Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0015 CARLA ROAD
��' . �, e ,}� m Town of Barnstable@ Building PostTh�s Card SoThat�t�s' romthe Street..'.A roved"'=PlansIVlustbe;Retained,on 1ob�an'dthis CatdMust be K`e t txx�cwru.�. ,;� 5 �� Permit M' PostedUnttl°Finallnspection Has Been Ma'de�r; � � a Whe163 re a Certificateof Occu anc asRequired,such`Buldmgshall Not beOccup�ed until,a Final Inspection has been made .. - Permit No. B-17-4241 Applicant Name: BENABBY INC/DISASTER SPECIALIST Approvals Date Issued: 12/27/2017 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 06/27/2018 Foundation: Residential Map/Lot: 248 210 Zoning District: RB Sheathing: Location: 15 CARLA ROAD, HYANNIS ` Y Contractor;Name�,; BENABBY INC/DISASTER Framing: 1 Owner on Record: WALLACE ROBERT E JR& NATALIA A"SPECIALIST 2 Address: 15 CARLA ROAD _ ;N. Contractor Ucensen 108642 3 Chimney: HYANNIS, MA 02601 Est'Project Cost: $25,000.00 Description: Removal and replacement of fire damaged drywall insulation. Permit Fee: $ 177.50 Insulation: v # Replace beam between den and kitchen. sF Fee Paid:" $ 177.50 Final: . Project Review Req: i� Date - ? 12/27/2017 Plumbing/Gas ;: x✓y. ��r -- Rough Plumbing: Final Plumbing: d Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six XIM hibriths after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the�approved construction documents for whlch�th s permit has been granted. All construction,alterations and changes of use of any building and structures shallfbe in compliance with the local zoning by laws and codes. Final.Gas: This permit shall be displayed in a location clearly visible from access ire et or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical Ii , j Service: The Certificate of Occupancy will not be issued until all applicable signatures by theBuiiding and Fire Officials arprovided on this permit. Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing � ,> Rough: 2.Sheathing Inspection Final:. 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma Parcel Application P c��� �1I Health Division Date Date Issued Z12 7 /? ^ Conservation Division Application Fee ® �� e Planning Dept. 0 14V 06 7 Permit Fee Date Definitive Plan Approved by Planning Board OF&r^ �,� Historic -.OKH _ Preservation/Hyannis Project Street Address Village �C�_� h ItS J ' Owner }'Ln �e�r` Ld�= 1�� a Address Telephone (6V6 2a 6 /P Permit Request `22^p v g G vrr� �� c��l/��O �%�� ��•N� e.1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 2.61 70 Construction Type c��r�'^� Lot Size • 21V ci e. Grandfathered: ❑Yes ❑ No . If yes, attach supporting documentation. Dwelling Type: Single Family LPI" Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ®<o On Old King's Highway: ❑Yes �o Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Areas ft. Basement Unfinished Areas ft ' Number of Baths: Full: existing—3 _ new Half: existing ?D new _ Number of Bedrooms: existing _new Total Room Count (not including baths): existing _7 new First Floor Room Count Heat Type and Fuel: 2-Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes M-<o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No .Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: CA-Kisting ❑ new size _Shed: ❑ existing ❑ new size — Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use - - APPL-ICANT IN-FORMATION— - — --- -"�� (BUILDER OR HOMEOWNER) Name LAI- �D s?s Telephone Number Address ��(��� �v� License # 05-�5—V,?f � -vr/,�r 3 Home Improvement Contractor# Email Worker's Compensation # AVA A-x /-7 f ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ct / v4 �l SIGNATU DATE Z S V FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE .OWNER DATE OF INSPECTION: FOUNDATION FRAME a �4 INSULATION IT FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS:' ROUGH FINAL f FINAL BUILDING 31 If DATE CLOSED OUT ASSOCIATION PLAN NO. Tlae Commonwealth of Mussucl2usetts (. .:�- ...�•:-: :-='' � , Department of Industrial Accidents l Office of Investigations 1 Congress Street,Suite 100 ;y Boston, AM 02114-2017 .s www.mass.govhllia Workers' Compensation Insurance Affidavit: Bui]ders/Cotitractors/Electricians/Plainibers Applicant Information Please Print Leeibly Name(Business/Organizalion(lndividual): Disaster Specialists Addres s:s: P.O. Box 480 City/State/Zip: Sandwich, MA 02563 Phone#: (508)888-1113 Are you w emplo}'er?Check the appropriate box: Tile of project(required): 4. I am a general contractor and I 6. ❑New consttuctiou 1.® I am a employer with 20 ❑ employees(full and/orpart-tune).* have hired the sub-contractors a sole proprietor or partner- listed.on the attached sheet. 7. ❑Remodeling 2.❑ Iam P P P have d have no em levees These sub-contt•Actors g. ❑Demolition ship and p P - employees and have workers' working for mein any capacity. 9. ❑Building addition � insurance. . .comp. . [No workers'comp.insurance 1 10.❑Electrical repairs or additions required.] 5. ❑ We are a corporation gird its 3.❑ I am a homeowner doing all work officers have exercised their. 1.1.❑Plumbing repairs or additions myself.[No workers'comp. c. 152,ht 1(4),and per MGL 12.❑Roof repairs insurance requu�ed.]t c, 152,§i(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 now affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities bave employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. d a;;an empl yeT that is providing markers'co»�e;7sd!tori€ns".1011ce for nN etrrployees. Beloly it the policy gird job site informatiol'L ! Insurance Company Name: Advantage Workers ('ompensation lnsuranrp Co ` Policy#or Self ins.Lic.#': 4000171 Expiration Date: 611/ 018 #i Job Site Address: City/State/Zip: I Attach c copy of the workers' compensation policy declaration page(shoAvag the policy number and expiration date). Failure to secure coverage as required under Seotion 25A of MGL c. 152 can lead to the imposition of criminal penalties of a t fine up to$1,500,00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORI{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 utsurance coverage verification. Ido hereby certify it. der he wins aiul enalties o er'ury that the irzforrttutiou prorided above is true and correct. Si nature: -_-,� _..