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Home My WebLink About0016 HARBOR BLUFFS ROAD (,, - ___r __ _ ._ ,_ --- - - -- ------ -- i` i �� ! I c TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Maps Parcel /�5�� T , / ' / i Permit# '7 `t' skin Date Issued /b —a 7—9 b Fee o U Tax Collector Treasurer Project Street Address /to ALb�� /� ' `Village Owner Address ._SAtme_ q.s o Telephone a 3 3 Permit Request a X fH Pr3 - /y`.S�An1 ��,;, t Square feet: 1 st floor: existing Goo proposed 2nd floor:existing. proposed Total new Estimated Project Costb_S-oo 'Zoning District. Flood Plain Groundwater Overlay Construction Type woa ti i Lot Size Grandfathered: 0 Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family r Two Family ❑ Multi-Family(#units) Age of Existing Structure 2 yrs 'Historic'House: ❑Yes Flo On Old King's Highway: ❑Yes 3-90 �Basement Type: 'Full ❑Crawl ❑Walkout ❑Other .t Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) O° Number of Baths: Full:"existing 2 new Half:existing new Number of Bedrooms: existing `Z- new + Total Room Count(not including baths): existing % new First Floor Room Count Heat Type and Fuel: ❑Gas Oil ❑ Electric ❑Other Central Air: ❑Yes W<o Fireplaces: Existing — New Existing wood/coal stove: ❑Yes L9-IGo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:Ell existing ❑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 BUILDER INFORIV�ATION k,'- Name :i ,:8 S4rn ,,-o Telephone Number OF dress 2-3 AMC, (Afc— C.c,,_e /License# g � 2-2 aug -/'Home Improvement Contractor# 1/V rd,3 .1 Worker's Compensation# ----- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE _ Via/ ? 7/ ` FOR OFFICIAL USEONLY r '. PERMIT NO. DATE ISSUED cl MAP/,PARCEL NO. 75 y ADDRESS VILLAGE e ,. OWNER e i DATE OF INSPECTION': FOUNDATION FRAME r n INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ` FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. } r °F VE r� The Town of Barnstable • a�sresie. • 9 � Department of Health Safety and Environmental Services rEo►�.�' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crosser Fax: 508-790-6230 Building Commissioner Permit no. Date ` AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. ✓Trype of Work: fe - R.an r1- Estimated Cat ,/Address of Work: A r kbu, Owner's Name: #Oe c ►r Z15ate of Application: /0/2 7/5 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav The Commonwealth of Massachusetts ........ Department of Industrial Accidents A - -- office - 0 of/nlresti anions 600 Washington Street J Boston,Mass. OZIlI Workers' Compensation Insurance Affidavit name: I,l��(V �P �.'G�-►O v location: Z 3 jS& G 9jt ,.-,e phone# QF3�•- ❑ I am a homeowner performing all work myself. Ckflam a sole ro rietor and have no one workin in any ca acity ❑ I am an employer providing workers' compensation for my employees working on this job. comvnnv name - address: city phone#: insurance co. V01icV# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have - the following workers' compensation polices: company name- address: city: phone#: .. insurance co. olity# company name. address: city phone#: Insurance co. ,. : . . olicv# // N 0a/%/i%%% / Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of SI00.00 a day against me. I understand that a copy of Oda statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true dfeorrecct Signature V Date L1/ 2 7r FF _ Print name l Q Phone# 2F-uP Ccontact e.only do not write in this area to be completed by city or town oMcW n: permit/license# ❑Bullding Department ❑Licensing Board f immediate response is required ❑Selectmen's Office ❑Health Department rson: phone#; ❑Other (revised W95 PIA) Information and Instructions w Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any cormaa:-, of hire, express or implied, 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, r the receive: g g ga$ to r o C. J rP g g P P Y trustee of an individualpartnership, association or other legal enti ty, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewa.i of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants _ Please fill in the workers' compensation affidavit completely, by checldng the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insairance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. MAX City or Towns Please be sure that the affidavit is complete and printed 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 in the permit/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. FRI The Department's address,telephone and fax number- The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Inaestlgatlons 600 Washington Street Boston; Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext 406, 409 or 375 I i .. 4 , 4y�' �`!^y.`TF[•T C¢''f4y'££ �-vF`".-'i".-ri4`-.. § i G ,,•F,,pt ` ivytr 1, MMfir` t} t yam. s z F w - z� g_ "YT" G fg' T w ,;: � ch S-t�e4�`�''e�r'gb•".