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0009 NOBADEER ROAD
g /1/odc�/ee.- �4�', ---� - - - -- " � _.. - �� i t +'I Town of Barnstable Building • �.•w+ .:�„,, i �� � ,� ��"°��"�� x. �L �.,_yve w � �m .a..ar.�r� .,�-a*"�":,A' '""",�'ne- .eel, °` .y e RAIRN mw )Post This CardSo Thai it isvUis�ble From the Streeta Approved-Plans,Must�be,Retained on Joband this Gard Must be Kept „ 1639 Posted�Until Finali:lnsy action He"s'Been Made : '' - R " "Whe're a�Certificate�of�Occu ant •is.Re uiredsuch;Buld�n shall�Not;be Oceu ieduntil,a Final.ans action has•be�en�me�de Permit -Pe"rnit No. B-18-2580 Applicant Name: Matthew Harris Approvals Date Issued: 08/14/2018 Current Use: Structure Permit Type: Building-Insulation Residential Expiration Date: 02/14/2019 Foundation: Location: 9 NOBADEER ROAD,HYANNIS Map/Lot:250 132 Zoning District: RD-1 Sheathing: -- Owner on Record: GUINEE,WARREN C&JANET T Contractor Name$-- MATTHEW D HARRIS Framing: 1 Address:. 9 NOBADEER ROAD I Cont actor""License: CS405679 CENTERVILLE, MA 02632 Est Protect Cost: $3,500.00 p Chimney: Description: Add Insulation to crawlspace Permit Fee: $85.00 Insulation: Project Review Req: - � Fee�Paid k $85.00 Date s 8/14/2018 mal. �4 � Plumbing/Gas � .' Rough Plumbing: _. ._ k Building Official � Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authoz Eby this permit is commenced within six m`oriths r issuance. Rough Gas: All work authorized by this permit shall conform to the approved applicat on and the approved construction documents-for which tl is permit has been granted. All construction,alterations and changes of use of an building and structures shall b in compliance with the local zonrri b laws and codes. g Y g P g Y Final Gas: This permit shall be displayed in a location clearly visible from access street or'road and shall be maintained open for public inspect o n for the entire duration of the work until the completion of the same. 44. •4 Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and FirbjOffUals arse prowded on th s permit. Service: Minimum of Five Call Inspections Required for All Construction Work: r 1.Foundation or Footing r, Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed, Final: .4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. p p pp g Final: "Persons contr with unregistered contractors do not have access to the guaranty fund" (asset forth in.MGL c.142A). • Fire Department Building plans are to be available on site Final: 1<111�9 All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 1 - LOT 34 N�7�j1o„� LOT DRAINAGE 36 j�� 7� /EASEMENT �O ti LOT 33 3 Qj CB 0 l� .\ X/ R=28 6 �' RES. ZONE.- "RDI" This MORTGAGE INSPECTION Plan is For FLOOD ZONE- "C" a e Onlv TOWN: _ _ ___---------- REGISTRY OWNER: _WARREN C &_JANET T GUINEE ----- - DEED REF: _J'ZF-1186�--_____BUYER: t?E�'�ApVC' DATE: _12�15�97 _______________________ -- - PLAN REF: _4059�_C S .1_____-SCALE: I"= 30FT. I HEREBY CERTIFY TO FLQ11jH -Off `,H 00 , � ___THAT THE BUILDING <,r` YANKEE SURVEY SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS CONSULTANTS SHOWN AND THAT ITS POSITION DOES _ _ CONFORM = '' Ul A A `�. 1 SUITE 40B TO THE ZONING LAW SETBACK REQUIREMENTS OF THE _ NIERITHEW�I = ) TOWN OF _BARNSTABLEJ_____ ______AND THAT No 3_i.98 INDUSTRY ROAD IT DOES_ NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD, Ic MARSTONS MILLS, MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED_ 9,�� _ l N�FE55`��N TEL: 428-0055 COMCU 11it —Panel 250001 0005 C �v0 5,uEi'+Ey%/ FAX: 420-5553 __ THIS PLAN NOT MADE FRO '[ STRUMENT 22259 DCB P A. LS ------ SURVEY NOT TO BE USED FOR FENCES ETC. I ' p i— x " i '- , I �a� 1Z I O 1.� i Ce ALQIL o S y f r,^ ii Iry d..cow o..y 4L.�r 10, 07 Uc Nv� o •� Vl /3, a�. .�.� L C AyPull-6AGK ` —... . W 1' I .O I_ 1aXL83�ceL 4,Awl 6LE ^I- y i 'I rEr I - I m. I yLOgAp CN0 FL002 �D15T5�. a� �� p �(. •� O - n ® - . Mo. 200M �((�I1 .(OPo7QNA-4_..DIwP VAULT CL/.. CONIC. &ITD 9". II''LLII IIII I''''''III 9•;F H w�C FLOOQ 1/�` DcoP cowc. 6 �Ef :3 oAr.' — — DOTTED LI.IE wo1 /tDNC_ozop Vl 6434r8Y 1IrI I 1 SijEL -©GRILL I./ld.- • �. � ..- � _ 'FIZD nIT �LEV RTtnwJ � i `. w,u..:.c+f�:�-_ac"mweQ t FOUuDAT1or PcAN e y• .. '•: - C 14-0" w: - FLciD2 PLAo.I �_A5-P-EP t)"NE....C.Aa.L) PIM&E+ ✓OFFIT UbIJT - - at RA7r-7-Sa5 e)vbc. : ^ /SAF FELT - - _ f15 PHA4r KOOT �a°LDA PLy 9HEAT141AY' .. I. - ALL.A fi urTE et y APO UTf - _ q+- IA Y Ix 3 2A'KE I"'.'.,. - - - - .. 12 1 ._to R 30 LLG. GCOoR - _..J; Llb (L 11 WftLLS SIDIraG —L 5"17TW.SrOE+ 2EAR+- - C� FRONT ROU4N CLAP 13V) 1 J10 +aYTLP Pc A7. L^ Ix5 Tic/,N DOOR-; Ixa FASuA:So>=Fir c Px6 F/t!EZ6 WW/BEDAIL06: i �Rli MATCH ex yr. I - - L- � A4 9 4 AenewaAP 41 I I L S�12 SSG rI •%"� /J"CI X PI SHEATH/NC. 0.j k<,Ow �dxY SHOE i T- - = r e '1V rAp 2 AN'LHO.e BOL73 __ .-- -- dxc PT. 5/cL u7/„ScAC Ibl o LiaE uouLD WAIL) Y-O°. SIUIW 0aor IF 9'C6LY, RIbFIT E f\tA1Cnl REa2 eLe�A-rin.l . C>; N/69 6✓1i6'K 8' _ DROP. T/O`Ouly 6ACK 1 WINWWI Dd04 LNEOU LE _- _ I CDAT rr6. �i3P 5 FRAAt./.NV. jf=C:il,CA1 �tAIP PROOF —A —Or�=s R.O. 6LnSS circ Or..eR . ._._ [.Fa �4"=l_U:'•. L�iELOW '6RADC �d%685 eEl DOOE _ ' F- -0�:u✓ vAwx Fpe (TU/NEE 2Eyl OeNGE ADDITION IV'.ap/ �, , � ,. � � � � � � � � 6y fNARON /NALONE-]-p•I NyON 'S08'77P'G67y » - rCl-tAP1221 HOME 1.0. g2jL. 9518 •w/pyt� . 1A o ax�ooV. p.r. - - kTDP.ax{. Ar. ILL W II ATV bxb Pr. Poyry - ATDP la'snAA TvdEf V'HI&H CTyN i C � W �R LEGT ElEVF4TO0 P , 1 F600R PL Ar1 S"a '-0" 3 4.vRT as.cvy PT bxc Pt Po3 f . t/ .Y•HIoH(ryn.) Q16Nr. �LEvAno l _ _ .. ' 6vLvee �ECC L�yovr ':: i pg I . _ (iy OAROw MA IoNE_SDN.VJ.pal.SOP 77P 667Y ------------ r f/I c!AP/�ti N oHE IA e, ydP 95/P ��=Join I r : AIL rx u o -a Y1 I nla IW Y cd - ' Ttl / -.O J n�- ., �'' 4w•nL : _ I AS.Tutu Ay wvwl eLE I 1SX4B STLEL y'CONC.SLAB �NO FLO02 7DISTSy O �� _MUD 200M - ^; i 40PFIOAIA�._.'DM1OP .w� I��T LIf_ `IlV I 9•;fljlfN W�yLG1�l2 r�ou�. b' 1 oeo )Ef 3'70AZ, DOrrED uNc Woo n . I - ..CUERIFY LJ/td IU .r ���_ `Y IF 9'"_GONG.DROP ' I GL SLray Cv" --- , _-__.