HomeMy WebLinkAbout0061 THIRD AVENUE � / � �
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COMMONWEALTH O F MASSACHIJSE
—Ec JFJ'Ar::MMNrr OF TNDUS7-RIAJ ACCIDFTiTS
L 000 '\V/6HrNGTON STkP=
lames: Ganoae� liOST(DN, )AASSACHUSh=S 02111
�c—�-ss•one WO RICERS'COMPENSATION INSURANCE AFFIDAVIT
(licensee/permirtcc)
with a principal place of business/residence at-.
q S k W�,k L✓r✓a s LA, L) PKA
(Gry/Stacc/Zip)
do hereby eerzi6-, under the pains and penshies of perjury; char:
O J am an cmpL0Ycr.prcviding the following workcrs' compcnsacion coverage for mycmployccs working on This
job.
Insurance Company Policy plumber
I am 2 sole proprictor and havc no onc working for mc_
(J 1 2m 2 sole proprictor,gcnerzl eonmaor or homeowner(tirdc one) and hsvc hired the eontt2aors listed below
who havc the following workers'oompa=tion insuran«politics:
1amc of Conrmaor Insur=cc Company/Polia Numba
N2mc of Contractor Ins=ncc CompanylPolicy Numba
lame of Contmaor Ins=ncc Company/Pol.ky Nuff x=
Q I 2m a homeowner performing all the work myself
NOM- Plcuc be a�-tc that wbs7c)oracowaca who etaploy persons to Lo ea:iotca�ec.eooctnsaioo or repair work on a
Zwclling of not more tba.a tbrcc uniu is WL46 the bomco--mcr also residcs or cc the Frouads appuruomt tbcrcto arc Dot EceerallY I
<on:idcrcr to b<craploycrs aMecr tb<�1or:cri Corapcasatioa/act�GL C.152.sect. 1(5)).appliutioa by a boracowacr for a liccas<
or pernit r..:y evidence the lqJ- sums c!zz cr-;:loycr undcr the'Wcrkcrs'Corzpcasatioa/ut
i caccrscanc to-c a copy of roil ss-tcmcnt will ix for vecd to&,c Dcp:.::.-cnt cf)ndustri-1 Acodrnu'Orscc of lnsc:zncc ror.covcrxYc
s�crifie:tion crsd that.failure to secure eorcrgc-s reSuired under Section 25A cf MGL 152 can lead to the imposition of iminal penJtics
consisong of a fine of up to S1500.00 andcr imprisonment of up to one year and civil penalties in the form of:Stop Work Order and a I
fine of S I oo.` a d2 against mc..�
Si,,ncd this'A J LQP, 6 d2Y of 19 g3
i
iiechsce/Pcrmiacc Licensor/Pcrmittor
s
\Assessor's office(1st Floor)-
Assessor's map and lot number
Conservation(4th Floor):
Board of Health(3rd floor): E ; • •
Sewage Permit number D�y:ntc
t O
Engineering Department(3rd floor): 039.�
House number -
Definitive Plan Approved by Planning Board ! 19
APPLICATIONS PROCESSED 8:30-9:30 A. and 1:00-2:00 P.M.only '
TOWN OF BARNSTABLE
'BUILDI,HG INSPECTOR
f
APPLICATION FOR:PERMIT TO
t
TYPE OF CONSTRUCTION
+ 19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location
Proposed Use
Zoning District Fire District l�—
Name of Owner!✓t �l �1 C C) Address-
Name of Builder /Y�o,3 a Address
Name of Architect Address
Number of Rooms , Foundation
Exterior ` Roofing—
Floors Interior
Heating Plumbing
Fireplace Approximate-Cost 5 6D
Area
Diagram of Lot and Building with Dimensions Fee�l y
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 Si ipervisor's License —��
McEVOY, WILLIAM
36413 Re-ROOF
No Permit For
Single Family Dwelling
Location 61 Third Street
Osterville
Owner William,.McEvoy
Type of Construction Frame
Plot Lot
Permit Granted December 28, 19 93
Date of Inspection:
Frame 19 ,
Insulation 19
Fireplace 19
. r -
Date Completed 19
r
' r .
,
1
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TOWN OF B ' , .t .
ABLE, MASSACHUSETTS J BUILDING
ARNST PERM(T
DATE Decimbur 28, 19 93 PERMIT NO. N 4 7
APPLICANT Thomas DeMayo ADDRESS 9 North Winds Lane, W. Barnstable
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO RE-ROOF . �_) STORY Single Family DwellingNUMBER OF
DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
i AT (LOCATION) 61 Third Street, Osterville ZONING
DISTR ICT—
IN0.1 (STREET)
BETWEEN AND
(CROSS STREET) • (CROSS STREET)
_ LOT
SUBDIVISION LOT—BLOCK—SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN'HEIGHT AND SHALL CONFORM IN CONSTRUCTION
r
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
4 (TYPE)
! REMARKS:
AREA OR! VOLUME No Area Change ESTIMATED COST $ 1500.00 PERMIT 50. 00
F (CUBIC/SQUARE FEET)
OWNER William McEvoy
61 lnird Street, Usrery lle BUILDING DEPT.
ADDRESS BY y
i
TOWN OF�BARNST'ABLE, MASSACHUSETTS BI�ILDING P R T�•.
A=140-00'� /7�7
t`j: V. DATE Dt�LZ'Y1}JF-'� �C� 19 Y93 PERMIT NO'. •••
APPLICANT +homersDeMayo ADDRESS 5 NOrtn; 1'nds,,Lane, W. 3arn td e
(N0.) (STREET) (CONTR'S LICENSE)
PERMIT TO
RE-ROOF STORY Single Family Dwelling
NUMBER OF
DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 61 Third Street, Ostervllle ZONING
DISTRICT
(NO.) (STREET)
BETWEEN " AND
(CROSS STREET) - (CROSS STREET)
LOT
SUBDIVISION L'OT BLOCK SIZE
-'" BUILDING IS TO BE FT. WIDE BY FT. LONG BY -FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
1
REMARKS:
AREA OR NO Area Change 1500.00 % PERMIT 50.00
VOLUME ESTIMATED COST FEE
S (CUBIC/SQUARE FEET)
OWNER
William McEvoy
a
)D1 P 11 t Stieet, 5 LC Ji• .,1C BUILDING DEPT. g
ADDRESS By
THIS PERMIT.CONVEYS NO RIGHT.T.O OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR O
PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER-THE UILDING CODE, MUST BE AP-
PROVED BY THE JURISDICTION. STRE+ET•OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLII,C SEWERS MAY BE OBTAINED
FROM'THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROWTHE CONDITIONS
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE. SEPARATE
INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND
I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MINAL INSPECTION
TI 70 BEFORE
FINAL INSPECTION HAS BEEN MADE.
3. FINAL INSPECTION BEFORE
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
1 1 1
.FIB
2 2 2
3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT
1
2 BOARD OF HEALTH
OTHER, SITE PLAN REVIEW APPROVAL
WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE
TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS,NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN
CONSTRUCTION. I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION.
L
BUILDING
PERMIT