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HomeMy WebLinkAbout0141 WINTERGREEN CIRCLE n . �► _ _, ,. ,, ,, . ,, , Sr - .. _ � - .. � �. .. n ,. �� ,r � . .� .n ', �. _ -.._ry _ t"�.. 4 ��:►...-_.-!�'ti. .'.�..'n'R,..w�.+^�.•.-r+.�.,.,.q...:i..,...n �'ertiv+....,�+w_1...--�^..w��..�-ti.� .��...v .I"�..�..w�.�.o.+- _ .� ..w..!!'r-�-., z+.r�...- w�.,. - �F THE � Town of Barnstable *Permit# NQ� ti� Expires 6 month om issue•date Regulatory Services Fee BARNSTABLE, MASS V t639 Thomas F. Geiler, Director �p t6gq. A,0 rF0 MP( Building Division ��3 I ) Tom Perry, CBO, Building Commissioner 200 Main'Street, Hyannis, MA 02601 �•�/�3/09 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 'rop rty Address__/� + (residential Value of Wort. 90d `--- Minimum fee of$25.00 for work under$6000.00 C)wncr's Name&Address /� l J6'ic!�/1/ l // vv Contractor's Namea S/eo elbl e—c�- f I'No Telepl ne Number, 1 Ionic Improvement Contractor License# (if applicable) /� fl-4. 1 Construction Supervisor's License # (if applicable) ❑Workman's Compensation Insurance �q� �� PERMIT Check one: ❑ I am a sole proprietor ❑ I the Homeowner JUL — 9 2009 [31Thave Worker's Compensation Insurance TOWN OF BARNSTABL Insurance Company Name et{/ ` �YJ� �/,/ �0.: 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/doors/sliders. U-Value �,-)�J (maximum .44) W)tN/�01✓v�` '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 is required. SIGNATURE: �?.'WPI ILLS\fC)RMS\huilding permit forms\EXPRESS.doc Revised 100608 :.//gyp f•'.nrmme:rt.ta+all/t,•f� Gla,F:ocleu�l� j Board of Bf<ilding Regnlatiens and Staadards , HOME IMPROVEMENT CONTRACTOR } z Registtat#on: 126893 i Expiration: &3/2010 Type: Supplement Card The Home Depot At-Horne Service DARREN DEMERS 3200 COBB GALLERIA PKW`f#20 ATLANTA.GA 30339 Admioistntor License or registration valid for individui use only before the expiration date. If found return to: Board of 13uilding Regulations and Standards One Ashburton Place Rm 1301 Boston,Ms.02108 Not valid without signature f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information cc//�� Please Print Legibly �Name (Business/Organization/Individual): x ,& U U"7 LL / S VPAddress: City/State/Zip: 30-3V Phone#: Are you an employer?Check the appropriate bo Type of project(required): Xemployees I am a employer with 4. am a general contractor and I 6. ❑New construction (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. emodeling ship and have no employees These sub-contractors have g. ❑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.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 1 LE]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. (Contractors 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'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ew gamos S Policy#or Self-ins. Lic.#: 35 6 ` l Expiration Date: `j 1 h 0 Job Site Address: /7/ WiXdC+W''e y eppG!'e City/State/Zip:Q �il t�lG f//�� 0�S.S 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 certify under the pains and penalties of perjury that the information provided above its true and correct. Signatur yf� Date: ��/ Phone# q(O t Official use only. Do not write in this area, to be completed by city or town offcciaL 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 Phone#: Contact Person: l ' • , The Commonwealth of Massachusetts Department of Industrial Accidents OJJ3ce of Invesdgatlons 600 Washington Street Boston, MA 02111 www.mass.gov/dla Workers' Compensadon Insurance Atfldavit: Builders/Contractors/Electricians/Plumbers u Ucant Information I i Q Please Print Legibly Name(BusinesdOrgenizatioNlndivittual): � /z Address: .Z �- City/State/Zip: U/. Phone#: 5 0;�- 1,2cd, ' GfVC2\ Are you an employer?Cheek the appropriate box: Type of project(required): 1.01 a employer with 4. ❑ I am a general contractor and i loyees(full and/or part-tune).