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0142 SEVENTH AVENUE (HYANNIS)
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ���� Parcel Q rn S Application # b h Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/ Hyannis Project Street Address /`( Z A V-� Village 10 e. T ti AAjA11J �Q i Owner h2 Address iK Z tiT►-� A v c Telephone Z 3 -2 Y C -0 3 2 Permit Request Ca Al JTA✓ac ,5Uw O-eCk 6Jl 61 PCIeJ)0 h,' I'"{9I e V w oo 0 lr I—) A2e (� V e C IR �. , G- t 7AA!9yltiAAh r?Ai v yi cr , (a�q a-c f� noyn�D �DeCk is 4A�QP Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation -1 9 K Construction Type 4,ev Lot Size %J A C#Lf Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0"_ Two Family ❑ Multi-Family (# units) Age of Existing Structure Y�-1YA / Historic House: ❑Yes U-No On Old King's Highway: ❑Yes 01 o Basement Type: ❑ Full ❑tirawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) O Basement Unfinished Area (sq.ft) a 6 Number of Baths: Full: existing 2; new Half: existing. U new Number of Bedrooms: 3 existing _new Total Room Count (not including baths): existing �1 new First Floor Room Count Heat Type and Fuel: Urtas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes O'ko Fireplaces: Existing New Existing wood/coal stove' -❑Yes; 0'I�o 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# rn Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ���} � ..�i Telephone Number Address 3 ?H 1 A.. 'e 7 License# d 1 L G L (�eA l-e yX v I k-t AA Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r I SIGNATURE DATE • f " FOR OFFICIAL USE ONLY t' APPLICATION# r DATE ISSUED 4 MAP/PARCEL NO. 4. I� F ' ADDRESS VILLAGE ` OWNER F ' DATE OF INSPECTION: FOUNDATION FRAME ` INSULATION f; FIREPLACE ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL E+F GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. F, l 4 The Common wealih"of Massachusetts c ^, Department of Industrial Accidents- E i Office of Investigations r• ir 'u ! 600.Washington Street t ll,ii; Boston, MA 02111 www. g ,mass. ov/dia ' Workers' Compensation Insurance Affidavit:Build ers/Contractors/Electricians/Plulmbers Applicant Information Please Printtegibly Name (Business/Organization/Individual):.- At k4 ReA- Z', ' 4vJ7h vC11 Address: 771 N l ti�ey City/State/Zip: .v ✓ ® Zd Phone #: ,fib-2 / —F�l �r �h l fir,./Lry 3Z . Are you an employer?Check the appropriate box: _ Type,of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor, I 6. New construction epployees(full and/or part-time).. * have hired the sub-contractors 2. I am a sole proprietor or.partner- listed on the attached sheet. t r 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance - 5• ❑ We are a corporation and its required.] officers have'exercised their ]0.❑ Electrical repairs or additions 3.❑ I am a_homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. .c. 152, §1(4), and,we have no 12.❑ Roof repairs insurance requited.],t employees. [No workers' comp. insurance required.] - 13.[ Other / oG k *Any applicant that checks box#i 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 a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers':comp.policy,information. lam an employer that is providing workers'compensation insurance for my employees. Below,is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Dater Job Site Address: . J{ v t.,,7h A y z' City/State/Zim 6�y�Al Attach a copy of,the workers' compensation policy declaration page(showing the policy number and-expiration date). Failure to secure coverage as required under Section 25A of MGL a. 152 can-lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si nature: 1� Date: Phone#: L Official use only. Do not write in this area;to be completed by city or town'official. . " .City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: ( ( 1 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, 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 m6re than three apartments and wifo 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•empl6ymertt be deemed to be an employer." MGL chapter 152, §2kC 6)also'stafesthat"every state or local lieensing 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,MGL chapter 152, §25C(7)states"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." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit 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. Self,insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials 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 Abe sure,to fill in t vpermitllicense number which will be used as a,reference•numberrF,In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your 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 Investigation$ 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www.mass.gov/dia /ze �omv»ZoruuecilC/i o ../�czoauaet�a Office of Consumer Affairs&Bifsiness Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: .,1.,11859 . Type: Office of Consumer Affairs and Business Regulation Expiration. 