- - Date: .._ _ ..y'.. ,--7.. - Phone#: lJctS &Vz� l io7 Officirtl tse�only. Do not write in this area,to be conq)leterl by city or trnvtr ojficiaZ City'or Ta�tim: Pertuit/License f, IssuingAuthority(circ�on 1.Board of Health 2.Building Dep'ftrtment 3.City/Toiim Clerk t.Electrical Inspector 5.Plumbing Inspector G.Other Contact Person: Phone#: ' t Form UY"9 Request for Taxpayer Give Form to the (Rev.December entoft20eas Identification Number and Certification requester.Do not Department of the Treasury send to the IRS. Internal Revenue Service 1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank. Benabby,Inc. C\i 2 Business name/disregarded entity name,If different from above m Disaster Specialists °- 3 Check appropriate box for federal tax classification;check only one of the following seven boxes: 4 Exemptions(codes apply only to ° Individual/sole proprietor or certain entities,not Individuals;see ❑ p p' ❑ C Corporation ❑✓ S Corporation ❑ Partnership ❑Trust/estate m instructions on page 3}: m e single-member LLC •�°-a-� ❑Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)► Exempt payee code(if any) `p Note.For a single-member LLC that is disregarded,do not check LLC;check the appropriate box in the line above for Exemption from FATCA reporting _ the tax classification of the single-member owner. code(If any) IL ❑Other(see instructions)► (AppNes to accounts nrelmernoe outside the U.S.} U c 5 Address(number,street,and apt.or suite no.) Requester's name and address(optional) o P.O.Box 480, 9 Jan Sebastian Drive m8 City,state,and ZIP code to Sandwich,MA 02563 7 Ust account number(s)hers(optional) KOM Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid resident alien,sole proprietor,or disregarded page entity,see the Part 1 Instructions on page 3.For other entities,it is your employer identification number(EIN).If you do not have a number,see How to get a T!N on page 3. or Note.If the account is in more than one name,see the Instructions for line 1 and the chart on page 4 for Employer Identification number guidelines on whose number to enter. 0 4 - 3 2 1 1 6 1 6 0 7 Certification Under penalties of perjury,I certify that: 1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and 2. 1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that i am no longer subject to backup withholding;and 3. 1 am a U.S.citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(if any)indicating that i am exempt from FATCA reporting is correct. Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interef nd dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,acquisition or abandonmen ecured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than inter st dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions on page 3. Sign Signature of Here U.S.person Date► General Instru ti S •Form 1098(home mortgage interest),10 8-E(student loan interest),1098-T (tuition) Section references are to the Internal Revenue Code unless otherwise noted. .Form 1099-C(canceled debt) Future developments.Information about developments affecting Form W-9(such .Form 1099-A(acquisition or abandonment of secured property) as legislation enacted after we release it)is at www.irs,gov/fw9. Use Form W-9 only if you are a U.S.person(including a resident alien),to Purpose of Form provide your correct TIN. An Individual or entity(Form W-9 requester)who is required to file an information If you do not return Form W-9 to the requester with a TIN,you might be subject return with the iRS must obtain your correct taxpayer identification number(TIN) to backup withholding.See What is backup withholding?on page 2. which may be your social security number(SSN),individual taxpayer Identification By signing the filled-out form,you: number(ITIN),adoption taxpayer identification number(ATiN),or employer 1.Certify that the TIN you are giving is correct(or you are waiting for a number Identification number(EIN),to report on an Information return the amount paid to to be issued), you,or other amount reportable on an information return.Examples of information returns include,but are not limited to,the following: 2.Certify that you are not subject to backup withholding,or •Form 1099-1NT(interest earned or paid) 3.Claim exemption from backup withholding If you are a U.S.exempt payee.If •form 1099-DIV(dividends,including those from stocks or mutual funds) applicable,you are also certifying that as a U.S.person,your allocable share of any partnership income from a U.S.trade or business is not subject to the •Form 1099-MISC(various types of income,prizes,awards,or gross proceeds) withholding tax an foreign partners'share of effectively connected income,and •Form 1099-B(stock or mutual fund sales and certain other transactions by - 4.Certify that FATCA cods(s)entered on this form(if any)indicating that you are brokers) exempt from the FATCA reporting, p port g,is correct.See What Is FATCA reporting?on •Form 1099-S(proceeds from real estate transactions) page 2 for further information. •Form 1099-K(merchant card and third party network transactions) Cat No.10231X Form W-9(Rev.12-2014) ACC CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDfYYYY) 6/l/2017 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 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 CANEACT Gabriel De$ouza Murray & MacDonald Insurance Services, Inc. PHONE E (508)540-2400 aCNo;(500)209-4111 550 MacArthur Blvd. E-MAIL abriel@riskadvice.com ADDRESS:9 INSURERS AFFORDING COVERAGE NAIC 0 Bourne MA 02532 INSURERA:Tokio Marine Insurance INSURED INSURER B Advanta a WorkersColn ensation Benabby Inc, DBA: Disaster Specialist INSURERC: PO BOX 480 INSURERD: 9 Jan Sebastian Road INSURER E: Sandwich MA 02563 INSURERF: COVERAGES CERTIFICATE NUMBER:17-18 Master GL 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 SUBR POLICY EFF POLICY EXP POLICY NUMBER MMIODIYYYY MMIDD YYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE ❑X OCCUR DAMAGE0 RENTED PREMISES occurrence $ 100,000 NEW GENERAL LIABILITY 6/1/2011 6/1/2018 MEDEXP(Any one person) $ 10,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑PRO- LOG PRODUCTS•COMPJOP AGG $ 2,000,000 OTHER: Professional Liability $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Peraccident $ AUTOS AUTOS ( ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per acrid n $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000 DED I I RETENTION$ NEW UMMRELLA 6/1/2017 6/1/2018 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y r N _ STATIJT ER ANY PROPRIETOR(PARTNERJEXECUTIVE IE.t EACH ACCIDENT $ 1,000,000 B OFFICER/MEMBER EXCLUDED? N l A (Mandatory In NH) NEW WOPMRS COMP 6/1/2017 6/1/2018 F.L.DISEASE•EA EMPLOYEF $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below L.DISEASE-POLICY LIMIT $ 1,000,000 A Professional E&O NEW E&.O/POLLUTION 6/1/2017 6/1/2018 Policy Aggregate 2,000,000 Contractors Pollution Per Incident 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be allached 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 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (y C Finigan CIC,CRM,CMI 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD N S025 0(114nr1 y a` � '✓/tC- iprvni�ren�r,[creri�t�aff,�G'�iidlcrc�tt�e/lJ j,ICenSC Or 1'C office of Consumer Affairs R Business Regulation registration valid for individual use only Of HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: ' _J Registration: fl08642 Type: Office of Consumer Affairs and Business Regulation Expiration:.._',8_/20/2018 Private Corporation 10 Park Plaza-Suite 5170 KWT_= Boston,MA 02116 BENNC/DISASTER.SPECIAT, -_ - IST RICHARD LENNOX 9 Jan-Sebastian Way Sandwich,MA 02563 .