HomeMy WebLinkAbout0085 BRANT WAY �5 �rw�t LUa�
� \
P�oF� TOwti Town of Barnstable Permit#
o Expires 6 mon esfrom issue date
' Regulatory Services Fee
+ BARNSrABLE,
MAC $ Thomas F. Geiler,Director
1639.
plED MAC A
Building Division
Tom Perry, CBO, Building Commissioner
200 Main Street,Hyannis, MA 02601
www.town.barnstable.rria.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number J571o7y7
i
Property Address 5 T3 y4w0,+ S , W ll
Residential Value of Work y Minimum fee of$25.00 for work under$600.0.00
Owner's Name&Address i D
Contractor's Name Cjr92y 6►2A ftwt^. Telephone Number —7 b
Home Improvement Contractor License#(if applicable) 23 05
Construction Supervisor's License#(if applicable) Ll
Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ m the HomeownerX-PRESS PERMIT
I have Worker's Compensation Insurance
,OCT
Insurance Company Name L 1 ��2r7 YVl V�V 14 I
Workman's Comp. Policy# TOWN OF BARNS TABLE
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
0 R-roof(stripping old shingles) All construction debris will be taken to O VIA*)S�k'2
❑Re-roof(not stripping.-Going over °existing layers of roof)
❑ Re-side
#of doors
❑ Replacement Windows/doors/sliders.U-Value (maximum .44)#of windows
*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 Perrnission.
A copy of the Home Improvement Contractors License& Construction Supervisors License is
re uired. .. i
SIGNATURE:
Q:\WPFILES\FORMS\buildin;'permit forms\EXPRESS.doC
#� t
T
The Cornorwealth of.tMlassa�oihltsetts
DepariOent of Industrial Act dents
Office.of Investigation=
600 Washington Street
Boston, MA 02111
' iV)Y3V.IIraSS.gOv/dla
Work rs' Compensation Insurance.Affitda�vit: Builders/Cbntractors/Electricians/Plumbers
A lican information Please Print Le ibly
Name(t3usi ess/organizatign/lndifuidual):
Address: gh
E �
City/StateZip: o r S i M b0 Phone0: -?
Are Xpu an ployer?Cheek thi appropriate bo1i.
1• 1 am a ployer with 4 I am a general contractor Type of project{required);
�— ❑ 6. []New construction
employ s(full and/or part tune).* have hired the sub-contractors
2.El 1 am a proprietor or paru(er- listed tin the attached sheet 7. �Remodeling
ship anc have no employee,-- ' These sub-contractors have g; Demolition
workin or me in any capn.lty. employees and have workers'
[No woi k s'comp,insurarce comp.iissurance.x 9. []Building addition
require .] 5. [] We area corporation and its 10.El Electrical repairs or additions
3.❑ I am a It aT aeowner doing all Work 6(ricers have exercised their 1 LEI Plumbing repairs or additions
_..mysel# o workers'.comp• tight of exemption per MG
.12. 00f repairs
t
insuran required.) 152,§1(4),and we have Ad
erraployaves. [No workers' 13.❑Other ^
comp. insurance required.]
*Any applicant tha checks box#J must also fih out the section below showing their workers'comp�n ation policy information.
t Homeowners whc si bmit this affidavit indcaing they are doing Ali work and then hire outside cor:►rectors must submit a new affidavit indicating such.
$Contractors that cliec c this box must attached in additional shcct$hewing the name of the subcont-Wors and state whether or not those entities have
employers. If the s b contractors have employers,they must provide their !workers•tromp,policy vur6ber.
I am an emplqjer that is pro
vidingwgrkers'compensnttaon insurancefor my e n�loyees Below is the policy andjoh site
information.
Insurance Comlany Name: L� u nT tM V yy9
Policy#or Se4i .Lie.#: _ Expiration Date:
Job Site Address: Jan d
+ itylState-lZip: I& P
Attach a copy f the workers'compolsation po y di claration page(showiarg the policy number and expiration date).
Failure to securf coverage as requir d Ender Section 25,4 of MGL c. 152 can lead the imposition of criminal penalties of a
fine up to$I,50.0 3 and/or one-year utiprisonment as, ell ascivil penalties in theforrn of a STOP WORK ORDER and a fine
of up to$250.Jo
a y against the violator. Be advised that a copy of this staterren may be forwarded to the Office of
Investigationsthe DIA for insuMiceueoverage verifi�jtton
I da hereby ter fy under the pains:4npe )hies oferjury that the information provided above is true and correct
Sig atum- m h0
Batt
Phone d: �7 1*
Official use 4nl Do not write in this area,to be cd*plete!by city or town !fr iaL
City or Towlt: Permit/License h_
Issuing Aut ri (circle one):
I.