• have hired the sub-contractors 6. ❑N w coasinrction 2. I am a sole proprietor or pager- listed on the attached sheet. 7. [ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' g (No workers' comp. insurance comp. msurance.t ❑Building addition 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 11.❑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.❑Other comp. insurance required) *Any applicant that checks box NI neat also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this aff davit indicating they are doing all work and then hire outside contractors mutt submit a new affidavit indicating such. tContrwtors that check this box mutt attached an additional sheet showing the rumte of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they mutt provide their workers'corrtp.policy number. am an employer that Is providbrg workers'compensation insurance for my employees Below is the polley and job sfte information. (( /' Insurance Company Name: J f° � ( Policy p or Self-ins. Lic. K: Q od Expiration Date: L ob Site Addrem. CityiState/Zip: Attach a copy of the workers' comp�sadoo 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 S 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 S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Once of I vest/ atio o the DIA for insurance coverage verification. 1 do hereby ceerdfy under the pains and penalties of perjury that the information provided above is true and correct Sig0ature: l � �J%V �"l1�'P��✓ �:�i/�' Date Phone #: y "4 L2 02 l 6 7-.1 t Of a al use tin y. Do not write in this area,to be completed y city or town o,Q'lciat City or Town: Permit/License 0 Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/'Town Clerk 4.Electrical Inspector S. Plumbing Inspector t 6.Other Contact Person: Phone V: G Board o f uilcn e u a tl s anTidtffjres flit: HOME IMPROVEMENT CONTRACTOR Registrati.on: 153140 rR Expiration: 1 0/31/2010 Tr/# 278191 Type• D BA A. NU-VISION INSTALLATIONS . STEPHEN RESTAINO- 32 OVAL DRIVE WEST YARMOUTH, MA 02673 Administrator I.icense or registration valid for individul use only before the expiration date. if found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301. Boston, Ma. 02108 Not valid without signature r Licensee Details Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security(EOPS) Mass.Gov Home Public Safety Department of Public Safety Licensee Complaints License Type Home Improvement Contractor License Y 153140 Restriction Company Nu-vision Installations Name Stephen Restaino Address 32 Oval Drive City,State,Zip West Yarmouth,MA,02673 Expiration Date 10/31/2010 Status Current No complaints(ound for this Licensee. flack To SgarCh b ✓i.V1.: P !a License: CS SL . 99560 Restricted to:. VVS STEPHEN RESTAINO. a 32 OVAL DRIVE WEST YARMOUTRY, MA:02673 . ` �} �-�- --� -�-� expiration: 1/2212012 t,11)11.)k��IO!Ii'1' 'Tr - - 99560 V 5 iG✓1 i vt.5 r JUN-12-2009 13:11 HOME DEPOT HYANNIS P.001/004 HOME IMPROVEMENT CONTRACT • PLEASE READ THIS Sold,Furnished and lnstalled by: Branch Name:'Bost►n Date: /ti THD At-Home:Services,Inc. d/b/a The Home Depot At-Home Services Branch Nnrnber: I 345A Greenwo6d Street,-Unit 2;Worcester,MA 01607 ONorth 33 South 31 Toll.Free(800)657-5182; Fax(508)756-8823 ;Federal ID#75-2698460;ME.Lic..#C 02-439;RI Cont.Lic#16427 CT.Lie#565522;MA Home lmprovement.Contractar Reg.It 126893 Installation Address ll_ g ' O'n City State Zip Pumbaser(s): Work Phone: 136mePboue: CcnPbone:. Home Address:_ (If different from 1asE llation Address) ... City. State Zip &r6atl Address(to ri ecivc project commnnications'andlic'm'e Depot updates): 0 I DO-NOT wish tc receive=y'marketing emails from The'Home-Depot i Proieet Inforination: Undersigned("Customer'),the owners of the pioperty located at the above installation address,agrees to buy, and THD At-Home S.vices,Inc.