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HomeMy WebLinkAbout0087 CAMP OPECHEE ROAD r7 C • i p 0C�e C j+C- � y Town of Barnstable *Permit#6-1'l Regulatory Services Fee t5monthsjromissa�edate 1ARNSTABLE, � ' . Mass. � Richard V.Scali,Director Building Division � a Paul Roma,Building Commissioner rL r 200 Main Street,Hyannis,MA 02601 JAH 1 ? 2017 ���✓ www.town.barnstable.ma.us Office: 508-862-4038 1OWKI Faam+ 081790�=6230 EXPRESS PERMIT APPLICATION. - RESIDENTIAL ONLY, W Vaud without Red X-Press Imprint Map/parcel Number �� r Property Address w42 Residential Value of Work$ G 5- X 0 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address �� ✓t-t Co v( Contractor's Name �i e vi �,,� Telephone Number ;7,f/®.?er7/173 7 Home Improvement Contractor License#(if applicable) 3 2 Email: Ce T Cc),j V. Construction Supervisor's License#(if applicable) 7` Workman's Compensation Insurance .. Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name lM ���r✓ g: G� 'u. Workman's Comp.Policy# idf C -—3/ -- 3 R 4 f Z <f 02 f� Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) - '$ N //// Re-roof(hurricane nailed)(stripping old shingles) All construction.debris will betaken to �r—au� �t ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof), ❑ Re-side ❑ Replacement Windows/doors/sliders.U=Value (maximum:32)#of windows ' �. #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 requir SIGNATURE: "J✓ Q:\WPFILES\FORMS\building permit fonns\EXPRESS.doC 06/20/16 . i I The Corrzmompeah*of f Massaclrt D Department a,f!'udusbi l Accidents Or"Ofrn tiaras. 600 Washbigtort Street Bastion,MA 02111 -- tvFsnv-masxgov1dia TQT rya Cumpewatian Lm Fmce Affidavit 13IDflder-s/Cm&dctursXle dcianS hu 1bers Applicant InfOrIImfign Please Print�E�Y Naffie uCfT:.G Cd-u l�tL �'L�y1� f3t vc�c r c? Are you an employer?:Cheekthe appropriate box: T of project r I am a general coatrsctar and I Fly Tom'] (required): L❑ I am a employes vdth ❑ 6. ❑New constructiM employees(Ed an&or part-dime).* havehired1he sub camactors I El I am a sole proprietor orpartner- Tilted on the attached sheet ?- ❑Remodeling shy and have no emp1wees These sub-contractars have g. ❑Demolitiaa waaicing faunae in any capacity. employees andhaee wodwrs' 9..❑Snip sdditioa ` JN¢ 'pomp-insurance Camp.to surance I required-] 5. We are a corporation and its 10-❑Electrical repairs or adQioas 3.❑ I am.a homeovner doing all work officers have es excised their 1 L❑Plumbing repairs or additions. mysel€[Na wo&ers'camp- right of ememp6on per MGL 12.❑Roof repairs ir�catranrerPt�4E11Tpd i C.152, §1(4),andwe have na employees.[NoworkPrs` cozp-insurance required.) ',yap apgffCzntdat cheftbos OF11 most also Sno�,��rn�u�►.sue&���aa��agor���� ��ameoaraers who snb�i aril�dari im,�mg�p are t]oin�a3f wad and then hie a�¢tsi@erm,+,arer,.zymsrt sn5mic a new affid�t; snrSf - Ica nto ffistcheckthisboxmostetRf-I =addiiio sheetshowing the nice of the and state Whetherarratthoseeahtieshave employees.I€thesoirraat�eshase empIvp$es,tfieym�utpavvidethe9r sradrrss'flomg.galicg a�lsrz . lam an ursrirance for my em playem $eNv is the porky=d job side F - irt�orrncrtiata. , Insurance:Company Nam: Paficy-"*L or Self-ins.Lic. Expiration Date: Job Mfe�Addr g�. •' citylstder-,V: �, �'J C� .�'�2 —�' ' Attach a-copy of the workers'compeasationpoEcf declaration page(showing the policy number and expiration date). Fare to secure coverage as required under Section 25A of MCL m 157—can lead to the imposition of criminal penalties of a fine up to$1,50a OD ani or oae=geairimpFisonment,as well as rim penalties.in the fot=n of a STOP WORK ORDER and a fsme of uplo$ZSO.DO a dap against the viobdar. Be adidsed that a copy of this statement:n*y use forwarded do the Office of Investigations of The DIAL far iravmance coverage verilicatian- I Ira Iterelry cent6 pains andpenalf