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0079 WILLIMANTIC DRIVE
7-F TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued off, Conservation Division V-W Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ©w Historic - OKH _ Preservation/ Hyannis Project Street Address 7 f, '7�i� + D Village'_ / / / U Owner �� ��! r � .s° 4 MOW Address Telephone S&b gr 3 7 Permit Request Square feet:. 1 st floor: existing proposed �w 2nd floor: existing proposed /1�&,*-Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 4 Construction Typed A ov- Lot Size 2, Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 12�' Two Family ❑ Multi-Family (# units) Age of Existing Structur Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: r�Full ❑ Crawl ❑Walkout ❑ Other Co Basement Finished Area (sq.ft.) 1/0- At It', Basement Unfinished Area ( ) 0 lT' C= Number of Baths: Full: existing 2— new Half: existing new - : Number of Bedrooms: existing _new r X Total Room Count (not including baths): existing 7 new NON•C First Floor R om Couo. . Hdat Type and Fuel: ❑ Gas, UKOil ❑ Electric ❑ Other Central Air: ❑Yes o Fireplaces: Existing 4 New Existing wood/coal stove: ❑Yes UK Detached garage: U existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: Elexisting ❑ new size_ Attached garage: Elexisting ❑ new size _Shed: blexisting ❑ 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) y Name Telephone Numberr `� Address"�� / llr "b� �l License # Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR -DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED, MAP/PARCEL NO: ADDRESS ' VILLAGE OWNER _3 a DATE OF INSPECTION:. r FOUNDATIONS FRAME �KIV WN INSULATION � t t &1494 ( FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL . GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Town of Barnstable Regulatory Services i s sn MASS. Thomas F. Geiler,Director 16yq. Building Division Thomas Perry,CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstabIc.ma.us Office: 508-862-4038 Fax: 508-790-6230 PLAN RE`'VIEW z.o t Lt Owner: *S&AJe-r96& Map/Parcel. ��3 060 Project Address 97 U)t u'I*f¢-izCe R Builder: 1VI The following items were noted on reviewing: VUuz+ 0vt o-a-t ` e- R e-ALA-\re-me viI-s e -F01 L LI d . A lope.lG0+8ce,_ f'ikCts b .oravia�e . Reviewed by: Date: 'EllaZ( K Q:Forms:Plnrvw f f[te Comrrronygmkh of Vassachuscls De wftnent of fndmsk cal Accidents- Office.of f wesagalions 00 Wasshmgfow&reet Boston,MA 02111 wniv. nasmgo-ldia Wbrkeis' Campensatian Insurance Affidavit:Builders/Contract-orsMectricianMumbers Applicant I>afarmafi�n Please Print � . b:. PI Name(gmkem(O fion/l &vidnal): 419 16-1 City/Statr_/Zip: G�S 0 IV s 1- Z1.5 ..g- S,6 P' ;K Z e /e;3 _ . ...-Are you an.employer?!Checktlie-_app.3�gpriateboz=--- --- -- _-_._-- -_ ._.. _.... - T. of o"ett.•req 1_❑ I am a employer with 4. ❑ I am a,general contractor and I employees{full andlorpart-time)_ * have hired the 9Ya-contractors 6- ❑New oonsfrxx Lion 2:❑ I am a sole proprietor or partner- listed on the attached sheet 7- ❑Rem,odeliag ship and have no employees These sub-contractors have g- ❑Demolition worlang for me m any capadtjrm employees and have workers' 9_ ❑Building addition U90.workim.camp.Maxanre comp_ins ranval 5_❑ We are a corporaticagand its 10_�metrical repairs additions required-] 3_ ,am a homeowner doing all work of&.zrs have exercised their 1 L[]Plumbing repairs or additions Myself[No workers'comp- right afeI(,!D tan r,per have n 12-0 Roof repairs itrst>;rance required.]T � �152,§1(�,antiwe hati*e no effiployees.[No Workers' 13-0 Other cam_ms xanm required. *Airy zDpbcat dirt chedss boot IK toast also fill out the secfian below shaving rhea aodtets'compenssliau pnlicp infntmatiaa. i Hnmeawners who submit this off davit itffcjtarg dv y am doing al undo m4 then hat oat a&contractors nmst submit a nZw afdsc ii in.isr�t�na sarli Icanhactots that check this box mast sttscbed sa additional sheet sbvwing the nmne of the s xlon and state whether ocnot tb ase Mies hmm tmzphtyees. If the sub-contncfots have exnpI65- s,tlhey nntst provide their workers'comp.policy number- lam ara employer iFiat is prm id&W tvorkers'conq;eu anon irmirance for nzy am pkyecu Belau is the poYiT and}ob si5 e infotmalion Insurance Company Name: Policy#or Self ins Lim Fxpiratio:nDate: job Sites Address CitylStatelzip: Affac hL a copy of the workers'compensation policy declaration page(showing the policy number and expkation date). Failure to secure coverage as regairedunder Section 25A of MGL c- 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.Oa and/or one-yearimprisoum:ren�as well as civil penalties in the form of a STOP WORK ORDER and a fine ofup.to S250-00 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 verifcatiosi_ I do hereby a the irs nd penalties ofpet�tuy that t he information prcmided above is trice,and correct Simature: Date: 3 Phone 4: O fj`dol use oniy. Do not evrite in this area,to be completed by citj or town off ciaL City or Towa:. PermidLicense# L'ssning Authority(drele one): 1.Board of Health 2.Building Department 3.CitTITown Clerk 4.Electrical Inspector S.Phtmbnag Inspector 6.Other Contact Person: Phone 9- 6 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 Iocal 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 arty 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 incnrarnce 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 certincate(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 Otffcials 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 M 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 than 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 burn 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 Tndtrstdal Accidien Office of kvestigafiom Gt)O Washington Street $4stoa,MA G2111 Tel.A 617-727-4900 W 406 or 1-977-I ASSAFE Revised 4-24-07 Fax#Cal? `27-7-749 vi .masS.goefdia f Town of Barnstable L Regulatory Services �oF Toiyy Richard V.Scali,Director P ° Building Division { 4 { F anatasT"M « Tom Perry,Building Commissioner r$ 11 ��� 200 Main Street Hyannis,MA 02601 RFD MAt° www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print �J DATE: JOB LOCATION: number village "HOMEOWNTER": i, name �Q '� home phone# work phone# CURRENT MAILING ADDRESS: ;7/' 911f�11/f9/f/l/f c 0 le 'A/4,f j--J.�/f 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. DEFMITION 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 fans 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 igned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection pro d 2ments and that he/she will comply with said procedures"and requirements. e o m...r 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 form/certification for usein your community. Q:\WPFILES\FORMS\building permit fonns\EXPRESS.doc Revised 061313 � E T Town of Barnstable Regulatory Services r t San MASS.teg Richard V.Scali,Director 1639. �0 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 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- (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. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:O WI,MRPERMISSIOI\TPOOIS MENEM wwiwwwiwiwwi■■i■w■■■ MESS ME EMSEEMMMMMMMEMEEMEEM EMENNE o�MEN ONEME ME= ESEEEEEEMEE�MEMo ■ MMME� SSE ,^ � oM�SESSEMi�oMEM ED-�EI ll_EM so QUEENIMERRIVE MMEMMEME mmm_- -�Mmlmilm ■�� "`.es ' ..ram;!.rlr...n... .. .r.... .••n.. ..-r--..r .r+.i.. i1�e.A�ei..y n. is s.�r�iwr v� �►. � rs.rc- r� a ; M ISM so No _ M RE/% ■loWOMEN olio \ MONSOON NME me E11 I mollimill WA MMI-16, MENEM OEM liW°E�ESM�mini ISMI�E � ■ loot SEEM ME ■IMON ISM MEN MINIS IME EES■MEMEME000SM EMEMoESMEE "ANN MEMSMMEwMMEEEME AMEN ■ Eo■MMEMMEN EmEE�wwSM��1Ml�MESEMMMEEEMMME != +— !" �- � , ,. ��,�• I .� , .n _, 9 � 1 .� i -_ _ _ .. f Lo-r IO2 14o.oc) Lnr IUI 2Z, OSo s.F, kAj DEGK "v)St L.D T 1�L STb nr D k.2 U G 64eAq * ,7g 57 WILLIMANT-1 DRIVE �o� RON�4LD .cyan NATOIJ. 0 o;:3pMp om , '111 i S ew� �„Q� abate i Ioly), �27�e m� -e -fir A� � 4-o S-�e-�- Lor 102. IDS. ,40.ob .. - LDr tol 2Z, Oso S.F, DEC �T �06. ► �St _ J�L STZ) • D Wf1 LI N C GA12/FGF f1 Q IIR� s7 .. 111LLIM NT1 DRIVE R�NALD cyGN NATULJ. ,,, Gol Scale: 1 �( � D P 6FtS NA` `•fitb SUR OR. ?` D HEflEBY CtATIFY.'THAT THE A-M:ERICAN SIJRVEYI•NC'GO,.,,_.-' NY: :•..: BOVE MOR . 'A F :INSPECTION :? P AN.�yAS p 1264 Main Street, Walthann, MA 62451 7 , 3-6477.. CONNECTK?fV WIT (ANEW MORTGA►G E AND 13 NOT 10_&AED OR REPFM- SENTED TO BE A.(;AI�Ib.QR PROPERTYa '::>r.. LINE SURVEY. 1dQ C06jNERS W$q THE L�'CATIQN OF THE 11RIGINAL RECOR y D I T . 60U1JTY pEGISTRY OF DEEDS SET. IT .;. l73'ED FOR Eat DWELLIN18 9W©.WN HEREON EITHER:BOOK TABt1SHINGF F1tNC)r;:. KEDGE O 1NA8 IN OMPW*NCE WITH THE LOCAL. PLAN RR ERrENCE: Q. . BUILDING LINES.-THE LAND AS SHO . APPLIdME Z4 IING SYLAWS IN EF QRAWN:15tI4?'bWN OF ASSESSOR'S HEREON 19 BASED,tJN:CLIENT FUR. FELT V►►NU 6ONSTRLiT41•WITH.RE P st PARCEL NISHED. INFORM;kTIAN':'MD MAY BE OPECT*1''0 120NTAL @TI N9�fJNA1 ADDRESti�;'` +.' v SUBJECT TO FUATti R: OUT•SA{:ES,: RE OL°I9SSt�i'S ONLY),f,7ft .EX#mi l" ' . s. f::: TAKINGS,EASEMI NI`SUD RIGHTSOP FROM 1- LA''t0N EmPoRCS)yIENT AC= BORRO>)!t! fi?,' WAY. UQ ESP -" TY IS EX TIONUNi?EFtM SS.G L 7'I7Lt:VII CHAP !' TENDEDHEREINI'OTH$LANDOW96 .40A SEC. 7 UNLESS -OT.H.ER-W.ISL� ''UBj.c..T LCING LIES IN FLOOD ZONE � OR OCCUPANT,iT IS f�OT INTgNbED NOTED OR SHOWN HEREDN. A CON AS SHOWN ON NATIONAL FLOOD INSURA C OGRAM FLOOD TO BE RECOADLb..: ...:::;' . FI.F�MC,IK`I'ORY INSTRUMENT SURVEY ,f.NSURAI!s10E RATE MAP DATED 7 DATE fS ADVI!$ D WHEN STRUCTURES ARE COMMLIN -Y_PAtJEL# —_254-3�0!B.o i'• SHOWN TO 8E°.:1 OR LS.S.fROM CLIENT �: �. PROPERTY 6R: .REQUIR€b ZONING. ' F!I ' :Et) b ,AATED EO CLIENT,RF;aw ~ BY .1.O.M 4•_ :;� ' SETBACK LIN°�S, ••:..:• DATE p `.�,.B ` PGE. Assesso?s map and lot -number /a 3 Sewage Permit number TOWN OF. BARNSTABLE i BASISTAIM. : E 101M BRLDING INSPECTOR 4: APPLICATION FOR"PERMIT TO ....... ....V/..f.�.�.........L�..a_8J3.C9..z......................................................... 6 .14 TYPE OF CONSTRUCTION .......... Q..Ga.D................................................................................................. o , /�A Q� .... ... .. :4� ...A..........19.r'/ TO THE INSPECTOR OF BUILDINGS:._._; The undersigned, hereby applies for a permit according to the following information: Location ........./.... .. J/.��f�.. .f ll! (rG..�.....i�.*J... ..c3../.q. ..7P,4.,-.S'........MIr..1IS.j.-M. - ,• 5.......... ProposedUse ... ..... a.lyl /y..... � .................................................................................................... Zoning District .....T.fi.. .......................................................Fire District .....C.'.Y9 4px....................................................... Name of Owner ..1.7'..�. .. .�.....1.� �� 7�.W ��r.. c?/V /.G....�� . ...........V.; . �............ .... .......Address ....... ..�. Nameof Builder ....SA�....F..........:..................................Address .................................................................................... Nameof Architect ...E,) .. L.)'=............................................Address .................................................................................... Numberof Rooms .................... ............................................Foundation ...!EIEM.:CY ................................ ................... Exierior ..W..,00z).........5.. /..�G..L-e.S.........................Roofing ... ...Sf..P.l`1�2....(.T..................................................... Floors ..... .L./ 7...................................................Interior ...C.V.d(.P.D................................................................ Heating ......f.q.N)!�..........................................................Plumbing ..../.yo. ff............................................................ Fireplace ...........I B.N. ......................................................Approximate Cost . ................. Definitive Plan Approved by Planning Board -----------_______-----------19________. Area ..................... Diagram of Lot and Building with Dimensions Fee /...... ................ SUBJECT TO APPROVAL OF BOARD OF HEALTH o5 6, Nov SE Of i aRat;E y.� w G L a ci 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. /� Name ... .rQ, dt......... Ames, Alfred R. \^' . � ^� �mrm�e l7�7� ' . No ................. Permit for ------------ ' � -------------------------- � - 79 Willimantic Drive Location ---^---^-------------- Marwtona Mills --.—.---------------------... . . ` Alfred R. Ames' C�vvner ---___________________ - frame - Type of.Construction -------------- ' ~ � � . ---------------------.----.. � ^ � ` ' Plot ............................. Lot ................................ � � . ^ ' . - ^ � � Permit Granted ...........0ctmbmr...8.........lg 75 - Dota.of |inspecfion q | , �~ | ~ Date Completed . ----'lq - . � ' ^ PERMIT REFUSED � | �� lg ` | — -----------'-------- --------------------------. ----.------.-----------~---. � ^ / ,----.—.----.—.--------.----. � . ` � ' ~ --------.. -----...-------..."— � ' . F ' Approved ---------------.. lA � �^ ` --------------------------. ^ . ° ------------------.-------.. . � � � /.a :� 'l7� <,� Ass ssor'� map,and lot number .................. ...............:.:... _ i Sewage Permit number .. r . 'T"E.r°�° -TOWN - OF BARNSTABLE , Z BAWSTABLE, i t MABEL 9 BUILDING INSPECTOR e am A" � � C co r APPLICATIONFOR~PERMIT TO .............:..........:...................,.....,.......................................................................... TYPEOF CONSTRUCTION .........1. {)./l/14).................................................................................................. ........ ................................19........ TO THE INSPECTOR OF'BUILDINGS: The undersigned' hereby applies for a permit according to the following information: '7 ,*-A Tir �?/7 �i I -q d C .,74r A,I 1 Location ....._................................../t.............. .... ...............................,..:.............................................................. .................... Proposed Use ��' ... ........0. :...............'.............:.....::^.. .................................................................................................... Zoning Districts _...........................Fire District .................`✓�p^� . ....................:........................ ............................................................ 1d Name of Owner .. .....� .. I ......Address .. ; �t 7.. .... � Nameof Builder ... ...............................................................Address ....................... Nameof Architect .... ........ ............................................Address .................................................................................... Number of Rooms ..............................................Foundation .....- ..n:1. .. n�T... ..................... .............................................................. Exterior /Jr',nla f/r; /�'%„' I .p <..........................Roofing ... l=f :.. .T................................................. ' Floors ..............................................................Interior .....�.. ... Heatin ��' r Plumbing '��� ^. r g .............. `?!....:...................................................... .................................................................................. Fireplace .......... f'' h�! ................................... Approximate Cost . ..1���................................................. ................. r' Definitive Plan Approved by Planning Board -----------_______-----------19_______ : Area ...............:......._y...`............. Diagram of Lot and Building with Dimensions Fee ............... ....Y. SUBJECT TO APPROVAL OF BOARD OF HEALTH t orte Oa d �C S ���' F til I hereby agree to conform to all the Rules and Regulations of"the Town of Barnstable regarding the above construction. / Name .. ............�;' -,'.... .�. .. . '':4............ Ames, Alfred R. 03-,60 � ! y " _ T l( 17979.. Permit for. .:,;•gatlage 79 Willimantic' Drive ' Location ................................................................ Mar s tnas Mills ' •. Owner Alfred R. Ames frame , r Type o Construction .............-�....:..................... •• - 5 .......................:........... ............ Plot Lot............ . Permit Granted ......., ..ctob 8?jj 19 75 ` Date.of Inspection k ate Completed ........ .....19 PERMIT REF•SED ' ................................... ................... 19 - ............ ..................................................... .......... ......................... ................................................. - - - Approved 19 ,/ .................... .............................. ....... ......... ... ..................................................