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Home My WebLink About0098 SEVENTH AVENUE (HYANNIS) �a' �S��vrH flv�; � �—_ f— � d> + Application number ,e 7. ( _ O Fee............... I....................... ............... �. •' �� KAMM Building Inspectors Initials.......... ................... (-EB �� Date Issued.............. /.� ..L� ......................... TOWN fj� BARNS NU Map/Parcel.. ........................................ TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: K 2 fi--� kt-- NUMBER STREET VILLAGE Owner's Name: � ; I��r Phone Number y�tt y KZ-- ))a Email Address: Cell Phone Number Project cost$ Check one Residential V/ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: - Date: TYPE OF WORK ❑ Siding ❑ Windows( change)header char e)# 52/Lation/Weatherization ❑ Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going.to CONTRACTOR'S INFORMATION Contractor's name mike McCarthy. constrIletin" PO Box 52 Home Improvement Contractors Registration(if applicab &t Dennis, MA 0267@ittach copy) Cell (508) 280-6964 Construction Supervisor's License# CSL-58633 (aiMCCAIM393 Email of Contractor cyie -C-,Phone number ALL PROPERTIES THAT HAVE STRUCTUR S OVER 7SAARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER.............................r............:,................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or> Yes No____,if yes, a gas permit is required. Natural Gas Yes No ,if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval, *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE.EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date LIC 'S SIGNATURE f Signature / Date 2-6L I I All permit applications arYsubject to a building official's approval prior to issuance. a l DocuSign Envelope ID:5EtIADA16-12F8 4175-861A-FF8B225F74A2 ' SO O �Sb 2-21 Permit Authorization ove Forte "Site IQ: 3585967 CuStom:& Donna Miller " Donna Miller :owner:of tFie'property located at;, .(owner's Name;printed), 98 7th Avenue West Hyannisport, MA 02672 (Property Street Address) (City) hereby authorize the_Mass Save'Home Energy Services Program assigned Participating`Contractor listed below to act on my behalf and obtain a building permit to performinsulation and/6r'w6atherizatio4i work on-my property. DocuSigned by- - Owner's;Siignature: 1818WMABNEA... Date 1/z2/zo19 ( 9:50 PM EST n000 0000000 0 aoci.e+aa �€ _oa0000*90o00-00000000004'a0+aipp0ge e****u00000.v„ FOR OFFICE USE ONLY: We have assigned,the,follouving Mass Save'Home Energy Services'Partici,patl'g.Contraetor,to the above referenced project C. A ` Participating' ontractor." Date Name: RISE Engineering Phone: 401-784-3700 Email: Page 1 of 1 'FurOffice Use Only,:: Rev.102615 as _ - The Commonwealth of Massachusetts _ Department oflndustrialAceidents j Congress Street,Suite 100 Boston,MA 02114-20I7 www.mass.gov/dia I-Var(cers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please PrintLegibly Name{Business/Organization/Individual): Mchael McCarthy �'I'�•-�T'v�r. rat. Address: PO Box 52 weS� a I11A -- ----------- --- - City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): L[ I am a employer with `�. employees(full and/orpart-time).* 7. New construction 2.❑I am a Sole proprietor of partnership and have no employees working for me in $. Remodeling any capacity.[No workers'camp.insurance required.]. 3.D I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 10❑Building addition , 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.[:]Plumbing repairs or additions 5.❑I am,a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof airs These sub-contractors have employees and have workers'comp.insurance.! ❑ repairs • 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.blOther ►�y i��I,. , 152,§1(4),and we have no employees.[No workers'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 anew 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 subcontractors have employees,they must provide their workers'comp.policy number. Iam an employer that isprovidiitgiporkers'compensation insurance for my employees Below is thepolicy andjob site information: Insurance Company Name: N��t'or��l Li c�,; i + �►�C -T�c Policy#or Self-ins.Lie.