w afg fiiat the iqfbrma&a pm hW abm e is bus mid cmrmt S;.ffiature: Date D/ `e l 17 Phone rg 1 ,Yl 2 C,%7•— / -7 37 i +DjoWat ass an1r. Do not wr&r in dib area,to be completed by cifp arlown offi al My or'Fmsa: PeruatlLicense� Issuing Axffiaretl'(carte ow): L Board of$eaItfi zz BTc$ag Dept 3.celirawn caerk 4.nectrical Inspector S.Plumbing Inspector I.Other contact Person #- 6 Information and Instructions. ' As&cac�seft Ge1=7al Laws M req=es all=ploy=to provide WO11X s'M1npensat1an far tb=employees- p=S11333tto this state,an erVloyee is defined as"_.Cvey person at ffie sax-vice,of anon under any contract ofhh-e, egss orimphul oral orwritftn." as`°an mdivi&A partnership,association,corporation or oilier legal ez�y,or any two or more An emplvy�is defined Of the foregnmg a ngaged m a joint eot�,and mclndmg the legal re:, s $yes of a deceased employer,or the receiv=or trustee of an mchvidual,partazmhip,association or otberlegal mfitY,employing employees. However the ow=of a.dwelling house having not more than three aparimends and who resides therein,or the ocrrgsant of the - dwmllimg horse of an.adier who cz ploys p=sos to do M airtm ce,caust•rr c i on or repair wok an such dwelling house or on the grounds or bm7dmg appuriesnarrf lh=to shall not because of such employment be deemed to be an eanployer." MCH,chapt z 152,§25g6)also sues f lzt"every sfata or local licensing agency sh,-M withhold fie issuance or renewal of a Iicerxse.or permit to operate a buskers or to construct bmZdl gs 4a the:commonwealth for asry applicant,who has notproduced acceptable evidence of compPrance vwit>i tha iasuzatfce eoveX-age required." Additionally.MGL chapter 152,§25C(7)states-Neer the comet enwealiffa nor any of its political subdivisions shall fl-n into any eontcart for thepm-hu nee ofpnbhowontumzI acceptable evidence of compliancevmfi the insm-anc-6, regcm.-CM=tS of dais chapter have been prexaoted in the eonfradmg Mthozity." Applicants - Please fill out the wc)fl='compensation affidavit completely,by cb=king tb e bones!hat apply to your situation and,if necessary,supply s)name(s), add[ ss(es)aadphonennmber(s) along with their cextifieate(s) of insormce. Lmnitrd Liab�7ity Companies(LLC)or LnnitesdLiabilityParinembzps CLEF)widi-no employees other fhan the members or parfnm-s,are not reqairrd to cry workc2&"compensafion iastnance. If an LLC or LLP does have employees,a policy is mquir: Be advised that this a$dayitmaybe sabmiftr-,d to the Department of Industrial Accidents for confirmation of fi m cp coverage. Also be sure to sign and date the affidavit The affidavit should be retamaed to the city or town that the application for the permit or license is being rDqueshA not the D epaatmeat of ; LnA s trial Actual=-r- Should you hm any gnestions regardmg the law or if you are regzraed to obtain.a work=' compensation pofiey,please caIL the:Department at the nnmbea list i below: Self-msm-ed compamies should enfyz their seifin gran cei license,number an the: line City or Town Officials i - P lease be sate that f$e.afidavh is completes and prirded legmly. The Department has provided a space at the bottom of t$e affidavit for you to fMolt m the event the Office of Investigation has to coact you regardmg the applicant b . In�addition applicant a ce ruin e5 ,an aPP Please b e sure in fi71 m the pr�itlIicenSe;IIuinbeT wrhlch wl�be Bsed aS referca that must sabnzit miibiple penis l ii cen ce applications m arty given year;need only submit are affidavit mdicalmg con-ent policy infarmation.Cifnecrosary)and IIudes`lob Sitn Addre&*tie applicant shoud write:"all locations in_-- (city or fawn)_"A copy of tie-affidavit that has been officiany stamped or marimd.by the city or town may be provided t a the applicant as proo-fthat a valid affidavit is on file for fat= pewits or licenses. A new affidavit