Board of eal h 3. Building Deportment 3 Ctty/7 o►vr'.Clerk 4.Electrical inspector 5. Plumbing Inspector
6.Other
THE Townof BarI1Stable
Regjulatory Services
i saxtvs}resl.e, ` Tho`rnas F. Geiler,Dkeetor
y Mnss �' 1 ;
Nw� Building Division
Tom Perry,Budding COY0131issiOnel#
Z00 Main Street,Hyannis,,, A 02601=
www. town:barnstable ma.us
Office: 508-862-4038
Fax: 508-790.$230
3 -
Property Owner Must
complete and Sign This Section
If tJsi Builder I
I, k5_ l i/ lJE
as Own'r of the subject property
hereby authorize. C�A ' to act on my behalf,
Y p
in all matters relative tovork authorized b this bt' u]�g emit application for:
s (Addyss of J31
d )
4
pI �o
S f ate
natureo eri
l x
Print Name
If Proberty Qnw er is applying for permit please complete the
Homeowners License Exemption Form o> the reverse side.
Q:FORMS:O WNERPERM ISS 1QN
r ® - DATE(MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE , . 7/26/2010
PRODUCER FRANK L HORGAN INS AGENCY INC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
44 BARNSTABLE ROAD ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
HYANNIS, MA 02601 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
(508)775-5830
508.775-6688 INSURERS AFFORDING COVERAGE NAIC#
INSURED GARY GRAHAM INSURER A: LIBERTY MUTUAL GROUP
DBA CARPENTRY SPECIALIST INSURERS:
66 BRANT WAY INSURER C:
HYANNIS MA 02601
- INSURERO:
INSURER E: -
COVERAGES
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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADO'L POLICY EFFECTIVE POLICY EXPIRATION -
TR h= TYPE OF INSURANCE POLICY NUMBER DATE MM DD DATE(MMIDDIYYYY - LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY P REMISES'Ea occurrence �$'
CLAIMS MADE OCCUR MED EXP(Any one person) $
PERSONAL&ADV INJURY $
GENERAL AGGREGATE $ -
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $
POLICY PRO- LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
ALL OWNED AUTOS BODILY INJURY $ -
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY- $
NON-OWNED AUTOS (Per accident) -
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: qGG $
EXCESS/UMBRELLA LIABILITY ! EACH OCCURRENCE $
OCCUR F—ICLAIMS MADE AGGREGATE $
$
DEDUCTIBLE $
RETENTION $ $
A WORKERS COMPENSATION WC2-31 S=328005-020 3/23/2010 3/23/2011 WC STATU- OTH-
AND EMPLOYERS'LIABILITY y 1 N
ANY PROPRIETOR/PARTNER/EXECUTIVEFY] -. E.L.EACH ACCIDENT $ 100000
OFFICER/MEMBER EXCLUDED?
(fiiandatory in NH) - _ - - EA..DISEASE-_EA EMPI_1)YE $ 1 r10(100
` if
yes,describe under -
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Workers Compensation Insurance:Part One of the policy applies only to the Workers'Compensation Laws of the State of MA.
THE WORKERS'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR GARY GRAHAM
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION
TOWN OF BARNSTABLE_ '• . DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
ZOO MAIN STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
HYANNIS MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES. - -
AUTHORIZED REPRESENTATIVE C
Jeff Eldridge
ACORD 25(2009/01) i938-20G9 ACGRD CORPGR Tl0?• ! ;i sarie'.
G. 2
License or registration valid for intlivi.dul use only I'
before the expiration date. If found return to:
Board of Buildmg'Regulations and,Standards:: .
