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;y ero"r'M"�•irw!1�� 1 6U d0a s ' 0 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map- Parcel-' Application # Health Division Date Issued ZO101 Conservation Division Application Feed �o Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis l� v Project Street Address &S ec..v1 e L,-) A krf Village 0 Sit'v 1 11 P Owner Alec any.._.... ��_QAA,- -, Address 4 m P Telephone S ©43 CA a s 3 4) Permit Request _!�o w►BtrP L.►7 i m d&LJ CQ =K 5�-��\ 0 �- Square feet: 1 st floor: existing3.3 proposed _0 2nd floor: existing proposed _Total new).S•/S' Zoning District Flood Plain Groundwater Overlay Project Valuation �YOO , -- Construction Type im e Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family units) Age of Existing Structure labs Historic House: Yes r9"No On Old King's Highway: ❑Yes &eNo Basement Type: ❑ Full ❑ Crawl ❑Walkout House: Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)_�' Number of Baths: Full: existing_ new _� Half: existing 01 461a Number of Bedrooms: existing _new a Total Room Count (not including baths): existi g _new�_First Floor FToom Coun 6✓� Heat Type and Fuel: ❑Zo ❑ Oil Electric ❑Other cr, Central Air: ❑Yes Fireplaces: Existing C_New _ Existing woodicoal sto7_: ❑. s 0<0 0 0-- ' xisting ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing 't! new size_ Attached garage exi/sting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Autt rization ❑ Appeal # Recorded ❑ Commercial ❑Yes 0"No If yes, site plan review# �IAP � " Proposed Use Current.Use -� - - � p Div APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number bT- q L 6 Co ddress h.O.�o 3 10 License y i 0 Home Improvement Contractor# 1 [ 13 U O a, Worker's Compensation # G l - oG ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO G_NATU USI RDATE s FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL N0. �C l ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION i FIREPLACE f ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ` FINAL BUILDING t "n DATE CLOSED OUT ASSOCIATION PLAN NO:. } r i n The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations _ 600 Washington Street �1 Boston, MA 02111 _ www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): I' QP IP-Am N,- `�{^hQu -,H C_ Address: `N-p. —%-&O K:JJO C&ke_4-v4 1 lk W _tea(;K71_� City/State/Zip: Phone #: LT Are u an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and I - 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. WRemodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.) required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 LEJ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. �&"CAAC,,Insurance Company Name: ►�.tt` i C �.y� TM,kt IAG Policy#or Self-ins. Lic. #: (4c ( -I av Expiration Date: j 1 1 1 1 0 Job Site Address: od9 A/'t�tw� (` 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$1,500.00 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 DIA for insurance coverage verification. 1 do hereby certify f'nder the s and penalties of perjury that the information provided above is true and correct. Si natu ::/A/ < Date: l — O Phone#: t7b — GA 0 �0 Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: S }� A Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." .. Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(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 Officials 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. 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 that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be 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 Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia I ✓ 03/12/2009 14:37 5083932273 NORTHWOOD INSURANCE PAGE 01 DATa(MwDarr'rr► CERTIFICATE OF LIABILITY INSURANCE OP ID TO AG 03 12 09 AR ROGER-1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 7pUCEJt ONLY AND CONFERS NO RIGS UPON THE CERTIFICATE RTIFICATE D HOLDER-THIS CEOES NOT AMEND,EXTEND OR ZTorthwoOd Ina. Agency. Inc- ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 540 Main Street, suite 9 Hyannis MA 02601 INSURERS AFFORDING COVERAGE NAIC I Phone: 508-771-1632 Fax:508-393-2955 INSURER A. AM>:+RICAN I1MENATIONAL INSURED INSURER B: pwnerAl Cweuwlry 1:neucfnow Co• - INSURER C' RpQ ars & Ma=Gy, Inc• Q,Q Box 310 INSURER D: Oatib rville MA 026SS INSURER S: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOVIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS ANO CONDITIONS Of SUCH M POLICIES.AGGREGATE LIM►T'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS wm MM/D LM TYK O/VMJRA110E POLICY NUMRQR DATE OATS EACH OCCURRENCE f$1,000 000 GENERAL LIAWL11Y S$50,000 $ }( COMMERCIAL GENERAL LIABILITY CCI0395 621 03/20/08 03/20/09 PREMISES Ea 00%'QnwMED EXP(Any one person) :$5,000 CLAIM6 MADE a OCCUR PERSONAL 6 ADV INJURY T•$1 000,000 CC10395621 03/20/09 03/20/10 GENERAL AGGREGATE $$2 00O,OOO PRODUCTS-COMPIOPAGO El$2 000,0O0 OEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC COMBINED SINGLE LIMIT s AUTOMOBILE LJABIL(TY (Ea gw(lem) ANY AUTO BODILY INJURY � ALL OWNED AUTOS (Pe(person) SCHEDULED AUTOS BODILY INJURY s MIRED AUTOS (per awdent) NON-0WNED AUTOS PROPERTY OHMAGE S (Per eoddent) ALTO ONLY-EA ACCIDENT i SAMON L ABILITt OTHER EA ACC 6 ANVAUTO AUTO ONLY: AGG S EACH OCCURRENCE s lXcas"M6RELLA LUUV-ITY AGGREGATE s OCCUR a CLAIMS MADE _ i DEDUCTIBLE f RETENTION f X CRY LIMITS ER ywORKIR3 COMPMATM AND A EMPLOYEWLLASRM WC176-00-17 01/01/09 01/01/10 E. .EACHACCIDENT s$500 000 ANY PROPRIETOR/PARTNERIEXECUTIVE L.DISEASE-EA EMPLOYE 1$500 000 OFFICERMEMBER EXCLUDED? M y�dnoriQe MWer E.L.DISEASE-POLICY LIMIT S$500 000 SPECIAL PROVISIONS below OTHER OE8CWm0N OF OPERATIONS I LOCATIONS I VRHICLEB I EORCLUSIONS ADDED ENDORSEMENT I SPECIAL/ROVi8WN5 CERTIFICATE HOLDER CANCELLATION $}ILRNSTA SHOULD ANY OF THE ABOVE DESCRIBED PGLtdes BE CANCELLED SEPDR!THE EO(P DATE THEREOF,THE ISSUING INSURER VML CNWAVOR TO MAIL DAYS VVPJT N NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT,SILT FAIR.UR!TO DO 8O SHALL. Town Of Barnstable IMPOSE NO OBLIGATION OR LIAGILITY OF ANY KIND UPON THE WOUReR,ITS AGENTS oft 367 Main StTOAt REPRESENTATIVES. Hyannis MA 02601 AU RESENT lvys ®ACORD CORPORATION 1988 ACORO 25(2001M) 9` I i Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Construction Supervisor License License CS: 16174 Restriction: 00 �i •` r; Expiration: 5/7/2010 i Tr1! 