Loading...
HomeMy WebLinkAbout0477 WIANNO AVENUE �( �s ) � J � ���� I� �. n .. � � � n � '-. I _::,:% ` -PRESS PERM0T MAY 06 2013 T_ z own of Barnstable *Permit b cS6 Z� Z N OF BARNSTA E Expires tanthsjrom issue date wkwatory Services Fee s�xxsresr.e. M 8' Thomas F.Geiler,Director 1659. Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town barnstable.ma.us Office: 508-862-4038 Fax:.508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number D 4 Z Property Address �- esidential- Value of Work w© Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Z A'.ov -7t) t, L/l� l C,L r9 s,?— �� Contractor's Name �����nu/S Telephone Number��ya-�' YQ00 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner D-have Worker's Compensation Insurance Insurance Company Name 9j±& &D Workman's Comp.Policy Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris'will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. . Separate Electrical&Fire Permits requirecL *Where nrquired: 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 required. j� � = SIGNATURE: r 77se Cowrrrouirealth of Massachuseft Dgwrbttent of Industrial Accidenft 09W afinvestigadons 600 Washmgidn Street Boston,M4 9211.1 . wfvw.j"ass.grrvldiu Workers' Compensation Insurance 4M&vit BudderslConhmctors(Eectiici:a.ns/Ph tubers Applicant Information Please Pit LeeIbly NameM m&3ividua1):&ZM L-L 4—�� nyag= Address: `6 7 y C•itylState(T4p: ! Are employer?Check the appropria6 boa~ Type of pm]eet(required'): I- �I am a employer with 4- ❑ I am a general c-unfractar and I emgloyew{full andfor par"me). * have hired.the sub-�s�#tacboss 6- ❑New cansfr�mcii� 2.❑ I am a sole pmpriekoi or parr listed to the attached sheet', 7. ❑Remodeling ship.and have no employees Tie mb-ccntract-nrs have g_ ❑Demolili'oa wodd%- for me in any capacity. employees and:have workers 9. ❑Building addition !NO wodm s'camp.MSLUance camp-"""`a`�`$ ❑ We are a corporation and its 1 D.❑Electrical repairs or additions required-] 5. 3_❑ I am a homeowner doing all work officers have Pxz*r+=ed their 1l_❑Plumbing repairs or additions right of esemptifln per 1vIGL myself [No workers'comp- 12.0 Rflofrepsirs 4)§l c.152, ( ,and we have no ,,,���e regatred.] .t 13.❑Other employees_[No workers' comp.insoraom required-] *Any Wprrc m that checks box f1 amsi also mow that section below showmg their wodem'=vensaftm pommy w&m: atL 1 Ham wnets who submit thus a€Hdnrtf mdicanng they arxdmng sH woo Emd dm tax outside contrscrars umst submti anew affidavit m i=tmg sacb. lCon=ct rs that check this boat most attached an-11a;ei—mot sheet showlag the amme of the and state wbetbu or not thoseentities hsee emptoyem Ifthe snb caa=ana have Employees,theYmnstpmwide tieeir workers'camp.policy number. 1 run mt employer dlaat is proviNng insarrance for fitly'arrrplaymm Below is thePO&y and job site information. . Insurance Compaary Name: Policy-9 of.Self-ins.Lit Job Site,kddrew: �`77 lv�.�1-ia�dt7 df1d�� CitylStateV4:6sT ✓�eG�, o , Attach a-copy of the workers'compensation policy dechratic a page(showing the policy manaber and mpirat an date). Failure to secure coverage as required under Secticn,25A of MGL r L52 can lead to the imposition of criminal penalties of a fine up to 31,50000 andlor one-year impxisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine o€up to$250_00 a day against the viodlatur. Be advised that a copy of this statement may be forwarded to the Office of Immstigadons of the DIA for insauance coverage vezfficatic n 1 do hemby certaj'y under the alnd puss ofpedury dud the informatlioa provided ahave is bw and correct Date: Phone# OJeiai am only. Do not Write in this area,to be eompleigd by city or tmm o f w&L C or,Town: Permitl acense At 4. Issaing Authority(cu�cle one): 1..Board of Health y.Bwllliug Department 3.