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HomeMy WebLinkAbout0316 SEA STREET (5) Arm PLI Ve��-. ept.(3rd floor) Map arcT l �c � 1 4 o House# � J to FJJ Date Issued - —�'q 1:00-4:30) (off ROS Fee. A UCl Conservation Office(4th floor)(8:30-9:30/1:00=2:00) �' L ejrr�1 ` n�_ aLl/ Planning Dept. (1st floor/School Admin. Bldg.) fl �1HE Definitive Plan Approved by Planning Board ► 19 Oda`� , • BAR ABLE. ©(, MAS& P TOWN OF BARNSTABLE FD59. 366 aqt 00 � Building Permit Application 30(,, �q1 00 Project Street Address 3 (o S ec.Z (�-; i T 0 1 c Village t V1 y CL A m t s r Owner Ca 4�e -M c-L c�-n"e-c- Co%%pp rl�s S o < , Address 3 i co 5 �. ST . Telephone _- F r S i Qcc0 pC"A 0 0 Permit Request 1� (Z f- ctc,e- CX t n q D��Ks C3 S Q vn2 CJy1 tq Ur t First Floor square feet Second Floor square feet Construction Type - Estimated Project Cost $ -I 010 0 0 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No / Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units 2 Age of Existing Structure © Historic House ❑Yes UNo On Old King's Highway p Yes---'J2 No 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 No.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 Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - e Current Use Proposed Use Builder Information Name }fie<c M0,Y►\CL r q Telephone Number y 5`O Address V ihn a,r i License# � Ma-C84on S M, I S M qt 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 BETAKEN TO �gCO'wi <'S Oven SIGNATURE cN DATE c BUILDING PERMIT D NIED FOR THE FOLLOWING. SON(S) 4 P FOR OFFICIAL USE ONLY .ERMIT NO. DATE ISSUED _ MAP/PARCEL NO. - - - AV,a ADDRESS VILLAGE ~ - OWNER tj, DATE OF INSPECTION: FOUNDATION x FRAME INSULATION FIREPLACE x , ELECTRICAL: ROUGH FINAL' PLUMBING: ROUGH FINAL-' GAS: . ROUGH FINAL'' FINAL BUILDING T ~ DATE CLOSED OUT ASSOCIATION PLAN NO. y 11 • • • 1 1 O 1 •• OR MAIN Ilk i s^ ■ Y � ► ,ram•• i, 1, ,, ,, 4 � j j ��� � ij 1► 1 4 1 1 i t 'tl 1 Vs^� CAP l co ?off 3 Z „19 i b CE C� i 14. 5'► r� /� °�' CP V c l r ( �z h S CP pC. LP v f N •�� ,' .. _ � ewi. .t. t t,F�ia�:.�•I.� =?:Me'A-.t'.'F.db�'?`t v..dN..�'J...._/. _y�; fit' - ':' st '✓fie U/dlYl/�YLO�ZL!/CCLGCIL 6�`/I�LCd�pTiLClt1U.G1 7 .t,� DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE �. Nueber Expires: Restricted To .Y 1G 'KERRY N �NCNANARA %f ER i �w► Pa BO%'1144 O'STERVILLE, NA .02655 e '1: `1T�`-i{^.Te.'� Cwa•+ •�\l:�{t"�' :i:-�S-r'j'�s-.R.��. _ 1"§41 .. !� �/W` V • �{ ry nr ����tiipfr��� ;^s�T#&:.�� • t 47:' .c�a $' 1' +c- i�'Yt. .&�r ��.r ll '��.,� i' '.��s�Kk„`�'7r�•-• �€�'�� -�' fix$''��e �-3�+.,. +,ax xl<• 4 _ x#.5>=3�u y.< r;S _"`,,.h'F'. ill' is 5. rf an-g— R I One :Ashburton 'Place „Room 130 '' '' � . 4 ,erg, �{ 7��'- `d�R�'F sv�.F �(� �,�hhNM'}j ���5�•�y`��-j,3... Boston , '-Massachusetts 02108: '' � °� t t S qr a A Ir -: ,G...+s �•' .c. QC" �r�: �`.� "+ fiy `t ri t S���i�'fi�T _ -G •s �=` e � x:+'�e 4 n.,E s .. n a ,.� a � ws� t�. � � ,vy war i}p y -� s i k :'3"c« 'H 14E.:IMPROVEMENT "CONTRACTOR Registration 118118 "Expiration 02/01%99 �a k- �* W,WA T "PRIVATE C012P'ORAIION #,� � µi #{ .- P •t -E` .+ rs t r1'se+� � r �' '•��- 'S' 4hrtaitis\ ` '' n NP N TOR ,. 3 n _ i µ�``.t f.b. i .( f } �_ .t iC "�. �•�� �" ya '1„ 5-yF Registration f18118 , , CAPE COO A& ISLANDS PROP MNGMNT _ a5J 3 KERRY M . ' MCNAMARA YPew PRIVATE CORPORATION tLm Y '37 QWHITMAR` ..RD y '; ,AMC' ` �F "� hEzprationOZL01/99 } "eMARSONS MILLS MA 02648 fi5; s : . � { CAPE COga 8 ISLANDS PROP lIN6NN k KERRY 0, NCNANARA f x. 07 OHITHOR RD Yr�> ADMINISTRATOR ARSONS MILL NA 02648 Je s�.a:iar.:... e.- r� :✓ �. 5y: .� ®wn 'o -� table .0 The T F • . :} - • I Service.. eaaxsr enta 1e� D-epartment of Health Safety and Envtronm Building Division 367 Main Street,!Hyannis MA C60I' M ' Raica C Office: S08-7 90-6Z? r Buiidinz C.: Fax: 508-7 90-6Z 0 For offce'use Only Permit no. Date D AFFIDAVIT HOME MWROVEMENT CONTRACTOR LAW SUPPLEMr.