-.- _ .X-.JdOTE__OOoi•..,.Wl.l.�:.Dc 1-9"-sZ.L"(O(JEIQ.EL FOUIJDATlol1 RAN e:y• _ • ' . - 14-0" __ FLOD2 PLhwl _ --6-S-pEQ O.NoN.E._Gls«� . .. RIDGES 50Fi rT UE NT _ - ' .IX IJ RED bE az ID R�+FTca.S a/c't7c. . n 154 FELT ASPNAGY P-00= ALLM GUrTEet"t l/PO UTf - yt_ _ ' 'Ix8 rt3 RA'ICE ' OL. .ta e R'SO LLG. FCoo 12 41" "I WALLIC a+Ip �� SrpING W�C SHINGLEf � - _. S•TTW.610 Er 2E Ak O Lr FRONT ROUGH CLAP OU/I L - _ I� — Ix5 TKIM Doo Rf o ;Oxb FR!EZ6 rJ1 BED 111L03: o? M4TLH Ex.fr I I Mow IZAP 4 1-- .�;,"/ /a'C DX P�SHEATHING _LFL �1 Ex•yT. o' ..— o !3o c2Z ��dz45140£ I T I AP y AN'LH O.e BO•ls L..._-_.1.. _ .- _._ _ r ..I PT, 311L WJ,SEAL - DDTED uNE NVJLD .8(ONL. cuAl:Lf I/'-O° 51VIUL DhOP IF9'LDI.Y, mil/RIhFIT E JA1Cn1 RE112 CLe vATtn.l N/GH b/,/6"+c 8' SOP. 710.Oa Ly 6nLIC 4o 4)7 T76. r7ye) WIr�Dpw♦ DUD4 �GNEOU LE _—_._ i, F-RA M.LNG_ jtC)/QAI, -D.IAtP PROOF ♦. .v v.aO r� P.o. CUSS Llr� ores eR _ B&LoW 6PADe a adX L8 s51'eL vooe _ _ - e 34— 'NY �I> '-- ._. .. D o•xJ su 1k,R IS Lr /�� /(ram 6101liEE REy NG IDe6 ADDIT/DAI IV'.a01 d- VE Iv+ " :7. I By fRARO J IWALeWe- n-pHNj-oN 508-,77r G67,v - - • -PA .-- A0'.77 1+0"e 1.^0', V11.. 4518 _ I C AMP ra''}R.IA 7w6ef v'HI&H � 4 �a a o pp� fc- tRA,v/uv fav vl�cJ/arnuu.on-°ne.v P�w,ii - k ,_•,a.. i-o' 3 4 4wY RT. - J 'OG. ✓�-dxi0 P.T. .. - d-'—Py Pr Lxb PT.Fes dE •H16 ryR) R16 HT EIEVAYIOI I LP 9L fNARO:u MA LONE-3'o N,vyo,J'SOF 77P"667Y . fp-44O/7zi'N O.VF.I vle. 4dP 95/P ��'7airt EPA Department of Industrial Accidents � --' � -� , OIfICd Ol/DYCStl�1l/0OS - 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: U Y`T" location: D Y3 4 ,-2)i5r6� 21 . city L iL%1 E ILJ t t.L9 ohdr4e'A—�) / /Q - '`I,5,34 ❑ I am a homeowner performing all work myself. ❑ I am a sole etor and have no one working in anv achy I am an employer providing workers' compensate n far my employees working on this job. rnm anv name_ address ti ; ' ' hone# :: ..._..__,.... p. oNcv#' � ra 0 or ❑ 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: . comyany name. ...... .... ::.:....:.:>::::: .......:.;....: ;:... address.... : :.:-:.':. :::.:.:....:::.:.....:..:....:....:..:.::...:. ... .......... .. ... .............::.::::::.::::::.:.:.. ::::.::::.::::: ::..: ............. MM :.:..... "::: .::;:-:.::.:. r ..�•:.i::6:•i%v:::::i-::vi:k::!i'+iii:i�ii:i�i:Yii:.:; w 0::::'{:i'.:�•::{::j�.T: :::::::.:...:::::.::.:..:::::::.::.::: .::::::::.� X. ...................................::::.::::::::v::.�:::::::.�::..:�.�:::::.:.:...::•::::::::.:....::::::.:�::.::v:::.�.�::::::: ...::�:::�..:.�.........:....... ..:n....... :.i�JY:AIM:C�w:•:i:'�::• ttsnrance.ca... _.... .._ ,.: ............ ...... oGcv#. •:.:... . I :. ,..::. ;.:: -•. camn .: .... :: ::.> "... :address. ;: . ......... .. . . C1tV: p ,... .. .:.......::';::..... :;•::: ::: ::::::::;<a::::::�:.;>: ;:.;>::::::::::......::::::.; :::..:::::::...::..;;•;:;::::c::::.:::::::::;•:::::::::._:.;:.>:,::.,:::::::::t:::::::>:.:.;..;:.........;.................:..:............ :....mot>.....:...:. nsvrsace _ ....... ...... .. _.. ,. .: .: :. oiicv#• ZliUM / / / Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of crbnb al penalties of a fhne up to S3,500.00 and/or one years'tmprtsonmmt as well as civil peaaltlrs in the form of a STOP WORK ORDER and a tine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. I do hereby certify under the pains acid penalties of perjury that the information provided above is ow.and correct Signature Ctizc� z•c /� '_/� /C Cc �i_s.� Dale 3 .� Print� 1zc IJEIz1 C;� I/- ,74-scr > # y %— 9.5 f% otHdal use only do not write in this area to be completed by city or town otSdal city or town: perm it/llcenu# - • ❑Building Department O checkif t�„aint respoi se is required ❑Selectz n[Board ❑Seleetmm's 01nuu _ ❑Health Department contact person: phone N; __.:—(:]Other (mvud 9/95 PJN The Town of Barnstable • v♦yNCT.�Ai� • 9 � Department of Health Safety and Environmental Services 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 - CIL certain exceptions,along with other requirements. - Type of Work: (i� a 0� C-5)jq SSE nt. A )ri �t. Cost Address of Work• -1 /VU��� �� � CAIT6e,V 4 UL Owner's Name W Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under 51,000. . 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: �40 Dat Contractor Name Registration No. ell P-!ZZ% 4rM 6- OR ,yy,vw Date Owner's Name -6Te'�oyeo�wouoeal!/o�.,�lZaaaaaaeQ' ✓lze TDam'unzorz�ue2U,t'6 a` /!/GCtQ6ac�uc4e�ii I(_ i SAFETY 1 DEPARTMENT i�F PUBLIC R STY HOME IMPROVEMENT CONTRACTOR UvRegistration 100740 CONSTRUCTION SUPERVISOR iICENSE Type — PRIVATE CORPORATION Numberi Expires: ` Restricted-T,o: 00 �, CAPIZZI HOME IMPROVEMENT, INC 1s as Capizzi, Sr. -A /THOMA$ CflFi?tT ' ADMINISTRATOR i645 Newton Rd. 1645 NE�ITOWN RC Cotuit MA 02635 t � COTUIT, MA 02635 `- ✓fie i�anvntoncueal/�- a��-laclu.�eli {� DEPARTMENT OF PUBLIC SAFETY CONSTRUCTI4',SUPERVISOR LICENSE Number _ Expires: x i g RestrctedTo, 00 i, F ', s THOKAS„X-;l#lzzI JR i$ � '280 PERCTVgI DR �r` 4F W BARNSTABLE, NA 02668 a ��� - 6 ^✓lze �anvrnanarea� a l�a�xracla.�retlJ" t` �> DEPARTMENT OF PUBLIC SAFETY i I CONSTRUCTION SUPERVISOR LICENSE Number - Expires: Restricted�To: 00 r FREDERiGK;V,"RASCH III k �1060 BOURNE•RD P PLYMOUTH, MA 02360 ` t SPECIFICATIONS AND I�mmTP 1 OF FILE COPY CAPIZZI HOME IMPROVEMENT PROPOSAL Established 1976 , Serving the Cape for 22 Years W 1645 Newtown Road Cotuit , Massachusetts 02635 508-428-9518 1-800-262-5060 Fax 508-428-1547 a e. 1/1999 kl` �� r'M'suL RE�f GUINEE /■ Job Address : 9 NOBADEER RD. Name: MR. WAR Address: 108 SEIG CRIED. LANE k5 U Town: CENTERVILLE �Z City: COLUMBIA, SC 29229 ■ Home Phone: 803-736-5784 �4cvk�3 ■ Other Phone: 508-790-4536 Fax: 803/865-9001 ■ �� -� • ■ Cc15 ■ Estimator: '3/JR tea✓ ■ Job No. : � 16464 ■ We hereby submit specifications and estimates for an addition to the existing �� house for a 14 ' X 20 ' gable-style addition on right side for dining room and aj U'; storage area . 