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HomeMy WebLinkAbout0095 OAKVIEW TERRACE � � { s .; ,. 6 r Jr ip / I �i ��ti` I �� _ lb ' �a �' � 1� � Sews �''�e �� ���� ' I � (� Sm�, �,� ; GF� �, ^^ I (per Y �j i qozj oFt ram, Town of Barnstable *Permi #' it mor h Ezp s{eom iss e�— = WTRegulatory Services F HAerlsrna Richard V.Scali, Director rFo��A APR - 9 2014 Building Division Perry,CBO,Building Commissioner TOWN OF BARNSTA 00 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY j of Valid without Red X-Press Imprint , Map/parcel Number (, Property Address l r f. 4 , ©Residential Value of Work$ 2- '0A / Minimum fee of$35.00 for work under$6000.00 Owner's Name&AddressA Imh��< 1 c Contractor's Name ��� � G �, Telephone Number Home Improvement Contractor License#(if applicable) - Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance C�heck ne: L­r 1 am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance - Insurance Company Name �o7- k: �t Workman's Comp.Policy#ter Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) [�-Ie-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to L>U l ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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. SIGNATURE: , if Q:\WPFILES\FORMS\building`permit forms XPRESS.doc Revised 061313 ' � , „ o�✓ aaaac�urae�a License or reg►stxataon-valid for mdividul use only; Office of Con Aff, B smess_Regulatign ijefore the expiration date. If found 01e n,to HOME IMPROVEMENT CONTRACTOR TyN� Office of Consumer Affairs and Business Regulation Registration 150919 10 Parh Plaza Suite 5170 DEN. �.. Expiration. 5/812014 haston,MA 0211b BIL SWANSON/BULLD7GREMLING. / 1 WILLIAM SWANSON 50 CAMELOT RD. �. G �% , BREVVSTER,MA 0253a Underse retar/ i ` Not valid" it out signature 4 Massachusetts - Department of Public Safety Board of Building Regulations and Standards . Construction Supervisor I & 2 Family $ License: CSFA-046164Ty WILLIAM A SWAjYSO 50 CAMELOT RI;i N BREWSTER MA7,0263, 1 9 i J,•�...� ,4 )r,u�` Expiration 04/25/2015 Commissioner r 1 04/07/2014 06:12PM 5084324588 PAGE 02 t so,. Town of Barnstable Regulatory Services Ricb"V.scale,Interim Director Building Division ; Thomas Peary,CBO Btdlding comoner 200 MM Street, Hysm*MA 02601 www.town.barnstable. w Office: 508-N2-4038 Fax: 508-790.6230 Property Owner Must Complete and Sign This Section If Using A Builder John�Bern - rdes of subject property hereby authorise ' to act oa my behalf, in all matters relative zv`wer -authorizb&bp ti is.b�'petu t application for. 95 Oakview Terrace Hyannis (Address of job) 4I7i14 1-4 M f Omer Daze hn Bernardes Piint Name if Property owner is applying for permit Ohm compile the Homeowners License ftemptim Farm an Me reverse sde. TAJCEvna P%Wtd;ngchu*uWU% ss P stl ss.eoc Revised 061313 The Commonwealth of Massachusetts, Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: 43 637&4�4/ 4 City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): L❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.�am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g° ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their I I- Plumbing repairs or additions 3.