The URL can be used to link to this page

Home My WebLink About0017 ARGYLE AVENUE r 11 1)4r.1 1 1� -1yo I - i, - moo "PIK. It "gp, vW .10'. ?54 V, '41 71 C 'VP Yf, 4 o 11& laut MR.-zo; N two Mal MUM f NMI YMIT, it�it i -mums -IV 0;n AIA �plg .jyi ov:� Ir, SI,N 0� J PT i 11 i iii,j"I"",il 1, vM gnamcgm qujur,�g� � -'r-g".1,111 -7 001'4' NMI, UM �v .80 iam 1, YEA, moo ji W 11 !A &JAN ILI ii J �I g ivkRK' o� ,�gp-, R.)",%9,11 - T wa gi ZPM Mfg X, tX"Xi-pl;4% 3 IMM ".;'M .1.11, 111.1 n,��pmpmwqg 4 � WT -MWOR!ATA P '04 ltl iq t "gT1 !Ie 7;f 4%. tr I, ,�j A 1!! K q�d N=- ig I oil [Nis, 'A i 5 i HA4,114 "Im OWN ff I V, g T Ncti g,, Wliil Hli ��qkvy - I . � �,qg q '11) 1 A� � Sm .Y,� 4 -A ('il OR MIT 11-�Nl & wi N "NOT IWO WINE ng An'v ifvg g C& 1wou MUM NMI P111 -RA �iq;jn;,si;I;jfl(� , Alt' nj RIM q Mtn lit ilf! lq� pill �FP ?Emit Ma T541 HER; ggjayw,4�,14,nm.'f MORE N HP All At'.' %, MIR q% No ENO A 7A I;pjg�7"I'l. A, 1ji"'tw W1 ISA Ulf T%� !?k,' 4 P,Sffilv 415 1%j, xwwwml DIM SIM miq aj Af V, TION i�i'AUAIIVIIIKIHIN T. M;fe jw�I ;*3111 V. U VA NA 00 1� NO llplllfll� Ar N V10IT Pp, OWN i Qtq �A .j mi-E ig"Im,' =2114 ps , Z�!� Milo lit 1115 KIN 0 U C:� o /20 S�Q �tHE„ Town of Barnstable *Permit# Expires 6 months from issue date "T Regulatory Services Fee S c� snaxsTABLE, MAM 9q, 1�' Thomas F.Geiler,Director X-PRUSS PERMIT Building Division Tom Perry,CBO, Building Commissioner AUG 1 2013 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us T Office: 508-8 3RESS PERMIT APPLICATION - RESIDEl �AL®O�l�" LY$! �9�L EXPRESS �Not Valid without Red X-Press Imprint Map/parcel Number Property Address ru Residential Value of Wor $ // tp Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name � 9 �� Telephone Number ( 9L;axa&�5 Home Improvement Contractor License#(if applicable p(, Email: Construction Supervisor's License#(if applicable) cS'DD OWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name ejo5 zj�P_l Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side E;KReplacement Windows/doors/sliders.U-Value X (maximum.35)#of windows /D #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: " C:\Users\decollik\AppData\Local crosoft\W ows\Temporary Internet Files\Content.Outlook\8R76BDVA\EXPRESS.doc 'Revised 061313 Authorization Form: as owner of the subject property, hereby authorize Baker&Associates to act on my behalf, in all matters relative to work authorized by this building permit application for Address of property: 17 Argyle Ave. Centerville,MA Signature of owner: G _�a" Print Name: Date: l 13 r Cl k, M; Office of Consumer Affairs and Business Regulation 10 Park Plaza ® Suite 5170 Boston, Massachusetts 02116 Dome Improvement Contractor Registration Registration: 162600 Type: Supplement Card Expiration: 3/26/2 015 BAKER & ASSOCIATES INC. RICHARD GARNEAU -- 521 SHOOTFLYING HILL RD - - CENTERVILLE, MA 02632 -- Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card SCA 1 0 20M-05/11 �iLe�Q711)IL4)IflJG'C[1�f7 Q��'l"CIIJJQCft[[JP✓CJ Mce of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration: 162600 Type' 10 Park Plaza-Suite 5170 ` Expiration: 3/26/2015 Supplement Card Boston,MA 02116 BAKER&ASSOCIATES INC. RICHARD GARNEAU P.O. BOX 923 g _ CENTERVILLE, MA 02632 Undersecretary Not lid with ignature ` Massachusetts - Department of Public Safety . T Board of Building Regulations an y d Standards Construction Supersisor License: CS-009714 t I - RICHARD P.GARRiAU JR 251 Woodside RC, - - West BarnstablelMA Commissioner Exp,rat,o- 04/04/2014 o P5 ... The C°ontmontveatth of Massachusetts Department o,f bdustrial