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HomeMy WebLinkAbout0012 ANTHONY DRIVE .,4rll'oN y i 4 71 } •}tom + l s - I. t ! t�'+r v t 71 1 A•' , , Y I r + 1 + ; t i + 4 t J I + r � ' _ p UARD , 1 ... ._ ._+ "77I a .. 1 } 1 f C'��744=>Y -TN,4T Th/�- a�c1!� ;CaC,47"/��(/ - ,477o,4J ; (� ��►JtS 5.�/0W/v,yam 2E0.[/Cowl dG Y.S`Grp/rho w.: I+ SCA Z- 7-•�•�� SET BA. Cl- - C> OATS S� EQIU/,eE�s'1ENTS .eE � r LC GOCAT�"a Ltd/Ty/�_ • . , r C3AXTE.21s...t/YE Git/A�f/ �2EG/S7`E.2E1� SU,2YE}i Thies .. � J 5 roe ':�O ILb 111.1 ri z: - i r 0 4 EU Rs-t� 1 8N1 T O NPTE HANGES PnT: I pa P� ..v � I t � l I I I I � f I I ....M...�........,,.._.....,ar+..a.«.-,»�,:,..a�.n:•,y.,ya...�.�.a!^y.,�-:.y,�..,• ••.wr,.,..rux.+a„m,<.;...nears,�-SR .ex:s^ 4'�aXt?.;�' __ W 0 J. A �r_ x ' . ^y■ •5 F ' J Y 3 3 Lr i _ e _ - } i t a V}.I to Ai Or rt � r : j 6 r i I - Zt4 DIN lit 2A, 2 O . j 1 Z, 6, 3/p44 z44 Co h L v 4-c� 4M N a� z4�E� vv%c.L-L f o r f - G, r D r' - — — - t It's t i .Q 0 0 O^ I t 1 � I 1 l � � i - N r�` f * j2e ��c, Se � 7 c7l Assessor's office(1st•Floor):. ;��y��, n Assessor's map and*lot number 2X� rq 1� f/?,iy/ Board of Health(3rd.floor): Sewage Permit number �"�7 � :'r • Engineering Department(3rd floor): y^� _ };: e riva House number ►OC.� sj 1639.�`�� Definitive Plan Approved by Planning Board / 1:9'�d ' ' °rltr APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only 'AA A P P R 0 vTDO.WN OF BARNSTABLE Barnstable Conservation_cor; D�SING .'INSPECTOR 0f6FHJQATION FOR PERMIT>*e Q. TYPE OF CONSTRUCTION l Pv�/ 44/yyik { 1 19 �l TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location b6t Proposed Use Zoning Distric /�t � `A Pdam/ Fire District Name of Owner ` , T Address / g� 603 Name of Builder Address Name of Architect Address Number of Rooms to Foundation �Lr Exterior Roofing i Floors C Interior � Q Heating `/iJLGCJ <�" LQ Plumbing Fireplace V" o�V� Approximate Cost / Area / -� 5 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 Construction Supervisor's License CCHT 34588 Permit For 1 a Story. Single Family Dwell ng Location Lot #2 ,,. 12 Anthony Drive H anriis ..�. Y rL . Owner. CCHT Type of Construction Frame Plot Lot _ _ Perm_ it Granted _September 25, 19 91 Date of Inspection 19 - a Qom .19 - ar - r s O ri • a .. <k TOWN Ot_8B , TABLE, MAS�A.. +� PERM11. A=272_6 � �t 58$ DATE Seutginber 25, 19 "31 PERMIT NO, o APPLICANT_ Baysidt-, Bldg. Co• ADDRESS Centerville #005645 (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO 13Ui .1 [)Wf' T '^(�' ( ) STORY Si;'lC{le �'am jJ DW'G;,(,Iiaq NUMDWEBE IN OF UNITS -(TYPE OF IMPROVEMENT) N0. (PROPOSED USE) 10 AT (LOCATION) Lot 02 ld Anthony° / a Drive Flyannis ZONING RC-1 / DISTRICT • (NO.) (STREET) BETWEEN .AND - - (CROSS STREET) (CROS-S'j`ST BEET) s SUBDIVISION LOT LOT BLOCK SIZE BUILDING IS TO BE FT, WIDE BY FT. LONG BY FT, IN HEIGHT AND'.SHALL CONFORM IN CONSTRUCTI- TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) 3517 = Sewer REMARKS: - i Bond AREA OR, VOLUME 816 SC3�. it. + ESTIMAT ED COST FEE$ 60/ 000•00 PERMIT $ 65• 25 �- (CUBIC/SO DARE FEET) _ - � - � OWNER , CCHT `: -. ADDRESS Box 603, bar"stable BUILDING DEPT. � BY f e / r ,THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY C ► PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE A PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINE FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONOITIOI OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL •APPROVED PLANS.MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN '1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAELECTRICAL INSTALLATIONS. PLUMBING ID 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBFINAL INSPECTION TO LATHBEFORE : FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE ' OCCUPANCY. . POST THUS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 40 2 2 3 /^` HEATING INS ION APPROVALS 6NGI ERING DEPARTMENT 2 BOARD OF HEALTH 1-7 OTHER SITE PLAN REVIEW APPROVAL ti. WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS TOR HAS APPROVED THE VARIODU INDICATED ON THIS CARD CAN 1 S STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CONSTRUCTION, PERMIT IS ISSUED AS NOTED ABOVE. ARRANGED FOR BY TELEPHONE OR WRITTI NOTIFICATION. ��f��p� ,F�',�c��*'�� '?✓ ,,. , p r tt, y-"Yt�' s�'.. 4 Q'TM[> TOWN OF BARNSTABLE Permit No. .34588,,, BUILDING DEPARTMENT I '�"'� I TOWN OFFICE BUILDING Cash t679• / HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Cape Community Housing Trtist Address Lot #2, 12 Anthony Drive Hyannis, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL .NOT BE VALID, AND THE BUILDING.SHALL- NOT :BE OCCUPIED UNTIL ' SIGNED BY'THE. BUILDING.INSPECTOR UPON .SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH'SECTION 1°19.0 OF THE MASSACHUSETTS STATE BUILDING CODE.. .December 91.. 19. !�! 'GG'`" ... Building Inspector Town of BarnstableBuilding s rwxiv�rtosnmi� Post',This"Card So That it is Visible,FromAKf a Street-Approved Plans Must be Retained on Job an,d this Card Must`be Kept > Posted Until Final Inspection Has Been;Made ,' .; i Where a irermit Certificate of Occupancy is Required;such Building shall,Not-,be Occupied until a Final Inspection has been made Permit No. B-20-548 Applicant Name: Michael Maher Approvals Date Issued: 03/06/2020 Current Use: Structure Permit Type: Building-Insulation.-Residential Expiration Date: 09/06/2020 Foundation. Location: 12 ANTHONY DRIVE, HYANNIS Map/Lott 272-002-002 Zoning District: SPLIT Sheathing: Owner on Record:'GALLANT, MARK D&DIANNE , Contractor Name:'yMICHAEL MAHER Framing: 1 Address: 12 ANTHONY DRIVE Contractor,License: CS`109089 2 HYANNIS, MA 02601 Est Proie t Cost: $3,700.00 Chimney: Description: Air seal and insulate the attic,Insulate the knee wall,and knee wall Permit Fee: $85.00 slope,vent a bathroom fan to the outside Insulation: r Fee Paid:. $85.00 f Final: Project Review Req: F✓° Date 3/6/2020 Plumbing/Gas Rough Plumbing: Mrr � _. - ui m icia This permit shall be deemed abandoned and invalid unless the work authorized by-this permit is commenced within six months after issuan Final Plumbing: All work authorized by this permit shall conform to the approved application:and the'approved construction documents for-which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws.and codes. Rough Gas " This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the 'work until the completion of the same. " , Final Gas; The Certificate of Occupancy will not be issued until all applicable signatures by the Building and.Fire Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flu lining is installed r - Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (asset forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: s�cl— Sonnabend, Matthew From: Nicholas CaraDonna [nicholas.caradonna@icloud.com] Sent: Tuesday, November 25, 2014 6:00 PM To: Sonnabend, Matthew - Subject: Complaint filed from BPD Website My name is Nicholas CaraDonna and we live at 142 Sunnywood Drive, normally a quiet neighborhood, until this past year when a neighbor to the right' rear of our home has erected two big tents on his property and runs heavy equipment in a, residential area, the noise is so pervasive that the sound volume is making impossible to live here. He runs this stuff after lam and again after 5pm with no consideration for his neighbors. This+in not industrial area! The noise levels are such that they invade every part 'of our home. Enough is enough with the noise! Please investigate this inconsiderate noisy neighbor -on Anthony Drive.'