-I T TO PERMIT APPLICATION uit= that the "recanstruction, alterations, renovation, repair, moderni=licrt. MGL c. 142A rcg y re-e-'rming conversion, improvement, removal, demolition, or constrnctloa of as addition to an p s ining at lest one but not more than four dwelling units or to owner occupied building conta structures which ore adjacent to such residence or building be done by registered contractors, certain exceptions.along with other requirements. LC'Type of Wont: Fst. Cosv,� - Address of Work: C < Otivner's Name -.��.a�vy ear �'h�o �SSc*►C Date of Permit Applicztion: I hereby certify that: Registration is not required for the following r=son(s): ___Work excluded by law Job underSI,000. Budding not owner-accapied Owner pulling own permit Notice is hereby given that: GZ-i� OWNERS PULLING � OWN PERMIT OR DEALING WITH UNRE T HAVE CONTRACTORS FOR APPLIG�B GRAM OR GUARANTY FUND UNDER MG= WORK Do - I4ZA ACCESS TO TSE ARBITRATION PRO SIGNED UNDER PENALTIES OF PERKY 4Daze for a ermitthe agent of the awaer.CintractorName The Commonwealth of Afassachusctts Department of Industrial Accidents 1- ;VW Office oflnvestfgatlons ':;" :='r hp!l If'aslri►r;,,tun Street Bo on. A1a.0 02I11 Workers' Compensation Insurance Affidavit • h •tot information: Plestse PRINT iW1''',�p"""'"""�" -._._.. ... ._. bpi L� ... ..... .._L..... name: Location: BOX t14� (_� siex-V ZeeS) city V nhone# M 1 am a homeowner performing all work mvself. FJ 1 am a sole proprietor and have no one working_ in any capacity • .. :-wn. ...w..,"..�_.v..............._w+•�..f1w.w.i.s'�7trr7+.�..wwr+I.7►!+'�:riT�w..+w..�r•�...r��.....�.�..•,....r�. w��.w..� ..w'r,.-_...--_..... rd i'am an emplover providing workers' compensation for my employees working on this job. cnrnnanv name: � P address- �<k mom, city: nhone#• insurance co. poliev# [j 1 am a sole proprietor. general contractor, or homeowner(circle ale) and have hired the contractors listed below who have the following workers' compensation polices: IN company name: city. DJ �I Q.t!1 i1 l P t J►hnnc#• 2,92'o So3 insurance co. l `jyAy'T+�e__ S7AI+,+ LAIC 3S _._ ____.... .._ ._.�_�....._. -Lv....•.�y_i.:- ra..av-.....rJ�:-_ - - �—a 7T..j^ ..Sl;__ _ �::�:m.m►-��s.a-_-� cmmpanv nnmc: address• rite: ohnne#- insurance co. policy# At tach additional sheet if necessaty� +:_:.. __"'=z""'.:�•.•%"'' ''"`w=..•: '^-- _"'�'Y"'�. r:Iilure to secure coverage as required under Section ZSA of 111GL 152 can lead to the imposition of criminal penalties of a line up to 51.500.00 andiur une years'imprisonment as well as civil penawes 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 Olrice of Investigations of the D1A for coverage verification. I do herebe cerri trier 1/1e pa'iis d penallies of periun•that the information provided above is true and co' ect. Signature Date Print name kid '�.0 l�' a ma f Phone# Li2 © `� �r official use unly do not write in.this area to be completed by cin•or town official (I� city or town: permit/license# rIBuilding Department CILicensing Board 1]check if immediate response is required C3Scicetmen's Me" 1 allealth Department contact person: phone#: rJOIhcr s f. Information and Instructions ion Massachusetts General Laws chapter 152 section 25 requires all emplovees to provide workers' compensation for tl; employees. As quoted from the -law-. an emph�ree is defined as every person in the service of :ututher under any contract of hire, express or implied. oral or written. An c•mph rer is defined as an individual• partnership• association. corporation or other legal entity. or any two or me the forcuoins cnLagcd in a•joint enterprise, and including the le;,al representatives of a deccascd employer• or the receiver or trustee of an individual , partnership. association or other legal entity, employing employees. Ho%%,eyer ONVIler of