A cciderris Office of Investigations 600 Washington Street tutttfst mass;goa3/rlirr Workers' Compensation Insurance Affidavit:B ders/Conti-actor•s/Electiic ans+Ptumbers Applicant Infunnation Please Print Leyibl Name oriIri&idaal): q '� Address: City/StateJZ ip: Phone -(W� Are you an employer'Check the appropriate boa: T of project(required): I.9 I am a employer with 4. ❑ I am a general contractor and I Type e a { t d$ employ=ees(full and+or part-tire).s have hired the sub-c 6. ❑I�te�construction 2_❑ I am a sole proprietor or partair- listed on the attached sheet. `l. ❑Remodeling ship and have no employees These sub-contactors have g- ❑Demolition working for me in any capacity. employees and have workers' � ❑Building addition [No workers'comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its M EJ Electrical repairs or additions 3_❑ I am a homeowner doing.all work officers have exercised their l L❑Plumbing repairs of additions myself.[No workers'comp- right of exemption per MGL 12..❑Roof relmn insurance required.] c- 152,§1(4),and we hatiT no employees-[No workers' 13:❑Ether' comp_insurance required.] •Any applicant dint checks box#1 m=also fill oiu the section below showing their workers'compensation policy mfonnati m. _ Homeowners who submit this af5davir m6cating they ace doing all work gad flues}sire outside contractors mast submit a.new aff dadawt mdicatimg such. tContractors that check this box must attached an additional sheet showing the msme of the sub-coz=tm and state whether or not those entities have employees. If the sob-coataaetors have employees,they must provide their workers'comp.policy mamber.. lam an emploiw that isprmidfug workers'comTensation insurance for my ertTkyees. Bdow is the policy atnd fob site information . Insurance Company Name:�� Policy##or Self-ins.Lic.##: Expiration Date: Job Site Address- �.L13//U_ .l t e CityrStateiZip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required gander Section 25A of MGL c- 152 can lead to this imposition of criminal penalties of a fine up to$1,500-00 andior one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine F of up to$250.€0 a day against the violator- Be advised thatt a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do herr4 certirttler tke priitfs atirl pearradties oPeffaas t'tarot the irriarmatinar prcrvirbf ab,�+ is true art,}correct Si tore: 0Date- Phone#€: O rial use only. Do not write in this arena,to be completed by°dV or town officiat City or Town: Permit/License Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CittlTown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: i 6 . Client#: 9742 2BAKERAS VA IE(MMIUDIYYYY) AC;ORD-M CERTIFICATE OF LIABILITY INSURANCE 04/25/2013 THIS CERTIFICATE IS 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),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.IF SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemetH(s)- FKUUUCEHCONIA I NAME: Dowling&O'Neil PHCDNNU EA:508 775-1620 ac Hui: 5087781218 Insurance Agency E-MAIL ADDRESS: 973 lyannough Rd., PO Box 1990 INSURERI3)AFFORDING COVERAGE NAIC A Hyannis,NIA 02601 INSUREH A:National Grange Mutual Insuranc INSUHLU INSURERS:Associated Employers Insurance Baker&Associates,Inc. aysuHEH c P O Box 923 Ui3URER D Centerville, MA 02632-0071 wsUHEH E I INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE I-'OLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CCN RACTCR OT-IER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY EE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CCNDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN3R