("The Home Depot")agrees to furnish;deliver and arrange for the iastallatioti(-fostallation")of all'materials describe I on the--bclow and on the referenced.Spec'Shcet(s),all of-which are�incorporatod into'dins i,ontraot by-this reference;along with tnyapplicable,State Supplement and-Payment.Summary attacbcd hereto and any.Change Orders(collectively, "Contract): Job#: aam_Ip _.) oducts:. Spec Sh s #: Pro cct Amount E1RoofinS.E3Sidio9V Windows El insulation •q �.� ;❑Gutters/Covers ntry Doors'❑ O.RoofiagElSiding U Windows El Insi Llation $ ❑Gutters/Covers_❑Entry Doors-❑ offing OSiding o Windows Insulation- -[�Guttere/Covcis ❑Entry Doors 0 $ Roofing OSiding Windows 'Insulation $` ❑Gudm/Covers❑Entry 16nr ❑ My n um25%Deposl:ofConu=Amountdue•upon,exemtion4Dfd&cDnbmeL- ; MAinePt rsma;.n stt otdcpoatwr*tW=-one-third•oftheContractAmount Total GontractAmoutic:' Customer agrees that,immediately upon completion of the.worlc.for each Product,Customer will execute a Completion Certificate (one for each.Producl. as'defined by an individual Spec Sheet)and pay•any' balance due. As applicable,each Customer under this Contract agrees to bej)intly.andseverally obligated and liable hereunder. The Home Depotnese,vcs the right to issue a Change Order or.termivate this Contract or any.indiyidual Products(s)-included herein,at is discretion,if The 1�imeDepot-or its authorized service provider determines thatit cannot perform its.obligations due to a structural problem with the horn:,,environmental hazards such as mold,asbestos or lead,paint,other safety conce ms,,pri=g a rocs or because work.required to eotnl lete the job was not included in the Contract. Payment Summary: The Payment Summary#� •0' 'included'as part of this Contract,act,';,forth the total Contiact.amount and 1 ayments required for the deposits and-final payments by Product(as,applicable): NOTICE TO CUSTOMER You are entitled to a :ompletely filed-in copy of the.Contract at the time you sign. Do not sign a Completion Certificate(note: there is one Complet on Certificate for each listed Product-as defined by individual Spec Sheets)before work on that Product is complete. In the event of termi ration of this Contract,Customer agrees to pay The Home Depot the costs of materials,labor,expenses and services provide I by The Home Depot or Authorized Service Provider through the date of termination,-plus any other amounts set forth In :his Agreement or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO TIM E OME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENTS MADiE, WITHOUT LIMITING THE Hd ME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Acceotnnce and Autl iorimtion: Customer agrees and understands that this Agreement is the entire agreement between Customer and The Home Depot with regard to the Products and Installation services and supersedes all pprior discussions and agreements,either oral or written,reWi[t;to said Products and Instillation.Tbis eement cannot be assigned or amended except by a Writing signed by Customer and'Me i Home Depot.Customer acknowledges and agrees that Customer has read,understands,voluntarily accepts the terms of and has mmi,cd a copy of this Agreement. h Accep ed by: I - l/� « 0 x �G I I(1 ®'� to tore Date Sales Co tant's Si tore Date LL In Telephone No. a=10 D�� Customer's Signaurie Date 1Sales Consultant License No. CANCELLATION: ;CUSTOMER MAY CANCEL THIS' (as uppli-blc) AGREEMENT WrIl TOUT PENALTY OR OBLIGATION BY DELIVERING`7RITTF.N1 NOTICE TO THE HOME DEPOT BY MMM GHT ON THE THIRD BUSINESS DAY AFTER SIG]PING THIS AGREEMENT. THE STATE SUPPLE 4IENT ATTACHED HERETO CONTAINS A IORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STAi 7E. NOTICE:ADDrI ONAL TERMS AND'CONDrUONS ARE STATED ON TM REVERSE SIDE AND ARE PART'OF THIS CONTRACT 244591 1 Arm (�n WINDOW SPECIFICA ON SHEET - Spec.Sheet is ! i e* �'](� t Sheet: Customer. , / _�W tY's' � yew j,� o d y JobB 11 Consullanl: //y) o �J� vvl 10 O Data: NE:rating Window New i ow Measurements ds lobo Hinge Locatlotts Productpptfons Optbna iromoutside, p" loeaKion ( —- Left to Right COfor Rnnnh Aw..