Q One Ashburton P1ace.Rm 1301
Boston,Ma.02108
Not alidwithout signature —
t
lie ZDo��vn�anc�ealC� a �r�aa� rcoett 1'
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration: 123659
EXPIrat on 3/25/2011 -Tr# 281647
Type. Individual
Gary C. Graham ! ,
Gary Graham
66 Brant Way ,.,
L,
Hyannis, MA 02601, Administrator
U
}
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION A4<1 10�6
Map ��lay� Parcel Permit# -7
Health Division nSe,.?r � W€'I'G BA,�;f�sTABLE Date Issued � �
Conservation Division k I0� r #4 A Application Fee
Tax Collector . Permit Fee
Treasurer —---- APPLICANT MUST OBTAIN A SEWER
11VISION-------_.. CONNECTION PERMIT FROM THE
Planning Dept. ENGINEERING DIVISION PRIOR TO
CONSTRUCTION.
Date Definitive.Plan Approved by Planning Board GG9� 4
Historic-OKH Preservation/Hyannis 1
Project Street Address &,9)UT L_141
Village &#^1ay
Owner GZi- SJ ,QI FoX Address SZ2� , _l09
Telephone j
Permit Request /4S- EXISAu Oi � /gig% ' / l
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation '4`7 0 o° Construction Type
Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family &r"— Two Family ❑ Multi-Family(#units)
Age of Existing Structure y2s 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
Number of Bedrooms: existing new
Total Room Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# _ Recorded❑
Commercial ❑Yes ZNo If yes, site plan review#
Current Use �t-S i® ��) Proposed Use 5i4
BUILDER INFORMATION
Name 0), 6g-g'41A.- Telephone Number
Address UANT i&A License#
141yrv1s Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 0WA057- Z
SIGNATURE DATE a S 10
FOR OFFICIAL USE ONLY
i
PERMIT NO.
DAi'E ISSUED
MAP/PARCEL NO.
4
ADDRESS VILLAGE
OWNER '
DATE OF INSPECTION: �JQ
FOUNDATION �D NR 7-v ,d aS Q� ,(Y ,n � `0,
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUG7$ FINAL
FINAL BUILDING ^
f
s
—DATE CLOSED OUT �?
ASSOCIATION PLAN NO ^�
/4.
°FtNEt°�� The Town of Barnstabl
BA Department of Health Safety and Environmental Services
MASS 0
' Building Division
A�fo may.
367 Main Street,Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
PLAN REVIEW
Owner: S�/����'Y � .� Map/Parcel: y
Project Address: S 461? ti T bi/f'2,1 Builder:
The following items were noted on reviewing:
it
Reviewed by:
Date: / D
. The Comoron ivedth of Massa6 usetis
' ___ •`
Department of Industrial Accidents'
V I01i'Mwon
600 Washington Street _
Boston,Mass. 02111
Workers'..Com ensation.Insurance Affidavit-General Busine§ses
// /� y �„gyyeh• ,:�trf ecyr►fA `'•jM f .i F 'F. . 'a3t1 7 '
s•�.�" 'Vat, :�,. •�.r. .. .n „- . _ .�:)+'•• '
• sore. ` �� ..
ad �dress: ( 4
.4 •h •e# -77
work site locatioti full address
(� I am•a sole proprietor and have no one 13psiness Type; []Retail 0•Restaurant/Bai/Eating Establishment
El Office
vvoilang in any capacity. [] Salt~s(mclnding Real-Estate,Antos etc.)
[]I am an e= to er with . eta•lo•ees'�full& art time: ❑Other //%////G/%�%/
NOWNr�Now,%//////is� i%% � /�
I an��loyer providing viorlrers compensation for my employees working on this job.
t:L� •[:5t• •�.l.,:.4•lt lt.` .•i!r•i• ° ti•it�•:r{1 •t• .�'1 �•'•�'' '
!d 'fllne: ''„?'':j^. ,i,r;jr. `:'L'•::.;•j'^�i',••�• •.��.i:',�i ':' fit:• y'
COIII 9II'Jl _ ;t• ri: r.,• t ,i t's:. :n' :l a t(:i:
.l,` ..5.a::: '.i�r•Et:. �S. i,t•rt•e,:itlj:ii'.•.,?i� _r.ic.:. �.r:>. ..3.•" i. •::t"••5','' 3:.•, :• •
�di3ress: ( �. :F•,. :,. :'• 1 �'' :L " ;%t''S 'S }t'!•:i' ' ,{:'' t...
+� • .;;:. ., •+��••s•' •,.' ..fir: l 1ti: •,, .; •;:
' .,, ��• A••.X,;^:,1•:J.iryv.l- _ 4: .,x'`:-'�xti;• ..4.••' {'• ,::.,',•'.•. :;.t;, ••� C.• j• .:t; •r �t
' '� Z`: f'!1•;?