2377 CHARLES D ROGERS PO BOX 310 OSTERVILLE, MA 02655 Update Address and return card. Mark reason fur change. ors cn� ., soM ono�•rcoaeo Address I.. Renei��al ! ; L.usl ��+e '(Oominrosw�ea� o�✓�Laeaa�iueel�d Board of Building Regulations and Standards Constructlop Supervisor.Lic nse j_.v LicePse.\,CS 16174 IE�Cpir. tlQf_5(7/2 10 Tr# 23727 . e.: r;•o;i.Aq t;;s. �.'� 14 } N. u.,;, ; CHARLES D ROGER&, PO BOX 310 OSTERVILLE,MA 02655 Commissioner j gl-w T — Board of Budding Regula ons an tandar s One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement.Contractor Registration Registration: 100134 I Type: Private Corporation Expiration: 6/9/2010 Tr# 267677 ROGERS & MARNEY, INC. Charles Rogers P.O. BOX 310 Osterville, MA 02655 Update Address and return card. Mark ruson for change. Address Renewal 1_1 Employment Los(Card )PS-CAI 0 SOM�07l07-PGB400 S14- ✓�r. 'V�osnd�ran�oc��.�� n�✓tlauri�.��.le(�a Board or Building Regulations a id Standards License or registration valid for individul use only i HOME IMPROVEMENT CO RACTOR before the expiration date. If found rcturn to: Registration: 100134 'Board of Building Regulations and Standards Expiration: 602010 Tr# 267877 one Ashburton Place Rnl 1301 Boston Ma.02108 I! ;; ,.Type: Private Corporation I ROGERS& MARNEY,INC, / I' 1 Charles Rogers 445 WEST BARNSTABLE ROAD Osterville,MA 02655 Administrator Not valid without si aturc �p1HE Tph, Town of Barnstable Regulatory Services HA ` MASS. v ��. �,, Thomas F.Geiler,Director �A 1639. �0 lE0rV1A�14 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 I, X-ySp'P., CA'26�sll Nc�'M e. , as Owner of the subject property hereby authorize ROGERS & 'MARNEY, INC. 10,act on'mybehalf, --in all matters relative to work authorized by this building permit application for(address of job) J Si ature of Owner -Date �ASEAf f/J'Y �D1WiW CT J , Print Name Q:FOPIMS:OWNERPERIMISSION if ? �� S,��� `� `Town of Barnstable oF.�t+e tx�•.,w:l i1, ,,• *Permit# Expires 6 m ' ue date -�R .2 IBM ;� Regulatory Services Fee xuwszw IA OF 113ARNS ABLEThomas F. Geiler,Director Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstab le.ma.us Office: 508-862-4039 EXPRESS PERMIT APPLICATION - RESIDENTL4L ONLY Fax: 508-790-6230 Not Valid without Red X-Press Imprint Map/parcel Number 3�3 (5 1 Property Address Zqi SEA. %1 eVj %IE DS��2J1�C VResidential Value of Work 4 GO Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address t) 5Eik d f Cvv ACE p STL�YU/Il.l,(.' .�nA D26 Contractor's Name Irl) tL� Telephone Number 56$ =I - 72,155_ Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 1 <7 ❑Workman's Compensation Insurance C ck one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request (check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) Re-side ❑ #of doors Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *'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 r quired. SIGNATURE: QAWPFILEST0RMSlbuilding permit formAEXPRESS.doc Revised 070110 Oa,,,,nzaauea�/ /�«aaaclu�aelta i ' c License or registration valid for indivrdul use only ; _ Office of Consumer Affairs•&Business R'egul i 1001 before the expiration date. If found return to: HOME IMPROVEMENT CONTRpCTQR d i w Office of.Consumer•A"ffairs,andj,, SQ trie's..vRegulation I Registratiorr�-,a 2W 6 10 Park Plaza-Suite 5170 ExpiratioA`1118_/2-011 Tr# 291d9Q° Boston,MA 02116 � r 7� TYpe In rvidualrui EDMUND V.LACEY::JF3 =! EDMUND LACY�J$� fj T 137'STURBRIDGE� Undersecrgtary Not valid without signature OSTERVILLE,MA 02655_5% iVlassachusetts- De rau m -I rt cnt of Puhltc Safe"- Board of Building Regulations and Standards Consstfuctiori`$upeevisoF"Cice j`License. 'CS 75573 Restricted to: 00 EDMUND V LACEY JR � 137 STURBRIDGE DR OSTERVILLE,.MA 02655 Expiration: 9/19/2011 C'ununissiuner Tr#: 4667 - . y The Commonwealth of Massachusetts ( Department of Industrial Accidents Office of Investigations ! El r i 600 Washington Street Boston, M.4 02111 r www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leiribly Name (Business/Organization/Individual): [ l..Ace -12- Address: t3 1 5 Tin 12 (7121 11>r1' tV _ City/State/Zip: .051 U_\/ILt.1� NAlk o265S5 Phone #: SC)'9 22l 72t7 Are you an employer?Check the appropriate box: Type of project(required): 1. ❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet. # 7 ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site + information. Insurance Company Name: Policy#or Self-ins. Lic.#: 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$1,500.00 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 DIA for insurance coverage verification. I do hereby certi un r th sand penalties of perjury that the information provided above is true and correct. Signature• Date: Phone#: SU$ ZZI ''7 7-1S5 Official use only. Do not write in this area;to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or.to construct buildings inthe commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(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 Officials 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. 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 that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be 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 Industrial Accidents Office of Investigations' 600 Washington Street Boston,.MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/cha T r ti Town of Barnstable Regulatory Services yHg Thomas F. Geiler,Director Eo Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis,bAA 02601 www.town.barnstabie.ma.us Office: 508-862-4038 Fax: 508-790-6230 O Propertyvine r Must Complete and Sign.This Section If Using A Builder I, 4190Jr a Kef'F'I E , as Owner of the subject.property hereby authorize •ED L~] to act on my behalf, in all matters relative to work authorized by this building permit application for. 299. 5C-A J It5W Arc_ 05i 6Zdjt_t,L- (Address of Job) VI • 2 23 ci Signature of Owner. Date �rkf�FR�ti. Print Name If Property Owner is applying for permit pleas e complete. the Homeowners License Exemption Form on .the reverse side. 1 �ofitrofyti Town. of Barnstable y�P o Regulatory Services Thomas F. Geiler, Director KA QQ � t639. ,�� Building Division PrEO {1 Tom Perry,Building Commissioner 200 Mairi.Street, Hyannis,MA.02601 wwfw.to wn.b arnstab l e.ma.us Office: 508-862-403 8 Fax. 508-790-6230 HONIZOWNER LICENSE EXEMPTTON Please Print DATE JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURIZINT MAILING ADDRESS: eityhown state rip code ne 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,prm ided•that the owner acts as supervisor. DEFINITION OF BOMEOWKER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which.thcre is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constn}ets more than one home in a two-year period shall not be considered a bomeowner. 