4 �( �L, �,a �� �'a✓ S '�„�"' Item 1 . SITEka - Builder to provide plans and specifications. . - Builder to provide permit. - Builder to protect existing during construction. - Owner to move all personal objects , furniture, etc. , from work area. Item 2. DEMOLITION - Builder to remove existing slider and wall shingles - Builder to provide clean upon a .continued basis AND all debris to be removed from site. Item 3 . EXCAVATION - All excavation, trenching and backfill necessary for poured concrete footing and foundation. Item 4 . FOUNDATION - Footings: 8" x 16" continuous poured concrete. Walls : 8" x 48" poured concrete. Slab: 2'.' poured concrete dust cap in dining room and 4" in storage area for floor. Complete waterproofing. Vents : [21 two vents . Access : Cut opening from existing basement for access . [1) one foundation window. Item 5. FRAME TIGHT - Floor: 2 x 10 joists , 16" O.C. .with box sills , bridging and 5/8" CDX plywood in dining room area. Wall : 2 x 4 studs, 16" O.C . with 1/2" CDX plywood sheathing. _ Roof : 2 x 10 rafters with 2 x 6 ceiling joists, 16" O.C. with 1/2" CDX plywood sheathing, ridge board, fascia, soffit and collar ties cathedral . ACCEPTED 'B �7 1�c �.LLu.r DATE THIS PAGE !S- ARTIOF-'AND -IN' c6NFORMANCE WITH PROPOSAL #16464 IT - Town of Barnstable *Permit# 0 UpiRegulatory Services Fe =sr e dRrV ue(late rswxvsr�i3[E. � sass. _ �BLE Thomas F. Geiler, Director Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www,town.barnstab le.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL;_ONLY Not Valid withoul Red X-Press Imprint Map/parcel Number t4 YA-N Property Address SVe� ><'P �r✓ C�._<< , / lI'l/�3 � L Residential Value of Work*;--5-00 Minimum fee of$35.00 for work undec$6000.00 Owner's Name & Address Contractor's Narne Telephone Number��__)_, i.P hs` Home Improvement Contractor License #'(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner ❑ .1 have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy 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 rood' ❑ Re-side Air 'Replacement Windows/doors/sliders. U-Value (maximum .35)##of doors 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 required. K SIGNATURE: a � . Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 072110 ��olTti Town of Barnstable Regulatory Services yaAj�ST8 $. Thomas F. Geiler,Director $�rQ . A�m Building Division Tom Perry; Building Commissioner r : 200 Main Street, Hyannis, MA 02601 www:town:barnstable.ma.us Office_ 598-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: No kicrweli � f�iZ�t°itiis�Af number street f` village ".HOMEOWNER" /GIYYrPs�l (�f//h ec --: 9_G3`S �-3it name 'home phone# die y CURRENT MAILNG,ADDRESS; city/town state zipAde The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION`OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended'to be, a one or two- family dwelling,attached or detached structures accessory to such,use and/or farm structures. A.person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official.on a form acceptable to the Building Official, that he/she shall be'responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations., The undersigned"homeowner"certifies that he/she'understands the Town of Barnstable Building Department minimuminspection procedures and requirements and that he/she will comply with said procedures and requirements. Si gnat— ure of Homeown(r,-- T, Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet'or larger will be required to compay with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt fromahe provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);'provided that if the homeowner,engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor."; Many,homeowners who use this exemption are unawarethat they are assuming the responsibilities of.a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case;our Board cannot proceed against.the unlicensed person as it would with alicensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner ' certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several.towns. You may care t amend and adopt such a form/certification for use in your community: p Q:IWPFILESIFORMSIbuilding permit formslEXPRESS.doc Revised.0721 10 W- OF SHE A, ■ M • BARNSTABLE, MASS Town of Barnstable prFD MAC A Regulatory Services Thomas F. Geiler, Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.ba rnsta ble.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign.This Section If Using A B uil r z Owner of the subject property f hereby authorize 1 to act on my behalf, in all matters relative to work auth rize)by building permit application for: (A d ss of Job) Signature of Owner Date Print Name (: roperty Own is applying for permit, please comple e the Homeowners License Exemption Form on the reverse side. QAWPFILESIF0RMSlbui1ding permit forms EXPRESS.doc Revised 072110 They +Camnioniveal'th of.t'f assadn*isetts = --- Department oflndi strial Accidents ' 0.01ce Of investig afions 60.0 Washington-Street Boston, A14 0211-1 1•asiw►%rirnss goy�,✓rlan Worlters' Compensation Insurance Affida-vit: Builders/Conti-act©i-s/Electrici ens/Plumbers Applicant information Please Print Legiblti Nartle (BtisineaVOrgaui-7ation/tndividtial): 1,1�Y,VeW tly"I�i'Ate ef Address:_ ey Cityl'StateJZip: Phone#: 5 e)9 Are.you an employer? Check the appropriate box: Type ofproject(required): 1.❑ I am a employer with 4• ❑ I am a general contrJanand I enmployees(Rill and/arport-tune)• + have!tired the sub-ctors b- ❑New constnic.tion ?