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HomeMy WebLinkAbout0009 ANSEL HOWLAND ROAD q �� ��-1 O���la�� r r I �� I i 0 am � O �VIM T f able Building o o arns �4 Town Post T,#usCartl�So That�twis VisibleKFrom�lie�5treet pproved.=Plan,=Must�erRetafned on,�Job any �hisSCa'r IVlust be'�Kept ;`: flA$1V•S[AB1E..� �'.�,'�.�.= s ;� i,:s. �� �'�� ,a �„� �: ti �z,_ .w,.. .� � �`; � �a�.�" Postednllnirl fmalnspectiol��Has Seen Marie �� � Permit �R Wher `a Certrficate;of OCpancy+s Itequrred,sorb ABdr�ng shallNot be Oc�c red unta"Final Inspection h�as�been made. Permit No. B-17-3239 Applicant Name: Jonathan Whipple Approvals Date Issued: 09/25/2017 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 03/25/2018 Foundation: Location: 9 ANSEL HOWLAND ROAD,CENTERVILLE Map/Lot 173 216 Zoning District: RC Sheathing: Owner on.Record: SPERANZA,STEVEN A&LEO S T.RS ame: JONATHAN N WHIPPLE Framing: 1 Address: 9 ANSEL HOWLAND ROAD -078683 2 CENTfRVILLE,MA 02632 gs# roJectCost: $3,481.00 Chimney: q Description: Insulation.Air sealing.Ventilation chutes. Installing#be gl�as3 in attic. P-", - I e: $.85 00 AV Insulation: Project Review Re Insulation.Air sealing.Ventilation chutes Inst lli� fiber lass in fee Paid" $85.00 J 4: g final: attic. Date 9%25/2017 T rNOW �4 Plumbing/Gas n Rough Plumbing _ Building Official Final::Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within sixfmonths after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application anted t eapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structur s shall be in compliance with the local zoning by ws a codes. Y final Gas: This permit shall be displayed in a location clearly visible from access street o road and shall be maintained open for publrc rnspequon for the entire duration of the work until the completion of the same. M irk �' \ry Electrical The Certificate of Occupancy will not be issued until all applicable signatures the i3uUding and Fire Officials are pprovidedd on this,permit. Service' Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection � 3.All fireplaces must be inspected at throat level before firest flue lining is installed final: 4.Wiring&Plumbing Inspections to be completed prior to frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. y Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do riot.have access to the guaranty fund"(as set forth in MGL c.142A,). Fire Department Building plans are to be available on site Final: AII.Permit Cards are the property of the APPLICANT-.ISSUED RECIPIENT Town of Barnstable p BA 200 Main Street, Hyannis M.A 02601 508-862-4038 Application for wilding Permit Application No: TB-17-3239 hate Recieved: 9/20/2017 Job Location: 9 ANSEL HOWLAND ROAD,CENTERVILLE Permit For: Building-Insulation-Residential, Contractor's Name: JONATHAN N WHIPPLE. State Lic. No: CS-078683 Address: Webster, MA 01570 Applicant Phone: (508) 279-1110 (Home)Owner's Name: SPERANZA,STEVEN A&LEO S TRS Phone: . (774)228-2439 (Home)Owner's Address: 9 ANSEL HOWLAND ROAD,, CENTERVILLE,MA 02632 Work Description: Insulation.Air sealing.Ventilation chutes.Installing fiberglass in attic. Lr� ZM t Total Value Of Work To Be Performed: $3,481.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Jonathan Whipple 9/20/2017 (508)279-1110 ' Applicant pate Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $3,481.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 9/20/2017 $35.00 Paypal Paypal Total Permit Fee Paid: $85.00 9/20/2017 $50.00 Paypal Paypal ws f of Town of Barnstable *Permit# SU P� Expires 6 months from Issue d, le s ; Regulatory Services Fee . 