HomeMy WebLinkAbout0026 POINT HILL ROAD f
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UPC 12543
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HASTINGS. UN
Town of Barnstable Building
DA11UNgrABLE Post This Card So That it is Visible From the Street!-Approved Plans Must be Retained on Job and this Card Must be Kept
MAM Posted Until Final Inspection Has Been Made. Permit
39. Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made.
Permit No. B-20-1317 Applicant Name: Raymond Ferrante Approvals
Date Issued: 05/27/2020 Current Use: Structure
Permit Type: Building-Deck Expiration Date: 11/27/2020 Foundation:
Location: 26 POINT HILL ROAD,WEST BARNSTABLE Map/Lot: 136-024 Zoning District: RF Sheathing:
Owner on Record: VARNERIN, ELLEN&FERRANTE, RAYMONDI F Contractor Name: DAVID A. CARROLL CAPE COD Framing: 1
REMODELING AND DESIGN
Address: 26 POINT HILL ROAD 2
WEST BARNSTABLE, MA 02668 -Contractor Contractor License: 123111
Chimney:
Description: Replace original 20x11 rear deck that has failed with new Est. Project Cost: $40,000.00
# Insulation:
deck/wrap around. Permit Fee: $ 110.00
i l
Project Review Req: Fee Paidf $ 110.00 Final:
Date/ 5/27/2020
Plumbing/Gas
i
Rough Plumbing:
Building Official
Final Plumbing:
j This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas:
All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted.
M r ► t Final 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
work until the completion of the same. Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service:
Minimum of Five Call Inspections Required for All Construction Work: Rough:
1.Foundation or Footing
2.Sheathing Inspection Final:
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 Low Voltage Rough:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation Low Voltage Final:
7.Final Inspection before Occupancy
Health
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. Final:
"Persons c rac with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department
F-� Building plans are to be available on site Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
- ��
�tNE tq4,. Application number .... ...........................................
Fee .............................3..,�s-..7.
B MASS.
S Building Inspectors Initials...... .r. .... .....................
RESI
'�dMP Date Issued................. .... .............................
MAY 0 Npp2��nn01I1��9++ C 2
TOWN OF
p�iflll��7TABLE Map/Parcel......l�.l..�.........Q.��.................
TOWN OF BARNSTABLE
EXPEDITED PERMIT APPLICATION:
ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION
PROPERTY INFORMATION
Address of Project: 26 Point Hill Road West Barnstable
NUMBER STREET VILLAGE
Owner's Name: Raymond Ferrante Phone Number 508-942-1212
Email Address: rayferrante@outlook.com Cell Phone Number
508-942-1212
Project cost$ $70,000 Check one Residential X 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
M Siding M Windows (no header change) # 18 ED Insulation/Weatherization
Doors (no header change) # 6 Commercial Doors require an inspector's review
ED Roof(not applying more than 1 layer of shingles)
Construction Debris will be going to Yarmouth Landfill
CONTRACTOR'S INFORMATION
Contractor's name
Cape Cod Remodeling and Design
Home Improvement Contractors Registration(if applicable) # 123111 (attach copy)
Construction Supervisor's License # (attach copy)
Email of Contractor dvecrlll@hotmail.com Phone number 508-564-7676
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
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# Model/I.D.
Fuel Type Testing Lab
Offsets from combustibles: front back left side right side
HOMEOWNER'S LICENSE EXEMPTION
Homeowner's Name: V 140A.)b
Telephone Number $_ 9 7 —��-��� Cell or Work number 9Z-12-1�
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 Ate Town of • arnstable.
'Signature Date__U
V IT It I
APPLICANT'S SIGNATURE
Signature 4_
Date
All permit applications are subject to a building official's approval prior to issuance.
i
The Commonwealth of Massachusets
Department of Industrial Accidents
Office of Invest1gations
IF 600 Washington Street
Boston,MA 02111
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Nagle (Business/Organization4ndividual):
Address: Zt PQ)),)T /LL 14
City/State/Zip: Phone#: SO . fly
Are you an employer?Check the appropriate box: Type of project(required):
I.❑ I am a employer with 4 A 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 t
required.] 5. ❑ We are a corporation and its 10.[1 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
Wince requirod.]t c. 152,§1(4),and we have no
employees.[No workers' 13.❑Other
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hue outside contractors most submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lie.#: Expiration Date: p °"
Job Site Address: �Ic 9fI-�0 G� City/State/Zip: l�,f�}�l�IuS"I-A X,4-!
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
Investigatio9kof the DIA for insurance coverage verification.
I do here:y c fy under tl pair a caldes of perjury that the information provided above is true and correct.
-- Si Date:
Phone#:
Official use only. Do not write in this area,to be completed by city or town ojj'iciai
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#:
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 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, §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(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
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 bike 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 Industrial Accidents
(lice of Investigations
600 Washington Street _
Bastian,MA 02111
Tel.#617-727-4900 ext 406 or 1-877 MASSAM
Fax#617-727-7749
Revised 4-2407
www.mass.gav/din .