must be filled.oiat earth year.Wh=a home owner or citizen is obtaining a erm license or pit not relat r d iD any burin=or commercial 4eutzre (ie_a dog license or pew to bum leaves etc-)said person is NOT resqqiaEd to completes this affidavit The Office of Investigations world Irk-,to thank you m advance for your cooperation.and should you have any questions, please do not hesitate to give us a call The Depsrtmenfs adrhesss,telepb me and fax nrsnbea: Dgartrnen#of 1ud�Accidenta B MA Oil11 Fax#617727'749 Revised 424-07 - - ov 1 , Town of Barnstable Regulatory Services Richard V.S=14 Director 1639. ► Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,.MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 lFax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. s Signature-of Ownei Signature of Applicant Print Name Print Name Date y Q:FORMS:OWNERPERMISSIONPOOLS Town of Barnstable Regulatory Services p1F Richard V.Scali,Director Building Division Paul Roma,Building Commissioner 039. ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 - Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village. "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: r 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 homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. 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 dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one 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 35,000 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit fomu\EXPRESS.doc 06/20/16 �► -s -sr: f t w Legend i * Parcels - T25: __.. 21Qt1 :: ! F - own Boundary f'. Railroad Tracks �. Buildings , r _ {{._ 21Qt1Q5" ' 21Q 3 Q64 Painted Lines 19�50 ##325. 24 Parking Lots #�$ gam. . _. { !'! I Paved , �;:' -•_,_ - J ;: Unpaved .. 127 !!a. Driveways 190216 t � M Paved b Unpaved ed# i: Roads Er,� {{ +t E fridges .. . { Paved Roads 94252r {, 210004 w Unpaved Roads a - 2191391143 Marsh nr `�.,,,� y• !; - Water Bodies 77 210l)03001.' 190254 $7 ! 210140 E jE 21b1 1$6174 X � S ydafttrt gay02 t' i 79AM: r/ 2101 t1A3' i p 50 �. ; i C73 3I`76 190104 t . #346 A� �t 21015`1: 210002 A -- 19.0106 210148: �_ 0_ .. #322: .17 '.. Map printed on: 1/10/2017 This map is for illustration purposes only.It is not parcel lines shown on this map are only graphic -Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026ol O 83 167 0, an on-the-ground survey.It may be generalized,,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: 1 inch= 83 feet cartographic errors or omissions. gis@town.bamstable.ma.us. 5. Contract # 675 CUSTOMER INFO: JOB LOCATION: Skip and Lisa Simpson 87 Camp Opechee Rd. 1 South St. Centerville, MA 02632 Hyannis, MA 02601 y AGREEMENT BETWEEN Skip and Lisa Simpson 11/27/2016 AND Baltic Company,Inc Linas Revinskas Baltic Company Inc,hereinafter referred to as General Contractor(GC),on the one hand and Homeowner Skip and Lisa Simpson hereinafter referred to as Customer,on the other hand,have concluded the present contract as follows: 1. THE SUBJECT OF THE CONTRACT 1.1 Contractor undertakes hereby'to supply all labor necessary to complete the Asphalt Roofing installation as proposed in the job estimate#639(11/01/2016),said proposal being an integral part of the contract. 1.2 Customer undertakes to pay in the order and terms.established by parties in the present contract. 