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 cornpliancc with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner'certifies that.he/she.understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner 9 Approval of Build ng_Official Note: Three-family dwellings containing 35,000 cubic feet or larger'will`be required to t:o*ly'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 rcquiricd shall be exempt from the provisions of this section.(Section I D9.1.1 -Licensing of construction Supervisors);provided that if the homeowner rngages a persons)far biro to do such world that such Homeowner Shan act as supervisor." lrfany homeowners who use this exemption an unaware that they arc assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for.licerrsing Construction Supervisors,Section 2.15) This lack ofawanmess often results in serious pro ms ble ,particularly when the homeowner hirrs unlicensed persons. In this ease,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The:homeowner acting as Supcnisor is uhimatcly responsible. To ensure that the homeowner is fully aware of his/her rrspons-ibilidcs,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 forn-Vicertifreation for use in your community. a v� 000136 �OFSHE rp� Town of Barnstable *Permit# Erpires itl, frow r issue date Regulatory Services FeeLP RNSTAB[.E, A r � 16 a $ Thomas F. Geiler,Director rfD MAt TOWN OF TABLE Building Division Tom Perry, CB0, Building Commissioner 200 Main Street,Hyannis,MA 02601 , www,town.bams table,ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid fvithont Red X-Press Imprint Map/parcel Number �3$ OZ( Property Address 7—IT9 S ejoh J 16V1 PcJ6 05Te2✓6� . .: [Residential . Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 1 A 1J P PjjD AdnaERt iv !;V-Lao-rr- • Z4q Saltyl�w kJ� Contractor's Name C--QfA%tn/Q V ' LAC-41 5R: Telephone Number S'pS ZZ! -12ts Home Improvement Contractor License#(if applicable) 1 Zq A 1 Fi Construction Supervisor's License#(if applicable) C-5 "I 55 73 ❑Workman's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken-to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors Replacement Windows/doors/sliders.U-Value (maximum .44) #of windows Pr�eciLStr+✓ 'too 5e z%d,'S f'-R.tr✓o* V crvo swDuR- *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. t A copy of the Home Improvement Contractors License & Construction Supervisors License is q fired. SIGNATURE: Q W-fPFILES\FORMS\building permit fonns EXPRESS.doc ne.,4—A nnnuno iKissachuset`ts- Department of Public Safct, Board of Buildin« i.. Rc!rulations.and Standards Construction Supervisor License License: CS 75573 Restricted.to: 00 . EDMUND V. LACEYJR � 137 STURBRIDGE DR OSTERVILLE,'`MA 02655 Expiration: 9/19/2011 ('onnnissioner . . Tr#: 4667 T1. _ Office of Consumer Affairs&Bus iness Regulation License or registration valid for individul use only �_ HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registrations 29816 Office of Consumer Affairs and Business Regulation Expiration:=1=17.872011 Tr# 291490 10 Park Plaza-Suite 5170 �. ==� Boston,MA 02116 Type; Ii cf 11.tlua ;�� EDMUND V.LACEY==JR EDMUND LACY�.R.; F�('V c, _- a 137 STURBRIDGE�•R=-_—11f OSTERVILLE, MA 0265`5 i`� Undersecretary Not valid without signature 1�y t 4 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I' 600 Washington Street °1 Boston MA 02111 www,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): L' L(cCZJ X. Address: It 1-75TuR(39-1A66 0it- City/State/Zip: %rtL4.e Pr 02_6 S Phone #: 5o8 zu - 7Z1s Are you at!employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sttb-contractors have g, ❑ Demolition working for me in any capacity, employees and have workers' 9. 0 Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or addition 3.❑ I am a homeowner doing all work officers have exercised their I LEJ Plumbing repairs or addition myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13P Other OcoR R:CRitC K40 comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'co inpensatio n insurance for my employees. Below is the policy andjob site information. Insurance Company Name: Policy# or Self-ins. Lic.#: 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$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fin of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify rnd r the ap ins and penalties ofperjury that the information provided above is true and correct. Signature: Date: /Z z 0 9 Phone#• 6,0Z ZLI -'72�5 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority (circle one): r 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: / i Information and Instructions I' Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, 4 express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)slates"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work u.unh] acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s);address(es)and phone number(s)along with their certificate(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 pen-nit 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 Officials- . 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. 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 that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be 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 Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia �FIHE rod Town of Barnstable do Regulatory Services vH^ '.�'� Thomas F. Geiler,Director 019. 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 I, as Owner of the subject property hereby authorize 610 L KCZ TR. to act on my behalf, in all matters relative to work authorized by this building permit application for. Z�'i9 S��Gvy. FtJ�. oy,Mt�►/«Lc_� (Address of Job) Sig a e of Owner Date 4i&o�ett'-(9 Vrint Name If ProyeM Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. A Town of Barnstable pIj IKE Y, Regulatory Services s Thomas F. Geiger,Director • 1A"Tr"LE, . i41ASS q� t6jq. ��� Building Division . prfD��yp Tom Perry,Building Commissioner ' 200 Main Street, Hyannis,MA 02601 www,town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 FIOMEONVNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street. village "HOMEOWNER": name home phone# work phone 4 CURRENT MAILING ADDRESS: city/town state zip code The current exemption for."homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION 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 farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such. "homeowner"shall submit to the Building Official on a form acceptable to.the Building Official, that he/she shall be responsible for all such 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 undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department. minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 1,09.