❑ I am a homeowner doing all work ❑ g P ° myself. [No workers' comp. right of exemption per MGL 12.E2400f 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..Lie.#: Expiration Date: Job Site Address: City/State/Zip: 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 the pains and enalties ofperjury that the information provided above is true and correct Si ature: Date: ll 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): 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 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 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,if necessary,supply sub-contractors)name(s),addresses)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 permittlicense 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.Anew 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 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia yw l.;ti iVa 'SS to Ue :r �ERTIFICATE. OF L�ABILITI JR�C° Y 4 e a1� DATE(MM/DDJYYYYj 01: 4/2014 k ° THIS CER FICA�E 181ss1►ED A MATTER OF INFORMATION ONLY AND:CONFERS NO RIGHTS ON THE CERTIFICATE'.. { /inSl1r811Ce HOLDER THIS CERTIFICATE DOES N"0' D EXTEND AMEN OR j ALTER THE COVERAGE AFFORpED BY_THE POUCIES.'BELOW. y, ster; MA 04613. MUMS AFFORDING COVERAGE 7 NauRED +, , NAIC 0INSURFRA Trans!®IS insurance 7-- Willliam A. Swanson INSURER ;r •. INSUREii9; .` �. 50 Camelot Road ER C: , Brewster,-MA 02631 INSURER D: ;s ¢ INSURER'S' #F COVERAGES r THE POLICIES OF INSURANCE LISTED BELOW HAVE;BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE;ISSUED OR MAY, PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL NE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INeRo TYPE OF INSURANCE POLICY NUMBER TTE IMM qT / LIMITS GENERALLIABILITY EACH OCCURRENCE WL $ C4MMFtG GENERAL LIA91LrtY REM 5 ENTED- ❑ CLAIMS MADE OCCUR P. I ES Ea o } , Q1,7ME EX (Any orte -, 80NAL&:ADV INJURY € e a PER N _ j , GENERALAGGREGATE . ' $ '�- - GEN'L`AGGREGATE LIMITAPPLIE$Pr iZ; - - - - '�^' ' PRODUCTS COMPlOP AGG $ POLICY PROJECT LOC _. It AUTOMOBILE LIABILITY ` ANY AUTO E�SINEaD SINGLE LIMB 0 R ALL OWNED AUTOS [ /+? x SCHEDULED AUTOS BODILY INJURI� x g I I 2: F HIRED AUTOS IL ^ BODILY INJURY*1 >1 + { + W. s NON,O WNED AUTOS ' t i. r (Pe[BCCItlB,tl)z 1:';€ am 'PROPERTY AMAGE r (Peraceldent)_t I '1t1 GE LIABILITY AUTO ONLY-,ACCIDENT„ `{, + ANY AUTO .'EAACC ?,J�" 'i •� AUTO ONLY. AGG EXCEBS/UMBRELLA LIABILITY EACH OCCURRENCE' $ t 1 OCCUR CLAIMS MADE AGGREGATE- $ �xl .y Y'+ L L ^TIBI..E c�F �� -f.•� '`+rl'.ES � ,�' �(''�,,,Y#" $, -c !' i 4RETENTI k• VYORKERS OOMPENS AT10N AND - $ O E i,. ::. .. J EMPL Y k>3•LIABILITY a _ _ TORY LIMITS' 'ER A ANY PROPRIETOR/PARTNER/EXECuTIvE IEUBAA25360-A-13 05N6/2013 0.5116/2014 . E.L.EACIincclOENr $< T100,000 OPFICER/MEMBER EXCLUDED? 1;p0,000 IFyyeee;dasrr;ho under 1 EL DISEASE.EA EMPLOYEE'- $ SPECIAL PROVISIONS below s:,l• 00,000 DISEASE-POLICY LIMI $ OTHER 47 �+ R � VUilllam Swanson ie covered by the workers compensation policy.,' .. . .- . , i = CERTIFICATE HOLDER CANCELLATION ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE, ANCp,I.ED BEFORE}TN6 6J 1RATION Town of ftfmstable = t ZDO Ma111;Stfeet ATE THEREOF,THE ISSUING INSURER WILL LNDF11VOjr-i MAIE 1- ' DAYS,WRITTEN, . "r x NOTICE TO'THE CER7IRICA7E�R7 R F1A91�Et D T t FT BUT FAILURE TO DU Bp,S/1ALL ` 'i Hyannis MA-02601 . 