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Home My WebLink About0545 LINCOLN ROAD EXTENSION �5"LI S f,,i., ca I n �cl. ��t�-. r �� I Town of Barnstable *Permit#,/�&v i ) 3 3 Expires 6 months from issue date -PRESS PERMIT ]regulatory Services Feec_�2_ Thomas F.Geiler,Director JUN - 12007 e Building Division OF BARNSTABLE Tom Perry,CBO, Building Commissioner TOWN200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERAUT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Lnprint Map/parcel Number 7 l t 9 Q Property Address 6,y 1`- ¢'► 11. E' C' Residential Value of Work J` 7c� b 1 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name `NAP0Y__, V1-e0�e.,,t Telephone Number 66 S q ode) (001 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#.(if applicable) D orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner G-'rhii e Worker's Compensation Insurances Insurance Company Name 1 Workman's Comp.Policy# `"�& 1 1 _0_1 1 I Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) []Re-roof(stripping old shingles) All construction debris will be taken to Z: ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner mu ign Pr9perty Owner Letter of Permission. A copy of Ho ent Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revise061306 4 , The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations + d 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers ADDlicant Information _L Please Print Le 'blv Name(Business/Organization/Individual): . �� e 0 1 mac? Address: City/State/Zip: Phone cool1 Are you an employer? Check the appropriate box: Type of project(required):. 1.E] 1 am a employer with �'3_ 4. I am a general contractor and I . employees (full and/or part-time). * have hired the sub-contractors 6. El New construction . 2.❑ I am a sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. Demolition workingfor me in an capacity. employees and have workers' Y P tY• 9. 0 Building addition [No workers' comp.insurance comp.insurance.# required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.D Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' .13.0 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 new 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 have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: —7� y� D 0q�� Expiration Date: ��'8 Job Site Address: C �' F�e�r� ` Yl City/State/Zip: C� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK 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 insurance covoCze verification. I do hereby certify under he p s d p alt' s j4perjury that the information provided above is true and correct Signature: Date: 9 Phone#: bD� �(,skQ &P/4/ Official use only. Do not write in this area,to be completed by city or town ofjcciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract 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,or the g g J receiver or trustee of an individual,partnership, association or other legal entity,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, §25C(6)also states that"every 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 commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"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 in.Q.urance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-conti•actor(s)name(s), address(es)and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials 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. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in for our cooperation and should you have an questions, g Y Y P Y Y please do not hesitate to give us a call. The Department's address,telephone-and fax number:. The.Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington€Street Boston, MA 02111 Tel. 4 617-727-4900 ext 406 or 1-877-NIASSAFE Revised 11-22-06 Fax 4 617-727-7749 wF.mass.gov/dia i y' r. tr. MARK HE"S T 70? ' 35 PEEP TOAD ROAD _ CENTERVELLE MA 02632 i 508-420-6216 CELL PHONE 774-238-2938 RO TTED TO: WORK PERFORMED AT: Ed Ash .: 545 Lincoln Roa SAME Hyannis MA 02601 508-775-7612 IVE We herby propose to furnish the materials and perform the labor necessary for the completion of the c following; New Roo "< Remove 1 laver of existing shingles t Install 8"drip edge (® Install ice&water shield at edge Install 151b.felt paper ` Install certainteed woodscape 30yr, algae resistant shingles Color *Please fill in. Thank You Replace plumbing boots t' Cut ridge&install cobra vent IM Storm nail all shingles A All debris cleaned daily Price includes material, labor&dump s PTee �2 Q All material is guaranteed to be as specified.The above work will be performed in accorandance with the specifications submitted and completed in a substantial workman-like manner for the sum of; J. Three-Thousand Five-Hundred&Seventy-Five dollars($3,575.00)with payments as follows; *Any alteration(s)from above proposal involving extra costs will be added under a separate written agreement and become an extra charge. RESPECTF LL SU TED: ` 05-18-07 Mark Herbst tr ACCEPTANCE OF PROPOSAL The above price,specifications and conditions are satisfactory. We herby accept this proposal. You are authorized to do the work and payments will be as specified above. p'1 . Signature *This proposal may be withdrawn by sai r pany if not accepted within 30 days i c' -� .. f. % ; TOWN OF BARNSTABLE _-_------ 24852 r: Permit No. -_------__-.---- _ Building Inspector r - Cash a Oil" ` — OCCUPANCY PERMIT Bond ---------_--_-_� -�0_-- Issued to Eugene E'. Duquette rAddress lot #47 .7 545 Lincoln Road Ext., Hyannis Wiring Inspector � j/ Inspection date Plumbing Inspector Inspection date Gas Inspector �i"04-- K°'st-.'ae„��.�., Inspection date �,� Engineering Department f, �r �,# +d Inspection date Board of Health Inspection date✓5 �.r. 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 BUIL(�DING CODE. ................................ .... 19......_„ ......................................................... ..... � -air ..- Building Inspector .: .n, r+ .:.: _ L z,c.. ;. ..:�.r:. ."..- _ r� .. f.e'P�'«i - . � - ..•.h .n ... _ -. _ ._ 4 v .. Assessor's map and lot number ......�...`7�.. Izvv .... t �-- �oF THe rot Sewage Permit number ...........:.;.............1 ........................ ._ . ._�_ B>BH9TABLE, i House number, ...a r.......................`-C._.....`..�.....I . 1, ra MAM ...................... 1639• �9 TOWN OF BARNSTABLE BUILDING LNS _- APPLICATION FOR PERMIT TO ..... .