( tyffown t ;t Electrical Inspeo or 5.Phmbimg.F]LSpBCttlr + RAENSfABLE + ,0� Town of Barnstable Regulatory Services Thomas F. Geiler,Director. Building Division Thomas Perry, CBO Building Commissioner 200 Main.Street,• Hyannis,MA 02601 www.town.barnsta ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature f 016ner ate Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on,the reverse side. QAWPFTLES\FORMS\building perinit foum%XPRESS.doC _ �oF T Town of Barnstable a i ' Regulatory Services ' LIRNSTABLB ' Thomas F. Geiler,Director asass. E1639. � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.m.a.us Office:. 508-862-403 8 Fax: 508-790-623 0 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village . "HOMEOWNER": name home phone# work phone# 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 15,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt From the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for . Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fomi/certification for use in your community. Andy Roth MurrayandMacDonald (2/5) 05/06/2013 12 :43 : 09 PM -04- VDAC li WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (GS60UB-5033P43-5-13) RENEWAL OF (6S60UB-5033P43-5-12) INSURER: HARTFORD UNDERWRITERS INSURANCE COMPANY NCCI CO CODE: 10456 INSURED: PRODUCER: KENDALL & WELCH CONSTRUCTION MURRAY & MACDONALD INS INC 550 MACARTHUR BLVD P 0 BOX 490 BOURNE MA 02532 OSTERVILLE MA 02655 Insured Is A CORPORATION Other work places and Identification numbers are shown In the schedule(s) attached. 2. The policy period Is from 02-06-13 to 02-06-14 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s) listed here: MA o B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 500000 Each Accident �— Bodily Injury by Disease: $ 500000 Policy Limit Bodily Injury by Disease: $ 500000 Each Employee o� C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A D. This policy includes these endorsements and schedules: a� SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE o= 4_ The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Q Plans. All required information is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 02-1 6-1 3 WC ST ASSIGN- MA OFFICE: ORLANDO DA HTFD 05G PRODUCER: MURRAY & MACDONALD INS 75NHN owaoa Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-083484 -,%:.I I♦ ,)/ RONALD W WEL011 ';, U, 85 BRIGANTINEZR� HATCHVE LLE NA 02 36: -- Expiration Commissioner 07/11/2014 Mi1NS11CI1 Se1tS- Dej)W'hnent of Public Sut'ety .V Board of Building; Regulations ► nd Standards Construction Supervisor License. License: CS 70086 DAMON L KENDALL <>, 48 KOMPAStDR FALMOUTHMA 92536 Gi--G— —� Expiration; 1/21/2012 <'11111111IY:1I0nPr 7r/f; 9 5 Office of Consumer Affairs&Business Regulation jumeuse ur reg►strauun vanu iur murvrum use unry HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ` Registration: .•128405 Type: Office of Consumer Affairs and Business Regulation Expiration: 4/5/2014-- Partnership 10 Park Plaza-Suite 5170 Boston,MA 02116 K ALL&WE4pMf ?.fJv�fi tU TI;ON DAMON KENDAIj, 54 KOMPASS DR. -:.:..r.. .: FALMOUTH,MA 02536.:;`-: Undersecretary Not valid without signature cr. t a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �d7 Permit# Health Division Date Issued Conservation Division otl po, Fee �v�,S<0 Tax Collector Treasurer l .tea !N Gr C.R.k 1 h Planning Dept. SEPTIC SYSTEM MUST BE __ _ . INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board WITH THE S Historic=OKH Preservation/Hyannis ENVIRONMENTAL CODE AND TOWN REGULATIONS Project Streei Address _L-171 UV I 4"n 0 *vQ 1 Village Owner bu(I l fg IN Address 113 C I�� '��. iN� ����'�► Wl� 431�161 Telephone D1 ) Z3 q31 Permit Request A-4v140y 4Ii15h6li f/0y►F P)X �P PIU tAl vy, (0 51410 taw 97101 (44 Tty✓P(1 Ivl �PX�S�i✓►5 Fed pfrhf . Cou5frtti Oyf f-rPI- I{u'i- (0luf�o/1*1, �v -RW-410� S11b 014A (451ul1 two bouW f4wiy t, wdow l,411S. Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Estimated Project Cost 1-V00 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Familn5o Two FamilyaC❑ Multi-Family(#units) Age of Existing Structure V'5, 404istoric House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: dull Jvrcrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) nowt Basement Unfinished Area(sq.ft) 200 Number of Baths: Full: existing 3 new Half: existing Z. new Number of Bedrooms: existing new ,1 Total Room Count(not including baths): existing 9. q new First Floor Room Count Heat Type and Fuel: g(Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing Z- New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name tg fGk9q �vuy Telephone Number Address (`Q 13o J 33q License# 04-7 Z.Q 0 if villp iM� pZ10 i� Home Improvement Contractor# 9 Worker's Compensation'# iti��02 �bq 0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 13V114 5 SIGNATURE MI kt (5;WUWDATE 3 111 4 FOR OFFICIAL USE ONLY •' PIRMIT NO. DATE ISSUED MAP/PARCEL NO. ' ADDRESS VILLAGE ` > OWNER - r DATE OF INSPECTION FOUNDATION rt FRAME INSULATION - x FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH %' •_ FINAL _ f , •' FINAL BUILDING Alit ? DATE CLOSED OUT ASSOCIATION PLAN NO. ; '� cl Q z STANDARD LEGEND NOTE:not all symbols will appear on a map GOLF COURSE FAIRWAY EDGE OF DECIDUOUS TREES % 1 x EDGE OF BRUSH ORCHARD OR NURSERY V- - EDGE OF CONIFEROUS TREES MARSH AREA EDGE OF WATER DIRT ROAD DRIVEWAY PARKING LOT PAVED ROAD DRAINAGE DITCH PATH/TRAIL PARCEL LINE** i MAP 110 E----MAP# % #196o E PARCEL NUMBER 7 HOUSE NUMBER j � \ ���.� 2 f00T CONTOUR LINE to 10 FOOT Elevation CONTOUR based on NGVD29 4.9 SPOT ELEVATION STONE WALL ..X..............X... FENCE ORETAINING WALL RAIL ROAD TRACK =- STONE JETTY 62 SWIMMING POOL 7 PORCH/DECK / \ BUILDING/STRUCTURE 9 �r DOCK/PIER HYDRANT 1 6 VALVE O MANHOLE / o POST 0" FLAG POLE T O W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M S U N 1 T .� SIGN ® STORM DRAIN w 4 H PRINTED SCALE:IN FEET *NOTE:This map is an enlargement of a **NOTE: The pa«el lines are only graphic representations DATA SOURCES: Plonimetrics(man-made features)were interpreted from 1995 aerial photographs by The James 6- 1 P I - 1"=100'scole map and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company. Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0 UTILITY POLE o TOWER 0 20m -40 Notional Map Accuracy Standards at this do not represent adual relationships to physical objects Corporation. Planimetrics,topography,and vegetation were mapped to meet National Map Accuracy Standards p LIGHT POLE O ELECTRIC BOX I INCH=40 FEET* enlarged scale. on the map. at a scale of 1"=100'. Parcel lines were digitized from 2000 Town of Barnstable Assessor's tax maps. i _ s . s � S f W } � I -+C Ofl• 'r x c 0 S cr a— S - � � � a AZ 4 C � � S • T CQ p m � A y c_' o T1e �omvmauuealll o�✓fitaaoac/uae BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR t Number. CS O47291 , Z . Expires:02/22/2002 Tr.no: 18719 Restricted To: 1G MICHAEL J GARDNER PO BOX 334 OSTERVILLE, MA 02655 Administrator ONE INPROVENEN� E CONTRACTOR % Expiration• 114949 IU11/01 UBA `NICHAEL QrGARDNER BUILDER --MIKE WNW WINTERGREEN CIR :' t ADMINISTRAT6R OSiERVILIE t The Commonwealth of Massachusetts a j= =.ow Department of Industrial Accidents Of//IYBSI/ OWNS 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance davit name (C�tli�) location f 0 of city C W/(I VA vhone# ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working is any capacity rwidin wRkers' compensation for my employees.working on.this job.:;: : I am an em foyer p g...............................:.::.:..::::. vn ame t �r � _ :.::. :.::::..: . . ....:.: _. ... . _.:.. a ...................... .......... :. o n cm >?>: <...................: ':< `<: ' >: :.?<;> ><> ?:>%�''<< <'.>`><`:>: »>>'<» »>>> >: »: >: < `.... as dre 1. ... ::.::::.::..::.:::::.:::.:::.