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Home My WebLink About0044 UNCLE WILLIES WAY y�J Uncle Cc� , Ili es 4Ian Town of]Barnstable *Permit# / $� Expires 6 months from issue date Regulatory Services Fee 11A ,11 S Thomas F.Geiler,Director X-PRESS PERMIT Building Division Tom Perry,CBO, Building Commissioner JUL 3.1 2006 200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTABLE www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address �� r�R_ l\A/fy ❑Residential Value of Work I s Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address o. Contractor's Name G\V NrN, �,� ¢l g Telephone Number `77 ' V 0 Home Improvement Contractor License#(if applicable) U Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance NN-_2eck one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance y.� Insurance Company Name 1 { \NA V Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file.. Permit Request(check box) n [g\Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ZkRe-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 Improvement Contractors License is required. SIGNATURE: , '4-lz Q:Forms:expmq Revise071403 1 ne c,ommonweairn uj jnas•sucnu5e1t3f Department of Industrial Accidents Office of Investigations 600 Washington Street ` Boston, MA 02111 I.'wI.'.mas&gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plui36bers Applicant Information (Plleasse Print Legibly Name (Business/Organization/Individual): I k 011S:S �,,�c •, c,v a�y 1, 4�p b Address: City/State/Zip: - 4, Mo\ Phone#: U CIO —TI Are you an employer? Check the-appropriate box: Type of project(required): i.❑ I am a employer with 4. ❑ I am a general contractor and I 6• ❑New constriction employees (fall and/or part-time).* have hired the sub-contractors 21K I am a sole proprietor or partner- listed on the attached sheet # ❑ Remodeling \ship and have no employees These sub-contractors have 8. D Demolition working for mein any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers' comp. insurance 5• ❑ We are a corporation and its required.] officers have exercised their 10.❑ 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 12.0 Roof repairs insurance required.] t 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 wbo 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: /i 1-_�_r Policy#or Self-ins.Lic, #: I7Z/I- U 13 Expiration Date: l d S-0 �i A Job Site Address: T� ah<,�v !., s y City/State/Zip: an n>s zyt 7"�o l 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 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 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: Signature: �� iP� Date: 74622( 61 Phone#: ! 0 3 — 7"7 / ` 7 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.Plum bi>3a inspvs nor �I 6. Other i • I Contact Person: Phone#: 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 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,§25C(6)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,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),addresses) 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 be sure to fill in the permit/license number which will be used as a reference number. 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 bum 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 Investigations 600 Washington Street Boston, MA 02111 Tel. 617-727-4900 ext 406 og 1-877-MASSA E rax r- 617-727-7749 Revised 5-26-05 wwvNr.mass.aov/t"iia °USE f Town of Barnstable Regulatory Services 9a�x $ Thomas F.Geiler,Director ' Building Division. �r Torn Perry, Building Commissioner 200 Main Street, Fjymnis,MA b2601 www.town.b arnstabl e.ma.us office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and.SignThis Section. 'If Using ABuilder o C a r�► ,as Owner of the subject property hereby authorize �� l`T- a 4 Q l a, to act on m7 behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) D � ,Sign e of Owner Date • � �� l � 3 m � g G � a`''�YET • Print Name Q:FORMS:o WNERPERMISSION 91te � Board of Building Regula ions and Standards One Ashburton Place - Room 1301 " Boston. Mass,;achusetts 02108 Home Improveme6c, ntractor Registration Registration: 130611 ` Type: Individual 4 -- Expiration: 3/31/2008 CAROLYN BOBOLA CAROLYN BOBOLA 24 ST. FRANCIS CIRCLE { HYANNIS, MA 02601 Update Address and return card.Mark reason for change. 1Ps-CA1 0 5oon-04/05-PC8698 D Address E] Renewal F-1 Employment Lost Card a j �„�' ` • TOWN OF BARNSTABLE Permit No. _-----_20311 � e Building Inspector Cash ____-- '°o OCCUPANCY PERMIT Bond --- X No building nor structure shall be erected, and no land, building or structure shall be Sised for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to J. Albert Bassett Address Box 33, South Yarmouth, MA lot #20 44 Un cle Willies Way, Hyannis Wiring Inspector Inspection date Plumbing Inspector i Inspection date Gas Inspector Inspection date Engineering Depar ent- Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ..................................................._, 19_._— ........................... ..... ............. _ _ .. .. Building Inspector t4 `J„�•;` .e TOWN OF BARNSTABLE Permit