.•,1...ir•:. :.• .:,. ,i• ,,.''w+rt�:w,�' •.;6+.4 01•' •ti•1:%w:t•k:'... O11C. ` ^��� +
Usiirarice.co:'l,.r.:,:..t:..i • ::.:_,.. :... .
T am a sole proprietor and-have hired the independent contractors listed beltiw•who have the following workers'
•compensationpolices:
+. •f. .e 'f: :1.:; 4';r:�il:,'�,;+•' :r:r.�y'i••,ifa?Lh't :r:trt:,T_::
9IICOMI
IISj17
iy':''t., :L;. is •r. :�•:: .i .p;. t 1 •: .1 S`•,,1i;}:;•:
eC1dLe59: ,t.• ':{ •L''P'•="'•'i;•• '! •. ;•�: .. •rr l:: -.r.
, •• :�• : .,u.;iii'!';. ri:i:l .:(• f' •.L,�• �, 5t' .; 'ti'• — •hJ r�,,;r;t• •
Cl .. •,r, —a.'•} \.+4.U'i. trr^ '+ t: 4.•t: .i,}"n '1r••'::••r
I�:::I:• y1, •H`�:�.� ��r.,�f%:rp,i ..i''f, Yi F:rYo. 't�}�i:: Rt.t"I� •l;i,•�.' ,1;::. •,j.,., .r•'.•. •:r-t:
'
_�. .. :. , ,:r 'i1J i eA •r t• .1, ;r 1, r tt• r.t.' J°^M':''y '9.�.
+ .:h•r.i: �:Y y:J:I `L'pi ,Y�;�•' ,y .`'''(.•;.�'., :p=;�.},,j Yt. j1,..�'{: °"'.:t>.:'- .•t:a r 't•. ,
!f:=. '.l:'rr,' „r,•:.i•. :t.".f: •y,t,tYl'.,''i.a:....:.' ..< r +.�
coin'ari. risuiea
addressi :I;e 1,`�'
. .+ y 1 4.♦6.. .ri. "i'i.:,r,yL .�'• (' 'ri::f'^�.'•' ' :•4• ',fit;.;7
t .r .. t~ �j• ' 'i;•• ''�''• our-. ' •(' •'.• '• .
• •�.' ' .4,• '::•.-fie•: ..+:r— • .•.i,� .:r-1.�.•�it''' '{/. 1.7:vti+•.�J •P.. •1�'''L:t�dr'�' y, _ ;;�,.:y ''' •t�i.,"
w i-R; 1 ',r. :r .•�?'•' ';+�., :i•.'•a."': iS _J.a. �O11C,•:ft •• '.t. ,(�;1,'tiy'•.+f�N.: _ ':*' •',E
�,''f 5•ct:CO:•i'..�r'l'+:'r!•'r,', .f�' •�t' '•Y...' :r`1'i,';:,t�.; �'•:. 5:.�• +; ;.
Mpi
ofs
iiisu'raiic.
sition of criminal Penoltics
Failure to secure�VeragtRsreqa penalties to the form of a STOP WORK Oder Section 2.5A of MGL 152 can land to RDER R nd a fine of 100.00 day againstmme. I understand that and/or
one years'imprisonment as well p
copy of this statement may be forwarded to the Office of Investigations of the DIAfor coverage verification
I do hereby certify nder the pains nd pe ties of perjury that the info provided above is true andlortect
Date � a
Signature Phone#
rjrespoimsc
lg �✓ G
e only do not write in this area to be completed by city or fovea official
permit/iicense# ❑Building Department
n: []Licensing Board
❑Selectmen's Office
if immediate response is required ❑Health Departmentphone#; Other
erson 2003)
• s
Information and Instructions.
Massachusett$General Laws f ch pter 152 section 25 re quires all employers to provide workers' compensation for their.
employees: As quoted-from the `Iaw";an employee is.defined as every person in the service o another under any contract
of hire; express or f#lied; oral or written.