AD UBR POLICY EFF POLICY EXP LTR IrvE O►INSuttANCE INSH VIVOPOLICY NUMULK MMi (MIWDD/YYYYi uMNs A GENERALLU�BILR-Y MPJ7223M 1912013 04119/201 EACH OCCURRENCE $1 000000 X - I)AMAI'r I C)FCFN IFI) C:UMPAFHC;IAl (+NFHAI I Aril IY rREIVISES�En ucwllwtcn :h5Wdd0 CLAIM-'-MADE I ^I OCCUR NIEL)EXr(Any unnpn,WJ,0 $10000 -- FP-HSQNAI R AUV INAMY $1,000,000 ' GENERAL AGGREGATE °y2 000 000 _ GIN'I AI;C;HF(;A I r I IPA I I AFFI If-S FFM: FPti)I)I1C;I_i-(;:)MF/(7F A[;(; s2,000,000 i;i)MHINFu SIr)i;l F 1 uan AV I OMOtlILE LIAtlILII Y (Er aecrtlexll} , A14Y AUTO EODILY INJURY(r'uI p91tlUI11 3 _ ALL OWNED SCHEDULED P.oim Y IN.RIHY(Fnrncnrlr..rt)F '6 All I<:;i Allll),i --"- NC:N-OWPIH) + FNOI`F-HII1)AMA(;4- HIHFII A1110;-i AUTOS P.,y UuJ Q _ :F UMBRELLA LIAO Hi)i;Cant FA,;H6i;f:uHHFIvi:F $ I E7(C6S6 LIAU CLAIM&MADE AGGREGATE $ III. IRF I FN I ION$ WUHKENS CUPAF'ENSA I ION JVc'SI AI{T ER B AND EMPLOYERS'LIABILITY WCCS0050024542013A 23/2If13 041231201 X n" ANY rrz.n RIETORIf ARTNER/EXECUTI'IE Y1 N F.1 rAC;H Ai:i;II1FNl :fi500 000 0FFI(',FH!MFMHFK FX(:I I INF I)? N)A -- E.L.DISEASE-EA EMPLOYEE $.5(}Q 000 (Mandatory In NH) if y x,dj"ibn ulrtlnl . DESCR r'TION OF Or ERATIONS bub. FDI Cy 114.�I1 :ti500,000 I UESCHIP I ION OF OVEHA I IONS I LOCAI IONS 1 VEHICLES(AtUch ACOHU 101,Ad C910na1 Hsmarks Schadula,If M WG spaca Is raquvad) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions., { CERTIFICATE HOLDER CANCELLATION ) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE i Town of Darnstable n IC cxnlni.Tlori DA.Tc n II NOnO[ WILL De DCLrocneD m 200 Main Street ACCORDANCE VAT" THE POLICY PROVISIONS. Hyannis,MA 02609 AUTHORIZED REPRESENTATIVE NM 01988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) . 1 of 1 The ACORD name and logo are registered marks of ACORD LS1 #S1104031M110402 APR-24-2013 09: 11AII Fax: Id:BAKER & ASSOCIATES Pase:002 R=9 Town of Barnstable tHE 1p�� o Regulatory Services Thomas F.Geiler,Director * RARNSTABLF, M�: ��$ Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PERMIT# � L 3 9 1 FEE: $ SHED REGISTRATION 120 square feet or less 1-7 A 2 CY L- /E VE, C. t 1✓2-Y2 y i L-Z- Location of shed(address) Village lv /� /✓LDS ( ��) � ��,-�� Property owner's name Telephone number r x " Size of Shed Map/Parcel# Signature Date rn Hyannis Main Street Waterfront Historic District? Old King'§Highway Historic District Commission jurisdiction? Conservation Commission(signature required) i�L V Z PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 4 LOT 1,5 g ' N 9 0 ' ti0 /1/ �•�" 1 9e Op"A. \\, �� LOT 14 LOT Q 4 SN*._, --- -. 7 1 =.NSE �/17 == :ti o ryj. t It N t 2 _ o J _ �.cow; -----.• �. -�: ':- -,fir __-- N n , :10 `3 L' BOO OO •/VY '1 N�F'T'C'I'fON Plan is Foy FLOOD. ZONE' „C„ RFS ZOIVF,. RD-1,. NMO R'I�G r�G E I 0..1�,►: use o�,l •�j�i'Iv: ' —;�'.:L:; - •-- —__.. -6 U Y1�;1�: 1ZG'£��}' �J��.L1v��' .11. — — DEED tMF _S'lF I° 1� — _ _ SCALE:1,._ 40 — _FT DATE: _2=5 9 --- PLAN REEF: 1%678_J _ -- — .►y;' I HEREBY CERTIFY TO 99LV1�' _d'l'�'L' ---- ----- --- ��,�f YANKEE SURVEY ___________ ___'THAT 'THE ,BUILDING ��•.----�,�, . . ,, . — OW o . SI -- ON .Tills PLAN IS LOCATED ON THE GROUND AS �'�v BL �� CONSUL'1AN1S S CONFORM 0L 40B (SUITE 1) SHOWN AND THAT ITS POSITION hOE:•• - <" 1NDUS'TRY ROt\i) 1'O 'fliF: ZONING I.AW SF T81\r'I� 1'tF:GZt111%F;�II:N'TS OF 'fill; slilllS)" TOWN _ \; T•I/11.,I:_: AN `I'IiA'T L`I"�' `�0�'� �� MA1tS'I'UNS h911.r.S. h1,1. O'�G �tl IT [)0[::S �U/-- ��` ;�S'ir�' 'I'LI.: �t2a-OU55 !