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0192 SEVENTH AVENUE (HYANNIS)
ale-. ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map i5 Parcel 07 9 Permit# � 6 Health Division Date Issued 9 °� Conservation Division 0e ��� �,� 0C��7i /©� VrApplication Fee Tax Collector ' ` Permit Fee 4 Treasurer lJ,.� � SEPTI!CSYSTE NI MUST fBE Planning Dept. A/ ✓I-- INSTALLED IN COMPLIANC Date Definitive Plan Approved by Planning Board LE ENVIRONMENTAL C6DE ANE Historic-OKH Preservation/Hyannis TOVWi REGUU.'T1C.% Project Street Address /9't 2 �}l/ , y`e 'l l s ziPo n-7— Village n/, S Po Owner [ C,C_ 1-4 (7v el C�'�►�`— Address e_1FrW 12j0_ ,AJG C-rk ..� Telephone Ce(7 - 3 3 2 - 0 Permit Request &2,d 0-3 R' oa F Square feet: 1st floor: existing loo® proposed 2nd floor: existing proposed Total new Zoning District Flood Plain ; Groundwater Overlay Project Valuation 5!e�`�' Construction Type e. Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 12 Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes eNo On Old King's Highway: ❑Yes 510 Basement Type: ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) xi (( Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new aJ Half:existing 9 new �1 4�- Number of Bedrooms: existing new Total Room Count(not including baths): existing ' new XJ Af First Floor Room Count Heat Type and Fuel: fGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes �_:'No Fireplaces: Existing New Existing wood/coal stove: ❑Yes Zo Detached garage:❑existing ❑new size Pool: ❑ZZiing Cl new size Barn:❑existing ❑new size's Attached garage:❑existing ❑new size Al (� Shed: ❑new size Other: Zoning Board of Appeals A�thhorition ❑ Appeal# Recorded❑ y Commercial ❑Yes 9f P es, site Ian review# y Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address /:' ti t' License# O 3 7 C,3 CA co . ��a w>�� �" _ �2 6 Home Improvement Contractor# 12c9y y 0 Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO A C6Q-1-e C SIGNATURE DATE (e FOR OFFICIAL USE ONLY "PERMIT NO. - - -. DATE ISSUED MAP-/PARCEL'NO. rl A f ADDRESS VIL IAGE,t / 1 OWNER ! s + _ DATE OF INSPECTION: t ' FOUNDATION FRAME ° INSULATION FIREPLACE Ijb ELECTRICAL: �+ ROUGH FINAL' { ;I PLUMBING: ROUGH FINAL : I 4 GAS: ROUGH FINAL: f '►f.. f I tlFINAL BUILDING f"= .. • ! ¢ r ` DATE CLOSED OUT ASSOCIATION PLAN NO. r 5 / ' s r The Commonwealth of Massachusetts Department of Industrial Accidents ^— = exce offoyestfff8 foss _ 600 Washington Street - Boston,Mass. 02111 Workers' Com ensation Insurance davit r�aioa�i�i���///ate �. name: , location: - - hone# city ❑ I am a homeowner performing all work myself. ❑ I am a sol rciprietor and have no one worldn M' ca aci FllllllllllllllflllllIIIIIIZIIIIIIII rkers co ensation for my employees working on this job. 0 ;{{.,•{r ?::Yit` K4:t:,;i :">{,?,'fi';4';itakkt'.,gy;{}.: 'din w }:,4: :• .:t m to er �... 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I do h the pains en es o Perjury that the information provided above is into and correct ereby n `Yi(2 �'�C� - Signature Date�'— Phone# ��` C1 - Print name ` do not write in this area to be completed by city or town official oMdal use only perIIdt/license# OBuilding Department city or town: ❑Licensing Board Selectmen's Office. ❑dieckif i,nmediate response is required ❑Health Department contact person: phone#; _ O Other (fcviaed 9l95 P7AJ 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. c shall withhol d the issuance or'renew al MGL chapter 152 section 25 also states that every state or local licensing agency . of a license or p applicant who has permit too operate a business or to construct.buildings in the commonwealth for any 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. 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 along with a certificate-of insurance as all affidavits maybe submitted to the Department of Industrial Accidents for confirmation of hmu-ance 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 not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you being requested, are required to obtain a wormers' compensation policy,please call the Department at the number listed below. li City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom f the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference niir6ei r. The affidavits may be retame3 to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would litre to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Departments address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents gMce of investlgatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 nhone#: (617) 727-4900 ext. 406, 409 or 375 i Town of Barnstable Regulatory Services ?sT^B Thomas F.Geiler,Director mass. 039. 