1.3 All work is to be performed according to the specifications submitted, in a substantial workmanlike manner, per standard practices. Any alteration of.or deviation from the submitted. specifications involving extra cost will become an extra charge over the estimate, but any extras -must be submitted between parties of this contract. Z. THE PR10E A1VD THE TOTAL SUM OF THE CONTRACT 2./ Estimated price for the home improvement project is two thousand five hundred and thirty dollars($2,530.00).This price includes the cost of labor and materials. Baltic Company 87 Camp Opechee Rd,Centerville MA 02632 Linas Rcvinskas 781-267-1737; oflice/fax(508)744-6811 M.C.S.Lic.N 094476 HIC N 152372 3. DESGR,IPTIQN OF THE,PROJEC T 31 Permitting performed. Roofing .materials and supplies supplied;- ExiAing roofing removed, hie: tt F , hcd e rooEl h i oce and Water S Hine and d: o on all'critical areas #15 felt paper applied on entire roof r . Aluminum drip edge httalled on the botio n edge of tl'e roof line Architectural asphalt(Ccrtainteed)roofing shingles installed; r Ridge vent:andrldge capp>rig installed' Roofing debri,s:removed•and;dtspo.sed, Note T}e rate far,additional catpenfiry.services; if neelc d �s $SS/l plus material cost ;lt will'=ue P erfomted.only after home owner's approa{al; 4 TERMS.OF PA, YhIENT 4.1 Customer undertakes to pay'in two payments schedule' 4 2 M%depasit of the estimated Rooting arnournt($'75;9.00) -/:3 The.rernaininl;amount.for looting($ 1-,Z71 �0.)~should bcpaid after project cnrnptetion 5 OTHER CONDITIONS' . 51 A11 :changes and.:add�ti:ons under the given; Contract are valid;:if they arc:accomplished in; wr>ting and signed by`both part>es'of the.Contract:.The present Contract is made>n duplicate of one for each:;:af the partles: All copies have an equal validity 7.he;cnntracfi inuri s fru the date of its Signing. After sygnirig the Gntractall previous negatiat>ons,and correspondence;on:ii lost force. D 2, OC may at its discretion engage subcontractors to pertarm work hereunder, provided GC; shall fully pay said subcgnfiractor� and- in It instances remain ;re�pi itsible for the: proper: c mphAiow.of t1l s Contract= r 5,3 GC agrees to rernpve all;;debr s:Nand leave the:premises.in kiroam clean condition. 5; GC shall rafi.lie llablc for any die 'to clreurnstarices beyond.'its a�ntrol >ncludingF strikes;; casualty,weath candltlori5 or general ui avallala111ty of suppl es and Inaterrlals: Contractor Lina`s Revinskas Customer Skip As � gT$gvp g �� vtre�v+.vtica Signatures . Si natues . _ _ F Date: t f 7/2t}l G Date: : C alhc Gnmp tnv 87 C imp Uhechie Itd,`;Center�.illc MA 07 2.` I iim levinskos 784-267-173.7; offio fax(kgj,744-691 P' Lie.-!}09447,E: 42372.' Mass. Corporations, external master page Page 1 of 2 �y1„'Nr SJ if Corporations Division Business Entity Summary ID Number: 042238763 1 Request certificate„ New search Summary for: HYANNIS BUILDING AND DEVELOPING ASSOCIATES, INC. ; The exact name of the Domestic Profit Corporation: HYANNIS BUILDING AND DEVELOPING ASSOCIATES, INC. Entity type: Domestic Profit Corporation Identification Number: 042238763 Date of Organization in Massachusetts: 09-06-1955 Last date certain: Current Fiscal Month/Day: 03/31 Previous Fiscal Month/Day: 03/31 The location of the Principal Office: Address: 1 SOUTH ST City or town, State, Zip code, HYANNIS,' MA 02601 USA Country: The name and address of the Registered Agent: Name: GEORGE F. SIMPSON Address: 1 SOUTH ST. City or town, State, Zip code, HYANNIS, MA 02601 USA Country: The Officers and Directors of the Corporation: Title Individual Name - Address .PRESIDENT LISA A. SIMPSON 75 NORTHWINDS LN. W.,BARNSTABLE, MA 02668 USA TREASURER, GEORGE F. SIMPSON 75 NORTHWINDS LN. W. BARNSTABLE, MA 02668 USA SECRETARY LISA A. SIMPSON 75 NORTHWINDS LN. W. BARNSTABLE, MA 02668 USA DIRECTOR GEORGE F. SIMPSON 75 NORTHWINDS LANE W. BARNSTABLE, MA 02668 USA DIRECTOR LISA A. SIMPSON 75 NORTHWINDS LANE W. BARNSTABLE, MA 02668 USA http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=042238763&... 