Loading...
HomeMy WebLinkAbout0028 CAP'N JAC'S ROAD � g � �n ��c s ' �°' � , v v r I r t u ��i o �,�, ..,.—�..�.. ,•-.,r I 1 1 i �I t+ I d r, M r P O z �n a Engineering Dept. (3rd floor) Map e Parcel 65-1. (000-v Permit# ems' House# Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00- )G ' 3�7, ee S,enci IC Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) SEPTIC SYSTE T BE INSTALLED IN CE Board 19 WITH 1� ate. ' ND 014MEN TOWN OF BARNSTA � ����, �v Building Permit Application EIV 7 E\Q�v I Project ddress Villages- y Owner yekyro, C C'%5 ezDo0 OS Address Q$ Telephonej0$ c,a- Permit Request J First Floor square feet Second Floor square feet Construction Type �rn mX%Cp Estimated Project Cost $ �5C -00 Zoning District R12 Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family M/ Two Family ❑ Multi-Family(#units) ^ Age of Existing Structure %%4 Historic House ❑Yes WINO On Old King's Highway ❑Yes I(No Basement Type: dull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing�_ New Half: Existing j 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 Use Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# 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 TO SIGNATURE BUILIING PERMIT DE D FOR THE FOLL WING REASON(S) FOR OFFICIAL USE ONLY - t; c C PERMIT NO. r �"I w or DATE ISSUED MAP/PARCEL NO,',. < - _ ADDRESS VILLAGE, -� r OWNER DATE OF-INSPECTION: { FOUNDATION _ FRAME INSULATION - 1 FIREPLACE . ELECTRICAL: ROUGH FINAL- PLUMBING: PO,UGH FINAL GAS: A`�,p + GH ' FINAL - FINAL BUILDIN S f- �� e' - - Q }� :. "# na" rof . DATE CLOSED©iTTL t ASSOCIATION PLAN NO. - t 4 LE FAM t�.�! - 3 Y P•O'o�K . \ uQ• / ; , 4. CL' I o et330 6.P. D gZ; o. to • .. O l t. E• •� �9�Ttt. -�-Aw�c..• 330 x 150% Otis `� : . ' l000 :otgPosc�l_' Ioo'O u �sTAJC i 5lccwAu./aesc► ` 226 S, F• ,..__.:..� � :�.. _ ' _ .t_L• _ 633' -: .�,• .t' 2�G ic' 2e o s'467Z G.P. D, Q �.�'": :. : I ,, $• r► �loTTo J6n, NZMA•i ' 113 5•F o ' ,. ' . • : :, ;-J`- :. . ,. . . :17.�.x 'o.e 83. �� :i .93� G.;/P1�: 'y •,►` ;4g:r or it......:..► at..'U6eStCvwl� ��I i✓;!p:Qt p ,. ,:.v, I : �•. i 'tH ` .- I�. =� '4 R it , L. T. .,. : .t:• . ; t�.'u w1� w I - ,..•, - . r -;_ �...+'-..•i».;_:.J . 10 ..... . } ..t..;•: r• 'f r'�I'� ��.,'. .. •.��• •' C !'I•�.�. �' 't.. ., •; ;T �� 'Try �l.,;::'�.,. .,1.''.�I:, ,t.l.l 1_'_t.i.•i.lf �e:,t . . . . .•{� .� 1' ���((( t• •i :. ' .:i ;. �� , :'• - - � � .�-tl ► 1N1.. ;� ..t,..�.f......,i-•;._. e..i�.�:;a-%�- I-i r•�:.�';.^•:�t• I. ;� I• �•,Ll.•;.,•. ;. ,I tom_. .i ��ti1•t�;:itr;, j t e. ,.j11 Cf Al k I C.� ► t i ' — . . I "�----"...•:t; `A utiltlulttlllll• r • I C. _ : '; . I I, 1, ,..' 06 tFiUIIN"tv �:�, � : ; h� •; ! ' I ,.�' : 'r� , ,�0. ; ;' . ' t tri I—+••rsl; �P. .: . ...�, ':. •,,p� � . .. ; 1 �•'-� ' ' ti �.! i � .. t• �. ` r a . ; e .::..:•r. -1�.{i• NAIL . I....,,.„}'•'•tit•r,_ .I ••..*�,.._.•.•�._.,_ t I I..• �.. . ' ••• line) t lor'Fav •r '•r.r.r..• .1..;:.,._ ... • i.. ... . .I I 1.• .. I �I/ I . � 114 T. •;i tUv • ` ;"� •: a-N T¢.� • 4 PPE twv ,,• , • ., ,4-. • •" j Lo4M.�j:i w�p� tuu 4bG.. M. D15r t; •►_; . ,e. .� � •r.,,, .t. .�,, »_ .�� ,. .i - r• , lL,h/*. , ' Tr-t•ll.L , } �p' .•� •.� . ...•'_�-+'J>- I _; _i.t.' (t7b0 tl I.d j l uV. tt•td'r/' . . R• } ++'_-".{,.�°�"' OPAL,Ft T ....•.�...�3 �e. 7�/( 7 ....�._.- --f ,y _. ....�.....�.�.�.+. UATO 777 :I : .. �/FiNEt. :. STU►IG� '' E�r�U� . ' : . . � .: I : � ^+t•� CE2T t Ft q-D pQ0Fri ..E- ' i ; : lol.t Y AR.AJsTABt�. I Ucpr A.T- WEs8 uo . SGo,t..E� ` I :.. .. ..:-- i _ :. SGA.Lr= .� wgrF2, :.. ... . a t� tzEs-ezm-&jc:E=' t cLcrl F-f ' TµAT T"f-- •F-tovpi o A-M o Q 51,401N Y S W t T !'s H Tk . ' �►IDEt-1►•t Es �.._�" I .,. t•iC 2Cra u:,t • Gotic Pt•: . •.