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Home My WebLink About0359 WHEELER ROAD �� v �A% Town of Barnstable *Permit#:P I _ 2250 ��6 months from issue date Regulatory Services snxxsrneM : Mass. Richard V.Scali,Director V V Building Division Tom Perry,CBO,Building Commissioner rn Q 8 2016 200 Main Street,Hyannis,MA 02601 •Vv www.town.barnstable.ma.us I t 1 U! Office: 508-862-4038 l'U OF g�i�� r5�D8�7�0-6230 EXPRESS PERMT APPLICATION - RESIDENTIAL. ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address 4esidential Value of Work$ J U D. Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address prjr, f( h4 KW114k,00Ce [ Contractor's Named-faA&tA� Telephone Number 5A:S:5gtea Home Improvement Contractor License#(if applicable)//�� ' Email: Construction Supervisor's License#(if applicable) (�S S L � p ❑Workman's Compensation Insurance Check one: O'7am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Vtdwv Workman's Comp.Policy# 00 ( V Copy of Insurance Compliance Certificate must accompan each permit. Permit que check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is equired. SIGNATURE: AK-Le e I Ij C:\Users\Decollik\AppData\Local\Microso Win ws\Te orarytntemetFiles\Content.Outlook\2PIOIDHR\EXPRESS.doc Revised 040215 i Property Owner Must Complete and Sign This Section If Using A Builder 0 I - t ,as Owner of the subject property hereby authorize Aoda � e to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) kz 6 S afar f e TDaterI f t -,,PIntNamd If property owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. .�....._...-.....n.:_._.rmrr_.,r�.._r...i1..=lr'a�-'*J...-.A:..Nr-2�ntw.ac:.L}.��^r�' .oC.ra......+._r-.L•4::i,:tM+=`.:..:t.-.:J.:-7.:;ex.-•Xc_,.�sr..... .o .............a._...; s..- _ ...... ._, The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigadons 600 Washington Street Boston,MA 02111 ivvv mass gov/dia Workers' Compensation Insurance Affidivit- Builders/Contractors/Electricians/Plumbers Applicant Information (` Please Print 'b Name awsmees�siownizationnndvidoaq: ✓` J Lt/1/L Address: S /5 p- City/StateJZip: Phone 9- Are you an employer?Check the appropriate box: T project am a general contractor and I 3')Pe of p Iect(Pe9�� 1.El I am a employer with 4. ❑ I g 6. ❑New construction loyees(full and/or part-time).: have hired the sub-contractors 2 a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling and have no employees These sob-contractors have E g- ❑Demolition working for me in any capacity. employees and have workers- [No workers'camp.insurance comp-insurance required-] 5. ❑ We are a corporation and its ME]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL repairs insurance required-]I c. 152,§1(4X and we have no employees-[No workers' 13.0 Other comp.insurance required.] ;Any applitsm that checks box#1 mast also fill out the section below showing their workers'compensation policy infornatiao- Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors nmSt submit a new affidavit indicating such rCaut actors that check this box must attached an additional sheet showing the name of the snbtamnactors and state whether or not those entities have employees. If the mb-contractors have employees,they must provide their workers'comp.policy number. I inn an employer that is providing wvorkers'compensation insurance for my enrplo5veL Below is Bee policy and job site information. �--� Insurance Company Name: P l Policy#or Self-ins-Lic-#: V' Expiration Date. Job Site Address: ' City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c 152 can lead to the imposition of criminal penalties of a fine up to`11,500.00 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 W for in=mce mrage verification. I do hereby certi u der the pain am d nalties of p my tha a info►wt on provided above is true and correct Si hue: ate: Phone M Official toss only. Do not write in this area,to be completed by city or tmvn official. City or Town: PerxmtfUcense 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##: 6 Office of.Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston;Massachusetts 02116 Home Improvement Contractor Registration Registration: 134313 Type: DBA Expiration: 10/24/2017 Tr#' 270759 DAVID SAWYER CONSTRUCTION DAVID SAWYER -.318 MEIGGS BACKUS RD. - ......SANDWICH, MA MA 02563 = - Y Update Address and return card.Mark reason for change. f Address Renewal Employment Lost Card SCA 1 u 2OM-OW11 cis V/ae �p�ront.�etueull/o��/j�ii�ia�r«elfs _ Mee of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation gistration: 134313 Type' 10 Park Plaza-Suite 5170 piration: :=1Qr14_k2017 DBA Boston,MA 02116 DAVID SAWYER CONSTRUCTIC)' DAVID SAWYER 318 MEIGGS BACKUS RD." SANDWICH,MA 02553 Undersecretary valid w' out signature 1. < " Massairhusetk� �Department-ofpublic Safety �• t. ' Board of:Builuirig•Rigulatiors ar.d StaridaYds u ^ 1 C u vn'SLper-FiiGi peCiaiti' License: CSSL-098859 DAVID R SAWYEA ' < 318 MEIGGS BA - u OAD} SANDWICH MA%025�. Expiration f . -Commissioner : 01/27/2017 u WORKERS COMPENSATION AND EMPLOYERS UABILITY INSURANCE POLICY . INFORMATION PAGE AGENT NO 3020 OFFICE:-NO 3020 MARK SYLVIA INSURANCE AGENCY LLC 404 M C RVILLE MA 02632 16 FARM FAMILY CASUALTY INSURANCE COMPANY 508-428-0440 NCCI COMPANY NO. 16721 POLICY NO 2001W6406 ,k _ INSURED AND MAILING AD RENEWAL OF N0. 2001W6406 EFFECTIVE3105/16 DAVID SAWYER , DBA SAWYER CONSTRUCTION 318 MEIGGS BACKUS RD SANDWICH, MA 02563-3131 THE INSURED IS' INDIVIDUAL Workplaces covered by this 'policy: ST WP NO. ADDRESS OF WORKPLACE RTG.BUR NO. INTRASTATE NO. , MA 01 318 MEIGGS BACKUS RD 210677 SANDWICH MA ,, rurr:::vr, my ...........r�::{v'r:n,.v::nvr m!<!! !M!!.!!{!Mr(-.+};{{:�•vttiti iC4:t!i>r.�}. % f v{'.: .. ....; :::.::�::.r:.,�r.Yrr .:?.;'};,:,?}}?:G_';:}":.v.�a.?:" ,c•,.,.::.oxa..,.,.::.}. '•2"v�'�3•-y yam- uXKK' .v:::,:,�-; ';-i4+'%T ^�'.. ..q•F.--{....<:b,v':!'::}yci�.•:,.-�"S,r•.+•:+-:�:isx"-.":,�.\�:�?..4-?.Y::a'?Z'.-.'•'^�^�'{.',-'''^•�.'•orQ•'��'. ..�:K�':.'�,.•N;\ v}"•':r:${,}: :?�-`.\,•\,Y�".�.'-•�'•..h}l�r-+� . r )� } t . � {. : r.r ri?> - { . -4:�'ffv::_?-r•--.r3ikX+ �.v:.w..,,vv.{i'nt?::�-?'>i>-\''Fir''L.rii•{..�yr�'.L(vv'�.}ff'.<L��v{��i'1N{vt:=_�i 1;\jsu i'v:'}\i-:}�vii�::Ca�::nivy'�4.'i\f-`.�•'�.:li.%-.w.L}}. V...�-:..:.:;•fi..^:v->:.� ........ wn.:. ,.....,,:,,xuv?'Z=..�.�:{ivQ:i•.v:....v::\.�.�.'...{.:.tv:, ...h., !:4.....-..: - ......n[i�'t•?::{:.;{-{{{{•:i•:::::i"{J:tiy.-->::ti•??n{tit•:iv??:<•::-....':"�::::....z-........ The-policy.-period'-is from 3/05i1646 3/05/17 -1101 A.M. Standard Time at the insured's mailing address. i,,,,.{r}.»??::vc:-.,...,..n n:,.rti.�...,.. «{..•}{L:2•'....:\t.'.::tn ti: K� , '•jn . n:2i>�^4..%;�;:::.!.�r-%;.{.i jRr!'.?{r £.C �: .,`}:+�•.:�'>S:+r:"�"-."^.•`ra:?�;:�\4�_i}::}x,}}r`lY}::w. r ,.•,:T. -.�.... ..,�: ;:{f...,,.,.�tt•...,.ff•.:{{,C•,4.{•n ..>: �:,$.`\`t!,:.,�rn!,+.-::,::::.,�:r..r...{:?-:t�{,.:.-::::,.•.. ' �� .. ::.-;-'+C}v::%.rrxc��,..{{:!,�::�.{.�:�?:�:?�'.-::(`x-:a.:rA:::.2::s.3^.;,::�::Cfi!;•'C�:.ra��•.,},: $4�.'-:',:aa>Sk:..v`?,�:y ' ...yr,;,:}�'x'.', :.n,+M->}:�}>}:„<,vxi:.•-:•:;tr.::v%:;.:o:.;-.wn-.� :9v..::J.'n,,:::�?:v..{.+:.:-.r::r.•v-•..:...r-:-.. ? A.•Workers_Compensation<Insurauce: Part.One of the policy applies to the Workers Compensation Law of the state listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A.. The limits of our liability under Part Two are: Bodily Injury By Accident Bodily Injury By Disease Bodily Injury By Disease $ 100.000 each accident $ 500,000 policy limit $ 100,000 each employee C. Other States Insurance: Part Three of the policy.applies to the states, if any, listed here: All states except the states designated in item 3.A. of the information page and ND, OH, WA, and WY D. This policy includes these endorsements and schedules WC 00 00 00C WC 00 00 018 WC 00 03 15 WC 00 04 14 WC 00 04 22B WC 20 03 01 WC 20 03 02A WC 20 03 03D WC 20 04 05 WC 20 06.01A copyright 1937 National Council INSURED COPY pROCESSED' 02/01/16 on Componwdon Inemsnce WC 011 00 01 s laatArw„ nfl:rn_ Pn-9:2—ArM ® or annry nirw vnoie-i.,%9n,sai:a 4 S � David Sawyer Construction 318 Meiggs Backus Road Sandwich,MA 02563 508-539-1992 Proposal Submitted To: Work Address: 359 Wheeler Rd Marstons Mills,Ma 508-776-5225 Worked to be Performed: *Strip Roof-Replace with CertainTeed AR Architect Shingles Color-customer to decide *Nail Plywood as needed *Clean Gutters as needed *Install: White Aluminum Drip Edge