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BIKE r Town of Barnstable *Permit# 18 S-3 S(
'b Expires 6 months from issue date
Building Department Services Fee
�.� -Zs
irtsTesi.E Brian Florence,CBO
9 MASS. $ Building Commissioner
i639•
'°iEc ► 200 Main Street,Hyannis,MA 02601 1
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERAHT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number 0 >Z
/ ,�[.rt: (,.I6 i 8Af gSTv�-l3C_
Property Address P
� � (o D/!�T /1- � K�• ,S
R-Residential Value of Worrk$02/ 700.ff/0 0 Minimum fee of$35.00 for work under$6000.00
U Owner's Name&Address /� LG h-X/A4lK 114
Ala Po�>J►r /4;u R D. Gt)f - 9 tXNS 7,fa6,E
Contractor's Name t.l . N 1�/L--r3/� Telephone Number
Home Improvement Contractor License#(if applicable) I tj G (O Email: C>[-j WL - i3 �1- 0 CMi+iL
Construction Supervisor's License#(if applicable) 0y(o i I
❑Workman's Compensation Insurance ► 0!�.
Check one:
['1 am a sole proprietor
❑ I am the Homeowner r T vJ j ^-
❑ Ihave Worker's Compensation Insurance TO WIN
Insurance Company Name
LE
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Reque heck box)
Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to V/A]"0ulff 4OAtf
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows
#of doors:
*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:
Q:\WPFU,ES\FORMS\building permit forms\EXPRESS.doc
08/16/17
✓tee vwiuie�uue�uu�of✓�l�Gt�;4zhceJeld�
office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TltTgxIndividual before the expiration date. If found return to:
Re istratfon- Expiration Office of Consumer Affairs and Business Regulation
d 05/22/2020 One Ashburton Place-Suite 1301
DAVID H WEBBY
- Boston A 02108
I Ioson -
�<
DAVID H.WEBB ,
179 TEATICKET HIGf�IV�4ln 0
EAST FALMOUTH,MA 02536 Undersecretary Not valid without signature
.. ................
, .
Commonwealth of Massachusetts
�� Division of Professional Licensure
Board of Building Regulations and Standards
Const`,i2tr{�StSP?rvisor
-� r4pires: 10129/2020
CS-046189 ? - - �•
DAVID H WEBB U y
179 TEATICK HIGIiVIIAY aC
EAST FALMOUTH�MA 02538 C4CCommissioner
Unrestricted-B�Idin ruction Su less thangs of an penrisor
35,000 cubic feet(991 cubic se group which coat
Space. meters)of contain
enclosed
t
Failure to State Build Possess a current edition
g Code is ry of
For inforrr�tion ah r revocation oftthis license us Call(617 io Ma hfsch efts
)727.3200 or visitut mass.gov/dpl cease.
f
T7ie Comrtr yrivealth q,f Masyadruyetts
Deparbnent o,f 1nd-ushial Acciderds
- - Qffce o,f 1r tigations
600 Washineon,street
y Boston,41A 02111
tvFv��rnas�govfiiin
Workers' Campensat on Insurance Affidavit:Builders/ContractarsMecEricians/Phu nhers
AppEcant InformatiGn Please Brent Le��11y
Nate3nsmess�DFganizatian/fndividnat
Address: P O- Rts,c If e.i
Phan S Q'�— ✓���'G -r j�aZ
Are you an employer?Checkthe appropriate box: ' Type of project(regnireo:
1.❑ I am a employes.uith 4_ KI ant a general contractor and I 6- ❑New consfzuetion
employees(full andfor part-time).* have hired the sub-contractors
F�lra paw, Iisfed on the attached sheet: 7. ❑Remodeling
2.❑ I am a sole proprietor or er-
These sub-cmtractors have Demolition
ship and line no•d�nplog�ees g-•❑ i
wotiang for me in any capacity employees and haye wo6cers' 9_ ❑Building addition
[No worken. comp_insurance comp-insurance-1
5_ ❑ We are a corporation and its 10_El Electrical repairs ar ad&ions
3.❑ I m.a homeoumer doing all work officers have exercised t]ieir 11-Q Plumbing repairs or additibms.
mpsPmyself.[No workers'comp_ right.of exemption per MGL 13.❑Roofrepairs .
insrrancerequire&]F c.152, §1(4�and we haven
employees-[No workem' �-❑Other
comp-msurance required-]
'AnygTHcsIItd mtchedtsbosff1mustalsoffio th2sactioabeTawshmriugthenwoaiseis'campensatiaapoTicyiafoffiauua
1 Eameawnaswho snbmut dns dffdacri lnd= mg they are doing MUwa¢k aadthenhzM outsidecontracmrsams*Mffi=aanewaffidsk indicath6 sad L
ICaattxctats ihat check this ban[must attached=addidiwal sheet showing then=e of the sub-caa lnchrg sad state whether ar not ihnse entities have
empsayees.IfthesulrtaatrBcft=hive employee%they Mmstp'mvidetheir vkmrken'romp.palicgnumber.
