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HomeMy WebLinkAbout0046 BABBLING BROOK ROAD �lG �L b/i� B2a� � i t ,_ t a �-� �� i2�. r � 4,. I � `�� � �� �, f i �. yG ���brbli� �rzx�C�'� _r '�, �, , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel AP•VP lication V r. Health Division Date Issued ZPSI) k— Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address, Village Owner �+! � � � d �d Address Telephone .Permit Re Nuest =oWe lu k e�/ �i yam,/ BJ � h 616 #nr'- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Typey � /�' Lot Size Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. Dwelling Type: Single Family _2�__Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old KirtZc Highway= ❑ s ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other M z Basement Finished Area (sq.ft.) Basement Unfinished Area (sq. ) Number of Baths: Full: existing new Half: existing 66W w a} Number of Bedrooms: existing _new rss 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: ❑ 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 Au orization ❑ Appeal # Recorded ❑ Commercial ❑Yes o If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ivm Telephone Number Address V License Zb Home Improvement Contractor# w _ Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS ROJECT WILL BE TAKEN TO YPAP SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED h" F. 1 p• MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION G' FRAME INSULATION FIREPLACE L` ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL C GAS: ROUGH FINAL FINAL BUILDING D-ATI=;CLOSED OUT Y RSSION PLAN NO. .. ..� 1 ti Massachusetts - D6partment of Public Safety :.-Board of Building Regulations and Standards Construction Supervis6l, License: CS-100988.. HENRY E CASSMV 8 SHED ROW WEST YARMOiFTH Expiration Commissioner 11/11/2015 Office of Consumer Affairs and Business Regulation : 10 Park Plaza -' Suite 5170 Boston,'Massachusetts 02116 Home Improvement C6: tractor.Registration Registration: 153567 Type: Private Corporation Expiration: 1 211 5/2 0 1 6 Tr# 259188 CAPE COD INSULATION, INC ' HENRY CASSIDY 18 REARDON CIRCLE -- SO, YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. Address Renewal R Employment Lost Card .1 db 20M•05/11 , v/ae tpa»r��aareeueri�Cl c�C�/T/�ciaJcce�uJeCGi - �\ office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistratlon: 1.53567 Type: Office of Consumer Affairs and Business Regulation xpiration: ..;,1.21:1.5/20:1:6 Private Corporation. 10 Park Plaza-Suite 5170 , Boston,MA 02116. .PE COD INSULPTION,;INC'.,': :..- .NRY CASSIDY REARDON CIRCLE' �.YARMOUTH,MA 02664 Undersecretary NO(valid wi ut sign •e ,r The Commonwealth of Massachusetts Department of Indust rialAccidents w W Office of Investigations d I Congress Street, Suite 100 Boston MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/El ectricians/Plumbers Applicant Information Please Print Legibly Name (Business/Or 'zation/lndividual): Address: 1 Gov City/State/Zip: ti� I "t� Phone #: t7 ��� Are you an employer? Check he appropriate box: general contractor and I Type of project(required); 1.�' 4r I am,a am a employer with ❑ a g employees (full and/or part-time).* have hired the sub-contractors 6: ❑New construction 2.❑ I am a sole proprietor or partner' 'listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have. 8. ❑ Demolition , working for me in any capacity• employees and have workers' . ❑ [No workers' comp. insurance comp. insurance,t 9. Building addition •- required,] 5. ❑ We are a corporation and its 10,❑ Electrical repairs or additions 4. 3.❑ I am a homeowner doing officers have exercised their all work 11.7 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no �.