No. --------_20311 Building Inspector Cash __ OCCUPANCY PERMIT Bond _x "No building nor structure shall be erected, and no land, building or structure,shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to J. Albert Bassett Address Box 33, South Yarmouth, x�,11 lot #20 44 Un cle Willies Way, Nyam'Ls Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector f Inspection date Engineering Department f � Inspection date- THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. .............................................._....., 19_._....._ ..............................................................._� Building Inspector „�•""'. TOWN OF BARNSTABLE 20311 Permit No. --------_--- - Building Inspector sAUeTAU Cash -----___-- .... OCCUPANCY PERMIT Bond _ x "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permits therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector.” Issued to J. Albert Bassett Address Box 33, Swth Yarmouth, MA lot #r20 4 tin cle Willies Way, Hysnni.e Wiring Inspector Inspection date Plumbing Inspector ", Inspection date Gas Inspector Inspection date Engineering Department V/ f / Inspection date•' THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ........................_._..._............�, 19-......... ......................_.................... ................_ Building Inspector 3a 3 9� D� ,mac ✓dal- -/G� ��" : SEPC Assessor's map and lot num r ...............:..................... SYSTEM MUST BE ypi TH E t01� INSTALLED IN •COMPLIAN;CE Sewage; Permit number 7 ........ .. .................................. WITH ARTICLE II STATE -� 'SANITARY CODE AND TOWN 33sa9 E ; " House number :. - 9 Maas L . REGULATIONS. oo 039. 9� 0NO c" OWN OF BARNSTABLE ~° -4 -15) " _? ,: k U` A, BUILDING " INSPECTOR LA <'? APPLICATION FOR PERMIT TO .............Oxte.. III,.a, ..YaQI31�.............:........................................................... ' TYPE OF CONSTRUCTION 1No od fre.m.e .......................................................... 6� c,) .... une...15..........................19..78 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location LOt 29..U �.�e.. �.� e.s... ay... x1.. y .s,..: 5,5........................................ ................................................ . ProposedUse ......................... )I.Qz.'P............................................................................................................. Zoning District ........................................................................Fire District ......OQ]4]�r.�Cx'VX.�.�.�.��5 Pi. '.TY�,a�.6:............. Name of Owner .................... ..IBAZA<%tl.....Address ...............B.R;C...3$3...`Smith..XA=Qlltla,�...Ma,SB. Nameof Builder ..................t$.aMP........................................Address .................................................................................... Nameof Architect ................S.=Q.........................................Address .....:............................................................................... Number of Rooms ................f3...VO........................................Foundation ....P Urad..C.onar.e.te................................... Exierior ..................................White...aeder...shingleRofng .........Asphalt........................................................ Floors ....................................har'd..waod..........................Interior .......:..drywall........................................................ Heating ...............................Hat...Wat.er'..........................Plumbing ..........P.ja,%t.:La..................................................... Fireplace ................................�A..UVUIS...r.QQM.............Approximate Cost .........30a.00.0;:.................... ...................... Definitive Plan Approved by Planning Board -------------------_-----------19_______. Area .....1508.......................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the ove construction. Name . ... ................... ]Bassett, J. Albert 20311 one story 'No ................. Permitfor .................................... single family dwelling ............................................................................... Location ....44...Uncle. . ..Willies. . . . ...Way.................... ...... . .. .. . . . ...... ...... Hyannis ............................................................................... Owner ......J. Albert. . ..Bassett. . . .. .... ...... .. .... . . .... ........................ Type of Construction ............frame.............................. ....................................................................... Plot ............................ Lot .......f20 ....................... C" c- June 16 78 Permit Granted ............... ......../ ...............19 Date of Inspection ....... ..c?j 9 ... ............... Date Completed ...=s ... . . ........19 PERMIT REFUSED . ...................:%........................................... 19 ................................................................................ tD ................................................................................ .......................................................................... ............................................................................... Approved'................................................ 19 .......................................................................... ............... ....................................................... zz (A d Assessor's map and lot number' ............................................. oFTNEto Sewage Permit number ...- ................................................. BARNSTLDLE, i House number ...............7................ ....................................... 90 Mnsa ' 0 MPY. IL_ tr\0� TOWN OF BARNSTABLE Y BUILDING INSPECTOR APPLICATION FOR PERMIT TO One... "''� ry'" '^'"........................:....................................................................................................:.. ,anted frame TYPVF CONSTRUCTION ..........................................................:.............................:............................................ Jti?? ... ..........................19..'7 8 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................................... .,nt:.,2n T.nn I t'...�.. '1 1 1 cl. ..�.f''r'•...i n "Fywnni n a ca. Proposed Use nnA f' mi tr 31 om,R Zoning District .......................................................................Fire District .......t`...c..x.�.i.,t..r.�..r..�..t.i..'.[...l.m.......{.i.q.. r .7.,.l..:I..F:a.............. w Name of Owner ,T., A1hArt ?3u`?. P. Address ... YA.'.+n',t Name of Builder SAme .................Address .................................................................................... ................................................... Nameof Architect .................S.nynf•........................................Address .................................................................................... Number of Rooms f' ........................................Foundation ...Pn!t.ne�r Exteriorz,;'hl t K+ ......... A 0-110l ........................................................ hn-nri r+� ,�..........................Interior ..........C?vvv„ ^ I I Floors I....... ,.0................................................................... ............................ Heating fi ^.�..........................Plumbing ... �.a s Fireplace n 1 't +n . .. , ,...,•.,..,.__Approximate Cost .........:�� ...................................................... �QO Definitive Plan Approved by Planning Board _______________________________19________. Area .....1:`.0.8.......................... Diagram of Lot and Building with Dimensions Fee ........ !?..,r,)........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. r� Name ....... / i �. Bassett, J. Albert%= .1=29,2-323 , 20311 one story No Permit„for \' single family dwelling 44 Uncle Willies W y Location .............................................. ...... ,....... Hyannis J. Albert Bassett Owner .................................................................. Type of Construction frame ............................................................ ................... Plot ............................ Lo 0 ................. J ne 16 78 Permit Granted ....... ...............................19 Date of Inspection ....................................19 Date Completed ,.....,,. .............................19 PERMIT REFUS ........................... .�. ..... 19 .................. .... .�e -/�r- ........ .... 1 Approved ........ .............. . ............. .. ..... 19 1 ......................... ........ ........... ..................... r SOIL LOG �Xy id!,l llJ4�C 2".PEAS TONE LOAM B FILL 12 MAx 9.I. DIST �,° q,' BOX I, ° ! E� rim �7i24"MIN.MIN - 1000 I I 1000— GAL- d , cl GAL. I " °o PRECAST OR SEPTIC Ss-4�._ 13 7 sf1e °�.i BLOCK ° TANK °,,, ° a SEEPAGE PIT o' is I'° -t ° - 20' MINIMUM -- -- -- ---t"io ° �. �o TO fall 5�! ta. 9/ 7 FOUNDATION o J I I %: WASHED STONE ELEVATION SKETCH 10' -----i P[RC. RAT[ SCALE I' = 4' TEST B Y TOWN INSPECTOR: A /+ BACKHOE OPERATOR -•A 137sssTi �rz TEST MADE ON :-- 30 7P �.)Esf1'n�yedd�t./y tl�w(3�dr�o�>,s�=330y.p.��r1,� 9art��?�Qrvnc�e•r} - �') 5 de waf/s - >88s.F: x 2.s0 9Pdls,�' _ 4 7D 9p 80f6m 79 " x 1,010 = 7 ' 0 4 f �EXp" D-$oic ,-4 , __._..FU Lot /9 c h L dT z I � M 10,4 70 Lafi 8 `I S' I' HEFT' 8Y CERTIFY 7'HHT THE BCt1C6 Mark.' Top C,"B 3TrzuCTu2ic Shbw& EIr= 1 , w,4zS 4oC,RTW Ju/1E / 2r /978 AND 0V/Yir0/21XS as�ey-s'T19d�..E /'Y1A.tS. I FM�s 102 Es -7 v LAPSLEY N ,l No.22597 {JJ `4 ELEVATION T SCHEDULE ND 5U`1� PROPOSED SITE PLAN I INV AT FOUNDATI N = 5 4 SEWAGE SYSTEM DESIGN 2 NV INTO SEPTIC TANK = iaIN ,1 �/f{ ' 3. ' NV. OUT OF SEPTIC TANK = 02.(�b /�� / r�A N//��,► �t /�,A,J« ? 4. INV. INTO D(STRIBUTION BOX = 1011 (tAt20- U',4COW/LL/ES WAl) ; SCALE: I"= 20 'q16, f? 19 71 5 I NV OUT OF DISTRIBUTION BOX = 101'13 C— 4° 3V j? �K OF f CAPE COD SURVEY CONSULTANTS �� DA G 6. INV INTO SEEPAGE PIT = jF W. ROUTE 132 ,�� NkKECHNIF 7. BOTTOM OF PIT = 95" HYANN!S, MASS No.14704 Q A DIVISION BOSTON SUNVEY CONSULTANTS, INC. � ( :I 6 BOTTOM OF STONE LAYER = a�` 8 F` t