I ant an employer thatispravh nng ivorkers'eompettsafian iumirancefor my anrpLajwes. $eroly is flee pa cy and job sue
inf ormaftom
Insurance Company Fame:
'Policy 4t dx Self-ins.Ilc_- Expiration Date:
Job Site Address: ` �.6 PO,'�u i 14�L D. eifyfstatel i Gr1, L#PA&7'rA(,F 441t
Attach a copy of the work-ere compensationpolicyded iteration page(showing the policy number and respiration date).
Failure to secure coverage as reguiredunder Section 25A of MGL c 1572 can lead to the imposition of criminal penalties of a
fine up to$00D.00 andror one-year imprisonmad as w&. as civil penalfies.in the form of a STOP WORK ORDERand a fine
of up to$250_W 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 do het-eby.c aztr-der the ''is andpen - afgarjul}'thatf�Tie infot�rrdtdw prini&dabom is buds acid correct
Sitmattrre. M Date:
Cq-
Phone ik
O &ial use only. Do not avrfte in this area,to be completed by daffy ortoitm of fiat
Cl€f or Town: Perrniff icense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.[ifSlFown Clerk 4.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person: Phone#:
-- ---— ---- - --- - - 6
I
Town of Barnstable
Building Department Services
MAM Brian Florence,CBO
6 ►�0 Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.maxs
1
Office: 508-862-4038 Fax 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I elle.4V l rKJ-r'i 1 ,as Owner of the subject property
hereby, authorize i / �� i�/� to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
**Pool fences and alarms are the responsibility of the applicant Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
0,4,,J
/ G
Signature of Owner (c
� Signature of Applicant
Print Name Print Name
Date
Q:FORMS:OWNERPERMISSIONPOOLS
Rev:08/16/17
WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
' F Information Page. WC 00 00:01
Atlantic Charter Insurance Company VDAC
NCCI Co. No. 29211 Policy Number WCV01243703
1. INSURED: Prior Policy Number WCV01243702
Robert Tyndall Producer:
Tyndall Roofing Miller McCartin, Inc. DBA Dowling & O'Neil
PO Box 1093 PO Box 1990
Forestdale, MA 02644 Hyannis, MA 02601-1990
Federal ID Number 999100972
Business Type: Sole Proprietor Risk Id Number:
SIC 9999 - NONCLASSIFIABLE ESTABLISHMENTS
Other Named Insured: See WCE106 Other Work Places See WCE107
2. POLICY PERIOD: The Policy Period Is From: 07/15/2018 To 07/15/2019 12:01 A.M. Standard Time
at The Insured Mailing Address
3. COVERAGES:
A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states
listed here:MA
B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3A. The limits of our
liability under Part Two are: Bodily Injury by Accident $ 500,000 each accident
Bodily Injury by Disease $ 500,000 policy limit
Bodily Injury by Disease $ 500,000 each employee
C. Other States Insured: Part Three of the policy applies to the states, if any, listed here:
COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06B
D. This policy includes these endorsements and schedules:
See WCE105
4. COVERAGES: The premium for this policy will be determined by our Manual of Rules, Classifications, Rates &
Rating Plans. All information required below is subject to verification and change by audit.
Code Premium Basis Total Rate Per Estimated
Classifications No Estimated Annual $100 of Annual
Remuneration Remuneration Premium
See WC 00 00 01
Minimum Premium: Deposit Premium:
$550 $7,194
Total Estimated Premium $9,085
Interim Adjustment: Annually Surcharge(s) 395
Servicing Office: Total Premium and Surcharge(s) $9,480
25 New Chardon Street
Boston, MA 02114-4721
Issue Date 06/29/2018 Countersigned By: '... �,t�: OQJ-4- Date
Popyright 1987 National Council on Compensation Insurance Form:100mvnt4
s�
Town.of Barnstable *Permit#
Expires 6 months from issue date
II : Regulatory Services Fee �6
• a 39 & • PERM
MASS,i639. �' Richard V.Scali,Director X"ES7S IT
♦0
CFO MA't A
Building Division .
Tom Perry,CBO,Building Commissioner AUG 2 5 Ziii4
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us TOM OF
Office: 508-862-4038 0
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
� Not Valid without Red X--Press Imprint
Map/parcel Number i L AcD
� 2
Property Address I t 1 1---�
Residential Value of Work$ � �� ,00 Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address (i,�r �L rM fr1A.- CA 14 :e,
I n 1 1 )
Contractor's Name o,5b;, 50,1 Telephone Number L7 (a C{
Home Improvement Contractor License#(if applicable) L� Email: Gbtc&v1 .V'Oc �: t 1M�1
LdVA
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ lam the Homeowner
;1I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy# — �',Q-j C{
Copy of Insurance Compliance Certificate must ac�com'pany each permit.
Permit Re uest(check box)
Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken toao1J nq
!!❑-1Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#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.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
r uired.
SIGNATURE:
QPFILES\FORMS\building permit fonns\EXP:\W SS.doc
Revised 061313
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Deparfinent ref Indrkstrud Accidents
- f�`zce o,f�rrt.�g�Etioru
60:0 J 'ayhington S&eet
Rastan,MA 02MI
' www.inass-goVdua
Workei.-s' CouipensafiaiaLasuranceAffidavit:BuFildersf,antra:ctors[Mectricians/Kumbers
Applicant Lafermation Please Print, ib y.