• _ _--_- . -Says,tfay5,eSOwe, _ - --•--.-•^••a - - -- --go)ban-- --FoTdars CsmtNs,fPnl, . NJ m use L.R or S ' Gfass _ fdisettems Hardware u�i z S F ° o Screens Code For doors use F- RoorA Style 1M1Ataps v a o` �, a a "S"astatlonaryof Floor Coda IN S Code Sertes ode dull 'X'a operalfng e B W e ,a x . H 0 PL. ,7 w A - w 0 x rap cofor Specig CQHSIDERA7I+CNS: WOW Caaing Type Bay or Bow window: Seatboard Katerka zMrvyI­T•Btrch or Oak) . Bay P-Jecton An*j3D r or u e J Bay FlauJcer Type{DH,SHa Cahn¢ . Ide- tf tied to oofrff;ooforof eoMt enafirfaf � Constree4 Roof(Yss a NoJ r f have revfnvd and e�yee•AMt at the lob epectRwtioro above and U,e O Ciardan Window: SPeclaf Tenn and Conalms on the back:or,he yeDor(Cuatot W)copy . N Sealhoard Wterlak(vinyt ony+�lTrfte Pkx .Birch or oak) 7 N (/J�� .i WaIlThIGtnaf e,u,ea .0 Z sfomex Sdgnatura ' hAdMIonal Shoff es or No �.Tlen4mpda.p rmrw/i•;tawr.ee.eely wh. - ac«awnan LY`A•T-e M•.rs[lrpct YeB,r•Caalxra Phl•f:d�e Ottv.lml �- Town of Barnstable FSHE Regulatory Services :i; y •n Thomas F.Geiler,Director 1ARNSTABL6. 9 � . Building Division s6 Myt Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 'Y Office: 508-862-4038 Fax: 508-790-6230 PERMIT# (- 2 FEE: $ o�s SHED REGISTRATION 120 square feet or less Location of shed(address) Village. Property owner's name Telephone number Size # of Shed i U p u, r Co v :Z P� Signature Date o Q7 w r� Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) y PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. �{« . y PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 1 ZS NOT STANDARD LEGEND E:not all symbols will appear on a map GOLF COURSE FAIRWAY =� EDGE OF DECIDUOUS TREES f' EDGE OF BRUSH ORCHARD OR NURSERY v-Vv-v EDGE OF CONIFEROUS TREES \ MARSH AREA — — EDGE OF WATER AMP 1 1 / DIRT ROAD DRIVEWAY PARKING LOT 42 PAVED ROAD — — — DRAINAGE DITCH # 141 -----� PATH/TRAIL _ 1 PARCEL LINE MAPI)a E---MAP# 21—PARCEL NUMBER #leeo —HOUSE NUMBER .... .•.. -- 2 FOOT CONTOUR LINE 10 FOOT CONTOUR LINE Q 6 ! j/4.9 SPOT ELEVATION M P 119 o STONE WALL - FENCE 5 RETAINING WALL # +-r RAIL ROAD TRACK © STONE JETTY SWIMMING POOL PORCH/DECK _ 0 BUILDING/STRUCTURE .............................. �11 FLH=' DOCK/PIER/JETTY 1 119 Q HYDRANT ............... 41 6 VALVE ® MANHOLE i O POST pW FIX POLE T O W N O F B A R N S T A B L E O E O O R A P H. I C I N F O R M A T I O N S Y S T E M S U N I T o SIGN ® STORM DRAIN r PRIMED SrX IN FEET *NOTE:%map is on enlargement of o **NOTE The good Goes are only graphic representations DATA SOURCES:Planimehia(mar•node features)we interpreted from 1995 Deal o TOWER 1'=IDLY sale ma and NOT meet of Wproted photographs by GEOO ,,,.�2�e P � propeAy bouudaries.They am net hue batiar�and W.Sewell Company.Topogaphy and vegetation srere m from 1989 axial �� � U11lIlY POLE 'rI 0 20 40 Natland Map Aanocy Standards at this do not repres/et oM raWws ips to physial obiam Capomtion. Monlreoris, and vqp tan ware mapped to not Naliowl Mop Accuracy Standards r 110-40 FEET• enlarged scale• on the nap. at a sale of 1'=100. Pond aes wne hi izli ed from 1999 Town of Bamstable Assessor's tax maps. 4 UGHT POLE o ELECTRIC BOX \sitemaps\Public\m119p42.dgn Nov. 23. 1999 11:44:54 I • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION p U Parcel ��S ' ��� �° r� Ma Permit# sr�LLet)��^� z, Health Division � V' ®a5,14a��fC�d Conservation Division Z �. � ��fv+r,�L e�ee Tax Collector Treasure , 62 Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address W 6,�t Ttsrt GQL��J �'(R C Lrs � / Zor 3 Village 01c7Z w t U 11C Owner ED a MA� ��,��b9-�IIJ Address Telephone ur— Permit Request 3 isespt- d VJ5 ��►J / / Square feet: 1 st floor: exislltrring9 proposed 25�2. 