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HomeMy WebLinkAbout0021 MYRICA LANE i - --� TOWN OF BARNSTABLE, MASSACHUSETTS BUILDING IT A= 2 ,7.�" r u91- 00 - 4 DATE Jul s. 19 `f J .. PERMIT NO. APPLICANT 1C:+k �';erl!ei ADDRESS C•:ii3CE:i.V. lit- ._ (NO.) (STREET) "-ONTR' LICC ICON TR'S LICF NSEI PERMIT TO STORY S.'. '_�i�.%' 1'u.i0l.j.•< 7 <.� NUMBER OF. (TYPE OF IMPROVEMENT) NO. i,w lid•.DWELLING UNITS 44 (PROPOSED USE) AT (LOCATION) Lot #6, L 1 Ha IY:-_%a Leme, ZiyaIlllla - - ZONING (NO.) (STREET) DISTRICT BETWEEN AND _ (CROSS STREET) (CROSS STREET) SUBDIVISION LOT LOT BLOCK - SIZE - BUILDING IS TO BE FT. WIDE BY 'FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE - USE GROUP BASEMENT WALLS OR FOUNDATION - - - 1 (TYPE) REMARKS: Town SewL-r #3!�7 71 Jacque: Florin- p ff , .300 bearses Way, tiya;:nis AREA OR VOLUME °092 s--cl. -f L• PERMIT f� w _ ESTIMATED COST $_ FEE $ l U 7. 5 V (CUBIC/SOUARE FEET) OWNER bayberry ADDRESS Uu -� -�vc;. �n j,-i �� ,'1;;1 BUILDING DEPT. I ' By THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TUMPORARILY'-OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDIC'T•ION:--STREET' OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWFRS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLIC ANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. - MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ELECTRICAL,. PLUMBING AND 1, FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANI CAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. - - POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 - r l N 1Q l \ ��.• 2 - Ncv -• 2� -�� 3 jk o3r /- HEATING INSPECTION APPROVALS INEER NG D E P A E- �'/ / �. TE C Z'Z- CS-+ / BOARD OF HEAL H OTHER SITE PLAN REVIEW APPROVAL t WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT ''W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK 15 NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. PERMIT ;S ISSUED AS NOTED ABOVE. NOTIFICATION. S 3 1 ' TO - Y Yr TOWN OF BARNSTABLE o` Permit No. ........ , / BUILDING DEPARTMENT Cash ]28.QO... TOWN OFFICE BUILDING HYANNIS.MASS.02601 Bond ................ ; CERTIFICATE OF USE AND OCCUPANCY Issued to Bayberry .Place. Realty Srust Address 21 Myrica Lane, Hyannis t, USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL I t SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN i REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE . BUILDING CODE. � 1 I .........., i9.9 4........... .................... i Buildin nspector I i IT '-PAYABLE TO:,. TOWN OF BARNSTABLE BUIL;_'";G CO M,ISSPO�NERS OFFICE Jacques N. Morin DATE 7—l_� '4/ AccT� � of aloo �o� oS 9 9`49(0 AK,7. /110)91 PO# APPROVED BY *ME>o TOWN OF BARNSTABLE Permit too g5K9 BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash x........... ML ib79 \ HYANNIS.MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Bayberry Place Realty Rrust Address 21 Myrica Lane, Hyannis USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. i ..June.. 29.... ... .... 19.94........... Building Inspector {n •.•:;J .ins, ;.:. -= � t .. .__,J > w .� a. .. .:C 1.. < TOWN OF BARNSTABLE, MASS ACHUSETTS UILDING ' P RMI"L „73-Usi-UC14 �� _ k DATE_ July 19 1 :jJ APPLICANT mark i•�en-Z`- ry PERMIT NO. NQ 35999 ADDRESS l..!: .'Yl.:i��'J..�. ?�C INO.1 (STREET) 4 1o'�i(i'is !CONTR•S LICENSEI PERMIT TO uui .L C1 U6$f-C.i 1;�,iiC:' (I '�) STORY S'_i i`L > ((� NUMBER OF 1 �� 1'�t-1t11 1 y (TYPE OF IMPROVEMENT) NO. - l�v'•` i DWELLING UNITS (PROPOSED USE) AT (LOCATION) Lot 116 21 Ha P1-'rica Lane 1"}` c3T.t11.'