` Undersecretary Not valid without sig ture Massachusetts Department of Public Safety Board of Building Regulations and Standards License:CS-055731 Construction Supervisor I RICHARD J LENNOX � .. PO BOX 480 v , SANDWICH MA 02563 `� L a � -•^� CA_— Expiration: Commissioner 11/07/2018 r' ,. of Basement 18' 10" off 'Li et 6OSK _ -~ 13F 711 ;81 6' 2' 8" N `rI' �--3' 1011----i oo Closen �3' 1�� talc i N 0 N Game.Room N � N �—3' 6" M Show Room `a 18' 4" _ 12' 11" 32' 511 L�J Basement WALLACE-CONTRACT 12/5/2017 Page: 1 Main Level �- 14'2" 21'3" 14'2" —� ITT' 20'11„ _ t _ .. 11'4" T Living Room p Bedroom «8-� 17 6 t IQ' Entry Den N a 23'4' 7^ Hafiway 15'8" - Kitchen 3" 5„ e Bathroom = Garage 23,2" 49'8" F ` r\n Main Level WALLACE-CONTRACT 12/5/2017 Page: 2 Level 2 14'4„ _ h-.�14'6" —�T _13'6" 13 R" - Eave E e 7„ ,,66 7„ ,1 11'6„ Oset tsetlOSet N T 10,9 q I a � � a Storage 8 Hallway 1 g �9s•• 13'1" � l I �6' % alk-in Closet N Bedroom 1 - 10'4" _ I'11" T .-3'3 �2'3' _ c ?'�•, - - osL - Office al I �Q Bedroom 2 ,r q° offset os t Bathroom Bath Eave a 'b 37'8" Master Bedroom j b Level 2 WALLACE-CONTRACT 12/5/2017 Page: 3 DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Contractor: Owner: BENABBY, INC. Sign Date ` h d Lr KR`6`x, Preside Owner/Bob Wallace Project Manager: Date Josh Dewey, Project Manager t M 1 J Commonwealth d Massachtisetts: Sheet Metal;Permit Map Parcel A — - 5 Date: I o / O /y Permit.# o _ OCT 12 2017 Estimated Job Cost:.$ -/, O o c�.c Permit Fes:.;$ LOWN O� 8AHNSiALL Plans Submitted; YES. ✓N Reviewed: YES. NO Business License#. Jr Applicant I icense,4 CR Business sIInformation: Property`Own/er/Job L,ocation.Infor nation Name: �t C96 / C3 Name Street: 02 9 �Gt!' o y�h_ Street; /J .O�l'�Ot, r City/Town: V a Aj N c 5 City/Town: T N 0' 1 o a(0 Q / Telephone:J�0 8 -7.7.5- 'J O 6 3 Telephone: Photo I.D.required 1 Cogy of Photo I.D attached: YES ✓--" NO si�tr Entiat J-1/M=1,�unrestricted license J-2/M-2=restricted to'dwellirigs 3-stories or less'and. commerezal ug:to l0,QQ0 sq. fte J 2-stones or.less Residential. l= family ✓ Multi family` . , Condo(Townhouses. Other Commercial: Office, Retail: Industrial Educational, Fire Dept..Approval_ Institutional_ Other, Square Footage: under 10,000 sq':ft:.✓ over`10,000'sq.°ft Number of Stories:' Sheet metalwork to be completed:: New Work: Renovation; +� HVAC ✓ Metal`Watershed:Roofing, Kitchen Exhaust:.Systen . Metal Chimney-[Vents:; ,Air Balancing, ; Provide detailed deseription:of work to be done:` ��IozE ✓ cmlu j 4r'U" g due- Za `('c rof- i i t • f AGE: INSURANCE COVER I'hav�e a currerit 1[ability insurance policy or ifs equftlentwhlch insets the requin:ments of M.G.-L.Ch.112 Yes® No❑ i . . � If you.have checked:yalvidicate.the.type-:of coverage by'chodking the4pproprtate-box below,. A liability insurance policy Other type:of indemnity [] Bond [❑ OW NEWS 1MSURANCE VtlA1VEf I am aware that the licensee does not have the insurance coverage.required by Chapter 1'12:of'the Massachusetts General taws,and that my signature on this.permit application waives this requirement. Check.One Only- Owner ❑ Agent El Signature of Owner or Owner's Agent By.checking this box[],I hereby certify that all of the details and k6rmation 1 have submitted(or entered)regarding this application are true and accurate to the best of my knowledge-and that all sheet metalwork and installations performed under the permit.issued for this application will be: (; in compliance withall pertinent provisloh.ofthe Massachusetts ftllding,Code and.Chapter112 ofthe General taws. 1 Duct inspection°required prior to insulation,installation:YES,. NdO Process Insnections- Date Comments Final Insgeecction i Date Comments. Type of License: 3y IN Master Citle" ❑Master-Restricted :ity/1'own E]Joumeypersort Signature of Licensee 'ermrt O ❑Joumeyperson-Restricted License Number.' =ee.S. , Check at www:mass.dov/da) �I l n sPector.Signature of Perm it Approval s i The COMMi7awealth.ofMassachusedts' •. l�eparbnent vflidustrial�ter�s D,fjce of Investigations G00 Washington Street Boston,:MA 02111 ivww mass gv►►/dia Workers' Compensation Insurance Afradavit: Builders/Contractors/FIecti c ans/Plumbers: A licant-Information Please Print-Le 'b Name(BusQrgamizali /Iatiivichtal)i •Adtress: 7 o J h /C City/State/Zip. y QNj►L 5, i►' a O d �� Phonei"25 0 , 7 7,Sr 08 .3 Are you an employer?Check the appropriate box: �,Typel lAproject(required): L R I am.a:employer with_Y^ .4 ❑ I am.a gene al contractor=anal full and/or art�tiaae * have'hrred tie"siurcontractors 6. Q New oonstraction . employees( P } I❑ I am a sole proprietor or:paitner`- listed on*-atfached sheet' 7. ❑Remodeling: These sub-contractors have: slop and.have no employees 8. ❑Demolition wodang forme m-aaYcapacity.` F Y .and have:workers' 9.. ' addition [No worlrers'comp.insurance camp.insurance$., .. xequire�} 5. We°area corporation and its 10.[]:fileatr oal;repairs ar add tions officers have ezercised.tbb-k 11.0 Phm`� ` r airs or additfmysions -"3.El I am a homeowner doing ill work � ep �. .. el£ o worl rs' right exemption per MGL 12.n Roofrepa c.15 . 1`4,and we have no insurance regiured.]:t 2,§ ( } . employees.[Na vmkers' irs 13.E Oder comp immranre tappi cant ihaf chinks box#1 also fit onf 8ie section below showing thca warkass'comptnsahon policy information:. Iiosaeowaeas who submit this'affidavit indtcxttiig Buy ate-doing ail work and didn hffe outside conteaators must submit a new affidavit and Ong such. tContractAts that check ibis bar muscat ached an additianal.shed showing ihi name,of the suDcmrtractors and slate'whetiier ar not entities have: cmplo}�es,.if thesubsrnttractorshaveea ]oY s.SizeYiaustprovidt.thci;woziaas'cgasp.'pwicynunbcr I gym.an.eptployer that IF, workers compensation insuratcce for.my enipdoyees -Below is the poTuy anil/ob site information. ce CompanyName-A-i t�1► % &)j L) ra,N C t Policy#or Se f-ins Lic..A C A O O s` J5-q 7 B J Expir On.Date: 1 a/ '1 � y Job Site Address: C [!f`�Gl� L/V /Stair! GW N O. .,.rig.l�Y �9_ !�A a 6 Attach,a copy of the workeri"comptmsatronphlicy deciarafiog page:(showing the policy number and ezpirataan Bats: Fatliue;bo seciae coverage as required.i 6 der Seclzon 25A of MGL c 152 ga�,lead to the imposition ofzrmsinal peaaliie's of a a. .