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Home My WebLink About0032 WASHINGTON AVE EXT. f 3 2 wA5ty7'AI4Mg �-Xr,- H -AIAII � "'' �° a i a ! , Parcel Viewer Custom Map Abutters Map Size Zoom Out flIn le JPG Ma -77 p• 327 Par_cel.: _032 rR �L l T Co on: _r Owner: DWYER, LEO I ' ` . eiV 26^30 327029 Location Information N _ Map & Parcel 327032 4S ' Location 32 WASHINGTON AVE EXT. Acreage 0.11 acres 309089 a a 37 Current Owner Mailing Address DWYER, LEO I y 32 WASHINGTON ST EXT -i HYANNIS, MA 02601 ` 3270324 Z 32 � Appraised Value (FY 2009) ". Extra Features $2,500 327027 Out Buildings $0 N 107 Land $130,400 " Buildings $88,100 309088 Total Appraised $221,000 N 27 327033 022 Assessed Value (FY 2009) Extra Features _ $2,500 0 38 Feet Out Buildings $0 w r Land $130,400 ,; Buildings $88,100 Total Assessed $221,000 Set Scale 1" = 38 Aerial Photos Jam. MAP DISCLAIMER ` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma Parcel TMUN OF BAR STAR Application # p .��F Health Division 2013 , Pate Issued Conservation Division .Application Fee�A S Planning Dept. Permit Fee p Date Definitive Plan Approved by Planning Board DIVIS10f9, 7' l 3 Historic - OKH _ Preservation/Hyannis Project Street Address 3a Village Owner Ce r Address S!�Vq\c Telephone Permit Request wt"P 1�h� \ r ��DES ( �� - �� p� �G ��5 am Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood, Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. 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 0 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# a Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name S/ &Tr Telephone Number - Address License# �� Home Improvement Contractor# r U 7� Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO II SIGNATURE DATE 7 Q w FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: T4FOUNDATION FRAME I INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL { PLUMBING: ROUGH FINAL GAS: ROUGH FINAL f FINAL BUILDING s f DATE CLOSED OUT r ASSOCIATION PLAN NO. License or registration valid for individul use only before the expiration date. If found return to: . Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116. • I No,Tali without signature t Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-053961 SCOTT A LOHR I �' .A' 23 GRAND OAK RD FORESTDALE r A 0 694 n i��"� Expiration Commissioner 06/09/2015 L ~' C�/�ie�pa��onccy�ecueall�o`C�/�hc�scze�zcveff Office of Consumer Affairs&Hus:aess Regntat-•i ME IMPROVEMENT CONTRACTOR egistration: 172:'2 Type: — xpiration: 5/31/2014_ DBA LOI k2 10ME IMPR6.VENEN `- SCOTT LOHR r u GnAI:D OAK RD g �xkU.,MP 02644 Underz_ecretir; ACOR 17 CERTIFICATE OF LIABILITY INSURANCE 05106P1013 THIS CERTIFICATE M ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW- THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOREED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT. If the certiflcale holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subod to the terra and conditions of the policy.certain policies may require an endorsement. A stet mwt on ttds cwoatd does not confer rights to the certificate holler in lieu of such endorsenwnt(sl PRODUCER =ACT Arthur D.CaNee kaunm Agency.Inc. PHONE FAX Spg 457-1715 Www.aHeeinsurance com EMAL 336 Giftd Street RMHOWN AFFoROM NAIC Falmouth MA OM9= •NOftww kllllrance INSURED � a•Aadla klsurance Lohr Home klglroverllent . INSURER 23 Grand Oak Road INSURERS: MA 021"1229 INSURER F COVERAGES CERTIFICATE NUMBER. REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT R TYPE OF INSURANCE EFF FxP LlrarB GENERAL UABLITY EACH occuRr:EncE 1000 000 A X RCL&cENERAL Y DAMAGE TO RENTED i 000 CIA.S.. X occxrR WS18M 05i01f2013 05101/�14 rwnow thy aw s5jW0 PERSONAL a ADV INJURY SI,N%Ow GENERAL AGGREGATE 2 000 GB&AGGREGATE UNIT APPLIES PER PRODUCTS-CONpIOP Am s2,000,000 X POLICY PRO- LOC f i AUTOMOBILE LIABKnY CObBWED SINGLE LNIT ANY AUTO BODILY INJURY(Par Pem) i ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(ParNON aeciOeA) _ HIRED AUTOS AUTOSOWNED PROPERTY DAhNAGE i UMBREIJ.A LIAR OCCUR EACH OCCURRENCE i EXCESS LOB HCLAAtS41ADE AGGREGATE i WORKERS COMPENSATXMN X I WC STATU- OTH• AND EN PLOYM UAGR 1Y Y I N majA ICER�R CLEX�� NIA WC20.20.003588.01 05i05/2013 OS10tM4 EL EACH ACCIDEW ( 000 EL DJSFJUSE-FA EMPLOYEE i 000 I deeaiba ud� ` - SCRurnON EL