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0318 WILLIMANTIC DRIVE
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'w n N... �..,. �.;l :�w.:�+1..ww�..b+�+...�.�...��.wlr���e�.L.� ./.'^ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# Of EP) U �r,.BAP14 TABLE O Health Division �"-�'�`� 61�10 3 Date Issued �-off" . -3 Conservation Division c003 JUN 20 9; 06 Application Fee � Tax Collector Permit Fee Treasurer C1 '1S161� SEPTIC SYSTEM MUST 6E Planning Dept. IXSTALLED IN COMPLIANCE Date Definitive Plan Approved b Planning Board VIM TITLE 5 PP Y g ENVIRONMENTAL CODE ANE Historic-OKH Preservation/Hyannis TOVWI REGULATIONS Project Street Address 3 / GW i ���r� 4..r i C)v yc Village Owner M rod,reel 'Y A,.,r+c /'?4/y!l3i1 YfAddress . 3 /8' Telephone Permit Request . a�Q/ ar /o .>s -2, o �, y r' aa/o/���� � a//,o z✓ C4� Q � .t/�����ia.-� ©-f �'lr.� /1'�- �Qo� ��o��®�.�+� 7r /oa�✓'oe� Square feet: 1 st floor: existing 7 G 8 proposed 7,5-2nd floor: existing 4 5/m proposed e::> Total new Zoning District IQ Flood Plain . Groundwater Overlay Project Valuation 3 0, 000, oa Construction Type ¢ao a co,d`✓l7.7 o� /As�i- Lot Size .Ode 6 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family e Two Family ❑ Multi-Family(#units) Age of•Existing Structure 4,e_5j4 ,e,& ab%f istoric House: ❑Yes 00ko On Old King's Highway: ❑Yes J21110 Basement Type: ❑Full ❑Crawl ❑Walkout O Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) O Number of Baths: Full: existing 2 new ® Half:existing new Number of Bedrooms: existing new O Total Room Count(not including baths): existing og new O First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil @tlectric Cl Other Central Air: ❑Yes 2r& Fireplaces: Existing l New_0 Existing wood/coal stove: James ❑ No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing Cl new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ONG If yes, site plan review# _ -- Current Use Proposed Use S trims Sli a�oi�'� O(3/9 BUILDER INFORMATION Name -Si �pi�m a..,ild., y Re-� ��11 Telephone Number S�cP - W25F— ��, ` Address License# C .S O-,r 6 9 6.5- VJ -oe« 0 Home Improvement Contractor# /f, � 7 2� Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L3 pu�`7iP SIGNATURE DATE 4�/9�03 t FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. V . r � ADDRESS VILLAGE OWNER y _ ` { DATE OF INSPECTION: N - !o i FOUNDATION fin° 7 .461 : 1 FRAMEK ! b3 INSULATION 103 FIREPLACE yl ELECTRICAL: ROUGH I FINAL PLUMBING: ROUGH ° FINAL GAS: ROUGH' FINAL , FINAL BUILDING C A DATE.CLOSED OUT = ' ASSOCIATION PLAN NO. s � ro The Commonwealth of Massachusetts _- - _ Department of Industrial Accidents gfflce offiryestfga[faos _ 600 Washington Street _= Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: I a �s•a �lr �'�°� location f �'`�/�l �•' ` ��/d C— V ci fy/�'3a�" .• � M� hone# ❑ I am a homeowner performing all work myself. I am a sole rietor and have no one workin m, ca achy %%//Oac/l//i%///GS///4///%/%Q//n%/%/o/%n//%////%S///�o//b/%%%%//G%/G%%/��%///////%%i�/l////%///%/%%% kern co ensation for my P :,,:«:<.;:.;.....:. {{r..>:.:}.:.:>}::.}a•>...:^:;>;; i.4�};-:: >v3?>ti> {`::'::':' errovidin wor .�...... v::.:..}...:.....:.�:.. ens v........\::.::.:....... 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Bred under Section 25A of MGL 152 cars lead to the i„1poaiHoa of criminal penalties of a lineup to si smo0 and/or FWh=to secure coverage as req derSection in the form of a STOP WORK ORDER and a dne of$100.00 a day against me. I underataad that a one years,imprisonment as well as civil penalties copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verldcation I do hereby certify wider the pains and penalties of perjury that the information provided above is true and totted Date Signature _ L3 aP/vim A�A�Phone# 74P� Print name official use only do not write in this area to be completed by city or town official permttUcense# ❑Building Department city or town: ❑Licensing Board [3sdechnea's Office ❑check if