- - .. fine up to$1,500 00 and/or one-year iiaprisamneat,as:well as ciez7 penal#ea is-t3ie form of a STOP WORK ORDER and a fine of to$250.00.a day a.gainst.the violator. Be advised that a.copp•of this stat t may be f wwarded fo the Office of Investigations of the DIA for instn me coverage verification. I do hereby certify un�dJer the pains.and,-penalies of perjury.that the information provided above_is id correct. Si tire: a' o Date C) ZI.O { / 7 Offuial use:only.".Do,not write n lhis.area,.:th be:canrpleted by city or town offcraL Qtyor Town:' Pt:rmit/License Issaing Authority(aide one): 1.Board of Health Z.Building Department:1.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector � 6.Other +. Contact Person: Phone#: f f Town or Barnstable ,, , ` . $. Regulatory Services uat�sz .:. , _ . > Thomas F Geiler,Di`reetar 16 M & Bu drug Division:,„ Tom Perry,B uildiag Commissioaer } 200 Main_S`treet 111anius,:1VIA 0260.1: WvrW-towiLbii stable ma.aS { Office: 5.08-862-4038 Pax: 508-790-6234 x � - Property Owner Must Complete and Sign This Section, If Using A,Builder U ,.as Owner of the surject..property hereb authorize v / t Y to'act on my behalf; in all matters.,relative to_work.authorized.by this bur,d petaitt` + /a L pq'.ti ob} z Pool fences and alarms are the responsibility of the applicant. Pools. are not to;be filled.'before;fence is installed and pools are not to be utilized.until A.final inspections are performed and'accepted. Signature of Owner S' e of Applicant t i god P.int Naine Ptait..Name t i Date i Q:FORI%.,O'WNERPERMfSSIONPQQLS "� ® � ,�,cc�e�r� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) ' 12/21/2016 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 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. CONTACT PRODUCER NAME: Rogers&Gray Ins.-Dennis Branch PHONE 508-746-3311 F",� o•877-816-2156 434 Route 134 E-MAIL Dennis MA 02664 A mail@rogersgray.com INSURERS AFFORDING COVERAGE NAIC fF INSURERA:Arbella Protection Insurance Com an 41360 INSURED ROBIREF-01 INSURER B:Atlantic Charter Insurance Company 44326 Robie's Refrigeration, Inc. INSURERC: 279 Yarmouth Road Hyannis MA 02601 INSURERD: INSURER E INSURER F: COVERAGES CERTIFICATE-NUMBER: 1585592575 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. 4 INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSD WVD POLICYNUMBER MM/DDIYYYY MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 8500061485 12/31/2016 12/31/2017 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE 0 OCCUR PREMISES Ea occurrence $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 MIOTHER: LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE $2,000.000 POLICYPRO- [X LOC PRODUCTS-COMP/OPAGG $2,000,000 $ A AUTOMOBILE LIABILITY Y Y 1020024673 12/31/2016 1213112017 Ea accideCOMBIREDt IN L IMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ AUTOS IED r SCHEDULED BODILY INJURY(Per accident) $ X HIREDAUTOS AUTOS NON-OWNED ROPERenDAMAGE $ AUTOS A X UMBRELLA LIAB X OCCUR Y Y 4600061489 12131/2016 12/31/2017 EACH OCCURRENCE $3,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $3,000,000 DED X RETENTION$10.000 PER $ B WORKERS COMPENSATION WCA00554701 12/21/2016 12/21/2017 X STATUTE OERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 'q NIA E.L.EACH ACCIDENT $500,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Additional insured status for ongoing and completed operations, waiver of subrogation, primary and non-contributory coverage is automatic under the general liability when it is required by written contract or agreement. Additional insured status and waiver of subrogation coverage is automatic under the auto liability policy when it is required by written contract or agreement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF BARNSTABLE REGULATORY SERVICES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING DIVISION ACCORDANCE WITH THE POLICY PROVISIONS. 200 MAIN STREET HYANNIS MA02601 AUUWMZED REPRESENTATIVE @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD COMMONWEALTH OF MASSACHUSETTS } SHEET METAL.".-W RS ' ISSUES THE FOLLOWING LICENSE AS A { I BUSINESS JOHN'R-ROBI'CkALi6 ROBIES REFRIGERATION INC I tr 279 YARMOUTH ROAD z HYANN IS,MA 02601 b I I COMMONWEALTWOF MA SACHUSETTS SHEET METAL WORKERS *, � ISSUES THE FOLCOWING:LfiCEN$E NFAS?ER UNRE$TRICTE ` r. ... JOHN R ROBICHAUD o 27'MARBLE RD k . ; BARNFSTIBI ',,,MA 02630 9608uf f 8/28/2019 316930t' ;I — B i 6 Rif t' . .T t CAA i 6ttC) - i � r EEL l _ I lr � I i „y�rti,..; ,t tti �"'�N�4��.�i�=���,ir��t�t�� � YP[��'�'/ D7"rk. �,4f,r����4�.'�§'�p�re'�+t[ �\�"�wti��-+rt.S�`.t�w.� ��,Y'"F'�`�1"�I�,;y�.. �ISt��.s s�k1�y.'n� }y'�y ���!t�•C•.LkU,�;�ti'S� ,dryF�45..p�'>'i�•t TOWN OF BAR eS oABLE Permit No. ____ ----_------ ____-.:-__ 2604 9' • p,„,�. Cash ” OCCUPANCY PERMIT Bond ____-- Issued to Bay.5 tde $GI,t Ql(t l2[�%'C0 f Address r ria, "..-ot 0484 15 CaAta Road, Hyanrct. f � Wiring Inspector > f //r Inspection date Plumbing Inspector{ 6^ f �L, Inspection date fGas Inspector SILLF 1! Inspection date yC)AA,* A4 A- AtEngineering Department Inspection date.i - 6Board of Health �. f �� �' r Inspection date _ THIS PERMIT FILL 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. ~ .....4 ... ...... .... . •, ... v N. ..................................................... .19 �.......... u y' e Building Inspector t - FROM �- TOWN OF BARNSTABLE BUILDING DEPARTMENT 'O. Fwau � 367 MAIN STREET HYANNI MA f 2ml Tom Cte k Phone: 77 -1120 SUBJECT: ` FOLD HERE - - ' DATE. 244 -1-994 MESSAGE t v bey c-cwtete unde,4 &a-&* .feftit 160 1 � � .1 j PteaAe Aet a ice. • SIGNED DATE REPLY - rGED-_ NST-RMf - - - RECIPIENT`.RETAIN WHITE COPY,RETURNPI NK COPY ' +• __ - ' + - 'PRINTED IN U.S.A. SENDER:-SNAP OUT-YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. -� � �yv � ;;� ' r' �= Sao -• J 47 i /0, z p� s,F7 Aa. • �o-T itb CERTIFIED PLOT PLAN NEWCONSTRUCTION ONLY � ROBERT y� _ IyE s�... p/.Y�1� /r' ✓..� ' muc,� , TOO OF FOUNDATION IS FEET WDRE IN ABOVE LOW POINT OF ADJACENT. ROAD. SCALE+ 3 0' DATE, /,/`� (ELCAE Enl(,�lV�'I�l ING Q Mi I3.g ys 1 � I CERTIFY THAT THE fo vivD,2 7iG�� E013TEREO RE®ISTERED D{.I�NT�,...�,,�... SHOWN ON THIS PLAN IS LOCATED QO NO, S°3 Z7 CIVIL LAND �-.-...-�. ON THE AROUND AS INDICATED Alm ( I ' ENGINEER >3URVEY4i3 .D i �{;,q ryj CONFORMS TO THE . ZONINO LAW $ ! Y . ,..... OF BARNSTABV MASS E.E.T CN.DYE 712 MAIN S T R H YA N A!S, MASS. SHEET.; L„OR ATE . RES. L AND SUWiV YOR AccPcenr'c(lff;.o n g+fl.. N Map Parcel 69 Permit# CY Conservation Office(4th floor)(8:30- 9:30/1:00- 2:00) Cate Issued r3�. Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) Fee Engineering Dept. (3rd floor) House# INE L�C L BARNSTABLE. 