.i ZONING (NO.) (STREET) DISTRICT BETWEEN AND (CROSS STREET) (CROSS 'STREET) SUBDIVISION LOT LOT - BLOCK - SIZE BUILDING IS TO BE FT WIDE BY FT. LONG BY ... b FT.. IN HEIGHT AND SHALL'CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION Town Sewer #3771 `TYPE' REMARKS: - - Jacque Morin- ($128.00) 300 Bearses WaY, 1=lyannis VOLUME AREA OR 209Z SCE. ft. - ESTIMATED COST $_ - PERMIT (CUBIC/SQUARE PEST) _ FEE ,$ 1 V 7. 50 OWNER Bayberry Place Keai ty TrEis` ADDRESS �U �earSC=S Way, Hyannis BUILDING DEPT.BY �.. �4 THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY"-OR PERMANENTLY.PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY, THE JURISDICTION. STREET, OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM'THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL INSPECTIONS REQUIRED FOR .APPROVED PLANS MUST 9E RETAINED ON JOB AND THIS ALL CONSTRUCTION WORK: CARD WHERE APPLICABLE SEPARATE - KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ELECTRICAL, PLUM I FOUNDATIONS OR FOOTINGS.' MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALSS ING 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILOING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH). 3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. - OCCUPANCY.- POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 i 2 2 z Nov HEATING INSPECTION APPROVALS NGINEER PA E Iq s � c� K O-J• Z`t-+Ci 3 / CARD OF HEAL H OTHER � SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION TOR.HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE INSPECTIONS INDICATED ON THIS CARD CAN BE CONSTRUCTION. PERMIT IS ISSUED A$ NOTED ABOVE. ARRANGED FOR BY TELEPHONE OR WRITTEN NOTIFICATION. Llew " Lo7- �, O { I$i 0'7 /ou.,iD�o,J 5i'< I CERTIFIED PLOT PLAN LOCATION 1i92N SCALE . .��-. 3�. .... DATE "'MY OF yqs PLAN REFERENCE EDW#1'1D lEY ^ I CERTIFY THAT THE ! ' .�vv4?7tr.cJ SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF BATlit/ST3q(3L�tr WHEN CONSTRUCTED. _ DATE REGISTERED LAND SUNVEY s� Assessor's office(1st Floor): Assessor's map aZlotmb a . Conservation v Board of Health 3rd floor): Sewage Permit number p" � sTUL t 3 Engineering Department(3rd floor): ee,,�1639'``�d° ouse number f e err —Definitive Plan Approved by Planning Board _ �� 19 �j APPLICATIONS PROCESSED 8:30-9.30 A.M.and 1.00-2 00 P.M.only /6 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT To TYPE OF CONSTRUCTION _ /yl 1s g? TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �T C�7'i'Z r AA-r� /!� Proposed Use Zoning District ham- G Fire District VI Any 1 S "V- Name of Owner_' 44GE Address 3 0 D /25e$ i/�l Ale4l Y Name of Builder mf+er WE ALZ Address � TEX ll% Name of Architect 4 SCff Address Number of Rooms Foundation ?r2 v>2 E-C'-( oxic`4'r- r Exterior ���d:�Q 1,Q 1 A Roofing Di'l Floors ��1 �C -f0 Interior _ ���t &Jt.B' /� Q t// Heating rlks Plumbing Z Z Fireplace t'S Approximate Cost 4, 000 Area L Diagram of Lot and Building with Dimensions �,�$ Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulation's of the Town of Barnstable regarding the above construction. r t Name Construction Supervisor's License C2 O Ct 0 �� BAYBERRY PLACE' REALTY TRUST No 35999 Permit For 12 Story , Single Family Dwelling' r Location Lot #6 ,'= 21 Myrica Lane ' i , Hyannis - Owner. Bayberry' Prlace RPa 1 ty Trig st - - Type of.ConstructionI Frame t Plot Lot Permit Granted July 1; 19- 93 i Date of Inspection 1 a 19 I Date Completed l�Yd�'<��j . 