Dame V U in
Ass:
CitytS tateJZip: 11.J Ph--4-7 U�
lire you an employer? etk.the appropriate box: T o ect(r
4_ ❑ I am a general ctmfractcir and I )� f�o J ���=
I_[I I am a employes with 6- ❑New mnstnr ioa
foyees(fti11 andlocpart#irne�* havehizedthe sub-contracfats.
pl
listed�� T�n a sofe proprietor or partner
on the attached sheet; 7- ❑Remodeling
and'natre no employees employees
emplosues-contractors have g- ❑Demoliti�oa
wor ale in a4 ci �_ n��es and have wofkers'
o�g -f y capes t5 9. ❑Building addition
[I`To,Workers., Comp..inmttanre comp-mmrarrrr
5_❑ We are a corporation and its 10_0 Electrical repairs or additions
3_❑ I'_ a homeuwner doing all work of ce s have exercised(heir I i�_❑Plamlying repairs or additions
myself [No 1vcrk='comp- right.of e�mmpfionper MGL I 3Zoof
ixte�ttstnreregnired_j t c-152, §1(4' and wa have no �
employees_[No Workers' 13_❑Other
comp_insuranc-required-
'Any sapticmf drat checks box m1 amst also fill otd the section below sbowmg ffi&wod'rers'corVensstion policy iafitnzfar
t HomemuEs XVIM submit dos s-Rdxvif i'dUrstimg lazy are&mg a3I ttmk and then hire oa tade coatracturs mast submit anew afSdarit sn"�surf
C mtmcmrs thst rfi xA tlli s boz mast sttached sa xdditinnxl saed shacc-m fhP name of tfae Mt�OM=Xlor5 sad state whets ocnoz ffmge zrdifies be
Employees_ Ifth—_sub-coot exam hsfie empIayee_%they must provide tt-._r workers'comp policy number
I am art empLgy2r that isprn-ticb�rg t.vorl ere'cantpgruiah"v.n irmztrance,for my enWLyeem $elotr is fhe pQ&cy and job site
ire�otmalio..n
i
Insm-ance CompanyNatne:
Policy fr Of Self-ins-UC_4k ! t Expiration EJate:
Job Sites ddiess: t \ Cifyr'StawZrp: Gl
E,ttacbt a copy of the-workers'compensation policy declaration page(shoving the policy number and expiration date).
Failure Sa secure coverage as regtzireduuder Sectiort SA of MGL c 152 can lead to the imposition ofcrimhtal penalties of a
fine up to$1,500.Oa andlor one-pear impfisomzzmTy as well as cirif penalties in ihe form of a:STOP WORK ORDER and a fine
of up.to S250.00 a.day against the violator_ Be advises}that a cDpy of this statement maybe forwarded to tine Office.of
Iurestigatitns of 13ie DTA far in�ce coverage verification_
I des hereby c rr. tkspains an psnatYias of ury fJtatthe irtifi afian prmddsdr a e is a-nif correct
SiEnature: Date:
Phone-9: �O T
02D-tirI use only. Da trot write in flits area,to be campieted by ciij or town offitiaL
City or Towa: Permitff icense 9
Issuin,-Authority(circle one).:
I.Board f Ile eith Building Department I City+rl awn Clerk 4_Electrical Inspector S.Plumbing Euspector
6.Oaher
Contact Pe san: Phone g:
6
Information and. Instructions
i
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuantto 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_"
I
An e Io er is defined as"an individual,partnership,association,corporation or.other legal entity,or an two or more
_ mP Y �P A � rP g �'� Y
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 152, §25C(6)also states that"every state or Iocal Licensing agency shaII withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for arn.y
applicant who has not produced acceptable evidence of compliance with the insurance.coverage requires+."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shal.I
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 aaznbe.,-(s)along with their certincate(s)of
insurance. Limited Liability Companies(LLC) or Limited Liability Pariver-shi�s(LLP)with no employees other than he
members or partners, are not required to carry workers' compensation insi duce_ If an LLC or LLP does have
employees, a policy is required_ Be advised that this affidavit may be submitted to the Departa-lent of Industrial
Accidents for confirmation of imirrance✓,over-.ge. Also be sure to sign and date the affidavit D e affidavit shoed
be retumed 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 he law or if you are required to obtai-I a workers'
compensation policy,please call thi Department at the number listed below. Self insured companies should enter their
self-insurance license number on the appropriate lme.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Depa invent has provided a space at the bottom
of the affidavit for you to fill out in he event the Office of Investigations has to contact you regarding the applicant
Please be sure to fill in the permit/hr-ease number which will be used as a reference number. In addition,an applicant
that must submit multiple permiJlicense applications in any given year,need only submit one affidavit indicating cu-rent
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 maybe provided to the
applicant as proof that a valid affidavit is on file for future persits or licenses. Anew affidavit must be gilled 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 affida-int
The Office of Investigations would h1ke 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 fix number.