19 f6s9 M 59., p � . ,bo rE0 IAA's A TOWN OF BARN STABLE ' Bu' imlkemit Application ` Pro ect S et Ad ss ` Villa - Owner �I Address �c L • Telephone 7 2 �- Permit Request First Floor awr= square feet 4' Second Floor square feet Estimated Project Cost $ �,Y�®O , Zoning District f�L� Flood Plain „�dN� C Water Protection Lot Size Grandfathered ? Zoning Board of Appe is Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family ' Multi-Family Age of Existing Structure xc� I S 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 Other (� Builder Information Name/ \,j Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# 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 DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) y - FOR OFFICIAL USE ONLY PERMIT NO. s J DATE ISSUED MP/PARCEL NO. ADDRESS VILLAGE , OWNER DATE OF INSPECTION: ' t FOUNDATION FRAME' � ^�� �• •} i � � .- r- ' � � • INSULATION s _ ! FIREPLACE . ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 3- DA.TE'CLOSED OUT ASSOCIATION PLAN NO. r , r THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA ".Z PPLICAT INSTALL"AND REQUEST IOR FOR:PERMIT FOR ELECTRICAL SERVICE 7,7 W inspector of i s iri P 2- 0 4A "MoNamw --n tt --,B T PJ Town Massachusetts U! Customer J of MIVAIunderground number L in the gill utility.,pole J! dd N t er's billing A ress -s u iom i at,b C i�� to.-T A.. Temporary tartin mpo n h st ange Date U el 4944 IFC W f%1C WA&&SC W t Service'entr a* 'ce' ol ag AM,%0.10 A '-iera Phase h . Wir e e size(cu... 06ndu t rper or eak:YOS,7��r, Number of mete Wpieer heater N �J t . Estimated load:Electric heat lights kwl.Range dryer,_. olor-, Ready.for first inspection— ea or ina Anspectid bectriCaI..Ce%ntrnM Telephone al..C ntrnM A X�d res; Additional Remarks-:' "07sr- Al &-ff -.4 JE 0 -7 4 7 77 e, Do Not Belowi Write --ELECTRICAL WIRING INSPECTION.CERTIFICATE _INSPECTOR OF DATE E E INSPECTIONS Temporary qaniii n Roughing i -Service- r S 7 and Mete Off 7 r Peak Meter a Final Approval NOT APPROVED 11-25-96 - ; P A A Disapproved* J& NOT*: AS A ATH. "For the following reasons -PtUS' 'LARGE ROOM AND BAS:' -BLECTR I t D INSTALLED -0* BASEBOARD."i`OWNER TOOK -NI.SH, RTR INST VER,�-EL BUT I WAS C I AN FINISHED- THIS WORK S TOLD ELCT -CERTIFICATE OF INSPECTION DATE and , b has complete a To the COMMONWEALTH ELECTRIC COMPANY.The installation-described e above as d+ id fiagr'this day been'inspected- ro -granted for connection *o y,our t* t approval service Inspector of Wires .......... WIRING -INSPECTOR TO BE.NOTIFIED rWHE N WORK READY FOR-INSPECTION Perm Mr. cir6' o ate.0tissue Permit Good he.Year 46.1 ct White Cum/Electric Green 4-Inspector �.,.i�.(;anwv dwii ticeipt Pink ,Inspectors Copy' Goldenrod.-Elecfricaf Contractor T n M/F n I Z C INSURANC7 COA GE. Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES(3 NO E] I have submitted valid proof of same to this office. YES E] NO 0 If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCEE] BOND [] •OTHER 0 (Please Specify) -7T—Expiration Date)- Estimated ,Value of Electrical Work $ Work t.o Star& 013-571� Inspection Date Requested: Rough&�-��4' -�Final Signed under the penalties of perjury: FIRM NAME A/ NO. Licensee A/ Signature dF576 LIC. NO&-Z957-Z Address Bus. Tel. Nor. —Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. 41 6 J PERMIT FEE $ (Sig Cure of Owner or Agent) r c. �c T3 TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. . DATE .. JOB LOCATION "Number Street address Section of town "HOMEOWNER" _.. ..,. Name Home phone Work phone- PRESENT MAILING ADDRESS ?''•'_ City town State Zip Co( The current exemption for "homeowners" was extended to include owner-occur dwellings of six units or less and to allow such homeowners to engage an dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to side, on which there is, or is intended to be, a one to six family dwellii attached or detached structures accessory to such use and/or farm structm A person who constructs more than one home in a two-year period shall not considered a homeowner. Such "homeowner" shall submit to the- Building Off on a form acceptable to the Building Official, that he/she shall be respor for all such work performed under the building permit. . (Section 109.1.1) The undersigned "homeowner" assumes ..responsibility for compliance with the Building Code -and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requireme* . and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be requirE to comply with State Building- Code Section 127.0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for whicha- buiic Permit is required shall be exempt from the provisions ofr:.th •s section (Section 109.1.1 - Licensing of Construction Supervisors) ; provided thi Home Owner engages a persons) for hire to do such work, that such Home shall act as supervisor. " r Many Home Owners who use this exemption are unaware that they are assun the responsibilities of a supervisor (see Appendix Q, Rules and Regulat for .licensing Construction Supervisors, Section 2.15) . This lack of ai often results in serious problems, particularly when the Home: Owner hiz unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home"Ownez as supervisor is ultimately responsible. �. ... To ensure that the Home Owner is fully aware of his/her responsibilitie communities require, as part of the permit application, that the Home 'O certify that he/she understands the responsibilities of a supervisor. last page of this issue is a form currently used by several towns. You care to amend and adopt such a form/certification for use in your commu: t Assessor's map and lot number .�,7e -4e..-� -�/Q...�::........ *THE /ra,z t Sewage Permit number .............xr.�.....,............ / yL� Z BARNSTABLE i House number / +� N 9• �e TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ................ ....:.................................. ................................................:...,............. U' � d` TYPE OF CONSTRUCTION .......�.�. 3"?.. ....... .................................................................................... ..............f..........!��a...............19.— TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........X.P—L....... :.*............1 ...........fZ?Gi., ........../Y/.`� .......................................................... (/Proposed Use ....... ,{.., !. i/ ............................................. .................................................................................. Zoning District ......... .. ......................................................Fire District ....... �� .......... ................................................ 1 Name of Owner ... ..................................Addressr . Nameof Builder ..4.!!!! .......................................Address .................................................................................... Nameof Architect ..... .. :.. A...... :'�. !.......................Address ................ 5 .......................................................... Number of Rooms ......6................................... .................Foundation ........'