>;::. :. :...... ... ... ......:.....:::.:.:.............. . .. . .. ............... ..:.. .... ...:.........:.: .. . ..: ....... :... ..: . .::::.::.. .. ...:::.:. f�...: .::.::...::.::.:::.: :. :::. #.. .,.. .. . ... . ...... • ..:. :>�>::::�<.;:;: :� ;:.:•. :::.;;:.�: :::::.. :::�}:::. . �......:...... hone ....::.:.::.��::.�>:;:•::;...::�>:�;:>::>::;>�.;:<::>. :.�:::;<::••.;�.:;:<::<�i::»::isz::»iR::<:»>::r:::a:�>::>::>:.:;.::.:>.�:»:a>::>:»r:�>::>si::»s>::»:;:.c:;:.;::<::z<:::::>:<:;:>r;:;::; �,::,:::..:.: ;;•.;:•. �:••:: insurance-co: ❑ I am a sole proprietor,general contractor,or homeowner(circle one and have hired the contractors listed below who have m the e vfollowi ng w..:o:r.:.kers,:c:.o........::.e:.:n..:.:s.:.a...:li :.::.o.:.:.:n...:.: Po..:.l..:i.:.c:.:.:e.:.s:.:.::.:: :. '.;; :::.: .....: .: : ::;..:..;..:. :;.:..:.. .:.:.:..::.;:.::: ; . : : : : : .; ::s . . m a.::are a z ` iiS.'•i:4i':+v tilt:i ii:}:;<:i::;::i:i };{!{i: ... .....ii:>i?ii.'•iii:;i:i;i:;:?:'r'ii:;i:;i i;}ry�ii:;::::;{:::j i:;{:y i{:;::':`.:'{:i'r'iiiiii: ..................... ............ ..............................................................................................................,::...................... ...............................................................................:::::::::........ iS:t i:...........i':;:y;Ji}'v.i: iii':::.}:r:. I.... .:-Me r.:� .; .�..�:•:.v. •#ii:::ii::Fit:•'.?i 4:::::v'::isi:!!�'i::'v:i.lit;:i;:;:i•:;,v,•,•,:t:•i:.i:•:•i R ibsurartc anv nam :::...: address.. ::....... . .....:...... ........... . ....... >> one: "i:'A: •,:��:::i:;i?.;ii.T;:�i?:;:;isi:':ii.;:;: '.j;`:?:;ji�S:.?i{:�:�i:;f}!%.;,ii}::":._:•::::.. 1 iR 0 inaran Failure to secure coverage as required under section 25A of MGL 152 can lead to the imposition of cr6ninal pendtles of a fine up to 51,500.00 and/or one yeah'imprisonment as well as civa penalties in the form be forwarded to the Once of Invesf a STOP WORK ORDER and a tigations of the DIA for coverage v�erf8catioa of 00 a day against me. I understand that a copy of this statement may I do hereby certify under the p and penalties of perjury that the information provided above is true.and coned SiSaature 311 Print name �`C ✓� `�'1� Phone# Ll 16 LN2 Z' omdal use only do not write in this area to be completed by city or town official city or town: permililicense# ❑ ��Bi:Depardnent ❑Licensing Board is required ❑selectmen's Omee ❑check if Immediate response req ❑Health Department contact person phone 0eylud 9/95 PJA) ppmam i ' ra6la.rsub� huc ipttie PAckam tar aas and TwaF=dY llnideatid BaildLoP Snarl with Fos"'Fade - MAXLMUM lYIDVIM1JI41 as ccii;n Will Flow 8a�t Slab �CO°�g �) U-veiue� R4xjLw: R mdwl- R-va u Wall Ash EMa=m-f' Pards�e A.valvet &valuer 5101 to 6600 HeatiaS DeSeee Dam Q 12r. 0.40 31 13 19 10 6 Normal 12% am 30 19 19 10 6 Now 9 12-- 0.30 31 13 19 f0 6 1S AFUE T 15% 0.36 31 13 2S WA WA Normal U 13% 0.46 3s 19 19 10 6 Normal y iSri titd+i ae 13 •��' USA+ ivw !S AFZJE W Is% 1 0.52 30 19 19 to . 6 tS AFVE x 180% 0.32 31 13 25 WA M N� T 19% 0.42 39 19 25 WA N� Z IVA � 0.42 31 13 19 l0 90AF«AA Ir". 0.S0 30 19 19 10 90A� Cc.x���d� wo►�� o�1y . 1. ADDRESS OF PROPERTY. LM U/1 u w n 0 M. (PE7kf /L lle� Wig oz log 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY #2): S. SELECT PACKAGE(Q—AA-see chart above):, NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303a OF 1HE Tp� The Town of Barnstable MASS, �0� Department of Health Safety and Environmental Services lEn�r a Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,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. rr Type of Work: �-O 0 f 0 U i✓ "r A Q0r L-V K d I! Estimated Cost '2-00 c0 Address of Work: Lf?'7 w(U l m o Owner's Name:t7 u lT D' Date of Application: �` I d 0 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 IMPROVEMENT 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: t CAI u 4 l OtAljw,/ Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav ESTIMATED PROJECT COST WORKSMEET Value LIVING SPACE square feet X$55/sq. foot= GARAGE (UNFINISHED) square feet X $25/sq. foot= PORCH 1 square feet X $20/sq. foot= 0 DECK square feet X $15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Cost i g990915b AssAsor's map and lot number ......................r.......: ........:.. 