� employees. [No workers' 13. Other, comp, insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit thisViidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities_have - employees, If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site Information. j 1 Insurance Company Name; I�, �(i�fjt Policy#or Self-ins• Lic, #: MOO 0 Expiration,Dater 1 � Job Site Address; f� bb l 0 K1411P A, City/State/Zip: .c Attach a copy of the workers' compensation policy declaration page(showing the policy number and-expiration date). Failure to secure coverage as required'under Section 25A of MGL c,•152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year,imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify n r pains and penalties of perjury that the information provided above is true and correct. Signature: 00F J, Date: l / Phone#: Official use only.-Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector' r = 6.Other Contact Person: Phone#: . . . ;'.1 1. ..­ / .Ij I I - . )- , 11.' r", "­I- CAPECOD•27 KLIGETT CERTIFICATE OF LIABILITY INSURANCE - DATE(MMIDDIYYYY) 6/1312014 HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS :ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES IELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED EPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, APORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,Subject to Te terms and conditions of the policy,certain policies may require an endorsement, A statement on this certificate does not confer rights to the ertificate holder In lieu of such endorsements), DUCER CONTACT jeers&3Gray Insurance Agency,Inc. NPFAX HONE Barbara DeLawrence Rte AIC No; (877) 816.2156 th Dennis,MA 02660 ADDRIESS:bdelawrence ro ers ra xom INSURERS AFFORDING COVERAGE NAIC N INSURER A:Peerless Insurance Corn an i �gEo INSURERB,COMMERCE INSURANCE COMPANY Cape Cod Insulation Inc INSURER C;Evanston Insurance Company 18 Reardon Circle INSURERo:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth, MA 02664 INSURER E; INSURER F ERAGES CERTIFICATE NUMBER: REVISION NUMBER: IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS RTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, {CLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE 9 POLICY NUMBER MMIOD�FF MM DD E YY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR CBP8263063 04101/2014 04101/2015 D PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE PRLIMIT APPLIES PER: , - GENERAL AGGREGATE $ 2,000,00 X POLICY 1 JECT LOC PRODUCTS-COMP/OP AGG $ 21000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 ANY AUTO 14MMBCKVMK 04/01/2014 04/01/2015 BODILY INJURY(Per person) $ ALL OWNED JX SCHEDULED AUTOS AUTOSBODILY INJURY(Per accident) $ X HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE $ Per accident $ X. UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS-MADE XONJ453614 " 04/01/2014 04/0112015 AGGREGATE g DE0-[Xj RETENTION 10;000 Aggregate $ 1,000,000 ORKERS COMPENSATION ND EMPLOER YERS'LIABILITY STATUTE oTTH z FFICERIMEMBERIEXCLUDED?ECUTIVE Ya NIA WCA00525904 . 06/3012014 06130/2015 E.L.EACH ACCIDENT $ 1,000,000 Mandatory In and E.L.DISEASE-EA EMPLOYEE $ 1,000 000 1 yes,describe ntler , ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY OMIT $ 1,000,000 RIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) ers Compensation Includes Officers or Proprietors, :tonal Insured status Is provided under the General.Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. ' 1FICATE HOLDER CANCELLATION 5 ; -R— PA mass save fIK.A(,.11��,♦'b.OY NIMs.KY - PERMIT AUTHORIZATION FORM k owner of the property located at: (Owner's Name, printed) , L 1,oV j (Property Street Address) (City..'gown) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. er's Signature Af Date 'FOR CSG OFFICE USE ONLY I Conservation Services Group has assigned the following Mass Save Home Energy Services . j Participating.Contractor to the above referenced project; CAPE Participating Contractor . Data Rev.12132011 + 1 Town of Barnstable �A �1HE Regulatory Services TOWN QF RARNST BLI Thomas F.Geiler,Director n AB .MARC : Building Division 211 ( 19' M 0- 0 � 039. � 'DrEn MAC a Tom Perry,Building.Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us w DIVISION Office: 508-862-4038 Fax: 508-790-6230 . , PERMIT# ;20 b FEE: $ 3. OD t , SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less �6 `in Location of shed(add less) Village Cei Property owner's name Telephone number w Size o h - Map/Parcel'# L�„-zi7iv�.h S ature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&.3:30-4:30 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 MUS BEACCOMPANIED BY.A . PLOT PLAN , Q-forms-shedreg REV:652813 i A . '16 202? , SiiT�4GiLs V , N 1 1 /7L4T THE STRUCTURES SHOWN WERE c� IN LOCATED ON THE GROUND ON v1•0/ 8 0 rH/S SK£rCH Is FOR PL o7- PJRPOSES ONL Y. AND SHOULD , 19,94 / = .4�o Nor BE uSEO FOR ANY OTHER PURPOSE. N OF 4g4s CAPE76O CD SURvirr C ,4NTS ENT£RPR/SE ROAD C. REGISTERED I.AND SURVEYOR o FRANK N raNNls, MASS WHITING v No. 29869 y O -� PRO✓EC r NO. o 3 - 12 S 9 Su_� i k C SA1t3 . Town of Barnstabl e *Permit# v 6 months fro sue die S E' RIV IT Regulatory Services l M,+ss. 01201� Thomas F.Geiler,Director 1639.'Old MA't& 4 . Building Division OF TQ�TOWNm Perry,CBO, Building Commissioner / EAFINSTA*SLo 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma us Office: 508-862-4038 Fax:.508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address 7 lIr � C�T � ���L 24 Z Residential Value-of-Work— Minimum fee of$3200 for work under$6000.00 Owner's Name&Address SQ /t �e G:Z, /3 LJPK 1 4 Arm� Contractor's Name 1V6 /10.,W Y s t y Telephone Number in- 33 —y71(3 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) C S —n° l-t r ❑Workman's Compensation Insurance Check one: ❑ I 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 accompany each permit. Permit Rep. (check box) R_Vroof(hurricane nailed)(stripping old shingles) All construction debris will be taken ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ 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: - f - The Commom-reafth of Massachusetts Dqwhnmt ofIndusoial Accidents Ogre of invesfigafions 600.Washington Street Boston,HA Ft211.1 w . nin .m'ass.govldia Workers' Compensation Insurance Affidavit- Builders/Contractors/ElectriciansfPhsmbers Apicant Information PIease Pint L1I Na=(Busing .aniza'cmflndividual): A606YL a f t N• 6�,i�rjiur,�►ti/� CitlStatelZip „� _� _ Phone#: 3r��j -4'7 Are you an employer?Check the appropriate box Type of project(required): 1.� I am a contractor and I ❑I am a employer With / ❑ �°�' . 6_ Ntw construction employees(fallandfor part-time).* have hired the sub-contactors 2.❑ I am a sole proprietor mpartner- lashed on.the attached sheet.ship +�. ❑Remodeling rind h2rve,no employees Thesesub-contractors lme 8. ❑Demolition employees and have wadcers' �r 1T14 for me in any capacity. }. ❑ er Build addition o workem'Comp.insuranceCpmp.mcnrarttr required] 5. El We are a coiporatica and its 1 t}.❑Electrical repairs or additions 1❑ I arts a homeowner doing all waflc officers have exrressed ekeir 11_❑Plumbing repairs or additions myself [No workers'comp right ofememptim per IAGL 12.0Roofrepairs insurance retired.]T c.152,§1(4� and we have no ME]tither employees-[No wwkess' comp.insurance required.}. *Any Wpficsni that checks box#1 mast also fill out-fbe section below showing their wodere c Pens tion policy infinm�oa I Homeowners wbe submit this affidsvit indicating&ey am doing alltva*and then bn:e outside coazascmrs mast submit a new affidavit indicating sack tractors that check this boa mast attached an additional sheet sh,octmg the name of the and state whether or not rinse entities have emp Iftbe soh-coataamns have eanpicy-s,theymustpmvide thm wark-e comp.policy number. fain ari otsplo�a3r titatis previdfarg wvrkeen,comperssahmt iirLmrance for my ertrployvm Below is thepapi y and}o,sits infortsr adon. . Insurance Company Name: Policy*car.Sew ins.Lic. Expiration Date: Job Site Ate: LZ ���;tin ��h���� City1Stat6Y4p:Cast„Ie L f� Attach a icopy of the workers'compensation policy declaration page(shoving the policy member and spirit un date). Failure to secure coverage as re eked under Section.25A of MGL c_ 152 can lead to the imposition of crimua.9l penalties of a fine up to S 1,500 00 andfor one-year i nprisoument,as well as civil penalties in 1he form of a STOP WORD ORDER and a fine of up to WO-DO a day against the violatr. Be advised ftt a copy of this statement may be