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0046 CEDAR TREE NECK ROAD
mot._, Town of Barnstable _ _ �. _ _, Building eeaxsrwei e iPosted,Until Post This Card So That it is`Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept NAM Final Inspection Has Been Made. 1639. Permit ° LWhere a Certificate of Occupancy is Required,such Building shall Not be occupied until a Final Inspection has been made. Permit No. B-20-823 Applicant Name: Anatoli Sivitski Approvals Date Issued: 03/16/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 09/16/2020 Foundation: Location: 46 CEDAR TREE NECK ROAD,MARSTONS MILLS Map/Lot: 075-028 Zoning District: RF Sheathing: Owner on Record: BERNIER,PAUL RAYMOND& DEBORAH ANN Contractor Name: ,ANATOLI SIVITSKI Framing: 1 Address: 46 CEDAR TREE NECK ROAD Contractor License: CSSL-106040 2 MARSTONS MILLS, MA 02648 Est. Project Cost: $8,660.00 Chimney: Description: replacing roof Permit Fee: $44.17 4 Insulation: Fee Paid: $44.17 Project Review Req: r� ' Final: - v _ Date: �`` 3/16/2020 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 after issuance. 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. 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: J Service: 1.Foundation or Footing i f 2.Sheathing Inspection _ Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: r Application number— - Fee ...... ..........:.....41.....:......................................... > ` ` JUN 19 2019 Building Inspectors Initials... ................................ - p �t pI1� OWA 'J� ul RNSi`1 BLE Date Issued......Ch. hl........................................ Map/Parcel........ TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOW S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: q(-Q )Ott id A tarSkv�S t i c 1-3 NUMBER _ STREET VILLAGE Owner's Name:_bebo(-q k 6e(rl ice" Phone Number � - 1 ' C1 70-7 Gf Email Address: d n ie,r i k 3O @gMC6(,COMCell Phone Number Cl� Project cost!'49kDo Check one ResidentiL Commercial OWNER'S AUTHORIZATION Gam. As owner of the above property I hereby authorize nQ to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK Siding in Windows (no header change)# J~ 0 Insulation/Weatherization Doors(no header change)# Commercial Doors require an inspector's review ' E-1 Roof(not applying more than 1 layer of shingles) Construction Debris will be going to k/M-1—toc Ttk CONTRACTOR'S INFORMATION Contractor's name ' SCE A-0-CCCL Home Improvement Contractors Registration(if applicable)# I `� jt'j (attach copy) Construction Supervisor's License# 0 O)L4 9T) (attach copy) Email of Contractor Sc r 7.01)ifiePhone number '!j 03-t/a Q-7�� ALL PROPERTIES THAT HAVESTRUCTURES 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.....................................................s..... *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 Ten X X X Additional tent dimensions can be attached 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 i 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# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side. right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Wor number 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 Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permitV.applications are subject to a building official's approval prior to issuance. Town of Barnstable . . Regulatory Services NAM Richard V.Scali,Director 1639. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I Deborah Bemier ,as Owner of.the subject property hereby authorize scoff Peacock to act on my behalf, in all matters relative to work authorized by this building permit application for: 46 Cedar Tree Neck Road Marston Mills,MA 02648 (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. Signature of Owner Si ature of Applicant � Pp Print Name Print Name Date only. Standard Staples delivery policies apply.You are r ponsible r understanding full Program details,which can be found at sta les.co ards. Never miss a deal again.A d u t our address book. Update your email preference subscribe I Privacy Policy Staples, Inc.,500 Staple Drive, Framingham, MA 01702 3 I I Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Cons►rucfmn'�Suloervisor CS-094500 Expires:07/22/2020 JAMES S PEACOCK _ 1046 MAIN ST.�UNIIT 7 . P_O.BOX 171 OSTERVtLLE MA-026S5_ Commissioner J/!1 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE::Corporation registration- g2WIrstion 151853 _..' '07/06/2020 SCOTT PEACOCK BUILDING.&REMODELING INC JAMES S.PEACOCK-. �lZ CG� -- 1046 MAIN STREET SUITE 7, OSTERVILLE.MA 02655 Undersecretary r Ac" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) 07/19/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER CONTACT NAME: Germani Insurance Agency PHONE 508 428-9194 FAX No): 508 428-3068 908 Main Street EMAIL E S: oerts@germaniinsurance.com I ADD INSURERS AFFORDING COVERAGE NAIC# Osterville MA 02655 INSURER A: SAFETY INS CO INSURED INSURER B: Granite State-AIU Holdings Scott Peacock Building&Remodeling,Inc. INSURER C: P.O.BOX 171 INSURER D: INSURER E: Osterville MA 02655 INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MMI ICY EXPLTR LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $ MED EXP(Any oneperson) $ A BMA0022118 07/05/2018 07/05/2019 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 JECT POLICY❑PRO LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 B OFFICER/MEMBEREXCLUDED? N/A W0005-81-5464 06/22/2018 06/22/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Scott Peacock Building&Remodeling,Inc. ACCORDANCE WITH THE POLICY PROVISIONS. P.O.BOX 171 AUTHORIZED REPRESENTATIVE Osterville MA 02655 Fax:508-428-7625 Email:scoff_peacock@vedzon.net ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information `Please Print Legibly Name(Business/Organhation/individual):SC-0 It PCO a0- aL &uj Wit) Address: f. b, 60K ) `7 I - )DLV-,- MQU ii C f, 5 Uuk City/State/Zip: SJ-C C V i I IP, /,.IA 00&SS Phone#: SIP, Are you as employer?Check the appropriate box: Type of project(required): L❑ 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' [No workers'comp.insurance comp.insurance 2 9. ❑Building addition 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 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 hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. _ Insurance Company Name: GrG�. 1 "�� � ' _t_hs a ra ri Policy#or Self-ins.Lie.#:I/y r-- D ,`~- t- S�-I- � Expiration Date: Job Site Address: 96 Cedar )r City/State/Zip:Ala r,5t )1S W/& P4067(pVe Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a. fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereb c u airs and penalties ofperjury 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 official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: �r caaE t Town Of Barnstable *Permit#6 hP O„ Expires 6 mmnNrs froin issue Ante uARNSTABLE. + Regulatory Services Fee 117 MASS.9. ,0� Thomas F.Geiler,Director ArfO1"R Building Division Tom Perry,C.80, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.rna.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 0-7,5 d Property Address_ t_y Celr I JUe ? a/. /LVResidential Value of Work 10r60o (Minimum fee of$75.00 for work under$6000.00 Owner's Name& Address -pC3w) .r ! 6e,r a lr er— y CD cect6e,V_ J re-,e AJP Gl_ d- i'14ce rS ,�IS /l111-Pls ate, Contractor's Name C©41- Pka Telephone Number J -_ Home Improvement Contractor License#(if applicable) B53 Construction Supervisor's License It(if applicable) as 4500 0Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Flomeowner I have Worker's Compensation Insuranceto Insurance Company Name, -G'Cc t%J J -C "V ,5 „ j%VA'�( 3011 Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. �C Permit Request(check box) Soin v", S"WK V,�vJ ❑ Re-roof(stripping old shingles) All construction debris will betaken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ,32 � - A Replacement Windows. U-Value ` 3 (maximum.go "Where required: Issuance or this pennit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Horne Impro rent Contractors License is required. SIGNATURE: Q:rorms:expmtrg Revise071405 I The CommonweaM ofMassrddlrrtset& D4=&rmt of bt&-zrtriadAcad=ft 600 Wash&gion&rF Boston,MA 02M t•vrvt%Lma-,mgov/dra arkus' Cm npensah-m 7nsm-mc e A avaL BuitdetslCtmtracftws U ers A=Hcan#Tnfcfr wtiGu Please Flit D iv IVaffie edd e— 7 cft3r/s._QS4eryi j)e, M/q*0a(pS-,-s- Dhow- .�j �— a8-71�23 Are you an employer?-Checkthe appropriate bow Type of project(require*- I. am a employes V*ith 4_ ❑I oat a gengtal caafmctilr and I ' eazplogee3(fall.andfor part-4ime)- s have hired i to 6. ❑Idew conshut-tion 2.❑ I am a sole proprietor orpartaer- listed on the attached sheeL T.�RIF!T.ndeliag. ship and have no employees These sab"conftactam have g ❑Demolition Wari-Iag fm MC is any rapacity. employees and bane wodwrs' [NQ`6 oXIMM,Comp_frISU M e comp-insum+ce I 9..❑Building addition repaired j 5. ❑ We are a corpora i-an and its 10-❑Electrical repairs ar adcEhoas 3-❑ I ami<a homeowner daing aU Work officers have exemised deir L.❑Roofrepaim lL❑Plnm errs or addifioms myself[No was'comp. of em=pfion per HIQ. ' repaired j i 1i2.§I{4�sndwe bayeao alum+ epais employees.