#: V 5�/C `� S�`/ Expiration Date: 15 i Q 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 MGL c.152,§25A is a criminal violation punishable.by•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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify trnd t e hhzs enalties of perjury that the information provided above is true and correct. Signature: Data: Phone#: -6 7C�> Official use only. Do not write in this area,to he completed by city or town offrclaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Office of Consumer Affairs and Business Regulation -I)F 10 Park Playa- Suite 5170 Boston,:` setts 02116 Home lmprov.` 1�actor.Registration .Type: . IF dV'K tiai MICHAEL MCCARTHY ` " Registration; 1t P.O:BOX 52 °':` •f ' '�_''� aoration: 06�tA"j.9 WEST DENNIS,MA 02670 Update Address and return card. Mark reason foucha"ge. SCA 1 i1 20M�05111 PI.QArlis I rl rnIflevnawnt rlta iC rd C�/ee�o�nmao��0�&3�,cr�ac%ueeQ2 Office of Consumer Atfalre a Business Regulation HOMEiMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Indvdual before the evirstlon date. If found return to: Office of Consumer Affairs and Business Regulation °�-k2 06/16/2019 10 Park Plaza-Suite 6170 ICHAEL MCCA .11 Boston MA 11 MICHAEL F.MCCjk 6 RANGLEY SOUTH DIE NIS,MA 026i30 UndersecretaryNot valid without signature t OMMOnwealth of Massachusetts —+ t Division of Professional Licensure Board of Building Regulations and St>thdards: Mihaet McC�liy y Conslr� #oh Constr tg ' . p�.rvisor GS-0 58633 Has sua;etis"ly eonlpletsd lcltl Fibier, 4 otallulose Training Course r ues 04f IAf2020' pd 23 l dl�y of August 2011 MICHA :L J MCC�4R PO B:OX 62 S WESTNNIS Mqf 01S `fir - °�YNilee;f�IlsIIslFmer• '�:r�ti ;-�� ' Norrafldiun/eessmboseed w�.w,..c.,........,,.. CCfilrni'ssioner CL Al w A OSHA 001558712 r � U.S .Department of—Labor Oxupational Safety and Health Administrallon a, ...... �.` 'f Michael McCarthy .;. &"°oessi'dl� a ireoftli oea has s„coessW!<ycernpleted a,wtou.ooa,patwnai$af i�e04 ety and;Heafih fily Training COirrse{n: rs ffi 32Hgptsoff:TassTon end e e , sal, 8 Health:: e e 1,,,, o to:unt ... ' �1+Ufedun.hw Assessor's offioe Ost floor} THE Assessor's map and lot number y 4?. .� l �.:... jSEPM MU FT°�o Board-of Health (3rd floor): r Nr 74 � ED I � I Sewage°Permit, number Q @ 2 BABaST�IfLL, J w 9 TITLE Engineering Department (3rd floor) " �, �. tl ` m� �c� �j House number ..:.. `'....1..o. JS..: .... t £. s ,bE Jo- C s � ......... .. APPLICATIONS PROCESSED ,8 30=9:30 A.M..-and' 1:00-2:00 RP.M.' only i� OWN REGUL�TI�i" TOWN OF BARN.STARLE° « B-UILDIHG INSPECTOR , z .. { APPLICATION FOR .PERMIT TO ..........................................rl ��3 ,v-(.. ......... .... ......... .... ......... - �Q.et�t ei2 V x_ ok TYPE OF CONSTRUCTION ................:. y.....:.. /l/� 1�./r✓G t2i/1 3i 9 � TO`THE INSPECTOR OF BUILDINGS: . The undersigned hereby applies for a permit according to the following information:, „ , Location f'lT/Eiv!/� /9x��ir�/. ee .! 1 �4�S' ... . . ...............w..(LO7 S_k .......... ... ................ ......... ... .... .. ... ..... �r. ,. ...... { Proposed Use ..`:... F:S.I�S.177.f ......................................................... ...: ... Zoning District ....: .. ..... .. .........Fire District ................ y./ AJf S ............. .............. p Oa1�n :.. ,.... r�0 ..� /�t/G Name of Owner .. ........Address -. . _ - . ...,�... _ ....j,......... Name of BuilderSF...... di . FiCS �l...... 7 .��v✓ .3) .. .NS' :... ...... .....:..Address .. ........ .. ...... .. .. Name of Architect ........... ... r....., ......... ..... .......,...Address ........iU+ .......................... ......... ..:............. .......... �}Cr..i n/6 Foundation : ..:............ .Number of Rooms ............ zdwt,n/✓a,� Si- r1L Y� e-by Ro+:ao fig S1O/)/¢G-Exte for .�. ......... 4 .. ...7. .................................................. Floors. /7�I�u .... $'R1i�yU�vit£.2..............lnterior ..:....�f ��2C9C1� f - e Heating ' l�Gv — Plumbing r3it'--.�. ............... .......... .' 'Z ... Fireplace .............. A roximate'Cost .... �� 6�d f� ..,, Definitive Plan Approved by Planning Board __ __________________ _____ 19 -__ Area :!U® i�!