immediate response is required ❑Health Department phone#; ❑Other contact person: (�eviaed 9/95 PJA) i 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 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 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 evidence of compliance with the insurance requirements of this 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 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 applican. Please be sure to fill in the perairt/lrcense number which will be used as a reference number. The affidavits may be reta rned'io 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 Office of lavestlgatlons 600'Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 nhone #: (617) 727-4900 ext. 406, 409 or 375 pFZHE Town of Barnstable Regulatory Services awxrrsrAsrE, • Thomas F.Geller,Director Mess. 9�'pTF 6,79. b� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-$62-4038 • Fax: 508-790-6230 Permit-no. Date AFFIDAVIT HOME MUROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERIYIIT 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. 3®% D� 'Type.of Work: Estimated Cost Q�/o�.�T o� � �oi•.• � Address of Work: 3/8 Lv�l1i.•��..���e �� /��'/-1��"J �i� Owner's Name: /17e Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 []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 HOME IMPROVENIENT WORK DO NOT HAVE ACCESS To THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c, 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: /43wf/0� Date' C�ontractor ame Registration No. Y ✓ir U �, OR r, .e Owner's Name I RESIDENTIAL BUILDING PERNMAJ FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET ,W LIVING*SPACE 9 �j2a x.0031= 2-o , ,� square feet x$96/sq.foot= /' • plus from below(if applicable) ALTE:R.ATIONS/RENOVATIONS OF EXISTING SPACE 9 2 square feet x$64/sq.foot= z �p x.003 1= ' plus from a ob l w(if applicable) ACCESSORY STRUCTURE>120 sq.ft >120 sf-500 sf $35.0050 ' >500 sf-750 sf .00 75 >750 sf-1000 sf .00 >1000 sf-1500 sf 100.00 / >1500 sf-Same as new building permit: X.003 1= �` : square feet x$96/sq.foot= STAND ALONE PERMITS N x$30.00 Open Porch = (number) x$30.00= Deck (number) Fireplace/Chimney x$25.00(number) Inground Swimming Pool Above Ground Swimming Pool $25.00 . Relocation/Moving $1so.00 (plus above if applicable) permit Fee y 7t0 CMR Appmd1z 1 ' Tableld,2.1b(continued) prneriptn'e packages for One and Two-Farnity Residential Buildings Rested with FosriI Fuels MAXIMUM MINIMUM g� •Heatirmg/Cmting GIaz3ng Glazing Ceiling Wall Floor 1:u=cat eter Equipment Efficiency, Ar='('/.) U•valuJ R-valuej R-value' R-value, Rw� l vd Ua? package 3101 to 6500 Heating Degm Dayz' Naraial 12% 0.40 38 13 19 10 6 Q (9 19 10 6 Normal R 12% 0.52 30 6 8S AFUE g 12% 0.50 38 13 19 10 N/A Namia[ T 15% 036 38 13 25 N/A 19 19 10 6 Normal U 15% 0.46 38 /NA 85 AFUE V 154/8 0.44 38 13 25 N/A I 85 AFUE W 15'/. 0,52 30 19 19 10 N/A Normal X 18% 032 38 13 2S N/A NIA 19 to Normal y 13% 0.42 38 19 6 90 AFUE z 18% 0.42 38 1—t— AA 6 90 AFUE 19 10 18% O 30 19 I0 1. ADDRESS OF PROPERTY: 0C. Z. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4, % GLAZING AREA(93 DIVIDED BY#Z): D r o/ �- 37 �c 5. SELECT PACKAGE(Q--AA-see chart above): /9 NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFO BUMDING INSPECTOR APPROVAL: YES: N0: q-forms-080303a 780 CMR Appendix J Footnotes to Table A2.Ib: i Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to Mof the total glazing area may be excluded from the U-value requirement. For example, 3 fl of decorative glass may be excluded from a building design with 300 IV of glazing area. 1 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table 11.5.3a. U-values are'for whole units: center-of-glass U-values cannot be used. The ceiling•R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation•thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 4 Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry, log)wall constructions,but do not apply to metal-frame construction. S The floor requirements apply to floors over unconditioned spaces (such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less th 50%below conditioned meat the same R-value requirement as above-grade walls. Windows and sliding glass basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are.for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes elettric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. . 