HomeMy WebLinkAbout0038 PRAM ROAD 3� dram dad
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_ , °: The Town of Barnstable
9 ��,�' Department of Health Safety and Environmental Services
BuiIding Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crosen
BuiIding Co
Fax: 508-790-6230 I mmis:
For office use only
Permit no.'
Date AFFIDAVIT 11 '
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
Type of Work: �PR eF)Ui Est.Cost d l 7 A 0
Address of Work:
Owner's Name C
Date of Permit Application: 06 d�
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 WTITi UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME MPROVEMENT 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 en the o r,
Date Contractor Name Registration No.
Thc• C1,r1111101111'calt/1 of:3lasrachusetls
-*-J: = Departnlc•,rt of Industrial Accidents
Of fCgfff1nyeSflgatlanS
•:�j=;i + _.� . 600 Ma.v ii,rhtu t Street
'�-•�.�'��" � +`. Bustoa..11ass. (1?.111 •
Workcrs' Compensation Insurance Affidavit
�liliiicint inftirntatinn Plcnse MINT Z-lily ,
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Inc^rion
tct l-G u"tyL l° 0- O r`� to�v� nhnne Sf -57Y 1?
[I 1 am a homeowner performing all work myself.
1 am a soli: proprietor and have no one work-in_= in any capacity
r, I am an empiover providing workers' compensation for my employees working on this job.
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I am a sole proprietor. bcncral contractor. or homeowner(circle otre) and have hired the contractors listed below who
the following workers' compensation polices:
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incnr^•trr ro Holier
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Holier �_
incur^nrc rn -
Atiach additional sheet if necessary r_� �^— •�ai�ii - ^rr•��y ~-"`+~`'�� _—r~
F:,,iurc to�ecurc ctrr•crat:e as required under�ectton:.°A of I►1GL 1S2 can lead to the Imposition of enmtnal penalties of a line up to S1.50U.UU andiur
unc cars' imprisonment a. %•c11:ts civii penalties in the form of a STOP 1vORK ORDER and a fine of S100.00 a day against me. I understand that
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cope of thi..tatenicnt mar be forwarded to the Ofl;ce of lavestigations of the DIA for coveragc 1•eriftc2tion.
1 do herebt•cerri urr t: he air tr ear lric f perjun•that the information pror•ided above is true
and co//rrect.
S i^_nature
b Date / O ls9 -f 7
Print mine Phone#
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'�ofricial use uni�• do not c••rite in this area to be completed bg cin'or tott•n alTicial `�•
city or tnwn: permitilicense d rtua.sading Department
QLccnsint:Board
�. ❑ check iriminediate respunse is required Jeleetmen'+Uffier
t..
1. 011caith Department
contact person:
phone to nUthcr-----
Information and Instructions
Massachusetts General Liws chapter 152 section 25 requires all employers to provide workers' coillpensation Cor
employees. As quoted from the •'iaw-. an emploree is defined as every person in the service of another under uny
contract of hire, express or implied. oral or written.
An employer is defined as an indiv'dual, partnership. association. corporation or other legal entity. or any two or ,r
• ve rise. and including the le%al representatives of a deceased employer. or tic
the for�_om_ cn_a_s.d ut a 'dint cr rP _ p
J
rccci\•er or tntstce of an individual . partnership. association-or other legal entity. employing employees. Ho«`e•.,c-
owner of a dvelling llotl.se having not more than three apartments and who resides therein. or the occupant of the
do ellin`_ house of another who employs persons to do maintenance ;construction or repair work on such divellin__ .
or on the __rounds or building appurtenant thereto shall not because of such employment be deemed to bean empic:
MGi_ chapter 152 section `5 also states that even. state or local licensing agency shall witlthuld the issuance or
,1_1%,al of a license or permit to operate a business or to construct buildings in the commons calth for arty
icant who has not produced acceptable evidence of compliance with the insurhnce coverage required.
Ad.Lc-tonally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the
perforntz::ce of public wort: until acceptable evidence of compliance with the insurance requirements of this chart.:
been pre!:e:ited to the contracting authority.
-- - -�.
Applicants
Plt:=c .'ill in the workers* compensation affidavit completely, by checking the box that applies to.your situation anz
suppiving company names. address and phone numbers as all affidavits may be submitted to the Department of
Industrial .accidents for confir►nation of insurance coverage. Also be sure to sign and date the affidavit. The
-Javit should be returned to the cin, or town that tite application for the permit or license is being requested.
r ale Department of Industrial accidents. Should you have'anv questions regarding the "law- or if you are requi-:
.o obtain a «,ori:e-s' compensation policy. please call the Department at the number listed below.
City or rowns
Please be ;ure that the affida%•it is complete and printed legible. Tice Department has provided a space at the bottom
the n'-dayit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. P'.
be _ _ to fill in the permit/license number which will be used as a reference number. The affidavits may be returner
"ie Department by mail or FAX unless other arrangements have been made.
Tile Office of Illvesti=stioils would like to thank- you in advance for you cooperation and should you have any quesm,
Pie::-Se do not hesitate ro _ive us a c=ll. .
The Department's address. telephone and fax number.
The Commonwealth Of Massachusetts
Department of Industrial Accidents
office of lmrestigations
600 Washington Street
Boston,Ma. 02111
fax r: (61 i7 727-7749
+ phone 617 -, -4900 car. 406. 409 or
fie �a�naizusea/� a�.�uc�uase(.Ct`
DBPARMIT Of PUBLIC SAFETY
CORSTRUCTIOR SUPERVISOR LICBRSB
Ruber: Expires".