2 se� `mi' Thomas F.Geller,Director Building Division . Tom Perry, Building Commissioner X-PRESS PERMIT 200 Main Street,.Hyannis,MA 02601 Office: 508-862-4038 J U N 2 7 2005 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENff9&b ffARN.STABLE Not Valid without Red X Press Imprint vlapfparcel Number ?rop AddressAIA4 LA Aw, Residential Value of Work d��� Minimum fee of•$25.00 for work under$6000.00 Owner's Name&Address Contractor's_Name_ /,Lg < � Telephone Numb e Rome Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 19 OWorkman's Compensation Insurance ' Check one: 0 Ip asole proprietor IJAIam the Homeowner I have Worker's Comte p/eensation Insurance Insurance Company Name Workman's Crimp.Policy# .- Copy of Insurance Compliancee'rtificate must be on file. Permit Request(check box) ET�Rroof(stripping old shingles) All construction debris will be taken to 1/l ❑Re-roof(not stripping. Going over existing layers of roof) Re-side [] Replacement Windows. U-Value ( ,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 Improvem tractors License is required. w Signature Q:Forms:expmhg • Revise063004 f , 1. T ;,n Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Regis tr no 126252 Board of Building Regulations and Standards wi E-fb-,,— —%2- --�s/�2006 One Ashburton Place Rm 1301 i AID Boston,Ma.02108 ' �;W' I.A.SLIWA HOME'I R��MEME T ��- ' J _ a ..._ IICHAEL SLUM time, I REDBROOK RD,7—\� ,/ IASHPEE,MA 0264,09 Administrator Not valid wit out signature 1 • r � i Town of Barnstable Regulatory Services r a 9 BARNSTAB I'E'g Thomas F.Geiler,Director `bplfo39. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, " Rif ��'�' ° , as Owner of the subject property hereby authorize ( � dG �-- to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date 6, L ell RtI4 Y Print Name Q:FORMS:OwNERPERMISSION Town of Barnstable *Permit# VE rp Expires 6 nionthsfron,issue date ABLE, Regulatory Services Fee ye- MASS. $ Thomas F.Geiler,Director Dp 1699• A�0 JEOMP't BU11C1111g D1VlSloll Tom Perry, Building Commissioner � ����� PERMIT 200 Main Street, Hyannis,MA 02601 1 Office: 508-862-4038 JUN 12 2003 Fax: 508-790-6230 ' EXPRESS PERMIT APPLICATION - RESIDXL NTIAL ONLY Not Valid►vithout Red A--Press Imprint TEMN OF BARNSTABLE Map/parcel Number Property Address q Cj Value of Work esidential Owner's Name&Address �acv�nc.� d�� �-►,� I se wj alra d 2d , t Z l Telephone Number—Wq - Contractor's Name T V4b Home Improvement Contractor License#(if applicable) (C>ep 4 D "Construction Supervisor's License#(if applicable) &kman's Compensation Insurance Check one: - ❑ I am a sole proprietor eI m the Homeowner ave Worker's Compensation Insurance . Insurance Company Name S nl AY—'� ct-e Workman's Comp.Policy Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over.33 existing layers of roof) ❑ Re-side placement Windows. U-Value (maximum.44) ❑ Other(specify) . compliance with other town department regulations,i.e.Historic,Conservation,etc:,, ce of this permit does not exempt Where regwred: [ssuan p Signature = Q:Forms:expmtrg } Reviscd121901 '" - _ T1t e Common wealth of Hassaclr uset7s Department of Industrial Accidents 91MCC vllnvestlgatlaos .- 600 Washington Street > 7' Boston,Afass. 02111 _ Workers' Compensation Insurance Affidavit �Rplic.„ntm ormation• - - a oo t y,ui , � a� >a Location �1 l V14-I S{� ' f IDI,I-)(a-KL V� c � i'•ene 0 I am a homeowner per,orning all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this;job. cromoanv/Iname: address cih nhone 9. in u ri c c Q r�C Qa li v wti Q I am a sole proprietor, seneral contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: address: cin•: - phone 9• insurance co, oolicv" commov name: address: cirv: nhone insurance co. oolicv" •'�ittach addtaonalsheetiCor_�ry '._ '�' : .•• ^' •.':'-•:^"_•— _ - -------_ --�--,,.•-_„�._ _ _._s,..,,._,..., Failure to secure coverage as re�;::ired under Section25A of,ti1GL lit can lead to the imposition of c`ranal penalties ora fine up tosuoo.00and/or one years' imprisonment as -ci! as ci.