[Nowadoers' 13-❑other comp-'amranm requixiA] #Any applicsutdmtdmdsbom#1madalsofiIloutthesecBoabeT4ws3zatda tbe¢worTcem'cumpeasatiaapuTcyinfncmaflioa M=WwneMvdw satmft rins affidarg kffimdigcityan=_$ampallwa&EdeumbirEaMtd&c=bxCorsmnstsubmitanewaffidamtiMdi sadi ciaa'ff=cbeckt1dsbmcmust madditional shad sb�tbenamecftbasub-cam msmdstatewheelie[arnottmsee�ha� e�lvyees.IftheanL c sbace emglof�rs,tfiepmustpravidutheir_dMW_mp.ponq � lam an etncpio�ar flintisprmririinrgwockers'eat ertsalimt iitszlrat3ts fvr eQrpl veer Betnev is flte paUcyy avid job'site €ncformatiom Iasuramce GamparrylETame: 'Policy�4*-orSelf-imlic Job Site Addy `-f(n Ct°�Qc���'r�e�, l�c�. cityrs �s s M%lls, A4,4a) yg' Af#ach a:-copy of the workers'compensationpolicf declaration page(showing the policy number and expiration.dafe). Fail=to secure coverage as requiredunder Section:25A of MALL a 1�can lead to the imposition of crimimai penalties of a fine up to$l,SODOD aadlor orie-yearimpdso=enk as well asrivd penalties ire the faux of a STOP WORK Olummand a free of upto MM a dap against the viokfor. Be zdsdsed did a copy of this statement saaybe fmwarded to the Office of Iaveategatioas oftbe DIA for i nsmMU M coverage verfficatio Ida heresy and psaahies afpedhry thatthe itaformagun provfiW ahm a is bus and amrect �-- Date: pig V-- Mr- V g- -762 06> OfiTzi d aw an]5� Do n at write in fhb areQ to be cmmpleted by Qip artown anal or Tawn:CityFerrmfiLiceEtse;g Issuing Au&oiity(Circle one): L Board of 2.Bu mg nepartm rent 3.gown elm 4 Electrical h=pector s.Phmmbmg h3spector .6.other C►ntact Perron: Phone - 6 o® AC CERTIFICATE OF LIABILITY INSURANCE DATE(MMMD/YYYY) 07/22/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Germani Insurance Agency PHONE FAX 908 Main Street 508 28 9194 ac No: 508 28 3068 MAIL Osterville,MA 02655 E-D Ess:certs@Qermaniinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:SAFETY INS CO INSURED INSURER B Scott Peacock Building&Remodeling,Inc. P.O.Box 171 INSURER C: Osterville,MA 02655 INSURER D:Granite State-AIU Holdings INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE wynPOLICY NUMBER MM/DD/YYYYI IMMIDD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY BMA0022118 7/5/2016 7/5/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED (Pe r er accident AUTOS ONLY AUTOS BODILY INJURY ) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ D WORKERS COMPENSATION WC 005-81-5464 6/22/2016 6/22/2017 PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500 000 OFFICER/MEMBER EXCLUDED? N/A .. (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ S00,000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more apace Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Scott Peacock Building&Remodeling,Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 171 ACCORDANCE WITH THE POLICY PROVISIONS. Osterville MA 02655 AUTHORIZED REPRESENTATIVE - -- - ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD i Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-094500 Construction Supervisor +. F s JAMES S PEACOCK . PO BOX171 f}R OSTERVILLE MA 02955':' r"d Expiration: Commissioner 07/22/2018 C%/rr �porrorrzc�rcuetc%/ o�C���adJriccc0e/� _ Office of Consumer Affairs&Business Regulation License or registration valid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: a Registration:;,;`1'51853 Type: Office of Consumer Affairs and Business Regulation - •` Expiration:i�77M/20.1°8 Private Corporation 10 Park Plaza-Suite 5170 ® � —- Boston,MA 02116 - „j% SCOTT PEACOCK BUILDING- REMODELING INC JAMES PEACOCK 1046 MAIN STREET SUITE=:7 OSTERVILLE, MA 02655 Undersecretary Not valid without signature uFo+e ram, ti Town of Barnstable b 9. ,.� Regulatory Services Ado a Thomas F.Geiler,Director Building Division Thomas Perry,CBO j 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 VAOL, 30"c�� as Owner of the subject property hereby authorize SCo-T-r Pea A 63Cte— to act on my behalf, in all matters relative to work authorized by this building permit application for: `f CG�A(- -TkG= Nt✓CIL &Qb M'4k5,on�S (Address of Job) 2-A A7 Signature of Owner Date. Ave— (3c.=2nJ,L� Print Name 'QAWPFILESTORMSUilding permit forms\EXPRESS.doc Revise020108 ,M to ,. Town of Barnstable *Permit# bS_aw) tF1E ►�, Expires 6 months jrom issue date Regulatory Services Fee - S • BAM � pER Thomas F.Geiler,Director MAR 201� Building Division Tom Perry,CBO, Building Commissioner OWS00 Main Street,Hyannis,MA 02601 ® www.town.barnstable.ma.us Office: 62-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number f7 T 07, Property Address y G &WIc sR 0 i S ` P\A - ;N Residential Value of Work &?I 8,C;9 25�: Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 1(h1 V A l Contractor's Name Y C. IVLiV1 e7 Telephone Number h a_ 312 1 Home Improvement Contractor License#(if applicable) 1'Zl Construction Supervisor's License#(if applicable) n(o 96S Q ❑Workman's Compensation Insurance Check one: ArTam a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name .Policy# ®S i 1`� 1 �oc,S� � � S�j 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 7 fir-V-Wl" ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors Wr Replacement Windows/doors/sliders.U-Value D , Z5 / (maximum.35)#ofwindows I ❑ 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. SIGNATURE: _ 3L . Q:IWPFILES\FORMS\building permit formsTYPRESS.doC PROPOSAL 417 w�eZ Cam 79 Mayfair Rd. �o AA South.Dennis, MA 02660 MA Lic. #069680 capecodwindows.com H.I.C. #124793 (866) 398-15.11 • Toll Free (508) 398-1511 • Dennis, MA PHONE DATE TO: M/M Hoby Cook 617-548-4400 1/10/2013 P 0 BOX 416 JOB NAME/LOCATION 46 Cedartree Neck Rd. Andersen Windows .Marstons Mills MA 02648 JOB NUMBER JOB PHONE 4400 / Down Stairs 617-227=1050 We hereby submit specifications and estimates for. > 1. Remove eleven wooden double hung windows, two from living room,-two from front^entryway, two from dining room, two from master bedroom, two from. Myrna's office, and one above front door. Replace / install with eleven Andersen "Tiltwash" double hung windows in same locations. * New Andersen "Tiltwash" windows will have a white vinyl clad exterior with a clear pine , interior, stone colored hardware, full screens, and wooden removable grilles with a 6/6 pattern. All windows are energy star rated 2. Supply interior/ exterior trim and framing materials where needed. New interior trim will be 2 1/2" primed colonial casing with Andersen clear;pine. stoolcap, . and.'the new exterior trim will be primed pine to fit the openings. 3. Insulate the cavities of the new windows 4 . Take old windows to the town landfill. 5. Make arrangement for delivery of the new windows. 6. Supply town of Barnstable building permit. * This proposal does not include any painting, staining, or other work not described above. . * All Andersen windows described above will be prepaid by the home owner. * Any changes to this proposal must be done in writing and accepted- by both parties. ** If this proposal is satisfactory, please sign the YELLOW.copy and return, with. payment schedule. ** Please make a check payable to Vasco Nunez Carpentry in the .amount of $ 4,713.35 for your new Andersen products described above and please include .this'check with your signed proposal. Allow 3-4 weeks for delivery, this is a factory order. We Propose hereby to fumish material and labor—complete in accordance with the above specifications,for the sum of: Nine Thousand Eighty Eight and 35/100 Dollars dollars($ 9,088.35 Payment to be made as follows: Labor: 50% Down payment to start at time of start. . . . . . . . . . . . . . . . . . . . . . . . . . .$ 2,187.50 Labor: 50% Upon completion at time of completion. . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 2,187.50 Total labor & materials to complete this job, less new windows. . . . . . . . . . . ... . .$ 4,375.00 All material is guaranteed to be as specified.All work.to be completed in a professional manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be'executed only upon written orders,and will become an extra Signature charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.Our Note:This proposal lay be workers are fully covered by Worker's Compensation insurance. withdrawn by us' epted within 730 days. Acceptance of Proposal—The above prices,specifications and con- ditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.Payment will be made as outlined above. �igna Si re Date of Acceptok- A .....::...................:..:..: ..... Massachusetts -Department of Public Safety Office of ConsumerAffair Buaides R g I c tact6 Board of Building Regulations and Standards ME IMPROVEMENT CONTRACTOR i Construction Supervisor 1 & 2 Family va tom: agistration 124793 � Type: r�x , License: CSFA-069680 i ;V i s X xpiration: 8/25/2013,. Individual VASCO E NUNEZ#II , �'�• Vasco E. Nunez,III I 79 MAYFAIR RD= It 1 South Dennis MA�02660;.. � •� Vasco Nunez, Ill .�..... ; I .,.. 79 Mayfair Rd. II Expiration S.Dennis,MA 02660 Undersecretary i Commissioner 10/03/201.4 I Restricted-One-and two-family dwellings or any accessory building thereto, irrespective of size. i Failure to possess a current edition of the Massachusetts ? State Building Code is cause for revocation of this license. l For DPS Licensing information visit: www.Mass.Gov/DPS ; . f elm r0� Pv ti Os ' IARNSMIS MASS 1639. ,0� Town of Barnstable ArFD MP't A 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 ll � IleC, as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name if Property Owner is applying for permit,please complete the Homeowners License Exemption Form on,the reverse side. 1WPFILES\FORMS\bui ldin• g permit ormslEXPRESS.doc �oF11 T � Town of Barnstable ° Regulatory Services + BAMSTABLF, • Thomas F. Geiler,Director 1639. �a`� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.m.a.us Office:. 