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to dQ 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,Section2.1 S) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC r' � r t � f M � i •' i � A. A (f7) Iq if L� - 7U, M � . - � - . - � '. y i I ' i ,��. -- I � I e - , . y. i i i I - as C-) L ENERGY C.'ONSFRVATZON APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE,- AND TWO-FAMILY DETACHED RESIDENTIAL'CONSTRUCTION (780 CMR 61.00) Applicant Name: r✓S Site Address: ` prim Town: ` - Applicant Phone: — 06 Applicant Signature: Date of Application: 10 14f _Og. NEW CONSTRUCTION: choose ONE of the following two'o Lions 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENIT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS 1vtAXtvrtlM MINIMUM Ceiling or Slab QOption 1: Basement Fenestration exposed Wall Floor Wall Perimeter kFUE HSPF SEE] U-factor floors R Value R-Value R-Value R-Value R-Value and Depth National Appliance Energy R-10, Conservation Act(NAECA)of .35 R-3 8 R-19 R=19 R-10 4 ft. 1987 as amended,minimums[)[ cater as applicabIr Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: REScheck Version 4.1.2 or later variant software analysis must be completed 780 CMR 6107.3.2 REScheck--Wtb which can be accessed at http-://www.(,-ncrgycOdCS.gDvhrschtck/ ADDXx O1�IS;OR ALTti' TZONS.TO EXISTING BUILD "****d R'5 YEARS OLD* *)3uildings under 5 years old must use option#1 or 42 in New Construction section above. Complete the following formula to determine the %o of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b _ a) SF — 10o x 1 A l = 3 4Ott = &SD % of glazing b a (b) Glazing area equals SF If glazing is<--40%.u9t.the chart below. If glazing is > 40 % rocee.'d to "SUNROOM" section 780 CMR 'TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA.ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM NQNNDvIUM Ceiling and Slab Perimeter Fenestration Exposed floors wall Floor Basement Wall R-Value U-factor R-Value R-Value R-value R-Value and Depth 39 R-37 a R-13 • R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be ased in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e. not compressed over exterior walls, and including any access o enin s). I SUNROOM—An addition or alteration to an existing building/dwelling unit where the total 0 glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form found in Appendix 120.P Engineering Dept. (3rd floor) Map 3 R' Parcel 11 c) / Permit# o� P House# ��9 a Date I pdr 10/2//92 Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) g'a - S Y � Fee a.1 �SYS E h Q n Conservation Office(4th floor)(8:30-9:30/1:00-2:00) ® *IVVI e�°ly�cotwpL � Planning Dept.(1st floor/School Admin. Bldg.) � O� Ce �p �.: S Definitive Plan Approved by Planning Board 19' �: Aft BARNSTABLE.MARIL ) TOWN OF BARNSTABLE - Building Permit Application Project Street Address �_q ct e A V t eVj 1a y e_, Village(r)_,Je c o'M e- Owner �a1nQ�+n 1Nt r i n�nwc� �r a��e12., Address `lQ l c��wau ���p� nk�n ����N5 0 `7 Telephone /( p a Permit Request l l h Q l- ti 1%1 n 1 N e ( I %m o e r IESE First Floor (,6 7� square feet Second Floor square feet Construction Type PaV�A- P Estimated Project Cost $ .120 30o. Zoning District Flood Plain YPc- Water Protection Lot Size I,32 04er.5 Grandfathered ❑Yes ❑No Dwelling Type: Single Family !]' Two Family ❑ Multi-Family(#units) Age of Existing Structure So Historic House ❑Yes la No On Old King's Highway ❑Yes ErNo 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 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# Y Current Use Proposed Use Ste, :5 ` Builder Information Name Telephone Number ,rn 0-6 t0A Address l( 3I n License# 19046so Home Improvement Contractor# 106(Zj Worker's Compensation# WcgS' ?$OLD? 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,;O g Cz Mckeck"6rr- e (�QLA&FAVQ SIGNATURE DATE ne JE, 1922 B I"INGPERMIT DENIED OR THE FOLLOWING REASONS) � � A FOR OFFICIAL USE ONLY PERMIT NO. ' DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE d^� OWNER - DATE OF INSPECTION: FOUNDATION FRAME s INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBINOc�. ROUGH FINAL GAS-- ROUGH FINAL FINALI TEDING DATE CLOSED'OUT p; ASSOCIATION PLAN NO. l Engineering Dept.13rd floor) Map 3 Parcel Oo;) Permit# House# Dat sued2 Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) FAT a p Y�TERI It ,V. w Conservation Office(4th floor)(8:30- 9:30/1:00- 2:00) ENVY h/��H T�TOMS LIANCE Planning Dept. (1st floor/School Admin. Bldg.) ��NME E 7'04,p4 ri R r F AND Definitive Plan Approved by Planning Board 19 BARN ABLE. s MAM TOWN OF BARNSTABLE Building Permit Application Project Street Address a 9 q S ecav �e u 9 A J e. . Village ('`hAevu,l)e, Owner l\\•r " la�c,n r��,c►.n� ern c,P_�2_ Address 'Ng"e_ Telephone 4 2 9 - (I 10 h Permit Request vcis '%N c- e- LV►4 pyr L5111 V.-Ack (. ,L'4-e_ -ci4oir- qiAev4 2CLM AS c e w 14, z First Floor square feet Second Floof U u� ware feet Construction Type Estimated Project Cost $ Qp, rjp(7 Zoning District PI--f= - Flood Plain Water Protection Lot Size 1,11 tic 9_t S Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family p Multi-Family(#units) Age of Existing Structure Historic House ❑Yes to No On Old King's Highway ❑Yes tA No Basement Type: ❑Full ❑Crawl ❑Walkout p 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 Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas L1 Oil p Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes p No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) O None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization p Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use _ Proposed Use Builder Information Name \AC, Telephone Number a 2 9-6106 Address License# 04 3 8 Cl A Home Improvement Contractor# th« 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-16 to SIGNATURE DATE Oec 1'7 I Q 9 7 BUILDING PERMIT DENIE FOR THE FOLLOWING ASON(S) T FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED .,MAP/PARCEL NO. i ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL, PLUMI3,I1TG: S ROUGH FINAL GAS: .. t# ROUGH FINAL FINAL BUH3? Gi ., . DATE CLOSED OTUT', ASSOCIATION=PLA,NO. >> q �� i�.,,..,..,,,�.,yy✓�wL.,�e.