forwarded to 1he Office of Is , stilt tiiuss of+he DIA for insurance cm-erage verifiratian- ' f do Iser¢by certi. under thepains an dpe ahies ofpetinq dWthe inf-oswiationpro dednb®va2 is hers and correct Phone#: ©,dial me only. ➢o not mrste in this avert,to be campUted by cb or tartm ofei L City txr T o�rn: PermitUcense# sn ag rinthority(Cirde one): 1..Baarxl.of Health 2.Bering Department 3. ytl tswn Gler4c 4.Electrical Fnspectvr .Phtimlaiu Inspector 6.Uther.. - r= phone#: . V05/01/2013 08:27 FAX 1 413 283 2556 Crimmins Graveline 0001 DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/1/2013 TIFICATE 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 endorsement(s). PRODUCER NAME:CONTACT Debra Grassetti Crimmins/Graveline Insurance Agency, Inc. PHONE (413)283-B378 FAX (a13)283-2556 1382 Main St. EMAIL ,dgrassetti@cgins.com P 0 Box 905 INSURERS AFFORDING COVERAGE NAIC 0 Palmer MA 01069 INSURER A:Preferred Mutual Insurance 15024 INSURED INSURER B;Liberty Mutual Fire Ins.—ARWC 16586 Nathaniel Messier INSURERC: 11 Conant Street INSURERD: INSURER E: Palmer MA 01069 INSURERF: COVERAGES CERTIFICATE NUMBER:CL135100599 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. POLICY EFF POLICYEXP I�TR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY M ! D/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 300,000 -DAMAGE TO RENTED1QQ,QQD COMMERCIAL GENERAL LIABILITY PREMISES Es occurrence $ A CLAIMS-MADE OCCUR PP0170566050 /9/2013 /9/2014 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 300,000 GENERAL AGGREGATE S 600,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 600,000 X I POLICY 7 PRO• LOC $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY fEa accident BODILY INJURY(Per person) S ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS PROPERTY DAMAGE NON-OWNED per accident S HIRED AUTOS AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ E DIED RETENTIONS WC STATU- DTH- B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y 1 N .. ANY PROPRIETORMARTNERIEXECUTIVE❑ E.L.EACH ACCIDENT OFFICERIMEMBER EXCLUDED? NIA 1/15/2012 1/15/2013 C53153683870112 E.L-DISEA$` A EMPLOYEr"1 (Mandatory in NH) If yes,describe under To be issued by Carrier E.L.DISEASE,.,OLICY LIMIT DESCRIPTION OF OPERATIONS below r DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,AddMoml Remarks Schedule,11 more space Is required) _ O %_n CERTIFICATE HOLDER CANCELLATION (508) 7 90-6230 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Jack Raczkowski 46 $abbleing Brook AUTHORIZED REPRESENTATIVE Centerville, MA 02632 T Gravelin CPCU/DJG ACORD 25(2010/05) ©1988.2010 ACORD CORPORATION. All rights reserved. TL-_ L.wn,.e P—in+nral rnnrlrc_nf ArORn ,; s Massachusetts -Department of Public Safety Board of Buildin 9 Regulations and Standards Construction Supervisor r «{ y VJS License: CS-091995 i`A NATHANIEL R MASS ' I1 CONANT ST PALMER MA 0069 Expiration Commissioner 01/12/2015 ,°� License or registration valid for individul use only Office of Consumer Affairs&B siness Regulation g y Of HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 451266 Type: Office of Consumer Affairs and Business Regulation Expiration: <524/2014 Individual 10 Park Plaza-Suite 5170 y - Boston,MA 07-116 VNAANIEL NATHANIEL MESSIER i 3152 MAIN ST BONDSVILLE,MA 01009 Undersecretary Not valid without signature • lARNSTABLE, + Town of Barnstable DIED Mpi A - . . - • Regulatory Services Thomas F. Geiler,Director Building Division Thomas Perry, CBO 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 as Owner of the subject'property hereby authorize TC to act on my behalf, in. all matters relative to work authorized by this building permit application for: (Address of Job) S' fore of 0,Jner D to Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on;the reverse side. Q:IWPFILESTORMS\building permit formslEXPRESS.doc �of r°wti Town of Barnstable Regulatory Services BARNSTABLE, Thomas F. Geiler,Director MASS. 9�'Ar1639. a � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.m.a.us Office:. 