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TOWN OF BARNSTABLE
SIGN PERMIT
PARCEL ID 139- 025 GEOBASE ID 7341
ADDRESS 32 WIANNO CIRCLE PHONE
OSTERVILLE ZIP -
LOT 128 BLOCK LOT SIZE
DBA DEVELOPMENT DISTRICT CO
PERMIT 46087 DESCRIPTION. "JAMES MURPHY, INC" - UNDER 20 SQ:
PERMIT TYPE BSIGN TITLE SIGN PERMIT f
CONTRACTORS: Department of Health, Safety
ARCHITECTS: and Environmental Services
TOTAL FEES: $25.00
BOND $.00 Ox
'CONSTRUCTION COSTS $.00
753 MISC. NOT CODED ELSEWHERE 1 PRIVATE P � E- ;
* BARNKABLE, •
MAS&
EO MA'S
B ILD G DIVISION
B
DATE ISSUED 05/15/2000 EXPIRATION DATE
f4 F-P- 1 2-0 0 1-1 E 11 1 Z,:. M 11 R F H`f*-R . E -'CIS'. 4 7'CI C10 Ci
The Towu of Barnstah)o.
Department of[UnIth, Safety and Ea-viroinuental Services
MAft Building Division
367 Main Sutet, Hyannis MA 02601
Office: 508-862-4038 Rv )h 0055CII
Fax: Bu ding Conunissionler
Tax Collectc)t
Treasurer
Application for Sign Permit
Applicant:_ ssors Qy'IDr--'C.
Doiab 7-siness As:.5J4aZL5- elephone No.,-�/—
Sign Location
ZoalrW-District.44.- Old Kings I-ligilway? Ye Hyaw-iis Historic Distr: -t?
Ye
Property Owner
Adch-&,,
Sign Contractor
Na-Mo. T lephone:
.50 kk
Address: CL3-��1�4,
Please drawagram a di of showing location of buildings and wdsting signs with
dimensions, location and size of the new aign. This ishould be drawn on the revers, side of
this application.
14 the s.".. co be olectrified? Yee (NOW'Ifyes, a wiring perI71.1't is required)'
I hereby certify that I aza the owner or that I have the Authority of the owner to ME .:e this
application, that the inf0mation is correct and that the uLe and const, 8,1411
to the provisions of Section 4-3of the Town of Barnstable Zonis 01"c[i n ce.
Sign&turo Of Owner/Authorized Agen c�141�
/
Size:
.Fee:__
Sign Permit was approved-
8.1gTiature of Building offici
ES XV OOoor
...........................
OFTNE r, Town of Barnstable *Permit# 4 '
es�s from issue date
tARNWABM ' Regulatory Services. e
.
s63p1639 Thomas F.Geiler,Director
p�0
'fo►�� Building Division Xm PRESS PERMIT
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601 JUN 15 200'
Office: 50M62-4038
Fax: TOWN OF BARNSTA
508-790-6230 LE
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number
x3Y-7
Property Address�a[ (�l t?N�0
®Residential Value of Work J•,?a0- Minimum fee of$25.00 for work under$6000.00.
Owner's Name&Address R-t-7'S - (ll)'AAJ rJ n
Contractor's Name�,(� rZ,,�,'✓ C Q, �a66 Telephone Number'
Home Improvement Contractor License#(if applicable) a �-
Construction Supervisor's License#(if applicable) r
?]Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
Ql I have Worker's Compensation Insurance
Insurance Company Name Go ti E,R.C.E E
Workman's Comp.Policy
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
�]Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows. U-Value (maximum.44)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***N Property Owner must sign Property Owner.Letter of Permission.
Home Improv nt Contractors License is required.