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: 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. Signature of 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. . O:\WPFiLES\FO'PMS\building Dermit forms\EXPRESS.doc t The Commonwealth of Massachuseft Departmmt of Industrial Acciden& Office of Invesfigadons 600 Washmgtmt Street Boston,.MA 02111 . WK".mas&gov/dia Workers' Compensation Insurance Affidavit Bugders/Contractors/Electxic ans/Ph tubers Applicant Information Please Print 1,.mbh Name(Busim-mXhganization/I &vidaal): 79 Mayfair:Rd. Address: City/State/Zip- Phone* S a cl ES 1511 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4- ❑ I am a goal contractor and i �1 am ayees(full and/tar r part err * have hired the sub-contractors 6_ ❑Ntwv construcfion 2_ I am a sole praprie2ni or partner- listed an the attached sheet 7. ❑Remodeling ship.and have no employees These sub-contractors have g. ❑Demolition w for me in employees and have twokers' working any capacity. $ 9. ❑Building addition [No workers' comp.insurance camp.rnsurance required.] 5. ❑ We area corporation-and its 10.❑Electrical repairs or additions 1❑ 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.]? c. 152, §1(4),and we have no 11M Other / employees.[No workers' comp.insurance required.] 'Any applicant that chedes boa#1 etmst also fill out the section below showing then waters'compensation policy information. Tt Homeowners who submit this affidavit in&cat rig they are doing aU wod andthe¢hire outside coertracmrs tan st submit a new affidavit indicating such `0nmc Drs that chew this boat mast attached an additinnsi sheet showing the name of the sub-cvntzacom and stsie whether or not those entities have emmplMes. Ifthe sub-caatmanis have emplayees,they must provide their workers'comp.policy number. la-in an employer that is ptovid3ng workers'compensaton insurance for tray empl4,em Below is the polity an d jolt site information. Insurance Company-Name: lly G� �� �• — Policy#or.Self-ins.Lac.#: (�� Expiration Date: 9— 12— Z G t 3 Job Site Add ess: 41L l-edALr Ir-e4 k�ffk '• City/State/Zip:Jgfi N,'(k f W OZto- A(tach 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 I,500_OG and/or one-yeas 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 veriffratioa- ' I do Hereby ce under the pains nd penal€es erf ped y that the iiformaat+rn provided above is bus and correct Si Date: — / Phone M qrp 161 ©j"acial am only. Do not write in this area,to be completed by city or town official. City or-tom: PermmitlLicense It Issuing Authority(circle one): 1.Board.of Health y.Budding ITepartnnent 3.t tyffown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact:1'qK 4 Phone#: 07� �� �a y Assessor's map and lot number, .... ..... ... .. FTHE Sewage Permit numbers House number ' ` ........................... �o Apr a• TOWN '-OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......: v P I. . .. !. .............................................. TYPE OF a CONSTRUCTION ....l::u C? f.:..(.� . b C1..:!: f......... `�.: ....� '� .....?��.......... ......�.................... ...............��:}.� .7................19. .�� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......1.r2.-.-....... �............. ........ .......:1 �.S..�c....... u4.C?...............4.. vJ Proposed Use ........r. i•�.�....� .. . Ir�. ..!.1. .f.4..f...Q.......................................................................................................... ... . . ZoningDistrict ..............._.......................................................Fire District .... `. ... .................................................. Name of Owner .....���!.�...�.,.k...........,L.<!. ..�i'lt.�.. ............Address .. 7.... . ...r�!.., b . tau / '.d.iF C �a :...f... l.jc• Name of Builder . . . .-i R.A.l1�..�. 1. ...... Address ..7...............' d „zG 1:P „ PIS ✓.;•,1,�„P....... ' Name of Architect ....... '...................Address ..... ...........{ ..c:.:..................................... Number of Rooms .............../ Foundation ....l.v.�.....�!;,• IC,(1.. f.. '..................................... J Exierior ... �a .� C�..t.?� �......... .{. .. a�.>!1,.1�............Roofing ... ::..?.�>s.:�.. .,Ir.:.�.�. .......... .................................................... Floors 't to 1�.....!ti.c;cj ....* ..Cc �.�:�-f.� f . IP Interior ... ;rx �ti.c� C . .t( r-: c F-.......... ................ . ....... .................. Heating �.Q::.�.t.. .1 ... r� >�... ! �;�,. Pry:......��.c..�.........Plumbing .....3..f ; i .......:.........�.. ..1.!=.:........�?::.f :'.. • •.�• .• �• •. Fireplace .............................. .............................................Approximate`Cost 1c.-© r: 6 .: ..................G................... Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH f r - OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ' !` ........ . i�Ci N...... . . ......... Construction Supervisor's License ...0!2 9L.S.U.....•...•.. JEFFERY, DICK 75-028 27449 TWO Sl�pry No ............. Permit for .............. . ............. Single..Family..pwellipg................... ........................ ......... Location ..Lot.....,.... 8 46 Cedar Tree Neck Road ....... . ............................................. Marston Mills Dick Jeffe7 Owner ...................... �y............. ...................... Type of Construction ..........1�K54W...................... .................................. ............................................. Plot ............................ Lot ................................ 'Permit Granted ..............1";" 85 ate of Inspection ...................................19 Date Completed ......................................19 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# -1 Health Division 03PG__;�Jnw,S TA g L E Date Issued 3 -03 Conservation Division �r So � � 6 1 901 HAY ,Y 30 PM I: 3 Application Fee a� Tax Collector I Permit Fee E 0 v Treasurer - --- - - .--, �uiVISfOP! --- :T�;o 1-j- 7-j.1 MUST DE Planning Dept. INSTALLED UM WMIPLIANCE i a. TiTLLE 5 Date Definitive Plan Approved by Planning Board r;-�: -�--: t�L CODE AND al Historic t0 4 rely( vation/Hyannis TLC-:'11 T10N Project Street Address 4 Village to (14) ► �� M ►A— Owner '' /I t-t�f3r0_ -E-mQ3n/4 CQrn�� Address vv`�� i5:__ Telephone �ia 6, 08a Permit Request Qs Square feet: 1st floor: existing I CCU proposed ( 2nd floor: existing /Zoo proposed 0 Total new Zoning District�l-- Flood Plain Groundwater Overlay Project Valuation VM66�h Z),ogo Construction Type W(DoC) T 8MP7_ Lot Size Grandfathered: 31es ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family O Multi-Family(#units) Age of Existing Structure 197 8 Historic House: 0 Yes No On Old King's Highway: ❑Yes 16No Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 6©O Basement Unfinished Area(sq.ft) 60cO Number of Baths: Full: existing �— new (fD Half:existing I new C� Number of Bedrooms: existing new Total Room Count(not including baths): existing / C ) new (�D First Floor Room Count Heat Type an:Zs el: as El Oil ❑Electric ❑Other Central Air: ❑ No Fireplaces: Existing New_ Existing wood/coal stove: O Yes h No Detached garage:O existing ❑new size Pool: O existing ❑new size Barn:O existing ❑new size Attached garage:existing O new size Z St:f9'existing 0 new size Other: tcry\ Zoning Board of Appeals Authorization O Appeal# N i� 9� Recorded 0 Commercial 0 Yes U_90 If yes, site plan review# Current Use Proposed Use ,M r BUILDER INFORMATION Name Telephone Number 9 Address License# 0D Z E3 Z 7 d ` Home Improvement Contractor# ! ( S 5©2_ Worker's Compensation#65' 6 u Ct-q -o ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATUR DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME oK -o-3 INSULATION OK (i- 'O A I { FIREPLACE _0 ELECTRICAL: ROUGH. FINAL PLUMBING: ROUGH, ;v FINAL GAS: ROUGH �o � FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. s —_ —_ The Commonwealth of Massachusetts i Department of Industrial Accidents office of/nsest/gations . t 600 Washington Street -= Boston,Mass. 02111 -S Workers' Compensation Insurance Affidavit i name: 4, C��A fZ i fZ�C 1 � location - city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole pgo rietor and have no one workin in any ca achy %%%%%%%%/%%///%%%/D �%%//O/%%%%%%��%%%%/%%%��%//G/%%%�%%%%%%�/%�%�%�%/%/�%��%/�%%/ I am an em Toyer providing workers' compensation for my employees working:on this job. -W-1 ...................X IX `Je..... pro m . .................................::::...::.. ...:::.....:.>::: ...:.:::.......... ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the folio workers' co ensation olices: };e>> ;{.,{ J'aut ?:>n; :n �co J.a ..:>::..::.:::..::.::: :.:::. :.:::,.: ::::::.::::::::: : ............:.............:...............::.........................:....................:........:...............................:...................................:. <:i<:?}:>ii:i:':'?ii i:Y iii?i?`};;%:iiii:?'::?{i:;i:S:::?'+::::.:•::;>:;?:`}:{!�!?.'flit'?21i:i�iiiiii i:�:+`t:i:::::ti'riii::::'::iii:;:i:;:jy}:i{:}:; : / 1.S on :s.:.:,:::r i$:CCi{ii:�ii.'•::i:+: �}:ti i{ ........................ .......... .:............... .. 4 ................................ ............................:............:.:..::...,....::•v.v::::::•w.a.... .........,-:::::.:•:::::•}}i:L•}::v:i}':•:w:::::•.:�w:::;:.:v::?:`iii:i��•>}{,i::{>�.R':l•'• ..Y..:::: ::L..::::.:•:w:::w::::.v:::::::::.v:::«..•i::::::::.:......:.....::....w::::::•}:?::}•.:.i:'.;.:.......... {•.....�..:.............. ................... :.::::::.::::.v..«:.,...... .. ..........:•• �}}i}}i:+.{.