9 OFTMETO Sewage Permit number ........... ...... ....... ... .. �o 1 33ADH9TADLE, i House number .. ..... ...... 7. •%.............................. ...... 9 rasa ape,i63q. 90 CFO MPV a� 1 TOWN- OF BARNSTABLE B- ILDING INSPECTOR APPLICATION FOR PERMIT TO .�% P -'... ... `. C7 ....................... ' ............................... TYPE'OF CONSTRUCTION �'� ���` ` ..... :.................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 7. t'/t7I it/© A/f� �'�?' ��U/GL /�l/ ,.... ................................... ..a..................... ProposedUse ... /..-ot/........ ....................................................................................................................... cc Zoning District ....� ... ..�...................................................Fire District .. S7S/2.W.L(—.4F.. _l JJ m / ..... ..... / Name of Owner (�1.e. .��. .!!e.(4!S�fyl.�. .tI.dw........Address �(Q ... .!. .. ... �s��� �/�.e.. Name of Builder ....... ........Address Name of Architect ..:......... ........................................Address y ...... ................................................................................... Numberof Rooms .................................................................:Foundation ........ �01�.f/r• . ...:....:...................................... c�o-J Exierior ..........................................,................................:........Roofing ........ .................:........:....................... Floors a ..............................Interior ...... .... ......,..1......................................... ..... :....................................................... Heating .............................Plumbing ......................................Approximate Cost Fireplace ............................................ pp ial ................................ ....... . ................ Definitive Plan Approved by Planning ,Board -----------______-----------19_______. Area l..Y...Q.. ... ..��Tl Diagram of. Lot and Building with Dimensions Fee �- 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 .`� ...... ........................... Construction Supervisor's License !'`..©.�5�..�r.4./..... SHIELDS, ROBERT /M. RYAN 24624 Permit for ,REMODEL....&....RE-.ROOF ..... .. .... . ....... Single Family..Dwelling................ Location ...477 Wiano Avenue ............................................................. Osterville ............................................................................... Owner .,Robert....Sh.i.elds,.... .. ...l .. .... .. .... .... .. .... ...)Ryan Type of Construction ......Frame......................... ............................................................................... Plot ............................ Lot ................... .......... Permit Granted ..,December 8, -19 82 ............................ Date of Inspection ....................................19 Date Completed ..................4k-.,53........119 As- sor's map and lot number ........................:.......�..:........ F THE t ` ' 0 0 Sewage Permit number � cl i/ ..... !'�L�LY:7A. BAHBSTSDLE, i House number ..M. 7./../..: q NAM oo�0 YAYt639.a\00 TOWN OF - BARNSTABLE s BUILDING INSPECTOR APPLICATION FOR PERMIT TO �f11.�1 �/...fi...I?�`.....G2?. ............................................................... TYPE OF CONSTRUCTION tNDv� �� /'.. ........... ................T............................................................................................... ............................... TO :THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 7..7 Gt1 r i41VO ...... 0 �?�/�U/C LPL...........