SCOTT CIMENO\ aF � � yr 39 BASS RIVER LNt� SO DENNIS,MA 02661' Undersecretary HASTINGS Meadow Condominium Board of Trustees 135 West Main Street Hyannis, Massachusetts 02601 (508)420-0047 September 5th, 2013 Michele Piper 135 West Main Street Unit 24 p Hyannis, MA 02601 Al Dear Michele, The board of trustees is in receipt of your request to replace/perform work within your unit at Unit 24, Hastings Meadow Condominium in accordance with the rules and regulations or by-laws of the condominium association. Aster reviewing the work-requested;the-following ywps provided.-.,- WORK TO BE COMPLETED: Replacement of(5)windows and sliding door DOCUMENTATION: 1. A copy of the BUILDING PERMIT HAS NOT been received. 2. A copy of the PROFESSIONAL license HAS NOT been received. 3. A copy of the certificate insurance and/or workman's compensation insurance naming HASTINGS MEADOW CONDOMINIUM as an additional insured HAS NOT been received. 1 � i � CONDITIONS 1. The three items listed under documentation must be submitted to the board of trustees at least 72 hours prior to the start of the work. 2. The identification of the carpenter performing the work must be verified by the grounds manager at the time of installation. 3. All materials to be taken off the property and not placed in dumpsters on the property STATUS: APPROVED (Conditionally) Should the work completed and/or item installed not conform to this submission,the board of trustees will require removal/correction to comply with this approval. If you have any questions please contact Craig Johnson at 508.775.9445 or John Pupa at 508.420.0047. Cordially Cre Dorey / Board President s Hastings Meadow Condominium ; Cc: Pella E { i r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application fc�J/�-� Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis y--Project St_reet/AddA Village �!�/ 7.!AblS edlo ,, Owne�li/ �� ��2 r`Address / _6V' lAYI AA15-1- Telephone-"'� Permit'R�ue t Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 1;�I:rcject Valuatiori Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supportin0ocu8entation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old Kin gV'S Highwayl ❑Y ❑ No µ C'` Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft,, _ Number of Baths: Full: existing new Half: existing net Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type�nd 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 mil GLyd!ly� ('"""`Telephone Number 52'� - '2y4 —5719- Ad-are sW! 8 ® X 0 License_# �L y Gv✓+ ca 3 0 Home-Improvement.Contract_ o /_d4 L/� &RZ:D_ff49 i Worker's Comp ensatio�A�✓Gel4�01 r' ----ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE`"";— _-_ - /DATE a' fo- l l ,A F FOR OFFICIAL USE ONLY APPLICATION# DATE.ISSUED_ F MAP PARCEL NO. I - r ADDRESS VILLAGE OWNER DATE OF INSPECTION: )*O.UNDAT.ION a J��V�' INUt 4•- r' FRAME INSULATION 1_su << .�i .•s FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL f GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. _ Ii I,'! r ; E The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington ,Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): S Address: - MfnDY'01. 'r, A�on NA A 3 a a City/State/Zip: a3 Phone #: a —I'1 Y Are you an employer? Check the appropriate box: Type of project(required): 1.�K] am a employer with 4� ❑ I am a general contractor and I. employees(full and/or part-time). * have hired the sub-contractors 6. 0 New construction 2.El I am a sole proprietor or partner- listed on the attached sheet. 7. Ej Remodeling shipand have no employees These sub-contractors have $. Demolition working for me in any capacity, employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11. Plumping repairs or additions myself. [No workers' comp. right of exemption per MGL 12.E] Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.