2/4/2-013, " DBA 10 Park Plaza-Suite 5170, - Boston,MA 02116 MI AEL RENZI tONSTRUCTION`. MICHAEL RENZIR t 387 PHINNE�Y-S LN rk CENTERVILLE, MA 02632` ' -� Undersecretary Not val' thout signature 4 s - � iNlassachusetts- Department of Public Safety Board of Building;Re�-ulations and Standards Construction Supervisor, License License. CS 58266. Restricted to: 1 G MICHAEL J, RENZI 387 PHINNEYS LN .< CENTERVILLE, MA 02632 Expiration: 1/30/2012 ('ununissioner Tr#:.13520. r w b21�1'1bd� �_.Z _ _ r'==E'9= ':=K�°�NZ PAGE �82I05 Town - Bar Regulatory Services hum ' ' auras F.CdIer,Director :5 BuRding Division Tom PerUp BuUftg+Ca�aaaSssxQxxefi 200 Mein S'sM; HYmmis,MA,02601.s Office: 508-862408$ Fax: 508r790-6230 Property Owner must , Campxete and Sze,, Tills Seddon if using.A, ;Ruadex I as ownet 6f the subject FOP hereby=60rize G to act oa=y beh4 im sL matters zelative to k , p ed b d pesr C s ap cation£at: (Address of,jo'a) P true f Owner 6 Prrt Name r i!I 47FOs�S:Ov�V- R�rr.�.�tnr- � a \b r 0 - yr - o u o' ti oA- Ll yac � -�v� P�htfo � y yxy ?0J(1 w .t�� 1 n�i O:p �Ll/�n � , �' H.t �J. H•-v 0' 9'�l 5'6.�fTj To k9�{ NA (� �PkJ H UL) J1fnP A p t Cuaev)4 FOREST ST. 90.00, G=15.71' EX SCR.. DWELLING � ay PORCH 1 V 26,90' 34.26' p CO NC. PTO, u� o � 100.00" CER TIFI D PLO T , PLAN CHAMBRE RESIDENCE 142 SEVENTH AVE W. -HYANNISPORT, AAA DATE! FF13. 14, 2011 DRAWN; RRS SCALE:1"=20' J06 #. E00905 DWG. Cpp EASTBOUND LAND SURVL'Y NO, INC. A.O. BOX 442 FORESTDA,LE, MA 02644 FOREST ST. so.oD• L�15.71' MBLU 245-68 142 SEVENTH AVE. W. HYANNISPQRT, MA 72.76' w SCR. DKLLING PORCH ai w 28.90' r` jj PROP. � o DECK@0 a 20' MlN. Mi a� t � d 100,00• CHAMBRE RESIDENCE I CERTIFY THAT THE IMPROVEMENTS SHOWN of 742 SEVENTH AVE— HAVE BEEN LOCATED WITH AN INSTRUMENT �wP`T� �ss�� W_ HYANNISPORT, MA SURVEY, DATE: FEB. 14, 2011 DRAWN: RRS ROBE ,., JOD #. E00905 o SYKES SCALE:1'•=20• DWG. Cpp No. S547 B o EASMOUND ` ST��s LAND SURVEYING, ,INC. ROBB SYKES, P.LS. DATE L 0 P.O. BOX 442 FORESTDALE, MA 02644 COKI- Lc- Tzf:7- �I+KE TOWN OF BARNSTABLE . ti Bu1�i111 g Application Ref: 201101957* sARIvsTASI.E, Issue Date: 04/20/11 Permit 9 MASS. �ArFG 3�a� Applicant: MICHEAL RENZI CONSTRUCTION Permit Number: B 20110777 Proposed Use: SINGLE FAMILY HOME Expiration Date: 10/18/11 Fcation 142 SEVENTH AVENUE Zoning District RB Permit Type: DECK/PORCH RESIDENTIAL Map Parcel 245068 Permit Fee$ 60.00 Contractor MICHEAL RENZI CONSTRUCTION Village HYANNIS App Fee$ 50.00 License Num 111859 Est Construction Cost$ 18,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND CONSTRUCT A SUNDECK OUT OF PRESSURE TREATED WOOD THIS CARD MUST BE KEPT POSTED UNTIL FINAL WITH AZTEC INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: CHAMBRE, PAUL 8i CHRISTINE BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 1066 N WATERWAY DRIVE INSPECTION S BEEN MADE. FORT MYERS, FL 33919-5922 Application Entered by: PR Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY'•STREET;ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER>TEMPORARILY OR PERMANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED.UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC`SEWERS MAY BE-OBTAINED FROM,THE.DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION.RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). Ir MR,VAIWRA ik M. o e S r ,e BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS f5:0 �- 2 2 2 3 / f `r r 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health Obo l-eh QA o�oa \ �qt` d 1 ti H ry S u�c,�. _ \k A yQclti suQeDK—T Ll ?aJ(1 HK/ 0r To ke mt 14t4 Q .e o f A-T 1�6`S �/1-0.) a 17 J o ti�`�I �� f � � � �a I �� s��-� � ,��� 1 �" � � 9' f < 1HE ' {` TOWN OF BARNSTABLE • • .ng Application Ref: 201003384 • BARNSTABLE. : Issue-Date: 07/07/10 Permit 9 MASS �ArFO 339. a�� Applicant: Permit Number: B 20101325 Proposed Use: SINGLE FAMILY HOME Expiration Date: 01/04/11 Location 142 SEVENTH AVENUE Zoning District RB Permit Type: DECK/PORCH RESIDENTIAL Map Parcel 245068 Permit Fee$ 60.00 Contractor JONATHAN TYLER Village HYANNIS App Fee$ 50.00 License Num. 072579 Est Construction Cost$ 4,200 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND NEW DECK 13X20 FT AND 29"OFF GRADE. EXISTING CEMENT PATIIOTHIS CARD MUST BE KEPT POSTED UNTIL FINAL LTO REMAIN UNDER NEW DECK AS ADD'L SUPPORT. INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: PUCHKOFF,ANNE C TR BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 74 BRADFORD COMMONS LN INSPECTION HAS BEEN MADE. BRAINTREE,MA 02184 Application Entered by: PR Building Permit Issued By:,, 1�� THIS PERMIT CONVEYS NO RIGHT TO OCCUPY'ANY STREET,ALLY-.OR SIDEWAL!