��f��:........................................... ................. ... ........................... Proposed Use ��--i..... G Zoning District .... ../............................................................Fire District ................................... Name of Owner ZhP..r7` SA il°.I !!/.: C��YI Address! %4..... �......... v -.:.....Q,S�C'�v1/6.��,• �� Icy �. �L� S C��IPIot Name of Builder :. ?...... .....5......... .CQAn.. J!37/7 ........Address J.J��:.......!���f............. ..........................1............... Nameof Architect ............ ...........::............................Address ................................................................................. 9 , Numberof Rooms .....(i.............................................................Foundation ....... ( :I. ................................................ ExieriorcsaoJC ...................................................Roofing ........l!„r6�-C,............................:.................................. .......................................................................Interior .......... dd� Floors .....:......:.......................:.................................. Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost ...� f ..........................f....................... Definitive Plan Approved by Planning Board ________ __________________19________. Area Ao....... .. I Diagram of Lot and Building with Dimensions Fee ............................ 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 . �'�` ....C. .. ............................. r ,---Construction Supervisor's„License or� � 1 ...... SHIELDS, RQa&X2, /M. RYAN 1,* ..24624 Permit for REMODEL & RE-M-DF ............... ... ................................ Single Family Dwelling ................. ............................................................. Location .477 Wiano Avenue ............................................................... Osterville ................................................................... ........... Owner ...Robert. . ....Sh.l.el.d.s/ M. Ryan .. .... .. .... .... .. .... .. . ......................... Frame Type of Construction .......................................... ................................................................................ Plot ......... ................... Lot ................................ Permit Granted. .....D.ecembex...8..........19 82 Date of Inspection ....................................19 Date Completed .......................................19 1A TOWN OF BARNSTABLE BUILDING PERMIT PARCEL ID 162 007 GEOBASE ID 8978 ADDRESS 477 WIANNO AVENUE PHONE Oete`r,vi l le ZIP -- LOT 2 LC 181 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CO PERMIT 11215 DESCRIPTION INSTALL RUBBER ROOF 12•X 20 PERMIT TYPE BROOF TITLE BUILDING PERMIT FO9paa rent of Health, Safety CONTRACTORS: CAZEAULT .& SONS:- and Environmental Services ARCHITECTS: TOTAL FEES: $50.00 per BOND $ 00 CONSTRUCTION COSTS $1,000.00 434 RESIll ADD/ALT/CONV I . PRIVATE P114 # MASS: 039. ►��� OWNER DI CAMI LLO, GGAR'Y T Fp ADDRESS 1001 ST GEORGE'S RD BALTIMORE MD B U I L VIS !9j,'/ DATE ISSUED. 10/26/1995 EXPIRATION DATE BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS' PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. I MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL I I WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX'. CARD CAN BE ARRANGED FOR BY. 'I VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. 508-790-6227 I I I I I I I � i Assessor's Office(1st floor) Map I Lot d 0-7 !z c, Permit# ) Date Issued /0 2L Board.of Health(3rd floor)(8:30-9:30/1:00-2:00)ei?