[XOther.&(e -d 0Qy 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: 0� Policy#or Self-ins.Li.c.#: \N P L1 9 D I (Ao Expiration Date: 0 Jab Site Address:A _L mn IV 1 City/State/Zip: hy)j.W WWI 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$1,500.00 and/or one-year imprisonment,as well a$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 J sins and penalties of perjury that the information provided above is true and correct. Signature, a a 3 \ Date: Phone Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk, 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person:_ Phone#: {A , DAV0001 OP ID:TL ACORG7g DATE(MM/DD/YYYY) `... CERTIFICATE OF LIABILITY INSURANCE 11/2112013 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 J.K.Olivieri Ins.Agency PHONE FAX 64 East Grove St. A/c No Ext: A/C No): Middleboro,MA 02346 E-MAIL John Mario Olivieri ADDRESS: INSURERS)AFFORDING COVERAGE NAIC# INSURER A:NGM Insurance CO. 14788 INSURED Davos Contracting LLC INSURERS:Guard Insurance. Elias Nossos 31 Memorial Dr.,Suite I INSURERC: Avon,MA 02322 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - TYPE OF INSURANCE -^�D POLICY EFF POLICY EXP- - LTR POLICYNUMBER MM/DD/YYYY) (MMIDDIYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 500,00 CLAIMS-MADE ®OCCUR MED EXP(Any one person)_ $ 10,00 A X Business Owners MPP2434V 05/24/2013 05/24/2014 PERSONAL,&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X PRO- LOC $ . AUTOMOBILE LIABILITY Ea OINE5 SINGLE LIMIT $ 1,000,00 A ANY AUTO M1 P2434V 07120/2013 07/20/2014 BODILY INJURY(Per person) $ ALLOWNED X SCHEDULED BODILY INJURY Peracddent AUTOS AUTOS ( ) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS PER ACCIDENT UMBRELLA LIAB OCCUR - EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED I I RETENTION$ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ORY LIMITS ER B ANY PROPRIETOR/PARTNER/EXECUTIVE DAWC440166 01126/2013 01/26/2014 E.L.EACH ACCIDENT $ 100,00 OFFICERIMEMBER EXCLUDED? ® N/A (Mandatory In NH)If yes,describe under E.L.DISEASE-EA EMPLOYE EMPLOYEEJ$ 100,00 - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Elias Vossos and Paul Downing are excluded from WC coverage. CERTIFICATE HOLDER CANCELLATION TOWNBAI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St. Hyannis,MA 02801 AUTHORIZED REPRESENTATIVE ` ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD HASTINGS Meadow Condominium Board of Trustees 135 West Main Street Hyannis, Massachusetts 02601 (508)420-0047 September 5 th, 2013 �. Michele Piper �QS 135 West Main Street Unit 24 Hyannis, MA 02601 Dear Michele, ' The board of trustees is in receipt of your request to replace/perform work within your unit at Unit 24, Hastings Meadow Condominium in accordance with the rules and regulations or by-laws of the condominium association. Aster reviewing the work requested,the following W,?s.provided:. _. WORK TO BE COMPLETED: Replacement of(5)windows and sliding door DOCUMENTATION: 1. A copy of the BUILDING PERMIT HAS NOT been received. 2. A copy of the PROFESSIONAL license HAS NOT been received. 3. A copy of the certificate insurance and/or workman's compensation insurance naming HASTINGS MEADOW CONDOMINIUM as an additional insured HAS NOT been received. CONDITION 1. The three items listed under documentation must be submitted to the board of trustees at least 72 hours prior to the start of the work. 2. The identification of the carpenter performing the work must be verified by the grounds manager at the time of installation. 