}}}:{+.':},v.:�v:m:�::::JL`.y::n:w:d v:.v}'.:{•:{::}v:.v. :!+f. ::. .:::::::::::}::::..�::::::::..................................... .. /`'Il�jl��l%/li.. «> :?:� `%�;::�'?;:;:;{?;}:t`.`:''?:i:;''.::,>.:`•;::�:+.%$f::�:�i:::`!c::ii'�:!;:`.;:��:j;iv�:< . .:;::�:2:;:;:::f:'ji:«:;::<�:Sf:2<�:;';::?{>:yti;:}^:i::is�:`;::J�i::i:::•':::?:i'r::'r::::}:•.;';':;is�:G:;:�i:'y!;}::::{~::>'{>:<;`!:!.;?wn; i a ;aura :c n ;•J +' .r 'ailifr :>h :i:CviF•:w:::.• ....:.................... :lrlyurirnet,::co.:.}:.;:;.;:<:.;.<:.}:.;;:;.}>J:.:.<:.J:.J::.}}J':«{{:.:::.::::.:.::.:.:::::.:.:.::::::........................:.................. •o ...... . Failure to secure coverage as required under Section 25A bf MGL 152 canlead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I Understand that a copy of this statement may be forwarded to the Oiace of Investigations of the DIA for coverage verification I do he e p e per.i t the information provided above is truo and correct Signature Date 5S- Z " Phone# Print name S��' 4��3 z7 official use only do n`ot write in this area to be completed by city or town official city or town: permit/license# ❑Budding Department ❑Licensing Board ❑check if immediate response is required ❑Selechnen's Otflce ❑Health Department contact person: phone#; - ❑Other (cevieed 9/95 PIS r Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express'or implied, oral or written. 5 •' r I ; t 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 section 25 also states that every state or local licensing agency.shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company naives, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of tfie affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicaat. Please be sure to fill in the perinit/license number which will be used as a reference number.`The affidavits be ietiuned tr the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a'call. The Department's address,telephone and fax number: r. 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 ext. 406, 409 or 375 ZME,p�yO Town of Barnstable N Regulatory Services gpMgrAHLE,MA9.R. Thomas F.Geiler,Director 1639..�a`°� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. ' s Type.of Work: Estimated Cost V NDe?12A f cam,pcfZ�:3 Address of W ork: 4 4 CAA�i2c--��CC ec. M AJ2_ M, l_cs M Vk, Owner's Name: Date ofApplication:,-55 ` 2� — CIS — I hereby certify that: Registration is not required for the following reason(s): i []Work excluded by law []'Job Under$1,000 Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name °F�► r�,ti Town of Barnstable Regulatory Services * saxxsraetE. • v MASS. Thomas F.Geiler,Director s639. �0 ATE039Ip Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 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 p�c- �I1c�C �c 1p%,o acton my behalf, in all matters relative to work authorized_by this building permit application for: - S�Addrtis of Jbb� (Y-) pr�——,5;; Signature of Owner Date Print Name Q:FO RM&O W NERPERMIS S ION f BOARD OF BUILDING REGULATIONS Y License- CON-STRUCTION SUPERVISOR Numb�e�C- 002827 �03 Tr.no: 12016. }� _ isle R 5tr eted I PETER J BILO 83 B.UNKERHILL : •,2 �• .».�x�i OSTERVIL_ MA 6 5y Administrator ' -- - ' . OT, aa::: Board of Building Regulations and Standards HOME IA PkOVEMENT CONTRACTOR Regi tration. _15502 � IE A:iraf0bM 4 nhi�"i'wdual PETER J.BI1_0.�`- PETER BILODE. 83 BUNKERHILL RD'" OSTERVILLE,MA 02655 Administrator Property Location: 46 CEDAR TREE NECK ROAD MAP ID: 075/028/// Irslon ID:4566 Other ID: Bldg#: 1 Card 1 of 1 Print Date: 05/30/2003 10 CONSTRUCTION DETAIL SKETCH Element Cd. Ch. Description Commercial Data Elements Style/Type 3 Colonial Element Cd. Ch. Description Model 1 Residential Heat&AC DK Grade - Luxury Grade Frame Type Baths/Plumbing WDK 32 Stories Z.2 2 Sty w/UAT 1 Occupancy 0 CeilingfWall ooms/Prtns 14 -1 xterior Wall 1 11 Clapboard /o Common Wall 60 2 Wall Height 18 14 AT 44 Roof Structure, 3 able/Hip UgTR 24 MT MT Roof Cover 3 sph/F Gls/Cmp CONDO/MOBILE HOME DATA A US Interior Wall 1 05 Drywall Element Code Description I actor 2 Interior Floor 2 2 12 Hardwood loo rAdj 6 2 _ 00_ _1 2 Unit Location 14 eating Fuel 3 Gas Heating Type 5 Hot Water umber of Units C Type 1 None umber of Levels 24 ir 28 IV /o Ownership _ HS Bedrooms 4 4 Bedrooms AS 13 Bathrooms .5 1/2 Bthrms COS TIMARKET VALUATION 1 Full+1H 60.00 FOP Total Rooms SizeA Rooms n Adj.Factor .875 j.Base Rate 0.87514 PTO ath Type Grade(Q)Index 1.64 21 Kitchen Style dj.Base Rate 86.11 Bldg.Value New 378,453 A Year Built 1985 ff.Year Built (A)1990 act- 4 rml Physcl Dep 10 MIXED USE uncnl Obslnc 0 �i(��—�— Zx F con Obslnc 0 pecl.Cond.Code da �d 1010" Single Fam 100Spec]Cond% 10 Overall%Cond. 100 eprec.Bldg Value 378,500 OB-OUTBUILDING& YARD ITEMS(L)IXF-BUILDING EXTRA FEATURES(B) Code Description LIB Units Unit Price Yr. Dp Rt %Cnd Apr. Value SPL2 Pool Vinyl L 720 24.00 1986 1 100 14,900 GRN2 COMM GLASS L 190 8.00 1900 0 100 1,500 BFA Bsmt Fin-Aver B 19092 15.00 1990 1 100 149700 FPLl Fireplace B 1 3,000.00 1990 1 100 2,700 FPL3 Fireplace B 1 3,000.00 1990 1 100 29700 BUILDING SUB-AREA SUMMARYSECTION Code Description Livin Area Gross Area E .Area Unit Cost Unde rec. Value BAS First Floor 1,575 1,575 1,575 86.11 135,623 IBMT 11asement Area 0 1,484 297 17.23 25,575 -FAT Attic,Finished 616 1,232 616 43.06 53,044 FHS Half Story 64 91 64 60.56 5,511 FOP Open Porch 0 189 38 17.31 3,272 FUS Upper Story 19262 1,262 1,262 86.11 108,671 GAR Attached Garage 0 624 •218 30.08 18,772 PTO Patio 0 189 19 8.66 1,636 UAT Attic,Unfinished 0 624 156 21.53 13,433 WDK Wood Deck 0 1,496 150 8.63 12,917 [. ro ylLease Area 3 517 8 766 4 395Bldg Val: 378,453 Property Location: 46 CEDAR TREE NECK RD MAP ID: 075/028/// Vision ID:4566 Other ID: Bldg#: 1 Card 1 of 1 Print Date:07/27/1999 Description Gode Appraised Value Assessed Value %LANGSTON,JOHN R 6 CEDAR TREE NECK RD SIDNTL 1010 261,60 261,60 801 MARSTONS MILLS,MA 02648 RESIDNTL 1010 6,30 6,30 1999 Barnstable,MA ccoun an e . - ax Dist. 300 Land Ct# er.Prop. #SR VISION Life Estate DL 1 LOT 8 Notes: DL2 GIS ID: jotal 35U,Lu 1 3 , qu vi r. Code Assessed Value Yr. I Code I AssessedValue Yr. o e ssesse a ue MINISTRATOR SMALL BUSINES 7259/187 08/15/199 U I 10 L FFREY,RICHARD&JUDITH 4290/078 10/15/1984 U 1 77,001 Z ANGSTON,LUBA K*M792 10837/302 CGRATH,WILLIAM F 3177/ 52 Q ota. , ota. 401,60C—-7-o—taT. 398,40( This stgnature ac now a ges a vlstt by a Data Coftector or ssessor Year yp escnption Amount Gode Description Number Amount Comm.Int. A SUMMARY Appraised Bldg.Value(Card) 244,400 Appraised XF(B)Value(Bldg) 17,200 ora Appraised OB(L)Value(Bldg) 6,300 Appraised Land Value(Bldg) 112,300 Special Land Value VOID 1/93....... Total Appraised Card Value 380,20 Total Appraised Parcel Value 380,20 Valuation Method: Cost/Market Valuatio N�o Appraised arce ii ue380,ZUU Permit ID Issue Date lype Description Amount Insp.Date o Comp. Date Comp. Comments Date ID Gd. Purp6-sWRFs-u7F--' B33999 10/1/90 AD 8,00 1/15/93 0 MM ADD'N —1129811 8/1/86 P 10,00 1/15/87 100 NIM SW.POO �B27449 1/1/85 ND 120,00 1/15/86 100 MM 2 STOR 841008 6/1/84 SP 0 MM Bff Use Gode Description Zone D Prontage Depthnits Unit Price 1.Eactor N.I. G Iactor Nbhd. Adj. Notes-AdilSpecial Pricing Adj. Unit Price Land Value Single Yam , •, o es:I U I BLDU 90,000.0c , 1 1010 Single Fam RF 3 1 1.24 AC 20,000.0 LOC 5 LOC 09BB 0.9 PCL(1.,U11)Notes:11 1RES 18,000.0c 22,30 Total an nitL.L1 Aq 7 otat Landa u11L,jut Property Location: 46 CEDAR TREE NECK RD MAP ID: 075/028/// Vision ID:4566 Other ID: Bldg#: 1 Card 1 of 1 Print Date:07/27/1999 Fodeloi Description omznercia Data Elements o oma Element escnptzort esidential ea- Frame Type Baths/Plumbing Stories .2 Stories w/Un Occupancy 0 eiling/Wall ooms/Prtns Exterior Wall 1 11 Clapboard %Common Wall 2 Wall Height 14 Roof Structure 3 able/Hip oof Cover 3 sph/F GIs/Cmp 18 44 14 AS Interior Wall 1 5 rywall ement Code— escrzptzon actor AR AS MT 2 uS Interior Floor 1 2 Hardwood omp ex 2Floor Adj 2 Unit Location 18 1 2 eating Fuel 2 it umber of Units 6 2 eating Type 5 of Water umber of Levels C Type 1 one /o Ownership 14 edrooms 3 Bedrooms athrooms Bathrooms 24 16 0 Full na I. ase e otal Rooms 7 Rooms ize Adj.Factor .89726 de(Q)Index .55 13 ath Type kdj.Base Rate 66.76 FOP 13 1 Kitchen Style 3ldg.Value New 249,349 13 ear Built 1985 ff.Year Built 1985 rml Physcl Dep 2 uncnl Obslnc con Obslnc pecl.Cond.Code a/o 0 pecl Cond Go de escrz tion Percentage verall%Cond. 8 single tarn luu eprec.Bldg Value 44,400 Go de escrzptzon nits nit rice r. p t o n pr. a ue but irep- ' SPL2 Pool Vinyl L 72 7.5 1986 1 100 4980 GRN2COMM GLASS L 19 8.0 1900 100 1,50 BFA smt Fin-Aver B 1,09 15.0 1985 1 100 14,40 Code Description i ing rea -Gross Area rTVal: eprec. a ue BMT asem nt Area 1,48 19,82FOP orch,Open,Finished 6 86FUS pper Story,Finished 1,36 1,36 91,06GAR ttached Garage ` 62 14,55UAT ttic,Unfinished 1,85 12,41WDK ood Deck 81 5,47s tv ease rea Assessor's office(1st Floor): Assessor's map and lot number .J Conservation(4th Floor): `s �/7 C J',- `� Board of Health(3rd floor): �' SEPTIC SYSTEM N1I1ST MUSTADLL Sewage Permit number ,�' -� ��� INSTALLED Ong COIUIPLI�d rua 039. Engineering Department(3rd floor): `�/ WITH TITLE 5 House number , 1 [,2 ONVIRONMEkNTAL COO Definitive Plan Approved by Planning Board 19 + � �C��Q�L�� ��® APPLICATIONS PROCESSED 8:30:9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR I APPLICATION FOR PERMIT TO 1--13tJl i �► �Z.1.