_ Fee �D Engineering Dept. (3rd floor) House#1 SEPTIC$YSTE SE' -� INSTALLE®IN . SCE ITN LE. 19 P�E6tlT AND TOWN OF BARNSTABLE Building Permit Application "froject Sttrr Addre Village ,/6wner \ Address ✓Telep one ermit Request d Total 1 Story Area(include 1 story garages&decks) square feet Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use r , Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other l /' Builder In��formmation , N e �U / �5 COPZe l' 11)�����"Telephone Number n �� Address z- #4, Y� License# -Home Improvement Contractor# /©-3 �� l ✓`Worker's Compensation# 60 G C./F6/9 S CAI 965� 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 e c�© C ��/� DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) w 'FOR OFFICIAL USE ONLY . e r. s J`• ' z PERMfr NO. 1 , DATE ISSUED Y t n s MAP/,PARCEL NO. r. ADDRESS VILLAGE OWNER n ` t DATE OF INSPECTION: , r c FOUNDATION,- FRAME INSULATION ' FIREPLACE. i ELECTRICAL: ROUGH FINAL ft7i 6. . PLUMBING: ROUGH. FINAL t;r' Y GAS: wOUGH FINAL f 3d tcy �• • S V FINAL BUILDIIiG- z DATE CLOSED OUT. ASSOCIATION PLAN NO. �. f � y The Town of Barnstable 1�P Department of Health Safety and Environmental Servrnces _ Building Division 367 Main Sttoct,Hyannis MA 02601 Ralph Ctossea Office: 509-790-6227 Bing Cammissi F= Soa-775--3344 For oT=use only Permit no. . Date AFFIDAVIT HOME SWROVEBIENTCONTRACTORLAW SUPPLEMENT TO PERBur APPLICATION MGL c 142A requires that the"reconstruction,alterations,renovanon,VcPairt won'Conversion, improvement,.removal, demolition. or construction of an addition to any owner 0=zpied building containing at least one but not more than four dandling units or to somas which we adjacent to such residence or building be done by registered contras with certain C=ptions,along with other e Type of Work: • �— 00 Est.Cost 006) x � ��� ;9r��0 Address of work: Owaer.Namc: 62-,O� �/ C Date of Permit Application: /DZ2-z�J — I hereby certify that: Registration is not required for the following reason(s): Work occluded by law Job under SL000 _Building not owner-occupied owner pulling awn pcmdt Notice is hereby Sh-cn that: _ OWNERS PULLING THEIR OWN PERMIT WORK DO NOWT HAGIS�CFSS TOCONTRA TIE RS FOR APPLICABLE HOME DER ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A j SIGNED UNDER PENALTIES OF PERJURY i I hereby apply for a permit as the agent of the owner. Registration No. Date Contractor name OR te �` COMMONWEALTH OF MASSAC HUSETTS / �^ l DEPARTMENT OF INDUSTRIAL ACCIDENTS �f 600 WASHINGTON STREET -ames Carripoel; BOSTON, MASSACHUSETTS 02111 _o►nm ssione- WORKERS' COMPENSATION INSURANCE AFFIDAVIT I, �AyL J (licensee/perminee) with a principal place of business/residence at: (City/State/Zip) do hereby certify, under the pains and penalties of perjury, that: [ am an employer providing the following workers' compensation coverage for my employees working on this job. iCAAl 1-9vC(C y LI) J�-:i t5 - t yCC.. Insurance Company Policy Number I ( J I am a sole proprietor and have no one working for me. I ( J I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation insurance policies: Name of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number Q 1 am a homeowner performing all the work myself. NOTE: Please be aware that while homeowners who employ persons to do maintenance,construction or repair work on a dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not generally considered to be employers under the Workers' Compensation Act(GL C. 152,sect. 1(5)),application by a homeowner for a license or permit may evidence the legal status of an employer under the Workers'Compensation Act. 1 understand that a copy of this statement will be forwarded to the Department of Industrial Accidents'Office of Insurance for coverage verification and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties consisting of a fine of up to S1500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a fine of S100.00 a day against me. Signed thisday of . 19 1 censee/Permitter Licensor/Permittor : , a�:���:is. CERTIFICATE OFtiINSURANCE '` �� ISSUE DATE(bIM/OD/YY) ;4t1lL`ia:::.�•.:�:':-_�..-:;ti•:.;.7a.:_.';..i::'.,:.•u>. ra'�r..