1 a # IMPOSE NO OBLIGATION OR LIABILITY OF ApY klNq UPON THE INBH -AM OR EPREBENTATIVEFi• " *UTAORVE6RE1PRESE6IfATNfi vtst M ti;:i \ w 3 'ACORD.25 20 1. U /OS) , U-®ACQRI ( ,CORP OiRKKfji&1988 r ' .. Date is, CERTIFICATE OF LIABILITY INSURANCE r: oaTE(MevoDrrvva) ` r, �A1/14120.14 TENS CERTIFICATE IS ISSUED AS A'MATTER OF:INFORNIQTION insurance ONLY AND CONFERS No RIGHTS`-UPON THE CER"10, E �:�3144 HOLDER.THIS CERTIFICATE DOES NOT AMEND,.EXTEND OR ' �Sier, MA OT613 ALTER THE COVERAGE AFFORp�p BY THE PbL1c:1ES BLOW ' INSUREDS AFFORDING CO 1/ERAGE ABURED IN9URER.J ', Tfdvesi Insurance k WlllimA. Swanson INSURERe; . 50 Camelot Road INSURER C: Brewster, MA 02631 )NBURERD: INSURER I,; COVERAGES - -THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOT WITWBTAN, ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO-,WHICH THIS CERTIFICATE MAY BE 1SSU,ED OR:(ti11Y }; PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN.15.5UBJECT TO ALL THE TERMS EXCLUSIONS'AND CONDITIONS'OE SUCH;';i 1 POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.. INSK LTR INeRD TYPE OF,INBURANCE POLICY NUMBER_ TE.IM TE " .LIAAITS GENERAL LIABILITY EACH OCCURRENCE 8 COMMERCIAL GENERAL LIABILITY, ENTER .CERIMS MP�DE, ..000UR PREMI ES Ea e S L MED DT(Any one Pelson) ffi ,r PBR80NAL'&.ADV INJURY GENERAL,AGGREGATE GEN'L AGGREGATE LIMITAPPLIESPER: PRODUCTS.COIdPfOPAGG $' Y POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMB S ANY AUTO (Ea accidan1)_ ALL OWNED AUTO$ -4.� BODILY INJURY SCHEDULED AUTOS `(Par parzon)�lit $ MIRED AUTOSBODILY INJURY I' $-: VM = NON 1 r nl'•NON-OWNED AUTOS Pee de°0 UT x • ..',. I ram- a� u PROPERTY DAMAGE" (Per awident) �L $ . GA GE LI ABILITY RA A6 ILITY - —AUTO {{ rm A UTO ONLY_ 9 ACCIDENT. $�.. ANY AUTO _ OTHER THAN �: EA ACC $jI AUTO oNLr AGG. $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE DEDUCTIBLE RETEN TI N O $ r - s NfOR11((�gg OOMPENBATION AND _ I?MPLOYERB'LIABILITY a ✓ .TORY.LIMITS ER A ANYPROPRIETORJPARTNERJEXECUTIVE IEUSAA25360-A-13 05/16/2013 05/16/2014' E.L.EACH ACCIDENT $ 100,000 OFF-ICERWEMBER EXCLUDED? IFveg,descrho under ye ELDISEASE.64 EMPLpYEE... g 1 RP 000. 5PECIAL PROVISIONS Defow- E.L_DtSEgSE,POLICY LIMI S 00,000 OTHER : _.. - .. . : _William Swanson is covered-by the workers compensation policy. 4- CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED SEFORG THE EXPIRATION Town of Baimstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL $ DAYS W RIITEPI 200 Main Street Hyannis, MA 02601 NOTICE TO THE CERTipICArE�HOLDER NAMED TO THE LEFT,BUT FAILURE TO p0 So SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIN¢UPON THE INSUROI rrS At#ENTS OR REPRESENTATIVES °? AUTHORIZED REPRESENTATNE w; �� s T Town of Barnstable *Permit# `7 -0 Expires 6 mouths from issue date C�STABGE, Regulatory.ServicesJA KAN• $ Thomas F.Geiler,Director sbg9• ♦0 '°TEv►r► Building Division Tom Perry, Building Commissioner X-PRESS PER 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 JUL 2 2 2004 Fax: 508-790-6230 j EXPRESS PEMT APPLICATION - RESIDENTIA L16F BARNSTABLE Not Valid witliout Red X-Press Imprint Map/parcel Number Property Address Value of Work r 2-feesidentW Owner's Name&Address ev 4' t Afc ) i Name � ,`,- � Telephone Number Contractor's Home Improvement Contractor License#(if applicable) Cons n Supervisor's.License#(if applicable) Workmen's Compensation Insurance Check one: ❑Wauasole proprietor he Homeowner Worker's Compensation Insurance Insurance Company Name 4m- ee Gc.