Restricted To, 00
�► 0114-e ROBERT E KITCHELL
452 STRAWBERRY BILL RD
CRRTERVILLE, UA 02632
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Restricted To: 0A
00 - None
IA - Hasonry only
iG - 1 & 1 Fasily Hoses
Failure to possess a current edition of the
Hissachusetts State Buiilding Code
is cause for revocation of this license,
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Single Family - Long Report 11/05/97
Address 38 PRAM ROAD List Price $95,000 �. Page 1
Town Barnstable Orig List Price $95,000
List# 7035008 Listed Date 10/21/97
ListType MILS Listing Status ACT DOM 15 ,
Style Ranch Rooms 5 FBaths 1
DescStyle Beds 3 HBaths 0
YrBuilt 1978 Actual #Lvls 1 TBaths 1
Garage No Garage
OccupBy Tenant Leasbl N Fplce Y
SepLivQtr No Separate Living Quarters Bsmt Y
County Barnstable LotSize 0.25 YrRnd Yes
Village W Hyannisport LivSpc 801 to 1000 MlsBch 5/10 to 1 Mile
ConvenTo School, Shpng BchDsc Ocean
Area Street Public, Paved,TMaint BchOw Public
Subdiv Dock NoDock OthAcc
Zip Code 02601 Pool No DscAcc
Basement Full, BulkHd, IntAcc Floors HdWd, Tile
EquipAppl Roof . Pitchd,Asphlt
InteriorFt SpclFnc
ExteriorFt ExtLgt, Patio, PrvSto, Screen, StDoor, StWind
Siding Shing WtrSwr PriSew, TwnWtr, Gas, Elect, Phone, CAN
HotWtr NGas HtCool NGas
Foundatn Main 44 x 24 Assoc No MshpReq No YrlyFee $0 FeeYear
EL x Feelncl
Irreg N Conc AdditSvc
LotWidth Depth Irregular LotDesc
Ad Copy WALK or SHORT DRIVE to CRAIGVILLE BEACH from this 3 BEDROOM, 1 BATH RANCH in a quiet
residential area. LIVINGROOM with FIREPLACE, HARDWOOD floors throughout, gas heat, full
basement, exterior storage shed, patio&situated on .25 ACRES.
Directions WEST MAIN, to OLD CRAIGVILLE ROAD, left on OLD TOWN ROAD, right on PRAM to#38.
Rm ksAl1
LocalRmks
Showlnstr Appointment Required, Call Listing Office,Yard Sign
OwnrName rufo AssmtStat Assessed
Addr1 TitlRef B 3102 P 186 LCO LandAsmt $22,000 UFFI N
Addr2 Plan Improvmnt $76,100 Asbest
Twn/State PlnLot TotalAsmt $98,100 UTank N
OwnrPhne Zoning Taxes$ $1,186
Map# 268 AnnualBttr $0 Use 101 -Single Family Tax Year 1997
Parcel# 047 UnpaidBttr LPaint No FloodPlain Not in Flood Plain
Expires ListOffice Coastline Real Estate, OfcPhone - - o ee o
COAS
ListAgent Murdock, Marie CoFeeSA 3% CoFeeDDA 3%
Other
Room Dimen Level Features
Living Room 1 Fireplace,Wood Floor
Kitchen 1 Tile Floor
Master Bedroom 1 Closet,Wood Floor
Bedroom 2 1 Closet,Wood Floor
Bedroom 3 1 Closet,Wood Floor
Bathroom 1 1 Tile Floor,Full Bath
Laundry B
Intended for office use only-Information Deemed Accurate but not Guaranteed-printed by Roy Robinson,III,Realty Executives-#7035008
Q� Parcel �. JS Permit#.IJngi ept.(3rd floor) Map O �J
House# ' '�_ Date Issue.
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) - Fee-
Conservation Office(4th floor)(8:30-9:30/1:00.�2:00)
Planning Dept. (1st floor/School Admin. Bldg.)
Definitive gfre�
pproved by Planning Board 19BARNSTABLE,t619-
TOWN OF BARNSTABLEBuilding Permit Application
PressVi11 S' /
Owner /V/ /�Sv Address
Telephone jo�-7 93S-- ?30& w® aR,J �� o i.►'ro/
Permit Request
First Floor t� square feet Second Floor square feet
Construction Type 0?
Estimated Project Cost $ /;7,90
Zoning District (F-e5 r Flood Plain -,ZIV Water Protection tid
Lot Size a Grandfathered ❑Yes ❑No
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes No On Old King's Highway ❑Yes 0'40
Basement Type: 4 Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) JJ_52�2 Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing New e19 Half: Existing _ New
No. of Bedrooms: Existing New
Total Room Count(not including baths): Existing New First Floor Room Count S
Heat Type and Fuel: d Gas ❑Oil ❑Electric ❑Other
Central Air ❑Yes LJ�4o Fireplaces: Existing ' New Existing wood/coal stove ❑Yes 4No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) _4_A01J/'
❑Attached(size) �/�/�(� ❑Barn(size)
❑None ❑Shed(size) A.
❑Other(size) 4;r2,0c_t0
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ,�j No If yes, site plan review#
Current Use Proposed Use
Builder Information
Name Telephone Number
Address License# 4!f 5 0,SAD O
e - Home Improvement Contractor#
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 a G DATE
BUILDING PERMIT D NI kFOr4EFOLLOWING REASONS)
FOR OFFICIAL USE ONLY
RMIT NO.
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE;
OWNER ^ ,
DATE OF INSPECTION: ° - -. d* F t 1
FOUNDATION
FRAME
INSULATION
FIREPLACE
"ELECTRICAL: : - ROUGH FINAL' a
PLUMBING: ROUGH FINAL a
s
GAS: ROUGH FINAL; - -
FINAL EUILDING __.. �.• - _ - .
d
DATE CLOSED OUT '
ASSOCIATION PLAN NO.
L