�7 ar, S"�r"`i'+d'�.'ktS- $,m., wh 1 0 aP ��r. �'ti'Dea • T. x. �r 1 - ca - _Y> iIONE IMPROVEMENT'CONTRACT OR; Registration �114803 µ �_ 4Ezpiration �" 10/21/94 44:1 x3DESTEFANO CONTR. DAVID S q..OESTEFANOy ABBEY GATE IN � �p COTUIT MA£„n 02635 " § . • � MINI TOR r^'� �� I_ a ,HOME .!IMPROVEMENT CONTRACTORS REGISTRATION j �. = Board of Building Regulations and Standards `One Ashburton Place - Room 1301 .Boston, Massachusetts 02106 - ' I HOME IMPROVEMENT CONTRACTOR L--------------------------•------- P.eg:stration 100740 Expiration 06/23/98 Type - PRIVATE CORPORATION HOME I}IPROVE:!E•'[T C11TUCT11 • N � � Registration 100740 CAPIZZI HOME IMPROVEMENT, INC. I Type — PRIVATE CORPCRATION Thomas Capizzi , Sr . Expiration 06/_3/98 1645 Newton Rd . I Cotult MA 02635 CAPIZZI HOMC IMPROVEMENT, INC Thaws Capiz_I, Sr. P-71 Newton Rd. ACMMISTMATOR Catuit fA OZS-: I DEPARTMENT ONC ASIiDUIl t DOSTUN 'kUG.TION .SUPERVISOR LICCNSC ��j's.:� ",•� =Expires: . _ S7. , -I' ' Z�L- :t JR: .� ►S�Xi�3•GAPI - ____ -�• �k5 ABL,i;,, A` 02668 - h � �? •. e - • _ The Contmonti-ealth of Ma .vac•husetts •^:i ;, "i:": �:=�' DcpartnieW rJlnthrstrialAccidents Office ollnyestigatinns L. 600 11 iultitt;;ton Street Boston,A1a.u. 02111 ` Workers' Compensation Insurance Affidavit AFvlican_inf rm tin ^`"r?-' rP(�aye PR - R t.;,,• �, .- .,- _ -- ----.--_•__r_am : / Z L rx-z ? ' i location: cit-,• C�077/�7— i�/f 4ZG 3 �' rhonc« V2.9 Vrl I am a homeowner performing all work myself. O I am a sole proprietor and have no one woe•i to an y ny capacity ...ar�.^'.� "'rgc:--.,.?n,�:rr- rW r.n�aows•�,+,.y�,+ ..:_.. .. 1 am an employer providing workers' compensation for my employees working on this job. comnany name: address: city: hnn #• r insurance co / �' / i�yL %�' 4� ollc � # 1 am a sole proprietor,bcneral contractor,or homeowner(circle one) and hay:hired the contractors listed below who have the following workers' compensation polices: company name address: cih hone#: insurance co. Policy# pry— G. . .Z._ company name: address cih•• insurance co. olio.# `�ttJic6 sdditional•shcet if ricccssa �w�z,,:rc-":o•:�< '.rti �"^""'"`"'�";"'*;'-�4-�`<�-•-••�'-w•,c�;K-r--•T-a •S'. tf_....�_._._—..—.__..—.—.—�.__.��.n"'• �fk � - +r��,S•-r 4'cr` ��rLry,.a�sL�^--":n��.� ��i-^�.:.k�•e�±Ww��...as�,C3J1~L:d�;s�;¢y.' ... Failure to secure covertge as required under Section 25A of A1CL 152 can lead to the imposition u'criminal Penalties of a fine up to S1�UO.(10 and/or one years'imprisonment as well as civil penalties in the form ora STOP NVORK ORDER and a five of 5100.00 a day against me. I understand that a copy of this statement mai he forwarded to the Office of Investigations of the D1A for coverage ve-ification. I do herrht•certify turd 1 7- aii s and realties of perjury that the information provided gore is true and correct. Sianaturc D_te Print name i !I Fone Icial use only do not write in this area to be completed by city or town official rll� � _ • city or town: permitgicense 9 af3uilding Department ❑Licensing.[Board U. E)check irimmcdiate response is required [3Sclectmen's Office C)llcalth Department contact person: phone#• 0Othcr WE : . The Town of Barnstable MASS• easivsTnstE, , 9g, ' Department of Health Safety and Environmental Services OrEoi�.�a Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with ther requirements. �� TiPiird�✓�ay� S�1�/r✓G Type of Work: !-u>//aiy / gym TD/-► Est.Cost Address of Work: t y,FC1/ .� i�i't/e✓ Owner's Name"�>�j�,,f/ Date of Permit Application: 12 /d—� I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply,for a permit as the agent of the owner: Date o ractoor�Name Registration No. OR Date Owner's Name Engineering Dept.(3rd floor) Map Parcel 135' FPermit# House# fp r—JJ Date Issued G �" S d oor ( 5 --9:30/1:00-4:30) Fee 'Conservation Office(4th floor)(8:30-9:30/1:00-2:00) l Zip C, Planning Dept.(1st floor/School Admin. Bldg.) THE Dpectreet" n Approved by Planning Board 19 ; RNSTABLE. 19. TOWN OF BARNSTABLE Building Permit Application P Address c;z Village �� O ,,�� Owner ge ��?�3 /®/e 1d11jA2z6 Address w' 0 Telephone Permit Request I///Ii a-g I-a l,v' First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ ze:noo Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Ld� Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes I*lo If yes, site plan review# Current Use Proposed Use Builder Information Name I'a Z Telephone Number 412�9=qS loo Address ,�TJvt IVR lam' License# 6';d 3 2-- Home Improvement Contractor# j0D 71`6 ,Z, �� Worker's Compensation# OR-A&-Rk)d 921;iv 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 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY p PERMIT NO. DATE ISSUED 1 MAP/PARCEL NO. ADDRESS VILLAGE , i OWNER i I s DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL • t GAS: ROUGH FINAL FINAL BUILDING , DATE CLOSED OUT ASSOCIATION PLAN NO.