•ry£�,.... s .j`6 � ,/'`, k.5. C. .............................................. TYPE OF CONSTRUCTION ........ ..... ........................................................................ !.. ............ : ..............19.0 TO THE INSPECTOR OF BUILDINGS: t The undersigned hereby applies for a permit according to the following information: RLocation .L�.T...y ...., � �. -. .. .� J....r..:.: !. /..?�'.!�:..(. S 5................... .. ................... j� S :-. 4 L: r Proposed Use ............t.l.,�.... .................................................................................. .............. Zoning District ..............Fire District . Name of Owner ,e U.fs. ..�l.L... ..,.. !�.A '. .......::..Address .P.°.ff�..... ........ �......r�.. K,.........a... Name of Builder .............. .�'� ......................... . ....Address .. .........56.:.U, t ecGUTh U Gy Nameof Architect ..................................................................Address .................................................................................... r Number of Rooms .........................!••.....................................Foundation ...('C>. .13Z;..ru." Exterior .............WcO....6......S. ki ^ ...................Roofing ......... SRA..T......S........................`._. .................. Floors ...........�.�VA�........................................:.......................Iriteor ..........64Y.041.e::............ Heating .. .. ..... .1`L.... .. ..................... .........Plumbing ....... .... ' .......� ............... Fireplace .........y4E.-S.......................................................Approximate Cost ....:.:.....t.?` L �. .......................... .. Definitive Plan Approved by. Planning Board --------------------------------19-------- . Area'... j —6 Diagram of Lot and Building with Dimensions Fee "�T SUBJECT TO APPROVAL OF BOARD OF HEALTH X a. OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS .`3 .r 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 DUQUETTE,; EUGENE E. A=-2-:712=18 4 No 24852 permit for One Story ................ ........................ .......... Single Family Dwelling ............................................................................... Location Lot #47, 545 Lincoln Road Ext. ................................................................ Hyannis Owner Eugene E. Duquette Type of Construction Frame ................................................................................ Plot ............................ Lot ................................ 1 March 15, 83 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 C fAj I (f� , r ory V &'Asr's map and lot number .. ./. ........ %THE•t 3 -/�.Sewage, Permit number ..................... At� ..... .................. . _.. p _ Z BARNSTABLE, i House•number .................. ; ................. �. ^c" ia� , 90 MASIL Qi.................. q �s 1639- aA6 u y y t o+ PF' . OVA a\ TOWN OF BA BI STaABILSE, , 4ENIM BVILDIAG INSPECTOR APPLICATION FOR PERMIT TO ..... .�.!Y G....<..:.�. !'ll.L-.y..../ ..C�:.............:.................................. TYPE OF CONSTRUCTION :......:IA.,?. o.)....... ..............................:......................................... 5.1..0 N..:.�?......... 19.�v TO THE INSPECTOR OF BUILDINGS: ° The undersigned hereby applies for a permit according to the following information: Location Lo � L f� �lV Q.� .N.. .11J...."....:.......IV „iSS.................... ...................................L. ..... Proposed .Use ............ .1. .:................:...................................................................:......:......................... Zoning District ........ 99 .. I :e....i..................................................Fire District ..............:.y/�.Af,/,I/�............................... ... .. Name of Owner ...........Address .D`.lC�..... �..... �.L^'...S..T'.... .a... Name of Builder S Address :AT. ,g........ ................. G �6G4 Nameof Architect ............................................:..........:.........Address ............:....................................................................... Number of Rooms ...............................Foundation ...�cs. ..�.(3,ctfI.............................................. ` INGyo 'G LCi 6`r S L S r,W6 L Exterior ..........:..............b...... .`l..:..W.....................................Roofing ..................p.l�... .............. .. .................. S Floors ' l!�G Interior .......... Z`. t . . .............................................. Heating� .:.../.... ...... .. ..........................................Plumbing ............ .... ............ .................. Fireplace ........:... . G... ...:...................................................Approximate Cost ..........:. ✓.�J B. ............................... Definitive Plan Approved by Planning Board ----------------------_---------19________. Area ....... ... ......... ......... Diagram ,of Lot and Building with Dimensions Fee �9 :... .1•••••`•••• ...... ...... ...... SUBJECT TO APPROVAL OF BOARD OF HEALTH '/V.� s 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. Name2.� . ... .. .. .................. Construction Supervisor's License .�..v.,. .k..�.,�......... DUQUETTE, EUGENE E. 2485 2 One Story IT :.. Permit for .................................... Single Family Dwelling - .......................... ................................................. t Location ......................................................Lot #47, 545 Lincoln Road Ext. Hyannis " i .. ...... ..... ..................................................... _ g 'Eugene E. Duquette " Owner Type of Construction.......Frame.................:....... - .. . i ........ ..... .. ................ ..... ............... r Plot ..:..... .................. Lot I • March 15, 83 Permit Granted .....,: .................. ..........19 t , Date of Inspect o/::'�R. ........� „..7.......19 `..� 1 Date,Completed .... �.��.�/ :l 9 i ' ',* X., Al 47 20 to L0TCo v 4 AAA! � N�c�c"3Y c�.�r/�Y` 7"`f•+�F77'" 7-)(�E escii�..aiw� / ,�`��`-�. _4WONCYiV.t1 O.V 77A•/t0 A4 A;iA! t S LOC R7""45-a O..- TX,-er �lf��r„I� "•'.,. .vim• ' C�.�cyc%v f .�i►S ,3Na'.�svN "OAr--CkA✓ A*A_'C3 r"o9r /7' T%�... ;�._._e. co�v,�-o;�.sr rya rw�s- rc.vi.�.f� '• � �. ��. .�� y .. Q 4-v 4,v G. 4L C_— 'e— L>AT� r