'For Heating Degree Day requirements of the closest city or town see-Table 15.2.1a NOTES: a) Glazing areas and U-values are maximum acceptable levels.Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall, floor,basement wall,slab-edge, or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement o oors sfor tless than ortequa Glazing the U value requirement(0 35 for doors)-weighted average U- value of all windows i ,ypFTHE row Town of Barnstable vJ �O Regulatory Services H E'MAS&q Thomas F.Geiler,Director nsnss. s63 . `�$' prED a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize S�c✓c S�go�� ,P��;A .l'�4�irn JQ�i./o%Fy to act on mbehalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Iqd zf Signature of Owner v Date Print Name Q:FORMS:OWNERPERMISSION _• � �'/e �amirizanG'�ea�i o�✓�aaaac�u�ve�. Board of Building Regulations and Standards i HOME.II C�VEMENT CONTRACTOR RegsEraE o= 09728 jaf�atto4%2004 SHAPIRO BUILDI GRME1 �fEVEN SHAPIRQ;^ 'IF 4 Deer Ridge Rd. ~ _ i MASHPEE,NIA 02649 ` " ` - = Administrator I. 4 p GTfze OARD'OF 6,a i ✓ aaaac�u�ae BOARD OF B;UILDI:G REGULATIONS License: CONSTRUCTION SUPERVISOR i Numbee GS 056965 Birthdate MAW-1955 l EkpiGeS:. 2g 2 04 Tr.no: 7722 Rtrob. 0*0A J 11 r-t� STEVEN M SH-AP Or' 4 DEER RIDGE RDA - MASHPEE, MA 02549 `� Administrator r OLL OL PROPOSED ��,• APPFbN LOT 28 195�8.4 5F. � F GERT 11=I ED PLOT- PLAN LOcnnw-: ,15 WILLIMANTIG.DR., MAR5TON5 MILLS, MA VEN W. `= PREPARED FOR: 6HAPIR0 J�UILDINO " UMBAl rvi 56ALE: DRAWN PY: � G 4d TMW l9NofSS10�P�Q J06 NIMDER: DATE: SHEET: SURIJ 03--ml) MARM 27, W03 GPP-I VIVELLER & ASSOG I AT-ES I(v4 FA-MOL TH RD - SUITE 46 CENTERVILLE, MA OZG32 TEL: (505) 775-0735 N FAX: (508) 775--0754 PROFESSIONAL ENGINEERS & LAND 6LRVEYORS 06 roof ..�f� we!/ .: • I � k j-4 6 jr a s ►w�Py-'f c or 4�v.+��� 1� + ✓Cow R 30 /.0f/ n .r,4 47 rAr /N.�4/��I4✓ 73PO r j 1 j 4 •' i IA Arrf ayV SIT 4 T `\ •`!7 1 L ®lamq - �lw '7),77i s� a 1 Al 1 F1 CD, f r6 a¢ r It/117 le v . ez !/`� -�.` �,/,t�grac� .�'Z.�• �e1`t �:";��a c Y �I'S ti �c�b�r ��•to� .' . � S�i--,/�s � .v 4.%�, ::� .. tit�-'• dc.r it � T, S�GlJL S� ��oiio TOWN OF BUILDIi PARCEL ID 306 079 GEOBASE ADDRESS 285 SEA STREET HYANNIS LOT BLOCK DBA DEVELO PERMIT 64694 DESCRIPTION 10 PERMIT TYPE BADDS TITLE BU CONTRACTORS: PROPERTY OWNER ARCHITECTS: TOTAL FEES: $35.00 BOND $.00 CONSTRUCTION COSTS $800.00 328 OTHER NONRESIDENTIAL B DATE ISSUED 10/22/2002 00-1 10-01 r W O , 3D o Z: 73 `=t r r*� �E*SIN OF CHARLES F. G o FEWo11EN^ STRUCTURAL A NO.34359 ?o��SOON o 3 1 �J i /..�. 4.a�}�.c v c� ��e�.�.a �►s '.l ' �r �+rM/� tti fi.ys.. ev•!/ Flo �''�'t' k•,,,,, W/1 J ` �' t//�v+ ,�+r' we0000 t •- 4 POW /&" Poo; #Aowpv wo Ne• : , 4N do,,—• /N r ��� Z rr � t �3 (3e� �► � e 00 io ' f f f i .__...,i........�^✓ -....._�.uY:�a.Cv:aY..onso+.�.n.ue..rr..........ww�w..n...a..�+.._ �..... -- a 1 ,. /J¢,J o�I � // Al - i r • r) Map I O 3 Parcel O .GO I Permit# 3 / a-7 House# 3 $ Date Issued QQ Board of Health(3rd floor)(8:15 -9:30/1:00-4�;O) Fee d$ .cam Conservation Office(4th floor)(8:30- 9:30/ 1:00-2:00) Planning Dept.(1st floor/School Admin. Bldg.) 1HE Definitive Plan Approved by Planning Board 19 BARNSTABLE. �4 L TOWN OF BARNSTABLE �~ . Building Permit Application Project Street Address 4 Village vAlfl X Asp%atis /11 l45- Owner a Al-A-1 4 /-1 G /mil A N&,5' Address V,, Telephone Permit Request First Floor square feet Second Floor square feet -Construction Type - Estimated Project Cost $ 2 nc�n o T. Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑' Two Family ❑ Multi-Family(#units) I 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 No.of Bedrooms: Existing —New 4 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 Garage: ❑Detached(size) 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 c Name h'� %��Go<l� Ca�l�'7 �Nc• Telephone Number 7-2 S 7 Address e/ 7— ! l License# /o T f�%T1/✓�io�/c l/il c��c���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 DATE BUILDING PERMIT DENIED FOR THE FOLLO G REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. h t DATE ISSUED r '` MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: - FOUNDATION - FRAME ' INSULATION .FIREPLACE ELECTRICAL: . ROUGH FINAL PLUMBING: ROUGH FINAL - GAS: ' ROUGH �FFINA�L ; FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. �I y The Town of Barnstable ""Ot �' De artment of Health Safety and Environmental Services •`° Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissions For office use only Permit no. Date Q ' 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. Est.Cost Type of Work: � d d"� Address of Work: 7G G vy>Z• � /�� ����� — Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under SI9000. 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 HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY i I hereby apply for a.permit as the agent of the owner. Date Contractor Name Registration No. `i OR Date Owner`s Name r The Commonwealth of Massachusetts Department of Industrial Accidents iAl Office 911A7lyeslfga&VJ7S 600 Washington Street Boston,Mass. 02111 Workers' Compensation InsuWMA �rraunc�e�//Affidavit i name: location: city hone# ❑ I am a homeowner performing all work myself. ❑ I am a sole prcmnetor and have no one working in any capacity ❑ I am an employer providing workers' compensation for my employees working on this job. com nny name• o' . ..... ::. ....: ..:..•.. ..::::..::...::.::.:•::... address: city:�• p i©lZ.�✓�//��� e: phone# ��S_ 7 ��-� insurance co. olicv,# t d l ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compennsauon polices: camp anv name address phone#• �' "f.�'��::•::>.::>` :?:�'>.> city insurance co. W� ,i nlicv# :.. company name: address: :...... .. hone#: .. city :. .. insurance co.. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of 5100.00 a day against me I understand that a copy of this statement may be forwarded to the Omce of Investigations of the DIA for coverage verification. I do hereby certi r e p an penalties jperjury that the injornration provided above is truce and correct Signature Date 2 _ Print name i G>���T C.. 4�/dTcS Phone# 7 7 s' �y�•� IN official use only do not write in this area to be completed by city or town olIIdal perndtllcense d ❑Building Department dry or town QLtcensing Board response is required ❑Selecanen's Oltice checitif immediate reap 4 ❑Health Department contact person phone N; ❑Other. lttvam 9:95 P)A) 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 anothe '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 o 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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewz 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 evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. . Applicants r 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 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 retained io 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_ - oHICe of Ines lgatlons - 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 • phone#: (617) 727-4900 ext. 406, 409 or 375 SHED REGISTRATION location of shed(address) property owner's name f X /0� size of shed signature date Old King's Highway Historic District Commission jurisdiction? THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN shed File No: 1 1 5 5 1 Client: Morse & Newell Deed Book: 2 8 6 4 Page: 270 Owner. Michael. J . & Donne M. McManus Plan Book: 157 Page: 97 Lot(s): 28 Applicant; Michael J . & Donna M. McManus CertofTitle: Census Tract No: None Available Assessor's Plan: Lot(s): MORTGAGE INSPECTION PLOT PLAN N/F Harold W. I N Knowlton B A R N S T A B L E _ .. 