� Diagram. of Lot and ,Building with Dime`n.sions w Fee �G M e . ' • ° ... ... +............. SUBJECT TO APPROVAL OF BOARD OF HEALTH ♦ y K - OCCUPANCY PERMITS, REQUIRED FOR NEW''DWELLINGS I hereby -agree 'to conform to,all the Rules and Regulations of the Town of Barnstable.regarding the above construction. .> ';Name .. ..... . ...... .............. Construction Supervisor's License ..�G1lf`%3/.............:::.. ti MILLER, LEONARD S. No `31954 Permit for .UMPREL................ ng........... f Location .... ...."r .... , _ - - :t ..... ..West°. .y. Tlxla s. ?Az. ...... ........ OwnerLeonard, S M�..�,1.� .... .......... - - `� "�! _� � .. ` `}i .. � ��_ ^- `' x � • • Type of'Construction .........Frame .................... ............ ' .. ..... .... r• ...... ... ......i.... .., , .�t - ' ✓: rS` s'... }: t �},K— ' P ..rr. .. Lot ......8 lot ..... ......... ,• i - { Permit j Granted June.. ?.�.�:......... 19 88 , r Da a (if-Inspection .... 19 Date Completed ........ ....... ................19 a Ap CD y9 . ww r • • �' r L T'f [ i 'ram^ a3� •.�,�„,• �.` .�.- .',�, �` � - ,. - F .�, , <• - Y Assessor's offioe (1st floor): Assessor's map and lot number .. ....a ,0.,1 ,..,.. x F THE ro�i Board of Health (3rd floor): �/) (Q//�./ Z5 I..... " •Sewage Permit number .............. �..-............... i BasasTULE, . Engineering Department (3rd floor): rasa House number / 0 -�5 4 39• 0 t6 .......................................... pj�0 Mix I'. APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 f P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR }� APPLICATION FOR PERMIT TO ....... F"t..........� ...................... .................................................................... TYPE OF CONSTRUCTION .......ev.MJ ........ ... � �D/n✓G 4� � F?/los oc � ............. ... .... ..... ................... ........................5 3............ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: \ Location < (y 7 . fiv�/� . 1( 1 �jL�� n iS�oo !% /M�9 S S' J CZ S�......................................................... .......................... ........... ............................... ........................... Proposed Use ...... F S.!."f.. n.! >...r............................................. .......................................................... ......................... Z ....................Fire District ..............`7 to,4,vV S Zoning District ................................- .................. - F....`...................................................... Name of Owner./rFa•t��/�rc /CL�/� Y� Address �� /}t/G-:�vGf�. Gt� 11-14�„IIVAK,T ��1 ............. ............................. ,. ...........; ....... Name of BuilderS,p �d/L7�f�S— // �/�+/ �aC} /-41-, ✓ S) � jEtr��/S' ..........................................................Address ................................•:.......�................:.......................... Nameof Architect ................ .:......................................Address ........s ... .................................................................. Number of Rooms ........ ......................... ...........Foundation �Xr$�n/6 • Y ......................................................................... Exterior ................................. Roofing Srd It, Floors ....................................................................... ..............Interior .................................................................................... Heating ....... g `J ..................................................................Plumbin ............................ ..../� r?..1..�—r. ............... Fireplace N ..Approximate Cost ............................................................. ...................................................... Definitive Plan Approved by Planning Board -------------------------- �(Jd Arc�i C ------f 9-------- • Area .......................................... Diagram of Lot and Building with Dimensions Fee DO SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all,the Rules and Regulations of the Town of Barnstable regarding the above construction. ~ Name ....(. ; ,2i�' ... "/!./ y'........................................ Construction Supervisor's License �Jr lh3 MILLER, LEONARD S. A=245-058 . .� No .,319 5 4 Permit for .,Remod.e.l . .. ................. Single Family Dwellin.q........ Location .98...7.t. ......h Avenue... .. ....... ................................. West...Hyannisport................. Owner ...Leonard. ...S.....Mille.. .. . ................r .................. Type of Construction Frame ............................................................................... Plot ............................ Lot ................................ Permit Granted .......June 2, 19 8 8 I Date of Inspection ....................................19 Date Completed ......................................19 r ii iAf �� cP° �e— G�� ` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION s Map 40 Parcel Permit# k 3 _7 YA i, Health Division b �t'� f(.pW Date Issued oZ JF- e � Conservation'Division �.� �� ''1, Application F Tax Collector InAloLdmPermit Fee Treasurer EXISTING EPTIC SYSTEM Planning Dept. LIMITED TQ== ; OF B Date Definitive Plan Approved by Planning Board EDROOMS Historic-OKH Preservation/Hyannis Project Street Address .,2o�r'�.^y ��. Village 9 Owner T/�'Ji�i � � _� Address Telephone Permit Request < � f Square feet: 1 st floor: existing proposed 2nd floor: existing proposed ' Tntl new; o 2 Zoning District Flood Plain Groundwater OverlayCIO Project Valuation Construction Type X rn Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting ocumentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑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 Number 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 Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name4J_Z,C Telephone Number ;�__a Address License# e!57 0 y�a�� a:�r � �� Home Improvement Contractor# Q eJ Worker's Compensation# jV C 3/7.36 C�G�� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE _%/r�t 5 �0 ,) FOR OFFICIAL USE ONLY r 4 1? 9 f t• , PERMIT NO. DATE ISSUED J! ,� MAP/PARCEL NO. r ADDRESS ,i f ' VILLAGE -, OWNER t DATE OF INSPECTION: FOUNDATION , FRAME INSOL,,ATION �� df- -,2-ot 0 ' 1 FIREPLACE ELECTRICAL: FINAL Yyo PLUMBING: ROUGH FINAL GAS: ROUGH4- FINAL FINAL BUILDING q' M DATE CLOSED OUT rl a ASSOCIATION PLAN NO. f oFIORE roe Town of Barnstable °T Regulatory Services ,z BARMSTasr a, Thomas F.Geiler,Director rf Mass. 9�prfs6yD rya+s`�� ' Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 4 . ye .. Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION' 'M(3t 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. 77__ Estimated Cost Type of Work:, Address of Work: P Owner's Name: Date of Application: I hereby certify that: . Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: TH UNREGISTERED OWNERS PULLING THEIR OWN PERMIT OR DEALINGMEN'IT WORK DO NOT HAVIl CONTRACTORS FOR APPLICABLE HOME IMPROVE CONTRACTORS THE ARBTTR I ON PROGRAM OR GUARANTY FUND UNDERMGL c.142A. ACCESS SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: p ew 3 O Registration No. at Contractor me i - OR Date Owner's Name ' • '� Y. : . _ Qom' k ., Q:fom-s:homeaffidav The Commonwealth'of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7I"Floor -,L J Boston, Mass. 02111 Workers' AU7t Conm e....�n sation Insurance Affidavit:Buildiing/Plumbin lecttrical Contractors � � '01 name• i"� �oI�Z1�� .. address z!-f"_/ C c o,� Allc t Z2L-1 ^ city / '�• /�/�tt�� //'T b/— — state: /�/`1 zio:04I& Rhone# 1 �L5 .�i� f l/Q7 work site location full address): ❑ I am a homeowner performing all work myself. Project Type: New Construction emodei _ ❑ I am a sole proprietor and have no one working in any capacity. ❑Building Addition ❑ I am an employer providing workers' compensation for my employees working on th•s job. company name: �' '•� address: citv: 1phone#• e woe "I G2- �7 : insurance co. lic # /� C A 3�s/a,m�: / 3 6 ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers'compensation polices: company name s address: city: phone#: insurance co. policy# . . _ # ,. M *xS=�3 " company name: address: city phone#: insurance co. policy# Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a 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 Office of Investigations of the DIA for coverage verification. 