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HomeMy WebLinkAbout2461 MEETINGHOUSE WAY/RTE 149 / �' --- --�--- _.�___. _ ,_..,_. _ __ �... �,.�........_. _ t.,- ....�.,. �.,....�._.�. _. aa 1 a :I 1' l S u e 1 1 a i Q c Q eA M s .a t� a 'i r 1� J TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 11F - Permit# Health Division —UV\ Paq�(241,v dabq/ 2. =' _` Date Issued Conservation Division �g UcC�C3\ i I Fee Tax Collector p 0 SEPTIC SY TEM MUST BE Treasurer l� !S 1�v 1 N COMPLIANCE Planning Dept. E 5 CODE A APPLICANT MUST OBTAIN Date Definitive roved b Planning Board 4I � HIV'NIt, OPENING PERMiT Y 9 �n0� .��00 i a041' PRIO W�ROII S INEERING DIV Historic OKH OCT 1 8O IV TRUCr(ONOTIO Preservation/Hyannis � /©:o Project Street Address �I Village i ��� ti r9�2 �L� Owner ���9. y A� 9 o.A- Address Telephone J^D Ff— ,S `r' O — y y • Permit Request 6, Sig--wet C'O < <-� S f���t. /�--�'t, f) �'1i1/,—�z�• K _ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation 3,�6D. a Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfatfiered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: Cl Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes Cl No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:Cl existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:Cl existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial des ❑ No If yes, site plan review# Current Use Proposed Use / BUILDER INFORMATION Name /-�7` r-r� �j�y/J�A-v �L�1 Telephone Number S-49 7 Address !?®. 4 o,Y l 6 c/ 7 License# O 3 // o C LYE s �lil� ® 2 C 19/ Home Improvement Contractor# /02 sy Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 4 f f✓��o G-C SIGNATURE DATE ,C�—! '5�- --0 / FOR OFFICIAL USE ONLY i .. h PERMIT NO. DATE ISSUED MAP/PARCEL NO.. i ADDRESS VILLAGE OWNER.) n DATE OF INSPECTION: FOUNDATION - FRAME r . INSULATION FIREPLACE ` ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH -FINAL y GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT k= ASSOCIATION PLAN NO. _1 F The Commonwealth of Massachusetts —j- -' Department of Industrial Accidents , LOJIIeB 01/0YCSUpBUODs 600 Washington Street C Boston,Mass. 02111 Workers' Com ensation Insurance davit r r ri rorai riiirir/ ������ �� r name / 1C/��f- lfl �f o location: 6 T� �. phone# ❑ I am a homeowner performing all work myself. 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I andes>tmd that a copy of this statement may be forwarded to the Otnce of Invesdgzdom of the DU for coverage verideation. the array ateltiet o the the informado>Y pro►aded above is trtt.erred correct � I do hereby certify P P fPer11' sipatnre # / Print name /`�-t�7`�r'' G � lop oincW use only do not write in this area to be completed by city or town otlldal pemdt/llcense# �� g D a scent city or town: ❑ucenvnt Board ❑Selectmen's Office ❑check if immediate response is required ❑Health Department phoneq: contact person: �p<her (,amao 9195 PJA) • s • Information and Instructions for Massachusetts General Laws chapter 152 section 25 requires all employers to proon in vide serorkeice of another endeatior any their employees. As quoted from the "law", an employee is defined as every pens of hire, e•cpress or implied, oral or written. o or An employer is defined as an individual, partnership, association, corporation orof a deer ceased al ) or plover, w the receive= 0. the foregoing engaged in a joint enterprise, and including the legal representatives partnership, association or other legal entity, emploving.employees. However the owner of a trustee of an individual,p p, 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 '= urtenarrt thereto shall not because of such employment be deemed to be an employer. building apP MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issu Leant who ce or h of a license or permit to operate a business or to construct buildings in the commonwealth for any app the not produced acceptable evidence of compliance with the insurance coc v�erraagfbrequired.theoAdditionally,cbliicc wok until commonwealth nor any of its political subdivisions shall enter any have been presented to the co^**� '^� acceptable evidence of compliance with the insurance requirements of this chapter authority. Applicants i! r ' compensation affidavit completely,by checking the box that applies to your situation and Please fill in ,he workers camp - - with a certificate of insurance as all affidavits maybe supplvmg company names,address and phone numbers along of Industrial Accidents. Should you submitted to the Department of Industrial Accidents far canfizmation of insura^ a fie. Also be sure to sign and-, or town that the application for the permit or license is date the affidavit. The affidavit should be returned to the city or an questions regarding the being requested, not the Departm "law"or if}'c ent Y are required to obtain a workers' compensation policy,please call the Department at the comber fisted below City or Towns Department has provided a space at the bottom of`= Please be sure that the affidavit is complete and printed le}bly. The Dep the applicant. Please affidavit for you to fill out in the event the Office of Investigations has to contact you regarding be sure to fill in the permit/license member which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. in advance for you cooperation and should you have any gnest►ons. The Office of Investigations would like to thank you please do not hesitate to give us a call. / %/ The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Investigations 600 Washington Street Boston,Ma. 02111. fax#: (617) 727-7749 phone #: (617) 727-4900 eat. 406, 409 or 375 GTE BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 031106 Birthdate: 07/04/1955 Expires:07/04/2003 Tr.no: 12449 Restricted To: 00 PETER G MANDRAVELIS PO BOX 1647 ( -; HYANNIS, MA 02601 Administrator ROME IMPROVEMENT;COMUET@Dw -402359' i 07/Ol/2001 s " = Type, Individual PETER G. MANDRAVELIS Peter Mandravelis (�coM`o 6 lvlairvien Avenue ADMINISTRATOR Dennis MA 02638