(OR ANY PART THE REOF��=EITHER TEMPORARILY,,OR PERMANENTLY ENCROACHEMENTS ON PUBLIC PROPERTY;NOT:SPECIFICALLY-PERI IITTEp UNDER THE BUILDING CODE,.MUS,T,:BE APPROVED'BY;T.HE JURISDICTION: STREET ORALLY GRADES AS WELL AS DEPTH AND LOCATION OF�PUBLIC'SEWERSMAYBE OBTAINED FROM THE DEPARTMENT OF,,P,UBL-IC'WORKS. THE ISSUANCE OFjHIS PERMIT DOES NOT.RELEASE THE APPLICANT FROM:.THE CONDITIONS,OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LIN ING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6. FINAL INSPECTION BEFORE OCCUPANCY. .WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). „, , MOW r'k $3,,,r rmr, 4 in,'r$ t„, oaf 04__ R_ BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health VIE YAt f, �V � � -PA l e TA® . !I MAY-20-2011 09 :37 AM EASTS4UND}LANL-3SURVEYING 508 477 6411 P. 01 FOREST ST O00' h'µ a M OLU 248-68 � 142 SEVENTH AVE. W. HYANNISPORT, MA ' EX. EX. SCR. DMUING Z ' PORCH TUBES TYP) ON o rya 100,00, C�Cam- FO LLDA T 1 0 As-B UIZ T PLAN I CERTIFY THAT THE IMPROVEMENTS SHOWN � of M,rs 1425�EVENTTH REMc. HAVE BEEN LOCATED WITH AN INSTRUMENT �' �r W. NYANNISP't7RT' MA SURVEY' DATE. 5-7-11 DRAWE RaS SYK SCALE.I" 20' J08 Eoo906 No. M4r8 L`ASTBOUND S- 0 ( LAND SURVEYING, INC. ROBS SYKES, P. . DATE P.O. Box 442 FORESTDAL& MA 02644 Town of Barnstable THE r .. `� S��':� �^ �oF ° Regulafo y S'.erv.119 o� a,z�, Thqmn4s F.Geiler,Director BARNSCABLE, " �t. MA89 }Building DivisTon 0 1 ATEo MAC a Tom Perry,Building Commissioner 7 200 MaiTQ treet Hyannis,MA 02601 y town:barnstable:ma:us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# C' 'FEE: -SHED REGISTRATION _ -,120 square feet:or less AWN S . Location of shed(address) Village $03 2,bo_3coo l - Ci7kv-I&LLt Property owner's name Telephone number Size of Shed Map/Parcel# S01rue tr Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required)' Sign off hours for Conservation 8:00-930`&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. ti THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:042S06 - f r FOREST ST. 90.00, �bm 15,7 '' Q e� EX. SCR. DWELLING °j PORCH ai ( 34-26' Q � CONC. PTO. � N p d to �r ai 100.00, CER TIFIE D PL o T PLAN CHAMBRE RESIDME 742 SEVENTH AVE. W. HYANNISPORT, MA DA TE. FEB. 14, 2011 DRAWN: RBS JOB # �o0s05 SCALE,1"=20' DWG. CPp EASTV 0 UND LAND SURVEYINC, INC. P.0. BOX 442 FORESTVAI.E, MA 02644 Town of Barnstable' TO 'riv 0r BA Regulatory Servkes ' ' 'C J!c aARxsTANS, Thomas F.Geiler,Director . 1639. Building Division 6 Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us1 ' Office: 508-862-4038 Fax: 508-790-6230 PERMIT4db FEE: $ 3"S SHED REGISTRATION 120 square feet or less Location of shed(address) Village l AU V PropeAy owner's name /r- Telephone number~ �I 1 Size of Shed Map/Parcel# �79 a A/® Si to Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) \(X PLEASE NOTE- IF YOU ARE WITHIN THE JURISDICTION OF-ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. :w. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg a REV:121901 j. MORTGAGE INSPECTION PLAN (THIS PLAN WAS NOT CREATED FROM AN .INSTRUMENT SURVEY AND IS FOR MORTGAGE PURPOSES ONLY, MACDOUGALL SURVEY WILL NOT ASSUME LIABILITY FOR ANY OTHER USE). N FOREST 'STREET '. M 90.00' 100, 'j llO M m I -_- - __ 00 42 PARCEL 1D: z I - #1 - 0 245/077 —I D Z oo��G C -_ PARCEL ID: 9� -- 245/068 C. 100.00' PARCEL ID 245/076 PARCEL ID: 245/069. NOTE: PRE-EXISTING, NONCONFORMING I CERTIFY THAT THIS MORTGAGE INSPECTION PLAN WAS PREPARED IN ACCORDANCE WITH 250 CMR SECTION 6.05 OF THE MASSACHUSETTS RULES®ULATIONS FOR THE PRACTICE OF LAND SURVEYING. THE BUILDING SHOWN IS NOT AFFECTED BY A SPECIAL FLOOD HAZARD AREA AND DOES _CONFORM TO THE LOCAL ZONING BY-LAWS IN EFFECT AT THE TIME OF CONSTRUCTION WITH RESPECT TO SETBACK REQUIREMENTS OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MASSACHUSETTS GENERAL LAWS CHAPTER 40A SECTION 7..REFERENCED DEED ABJECT TO AND WITH THE BENEFIT OF ALL RIGHTS, F WAY, EASEMEN VAl10NS AND RESYMC11ONS OF RECORD, IF ANY THERE BE AND INSOFAR AS THE SAME ARE OF LEGAL FORCE AND EFFECT. ` TOWN: BARNSTABLE (W. HYANNISPORT) DATE: 10/30/09 APPLICANTS: PAUL & CHRISTINE CHAMBRE CERTIFY T0: SOVEREIGN BANK SCALE: 1"=20' SNOT TITLE REF: 1 491 5/1 38 MacDougall Surveying y& PL REF: 34/23 & 109/63 & Associates z EDW, D sct, FLOOD ZONE: "B" �++ P.O. Box 2428 A. COMMUNITY .PANEL: �pNE 250001-0008--D Mashpee, Ma. 02649 + Io.28 DATED: 07/02/92 CURRENT ZONING: "RB" ph. (508)419-1086 ru R Q/qj R� fax. (508)419-1067 email: macdougallsurvey ;1 JOB# 10558 ®Comcast.net ' TOWN OF BARNSTABLE.BUILDING PERMIT APPLICATION Map Parcel �1 Application # o Health Division ' Date Issued t Conservation Division ..'-,.Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address t4 a u ,z TA ,A V ,F Village LAJI _ Owner �lJ L Address Lk & :'De i fE U AV Telephone Permit Request G_ ,It M2cJ Square feet: 1st floor: existing proposed L4�00 2nd floor: existing _proposed t5n Total new Zoning District RES Flood Plain �J Groundwater Overlays Project Valuation �o1Z3('� Construction Type 06 k e i r C Lot Size Grandfathered: ❑Yes O-No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure o1 Historic House: ❑Yes UNo On Old King's Highway: ❑Yes allo Basement Type: ❑ Full &Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /4's Number of Baths: Full: existing new (0 Half: existing © new �V Number of Bedrooms: _3 existing knew Total Room Count (not including baths): existing new © First Floor Room CountCM J� - Heat Type and Fuel: $LGas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes �SNo Fireplaces: Existing 1 New o Existing wood/coal sfove"0 Yes 0,No Detached garage: ❑existing ❑ new size Pool: ❑ existing ❑ new size _ Barn:10 existi g ❑new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial 0 Yes ❑ No If yes, site.plan review-# Current Use L Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name To d\J ATOP R►v i `I L Iz 1-z. Telephone Number _ S� Address oZ `?UX © /1� f License # "7 Q Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �JA SIGNATURE DATE -7) a I o FOR OFFICIAL USE ONLY . . APPLICATION# DATE ISSUED MAP/PARCEL NO. f r ADDRESS VILLAGE > OWNER . 