#�- Workman's Comp•Policy# IYL W-C Aqs 1 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 ❑Re-roof(not stripping. Going over existing layers of roof) Vside lacement Windows. U-Value { .44) �' r1�p � *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. ome Impr ement Contractors License is required. Signature Q:Forms:expmtrg Revise053003 oF•cHe rod, Town of Barnstable Regulatory Services Thomas F.Geller,Director q s639 �� Building pivision �ATFo ,�a Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 VnM,toWn,b arnstable.ma,us Fax: 509-790-6230 Office: 508-862-4038 Property owner Must Complete and Sign This Section If Using A Budder as Owner of the subject property .'to act on my behalf:* hereby authorize all e to work authorized by*is buddings pet application for: in =natters relativ (Address of Job) y 7 � at�Ze 1gnature of e a Print Name 067-A-Q4 7 6100 Renovations Double Hunq - Vinyl Argon/Low E SC -- db - afaw 0 . 3f0 . 2 0 . 4 oft, %r - j 40 y '►"ti h I 11[1 s REFS s54f 9mm iJ mar oaa�t. '� w 4m Qcder 0.3367Z29O20001 40199 fm i h >,, 9osM of►ipHdteg ad Sntda"b } , Reafst��tion: 1M93 Types supoemw t Card Home Depot A1440me Semmes x �c AUOETTE 3200 COBB GALL.ERIA PMY M26 + 'TA.GA 30Ci.'i9 Ad9dm1%O~ r a 4tsse sor'sOffice.(1st floor) Map, Lot Permit#rvation Office(4th floor) ' — Date_ Issued Board of Health(3rd floor)(8:30-9:30/ :00-2:00) Q ^`: 'fZ�Fee ®� Engineering Dept. (3rd floor) House#1 SEC SX Definitive 19S' ALL ® TOWN OF BAR,NSTABLE ��"' Building'Peiriinit Application /Project StreTss lGt lc V!�iLJ ''�Village l Owner 2S pa;-f ZGLl7r 1 S�- . Address �'/'Q Yt1 .Telephone 7�d Permit Request a vz /aakt-" vy �` .NN:* QccG�t l o w l] //^ a U1S ,,/ t LUl /J� GUI "L � S�fv�.� �2t.�� ef' 'f� r�2N�G,icvi�+� Gt�fi��(c Total 1 Story Area(include 1 story garages&decks) square feet a 1 Total 2 Story Area(total of 1st& 2nd stories) square feet Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths .2 No.of Bedrooms Total Room Count(not including baths) b� First Floor Heat Type and Fue1N�411;;'/n Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other /J Builder Information Name . 10AI'VC1 �� ali D 6&1 / Telephone Number �,7 F/ 7 E.7 2 /Address y 7 PUr7`/ux) 7`G t--� --license# �r�/� L Q 3 1 3-1 ) Home Improvement Contractor# /B F 7 /Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE✓ / DATE ;7 z BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) r` -FOR OFFICIAL USE ONLY F w PERMIT NO. a DATE ISSUED ' MAP/PARCEL NO. ADDRESS y - VILLAGE OWNER 'j t ! k _ r DATE OF INSPECTION: FOUNDATION b' V" FRAME: INSULATION 'FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH 'FINAL GAS: ROUGH FINAL FINAL BUILDING V DATE CLOSED OUT � ASSOCIATION PLAN NO. ' ' r a • 4 To Data Time �•.