1/10/2017 Mass. Corporations, external master page Page 2 of 2 Business entity stock is publicly traded: ❑ The total number of shares and the par value, if any, of each class of stock which this business entity is authorized to issue: Total Authorized Total issued and " . Class of Stock Par value per share outstanding No. of shares Total par No.of shares value CNP $ 0.00 2,000 $ 0.00 77 ❑ ❑Confidential ❑Merger EJ Consent Data Allowed Manufacturing Note: Additional information that is not available on this system is located•in the Card File View filings for this business entity: ALL FILINGS Administrative Dissolution ^° Annual Report Application For Revival Articles of Amendment v' View filings Comments or notes associated with this business entity: YNI SO s �New search w . . http://corpssec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=042238763&... 1/10/2017 (��'-lzeomvnwruueaCCfa a�� �ac�ivaeG License or registration valid for individual use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration: `'-152372 Type: 10 Park Plaza-Suite 5170 - Expiration s—.WZWZQ18 DBA Boston,lVTA 02116 BALTIC COMPANY-, LINAS REVINSKAS�r j�5 - 87 CAMP OPECHEE Rl) CENTERVILLE,MA 02632- Undersecretary Not valid without signature • i i nt of Public Safety - Massachusetts De p attme Regulations and Standards Am. ,Board of Building Reg ' CS-094476 4 License: rvisor. Construction SuPe LINAS REVINSKAS D 87 CAMP OPECHEF CENTERVILLE MA _ k _ n Expiration. n CIA, 1010212017 Commissioner, I r CNAETY+.d UI 1 1- 0 -33 - 5 Fax 1 605 33503 0357 www.cnasurety.com Po Box 5077 Sioux Falls SD 57117-5077 Email: uwseryices Uncnasurety.com h February 24, 2014 Agent Code:,. 20 18009 _Town•of-Barnstable--- Building Inspector Town Hall 367 Main Street, 4th Floor , Hyannis, MA 02601 Re: Bond#61923837'- Baltic Company Inc. 87 Camp Opechee Road Centerville, MA 02632 - $400.00 General Contractor : City of Town of Barnstable, MA Company Code: 601 - Western Surety Company We have received a request to cancel-or nonrenew this bond. We wish to comply with the principal's request by taking advantage of the cancellation provision pertaining to this bond. You are hereby notified that this bond is cancelled and voided as of April 3, 2014, or the earliest time permitted by applicable law, whichever_is later. Thank you for your attention'to this matter. a_ cc: Bryden& Sullivan Insurance Agency of Dennis, Inc. Baltic Company;lnc. f 4 Underwriting Services N ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 0d Permit#003 / f 1 - --Health Division ; � G�� V Date Issued Conservation Division a Feet' Tax Collector ; s,- , Treasurer _ c i. � — SEPTIC SYSTEM MUST BE ° Planning Dept. INSTALLED IN COMPLIANCE WITH TITLE 5 , Date Definitive Plan Approved by Planning Board ,.'ENVIRONMENTAL CODE AND TOWN REGULATIONS His�� Preservation/Hyannis p ) ,�� _Project Street Address �7 �C�E� 1© Q� � ( I'f 1�CEi1 i2f s D6n. D Ei/, /ts�7,0 Village / U6 t Owner CI ,,k eilaldress 5)aTI4 s7-, 17�11/l2iZ�S dd�0/ ruor Telephone Permit Request o. ream (qX _-9i '3 t jirtACC Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation A A m Zoning District Flood Plain Groundwater Overlay Construction Type Ob � Lot Size Grandfathered: ❑Yes (No If yes, attach supporting documentation. Dwelling Type: Single Family \ Two Family ❑ Multi-Family(#units) Age of Existing Structure \ Historic House: ❑Yes No On Old King's Highway: ❑Yes KNo Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing, new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: 0 Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:0 existing ❑new size Pool:❑existing ❑new size Barn:0 existing 0 new size Attached garage:❑existing ❑new size Shed: ❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ( No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name 1 ZZ/ &)21C 2�;I�� Telephone Number ��� '�l 6`F, Address ed, License# Cn.—at T NA &�k 3� Home Improvement Contractor# Worker's Compensation# Gt1 C 3 q ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE G!