dwelling house haying 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 dwellin;_ lip or cn the `_rounds or building appurtenant thereto shall not because of such employment be deemed to be an empio. MGL chapter i s2 section _5 also states that every state or local licensing agency shall withhold the issuance or rencti�a! of a license or permit to operate a business or to construct buildings in the commonwealth for an} applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionallv, 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 tite insurance requirements of this chapter been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The .� h. affidavit should be returned to the cit}' 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 require- to obtain a workers* compensation policy. please call the Department at the number listed below. City nC rowds Please be sure that tite affidavit is complete and printed legibly. The Department has provided a space at the bottom the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. PI be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returnee the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for;you cooperation and should you have any questic please do not liesitate_to give us a call. The Department's address. telephone and fax number: ' The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigationsr. 600 «`ashington Street Boston, Ma. 02111 fax #: (617) 727-7749 Phone #: (617) 727-4900 ext. 406, 409 or 375 r • • • • • WITC14 Ilk M ki I I 1 1 • GRANITE `STATE INSURANCE COMPANY 13102 3681$ WC 354-14-6,9 SEND CORRESPONDENCE TO: AMERICAN INTERNATIONAL.CO. PENNSYLVAN I A P.O.BOX409 • • • • • PARSIPPANY, NJ 07054-0409 • • •• • • • PHONE: I-800-645-2259. iCAPE COD & ISLANDS PROPERTY MANAGEMENT, INC. �� Member Companies of 'PO BOX 1 144 American International Group OSTERVI LLE MA 02655-0000 EXECUTIVE OFFICES: 70 PINE STREET, NEW YORK,N.Y. 10270 I.D •• •• WORKERS COMhENSATION AND DOWL I NG & O I NE I L INSURANCE AGE EMPLOYERS LIABILITY POLICY 222 WEST ,MAIN STREET INFORMATION PAGE P 0 BOX 1990HYANN I S MA 02601 INSURED IS CORPORAT ION PREVIOUS POLICY NUMBER WC 3355303 (RENEWAL) OTHER WORKPLACES NOT SHOWN ABOVE TEM 2 POLICY PERIOD 12:01 A.M.standard time at the insured's mailing address FROM 01/15/98 TO 01/15/99 1EM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $— 100,000 each accident Bodily Injury by Disease $ 1300,000 policy limit Bodily Injury by Disease $ 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT WC 20 03 .06A rEM 4 The premium for this; policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans.' 4. All information required below is subject to verification and change by audit. Estimated Total Rate Per Estimated Classifications Code Number Remuneration $100 OF Re- Premium ® Annual ❑3 Year muneration ® Annual ❑3 Year SEE ATTACHED SCHEDULES TAXES/ASSESSMENTS/SURCHARGE S S9$ XPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) $190 MA INIMUM PREMIUM$ 1I00 MA TOTAL ESTIMATED PREMIUM ,$2,645 indicated below, interim adjustmerts of premium shall be made: 1 k ❑Semi-Annually ❑ Quarterly"V ❑ Monthly DEPOSIT PREMIUM$ 2 645 ENDORSEMENTS(FORM NUMBER) ; {, SEE ATTACHED SCHEDULE 01/29/98, ASSI.GNED 'RISK 66 Issue Date Print Date: 01/29/98" `f Issuing Office Authorz Representative � iWC 00 00 Ol 39967 INSUREDIS COPY DECKS If located in OKH or Hyannis Hirric District-Certificate of Appropriateness is needed Map/parcel�iumber - Sign-offs fr7th : He Conservation_ T C ctor Owner's nam &�ddress Deck D' nsions Estimate Cos Complet dwelling7infoition for the Assessor's dept. Applicant's telephber Plo an Two sets of plan/with cross section Workman's Comp.Tonn Mome nvement(' *ate±nr's Affidavit c ' er s se AND Home Improvement Spe ' se OR __ o wner i xe do ck exp' a on license s —Ch xpiration da q-forms-PERMITS I Rev 6/2/98