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Home My WebLink About0100 WASHINGTON AVENUE .� �jo ft� L� .; i� Lwp i ngineering Dept.(3rd floor) Map ' Parcel J,-T G Permit# /r�0 House#, I.DC) F!35 Date Issued 1a —16 9 Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee, Cohservation Office(4th floor)(8:30-9:30/1:00-2:00) - Planning Dept. (1st floor/School Admin. Bldg.) n THE De ' hive I Approved by Planning Board 19 BARNSTABLE. ` tED 9. TOWN OYBARNSTABLE Building Permit Application ' Projec treet Address Li 0.0 1 YL Village 4u„ ab- k Owner 11�1 Yl . � �` ' �/i, �C�Address Telephone Permit Request a s First Floor square feet Second Floor square feet Construction Type ' 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: '❑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 Name Telephone Number Address `7/j T�py�C�„� 014 License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE - DATE BUILDING PER , HE F LOWING REAS N(S) I FOR OFFICIAL USE ONLY of PERMIT NO'. • _ � ., • � � max'' ` DATE ISSUED yf MAP/PARCEL NO. - ADDRESS i VILLAGE OWNER : DATE OF INSPECTION: t FOUNDATION FRAME INSULATION f FIREPLACE _ ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH ` FINAL - FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. vFrrer� , .� a♦ theTown ®f Barnstable g Department of$ealth Safety and Environments ers'lces 19— Building Division 367 Main Stt=,Hyannis MA 02601 Raipn C=tr. Office: 508-,90-6227 Building Corn.--- Fax: 508,90-6220 For office use Only 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 than ditton to any dwelling pre-units aring to owner occupied building containing at feast one but not IDo contractors, r to structures which are adjacent to such residence or building be done by registered ih certain exceptions,aiong with other requirements Est. Cost Type of Work:—44--7 Address of Work: Owner's Name Date of Permit Application: /�� AI hereby certify that: Registration is not required for the following resson(s): Work excluded by law _ _ ob under SI,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: PERMIT OR DEALING WITH UNREGZ OWNERS PULLING THrI t OWNHOME vEmENT WORK DO NOT HAVE CONTRACTORS FOR APPLIC.1BLEGItAM OR GTJRA►R FUND UNDER MGL 4Z.� ACCESS TO THE�gITRATION PRO SIGNED UNDER PENALTIES OF PERJURY I hereby apply fora permit as the agent of the owner: s /b 5 Cantracror Name Regiss=dOn i`lo• Date w Tllc• C!l/lllllfl/1II•culf/1 of:3fusruchuscin Depurl"Ielll of 1udu tr1G1Acc dens . ;_ ��• ��;� �,!� O�cee/Imres�lgatlons 600 1f i�shin�;lnlr S1rCL'1 Btslulr.Muss. U3111 Work-em' Compensation Insursnec ARduvit A i;nlic nt rnfnrnintinn- NTIe�+Illy C. P Inc nrt ``l I 1 am a homeowner per:ormlin_all work myself. I am a soie proprietor and have no one working in an-'capacity 1 am an emniover providing^workers• compensation form•empiovees working on this job. cmmwim n tmv- 'itiri rice• nhnnt-a• incnr..nrr rn, Zr-, a soic 7roprie:pr. ;cne contractor. or homeowner(circle otre/ and have hired the contractors listed beiON%* :he oilo«•ir,- workers* compe^sation police_: cnmr�in� n:tmr� �ci, rrc ctr "hone a• m—r-^rr �-n M r,•....nt �'tl1 t.. ;ti:irr.c• ri,,.. nhnne a• nnlicr+� in,;r-nrc rn. --- Att:r.-, aLiditional Srcet If neces--!-Ir5'-`� � i'ii `-: ... .�......•� '•-.- -.. -.��..��....v-. --- ... —.� F::;iurr in securr cover.^.cc:is requircu unucr nccuon_SA of MGL 153 can lead to the imposition of entarnal penaiue3 al a line op to SI.OU.UU anurcr tine c^r5' imprt.iinmer.t:is well:is cisii penalties in the form of a STOP IN 'ORK ORDER and a line of SI00.00 a dag against me. I understand t1:t co^. .if Mi.%smicnicin nia) tie furn:irdcu to the Office of Im•estic:tions of the DIA fur coreraee verification. !r:'o :ir.-ebi ce. .n :uuirr• re rs arm ics ajper/un•r/rar the ormatiarr provided ahvve is trur rurd corre ct. Date Phone lo E• .)ITiaai use unto• du nut write in this area to be completed b} cirti or totrn official rrrmit/license>: r'tluildin_Departmcrt CiUcensin_ Huard — :pies; ii immctiiaic rrs�unse is required =Scicctmcn's UfGcr [11c2ith Departmert phone t;• ^'Uhler information and Instructioas MaSS:.Ci;USGtS Gencr::l Laws chapter 15= section 25 requires all employers to provide workers' col"Pcns:.tit:n e:n;,im c;:,. .4s quoted from the "la��".an elllploree is defined as even•person in the service of :uutthcr.undcr :: cot:;rac: of hire. =%press or implied. orni or written. An enipin.ver is defined as an individual. ,partnership. association. corporation or other legal entity. or an}• M-o or 111c �ore�_oim: d in a joint enterprise. and including the le=1 representatives of deceased employer, or:1:c rc.=Ver or:ntstce of an indivkdual . pannership. association or other legal emity. employing employees. Hot%=•. c oWl"Cr of a dwellitl__ house having not more than three apartments and who resides therein. or the occupant of dN\cilinc house of another N%,Ilo emplovs persons to do maintenance, construction or repair work on such dwc.i:_ or on the _rounds or building appunen2nt thm. to shalt not because of such employment be deemed to be n �iG;_ l::r.:cr !