�i� !AWHILE YOU WE )PUT M42 of Phone Area Code Nu er Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL Massage Operator �'+S\ AMPAD 23-021-200 SETS `1.11.] EFFICIENCYe 23-421 400 SETS CARBONLM The Town of Barnstable • BARNSTABLE. `• Department of Health Safety and Environmental Services MASS g t6 %F nAP•a Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection'( orrection Notice Type of Inspection Location �_� Permit Number --W Owner $��-S Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: oLT C:2 E A4A IE*�l a� Co F (Dv,— Val Y7-Y �.br --S Please call: 508-790(-`6227 for reeinspection. Inspected by Date 1I-' 2=1 ' q,!�- The Ctrnunonwealth of Massachusetts =1:_- Department of Inditstrial Accidents _ E 011iceo/lnvest/ga110ns '•', ': `fit 600 Washington Street Boston, Mass. 0 111 `- Workers' Compensation Insurance Affidavit Anphcant mformatlon: Pl/e/ase MINT lealbly sa name: location: / (/ //(e tA) r j U c• zzwNt� r •# 7�O /7V 1 am a homeo mer performing all work myself. I am a sole proprietor and have no one working to any capacity t-�.E �?�• ..t Tt+'..tt7 J tr3 T '�'.d�� :�Xi.:'W.!IPI'L'E�'•�"w7s's`+o'':d!M_e' L...dr:...��it�n.it'= —:!ai_-:as.�' Ms�f.+aiS3`�u.�tas ""ti�lauic.a.u.—____ --_ :._..a,.,._.::.r.. ,�'..,, ... rs •.,;•: _ r:rsi..-' _ 1 am an emplover providing workers' compensation for my employees working on this job. enmeany name: address: city: phone M . insurance co. policy# 1 a sole ro rie general contracto o homeowner(circle one)and have hired the contractors listed below who have the following worke a'olices: Loll coml►any name: � /NBC !f'•/NI,S L1 ��'t�w �,l �• ��Ct f� it ..t,f address: /d dlxea Zell city: p Clr,Sf� / v phone#: zr t/' insurance co. -SP I CYw�IOy policy# L»isi. ':.s... i _ :as sFi. a s�•sr°y= ram'z'^^t`+ � -" ia�`4i►ss�9�iC .r���?S47Cfi C/ +0�'. t'TM -=- ^zr!^9{x�rTM � J Zomnanv name: 111vvv/// address: '�D�Z / �4 city: �U Z Z0.r�S /TI- phone insurance co, icy if:Attach additional'stict t Failure to secure coverage as required under Section 25A of 111GL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do berehr CL�'ltlf�j under lire pains and penalties of perjury that the information provided above is true and correct. /Signature �//Gyve,y 1�7- -Date _7 — T Print name Phone# 4/ZS 7�2 3 �ofTicial use only do not write in this area to be completed by city or town official + . city or town: permidlicense# r'IBuilding Department Licensing Board check if immediate response is required OSelcctmcn's Office [311calth Department ' contact person: phone#; MOthcr (revised 3195 PIA) The Town of Barnstable g Department of Health Safety and Environmental Services 619. Building Division 367 Main street,Hyannis MA 02601 Office: 508 790-6227 Ralph Cross= F= 508 775-33" Building Commission: 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 pm-adsdng 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. �Tof`Work: lJil/e rQ o Est.Cost 1410 ✓Address of work: jj�y 41AI-V t,J /OR•ner.Name• e�lg S Za, l 1 � Sly Date of Permit Application: icy, I hereby certify that: Registration is not required for the following rcmon(s): „ Work cccluded by law Job under S1,000 Building not owner-occupied. Owner pulling own petmtt Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WPI'H Z�NREGIS'!'ERED 