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0046 MEADOW LANE
i UPC 12534 No.2 3LOR HASTIINGS, MM s9 'r i N �- Application Address Parcel Owner 200807021 46 SEA MEADOW CIRCLE Description Status Project Department Received Est.Start 246236 SHEA,FRANCIS W II&CHERYL TRS HOT WATER TANK AND BOILER Complete 12/18/2008 200807022 46 SEA MEADOW CIRCLE 246236 SHEA,FRANCIS W II&CHERYL TR'. Complete 12/18/2008 BOILER AND WATER HEATER 200900372 46 SEA MEADOW CIRCLE 246236 SHEA,FRANCIS W II&CHERYL TRS CHANGE ALL DEVICES AND WIRING IN AREAS WERE NEEDED TO WATER Expired 01/30/2009 200901638 46 SEA MEADOW CIRCLE 246236 SHEA,FRANCIS W II&CHERYL TR! REPAIRS FROM BROKEN PIPE,NO CHANGE TO FLOOR PLAN,REPLACE Expired 04/21/2009 200902345 46 SEA MEADOW CIRCLE 246236 SHEA,FRANCIS W II&CHERYL TRS REMOVE EXISTING 2ND FL DECK(4X5 FT)AND BUILD NEW 2ND FLOG Active OS/29/2009 200902626 46 SEA MEADOW CIRCLE 246236 SHEA,FRANCIS W II&CHERYL TRS BURGLAR ALARM Expired 06/11/2009 261001025 46 MEADOW LANE 133020 LAMMINEN,TOIVO A JR&JOAN A 03/10/2010 201301337 46 MEADOWLARK LANE 117172 CAVICCHI,MARY P&WILBUR 1 RE-ROOF MISTRIPPING OLD AND GA ES- T TAL FOOTPRINT Complete 201305021 46 MEADOWLARK LANE 117172 OSPREY ASSET MGT,LLC DEMOLISH BREEZEWAY AND GARAGE TOTAL FOOTPRINT 22 X 26 Complete 07/O6/2013 Active 07/26/2013 201308235 46 MEADOWLARK LANE 117172 OSPREY ASSET MGT,LLC BUILD NEW 23X14 DECK il/OS/2013 KITCHEN SINK Complete 201308236 46 MEADOWLARK LANE 117172 OSPREY ASSET MGT,LLC Complete 11/08/2013 201403866 46 MEADOWLARK LANE 117172 OSPREY ASSET MGT,LLC INSTALLED 4 NEW BRANCHES OFF OF THE EXISTING SYSTEM TO SERVI Complete 06/12/2014 COOK STOVE 67788 46 MEADOWLARK LANE 117172 CAVICCHI,MARY P&WILBUR J 12X44 TEMP MOBILE HOME Complete 03/31/2003 03/31/2003 68076 46 MEADOWLARK LANE 117172 CAVICCHI,MARY P&WILBUR J TEMP TRAILER CONNECTION Complete 04/10/2003 04/10/2003 68084 46 MEADOWLARK LANE 117172 CAVICCHI,MARY P&WILBUR J 04/11/2003 04/11/2003 69865 46 MEADOWLARK LANE 117172 CAVICCHI,MARY P&WILBUR J CONNECT MOBILE HOME TO EXISTING SERVICE Complete 07/O1/2003 07/01/2003 SECURITY SYSTEM NO INSPECTION Complete 71128 46 MEADOWLARK LANE 117172 CAVICCHI,MARY P&WILBUR 1 REPAIR WATER DAMAGE Active 08/29/2003 08/29/2003 71335 46 MEADOWLARK LANE 117172 CAVICCHI,MARY P&WILBUR J 15 FIXTURES Complete 09/05/2003 09/05/2003 71336 46 MEADOWLARK LANE 117172 CAVICCHI,MARY P&WILBUR 1 RANGE/DRYER Complete 09/O5/2003 09/O5/2003 71448 46 MEADOWLARK LANE 117172 CAVICCHI,MARY P&WILBUR 1 ROUGH WIRE FLOOD DAMAGE Complete 09/12/2003 09/12/2003 73486 46 MEADOWLARK LANE 117172 CAVICCHI,MARY P&WILBUR 1 BASEMENT HOT WTR TANK Complete 12/10/2003 12/10/2003 RANGE/WTR HTR/DRYER Complete 73487 46 MEADOWLARK LANE 117172 CAVICCHI,MARY P&WILBUR J 12/10/2003 12/10/2003 I r Application number ��� � Fee .......................1.3..s�.................................. ........ ' Building Inspectors Initials..... MAR 2 2 2019 i Date Issued... .... �. ................................... TOWN OF BARNSTABLE Map/Parcel........1/ .................. TOWN OF BARNSTABLE m.o w 10 -_EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION i-� (� Pk' g d, ow 1.a+�e_ W Address of Project: � _ NUMBER STREET VILLAGE Owner's Name: ,) a G '/�o b Vk " �'��' Phone Number �o Email Address: ^�a�- g�� S adS Cell Phone Number '5-0 33 6 q- -i-�? d J Project cost$ Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK ❑ Siding ❑ Windows (no header change)# ❑ Insulation/Weatherization . ❑ Doors(no header change)# Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s) will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. . Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or>Yes No , if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm. Commercial,events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# 6 C) !�5 Model/I.D. C s Fuel Type W° L a Q _,4Testing Labf Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: D Telephone Number 5-2v 7(o ?o Cell or Work number d 3 (0 I'understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the T wn of Barnstable. Signature Date Z l APPLICANT'S SIGNATURE Signature Date All permit ' lications are subject to a building official's approval prior to issuance. Town of Barnstable Building sSABLK s Post This Card So That it is Visible From the Street-Approved Plans Must be Retained.on Job and this Card Must be Kept v MAM Posted Until Final Inspection Has Been Made. Permit 1639. �e Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-942 Applicant Name: HOKANSON, ERIC T& KENDRA S Approvals Date Issued: 03/25/2019 Current Use: Structure Permit Type: Building-Stove Expiration Date: 09/25/2019 Foundation: Location: 46 MEADOW LANE,WEST BARNSTABLE Map/Lot: 133-020 Zoning District: RF Sheathing: Owner on Record: HOKANSON, ERIC T& KENDRA S Contractor Name: Framing: 1 Address: 46 MEADOW LANE Contractor License: 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $0.00 Chimney: _ Description: new castle stove model 90408 Permit Fee: $35.00 Fee Paid: $35.00 Insulation: Project Review Req: Manual must be on-site for inspection Date:. 3/25/2019 Final: Plumbing/Gas Rough Plumbing: Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after,issuance. Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work:' r Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: S.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: The Commonwealth of Massachusetts Department of IndustrialAccidenis rA Office of Investigations '- 600 Washington Street Boston,MA 02111 I www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le gib Name(Business/Organization/Individual): G 6 Address: 1. City/State/Zip: LA) � � L°� Phone#: Are you an employer?Check the appropriate bow Type of project(required); 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 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 comp.insurance. required..] 