_❑ I am a sole proprietor or partner- listed on the attachet- 2_ �Remodeling shipand have no employees These sub-contractohave 8_ Demolition �trarl,ing :for me in any capacity. enmployees and Haveers' [No workers' commp,insurance comp_insurance. 19. .Building addition recluired.j 5- We` arena co. orationts 10.❑Electrical repairs or additions officers have exercised ir3(�I.anm a home-olAmmer doing-all vwk 11..�Plumbing repairs or additions mysel€ [No workers'comp. right of exemption peL 12.�Roofrepgirs iras-urance:required.]t c. 152 §1{4),and.wenomp ye [ 13.❑ O#her ��'e 10 es. a urorlc mC az&ccMp_:insurance requ ;Any appticavt that checks box fl mu t also fill out the section bel6w showing their workers'mmpeusation policy inforrnatian- pp��H.o�nteowners who submit this-affidavit indicating:they are doing all�wMt and then hire outside contractors must submit a isew affidavit indicating sac1L tCGutraclors that cheek this:boa must attachsd so additional:sheet shm-ing the name of the sub-contractors 3n.d state whether or not those entitie:5 haL,e employees. Ifthe sub-c.ontsactors:hace employees,they:must provide their workers'comp.poli cy number. lain an employer that is providing it orkers'camper Sn6on hisrrrance for lrty'employees. Beto:w is the paic nand job site informatiaat Insurance Company Dame: Policy#or Self-ins-Lic: Expiration Date: Job Site Address: City/Stat&Zip: 4ttach a copy of the warkers'compensation policy dtcla.ration page(showing the policy number and expu-ation date). Failure to secure coverage as required under Section 2.5A 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 D.IA for imurance.coverage verification. I do heroky certify tinder the pains and realties of p erry that the information prm�ided above is trsr.e and coy rect. Si tore: Date: Phone#: Official use only. Do not irate to t1►is area,to be completed by,MY or town ofciaL City-or Town: Permit/License# I3.. irlg Authority(circle one):.. - - 1.Board of Health 2.Building Department 3.Cityffo-sim Clerk• 4.Electrical Fn-spector S:.Plumbing Inspector 6.Other Contact Person: Phone#: 6 ZI 01'- Town of Barnstable Expires 6 monlh�rOV_ue date * Regulatory Services Fee s r BARNSTABLE, Thomas F. Geiler,Director Building Division VV 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 Redn'X-Press Imprint Nlap/parcel Number-- 7� yanhcs Property Address_ (DO P,& �sidential Value of Wort. d® .° Minimum fee of$25.00 for work under$60 00 Owner's Name&Address /e?Le 6C- CC' t 14690 Contractor's Name C Telephone Number _�i I Ionic Improvement Contractor License#(if applicable) -a ll t ® . Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: AUG ❑ 1 am a sole proprietor ❑ am the Homeowner N OF BARNSTAB�,E I-�/I have Worker's Compensation Insurance T�� Insurance Company Name -ef-}-Ci AI �`T!✓- .� �� (/('/ , Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. Perm it Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over. . . existing layers of roof) ❑ Re de- ` Replacement Windows/doorsrsitders. U-Value06_S_S (maximum .44) *Whererequired: 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 is required. . SIGNATURE: Z� � J.". P1-ILLYWORMS\ rms\EXPRESS.doc. Revised 100608 The Commonwealth'of Massachusetts ` -Departmentof Industrial Accidents Office of Investigations 600 Washington Street 14 Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individua]): _ff Foov- 0 c I�Vcl' Address:—//37 e1w k q)is City/State/Zip: PA 00 � g S Phone#: �� 1 /11- Are ou an'employer?Check the appropriate box: Type of project(required): 1. am a employer with 10 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑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 working for in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance. $ 9. [D Building addition required.] 5: ❑ We are a corporation and its M❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself o workers' right of exemption per MGL y comp. 12.❑: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-contmoors 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 thepolicy and job site information. n Insurance Company Name: &WC01111??Llftl(+ Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: l v( e, City/State/Zip:64111C�� 3� 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 under thepains and pen alties ofperjury that the information provided above is true and rrect. Si nature: Date: Phone#: _ Official use only. Do not write in this area,to be completed by city or town official City or Town:.. Permit/License#. Issuing Authority(circle one): L Board of Health 2.Building Department 1 City/Town Clerk .4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: uate- To,Oe(TrO�aOde OP to S G9/ /08 OF LIABILITY INSURANCE m-i CERTIFICATE I I(IS CERTIFICATE IS AS A MATTER of INFORM-ATIOt'l ............ ONLY AND CONFERS No RIGHTS UPON THE.CERTIFICATE DOES NOT AMEND,F.ATEND OR HOLDER.THIS CERTIFICATE . COVERAGE AFFOR _j)By THE poUctES BELOV4. .....------- ,HxjjjtC-r r 4'nSu-ranr-e, Inc. ALTER THE. '3tiq old River Road, P-0. BOX NAIC il 14,invi,110 1>,l 02836-0001 INSURERS AFFOR DING phone: Moon A540clates TnC' DB;i, Gutter Ralmot d��Zsen Of RI DRA Renewal b I ...... -F DSA cutter Hey.met R00fiug P 113*7 Park East Drive ------- RX 0289S —------------ - -------- cOVERAGES , r4Aorn�)rr !— Or n 10 ALL E c ------------------- t-'ve 6E'E���4t:m'ct:� y 0 j —VF 'n," T trFFEM:U 'rojT, VtKA Lor AeT DATE o 0 6 0 SO z Ttl;Z(D��T Mt --- 000,0 Ts i o o o ....... A 1,3 2 00000 0 0000 CKVAk,'kAtl 'j'000000 /16/09 0911ci/08 09 BIS26619 i�j'-X'qt y i-WLP" ---------- Ev & ............... ------------ EA AC-- —--------- 10 09/16/09 CUS26619 09/16 13 .......... .............. 