�. At.JD Sk'TBAGK. :QOIrZM��•1Tii OF 1't•1E QL.. N �U1G. fe«•� t_ TO VJ o:a' S A i?1J L VILE i; L.Oc�dTE3� W 1T1-ll N Z' E �l�Oob Pl-A1 f,.l. ��?fa�'F� �1.1 Z7 l �.I oA�r�- 3=30 - 94 � �,c„X•re e a u�� «C. . !.. .... . ILA t5T a ucr> LAaJ o �,J2vE`fi I .T"14 PLAv It," UOT 1WED OLl Au TeOME-MT OtTt~:.tZVI� i r Artl�rafa• .SUevc/ >y Tt.t�► OFFSCT� it-touts uoT 156 USeA AP' SAN,- K- N, i I FT . f. _. Ao i N - — a �Cr S c:;- ZOUI)D A-k"L PdZo v►moo L` -o 2" Z "V (D S elf �p.�ct� ..�``,x. : T1rc• Cunntrunll�cultlt uf:Itussuc•11usc1Zs Depurtille"t of Industrial.4ccidents plegallMOS 92tlans !f'aslringit) Street 4' Btivim.9lusa: 02111 Workcrs' Compensation Insurance Afrdavit �IiPiic mt informatinti Plc•tse gm71�;@V 0 1os incntion• Zt� e � 2 X—am v- hr • C,a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 'jfI am an empiover providin_ workers' compensation for my employees working on this job. ennin•in-• namc- add rrac• tiny• nhnnc ft• • in-nr•ince rn nnlict•!! I am a sole proprietor, general contractor• or homeowner(circle vtrcj and have hired the contractors listed beiow who the �611o%vin_ %vorkers• compensation police.-: cnmr•mv rininr• atirirr«• fln" nhnne H' invirrnnrr rn nnlic� __ _••_ emmn:lnv n-iinr• adrlrr«• rift nhnne/t• inwr•nce rn neriev _ _ Attach additional sheet if neccaiiry- _^v; --+�" •�• - �••- .rr..,.e..��s�: '...r�.w=:- �.. F:niurc to s"ccurc cover age as required un cr tection L5A of NIGL 1S3 can lead to the imposition of ertmtnai penalties ofa line up 10S1S00.00 anurur unc z c rs' imprisonment a. ��cll :ts civil penalties in the form of a STOP NVOR1:ORDER and a fine of 5100.00 a day against me. 1 understand that cop) of this staicnictit ma% be funvardrd to the orrice of lnvestirztions of the 01A for covcr2Cc retarieation. I do herenv ccrriit•under the prtitts d penal 'es ojperjurt•dear the injormarion prorided above is truce urrd cza orrect � Date b l /�-' Print name Phone 9 ' africiaJse only do not write in this area to be completed by tiny or town ofriciai - Ett f• city or tmi�n• permidlicense>f rltiuilding Department C Oucensing hoard [_ f t L ` check if imincdiatc respunse is required C,eieetmen'+URcr r. 1. Cticaith Department i r phone N: contact person: nUtlier ` Information and Instructions Massachusetts Genenil Laws chapter 152 section 25 requires all employers to provide workers' conipensatittn';, etnnlo -ces. As ducted trcim the "1a��". all cmrlot•er is defined as every person in the service of anther under ::. contract of hire. express or implied. oral or-written. An emp/urer is defined as all individual. partnership. association. corporation or other legal entity•, or any two or the foregoing engaged in a joint enterprise. and including: the legal representatives of a deccased employer. or:hc rccci n �cr or ttstce of an individual , partnership. association•or other legal entity, employing employees. Ho%vevc. owner of a divellin_g house having not more than three apartments and who resides therein. or the occupant of the dwellin�_ house of another who employs persons to do maintenance ;construction or repair work on such dwelling or oil the __rounds or building appurtenant thereto shall not because of such employment be deemed to be :tn et:;p MGi_ chapter 15: section :5 also states that every state or local licensing agency sliall withhold the issuance or _ti�al of a license or hermit to operate a business or to construct buildings in the commotmcaltlt for sm ;cant Who ltas not produced acceptable evidence of compliance with the insurance coverage required. ,Aau.:ionall\-. rtcittter the commonwealth nor any of its political subdivisions shall enter into any contract for the pertorniz::ce of public work until acceptable evidence of compliance with the insurance requirements of this c/iac:: bee:: pre::z:tted to the contracting authority. altltlic-,nts Please 'ill its the %vorkers' compensation afTidavit completely, by checking the box that applies to your situation sucpiyin_g company names. address and phone numbers as all affidavits tnay be submitted to the Department of !r•,dustrial .-accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The -.:at•it should be returned to the cin• or town that the application for the permit or license is being requested. r- :he Depar tntent of'Industrial ,Accidents. Should you have any questions regarding the "law"or if you are req:::- .o obt:.in a \%•orkc:-s compensation policy. please call the Department at the number listed below. city or Towns Ple Y:e be :ure that the affidav it is complete and printed legibly. Tice Department has provided a space at the bot`crr the �•- aa� it for you to ftil out its the event the Office of Investigations has to contact you regarding the applicant. P be _ : to fi11 in the permit/license number which will be used as a reference number. The affidavits may be return-1 -ae Deparvnent•.by snail or FAX unless other arrangements have been made. The Office of ltrvestigstiails would like to thank you in advance for you cooperation and should you have any quest: piease do not hesitate to _give us a =11. The Deparr;,enr:s address. teiepilone and fax number. TIte Commonwealth Of.Massach�userts. Department of Industrial Accidents = ` =• Office of Investigations 600 «'ashinbton Street i Boston,.M.,L onji fax r`= (617) 7Z7-7749 nhone =. :61—) = -4900 406. 400 or THE The Town of Barnstable ���' Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossr-" Office: 508-790-6227 Building Commis- Fax: 508-790-6230 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, mode exit n, conversion, improvement, removal, demolition, or construction of an addition to any Pre -ezisting 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. Type of Work: Est.Cost Address of Work: Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law _Job under 51,000. _Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIROWN PERMIT OR DEALING WITH UNREGISTERED CA13LE HOME MoRoVEM= WORK DO T HAVE CONTRACTORS FOR APP II N PROGRAM R GuAARANTY FUND UNDER MGLO 142A ACCESS TO THE ARBITRA SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATION Numbel Street addresst Section of town "HOMEOWNER" - Name Home .phone Work phone • PRESENT MAILING ADDRESS ,.. o "' 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 such homeowners to engage an in- dividual 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 re- side, 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 OfficiE on a form acgeptable to the Building Official, that he/she shall be responsibl for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the Sta Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Departunent minimum inspection procedures and requirements and that he/she will comply with said pro dur and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a person (s) for hire to do such work, that. such Home OwnE shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction' Supervisors, Section 2. 15) , This lack of awarene often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "Owner acti as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/tier responsibilities, ma. communities require, as part of the permit application, that the Home Owner 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 to amend and adopt such a form/certification for use in your community. E Asse'ssor's`;hmap and lot number (/�dJT���l.... i..