�!?�IZ �"�.....Cfi�!tG ���C'.................. Exlerior ....... I1t.E�t�L�G6!} .....!!`'r.....�7................Roofing ................ '0. ?A)/ ......................................... Floors ........ lisp ?r?a ......V.1XV ✓........ ..........................Interior .........`�!? ..� : ' ... ... .. A. .......... Heating ..,'ll......... `a..................................Plumbing ....... V. ..... � t �?C�� r .. `cx'.-4 Fireplace .... ...............................Approximate Cost .� . . ..1................ .......................... Definitive Plan Approved by Planning Board ----------------__-_ �' '.. -------19-------. Area,..:f:�....,:�...�....".............. Diagram of Lot and Building with Dimensions Fee /`� / SUBJECT TO'APPROVAL OF BOARD OF HEALTH f 1 I E � 11 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS -Vol, I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .......... 122:`:'�'. Construction Supervisor's License ...I .............................. BAYSIDE BUILDING CO. A=248-210 t No*;26041 permit for .•1 Story Single Family Dwelling ............................................................................... Location Lot 48, 15 Carla Road ............................................ ......................H(annis.......................................... Owner ....Bayside Building Co. .......................................... Type of Construction .....Frame ..................................... ................................................................................ Plot ............................ Lot ................................ 't • i Permit Granted ...FebruarX J! 19 84 Date of Inspection ....................................19 Date Completed ................:.:.:.................19 i . or's map and lot number c1 �.. ..: .... uFT Eto . o Sewage Permit number 3.... D........�, ......... h h Z BASISTSELL i House number ...................................... lJ`J.. �............. f � ALLED 14 CC�i+;..-�;.�..._ ' rasa � WITH TITLE 6 OO i639 TOWN OF BARrN,��VABLE, BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........ ...... <N l.... �N' j ......:�............ ............. TYPE OF. CONSTRUCTION ....... d&......:i (z�: x .... ..............l..........6 ...........19.4�3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for anpermitt according to the following information: C�Location ........ .T .......Yk............4�.� ` .......!��. .......... .......................................................... ProposedUse ........ ................................................................................................................................. Zoning District ......... ..!.................................................... ..Fire..District ..... . 3................................................ Nameof Owner6�(,al........` ..................................Address ..................G.. ................................................... Nameof Builder .......... �+.......................................Address .................................................................................... Name of Architect J.4.. 1..... ..0.....................Address ................ ......................................................... Number of Rooms ......4........................................................Foundation ......��, .z�.....icfrKG C.................... Exterior .......4>1.�4�. 1� /.....!?` C................Roofing ...............W.V.—d.Z f(J .................................... j .�...... ............................. /Al Floors ........ z ...... Interior .......C���&'.S.tl✓ .. ....)XIA,.......... r Heating ....... ...1 ...........5 ?� ..................................Plumbing ..............�................ P!2 :........ .. .. � Fireplace ....lJ. dl,. .v�............... ...............................Approximate. Cost ............./.. .. ................................... Definitive Plan Approved by Planning Board _________________-___________19---_---. Area . ... ... ......�1... Diagram of Lot and Building with Dimensions Fee SUBJECT T APPROVAL OF BOARD OF TH I V� Y f f 1 / 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 ... .......... ........... BAYSIDE BUILDING CO. 26041 ............... Permit for ......��L�tory............ Single Family. . Dwelling......................... Lot 48, 15 Carla Ro-ad Location ................................................................ --7 Hyannis ................. ............................................................ .......Owner Bayside Buildinq co .. ........................................................ Type,of Congtruction Frame......................................... ..................................................................... ....... 'Pil6t............................... Lot ............................... Permit'Granted ...-FebruaiVJ,.............�q 84 .................. ... Date of ......1-9 Date Cal rnpleted .....� 1/.. .......... ...... 1C The Town of Barnstable Department of Health Safety and EnvironmeII l Services Buiilding Division 367 Main Street,Hyannis MA MW I Ralph Crosses Off= SOS-790-6227 Building COMM- F= 508-775 3344 For office use aniq Permit no. Date AFFIDAVIT H A OME DWROVEMENT CONTRACTORI W t supPLEMENT TO PERMIT APPLICATION c�ion,alterations►renovation,stgait;=dernuanon'convention, MGL a I42A requite that the"ttcorutr'uowner ed deatolition, or ooasnuaion of an addition to any pm' �adjacent maro�al: units or to s building containing at least one but not more than four dweIIiag om along with other to such residence or building be done by registered�tra�on5,with certain=Cqa Type of Work Cash®' Address of Work: • Oatta.Name: - � Date of Permit Application: I hereb<certify that: Registration is not required for the following reason(s): Work cmduded by law Job unmet SI,000 Building not owner-occupied Owner pulling own Notice is hereby gi<vn that: CONTRACTORS OWNERS PULLING THEIR OWN PERMIT OR DEALING IT NOT ��S .� .R FOR APPLICABLE HOME MROVE E'NT' WORK ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c I42A SIGNED UNDER PENALTEM OF PEPXMY I hcrcby apply for a permit as the agent of the owner: u Date \ Contractor name --strauoa No. OR ' T (lj The Cumnyonr+•calt i o !l tasrachuscnx •• 1� l j..�i� t• • . Dc parfment of Industrial Accidents �.`. if i. ';a% 600 I axe in.;lon Street Workers' Compensation Insurance AMdavit AR. t "t Please PRIM i�Ly loaminn- nhnne P ❑ 1 am a homeowner performing all work myself. ❑ 1 am a sole proprietor and have no one working in any capacity ❑ 1 am an employer providing workers' compensation for my employees working on this job. address- City: nhpne#t nniic�•# • insurance co ,��. I am a sole proprietor general contractor,or homeowner(circle one)and have hired the contractors listed below who owing wo •ers' compensate poll es. to Camn,inv n-.1MCE address• city: phone#• insurnncc ce nolicv# � •• c .