3 :r DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 4 The CornlHonwCUjth of Iassachusetts Deparfrneni oflndustr'iaf,4ccidents Office of rnvestigalions 600 lTlashrneon Street Boston,kvi NIA 02X11 VWW,mass.gov/dia Workers'. Compensation Znsnrance davit: Builders/Contractors%EIectricians/PlulillE ebL Please Print Lt- Applsca InZnformatiWi dame (HusincsslOrgani�tionllndividual) �0 to P�y Lj ----------------- Address: 1� OLM t`` IU, S j►'1�}.. B k Phone.#:- SP ` S roe{-" City/State/Zip: y Are you an cmployer7 Check the apprnprlate box; Type of project(required) 1.❑ ) am a employer with 4. ❑ l dam a general contractor and r 6. 0 l�cw construction employees (full an p�.�t)•* have hired the slob-contractors , 7; Remodeling 2.� 1 am a'sole proprietor or partner- listed on the attached sheet, ❑ ship and liavc no cmploycas These sub-contractors have g,, ElDemolition c,>zployees and have workers' 9 � Building addition worjdng for me in any capacity. , comp. insurance.$ [No workers' comp.insurance 10.❑•Electrical repairs or addLtiol required.] 5: []'We area corporation and its ofEcers bavc exercised their 11_[]Plumbing repairs or addidor 3,❑.�T am a bomeowncr doing all work right of exemption per MGL myself [No workers' comp. riot Roof repairs p, ISM, §1(4), and we have no ins,„ancc required]t� . I3.0 Other . tmployees. [No workers' comp, insurance required.] fAny applieanl that checks box#1 must also fill cut t},e section below showing the r tvorkcrs' eompervrahon policy infarrnation: t HomcawntrS who rubrait this a,Yidavit indicating they arc doing all work and tha,hirr outside contrecinrs must submit anew affidavit indi rating such. XContracLon Brat check thix box must attmhcd an additional;beet showing the Tian-jr of the sub-contractrn s and sfsic whether or not thoso entidcs have employees, Lf the sub contractorr have crnployccr,they mu rt prn466 their workers'cDnV-policy number. ra.rn n employer that isproviding.workers'compensali-0n.irtsurancefar.rny employees I�eLatV is the paltry artdjob sfte a info rm a1 l o rt fnsurancc Company ITame: . Expiration Date: Policy# or Self-ins. Lic.#: fob ob Sitc A-ddress: Attach a cope of the Yorkers' compensation policy declaration page(sho�w�ing the policy number and exFiiratiDu datz). Failure to secure covcrago m requirtd under Section 25A of MGL c, .152 can lead to-the imposition of rrimiri al penalties of a find up to 51,500,00 and/or one-year irrcpriscnrnent, as wall m civil penalties in the form of a STOP WORK ORDER and a iu of up to $250.0D against the violator. Br, advised that a copy of this statr-merit may bo forwarded to the Office of Investi atiow of c b f u crvf-.r-tcrr.vtrificatiom X do her by ce ertaltzes bf p erjury tltcrf the informaizort provided above is Crue and•cotTert Datt: -7 aL` `� _ Si attire: Phone #: 0Q" 31 �7qS�. Officiad use only. Do not write in tltu• area, to be completed by city or town off;c1.aC City or ToWa: Permit/License# l"ssuing Authority (circle one): 1. Board of Health 2, Building Department 3. City/Town Clerk 4. Electric:.rl.Inspecfor S, Plumbiog inspector 6, Other Information and hist 'U.c ions Massachusetts Gcneral Laws chapter 152 requires all cmployessotomprhc dewier of anotb r ndcroany contra t Oflbi o, Pursuant to this statute, au erraployee is defined as ...cyrry per express or implied, oral or written-" hi association, corporation or other legal entity, or any two or more An amplAyer is dcfmrd as "an indiyiduat, partrrcrs P cn a cd in a Dint cntctprise, a.nd including the legal representatives of a deceased employer, or e of the foregoing g g J g {�, p yin e to ecs. However tho receiver or trustee of an individual,partnership, association or other le al enti cm to g Y owner of a dwelling l]ousc having not Moro, than three apartments and who resides therein, or the occupant of the r TCpRjr Work on dwelling house of another who employs persons to do roaintcnan�c'of su h emolooyment be deemed to bedan e P�°o or on the c gxo ends or bvald�ng appwrlc nan`thereto Shall not b- P MGL chapter 152, §25C(� also states that"every stsrte or local licensing agency shall t'Tthhold the issuance or rancw2l of a license or permit to operate a business or to construct buEdlnn gs�in ghee ernmon e coveragnrequired."� or appllcaAt who has notproduced•acceptable c�idence of cornplianee�7 Additionally, MOL,ohaptcr 152, §25C(7) states "Ncitlicr the on blo cvidencc of onzplienf its ee vt"th the rinsuran�e enter-into any contract for,the performance of public work untilp er have been presented to the contracting authority. zcquirezncnts of this chapt Applicants' the boxes that.apply to your situation and, if` . Please fill out tho workers' compensation affix ss csrPandlYhon nGcEag umbcr(s) along with their ccztificetc(s) of necessary, supply sub-coatractoz(s)namc(s), ( ) P insurance, l.imitcd Liability Comparrics.