2nd floor: existing proposed Total new'r Estimated Project Cost (`t' 30� - Zoning District Flood Plain Groundwater Overlay Construction Type F:rZA-M!E_ Lot Size Grandfathered: ❑Yes O'No If yes,attach supporting documentation. Dwelling Type: Single-Family O' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes Ua<o On Old King's Highway: ❑Yes e165 Basement Type: ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half: existing new Number 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 Detached garage:O existing ❑new size Pool:O existing ❑new size Barn:O existing 0 new size Attached garage:O existing ❑new size Shed:0 existing 0 new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name-1 '�'Rnt j rP�4L&,03 Telephone Number Address -_4 0 License# DloSLQ_`f Home Improvement Contractor# Gk&Lf(aD i Worker's Compensation# LC-A. C t2R(0,373 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE _ �Z lO " 9!j r FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS - VILLAGE r OWNER DATE OF INSPECTION: FOUNDATION FRAME, INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL` PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 4 I ' gyg-"jg.gs� J; fn -14 j", C. Ra T 14 .... ... .... a t t vwooz b PIG A.- b 113 FO44 elD ft It q'.g."v r AAHo6APy 17E-c-ra& Ayop Sig"Pr.��j. .z K X -"&v kek JW6n Wly."CMAr, P rOO 'r S.i�A. x& +cevAA Tm) ro P. q Ph'U, f-I.D&< 0 V'r- CIE D A Q. Lr' 23,016tY. oo r.c ev*R. 'eu j.O.. OPT. cc-vAp ASPHALT AADor' Ov+ayacox PLY, T' lya'C.4C AP- $A AfC#4 a ALUu, &VTrF-Z, �5.PDVT.� f: lxf. #L4E If- 0.7T- -ro epbc�- .-,AT'of q oven'. 5c:K"): -.r--.L. cove r.Y'c PAPO+.L DPUla)P- F�, + I-fLO�yi qxy P.T. pa.� Id/IX5 PIA).i• A"P N'k 4 'n <1.5 P1.19 Mkoy) PAOIL15 • MA 9obA� Rook' to.>. Aeow —'5,vt rb D.K 0) efb"oc 16"JM— afl"'o'. P.-r. Pty Swfixr�J 6 Q r- p r. j ILI -tdl C AC j. all co.l. v.,4 T C." 110'en02 15D'r PER eooE T'Of Cz"4 r F14 L DAMP Poto,o'F fmw a GIN DE 8�)AL 10"3DVA-7PdEV lZew o/ "t. P.T. jeofr3 v L STANDARD LEGEND 125 NOTE: map GOLF COURSE FAIRWAY �^ EDGE OF DECIDUOUS TREES EDGE OF BRUSH ORCHARD OR NURSERY v—v-V-v EDGE OF CONIFEROUS TREES kJ l\ MARSH AREA — — EDGE OF WATER DIRT ROAD MAP119 — DRIVEWAY �—PARKING LOT • ��PAVED ROAD 42 — DRAINAGE DITCH 141 ----- 1 PATH/TRAIL 1 PARCEL LINE rear 110 <- ---MAP# 21-< PARCEL NUMBER #lean—HOUSE NUMBER 2 FOOT CONTOUR LINE ---:�- 10 FOOT CONTOUR LINE `,•�4.9 SPOT ELEVATION f STONE WALL M P 119 -X—X- FENCE 5 I �► ® RETAINING WALL RAIL ROAD TRACK STONE JETTY SWIMMING POOL PORCH/DECK 0 BUILDING/STRUCTURE �1p Q DOCK/PIER/JETTY A7 1 1 I HYDRANT ---.--•...... a VALVE OO MANHOLE . ........ 41 . 0 POST o'P FLAGPOLE T O W N O F B A R N S T A B L E O E O 0 R A P H I C I N F O R M A T I O N S Y S T E M S U N I T v SIGN ® STORM DRAIN N PRINTED M.IN FEET *NOTE:This map is an enloWment of a **NOTE:The parcel goes are only graphic representations DATA SOURCES:Planimetrirs(man-mode features)were interpreted from I"S aerial photographs by The James 1°=100'scale mop and may NOT meet of property boundaries They are not no locatlor4 and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0 UTILITY POLE ❑ TOWER 0 20 40 National Map Accuracy Standards at this do not represent actual relationships to physrml objectsCotpomH tdq on.Plonime to hy,and vegetation were mapped to meet National Map Acajmcy Standards ¢ LIGHT POLE EIECTR((BOX 11N01=10 FEET* enlarged sm e. on the map, at o smle of 1°=100'.Paroel were digitaed from 1999 Two of Barratabie Assessors tax maps. \s4te,r psi. gblicXM119p42 d t u. a , 19�19 11;44.54 HONE IMPROVEMENT CONTRACTOR Registration 126560 Type - INDIVIDUAL Expiration 06/21/00 ` j AIBERT R. BROWN 34 HORATIO 'LN G� �.