Signature
Q:Forms:expmtrg
Revise063004
-S
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street, 7t"Floor
Boston,Mass. 02111
Workers Com ensation Insurance Affidavit:Buildin /Plumbin /Electrical Contractors
btai x et a ] g�;.
address q S .►tie a Ea
aeity state:'
w zip: ® '2-(o O i phone#
work site location(full address):
❑ I am a homeowner performing all work myself. Project Type: ❑New Construction[]Remodel
Iam
ama sole proprietor an64d`,'have
nioo ione{wp^oisrk n +c��..•ac'ity,Y': �% kt`.•~rS <t ;;�Bu'ii4lrn% ddition
' R" RN rin r.i
•§:!t45f •,gY,:!'o'r.tY�� '',.•`' .':rCf�' b.n^f'F
�] I am an employer providing workers'compensation for my employees working on this job.
company name:
address:'
city: phone#•
insurance co. 1DOliCV#
:y�'��a•c��.''.�.•.'.�`t,�'CSiS:iiEiJZ:3.�14tiaia�P��"iv`�;ul$•:fn41.�.ca�i�, +'!b:�,it.'3'r•N9�::C:i).��?6�ui�f?4:�'u]`,'f[i+�'4`,:'.'Ati"f,'iov'S•:��':�:it`s'.�"%�G�:-ra:�.r.�+'trm�''..+viraY:fa ,i�'��iz�. K^.
❑ I am a sole proprietor,general contractor,or.homeowner(circle one) and have hired the contractors listed below who have
the following workers'compensation polices:
company name:
address
city: phone M
insurance co. 01ic #
'�:`'•r ..t�•d ' �C.i1( 4r4-1'r� ... W�.. r �yfi'�:. Yi�S'•••f:•:Yy .'.:T:9:.•.S•9•�...•;!. .i'7. � �'.7.r: I
4�', .,,�'�: :fir' '.%S» t.;.=, .. . . .4 �Mi,,.r •.2��.,•:t•Y¢.R iG:l G?ue:.. .:a�'.:w.JY,r3:'.z�,.:y:�r;::' °+t�1'.ti.i�F•'r.':'E;J�s�<r;?!,;"�i-m'�tlk
-company name:
address:
city: phone M.
insurance co. policy#
�..�,..... .� v AWN.
:vj� •" �Y �` r" :. �at+�st� `a
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the Imposition
'of criminal penalties of a fine up to$1,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a-
copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification.
I do her by4rtifyu er the pains dpenalties of perjury that the information provided above is true and correct
'Signature ` •Date _o 611 �
'Print name t AV l -0 �• � ��t N� Z Phone# 4-06 -`'® 710 8
official use only do not write In this area to be completed by city or town official
city or town: permit/license#
❑Building Department
❑Licensing Board
❑check if Immediate response is required ❑Selectmen's Office
❑Health Department
contact person: phone#; ❑Other
(reviscd SepL 2003)
I
Information and Instructions
Massachusetts General Laws chapter 1.52 section 25 requires all•employers to provide workers' compensation for their .
employees. As quoted from the"law",an employee is defined as every person in the service of another under.any
contract of hire,express or implied,oral or written.
An employer is defined as an individual,partnership,association,corporation or other legal entity,or any two or more of
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver
or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a
dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of
another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds
or building appurtenant thereto shall not because of such employment be deemed to be an employer.
"�-
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required.
Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the
performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have
been presented to the.� contractingp authority.
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Applicants
Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please
supply company name,address and phone numbers along with a certificate of insurance as all affidavits may be
submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and
date the affidavit. The affidavit should be returned to the city or town that the application for.the permit,or license is
being requested,not the Department of Industriaf 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.
,� �•� e �H� *g , >- `Zi rr'3� s'� �' {�lr:�ta>-asa..Za•. q:•,er.:[:'�rl�a ,
rl"'^.'ri '� � ~y } _ {� �g'��,^:''1 n .'F�n'ft...:.�.�3f�,,,.�.t•°'-ir:r��� ttfa' �:tvr:;s :,vr'�i+:�iY� �`� kt.
'ar3' w• •r• .� ���`��,���'CTtfY 5..,. g'.» •rer w,i'.. ac,.t`::
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of
the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance fdr you cooperation and should you have any questions,
please do not hesitate to give us a call.