� J. THE t Sewage Permit number ....91..................................................... BARNSTABLE, � -umber ......................... ! .b....... ............... O * aHOtse 9• •E wX Or TOWN OF BARNSTABLE BUILDING INSPECTOR . APPLICATION FOR PERMIT TO ...........COTls tY'UG t Dwel1;LZK; TYPE OF CONSTRUCTION ifnnd...f Q:....:....:.........................:................................................... NAV 8 1984 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Lot 72 Capt o Li i ah I.s.-Road�...r�i e .....�`?.:. a r 0 s c. Location .......................................................... ............................... Proposed use.`.....Single...fam. ily .. .. .... ...z..................................................... ............................. Residential Cent—Oaf Zoning District ..:.....................................................................Fire District .........................:..........:......................... ................. Name of Owner ...J91e.S,,,K....Smith ...Address ...........$arnstable Name of Builder K.....;aTith..............................Address ..................................:. Nameof Architect .....:.....:.......................................................Address ..........................................: Number of Rooms .......Foundation .....,U(??i7'Pc ...G,()X?C`.,:r.`,P,,,tP......................... Exierior ..,clapbgard..&..W e C ,s s ...........Roofing asphalt ............ ................................... .......................................................................... Floors .,...hardwood .Interior drywall bArNo.od........................................................... ..................................................................................... Heating a•e waxrm a .r ....Plumbin at.'b..s................ Fireplace ..0rie pp ? Approximate Cost ..... 55. .000 ....................................... i 3Z/ Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area .......................................... Diagram of Lot and Building with Dimensions Fee �S SUBJECT TO APPROVAL OF BOARD OF HEALTH . t�G• Uc�J1 cs Cl 9.J 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 ....... 1.D.j.. .�. S, o Construction Supervisor's License ... .............................. / y �Jr � cCr o-a SMITH, JAMES K.- A=194-23 No ..2.6432' Permit for One Story Single Frmil „Dwelling .... . ........... Location ... .......:.................. ... West Barnstable Owner .....JameS:.K....Smith . . ......................................... Type of Construction Frame ................................................................................ Plot ............................ Lot ................................ Permit Granted ......My..15.,....................19 84 Date of Inspection ....................................19 Date Completed ................... i s s • �> a TOWN OF BARNSTABLE Permit No. ---------26432----------- . Building Inspector cash f n' . ------________________ '�tapY OCCUPANCY PERMIT Bond ----____----x_f_I_ , Issued to James K. 'Sarith ,Address' .� lot #7 28 Cap'n Jac's Roast, West Barnstable Wiring Inspector � �*� Inspection date Plumbing Inspector l c N 1 Inspection date ,/Gas Inspector > .Inspection date 4 T�At A Engineering Department ` -� a' . � 1` - + Inspection date/-/ Board of Health 1 f 1 `t ey--i Inspection date v THIS PERMIT WILL NOT BE VALID, AND THE`BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE,z-WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. law 1 ................................................ .19......_._ ..... Building Inspector i I St u G LE- FAM I L•�-e - 3 ! Y�P.DoArl /� _._'' - I : /.