•il penalties in the form of a STOP WORK ORDER and a line or slDo.00 a day against me. I understand thati copy of this statement may be rcr—arded to the Office orinyestigations orthe Dl.% for coverage verirteacon. I do here Berri er the airs and penalties ojperjur•that the information provided above ?s true and correct. Sien.ature —� Da:c p P-intinamc 1 �OWIAS C—Al 2Zw 3C. Phcr.c rA otTcial use onh• do not -. .:e in ;his area to be completed by city or town official official t cit or tnwn permit/license = -Building Department C check irimmediate res -sc is c uircd C`icensin;Board' C a �_electmen's O(Tie; r - (';Health Department conuct person: phone 9; -Other t . YrsP!mktlrfHrMrMc+ 1441atdvt4dn'�bili2;ecih+ti':�I;?'ru°t'«�nyh4.MlcAi04+A r..� Cr4� ✓7e �oo�os�we o�✓uaefac✓uiee!!b hoard or Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 100740 Expiration: 6/23/2004 Type: Private Corporation , CAPIZZI HOME IMPROVEMENT,1 11(lomas Capizzi,Jr. 1645 Newton Rd. Coluil,MA 02635 �"� Administrator ?f> •� ✓fie Go��m�on�ueall� o�✓�Z/aeJuc�rude!!e e 13OARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR 1 •. r < Number: CS 057032 S +, Expires: 09/26/2003 Tr.no: 5790 Restricted: UU TI IOMAS X CAPI711 JR 200 PERCIVAL DR �� W BARNSTABLE, MA 02660 Administrator s 03/26/2003 15:21 5087601407 NORCROSS & LEIGHTON PAGE 01 „ CERTIFICATE OF LIABILITY INSURANCE "'�`�'°°"Y' ACORD I 1 03/26 03 PRODUCER THIS CERTIFICATE 1s Issum AS A MATTER OF INFORMATION Norcross i Leighton Caps Loc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE C.J.mocarthy Ins.Agency,Inc. MOLDER.TIOs ceRTIFICATB DOES NOT AMEND,EXTEND OR 437 Station Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. So.Yarmouth MR 02664 INSURERS AFFORDING COVERAGE Phone: 509-394-0946 lax:506-760-1407 INSURED INSURER A: National Granas Mutual. Ins. Ca *mRE R B: Wety Insurance C as Ca�iszi How rovement Inc. INSURERQ Guard Insurance GE Rut Nei�tvw�i INSURER a cotuit lf11 O 6 INSURER E: COVERAGES 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.AOAREOATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Iff TYPE OF INSURANCE POLICY HUMMER T VMITS GENERAL LIABILITY EACMOCCURRENCE 51000000 I A X OOMMERCAL GENERAL LIABILITY MPS02733 04/01/63 04/01/04 FIRE DAMAGE(Any oMfin) $300000 CLAIMS MADE a OCCUR MED EKP IAny om Pam°") f 1,0000 PEIMNAL6ADVINJURY $1000000 OENERAL AGGREGATE $2000000 OWL AGGREGATE LIMIT APPUES PER: PRODUCTS-COMPATPAGG s2000000 POLICY PRO- JECT El LOC AUTOMOBILE LIABILITY O BINED SINGLE LIMIT 8 ANY AUTO 1601064 04/01/03 04/01/04 G : ALL OWNED AVTOS BODILY II•UURY 11000000 X SCHEDULED AUTO$ 0 X HIREDAVTOS BODILY INJURY $1000000 X NON•OWNWAVTOS (P..,aitlenq PR RT OPEY DAMAGE 1500000 (Pu rtouid�l}q OARAGE LIABILITY AUTO ONLY-FA ACCIDENT 1 ANY AUTO THAN EA ACC S MAUTO ONLY: AGO S Exam"LUBIuTY EACH OCCURRENCE 6 OCCUR F7 CLAIMS MADE AOOREOATE S DEDUCTIBLE $ RETENTION S : WORKMSCOMPENSATIONAND X IMIT6 ER IF C EMPLOYERW LIABILITY CAWC401043 01/01/03 01/01/04 E.L.EACH ACCIDENT 1 100000 - EL.DISEASE•BA EMPLOYO 1 100000 EL,DISEASE-POLICY LIMIT s 500000 OTHER DESCRIPTION OF TIONb V=TIDN&VOI x CLUSION6 ADDED BY ENDORSEMENTWECUIL PR CERTIFICATE HOLDER N ADDITIONAL INSURED;INSURER LETTER: CANCELLATION 61401JLD ANY OF THE ABOVE DESCRIBED POLICIES OE CANCELLED BEFORE THE RXPIRATION DATE THEREOF,THE HMING INSURER WILL BNOPAVOR TO MAIL I D DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT.BUT PAILURE TO DO SC SMALL '.