�..e .. .X.i a:.::'• .:..... PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PM SWAN&CP.00KM INS.AM,INC. POLICIESBE P.O. BOX429 COMPANIES AFFORDING COVERAGE ORLEANS, MA 02653 COMPANY A fLETTER Maryland Casualty Insurance COMPANY INSURED I LETTER BAmerican Policyholders Insurance Co .__ aul J . Cazeault etal COMPANY c LETTER )BA Paul J . C a z e a u l t & Sons Roofing ±--------------- — . O . BOX 2 7 8 1 ; COMPANY D LETTER rleans , MA 02653 -----'— — --------- - — ! COMPANY E LETTER COVERAGES .,`, •Lr•=..•^�a. ..w.�'�.7{i.•'e::wtsd��.�s'.�.:::�'.... ":i.t�i/wt..::::w+..� '..r.:�r...:�^.a.-::is?:.1+I:w�r1;a`..ni:i:J:i.L.-. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DE$CRIBED HEREIN IS SUBJECT TO ALL THE TERMS, _EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DO/YY) ; DATE(MWDD/YY) GENERAL LIABILITY GENERAL AGGREGATE-— $1 ,O O O,•0 0 0 - X X COMMERCIAL GENERAL LIABILITY 'PRODUCTS•COMP/OP AGG.__$1 3.0.0.0 , O 0 0 A -... _ .. CLAIMS MADE X.00CUR. C F P 2 5 5 5 2 8 12 5/ 1 /9.5 5/ 1 /9 6 PERSONAL a ADV.INJURY $—S 0 0-.,0 0 0 OWNER'S 3 CONTRACTOR'S PROT. EACH OCCURRENCE---_i_ S_O O.,-0 0 O _. I FIRE DAMAGE(Any one fire) °i 5 0 0 0 0 --. .....__-•-- --._-..__ MED.EXPENSE(Any one person) $ 5 , 000 AUTOMOBILE LIABILITY COMBINED SINGLEANY AUTO i -' LIMIT -- ALL OWNED AUTOS BODILY INJURY _ _ SCHEDULED AUTOS (Per person) -----^— ---- HIRED AUTOS ! i BODILY INJURY s NON-OWNED AUTOS (Per accident) _GARAGE LIABIUTY PROPERTY DAMAGE i EXCESS LIABILITY :EACH OCCURRENCE :i UMBRELLA FORM I `AGGREGATE !$ -- --- OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION I X 'STATUTORY OMITS AND : WCC1861950195 18/9/95 18/9/96 EACH ACCIDENT S1001000 - - I DISEASE—POLICY LIMIT 1450 Q EMPLOYERS'LIABILITY DISEASE—EACH EMPLOYEE $10 Q Q Q Q OTHER i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Roofing CERTIFICATE HOLDER_..r::nf>_ .. _.:....,d�; .........._. .....' ..:...:'.:s.'•CANCELLATION.:z :�er3.::"cyis::... 'is:►• "sc %.r�: "F .:Q! - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO 1 MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 1 LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE (JW ACORD 25•S 7/90 CORD CORPORATION 1990 I I COMMONWEALTH OF MASSACHUSETT DIVISION . BOARD IN PLUMBERS—A:N-D.. GASFITTERS IMPORTANT NOTICE GF LICENSED-"AS=AN.,:_LTD-ULPGI PERMITS FOR PLUMBING AND GAS FITTING ISSUES-THIS CIGENSE TO INSTALLATIONS ON STATE OWNED OR USED FACILITIES MUST BE FILED AT THE OFFICE OF THE STATE BOARD. , TYPE PAUL J G`A':ZEA�ItLT` ::._; -�,�� m LT PO BOX 278I ORLEANS `'�'``.`,L; :02653-1999 700447 3077 05/01/96 7004 7t� LICENSE NO. EXPIRATION DATE SERIAL NO. Failrro to�c�-�::z a carr�nt COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY Massaatopezn 3tatrBr ent OF ONE ASHBORTON PLACE Code iseassrforrwoas0ea MASSACHUSETTS BOSTON,MA 02108 oftbiallae.M. ���71 d J L ^E N S E CAUTION EXPIRATION DATE C O NI S T It. 'S U P E R V I S 0 R 1 0/2 0/1 9 9 5 EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST RESTRICTIONS THEFT, PUT RIGHT THUMB NONE 06/30/1993 026325 PRINT IN APPROPRIATE BOX ON LICENSE. A PAUL J CAZZAULT 9 1560 MA I'N S T BLASTING OPERATORS C OSTERVILLE MA 02655 m MUST INCLUDE PHOTO. PHOTO(BLASTING OPR ONLY) FEF{//..0•rt t.Li 00 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER P ''� "�r THIS DOCUMENT MUST BE « SIGN NAME IN FULL ABOVE SIGNATURE LINE CARRIED ON THE PERSON OF SJGWffi IRE OF LICENSES THE HOLDER WHEN EN• OTHERS-RIGHT THUMB PRINT GAGED INTHISOCCUPATION. ONE {'i,i��yS •iIJ� .. i � �:�ie �ar►e,��o�ruu�a� o��!��a�c�uaetta I I HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building Regulations and Standardsl One Ashburton Place - Room 1301 Boston , Massachusetts 02108 I I HOME IMPROVEMENT CONTRACTOR ------------------ --!O' Registration 103714 Expiration 07/09/96 Type - PARTNERSHIP I HOME F Regist Paul J . Cazeault & Sons Roofing I Type - Paul *J . Cazeault Ezpira 22 Giddialt Rd . P .O . Box 2781 Orleans MA 02653 I Paul J