. F , Thank you, Nicholas CaraDonna , Sent from my iPad '`) b • t � , t S 1 § 240-15 BARNSTABLE CODE § 240-16 Minimum Yard Setbacks (feet) Maximum Minimum Lot Minimum Minimum Lot Building Zoning Area Lot Frontage Width Height Districts (square feet) (feet) (feet) Front Side Rear (feet) RC-2 43,5602 20 100 203 10 10 301 1 Or 2 1/2 stories,whichever is lesser. 2 A minimum lot area of 87,120 square feet is required in RPOD Overlay District. 3 One hundred feet along Routes 28 and 132. [Added 10-26-20001 § 240-16. RAH Residential District. [Added 11-5-1988 by Arta 91 A. Principal permitted uses. The following uses are permitted in the RAH District: (1) Single-family residential dwelling (detached). (2) Affordable single-family residential dwellings subject to the special bulk regulation contained herein. For the purpose of this section the tern "affordable" shall mean dwellings sold or leased by a nonprofit corporation and/or governmental agency whose principal purpose is to provide housing to eligible tenants and/or buyers. B. Conditional uses. The following uses are permitted as conditional uses in the RAH District, provided a special permit is first obtained from the Zoning Board of Appeals subject to the provisions of § 240-125C herein and subject to the specific standards for such conditional uses as required in this section: (1) (Reserved)? (2) Windmills and other devices for the conversion of wind energy to electrical or mechanical energy, but only as an accessory use. C. Special permit uses. The following uses are permitted as special permit uses in the RAH District, provided a special permit is first obtained from the Planning Board: (1) Open space residential developments subject to the provisions of§ 240-17 herein. D. Bulk regulations. Minimlmn Yard Setbacks (feet) Maximum Minimum Lot Minimum Lot Minimum Lot Building Zoning Area Frontage Width Height Districts (square feet) (feet) (feet) Front Side Rear (feet) RAH 43,560 125 — 30 15 15 301 RAH 10,0002,3 20 75. 30 15 15 301 7. Editor's Note:Former Subsection C(4),regarding family apartments,was repealedll-18-2004 by Order No.2005-026. See now§240-47.1. 240:20 05-15-2008 § 240-16 ZONING § 240-16.1 ' Or 2 1/2 stories,whichever is lesser. 2 Provided that each dwelling is connected to the municipal sewage collection system when the site is located in a Groundwater Protection Overlay District. 3 As an alternative to individual lots,more than one single-family dwelling may be constructed on a lot,provided that the area of any such lot shall contain not less than 10,000 square feet of contiguous upland for each single-family dwelling constructed.When more that one single-family dwelling is constructed on a lot said dwelling shall be at least 30 feet apart. § 240-16.1. MAH Residential District. [Added 2-28-2008 by Order No. 2008-0771 A. Purpose. The purpose of this section is to authorize by special permit privately initiated affordable housing by for-profit or not-for-profit organizations that: (1) Provide for residential development in a manner that is consistent with existing neighborhood development in terms of density and housing types; and (2) Authorize an increase in the permissible density of housing in a proposed