.1.� ,.. •y. 1' �[; -� _ � - ra+:. � Ye trY bw'.'+�sjaC(h•;`�,�e{3' 3if' �;��`.�,.�'..'�;• i 'n.�:��; •
i:= ,,. 8':' •�'i�'at •.,;i�+W� �,,a�J ;�,° Xt' �• F c+FT-•,�_""''.. •' � �, .y,..• }.
�r. '�N.�`dX��',R,r��yJ .f: ,. 't'' ixsva i$. '`'`,-6�r ..•3r.^_:.. � ',���L'at` al"'t.i �'"'`' b ic:£: rrg,�,�y
The Department's address,telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of Investigations -
600 Washington Street,?h Floor
Boston,Ma. 02111
fax#: (617)727-7749
phone#: (617)7274900 ext. 406 .
cf�"ElOwti Town of Barnstable
Regulatory Services
II Thomas F.Geller,Director
f 5 ���� Building Division
TomPerry, Building Commissioner
200 Main Street, IiYmnis,MA 02601
wwwAown.b arnstable.ma.us
office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using ABuilder
as Owner of the subject property
Co�� S J P P
hereby authorize
���L ►.�Ez to act on my behalf;
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Y I .,Lax", 06- 0�_ co �
J
Signature f Owner Date
Co
Print Pdame
.a,•... ,.—.,nn.i+rf��n++trIT)�ROOTf1T.T
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✓,lce '[jo�r�nzoouvea� a�✓�aaaacLucaelld !.
Board of Building Regulations and Standards License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Board of Building Regulations and Standards
Regist 142802 One Ashburton Place Rm 1301
0/2006 Boston,Ma.02.108
r GUERVO BUILDI 831 L� G
PABLO MARTIN
49 SMITH ST
HYANNIS,MA 02601 Administrator Not valid wit ut re
/
'
TOWN OF BARNSTABLE
. NAG& � � NN� 0 ��� INSPECTOR
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1639.
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APPLICATION FOR PERMIT T�� —.A��.��,�^.rx---x—'�����.. —.. .......
(
' TYPE OF CONSTRUCTION '^�^ �~�'
-------~°—.��----..�~=-----�~°---==.-------------..
' -------- ---.l9
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TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for p the-following information:
^r
Location `~,�r�,�z /---'����/w ---.:--------------.
Proposed Use ------------------------------------------------
'
Zoning' District — ' . ---'----..Rve District
Nome of --------'AJ6,ex ..........................
(� �
Name of Builder — -----------.A66ress ...... .---------.
Name of Architect ----....---------.-------.A66neo --------^' ----. --------. |
Number of Rooms ...... ......... ..............................................Foundation —
Ex/e,io, . .------------'RonGng . ...................................................
"
Floors ..............................---------.--_.|nte,iov . ________________
°�
Heating ' ------P|um6ing ----',�/-������_______________..
R,ep|ooa ' App,ox)mo�p Cost � '
—'~=`~^..~�`-------�-----------' ----------------.
DifinNve Plan Approved by Planning Board lQ-------- ^ �� 0
'
Diagram of Lot and Building with Dimensions
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| hereby agree to 'conform to all the Rules and Regulations of the Ton of Barnstable regarding the above
construction.
l
� Nome .. ...........
/ . —. _----.—.—.—.~.----.~---.---
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/
Curtis, Jerald '
11411 1 1 2 story,
No ................. Permit for :...................................
single family dwelling
................. . .................................... .................
33
2, 1
Locatioc� �1anno Circle
Osterville
...............................................................................
Jerald Curtis
Owner ....................................... -
Type e of Construction frame
................................................................................ 0 7
t -
' Plot Lot #12$
t
Permit Granted ......°November 19
7
Date of Inspection ....................................19
Date Completed
PERMIT REFUSED _.
............................................................... 19
................................................... ........................
.................................................. .........................
i
ApprovedK,..,.......................................... 19
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............................................................. .............. f
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