An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of
the foregoing engaged in a�joint enterprise,and including the legal representatives of a deceased,employer, or the receiver or
trustee of an individual,partnership,association or other legal entity, employing employees. 'However-the owner of a
dwelling house having-not than three apartments and who resides therein, or the occu pant Ibf the,dwelling house of
another who,emplbj�spersoris to dol,maintenauce, construction or repair work on such dwelling house car on the grounds or
binding appurtenant thereto shall not...
ecause of such:employment.be deemed to be ari employer.•
MGL chapter.152 section 25 also'sfates that every. state'or lbcal licensing-agency shah withhold the issuance dr renewal
of a license or pern??f to operate a business or to construct buildings in the.commonwealth for any applicant who has
not produced aceeptable'evidence'of.compliance with the insurance coverage regdii- d: Mditionally,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 t�e insurance requirements of this chapter have been presented to the contracting
authority.
Applicants
Please the workers eompensafm affidavit carrpletely,by checking the box that applies to your situation.• Please
supply company name address and phone numbers along with a certificate of insurance as all affidavits may be submitted
to the Department of Industrial Aocidents•for confu-rnation 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 .
Plemebe sure that the affidavit is complete andprinted legibly. The Department has provided a space at the bottom of the
affidavit for you to fill out in the.event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill n the permit/hcense number which will be used as a reference number. The.affidavits may be.retmued to,
mail or FAX unless other'arrangements have been made.
the Npartment by. • •
The Office of Investigations would like to thank you in advance for you cooperation and sliould you have any questions,
please do not hesitate to give us a;call.
The Department's address,telephone and:fax number: : • ,
• Tb.e Commonwealth Of 1ldassachusetts .
Deparfinent.of Industrial Accidents
mice of Wtestwmns
600 Washington Street
' Boston,Ma. 02111
fax#: (617)727-7749
.. Jr- ii+rn "^PT..4^nA __.L '�nC
f
1
Town of Barnstable
o�c►+E royyo� Regulatory Services
• -�' Thomas F.Geiler,Director
Build ug Division
��lFo Mpg k Tom ferry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Fax; 508-790-6230
office,. 508-862-4038
• permit no. ��� �,,� .
pate S —
AFb'IDAVIT _
CT OR LAW
SUPP MNT TO PEPMT.0 A.PP CATION
MGL 0.142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
o er-occu ied
unprovement,removal,demolition, or construction of an additionnotr or toratructur g which are adjacent to
building containing at least one but not more than four dwelling
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.
EstimatedCos�/O0L
'type of Work: I GI u DIi
Address
Of Work: aS I139-AP'r 1d4
�►'1 S
Date of App
I hereby certify that:
Registration is not required for the following reason(s): ;
[]Work excluded by law
[]lab Under S 1,000
❑Building not owner-occupied
[]Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN P' HOIT OMUROYEMENT'WORKDO NOT HAVE
COI�'IRACTORBFORA7'PLICA3LE HONtE
ACCESS TO THE ARBITRATION PRO GRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UNDER PENALTIES OF PER MY
Thereby apply apermit as the agent of the ovr4er:
Its istrationNo.
s `� Con
Re actor Name - $ _
Date
OR
Owner's Name '
i •Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration: 123659
Expiration 3/25/2005
Type. InOlAdual
Gary C.Graham ;
Gary Graham i
66 Brant Way
T Hyannis, MA 02601 �`
I Administrator
e
f:;. ✓)W VdI72�Yb742U/ �`i�2�x��G7�;ftll4P000 ,¢ _
BOARD OF BUILDING REGULATIONS .{
License: CONSTRUCTION SUPERVISOR
Number CS, 042246 I
Birthdj9itei,�0372011959
Tr.no:. 18782
`ExpiP�s;:�03120/2006 , .
Restric��d::-.00 ,
GARY C GRAHAM
66 BR'ANT WAY
Act' 4cmHYANNIS, MA 02 % 1 +" ' ng ner
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PowTME rowtio Town of Barnstable
h Regulatory Services
`s EAM M - Thomas F.Geiler,DirectorKAM
,
9� 1639• Building Division '
Tom Perry, Building Commissioner
200 Main,Street, Hyannis,MA 02601
office: 508-862-4038 Fax: 508 790-6230
t Property Owner Must
Complete and Sign This Section
If Using A Builder
.MOwnes..ofthe.subjectptoperty-
_.^ . .. hexebp authorize : . .to:act on my..behalf,.
in all matters relative to'wotk authorized•hy this building.pesmik-application--for-
(Addtess of Job) -
S�a�Ofex bate
Print Name
t
T
o�TbE TOWN OF BARNSTABLE Permit No. .3 85
BUILDING DEPARTMENT
TOWN OFFICE BUILDING Cash
HYANNIS,MASS.02601 Bond ........ . .I Q/O
CERTIFICATE OF USE AND OCCUPANCY
Issued to Capricorn Realty Trust
Address Lot #14, 85 Brandt Way
h'l(inniS i4t;1SSaChusetts
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 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
dune 18 , 87 ...... .c it
..... , 19................. 4.