development, provided that the applicant shall, as a condition for the grant of said special permit, provide housing for persons of low or moderate income. B. Principal permitted uses. The following uses are permitted in the MAH District: (1) Single-family residential dwelling (detached). C. Special permit uses. For the purposes of this section, the Planning Board shall be the special permit granting authority. The following uses are permitted as conditional uses in the MAH District, provided that a special permit is first obtained from the Planning Board subject to the provisions of § 240-125C herein and subject to the specific standards for such special permit uses as required in this section: (1) Multifamily affordable housing developments connected to the municipal sewage collection system. D. Bulk regulations. Mini- Mini- Mini- Minimum Yard mum mum mum Setbacks' Maximum Lot Area Lot Lot (feet) Building Zoning (square Frontage Width Heightz District feet) (feet) (feet) Front Side. Rear (feet) MAH 87,120 200 = — 60 30 30 30 NOTES: 'For developments within an existing structure previously used as a nursing or convalescent home, yard setbacks shall be the setback to the existing building footprint or the setbacks stated above, whichever is less. 21-leight shall be measured from the grade plane to the plate. 240:21 05-15-2008 Barnstable Assessing Search Results Page 1 of 3 . . sacs, t ► * � • Home: Departments:Assessors Division: Property Assessment Search Results New Search New Interactive Maps >> Owner: 2008 Assessed j Values: GALLANT, MARK D&DIANNE 12 ANTHONY DRIVE Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $ 138,400 $ 138,400 272 /002/002 Extra Features: $0 $0 Outbuildings: $400 $400 Mailing Address Land Value: $ 147,000 $ 147,000 GALLANT, MARK D&DIANNE Totals $285,800 $285,800 12 ANTHONY DRIVE Residential Exemption Received=$105,082 HYANNIS, MA.02601 2008 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Community Preservation Act Tax $35.67 Fire District Rates Town Barnstable FD-All Classes $2.04 $6.58 C.O.M.M.-All Classes $1.03 Commercial Hyannis FD Tax(Residential) $437.27 Cotuit FD-All Classes $1.33 $5.80 Hyannis-Residential $1.53 Personal Pr( Town Tax(Residential) $ 1,189.12 Hyannis-Commercial $2.35 $5.80 Hyannis-Personal $2.35 Other Rates W Barnstable-Residential $1.86 Community F W Barnstable-Commercial $1.86 W Barnstable-Personal $1.86 Total: $ 1,662.06 Construction Details Building rpp�rty Prokpertetch veSekdetch & ASBUIL.T Ca Building value $ 138,400 Interior Floors Carpet Style Cape Cod Interior Walls Drywall http://www.town.bamstable.ma.us/assessing/assess/`displayparcel08map.asp?mappar=272002002 7/2/2008 Barnstable Assessing Search Results Page 2 of 3 Model Residential Heat Fuel Gas Grade Average Heat Type Hot Water Stories 1 Story F A AC Type None Exterior Walls Wood Shingle Bedrooms 3 Bedrooms r , Roof Structure Gable/Hip Bathrooms 2 Full 3... Roof Cover Asph/F GIs/Cmp living area 1171 Replacement Cost $148824 Year Built 1991 Depreciation 7 Total Rooms 6 Rooms ; Land CODE 1010 Lot Size(Acres) 0.32 Appraised Value $ 147,000 AsBuilt Card N/A Assessed Value $ 147,000 VI@W Interactive Maps » Sales History: Owner: Sale Date Book/Page: Sale Price: GALLANT, MARK D& DIANNE May 15 1992 12:OOAM 8032/290 $80,500 CAPE COMMUNITY HSING TR INC Oct 15 1991 12:OOAM 7716/162 $ 1 CAPE COD COMMUNITY HSING TR Aug 15 1991 12:OOAM 7631/300 $ 1 BARNSTABLE HOUSING AUTHOR'Y Aug 15 1991 12:OOAM 7631/228 $ 1 BARNSTABLE HOUSING AUTHOR'Y Nov 15 1987 12:OOAM 6007/052 $1 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value SHED