_ LII:: I'1'hilN `I'l11; SF'l::C'I�L-FLOOD FfA'l.,AIZD �� b OWN ON THE H.U.D. �iA['_DA'1'Ell_fLCl� � FAX: 420-5553 AS SHOWN - ' AREA � .�•-G Cc �.tntty-Panel u 50001-010 rtUMEN'f III IS l'I.AN NUT MAI)G FROM AN 26/�� 5'l)S' -- I FTC NOT OT 9.0 RE USED FOR Town of Barnstable *Permit# -9 Yf?Coco C X-PRESS, PERMIT Expires 6 months from issue date FEB e� 200� Regulatory Services Fee Thomas F.Geiler,Director TOWN OF BARNSTABLE Build.ing.Division T).ZhLlcs Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable,ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERA UT APPLICATION - RESIDENTUL ONLY m Not Valid withau[Red X-1'ressImprint Map/parcel Number Property Address [9/Residential Value of Work 00 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 6, Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) '�''I J 10 Construction Supervisor's License#(if applicable) 9 9 I ❑Workman's Compensation Insurance Che one: II am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) VRe-roof(stripping old shingles) All construction debris will betaken to * ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) . *Where required: Issuance of this permit does not exempt compliance with other town departmcnt regulations,i.e.Historic,Conservation,etc. ***Note: Property O must si roperty Owner Letter of Permission. op th ome Im ement Contractors License is.required. SIGNATURE: Q:Forms:expmtrg Reviseo61306 • 4� �OOHEr Town of Barnstable. Regulatory Services r WAS& Thomas F. Geller,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,Mk 02601 Yet WAown.barnstabk.ma.us Office: 508-862-403 8 Fax: 508=790-6230 ProperCv Owner Must Complete and Sign This Section If Using A.Builder as Owner of the subject property hereb authorize to act on my behalf in all matters relative to work authorized bythis Molding permit application for: (Address offob) 09 Signs of Owner Date Print ame Qf0RMS:6WNERPERM]SS10N , - Massachusetts- Department of Public Safety Board of Building Relrulations and Standards Construction Supervisor Specialty License License: CS SL 99138 Restricted.to: RF WS JAMES CURLEY 287 FULLER ROAD.. CENTERVILL•E, MA 02632 j i - j <� Expiration: 1/28/2012 ('unmiissiuner Tr#: 99138 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: Registration:__124310 Board of Building Regulations and Standards Expiretion 6/1/2009 Tr# 130873 One Ashburton Place Rm 1301 Boston,Ma.02108 Type�_andividual James Curley _ a' James Curley 287 Fuller Rd. Centerville,MA 02632 Administrator Not valid without re - - The Commonwealth ofMassachusetts Department oflndustrial AIjcidents Offtee of-1"nvestigations 600 Washington Street Boston,MA 02111 www.rrc ass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians /PIumbers Applicant Information Name usiness/or Please Print Legibly (B ganization/Individual): Address: X City/State/ZiP: Q U'U�kone.#: Are you an employer? heck the appropriate box: 1.❑ I am a employer with 4. Type of project(required):. ❑ I am a general contractor and I Vi'am mployees (full and/or part- ime).* have hired the sub-contractors 6• ❑New construction. 2. a'sole proprietor or partner- listed on the•attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have working for me in any capacity. employees and have workers' 8' ❑Demolition [No workers'comp.insurance comp.insurance# 9. El Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their , m se1L 11•❑P Bing repairs or additions . y [No workers' comp. right 6f exemption per MGL insurance xequired.] t c. 152, §IN,and we have no 12• Roof repairs employees. [No workers' .13.0 Other ' -comp.insurance required.] • • t'Any applicant th