5. ❑ We are a corporation and its 10.❑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 13` ]Other (,�O� N�- employees. [No workers' comp.insurance required.] 1 "Ve *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 vyhether 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 isproviding workers'compensation insurance for my employees. Below is thepolicy andjob 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 egptration 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 certi under the pains and penalties of peJFury that the info on provided above is true and correct. Si afore: hate: Z 1 Phone#: G (D 7— 35 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Perinit/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#: Information 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 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 also states that"every state or local licensing agency shall withhold the issuance or ap 152,§25C(� renewal of a license or permit to operate a business or to contract 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 Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to-your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(ILLC)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 T..a...4.4: t a.r1P,++c auestions 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 shouts eni er nneu 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 applican 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 permittlicense 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 town)."A copy of the affidavit that has been officially stamped or marked 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 hike 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 Commonwealth of Massachusetts Department Of ludustrial Accidents office of Investigations 600 Washington Stl=t Boston,MA 02111 Tel,#617-727-4900 ext 406 or 1-M-MASSY Fax#617427-7741 Revised 4-24-07 w_mass gov/dia A=133-20 JI JOSFPH D. t;cLuz J rELHPHONEt 775-1120 Building Commiuioner EXT. 107 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 August 30, 1988 2nd Notice Mr. Vincent Alberico 46 Meadow Lane West Barnstable, MA RE: 46 Meadow Lane, West Barnstable A=133-20 Dear Mr. Alberico: It has been brought to the attention of this office that you have erected a garage on your property located at 46 Meadow Lane, West Barn- stable without approval of the Old King's Highway Historic District Committee. There is no building permit on file in this office to auth- orize construction of a garage. Please contact this office within seven . (7) days of receipt of this letter re the above matter or legal action must be taken by this, office. Very truly yours, Alfred E. Martin Building Inspector JDD/gr Certified mail: P-539 082 838 R.R.R. JOSFPH D. DALUZ. TELBPHONE: 775-1120 Budding Commiuiontr EXT. 107 TOWN' OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 July 12, 1988 Mr. Vincent Alberico 46 Meadow Lane West Barnstable, MA RE: 46 Meadow Lane, West Barnstable A=133-20 Dear Mr. Alberico: Please contact this office immediately re the garage 'located .on your property at 46 Meadow Lane, West Barnstable. Very truly yours, Alfred E. Martin Building Inspector AEM/gr Certified mail P-539 082 829 R.R.R. JOSFPH D. DALUZ TELBPHONEc 775.1120 Building Commissioner EXT. 107 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 July 12, 1988 Mr. Vincent Alberico 46 Meadow Lane West Barnstable, MA RE: 46 Meadow Lane, West Barnstable A=133-20 Dear Mr. Alberico.: Please contact this office immediately re the garage located on your property at 46 Meadow Lane, West Barnstable. Very truly yours, • 4 Alfred`-E. Martin Building Inspector AEM/gr Certified mail P-539 082 829 R.R.R. O5TNEro g. aj- Q B"°"'T'°L`• 'r�a�. OFFICE OF-,PLANNING AND DEVELOPMENT y 367 M aln Street (617)775-1120 Hyannis, Mass.02601 Ext.160&*-190 July 6, 1988 Ms Geralyn• S. Garvey, Executive Director Independence House, Inc. 105 Pleasant Street Hyannis, MA 02601 RE: 6-7 Park Street, Hyannis Dear Ms. Garvey: This property is located in an established area zoned Professional/ Residential District (PRD) by our Zoning- By-Law. There are no plans to rezone this area at this time. Attached is a copy of Section 3-2.1 entitled PR Profes District. sional residential P I trust this information may be of some help to you. r ' Very truly yours, (JosephrE. artell, Vice Chairman nstable Planning Board ' JEB/gr enc. i i 3-2 Office Districts 3-2. 1 PR Professlonal Residential District 1 ) Principal Permitted Uses: The following uses are permitted In the PR District: A) Single-family residential dwelling (detached) . B) Two-family residential dwelling (detached) . C) Professional offices. D) Licensed real estate broker's office. E) Nursing home. F) Rest home. G) Medical/dental clinic. H) Pharmaceutical/therapeutic use. 1•) Hospital (non-vetertnarlan) . J) Multi-family dwellings (apartments) , subject to the following conditions: a) The minimum lot area ratio shall be five thousand (5,000) square feet of lot area per each apartment unit for new multi-family structures and conversions 'of existing buildings. b) The maximum lot coverage shall be twenty per cent (20%) of the gross -upland area of the lot-or combination of lots. c) The maximum height of a multi-family dwelling shall not ex- ceed three (3) stories or thirty-five .