-.�;��:'-• �.eirar+•4...-sPers+er+r'r--T'r^s'°.�F'- - - '�RP_�i�•*/!�:;�R?:!+� ..r1+..-- - nm env name.. address: cin phone 0: insur�nc �� '' ppiiey# - Attach addid'dnal'sheRfraiieiiar�: w: w�^�'•-.r.'-'�"".�''�° _.::.: :""'." ���r" "' Faiiure to secure coverage as required under Section�ZSA of AIGL 152 an lad to the imposition of criminal penalties of s fine UP to SI.500M nor une Vean'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of SI00.00 a day agaian me. I understand thr COPY of this statement mad•be forwarded to the omce of Investigations of the DIA for coverage verifiadon. 1 do hereby cenify under the pains and penalties of peryurr that the inforemtion provided above is true and correct Signature Date Print name Phone# otTciai use oniv do not write in this area to be completed by city or town ofilcial city or town: permit/lleense# rttluilding Department DUcowng nuard check if immediate response is required aSNeetmea's Orrice (31ialth Department contact person: phone fit nOther- �.r.�.�.....-" Information and. Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for . employees. As quoted from.the "law", an emplmyee is defined as every person in the service ofanother under any contract of hire. express or implied. oral or written. An empinrrer is defined as an individual. partnership. association. corporation or other legal entity, or any two or IT 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 owner of a dweilinL house having not more than three apartments and who resides therein. or the occupant of the dwcllin house of another who employs persons to do maintenance , construction or repair work on such dwelling or on the arounds or building appurtenant thereto shall not because of such employment be deemed to be an emplo MGL chapter 152 section 25 also states that even• 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 commonli•caltli for any applicant ,%yito 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 chapte been presented to the contracting authority. r ..�.. ' •.. �.—�!'�lt„rT+;;r.:y. , •.y.. '.r:z'1:Q���:•;-3:.�cr.i�i��,,.1.•;`` .,.e,• .!+�%+� Applicants Please 'I'll in the workers' compensation affidavit cornpleiely, by checking the box that applies to your situation an be submitted to the Department of '' g r address and hone numbers as all affidavits may P supplying company names. addr p 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 requi, to obtain a workers' compensation policy, please call the Department at the number listed below. .�.,w.. _ •.�,...'-�•. ..,w.. :•��r a::'•'il'+r�'��%s%-•' rill.�..;3a. -rt,'uti•-'.. _ City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottorr the affidavit for you to fill out in the event the Office of Investigations itas to contact you regarding the applicant. F be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returne the Department by mail or FAX unless other arrangements have been made. T7te Office of Investigations would like to thank you in advance for you cooperation and should you have any quest: please do not hesitate to ;give us a call. T7te Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents r' Office of lnvestigadons 600 Washington Street - Boston,Ma. 02111 fax#: (617) 727-7749 nl,nn(- # (617) 727-19PO ext. 406. 409 or 375 ., «........,...- y,.,. ........... .,.� ... . r.� _�... .».., ,._, ......._.. .. ...... .�.;.....,. ,«,.,..«,. _,....,.:z�._au_ ..vim .k...a,.i.... .. a... .;i,.....4c'�i .. �t�S.�t w S.- �' f j -7' .9 3 -7 z. w44, s? U 7 4 7 ti 6 '202, SIF7. A� s LoTb /oa ' �pOfy CERTIFIED PLOT PLAN o MOfitRr NEW CONSTRUCTION O N LY ltc r ,TOP OF FOUNDATION 19 FEET 8 WZRE IN ABOVE LOW POINT OF ADJACENT ROAD. SAAA S fAS L9j W1k . SCALE, 1 = o GATE, - GE G/ EE ING ,84 ys G{.IEMT ,,, I` CERTIFY THAT THE All._�5411_4_�I w I 91te 4211 0 DEPARTMENT OF P iLIC SAFETY PAID 2110 -ONE ASHBURTON PLACE, RM 1301 BOSTON,; MA 02108-1618 F8 15 96 CONSTRUCTION SUPERVISOR LICENSEw Number: Expires: Restricted To: 100 1 € m Ate_ ; SPIROS A BALODIMAS ,�q Detach bottom fold sign on f / 35 CARLA RD .: 0 back, and laminate license card. HYANNIS, MA 02601 ; � Keep top for receipt and change of address notification. -- ---7fie Vain rreoazurecr�� o�✓f�aaaacti�caelCa DEPARTMENT OF PUBLIC SAFETY Restricted To: 00 4 21- 1 U CONSTRUCTION SUPERVISOR LICENSE 00 - None Number: _ ' Expires: 1G - 1 & 2 Family Homes Restricted'.To; 00 Failure to possess a current edition of the Massachusetts.State Buiilding Code v x, �uv SPIROS A BALODINAS is cause for revocation of this license. 35 CARLA RD HYANNIS, MA 02601 ; HOME IMPROVEMENT CONTRACTORS REGISTRATION -* oard of Building Regulations and Standards One Ashburton Place — Room 1301 Boston , Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR - Registration 116642 Expiration 07/04/96 Type — PRIVATE CORPORATION HOME IMPROVEMENT CONTRACTOR Registration 116642 Type - PRIVATE CORPORATION SPIROS A BALODIMAS Expiration 07/04/96 SPIROS A . BALODIMAS 35 CARLA RD SPIROS A BALODIMAS HYANNIS MA 02601 SPIROS A. BALODIMAS 7 P!� ARLA RD ZmINsrw+roa HYANNIS MA 02601 I or `4 3�11�Fb'!�.:r .q•.; r->/':/��'r�'�- _.��'?Uti..�/=a��1 uc.� , i * �. 7.7 i JG r—z��-�c,/�c Gee r"� C 7 5 p ' A ' z>— v 79 Ar )KEG., `�'" ��• War col - G ai_ .Jo G 1/.00 Ni�T7f � �. ✓Lr/1/iv Tf��r S !a !.p 56_T Aef<,s _ ��ice;/-i r:(��� FAR- GA2AG C7-� (�AT P R.o CERTIFIED PLOT PLAN Of LOT (1� OSERr yGtA J(� / R.l 'rn °r'�F�/'Y r NEW CONSTRUCTION ONLY TAP ®F FOUNDATIONIS FEET., � �oRcoc� IN — ABOVE 6.OW POINT .OF A®JACI�NIT \ .�. ��t jI A.4 h "t. " ► o. } � SCALE$ J ,�_- 3 v' DATE: /j 8 LOCc,CS �/g Y 5 i��"� c E' g a lld� I CERTIFY THAT THE C�.IENT.K SHOWN ON THIS FLAW 13 LOCATED t E®ISTEREI7 RE®igTEREI� JobWo^'8,3 7:7¢ ON THE GROUND AS INDICATED" AN#I CaVll.. LAN® '"�"" CONFORMS TO THE YONOilyB `LAWS ENGINEER SURVEYOR tit. { OF NARNSTADLE . MASS i 4 A 7 t 2 M A i^N- S T'R E.E.T Ways �9 � e. ... _.�-- NYANRIS, MASS.- SHEET, L... OI�._�, ATE RES. LAND SUf V�YQR .,., E I( � Assessor's map .and lot number ... 7- 'a Q........... oFTHE ro J SEPTIC SYSTEjW DUST BE ,,,Sewage Permit number ........:......... ........... �.`�.,....C.:.:.1. -; :INSTALLED IN COMPLIAN(+ P o WITH TITLE T LE 5 Z 21AHB9TADLE, i House number .................:......::........:........:...... a ENVIRONMENTAL CODE A , 1639. TOWN REGULATIONS 0UriAr TOWN ' OF BARNSTABL" E BUILDING INSPECTOR APPLICATION FOR PERMIT TO` .... . `i. �� ............................................................................. TYPE OF CONSTRUCTION ............ .. -J................................................................................ �r ............ . .......L7...........19..