Building Inspector
.y
yC }v
�f
`�..�•.w TOWN OF BARNSTABLE
BUILDING DEPARTMENT
= NARIST
rua AS TOWN OFFICE BUILDING
�g t639. HYANNIS, MASS. 02601
�e r►,r�
MEMO TO: Town Clerk
FROM: Building Department
DATE: �� e J07
f
An Occupancy F Permit 'has been issued for the building authorized by '
Building Permit $k.........: ,/c S�} ...................................................
..........................................._...................................................._........................_
issued to
< , Please release the performance bond. �,,
-
,. .,-.. , .:.� -'r..t. .. -g-a{�..a+r. a�:Fe.o,.eae°_t, - ',b;•r.aw.•r,�:`.:�'� - - .,,a n
I
-272'-3
F
„ r`gnco r . , � Y
I r APPLICANT ADDRESS �o � UU�� y `•�
(NO.) •N- (STREET) .(CONTR'S LICENSE)
Build dWelli>l UMBER OF
PERMIT TO g' (_�iSTORY Single family dWellirjWELLING UNITS 1
/ (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) .
AT (LOCATION) lot #14 85 Brandt Way, 1I` annis DISTRICT RC '.1
(N0.) - (STREET)
BETWEEN AND
(CROSS STREET) 4?ES (CROSS STREET)
LOT
SUBDIVIS N • T BLOCK S17.1=;
BUILDING IS*TO BE FT. WIDE BY �'A,FT:�(LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
x XA y..
TO TYPE USE GROUP _ "BASE MENT.WALLS OR FOUNDATION
(TYPE)
REMARKS:
} I�
REA OR
L,U SCi. C• ) , 40 ouo PERMIT
VOLUME
' ESTIMATED COST � FEE
,. (CUBIC/SQUARE FEET)
Capricorn Realty 'I'rusc , .
OWNER r . f
c nkll ou'C;1 Foal(, rill iryis . 1"if, Ua:b:il BUILDING DEPT
ADDRESS BY �•d f r
• c C F r !
THIS PERMIT-CONVEYS NO ;.RIGHT. TO OCCUPY ANY STREET ALL'EIYa.OR SIDEWALK OR ANY PA.RT THEREOF, EITHER TEMPORARILY OR
PERMANENTLY..ENCROACHMENTS ON PUBLIC PROPERTY, NOT 'SF,E'C(F,ICALLY PERMITTED UNDER THE BUILDING CODE, MUST BEAP-
PROVED BY THE JURISDICTION. STREET OR ALLEY..,GRADES AS WELL"'AS DEPTH AND LO:C`ATI,ON OF_;PUBLIC SEWERS MAY BE OBTAINED
FR"OM:THE'DEPARTMENT OF.PUBLIC WORKS. THE ISSUANCE OF THIS,-PERMFT'DOES NOT RELEASE THE,;'APPLICANT FROM THE CONDITIONS
0 AN(Yt,(ffL-IC�ABLE�,S�1BgI,VJ. I "N RESTR1h4dIONS.' c, -};•'� ;,i,.
iN IMUM OF:'LTHREE':'"CALL -:lit` APR ROVED pL•'A NS.MUST BE-RETAINED ON JOB AND THIS 'WHERE APPLICABLE SEPARATE
SPECTIONS REQUIRED FOR i \'�� rPERMITS ARE REQUIRED FOR
LALL GONS.TRUCTION WORK a '_ CARD KFFPT�POSTED UNTIL Frj'N-&C, N.SPECTION HAS BEEN
y,y t :.I,T- - ELECTRICAL, PLUMBING AND
10. FOUNDA*+IONS OR'FOOTi�N,G MADE.' WHERE A CERTIFICA�TEXCSF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING ST.RUC:TURAL •QUIRED,SUCH BUILDING SHALLN,OT�i (=='OCCUPIED UNTIL '
MEMBERS(R.EADY!T' 'LATH): FINAL INSPECTION HAS BEEN
3. FINAL"INSPECTION 'BEFORE
OCCUPANCY.