(35) feet, ' whichever Is lesser. d) The minimum front yard setback shall be fifty (50) feet or three (3) times the building height, whichever is greater. e) The minimum side and. rear yard setbacks shall be not less than the height of the building. f) A perimeter green space of not less than twenty (20) feet In w4 dth shall be provided, such space to be 'planted and maintained as green area and to be broken only in a front yard by a driveway. g) Off-street parking shall be ,provided. on=site at a ratio of one and one-half ( l .5) spaces per each apartment unit and shall be located not less than thirty (30) feet from the 25 base of the multi-family dwelling and be easily accessible from a driveway on the site. h) No living units shall be constructed or used below ground level . i ) The Zoning Board of Appeals may allow by Special Permit a maximum lot coverage of up to fifty per cent (50%) of. the gross area of the lot or combination of lots. 2) 'Accessory Uses: The following uses are permitted as accessory uses In the PR District: A) Renting of rooms to not * more than ten ( 10). persons by- 'a family residing in -the dwelling. 3) Conditional Uses: The following uses are permitted as conditional uses in the PR District; provided a Special Permit is. first obtained from the Zoning Board of Appeals subject to . the provisions of Section 5-3.3 herein and the specific standards for such conditional uses as required in this section: A) Renting of rooms to not more than ten ( 10) lodgers in one (1 ) multiple-unit dwelling. B) Public or private regulat1ion golf . courses subject to the provisions of Section 3-1 . 1 (3) (B) herein. C) Family apartment subject to the provisions of Section 3- 1 . 1 (3) (D) herein. D) Windmills and other devices for the conversion of wind energy to electrical or mechanical energy, but only as an accessory use. 4) Special Permit' Uses: (reserved for future use) 5) Bulk Regulations: ZONE MIN.LOT MIN.LOT MIN.LOT MINIMUM YARD MAX.BLDG. MAX.LOT AREA FRONTAGE WIDTH SETBACKS IN FT. HEIGHT COVERAGE SQ.FT. IN FT. IN FT. FRONT SIDE REAR IN.FT. AS % OF. --------------- LOT AREA PR . 7500 75 -- 20 7.5 7.5 30 # 25 I, # Or two (2) stories, whichever. is lesser, except that hospitals are exempt from height restrictions in •the PR District 26 JOSFPH D. DALU2 TELHPHONEt 77a.i 120 Building Commiuiuner EXT. 107- r TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 August 16, 1988 . Ms. Susan Mattson 359 Church Street West Barnstable, MA Dear Ms. Mattson: This office has received' a complaint alleging that you have an illegal apartment in your dwelling. Please contact this office for an appointment to discuss the ' above matter. I will expect your reply within seven (7) days of re- ceipt of this letter. Peace, Jse hD. Da uilding Commissioner JDD/gr Certified mail: P-539 082 835 R.R.R. Nl- __ - _ S _Z6 �.ec r � - i i r L t 4 I P Jos!?PH D. DALUZ TELHPHONEs 775-1120 Building Comminiontr EXT. 107 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 August 30, 1988 2nd Notice Mr. Vincent Alberico 46 Meadow Lane West Barnstable, MA RE: 46 Meadow Lane, West Barnstable A=133-20 Dear Mr. Alberico: It has been brought to the attention of this office that you have erected a garage on your property located at 46 Meadow Lane, West Barn- stable without approval of the Old King's Highway Historic District Committee. There is no building permit on file in this office to auth- orize construction of a garage. Please contact this office within seven . (7) days of receipt of this letter re the above -matter or legal action must be taken by this. office. Very truly yours, Alfred E. Martin Building Inspector JDD/gr Certified mail: P-539 082 838 R.R.R. Town of Barnstable Building PostBARNWABLM ,,This Card So That it is Visible From.the Street-Appr thi Ca oved.Plans;Must be Retained on Job and s rd_Must be Kept MASSL `� Poste&Until Final Inspection-Has Been Made. rm • Where a Certificate of Occupancy is Required,such Building shall[Nofxbe Occupied until a:Final'Inspection has been made. Permit el mit Permit No. B-18-1945 Applicant Name: RetroFit Insulation Approvals Date Issued: 07/16/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 01/16/2019 Foundation: Location: 46 MEADOW LANE,WEST BARNSTABLE Map/Lot: 133-020 Zoning District: RF Sheathing: L. Owner on Record: HOKANSON, ERIC T&KENDRA S Contractor Name�. RETROFIT INSULATION, INC. Framing: 1 Address: 29 TORREY ROAD i Contractor License: 160461 2 EAST SANDWICH, MA 02537 �� Est. Project Cost: $5,138.00 Chimney: Description: Air Sealing,install R-21 closed cell spray foam insulation to the -Permit Fee: $85.00 crawlspace perimeter wall,sill and joists. Fee?aid;f t $85.00 Insulation: ' Project Review Req: Final: I Date: 7/16/2018 Ldls.T(rv� Plumbing/Gas Rough Plumbing: -----�--� �_` \Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afteriissuance. All work authorized by this permit shall conform to the approved application and the�approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures'shall be in compliance with the local zoning by--laws and codes. This permit shall be displayed in a location clearly visible from access street or r road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. _ J Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection � . Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) h:Low Voltage Rough: 6.Insulation g g 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. V7 ' Health Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A) Final:. Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of Barnstable RECEIPT ` HASSL 200 Main Street, Hyannis MA 02601 508-862-4038 %639 6. Application for Building Permit Application No: TB-18-1945 Date Recieved: 6/18/2018 Job Location: 46 MEADOW LANE,WEST BARNSTABLE Permit For: Building-Insulation-Residential Contractor's Name: RETROFIT INSULATION, INC. State Lic. No: 160461 Address: 644 RODMAN ST, FALLRIVER, MA 02721 Applicant Phone: (508) 989-6436 (Home)Owner's Name: HOKANSON, ERIC T& KENDRA S Phone: (774)209-9160 (Home)Owner's Address: 29 TORREY ROAD, EAST SANDWICH, MA 02537 Work Description: Air Sealing,install R-21 closed cell spray foam insulation to the crawlspace peri ter wall,gilt and qDists. -. ZE Z 0 00 co r CA rn N 8 Total Value Of Work To Be Performed: $5,138.00 r— M Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that 1 am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued, it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 _ hours in advance. Signed: RetroFit Insulation 6/18/2018 (508)989-6436 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost $5,138.