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 ovener l j Date Contractor name Registration No. OR Date Owner's name COMMONWEALTH 'DEPARTMENT OF PUBLIC SAFETY ' OF }" ONE ASHBORTON PLACE MASSACHUSETTS BOSTON,MA 02108 ' yd LICENSE EXPIRATION DATE CAUTION 10/28/1996 CONSTR. SUPERVISOR EFFECTIVE DATE LIC-NO' FOR PROTECTION AGAINST RESTRICTIONS THEFT, PUT RIGHT THUMB 00 08/16/1993 061060 "PRINT IN APPROPRIATE i y -. ; . BOX ON LICENSE. DONALD B CAMPBELL..? ="BLASTING OPERATORS 671 .MAIN ST POBX 1371 ,.MUST INCLUDE PHOTO. PHOTO(BLASTING OPR ONLY) FEE: -. tOTUIT MA .02635 - - i.- NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY FiUsra tepee"ss a Carraat . 'HEIGHT:, STAMPED-OR-SIGNATURE OF THE COMMISSIONER 'yasaaaAssittaStah Brlro�p� Q. THIS DOCUMENT MUST,BEf CARRIED ONTHE PERSON OF 1'. S RE OF LICENSEE « SIGN AIAME IN FULL ABOVE SIGNATURE LINE S. THE HOLDER WHEN EN-' OTHERS-RIGHT THUMB PRINT GAGED IN THISOCCUPATION. Iw- y4 � .yIOME IIiR Q EMEN. 1tAfTO �' ` }Regis d 1 879, ype D;I;'IDUA - r � ,� zpiat o 08k 5i �• 1 Pit ma 4 ''f ADMINISTRATOR � s J. v. AK VIE R = 52.50' O QCY L = 30.00' IT = LOT 46 co Jp N76.5 �10 103.28 ; 5 LOT LOT U, 48 45 o===iis- j�--___ cs r�. LOT --_ 47 � 230.12 5 N78.o4,14,,E " " MORTGAGE INSPECTION Plan is For FLOOD .ZONE.- "C" RES. ZONE.' RB This Bank Use Only TOWN: 1Y3'ANN6S ________-- REGISTRY OWNER: _aAAV 2_A-__ZV,&Q------------------ DEED REF: 3B115h _ _-- ___---BUYER• JWFJNA1YC,E------_-------- - DATE: _1WV__V1.---- _------ PLAN REF: _J4Q��� --------SCALE:1"= 40� FT. I HEREBY CERTIFY-'TO 1Y.QBfESTF.Ii Ca1111�T.Y_JuaV �H of .i4 YANKEE SURVEY FO_R_ SA V_IN_G_S____ ___ _____THAT THE BUILDING �`� SsS' SHOWN ON THIS PLAN IS-.LOCATED ON THE GROUND AS ��a�r PAUL ` , CONSULTANTS SHOWN AND THAT ITS POSITION DOES CONFORM A. In TO THE ZONING LAW SETBACK REQUIREMENTS OF THE ;= rnE irH 98 H 143 ROUTE 149. T �Jo. 32038 Q TOWN OF —RARAMSTABLF___ ___-----AND THAT •. . �o MA RSTONS MILLS, MA. 02648 IT DOES_ A Qf_- LIE WITHIN THE SPECIAL FLOOD HAZARD "\ pf':STE?�`SJr`. TEL 428-0055 AREA AS SHOWN ON THE H.U.D. MAP DATED 8091Q5__ ipNO FAX 420-5553 C m u n i t -Panel # 250001 0008 C `°�' • THIS PLAN NOT MADE FROM AN INSTRUMENT 7812 DFG` �A A. ERI EW PLS SURVEY NOT TO BE USED FOR FENCES ETC. j. VIE R = 52.50 A C E L = 30.00' OAKRR F : LOT# 46 -1b 6"58'40 N7 , 163'28 �� LOT LOT 45 _ 48------------- , Q%O LOT'.47 stern �- 5�`• 230.12' N78-04'14 E RES. ZONE.- "RB" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C" Bank Use Only TOWN: _b%ANX-15-_ __________ REGISTRY OWNER: ------------------ DEED REF: _ 3��51, -----------BUYER: JVZLYANCE---------------------------- --- -- DATE: -1Z1L�-2L--------------- PLAN REF: -34Q192 ____ _--____-SCALE:1"= 40-__FT. I HEREBY CERTIFY TO �Y.QBCESTER L WAT-'_IN�SJ1TSL71QN 6F ' yANKEE SURVEY FOR SA VINGS ______________THAT THE BUILDING ��4t`�H t�gs�r� SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS ,F> PAUL �. CONSULTANTS SHOWN AND THAT ITS POSITION DOES __-_ CONFORM ! A. In TO THE ZONING LAW SETBACK REQUIREMENTS OF THE MERITHEW N 143 ROUTE 149 r�-� o. 32os8 � TOWN OF _—_BARNRTARLE_____________AND THAT yo MARSTONS MILLS, MA. 02648 NOT °fc- ��` _�� _ IT DOES______ LIE WITHIN THE SPECIAL FLOOD HAZARD - „r, .atE. ,�, _ TEL 428 0055 AREA AS SHOWN ON THE H.U.D. MAP DATED 8/�9-/B5-- 0414< <ANO FAX 420-5553 C munit —Panel # 250001 0008 C q _ ___ ___ THIS PLAN NOT MADE FROM AN INSTRUMENT 7812 DPG AU A.