19 ;# ILI OZ rr v - . 4 a ' + 1HE T,,,,,.. o Town of Barnstable, Massachusetts Department of Planning and Development wtNSTna[.E, MASS. m Office of The Planning Board �p 039. �0 TEo MA't°i 367 Main Street, Hyannis,Massachusetts 02601 (508)775-1120 ext.190 j June 20, 1989 Aune Cahoon, Town Clerk . Town of Barnstable Town Hall 367 Main Street Hyannis, MA 02601 Re: DEFINITIVE SUBDIVISION 4701 - SPECIAL PERMIT MODIFICATION Open Space Subdivision 4701 : "Bayberry Place" ; Subdivision Plan of Land In (Centerville) Barnstable, Mass . Prepared For- Baybet•r•y Place. Realty Trust, Jacques N. Morin, Trustee; Plan dated 12/20188; Low 8 Weller Engineers ; Assessor's Map 273, Parcel 86, 90, 91 , a 110-'4 . At a duly posted meeting of the Barnstable Planning Board held June 19, 1989, it was voted to APPROVE: the request to MODIFY the SPECIAL PERMIT, pursuant to Section 3- 1 .6 of the Zoning Bylaw of the Town of Barnstable, to .allow the reduction in sIdeyard setbacks from FiFteen ( 15) to eight (8) feet for all lots, witFr the EXCEPTION of lot.!; 1 , 39 ll , and 12 , in subdivision #701 , "Bayberry Place" . Respectfully, IF !mil Jos p E. BartelIT Chairman N -, nstable Planning Board - JEB:vk o% J • i ................ ............... THESE PLANS MAY 14O'T FiE REPRODUCED IN liliiCt.r OR PAR'[ UNDER ANY"' NYC: f;t.)45; 1'p.IK:EES * vloLawrs mi,LH:u:(:-:pgJ,lf Icf:,il I;,-w.J - Q91�92 by YaMSI,N%!:...n., / ............... .. ....,..... ...VllptL�VIE I El 117 • � osPa.u7 .I .ems <. i I 3r.'fL:uv 7iall• ,Ir I j ._q'wlJurz>,,1Tzlh �I Ls.,:otier:�nco--- i -- _..I I 71 _ I I NOTICE!!! TO BUILDING OFFICIALS DUE TO CONSTANTLY CHANGING BUILDING CODES,TECHNOLOGIES.AND _ F MATERIALS l'.4F CANNOT GUARANTEE OUR PLANS FOR CODE COMPLIANCE MORE THAN/�,.yEAR AFTER THEY HAVE LEFT OUR OFFICE.IF THIS PLAN HAS BEEN S EMITTED FOR A BUILDING PERfAIT AFTER�r PLEASE CONTACT OUR OFFICE SO THAT WE MAY RECHECK IT. ' � � TursL scFj. ,t825 TES. INC. FOR CONSTRUCTION AT THE FOLLOWING —' -- ----------- LOCATION ONLY: .. ...�.:....I FOR Jacques Morin,Morin Realty LOT 5,MYRICA STREET,HYANNIS,MA i le .Y ItjL5 L" SS I I 1 ----------------- I I , III I I� at 'KITGMKJ,1 1 I � _ I o' po El M I I &-fr M; FICe Pt,nr-6_.__.....;� If, _.} E unJt 0 at Llytt-.1ioI FYI i I , Rt"vE a _�-- -71_ = =i •=—� L � As/iwsT ----. r ----i-- -=� •.gwfe.•.T..-- � tL——jy � cFa.. 2i ii I q•x'1'or1 1iJsuL. I -'G I � I Ij I •--J _._ � - ve x F'b-4- .y: I , .I 1 I i .. .. S ♦ .. —ems""'.__ � Gam- N t/�- bFK UuE i 1�r. -.__.. . .... ......_ --_ ___. ._ _ ___ G ................ . .....�......... G� I Gw 1�9.3 G.a-1:.'iTFJ� `�' _ 1 2 � '♦.'i' ' i YAROSH ASSOCIATES, INC. F I SST �"Lc�R f��r`1 _ ♦w�",�t:,: P,.I,,:«: j aFT ".. �1^ 3 r;r _ r I ; SAM E" CoAaSTrVCT!e(1) ' i I • . T f B3Q bw : 11RY:.1 V �e L C•it-•p MTE P - I - ty Jill i - �. WK. { i i , 17 : , 1 — �. _:— - 2 _4 t w CW i1i cW I w� � � � ' �� �- T- i� -_-- •° � 2^per eF .. ._. .. .. ... - r I P.T. I i I L-e4K - 'It'• .- ._. .... IB��9�....1. .... .:..... ... I g_ �_}u �� .y --------t--�- --T—'- I--.—.. .. - _ U. k N, WI / u1� I v LOFT I 4 vewti vs 4 4 --fix..-� 5_I�wry CEn+�PP<�vE 25 • 19•.... 5 IZ'c• I.}'a` ... .............:.................... I. . 