3500000 WORKERS COM1,CqM&-Ml"ANC0.8 DI/09 iE E - 4tr t q z 4'w'ff, -—PRW*Si 5 - Rs Ri' �'F OPE W EXPIRA"' CERTIFICATE HOLDER —1 ANY Of Aa"eE"s�CRQtV F DAYS WMIT' 94SURE"you o 6t4A!' THE c"e;JWICATE HOLD"kV'"-V Cont_ Reg. 5aard L)'Pt. <)f Admillistration z as MlLny Of air i<No UPvfd n Y < ra.trvr� � c °T one Capitol gill AIM, 908 providence RI 02 05RD COR�OiJATiON I ,,c0RD 25 470410S) yv 3'1� ,��� a coto•��.�I Q g I� 37.�' �PrXtea Q t x x $' P��nae�" a g ' o2ob Customer Name: V/ Year Built: Renewal by Andersat of R1&Cape Cod LO Renewal nadttiu- ���f2 21] Custoomer IDS:, 1137 ark East;ID Cl- bYA1lC�eifl. Sales Agreement P City Srace Zip- Order Number. �oottsaeloet.RI 02895 rtwooaa RE►LACrwEW mAndom,Cm.pmv Phone-Hojne: O L k 832J S 1T 3 V/S' Page: of Date: Umm 62 RI 12259-MA 119353- Enl 725 UNITS Tedml Ml C,C- J* ��N S /A!j IC GRILLES F Noomh £: st = k ai pia ► cgs a e a a isa L to � soma s to-L it TT sl Jf37 N _ 5 1 ^. - - n - Jn9 n n. b n Proposal: tsar do.boon v nduve and dmn eo be pmYWcd r«ebe moil mroanc emued o 6e t>ti C is Or a9e5 Subli 1 Mq n .,eel rot dip.oat. 'm eo.�pnmoe y.ba6 Cmeaan:c.nd xmew.t br Mangy d 1samwg' .Wisp.Ra lmc[TomoB`eo.ecc) f9ylneet MelhOd Sth low pda how n.K Z pl dndeesen sat- sv� 1Z/S C O✓J>7} n Custrmer Ac rw.�e enby mm a o f—h dt—d.-..A d—,end W m die d& ,$ Cretin Card L rn..b;� undetag�ed egpax m pug ehe.mome smed m,his.g--.ad.cco�dirg m e—baeoi 1-�b OAF At rt ��•A tl�y /5 Fill Credttt or 6gasas L See Reverse Side fat Yearns and Conditions of Sale.You,the btryer,may cancel 0 G E this tttrnsaction at say time to midnight of the third business day a&et �X k,ja7 /h' Eon A& FL7�.t teat ❑ the date of this ttansactionpP]esee see attached notice of cancellation for an rL SS explanation Of ,. ... J n G ASi.adlanmua Caedla«E�cmo 3 G Saks ilex t.9 .dkr�cava�.cd wwkPatmkCost � AdRdwA yreaaoa Ill Aftd" a vr�+��s� C n Speoal Order Notes littal Amorx of ABtsaatent �.! a O D— se..o.er r>.t� R---dbreoammW—g-9>l a+etsR Ill amr +bypiNixauHnya teErall�Andes aeodud>Kaaham rwecnoceaatneae�mmonrtpnidna °t+'°�tp"4*W 9 �aa+aaa� .ekn...r doas.atguraneete d.t.mrmwiwyre y�maemdynael6wergdarymeaedr.ua' Balaue0u onCatrostim J Oe neeacd'u not Ydrulnd PoofudylW.du4Yr sdeydu!rplUtyd kdixnw.d Juana Y6idlhlimwe�Amngleg17 LJ a��p.m�wn onekap athr neu unity V�emmoer Was andduojB reuMtlR��s�pm ta.appwf. immabon »inroiwd. neus.ee..ned uau ens arape,a ooadaalon eehb wsbc Prim includes tabn5 material%tnrulluton. mad a,a wa d.arrarnxssdun and ranwal,and do of aw�mdwnnnam. 'MNor-IiDyNdasen Yeiiwt-YunUatlm and;-Fb.�eoxter P� P"a'dl � t�etr: urmk: rti J 'toned 41.dm'ed Ae Yard 4A.�•up�nm�dodAvsn�r Cgmtlm,0 -M ivb nF3003A l Y I t Restrictid to: RFAS M1la»gUsg,rtti DtpartmeniofPublicSafctv IA Masopryunly. Board of Building Regui atums and Standard`s h;R Roof,rCnv�ring Cons#riic#tAr}.Spervisgr Speci;aity License WS Wiro�ts anci Sickln x ,,: �cense; GS SL §§� � ,% 4 - SF: Sold iu,41urtting DnYks�g' Restricted to*.R��✓v5 DM Detriaon,r,ttiy JAMS ���� , n w Failure to�os5e�g�et►rrettt�t11tiQ1►�I the �. 3 Massuektus,ett�State Builtkits dude 49 Pt INE ReAD @ /1Pf=Rf�,a18@ ,h Y is-cauac fot revoLatinn of tlt:E�114enSe:: ; Refer to .'WWV►!mms.'Got/DW Al Expiratwn 3t23/2012 !'onur,ivsibner 'Sr# tJ646 z i n = od of Briltig Regina ions.and Standards One A9hbu ton Place - Room 001 E Boston;_Tv.rassachusetts.02108 t om m,'r' o�vement..contractor Re strat �n Registration: �' ,: �� � �� TYpe;. private��rPe�i�ll®fl • Eicpirati®n 7/2 Tt $w 4 MOON ASSO [N JAMES MOW. k - !3 -- 11371 �. " '' :'' Update Address and r�,uru surd,rT1?arlt+.Ymtlik ftki ! z • L. Address.. �:. � l�01ke>vai`"[:_� li;tltllf0�I11e11t ` oPS-CA1 %I 5om-oWo6-Pgmb r F \ 110flrti aP i)ti{ltiia 14E ►Irstioae fiatl toad rris License or registratlon Yaild for}indl►IQui 03e ttfll li09 IMPROV( NiIN CONTRACTOR. 'before the expiratkiou date-'.Tk ftiu>id t�furn iit : +Board of>t3uilding ftc�ulakltlub untl:�iandiirtl� one Asl'burtau[lose ftiu-t01 E- Fifa'ffit3A, 7/24/2000 Tr#. V130185 r,. t P 'Roston,Aga.0210 t T �, itiv to Corporation MOON Am 9 1 NO JAMff§ MOON 1197 PARK W 9� X tfliOOfyOOir',R!i� 9i� Adminlsrretor Nat va►dttltdiit 3lgnutitr� ; gl h r has n Df _ V'o -L10_�. H1C: Registration Lookup Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Mass.Gov Consumer Affairs and Business Regulation Home-> (OrSUIre-r> Housing Information > Home Improvement Contractor Progra ' > RELATED LINKS Home Improvement Contractor Registration Lookup alone Improvement Contractor The list is current as of Thursday,August 06, 2009. Registration.Home Page You can search/filter the registration list by any of the criteria below. Search by Registration Number r119535 Searc Search by Business Name Search by Contact Last Name First Search by City _ W...:.: Zip Code Search Search by Last Name __ � First _ Search by City Zip.Code Search: Search Results BUSINESS CONTACT EXPIRATION COMPLAINT NAME NAME LICENSE RESTRICTION 'ADDRESS DATE STATUS 1137 PARK EAST DR. N/A DAMES' 119535 WOONSOCKET,RI 7/24/2011 Normal 02895 ©2009 Commonwealth of Massachusetts http://db.state.ma.us/homeimprovement/licenseelist.asp 8/6/2009 a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 'Map v - Parcel Permit# Health Division � G� Date Issued Conservation Division . 