Ice&Water barrier on all edges of roof Underlayment Paper System Hurricane nail shingles Ridge Vent Pipe Flange *Remove roof vents and fill them in Total Labor&Investment S 5.125.00 five thousand one hundred twenty five dollars All materials guaranteed to be as specific,and work to be performed as stated above in a workmanlike manner. Please remove and/or secure any fragile household items. Not responsible for broken or damage to household items. Five year Labor Warranty/Plus Manufactures warranty. Contract may be withdrawn if not accepted within 30 days. Pleal see back fo additional to s. / l Respectfully Submitted �1 Date Acceptance of Proposal The above prices,specifications and conditions are satisfactory and hereby accepted. You are authorized to do the Work. Payment is due in full at job completion. Owner signatur r Dat ap T5 2 Parcel 00 P. O o Permit# ? 6 w House# Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00- 6j- Conservation Office (4th floor)(8:30- 9:30/1:00;2:00) q100 Planning Dept. (1st floor/School Admin. Bldg.) Definitive Plan Approved by Planning Board 19 WOW T .� TOWN OF BARNSTABON AND Building Permit Application TOWN REGULATIONS r Project Street Address Village Owner A A k.yA. Address 3 6-9 wI-et Telephone IV E' " Permit Request a C__� Sc,Me,�Ci��Di►n�- First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ c�du Zoning District Flood Plain Water Protection Lot Size AC&d—s Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 3 d 12 s Historic House ❑Yes goo On Old King's Highway ❑Yes RNo Basement Type: ❑Full ❑Crawl go Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 2— New Half: Existing New No.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 O No Fireplaces: Existing New Existing wood/coal stove ❑Yes ®WNo Garage: aDetached(size) 2-t)f-.1�-E Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) _ ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# 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 SIGNATURE ,/ /`71L�i.H,� iv�¢[�/ DATE '- J� BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) -4"4 :�, : a Ila) r m FOR OFFICIAL USE ONLY PERMIT NO. ', DATE ISSUED > MAP/PARCEL NO. z ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION _ FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 'DATE CLOSED OUT T a ASSOCIATION PLAN NO. i k 3 �9 w l2 e-4e r ca /s`�' t➢� �6 ch ae,.l�'e f,r s N 9 e�k , �dvs� `"� oFtME Tp Department of Health Safety and Environmental Services Building Division L tiaitrtsrnBr E. = 367 Main Street,Hyannis MA 02601 ei/►ss. 9 ra?q. Ralph Crossen Office: 508-862-4038 Building Commissioner Fax: 508-790-6230 HOMEOWNER LICENSE EXEMP`n0N Please Print DATE: 3S� �veL�h '� JOB LOCATION: stray village number "HOMEOWNER": Ae_> &&& _ home phone# work phone# name CURRENT MAILING ADDRESS: city/town state zip code hom ers to include owner-occupied dwellings of six units The current exemption for" or less and to allow homeowners to engage an individual for hue who does not possess a license, row_ that the owner acts as supervisor. DEFINMON 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,cone or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home Officinal twn a o-year period acceptable to the considered a homeowner. Such"homeowner"shall submit a the Building 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 resp onsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. th The undersigned"homeowner"certifies that he/she understandse Town of Barnstable Building andthat will comply with said Department minimum inspection procedures and requirements procedtues and requirements. ale�Signature of Homeowner Approval 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 EXEMI'nON 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 Supem »sots);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor. the responsibilities of a supervisor(see Many homeowners who use this exemption are unaware that they are Lwuming Appendix Q,Rules&Regulations for Licensing construction Supervisors.Section 2.15) This lack of awareness often results in lieeaszd persons- 1n this case.our Board cannot proceed against the serious problems,Particularly when the homeowner hires un uniiccnsed 