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 6/18/2018 $35.00 XXXX-XXXX-XXXX- Credit Card __ __ 3296 Total Permit Fee Paid: $85.00 6/18/2018 $50.00 XXXX-XXXX-XXXX- Credit Card 3296 rTHIS IS,NOT A°PERMIT r{ ` Building Detail Page 1 of 1 htikSS ,' r/A . � Logged In As: Building Detail Monday,June 26 2017 Parcel Lookup Parcel Detail Building 1 of 1 Code Description Gross Area Effective Area Living Area BAS First Floor 1696 1696 1696 BMT Basement Area 894 0 0 WDK Wood Deck 948 0 0 FAT Attic, Finished 576 86 86 FEP Enclosed Porch 84 0 0 FOP Open Porch 12 0 0 Extra Features Code Description Units Unit Price Year Built Value Comments BMT Basement-Unfinished 894.00 26.01 1993 $18,900 FPL1 Fireplace 1 story 1.00 4,580.15 1993 $3,500 FEP Enclosed porch-roof,ceiling 84.00 67.47 1993 $5,300 FOP Open Porch-roof-ceiling 12.00 49.37 1993 1 $800 Out Buildings Code Description Units Unit Price Year Built Value Comments FGR6 Gar w/Lft Avg 768.00 44.38 1975 $20,100 UNFIN 2ND FLR SHED Shed 192.00 14.64 1974 $400 WDCK Wood Decking w/railings 948.00 17.68 1996 $9,000 http://issgl2/intranet/propdataBuildingDetail.aspx?PID=8412&BID=8748&N=1&NN=1 6/26/2017 i , E Town of Barnstable *Permit Expires 6 months from issue date Regulatory Services ItIft�► � Fee MRYSTABLE. R OVA v� '. `08 ichard V.Scali,Director 0 :� , -O. 60 Building Division t ®L�j 4 Tom Perry,CBO,Building Commissioner 1411 �� `� ®,6 200 Main Street,Hyannis,MA 02601 0,41 www.town.barnstable.ma.us UUl�'Ig�C Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address y 6 t",- -e r•�o w L- �•t.� � • ��+r�-A o, Residential Value of Work$ �4 b D 0 •fro Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 1E-<�cyL o-_p k a•+, s Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner 1 have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side a [replacement Windows/doors/sliders. U-Value (maximum .32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical& Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic.Conservation,etc. ***Vote: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is require / SIGNATURE: C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Contenl.Outlook\2PI01 DHR\ExPRESS.doc Revised 040215 i _. Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division • tinsas AM.e. • Tom Perry,Building Commissioner XASS. .639. `��' 200 Main Street, Hyannis,MA 02601 a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: L4 G T*IN G A. `Z number street �g village "HOMEOWNER": � '� � � � � � A•tr� S y'r` SOS �x Ct X fl`► name home phone# work phone# � G CURRENT MAILING ADDRESS: l --70 r•T- e <�e 0 � .A 1 li> LL NN D a S 1-7 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who-constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures a uiae s and that he/she will comply with said procedures and requirements. S gnatur Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules& Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PI01 DHR\EXPRESS.doc Revised 040215 1 27ie Comynonivealth of Massachusetts Department of r4dustrial Accidents _ Office of 11mWstkWdGrrs 600 Washington,street Boston,CIA 02111 wymv.maszs�govldia '"'Grkers' Campensafian Insurance Affidavit- BuilderslContractors/EIecEricianslPlu nbers Applicant Infarmatian Please Print I*ibIY Name(Busmess�ani;mfiona&vi� �n7 or= A( Z Address: CitylStatetZip= L,; krst Phone C-b. 3 Are you an employer?Checkthe appropriate box: ' Type of project(required): I.❑ I am a employer with 4 ❑I am a general contractor and I employees(full audfor part-time).* have hired-the sub-contractors 6 New Remodeling construction 2.El am a sale proprietor orpartner- listed on the attached sheet~ 7. ❑Rt modeling ship and have no employees. These sub-contractors have g_,❑Demolition waddng for me in any capacity. employees and have wodcers' 9. Building addition [No-%7xkP s' comp.insurance comb.MSMnce.I ❑ g required] 5. We are a corporation and its 10=❑Electrical repairs m additions 3. f am homeowner doing all work officers haveexercised their 11.0 Plumbing repairs or additions rrlyf_[No woilmrs'comp. right of exemption per M-GL 12.❑Roofrepairs insurance required-]Ti c.152,§1(4�and we have no employees-[No workers' 13. N Other:7 9\.�,_{ comp.insurance required.] #Any applicaotthat checks box Kmn also faloutthe section belawshaning their workerecompensatinn Policy irdormation. Homemwous wbo submit this aflidmir in citing they are doing O want sad dim hire outside contactors nmst submit a new affidayst indicating.satli rCanaactors that check this boot must attached`as sdditiand sheet showing the name of the sub-ca=scoo-a sad state whether or nat these entities hn employees.Iftbesubtonto c rshave employees,theymustpnnide•their workers'comp.pormy number- I am nee enepIoy�er that rs protzdueg workers'coerrperrsat:'art insrirarece for Trey*eneplo3�ees ReIow is the policy and jab site information. Insurance Company Name: L o Policy 44f,or Self-ins.Ile-11: C F_xpir&on Date: Ny Job Site Addr=—_LL6,9 M Pis_ . sue,,, City/State ZTp: Attach a copy of the corkers'compensationpolicydeciaration 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$1,50Q0D anc3for one-year imprisonment,as we11 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 maybe forwarded to the Office of Investigations.ofthe DIA for insurance coverage verification. I tfo heraby cerli: rard the ',s met penalties ofpedury that in fonnafiou pmided abmv is bus and carrect 1 Signature: Bate: l I6 1 b Phone iF Kb U.', Ofj`icial use only. Do not mite in this area,to be completed by city ortbirn o fjrrciaL City or Town.: PermitUcense# Issuing:authority(circle one): 1.Board of Health 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: f Information and Instructions M cachusefts C,-ehPaal Laws chapter 152 reqaires all employers to provide workers'compensation for their employees. pursuaattD this statutp,an m ployee is defined as."