• IMPOSE NO OBLIGATION OR UASILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR r REPRESENTATIVES. AUTHORED ATIld zzc ACORD 25.9(7I971 OWCORD COMPORA11ON IM li►tltl" .11ilci. '1'UL' 12:21 FAX 1 .riUb 771 3217 IiA$VL'Y 1Nll. 1NC. - I(7JUU1 ff en Iwo U-Value Test Results I=00 • Based on residential sizes • R Value 1 divided by U-Value • Whole window values • U Values are subject to change • U-Values in accordance with NFRC - 100 without notice Windows Clear Insulated Low-E AdvantE ge • Classic Double Hung (Mechanical) 0.51 0.40 0.37 • Classic Double Hung (Welded) 0.5-1 0.39 0.36 ��� • Classic Plus DH W/CFW 0.33 0.27 0.26 tOY--, Signature Double Hung 0.51 0.39 0.36 • Sighature Double Hung (Welded) 0.60 0.39 0:36 • Slirnline Double Hung 0.52 0.40 0.36 Thermal One Single Hung 0.53 0.41 0.37 • Majesty Double Hung 0.54 0.44 0.40 Majesty Fixed Casement (PW) 0.53 0.40 0.37 - Majesty Picture Window (DH) 0.53 0.43 0.38 •t�/r/i jrt�Casement7iny 0.47 0.36 33 - Vinyl Casernent/Awning & Thermal Panel 0.32 0.26 0.25 • Vinyl Designer Shapes 0.49 0.34 0.30 + Vinyl Hopper 0.47 0.36 0.33 Vinyl Picture Window 0.46 0.33 0.30 • Vinyl Roller - 2 Lite & 3 Lite 0.50 0.38 0.35 VICON SERIES Clear Insulated Low-E AdvantEdge New Construction Vinyl Window • Vicon Casement/Awning 0.47 0.36 0.33 • Vicon Picture Window 0.46 - 0.33 0.30 • Vicon 1000 Single Hung 0.53 0.41 0.37 • Vicon 2000 Double Hung 0.52 0.40 0.36 • Vicon Classic Double Hung 0.51 0.40 0.37 • Vicon Designer Shapes 0.49 0.34 0.30 HARVEY PATIO DOOR Temp. Clear Temp. Low-E Temp. Argon * Solid Vinyl Patio Door 0.50 0.41 0.38 • Vicon Patio Door N/A N/A N/A . - • : • Model FS 0.58 0.37 0.41 • Model FSF, - - 0.40 • Model VS 0.60 0.43 0.47 CAPIZZI HOME IMPROVEMENT INC . SPECIFICATIONS AND ESTIMATES PAGE 6 OF 6 STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, n �p OWN THE PROPERTY 'LOCATED AT Q w,c�,[1�1 �W IJLwk - � IN Ul �l� MASSACHUSETTS. I HAVE AUTHORIZED TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSTTS STATE BUILDING CODE. I GIVE MY PREMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: G�/e OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: } 'C�l ocm o uuicl r zl-" APPLICANT'S ADDRESS: 1645 NEWTOWN RD. , COTUIT, MA 02619 APPLICANT'S TELEPHONE: 5081428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: ACCEPTED BY DATE 7 �� THIS PAGE IS AR OF AND IN CONFORMANCE WITH PROPOSAL # TOWN OF BARNSTABLE�BUILDING,PERMIT APPLICATION Map - Parcel Permit# Kg31t4 eieiert Date Issued ? ct C� on Fee ��,� Tax Collector`- Treasure d'�D Planning Dept. Date Definitive Plan-Approved by Planning Board Htsteie--OKH Preservation/Hyannis Project Street Address �'C�l SEL I`f CJT,cI�-r�4T lb Rb . Village .Owner hl9ZcSCr Address S Cvme_ Telephone r7 Permit Request So(i c1 8 '� " "Lq l i Ic t&S Square feet: 1 st floor:existing proposed 2nd floor: existing proposed Total new Estimated Project Cost} Zoning District Flood Plain Groundwater Overlay J Construction Type ` S� a Lot Size Grandfathered: ❑Yes aWo If yes,attach supporting documentation. Dwelling Type: Single Family 0"',*Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ONo On Old King's Highway: ❑Yes 3 Basement Type: 0 Full ❑Crawl O 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 ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:O existing, ❑new size Pool:O existing 0 new size Barn:O existing 0 new size Attached garage:O existing ❑new size Shed:0 existing O new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes Ir No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name � 9� Z2 r /-1ZrYm6- Pk6L"1W Telephone Number �'`1S/8` Address !(� S � S j-wuY k/ i�C4_ . License# . C 7Ucl ✓)'j A- Duo,9_5`7- Home Improvement Contractor# Worker's Compensation# _ur �BoZ 8 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO C��,�irtZ V/ ' r SIGNATURE DATE `I LP FOR OFFICIAL USE ONLY , r PERMIT NO. DATE ISSUED .�� r Y t .I . + = _ i .i' .• — ,.. •. .. '. -� - ; , � ....