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ARCHITECTS PLANNERS -r - - o::2 � F WALL FRAN11r`ICo S�:�TIC�L.Jc ... ..... s iPE aSI a I�O E I<:ta:HIES TT E S Perm * Town of Barnstable ' Expires 6 months miss ,x+ Regulatory Services Fee seax"nBLe M^9 S Thomas F.Geiler,Director' 639. � (Li Building.Division Tom.Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number &-730q, _ Property Address C}l Ayri&ok t"eAA ry ,,,ti .... � u, Residential Value of Work at') Minimum fee of$35.00 for work under$6000.0.0 Owner's Name&Address &b,C-zAU51C1 110 4,,tA�f lt�� ,yet'A'A /nA diLnti Contractor's Name (Tg f r-e y Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 7 S 7 ❑Workman's Compensation Insurance 'PRESS Check one: I am a sole proprietor I am the Homeowner MAY 16 ZQl ❑ I have Worker's Compensation Insurance. I 2 Insurance Company Name 710 VV Workman's Comp.Policy# STgBL, Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over - existing layers of roof) 9,Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. .A copy of the Home.Improvement Contractors License&Construction Supervisors License is requ' SIGNATURE: C:\Users\ ecollik\AppDa oc croso indows\Temporary Internet Files\Content.Ontlook\DDV87AAZ\EXPRESS.doc Revised 72110 Y t, The Commonwealth of Massachusetts Department of Indrtstrial Accidents Office of Investigations 600 Washington.Street Boston,M4 02111 iovitu mass gov/dia `Yorkers' Compensation Insurance Affidavit:Budders/Contractors/Electricians/Plumbers Applicant Information - Please Print Leeibly Name(Business/OrganizationQndividual): Address: r QnT City/Statelzip: (a no qv h Rd& Aj f%7 Phone#:. 0 Are you an employer?Check the appropriate box: T ' 4. am,a general contractor and I �e ofroJectre(required): �d): 1.El I am a employer with I❑ g ❑6. New construction employees(full and/or part-time).* have hired the sub-contractors e 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 aP h' 9. ❑Building addition [No workers'comp.insurance comp-insurance-1 required-] 5.❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised then l l.❑Plumbing repairs or additions right o MGL myself.[No workers'comp.• � f exemption per 12.❑Roof repairs insurance required]T. c.152,§1(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 i Homeowners who submit this affidavdt indicating they ate doing all weak 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 rrurst provide their workers'comp.policy number. I am an employer that isprotiding workers'compensation insurance for my employees. Below is the policy and job site information Insurance Company Name; x, Policy 9 or Self-ins.Lie.4: Expiration Date: Job Site Address: City/State/Zip:k 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 coverage verification. I do hereby certify un t/e pains and penalties of peduty that the information prosdded abm=e is true and correct Si 'l Date. ne#: Offlefal rise of Do not write in this area;to be completed by city or town of ciaL City or Town: Permit/License# ~ Issuing Authority(circle one): 1.Board of Health 2.Buiilding Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: . 6 BARNnABIX MASEL 165%a, Town of Barnstable ' s Regulatory Services - Thomas F.Geiler,Director _ x' .` Building Division Thomas Perry,CBO Building Commissioner, 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: y508-862-4038 Fax: 508-790-6230 Property Owner Must , Complete and Sign This Section If Using A Builder Carol - - . • , - . I;''961 .r. Arbye s - ,as.Owner.ofthe.subsect`property u, ;' _ F e.'a.« :r... 3,-n3:'. y•. s. -xj ,. .c r.