3 12- Fee �� N� x 1Tax Colle >i STEM 11US SEPTIC SY Treasur r INSTALLED INCOMPLIA�NC' Ir.m Planning'D`ept. ;• WITH TITLE 5 ENVIRONMENTAL COS Il Date Definitive Plan Approved by Planning Board ,`' TOWN REGULATiMS Histo • H Preservation/Hyannis Project Street Address I N d 8 a ,1 L5A R> . Village Owner Address )OA :Sle6�E6 .2/ll &622&6, L. TelephonePermit Request � aCd� 61"h!5STYkc A-aDiridN Y14C +Ynti-L, .46/n'1A,5e) a^,d Square feet: 1st floor: existing proposed d 50�2nd floor:existing proposed 'i Total new a Estimated Project Cost -30, Zr&V Zoning District Flood Plain Groundwater Overlay Construction Type 600D t omle_ Lot Size Grandfathered: ❑Yes $4% If yes, attach supporting documentation. Dwelling Type: Single Family a Two Family ❑ Multi-Family(#units)' Age of Existing Structure %ate Historic House: ❑Yes (J�No On Old King's Highway: ❑Yes to Basement Type: �Full ❑Crawl ❑Walkout ❑Other ` Basement Finished Area(sq.ft.) t t Basement Unfinished Area(sq.ft) Number of Baths: Full: existing c5� new Half:existing new Number of Bedrooms: existing 3 new _ Total Room Count(no;Gas cludin baths):existing new First Floor Room Count Heat Type and Fuel; � ❑Oil ❑Electric ❑Other Central Air: ❑Yes Fireplaces:Existing New Existing wood/coal stove: ❑Yes Odeo Detached garage:❑existing ❑new size K&C Poo:❑existing ❑new size Barn:❑existing ❑new size 'Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# /l( Recorded❑ Commercial ❑Yes M No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name 0,V1 S/hPP,O UE1rn� Telephone Number Address E(w-i 00 N R : License# C� S °fo"t /74q CoTLJ l i M rA OQ�35✓ Home Improvement Contractor# 1 UO 74o Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ooW-4 d) 5't[. SIGNATURE DATE _ ��41 J., - FOR OFFICIAL USE ONLY, PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS. '' :w VILLAGE OWNER 'r ,'i - , •' � _ - 4 , r . -a - r.r I tit DATE OF INSPECTION • 1 r FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING:. ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT -r ASSOCIATION.PLAN NO. • � rI The Town of Barnstable • a�n*tai'Au�r • 95 � �' Department of Health Safety and Environmental Services ` °r ; ��� 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 other requirements. Ome P1-C;iUrC Type of Work: �,, Est. Cost ll��nl•J �d . 1 (1 Address of Work: /V/) �-� ' `'e n l Z le Owner's Name .()PIep l &tL AJ6 Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. 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 Owners Name e commonweaun 0 Department of Industrial Accidents Office 911nuffooffoos �- 600 Washington Street Boston,Mass. 02111 —' Workers' Com ensation Insurance Affidavit a name: n - location: � `�-/r�.�Q.n1�� `�C.1J( ' city q J-3l0 ❑ I am a homeowner performing work myself. ❑ I am a sole etor and have no one workcin in acity I am an employer providing workers' compensate n for my employees working on this job. I .::. cum env name. -gadress .... a hone# c ,� . .. lnsetranee ca '; _. .: oki # .. . .. ... ❑ 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. ......... con any name. 2i3i i:? ^:% ;:;: :>;;?;:::Y :.';:;ii:3:::i:r>:i::� ?:;i3 i'?:;;2 %:;;;: :......:......... ...: :;..::,:..::.::.........:.::.;.,.....::;;::..:::::.::::..:.:::..:......................:.::.:.........:..,.....:::....................... <z>•: b: ::::•:: :::: s: 2:.;;;5;s;: ;;::< s+:: ;:>. c: C::i:`:::: ::s::i:` ;';: ;::;;:%:>::';5: ;:::1: ;::<:;:;:;:::; ;::::;:.;;,.;;. ;;;: ;::;:�:.:,.<j:?.......... address:. .__... ..._... ._..... .. . ...._. _.._.... .. :,:.: ..:ff :.:.:.::.:.. ,...... > .........:..... :a :::::.::::..::.�:::::::::: :::::::::::::::::.�:::: :.::::....,..:::::::.�:::.:........................ :. .:.: :::::::::' :::::.:.::...::::.:::^l�i:!C::f:OT:^iT:i:.�:TY.Q`.^>ylH.AW.v.•:w:i!4:i:: ahsnrance.ca. oGce# .... ........ aav name: ..................;;:;:,:.:;;: ...... :>:;; ;<;, :.:..:.: address :: ... hene#. .... ...... ...........................................................................................:::.:... ::v::.�' .. .::::.:. .. .. ..................................... .....:::.:.....:.::.}:•:::....v........:::..... ....::::::::i:.....:.::.:::::....::::i.. .:..................... ....v.:........ .. .. .. ..................................................................:.......:.:::::......... :::: :. ..........................::........:.:: :;:,w \M ..;::...::.:.:::.::.:............:. . . •.....:::.......::......:.....:..:.::.:::::::•.:......::...:::.:::::.::..:.:. �'H '.na....!!!:!is n"rsnce cQ:.: uliev#. X. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a am up to sl_smoo and/or one years'imprisonment as well as dvil penalties in the form of a STOP WORK ORDER and a tine of$100.00 a day against me. I understand&at a copy of this statement may be forwarded to the Offfce of Investigations of the DIA for coverage verification. I do hereby certify under the pains �aJnd penalties of pperjury that the information provided above is tru.-and correct. Date Prini name �'C TJE�1�� ��- f�s N Phame# / b— 915 A; otIIdal use only do not write in this area to be completed by city or town offida1 dty or town: permttlliemse# ❑gdldhng Department ❑Lieensuq Board checicif immediate rmpumm is required ❑SeleettneWs Ogee _ ❑Health Department contact person: phone#; ❑Other Omod 9195 Y1N ✓he VronvnzaneveaN o1,A4zjjacXuJef 0EPARTijjENT ')F PU8LI, :;AFETY :0NSTRUCT70N' Sli:'_RV:SOR EN Number: , :a-r_ CS a9l464 02'>.+f'_001) { �/ce�aamrnontaea�i o�/�aatac%uaellb Re5�ClCted T0: )I:1 ',? HOME IMPROVEMENT CONTRACTOR . /THOMAS CAP I' i Regist'rat>on, 1067.40.< :6dS NEWTO!JN O Type PRIVATE CORPORATION ,OrhiT, :ip 9-6s; 'Expiration ' . 06/23/00 aCAPIZZI HOME :IMPROVEMENT,:INC as. Capizzi, Sr 1 45 Newton Rd 's ADMINISTRATOR Cotui _MA 02635 t` - -- . ✓he �anv»za�rzzueah� a�:.G�Czu:ac�adeCf DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number: Expires: x Restricted Ta;: 98 TNOMASl-z`CAPI7_ZI JR PERCIVAL OR :I W BARNSTABLE, MA 02668Y [� `� �✓!te l/]O�llt/IYEO)tt/Jealli2 O`�.�G�JLLCiGaJO.� DEPARTMENT PUBLIC ARIMENT OF JBl_C SAFETY r f CONSTRUCTION SUPERVISOR LLCENc c Number: expires: __- Restricted To; 00 _ FREDER-ICK.V RASC4 III ia60 BOURNE RO PLYMOUTH. MA 02360 BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE•PRI'-kT: JOB LOCATION: rZZ� � N L _ STREET VILLAGE OWNER OF PROPERTY: Llyd "- b.L[� CONSTRUCTION SUPERVISOR: NA`>✓ LICENSE NO. PHC\r. NO. ADDRES S: 1&75- LICENSED DESIGNEE: /00 "77'10 (IF OTHER TH-0 SUPERVISO NAME V LICENSE NO. 2.15 RES?ONSIBILITY OF EACH LICENSE HOLDER: 2.15.1 THE LICENSE HOLDER SHALL BE Fi,-LLY AND COMPLETY RESPONSIBLE FOR ALL WORK FOR WHICH HE IS SUPERVISING. HE S_iiL BE RESPONSIBLE FOR SEEING rHkT ALL WORK IS DONE PURSUANT TO THE STAT2 BUILDING CODE AND T'r.E DR.