Shed 64 $400 $400 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area (Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck http://www.town.bamstable.ma.us/assessing/assess/displayparcel08map.asp?mappar=272002002 7/2/2008 Barnstable Assessing Search Results Page 3 of 3 FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/assessing/assess/displayparcelO8map.asp?mappar=272002002 7/2/2008 �� ' �,��,� i �� � dw� [ �� �. �VJw� 1 y I ��-g J �s } Assessor's Office 0st floor Ma Lot p� Permit# �� Conservation Office 4th floor 3 ��3 ��'' Date Issued ��� 7, 9Is 1�Pw TWA -sewer l Z ONNI�APPLICANT MINPERMIT F A 8 ENGMEBB 0 DXMN Engineering Dept. Ord floor) House# /02 CONMUMOK Planning Dept. (1st floor/School Admin.Bldg.): s ,EMAS, t M .. Definitive Plan Approved by Planning Board 19 �O MR1 (Applications processed 8:30-9:30 a.m. & 1:00-2:00 p.m.) TOWN OF BARNSTABLE Building Permit Application Project Street Address i 4- A N I O N \/E . L� Village In N N 1 S Fire District Owner M H 2 K' d D /(i N E Co C b I N T Address /Z 9 N 1 D O N S N 2 I Y Telephone -7 7 S-- 2 S H y A iq N i S Permit Request: /i-) d 2t1-7 dl� JZ- /o T/7'� /� �s j iIV C� Zoning District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of ApMls Authwization Recorded Current Use Provosed Use Construction T C Eaistin2 Information Dwelling Type: Single Family Two family Multi-family Age of structure Basement Historic House Finished Old King's Highway Unfinished Number of Baths G L No.of Bedrooms 3 Total Room Count(not including baths) First Floor Heat Type and Fuel Fib�F 2c kJ �c i 419 enttrral Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn t None Sheds Other Builder Information Name l i9 i 11WXqve1*bVT Telephone number Z S S U Address 6 4S NSW R-6j ' &9� License# �o%u i % /W 026 3 5— Home Improvement Contractor# / v 0 71q6 Worker's Com nsation # e 23 / Y-3 6 -Z/CA09 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 111,Cfdw7-tl �v � Project Cost 2 7C76 Fee SIGNATURE ,%' DATE 3- Z3` �F 3 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T 3/27/95 37554 FOR OFFICE USE ONLY 272.002.002 12 Anthony Drive (Lot 2) 'Hyannis ; ADDRESS VILLAGE Mark & Diane Gallant OWNER y DATE OF T1JSPEC7ION: FOUNDATION - FRAME 1 1 INSULATION , FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ' - GAS: -3 ROUGH FINAL FINAL ING: A DATE t�0.SED OUT: ASSO*!ff LAN NO. „ t • f� jj f ,,�. I ✓ VdlfZil�2492C11eald ; HOME IMPROVEMENT CONTRACTORS REGISTRATION oard of Building Regulations and Standards ..One Ashburton Place Room .1301 I f Boston, -Massachusetts 02108 I . HOME IMPROVEMENT CONTRACTOR i Registration 100740 Expiration 06/23/46 i- Type —PRIVATE CORPORATION i -7�° � u° I -HOKE INM. VEKKT CONTRACTOR- - ` _Moistratloo .100740 I - i Capizzi Home Improvement, Inc . I Type -. PRIVATE CORPORATION - I Thomas Capizzi , Sr . -Expiration - >06/23/96 1645 Newton Rd . i Cotuit MA 02635 I Capizzi Hose Isprovesent, Inc Thomas Capizzi, Sr. G� w��4 Newton -RC. i I AOMINIST OR Cotuit NA 02635 Restricted To: 00 DEPARTMENT IF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE I 10 - Dole hiber: . Expires: Dirtidite: lA - Masoxry oily CS 141189 10/29/1996 10/29/1918 16 - 1 t 2 WHY Holes Restricted To: 10 y.,lL..L_ -. . t)AYID N 1EBB commisu*&R 106 PLUM NOLLON RD 1 E FAL MOUTH, NA 62536 - t �} COMMONwEALTH OF MASSACHUSETTS R ti DEI`AK;MFNr OF LNDUSTR,IALACCIDEN"I'S 600 WASHINGTON STREETBOSTON, MASSACHUSETTS 02111 fames: Canooer �c--n:ss'one WORKERS' COMPENSATION INSURANCE AFFIDAVIT 1• ,q /� oM ,E PRO yEM,�/V T (licensee/permiaec) with a principal place of business/residence at: S E T