checks box f must also out the section below showing tbeir workers,compensation policy information. Homeowners whoo o submit this affidavit indicaticat ng 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 additinnalsheet showing the name of the sub contractors and state whether ornot those entities have employees. If the sub contractors fiayo employees,they must praride their vrorkcrs'camp,policy number. lam an employer that is providing workers'compensation insurance for information my employees Below is the policy and job site Insurance Company Name: - Policy#/or Self-ins.Lic.#: Expiration Date: lob Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and e as re expiration date), Failure_to Secure coverage ; required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to S 1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORD of up to$250.00 a day against the violator. Be advised that a copy of this statem and a fine e Investigations of the CIA bran overa e verification nt maybe forwarded to the Office ER. Of Ido h eby certify er epairs• d enaldes aft erjury that the information provided a nve is ' " e and correct: Sienature: Dater V Phone Official use only. Do not write im this arecz,'tb 11 completed by city ar town off ,, City or Town: Permit/License# Issuing Authority(circle one I.Board of Health Z.BuiIdingDepariment 3, City/Town Clerk 4.Electrical Inspector S.Plumbin�Ins rector 6. Other o P Contact Person: Phone#: Engineering Dept. (3r obr) Map Z 2 Parcel Permit# t � House# J=..LS+ Date Issued Board of Health(3rd�loor)(8:15 -9:30/1:00-4:30) 0 � Fee 7 •9 0 ze Conservation Office(4th floor)(8:30-9:30/1:00- 2:00) Planning Dept.'(lst floor/School Admin. Bldg.) - SEPTIC SY ST BE Definitive Plan Approved by Planning Board 19 INSTALLED ANCE WIT TOWN OF BARN5TABL VIRONME E AND T®WN RIEGR� ATOMS Building Permit Application Project Street Address ^�(' (� �G ,/ Co-j:s -B 4 I c e Village Owner Address Telephone 7 7 � 9 Permit Request First Floor square feet Second Floor square feet Construction Type z, 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 g g 3 Historic House ❑Yes Jd No On Old King's Highway ❑Yes �ff No Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing Z New o Half- Existing c New No. of Bedrooms: Existing `New Total Room Count(not including baths): Existing New d First Floor Room Count Heat Type and Fuel: JdGas p Oil ❑Electric 0 Other Central Air ❑Yes �dNo . Fireplaces: Existing I New 0 Existing wood/coal stove ❑Yes �dNo Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) M 'Attached(size) Z ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes �d No If yes, site plan review# Current Use Proposed Use Builder Information Name X1id / Telephone Number r �� 2 / Address L License# ®-5,6 3 LY6 alta Home Improvement Contractor# lI 2 d q l Worker's Compensation# 4, C A 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 PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY _ PERMIT NO. DATE ISSUED MAP/PARCEL NO., Y r ADDRESS d VILLAGE OWNER t' DATE OF INSPECTION: FOUNDATION FRAME - 9 7 r INSULATION ' FIREPLACE - ELECTRICAL: ROUGH FINAL PLUMBING: r-ROUGH FINAL . va m GAS: OUG7fj'7 FINAL � d , a, FINAL BUILDi DATE CLOSE"VW M Cl rJ" Wo V.i -- + tRl � � 1 ' ASSOCIATION�PLRN NO: + + m r . ! t . Thc• Common wealth of:1 tassuc h u.v&1 • i: ;_._. �;_.. Department of Industrial Accidents F office of/ gal/ons 600 N'ashiartuir Street - Boston. A1uas. (12111 Workers' Compensation Insurance Affidavit �linlic.int iriforrnatioti: - Plc-nse PRINT'le `""""""-"�'"'�'-'�'� name location- city nhonc# I am a homeowner performing all work myself. ' I am a sole proprietor and have no one working in any capacity ,.' Fam an employer providing workers' compensation for my employees working on this job. AZI cnnt tarn• name: Rhone#: insurance co. Cl I am a sole proprietor. general contractor, or homeowner(circle ate) and have hired the contractors listed below who have the following workers compensation polices: comnativ name: address: cin•: phone#: insurance ro. nnlicy# _ comnnn.