POST THIS 'CARD SO IT IS VISIBLE ,.. FROM" STREET
BUILDING INSPECTION APPROVALS r; PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
y
4. /�
2 2 (� 2
3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT
1. In
OT R. '2 BOARD OF HEALTH'
WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT ''':L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE
TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN
CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION.
9
�. , �'r ,'$ ` __ `�. �� `�/�L ICJ///�(�•� _.._�_,.z„
A n I
�sessor's ma'. and of nu be .K
THE Tp�
Sewage hermit number ...
�; ? �-�-� ram,• Z BARNSTSIILE, i
House number ... ..... ... ..:•�........ .. �"••"-:...... rp r a
` pp�16}9•
'ED ixV
TOW=1iT: "OF BARNSTABLE �=
s 4 BUILDING ,. IHS PIE CTORR
. '
APPLICATION' FOR' PERMIT TOCOriB LLat •Sk.ng @• FaIDu�• •DWe -1-- -n . �• .
TYPE OF=CONSTRUCTION ......W0.Od•.F ................ ... "
Seta tember.J6S j5 �4 J�19aa,: s
TO THE INSPECTOR OF BUILDINGS �'
u, t ~j Y to t
The'undersigned hereby applies for a::permit,according to the following-, information r ;
Location ...1�`..'Brant ZY.ay Hyan��:s Pda. «
Pr Use * s y rh ................:_'
Zoning._District _ ,' r � s'
.�.,� Fire Distract
- annis
Name of.Own _
apY•ic�x ~Realer .Tru��t _r Addres576� 'a�ttits'�1`Ch=RbAd, _H IXM-ii�� "Mass• _
Name of Bui "' _..Address ....... ...
Banco Real=.Est:Dev: z�'. ,Intt. - , - - z
Name of Architect. .:::.... ....:.. ................... .....:.Address ....... ....
Number.of Rooms .. ..:.....Foundation- .............................................',S., _�, .... ........ ......... ........ . . �
,. . P
Exterior '. ,. ,:: .:...(..Roofing :. ... .....Clapboard a�d�oY' �hig].�s Aspha7: =Shingles.- - �, _
Floors :..... ..... ...
Interior ;
.,--- Cape.t.. ... .... .. • . _. ' Sfieetrock•---
" Heatin :.. ...Plumbin
g Gas--- g.W.�1. g mwo L�opper
Fireplac ` Approximate Cost
�1Vone .
Definitive Plan Approved by Planning Board __ _________ ----___19 ______. -.Area :. .. . . .'..'.:. `
with Dimensions of Lot. and. Building Fee .......... ..
SUBJECT TO APPROVAL 'OF BOARD OF HEALTH
74
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. r
Name
_:Pres. x
Construction Supervisor's License ....................................
x 000989
CAPRICORN REALTY TRUST
T
'No 30185' Permit for ....1�:..StQ y.............. r -
r �5in le Famii Dwell
lag - • - - `� , , _ = a - _ �: - „ 4 � ,- . . .
�a.....$..................Y...............� ..................... �^
Lot a ..BXa:[1$JC .ToIay location .................9...:.... r _
F Hyannis ...................
•
Owner Pricorn Realty Trust _
T YP e of Construction. Frame . ............ t- •,j r _ _
...........sq.......................... ...............................-
Plot Lot ............
November 14,, £36
PermirGranted .......19 ..
r
Date of, Inspection ........19
/
Date Com lete f� �.. ........ 19� p V
' � � - ., va � * .. .• - -r (fir 'r
�w .
Assessor's map and lot nurrSber ...�-12-).— 1 ..... ...§V, h ` Q%,Of THE
�✓� 1. /�J %CJ �/ 6�v ��
-
Sewage Permit number .... ........................................:.......... ,.
Z BARNSTABLE. i
House number .................. 1 ? %� ��.... 90 rasa
� 9
: TOWN OF BARNSTA-BLE
BUILDING INSPECTOR
r''* kPPL1CATtONttFOR PEWtV onatxuat 4kn9 .� '` ; �
TYPE OF CONSTRUCTION ....Wood.-Frame...................................................................................................... '
y p i
t .............
x 1 /.L7 f
• Segtem�ber �
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Locationo,t...#..../...L�.....gBrant ............................
ProposedUse ................................................................:................................................................I.... ......................