-sg-"t.:-SA�f�..ti1.�`-�...a'1 '}+w"-.+t:a", -h.r+`^-�,t ..1.� -�d-w.n.n:..K.ryrw�',r '_n-*- Engineering Dept. (3rd floor) Map Parcel (� Permit# House , �%� Date Issued I��/��97_ Board of Health 3rd floor 8:15 -9:30/1:00-4:30 Fee Conservation Office(4th floor)(8:30-9:30/1:00 2:00) - r Planning Dept.(1st floor/School Admin. Bldg.) DIME Definitive Plan Approved by Planning Board 19 t - BARIMABLE. MASS16 p �ED fAP�s� TOWN OF';BARNSTABLE Building Permit Application Project Street Address 29 u, Ao Z Village Owner (�\c . a�,,nn��,n w► nrn c�A ?_ Address e_. _ Telephone -Q 2_t3 - I O h I' Permit Request S-�y t pc tsk' r ceA c-. � A e e.. 4W 1 AY."e i ,cls�� v. ) � cPC- 'qiAek4 z4a V a,0 cn a hl�i ti vv��. / n v , c,a Yew✓i / First Floor square feet Second Floor v , square feet Construction Type Estimated Project Cost $ 4 o I non ' Zoning District Q-t- - Flood Plain Water Protection Lot Size 1 32 AC 9-s g Grandfathered ❑Yes ❑No s� Dwelling Type: Single Family U Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes `p No On Old King's Highway, ❑Yes. � j No Basem of 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 _ 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 Vie S, � � �c3w,`�� Proposed Use Builder Information Name 1\\.n�,�eu `C-�nc„ Telephone Number -4 2 f3- 6106 Address 9,K co License* 04,3 g cf 4, 0_s Pc v" I e. . Home Improvement Contractor# i nn t 3�q j. 7 r; V- i 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-16 Inc, SIGNATURE DATE Dior- 17 BUILDING PERMIT DENIEY FOR THE FOLLOWING REASON(S) T FOR OFFICIAL USE ONLY j PERMIT NO. M •DATE ISSUED I MMAP/PARCEL NO. ADDRESS VILLAGE v OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ` '• ' ELECTRICAL: ROUGH .. FINAL i PLUMBING: ROUGH FINAL GAS: ROUGH ` FINAL` FINAL BUILDING , DATE CLOSED OUT- + ASSOCIATION PLAN NO. ' o • The Town of Barnstable NAMS Department of Health Safety and Environmental.Services Building Division 367 Main Street,Hyannis MA 02601 O1E= 508 790-6227 Ralph Cmsscu Fos 508775-3344 Building Comm For office use only Permit no. Date ' AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMITAPIUCATION MGL c. 142A requires that the"mconstruciion,alterations;renovation,repair,modernization, contusion, improvement,.rcmcnal, demolition. or construction of an addition to any pre-rxdsting owner oeargied building containing at lout one but not more than four dwelling units or to structnts which are ad}accnt to such rrsidencc or building be done by registered contractors, with certain=eptions, along with other mquircmcnrs. Type of Wont: _ r04 4 s i FsL Cast O oc�o Address of Work: 29 4 _��,4�► per. �.ie Qstery.11 0,%mcr.Namm K\ Date of Permit Applicuion: 9 9 fz I hcre:bv ccnifv that: Registration is not required for the following rrason(s): Work=eluded by law Job under SL000 Building not owner-occupied Owner Pulling own permit Notice is hereby given that: OWNERS FULLING THEIR OWN PERMIT OR DEALING WITH I7NREGISi t, CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c I42A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the cmmer. Dec- i? _g 1 997 . Rbcec5 A 1\\QAVlf4 MAC- Date Condactor name j Regisuation No. rF _ The Commonwealth of 11lassachusil Department of Industrial Accidents � �-.. _= olrceo//m+es6galiens 600 Washington Street ' .=~ Boston,Mass. 02111 Workers'Compensation insurance Affidavit me: 1pGatinn• city hn ❑ 1 am a homeowner performing all work myself. Q 1 am a sole pfoprietor seed have no one working in any capacity ®'am an employer providing workers'compensation for.my employees working on this job. ra an n 9zhone, I O'b insura ¢t 1. olio 'H 80 ❑ I am a sole propriet eneral contractor r homeo ner(e!n ie one)and have hired the cortaactors listed below who have the following workers' corn ensall po ices: !Dm•�tnny r9ri cc 0, :. .. .. . tptn tan . . � � • -insurance cOr - tiolicV#' ' a _ Failure to secure coverage us required under Section 25A of 1,11111]i1.152 can leaf to the imposition 1,1'critninal penalties o(a I up to Sit5o0.00 an&ar one years'imprisonment as well as civil penalties its the furm of a STOP WORK ORDER and a fine Of$100.00 a day against me. t underhand that a copy or this statement may be forwarded to the()Mce of Iovestigatinas of the B A for coverage verification. I do herehv certify carder rl a pains and tna/tt ojp jury Mat the information provided above it tray and carrm. Signature ate 7 ( Q 12 Print Hume hone# 2-5— 6106 nr4tial uac nnty do not wnte In tbia area to be completed by city or towo otfieim, city nr town: pertniUlieennc it Building Department Q check if Immediate response is required Q1,ieenaing EtasrdQSclectmen's Otrec contact person: QHcaith neparlment phnat p; _ Other .tmiad troy PJA! "••• 1M/DD. ............ .......... NYISUEDATE 08 06 97F IN T . rxouucER -FOLIC CLRTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TILE CERTIFICATE HOLDER.THIS CERTIFICATE W.H. E$ BAUGH INS . AGCY. INC. DOES NOT AMEND,EXTEND Olt ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 805 WEST MXIN STREET HYANN I S, MA 02601 COMPANIES AFFORDING COVERAGE CODE sua-cone COMPANY LETTERA EASTERN CASUALTY COMPANY B INSURED LETTER DAVID R. COX D B A COMPANY / LETTER C DAVID COX REMODELING P.O. BOX 401 COMPANY LETTER D SOUTH YARMOUTH, MA 02664 COMPANY E LETTER THIS IS TO CERTIFY THATTHE POLICIES�OFfiN••�S�� INSURANCE LISTED HAVE.... E..E...N ISSUED TO +' INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRA T OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLIO DESCRIBED HEREN4 IS SUBJECT TO ALL THE TERNIS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDyi ED BY PAID CLAIMS. CO POLICY EFFE IVE POLICY EXPIRATIO LTR TYPE OF INSURANCE POLICY NUMBER LIMITS DATE(MM )NY) DATE.(MM/DDNY) GENERAL LIABILITY GENERAL AGGREGATE S COMMERCIAL GEN.LIABILITY PRODUCTS-COMP/OP AGG. S CLAIMS MADE a OCCUR. PERSONAL&ADV.INJURY $ OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ v J FIRE DAMAGE(Any one fire) $ M ED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE ANY AUTO LIMIT 5 ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per Accident) $ GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACIIOCCURRL•NCE E UMBRELLA FORM AGGREGATE E OTHER THAN UMBRELLA FORM STATUTORY LIMITS A WORKER'S COMPENSATION W V 2 0 0 0 8 3 4 0 7—15—9 7 0 7—15—9 8 EACH ACCIDENT E..:..,....:.10.0.,•0..0..