—Iw1ERi EW PLS SURVEY NOT TO BE USED FOR FENCES ETC. i .'x To Date 6 Time WHILE YOU WERE OUT Of Phone Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT j RETURNED YOUR CALL Message cJ r Operator �1 AMPAD �JL] EFFICIENCYp 23-023 CARBONLESS -_2 Assessor's map and lot nunOer ............................................ Pao*.tNE Sewage Permit number . ... ....... SEPTIC SYSTEM MUST .. ......................................... . INSTALLED IN COMPLIA ARNS.TAXI, House number ..... r rasa ................................................................ WITH TITLE 5 ENVIRONMENTAL CO,F,-- ;A,' TOWN 'OF BARN-STARLE ""'.. BUILDING INSPECTOR kg....................... APPLICATION FOR PERMIT TO '00 TYPE OF CONSTRUCTION .... ... ..... ..... 7.4... ... .................9.161 ....... .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........................................................................... ProposedUse ........... .. ..........................................................I......................... Zoning District ......... ....................... ............Fire................. District ..................................... Name of Owner ... .. ............................. ...41 Nameof ................................................ ......................................... -------------- Nameof Architect ...................................................................Address ......................................................................... ........... Number of Rooms ........................61-1......................................Foundation ... .......kP Exterior 1P............................................Roofing ......A x.p. Je................................................ Floors ... ....... ....Interior .....f -2ecck................................ Heating .......... . .............................................................Plumbing` cop .. F.... .................... Fireplace ...................... ...........................................Approximate Cost .......... ......................... Definitive Plan Approved by Planning Board --------31---1-113----19--- Area . ....�. Diagram of Lot and Building with Dimensions Feoi I...........cz)ls .................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH / o I hereby agree to conform to all the Rules and Regulations of the.T6wn of Barnstable reg�g ding the above construction. 1 4/ 4 i-i. . ......... Name ........ . . ......... ....... ........... 1--C'!CAPRICORN REALTY TRUST On .$. .Q .. ............ No 2.25.7.9.... Permitfor ......G.. � ��7 ......... .......... -+ Location ..Lot. ...#47. .... ... 95 Oakview. . ...Terrac. e ,. ..... .. ..... . .... ..... ....... ..... ....... ... Hyannis ...................................:........... ............... Capricorn Realty Trust ; Owner .................................................................. ^ 1,ype'of Construction Frame Plot ......................... .. Lot :.......................... --• - Permit Granted ...... C. ober...1A.,.....:19 80 Date of Inspection .....................................19 f o;L- Date Completed ........!....... ............. 