DISEASE-POLICY umrr s SMON DESCRP110N OF OPER 171NS/LOCATIOIfS vENNG E8(Atdeh ACORD 101,Addtlorol R«nrb 9eMdda.a man apnea is ragaMad) General Wea hafttion,klauletlon,Window and Door Replacements CERTIFICATE HOLDER CANCELLATION Town of Bamstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 13EFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Depubnent ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hymnle,MA 02M AUTHORID REPRESENTATIVE <EPRO 01888-MO ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD [8] 10, Housing � Assistance kill Corporation Cape Cad HOME.OWNER I RESIDENT WEATHERIZATION WORK PERMIT&FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE THE APPLICANT HOME OWNER. l w �L--- hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation(herein after referred'as "Agency) on the property located at: Yj 14V AM!,"70, The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather-stripping &caulking of windows and doors, Insulation of attics, sidewalls&basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. In consideration of the weatherization work to be•done at my home 1 agree to the following: 1. I give permission to the"Agency'its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property, 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5)years after the weatherization work is completed. I have read the provisions of this agreement as listed and freely give my consent. Home Owner`(Signature) ��--� .Date: Agent: (signature) Date: o 3 HAC approved Weatherization Company: Adam T Incorporated All Cape Energy Alternative Weatherization Building Performance Contracting LLC --cape-Cod Insulation Cape Save Frontier Energy Solutions hr Horne Improvement Resolution Energy ''eo---,.:-til a's;f:,-}}LS.;::�t?:- n.t•>_�:: ..-tt?�:y ,..�,. _•,ri.?` t-_ •} a 2� �7S a Assessor's -map and lot number ...3.!�7 � . Sewage Permit number ...................................................:.... �� rr HAHHSTADLE,Z i House number ..:..."hf. 9 ............ ro rAsa 2639. 0� 'EO MP-t 0r TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO _ TYPE OF CONSTRUCTION ...................................... •'•••......... .................... �.................19 . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............"1Z .. ..W.................. ........................................................................................................................ /� Proposed Use ................................�'�fY��..- ... . .0... ......0,—?...... ........... ....idd:n. Zoning District.: ............... .................................Fire District ............ ..... . . ........r:4.•r-�'. .... ........ ................................. �� .. Name of Owne ........ ` .... ........................................Address .. ...%G�10 7........................C ��^� Nameof Builder" .......... . ......................................................Address ................. .....-......................... Name of Architect .........................................Address................ � Number of Rooms ....... ...........Foundation Exterior ..................:..........:..:.*.................................................Roofing ...................a�........................................................ ....Interior Floors ............................................... .................................................................................... ................................ Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost .................................................................... Definitive Plan Approved by Planning Board -------------------_----------019________. Area ........ .. ......... ............... Diagram of Lot and Building with Dimensions Fee ............ SUBJECT TO APPROVAL' OF BOARD OF HEALTH 4 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 ....... ... /. ...... ...... F. MONAGHAN 23641 DEMOLISH No ................. Permit for .................................... DWELLING ............................................................................ Location Wa.sh.i.ng.ton...Avenue. ............. . ... ..... .... .. .... ....... ..... ....... .. . .............. Hyannis ................................................................. Owner ...........................FAfMong.han.............................. .. ....... Type of Construction ....Frame....................................... Plot ............................ Lot ................................ 16 , 81 Permit Granted .... ....................... Date of Inspection ....................................19 Date Completed .........4W............... 19 07 it '7 Assessor's map and lot numbe>.•• ....✓..... . o /� q./( T THE TO�� ewage Permit number °........................................................ a • B9HBST1►DLE, i House number ...........<.Fl.... ..:.. O��/ ..S.�c ................ 'off MAS 639. away a� TOWN OF BARNSTABLE BUILDING �I.HSPECTOR APPLICATION FOR PERMIT TO ...../ � . ......................................................:............. ....... ......................... TYPE OF CONSTRUCTION . . � 1 .... ............................................................................................. //.x... ............... .......19g . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......ill/�t' lT .. /...K.UIr ................... ,ems/ d / 4n. ... ..Proposed Use ....... ...... .......... .... .... .................................................................... Zoning District .....1, c!Gr� .....................Fire District // ✓Y .....((.................................... �l Name of Owner�"�' K... jl..:l..e .:......Address �L1r... �!.?� . .•... ••••:`? •• Name of Builderra ..................Address .............. .......... Name of Architect AK.... ........ .. ....... �.:...Address ... All // �./........?��....................�...... I / Number of Rooms .............L..o............................................Foundation � .............. Exterior' y <..... .................:.. ......................Roofing ....... .......a4VI V16a. • Floors .LW4...Interior ,r� ..... ..................... �.... / !i'�!fec-'............. ,/ max' Heating '� ........Plumbing ............ C./0.................................................. Fireplace ...........,e/h. ......................................................Approximate Cost ....... 1..... ... .............................. ryry / 4 Definitive Plan Approved by Planning Board -------------_------------------19________. Area ....C74I.o..V... ........... Diagram of Lot and Building with Dimensions Fee � . .1 SUBJECT TO APPROVAL 'OF BOARD OF HEALTH g` 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 ' ' .:.". .:. 4eNl&� ........... Frank A=327-10 &22 � Monaghan, . ' ` w~ . . , 2�7�� a lO units No —.----. Permit ---.--.. �---... to ��1 ---.-- .-----------------^ , �n� & 0ortb St Location —.��9��9��—.—..�--------.�. ' -----..��f�---.---.—__----- '. 'Frank Owner —..`� � .Monaghan��--------.. Type of Construction --..��gg��------- , - ~ _---.—.----------..----~----- Plot ............................. Lot .....................---' ~� 82 Permit Granted --..�"�"�.Janua�.y----.25' ~�lg , _ , Dote of Inspection .................................... Q ° uo,= Cpmp/=,=o ' \ .. ' ~ - ~v ` ^ � � .- | 1 Assessor's map and lot number., .... � . .... %♦ �1 1t c Sewage Permit number ........................................................ d� BABH9TSFILE, i House number ! ......:...(..!`1�C11 % " l 9 Mnba .................. ........... �p 1639. \0 0 M a• TOWN OF BARNSTABLE BUILDING_ INSPECTOR APPLICATION FOR PERMIT TO ......CIV...../�70.7Z . �?D ...A .......`1 ............ TYPE OF CONSTRUCTION ..... �� :Z/........................19.g` TO THE INSPECTOR OF BUILDINGS: The undersigned hereby'� applies for a permit according to the following information: Location f:.' / h'/i//S � ��'h�..�N/V........41CJ.......................... T�l .. ProposedUse ......... ......... ............... .. ...... ....................................................... ......................... Zoning District �I, O�*�-A ?....................................Fire District 1 t11-1 V V1,3 Name of Owner '..'. G�.... � . /;!7?r ...................Address f �i4�!Y...y—7l'...(f��' t '*�?.......................................i <- Name of Builder"� / ll'+ 1 �71r`?/ �rr/Il...........Address :�?z R.....:........................................... .. , .Irk.....: ,i ..�rl c3 . r .>�,1: �' Name of Architect .........:...........:.... ...........r.........