�1.i���cA1 PCi A �2E *lav5'e V TYPE OF(CONSTRUCTION y Lt�a 4 '� �' �s 5 ClJ Con)c.a+� a".J 5- 19 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following'information: Location _46 (-PO Arz '7-4 c-,E- ,k)L°Gr-- " g'� ti'l Proposed Use 94,--OVI.40lS� Zoning District ��I� � Fire District Name of Owner 5014�j 6 slaw Address- Name of Builder -gyp�'1'1("� 64-T-4'L Do Address 1l ` fl Name of Architect 0 Address Number of Rooms l Foundation � tZE9 COiIJCr W,T► d"h,tJ� Exterior -0 f�oan Z/,'l ASS Roofing Floors cz A)(-Xk b Interior Heating Plumbing Fireplace Approximate Cost 000, I Area oZ a O Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name 64 TZ `O o Construction Siipervisor's License ���Z t , ;. L'ANGSTON, JOHN y., No 36717 - Permit ForB Tr,D GRFF. oUSE Location 46 Cedar Tree Neck Marstons Mills - Owner, John Langston Type of Construction Plot - Lot Permit Granted May 20 i9 94 - Date of Inspection: - Frame - 1 19 Insulation 19 Fireplace 19— Date Completed - 19 yr r = az � . vj- 4` t ` COMMONWEALTH OF�- ._ � MA$SACHUS��"TS `c =AK17YCE 'T OF LNDUSTRIA kACCIDENTS 600 WASHINGTON STREET fames J Carnooeis BOSTON, MASSACHUSET I5 02111 ;or n_sstone- WORKERS' COMPENSATION INSURANCE AFFIDAVIT gicenseelpermittee) with a principal place of business/residence at: 0-2,u1 K- k✓ u o d_2.S36 . (GtylSate/Zip) . do hen y certify,under the pains and penalties of perjury,that: am an employer providing the following workers' compensation coverage for my employees working on this job. — 4tUCA-j Insurance Company Policy Number ( ) 1 am a sole proprietor and have no one working for me. () I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation insurance policies: Name of Contractor Insurance Company/Policy Number Dame of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number 0 1 am a homeowner performing all the work:myself. NOTI=.Please be aware that wbilc homeowners wbo employ persons to 6 eu�intenanee,construction or repair work:on a dweliinc of not more than t^rec units in wbicb the homeowner aiso resices or on the Frouncis appurtenant thereto are not tener2l1v considered to be cmolovcrs ttncier the Workers' Comflcwation Act(CL C. 152.sec 1(5)),application by a homeowner for a license or permit may eviccncc the Jccal sutus of as employer under the workers' Compensation Act_ I u^ce.^-;:nd t�,:;:co�N-or t:.is st:te:ren.wiL be forwa:ctG to trc ✓c�a: �.t of Incus--I Accidents' Ofncc of Insurance for coverage �cr.:i :;ion arc : -. .-.,:rc to scL:-c covc.--cc:.s rccui.cc uncc: Sccn'on ' G'— s c_c:.ni icad to List imposition of criminal per-J ccnsiscr,F of:fsnc of up to S i 500.00 andor ir^�risorrn=t of uc to orc yc::me ci.ti pcncit.ics in the form of a Stop Work Order and a fine of S l 00.00 a cav against me. Sicned this ( � day of G t. „tea° yo y`•.p LpyJ�`'l�i y �j�J �Vwzs�P M' OF MASSAchus OEPArtrAq EXPIRATI EIS ONEAS BENT OFpuSll ON DATE BOSTON��RTON PLgCE tt 06D0g,A E 02108 RESTOHENS 96 CONST4`Z EjVs i F t EFFECTIV UPERVTSOR . 4 PHOTO ��. O' .�� �`H 1 /� O 2 1 IS Sri OPq Oryly) `, v y Aii r 1 0 FE1.00400 uOZtEMA 0OR Poe)( HEIGHT.' , C- ISSIONER OTHERS RIGHT TI'IUMB PRIpTT T RHO HOLDER �R B ,I GAGEOIN THISOCCU ATION., S TUBE OF LICENSEE ER r ---, - -- i A OJ J• Y c1, \� I�op .i10 1 `A IJ Y iloov Z'01f,: "c' This � 0RIGAGL i\SPECTIO\ Pla p Bank l-se t<---- �i C.LrI�I�'al' ���i 'EF, _lai.=i 1.1 _ Ll.'�'t' l=rf'-'w=,f---__ 1 ;\•.� ....is .'.. i."'!_,..--- -- --• ,!l'}__4' ...---- I e .\ �.�+•` .. 1..:,\N 1` ..11l^.:11 ED ON TiI G AS ! I�' _. _ :.;V-*N M." 'i!i`:1. 1 S PC;�'.MO DOES ---- CONFORM, ' Lv�. l ,.\`� cz ;` NT OF . 'J.I`. _ �\'_� _! — •..i i.. �'II• ..� ii... ....-�i.�.l:.... .'i.\':�1-� :,:s,1 .i.� � � - _ '1 - I ...:.:, .,- ._.v.l is N 0:'\ .:'i: _-.l.'`I.. ��: Il, "'`'--C�--f--I--- . ...� _. f• . o c l0'M�13. •W Y S 00 Ira x - o - g,-�40R Sa-,T ry ot- Jr.P. . FYAc$L AEowT 811 rjA4C-1 t1A'j P� F(zc)n^ MAc 4 CoRNr=.R &4 rxpr-4 Slar, OF DwIZ 44D . \N 31 t o,G. Ft6� i� �3% " FAbM ours,&r rmik of Fbu-4r)4r1o.4 Do Ndr- � T A-tA4oR,& rjW DoOR j 4y� (F�MeDroO , PIAcE goon Mer .3Y� ICI o"T"d D6, S FFuNDArO,J TR94rr D s I LL-SY o ' _ &RE&A.Liourfs- puOR chd5 L- o +1 a,•` e�Cd�r1e Ill Ilk /qCM; 14STALL Sit-LS COJr1r`1uOuS ALL ARow-Jr A+-tD T1RL)uG#{- �N LXX�R�W�y /�FTS..R �r�ISAu-rnK, CT'►c�� X-x JOB NO.(? /_D Q FOR: turdi-built OATS S- 1q_Sl/_D US 1 f�1�� .t x _SI c.(�.. -...----- Manufacturing Company REV. 11300S.Wr8o«�FmyRd.PatFend.OR97219 60 2444IM VEeir t1o7-E: vFsA ugr/ocE,; Nar \ VEWr C4WrRoL3 AWL UNZ. Rloc t CAP Rat,L 1IENT i4a44DLZ tstAit- • '• VErJr -''�-` 1/EaJr' TlE-c�44r1 AArrFR �.. 9 R I13 P�,+!, - / ... WrE R a EAr,-p-Am — vb Te-C94WS bar S-tlool� - . t+yIL VWX Gtmve r SIOS I&AR n r "I - TY 7->IG4 L r DeA,AI >,i&r CROSS 3CC rIo4. �y SILL ,441L orr era! l� ro tA. tire�t_ GA NAIL CAD W N . III-COWS G2=��1►Icu� kLccTt {�..ACir�f2 05 me NO Fa1.yyPic.4L CROSS-SE rlo►J y.� GA7E JV IO 11161 SET a 1 LS t�1auring Compare RFv 113M S W am., Fv VRd Pcr&nd.ON 97219 bob 2"A100 I _Ul v- - - _ 11 11 R�4R EWD Fui,l. bwR G40 Ft-El i +ABLE i RAFT" EAHE t 7'E � IL n + PLATE F C SEGr 0 � 2'/i'SCREv� N GREF�JNour� 5��4_ t.l=.dGrr� 7bP 0pt=,41Nc. 1n! s=ft VuLe-FcoR IDooR — CaRRy Foet.Jodrno-1 T44Rv& Ar FtCwR Lx-wu- i t �°D pcTA1L or AASE 0 1 i N YJA" a COP,4ER &APJ0+4r,0,4 Z 84SE V✓ALL. 1 -� F3ast I X X Fou 40ATIO4 {1 BASE WAIL GRACE Ty.P. EE DETAIL. S v rPLiED OV oc,►NER '-_ �FtooR� ' �111� •j =t'1- JOB NO. _0 I 7L 20 SOS.I T�m4qA../ l� di.—b t►�.i.L l� DATE Manufacturing Company REV. 11304 S.W.Baines Ferry Rd.Poeland.OR 97219(5031244 d 100 _ ..fir •.r. `.t`:' �,aa:w, 'r`Y _.�yi't »ti>aci.f•"rG:4':tom: �.a, t 'y''.rej"`+�'-"+k�'"�L.s,,....,. ,•.� a;'e •Rt 'a I / _ • t TOWN OF BARNSTABLE 27449 . Permit No. -------------------------- { n i Building Inspector Cash O qY� OCCUPANCY PERMIT Bond ___ - Issued to Dick Jeffery .Address Lot 8, 46 Cedar Tree Neck Road, Marstons Mills Wiring Inspector _ � ---`` Inspection date1>5 Q�—���--�• _ �, Plumbing Inspector � Inspection date Gas Inspector n Inspection date ?Engineering Department ;6/ Inspection date p / Board of Health sad .r Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL, VOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .... �... .._..... .............. .............. .._........._....._.._ Building Inspector ..� '�• TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING � rua �9► i6Jq' �� HYANNIS, MASS. 02601 . �o rya►� . MEMO TO: Town Clerk FROM: Building Department Cam, DATE: gl� An Occupancy, Permit has been issued "for the building authorized by BuildingPermit #...... ....... ............................................................... . .�.......................... .............................._...... issuedtom .... _...... ...................................................... ....„............__..........................�... I V Please release the performance bond. ' O 4 III Ifl� ( � � : • �• :� � . A17 Tip N \ le � 1 •. r ► 1 � f � , 1 41 �' f g 37.4 \ r C PLAN :. _ .. 7 0I`v POSE" LANDING . ZCNATZ,D � -�y' . ' a I i 9h-o . 7 y✓ILLIAi'JI c. .� LG .L (U�• N GE,2 T/.c/EO G.L d T T.UA T TNT Sh/4Wit/yE,2E0.1/COis-1pL YS fit//T�/ SCA L TE 7"//�,S`/OE,C/.</E A//0 SETBA Ck .c�.L.4�C/ .2E.�"E.2E•UC'E- � .�2EQU/.2EiL1EiC/lS OF T.�,i� 7`oN�it/OF oG: Z ,COCA TELL WiTh�/�,/ Th�E .�Loaaf�G4/.f! L-O'�' S 1 1 p Ou- �OS, l5� I►milCo OA T.E" ,ga xT,E,eE I(/oT BASE" d�c/Ate(/ �2EG/STE.2Ep L,Q�/O SU.eY�Ya�I 0,1,45'45'73r SyaL�/.1/S�vt�. ,t/o7- B� � c44L1�D c=�2C USEo 7-a oETEP-�fiv� ,w�-�./DES_ Y + ' Assessor's mop and lot number (27 M R�� / amoll.yInOU NMO ��iTHET�� Sewage Permit number ......�.>.4.rl00 ....... ,,NN 3CO3'1V1N3V9NoHiAN3 31lii HDAR • House number = BARNSTABLE. S ................................. .'I�ri �t!'i�'�"#ca 'O: �'3l � ���c91t.�1�1 roo Mb a ouc . todaS 39aye SYSTE M ST BE TOWN OF . BARNSTAir, SLrt)jeD COMPLIANCE TH TITLES e'"IIRO �MENTAL CODE AND BUILDING I N$�P E C T O R T(-%Wpl rqC-GULATIINS APPLICATION FOR PERMIT TO .... ........ w Q J1.I..i.... ............................................. TYPE OF CONSTRUCTION ....L✓.. D..D..... it.�,!11 e.......Fri..!!►•.�.Y........ .' �. !+¢•Q:t................. . ............... -cl................19.Sy TO THE.-INSPECTOR OF BUILDINGS: l _ The undersigned hereby applies for a permit according to the following informat' Location ...... .......... ........# ........N4zC ........tC�C.... .......... � n � �J ProposedUse .... r!tir.�. ........1 �.�.�.... .e.K 4.. .......................................................................................................... ZoningDistrict ............ .............................................Fire District ..... ' .�............................................................. Name of Owner .....bt,.G.k.......... ..F{.Mll;.. ............Address ... ......10&P.OL� Name of Builder ..,G...- ....... ............`.J..............Address .2 ......`4.Ify... A.-C.....�,*4j.L.!i.��a°...../'�i . Name of Architect J.1.'IX...... ..................Address .....ff.Y,.,vri.r►f..A.........AIK r..................................... Number of Rooms ..............IG............................................Foundation .... .......�B.i1• ................................. Exterior ..2t�... ....... rl ?............Roofing ... ................................................ Floors 4.0....t .CPIF ....>li' .../f! Interior Heating ...I..+�>AJ—`C.A..... ..... C'.c.I..........Plumbing ..... ...................r1.../44,1.F...........Pfu.+.��..`.'..- Fireplace ....3...........................................................................Approximate Cost .......�.,y�lQ.. A .4...r. .