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 coaununities require,as part of the permit application.that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the-Iasi page of this issue is a form currently used by several towns. you may care to amend and adopt such a fom�lcertification for use in your community. Q:FORA1S:EXEMPTN STANDARD LEGEND NOTE:not all symbols will appear on a map / 4t� GOLF COURSE FAIRWAY cacao EDGE OF DECIDUOUS TREES ' EDGE OF BRUSH r ORCHARD OR NURSERY V-v-v-V EDGE OF CONIFEROUS TREES 1 MARSH AREA - — EDGE OF WATER DIRT ROAD DRIVEWAY I4--PARKING LOT - M 2 PAVED ROAD - 2 - - DRAINAGE DITCH , / # 347. - - - - PATH/TRAIL MAP PARCEL LINE** &V 110 <- —MAP# 21 E PARCEL NUMBER HIe60 -< HOUSE NUMBER C# . 59 ----- 2 FOOT CONTOUR LINE :8 10 FOOT CONTOUR LINE Elevation based on NGV029 X 4.9 SPOT ELEVATION 00o STONE WALL -X—X- FENCE RETAINING WALL MAP 82 ++++ RAIL ROAD TRACK 1 - 1 STONE JETTY # 369 SWIMMING POOL PORCH/DECK BUILDING/STRUCTURE DOCK/PIER ------------- P� HYDRANT - e VALVE OO ' MANHOLE O0 POST Q FLAG POLE T O W N _ O F B A R N S T A B L E G E O G R A P N 1 C 1 N F O R M A T 1 O N S Y S T E M S U N I T a SIGN STORM DRAIN IN PRINTED SEALS:IN FEET *NOTE:This map is an enlargement of o **NOTE:The parcel lines are only graphic representations DATA SOURCES:Plonimetrics(man-made features)were interpreted from 1995 aerial photographs by The James 1 100'scale map and may NOT meet of property boundaries.They are not hue locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD UTILITY POLE p TOWER w e 0 30 60 National Me Accumcy Standards at this do not represent actual relationships to physical objects Corporation. Planimeirics,topography,and vegetation were mapped to meat National Map Accuracy Standards LIGHT POLE O ELECIRIC BOX WWs I INCH=60 FEET* enlarged scale. on the map. at a scale of 1°=100'. Parcel lines were digitized ham 2000 Town of Barnstable Assessor's tax maps. i The Commonwealth of Massachusetts t Department of'Industrial Accidents ,.. ._... U. � Office 011oYe501"fons 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Afrtdavit name locations cior I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in any capacity ❑ I am an emplover providing workers compensation for my employees working on this job. com anv name: address: city phone#: insurance co. oiicv,# • /i/%/ /////////o/i/%%ai/i/////////////////////%/////////%/%////i//%////////////////////i///////%////i//%/%///////////////%////////// ❑ I am a sole proprietor, general contractor. or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: ............... com anv name: address: city phone#^ ;::.:;z>::::::<;.;:>: ;...;:; .;. . iiisornnce ce. gal com anv name: - address: city phone#: insarantie co.. "" ' • Failure to secure coverage as required under Section 15A of MGL 152 can lead to the imposition of criminal penaltiesof a fine up to SI.500.00 and/or one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a COPY of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herebv certify under the pains and•p en alties of perjury that the information provided above is truo and correct signature Asa �'► `v a f l'ct��.b� Date - 0� Print name Phone# official use only do not write in this area to be completed by city or town official permittlicense is Mudding Department t dty or town• ❑LlcensWg Board response is required ❑Seleeanen's OMce ❑checkif immediate rssp ❑Health Depattnent contact person: phone#; (tevum 9,95 PIA) t Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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 thereu, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwellinghouse or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 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,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable eviLerce of compliance with the insurance requirements of.t ihis chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns I Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned fo the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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 Me of Investlgadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 The Town of Barnstable � eanueria�r• • MAM 9 �,�' Department of Health Safety and Environmental Services . Building Division 367 Main Street,.Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 BuiIding Commissione 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;.de alition, or cor.structima 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 requireme ts.o • Type of Work: - ¢ r S-/ a D `c"l� Est. Cost Address of Work: Owner's Name 4 f144 v 77-o'ws f� . Date of Permit Application: 0 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE H051E IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGZAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PER..TURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR 0 Y,--D Date Owners Name Building-•Department Complafi t quirt'Report Date: ` d v Rec'd by: Assessor's No.: Complaint Name: Location Address: lwr Originator Name• : Street: r�r Village: - _ State.. Zip• Telephone: D/L Complaint Description: �r r`L' i ✓i c C-k -C.t i Inquiry Description: For oiiicc Usc On/r Inspector's Action/Comments Date: j0 Inspector- --az Follow-up Action Additional Info. Attached Cop;,Dj=buoon. [Mute-Dcpx=cntFile 3'ellorv-lnSDeC[0r Property Location: 359 WHEELER ROAD, MAP ID: 082/002/001// Vision ID: 4961 Other ID: Bldg#: 1 Card 1 of 1 Print Date:08/02/2000 -CURRENT OWNER TQPO. UTILITIES=.STRT./ROAD LOCATION . CURRENT ASSESSttiIENT. _. IATKOWSKI,ARTHUR 3 jBelow Street as ] xcel View Description Code Appraised value Assessed Value IATKOWSKI,MARILYN J axed ell-- --�- --- _ E ake/Pond Froi ES LAND 1010 141,700 141,700 59 WHEELER RD ESIDNTL 1010 -82,000 82,000 801 RSTONS MILLS,MA 02648 Peptic y ESIDNTL 1010 12,800 12,800 VE DATA-Barnstable,A SUPP:-LEMENTAL DATA- ccount# 385229 Plan Ref. Tax Dist. 300 Land Ct# Per.Prop. #sR VISION Life Estate DL 1 LOT.A Notes: DL 2 GIS ID: Totali 236,500 236,500 REC F OWNERSHIP BK:VOL/PAGE SAGE DATE.: /u v SALE PRICE::V C . PREVIOUS ASSESSMENTS:HISTOR ORD.:.O ... . _ IATKOWSKI,ARTHUR 1268/558 Q 0 Yr. Code Assessed Value Yr. Code I Assessed Value Yr. Code I Assessed Value 2000 1010 141,700 1999 1010 141,700 t998 1010 141,700 2000 1010 82,000 999 1010 72,300 998 1010 72,300 2000 1010 12,800 999 1010 10,200 t998 1010 10,200 Total: 236,500 Total: 224,200, Total: 224 200 EXEMPTIONS OTHER.ASSESSMENTS This signature acknowledges a visit by a Data Collector or Assessor Year T e/Descri tion Amount Code . Description Number Amount Comm.Int. - y APPRAISED:vAL UE SUMMf1 RY Appraised Bldg.Value(Card) 67,600 Appraised XF(B)Value(Bldg) 14,400 Total: Appraised OB(L)Value(Bldg) 12,800 * Appraised Lad V al ue.(Bldg)N OTES . n 141,700 SpecialLand Value APPORT FY 88................. Total Appraised Card Value 236,500 Total Appraised Parcel Value 236,500 Valuation Method: Cost/Market Valuation et Total Appraised Parcel Value 236,500 BUILDING.PERMITRECORD - VISITLCHANGE:HISTORY _.: - .- - Permit ID Issue Date Type Description Amount Insp.Date %Comp. Date Comp. Comments Date ID Cd. Purpose/Result B19681 10/1/77 0 1/15/79 100 MM GARAGE 5/12/99 FS 00 eas/Listed LAND.EINE VAL UATION SECTION . .: ._ .... B#I Use Code Description Zone D Frontage De th Units I Unit Price L Factor S.I. C.Factor Nbad. Adf. Notes-AdYS ecial Pricing Ad'. Unit Price Land Value 1 1010 Single Fam RF 3 1 1.00 AC 100,000.00 1.00 5 1.00 18WA 1.25 PCL(1.,U15)Notes:15 1WATI 125,000.00 125,000 1 1010 Single Fam RF 3 0.34 AC 39,400.00 1.00 5 1.00 18WA 1.25 PCL(.34,UI1)Notes:11 1RES. 49,250.00 16,700 e , Total Card Land Unitsi 1.34 AC Parcel Total Land Area: 1.34 AC Total Land Valuei 141,700 Property Location: 359 WHEELER ROAD MAP ID: 082/002/001// Vcsion ID:4961 Other.ID: Bldg#: 1 Card 1 of 1 Print Date: 08/02/2000 _ CONSTRUCTIONDETAIL __. _ . '_ SKETCIi... ... _: u Element Cd. Ch. Description Commercial Data Elements tyle/Type 1 Ranch Element Cd. Ch. Description odel 1 Residential Heat&AC rade + Average Grade Frame Type DK WDK Baths/Plumbing TO tories I I Story ccupancy 0 Ceiling/Wall ooms/Prtns $ Exterior Wall 1 4 ood Shingle /o Common Wall 37 2 5 inyl Siding all Height Roof Structure 3 able/Hip BAS Roof Cover 3 sph/F GIs/Cmp BM COND...O/tYIOBIlEROME DATA - - nterior Wall 1 5 Drywall ;lement mm_ odem _ escrtption T_ actor 2 2 nterior Floor 1 14 Carpet Complex 2 Floor Adj Unit Location Heating Fuel 4 lectric. Heating Type 7 Elec Baseboard Number of Units C Type 1 None Number of Levels 2 %Ownership Bedrooms 3 3 Bedrooms $ Bathrooms 2 Bathrooms COST/1lMRICET.