• nntnc: nddress: cin phone#• insurance co. policy# Attach additional sheet if necessar-y-; =•�'�_=i%'_ + �-�i' _ - �_ ��•''�":�'r�" '•• +'��' T�-_T� -�� •-' =.. __..� :� __....•-�,ty..�.:�:,�.(.�;�r •-1�� -...w.�.�.WW��_...�_r-__�ilY!'�_l��i!••Mli i:_rJL Failure to secure coverage as required under Section 25A of AIGL 152 can lead to the imposition of criminal penalties of a line up to 51,500.00 andior one Nears* imprisonment ns wcll as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. 1 understand that a cope of this statctncnt mac be fori[•arded to the Office of Investigations of the DIA for coverage verification. J do hereht•certifi•sunder the pains td penalties of per)urt•that the information provided above is true and correct. Signature Date Print name (/(/1 �-4. -)4, .4, J G If L Z ZIP' Phone# ! / 0v 7 official use unl% do not -rite in this area to be completed by ciq or to��n ofTiciai (. cite or town: permit/license# rnlluilding Department Licensing,!Board check if immediate response is required Selectmen's Office 1 (:111c21th Department contact person: phone#: nUther . r. Information and Instructions MaSS:iChutietts General Laws chapter 152 section 25 requires all emplovers to provide workers* compensation for th+ employees. As quoted from the "lacy*% an etnplt{ree is defined as every person in the service of anotlier under an\• contract of hire, express or implied. oral or written. An eynpinrcr is defined as an individual• partnership, association. corporation or other legal entity, or ally two or mo the foregoing_ enuagcd in a joint enterprise, and including the le,al representatives of a deccasetl employer_ or the receiver or inistee of an individual • partnership. association or other legal entity, employing employees. However if- 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 dwellin_ he or oil the __rounds or building appurtenant thereto shall not because of such employment be deemed to be an employe state or local licensing agency shall withhold the issuance or MGL chapter 152 section 25 also states that even renewal of a license or permit to operate a business or to construct buiidings in the commonwealth for any applicant ,%f•ho has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter been presented to the contracting authority. Applicants Please fill in tite workers' compensation affidavit completely, by checking the box that applies to ;tour situation and suppivin`_ company names. address and phone numbers as all affidavits 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 require: to obtain a \yorkers• compensation policy please call the Department at the number listed below. City or rowns Please be sure that tiie affidavit is`complete and printed legibly. The Department has provided a space at the bottom c the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Ple be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned the Department by mail or FAX unless other arrangements have been made. The Office of investi=ations would like to thank you in advance for you cooperation and should you have any questie lease don hesitate to give us a call. of P _ 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 fax #: (617) 727-7749 '71 _d �.