�. i .i }t, • a DAL--( F',C-6/ • I%CU 3 - 3306-. P. D r-�Z� �/ • 'I Tr+O -,!., SF�ZG TA�.►K..• 330 )(. ISo7 I : 7 ,. Um 1000. wtsPdSat_� ptTf lu;sE I�000 w�3 sToNE:'.� I . . �.. . ; - � �.;�7�� , • . . :.. ..•� • ! � i �'t> ,: ! SlocwAt.L.%�aetao, _ _226 ,s• F: �,•�- , ; . - ;. , 2 26-X- 2,o • � ¢SZ Cr.�R'D.' • Q • � � � . . :�: , I �� -a ,-.-.-.-'--It: 1 ;•: :":. .""�.a,�`� �''T1- � ` ,�. j SOTToiA A2eA a� 1 ��3 S,F"` o . �j: ` ( : , : ,,, • ',� F. : , �. � `�-~.-.'-.� ToTa�-.vESt c ws,�,:S4S6rL� P... ,,-.�.; '7 •- ��r.�y1 . �.. ,,• Ir QE�,('�pL+dTtOtl Q1iTl_'' �• to how' .I a.j. F i, :+• __•..,....:- .!:' � , 1T: -r' �.:F r..,' .. , .J { 1. 1. i , ff t�7 I ���{{{ 1 'I.y � f 1 ^ r . 'i''1I •+ :, V.�J ,. .i-7. , ^I `,1C,A:AA 7 ; :• t Ij r .. / 'I Y�.} :�.wt..�l !' I ���._+.I ^`2t•Uli•fCq •,:„ t�Kt 'sue*`1�11•�'�'1g1, t ".1'� I �'.I.r'I '� t - ... t �'ar�►• ��, 7 y 1 i{ i-...- Y�tcy� - I• StM,t I ( -..��. YIN' AY -- t t 1 t µi I • t -- .._.._ ._fir • ..-F r r,iULII � � Y'Ii ! ji.���,.. ..N:Y. .��• .6m ''F:;-:. i.�,I�i: ' Nq;�99y� .1 '' i.�' . •�� � �..-� j'1• i.� \� . . ...'. �. '.(j'' E , A.. , = / I 1 1 I1.•-c,- ,-.. ,i`-v, 1 t `Qi - t '#'Q %s F•" .,_. ,r I t -I.r _ .I r :7 , , ..s.,M., rc�. Tr i F •r• ' ,•.w�,A+• .r•+-o•,a+n,. v,v.r-r_�rr�;t-t:t••'�.7:^"�:_1"."�'_., 't " .' � ��.•.r. r •! . ---.i I _// r • ` ' , a t r .• ,1 7 I,f .. -•`I' , i 1•W9f....�.ihYi 7 .�. •.1 .I.1. t s¢rP/c►+teM.. 77.�17C�i'7; �r _ ,,��E t --•— •.� lU�! ��1`� e � �' ti � i �' �� c� �-7" `��l•L '. ^ ��.. �,.:. ��!/��i � ' FJ1� �1... /�/,/. ,v•� .: if-at w.f.1•.i' rt � ' _: ! _• SvB:5o141�Ff- .t t D15T � �LQ � e- c �`.., j ):ck•a r �. >-Ni�.:d. „ ..µ;t, Scp'fIC. C... _ , •, ..r r i- -:: i. ! 2 ,,.;1: J1 r. I�✓ iio>R. . . .///•�r T7r,t.11L I _ I r r I fit I I bit/. f •, it ): 7. iJ r ty�tr• I , .. . I�� �,. 1 ._�_�.. ' R —.. ..._ r7 T••--+vir ..I i ,PIT I ���. �Als/�Y:'�!`.,Y'. WtTt,S� � ' ..� : .: ���' i.( • . .A ._.... , .. �±/• ._:"":- - ...--.•••:.±�1�►tr+t••nn*1.• L� AICL'. STD td 6 Cv—=2T t Ft FAD DI:oT PLA�~i.i` i ;!! it 20 Fri L.Er _ L.o1G/LT10" WEST $A FW STA i O - s.i.1. SGhLr-- I ,1�la'wgTE2.l ,..:. ... ., •,,;, ,-,i � i � : _ � : . : I ` . PL..Ja.tJ. LLF..FE2C-.t,.JG�;�: s = l ~C LCrl FI ! TµAT Tt*0 FPvpJ O A Tf o►.J 54�ow y --- �_�--+ ----•s.,.-. COAA 1 A►.iD r ar-8f.CWL _rQa4o0 ZJ-r- OF,..T W E i T4waW t, OF, BAC2:1�1LTASat - p,�to 15• NOT ' J. ►-�.. :, M l ' ' i_ot:A-t-r� wr IAI 1 pAT 3- 30 434- 5AXTEe. t, 17a v5TQ MC-D 9;U2vE`poeK I `! P l� �v �.1 uDT BASED oU AU TWME�•tT :Tµ OSTE:-2Vtth.uG. /t�tJb�rS• 1 ,. Suevcf "�`'TbIG oFFsc.T . -5"OU�t� uoT v56 uS� t.i . APl .tG A�-Jt T SA N l s ri%T f{, > - Assessor's map and lot number �9 [y '� -� F T E. Sewage Permit number .... ........tydS �11.1. D House nsimber .........................�.....................�............ .. s, rasa TOWN OF BARNSTABLE ' ' BUILDING INSPECTOR ; APPLICATION FOR PERMIT TO .. Construct„Dwell ng, ............................................ 'TYPE OF CONSTRUCTION .....................W..66A...fx:aMe...................................................................................... $4 19 'TO THE INSPECTOR 'OF BUILDINGS: The'Undersigned hereby :applies for a, permit according to the following information: Location .................Lot...72..cap.t...:.Idiah!s Road• ...relent ... '.�........�a::�a�n s ... G1o1c-..............:: :. Proposed Use .......Single famlly............:. ........................................................... Zoning District .....Residential.....................................:Fire .District ......Cent.t-Qgt..................................................... Name of Owner ...s141P.Q.Q...K......$A h..............................Address ............ .............................................. Name of Builder .sT.4M..0...K th............................:.Address ................................................:................................... Name of Architect ..Address i.:............................:........ ... Number of Rooms .5................................................:........ Foundation ..... ].O.lax!✓.d... .QZIDEt. ............. ........ .....: Exterior .... lapboard...&..w.tA..s:.:.................:............:.Roofing . a'pliaat............ ..............:. 'y ......... ........ ' 1 Floorshar'd39P.QCZ....................................................... Interior.:. , dr-wall................ ...................................................... Heating ..ga,S...1WaM...ail?..........................................:.....Plumbing .........2...1]a.thS........................................................ � . � � • Fireplace .........one...................................................................:....Approximate. Cost .........,..5S xpW....:.............:.:.......:... �...... Definitive Plan Approved by Planning Board -----------_------_._---------19--------. ;Area ...:...................J�. ............... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH i 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. �) i Name ........ ....!11... .�.......................... Construction Supervisor's License ...�.S��O / SMITH. JAMES K. No ..2 : .. Permit for ..One, Story Location ...... ,..:b -. . Nat. Owner ....�7r:U)e5..Z,...SIIU,ti1........ .................. ri. . t Type'of Construction ....Zrame.......................... . z. ...............,......................................... Plot ............................ Lot .................... ... .... 111, Permit�Gran'ted '..15.........................19 84 nl 4:Date of Inspection ....:...............................19 Q� .' ;`Date Comp/leetted —16..........190 a '�•. TOWN OF BARNSTABLE ° BUILDING DEPARTMENT i DAIMIT i TOWN OFFICE BUILDING � riva HYANNIS, MASS. 02601 �0 Ulf MEMO JO: Town Clerk . FROM: Building Department DATE: An Occupancy Permit has been issued" for the building authorized by BuildingPermit ._-.... ................................................._._...._._..' ._........ issued _~�� ,0t Please release the performance bond. �01C a Parce d.7 Permit# i 3 91 0 Conservation Office(4th floor)(8:30-9:30/1:00- 2:00) 0- ate Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) "' 464i ee 2S Z) Engineering Dept.(3rd floor House OL SI_PMUST BE 19IRl�TAMPLIANCEE�IVi8 'CE 5 C®x F.A:f3 TOWN OF BARNSTABLE Building Permit Application Project Stree ddress illage Owner Address Telephone o7 —07 Permit Request V. ` LAP* First Floor square feet Second Floor square feet Estimated Project Cost $ � Zoning District /P� Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure /a —f— Basement Type: Finished Historic House /J��}- Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including Paths) First Floor Heat Type and Fuel Central Air Fireplaces n1 Garage: Detached / Other Detached Structures: Pool Attached ✓ Barn None Sheds Other Builder Information _ Name �� Q ���, � �v� Tel phone Numbers Address (�Lice se# .,���� • GU a ome Improvement Contractor# 6 G orker'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 TO ,�� SIGNATURE DATE Z/i k BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY P�RMIT NO. DATE ISSUED Mike/PARCEL NO. •y ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION 1'1 .FRAME, INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL - PLUMBING: -- ROUGH FINAL GAS: `ROUGH FINAL - FINAL BUILDING to -29 °DATE CLOSED OUT sz � 1, 0 W r ASSOCIATION PLANINOX +` The Commonwealth of Massachusetts Department of Industrial Accidents N 6111) 11 ashington Street Boston.Mass. 02111' Workers' Compensation Insurance.Af idavit e mileaan nformatioonni- name: location• cit%. phone# I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity ��l m an employer providing workers' compensation for my employees working on this job. m addresse insurancea# a sole proprietor,g 1,contractor, or homeowner(circle one)and have hired the contractors listed below who have the following worke pensation polices: eompinny name- Sitx: phone incurnneeco 1��T/�r�l �CSyu!^�_ iX CO nnlicv/! zLie. �__:_ .�--: :.:-•• - . �.:.:..�:.:.ar�-=*•�►.?•--ren:���., _,:���- •� ,�+•,•;tomes_���.��r_��se,sa*r..:----.*•� anv name: address: city phone#: inenr+s ace ww ey}t Atiach additfoeal'sheet if tiieeu. art. is- i%X y-E-t•F---M " a"rsi. f—ailure to secure coverage as required under Section 3A of MGL 152 can lad to the imposition of criminal penalties of a fine up to SI300.00 mad/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a line of S100.00 a day against me. 1 understand that a copy of this statement maybe forwarded to the Once of Investigations of the DIA for coverage verification. " I do hereby eery under dye pains and penalties of perjury that the injonnadon provided above is nue�and coonveL Signature - ate —' /D n CA 40)y 05-09 Print name 0Y, d aPhone# �t official use only do not write in this area to be completed by city or town official gin•or town: permitAlcense# rnlluilding Department 3Ucensing board ' Check if Immediate response is required E3Seleetmea's Office �liaitb Department contact person: phone q;_ Mother (rnisedl-95 rJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide Nvorkers' compensation for their employees. As quoted from the "law", an emplm►ee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An empinrer is defined as an individual, partnership,association, corporation or other :opal entity, or any two or more of the form, in engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the CIOreceiver 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 1'S2 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 in 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 contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box 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 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. s�►sw���.l�!+e!Rn�w.....a�•eR _ ...1;"•a".r ii _�::.a •'.r'..�. ::`.. ' `S'a ^Se7�7�wif'.. �'•.'.'. .. ►- .".. •• .. •!Y�.;• �A.i'•..'L'.+.e,`j� .�:h'1'. +7.— w1�. .•.}•J1�f.�Wt. •T.!.�ii� ^Y'�•: 1!'•• •Y [•1•�•R 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 for you cooperation and should you have any questions, please do not hesitate to give us a call. i.7.:.^-a wv•a.w4"�'..•�y1"u'i' `•�-;r`: •%..:_�•-:rr.: - �w%::•......:�. 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 fax#: (617)727-7749 phone#: (617) 7274900 cxt. 406, 409 or 375 . : The Town of Barnstable $ Department of Health Safety and Environmental Services 6� Building Division 367 Main Street,Hyannis MA 02601 Office: 508 790-6227 Ralph Fax 508 775-3344 Building Commission: For office use only Permit no. Date AFFIDAVIT HOME 1WROVEMENT 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-edsting 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 Est.Cost U ". T of Work: "� CI 1 Address of Work: k2( Owner.Name:_4-Rir r!4— a y �1 S �Dateof Permit Application: —3 I hereby certify that: Registration is not required for the following reason(s): Work occluded by law Job under S1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: CONTRACTORS OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UN1tEED FOR APPLICABLE HOME IMPROVENCENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERJURY I hercby apply for a permit as the agent of the owner. Date Contractor name Registration No. OR bate Owner's name .M li ( ► 1 � 1 ; , W / 1 / 1 •« 1. �, 1 r : •• �� : �~•ram, c - r � ; q� � �� � ♦ �� �,� ®� ram® �� � i. �� ►'" ' '► • � � err ' u 4 LE FAM 1 t....f •• 3 Y .Do�K ��, �,� _ 1 t k�F`�:'. ! DA L.H 330 6-.P. D u4;GL .. 