'fie Cornmo iwea1&of Massach2usets
Dement Qf Industrial Accidents
Office of kvl stlgat%ans
500 washinaton sftQ t
Boston_1NIA 02111
Tel,9 617 727-4900 w 406 or 1-R77-' 4SS.AFE
Revised 4-24-07 Fax 0' 617-727-77C9
ww _�asgavvdta
i
I �
O;ttce of Consumer Affairs & Business Regulation- Mass.Gov Page 1 of 1
The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) f ��
Consumer Affairs and Business'Regulation.
ys
Home Consumer Home Improvement Contracting
HIC Registration Complaints
Registration# 154549
Home Improvement Contractor
Registrant Registration Home Page
Name . PAUL GUSTAFSON
.Address 14 JONATHAN CIR
City, State Zip PLYMOUTH, MA 02360
%:Expiration Date 03/19/2015
i
Complaints Details
:No complaints found for this registrant.
You can also view arbitration and Guaranty Fund history.
Back To Search
s Massachpse
tur
Board of Builds epar�retat o,P "
i Coristc ng Reg tatto !�hc S
a
License. CSSL}105967 ih
i
y^ PAUI GUSTt1F3 ��a:� �� c r
01Q
P1 JONA TT3AN CIRCL.
,mouth MA'0236077
{
k '•„� i.60^�►riissioner EXpir. to 4
r.
r.
Paul Gustafson
Exterior.Restoration Specialist
14 Jonathan Circle
Plymouth, MA 02360
Cell 508-269-1263 HIC License# 154549 CSSL# 105967
email at: gustafson.roofing@gmail.com
July 11,2014
Attn: Mr John Loughnane
26 Point Hill Road
West Barnstable, MA 02668
508-362-2082
Regarding : Reroof of Front Main,both sides of breezeway, adjoining garage section
and small left wing both sides.
Properly protect home and grounds during construction.
Remove and properly dispose of existing cedar shingle roofing.
Inspect roof deck and cut back deck at ridge to accomodate new
ridge vent. Renail as necessary.
Adhere ice and water shield along eaves,walls, chimney and valleys.
Apply 15# felt on remaining roof deck.
Install new continuous Cedar Breather underlayment over entire roof surface.
Inspect and replace copper step flashing as necessary.
Replace existing copper valleys,with new l6oz copper valleys.
Replace all soil pipe flanges.
Reshingle with#1 Blue label 16" red cedar shingles applied at 5" to the weather.
fastened with stainless steel ringshank nails.
Install new continous ridge vent along all ridges.
Install new red cedar ridge boards over ridge vent.
Clean gutters and magnetic broom grounds upon completion.
Total: $9, 850.00
Customer Signature:
Authorized Signa e• 6414
Page 1
Town of Barnstable ��
Permit#
Expires 6 months from issue date
Regulatory Services Fee
s i
• MUMSTABLE,
a
9 ss Richard V.Scali,Interim Director
QED MA't A
Building Division
Tom Perry,CBO,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMTT APPLICATION - RESIDENTIAL ONLY
lot Valid without Red X-Press Imprint
Map/parcel Number �P j� C f
Properly Address— a� �O;r1�y I��/ A. wee,� r�rUle__.
['Residential Value of Work$ �/ OG a Minimum fee of$35.00 for work under$6000.00
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable) Email:
Construction Supervisors License#(if applicable) rK&E !;+- ErRul
❑Workman's Compensation Insurance
Check one: MAY — 5 2014
eJ,
am a sole proprietor
am the Homeowner
❑ I have Worker's Compensation Insurance TOWN OF 13ARNSTA13LE
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Requ (check box)
r[\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
❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#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.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required.
C SIGNATUIRE:
Q:\WPFII.ES\FO \ ilding permit forms RESS.doc
Revised 06131
The.Commonwealth of Massachusetts
rIn rA Department of IndustrialAccidents
Office of Investigations
' 600 Washington Street
Boston,MA 02111
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/OTaniration/Individual): le�n /6 o A +"A-4t,—
dss: 2 IJ �Dik� /T . I( ket,
_City/State/Zip: _ �' 5�- a,t�!Phone#:Are you you an employer?Check the appropriate box: 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.incirrance t
ed 5. We are a corporation and its 10.❑Electrical repairs or additions
I am a homeowner doing all work ' officers have exercised their 11.❑Plumbing repairs or additions
J myself. [No workers' comp. right of exemption per MGL
12.❑Roof repairs
insurance required.]t c. 152,§1(4),and we have no
employees.[No workers' 13.❑ Other
comp.insurance required.]