-Q�n + -In6- 409 or 3 7 75 THE rayy� _ The Town of Barnstable umn. Department of Health Safety and Environmental Services rFowno�'' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commission 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 an addition to any preexisting buil ding containing at least one but not more than four dwelling units or to owner occupiedg g structures which are adjacent to such.residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: Est.Cost l Address of Work: / f� L11 Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work 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 MVROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL a 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owns . Date Contractor Name Registration No. OR J . Ar, ------------- 4" a -- Goo �zi MASSACHUSETTS U141FORM APPLICATION FOR PERMIT TO 00 GASFITTING w (Print or Type) �\ TORN OF BARNSTABLE Date 19_� Hyannis. Massachusetts Permit 1 Building Owner's AT: Location Naa►e r Type of Occupancy: New ❑ Renovation ❑ Replacement❑ GPlans Submitted Yes ❑ No ❑ M w W w s< s III s 1- w s w I- } s = o t- e s o r w o o s ►`- w a e r r < ►- w0 it w am H v J �' _ �' to. a: O09 s 66 0 r Z O O M < .<i s is a�i z < a: < < o o o tr a s O O s 1► e i o 0 o e s o a► H O SUS—aSMT. NAStMENT 1ST FLOOR !NO FLOOR SHO FLOOR ITN FLOOR ITN FLOOR aTN FLOOR 7TN FLOOR aTNFLOOR (Print or Type) Check one: Certificate Installing Company Name ❑Corp. • Address ❑partnership ❑Firm/Company Business Telephone Name of Licensed Plumber or Gasfitter :hereby cortlh dut ad of tho detaW sad a/OreuUso 1 Aa.e wMdtld(Of eater")18 0106"9010katioo ero tm ad accurate to tha boll of aq knowledge and doe ad rlemlky work and huafedens rarferrned Under Mrnil l and fur this arrUcodon arts be r sagWraa wo as rwaml Rowwass of Ua klaaod emu Slav Gas Codo ow charter 142 of the General Lava 1 have Informed the owner or his agent that I .do not have liability Insurance including completed operations coverage. Signature of Owner/Agent 1 have a current liability Insurance policy to Include completed operations coverage. By TYPE LICENSE: Plumber Title Gasfitter Signatyre of Licensed City/Town: Master Plumber or Gasfitter Journeyman DEPARTMENT 01,PUBLIC SAFETY CONSTRUCTION SUPERIPSOR LICENSE Nulber ;Expires: - •'Resticted:To Y00 `.KILLIAM L SCHULZE PO BOX 288 CENTERVILLE, 'MA 02632 ADM O�1 y OD Lor N2SZ4�?O,f, CONC r 14 LOT g 4 =-_-- HSE #17=_=-= ___: 1h: 1 .001 RES. ZONE.- 'RDI This MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C" Bank Use Only TOWN: 7' T YL�LZ REGISTRY OWNER: META C HENDRLV _ — DEED REF: _CTF 49441_ _ — _BUYER: JOtIN C ROSS_ _ _ _ _ _ _ _ _ DATE: 6/0402 - PLAN REF: 17678-J _ -S CALE:l"= 40_ FT. I HEREBY CERTIFY TO YANKEE SURVEY ___________________________THAT THE BUILDING ?ti' SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS PF"u CONSULTANTS SHOWN AND THAT ITS POSITION DOES --__ CONFORM TO THE ZONING LAW SETBACK REQUIREMENTS OF THE `' "�'I 40B (SUITE 1) "c 40. C*_=;:;s TOWN OF ---BARNSTABLE _ _AND THAT . , ,-; IT DOES_ NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD "�`, `q(oIS;�� `" INDUSTRY ROAD s' MARSTONS MILLS, MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED a/_19/85 _ TEL: 428-0055 Comnxt'�t -Panel 250001 0005 C '�'� ' ° FAX 420-5553 ___________ THIS PLAN NOT MADE FROM AN INSTRUMENT 20955 PAUL A. MERITHEW PLS SURVEY, NOT TO BE USED FOR FENCES, ETC