�= secltoil _,S also states that every state or local licensing agency shall withhold the issuance c. 1 of:: license or permit to operate a business or to construct buildings in the commoni•calih for uny :c::nt Ivito leas not produced acceptable evidence of compliance tiwitli the insurance coverage required. �e l\.. neither the commonweaIth nor any of its political subdivisions shall enter into any contract for:he per: n11z::cc of aublic work: until acceptable evidence of compliance with tite insurance .equiremenu of this cl:ac: hee:: _-rc:;z::tec to the contractirlc authority. {71)IIC::.iIS P!.cse :iii in :lie %vork:ers' compensation affidavit completely, by checking the box that applies to your situatio;: a:• sucp V;n_c names. address and phone numbers as all affidavits may be submitted to the Department of r. c._... .. n..• " nor contirinaion of insurance coverage. Also be sure to sign and date the sfiidati'it• Tile it _hcuku be returned' to the cin or.own that the application for the permit or trice..^.se is being requested. Seca-;ne:a of Industriai .Acc: -is. Should you have anv questions re_:riling the "law" or if you are 0 Cc:Z::. c compensation policy. please call the Department at the number listed belo-,t•. C ti, )r -krXi1. :i;a: the affida%•it is compie:e and printed legibly. Tlie Department has provided a space at the gotta- the :�it :or you to fill out in the cvent the Office of Investigations has to contact you re_ardin^ die appiic:n:. be _ . to till in the perrtlidlicense number which will be used as a ref=nce number. The affidavits may be ,ne D:c:,L ne::: by mail or FAX unless other arrzn:e:nents have been made. esti_stions would like to thank you in advance for you cooperation and should you have any quest pie'=2 ZJo :,ot ':e=hate :o give us a Tot: ,ecz,=_enr-s address. teiepnone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents -. . office of Investigations 600 Washington Street Boston,lma. 02111 fax 1_ (6I7) '727-7,749 6 i—) -- -=9Q0 c�:r. 106. 109 or _-- ' ., � .. � a � ;E `3 '�� if: k � i"•' "`�^e.�� f'ftn, �rT " i l 'r„ } �t �y �� u s � '" r -. �"F xit��,L'°✓ i-�, 1! t��''i, � s3.. �:, r „t4 i _HO n� m MEIMPRO A. �EMENT� CONTRALTO Bu1lcf�n RS REGISTRATION �t� R ne 9 -Regu?atl R _ Ashburt n p 0ns a=nd Sta : lace Room h` ndards - k $� 3�� ,Bost n 4 M� x _ assaohu 1341 `` t" #t�OME "IMPROV ` 'tix setts �02108 A , EMEN C x Re9tstratYo T OIV7RATOR a n x 112536 � ExPl r ' s at� on 04/06/99 � y DE �CONSj-RUCTrO ' y AN.:C ER �'FRAS N � rz x n f "TARRAGON UITa Pt ra n 263.5 u .p 7 b1 AM aw,l e n / a.�--� /Zos 7-)19 s 0�y0fTNETp�`ee TOWN OF BARNSTABLE Z 3AHd9TM i ON l. MASSACHUSETTS Solid Fuel Stove Permit DATE OF APPLICATIONS ( � ............... FIRE DEPT. ISSU G P RMIT ......... .......,.......................Coc ............ RT. NAME (owner) "J C'41-t � v ��........... NAME (Installer) 4�....�.a.�...5�.-�i�L S ......................... ....................�'....�................... ................................................ y ADDRESS j. ..... .................................... . ADDRESS.f......................................... ....1..........................................................,e... .. -I ;S ro ."........................ STOVE TYPE .....1aZ.-9.�d..(....?.,. ( '! '.''........... CHIMNEY: NEW ........................ EXISTING ........................ Manufacturer ..............v'� /'! a ✓!I............................................................ CHIMNEY: Masonry �i� e-)................................. y ................................................................. Mass. Approval CHIMNEY: Metal ....................................................................................._............ ...............N, ��...............GS .....5......�v.. This is to certify that the above installer has permission to install a solid fuel burning appliance at the listed address in accordance with an application on file with the . "!....d f �`-N S`....... Fire Department, ........................................... and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made under the authority thereof. /t IssuedBy: ............ .. �,,. ..............................................Title .........� �............ Date 7 .............. ..... ........ �. Permit to install expires 60 days after issue date Stove ?.`........ ......... �i........................................................................................................................................................................................................... CA StoveClearance ................/19. ............ .................... 