19 .. S S PERMIT REFUSED MW t ..... . .�. .... . t............ ......:. .,19 �. . .� ,§ ........ .."1t ..................................... ........... r ........ .. .............................................. t J f [ ... ... ..•.............................................. K.... 1 h Approved ................................................ 19 . ............................................................................... f ..................... ................................................. ... j - S \ :� .. - `'t t -I•'�.. tip. T '• 1. �• i - .., �(„ u � Nt "t 5 f JK Fv 5. -24 d' 1 \ ' V.). i Q o je j Z Q. u , SUNIMS i tiV SUR t :} 4 • CERTIFIED PLOW PLAN. " t WE L0 7" 4 7 )-1 V/� t,� --;; STRUCTION ONLY 4/ T1111 ®1y FOUNDATION IS .s& FEET ABOVE`ROAD L.Otl POINT OF ADJACENT A A' DIs ar A M SCALE: . A{- � ? DATE 40 CLIENT I CERTIFY Y HAY THE Lr®U�� W REGIS�EKED S�IO1�fN ON THIS- PLAN IS �,OCA7�® CIVIL Eff( JO® N®. �0 47 ON THE . GROUND AS INDICA lJCI D:L A NO i. EN®I�IEE' SUR EY®R DID �Yi /1. /I. / CONFORMS TO ,T�(�n g®WING �` i I •�� 0F ®A'Ili tV J.I ®b y 4W.A SS. 712 MAIN ST. CAI. Ov=' ? /? S�IE�`d'�®IB !' HYANNIS MASS. —. nagr� i i i F� ' ( i f � � f' Yr i �� � � � � � !� 1 � 1 .. t. { < i � � � ., � � F � i ti � , r y^' I. ` �� 4 .. �. 1 � _ ' ' i / .. i �• _ � � � ' �' I .# ` - i � � � ., � , r j ..�� � � i' 'i, ' ' ._ i �,�� �. ./ r x, --"OF' 'BA , NoTOWN RNSA Permit Buidarg Ins e.nn.n pector f �; sx Cash _ OCCU`PANCY PERMIT :Bond No building nor structured shall be erected, and n"o land, liiiildiig or structure ahall_be used for a new, different;;changed, or'enlarged mouse .w,ithout a: `Building, Permit therefor first laving been obtained.from the Building"Inspector..No building.shall be roccupied until a -'certificate:of-occupancy-_has been issued�'bythe Building Inspector.'' ' Issued c3 .to .:: 3ri' oYXt. RGa t H am i` ,9daress ti rLaf 4 r9 O31iV1@u' Teri 3Ct� ;y,"ay a. n s a. ;Wiring inspector Inspection date f • ,Plumb`in g 7hsP.- w'. Inspection date E s. Gas Inspecto n n :.` Inspection date- .._ " V •Engineering Department ' f J� r� �� r d . Inspection:date/+=. � � f r`'"X. THIS'.PERMIT WILL;'NOT BE VALID, AND THE BUILDING'-ShALI;_ NOT BE OCCUPYED UNTIL SIGNED BY THE ti.BUILDING INSPECTOR: UPON- SATISFACTORY: COMPLIANCE:,WITH :TOWN 7. -REQUIREMENTS ?Buildmg`Inspector { +: T. -- = f I�� � � a .� � _ .. _ — .. 4 I .• Y.,� ,�'� 1� . � le_:�aMilY..D�Kel ling................ ' Location ...4ot—A.47...g.5...Oakz/ieW`.Te.r.raoey � ..................UYA.ara,$--------------' � Capricorn, Realty Trust Type o, Cnn,/,up9p. ^ ' . . ". . � - � ~ � r",. .- ' Permit Granted ~ . "".e of .. ^ . Date Completed PERMIT REFUSED . . ' . . ' ' � __. ............. lV - // /� ^° ~ --'f°a�'`» '—''^—''^-----------'' ~ —.----.. ...--.---------------.. ' '---'—'' ............................................................ —.-------.-...—.—..---.----~...... ' ________-------- lq � ----------'---'--~^-----^'—'-- -------'---'------^^'`—'—^'~'—^^' | ' | . 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