HomeMy WebLinkAbout0316 SEA STREET (6) i C� - � �{
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Engib:_.:,nn`g Dept: 1403
(3rd floor) Map Parcel—� v
House# '. JJ Date Issued J 1
Boar�It. iil t_oor 8:a%3/_1:00-4 30) c �o� P,S Fee " , ,OCR 1
Conservation Office 4th floor 8.30- 9:30/1:00 '2:00 y� ` S
Planning Dept. (Ist floor/School Admin. Bldg.) j D Tr+e r
o�dyl.Do F
Definitive Plan Approved by Planning,Board 19
- : BARNSTABLE, - ',`/_ L+` 0 o V
MASS. VlY
k,36G a141 00 /
TOWN OYBARNSTABLE
Building Permit Application
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Project Street Address 3 1 (o S ecl GJ t
Village i�� Pt'A $
Owner Ct'.1C!e 1't S S o r Address ?, ►(c L '.
Telephone �s g^► Pc� c� � (rZO .2 ti:;�i ;
Permit Request 'Re-0 c1c,"p— cy,t s.-k n ct Y4\4?_ 63 Ct l V t 0 n
:First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $ I� p -
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family ❑ Two Family. LJ Multi-Family(#units) V 6 r✓ �_ '
r' g YP g
Age of Existing Structure - -! Historic House ❑Yes ' �SNo On Old King's Highway pNs -" No
Basement Type: 'mull ®Crawl ❑Walkout Ll Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing New Half: Existing New
x .No.of Bedrooms: Existing New
Total Room Count(not including baths): Existing New First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil Ll Electric ❑Other
Central Air p Yes J No Fireplaces:Existing New Existing wood/coal stove ❑Yes ❑No
Garage: p Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
p None L)Shed(size)
Ll Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded p
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
Builder Information -
Name Ke'`CC' C.Wo.vy c.I'q Telephone Number ``�2�5 `�C
Address )�7 �-u in +m 4v� k� i°� License# /01,
VY�G1 r�"tOY1 Vl'\ E S 1'1�I D 2 64d'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 `i ' ►QCC"M _Cl
0 VY\ �}
SIGNATURE DATES A,�
BUILDING PERMIT D NIED FOR THE FOLLOWING SON(S)
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DEPARTMENT OF PUBLIC SAFETY
C0NSTRUCTIOy rSUPERVIS0R.LICENSE j..
Nu�ber Expires.
Restrcfed To 16
- w KERRY!11 HCNANARA
PO`BOX 1144
OSTERVILLE, MA,.02655 `
oV gPg�R.ytEMEIv C T, A � �
ctrn RANN R I
gulao�is..ai� t�a�c�l �s �`
One :Ashburton Place
Room 13Q1 �� >r
Boston, Massachusetts 02108= � '� y "�
<HOME IMPROVEMENT CONTRACTOR " �� ` A{RT
1 �' x
� Isr41,
Registration 118118 Expiration 02/01%99i =ma' s _ �� - � ."
TYPe. PRIVATE CORPORATION �, .s : � � tr it
Q {
4 v4 y, 7T�O�
y, 3 HOME RPROVEREN` L� ACTOR
CAPE
COD & ISLANDS PROP
KERRY M `~MCNAMARq � +� TYPe PRIVATE„CORPORATION
ation
37 WHITMAR RD � 4299
ARSONS, MILLS MA 02648 - far i r � R, z`
CAPE CO
ISLANDS PROP MN61
KERRY N, RCNARARA 't
ON
�HITMAR RD
noMw*TaaroR ARSONS RILLS RA 02648
ti 5
The Town ®f Barnstable
.., .� ..
9 $� Dep.artment of wealth Safety and EnvtroninentaI Service
679- I Building Division .
3b7 Main Strcct,Hyannis MA=50I
' Raich C w:
Office: 508-7 90-bZ7 Building C.:
Fax: 508 90-6220
For office use aniy
Permit no.
Date AFFMAVTT
HOME ZVAOVE1"Y ENT CONTRACTOR LAW
SUPPLEM_-4T TO PERMIT APPIMATION
GL c. 147A rcquir= that the "reconstructlon, alterations, renovation, repair, moderaizrticn.
M re-ezistir.�
conversion, improvement, removal, demolition, or constr edon of au addition to any p
owner occupied building containing at Ieast one, but not more than four dw dangr-s tla ,or t.o
structures which are adjacent to such residence or building fie done by registered
certain exceptions.atong with other requirements.
{�
l� Est. Cast
Type of Work: �ei_ II C P—e-c t�
s't
Address of Work:
0syner's Name
Date of Permit ;tppjicztion:
I hereby certify that:
red for the following reuon(s):
RegiStriion is not rez;ui "
Worst exrJuded by imw
_Job under SI,000.
Building not owner-occupied
_ Owner pulling own permit
Notice is hereby given that: [Jj`tREGISi�AFn
OWNERS PULLING THEM OWN PERMIT OR DEALING W�
CONTRACTORS FOR ARK 00 NOT HAVE
PPI�IC�BI-E HOME
OR �RANTY FUND oNDER MGZ. 42A
ACCESS TO . gITRATION PROGRAM
SIGNED UNDER PENALTIES OF PER=y
4C.
ermit asthe:agent of the owner.
Ci]IIIIIIC2or Name1`Io
The Contmonit,&zlrli of Afassachuscay.