*Any.applicant that checks box#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 hue outside contractors must submit a new affidavit indicating such
xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp,policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
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 fin(,-
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 provideedj above is true and correct
�'Siffiaturre: T' �.: i Date: /�/ e,
CPhOne#: G
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 CIerk 4.Electrical Inspector S.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-152,'§25C(6)alsb 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 perfoffiance of public work until acceptable evidence of compliance with the iasu=ce
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-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)df
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 submif multiple permit/licease 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
(ie.a dog license or permit to bum 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 Commonwealth of Massachusetts '
Department of Industrial Accidents
Office of Westi~gationa
600 Washington Street.
Boston,MA 02111
Tel,#617-727-4900 ext 406 or 1-877-MAS8AFE
Revised 4-24-07 Fax#617-727-7749.
vrVVu.mass.gov/dia
I
i
Town of Barnstable
Regulatory Services
°tlt rqk� Richard V.Scali,Interim Director
Building.Division
a mwgsrAR(F, i - - Tom Perry,Building Commissioner
MASS
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6250
HOMEOWNER LICENSE EXEMPTION ;
Please Print
DATE: s7 q 5 - e
JOB.LOCATIOttI a[ U n7tt� �l I`i� Wv��ll1 s2/r41 's'�Gr
number street village
"HOMEOWNER": -- Gl� .,L r
-- -name home phone# work phone#
CURRENT MAILINGADDRESS: 67,-6r
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 and requirements and that he/she will comply with said procedures and requirements.
�_..
cure o o eo r
Appi-oval 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.
THE T � Town of Barnstable
' Regulatory Services
i ±
* lAtNSTABLE. •
BUM -Richard V.5cali,Interim Director
163q. �0�
Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstablema.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete.and Sign This Section
If Using A Builder
as Owner of the subject property
hereby authorize to act on ray behalf,
in all matters telative to work authorized by this building permit
(Address of Job)
Pool fences and alarms ate the responsibility of the applicant. Pools
are not to be filled of utilized before fence is installed and all final
inspections are performed and accepted.
Signature of Owner Signature of Applicant
Print Name Print Name
Date
a
1
�L
iz c
POOLVa
.
i y (/
t
w
l
/ 67
7
E I-APJE
wti ►.r„. .. .f•y��jryY�y..• .N�'i.NFR�^+'t�.Pw"r•'t'Fri�My�"_ - ..-- iSY�RI��'-.yY.�I.NF.rn
•
Asesso map and lot number ... .� . :y....:.....::' �" " f�rl� �Y l
1
„ STET 3 l�ft1ST ME
INGE
Sewage Permit number .... .'1....... ...................................... }a _ i
$� w � _
TO
• Pn �•� i L._;`. hiYlTOWNTOWN OF BARN �AULE
ypF THE ST
t0
BJHB9TSDLB, i
"6 .e0�c M a. BUILDING INSPECTOR
aY .
APPLICATION FOR PERMIT TO ..................... ......................... ..................................................................
TYPEOF CONSTRUCTION .................*VY'jaim..................:.............................................................................
,l ..... ..................19 .
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ......4e:,.�?,;1,,,........./..........................................................:..........................................................................................
ProposedUse ...... p. ! ! ....................................................................................................................... .
Zoning District ........ r.....................:.................................Fire District T...e.,7�� ! 5�.........................................
Name of Owner s �2' � �.��.eng4ddress &Y
Name of Builder ��1$E-!� r....... �.D& rZS.Address �� r '
Nameof Architect ........... .... .....:................................ ..:..........Address ..................,... .................�..................................... .......
Numberof Rooms .... ....................................................Foundation ....... ��;� 1 ���...............................
Exterior 1.�d0► ��/lV ..�r .........................Roofing ��r!?Al� LaI /ia1) �•.�../
........................................... _ .................... . .................................
Floors c4rg,.� �..r....................................................Interior ,�,/ � `lam /��L ...............................
Heating �aA�I -' " ...................................Plumbing ....... f�L���? ............................................
Fireplace ...... . .! ..................................................Approximate Cost ......... > D
Definitive Plan Approved by Planning Board _______ ----------__._______19_ �. Area 14
vil
,01—.2 S r .
Diagram of Lot and Building with Dimensions Fee ....
SUBJECT TO APPROVAL OF BOARD OF HEALTH
o .
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
F. construction.
Name ..............
'I
' Bridges, Robert /
> '
�
l73�5 l 1/2
3otory»
----.''.' Permit for ��......................
�^ eloQle family dwelling
� `
� —.—^-------.�---- -- .
r .
� 9n1ot Hill
locohon ~_Jl1&.�----.-----1�������--. '
� . .
� West Barnstable
--------------------------'
Robert Bridges
� Owner -----_________________
`
' frame
\ Typo of Construction ...........................................
`
--------------------------. �
` Plot ��
�} ---------� ----------'
.Permit Qronh*6 —�—. ..4............ 74
� Date of Inspection
//xI 75
.| Doh� Completed . ]A
}
PERMIT REFUSED
/ '
............................................................... lV
,
.---------------_---------- ,
`
��
—.._----------------�----..,— �
� /
� .,^.------------.-----.—.---.—
" . ` '
^) -------~----^^----^—^----'—'' �
`
� Approved ................................................. lA �
�
. -------.---------------.---.
'
`
--^--------.--------.-.----.... '
' ^
` ` .
Assessor's map and lot number ....... ....... ..................
Sewage Permit number ......::....... ..........................................
�F"THE T TOWN OF BARNSTABLE
Z EAWSTADLE, i
90 "6 9 BUILDING INSPECTOR
o OR
APPLICATION FOR PERMIT TO ....................... ................................:...................................................................
i
TYPE OF CONSTRUCTION .............:............. ...:...........;.....................................................................................