�......... .L... Definitive Plan Approved by Planning Board -----------_______-----------19 . Area ......aC�(,d ......— .......... Diagram of Lot and Building with Dimensions Fee 1`T 1. ` ......... SUBJECT TO APPROVAL OF BOARD OF HEALTH Nz J 7� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �f Name .. `'�.,....... ...................1!4 .... Construction Supervisor's License ..��YI�.,S ............ JEFFERY, DICK # .2 27449 7te •.No ................. Permit for .... .........S tQ .... ........ = .. . . ....Single Fa..... Dwe.. g.... .......... E Lot 8 _ Location •i.........46 ..Q(W�W.T1;6a.NeCk.Road .............Marstons•.Mil.ls................................ h ' Owner Dick Jeffery Type of Construction .Zr.zae........................ 4 �' , 'V< .:.......................................... . ............................... !Plot ....... Lot. ................. �': ......... _' r C.A7 Janu 21 r L 1 85 Permit-Granted .............�'.......i'... ......19 ✓Daate of•Inspecti .... ,, 19 ... ....... Date Completed . :. -7 `1;9 ' Q. .� .9' y� Jx Ir ,• e. zeZ 0F1 j� ` 'own of Barnstable *Permit#,,�I ' {�� Expires 6 mon s o issue d to ® Regulatory S er.vices Fee X0P y �7 . a� Thomas F. Geiler,Director / Building Division PrEo rw't°' r0wN o NSl ABLE Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www:town.barnstab Ie.ma.us Office: 508-862-4038 Fax: 5087790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number n3 13-02-8 I lo+ 3 Property Address Aleck— 0 •Zan inj Xgi�kz 114./4 az699 _ Residential Value of Work C/, Q ., o �4 Minimum fee of$25.00 for work under$6000.00 Owner's Name& Address • �i�n ���1�-��e �l�k �. . /17��s(��s �1�'l/s iL'1� a2.��ck_� '� Contractor's Name y • c:) (c/lp7__ Telephone Number Home Improvement Contractor License#(if applicable) Q e (moon C S j ( /Z-5/7 2.5 ❑Workman's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner. ❑ I have Worker's Compensation Insurance Insurance Company Name /(/'6; CC-) Policy#A7e n7//—7 Copy of Insurance Compliance Certificate must be on file. Permit Request(check.box) ����� / // ❑ Re-roof(stripping old shingles) All construction debris will be taken to l G�(i'fYIe6W6 ,�a"V/,t; / ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side f' Replacement Windows/doors/sliders. U-Value (J. 30 (maximum..44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e. Historic,Conservation,etc. ***Note: Property Owner must sign.Property Owner Letter of Permission. A copy of the Llome Improvement Contractors License is required. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Ynvestigations 600 Washington Street Boston, MA 02111 r wwwariass.gov/dia Workers' Compensation Insurance Affidavit: ;Builders/Contractors/El ectricians/Plumbers A Ucant Information Please Print Le 'bl 3II1e (BusincssJOrganizafion/fndividuan: SLQ h—r �� Address: r►^ 2 City/StatelZip: v� Q Z Phone.#: S6 Are you an employer? Check the appropriate box: Type of.project(requrired): 1.❑ I am a employer with 4. I am a general contractor and I 6 New construction employees(full and/or part-time).* have hired the shb-contractors 2' I am a'sole proprietor or pnmtr- Listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, E].Demolition employees and have workers' woi$ing for me in any capacity. 9. ❑Building addition comp.�u�'°�$ [No workers' gyp.-msu an c 10. Electrical repairs or additions rtgivred.] 5. � We arc a corporation and its � p 3.❑ 1 am a homeowner doing all work officers have exercised their 1 LE]Plumbing repairs or additions myself [No workers' comp. right 6f exemption per MGL 12 []Roof repairs incnrmcc required.]t c. 152, §1(4), and we have no 13 G7' Othcr employees. [No workers' comp.Incur-anco required-] 'Any applicant that eheel5 box#1 must also fill out the section below rbowing their workcxs'con4xnsz4cn policy infmToation. t Homeowners who submit this affidavit indicafmg&rcy=doing all work and then hire outside contractors must rubrnit anew a$davit indicating such- I--Mtraetors that cbmic this box must zftehed an additional rbcet showing the name of the sub-eontrat6ors and state whcthcr or not thMd entities have ernpioycrs. if the sub-ontnwtors have rsnployccs,they must pravi&their war"='comp.Policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insiiranca Company Name. ✓v �-- C� — Policy#or Sclf--ins.Lic.#: /;�p nay Expiration Date: n �.�� City/Statc/Ztp lob Site Address: �iJ (-�� � Attach a copy of the workers' compensation policy declaration page(showing the policy number and""X:Pet,-,nte). Failure to secure coverage as rcquirrd under Section 25A of MGL c. 152 can lead to the imposition of rrin-ririal penalties of a fi=Yip to S 1,S00.00 and/or onn-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 statcmcrit may be forwarded to the Office of Investigations of the DIA for incivancc coverage verification. I do hereby certi under the pains-and penalties of perjury that the information provided above is true and correct 5i c Date:- 6blzxf — Phonc 4- O j7cial use only. Do not write in this area, to be completed by city or town offu iaL City or Town: Perrn!ULicense# Tssuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Elecb7lcal Inspector S.Plumbing Inspector 6. Other Phone#: �0p-IHErp Town of Barnstable Regulatory Services �uxNfAss. ,� Thomas F. Geiler,Director i639 �� °Tfo�,tt.�a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02661 www.town.barnstable.ma.us Office: 508-862=403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property Y hereby authorize A C C) Mu ey z to act on my behalf, in all.matters relative to work authorized by this building permit application for: �n C��%�r/`�T�� /V.�C� 2�. � Ss I"I!✓1�S IVU (Address of Job) e, Za 2!;,C'r Signature'of Owner. Date b6 Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable op THE ray �. Regulatory Services antixsrwsLE ; Thomas F. Geiler, Director .� MASS $ . g, i619. Building Division pTF° �a Tom Perry,Building Commissioner . 200 Main Street; Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 5.08-790-6230 HOMEOWNER LICENSE EXEM ION Please Print DATE: !OB LOCATION: number street village "HOMEOWNER name home hone# work phone# CURRENT MAILING ADDRESS: ei.ty/town state zip code The current exemption for"homeowners"was e ended to inclu owner-occupied dwellings of six units or less and to allow homeowners to engage an individual f r hire who does no ossess a license,provided that the owner acts as supervisor. EFINTTION OF HOMEW R Person(s) who owns a parcel of land on' 'ch he/she resides or intends reside, on which there is, or is intended to be, a one or two-family dwelling,attac d or detached structures accessory.,to such use and/or farm structures. A person who constructs more than one ome in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the B rlding Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work e rmed under the building permit.. (Section 109.1,1) The undersigned"homeowne assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, es and regulations. The undersigned"homeo er"certifies that be/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of 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 log.I,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 permi t application, that the homeowner certify that he/she understands the rrsponsi-bilitics 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 fom✓certification for use in your community. I PROPOSAL �o VASCO NUNEZ.CARPENTRY 79 Mayfair Rd. SOUTH DENNIS, MA:02660. MA Lkc:;;l 686 H.I.C..#124793 (866) 398-15:1.1 .'.Toll Free (508) 398-1511 • .Dennis,WA ;PHONE` DATE ' TO: M%M Roby Corer =:548 4'4 00 5%14/200C R. O BOX e16: JOB NAME/LOCATION 4'6 CedartrEE _?desk Ro:: �rde user ::v endows Kaxstons Mills MA �3`264$ JOB NUMBER JOB PHQNE «00 rd.ows/Revised 508 `4'20 .6080 We hereby submit specifications and estimates for <' w> Remove L'1 tLng: W1S?uCJ4fJ, a~nG r'�: a 2 j z t _.. ey eV�n Andersen-"r1Zt !.?clSh =C0 series windows, in. same:' locations New Andersen '' 1 t r.twash Windows will have a w,=s t v��yl clad exterior with`:a .clear dire uterior, white i rd„<are,.; fUzr_: screens, . and e.,:^ o_a w;doc s7r lles':with. :a. 6!0 .pattern. Nei inciows. will have iltwash ability, .and Low �4.:G qo i. gGs. :f��l.e ins ilateci g a.ss 2 Suppl-y interior./exterior-trim, and any f ram.i c ma:teriv_s where needed: Exczriori will be 4..:primed '.pne .stac', or,.appropri ate size ao.'openlr hE,.interor trim ,cell. 'be 2: 1`%"' a.r 3 1/2"..primad coloi ai 'casing appropr�aGe: to one dpe ,ir� 1ti=itn Andersen ""iltwash":`s-too' :�a�_ stock. . .Take 'old wind'ot.s and. ar:y derJrls fro1T th .ob to :%oW' Make arrangement: -or de11. Iry "of.-:.new windows Supply town .ot 3ar.�sta...: oui.lcdirig peYm e L1T"ateQ COSt, .$50.t1.0 j , .payable '-- ,avance: This proposal .doe not irc ude any ..a_.:^_ nq-, cr other repairs not :described. above .11 Andersen products •described .above w_�- be 'ore pai ;_, tne.i om'e owner. nny..t.han:ges to this' p op gal: must: be won 1n:.i __ an L -accepted by. both parties If this proposal _s satisfactory,' please sic~ t._e YELLOW 'copy .and return Faith. payment schedu!e.. Dleas:e make a check oavable to Vasco 'Nunez .Carpent-y .inn the amount of..,$4352.04 for your °-.ew Andersen products described, above, -and please '_nclude this check. with your signed pronosal. .Allow 3-4 weeks for delivery, this 13 _ __c_...r.v order: -.k• � VaE..•Ac C; e —yr z Y i �r DTSCOV _ ... _ -� C-.. .