(LLC) or I;imi.ted Liability Partn�s�ps (�ap)with L�o o�LP does bavc�er�� the znambcrs or paztncxs, arc not required to carry workers compcos�on uas Of Indv-stri employees, a policy is required- lac adyiscd that this affidae tuma re to sis�gu and date thGDf£�dnt ntZbc af6dantlshould Accidents for confirmation of insurance coverage. Also b bo returned to the city ar town that thc'applicatio n for.the permit or liccnsc is oeinagr=qu to obtain aewflrkcrnt of Industrial Accidents. Should you he vc and A ti tnsthc nurrpdbcr listcd below. Sclf-insured companies should enter their coropensitionpolcy,please call th pep self asur-=n o license number on the appropriate lint. CIty or ToWP O;fticlals Plcasc be sure that the a£�dae bottDM vit is cozrrplcte grid printed legibly. The Department ntact°oudrgardm.g thctapplicantt of tho 915davit for you to fill out in the event the Oificc of Investigations has to o y Plcaso be sure to fill in the permit/liccnsc number which will oven eaar; n cd only submitonp affidalyit indicating current that must submut nsultzpae periaiti1 ccasc applications uz any gr Y policy information(if Accessary) and under"Job Site Address" tho applicaat should write"all Iota r town mayb nsr ndcd to thr oz y the r town)."A cbpy of the of daa sffidavr ras s on file fozllfuturc perMits or ceases A newity oaf5davit must be filled out each apptira nt as proof that a vah year.'Whoro a home owner or citizen is obtaining a license or pprza't not related io any business or commercial venture ed to complete this affidavit (LC. a dog kccasc ox-permrt to burn lcavcs etc.) said person is NOT rcqui.r Tho Office of Investigations would ldce to thank you in advance for your cooperation and should you heYe any questions, please dO not bcsitate to give us a call' TbcDepartment's address, tclephoac.am fax number: Thy Commonwealth Of MARSWhusC-tts D,-PUt�a�At of la 4str��l Accidents Office o'fttstigat .ams 600 WaSh V),a Street Buton, MA 02111 Tel; # 617-727-4WO ext 4.06 or 1-$77-MASSAFE Fax# 617-727-7749 Rcviscd 11-22-06 vrww.maSs"goY�dia document OOI.jpg 170OX2352 pixels 4/13/10 12:39 MORTGAGE INSPECTION PL (THIS .PLAN WAS NOT CREATED FROM AN INSTRUMENT. SURVEY AND IS FOR MORTGA MACDOUGALL SURVEY WILL NOT ASSUME LIABILITY FOR ANY OTHER FO 'REST TREET 90.00gloom 00 -..j M o > = 142 -= - _ o ° - � PARCEL IC 245/068 /n 100.00' PARCEL ID: 245/069 http://sz0088.wc.mai1.comcast.net/service/home/—/document%20001.jpg?auth=co&Ioc=en_US&id=10296O&part=2 Page 1 ., Y Ell . ItA4 PA ' OPOI �- �� Cn; oFYHer Town of Bqrnstable Regulatory Services x{�rxsTAn�, Thomas F. Geiler, Director Building Division Tom perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.ba rnsta ble.m a.us Office: 508-862-4038 Pax: 508-790-623 Property. Owner Must bmpletc and Sign. This Section If Using A Builder . A yY\`�Q � ; as owner of the subject piopetty hereby authorize D to act on my,behalf, ._ in all matters rrlative. to work.' uthorized by tkis building permit application for: (Address .of Job) CW)a F �I oZ � l•� Signature of Owner Date Print Name If Properly Owner is applying for permit please complete the Homeowners License Exemption PorrA on th'e reverse side. Town of Barnstable OF tHE.rorj Regulatory r�,ezvxces y Thomas F. Geiler, Director F HARNSTAB[.S, ,' M Building Division MASS.. ,alp. pJFi µa'tn Tom Perry,Building Commissioner 200 Main Street, Hyannis., MA 02601 ww)y.tovs'n,b2rnstable.ma.us Fax: 508-790-6230- Office; 508-862-4038 HOnfEoWNU R LICENSE> XEA4PTfON piense Print DATE: JO$'LOCATION: sheet village number "HOMEOWNER": home phone N work phone# name CURRENT MAILING ADDRESS: state zip code city/town ts or less The current exemption for"homers"was extended to include owner-oca>;1Pe d d`�'=oVded that thgs of e owner act and to allow homeowners to engage an individual for hire who does not possess , supervisor. DEI+INITION OF HOMEOWNER or is i ed Persons) who owns a parcel of lan h use d on Which he/she resides or intends o rrsduewhich and/or farm tructures,dA to be, a one or two-fanulydwelfing, attached or detached structures accessory to person who constructs more than one home u?lcial on.a afoprmrlacdceptable to the Building Official, that he shall not be considered a horneo me - s ha shall be "homeowner" shall submit•to the Building Off responsible for all such work erformc.d under the'-building erinif, (Section t 09,1.1) "homeowner"assumes responsi bility for compliance with the State Building Code and other The undersigned applicable codes, bylaws, rulcs.and regulations, ea Th'e undersigned "homeowner" certifies that he/she understands the Towol Barns s bld But.P ocadu8r Minimum inspection procedures and require 's)and�ent ments and that he/she`'nil comply y With requirements. Signature of Homeowner Approval of Building Official g 35,000 cubic feet or larger will•be rcquired.to comply with tho Note; Tbree farruly dwellings containin State Building Code Section 127.0 ConstrucHhOu Control. 