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 10B LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow individual for who does not possess a license,provided that'the owner acts as supervisor. homeowners to engage an indiv DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two- family use and/or farm structures. A person who constructs more than one family dwelling, attached or detached structures accessory to such home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such'work performed under the building permit. (Section 109.1.1) The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and.requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 15,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Assessor's map and ,lot number !.....AP. % t Via. TNE Sewa a Permit' number .............................. ......gSEPTIC SYSTEM . INSTALLED IN CC _;Ik'ITIUMLE i House number .......................... .. ..4A......... WITH TITLE 5 '°Q 039•�`0� TOWN . OF BARNSTA(BJLE'ui- j :( 1�°5� ' BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... fi'4k............6�'?L(.7........ h14 :! ....... TYPE OF CONSTRUCTION ............. ............riz.ez Iq.........................................................:.................... . P.r...... .........19 R3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies.for a permit according to the following information: Location ....Lai....... ....��Tart�4{�vG.��4?6�... A:1�.f. .��l�?�ituott�.f.�ac�v .�:T�Y�.�!��.,........ Proposed Use ........ �!vrf-1.l--...........Z.f�l!!! .7........:eTJF.3lG tl�lt ..............:.....-................................................... ...... . Zoning District .......................J.1..C....................................Fire District ........4 e..%T............05r.,.................................. Name of Owner ..................... ..Address 44VAf�1.`.�.�°!ly...: Name of Builder .... (K(H 9.0...L:....�.�P�kf'i4'!�fL!.�......Address ...t:55....0.�....OP.S�.J�R.I..�f►�s�t tit �'ccS Name of Architect ...Address .....CN /r4i�f ..,:. lT..................................... Number of Rooms .................�.lx........................................Foundation ......6.7..O..V.R f.''Q..........C.Ct�u�.7?.�--7:�..Glh....w.�Re4� Exterior ... ..........:...... .:....................Roofing h/OFi4 ...... .......................... Floors ...P0YC....... U'. !fv.... .y. ....G.Ar.k'..et:......C-.P..........Interior ....... .hE 7izo ci................................................... _— Heating .......CAS r-zk; .......!!1 ....... .� .................Plumbing .:..FhV..C......5.'1.xq!r,-.R.,I ......f:' ......4.O.s?.4r...... ' Fireplace .............�!C-..5.f...........�.�.��........................................Approximate Cost ...............7�..,..��.�. Definitive Plan Approved by Planning Board -------_---______---------__19_______. Area ..... e `. C�...... .... Diagram of Lot and Building with Dimensions, Fee. .............. .. .'...1..n...........:..... SUBJECT TO APPROVAL OF BOARD OF HEALTH �W ' l o � 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. p. f Name .... ................... `. ........................ Construction Supervisor's License ..... ......... A.- QjUAJLEY, PATRICK M. Ok 140 .26448..". Permit for ...... S.tOrY............. ............ .. ........ ySinqle Family Dwellin i ...........Single ....................g....................... Location ...Lot 14, 46 Babbling Brook R6ad .......................................... ......... ....... Centerville .................................................................. ..... ....... Patrick M. Crowley O�vner .......Patrick................................................. . Type of. Construction" .Frame...:.. j/ .............................................. ........ ................ Plot .............................. Lot' .............................. V '71 84 May 17, Permit Granted .......................................19 / Y ✓ - ' -• Y-'. Date of-lnsp4cti n/ ... .......19;-J Date Completrd 7:7 /,.�(... ...Y.A.194 V , A t W7V� V' r e Asses+or's map and lot number Fla t �rr �y'� - �-- � TH E T0�♦ e Sewage Permit number ...