&-f�II'fERVILLE NA 02632 can ev; ADMINIMMMR OEPARIMENT OF PUBLIC SAFETY ; C4NSTnC7T0.K.SUPERVIS0R LICENSE Nf► el'r _' . ..Expires: 4 Res t:},fw4ii 6B two#% A1B.ERT &r`BROWN 34 HORATIO LN CENTERVILLE. 9A 92632 i ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE square feet X $55/sq. foot= GARAGE (UNFINISHED) square feet X $25/sq. foot PORCH square feet X $20/sq. foot= DECK square feet X $15/sq. foot= OTHER square feet X $??/sq. foot= Total Estimated Project Cost 4c g990915b The Commonwealth of Massachusetts Department of Industrial Accidents p � ,==-- exce 91f/ayes0at/oos _ = 600 Washington Street Boston,Mass. 02111 — Workers' /�nsation Insurance davit name: location city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one worlds in anv achy �//// % %%%%%O�---- //I%%/%%%/%%%%/%%///%/%%//%////%%/%/%%%/////%%%%//%%/////O%%/%//////%/�'�////%/%///%%%%/%/ 'r am an employer providing workers' compensation for my employees,working.on this.job.:: :::::::::: :::::::::::: ::::::::::::: : ::: :::: P..°3' .p...................:.:::.::::...::,.:::::.::..::..............,.:::..::::.:::......................... :,.,.:.::::::::::::::......:........::::. :::::.:::...:.:............... :::: :::. :.........:::::::::.:.. ...:.<.::. ` e -*rfi r A c� til p tim :<ss:•:: �ddre :: :::.:.... .................::.:.: ..:.. one .:...:. . .:: city l .. :.................................................. insuranceco. .... ; '.�:Z3ff.:;:: 1�+►l� Gt ::;:.: ::;';:::.;..;.:.;.:....;;.>:;' oiicv#:;;': .:...>................ ......... .. ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have efollowing workers' compensation polices: mP :::.. ...........................................................................................,.:.::.,.:::..,,:...::::::.::.. xx X. a m tb � a n a a ire s ....... fie ..................................... cihr M.fv.. ............................................:...............:......::........................................................... •:r..........:.:::.�::.�:•:.�::::•::.... • _.�::::L::::::::•::. ::::::•:::::::::::.�..:........:n:::i'i:iiiif:iii:ti4:ti•:iiS:•i:•iii::};:;:;}G:4ii::i::•:�:•:.:::;:::;:,'•;: ..... ... ...... .................::::.�:.�.:::::::.:-......v........................: ...... ..........:................:.....r.........r.................. iiii:'::ii'J;LyiiiiXL4:L�:;iii:L; iiS:���:•ii:•i::��:�:�ii:::_::.. '.i'^:L•:tin:•if.}.v::•::•:'iii:•isti•:J:�:i•:isi::ti•i: :•iii:':':•i:•:':•i:titi4:'iti.�.i:•::::::::•.�::::.:y::•:.y::::::':::::•:..::::::..:::: �ll�♦ Wo .............. v:name:<::><:::»>:>::::::;<:;>.:::>:.;:;;;;:::;•:->:•;:.;:.:»;:;;;:.;> :..,.......,.....;; s . es dr ad ........... bn e�araiAce Loki Fa sure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Ste 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 tine of 3100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verincation. I do hereby certify under the pains and penalties of perjury that the information provided above is trrrw.and correct Signature a_ � Date /G g - Print name ✓� �'�O W •.J Phone# � - , - �O�8 Ccontaa only do not write in this area to be completed by city or town official town: permit/license# ❑Building Department ❑Licensing Board immediate response is required ❑Selectmen's Oifice ❑Health Department on• phone#; ❑emu' ouvued 9195 PJA) °FTMe r� The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 r" 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. /n Type of Work: ? -r(L� Estimated Cost Address of Work: Owner's Name: Date of Application:1 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under S 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 pe the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav