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Home My WebLink About0007 CROCKER ROAD �OC�i��' oa c� 1 iI �2 O C� fh Z O vi ch cs Lf) z v 1 U N 2 O Z ..l I a • a 'r TOWN OF BARNSTABLE Permit No. --------_---------- { DAUST Imo. ; Building Inspector cash .... ------------- — -- OCCUPANCY PERMIT Bond ----------- ` No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. .......................I............................... 19......__ .................................................................................................... Building Inspector moo I S'dAsh ,,. rAll .r. !Y *s a r M f �*tfif 9 4s� 3 E CERTIFIED PLOT " PLAN` : . Iya��3, 3� r� Rf N£%Y CONSTRUCTION /s .1 TOP OF FOUNDATI N IS J_� FEET IN ` - l BELOW LOW POINT OF ADJACENT , .0AJfJ\�STAsL ROAD. �, . .K. SCALE: HQ foe " DATE: 01 711000 . ELDREDGE ENGINEERING CO.IN I CERTIFY THAT THE ��i� ` CLIENTD= SHOWN ON THIS PLAN IS LOCATP.;t. } a� • GISTERED REGISTERED 7 Igos►G � CIVIL LAND JOB NO. ON TIE GROUND AS INDICATED'-, A D`� ENOINEER4_1 IIDR- BY: CONFORMS TO THE ZONING LAW 'tSURVEYOR A PA , OF QARNSTn Lam , MASS. CH'-BY'"s N0. (MAIN ST 712 MAIN ST. g 9� �S S0 YARMOUTH, MASS. HYANNIS, MASS. SHEET—Z OF DATE REG. LAND SURVEYO ' ,*AweNeor's map and lot number J7............171 de, THE- Sewage Permit' number ........................ ............................ ST LE, House number .............. .. ..... VAM TM 5 90 NAG& ENVIRONMENTAL CODE 1639- TOWN OF BN,RNS 1rXnrVTl10NS BUILDING INSPECTOR APPLICATION-FOR PERMIT TO ...13.01U).... ...... � pt�xr6 ............................. TYPEOF CONSTRUCTION ......WPOP.................................................................................................................. ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... qt......32,..... ....5T,..... ttA4-JQ.W1a.F .............. ........................................... ProposedUse ........ L1q. k7............................................................................................................................................. Zoning District .........Kl.-.-... .......................................................Fire District AVL�.....rM.0...�. Z%44A ........................ Nameof Owner ......d.AM(��.....P. 7.0........................Address .................................................................................... Name of Builder ......DO.Q.6......LV-59M;-L.............................Address ...P19K....kk.t(..... ..... ..... ............ Nameof Architect ..................................................................Address ..................................................................................... Number of Rooms ..........................................Foundation ......(f.0 .77 ............................................. Exterior ......C.(..q r W-4 K:1)..f...... R a a fi n g .......ASPR.ftr......Woo.kLr-�................................ Floors .......QWC�r.......... .................................................Interior ......... .................................................... Heating .....r-S.5..................................................................Plumbing .....t&PLIZ.....4n.R- ............................... Fireplace .........gri .........................................................Approximate Cost ......... .................. Definitive Plan Approved by Planning Board -----------MA --------19 Area ....................... ................ Diagram of Lot and Building with Dimensions Fee ............ ................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ............Name ... ............ .......... Olsen, James A=109-43 1 a,%? 696................ Permit for .....1:1-? family dwelling ............................................................................... Location ...........l.at..#32 Cedar..S.t.......... CZ70 Owner ...........James Olsen ....................................................... Type of Construction ...........frame.....I............... ................................................................ ............... I Plot ............................ Lot ................... T. Permit Granted ..................................Sept. 28......19 79. Date of Inspection .....................................19 Date Completed ...pl�- Vlf V.:..........19 PERMIT REFUSED ..... ...... ...................................... 19 0 I%- ......... .................... ................ a. ............................ ... ... .. .................................... rn A ............................... A p p Frot .....k� ......... 19 ............................................................................... .................................. Assessor's map and lot number.,.,./� ............. ......( � f7HE j' ��l / Q�� TO�r♦ 4, Sewage Permit number .... :/......(...!� ".:.......................... L DARNSTAaDLE, E House number ...:.:......... ...........�%!.�. ............................, vo ras O s639. \0� aYaYa TOWN OF BARNSTABLE BUItDIN'G INSPE-CTOR APPLICATION FOR PERMIT TO •Ia?1 i•2..... F-!R?1/ 11 ... tr 5l Irf;tx,( .............................. ' TYPE OF CONSTRUCTION f AX2.Q f • ................................................19........ .70 THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ! Location ......:1 1.........:7.......F.:DA(1.....:).T....... ............................................................ ProposedUse ........Ik::>I. %. ::............................................................................................................................................. Zoning District .......6 :..<..........................................................Fire District .c c7E. f.....L`: 1 l;,:J 7!7l! C Name of Owner ....... �.M.)? :::�.....(��. '>l'n �...... .............Address .......................................................................... Name of Builder D'7t J<;......1...(- .,..............................Address ...h�r7k.....l. 1'YlG.W tptJr f"31 �!� .......... Nameof Architect ..................................................................Address .................................................................................... r, Number of Rooms ....................��.........................................Foundation ...... F ............................................. Exterior ..... .1./ ..(�i'.,l�r�. ..: :...... PU):.'. :...�:-.�+`�.fGL�..``�..Roofing ...... .:Nl.o. ..T....S :� iV6;.....``........ Floors ......f.i+rLe T ......................................Interior J?e YQG%< ,i l .....Plumbin ...../,c?�'h'�..rr' i Lei~ �/ Heating ............................................................................. g ...............�...........�................................. �. Fireplace ........ ............................................................Approximate Cost ........ - Definitive Plan Approved by Planning Board ___________W_1_'_`�'L________19 1� _. Area //.......................... Diagram of Lot and Building with Dimensions Fee ......� -"- .......... .5.............. SUBJECT TO APPROVAL OF BOARD OF HEALTHG I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....r................... ....>................................................ Olsen, James Ot109-43 t/ No 21696..... Permit for .11-2••stary..s1an le.• family dwelling Location ............l.ot...#.32.... W. Barnstable Owner .........James...Ol.sen................................. Type of Construction �,_ frame Plot ............................. Lo� ................................ /ey28 79� . Permit Granted .. .......................19 Date of Inspection .......................19 Date Completed ........19 PEI MIT REFUSED ........................................ ............... 19 ............. ... .................... . . . ............ ....... ........... .............. ..... ..-.. ............. .cam .............. ...... Approved ................................................ 19 Town of Barnstable *Permit#.2��d .p�C � Expires 6 months front is a date �•�� 1 p 10�� Regulatory Services Fee Thomas tor Bu 1dinlere y�r g Division i+ �Ny 4�J Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA.02601 www.town.bamstable.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 7Prope Address / Residential Value of Work e co Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 1 '-el Contractor's Name —< Telephone Nurn&rso, �3 �3 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 ❑'I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. I Permit Req st(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 (maximum.44) ' •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: Q:Forms:expmtrg Revise061306 Y ,v The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a 600 Washington Street �< Boston,MA 02111 ,. www.mass.gov/dia Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual); Gl,,e_ Address: S'-2—0 n4�� City/State/Zi 4�_ Phone.#: Are you an employer?Check the appropriate box: Type of project(required):. 4. I am a general contractor and I 1.❑ I am a employer with 0 6. ❑New construction.. employees(full and/oipait-time).* have hired the sub-contractors 2.❑ I am a'sole proprietor or partner- listed on-the-attached sheet: 7. ❑Remodeling 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 C P•lnsurance.t required.] 5. a are a corporation and its 10.❑Electrical repairs or additions .3.ElI 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.U(Roof repairs insurance required.]t c. 152, §1(4), and we have no 13.❑ Other employees. [No workers 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. tContractors 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. lam an employer that is providing workers'compensation insurance for my employees. Blow is.the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 ]j above )I is true and correct. Signature•—._..0 Date Phone#: So �-.3 01 r0ffficlalonly. Do not write in this area, tb be completed by city or town officiaL n: 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 Contact Person: Phone#: - I Informationn and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,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 recei�cer oLtnt&tee of an individual,parhiershiu.association or other legal entity,employin�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 1523 §25C(6)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,MGL chapter 152, §25C(7)states"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 I Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contiactor(s)name(s),address(es)and phone number(s)along with their certificate(s)of i insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their self-insurance license number on the appropriate-line. City or Town Officials 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. In addition,an applicant that must submit multiple permit/license applications in.any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city-or Eton)."A copy of the affidavit that has been officially stamped or markdd by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e, a dog license or permit to burn leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commojawealth of�Iassa�lauseti s Dqpart=tnt of IndusAPieal Aeeidents Office of Investigations 600 Washingtaii Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-977-MASSAFE 9 Revised 11-22-06 Fax#617-727-774 www.mass.gov/dla °FTHE� Town of Barnstable. Regulatory Services ` BARNSTABLE,ASS.Mass. � Thomas F.Geiler,Director v M � `bplFo;r,p�p�e Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, ��}7 I n. �ylC�' SU , as Owner of the subject property hereby authorize ; to act on my behalf, in all matters relative to.work authorized bythis building permit application for: . (Address of Job) Signature of Owner . Date, V1�111� &r'YO�I�tI�CI Print Name Q TORMS:OWNERPERMISSIGN i r .. JiY Iv�Yn u.�-T! • Y BQAADrl=afl� , L•icemse C S '' 11V dVS . 0 3'S5l J. {. , f ' rtt $_ 966 f' wXN � g w1! ' �. P EV Ill{: FlitSrFaBLE G' r 'tY/'o`::ii�:' --J"�em�:�i Board of Buililiug Itegulatiaus 3 -- €w ( HOME IMPROVEMENT•:CONTRAC.TOR Licen 'or:,registl� (�p 4alid.for}L�ii>utdu '�' t : :. befor t!tex ira '.. :. e o�►1y ± Registratioric:..:1.53262 P ton datc.,..If Pouucl=fdturi�tp; . ,. • ._ Boar ±of Building Regulirtions and Staiil ±ds ,xpiratlari;_`j1/13/20t)8;:• ; T ..253908.. title�S�Shburton?lace t;ni 1.3 :1 � �TYPe P}Nate Corporation.. Bosto i,A-la.02108 - t .OGE&SON =:... ,S CDNSTRUCTIOWNC.:-. lEN ELDREQGE' :DAR ST. �::::•_ INSTABLE,MA 02668 ^-` _ • Administrator•. �}_-Not v;ilid x --------- i— . :, i �rithatit signature