{'ALU MON 0 Full Unadj.Base Rate 8.00 otal Rooms 6 Rooms Size Adj.Factor 1J6447 Grade(Q)Index .06 " Bath Type Adj.Base Rate 9.25 Kitchen Style Bldg.Value New. 78,625 Year Built 1972 40 ff.Year Built G)1983 rml Physcl Dep 14 uncnl Obslnc con Obslnc . ode_ Pecl.Cond.Code pecl Cond% 1010 Ingle Fam 100 Overall%Cond. , 6 eprec.Bldg Value 7,600 OB OUTBUILDING& YARD ITEMS(L}/_XF BUILDING EXTIL9 FEATURES(B) Code Description LIB Units Unit Price Yr. D Rt %Cnd Apr. Value FPLl Fireplace 1Sty B 1 3,000.00 1983 1 100 2,600 FPO Ext FP Opening B 1 800.00 1983 1 100 700 FGR2Garage-Avg L 624 25.00 1979 1 100 12,800 BFA Bsmt Fin-Aver B 864 15.00 1983 1 100 11,100 B LULDING SUB.AREA':SUMMARY SECTION'._. _ Code Description Livin Area. Gross Area E .Area Unit Cost Unde rec. Value BAS First Floor 1,040 1,040 1,040 59.25 61,620 PTO Patio 0 296 30 6.01 1,778 UBM Basement,Unfinished 0 1,040 208 11.85 12,324 WDK Wood Deck 0 488 49 5.95 2,903 Area 4,0401 2,8641 1 327 78 625 s Assessor's map and lot number J Sewage Permit number ...... Z� .r?.l�re::'` 'F !:..` ' :"'ti:... i".' 'f'�`'••� fNETo�o TOWN OF BARNSTABLE i � i DAMSTA.B-i i "6 9 t DYPY 6 DUI1LDING INSPECTOR o� a'e JD ' 'fir APPLICATIO F APPLICATION OR PERMIT TO ....... I tJ .®...:.(� d IZ! lrC�.........!R V.' /X a(................................... +� TYPE OF CONSTRUCTION .................��............................................................................................:....................... ............/. ..... ............19..7.7 L TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....�al/ �. ..L /Z.... 1 ....... ��.$T�l1J5...... 1�/� .. ...... � .. ........................... . . / Proposed Use . P ../ �� 7 /e.. . ........... ............................................................................................................................... Zoning District R E.....................................................Fire District ....C.- 0 ......... ............................................................... Name of Owner .940440k„ GIsATe � S r Address ...w. !ttI-ee Rd /�aQ2S7`aI1/ icyC Name of Builder kfi? , �(c.�. :a• ��ow:5,k. ..................... Address ................ .......:........................ ............ P Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ......................Foundation CQK SAP T'-....:�.�:aen�C ...... ................................ Exterior ....................................... .......Roofing rR� Asv /� ................................ .V. ............................................... Floors .Interior Heating ... ............................Plumbing .................AloA., .................................................... Fireplace ..........................................!V,/4............................Approximate Cost ......... ^ Definitive Plan Approved by Planning Board -----------_______-----------19________. Area .....?>.. .. .. .. . a Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH :L } • 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. l� wT. � 1.c1� ... Name . _ ..........,.............................................................. a Kwiatkowskiq Arthur D.,,,. A=82-2-0-0 19681 garage No ................. Permit for .................................... ............................................................................... Wheeler Road Location ................................................................ Marstons Mills ............................................................................... Arthur D. Kwiatkowski Owner .................................................................. frame Type of Construction .......................................... ................................................ .............................. Plot ............................ Lot .... ........................... Permit Granted ......... ctober 19 .......19 77 ......... . -Date of Inspection .............. ......................19 Date Completed ......................................19 PERMIT=REFUSEDe ........................................... ......... ... .. 