-.WINGS AS APPROVED BY THE BUILDING OFFIC-=J. 2.15.2 THE LICENSE HOLDER SiiLILL BE RES?ONSZBLE TO SU?ERVISE THE CONSTRUCTION, RECONSTRUCTION, ALTER.4TZON, REPAIR, {OVAL OR DaMOLT=ZON INVOLVING T::E STR?TCiJF-? EL='��VTS OF BU_iPTNG AND STRUCTURES ONLY ?LRSul i>iT TO THE STATE BUILDING CODE AND ALL OT HER Alp?L=CABL2 L:':J OF ir.E COMMON'wE-A TH EVEN T=OUGH H� %2 LICENSE HOLDER IS NOT THE V7RMI' BUT -, � .� i HOLDER B ON - z SUB- CONTRACTOR OR CONTRACTOR TO TEE PE YT-T HOLDER. 2.15. 3 THE LICENSE HOLDER Sr-.r L I'rMIEDIa T_L Y NOTIFY THE BUILDLgG C--ZCI_AL IN lWRI_:`;G OF THE DISCOVERY OF ANY VIO'_;TIOtiS WriICH A.RE COVERED BY THE BUILDING PERMIT. 2.15.4 ANY LICENSEE Wc0 SKILL WILL777. .I VIOLATE SUBSECTIONS 2.15 . 1, 2.15.2 OR 2.1;-3 OR ANY OTHER SECTION OF THESE RULES ANTO REGUL MONS AND ANY PROCEDURES, AS MENDED, SHALL 3E SUBJECT TO REVOCATION OR SUS?=-NSION Or' LICENSE BY THE BOARD. 2.16. ALL BUILDING PE?_'.IT APPLICATIONS S'rALL CONTAIN THE NA-M.- SIGNATURE A\TD LICENSE NUMBER OF THE CONSTRUCTION SUPERVISOR S-'O IS TO SUPERVISE THOSE PERSONS ENGAGED IN CONSTRUCTION, RECON- STRUCTION, ALTERATION, R=PAIR, REMOV:L. OF DEuOLITION AS REGUI A.TED BY SECTION 100, 1.? OF T'r.E CODE AND THESE RULES AND REGULATIONS. IN THE EVENT TF�T SUCH LICENSEE IS NO LONGER SUPERVISING SAID PERSONS, THE WOF{ S ,?L CEASE UNTIL A SUCCESSOR LTCLNSE HOLDER IS SUBSTITUTED ON TEE RECORDS OF T':<E BUILDING DEP?RVT. I HAVE READ AND UNDERSTAND MY RES?ONSIBILITIES UNDER THE- RULES AND REGULATIONS 'FOR LICENSING CON- STRUCTION SUPERVISORS 'N ACCORDANCE SECTION 109.1.1 OF T::E STATE BUILDING CODE. I UNDE35T_::: THE CONSTRUCTION INS?=:TION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILDING OFFICIAL. INSURANCE CCVEAA CE: I have a current liab'- - insurance pciicy or its su`:stcrtiaj equivalent which me-ts the requirements cf MCLCh.152 yes No ❑ - If you have checked_. ;,'.ease indicte the ' ;:c coverage by checking the box. A liability insurance Yc:ic( r O:her type of :.idemnity❑ Pond Cl OWNER'S INSURA CE WAIVER: I am aware that the rcansee dzes not have the insurance cover;e recuire= Chz^ter152 of the !.Sass. Ge ern.1 L-ws, an-- t~at my signature on tn:s err,.0 .--'i^ .,cn w rn.zn- �' D ...� �:'` acves this require .._ AdAjCheck one: a 21A Owner Agent l — Signature of Gti•ner cr O.yner ent SIGNATURE: ��/ BUILDING OFFICIAL APPROVAL: ' nyts+rmva,r . TOWN OF BARNSTABLE ' Permit .No- _.--_25645 I D� Building Inspector, :.:,. 4 + rrnc 7 Cash X DAM OCCUPANCY PERMIT, Bond ____-___..__.____L�__.__ Issued.to S L S TruS t ,.: Address'. lot #33�,, 9 Nobadeer Road, Centerville Wiring Inspector i ` 1 k�� Inspection date Plumbing Inspecto wyc� Inspection date Gas Inspector Inspection date Engineering Department.G✓ C_L[; „���2G.t�l���s ;_ �;-Inspection datelf- ' / i ,'Board of health , ' `` '/ x. ,Inspection date7�f';; THIS PERMIT 'ICI LL/NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY 11eBUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND :IN ACCORDANCE WITH SECTION 119.0 OF'THE MASSACHUSETTS STATE BUILDING CODE. �• .............................................. _._ Building'Inspector l 3h 5 - 1 U O `-- O T J -4 4 � r� NI ay nt� _ J e u(A L. lL •'� ' eSMr. I��' u/IUr 6:;-t4T I P I CATWN On the basis of my knowledge, information and �e'* gip' belief, I certify to The 0�LagrngvG I�jAtzhl'�T4.�L,� 1_N�A-55. that as a result of a survey made on the ground T onZol6ljU 9 I find that: The structures) are located on: the site as WM M vU,�tzvillt,h � P55�c.lniC Shown.In 6C,�i;41i v�be Tc,0/? Zor7,4 y /,�r1_�auJs e10 k-- lb-9 1, Q O , tr-..L►A oV T 44 ,Kb- 56 'The title lines and lines of occupation of the tN 0.F site are as shomi hereon. h The site is situated in Flood Zdone�t/oh-�Q w►«t^M Community Panel lio.ZScm/ eme,13 Date: o r WA « Date: William 1.. Warwick,ALS E, Ashessor's•map and lot number ........................... .::. - Tx Sewage Permit number I BAREST LE i House number ................................................. 90os,M639• e�. re 'EoMAR A. ` TOWN OF BARNSTABLE BUILDING 11SPECTOR r, . : APPLICATION FOR PERMIT TO ....... .I......:.�.%.. % , ....... ......:.. TYPE OF CONSTRUCTION .....................( .1. ..1✓......... v................................. j ............. ..................19 , TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following formation: Location ........4e ,77........ ... . . E ��r?-�� ..��-� .�..1 ............... 3. ... ® .. ... ........................................................................... Proposed Use ..:............ ....�d.. ........P. .�/ Zoning District ......................... ..`m?.. ..........................Fire District ................... Name of Owner ...j. ..�...1......... ....../. c ................................... ..(.. .......Address .. ................ r ........ ...� � Nameof Builder ......Address .................................................................................... Name of Architect �r,Q�.�.N..�J.�e / . .Address . �—/j Number of Rooms �„/ fg.-....O.rev ............. .. .........................................Foundation .... ..... Exterior .......�y,?'..Yl.� ����. 5..........................................Roofing ..... �� Floors ...� t � ,I/..r- �.��. � ........ Interior .....��.. . ............................ Heating .. . ................................................Plumbing ..P ....... .�."..........�.. � Gi Fireplace .. ..................................................................Approximate Cost .......... (�/..V ........... ... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area .........!.........D.................