-r s MAP/PARCEL NO. ADDRESS VILLAGE ' OWNER, DATE OF INSPECTIO FOUNDATION ' FRAME t - INSULATION + FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINALt r FINAL BUILDING /0-6 d DATE CLOSED OUT ASSOCIATION PLAN NO. i The Town of Barnstable s 9 M Department of Health Safety and Environmental Services ' P Building Division 367 Main Street,Hyannis MA 02601. Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires thai 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. _ 1 Type of Work: Est. Cost Cut) Address of Work: C��ri -� /��` •1-PQ,•,,� 1� , Owner's Name Date of Permit Application: 4— —� I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under 51,000. 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. etl P OR Date Owners Name ---__ The Commonwealth of Massachusetts - Department of Industrial Accidents Office of/aresdooffoos 600 Washington Street Boston,Mass 02111 r � Workers' Com ensation Insurance Affidavit name: location: city (J2M�.P�LIi�f ('1�� . phone C) 7 ❑ I am a homeowner performing all work myself. ❑ I am a sole etor and have no one worku M act /Z,70'////////%%/%//%%%%%%%%%%%%%%%/ %%% %/%%/%%/0%%%%/% %/%//////.0///,O%%///O/////%%/.�///%/%/G///////////%////%/i�� I am an employer providing workers' compensate n for my employees.working on this job. :;:>..:. m an name.:, . . i ..::> _ +. .:.....:::.;:.:. . ............... Q . . ` .... ...... ............ bxX ane#..:_:. <:_: ;: ::;.>: :;::>;::::<:;,:::>.<;:»' ??<« <'.: MMM ❑ 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: :...::;. : ;..... ..:.:. ............................... ...:.;.:: :;:.;;;;;:.;:.;:.;:.:.:................... :................................................................ address.. ..... :::::::.;;.::.. :.....................................::.:::.:... :_.: ;;:.;.:::..; :;:::.::::::...:::.::::.:.. ..... .::;.::.:::;..................................................::......:.::::.:::.:::::........,... ...... i� ...................................................... ..................... .................. :•.. . ..... ::.:•:.::.::.:::::::. .:. ol#'ty#� ;;::::.,.........:::.:......::•::••:::.�::::;>•:;;;ate.::::::::::::::.::.:::: .....:...................:::.::.:::.::::.. .. _.... ..... .._........................................................... :>:>:<: cunrp ny n m . :: :::.... ................. address: ; ..::: .................... :: ......::....... :> :.•. Faflme to acme coverage as regdred m er Section MU of MGL 15— czm lead to the imposition of...... al penalties of a tine up to$1,Moo sud/or rs one yea 'imprisomnent as wen as dvn penalties in the form of a STOP WORK ORDER aid a tine of$100.00 a day against me. I understand that s copy of this statement may be forwarded to the OfIIee of Investigations of the DIA for coverage verincatlon. I do hereby certify under the pains mrd penalties of perjury that the information provided above is true.gland eorred c signature L�e��2+ �� _Cc � Date Print name c�J l C,c (/- ff SCN Phase# 95 ��7 official me only do not write in this area to be completed by city or town official city or town: Permdt/lieeye# QBnilding Department t,..,...ai,f. OLicens ng Board O checicff - response is required Osdectmen's otace OHealth Department contact person phone#; _ Oother OrAnd 9193 Ply - - - ✓lie 61101vnzonw &I" 01,111zwaelccaef 0 DI'4 , icn/ :DNS RUCTfOii 'UPERV:QD-1_ Number: vn: CS: ;37a54 T� o�✓lt!aova �ae - RestriCted To: 7i ;£HOME. _IMPROVEMENT CONTRACTOR' x �!H0MAS' CAP I Reg i`stration'-'1OO74O : 16415 NEWTOWN RO _ Type PRIVATE CORPORATION_ rn,TUIT, Ap s,;' '.