_.every person in the service of another under any contract of hire, express or implied;oral or written." An ernplayer is defined as"an individual,par{nexsh�,association,corporation or other Iegal eutiiy,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 indivithaa],Par(nership,association or other legal entity,employing employees. However the owner of a dweIlmg house having not more than three apartments and who resides therein,or the occupant ofthe - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or budding appuntenauit thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§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, §25dM states"Neither the commaawm1th nor ally of its political subdivisions shall enter mtp any contract for the performance ofpublic work until acceptable evidence of compligace with the insm7a ce. r euts of this chept=have been presented to the contracting avfhoayf Applicants Please fM oIIt the workers'compensation affidavit completely,by chug the boxes that apply to your situation and,if necessary,supply sub-contractnr(s)name(s), address(m)and phone m aber(s) along with their cer(ificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnenhips(LLP)with no employees other than the members or partners,are not rquii ed to carry workers' compensation insurance. If an LLC or LLP dDes haTM employees,a policy is required. B e advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of msurince coverage. Also be sure to sign.and date the a ndavirt. The affidavit should berttrmmed to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Shouldyou have aay questions regarding the law or ifyou are required to obtain a workers' compevsation policy,Please call the Deportment at the number listed below. their s elf-insurance license number on the appropriate line. City or Town Officials t - Please be sine that the affidavit is complete and pried legibly. The Deparment 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 sine to till in the permit/license number which will be used as a reference number. In addition,an applicant that must submit mu14le pennit/license applications in any given year,need only submit one affidavit indicating current policy jo. r nation Cif necessary)and under"Job Site Address"the applicant should write"all locations in (city or tugi n)_"A copy of the-affidavit that has been officially stamped or marked by the city or town may be provided.to the " applicant as proof that a valid affidavit is on file for futu e permils or licenses_ A new affidavitmust be filled ot each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venue (L e. a dog license or peumit to buns leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would h1e.to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call- The Departmenfs address,telephone and fax number_ lie� ttl�of Machu�tts ' Depa l ment of 1ndmftial Accidents =ce of jltvest gafa= 6a4 Washingtan.St-=t Boon,MA G2111 TcL 4 617 727-49QO cxt 4-06 or 1-M-MA-S F Fax#617-727-7M Revised 4--24-07 90Vfdia a 0 Ica 16Q r Town of Barnstable *Permit# Q„ Expires 6 months from issue date Regulatory Services Fee • wtxsrnsi.e • . tynse. 039. a�� Thomas F.Geiler,Director Building Division -PRESS Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 44 www.town.bamstable.ma.us TO � '4R 1 0 �O]O Office: 508-862-4038 ®�N C)F BA �18-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONL ABLE Not Valid without Red X-Press Imprint Map/parcel Number Property Address /�� f�E'ti (t�1. Li, W, 14i;�S��hl� [Residential Value of Work 2Y'r'd Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address ; Lei mnI q6 &Ies�u., 1-h / FAG/n�' syIr Cbntractor's Nam�jh �if' fire Tele hone Number p Svc-7,!�d-L 7d Home Improvement Contractor License#(if applicable) 3,053 Construction Supervisor's License#(if applicable) q� � ❑Workman's Compensation Insurance Check one: _ ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance J Insurance Company Name '5'/1114 Workman's Comp.Policy#_ 020 LI/V3'7 •— Z— /0 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check,box) Sea me f O /,a C-4 2 S h7'1I e 0 R -roof(stripping old shingles) All construction debris will be taken to yS� UJA �❑Re-roof(not stripping. Going o er existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.44)#of windows •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&Construction Supervisors License is required. SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\4STGU5QO\EXPRESS.doc Revised 090809 ACORD rM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) 103/09/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Schlegel & Schlegel Insurance Brokers Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 34 MAIN STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. West Yarmouth, MA 02673 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: COLONY INSURANCE Timothy Keating Dba Keating Construction INSURERB: CNA 54 Lower Brook Rd INSURER C: INSURER D: South Yarmouth, MA 02664 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 'WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. SR A POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DDIYY) DATE(MM/DD/YY) LIMITS A GENERAL LIABILITY GL3594908 03/10/2010 O3/SO/2011 EACH OCCURRENCE $1,000,OQQ X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurence) $100,000 CLAIMS MADE X❑OCCUR MED EXP(Any one person) $5,00 0 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY PR0. PR-IECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ 'NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY ALTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESSfUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ B WORKEREMPLOYSCOMPBILITY ON AND O224N37-2-10 03/09/2010 03/09/2011 X TORY LIMITS ER EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $100,000 OFFICERIMEMBER EXCLUDED?If yes,describe under r E.L.DISEASE-EA EMPLOYEE $ ZOO OOO SPECIAL PROVISIONS below E.L. E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS TIMOTHY KEATING HAS ELECTED NOT TO BE COVERED ON HIS WORKERS COMPENSATION CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 21 . DAYS WRITTEN .NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIN UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRES TATIVE ACORD 25(2001/08) VV ©ACORD CORPORATION 1988 .dot• DeP►irtmurt.of Puhli�S th -` �lass�iChusctts- „ul.tn(�n� tnd St tntfs 1. ,:•: �t Rc,. License; { gu.irtl of Buildin.. a ais lty"..:. Construction r Sp -'.',License* CS SL 99351 Y. Restricted to: RF TIMOTHY KEATING BROOK ROAD 54 LOWER 02664 SOUTH YARMOUTH, MA Expiration: 511 V2012 Tr#: 99351 ' eiun�r Board of uildin 1ons and Standards ` TRACTOR HOME IMPROVEMENT PROVEMENT CON Registr ilo-i 143053 TO 268376 Ezp ationc—1412010 -�TYPe_�Ia KEATING CONS TIMOTHY KEATING _- a 54 LOWER BROOKS �%I Administrator SO.YARMOUTH,MA 02664 License 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 I . Not valid without signature oF� MASS,p,� Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO 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� �d 0'V'd 4' �r h► '."PI Y 41---, as Owner of the subject property hereby authorize 0A rt,v 41 to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of wner V Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporery Intemet Files\Content.Outlook\4STGU5QO\EXPRESS.doc Revised 090809 I The Coninto►tivealtlt of Massadjusetts Deparhnent of Industrial Accidents Office of Investigations 9J 600 Washington Street Boston,MA 02111 w►vtu►nasmgmldut Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Ptumbers Applicant Information Please Print I*Zibly Name(Business/Organiretionthichidual): --rill kP 4 f7 rt c, Address:-SY Z_c)&l el- �rfj Z/ City/State/Zip: - • e I'm a r e)266 y Phone Z 20 e Are you an employer?Check the appropriate box: Type of project r 4. ❑ I am a general contractor and I P 1 ( � ��' 1.�I am a employer with i employees(full and/or part-time).* have hired the sub-contractors 6. E3 New construction 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' [No workers'comp.insurance comp.insurance. 2 9. ❑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 I LE]Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL insurance required]i c. 152,§1(4),and we have no 12.❑Roofrepairs employees.(No workers' 13.❑Other comp.insurance.required.] •Any applicant that checks box#1 must also till out the section below showing their wo*ers'compensation policy information- Z Homeowners who submit this affidas it indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. +Contractors that check this box trtttst attached sa additional street showing the name of the sub-contractors and state whether of not those entities haw employees. If the subcontractors have employees,they trust provide their workers'comp.policy number. I am an employer that is prewiding workers'compensation insurance for my emplr yee& Below it the policy and job site information Insurance Company Name: 641-4 Policy#or Self-ins. /Uc..#: 6?Z 4W 7— 7 Expiration Date: -T& 707. Job Site Address: `7 Q mPS c(ri (_,., City/State/Zip: '�/: �G�nl'� !�/�•/+/ 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 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$250.00 a day against the iuzolator. 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 andpenalties of perjury that the information prmided above is brie and correct Siarnature• Date: zl dl ?ell Phone#: To--- 2, 0—2� Official use only. Do not write in this area,to be completed by city or town official. 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 Contact Person: Phone#: c e —V �f73: SYSTEM MUST BE 1 IPLIANCE Z'ee d i d SATE , CODE FIND TOWN ",r;n%, S '�"�.r TOWN . OF BARN�S�T'ABLE 33AWST"LB, i mum pYa DUILDING INSPECTOR APPLICATION FOR PERMIT TO l:J�- .�..�. .L:.: ............... ..................... ....................................... TYPE OF CONSTRUCTION ........ gip... ,,,, 1� ........................ ................................. ,............19 73 TO THE INSPECTOR OF BUILDINGS: The undersigned her bb applies for a permit according to the following information: Location ............� 4 8 ......... ...... i....... .... :................ �.. ... �. ProposedUse ......................... f�...>.. .V'................................................................................................................ Zoning District ............... . - f ..................................................Fire District .........7 !. .ti ...............&417-1 ..:........... Name of Owner ...`-.� (� 1 ...f .......1�..rP..1,5..........Address .........W471 ..r....��?�...........��.�G................. Name of Builder ............................... eAddress K! !Y/�-�/ ........................... .............. .............. . .... .. ............... Name of Architect ......yv�ww4t:-7. .......�!��.' ress ...........�.�:� �'�... ki/.s...�-.......... r... Number of Rooms ©© Aw.en� .......................�.......................................Foundation .......C�...�.' .....�.6:4c.V.ieT--. Exterior .f .. ........... `e.dt-.°..t7...........................Roofing ........../. .5. �f.[.1 ...................................... Floors ........ ................. .Interior .......I.... /�1✓.t. .................................. ..... .... ...... ..... .. Heating .r .......... .1.r.......................Plumbing .........C.4 ................................................... Fireplace .......................Y. S' ............................................Approximate Cost ....................�2 ...� ...................... Definitive Plan Approved by Planning Board -----------__ 19 Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH TA-Li L— b r t I hereby agree to conform to all the Rules and Regulations of the ar stab regar ' g the above construction. Name ... ..................... ..... ... .. .......................... Cross, George A. ' 4"'l /� ` No —.���!.�.. Permit for -------�����—.. . . sIngle family dwelling -----....----..'�-----..��------. '. /��� Lane Location ��\�,—..=���`�.����---------.. ' West ' Barnstable` . ----.---.------.--.--------.. George A. U°~sa Owner -----.�����___.�.�--_.____.. frame Type of Construction -------------- . . ��Zs .... ....... .........19 PERMIT REFUSED . . ' - ' . ^ � . ` / � . ' ~; lg . .� . ' . —~--. ----. � ~ --.-----------..---�--. , . . . --'~^^--'^^—^^~'^^`—^--^--''' - Approved lA - ' r--------------'' - , . � ' -------------------.---.. . ~ . � -----------^------'-^—^^^'' ' � } i Parcel Detail Page 1 of 3 04AtAss po Logged In As: Parcel Detail Tuesday,September 20 2016 Parcel Lookup Parcel Info Parcel ID 133-020 l Developer Lot LOT 15; LOT 12 _l Location 146 MEADOW LANE Pri Frontage 1161 Sec Road l .�.. _......�.....�1 Sec Frontage l Village West Barnstable !— l Fire District W BARNSTABLE l Town sewer exists at this address NO �l Road Index 1008 l Asbuilt Septic Scan: ;` Interactive Map 133020_1 Owner Info Owner JLAMMINEN,TOIVO A JFl owner %HOKANSON, ERIC l Streetl 29 TORREY ROAD l Street2 I — _�l City EAST SANDWICH l state MA l Zip 02537-1137 � Country I Land Info _.__.._._............_.._..._._._._..................................._.__........_................ .... __...__....._..............._..._........_.__._._.._................................._.........................................................._........................._................__.._.__......_..........._....................................__._...__........_.................._....._. Acres 12.22 l use ISingle Fam MDL-01 l Zoning RF l Nghbd FO107 l Topography I l Road utilities I r l Location Construction Info Building 1 of 1 Year Roof xc But wa 1974 Strucc Gable/ le l Living Roof ....� ACC s Area 178� cover Asph/F GIs/Cm p Type None J w __ Style ,Cape Cod wall Drywall Rooms,3 Bedrooms ' Model Residential Ior[Ha�rdw�ood Bath 11 Full-0 Half - �! �l Floor 6 Rooms a Grade Average Minus Heat Hot Water l Total 8 l Type Rooms Stories 11 Story Fuel Oil Fund- Mixed ation Gross Kid Area Permit History Issue Date I Purpose I Permit# Amount Insp Date Comments - Visit History Date Who Purpose 6/17/2016 12:00:00 AM Jeff Rudziak Sale Review http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=8412 9/20/2016 Parcel Detail Page 2 of 3 9/12/2011 12:00:00 AM Nancy Finch In Office Review 4/16/2010 12:00:00 AM Nancy Finch Abatement Review 1/28/2009 12:00:00 AM Karen Perry In Office Review 10/11/2007 12:00:00 AM Jeff Rudziak In Office Review 3/21/2007 12:00:00 AM Paul Talbot Cyclical Inspection 2/28/2006 12:00:00 AM Jason Streebel Mea + Corrected Listing 2/7/2006 12:00:00 AM Jeannette Kirwan Change of Address Sales History _ Line Sale Date Owner Book/Page _ Sale Price 1 12/12/2005 LAMMINEN, TOIVO A JR &JOAN M C178769 $526,000 2 8/15/1994 STEWART, BRIAN & L KAY C134621 $170,000 3 4/15/1993 RITTEL, ARTHUR C129728 $141,000 4 10/23/1992 ALBERICO, VINCENT P &JANICE M C128184 $1 5 7/26/1976 ALBERICO, VINCENT P &JANICE M C68014 $0 6 1/26/2016 1 HOKANSON, ERIC C208622 1 $350,000 11 Assessment History Save Year Building XF Value OB Value Land Value Total Parcel # Value Value 1 2016 $147,800 $29,500 $32,100 $260,300 $469,700 2 2015 $148,300 $28,400 $33,300 $252,700 $462,700 3 2014 $148,300 $28,400 $34,100 $252,700 $463,500 4 2013 $148,300 $28,400 $34,800 $252,700 $464,200 5 2012 $150,000 $27,600 $31,100 $257,200 $465,900 6 2011 $176,100 $3,200 $19,900 $385,800 $585,000 7 2010 $173,800 $3,200 $20,600 $471,500 $669,100 8 2009 $163,200 $2,600 $16,200 $333,800 $515,800 9 2008 $187,500 $2,600 $16,200 $318,100 $524,400 11 2007 $186,900 $2,600 $16,200 $318,100 $523,800 12 2006 $125,700 $2,600 $16,100 $324,200 $468,600 13 2005 $117,400 $2,600 $16,600 $294,700 . $431,300 14 2004 $95,300 $2,600 $16,800 $294,700 $409,400 15 2003 $86,000 $2,600 $17,300 $78,300 $184,200 16 2002 $86,000 $2,600 $17,300 $78,300 $184,200 17 2001 $86,000 $2,600 $17,300 $78,300 $184,200 18 2000 $63,100 $2,300 $18,000 $49,800 $133,200 19 1999 $63,100 $2,300 $13,800 $49,800 $129,000 20 1998 $63,100 $2,300 $13,800 $49,800 $129,000 21 1997 $67,500 $0 $0 $49,300 $129,800 22 1996 $67,500 $0 $0 $49,300 $129,800 23 1995 $67,500 $0 $0 $49,300 $129,800 24 1994 $64,000 $0 $0 $66,500 $143,500 25 1993 $64,000 $0 $0 $66,500 $143,500 26 1992 $72,800 $0 $0 $72,500 $160,100 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=8412 9/20/2016 i s Parcel Detail Page 3 of 3 27 1991 $82,600 $0 $0 $96,600 $198,000 28 1990 $82,600 $0 $0 $96,600 $198,000 29 1989 $82,600 $0 $0 $96,600 $198,000 30 1988 $67,500 $0 $0 $54,300 $121,800 31 1987 $67,500 $0 $0 $54,300 $121,800 32 1986 $67,500 $0 $0 $54,300 $121,800 Photos t i http:llissgl2/intranet/propdata/ParcelDetail.aspx?ID=8412 9/20/2016 •Ar XbK S `�C' vn� V S/LL ELE✓.-______ FEET 40 VE POdD �AE PL o r )OL A N ' LOCAT/O/V S C A L E =�`J� _ —ZOA T& 1n _ PLAN 2EF&�26A/CE : 4 4S 'b"ovQQ rc 4PtitH t!c A"say, A.0 Z'7, T TA/A7 TyE Exlsr- 'S /NG FOUNDAT/ON 40 CA710N /SCVeALM T,AYI.OR 45 -5wo?Vi 1 ,QwU Jjr -�_ _Con/Foe1y wlrAl ' �"� Ts-/E 8U/LDiNG .s'ETC3.4C.e,L�E.fJCiiaEMF,vJ' OF THE TOWN OF j. . _ lCp --- �,hp � /SA ` QE.G .vb t�Q oQ " �S . CTG.C�j ._ C� ELL 4-7-,-- B WILLOW ST YA2M0[/7;Zrr0.07;Mr4. Assessor's map and lot number JR3.... ....