�1�3t7 3Y'Si;_:�: U�tL• i We Propose hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: v_ne ,Thousand Sevent-v Seven and 04/100 Dollars dollars($ 9,077.04 ) Payment to be made as follows: -.bon: 50% Down payment to start at time c= start, :'_= per: it fee. . . . . . . . . . . .$ 2, 38"?.5G :.,abor: 50% Upon completion at time of complet_cr.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S 2, 33: .50 Total labor and hermit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4,725.00 All material is guaranteed to be as specified.All work to be completed in a professional manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders,and will become an extra Signature liiZr charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.Our Note:This proposal may be workers are fully covered by Worker's Compensation insurance. withdrawn by ccepted within 3 C days. Acceptance of Proposal—The above pries,specifications and con- ditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.Payment will be made as outlined above. Sig fe � O Si re Date of Acceptance; j PRODUCT 13;26G . USE'Wmi 771C ENVELOPE NEBS To Reorder:1-800-225-6380 or www.nebs.com PRINTED IN U.S.A. • ' . ✓/,re {ono?�rmza?uu o�'✓Zlauac�aurelA i Board ot'B.iitlding Regulatlonsand Standards HOME IMPROVEMENT CONTRACTOR Registration: 124793 i Expiration 8/25/2009 Tr# 132409 tndivldual Vasco E.Nunez,"II Vasco Nunez, III 79 Mayfalr`Rd. -8r•u j S.Dennis,MA 02660 Admtolstrator � 1 N1 issachusot, Dchai#iiunt of Public s tfeh Board of Building Regulations and St.ind:u-ds coilsttuttian Supervisor License � License: CS 69680 i ReMricted.to.:.,.1G 1 VASCO E NUNFZ 4 ' 79 MAYFAIRi RD i S DENN.IS, MA 02660 Expiration: 10/3/2010 I ('numis.iu�ci' Trm: 4248 �pFIKE io Town of Barnstable *Permit# y P p Expires 6 months from issue date „,MST,B,X, : Regulatory Services Fee ab cc Mass. 9 039, Thomas F.Geiler,Director Building Division F Tom Perry, Building Commissioner �s 200 Main Street, Hyannis,MA 02601 VI/4 ✓(/` Office: 508-862-4038 Fax: 508-790-6230 - 0A_ EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY ,A�// Not Valid without Red X-Press Imprint rVL Map/parcel Number Q�j _Property Address /��/i/7.rI�� /.�i�� ��G.0 �r //(1 S (Residential Value of Work kzJed Owner's Name&Address � idpd llJir•�� . �+O Contractor's Names//�1� D.�L ,t(��i Telephone Number Home Improvement Contractor License#(if applicable) /Z031? Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner OZ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy#� Qi .M1'. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will'be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement C ntractors License is required. Signature Q:Forms:expmtrg Revise053003 m w � ��ie�ovivnzoouiea� a�,/�adcac/iciaP.lts $oard of Buitdmg`Itlegplaho.nsand Sfan3a�xds r 1-CO;MoIIUIP=;F YOUR;'PICO.�h71�C�R' � y ° Reglsfr �t�6353 �� ° � ? pQ4 ,�+ `�� ,ate C6rporaiion DAVIfl C.OX, IN DAVID COX 1:9(LANV+ENDER LN; s°• - fu✓. W YARMOUTH,MA 02673 APd�inlSiistra�tor e From:HCcok To:Greg Ricketson Date:702003 Time:5:34:42 PM Page 2 of 2 I I I _t I Town of Barnstable � g Regulatory Services Thomas 8.cam,Dlre W Bulking Divislom TOM ft"a BwMft Co ouor i saa tDspec HYOW,MA0=1 MUM 5MU2.4038 I PAM 5M79042M ' I Prop" Otmer Must i Complete and Sign This Section If Using A Builder ! 1 •a Owaet of the sub*property to SrA on my'bebjA. in sn matters rda&e to work authoskxed by this bu kuzg permits .=44= pia •u .. W 1 �C'Ue= L -2 G y�? i (Addeo,.of Jdb) rI 63 I Lime i i PtistNttmt i I I I i I I i • I 18 39Vd NI A3NWW aW SdMod @95E©�b805 L5 9i E00�/Z0/L6 J Assessor's office(ist Floor): SEPTIC SYSTER1, MUST BE Assessor's map and lot number. S 0 a INSTALLED IN C01t."A��fi,��N �T"E ro Board of Health(3rd floor): ^• �Il� IIm �,'��� `�� Sewage Permit number ��} d�/� /DD � ;� - ENVIRONMENTAL CO E yreDLL Engineering Department(3rd floor): TOWN IREGULATI�NS � NAM& House number °° i 39• Definitive Plan Approved by Planning Board 19 �o MAY 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 TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersi ne(d hereby ap 'es for ermit according to the folio n information: Location Proposed Use "T Zoning District r L F Fire District co t►1 t'►'\ Name of Owner_T Address Name of Builder t�l 0Q 6-A"j Address-MLA Name of Architect Address �l Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing ="n4= Fireplace Approximate Cost Area Diagram of Lot and Building with Dimensions ! Feedi OCCUPANCY PERMITS REQUIRED FOR,NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Ba t ov c ruction. r Name �, Construction Supervisor's Licenseoon )o_7 LANGSTON, JOHN No 33999 Permit For Build Addition Single Family Dwelling _ . Location 46 Cedar Tree Neck Road Marstons Mills Owner ` ' John Langston Type of Construction Frame Plot Lot Permit Granted October 3, 19 90 Date of Inspection* 19 Date Completed 19 �. M acl • ilk Assessor's offioe Ost flcior): THE. Assessor's:map ci d lot number .......... Board of Health -(3erd floor): 0 OF Sewage Permit' number ......... .......................... 13AUSTABLE. MAGIL Engineering Department (3rd- floor): -.01 039. House number ....................... 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 ...... ...... ,.. ....... 0 0 1,.................................... TYPE OF CONSTRUCTION ... ... .... . ....... . . .. .. .... c ...L— ..v3.ek..........................................A . Qr .......2-. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: J 't, - M f� -wh ,�S S Location w....................................................................... ................. (LO7 ProposedUse ............ ............... ....... .M. e..........?........................*.......... .............................................................................. Zoning District ....... .... ................................I................Fire District ............ .............tz............ 4(a Name of Owner Vi .....Address .......Mftl�7YFO%IS IA4_LS . MA , .................................................... Address .................................................................................... Name of Builder ......... .•............ Narpeof Architect ...................................................................Address .................................................................................... Num�ber of Rooms ......... ...........Foundation.. ...................................... ....................................... Exlerior ....................................................................................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 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of h f T� Barnstable regarding the above construction. the'" wn a Name ... ... .......... ............................. ... ......... ............ Construction- Supervisor's License .................................... JEFFERY, RICHARD A=75-28 29811 LD No .................. Permit for ......................... .Swimming Pool ........ ........... ... ................................ Location ..Lot...#.8 4.6..C.e.d.a r...T.r.e.e..N.e.c.k..Road . . . .. .. . . .. . Marstons Mills ............................................................................... Owner. ........Richard -Jeffery ................................ .......................... Type of Construction, ........................... ............................................................................ Plot. ............................ Lot ................................ Permit Granted .... August................... 21,.................19 86 Date of Inspection ....................................19 Date Completed .......................................19 1111ce7 asssor's Office 1st floor Ma d Lot Z I/Boar ( ) P Permit#servation Office(4th floor) )y 1� Q Date Issuedd of Health(3rd floor)(8:30-9:30/1:00- 2:00)ngineering Dept. (3rd floor) House#1 °'��� � SEPTIC SYro E Planning Dept.(1st floor/School Admin. Bldg.) v INSTALLED �B Definitiv pp ved by Planning Board 19 �IRONM ND TOWN OF BARNSTABLE' pn� Building Permit Application Proj ct Street A ress 46 LEeR2 Tae-E A&c is R o, Village H/-aS?aKS N/lu,S' Owner .l o HAIn L ysA L 4n1-6 S Ton/ Address 57,i/fe- Telephone J Z8- 6 7/Z Permit Request /t/`EG✓ /2)C°Zo_ SHE-19 :Total 1 Story Area(include 1 story garages&decks) square feet Total 2 Story Area(total of 1st& 2nd stories) square feet Estimated Project Cost $ F�T,DOD+� Zoning District Flood Plain Water Protection Lot Size Grandfathered? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Wo®19 Ff-Zith ' Commercial Residential ✓ Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure N EZJ Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths. No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds /2 X Z Ol Other Builder Information Name eAT',1CV0 j3vic,oltt4 Go, Telephone Number //33 Address 2 3 J Eo46; tU)1TE2 Y>R- License# 0'f 2'12t /J4 0-4 S"rc Home Improvement Contractor# Worker's Compensation# An- wee- i g to 7l oo cy NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 94 DATE q f I D Ill S� BUILDING PER ENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. 9753 7 - August 16 5 DATE ISSUED g �.:189 .; MAP/PARCEL NO. 075-028' r ADDRESS 46 Cedar Tree Neck Road MA 02648 VILLAGE M�stons Mills, OWNER John R. Langston DATE OF INSPECTION: + FOUNDATION FRAME ' INSULATION FIREPLACE f ELECTRICAL: ROUGH .FINAL PLUMBING PUGH " FINAL _ - mc. GAS: r FINAL i FINAL BUILDII tl Cr ` • Cro gam• A . DATE CLOSED` ASSOCIATION .. I N(3 �� 11:02'9 17:02, 'CO17 i2i i122 Dtt'i• UW Abb+AI COIJUM/twa.Aj. ol amach"de i .Uoparfinotrl o�.