0uC0R'S> x> MPTION eowner erforming work for which a building permit is rcquired shall be exempt from the provisions "An hom P . a cs a crson s)for•hire to do such The Code slates that. y • of this section(Section Iop,),l -Licensing ofconstruetion Supervisors);provided that if the homeowner cng g P work, that such Homeowner shall act as supervisor." arc the articularly Many homeowners who uscshtructio Supcm.sors Scction 2I15)yTbis la k of gwarcnccsooctcnlrclsu)tsf in scrioussproblcrosppcndix Q, Ru)cs &'Rcgulalions for Liccnsing Con sup cm the homeowner hires unlicensed persons. In this cast,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homcown cr acting as Supervisor is u)timatoy responsible. 'Lies require,as part of the permil app)teation, To cnsurc that the homcowncr is fully aware ofhis/hrr responsibilities, many commune that the homeowner certify that he/she underfslands thc^responsibi)itics Of for utPs nsyouro otmmuanityagc of this issue is a form currently used by Massachusetts- Department of Public Safety Board of Buildin6.Re�"ulations and Standards i Construct.jo+a Supervisor License License: CS 72579 3'�. Restricted to- 00 y JONATHAN-V TYLER "1 2 LYNXH.OLM';CT HYANNIS, MA..026di- 1 Jam_ �- !�. Expiration:. 1/4l2012" t t'ununusiuner Tr--: 1,3117 Restricted to: 00 00- Unrestricted 1G-1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: WWW.Mass..Gov/DPS Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registratio,p� 64032 10 Park Plaza-Suite 5170 Expirat �8W4�2Q11 Tr# 287856 Type ; Boston,MA 021 i ) ovation REMODELING PrSS4ICFafEtG I JONATHAN TYLEt . 2 LYNXHOLM C&-' HYANNIS,MA 02601� u Undersecretary Not valid without signature J RNIF itf _.. - [7 a w -6 ti p e VA � � y } f ryai -- Town. of Barnstable *Permit Expires 6 mont s jr m is date Regulatory Services Fee S swxxsrnst e MASS. Thomas F.Geiler,Director 9� 1659 `�— �'FD Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY QNot Valid without Red X-Press Imprint Map/parcel Number ICJ Property Address S L V EST FA A V Residential Value of wor Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Pa U L C I-/A yv��t2 C_ IV) _ o / Contractor's Name Telephone Number 7��79S7��o a 6 7 a Home Improvement Contractor License#(if applicable) b"1 C) . Construction Supervisor's.License#(if applicable) g ❑Workman's Compensation Insurance �y Check one: -P����� T ERIMI G ❑ I am a sole proprietor. I am the Homeowner O E C t 7. 2009 I have Worker's Compensation Insurance TOWN OF BARNSTABL E Insurance Company Name '�V �' L1'—I Q S Workman's Comp.Policy# r ` S y d I 0-7 An p��.� l 4 — L� Copy of Insurance Compliance Certificate must accompany each permit. . Permit Request(check box) I� Re-roof(stripping old shingles) All construction debris will be taken to 13A.R NSTArBLi✓ ❑Re-roof(not stripping..Going over existing layers of roof) ® Re-side #of doors Replacement.Windows/doors/sliders..U-Value (maximum.44)#of windows 1�_ *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. A cop +of a Home Improvement Contractors License&Construction Supervisors License is SIGNATURE: C:\Users\decollik\App ata calwticrosoft\Windows\Temporary Internet Files\Content.Outlook\4STGU5QO\EXPRESS.doc Revised 090809 J b The Comnioniveakh of Massachusetts Department of Indusorial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 vvms mass.gov/dia Workers' Compensation.Insurance.Affidavit: BuilderslContractors/Electricians/Plumbers Applicant Information s " _ Please Print Leeibh Name(BusineWOrganizationdndividnal)- F`hn o N J L I 01-iGt' >A S S0C)AT I?s•IToPi rH A AJ Address: 1„�1�iJ, C� -�O y►-� < �-� 56l� I�-v.� M A. c a'b O T _ City/Stat&Lp: ..Phone##, 56 3 6 Y- -7 ci S? Are you an employer?Check the appropriate box: •Typee of project{required):. 1.❑ 1 am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time)_' have hired the sub-contractors 6. New constriction 2.❑ I am a sole proprietor or partner listed on the attached sheet. . y- ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition w for me in an c employees and have workers' °�`g y capacity..�'-• I 9. ❑Building addition o workers'[N comp_insurance, comp.insurance. 5.AX We are a corporation and its c 10.❑Electrical repairs or additions requited-) (T� 3.❑ I am a homeowner doing all work `.officers have exercised their 11.❑Plumbing repairs or additions myself [No workers'comp- rightt of exemption per MGL 12.❑Roof repairs insurance required_]6 c. 152,§1(4),and we.have no employees.[No workers' 131-1 Other comp_insurance required] hcam that checks boas#1 mast also fin out the section below showin their workers'c*Any aPe � g ampensatioa police information. T Homeowners who submit this affidasiriadicating they are doing all weak and then hie outside contractors mast submit a new affidavit indicating sucti',.,. lContractors that check this box must attached an additional sheet shooing the mane of the sub-cmaractors,wd state whew or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my emplgnem Below is the policy and job site information. Insurance Company Name: . Policy#or Self-ins.Lic.4: i) U 1,(' ` (2 J`.VV\(9 Expiration Date:_= 5 / Job Site Address: 51R V QitUT K Avwg i i City/State/Zip: YAIy.NiSAOA). ►'�A r Attach a copy of the workers'.compensation policy declaration page(showing the policy number and expiration date). Failure to secure cm erage as required under Section 25A of MGL c..