...................................
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location . .
ProposedUse .......:.....................................................................................................................................................................
Zoning District ......................................................Fire District ............ .... ..............................................
Name of Owner .. ..::.........:...:....: .............................. .........Address ... .................................. ......... ............................
Name of Builder ................:....................................................Address ....................................................................................
Name of Architect -...Address
.....................................................
Number of Rooms ........ :........................................................Foundation ...................:..................::......................................
Exterior .... .'....... .......... ......... ......... ....._..........................Roofing ......:."
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 ...................................................................................
'
Bridges, Robert
-
.......... - ^~M^~v dwe.l.ling
~�^� .
L~
���� Point Hill l �^�-
Locohon —..=��....................................................
____�_____Weat. �a6le_____. '
Ovvno, ........Robert_Br1dReo.................................
`
Type of Construction ---. ------'
--------------------------'
#9
Plot ............................ Lot ................................
�
�
Permit Granted October � � lg 74
~ , -------------.
Date of Inspection -----------'',lV
�
Dote Completed .......................................
�
L PERMIT REFUSED �
-----,---------------. lA
--------------------------'
,
--~----^^^-----------------''
�
..-------.-------..--~-------. . °
'
'-------------'-----`—'—^----
�
�
�
Approved ................................................. lV ,
^
------------------------'--
---------------------'—^~~—'
�
4
1 FEE
b �
acs TOWN OF BARNSTABLE, MASS.
add _ 19
0
i; clbo
0A•5 THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TO
pq V a
4=
b �s (PROPERTY OWNER) (ADDRESS)
riS=
03
aTO ................................... ........._.........._.........»................_......»_»_.......
(BUILD) (ALTER) (REPAIR)
d D N C
G G (TYPE OF BUILDING) (APPROXIMATE SIZE)
M
o eon LOCATION ................._......................................................................................._..._ .................................................................................................................».......
._.»_.
V y (STREET AND NUMBER) (VILLAGE)
FFFG+iii�
J NAME OF BUILDER O R CONTRACTOR ....................__..».».»_.._. ............................................_..._............_._................___..........._......
d °) Q APPROXIMATE COST ............................................... ............................................._...._.... _
y w eom I HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN
ry
OF BARNSTABLE, REGARDING THE ABOVE CONSTRUCTION.
o Pq 0
a _......._.............._........_............_........................_................................................. »......_...........__.................................................................._......................................................
��! d rA (OWNER) (CONTRACTOR)
V O~
a �....
..y ._._..._.._._..»....... ...._.......__...................
d
-99 BUILDING INSPECTOR
Subject to Approval of Board of Health.
u �
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r �
� 2�
r
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TOWN OF BARNSTABLE BULK RATE
COUNCIL ON AGING. . U. S. POSTAGE PAID
198 SOUTH STREET NON-PROFIT ORG.
HYANNIS, MA. 02601 PERMIT NO. 2
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Assessor's office(1st Floor): /- �/�
Assessor's map and l�ot/nummbbeerr o*T"E>o y
Conservation f -i� /_ l�0 7�-/• -�.� Q.. o
Board of Health(3rd I� SEPTIC SYSTEM MUST
Sewage Permit number �i� � g as% i INSTALLED IN COMP 3TULE
Engineering Department(3rd floor): WITH TITLE 5ra 9•���a°
House number �'�f� �lo NVIRO�IMEV�TAT CODE
Definitive Plan Approved by Planning Board 19°
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only
TOWN OF , BARNSTABLE -�-�
BUILDING - INSPECTOR
' APPLICATION FOR PERMIT TO �XflAh 1a 0 rn
TYPE OF CONSTRUCTIONS ee'=
v/ 1e7 19 9_
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies f+orla permit according too the following information:
Location Location + V n)#7 lei// k /ALL
Proposed Use C!7tOA/1c1 0 Y i S ncC -bedp 00 n
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Zoning District Fire District 0.-r6A1,*+,b4--
Name of Owner %;Nya C4 �' v ®Address Ot ',n 1• Ijlr`�/ (�,� �5 f&iIJ71�7
Name of Builder_„J t iz V e//a S Address C� i
Name of Architect �r Address
41a Number of Rooms • e- E } 1 Tih Foundation JU&I
Exterior. �' eo 41 S i�/s5 Roofing :,4
Floors '• < ��- Interior -4- i S i
A. 4AAMI
V yu, ot
Heating o S /iK Plumbing AI9e-
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Fireplace i n �t:✓1 a,/ Approximate Cost •% D1?d_6v
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Area
Diagram of Lot and Building with Dimensions Fee
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OCCUPANCY PERMITS REQUIRED FOR NEW PLLINGS�O
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.
Name
Construction Supervisor's License o ��
LOUGHNANE, JOHN B. & AUDREY M.