�,�:...Address ....:....:. ..........;.. Number of Rooms .............../..0...........................................Foundation & .................. - i..r�� ,M. .....//`�.................. . �- .:::. L/;�,h lid--- Exterior Roofing .......... e J Floors /'41 f/� � tf. ! 1_ �J .Interior ...... ...... 1"•,/ f? ,.,............................... f Heating.l"' � ? ..4.- ..........,.Plumbing .. Fireplace ....... t%Y' ...................................................Approximate Cost ....... ,C/ ..�� 4 ......... .... . Definitive Plan Approved by Planning Board -------------------_-----------19________ . Area —� S� 1--`.......................................... Diagram of Lot and Building with Dimensions Fee ...!* - ........... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW cbWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. , f Monaghan, Frank A=327-13 & 22 No ..237U.... Permit for ........45MAQ...kinlk.$.. to motel.,,....!'. C3 2— Location .......Wa sh...... i gton,Av�,.,,,&..ATox>;h..�:i~. ................... ............ ................................ Owner .......zmk.mmagmn.......... Type of Construction ...........frame.........: . ................................................................................ Plot .................i I ........... Lbt .................. .......'t -lar 82 Permit Granted .....Jan Y, .... .I� 19.........f. Date of InspLion ......j.......................4 ....19 14 Date Completed .................................i....19'i 1 7 r 74e� Assessor's map andot number .....:. Bpi?H E ' Q Sewage Permit number ...........................'............................ 1 : Z0oB9HB9TLE, House number ... . .....4 n8& i i639 a Mix k' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..................,�. "��' ........ .... ............. TYPE OF CONSTRUCTION ...................... ......... .L�--r' .......... ........................... ................... . ................................................19......... TO THE INSPECTOR OF BUILDINGS: The undersigned f/hereby applies for a permit according to the following information: Location1A1 )q. < .� (/ .................................................................................................. Proposed Use .......... .................. �`�1��! h.... 11 :... ......�i / I........! 'k.:... ��..... Zoning District ..... .............:......................Fire District ........... Name of Owner ....f ,,,.... ":...!..^...................Address .N.:. .... r' _....................................Address / -f�/ h�.Q--- Name of Builder' ............................. :....................................................... Name of Architect .................. ....--......................................Address ................................................................................. Numberof Rooms —.........................................Foundation......................... .............................................................................. Exterior ...............................::':................................................Roofing . Floors ......................................................................................Interior .................................................................................... Heating ........................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost .................................................................... Definitive Plan Approved by Planning Board -------------------------'------19________. Area ........ �c ............. Diagram of Lot and Building with Dimensions Fee 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, l,I, ... ( .. !.....% .. G/ ( :..d...... " F. MONAGHAN A=327-22 No 23641 Pe it for DEMOLISH ............ . ..................�?�h1�.� 2N. ................. Washington Avenue Location ................................................................ Hyannis ............................................................................... F. Monaghan Owner .................................................................. Type of Construction .....Frame..... ................................ ................................................................................ Plot ............................ Lot ................................ Permit Granted ,November 161........19 81 ................... Date of Inspection ....................................19 Date Completed ........................:.............19 —Y 4 i, Eigineering Dept.(3rd floor) Map Parcel f1 , Permit# House# Z ` 0. Date Issued 30 J l Boagd of Health(3rd floor)(8:15 --9:30/1:00-4:30) Fee n CA44 Lt, Conservation Office(4th floor)(8:30-9:30./1:00-2:00) Planning Dept.(1st floor/School Admin.Bldg.) �tME R D 'mtiv Plan Approved by Planning Board 19 ; _ BARNSTABLE. 619- ' TOWN OF BARNSTABLE 'f Building Permit Application Project Street Address S'IV 7 '/L" :9- Village Wt S Owner G `G' eV y Address Telephone Permit Request S 7-1Z L. First Floor square feet Second Floor square feet Construction Type 12 ;Z61 b Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 No. 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 Garage: ❑Detached(size) Other Detached Structures: p Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information r Name /`�7�/,� ? �' �� 1 � Telephone Number -? 7 A .� Address ? License# eiI/ �✓�L�� %.�'��c� Home Improvement Contractor# /Z5 l Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL COONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE . BUILDING PERMIT DENIED FOR THE F LOWING REASON(S) 1•� -•� FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS - VILLAGE ar OWNER , DATE OF INSPECTION: ' FOUNDATION - FRAME - INSULATION - FIREPLACE ELECTRICAL: ROUGH FINAL { ; PLUMBING: ROUGH FINAL ! GAS: ROUGH FINAL ' FINAL BUILDING [DATE CLOSED OUT ASSOCIATION PLAN NO. s w S r The Commonwealth of Massachusetts Department of Industrial Accidents Office 0f/8lreS998 Foos 600 Washington Street Boston,Mass. 02111 Workers' Co m ensation Insurance davit �'�/'�' 1- name: zs location' 40ir city phone# ❑ I am Aomeowner performing all work myself. ❑ I am an employer providing workers' compensation for my employees working on this job. comaanv name l®EGG � s address ; city /w Z�/L 14e� Phone#. -Z. insurance co. �_�!� �� —� olicv# ❑ 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: comaanv name• address• city phone# ... :. . ....::.::::: insurance cm :..:,. :..:.. .....:.:.:•::.: olicv#... <:;: '::.:'.;:::>:.>; rnmPnv name, ....... address: ;:.>:::>:>.: ;;:;>:>;>:<>::;;:.::.. .. phone# .. . ..:... .. insurance eo:. .......:::.:...::::::>;'::;:.:.. ..... olicv#.. Foliate to seeare coverage as required under Section 25A of MGL 152 can lead to the imposition of cri nfnal penalties of a fine up to$1,50o o0 and/or one years'Unphsonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 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. I do hereby ce the p ' and i ojper.' at the information provided above is trw and correct Signature j -; Date - Print name ,/�`� � -_> /,77 / � Phone# (E3 ficial use only do not write in this area to be completed by city or town official ty or town: permit/license# ❑Building Department ❑Licensing Board checkif immediate response is required ❑Selectmen's Office ❑Health Department ontact person: phone#; ❑Other. (remed 9/95 PJA) e r pf Q� ,j• The Town of Barnstable Department of Health Safe and Environmental Services P Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commissioner 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. Type of Work: (5�/ �/� � �'y Estimated Cost �.. fG`mac✓ Address of Work:, �_ Z,--e/��/q' TU 4/ Owner's Name: �. a vU � - Date of Application: I hereby certify that: Registration is not required for the following reason(s): pWork excluded by law (-]Job Under S1,000 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 or a permit as the agent of the owner. 11-72 ate Contractor Name Registration No. OR Date Owner's Name g1orms:Affidav ^`�� ✓`GP. (>Q�!!?/>/'L�Y/'LU1k(.l.�it:12 U� v�tiu�.3;�{rLu.r%Geu� I II i HOMEi I.MPROVEMEN:T '`,CONTRACTORS:. RfwCI !R!aT CC�N oard of` "ilding Regulations and Standards a One Ashburton Place - Room 1.:301 ! 1 BastoFl,�,. ass:etts ;0210:8 l� sachua;"�+y d'Y4` k MQME r IMPROVEMENT COIVTR m ,: E ,;lay w i0 �strat�at 1089I8_ k. � xpiratIon 48/270- TY.Pe I,NUIW 'DIJAL �� a�.:� HOaF PRO�IEMENT CONTRACTOR y rf' � ReciStration 108918 . Iz Type - iiJDI'lIOUAE THEODORE L HITCHCOCK EJ. Expiration 08/21/00 k PO BOX211/ 55 LISA LN ; W BARNSTABLE. ` MA 02668 THEOGORE L. HITCHCOCK P 90X 2i1/ 55 I_.SA Lid sa3ARNST881E MA 02668 ACMINISTRATOR }