�.,.: a .r.. •."f;: -3i.Y;E r..r:,t,t: . : _ .. ` . hereby,authorize ��Q to act on.my behalf,'. in all matters relative to work authorized by this building permit application for: a m r�cQ n� �l Ennis 0,966l- } (Address of Job -Si of Owner Date: Calm 7: Paoce,-�1 oYll ' �Arbae�ws�� Print Name If Property Owner-,is.applying.for permit,-please complete the Homeowners License ExemPtian Farm on tL�g reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Tempomry.Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 I 1 j i ✓xie �arrzrnovacaeall� a ✓GZadtu6e�d� q� -Office of Consumer Affairs&Business Regulation Ir; — q(HOME IMPROVEMENT CONTRACTOR 1�a j Registration 149773 ,. Type: Expiration..,,,,2R/2014;~ Individual JEFFREY WRAGG "- JEFFREY WRAGG; i 54 EILEEN STREET':. YARMOUTHPORT,MA 02675 Undersecretary j I 1 j } I tilussacbusctts - Departmcnt fit'Public tiafcts Board of Buildinr, Regulations an(I Standards Construction Supervisor License License: CS 75746 JEFFREY L WRAGGr 54 EILEEN ST. YARMOUTHPORT, MA 02675 Expiration: 9/20/2013 ( , ipmi.i mci' Tr=: 4202 R. Teomvnzo .Iddi oO&M-.414.4 t, Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:r.'1'49773 Type::: Office of Consumer Affairs and Business Regulation Expiration-01f_L14 Individual 10 Park Plaza-Suite 5170 w�E Boston,MA 02116 .JEFFREY WRAGG`,) t { JEFFREY WRAGG"� + _ - 54 EILEEN STREE� --- YARMOUTHPORT,MA 02675 Undersecretary N a' itho signature j al f. Town of Barnstable *Permit# - e2 79a3 792 , Expires 6 months from issue date Regulatory Services Fee_ Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis;MA 02601 www.toRm.barnstable.ma.us _ R RMIT Of Zce: 508-8624038 Fax: 50g-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL, ONLY (SAY ® 7 2007 Not Yalid without Red X-Press Imprint Pli _ j p p TA g p/parcel Number perry Address v'2 YID Ie: ' I r1�7 f''S Residential Value of Work Minimum fee of S25.00 for work under S61000.00 +ner's Name&Address ( 1 ntractor's Name M1, l &� Telephone INTumbei ,me Improvement Contractor License#(if applicable) 1 ME c'Ct�H'S' ivisoi's-Lzcente='`(if Epp eable) 1' ]workman's Compensation Insurance. Check one: , ❑ I am a sole proprietor ❑ I =the Homeovmer I have Worker's Compensation Insurance surance Company Name 4( orkman's Comp.Policy# 6 I c.� t 6 � l ���J � . )py of Insurance Compliance Certificate must be on file. ,rmit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to 4{ia ❑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 depa7t=nt regulations,i.e.Historic,Conservation,etc. ***Dote: Property Ovraer st sign rop ty Owner Fetter of Permission, A copy f the H e Imp ve Contractors License is required. iGNATURE: Farms:expmtrg nvise061306 ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d ' . 600 Washington Street Boston,MA 02111' wt*.mass.gov/dia ' Workers-Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information n Please Print Le 'bl Name(Business/Orgenintion/Individual): . Address: City/State/Zip: Phone.#: Are you an employer?Checkthe appropriate box: .'Type of pioject(required):, 1.❑ I am a employer with 5 4. [] I am a general contractor and I • have hired the sub contractors 6• ❑New construction . "employees (full and/or part-time).* deling 2.❑ I am a'sole proprietor or partner- listed on the'attached sheet. 7. [I ship and have no employees These sub-contractors have 8. ❑Demolition g'orkin for me in an capacity. employees and have workers' g Y P tY• $. 