3. All.materials'to be taken off the property and not placed in dumpsters on the property STATUS: APPROVED (Conditionally) Should the work completed and/or item installed not conform to this submission,the board of trustees will require removal/correction to comply with this approval. If you have any questions please contact Craig Johnson at 508.775.9445 or John Pupa at 508.420.0047. Cordially Cre Do.rey Board President of Hastings Meadow Condominium i Cc: Pella I ' F y assa h�+setts'- pss t rs of of'C�ubiic-S f #y Board of BOOding Regutafti®ns and Standards License: CS414247 } ttv $� g PAUL M iBOWN$ d t 180KESM,iickk6lA6, � ®CKTixv IN r:Q,� Inc Ex t 'Commissioner t?$/04i20'15 d n aW� f y qY i 3 s i Office of Consumer Affairs and Business Regulation. 10 Park Plaza- Suite 5170 C - -w Boston, Massachusetts 0211:6 Home Improvement Contractvr;Registrati.on Registration: 1264€36, Type: DBA z4 s; Expiration: 5/27/2014 Trf# 2253.1a DAVOS CONTRACTING CO. _— PAUL DOWNING 31 MEMORIAL DR 18 —_ AVON, MA 02322 t - -- --- ._...................._. __... _........ f'.Ilpdate Address and return card.Mark reason for change. n Address � Ytenewal i Employment � Lost Card SCA 1 is .20M-0511,r Consumer `er Afau�u.c Buff r�.sReg iatio License or r istration valid for individui use only Oflice of Consumer Affairs&-Busidess dtegulation e$ - Y ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to; egistration: 126406 Type: g Office of Consumer Affairs and-Business Regulation `expiration 5/27/2014 DOA 10 Park Plaza-Suite 5170 g Boston,MA 02116 DAVOS CONTRACTING CO G PAUL DOWNING f 180 KESWICK RD BROCKTON,MA 02301 .......: ._. - - — g- _.,_.: .. :.......................... Ugdersecretary of valid withou signature ;� ' �\ _ 1 1. V V �.,, .. �� 1 --�' N N . �, � � ^c -_ � w w � - N � A , , A # BARNWABLE, 'Town of Barnstable Regulatory Services Richard V.Sca➢i,Interim Director Building Division Thomas Perry,CBO 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 �h ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for:. 135 W. MOA) S+, Aar c39 (Address of Job) c �l\ Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. T:IKEVIN MBuilding Changes\EXPRESS PERMIT\EXPRESS.doc Revised 061313 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA r U - S s TOWN AM 4WABuild m ' —;--a ��: `� �.'S�YS • c �Y,i,,,$\ _. y ( �.? > s t OCCUPANCI( ,PRIWIT 5,, . a�+� fir., " '" No Y 1Vo building nor structure,shall be erected, and no land, building$r structure shall be, ' z x of �7 �. used, for a new, difFerent,"changed, ar enlarged use,vQ4hout �a Budding permit therefor first having`been obtained from the Bn�lding}Inspector�No liu�lding shaIl be occupied until a .� certificate:of occupancy has +been,.issuedby th'e Bulldmg> Inspector Issued A to :�C ddress F1`"'tei > t 1 5 1 ts t Y�i tstie.�rm mmu Wiring'Inspector s * ction date '1 .. -Piumbg Easpector , Inspection date. ti, a Gas Inspector i Inspection date Ebgineer4,Departnient Inspection date - t s ti> THIS PERMIT WILL •NOT,BE VALID, AND, THE'BUILDING SHALL NOT BE OCCUPIED UNTIL; >; y SIGNED4 BYE THE�BUII.DING INSPECTOR, UPON SATISFACTORY COMPLIANCE WITH: TOWN:, t k°;' �• .� .A�// H J _ 5'7 ik.. •a:_ �N .Building,,Ins*p'ect or T�'r.a'ri��,�- i'.:�� ''� +,..g,. `5..�' r .- a .. - - ✓�`''+:-;a+ Y t +.�:r .Y �, �{, 'A,` n. 5 -�-. ,z?- �"4j�i KPr•''Ta'cr S(� � d,1T. .�.. C. fT ? .,`^-�_.. ,r - x. .. ._ _ .. .,. ±�,..r"�...^r-w-•,,... ._.t'-'��'r.�4. o.. . .�;?.. .rn.. - _ .r. u•<�1..�s.:,$t'�F---Y' -"�" r ..,-err._. r�-,. .•. ``�„�•;` .e TOWN OF BARNSTABLE Permit No. ------229_50___�____ Building Inspector 11AUSTAU 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 ITnit 24 135 West min Street, Hyasmis Wiring Inspector � � ����� � Inspection date Plumbing Inspector Alf- Gas 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. ' A z*QVAWrXV_4 19 I` Building/Inspector _ _M