Departtnent of Industrial Accidents
Olticeo"VW
avestigar�ons
600 lVdAin ran Street
w Busrom Maas. (12111
Workers' Compensation Insurance Affidavit
Ple•tse PRINT Ieb �"�'""-'"�"
i li :int information': •"-'-� --- - - -
name: f f y Ytl`.C\V 21 =ja
lncntion Box ti t4 4 o s4ex-u e- 2�_S)
61,. j (et �C lz
nfionc>4
I am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity
•. . •_. .L. -.s-•._.-...: _.-.—-�r s...�tea.- �rr!r+:.a��'..^^+��+!�.r .+��..wr.,�+.�. �y..�.....��-.-.......� ....r,.--
( 1 am an employer providing workers' compensation for my employees working on this-job.
cooman name:
address: 7 �
city: phone#•
insurance co. nolic� #
[] 1 am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have
the followinz workers' compensation polices:
company nnme: A� ®�tf l �� 'T`. 0 IV,,2,1
b
addresr. ?'Z2 (fl:' � itt\ C�
cit... phone#•
J
insurance cn l `�l'(�� r Al,+ t soiic� t!
cemnanv nnmc: .
address:
rite: Phone#-
insurance co. nolicv#
.Attach additional sheet if m[ttC59ary-=.. �.;r• _ =+ --�%• y.-.• � _T"�'•%�•.•'... �'^`"••,•"�"^+%--+•r-' :'+•�•• �.T"'• •—.•'_'
-_.� i� '�:`: .�..-- L..•-, i_-...w._.._..1ry�_��..-.a-r.-.� iyl2•�.i��il..Mic::�.aL
Failure tm secure coverage:is required under Section 25A of 11IGL 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 andior
one*"ears' imprisonment as well as civil penailtics in the form of a S OP WORK ORDER and a fine of 5100.00 a das against me. ]understand that a
cope of this statentcut ma} be forwarded to the Office of Investigations of the DIA for coverage verification.'
I do herehr cetri xler the pairs d pettallies of perjun•that the information provided above is true and cor ectO
Signature Date
Print name i e C Phone r< f 28
official use only do not write in this area to be completed by tin or tour n oRciai
city or rots n: permiUliccnsc# rIBuiidin-Department
Licensing Board
check if immediate response is required USeleetmcn's Office ►_
�1lcalth Department
contact per-son: phone#; rlOther s:
GRANITE STATE INSURANCE COMPANY 13102 36818 WC 354-14-6.9
SEND CORRESPONDENCE TO:
AMERICAN INTERNATIONAL.CO.
PENNSYLVAN I A P.O.BOX409
j o •' • •• :• • •• • • • PARSIPPANY, NJ 07054-0409
PHONE:I-800-645-2259:
CAPE COD & ISLANDS PROPERTY MANAGEMENT, I NC. Member Companies of
DO BOX 11.44 American International Group
DSTERVI LLE MA 0265570000 - EXECUTIVE OFFICES:
70 PINE,STREET, NEW YORK,N,Y. 10270
I.D/i .. ••
WORKERS COMPENSATION AND DOWL I NG & 0'NET L INSURANCE AGE
EMPLOYERS LIABILITY POLICY 222 WEST .MAIN STREET
INFORMATION PAGE 1 P 0 BOX 1990
HYANN:IS MA. 02601
1SURED IS CORPORATION PREVIOUS POLICY NUMBER WC 3355303 (RENEWAL)
)THER WORKPLACES NOT SHOWN ABOVE
'EM 2 POLICY PERIOD 12:01 A.M.standard time of the insured's
mailing address FROM 0 1/1 5/98 TO 01/15/99
EM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the
states listed hen;:
MA
B. Employers Liability Insurance: Part Two of the policy applies to the.wor,k, in each,state listed in item 3.A.
The limits of our liability under Part Two are: 100,000
Bodily Injury by Accident $ each accident
Bodily Injury by Disease $ 500.00 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
_M 4 The premium for thi:> policy will be determined by our Manuals of Rules, Classifications, Rates'and Rating Plans.
All information required below is subject to verification and change by audit.
Estimated Total Rate Per Estimated
Classifications Code Number Remuneration $1000FRe- Premium
® Annual ❑'3 Year muneralion ® Annual ❑3 Year
SEE ATTACHED SCHEDULES
TAXES/ASSESSMENTS/SURCHARGES $98
DENSE CONSTANT(EXCEPT WHERI:APPLICABLE BY STATE) $1 90 MA
JIMUM PREMIUM$ 1")00 MA TOTAL ESTIMATED PREMIUM - $2,645
ndicated below, interim-adjustmerts of premium shall be made:'
❑Semi-Annually ❑ Quarterly ❑ Monthly DEPOSIT PREMIUM$ 2,645
ENDORSEMENTS(FORM NUMBER)
SEE ATTACHED SCHEDULE
r -
01/29/98 ASSIGNED RISK 66
Issue Date Print Date: 01/29/98 Issuing Office Authoriz Repre
9G7 sentative we 00 00 01
INSURED(S COPY
DECKS
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If located in OKH or Hyannis His oric District-Certificate of Appropriateness is needed
Map/parceliumber /
Sign-offs from:
He th
_ Conservation
Tax C lector
Owner's nam &,dddress
Deck D' nsions
Estimate Cos
Complet dwelling info Lion for the Assessor's dept.
Applicant's telepho a number
Plot.,P fan
Two sets of plawith cross section
Workman's Comp. form
biome vemer t C'^^*rantor'S Affidavit—
c ' per s ' se AND Home�Improv`ementSpe ' se
OR
o caner i xe ti
ck exp' a on license s
-Ch xpiration da
e
I
q-forms-PERMITS 1
Rev 6/2/98