`Expiration ::.06/23/00 _. `YCAPIZh HOMEIMPROVEMEN'T INC. G� homes Capizzi, Sr 1645 Newto n` ". ADMINISTRATOR _ - � COtu i t.MA 02R.635d ' -- ✓�ie -�a�nv»zcinzueal��. l�auJac�rcret�J DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number., Expires: Resh.i ed T6' 00 THOMAS X:-CAPI.2ZI TR �. j,W 28B PERCIVAL OR W BARNSTABLE, MA-02668 - a % �� � ✓fie �av,vina,zalecz`l�i o` =C`czv:tac�udeCt x- DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number:-- Expires: Res,tr:ic_ted;sTro;:' 00 I FREOERICK V--RASCH III i060 BOURNE RO PLYMOUTH. MA 02360 Assessor's offioe (1st floor): / FT NET a;ssessor's map and lot number :..... .F,l ..' .�f� �oard of Health (3rd floor): Q f jS Permit number .�..... l.� �L a(p� .... Z BASd9TODLL i Engineering Department (3rd floor): _ L M"ta 039 Housenumber ....I...........................................................:..... 3 `e APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only E P TOWN OF BARNSTAN E Cot)EAND BUILDING INSPECTOR no* dJ APPLICATION FOR PERMIT TO ..�� .!I.I..d�» ........ G. ...................................................................... TYPE OF CONSTRUCTION �" © � % ti 19..8^�r TO THE INSPECTOR OF BUILDINGS: The undersigan�ed hereby applies for a permit according to the following information: Location I.......... .,..... ...... .........C .1f7/?.V/X' .4 r..... .�If�sS, ProposedUse ..............C,l.... ....�.....5...�.. .�" .......... .. .(✓.. ....................................................................................... ZoningDistrict ............t.............................................................Fire District ................................................................................... Name of Owner J.6.1=1.<l...J.t..... t4. O.�.........Address c.f.:tl.Y,J�k..II o.w � .D.. �CF1 V� 554, Name of Builder JQ.9A/....J..o.. .. ./ N-5aAl.............Address9./T � ��....?Q 1yN�.. 1.. 1 !�Uj ✓` �. Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................... Fireplace ..................................................................................Approximate Cost ,✓............ � Definitive Plan Approved by Planning Board ---------------------_----------19______ . Area .. ......!..... Diagram of Lot and Building with Dimensions �¢ Fee .�: ........... .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH r ��u t t Su 00 'V, AP 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 n.. Construction Supervi or's License ..!�.�... ... . .. .... HANSON, JOHN J. f. No 31639 Permit for ....Build Deck....................................... ..... Single Family Dwelling ......................................................I.................. Location . Lot #21 , 9 Ansel Howland Road .............................................................. Centerville ................................................................................ Owner John J. Hanson .................................................................. Type of Construction Frame................................. ....... .......... .................................................................... Plot ... Lot ................ t. Permit Granted .....FebXuaxy... 88 Date of Inspection ....................................19 Date Completed ......................................19 49 L C) fo rent• +'. •. . . . �' �1~irjl�l�l �Q1rIC� .. .._,:_. - � � - - ---`^-Y.- ,"• :j_" r•,,� �',�•• i L10 GArG�'3/�GE fsRl tJC+L.jL � r .•�: . �r ¢'�1' � � � .. tadt L%.( ;rLow z tto K 3 t S So G-F'•D hrEi✓,e' -!�mr-prtc • 4-95 9.Prv. �15PDaAL PlT u;E loot Gd_, `' •�.f `. � .�.. , �..,.. �9'' -�t : SULWALL AG A, z 150 S.P. ' /S G.RU. f��' -;� p�•/t l 4 t : . . '8OTTC)A-A A20A w c o cr-. ' ; - I Per > �..�,•� t 1 1 TbTA t- M>41 L_�( Fc.cw 330&P ml. GEl1GDl.AT10U CZlaTE to 'to 2MIu'02 lass. r•, OF , - rda Joy; q. lo tS` ,.7..... ...... _.M1 •......_..._._.._: _._._ - ..r.-.... ....r .. _.. .. v i... .. r ..•_ . .. ..a... i. ..ter e . ..'"r: T�'�,--1..38•_:.• � • � -' : .•? 6.'S9.00 ToT F.io ��•C� . > T- /''Pik '.d!