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Home My WebLink About0095 WAKEBY ROAD q C, Y �� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �_Parcel 6 Permit# Health Division 9V— Date Issued Conservation Division Fee �.�` Tax Collector °"{ `�'�'� �-�,gig' � ��/ SEPTIC SYSTEM MUST BE Treasurer - INSTALLED IN COMPLIANCE WITH TITLE 5 Planning Dept. ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Addressy��/� Village Owner/1,,4/Z Telephone 41-267— . 2 4;�6 Permit Request 9daBA-1c., Square feet: 1st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost o&o Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family R' 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 W101 If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name�� Telephone Number I-1Z9--J6%57 Address La 0 C�Tv7 License# '2-- 1�; E— Home Improvement Contractor# Worker's Compensation# 09/046RZ, - 2S-2-G ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i SIGNATURE DATE i r FOR OFFICIAL USE ONLY ' P XMIT NO. 3 L.0 '1-3 ' r r• TE ISSUED - - MAP/PARCEL NO. ADDRESS - VILLAGE - OWNER ' DATE OF INSPECTION: ` FOUNDATION FRAME 1 INSULATION FIREPLACE ELECTRICAL:. ROUGH FINAL ' PLUMBING: ROUGH { ' FINAL • ° GAS: ROUGH. r� . ' FINAL , FINAL BUILDING 0 i= r r ri ,� t tQ DATE CLOSED OUT "' i; t'N ASSOCIATION PLAN NO. The Town of Barnstable 9 M ADepartment of Health Safety and Environmental Services >� �OrEo59. ►�� Building Division 367 Main Street, Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 BuiIding Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: F Est. Cost Address of Work: 8 ��J/�i�/yam U✓ ,�'/��N$ pI//��'s Owner's Name /%/-ram /'// ye&/�7Co6� Date of Permit Application: I hereby certify that: Re,-istration is'not required for the following reason(s): Work excluded by law Job under S1,000. BuiIding not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROG:ZAM OR GUARANTY FUND UNDER MGL C. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby ap/ply for a permit as the agent of the owner: �i&—9X JOd 7VV Date Con ctor Nampa Registration No. OR Date Owners Name Bosun, Mass. 02111 Workers' Compensation Insurance Affidavit ( IICAnI information Pt"c�s`c�'R[TV`i`Tcgt t Y= Ttl smc: loc3tion6 nhnnc I am a homeowner performing all work myself. ' O 1 ant a sole proprietor and have no one working in any capacity am an employer providing "'orkers' compensation for my employees working on this job: r—� nm any name: t .. insunince co-1— olio .6 z 22 9'Z c I am a sole proprietor. General contractor• or homeowncr(circle One) and have hired the contractors listed belo\% s-'ho have the follo\\inks workers' compensation polices: s.�nrsL' t nhnnc a: _ m any tie�si3dilfoaiT3�et1le r rn et e1Sd OA and/or Failure to secure co,-irage as required uadcr Section 25A of NICL t52 can lead to the impcsitioa at criminal pcaa,uo�. r one)'cars'imprison.mcat as well as chit penalties is the form of a STOP W OM ORDER and I rice of Stoo.00 a day agalost me. [understand that s copy of this statement may be for-"irdcd to the OtAce of Investigations of the DLl for coverage vc ficatiaa. (do hereby cerrij} ua r ins an enalues of perjury that the information provided above is true d correct. Signat ure Datc Print name e� Phone 9 :- oRcial use onl-- do not rite in this Brea to be completed by city or town ofGeial city or to»n: _ __ _ permit/liccnse p rlBuildiag Department QLlccnsiag Board oscicctmca's Ofrtcc i Q check if immediate response is required 0I1caith Department phone a: _ " - r'IOther�� comet person: 1_ _- 1 I HOME IMPROVEMENT CONTRACTORS REGISTRATION Board o= Euildinc RecLjations and Standares i ~ One Ashburton Place - Room 1301 Boston , Massachusetts 02108 OME I!`1PROVEM`N7 CONTRACTOR ------- ----------- ------------- - - ,ecistration 1007= 0 Ex a_ra_i on 06/23/00 type - PRIVATE COPPORA77ON IS 011 CAcIZZI HCM= iMPROVEMEN7 , INC .-, NC . .. Thomas CapiT_ Sr . _� ir,e °; C =:°".iiGV 1640 Nel �to rl P d I Cotu_t MA 02635 ! -- I I Cc_!__ r . ✓;K ��„r„�,�..�/�/, of,f�J,�a: OE-nP,iMENi OF PUS!?C SAFIFf CONS'%UCi?OA SUPE_41S09 LICENSE L4` • .. _ N� Eiairts: Bir�IdaCr: CS ISi832 14(2b(1454 {4(2b(?SS? Iest,k-tid Tc: {8 t�_ iACuS 1 CAP?ZZI JR h, Li 2eoue".101 a r, .,inn 1•" J RESIDENTIAL ADDITIONS OR ALTERATIONS A t If located: - ❑ North of Route 6 - any work visible from outside- needs approval from OKH ❑ In Hyannis -If work visible from outside- Check to see if it's included in the Hyannis Historic Waterfront District- if so it needs approval from them APPLICATION PACKAGE MUST INCLUDE: Map/parcel number Sign-offs from Health Conservation(if exterior work) [�- Tax Collector Treasurer E/ Street address Owner's name & address Permit request-full description of proposed project Square footage -proposed project Estimated project cost Complete Dwelling information for Assessor's Office Builder's information Signature Plot plan 2 sets of reduced (8.5" x 11: or 8.5"x 14")plans with cross section& framing schedule Home Improvement Contractor's Affidavit Worker's Comp form must include: Insurance company's name & Worker's Comp policy number Energy Compliance Form Copy of Construction Supervisor's License & Home Improvement Specialist's License OR Homeowner's License Exemption Form. Fee NOTES: CHIMNEYS Need Home Improvement License No plot plan required PIERS & DOCKS FjNeed Construction Super license AND Home Improvement License Owner cannot pull own permit q-foRev 8/12/98 ITSI Rev 8/1?198 ` i