3�a��� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,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. e d J S Estimated Cost Type of Work: `p��/4' �S � TZCS'�0 77 Address of Work: Owner's Name: Date of Application: 9_1�'a 7 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded bylaw ❑Job Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner Date Contractor Name Registration No. OR Date Owner's Name Q:fomislomeaffidav I . ES ' RESIDENTIAL B UILDING PERMIT FE APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW I,IVING'SPACE square feet x$961sq.,foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE _ p -- square feet x$64lsq.foot= x.0031= t-��.-- plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf-1000 sf .00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: x.0031= Square feet x$96/sq.foot= - ALONE PERMITS ,: r STAND x$30.00= Open Porch (number) x S30.00= Deck (number) Fireplace/Chimney �x$25.00= (number) Inground Swimming Pool $60.00 $25.00 Above Ground Swimming Pool r RelocationlMoving 5150.00 (plus above if applicable) Permit Fee �/ r { Df�HE rti Town of Barnstable Regulatory Services. f _ &AXNMBbUni'E'� Thomas F.Geiler,Director , o i Building Division.. TE µpX ' G Tom Perry, Building Commissioner I 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Al mplete and Sign,Thxs Section i --- - .------- -- .. - ---- ^If Using A Builder - ----- ---_-.�----___ - ,,as Owner of the subject ro „ l P. per'.. f hereby autlhorize to act on my.beh4. in all matters relative to work authorized by this building permit application for (Address of Job) , J {t-- bigmtuxe ot Owner Dat- iF. Print Name I r • .ry 1 l 1 ' Q:F0RMS:0V NLWERMLSSI0N 1 i i r t , �R4t'[Op�7UI➢LO4tI.I/CQ.U/�Q� � � i . BOARD OF BUILDI., REGULATIONS,y 'License: CpNSTRU.C;f101�SlJpERVISOR Ntimbe►.-:CS. 0$7.f;36 etrthdats�04/22f.�19�9, ,,�. - I Expires Q4/22G2Q04� Tr no 22215 v Restricted 90 DANIEL A.SPEAKM r 15`SPEA ANK WAY N HARWICH, MA 02M5 Administrator �/te.V�an»nan�ueall/ o�'./�.craoczc�ivac; , Board of Building Regulations and Standards:\ HOME IMPROVEMENT CONTRACTOR Registration 1-0040 y,. j , Expiration 1'Q/��03 Type Iridyidual DAN A SPEAKMAN CONSTRUCTI' ENN SPEAKMAN 15 SPEAK WAY _.. NO HARWICH,MA 02645 �ldilinairG gtol �' € ,��a -,1r �"% � �d✓ $�,_ ,r litµ. �,;�a 4 a 45 `. s l 94 �. . , i ^ C:\conservation.dgn 9/12/2003 9:34:40 AM L CAT1O OF PROPE TY 1N ""MAY `,*4aT 13 ACCIJ n.TE STANDARDLEGEND NOTE:not all symbols will appear on a map =— J GOLF COURSE FAIRWAY . . ' EDGE OF DECIDUOUS TREES 186 EDGE OF BRUSH ORCHARD OR NURSERY ' 7 V EDGE OF CONIFEROUS TREES MARSH AREA .. EDGE OF WATER DIRT ROAD _— DRIVEWAY PARKING LOT �--PAVED ROAD -- -- — DRAINAGE DITCH ————— PATH/TRAIL PARCEL LINE 24 MAPIlo < MAP# 21 E PARCEL NUMBER #1e60 E HOUSE NUMBER 2 FOOT CONTOUR LINE ---}�— 10 FOOT CONTOUR LINE Elevation based on NGVD29 V `,• 4.9 SPOT ELEVATION k c:x—x:a STONEWALL -X---X— FENCE RETAINING WALL 194 ?— RAIL ROAD TRACK STONE JETTY P 0 O'L SWIMMING POOL PORCH/DECK ❑ BUILDING/STRUCTURE +_ DOCK/PIER �-n HYDRANT e VALVE O MANHOLE o POST OFP FLAG POLE T O W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M S U N I T .o SIGN ® STORM DRAIN N PRINTED SCALE:IN FEET *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetrics(man-made features)were interpreted from 1995 aerial photographs by The James ❑ TOWER w ° a 1"=100'scale map and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD o UTILITY POLE 0 10 20 National Map Accuracy Standards at this do not represent actual relationships to physical objects (orporation. Planimetrics,topography,and vegetation were mapped to meet National Map Accuracy Standards LIGHT POLE o ELECTRIC BOX : 1 INCH=20 FEET* enlarged scale. on the map. at a scale of 1"=100'. Parcel lines were digitized from FY2003 Town of Barnstable Assessors tax maps.