9. ❑Building addition [No workers' comp,insurance comp,insurance. 10.❑Electrical repairs or additions required.] 5. F ] We are a corporation and its re 3.❑ I q a homeowner doing all work . officers have exercised their 11.[]Plumbing repairs or additions ' myself.[No workers'comp. right of exemption per MGL 12, oo iepairs insurance.required.]t c. 152, §1(4),and we have no ] employees. [No workers' 13.❑ Other comp,insurance required.] *Any applicant that checks box#1 must also fill out the sectian below showing their workers'compensation policy information. t Homeowners,who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. (Contractors that check this box must attached an additional sheet showing the name of the sub-contractors sad state whether ornot those entities have . employees. If the sub-contractors have employees,they must provide their workers'comp.polidy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site' information. Insurance Co any Name: ( Y I$'/ � C Policy#or Self-ins,Lic.#: L' ?D f 10�2 6 Expiration Date: lob Site Address: p�C �� ���� G`ity/State/Zip: - Attach a copy of the workers' compensation policy.declarationpage'(showing the policy number and expiration date). Failure.to secure coverage as requited under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip 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 maybe forwarded to the.Office of Investigations of the DIA for insurance;everagre ve ' anon. I:hheareby certify under t pains a penal o perjury that the information provided above is true and correct. : Date: / d Phone# b Official use only. Do not write in this area, fo,be completed by.city or town official 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 e Massachusetts General Laws chapter 152 requires all employ rs to p rovide 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 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 notbecause of such employment be deemed to be an employer." � g PP • 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." AdditionaIly,MGL chapter152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.thto performance of public-work until acceptable evidence of cornpliarire v�i#h'tlie insurance 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,it necessary,supply sub-contractor(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-in ra=a license mmber 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 ermit license applications in an given year,need only submit one affidavit indicating current p PP Y�• policy information(if necessary)and under"Job Site Address"the applicant should write"an.locations in (city-or town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on f le 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 fo 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 advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone-and fax number:. The Cw=QUW th of Mmaduseds Departmeat of ladwWal AcddeatS (.m" of Investigaltous 600 Wwhingtoii Street B-Wo�.MA 02111 - Tel.#617 727 4000 ext 406 or 1-877-MASSAFE Faye#617-727-7749 Revised 11-22:06 WWW.mass.