✓�....................................... BAUSTULL i House number .........................Ll 6.................,�`...7.1........ 'a rasa C i639, \� 0 MAY d' TO WiltN OF BARNSTABLE BOILDING INSPECTOR APPLICATION FOR PERMIT TO ....../ ....... .......... .......? TYPE OF CONSTRUCTION:............ .'�............! jz/1 E ................................................................................... ........ F '? ....... :...........19.�i3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: / Location [<�c �� f �I•�7�scivL ....:°.. ........... Proposed Use ........ anrP L. ...........1!F;qev.o� ...........' !-m . l!� ...................................................................................... Zoning District .................... ......................................Fire District ........ (2 ............................... Name of Owner ..................... . .. �. S !k2 .,,..AA , .... Name of Builder ....1. .,c l�/irz h .. ....1..1.E(�Hr��?�i«:!.5......Address ...�. .... L??....`1.�.sr.. .!1. .�Gar�Ns .... t �^ Name of.AchitectAf' .�� <! n�!..��s. :....a� s:e�:he....Address ..... ..................................... _ Number of Rooms .................5`.}..IN........................................Foundation ......(F-au. ......... `x..j14........1!4� Exierior ................. g:......................Roofing ...... ....... ..............!. .............. Floors .... n(i,-t.^.,......y......!�A26�F; U i~?.........Interior ..... .................................................. Heating ....... . ..... r >.......1! ..........?!�I?Z..............Plumbing ..... ..... 7���:n!?:`..:?......��Faz.......1..'✓t✓.�....... Fireplace .............�/E .,. .........�1. !. .....................................Approximate Cost ........... .....7r..... .) .......................... Definitive Definitive Plan Approved by Planning Board ------------_____-----------19________. Area �. >. ..... ....r�...... Diagram of Lot and Building with Dimensions Fee SUBJECT ffO APPROVAL OF BOARD OF HEALTH ! �I f i OCCUPANCY PERMITS REQUIRE FOR NEW DWELLINGS c :" 1� s I hereby agree to conform to all the Rules and Regulations of the Town of. Barnstable regardingythe above construction. ,-- Name .... ............................... ...... ......................... Construction Supervisor's License .....0................ ......... CROWLEY, PATRICK M. A=188-14.6 e" No 26448..... Permit for . 12 Sto Single Family Dwelling .................................................. Location ...Lot 14, 46 Babbling Brook Road .. ........ Centerville ............................................................................... ti Patrick... M. Crow12 ' Owner . ..................................... '.. .................... Type of Construction ......Frame......................... 1 ................................................................................ Plot ............................ Lot ................................ Permit Granted .....May ...17'.....................19 84 Date of Inspection ....................................19 Date Completed ......................................19 30 'is S , 6 "i +.r:..r.r ,.:..r. :+ . ��' .rr+. .. ,,.��. "+'.. F•`4. a. h r.,ax _. „ii.. .-. J i,_-�i.-.x..h.,,,,1 .-l�.:r... ...",tro'-,ni.✓+"_,. `d ��`t"E'b♦ TOWN OF BARNSTABLE Permit No. .�6445 BUILDING DEPARTMENT Cash { OUR; TOWN OFFICE BUILDING ""16 HYANNIS,MASS.02601 Bond ..`� .'. CERTIFICATE OF USE AND OCCUPANCY Issued to Patrick M. Crowlev Address Lot #14, 46 Babbling Brook Road Centerville, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 . '� ~��..� °•yew TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING rua HYANNIS, MASS. 02601 r MEMO,TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been �issued for the building authorized by BuildingPermit #.......c ��,,7�,1�/l,._........................................................................................................ ........................_............. issued to Jo......... f, ........ J� ................. ��..........l� Please release the performance bond. I C - -`yl '� feu' ✓� DEVELOPMENT Wianno Place J09 Main Street Osterville, MA 02655 428 7700 Barnstable Town Hall 397 Main Street Hyannis MA 02601 Attn: Joseph DaLuz Dear Mr. DaLuz: This letter is to notify you that as of January 9, 1985, I am no longer affiliated with the construction now in progress at 46 (lot#14) Babbling Brook Road in Centerville. Please remove our name and license number from the existing building permit as of that date. The new owner of this property is Richard T.. Powers 'of Winchester, Mass. Thank you for your assistance in this matter. Very truly yours, Patrick M. Crowley cc: Town of Barnstable Conservation Commission I f s 0 42. E � Z3,i A N J 6 , N c�,cZ � o / N d Z PN 2�3 4 oor 3� GJ _ 0 s�T 34�Ks O A O � °. SLOT PLAN Q THE S 7RUC 7URE S SHOWN WERE �N LOCATED 'ON THE GROUND ON �.�y� . s . �a MA SS. 7H/S SIrE7cH /S FOR Pz oT f�•9•y PURPOSES ONLY AND SHOULD , 19R4 1 " = �0 , ! No r BE USED FOR AN Y O rHER PURPOSE. �\,tkj OF 4f4S CAPE COD SURVEY CONSUL rANrs 76 ENTERPRISE ROAD C. REGIS rERED LAND SURVEYOR �� FRANK yG(p NYANN/S, MASS c WHITING No. 29869 y � O -V, QlsT���`.�� � PRo✓EC r No. o 3 - 0 S, 1 s; Assessor's offioe Ost floor): V�/G jjZZ�� /�, �, 0*,rHEro Assessor's map and lot number .... ..... Board,of Health Ord floor): D �' Sewage Permit number .................. ............ ........... .... ..� Engi eering Department (3rd floor): M (Wa4iH Za1 �O pTIC SYSTEM , + Hou a number ...............................7 �f �.I MSTALLE® IN CO war APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only ITH TITLE 5 zr g�� �AENTAL CODE Aid TOWN OF BARNSTA EGUL"O"s BUILDING INSPECTOR ,l APPLICATION FOR PERMIT TO ........................ ran,..`.. ....00M.....�mya.. G... PtJ r ................... TYPE OF CONSTRUCTION � / r i %/o� r . ......J... a ....... 1��..............1........................................... : ...a. .............19..d. TO THE INSPECTOR OF BUILDINGS: The Undersigned hereby applies for a permit according to the following information: n , Location ...... ....1,7 1���/.f'/. ......,��Tc.�?JIC.......��1� ..r/.!/.??�2.�1.1�.�'r........ryl .................... ProposedUse ......r, �»•i.c,./.... dn. ......................................................:................................................................... Zoning District ......... .. ..... ..................................................Fire District �Fr'l��.C'.!� !!4.L........ 1..4.4Ar Name of Owner .. �y � ....� ...... ./�/�L� . /Yz?... s ...................../��lr�a..s��........Gr.. d/:�c�/ .. Name of Builder ........( #...................................Address ............�•,e�f2'1-2.....,.............................................. Name of Architect .., � n�.....� flrY///?/ !4W..........Address .......G'.4/t�7—F/�1r/..G. . ................................. Number of Rooms .......... 06P...dl.!�.....................................Foundation .......Cr��/G.. 7-- ----................................ Exterior ..�j' �/.✓ �.mar—.........................................................Roofing .......... 31,f ..4.�................................................. Floors ......./.`...... ..................................................Interior .......... ................................. ' Heating ..............,...................................................................Plumbing .................................................................................. Fireplace .......... �� .f..........................................................Approximate Cost (!, a��f... ....................1................ Definitive Plan Approved by Planning Board ________________________________19________ . Area .........Z �..................... Diagram of Lot and Building with Dimensions $� O 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. 44 Name ^... ..... ..................... Construction Supervisor's License ... .1�/11Q./Z........ POWERS, RICHARD T. & MADELINE A. x, No ,• 3059�?.yPermit for ADDTTICN ............................ Single Family Dwelling .................................. ' location 46 Babbling Brook Road . ................................................................ ` Centerville ' .....................................................................I......... Owner ......Richard T. & I adeline A. Powers............................................... • Type of Construction. ..•Frame Plot .......... ............ Lot ................................ � r a Permit Granted ....Aja ...........r..............:19 87 ' • Date of Inspection 19 4Date Completed ...............:......................19 i t� E t Assessor's offioe list floor): K, t't. c THE c 'Assessor's map.and lot number .... . .. ....... .. . Q� �♦ 1 , �('� /�/ f T 'Board�of Health (3rd floor): Sewage Permit number .......... .. 9 .3�.{..C.!..2.�..:.\�¢ pMAX&B6B dL\E0�, J En i eering Department (3rd floor): 639• Howe number ...............................�....... O ........ OYo APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00-P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......... � ?' !��„(COOrvl . �Dc�YtrbpM G r yyr�c ...................... ....... .... TYPE OF CONSTRUCTION .......1�/e. ?Or..D..... JCfr'�r.2,i........ � ®�.�.� `1......................................... /'•�r�}��1' .. ................ TO THE INSPECTOR OF BUILDINGS: The 9undersigned hereby applies for a permit according to the following information: Location .......l�..... ....., RD............... .................. :.................... Proposed Use ...... , ,C Zoning District ......... >�..��..................................................Fire District ....(..FCC' 1!1..4.G.......�� /..i.l.s� ... 14 Name of Owner ..��i ,GJ.,(�....� ...... ".,!/,1t1� �/.f�' ... c Fess .....................��IK1BL1.!!! Name of Builder ........(� ....................................Address ............ f?'1- ............................................. Name of Architect ..ilC ,19^1..... r,4kY/s/jJ.al4e.l........Address .........'.4 �s�.2..d!1...G..1.�m................................. Number of Rooms .......... .....................................Foundation ......., Q'^.T..................................................... Exterior .. /.i!✓C�'. 'J.•........................................................Roofing .......... i! �z �a..<..�. .......................... Floors .......�. ...................................................Interior .......... 7 Heating .............. .................................................................Plumbing ............................................................................. Fireplace .......... . 1....... ............................I......................Approximate Cost .............. , d'v� ........................................... Definitive Plan Approved by Planning Board ________________________________19________ . Area .........2: ..... ................ Ap Diagram of Lot and Building with Dimensions Fee Napo................ 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 ' ^ •• •• -a..,.� ................... t Construction Supervisor's License ...�.11//'/Q../j ....... POWERS, RICIARD T. & MADELINE A. A=188-146 9, 40 No ..,3055 permit for ,Build Addition ................. Single Family...Dwelling...•..... Location ...46 Babbling. Brook Road Centerville Owner Richard T. & Madeline A. Powers .................................................................. Type of Construction .Frame ................................. .................................................................`.............. a Plot ............................ Lot ......... ..................... April 2, 87 - , Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 t R J r y ii I 4"9 U Z dS6 6 0 N � E J'' 3•s Q N Cor,c• 1 i IJ GJ O � .SST ijgGKs OFiLoniT 20' O � J V c �L-O T 7H£ STRUCTURES SHOWN WERE IN LOCATED ON THE GROUND �+ ON /�1 �iy M/�1AA SJ . TH/S SKETCH IS FOR P[0y- f"Ao' PURPOSES ONLY AND SHOULD S , Ig ie4 I " k' NOT BE USED FOR ANY O THER PURPOSE . OF b?qs� CAPE COD SURVEY CONSULTANTS C. �`%, 76 ENTERPRISE ROAD REGISTERED LAND SURVEYOR oo FRANK HYANN/S, MASS WHITING No. 29869 N,