/I DATE f S Cf FOR OFFICIAL USE ONLY x � �• ' PERMIT NO. ` DATE ISSUED MAP/PARCEL NO. ' ADDRESS i , . VILLAGE OWNER Cz f DATE OF INSPECTION: _ FOUNDATION ,"le FRAME �CU� INSULATION A — d"1 G f.. FIREPLACE . �`ti? a ELECTRICAL: ROUGH •. „ ,a � FINAL w PLUMBING: ROUGH �.. C-1 ' . FINAL _ e b GAS: ROUGH FINAL FINAL BUILDING hri - { DATE CLOSED OUT t s ASSOCIATION•PLAN NO. I 7 ' TY SAGIL - OVTLEI� P[lL CDDE ~�.' - _ . / 3 RECEyI/ED `rN Lt4H Tf OL Da.nHEl� (// LEAJE NytDEL bNT- A9ti bN'T V✓TSIDE ON SAME SW ITLN _ ,.. � ELEC. Se RutLs UPonrE IF ReQ, -. �t tLESOL ATE SPRINKLER SY pTt:/_\ 'TD OASE ME n`T - - Reno E E ,5 /J6 SHUTS Lr� SL 2EEN 900IE II ,U ' �JN SOeM REu°ns LED � T' T 3D"KNEE WALL.• To JUDe 'f� - •`+w>r_ PI•ATFaaA WI•+DDw rRAAAI✓(� . + Ex�,rl N(x coot. sung STAyJ.(S\DPEy� 51A•y3. - - Q � 7.7"L4 A'F WALL 7'9' TO END _ � NEW A 2nOF (All Np uy E� RJbtlER ROcr fV.v.tc ' REPAIR L21L/Nc NEW •S NEST ROca- (� RESI DE POG OF E:<r$T' YIp✓56 a. Q REMOVE Ex',T/N(. LLb. L SK CITE O Y �s 1— TR•u 9 r 0002 W/^'0O✓ �NEETROLIL N£W .MY Ally-A✓D�LL TD NDJyE INTE41DR - 105 O ATE LJA-. .t CL(,. NEW xQ 11 A.E DOAa_D MlN A\L INT. - C TD cOVER c.OJc, LIP UP AmA•..+�T r'IO✓$�: WH•TE VINyL GLI DERy O NEW b°Li SLrDER © , NE S�Wx 4 H)pH T—C V. IffR if DIRECTION EM T WlkL Y � OJE V 'PpulEfL Ohl RGOF yy pause C�Yt- b-' (/ / y•Ib � I •.+. I G:gy L t�+• EXI,]YV H'EA Ila' �- INT E RI O rc coiIc TYPE MLD6. OR G20WA) TYPE TOP ON J _ 17InOR 1. lae AIEJV— —__ ALL PAIA/T 13Y -1011LI ' /NT-L.1-1Z " - - {N'D ExTE 41 p/E. 9rJ ADD ITILN OAILJ _ Op1lC111 C2•10TE 'Ia RE PA y7 AIL Exl T. h10U}{ ASPHALT ROOF E%'ST. po.5E 15e TELr NCW ALVAI, GVTE Et SPOUT// VVEIL �d'•L7Y PLy ExT. W1G S11//i�L.Ej $rt�d•• T - v,I Y, <(•x F' SpAI 2DDN1 RJP DE 4- Q°OF REc:I, - !� . M ATeH COloa-J, Ar/ etOSE n5 Pe35/A 3LE Ve AS REQ, NT Al— boTre a� A.Ys+OUTS A'O �f�15 WIND✓•Jr GxT, L-E) ilMDV1Icp OVEC NLw Ixe DEL ExryT !I L ' Lox P\y fRIE:E � TD E 0- 7-T''+" `I • (:X•ST. CONr, e✓LAO RGA2 EI.F VATtDA) _ LEtT EJATivw] ._ TP1ir=T ELE V=t10/J )YA .. pcelr-y Ea(ISY. Z76I/ a II->Y NVH DER wI RO bl.y'� Ire Q S%Y'N/blI bLIDEC ' � G°Kid SLIt)ER .. 7hes°.IaTtirgs we,u;;&,—d by Capia HoIa N N .. l pane rafix the use nl Cepiul Homo FnpDt�ltlem. z?L O Pn c__ ,L' ampkyees and sueepmraclae.Anyone Wlp tlleeo drawings should field Yarlhy as ealsllrg oLVlmYpr�, ,�/..O • ., T dim ions,ar conformity M 1pW elld eOeEe g . kcodes Woerld the adequacy oldese dtawkga, P bl.etne hi disclaim serlyreaporelDllq•Id{gl�t . .. - taDDlBlrl9 whkh arise ham the WBo1 VIM cAny"ap"atller then employees 6 Cepkrl eWeof�gn IA:'. ttDme NnpmvemeM. - - F_DR coil�.�1G1Y var-95/d •••Misr ec, The Town of Barnstable Department of Health Safety and Environmental Services '�� ► Building Division ' 367 Main Street,Hyannis MA 02601 'r f ' Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,.demolition,or construction of an addition to any pre-existing owner-occupied. building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: C��11/1.(T6n1 /)�P/172 �� Estimated Cost Address of Work: CLU-49 Owner's Name: Date of Application: / L;_ 0 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under S1,000 OBuilding 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. Lo lDD 7 Daie Co tractor Name Registration No. �'o,n� sau�covF,MEut , OR Date Owner's Name g1orms•Affidav . The Commonwealth of Massachusetts Department of Industrial Accidents (� -- Office offove V92tfons 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit location- 3Y7 I am a homeowner performing all w4 myself. I am a sole proprietor and have no one working in any capacity c R-ram an employer providing workers' compensation for my employees working on this job. company name: /owd I/�Yl? address-: /(0'Y J� Ett)�3t t /J . city:_ Ca mull , Al 0- -3 Rhone# IJ�Of� insarance:co. -zttR-lCt f A-1ttr/e--1 cA-A policy# 2.7 —00 I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who