�c+B lOod Its 1000 ,�"9,n .PIT 1 y e WAswesD d STOW 0-7 •i CE.CZ,TtF1ED• 'P C• L: L b Ch'1 l U 1J :�•�ENT k':•1/!)�. C.:E ... . �, S CA — 1 �0� >?AT C 311 oIt3Z l GGaTtFti( Ta-(AT` TI-l� � ►a_'J 5"4L. .l pL4tJ Cr 1GE t�••16:.QL==otJ Gcav>,P1.�5 W 1'rl•� TN 51DE:LIN� �G►;'r''.i�.I auv Sr'rt!AGIC J'cAU1vGAA�uTS oG Tµc: 11� -toww OF � • 'A 4t> - .1 G G`� N�1<K•V i��� N�GI�I.�AI�;� LOGATEb• WITH Q TwX-- FLc)c>*P Pl.At41.: - � •t,.t 'U C�:��.1-.�.� " ,. t2CGlS'1"c=2ED � 1.�No t~SUZV�YoQ� TW 1-5 - :n�A►-1 IS LlOT L'A'SC'O OW pN OSTE�'Vtt..t,�t o /KASS• tl�sr�v.vtic_�.i; �,uc:•��.Y ,E-�11�c:. �� ,�,r�. S14c, nNt�t_icn.�-r AL AN F, t �, l.ro^c". -i_t tam•� t �• " TOWN OF BARNSTABLE • . Permit No. .------------- --- -. Building Inspector smn►n . Cash OCCUPANCY PERMIT Bond _- Issued to Alan Small Address � Wiring Inspector Inspection date Inspection date Plumbing Inspector ' �t . _ i.. . ,. Gas Inspector Inspection date Engineering Department Inspection date Board of Health 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. _.__.......... 19...... .. ............................ :._.................... __ ...._ Building Inspector Assj.�sor's map•and lot Aumber ,,, .../. �. F?HE ti Tod m EPTIC SYSTEM MUD Sewage Permit numbera ... J. a✓�:: Q� y� INSTA.4EID IN COMPLY e , Z I • f1. WITH.'TITLE..5 BARN T�LE House number Q ENVIRONMENTAL CODE ''o � 39• e� +� - � Tp�NIS 0 war a� TOWN' OF BARNSA ; l BVILDING :INSPECTOR APPLICATION FOR PERMIT TO ...V .. .........: .......................................... TYPE OF CONSTRUCTION y�° v "�r' ""A'� `'......... ..: .................................19. . TO THE INS'PECTQR!OF BUILDINGS The .undersigned here y applies;for a permit accord' g to the following informytion Location ~ .. : .:..:.. ..�� 'IS� . . ... l:f.-^ ......... r ProposedUse ....... ... :.....:................:..........:... .......................................... ....... ........................ Zoriing District .:.......... ......:.::.......:..... ..............:.:.:.......... ......Fire District .....:.: Nameof Owner CE -r .... ....................................... Address ... ..................................................... Name of Builder. .......... .........................Address Name of Architect ...::..........................................:.:...... .......Address ....:.::.................................: ' ........ Number of Rooms Foundation ......... .... e . ....... 47 Exterior : :.. ........ ......... ," '.�. Roof,ng a'4r .... ��` o Floors= �fr!`..... .................................. .......... . .......Interior, . .. ., Heating y/ t. . .r ..... ! Plumbing .. .. ...� ................................ t ass; _ r' t. Fireplace .... Approximate`Cost .......................................... Definitive Plan Approved by Plann g Board __ _________ :________19________ Area .. Diagram of Lot and Building with Dimensions, Fee SUBJECT TO APPROVAL OF .BOARD OF HEALTH s1 , O y I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable garding the above construction. Name*".-*....... ............... ..... ............................................ .SMALL-, ALAN 2 ..90...... Permit for One„Story,,,,•,..,, , Single Family,, Dwelling•,,,,,,•,,,,,, u Lot #21 9 Ans Location ��,.. OW.Ia31Gd: Rc:;. Centerville ............................................................................... 4 Y � ' Y Owner Alan Small .................................................. Frame Ty Pe o Construction .......................................... ............................................... j ............ Plot ...:........................ Lot ............................... r i� . i • PermitlGranted .,March .25,..............l9 82 i r Date,-of Inspection Date-Completed ;ZIAZW..7. Z. 3.........19 ''.f , ' PERMIT REFUSED ` ` .... ........... . ........................... ............................. ` •....