�"�.J�lacid�nts 600 WU s&d James J.Campbea Commissioner Workers' Cmimpensadon f ft= ce /davit /-F.&Lof 14 CA-M LP (4oeatedpam�.1 with a principal place of business at: - V�I GDC1&A(s-1 Z;4. V$_ Li do hereby certify under the pains and penalties of perjury, tl= I am an mplo er p Wing workers" p tion coverage for my empfaYees w( trot T b. Insurance Company I (� I am a sole proprietor and have no one worsting for me in nay .capacity I am a sole proprietor r homeowner tcirr3e ones and have bit contractors Arced below who we workers' �peasadon polider. Contractor Insurance y/Poficy Contractor toscIce It= 2 1policy Contractor Insurance Gempany/Policy I am a homeowner performing nit the work myself. I onems;ne:.�.as a coG' of his arse rrem w�7!beta rried m�.e OMM of imvadpdoat of dw OTA for eoaera�e va tffczion and drat nee.qe:s rsc::td under Section ZSA of MGL 1r2 wit lead m tm irnpeaww of aani*pence a of a Ace°f up to St,cr ireacs' imp tormaam u well at civil panaides in she tour:of a STOP WORK ORDER Ada MeatSt00.00 a d�apinsc me. Signed this �� of �f q5� • i4 Building Deparunent Lie s Perinittee ling Board Selecunens Office r - 4� ---------------- ________ ______ J === 00 tc 2q 3sub to. .not 6�. Dye (� 01 Q 1 w s�5 0 LR�376. 202- 96'." jy CgDAS 79'45'20 RES. ZONE.- 'WF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C" Bank Use Only TOWN: -------------- REGISTRY OWNER: __SM LL BUSINESS_AD DEED REF: __7-Z01t--6-7__________________BUYER: _JOHN_R_ DATE: ?LAN,REF2721_1&6-2-Z----U----A----7--f-------L----A---N-----D---S C-�-A-N-L- E--:-1-"-_----------- ---- 60---FT. .I HEREBY CERTIFY TO T_R_U_S_T_ CO. -------THAT THE BUILDING { SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS YANI{EE SURVEY SHOWN AND THAT ITS POSITION DOES --_— CONFORM CONSULTANTS TO THE ZONING LAW SETBACK REQUIREMENTS OF THE 143 ROUTE 149 TOWN OF ---42AREfLiB�-------------AND THAT MARSTONS MILLS, MA. 02648 IT DOES— NOT_ LIE WITHIN THE SPECIAL FLOOD HAZARD TEL 428-0055' AREA AS SHOWN ON THE H.U.D. MAP DATED_�LPZ—( — - Co unity—Panel B 250001 0018 C THIS PLAN NOT MADE FROM AN INSTRUMENT 6302 SUPNIFY. NOT TO BF USFI1 FOR FENCES FTC. : The Town of Barnstable.� Department of Health Safety and Environmental Services BuiIding Division .� 367 Main Street,Hyannis MA 02601 Ofrl= 508-790-6227 RalphCtosst Fare 508=775 3344 Bu mg Cm For office use only Permit no. Date AFFIDAVIT HOME nMROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c 142A requires that the"reconstruction,alterations,n novation,.n;pak modania2dM oonvasioa imprweareot, remmal, demolition, or consnuaron of an addition to nay PVC-existing aw= 0=4na building containing at least one but not more than four dwelling units or t4 sDructarts which ate adb= to such residence or building be done by registered contractors',with certain e=gxioM along with other ,,- Type of Work: A✓a� Art.Cost l2, ADO Address of Work: 46 6 c otik T2 eE OeZ IG t& J-1 rctTo�S tli��S Oaner.Name: ���N � L✓Rft Ls}�f,s'�n/ ,Date of Permit Application: I hereby ctrtify that: Registration is not required for the following reason(s): Work exduded by law Job under S1.= nilding not owrrer�oocapiad chmw Polling own PC Notice is he mby gh-en that: OWNERS PULLING THEIR OWN PERMIT OR DEALING VMM UNREGIS'IF.ItID COI`RRAC,TOR: FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO TW ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. /gl16111S-' r} C,a� l0S3J 2• / Date Contractor name won No. OR n Owner's name Ij'LI. S r 'x.' COMMONWEALTH DFPARTME�IT OF PU[�LIC 9A;U1- OF ONE ASHBORTON PLACE P•pu1A!^re^ c.usrRnt �s� " ��G MASSACHUSETTS BOSTON,MA 02108 klrearr,�r 1 "'l�fl �x: > LICENSE CONSTR.: SUPERVISOR 'CAUTION EXPIRATION DATE 1r 06/08/1996 FOR PROTECTION AGAINST 3 RESTRICTIONS EFFECTIVE DATE LIC-NO. THEFT, PUT RIGHT THUMB NONE 01/31/1994 042721 PRINT IN APPROPRIATE ,. 17681 � RRA PH J CATALDO 23� EDGENTR DR M POBX IN AT z MAQUOIT - MA 02536 INeL-UD m PHOTO(BLASTING OPR ONLY) FE5 �� NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED.OR-SIGNATURE OF THE COMMISSIONER 1 j•�, ""' �'��T. • THIS DOCUMENT MUST BE 04MANAME IN FULL ABOVE SIGNATURE LINE i { CARRIEDON THE PERSON OF S TORE OF LICENS EE THE HOLDER WHEN EN- OTHERS•RIGHT THUMB PRINT GAGED IN THIS OCCUPATION, ER I ' ilk II I. 9ESZ0•tlN�4)no�jE�''.�ge3i 8o1VHiS1N1waV i Y 1 1 )seM enti0"�e)eNBp3�tE7,o= ��a•��I � ' o� Bu.IPit�9:opje�e� ,����� • �;`��'� �rtu, � � • � •,. _.._ . r 4 i {ll+f'^� �'•���{, ��r5�`�,^7L'�l`;v?S'" i e r �}q.,4� r ` 96l9j/LOAxlv'U0111a�d�3'; I �: ' .• ; • ���xiwg�•tl80#,i� edA1. �f�s, T a�'� - , y �' •�tTES01:`x.uot)et)sjBea'�Ra.;•; , , ��i • 8013VH1N034N3II3A0Hd4V,3N0H • r 1 S.t , k I I � I l 0 7 o° ��, zz LIAM 'v L= j� n Y.E1 6` No ti T.UAT 7 A:S Fov�y�4T'ia�/ �C C.4 T/OTC/ S�/OWiL�yE.2EO.1/COis'1,dL YS Gr//r// SCA L SETBA C,4-- �E'gU�.eEic-1ENrS o,�' T.�/E' 7'-owiVDF •d,L•4�t! ,2E�'E,2E�C/C'� I 3arz�is-r43,�e A,vo /S `S(�tC- .i Z o� Z I W/Ty/iC/ .�LOan'AZ4 L-o i 8 1 OLi� Pos-r E3A XT,E,e Assessor's offioe (1st floor): [ Assessor's ma and lot number ........ "..��. .......:.. 7' ' SEPTIC SYSTEM MUST ' "ETo� p . _ Board of Health (3rd floor): INSTALLED IN COMPLI ��// p Sewage Permit` number ............... ....I... ..f O .o... WITH TITLE 5 Z B9SII9'lGBLL, Engineering Department (3rd floor): S . E9 VISONUENTAL �' 'oo ra 9• 3 House number .............................................�-1.................... b� '°�o�AY a. APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR oo � APPLICATION FOR PERMIT TO .......!.ru.�.�- .w L TYPE OF CONSTRUCTION .•4N..... .F�O�.It - L-- 4C� LLNeK ........................................ u..... ....-... ....,9.8.4� TO THE INSPECTOR OF 'BUILDINGS: The undersigned hereby applies for an permit according to thefollowing information: p :.4(o..... �1'.?AR. V 1`,��4?.....{V�` '�' 1� i Y\ � ...�.. S f?. 7- Location p. ....... ^ ... ...................... .�............... ProposedUse ........... .. ........ .... ...... ................................................................................................................... r Zoning District ....... .... ....�................................ .................Fire District Name of Owner ...... .. k0 R►` ..................F(5.�_y ....Address ......:.Mh.�5 ?tA5.... Name of Builder . ... L%.....pI�OLS .1NCAddress Nameof Architect .......:..........................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exterior .....................................................................................Roofing .................................................................................... Floors ...................................................................................:...Interior Heating .............................................................. '...Plumbing................. ...:.......... ....... .. .......................................................... Fireplace ..................................................................................Approximate Cos r Definitive Plan Approved by Planning Board ------------------------_-------19________ • Area ....... CJ�.. <,... .. r Diagram of Lot and Building with Dimensions Fee ®e �!C/ .SUBJECT TO APPROVAL OF BOARD OF HEALTH i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulotions of t wn of Barnstable regarding the above construction. c---Name . .... .. ............... Construction Supervisor's License .................................... JEFFERY, RICHARD No ....298.1.1.. Permit for ..BUILD....................... ..........Swimming..Pool. ........................................... Location ....Lot #8, 46 Cedar Tree Neck Road ........................................................... .......................Ma r.s.t.o.n s..Mi.1 1.s............................. Owner .....Richard Jeffery ............................................................. Type of Construction .......F.r.ame......................... ................................... ........................................... Plot ............................ Lot ................................. August 86 Permit Granted ................................ 9 Date of Inspection ..... ... . ...... 19 Date Completed ........... -.19 Awe 12 REVISIONS BY -R(DtTE VENT W/ A'�PHALT RooF SH(NG�L�S SHINGLE 1� 141-o" g,P O,, ' ---- RooF' GoNsT-RUG•('(piJ � --- ASPt�ALT Roo)= SHIt`(GrLES a� I j- 12AN c��SE R 2� 8 - _ I-5t: DELT P rFR or1 - iol T46 P1 E t'o'' �R•I�1) Fes. t�15tJt�.TIo►� 0 ; � f i I �xG I3eAM - I VENTED ALUM. DRIP i iH" : ___ WALL GoNSTtzUe-Tla►�-- _{ GEDAR LLAf 3oo.RD5 or!o' ly" GDyc PL'fWODD 4, t. :. GEpAFK PINE FLO R loo 2x� STUps � tG.�a,c. i 2+ .__. : GLAPP>oP•t�DS � 3 � Cx• tNSUL � G8 � Z I _ , /� PL�{wao� N I E i ��o c t><G sH tG t x nis5c° I T�'G PN FN f- CIO IL { w b-< T G PIKE--�I_ 51 D[_.- L..- L-�VATI�� STI!CS E I�o•G ( d 'r 3�2 GOr(G. SLAPS Q - Z , i Wi►HQoWs -ro PEE ANvEiz.S�N Pr -SHIELD LIJ WHITF UNITS W/ bl i` PINE TR•1M. ' N {-o{t Coy-e�l� • !COUGH -Irk FOR ruTURE F H.W. HEST —` -� - _ _ t i . AsPONLT 900F h�Ir�GL.Es /4'-v I tx3 Pt�tE 6�. or1 i — � Ix8 f'INE 6D. r , 2 /-P.T• �x � At`1+�I�Rti EN Rd Zt33S to - - — _ _ ___ __ __ — __ — __ --f�' to• F , , PF ' i coI I cc •` � . F y 1 i � TH rG ?1 91 1�IGrF� � UJ OPTION _ } I{_�I U G I= � DING G ( 1r co I _ 6 F- l3D.5 _ y • -. _ aLuM. GAP Ft.,a�"11NG i SL,o.l3 GC p o -- - LL LljiLL oN'W 1 �iroa f R GorJG Of'i' 1 _ I I T DRAWN CHECKS d V LpT' 2X GATE > ti t� r /t} _ I OtI Z CA E �(�. G�N L.�V�•T Iv t�1 o r' I N T S D�.. �- f._ VAS"I ,,�,�,� 1�-o tI d JOB NO. I_ FO LU r�'CHAT 10 rJ �'L..d•t`� 44 —CZ SHEET E � OF i SHE J i I I I I