HomeMy WebLinkAbout0030 ALDEN WAY 30 � 7U
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1
eering Dept. (3rd floor) Map b Parcel a y Permit# �
House# Date Issued
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30 • .O U
Conservation Office(4th floor)(8:30- 9:30/1:00-•2:00) .
Planning D (1st floor/School Admin. Bldg.) �1He
APMC A SEWER.
Definit' a Plan pproved by Planning Board 19 CONNEC OM THE
• ENGINE PRIOR TO
TOWN OF BARNSTABLE. cONST 'E°"�
Building Permit Application -
Proje Feet Address 3® 49•�� �• -
Village 64-44 d'i
Owner Ge jl&, Ob Pr<f9 As,r/ Address mf,
Telephone -
Permit Request
First Floor square feet Second Floor square feet
Construction Type ) '
Estimated Project Cost $ �
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths:. Full: Existing New Half: Existing New
No.of Bedrooms: Existing New
Total Room Count not including baths): Existing New First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
Builder Information
Name FRAS.ER CONSTRUCTION Telephone Number
Address ��. ��.,: .�RAUON � License#
z: w F--;;_2?192 Home Improvement Contractor# (T
Worker's Compensation# j SIS i/S�7 3 rS C3
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 BETAKEN TOi%�. tJ
SIGNATURE DATE
BUILDING PERMIT DENIED FOR THE F LOWING REASON(S)
/ FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED ` rs
MAP/PARCEL NO.
, L r4
, r
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:t
FOUNDATION-
FRAME
'
INSULATION ;
FIREPLACE
ELECTRICAL: ROUGH ' FINAL ;
PLUMBING: ROUGH , FINAL
GAS: ROUGH- FINAL
:FINAL BUILDING
DATE CLOSED OUTS " t
ASSOCIATION PLAN NO. t
The Town of Barnstable�$ Department of Health Safety and Environmental Services
Building Division
367 Main Slices,Hyannis MA 02601
Ralph Office: 509-790-6=7 Building EuiIding w•
Fax: 308.790-wo
For orrice use only
Permit no-
Date AFFIDAVIT
HOME IMPROVEMENT-CONTRACTOR LAW
: SUPPLEMENT TO PERMIT APPLICATION
MGL 142A requires that the "reconstruction, alterations, renovation, repair, moderni=atioa.
conversion. improvement, removal, demolition, or construction of an addition to any pret on to
owner occupied building containing at least one but not more than tbur 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
Type of Work: '
. �' �c� � _ Est.Cost
Address of Work: �� '�'�` - C��ci•�`�
Owner's Name C-e :&
Date of Permit Appilcntion• �
i hereby certify that:
Resistration is not required for the following reason(s):
{
_=Work ezcinded by law
_Jab tinder SI.000.
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING; THEID OWN PERMIT OR DEALING WITH UNREGLSTERED
CONTRACTORS N APPLICABLE H051E IMPROVEMENT WOR'C Do NOT "AVE
ACt�SS TO THE ITRATION PROGRAM OR GUARANTY FUND UNDER MGL I42A
BIG.YED UNDER PENALT M5 OF PERJURY
I hereby apply for a.permit as the agent of the owner.
O4,M.Lll 6
Date Contractor Name Registration No.
OR
Date
Owner's Nome
The Commonwealth of Massachusetts
y° y Department of Industrial Accidents
AffesWAwesaptlow
600 Washington Street
Boston,Mass. 02111
Workers' Co m ensadon Insurance Affidavit
name: FRASER CONSTRUCTION
ovation:
71 TARAGON CIR.
'
city hone#
❑ I am a homeown p orifi g wo myself.
❑ I am a sole ro netor and have no one worldnig in any capacity
I am an employ ' c on for my employees working on this job.
company name: 73 -IAQARf11 i GIR
,
address:
COTUiT MA 02635
_ 15,08) 428-2292
city: nhone#•
insurance co. policy# t /
❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who
have
the following workers' compensation polices:
companv name*
address:
dtv: phone
insurance ca s.: :;::: .:;.. 'oliN# ;';,•ssx:;.
campanv name:
address:
dtv: o phone#
..... .::....:.
.. :. :
Insurance eo. ........ . ............ .. ..::. .. lieu# ::;:,.
Failure to secure coverage as required under Section 25A of.*viGL 152 can lead to the imposition of criminal penalties of a One up to S1,900.00 and/or
one years'imprisonment as well as dvil penalties in the fora of a STOP WORK ORDER and a Qne of 5100.00 a day against me. I understand that a
hds statement-may be forwarded to the Olnce of Investigations of
copy of t the DIA for coverage verification.
I do hereby cerd ojerju that ha t rye information provided above is trw.and correct
Signature Date _
Print name pn,--�-, t c A c c in In Phone B Q 5'4-
Cdtycorttow:n
do not write in this area to be completed by�y or town official
town: peendt/llceme q :83
epartment
_ Board
diate response is required s OfIlce
artment
phone#c
(arvaed 9/95 P1A) e
l
t
HOME IMPROVEMEi�!
BOarc! Of Buildin' CONTRACTORS REGXSTRATIQN
R ulation8 and Standards
One Ashburton Place
Room 1301
Boston
MAssachusetts 02108
i
HOME. IMPROVEMENT CONTRA 'TOR '
Registration 112536
Type - DBA Expiration 04J
i 9,
FRASER CONSTRUCTI4 {
DEAN C FRASER ` HOt1E IRPROyT`CfittTRACTOR
Registration 112536
71 TARRAGON CIR f ' Type d8A
COTUIT MA 02635 E"xpiratieg 04/06/9q
FRASElt CONSTRUCTION
1�5 W I C. FEtASER
AM O§VWdR- 1 TARRAG@N CIR
. .. .. . �. -:'• _. COTUIT NA 02635
IJ
r.
+y
1
• SIDEWALLING
If located in OKH or Hyannis Historic District- Certificate of Appropriateness
' required unless same color/same materials specified on application.
Sign-offs from:
❑ Health
[� Tax Collectors' Office
Treasurer
❑ Owner's name& address
Estimated Cost
*Complete dwelling Information for the Assessor's dept.
Correct square footage OR number of squares of shingles (times 100 sq.ft.)
Applicant's telephone number
Signature,
Workman's Comp. form
Home Improvement Contractor Affidavit
❑ Home Improvement Specialist's License OR Homeowner's License Exemption
Fee
P
q-forms-PERMITS 1
Rev 6/2/98