&QVM0 Yll ARK HERBST & ev 0 3 TOAT) RO.A:35 PEEP 7. NTURV1f..J-,EMAQ2632 r. roll phone 774-2338-29_,8 TEE TO. WORK PER-FORNTED AT. ^I rn 1 C,4 �-A Al IV J.0 A-14''�' r- its OIL. We herby propose to furnish the materials and perform the labor neecessary for the completion of the following; Ate'Bs-,QL- 'Movil .A Irwa Y, e A --Ilke LL -12414;—M-Q z sia e WOO r VT.,T1 rc AL .11 Crlqj�j C 0 -nu,booiF R wljavc E LEIVP HMV"M AY-ds*is C� ed dait re r ot&orraw All material is guaranteed to be as spec ififted. Above work will be pe.6ormed in accordance with the specifications submitted f6r above and completed in a substantial workman liky manner for the sum oft aght-lho?-sand One-Hundred Dollars $8,100.OO)witb payment-, as foljovvs; 't -full wn-ounl d�.ie uj)on comple� *Array alteration(s) from above involving extra costs will be added under a written agreement and become an extra charge over and above signed proposal. RES EC P T'FT :1LVS D 04-10-4)7 -'A L A,,C.(.`El1TANCE OF PROPOIS The above, pric&i specifications and conditions are satisfacto we.herby accept ry, V and you are authori7A to do the work and payments will be as specified above. Signature: AF as i * 'This proposal may be withdrawn by said comp f not accepted within 30 days "V NOTICE NOTICE TO if V TO EMPLOYEES EMPLOYEES The Commonwealth of - Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED INDUSTRIES OF MASSACHUSETTS MUTUAL INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE, P.O. BOX 4070, BURLINGTON, MA 01803-0970 ADDRESS OF INSURANCE COMPANY AWC.7016215012007 01/10/2007 - 01/10/2008 POLICY NUMBER EFFECTIVE DATES P O Box 494 Leonard Insurance Agency Inc Osterville, MA 02655 (508)428-6921 NAME OF INSURANCE AGENT ADDRESS PHONE Mark Herbst 35 Peep Toad Road Centerville, MA 02632 EMPLOYER ADDRESS 01/04/2007 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer,if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER 9 07. Board o Building Regulations and Standards HOME IMpROVEMENTCONTRACTOR. Registration 126480 E)FR4 to 6f8/2008 Typeind (d ivual tA MARK HERBST MARK HERBSTrf 35 PEEP TOAD RD.:' i CENTERVILLE,MA 02632 Deputy Administrator �OP OF FOUNDATION ` CONCRETE COVER �I CONCRETE COVERS Ir •'0 4' CAST IRON " rTr ` .� I ,� 3,oo s 12 MAX. 12"MAX. OR SCHEDULE 40 4"SCHEDULE 40 PVC.(ONLY) ``'lY G� P.V.C. PIPE PIPE- MIN. LEACH i�. ' t L J, PITCH 1/4'PER.FT 333 PITCH 1/4"PER.FL PIT PRECAST ` - LEACHING .INVERT o PIT OR \vt CZEy �P �F o EL.4.`1<So,. INVERT INVERT o .I SEPTIC TANK EL. 6'j./Z DIST. ELGg,7g >_ EQUIV. i S a INVERT /000 BOX 1q pF Q; !'• �wC� G Z GAL. INVERT INVERT hi ww ��• 3/4"T011/2 �(f / pp, 'yHoLE's ELGS,9S do �- i Lt F► 7ZSz. � EL.c8.4o, ,� WASHED Act, b w STONE t \ I /8� 6'DIA. � —� r PROR LE OF GROUND WATER TABLE �4- SEWAGE DISPOSAL SYSTEM � ' � GA- � s'� jr I �p / NO SCALE lot D f✓ Zo s SOIL LOG WITNESSED BY : / DATE �7 3/ /�8y TIME S° oo�M �!^!' � BA•�y. BOARD OF HEALTH � d �� / i O •° tv� TEST HOLE I TEST HOLE 2 �"DGv p C ENGINEER AD � c�, ELEV. . . 70' �o. . ELEV. .7 6o. n. . . © ✓ Z zap s„Q-so,� Spa- � DESIGN DATA . NUMBER OF BEDROOMS 3. . . . . . . . . . . •-�'�IS� �ATLSE S�ivD SAwD TOTAL ESTIMATED FLOW . . 33G GALLONS/DAY s�a G2Av bZ 6 V9Z- BOTTOM LEACHING AREA SO.FT. /PITIC A P. t2 6L4o io8„ SIDE LEACHING AREA . . .��?�:� . . . SO.FT./ PIT/c p GARBAGE DISPOSAL . NoA./E.(50% AREA INCREASE) I TOTAL LEACHING AREA . .'3�78. . SQ.FT PERCOLATION RATE-�5 !.T9 MIN/INCH LEACHING AREA PER PERCOLATION RATE 538:7 SQ.FT. .Nc.WATER ENCOUNTERED ' ' NUMBER OF LEACHING PITS A17r�i.A1 �117;'/. es-� � �/,_ �►� i !'avre ( 2'T p/C S7r ✓� GN 'l`"' S/?� y 70 APPROVED . . . . . . . . . . BOARD OF HEALTH DATE . . . AGENT OR INSPECTOR � I LDT � v EDf JAR ry KELLEY N.. No. 26100 yAN v/S /`7A . LISLp QS�r JtNita. PETITIONER /</