-. AND EMPLOYERS'LIABILITY DISEASE-POLICY LIMIT S 500, 000 DISEASE-EACH EMPLOYEE $ 100, 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEIUCLES/SPECIAL ITEMS G` 7C ..A. t� Ci................. :....... ......... A N.. C, tTXl�N............................................................................................................................... ::. .. ..... . ... i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE y ROGERS & MARNEY #' EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL10 DAYS WAITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE ( P.O. BOX 310 LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR `I LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. ( OSTERV I LLE, MA 02655 AUTHORIZED REPRESENTATIVE #12773-5* d .. ...... ......U.....:.......RPORtk' IU... .:.. 45055 DEPARTMENT OF PUBLIC SAFETY 45055 ONE ASHBURTON PLACE, RM 1301 BOSTON, MA 02108-1618 CONSTRUCTION SUPERVISOR LICENSE Number: Expires: Restricted To: 00 P o ROBERT J COOK MAR 1 7 Detach bottom, fold sign on PO BOX 495 back, and laminate license card. FALMOUTH, MA 02541 ®° �'• �' ' Keep top for receipt and change of address notification. 'i HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building ' Regulations and Standards One Ashburton -Place - Room 1301 Boston , _Massachusetts 02108 j . ' HOME IMPROVEMENT CONTRACTOR Registration 100134.- Expiration 06/09/98 Type — PRIVATE CORPORATION Registration 100134 ROGERS & .MARNEY , INC . Type -. PRIVATE CORPORATION Charles D . Rogers e Expirations. 06/09/98 PO Box 310 Osterville MA- 02655 ROGER5 & MARNEY, INC.. Charles D.-Rogers p0_,Box 310.. • �`�''"°� ��U"sterville MA 02655 ADMINISTRATOR - r The Town of Barnstable $ Department of Health Safety and Environmental Services Building Division , 367 Main Street,Hyannis MA 02601 Office_ 508-790-6227 Ralph Crassm F= 508-775-3344 HOding Comm For office use only , Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACIORLAW SUPPLEMENT TO PERMIT APPLICATION MGL c I42A=pins that the"reconstruction,alterations,innovation,trpir,modernization, common, improvcmenL,rtmonal, 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 saucan=which are adjacent to such residence or building be done by registered contractor,with certain r ons, along with other ttquirztncnts- Typcof Work:\Y&aj T:7rAyAe beck Est. Cast ?1213��� Address of Wont: 29 4 O%mcr.Name:Nk-,r Vic " t MQ l-\1%N NCB �Ci 11PTZ Date of Permit Application: IS ( )A I hcrtln•catifv that: Registration is not required for the following inason(s): Worst crciudei by law Job trader SLOW Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THF3R OWN PERMIT OR DEALING WIMIIRREG D CONTRACTORS FOR APPLICABLE HOME INVROVEMENT 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 tmmcr: ,Je c� 47 oer5 ��e.•�w� Sir,. 10a13q Date Contractor name J Registration No. The Commonwealth of 11fassachusetts ! Deptrrtrnenl of Industrial Accidents '� � = � 011iCeio/In�estti'ga1�s U _ 600 Washington Street Boston,Mass. 02111 ^ Workersl'Compensation insurance Affidavit n8rne: Cation- city h ❑ I am a homeowner performing all work myself. ❑ lam a sole proprietor ttttd have no one working to any capacity am an employer providing workers'compensation for my employees working on this job. eit 11 S. -6106. " !BSnr�nee — + 0.S U olio # [ run a sole proprietor,general contractor,or homeowner(cln le one)and have hired the contractors listed below who have the following workers'compensation polices: i. s�tp-pang nlrne• ee e rG� .�tn Pe��� • ID9Ur8riee co. '' 'policy H• .. I ' tpin tan . an.us�ance CO. .. r Failure to secure coverage as required under Section ZSA of MG 1.152 enn lead to the imposition of criminal penalties or a fine up to 51,.509.00 and/or one years'imprisonment as well as civil penaltic9 in the furm of a STOP WORK ORDER and a fine of$100.00 a day against Inc. t understand flint a copy or Iltis statement may be forwarded to the WrIce of rovestigatinnu of the DIA Me,coverage verification. I do hereby certify under a pains jd ens ies ofperjyry that'IGe u{forntotion provided above is true and correct. Signature Qarc Print numc--2el 9%,V37 hcnc ri nl•licial use only do not write IIt this area to he completed by city or town offcimi city or town; perinMiceaac N r Tsuilding 0epartmenl Q check if immediate reapnnsc is required [31,ieeniiiap Board 0Selectroen's al lcalth Department Office contact person: pdnae k• —Other trevicM M95 PW Information and Instructions Massachusetts General Laws chapter 152 section 25 req►tires all employers to provide workers' compensationTor their, employees. As quoted from the "law",an employee is defined as every person in the service of another unider'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 0ui1dings 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 AATn act for the performance of public wotk unt%il,aicceptable evidence of com_pl_iance,with the insurance requirements of this chapter have been presented to the contracting authority. a Applicants Please fill in the workers' compensation affidavit completely,by clieek ag the bou that applies.to.your situation and supplying company names,address and phone numbers 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 cite 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 regardiitg.the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retumed to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would 1 ike 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 owice of tmresoiwons 600 Washington Street Boston,Ma. 02111 fax 4: (617)727-7749 phone#: (617)727-4900 ext.406,409 or 375 ✓fie �anr.-»ra�zueal� o�./r + uaeCtt'I oa?��r ENS OF eUSLIC P2Elr 5 5 0 6 2 TICENSE �?�; NOOa �= CONSTRUCTION SUPERVISOR ��.... KuE_ ti, E.,gires: 1 & 2 ?ali'!y ?O:ues LO ��?:5?:& d current edition 0i tGe _ . Re tric,uq. �: T !+?ss,rhes?tts State Pd ildia9 Cade i5 C3US2 for re"OCatiO^ OI this liCens?. 9 ?CND VIN C? CZN;TERVILL A. -Pam HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building Regulations and Standards One Ashburton Place — Room 1301 Boston , .Massachusetts 02108 j . . HOME IMPROVEMENT CONTRACTOR 1 Registration 100134. Expiration 06/09/98 — Type — PRIVATE CORPORATION 0-ElW006.6 , 6e Registration 100134 ROGERS & MARNEY , INC . Type -. PRIVATE CORPORATION Charles D . Rogers a Expiration.. 06/09/98 PO Box 310 Osterville MA 02655 R0GER5 MARNEY, INC.. Charles D.- Rogers G� 0'Box 310. terville MA 02655 ADMINISTRATOR -Asse'ssor's map and lot number �� � �,+... oFTNEtc �, ............ . QV �y Sewage Permit number 8�...... ...../....