�;P ...... Sewage Permit number .......................................I.................. � o THEY°�♦� TOWN - OF BARNSTABLE 2 . j B9HBSTADLE, i MU&"b q a• BUILDING INSPECTOR �'0 YpY APPLICATION FOR PERMIT TO :.....n........................................................................... TYPEOF CONSTRUCTION ..................................................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. .''. ............................................................................... .................................................................................... . Proposed Use ...:.......... ... ............:........................: ...................................................................................................................... ZoningDistrict ..................................................'......................................................Fire District ...i:'. ....................: - Name of Owner ...............Address ...................................... ........:...................... ::..........:.......... :............:..... Name of Builder , ...................Address ...........::.. .............. ......... ............. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ............ Foundation ...::........................:................................................ Exterior .........::..:. Roofing ...:..r. ..::.:... :.... ............................................... Floors .Interior �`` Heating ................................Plumbing Fireplace ..................................................................................Approximate Cost ........ ..... :....................`.................. Definitive Plan Approved by Planning Board :-------------_-----------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 ............................................................................... . ^ � � Cross, George A. A=133-20 �//»� " mom to � .,�; npm" for g--_g- � ....Location ---------.� � � Meadow Lane .. ..................................../ waac uaroacao ^ � -----------------' ' Cross bvvner ----~- A. — ame r',�� ' r- of Construction 4 � --------------' - � Plot � Permit Granted ' Dore or Inspection ` --- Completed '' ' 'PERMIT � � REFUSED i 19 ' ^ . ` ----- ----------------. ' � � / ----- ---------------- | | ' ----'' ----------^'--^---- -----"--..~----.-------.--..--. � Approved ............�-------....---- lg ' ^ -------'---------.,.-------- � ' . . . --------------------..---.—' � � I� i n i ♦.� 49 1 a, R Yp 4 I>e r v D S/LL. LLF-K__-- _ FEAT 480✓,6 POAD PLOT" PZ- AN LOCAT/ON PLAN 2e-F4- 2E A/C f-- R�c.►-u�.c�c L.Ca'�ti', S t+tC v C.`�'��=� l'.>�T c HEREBY C,6PT1 FY TNA T THE EX�ST- '��` w►.FKEn ;;e ING FOUoVDAT/ON 4OC.47/0N /S GbeQE . TAYIOFi 5 SHOWN AA/D .-_CONFOZ^-f W/TAl v►fQT C'. �. 10F T//E TOWN OF ���:.� �. C..«=.05� • 9 GI//GGOWsr. y<f�z.�-�our�/�.BT �1�. ' 13 .....: G 7. 2 - 74 ksses,se�s map and lof-•number O SEPTIC SYSTMq M�4$.T BE INSTALLED IN C.O� . P_IAWE Sewage Permit number � .. ... �i . . ,G. ... ..�✓ WITH AP""LE II STATE r < SANITAPY CODE MD. TOWN THE r � . Q�0* TOWN OF BARIAS THIL EAMSTADLE, i "b 9 a BUILDING INSPECTOR � n Mai ' APPLICATION FOR PERMIT TO .......f4e fl. .......... 0. ......................................................................... TYPEOF CONSTRUCTION ..................................................................................................................................... .........2..... ........................19... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ►. r'L?.fill ...... . ,!.1.G............... ................................................................. ProposedUse ... ........ .......:............................................................................................................. Zoning District ....1z....T.....................................................Fire District ..T........1R.RAZN................................ Name of Owner ..........Address ............................ Name of Builder .Wj.LLvtb.M.....Mv.LL.-mi.........Address ......seo.....�r..,.PE!'.V1V.S Name of Architect .......... .................................................Address Numberof Rooms ..........I.......................................................Foundation ...f<..C1n.......QU.LtC .1�................................... Exterior .`..t' ......1.--.. A. g ............. ,S Floors .......,d.2��'''. �' �.........................................Interior ........ *44,........................... Heating ......41.A e.%A.......11N.A..1Z...............................Plumbing .................................................................................. Fireplace ..................................................... ..'.....................Approximate Cost ......Aiom. V� s... Definitive Plan Approved by Planning Board A_A?S-_______Z_7_______19�p_. Area Diagram of Lot and Building with Dimensions Fee lam°' SUBJECT TO APPROVAL OF BOARD OF HEALTH �A S �Y I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... ....................... ........ Cross, George A. No 177�1 Permit for .....a-4 d.. sin le...g.... family dwelling 4' e Location Meadow. ..Lane J ...... ...... ........................................ } West Barnstable Owner ........:.............George ,A. Cross ............................................ k - r Type of Construction frame j Plot ............................ Lot ................................. e July 2 75 iPermit Granted ...............................:..:.....19 Date of Inspection' ... ! �'�.��7 Date Completed ..6..7 ....................19 i i PERMIT .REFUSED ......................................................... 19 ................................................................................ '� ............... ...................... o: :. ............................................................................... 't ............................................................................... Approved ................................................ 19