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH to �� \N OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to oil the Rules and Regulations of the T wn of Barnst9me regarding the above construction. Name ,. .............. Constructio Supervisor's Licensee.. ./../.....'. o . , . No~~ �3564.5_ Permit for 1'i-2_StoU.____. ' . . . . . . ' ' Si Dwelling ' - ----.^_--._—'`^----.����^-----. Location 9 ���cl --- —.. --.—.-.--. -- ' Ce�� l� ---'-�—'—''°~—^===---''r------'' Owner -_St._I^_S_]Croot._.________ ` , ' of C�nm�uci��o ...�Ir�����.—__.____.. '�' --''--~~—^^`~~'' ................................................ , Plot .. ---,.—, .— Lot '':--_------. ^ . ' ~~ Ootober l3', 83' � Permit . -�---.--._--. ..�—..lg Qota'nf1nxpection -------.-----.lq ~~' -Completed ^_� -_ . 4r . . -- ' � ~. . Assessor's map and lot number ......... THE h Sewage Permit number ...................... A NARNSTABIL House number ... .......................................................... rasa t639- 0 M TOWN OF BARNSTABLE BUILDING . INSPECTOR APPLICATION FOR PERMIT .TO .... ........................................... ................................................ .....................tom........ ....... .......... ........ TYPE OF CONSTRUCTION ...................... �2...0......... ................................. ............. .................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ '77 P-,-V......... ............................................. . ...... .............................. Proposed Use ................I I ........... ....... ..Le....................... ......................................................................... � I / C � Zoning District ......................... .......................Fire District ............................ ...................................... ........................................ C- - F -� 11P 1,1y;P,0jw? ...........;.............. ............................. . Name of Owner .... .......... ........... .....................................Address .Name of Builder ......Address .................................................................................... Address 7 4 i� Name of Architect 1. 9*------******** Number of Rooms ....................... Z. ........ ........................................Foundation ....Ve�. Exterior ...... .........................................Roofing ..... P�A�47............ Ap 1 ,4 ............... i I& ...Interior ...........; .........-2—c. <�:X....... ........................................ Floors ...... 71e�TIC, Heating ............Plumbing .....JPJA................. ...... . .............................................. ... ...... . Fireplace ... ............ .. ............................................................Approximate Cost .......... Ap ...................... �.- Definitive Plan Approved by Planning Board ----------------------------- Area ........1.. .1...... .7.................. Diagram of Lot and Building with Dimensions Fee ...... .................... SUBJECT TO APPROVAL OF BOARD OF HEALTH (-Ao k A. 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 C................................. S L S TRUST A=250-41 & 40 2645 1-1-2Story No ................. Permit for .................................... Single Family Dwelling ..........:.................................................................... Location ,Lot 33, 9 Nobadeer Road ............................................... Centerville ............................................................................... Owner ....S. L S Trust .................................................. Type of Construction ......Frame...... .............................. ................................................................................ Plot ............................ Lot ........................... October 13, 83 Permit Granted ........................................19 Date of Inspection .....................................19 Date Completed ......................................19 7-4 { TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION' Map Parcel .1 3 Permit# .Z Iealti-Biwsie Date Issued S 2 n Fee Tax Collector Treasurer ; RwWk@-Dept. F l Date Definitive Plan Approved by Planning Board H%Imt--f" fi P.resewa#+e /#yaA1+s Project Street Address Village l /-71;X 1✓y Lt j:� Y 7 Owner PiV-4 A!1�_AJ (.c L���4 Address. 10k sl&AA Xo Llt nb.l`a, �. Telephone (Sfo 3) `13 6 —=6-7 a `7!' Permit Request e. e L(C e L. W ,- 01� IS&M� Me �iz 00&r%i"nA , .o w f✓ Q.33 i n p leee Square feet: 1st floor:existing--.,.-- proposed 2nd floor:existing proposed Total new Estimated Project Cost 15W Zoning District Flood Plain Groundwater Overlay Construction Type LA D h& Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family..(#units) Age of Existing Structure Historic House: ❑Yes aw_o, On Old King's Highway: ❑Yes meoo Basement Type: ❑Full ❑Crawl .❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new . Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existin 'wood/coal stove: ❑Yes ❑No P 9 9 Detached garage:O existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization, ❑ Appeal# Recorded❑ a Commercial ❑Yes Ul o If yes,site plan review# Current Use Proposed Use JS V � - BUILDER INFORMATION Name izZ.j ding rih.gow—vicar Telephone Number q(;LT-�Cisl T Address J(2q_J5" GS�I 1�. License# 0,S 612_`7 - 0`jULr _rY1,a Dalo 3 Home Improvement Contractor# 160940 Worker's Compensation# we�5g":2 4 �g ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE� ^� �. G1,a P�t, �DATE FOR OFFICIAL USE ONLY PERMIT NO. -t r DATE ISSUED MAP/PARCEL-NO. • ,* � rya_i ~} . a. ` ro ', .7 +[ 'T .. -� t � `� t,. r ADDRESS t 1 VILLAGE OWNER DATE OF INSPECTION , FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH. FINAL y' PLUMBING: ROUGH FINAL GAS: r ROUGH s`. .FINAL FINAL BUILDING DATE CLOSED OUT a ASSOCIATION PLAN NO. • '