> TO THE INSPECTOR OF BUILDINGS: ` The undersigned hereby applies for a permit according to the following information: Location ..... .0 ...........,1 , ..1�9 ....tea �. ............................................................... ProposedUse .. .................................................................................................................................................. Zoning District ...... ......................................... 4ST/1�Vi District .. .fY . ... . ............... Name of Owner . . ..... .. ... . ....... ....... ..Address ...ls.? � e� Name of Builder .. . . ....... .. ....... .......................Address Name of Architect .. ....... ..... ............Address 1...... y. Number of Rooms ..................................................................Foundation .. . ............................................... Exterior WO..O."O Sf�//l� 1�� f�j�.ZT SIVIIUC� Roofing ............. ............. ..... ............................................... FloorsC!C ? ..................................Interior .................................................................................... Heating ..................................................................................Plumbing ....................:............................................................. Fireplace pp..................................................................................Approximate. Cost ..��.......5._.'�.�.�.':.................. .. .. .. Definitive Plan Approved by Planning Board ________________________________19________. Area ....../a..�.................... of ©o Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH i '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 ..< .. ...... ............ KOSTREVA, PEGGY A=248-210 'N106 addition to ... Permit for .................................... .A welling (gara�.e)..................... .......k................................ .... ............. Location .............15CaR .........r..1a.........oad............................... ...................................... Owner P.Q.9 9 y...and..Danie.L..Ko S*-treva•......... frame Type of Construction .......................................... ................................... Plot ..... ...................... Lot ................................ Permit Gra nted ......... ..19 :.I j Date\of Anspection .....................................19 Date Completed ........... 19P ir W. 0 , CO 5. rcM M 2 rn 0 20- f- M GO Assessor's map and lot number ... ......... I r Y QyO%THEtp�y ,;,Sewage Permit number ...........�....�. ... ..L A;. li MAHB9TADLE, i House number ................................................ ......... soo rb v �a 3 �0 .eJirO YPY p. TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......r✓.. Gtrt. ........................................................... ............... TYPE OF CONSTRUCTION ............... 1. -, .....:.......................................................................... ............ . ......r.�..rX..............19..rf TO THE- INSPECTOR OF`-BUILDINGS: The undersigned hereby applies for a. permit itt according to the following information: Location ..... ......... , ! ... - rr > ..�. ....Qa ............................................................... ProposedUse .. !�.../....................................... ..................... ............................................ ..... .....I......................... Zoning District ..... R.7......................................... District .:..4'.. . rye- ...gV4.0.. .......................... 0f Name of Owner .��. . ..... .. . � ! - .. ....Address ..... ...�a: .� Name of Builder .. .......... ,..................Address Name of Architect .. � -��+ ............Address �.3 a` :. -ve �! Number of Rooms ..................................................................Foundation `' WoU� ��//(� GF�L -� Roofing .,....... .. 4�/x- :�C7- SAIII C , Exterior ......................................................................... .. .. ... ............. Floors G1yt1 .Interior .-. ...... ....................'......... . . . ...... ...................... Heating ....Plumbing .................................................................................................. ......... ..... ............................................ Fireplace .......Approximate Cost . ........... ................... ........ Definitive Plan Approved by Planning Board ________________________________19________. Area ............�..........�'�.:(............. e* Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH. t , OCCUPANCY PERMITS REQUIRED .FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations o6he Town of Barnstable regarding the above ,,,,,,.construction. �— 1 Name .. ... . ............................. Construction Supervisor's License .494.6.714 ............. KOSTRM;A, PEGGY A=248-210 No 8106.... Permit for .....944tiMAQ....... ,'dwelling (garage) ................ .............................................................. Location ............15...C.Arla-Road...................... Hyannis ............................................................................... Owner ..........PPEZY.A..Daniel.xastray.a..... Type of Construction ........frame........................ ................................................................................ Plot ............................ Lot ................................ Permit Granted ....................June..27.....19 85 Date of Inspection ....................................19 Date Completed ......................................19 e-6j 0, N ON1, -FI?;--I.-:_"----.�...-_..-.-A�-i_-t�._!3-_,-t`—f:-—',.t i-V►—'—.1II';A-I L_--7?—_.r(Ii�C-..S---—.ie r—✓---i{em.--u_—I.r..—I_.."-s1.--G_..:-.--.1._._°L-A E2-L iS 4.-_�%2p►--r'4I'J.'Jc_.,lK--?a-t,J-i�t.—_b1`H i1-.,J.!r�L-.+hx.-'., .6.r ,tx.: :. ....'., -.R.._v" _, .:c'-�py7��...- —.I I�S!,!'_-r-I_t.--v,.- .x._l,.F a-..r-!-�!...-N,>-e�-.+,.-. -- ...f,.,__.,F_.___...f<.t-...:.I.iI+ JR� ip� �OR I(-III.�I_..e,.�--x _F:v- c1LJ u,tk UaP�'<.�71 Cx_I ;7 X T ?i _111�1.,,`,,?tN.,13, �,r,w�z PIC W4, ......... ASPHAIJ C_.OHPA,��T rjLl_ 0 C4 LL>H N 'IT H 1 Rcz, W I F_ f!R UoA R. o ,fi,(0, 0-r.,)�2 0 P L-1 I�D L;R P 60 a,01 o PLAH- F- \r+.a�x,1 t'��I+I-..._ . l..'�:.•..,..A_ rdl 0 - SCAL I DATE 5 08-428-6191 tp rill F4 � I o eviin -�,Ustom .2 1 1 i�SL�L wi i, (r, io (4A\VM esigns P1 [_x I ST I Kk,, - wH m-, r--tAw- X� copyright 1996 Reserved 0 Ste- 5 if 4a0�JiF_-r7 Kxc _ L L', c Le- OvT, Oi-i Lj I- 0 j k--U ! UZ t 7 C-0 K�C APP(Al 3.0 < A`4 LEFT FILEWVIC)�,d Ft?O JT F- LEVAD&4 FIKY FLOOP, rDLAO C_ 40 M.111,_�;`_,_,ir�7",1 17� -1 i S_3 5 0=8-4 1 Preliminary plans and layouts by D.C.D.are for the use of their customers only Any other use is strictly prohibite