6...... ... �. .................................................................................................................................................... Floor ............................................................................................................................................................................................................................................................. SmokePipe .............................9 N...................................................................................................................................................................................................................................................... SmokePipe Clearance ...........A......................................................................................................................................................................................................................................... Chimney , ay...... ...Y ..J............................................................................................................................................................................................................. Smoke Detector5,l........�........ hGi ........ (:. .. .............t../....... ...f 1...... ............. ......fi�tOM.f............C�L Y.......... h ti e.�,1:C.U ...... �t��.. 5 '�-� 140r c oc key, The undersigned hereby certifie t1at the installation of solid fuel burning stove and equipment made under au- thority of permit dated ....... .9.,�./............ has been made in accordance with provisions o the C monwealth of Massachusetts State Building Code now currently in effect and pertaining thereto .............. .................... '¢ 7 Installer INSTALLATION APPROVED ........6 ill...�1�. ....................... By: .. .. .. ..... ...zi..�.,.... :....................... Title• date G " 7 WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT TOWN OF B.ARNSTABLE Z DAUSTAn i 'oo 9. MASSACHUSETTS Solid Fuel Stove Permit / .0 6,. DATE OF APPLICATION ...............................................?....:....................... FIRE DEPT. ISSUING PERMIT ... NAME (owner) ......�`J. ... `t l ,,r ^, (7- + ............ NAME (Installer) a ? s� yr;:� � .................... ..... 00 ADDRESS ......... ADDRESS ....................... STOVETYPE ...................................:....:...................................................................:.. CHIMNEY: NEW ........................ EXISTING ........................ Manufacturer ............. `.''.. .^.: .`"'"!"'......::.........:..............:....:............:......... CHIMNEY: Masonry ....................................�../ ... d........................... c . 41 ,- ! - CHIMNEY: Metal Mass. Approval ................ �............... ...........�........................................ This is to certify that the above installer has permission to install. a solid fuel burning appliance at the listed �., address in accordance with an-application on file with the .......... .....�*".!..... �� `.:'�.'............ Fire Department, and.subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made under the authority'thereof. ` y Issued B \1r ...:� .. ��.'' ......................... . ........ Tale ... ...... ,..:.:.... ........ Date S �{ ��`/....y. ............. ..... y rj Y v r Permit to install expires 60 days after issue date ............°�4�.. ,Vj.......... 1tom.��......... .................................... . ... . ........................ ......... ............................................................................ Stove .. .. Stove Clearance ................. ��..,........: C ..........:......::�6.:`.�......::.�J,r. •,....................................... / 1� r° Floor .........................................................:......... ........................... ........................... . ............................ ................................................................... Smoke Pipe .:.......................... ............................. ......... .:....... ......... .............................................. ............................................................................................... SmokePipe Clearance ........... .:.....:...........:....................................................:....................................................................... ........................................................................ Chimney ................h/1 C'Srrd► Gk:. .'. .:S ......: ............................. ........ ................................................................. ......................................... .... t .........Smoke Detector r.........Chll �. If.4. a . . ...... �h. ../ T"....�t~l,rx1A.............. ( -{Ur fThe undersigned hereby certifies that the installation of solid fuel burning stove and equipment made under au- thority of permit dated ......... has been made in accordance with provisions.of the Commonwealth of Massachusetts State Building Code now currently in effect and pertaining thereto .`.y�:�:-. .... Installer INSTALLATION APPROVED ............................�1�h....................... By:.........L..,:.......r ........ ...................:............. Title: ..................... ...........f: ,,c. r 'date CI`" WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR - PINK: APPLICANT t