�........................... i Z BARNSTABLE. i House number ........................................................... 'oo M 9. 3 `e 11 MPY a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .. l ...... -`}. . t /(a.....r :. ..r /! t ^ ......................... 1G,�.,,. TYPEOF CONSTRUCTION ...:.:.-...........,.............................................:.........1.......................................................... J r ...................................19 ...� J - ' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 'f r :n,.........�.r r r ' .................. ..................................................................................................................................................... Proposed Use .....r ja,� .cam;x ,-a�'i ... ?.s. f. C as , ? ............................................................................................... Zoning District ...................... ................. .............................Fire District .... 2 .-: n fl ,�U2 NN Name of Owner' Name of Builderf _ .............Address ......... L Name of Architects! /•�c.....t Pfilr�.r x ...................Address i11-1 rr n,�!,, .' .............................................. �. y, .. Number of Rooms .......................................................Foundation r�. !., �...C,;!......'. i'Lvt r ._.. ...... !:................................ Exlerior ...............GrJ. ...........................................Roofing ......may } ..;1as� Pj!- gj%f1(��? ...................... Floors -� �' tiEl, ./J". t:- -,. .Interior / !'w,, [✓5!�!V � f'l( ..................... ............................................................. Heating. �! :i. ,:.. .:��-?�r�c ........................Plumbing - ...........,. .......................:.................. Fireplace ......s... ...........................................Approximate Cost ........`�1 r1 , r'1,�( Definitive Plan Approved by Planning Board ----------------_------------- �r ....a/./.. ........ Diagram of Lot and Building with Dimensions Fee .� 76' SUBJECT TO APPROVAL OF BOARD OF HEALTH Nis _ 1 — No / t a Zr- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS r --'� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ........ j ROBINSON, PATRICK & SUZANNE A=138-21 2 No 4562Permit for ..ADDITION Sin.......................le Fm y.,Dwell ng ............... ; Sea View Avenue Locatio . ............................................................. 4 Osterville Owner Patrick & Robinson_ .............. ... Suzanne.................................. W Type of Construction Frame ................................................................................ Plot ............................. Lot.........'........................ 2`b November 16, 82 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 t 1�3 A,Q'13) 1 r -AL `ss` _ ., '�,.r> �,� �i'+--.,� r�z�,1-t ra- v �:-�vy�: -�.� s: ,✓ �.,��'r!:na— _ s Assessor's office (1ts .floor): / j� Q D THEro` Assessor's map-and lot number ........................................ Q��♦ Board of Health' ,(3rd floor): Sewage Permi'4'number .....�S.a.-..�.`! �. 7.... ' Z 33AHd9TADLE, Engineering. Department{.(3rd floor): , �- 'S °o rIL b 9• e� House number .......:...................................... . "rt d•` ...... OVA Definitive Plan Approved by Planning Board ________________________________19-------- . APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TiOjN 'OF BARNSTABLE �3� SBUILDING INSPECTOR APPLICATION FOR PERMIT TO ...GJ..t.�-O....... -Q-L--IA� TYPE OF CONSTRUCTION ........f�'��0� S�r�Lvrt 1✓ L......................................... ............,............ 2--.3o...................19..�u'. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: n Location ........L..C. ...... ....L. ...'.QI.S.EV►C_LJ... L. ............C.. S2v�LL.e ...j.................................................. ^ ProposedUse �S� ..SLu71�.l -...... -....�-L�2 �n ............................. :................................................................................. `Zoning District �' �........................................................Fire District ........�- ? ..0 t ....'...................................................... ;"Name of Owner .. A G .. Scc�TC.ta (�Y./a�� �� J 2nS�� Address ................................................................................ . Name of Builder ...�.:5..��•7..T.1•ML2...................Address .. ?:.... CAS �I....LG J� k-\..�.......f.............. Name of Architect ....N .n-C-� !�''/\�, ................................Address ...pia!t�Gc'L....`la... .��S�E2V�l..c ............... Number of, Rooms ............. ....................................................Foundation .... C_C»C_2 ......................L....... Exterior .......J .'. -?4� .............................. Roofing ........�!`?C)O� .� :.�.. , .......................... Floors LUuUt l.)!->. ,1!.��.. .,. .Y� ✓ Interior ......... Heating ........ g ' .� ...�Ut���...........................................................Plumbin !�J. . .. R-.............:.......................................... Fireplace .. ............Approximate Cost 3�• . �yj .................. /� , `. ........ Area0 .'.... Diagram of Lot and Building with Dimensions Fee a. 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 Construction Supervisor's License ...�L� � ........................ 1 DIGAN}I]C3 , ABR\BAM A=138-021 No pe,mM lt|_Additioo 6 Garage __Siool��_�aud'ln_Dvvell ' ___� . . ' . ( ' ! Location �I^�t_�2l.x__2.9B...Seayiew_��!enoe , /| Osterville---- '--�--------- ----------- . . .. . Owner ...Abraham_D���etz________ ' � . . ! Type of [onm,u,tion . . . . ' . . ' - -------------------------- P|co ------�r-' Lo(----'------ ' ' ' , . ' �e�z�ar� 7 8� Permit G,on�uJ ----------- �',lV ' - � Dote of 'Inspection ------------lV � Dote Completed ------------'lg ' ^ , . . . . � . ^ . ~ ' � - . ~- ` . . � , Assessor's office (1'st floor): THE ` .... ...�. ..: o a �... "TIC SYSTEM MUSS"BE Assessor's map and lot number �•�•.••••••••� ' ` . d LED IN COMPLIANCE Q� Board of Health Ord floor): (-� Sewage Permit number :.... .� ".J�. ..a- .1J................... WM T ,E 5 i BlSd9TSDLE, Engineering Department (3rd floor): �S ... q ;��'��lERONMENTAL CODE AND � 'moo NAM. House number ....................................J�...17- . ..:............. TOWN REGULATIONS '°'�oYa.1a. Definitive Plan Approved by Planning Board -----------_--------------------19-------- . APPLICATIOUS PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M. only A_PPR0VED sa nstable,Con ervation N OF B A R N S T A•B L E l 1 IINDING INSPECTOR Si nod Dat* APPLICATION FOR PERMIT TO ... ........ ..CA ... t! .... ..��. iCj: r� ?...f.:......... TYPE OF CONSTRUCTION ........U�OPD....I...�LS1�C�2.►�'C�1�1�...................................................................... ....... ...:..........---..19$$ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: .......�...oT...*.�.\... 4.4.. .EWV..� W...iC1v.. ............Q.S ��t-mow:. �1� Location J.......................... ProposedUse ...... !!LLZ!,?TW.! ........2......4AI�..... qXL................................................................................. Zoning District ...... .. ....,...................................................Fire District ........ 0� Name of Owner V(14n......0PAV.-PXZZ,..............Address .....` ........ ..Ti.-.eA-T?-A/.. Name of Builder ... .. ('1C ....................Address ........ Name of Architect ....l 0.l*,1:!r:1SbALA................................Address ...P 0 W2Skl................. Number of Rooms .............I....................................................Foundation ...... O ..C.01a�;t . Exterior .......5�.\ ;t�. .......................................................Roofing ........ ...... ` .�5/ )........................... Floors ..... -OLXf .........................................................Interior ......uIJv.IU .S 4,e— t......................................... JHeating .... Oti•} ............................................................Plumbing ........ i7 ........................................................ Fireplace ....V0.0 ?A ............................................................Approximate Cost ....... ............ .:. ........... Area .........../........................ .... Diagram of Lot and,Building with Dimensions Fee LI7 .......... i • t OCCUPANCY' PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Ba nstable regarding the above 1 construction. d . Name ......0 . ... ........................................................... Construction Supervisor's License ... ................ E DRANETZ , ABRAHAM No ... Permit f 32626 Bl *�dg Addition & Garage or;..........j..... i ... .......... .................... Single Family, Dvklling ..................................... .......................... Location ....Lot #21 , 299. Seaview Avenue ............................................................ Ostervi.l- e, .................................. ........ ........................... Owner .....Abraham 6'r a n e t z ................. .................................... Type of Construction Fr�Lme ..........1.14....................... o .............................. ........ ........................... Plot ............................ Lot ................................ Permit Gronled .....February 7- 89 ........................... 9 Date of Inspection ........ ...... .19 Date -Completed ......... ......19 �,Assessor's map and lot number A........... F �0 TM E P Sewage Permit number :.8a'...5. .......................... b��D�: SvSTEiv. S 9T&BLE, i INSTALLED IN CORPPLIA,�;. �a House number .......................................................... 1/V9T0-I TITLE 5 °�.�te39.a\em� 0 UIV TOWN OF BARNATTUN ` ���EF ' 1241 ASTABLE CIMSERVATIC'M BUILDING I'N S P E C T O R APPLICATION FOR PERMIT TO ... TYPE OF CONSTRUCTION .......................................................... . ..........................1999'� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... .....:. .` ._.. �A_ A.._!'..`..!..n ?................................................................................................................................ ProposedUse ... .............................................................................................. Zoning Dis ' t ..........Fire District ......,.. 3 lie Nameof x(/3�!+.t►�..................Address .................................................................................... Name of Builder1�✓ n Q,�h.C� _ i, 4Q ..........Address .....' .t✓J..i2J.n..✓...X. ...................................... Name of Architect i?.....................�@rr.... . . .. .........���. ............:.....Address ...... .............................................. Number of Rooms ....... .. U ... .......................Foundation OneY�..1. D.C<� ..................... P./ -n...• .... Exterior . ...... .............�.��..:�?!t.�.���,........:...........................Roofing .....,,����!��/ ...�.�..�.......�.AJ..���...................... Floors .(/ ...... .. .... 1? .- . .....................................Interior ......�. _MXt / . D................................. Heating. !- .!tiw.. o'o).....................:.:...-Plumbing•.:... ...........................I............... Fireplace ...... ...........................................Approximate .... Cost . . �l�(7 �...Definitive Plan Approved by Planning Board -----------_______-----------19_______. AreaAno ..����.......... Diagram of Lot and Building with Dimensions Fee 7 SUBJECT TO APPROVAL OF BOARD OF HEALTH n n � S� E3 -,9a3 3 F,' , L I I I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS OL { hereby agree to confo�tollhe Rules and Regulations of the Town of Barnstable regarding the above { construction. 13 ? n 1 V "l u Name ...................... ROBINSON, PATRICK & SUZANNE No 245.62, -for 'ADDITION.............. Permit .................................... .....Single Family Dwellin.g........... .......................................... ........ ... Location ..S.e.a...View. e.w...Ay.enu.e.......... .... .. ..... ....... .. Osterville ............................................................................... Owner ...Patrick & Suzanne Robinson ............... ............................................... Type-of Construction ...EKAW.......................... ................................................................................ Plot ............................. Lot ................................ Permit Granted November 16, 82 ........................................19 Date of Inspection ..............19 19 Date Completed ........ DST, 'FL )Dr r-LnNS Y4 - I I,o. •ems'-d• ---------- - -•--"� I LI l I L ... .. \ L i FPauLy r-M. I' I �I I �I `• C J IrpLL I I / I Gil T-1-L� I +f To ry ' i in! a •`s�G 72G.4wYr, -d Cd-5'a' 2T.G-f4eA 3 � p"i .FZ.o. t2-�.�a✓���r��a.J�tis����. YJ.�arL z-n ��.cvl�.i .1.r•�Ju"oar Y,.-, _ o •FLOOD r-LnN5 yam,.= I,,o. •=�-�• ----.._...- -- •-----� IK- I r�;neoovN I FAOLI r-M. 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