-152 can lead to the imposition of criminal penalties of 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_ Be advised that a copy:.of this statement may be.forwarded to the Office of Investigations of the D for' ce coverage verification_ I do hereby a Undkt6A i s and penalties of perjury that the informtatfon provided above is true and correct Si tune: Date: / Phone#: d .Official use only. Do not write in this area,to be completed by city or town ofi'egaL City or Town: Permit/License# Issuing Authority.(circle.one): 1.Board of Health 2.Building Departn ent 3.City/rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other A a Contact Person: Phone#: o�TME • BARNSTABIX • MAM 039. Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property.Owner Must Complete and Sign'This Section If Using A Builder , I, U L- C H A n i�R= , as Owner of the subject property hereby authorize TO►y Al 1-k I�� � �( L.�\2 to acton my behalf, in all matters relative to work authorized by this building permit application'for: p I y s Ery 19 M 11 AV L �sT r1 yi4 wN 1 s p6,Q (Address of Job) )al► 6 0R Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\4STGU5QO\EXPRESS.doc Revised 090809 I' i�. f3biiY O, nlnitf It@ IY flti' �9 alit nn�a9 Construction SuperAhor.Licsnse 00-35;000 of enclosed space I: 1A-Masonry only. �' 1 �< Llosnse: CS 72579 1 [, I .2 Fatuily Homes ,. EXPI r tlan 1/4/2010 Tr# 14112 I � Failure to possess a current edition of the �lresFtfo� , `� I, ! Massachusetts State Building Code i is cause for revocation of tins license. JONKTFU 2 LYNXHbLM HYANNIS!,MA 0260'T" -j'-s Co�tYnis"i e ✓he Toomemco?�urea.(,C/a n�✓/.ZaeeadiueelZd ---- Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: va'` Office of Consumer Affairs and Business Regulation Registratioq x 1P4032 10 Park Plaza-Suite 5170 Expira 1. 811-412011 Tr# 287856 u .� „ Boston,MA 021 Type rlya t -or ration dd tq. REMODELING A �T3i1fi.: r= - JONATHAN TYL 2 LYNXHOLM COY,R r j HYANNIS, MA 026010 Undersecretary Not valid without signature .......... ..-- —— _. __.._.: ------------ -----... - -------- - - --- —- ------ --- P� VDAC TRAVELERS , WORKERS COtUIPEl�tSATION EMPLOYaPS LIABILITY POLICY f TYPE AR INFORMATION PAGi WC as o0 0; ( A) POLICY NUMBER: (7PJUE-0443N82-G-05) INSURER: TRAVE'L-RS PROPERTY CASUALTY COMPANY OF AMERT C? NCCI CO CODE: 1 357-9 i .INSURED: PRODUCER. R=MODEL=NG ASSOC AitS -NC- BRYDEN & SULL?VAN _NS AC 2 L}"r.(;}-►OLNi COURT_ 6-8 �ALMOUit; RD HY r_+ S MA 02601 HY ,!*lth_+ S MA o260 . insured is A CORPORATION Other work piace<:and identincE�ion numbe.,� are shown in the sc heduie(s) attached. 2- The poiicy period is from 05-02-08 t 05-02-i o :�� PM. at the insured's naiiina address. 3. A. WORKERS COUPENSA T IO_N INSL1.RANCE:. Part One of the policy applies to the'Workers Compensation Law or the states) listed here: MA EMp!OYi=RS LIABIL i t Y INSURANCE: Par Two of me.poiicy applies to work in each sate listed in item 3-,', The limits of our lia0 iity under Part I wo are: Bodily injury by Accidern: S .1 00000 Each.Accident Bodily Injury by Disease: S 500000 Policy Lama Bodily injury by Disease: 100000 aci? Empioyee C. OT�TEP STATES 1t�ISURANCE:. Par Three of the Doi icy applies to the states, r any, listed here: COVER:;GE REPLACED EY ENDORSEMENT Wr- 20 03' DGA ese endorsements.and schedules: D. This policy includes th Sc3_ LISTING OF ENDORSEMENTS - -�NSION. OF "+_.NFO PACE The premium for this policy will be determined by our.Manuals of flutes, Ciassincations; Pates and Rating m to vemication and.c3;ange by audit to be made 'ANNUAL! Y Plans. All required information is subie ST ASSIGN.: MA DA T E:OF ISSUE. 04-24-OS SMi OFFICE: DIRE C-T :SS_GN► EN 70i 232my PQnnHr,-P: RRYDEN & SULLIVAN INS AG B � a� K, I'4, . . I� Assessors map and•lot numb r ... .....,'............ YNe . ;. � ...... �oF toy 3eve Permit .number '...8 ...... . ... :..... .... .. .. L d� �� Z 33AUSTADLE, i Housenumber ....:...........T.......................................... : rasa A, TOWN OF BARNSTABLE BUILDING INSPEC'T.OR 4 APPLICATION FOR PERMIT TO ........ .....C.iL....... ..... . .. .!r .................................................... TYPE OF•CONSTRUCTION ...... (. ,....:.. 1 : 1... . .......:...19........ . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. ..........�.......... .........`.^....'" ....... ..�.. .. . . ...... ProposedUse ...:.................................... ......:.......................................................................................................:..................... Zoning District ...:.......R. ....................:............................Fire District ..... .. .... .!1.0v.......................................... Name of Owner ...S...... ."N4Z. .......Address k`pt... .... .. ::. ..: ..�1�... :... 3 `... Name of Builder ....1 !1.Ct:.n..... ............Address ............ ..... ....... ... ✓.U�Q�.................. Nameof Architect ..................................................................Address .............. ...................................................,.................. • Number of Rooms ..................................................................Foundation ........... ... .......................................... Exierior ............................................................................._.......Roofing ..........,... ... ... ..... .. •................................................. Floors ...................................:................................Interior .. ..,l..G.C�..4/V�-..............: Heating ..................................................................................Plumbing ..... ... ...: Fireplace ..........................................:.......................................Approximate. Cost ...... ..6l.a ................................. Definitive Plan Approved by Planning Board __------------------------------19________. Area .:. Diagram of Lot and Building with Dimensions Fee _ a i SUBJECT TO APPROVAL OF BOARD OF HEALTH Jd OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to.ail the Rules and Regulations of the Town of Barnstable regardingA _Z he ove construction. ` ame .... ....... ....... ............:..................... ...... ...... Construction Supervisor's license .........1... (. ::....... KUSHNER, DAVID A=245-*8 11.... Permit for ..addit-inn-ta......... •single„family__dwelling............................. r Location .. 42.. V�171.. Y. C311�..:................... r (� ......... Tks......HY.ar???ist?ort............:.................. 4 Owner ........DdY.id..Kushner............................. Type of Construction '...........Frame................ Plot ........................ ..... Lot -' ......... ........ Permit Gran.ed Ate s -1984 Date of,Inspection,............................ ......19 Date Completed ...... �D l - � .�_- �,,,., .f- .,.ems `�.,.} / /'•.-i � � cc✓ �,� t � �Y f s 1t Al r# Y f ssessor's` map and lot number ... ...T ...... .. .......... yoF THE log . ew c 1 Permit number ,...i:... ! ..........�.......: ........ ...... Z� d _4 <, l Z BARNST�LE, i House number .... M 039- TOWN OF BARNSTABLE 7 BUILDING INSPECTOR iAPPLICATION FOR PERMIT TO ....... .a,?4 ......CAA. .......... .. .................................................... TYPE OF CONSTRUCTION ..... ��.� ,).�.?{.. ► ........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit �according to the -following informati'o-nn: Location ..I.4........... ........�.......... ..........`.^..:AA1.........I........... U................................................... Proposed Use .....................................................................................................f.,. ................. ....................................................... Zoning District ............r.. .. ................... ...............................Fire District .,....1`-4a..G��1!(/1i(.1 ..............................:.......... Name of Owner a ..... ..,........Address ...... ..... ... Name of Builder ....� X�.........� ............Address .................. ..... .................... - f Nameof Architect'..................................................................Address ..................:................................................................. Number of Rooms ...................................................................Foundation ..........�`...J: ,>...............,. .................... Exterior ......Roofing r n Floors :........................................................:.......Interior ..c.... .. ..,• .5�1.:. ....................... ................ ................ Heating .......................................1.........................................Plumbing ... . .. ��.. .(r .......,........................... Fireplace ............................................ ................. .................Approximate. Cost ...........61t b .........................:...................... Definitive Plan' Approved by Planning Board ____ -_`_-__ - ��a:..scT.:. ----- -- 19- ---. Area ........ .................... _.r. / A Li Diagram rof Lot and Building with Dimensions Fee ....... ............................... SUBJECT ,T.O` APPROVAL OF BOARD OF HEALTH • 711 Ile . 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. . , f J > - -S / �: - Name ............ ...... ................................-..... ........ .............. ..... 5715 Construction Supervisor's License J O 1 .1 V , KUSHNER, DAVID A:--245-068 NO 6 Permit for ......addition...to..... "ar' single family dwelling ....................... Location ...........1...4.2.....S.gyeq �.,y(..It .............. ................ -Iniawrt............................ Owner. .................David Kushner ................................................. Type of Construction .....................D;.c-M.......... ............................................................................... Plot ............................ Lot ................................ Permit Granted ............... ....1984 Date of,Inspection.....................................19 Date Completed ......................................19