1000 �3 . : • :': . ; � � I r ; . . gS'633`� 1 1_1-.: 0 467Z fr.P D. Q ! ? . ' ' '' . Ij SoT'To AA, A2eA•I ' 1.1.3 5•F ; p j 043. :.� ' ..:...« . AI` �. ....� p;:'T� l:U(:':X=SaiW' j`�.:33p ::i�rP, L?�- .���� �, , � .!� i ; �! ' -I la� r � i ' •�� �'- -.j-!r� 1� VS- ra6ATc0W. :ZAT�'' l lu ¢mw , ' ►,�'�1: Y� '� .""' , �� �_1E '_ r .� • - ` 1 �••f Y,�, ,r f7 i� ;1•f^1.1. �.3;'�- ./..». .. •I. � 1' l• ,'; .,; �� 1 - r'. � r � � •'�-'I ��, ,. �.. ,. ,:.-::-•.,_!'i.iL.r;i.:;.rwi , {1 _;.;.: .•,..::'t.:.l �:• .. I �J� 1 'r '4:' 1 .. �`! � � .�(w.,1,� ' '� .:J.•,. t.•1 ltj.l �' ..:A♦ C. •� '� ' 1 ... �. � I •�a� :\�:'•`` '� ;`• �ZN .1:' •,._.1::t 1' urUlA��.-.' "..�.,v.:�-r` .. y� • _I l i 1, i I `i J�i�.�: ; S. •ii 3 f'ir "�• .: t;,�. �..1-...• t�j - il. �o. U41N (..W.- t" 4aa .. •ry1S Ii+ � ...tll r.r�-...• ..-. _.. �. I.. ►'r'.__ A ..r.�•M•r-•..� .p-r,•._V•n..•orttri•,Tir s.�_Z T•-».T.-'^'�f'^�-. 1 +� •••,�y:� ', i.,,-n..:,.�.....f•rv�..,...�«..--•+• ---i- � :�:- _ .. i..' _..... :1.' ' �.: .. t �-�+ t tL'D �t 1 OP'F41D'u{�4•.3� .i . is• L. . j.. _.��.;, �crr . .i3S77MC77M.. ,,DD -_' •.j w�c•'` -; �: :.��-�-: j ,.:, SvB:Sol�t.•l 1:.. o DKT 1•l:.r .s: ,-�. Nt••p.. r.,, ••-•i �• >�. :' � T7>,tJIL .r :. ;� .• -,• -• ; �" 1 �- �; I •f.{i t, :�,«•- y«T. �:.,. •'•i fi - ,' 11�1/4 f O ��� , i �� r-� r-' ?_ '� YJAWCO raTo w GEL � 111 � -tj' r: ' :_.+�=i-�.�:.�'• (�0 :i f�l l e+ `t a�/. (1.�� '_-: ` �•� '~"r l�-r�:'-!-�- . •� ., { :.: :... , • r i( . . . ; I I . . • • I : : C E¢.T �F t�a wt..o-r • Pc._A�:,i �20 Fr L.S- i i ; . . . `.. . L arto� WEST $A 9W. ' '�;, .. . : ./ i . •:: ::.. uo• .Se•est••IF:� � I ' . . . : • • � • . SGI�L� tll: bo`_... �taT'� ',�-;30.8 v wq?'ErL.! 1 CetTl F`( I T"AT co M P 1-Y S WITH T41.6. ' 1 �-1 r•t i �. AwD �skTTBAGK. M6,�.ITS OF Tt-J� QL. N �UIG ---t`>•r"��"r i1 Tpva" of $A1?1JLT RIB - �; IA�.TE� WlT1-11 {.1 'l" E FLDoD Pt-All.l. • �P R�1.J Z71 l�t 8 .V.� g4 r�'i, `1 . Q�C-.IST� RED LAJJD �(ZVE`(O� { OSTELZVtt� AAA-Ci5• .T1'�!S Pt_d4J ISr tJD'T 'BASED oU AU TP.uMWT • •'. i TOG- OFFS4T� ,,//iµtwl.b UOT �6 USeA APPLIGA�JT S,gl-tt=s tom. m%'T •{ To '�eT��trr�E. LoT. LIU54. Parks } UVCM WIT _ -s s i' Fall re to posaeaa a sort*&$ Restricted To: 00 MaraaeboWtv Seats INM/ap DEPARTMENT OF PUBLIC SAFETY Coda/a can"for►orocalloa ! ' CONSTRUCTION SUPERVISOR LICENSE.. DO - None o►thlel/eenaa. i Nuiber: Expires: 1G - 1 8 2 Family Homes Restricted To: 00 MARK R GUSTAFSON SQUIRREL ISLAND RD — IOAREHAM, MA. 02576 i i �iEe�ovwrxo�u o�./�a°°a`�`�aelln r. HOME IMPROVEMENT CONTRACTOR Registration 120967 Type - INDIVIDUAL Expiration 03/25/98 BRUCE K GUYON ,BBUCE K. GUYON G�r � "928 MAIN ST/SOX 581 ADMINISTRATOR SOUTH YARMOUTH MA 02664 ' o• TOWN OF BARNSTABLE Permit No. ---------26432----------- ew Building Inspector Cash --------------------------1639. OCCUPANCY PERMIT Bond ------ Issued - r Issued to James K. Smith Address lot #7 28 Cap'n .Jac's Road, West Barnstable Wiring Inspector -` �, j ff�. .<� Inspection date ` Plumbing Inspector ';r Inspection date r/Gas Inspector . r Inspection date Engineering Department Inspection date # ' Board of Health ,� +r t �' Inspection daterV ( +tom Es THIS PERMIT WILL NOT BE VALID, AND TH'BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. r.. .....................................� lg 'fs!jz..rSP 13 Building Inspector