126.54'- Lot 28 (SheLJ 20 , 000 S.F. ± +, C, Lot 27 BuIkr�ead Conc. cck S #318 O1''; Story Dwe 1 h nq j 00 Lot 29 . �n ��k C 00 lfl :.J 126.54 '± ' Date: 4/10/87 W I L L I M A N T I C D R I V E Scale; 1 "=3 0 ' I CERTIFY TO MORSE & NEWELL, BANK OF CAPE COD AND ITS TITLE INSURANCE COMPANY, THAT THERE ARE NO VISIBLE EASEMENTS OR ENCROACHMENTS EXCEPT AS SHOWN AND THAT THIS PLAN WAS PREPARED UNDER MY IMMEDIATE SUPERVISION . • THE LOCATION OF THE DWELLING AS SHOWN HEREON IS IN COMPLIANCE WITH THE LOCAL APPLICABLE ZONING BY-LAWS IN EFFECT WHEN CONSTRUCTED,WITH RESPECT TO � HORI,;ZONTAL DIMENSIONAL REQUIREMENTS . THE EXACT LOCATION OF THE DWELLING ----- SHOWN CANNOT BE DETERMINED WITHOUT AN D.N. WOOD ASSOCIATES, INC. . !;CCURATE INSTRUMENT SURvF`;' , NOTE: CONSULT AN ATT0RPJEY FOR 12 Welch Avenue, Suite 6 jilTERPRETATION OF LEGAL TERMS, Stoughton, Massachusetts02072 RIGHTS, AND RESPONSIBILITIES AS 1-800-942 (617)344-0202 DELINEATED IN YOUR DEED . ,ASH° As,' -,----_____--- ---- -----�`__-,,I I , \ I ' { �� W i�/�1 �� n ' �`,�� .� • � . - ` 13 sari •, • _ e ti 130. LOGAT/O.�/: SToNS mL I �EtFELC�t/G�t BElojG LoT -79 AS � Pz., sK, /5� 97. OF ahf. LOGOiTZMD OA/ 7WO � y,ro AI /io SNow.V I•N&keoA/ AwD TNogr i7' ;t3' Acti`F �� COiVFOrit�! Tn E r;WAF' M—CAWA/�r. p RaE r Gv, R AY-LfiN/s .of rNE TUKi.V o B6RAJSTABLE � v✓. iR. ^4 h/I./tA/ coNf.ctJCTLzD: ' 27807 SUR�� Yn)e Mo uTlhl , MA S S. aAr�- ; 1 L-QAJ V _ +* r LOCAT/Oh/: sTotiJS L iLEsFECG�t/CEt BE/SIG LOT '741 AS SHOWN PL. sk-; /57 FG• 97. t iyecEelY c!*,tTi Y rwlq'r 77wE �lv�Lvt"dP 'OF �DOES CO�t/FOLtA�! Tn ��' to.t//.t/Cr. o E.ejGE <•�,act 7 oW& 7VWAI O.0 B�i21V STABLE ' 27$07 YA�e M0UTH MA 5 S. Gr� eisor's map and lot number ........./ . . Ass ......... SEPTIC SYSTEM MUST" SE THE Sewage Permit-. number ................... INSTALLED IN COMPLIANCE WITH TITLE 5 i House number . BARISTAX LE, .. .. . .. .. . . ... .. . ENVIRONMENTALCODN AA & TOWN REGULATIONS DN39- A A TOWN OF BARNSTABLE BUILDING ' INSPECTOR APPLICATION FOR PERMIT TO ...tqM L71.0 .. ..... ......... ..... ..... ..... .... ....... ... TYPE: OF CONSTRUCTION ........................ ............................................................................................................. .... .. I.....19........ ..................... TO THE INSPECTOR OF BUILDINGS: The undersigned I hereby applie.s for..a permit accordi�ngq..to t he following information: Location ....... . . 7�.......t.1P.f ........................................ Proposed Use ........ . ... 2 bed-,*nv ........................................................................................................................................................... ZoningDistrict ................... ................................................Fire District ........ .................................... Name of Owner ...................Address ................ .................................. ................ Nameof Builder ..A......... ........................................Address ...90.x7i...... ........................................... Name of Architect .... .............64�, ......................Address ... . ............................. .....................................7............ Number of Rooms ...............................................:..................Foundation .0 �-/ l S................................... Exterior ......d . ............. ...W.&WA ......................Roofing .......... . ........... j.e.,........................................... Floors .... ...............PAXY .... 1 .... ....................................................Interior ...........10 ............................................................... Heating .......... .................................................Plumbing ........ ........................................................... 00 Fireplace ......... .M. ............................................................Approximate. Cost ...........610................................................. Definitive Plan Approved by Planning Board -----------—--—--—----------- Area- ........W Diagram of Lot and Building with Dimensions Fee .......4?!%............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ... ...... .Name .7z P. ...................................................... Construction Supervisor's License .... ................................ MCMANUSI MICHAEL No .... Permit for ....UiX4...PQrmer..... .......SingleJ4MjjyjAWqjjiiqg....................... Location .... ..... Marston ..Mj�j .................................... J.s........................... Owner Michael . c . ........ Type of Construction ..........Fxame..................... ........................................................................... Plot ............................ Lot ................................ Permit Granted .........Ju.1.y..3.0................19 85 Da'te of Inspection /0-/7-�.........19 Date Completed ......... M Ir F- Asses'sor's .map and lot number ...... Q...............Q v FT"ETo w' t Ir Sewage Permit number ................. .g......TJg ...... ....... .... Z DA"S'TADLE, ^ HOUse number ...........-. /........ q� MAM ................................ 039. I o'Ea MAY I►`e0 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............................................ �1iPd dov�rie Q�Ir �0.7M 'c ................. TYPE OF CONSTRUCTION 0 � f�rv1/.....L ..................... ................... ... . .. . .............................................................................. . ......................j a �..4......19f TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 1 q Location ................ .. .?......................GUr/lrwew�` t.7I.V ..�C�r;fu�w Y1.1LZ . . Proposed Use ........ LQ � �Gcckc ".. 2 �PGP YLL! l �J2fLi ................ .... .................. ... ............................................................................. Zoning District ...................f .........................................Fire District � `� -/ .- ���� ..................././..... P. .................................... Nameof Owner .e...�...../.................... ........ ...... ..................Address :............... .. ....... ... ..................................................:. Name of Builder ...................................Address /r?Q.? { S8Q/Y►ZUcc/� lv'~ Name of Architect .... � �CQ kf/VLitr,..C�:.................Address ✓Ok (✓Gt2dbr .�".:f......... ,........... J `. Number of Rooms 2 UST/j S?�f .t. ................................... ...........................Foundation ......................,......................................................... Exterior ......I0(!Y 01�X �.W!!/ Afjq4......................Roofing .... ,pi( h i......................................... . ......:................ Floors ................... ......................................... a I tl� ...................Interior ...........��................................................................... +..... Heating � ..................................................Plumbing eK� :>... d 'u�' ........Approximate Cost 10 'Fireplace ......... ....................:.:......................................... PP Definitive Plan Approved by Planning Board --------------------------------19-------- . Area / .0 Diagram of Lot and Building with Dimensions Fee ���............................................. SUBJECT TO APPROVAL;OF BOARD:401` HEALTH Y' G OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name �!`. .................................................. � 34 Construction Supervisor's License ..v. ..... .� . MCMANUS, MICHAEL 103-83-1/ ' No .... Permit for ...p g*i*id Dormer �' Single Family Dwelling. ............................................................................... Location .......LQ.t..28......3 Ri l.1.iman.t.iq..Dr ive Marstons Mills ............................................................................... Owner Mc.Man.u.s............................. .... ...... . . Type of Construction ......EKA.Ine........................... ................................................................................ Plot ............................ Lot ................................. Permit Granted July 30, 85 ... ....................................19 Date of Inspection ....................................19 Date Completed ......................................19 Ap- j �e TOWN OF BARNSTABLE Permit No. ----------_--------- 1 »nAU ; Building Inspector Cash _ oO'ra YPY OCCUPANCY PERMIT Bond ----______________ "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor 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 Farmer Home Corp. Address i7 bay Colony Ur.,Plyziouth, 318 Willimantic-L., -:,rstors Mfj' Wiring Inspector Inspection date .wee Plumbing Inspector T. f „ Inspection date 4 Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ...................................................... 19......_ .................................................................:::.: ..:.:......:..... ........ Building Inspector I i I , I /11 A tV / C ! v - i ' 39 ° 42-- ' 3 c 'E--� M M T , , O , 3 Z 141 MISN � FOu NuAT4 Ll (� LOT Ze � a.o, 0 0 o S,F, �ROBERT p IV (/ Z , M I j RUN+Klj No.PA20 F CERTIFIED PLOT PLAN Z g" k1l L L/MA•1✓rt c_Lvz1 vE _NEW CONSTRUCTION ONLY : � S 7Z?/VS IyI/L Ls TOP OF FOUNDATION IS _3_1 FEET IN ABOVE LOW POINT OF ADJACENT I A 11 klg I ASJ.9,,WAIsse ROAD. SCALE: / ¢p ' DATE : 91/3 7� `EC DREDGE ENGINEERING CO. IN CLIENT �'� NEB I CERTIFY THAT THE r-0t1A1P4 otv E .'--- ED REGISTERED -- SHOWN ON THIS PLAN IS LOCATED CIVIL LAND JOB NO. 790 Z- OA-- THjt,GROUND AS INDICATED AND ENGINEER ( SURVEYOR DR. BY: 4 -M• COLOR°MS,,;T�O THE ZONING LAWS OF 4, RI ' A BLE , MASS. 33 NO MAIN ST 712 MAIN ST. CH. BY -0 YARMOUTH, MASS. HYANNIS, MASS. SHEET__L OF / _ D.ATE _ { _`:R j G.-LAND- SURVEYOR_ of ' �- 7.4 Assessor's map and lot numbs .................. ..... ............. OF THE To `' SIf=P`IC SYSTEM MUST K' pn^ Sewage 'Permit number ...................�.A. 0............. WI TH ARTD,C E F B9HBST�L97 $J House number ......................�.................... _...................... St Y�➢15��I Y / roo�Mb 9 � ._ S 8�dt1 3 REGULATIQH'S. YF� TOWN OF BARN STABLE� � BUILDING h� 3?ECT0R � ? ' �� 1 APPLICATION FOR PERMIT TO .. �L ,tI.C;.1...... L!�CT.L.F,...� .�.L ..... .Ll.?. : > TYPE OF CONSTRUCTION .......... J001........ . .. :.`..Sr?......................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby ap lies for a permit according toAe following information: Location .......... ..............n�—K.....�,hJ.�.LLLM. %.. ......... Q ProposedUse ...................!... .. . r�+ ��....................................................................................., ........................ Zoning District ...........� ...................................Fire District . . ..4 KZj U—E ........... Name of Owner .!. tg4<Y.�.. .. (-..Address ....\ ...... Name of Builder ..................` I.........................Address ................................SA/ ! ..... ......................... /. d Name of Architect .................... ./.. ......:...................Address \�!�,. «< pp !.V. Number of Rooms � ..lam,. � �A' ..... ....... Exterior P F .............Roofing ...................AsPr1A.L` Floors- .......4:.. .1.. ...!... ..........♦'f`.. .. ....................Interior �.l .j�LK t.�.!�............................ Heating ......... Ash i.A!`l..I...........i: ,�-�.°..............Plumbing .... L. �. r �f. ...... . ........ ...... ................... Fireplace � .✓ �..........................Approximate Cost ........ /..Q 4 Definitive Plan Approved by Planning Board -----------_------_-----------19___ . Area .....�,�� ... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH --BQ/lam ' G I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... 'r .. ... ..........T. ,A. L kBaouer Home Corp. l l�2 otVr� mp ---. v ' dwelling �amiIy — ---'------------------' � Location .......3l8..Willimantic ..Drive ___.. �illa ----------Mars----------------. ~` Owner --.. 'Bomm..Corp....................... �ra�m Type of Construction ----—— -------- . ~ --.------------------------ �" � ^ #28 F1oi�.--------- �� ----------.. . . ~° e�b�� l8 ?8 Permit Granted ---..����---..�.���.]P ~ ' Dote of Inspection| ...... ` Jg - ~--' = - /~ Date Completed - ~ C | ' | ����0� ��F���� ~- �' -_-- '-- ---- - 19 / ................................. - .. / ..*����... ....................... .......................... — .................... Approved . ^ ` -------------r-- l9 ` . . ' --------.-------_.------.--.. ~ , - ~ ' . . .......... ' ' � .� — .i.`...r ..../ / /L. r' I`�.� :,�r✓ d /� /.'ram, !` Gf Assessor's map and lot number .............-- THE ' �oF toy F. Sewage Permit number ........:..........: ................... �`� °+► Z 89SHSTADLB, i House number........................it- ..................... ..:3.....F ............................. 'oNAS& 00 �0 0 ypY TOWN OF BARNSTABLE BUILDING INSPECTOR 1-1 APPLICATION_ FOR PERMIT TO .< .. /�a�`.�T('R I "►' �I r.�. 1 I ��rYi �1�1 � �.,� ... 's! TYPE OF CONSTRUCTION 1 i Z/`�f ) �" tf flit .................................................19.' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ,cation ..........t., .'!"................................ ..1... .:.::!.lt�j�......T lC.:............IVI VVAv4i..!!��.....r.�.�.!.� � ProposedUse .................. . :.�........ .!.?`..:......`....................................................................................... ....................... 1.... .. ..................................Fire District �� � .....S_it �s1 ) !.1 its- //I*-- Zoning ► ` f; d I District ....................................,. (_ Name of Owner .1`.f�/�I I I� �.. �I... .......��r1?..Address ...\Ck .... ............................................... 1 r J 7 Name of Builder � ...........................................A Address r� Nameof Architect ..................... �.. ...........................Address ......................... ::,.... .../ t....................................... Number of Rooms ........................ �. .... ...........................Foundation ........................................ F= El L n�'a ........ Exierior I I t...X LA 0 Ps� �. Il ............Roofing ....................//�C:.0)-\i\ l � ................... .......................................... .......................................... Floors Interior ....... .......................................... ..................................................................................... .............................: Heating. .. .. �•_ ..'...............Plumbing t� t� � ................................... _ ....................................... .. Fireplace ........................ ...............................................Approximate Cost ................................................ Definitive Plan Approved by Planning Board -----------_-------------------19_______. Are .....................................' r} y Diagram of Lot and Building with Dimensions Fee ^�-`�^``............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH r :) I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. l Name .......................................... .......................2 ..... . Banner ouue Corp. u=103 � 20587 No . / � � -----. Permit for ',»�'7— single family dwelling —r.f--------r---'---'—''°------ ` � 318 Willimantic-Drive Location . -------------------' . ' ^ Marotouo Mills ^ / —.'------.------------------ ` � Banner Home Corp. , Owner ---------------------- �~ frame . Typo of Construction -------------- . / ,=. ` 78 . ru,m^ Gna".vp Date of Inspection Date Completed . ' ' � lV � ' � ................... ^�~«�� ,f '� ----' ` . � . ............................... v ........................... - 19 ~ . \ ' -------------'—^----r'-----'' ----------------------^'^^^—' �