// +®.... V .... ....................... ..............• ri. s ' • - Approved ....... ........................................ 19 ....... .............................. ... ..................... vi V Assessor's map and lot number .... ..�..., ' � c��r4 j ?NE t. Sewage Permit number ...........:..............:................a.............. £., r t � Z BABBSTi►DLE, i House number 1�3............! .:.:..:..:......................................... 90 rasa 1639• 6� am a\ TOWN OF BAR.NSTABLE . BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............. �j � �''',? ............................................ ...................................................................... _ ff TYPEOF CONSTRUCTION '..................................................................................................................................... .................:...............................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....................................................................................................................................................................................... ProposedUse ............................................................................................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Nameof Owner ......................................................................Address .................................................................................... Nameof Builder ....................................................................Address .......................................:............................................ Nameof Architect ..................................................................Address ..................................................................................... Numberof Rooms ..................................................................Foundation .........•..................................................................... Exierior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost .................................................................... Definitive Plan Approved by Planning Board ________________________________19________. Area ....:...................................... 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 Regulation's of the Town of Barnstable regarding the above construction. Name .................................................................................. SMALL, ALAN A=172-216 No 23906 permit for One Story ........... .......... ......... ......... Single FamilX Dwelling.............. Location Lot, ##,21 9 Ansel Howland, Rd. ............ ..... Centerville ............................................................................... Owner .Alan,.Small - .............................................. Type of Construction ....FAZAMe......................... ................................................................................ Plot ........................ Lot ................................ Permit Granted .... March 2.5, 19 82 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED .......................... ........... �`sr ........................... ._.�.� �. ............................ ................................................................................ ............................................................................... ............................................................................... Approved ................................................ 19 .............:................................................................. ...............................................................................