h::•. the following workers' compensation polices: company name: • I i address• ctiv: phone#., in�pranx:co policy# comnanv name: atis€resr. _� city phone#: insaraneeco. policy# Failure to secure coverage as required under Section 25A of N1CL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/w one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature /}Q !p L� � ��, Date Print name _ _r4?6 Z)i'e I c"r— Y. RA-SO—H, F e :H. L. Phone#656 (contact ficial use only do not write in.this area to be completed by city or town official y or town:' permit/license# r(Building Department Ea C]Liccnsing Board check if immediate response is required oSciectmen's Office' �Hcalth Department : person: phone#; rl0ther , _P s (revised 3195 PJA) - - e, I �Al BOARD OF BUILDING REGULATIONS I_' F� RUCTION SUPERVISOR Vp�am•�nanwe¢l�a�✓lf¢au�c�i.meCCr t .r,. � I License: CONS T0570 05 7032 CS9e HOME IMPROVEMENT CONTRACTORff Registration: 100740 t} Exp.1�Qs 09/26/2l)0i Tr.no: 5742 00 Expiration' 6/23/02 Restricted;To:. ; • _ Type: Private Corporatio ` THOMAS X CAPIZ.ZI JR j 280 PERCIVAL DR = CAPIZZI HOME IMPROVEMENT, ` W BARNSTABLE, MA 02660 Administrator EK' � �-'� T4S N Con Rii, Sr. 1645 Newton Rd. ADMINISTRATOR COtUlt MA 026356/7 - � sr to 047U172007.CL/P 7 O•• I t„? /ze (�o��zrno�z� o�� �rvoac/iu�etl� i BOARD OF BUILDING REGULATIONS a SAFETY ` License: CONSTRUCTION SUPERVISOR f p G DEPARTMENT OF PUBLIC SAFE II CONSTRUCTION SUPERVISOR LICENSE Number: CS 007454 u r Number: Expires: Expires:02l24/2002, I'• Restrlctedlo:! 00 i �, I Restricted To: 00 .. • FHEOERZI;ti V;. RASCH III !. THOMAS CAPIZZI - 1645 NEWTOWN RD r-iLL�, Administrator �1z�,4+Ca5 B4)(,AM OoW3� COTUIT, MA 02635 1 4 f :O 0 _� FOUNDATION �, FLC10R ��Y OWNC-R� _� N li 1 1 r� Assessor's map and lot number ....F. :10-3 -0oo ,�C AA- . ........................... J. S �c e a THE age Permit number ........................................................ Os�r 8 rem 4 COA. z ABLE, q Housg number ........................................................................ Wrni pT. C-N 13 TOWN OF, BARNSTABVE,--;uLAnM,, BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........ ................................................... TYPEOF-CONSTRUCTION .......................... .... .................................................................................................. I gry.. z ........... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a per...,�, according to the following information: ................�L.................................Location ................F 7......... ....... ........ 0, ?.........Proposed Use ....... ...... ; ............... ./.. Zoning District ............ .................. . ........................................................Fire District ........... ........................... . .................... Name of Owner ..........T% .. ...... .. . u4 .....Address Address .....cmwr, 01 Name of Builder ......... ..............Address .................................................................................... Name of Architect ........... .... .. .. .........................:................Address ..................................................................................... lvll;4 Numberof Rooms ...... ..... ...........................................Fo.unclation .......... .......Ir ......................................................... Exterior ......... .......4___4......... .....................Roofing ......... ........ ...7 .... ....................................... ... Floors ................. ........ .............. ........................................Interior .......11. .....�—_/........................... Heating ..................b�e ..........................................Plumbing ...........A �t e................................................... Fireplace ..................... 