Hyanni
Zoning DistriR C-.&................................................................Fire District ... s.......................... ........................
Name of Ow%priaorn Real•tsr-Trus'r Addre765...Falmiju'CTt Roads"Hyarini
....Address
�. Name' of BA 'lo0•,Re�:,...F'i8`t•.Dev:•Co•:•�•ina: ....................:.....................
Name of Architect .................................................:................Address .........................
Number of Rooms ....,.....Foundation ...
Exleri° d/ - Roofing ........ASP�1 ... �L Ilg�eg..:...:.........................
_ C�.•apboQrd•••an • Shin •gj,eg•••••,••••••,•,••••• ,
_FloorsCarpet. ............................................ ......................Interior
$ ..........Plumbing
HeatinGas..... '•' �A.�........:...............
Firela ..............................................................................A roximate. Cost $410 .00� ao ....0.. .................................
,
Definitive Plan Approved by Planning Board ________________________--_---_19-__--_-_. Are
- ' a 1.56...sq• ftf
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 till the Rules and Regulations of the Town of Barnstable regarding the above
{,. construction.
Name V _ ...�.iJ.... .iy��/::...........................
• •t. :� • �.` _ t � Pies
Construction Supervisor's License ....................................
000989
CAPRICORN REALTY TRUST A=2q4-3
,2-
No ...30185. Permit for ....1.?...Story,,,,,,
Single family Dwelling
Location ......Lot #14, 85 Brant Way....,,,
..... ....... ..... ....
Hyannis
...............................................................................
Owner .....Capricorn Ro ..�Xtis>r............
Type of Construction ..Frame
..............................
..............................................................................
Plot ............................ Lot ................................
Permit Granted ... November 14, 19 86
Date of Inspection ....................................19
Date Completed 19 !
Zo °lo Come ► l .87
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TOWN OF BARNSTABLE ZONING
,►';����� OF Sa BY-LAWS DATED FEBRUARY 1986
PAUL
g R ZONE: RC-1
RYLL
No. 32446 o SETBACKS
cfs �f��sTFR�° f� FRONT 30
t 1_m40` ` SIDE 15'
� REAR a 15'
PROPERTY LINES SHOWN HEREON WERE COMPILED
FROM PLANS OF RECORD AND DO NOT REPRESENT PROJECT NO. 3-1348-05
AN ACTUAL SURVEY ON THE GROUND.
THE STRUCTURE-DEPICTED ON THIS PLAN WAS LOCATED - PLOT PLAN
ON THE GROUND BY SURVEY ON NOVEMBER 7 4986 in
AND EXISTS AS SHOWN AS OF THE DATE OF LOCATION. BARNSTABLE MASS .
THIS PLAN IS FOR PLOT PLAN PURPOSES ONLY AND SCALE: V - 20' NOVEMBER 10 1986
SHOULD NOT BE USED FOR ANY OTHER PURPOSE.
BSC / CAPE COD SURVEY CONSULTANTS
3261 MAIN STREET
DATE PROFESSIONAL LAND SURVEYOR BARNSTABLE VILLAGE, MA. 02630 (617) 362-8133
N
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6
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TOWN OF BARNSTABLE ZONING
. ��Nk OF of BY-LAWS DATED FEBRUARY 19BB
PRUL ZONE: RC-
RYLL N SETBACKS
No. 32448 0
�lp.c TER`��vQ ° FRONT 30
0`ac_�a ark SIDE 15
REAR Q 15'
PROPERTY LINES SHOWN HEREON WERE COMPILED
FROM PLANS OF RECORD AND DO NOT REPRESENT PROJECT NO. 3-1348-05
AN ACTUAL SURVEY ON THE GROUND. --
THE STRUCTURE DEPICTED ON THIS PLAN WAS LOCATED
PLOT PLAN
ON THE GROUND BY SURVEY ON NOVEMBER 7 4986 in
AND EXISTS AS SHOWN AS OF THE DATE OF LOCATION. BARNSTABLE MASS .
THIS PLAN IS FOR PLOT PLAN PURPOSES ONLY AND SCALE: V' 4 20' NOVEMBER 10 19B6
SHOULD NOT BE USED FOR ANY OTHER PURPOSE,
BSC / CAPE COD SURVEY CONSULTANTS
3261 MAIN STREET
DATE PROFESSIONAL LAND SU YOR� BARNSTABLE VILLAGE, MA. 02630 (617) 362-8133