19 ....... .... . .... ..... ........... ......... . . .... ...... ... .............. ......... .. . .............. .... . ........... .......... ......... ... ......... ..... ........ . ..... .. ........... Approved ................................................ 119 ............................................................................... ............................................................................... Assessor's map and lot numb � - — a Sewage Permit number ............. ... ................. Z �%TMErO� TOWN' OF BARNSTABLE Z. B,$35T LE, M� : n 9 a 1639 BVILDIN.G INSPECTOR z OO 00� u OYPV r -i APPLICATION FOR PERMIT TO .........td V�:,. ......... .!�.: 1?.. ........ . .. .................. TYPE OF CONSTRUCTION ................r:7 ......................... ............................................................... �y /.......v al............19.2.1 TO THE INSPECTOR OF BUILDINGS: `1 The undersigned hereby applies fo/raa permit according to the following information: Location .....1/j/../4 �.�..t t.r....l;✓.6.r.�,)........... ....... ...... ........................... ProposedUse ...... ` . L .................................................................................................................:......... ZoningDistrict ......... .....................................................Fire District ....c.-. ........................................................... Name of Owner Avm4 .g... .....Address ... R,4......J. Name of Builder ....&,17.......kl�-.:t.44..41 .. .............Address ........�'y:�!�c. it Nameof Architect ..................................................................Address .................................,.................................................... Number of Rooms Foundation .......Ge,.flkxA!.4!�.... ....................... Exterior Ce.da '... .k A�:. l A :' Roofing %� 1��...;�s �. Floors 4- .......................................Interior ........... . .............:................................... Heating .....................................: ............................Plumbing .................:.. te................................................ u c: Fireplace il�.�.. ............Approximate Cost Z �� -- ......................................... . ............... ........................................................ .. ........ Definitive Plan Approved by Planning Board -----------______-----------19 . Area .....�.. v...s':. ..:......... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Lt Kwiatkowski, Arthur D. 19681 garage No:................ Permit for .................................... ............................................................................... Wheeler Road Location ...........I............................. ..................... Marstans Mills ............................................................................... Arthur D. Kviatowski Owner .................................................................. frame Type of Construction .......................................... ............................................................................ Plot ............................ Lot ................................ October 19 77 Permit Granted ........................................19 0� Date of Inspection 9 .Date Completed ......... ......... 19 PERMIT REFUSED ................................................................ 19 ............................................................................... ............... ............................................................... ............................................................................... ..........................................................I..................... Approved ................................................ 19 ............................................................................... ............................................................................... PI-04 P(-Apj Pat paw lchoeAGE, 5��•�333 my - ., � 1 ; •f• -- Al + :S: �• }` i A VIA t �. tit } e i S• f: ra i �.®�s��r _� •a�:� :� ;x �, ems. ��a__.� _,. ,;; ��;:��:,