wN (City/St2tc2ip) . do hereby certify, undcr the pains and penalties of perjury, that: [ J 1 am an employer providing the following workers' compcnsation coverage for my cmployccs.working on this job. t TNT LT �- 239 S�a 2 / e/71? Insurance Company Policy Number ( J I am a sole proprietor and have no one working for me. ( J I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed bcloA, who have the following workers' compensation insurance politics. Name of Contractor Insurance Company/Policy Number Namc of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number 0 I am a homeowner performing all the work myself. NOTE: Pleasc be :wise that wbilc bomeowners who employ persons to do maiotenance,eoostructioe or repair work on a dwelling of not more thin three units in wbich the boencov+eer also resides or on the grounds appur%co=t thereto arr not gencrall}' considered to be employers undcr the Workcri Cotnpeasatioe Act(GL C. 152,sect.. 1(5)), applieat,oe by a homeowner for a license or permit may evidcoce the legal sutus of in employer undcr the Workers'Compensation Act_ I undcrstznd that z copy of this state 'cnc will be forwarded to the Department of Industrial Accidents'office of Insuranec for.wvera:c verification and that failure to secure eovenge as required under Section 25A of MGL 152 can lead to the imposition of-criminal penalcia consisting of a fine of u t 0 and/or imprisonment of up to one yesr and civil penalties in the form of a Stop Work Order and a fine of S100.00 a d . against m - Z 2- I n Cl Signed this day of Licensee/Pcrmirtcc Licensor/Pcrmittor 3 7-sss`ll oY t"E The Town of Barnstable • BAR\STABLE, Department of Health Safety and Environmental Services " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner For office use only 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. Type of Work: a 2'n4�2 Est.Cost O U - Address of Work: l Z !9 Q 1 / Owner Name: !y I g"r— tl P 1 o4 iy oi-, [ 9 41-6 19 'q / Date of Permit Application:. I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000 Building not owner-occupied 0%%Mer 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 oN•mcr:' Date Contractor name Registration No. OR Date Owner's name r STAIRS EXISTING BED ROOM REAR ELEVATION SIDE ELEVATION SCALE:1/8"=1' SCALE:1/8"=1' 13'-10"x 7'-6" TYPICAL ROOF CONSTRUCTION: NEW DORMER ASPHALT ROOF SHINGLES/15# FELT PAPER/ 1/2" CDX PLYWOOD SHEATHING/ 2"x 6" RAFTERS AT 16" O.C. 2 x 6"s at 16" C.C. EXISTING FLOOR PLAN SCALE:1/4"=1' TYPICAL EXTERIOR WALL CONSTRUCTION: WHITE CEDAR SHINGLES AT 5" TO WEATHER SIDES, FRONT AND REAR ELEVATIONS/"TYVEK" OR EQUAL BUILDING PAPER/1/2" PLYWOOD SHEATHING/2 x 4 STUDS AT 16" O.C. A-P I Z Z Home Improvement Ina. 1645 Newtown Rd Cotuit, MA 02635 (508) 428-9518 Fax (508) 428-1547 1-800-262-5060 CROSS SECTION SECOND FLOOR DORMER ADDITION FOR SCALE:1/4"=1' GALLANT, HYANNIS JOB NO: REV.DATE: *. t moo j STAIRS I; EXISTING i BED ROOM REAR ELEVATION SIDE ELEVATION ' SCALE:1/8"=1' ' SCALE:1/8"=1, 13'-10"x 7'-6" TYPICAL ROOF CONSTRUCTION: NEW DORMER ASPHALT ROOF SHINGLES/15# FELT PAPER/ 1/2" CDX PLYWOOD SHEATHING/ 2"x 6" RAFTERS AT 16" O.C. 2 x 6"s at 16" C.C. EXISTING 1 t FLOOR PLAN SCALE:1/4_1' TYPICAL EXTERIOR WALL CONSTRUCTION: WHITE CEDAR SHINGLES AT 5" TO WEATHER ? SIDES, FRONT AND REAR ELEVATIONS/-TYVEK" + OR EQUAL BUILDING PAPER/1/T PLYWOOD SHEATHING/2 x 4 STUDS AT 16' O.C. Y NPIZZ r Home Improvement Inc. 1645 Newtown Rd Cotuit, MA 02635 (508) 428-9518 Fax (508) 428-1547 1-800-262-5060 CROSS SECTION ! SECOND FLOOR DORMER ADDITION FOR SCALE:1/4'=1' GALLANT, HYANNIS JOB NO: REV.DATE:,