1 do hereby certify under t e pains and penalties perjury that the information provided above is true and correct Signature Date c �y Print name 4 b-*:2 D l Phone# 5 official use only do not write:inhisarea to be.completed by city or town official ^ city or town: permit/license# ❑Building:epe]nt ❑Licensing❑check if immediate response ied ❑Selectme❑Health D contact person: phone#; ❑Other (revised Sept.2003) ' : : Information and Instructions ; Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",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 section 25 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,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; V Applicants Please fill in the workers'compensation affidavit completely,by checking the box that appliesto your situation. Please supply company name,address and phone numbers along with a certificate of insurance 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 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. , + ,Zi 1 Y FEW" �'..a' 'g�k Riam City or Towns 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 to sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to 1L-ie 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 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,7`h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone #: (617) 727-4900 ext.406 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE , New Buildings $100.00 �^ D Residential Addition $50.00 Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE - square feet x$64/sq.foot= 00 x.0041= 6 plus from below(if applicable) - GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041= ACCESSORY STRUCTURE>120.sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf-1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: ' square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck . x$30.00= (number) Fireplace/Chimney x$25.00= (number) In round Swimming Pool $60.00 - g g Above Ground Swimming Pool $25.00. Relocation/Moving $150.00 (plus above if applicable) Pern-,it Fee. c Projcost Rev:063004 ej Town of Barnstable Regulatory Services rr LM, Thomas F.Geiler,Director 163 3 �p Building Division TomPerry, Building Commissioner 200 Main Street, liyannis,MA 02601 www.iown,barnstablepa.us office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section. if Using A Builder I , ,as Owner of the subject property herebyauthonze':'• to act on my behalf, in all natters relative to:work autho ' d bythis building permit application for; (Address of Job) ' tore o f Owner Date S . .Print hTame • j 1 .........rn.rninrcv�CD7�TCCTCIN c u B08r0I p'Ylfln ,,,,�� 1. g eg .tide an 1 ' HOME IMPROVEMENTStan ards. CONOF TRACTOR Regist •i� 104499 i 14/20 f os to Co ART DOLGOFF MOration krthur 801goff 19 McCormick Dr. d W.Bam abl 94 r AM— WIN M I�Q t ARON AO 1 i :•'f• l 1�a..�.•y. - ... a ... , a oFtN Town of Barnstable *Permit#_I293 Expires 6 months from ' ue date BAMMBM • Regulatory Services Fee r039.MABS. Thomas F.Geiler,Director • Building Division X-PRESS PERMIT Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 OCT 1 5 2003 Office: 508-862-4038 Fax: 508-790-6230 - TOWN OF'BARNSTABLE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number • i y Property Address Residential Value of Work -7 t;_0_0 Owner's Name&Address Contractor's Name r' .Mic"'"L, aww�(�_ Telephone Number (tome Improvement Contractor License#(if applicable) 3 S b Y construction Supervisor's License#(if applicable) C 00 b 3 9 71 ❑Workman's Compensation Insurance Check one: l ❑ I am a sole proprietor ❑ I am the Homeowner 911 have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# W 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) Re-side replacement Windows. U-Value- (maximum.44) *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. Home rov ent Contractors License is required. Signature Q:Forms:expmtrg Revise053003 °Ft1KE ro Town of Barnstable Regulatory Services RARNSTAB9 ''E'� Thomas F.Geiler,Director Eo;9. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I ,a er of the subject property hereby au rize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) LCI a' 'Itj /0//,p A-I Signa of Owner Date Print Name A.Dl1DL dC.f1R7HTCD Di+D T.TTCCTlIAT - ✓lie fDam�rearuuea/ a��/[Lac�iuGe�6 Board of Building Regulations and Standards j HOME IMPROVEMENT CONTRACTOR I t Registtatlohi .,, 32564 XpiratjR 2/27/2005 Itj vidual r F.MICHAEL DWIER F.MICHAEL DW 772 MAIN ST. OSTERVILLE,MA 02655 Adiniuistrator.