HomeMy WebLinkAbout0042 RUDDER ROAD �� � y� �.
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Assessor's Office(1st floor) Map Parcel ! ermit# - / j f a
Conservation Office(4th floor)(8:30- 9:30/ 1:00,_2:00) Date Issued _ 02 — 2 —9�
Board of Health(3rd floor)(8:15 -9:30 LE -4:45) _ Fee ��J, a--b
Engineering Dept.(3rd^floa�^j u #
�SME
Planning Dept.(1st floor/School Admin. Bldg.)
BARNBTABLE.
Definitive Plan Approved by Planning Board 19 *q,� "'"9.
seya .
TOWN OF BARNSTABLE,
Building Permit Application ,
Project Street Address
Village
Owner Address
Telephone
'Permit Request
f n
First Floor square feet
Second Floor square feet '
Estimated Project Cost $ o2 3�
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 /V Unfinished
Old King's Highway-
44
Number of Baths No.of Bedrooms
Total Room Count(not including baths) First Floor
Heat Type and Fuel Central Air Fireplaces
Garage: Detached Other Detached Structures: Pool
Attached Barn
None Sheds
Other
Builder Information
Name�rZ,0� V?F Telephone Number s 9— 9SZe
Address�G 7 <<-W77;W,0 ` 4 6"V Z - License# C3,5 2
Home Improvement Contractor# �i _�d
7 Worker's Compensation# 08 nwa IV 9;3 /AI
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 4�2-6
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
FOR OFFICIALUSE ONLY
PERMIT NO. _
DATE-ISSUED
MAP/•PARCEL NO.M
ADDRESS VILLAGE
OWNER `
DATE OF INSPECTION:
FOUNDATION - r
FRAME -
r --
INSULATION 7 =
FIREPLACE' '
ELECTRICAL: ROUGH FINAL -
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL '
FINAL BUILDING
r ° t
r t i
,
DATE CLOSED OUT . {
ASSOCIATION PLAN NO.
r
HOME IMPROVEMENT CONTRACTORS REGISTRATION i
oard of Building Regulations and standards
One Ashburton Place — Room .1301
• Boston, Massachusetts .021.08
t I .
HOME IMPROVEMENT C
Registration 100740 Expiration 06/23/96 r
Type. — PRIVATE CORPORATION
HONE INPROVMNT CONTRACTOR..., F
- I ,., "Istrstiu MONO
•Capizzi Home -Improvement , Inc. I
I Type -:•PRIVATE CORPORATION
Thomas Capizzi , Sr . I EYplrltlon -06/13/96
. 1645 .Newton Rd.
Cotuit MA 02635'. i Csplitl Nolte I1provelelt, INC -
Thous Coplul, Sr. '
-W&Y4W Newton id.
Cotuit NA 02635 F
e �ono..u�al�i �..11asao�4swe
Restricted to: 10
UEPARThIENT JV4 OEPARTMEIi IF PUBLIC S1f[r1
ONL ASHLUR CONSTRUCTION SUPERVISOR LICENSE I 10 - Role
COSTON, Rider: . Expires: :
16 - 1 1 1 rioilr Noes
NSTRUCT'TON SUPERVISOR LICENSE Restricted To: 10
mber: Expires:
IAVIR N UIEIB
_st r.ict ed 1u. 00 COWAWMER 100 PIUn NOLLOY RD I
E ranOUTN, sA 12$36
HOMAO`X CAPIZZI JR `� t
80 PERCIVAL OR
BARN.STABLE, MA 02668 ���
The Commonwealth of Massachusetts
Department of Industrial`accidents
oxceOIIMSI/ SONS
600 Washington Street ,
Boston,Mass. 02111
Workers'Compensation Insurance Affidavit
Applicant_information:
m••
location: Al !!�
.phone# _112t�,r/
I am a homeowner performing all work myself.
I am a sole proprietor and have no one working in am•capacity
�m an employer pro%iding workers* compensation for my employees working on this job.
company name:
address
city phone#•
insurance co �,�_�f T /'�� rOy?— policy# FIR` 5/1
I am a sole proprietor. general contractor. or homeowner(circle one) and have hired the contractors listed below aho ha,e
the following %worker_ compensation polices:
company name:
hddress
city: phone#•
insur•nce co policy#
company name,
address:
phone#:
insurance co policy#
WHEEIRMFURT
Failure to secure coverage as required under Section ZSA of MCL 152 can lad to the imposition of criminal penalties of a one up to S1,500.00 and/or
one vein'imprisonment as well as civil penalties in the form of&.STOP WORK ORDER and a fine of S100.00 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.
do hereby cert=undth 'ns and pe tes of pe ury that the information provided above is true and correct
Signature .
Print nameiC/iIZDt_„Z G0// Phone# �f2 �'�' J 2�
official use only do not ^rite in this area to be completed by city or town oMcial
city or town:_ _ permitAicense# riBuilding Department
L
nsing Board
check if immediate response is required _ ctmen's Oliiceltb Departmentcontact person: phone#-, (508) er
(revised 3;95 PIA)
. . . ° The Town of Barnstable
NAA& , Department of Health Safety and Environmental Services
Building ildin Division
�a
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Cross=
F= 508-775-3344
Building Cornraissione.
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.,=no%-4 demolition, or construction of an addition to'any pm-existing owner espied
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
Type of,Work: Est Cost
Address of Work:
Owner.Name: .
Date of Permit Application:
1
I herd certify that: -
Registration is not required for the following reason(s):
Work excluded by law
_Job under S1,000
ry - Building not cwneroccupied
der pumg own permit
Notice is hereby,given that: CONTRACTORS
WNE ORS PULLING THEIR OWN PERMIT OR DEALING WITHLINRE�
FOR . APPLICABLE HOME "ROVEMENr WORK DO NOT HAVE ACCESS TO 11M
ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A
SIGNED UNDER PENALTIES OF PERTURY
I hereby apply for a permit as the agent of the ov►'ner:
Date Contractor name Registration No.
Tv�-
OR '
n,.P Owner's name