No 36036 Permit For BUILD ADDITION
Single Family Dwelling G
Location 26 Point Hill Road Gl • , a f-y
West Barnstable
Owner - 'John B. & Audrey M. Loughnane
Type of Construction Frame -
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Permit Granted Jul :2 0 19f 93 4,
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Date or 'specti 1 /51�
Date Completed 19
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Via Nings nlgnway negivc:ai t dibw►,c Liliu:Lt
in the Town of Barnstable for a
CERTIFICATE OF APPROPRIATENESS
Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness 470
Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on g r h o p
accompanying this application for: - lJ
CHECK CATEGORIES THAT APPLY: JUN
1. Exterior Building Construction: ❑'New Building ® Addition II Alteration I
Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Ot er
TOWN OF BARN$TABLE
2. Exterior Painting: ❑ IN
3. Signs or Billboards: ❑ New sign ❑ Existing sign El Repainting existing sign
4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other
(Please read other side for explanation and requirements).
TYPE OR PRINT LEGIBLY DATE 2
ADDRESS OF PROPOSED WORK 26 Point Hill Road West Barnstable, MSESSORS MAP NO. �3
OWNER John B. and Audrey M. Loughnane ASSESSORS LOT NO.
HOME ADDRESS 26 Point Hill Road West Barnstable, Ma. 02668 TEL. NO.(508) 362-2082
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public
street or way. (Attach additional sheet if necessary).
Please see attached
AGENT OR CONTRACTOR Fellows Building & Home Improvement TEL. NO. (508) 477-5196
5 Main Street Mashpee, Ma. 02649
ADDRESS
DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side), including
materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed
locations of new signs. (Attach additional sheet, if necessary).
Expansion of existing bedroom by 10 ft. to include fireplace, additional
windows and slider leading out to 6 ft. wrap around deck
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Owner-Contrac r-Agent•
Space below line for Committee use.
Received by H.D.C. �
/C�
Date ZTh�4eicate is re y Date
Time
By 14
Approved IMPORTANT: If Certificate is approved,approval is subject to the 10 day appeal period
provided in the Act.
Disapproved ❑
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FELLOWS BUILDING
ANs od
& HOME IMPROVEMENT SHEET NO.
5 Main Street CALCULATED BY � "� DATE `�' 2 / T3
MASH_PEE, MASSACHUSETTS 02649
(508) 477.5196 CHECKED BY. DATE
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7ryr°� The Town of Barnstable
9� 1639. `0�' Department of Health Safety and Environmental Services
'�Fc►�+' Building Division
367 Main Street,Hyannis MA 02601
Office: 508-8624038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
June 14,2000
Audrey Loughnane
26 Point Hill Road
W.Barnstable,Ma. 02668
Re: Cape Cod Ballet School,49 John Maki Rd.
Dear Ms.Loughnane;
This letter is to make you aware that the Site Plan Review panel recently approved the construction of a
ballet school at 49 John Maki Road in West Barnstable. Although this is a residential area,the use is
exempt due to its classification as an educational,'non-profit entity.
You should note that John Maki Road is slated to be bujlt in accordance with the specifications of the
subdivisions plan. The applicant has publicly acknowledged this responsibility. In addition,this facility
shall not offer any public performances.
Please feel free to call should you require any other information.
Sincerely,
Ralph Crossen
Building Commissioner
The Town of Barnstable
Department of Health, Safety and Environmental Services
.. _ .� low Building Division
367 Main Street,Hyannis MA 02601 ,
Office: 509-790-6227 3 q'9.8 5- Ralph MCrossen
Fax: 509-790-6230 �� , as- 0 Building Commisso:::
Home Occupation Registration
Date:
Name:
� Phone
Address:
Type of Business: Map/Lot: /
INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation
within single family dwellings..subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the
activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor,no visual
Aeration to the premises which would suggest anything other than a residential use;no increase in traffic above normal
residential volumes;and no increase in air or groundwater pollution.
After re&u2don with the Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• 'The activity is carried on by the permanent resident of a single fancily residential dwelling unit,located
within that dwelling unit.
• Such use occupies no more than 400 square feet of space.
• There are no arsertcal alterations to the dwellingwhich:ur not customary in residential buildinp,and
there is no outside evidence of such use.
• No trafTnc will be generated in excess of normal residetcuai volumes.
• The use does not involve the production of of ensivc noise,%ibration,smoke,dust or other particular
matter,odors,electrical disturbance,heat.hare.humidity or other objectionable effects.
• There is no storage or use of toxic or hazardous materials.or flammable or explosive materials,in access
of normal household quantities.
• Any need for parking generated by such use shall he met on the same lot containing the Customary Home
*Occupation,and not within the required front yard.
• There is no exterior storage or display of materials or equipment.
• There is no eommacial vehicles related to the Customary Home Occupation,other than one van or one
pick-up truck not to e=ced one ton capacity,and one trailer not to exceed 20 feet in length and not to
caned 4 tines,panted on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indic:ctinz3 the Customary Home Oecupanon-
• Nthe Customary Home Occupation is listed or advertised as a business,the street address shall not be
I inducted.
• No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling uait.
I.the wed,have read and agree with the above restrictions for my home occupation I am registering.
Applicuu: T Date: f
Homeo . oc