'A..............................................Approximate Cost ...............��00............................... Definitive Plan Approved by Planning Board -------------------------------19--------- Area ......... . ...... Diagram of Lot and Building with Dimensions Fee ......c,.26,....... ............... SUBJECT TO APPROVAL OF BOARD OF HEALTH 7 /to, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnsto e re rding the above construction. Name ...... .. .....P.. .. . . ... ................................. Construction Supervisor's Licenie .......0-379 -) ............. PENDERGAST, J. F. `Ii o .... Permit for JBqild Garage.............................. Accessory to.Dwelling ...................................................................... CQam Location 87..........p-Opechee-Road................................. .. ...... ...................Q.enter.ville...... ............ .......... ...... .... .................. Owner ....J. F. Pendercfast ...........................A................................. • Type of Construction J)..c ....................... 0 0* ................................ ............................................... . J Plot ............................ Lot ................................ Permit Granted September 2.7.,._ --? 84 4? anted ............................ . .......19 Date of Inspection ............................ ......'19 Date Completed .. . ........... .19 7 ills 4. 4, N Assessor's map' and lot number .....�-�Q OQ� <x�a ................................ ........ Q Sewage Permit number ......................................................... ^� Z BA"STABLE, i HODSnumber ................................................................. .... 94ps,�N & q 1639. a MAY Or TOWN OF BARNSTABLE F BUILDING INSPECTOR APPLICATION FOR PERMIT TO I 4+ ............ .. ..it .!....:.. .................................................... TYPEOF CONSTRUCTION ..................� ..•. .............................................................................................. .l.... .... .................19t .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to�the�following information: Location ................ .........C� . . ....................! /...... . ........... . ilea.................................. Proposed Use ...... .�'�li�....... '1` ..., . .d� fit...... .. �,(,.y.....� M.A 1!aA_41....... .......................... Zoning District / ...........................Fire District G. . ................................ Name of Owner .......... ....i�^.. ... .... Address �.... .................! ...................... Name of Builder ...c1.,.. .�...... .oi!1 . .. .. ........................Address ............... Nameof Architect ........... �7..........................................Address .................................................................................... Numberof Rooms ........... ...........................................Foundation .................. ........................................................... Exierior ......... ...Roofin Floors • .. . .........................................................Interior : .............................................. .. f HeatingN -....................................... .Plumbing ) .....E� f,. ,. 1.................................... 7� 4 Jr 1 V Fireplace .....................-Al ..............................................Approximate Cost ............ ��............. _ .,. Definitive Plan Approved by Planning Board ---------------_--_----_______19-------- Area , ..)... ... . ���.I..::..�. Diagram of Lot and Building with Dimensions Fee ....... t0.s.0.4............... SUBJECT TO APPROVAL OF BOARD OF HEALTH / C; �.. X7 w.. Q r2J OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I Hereby agree to conform to all the Rules and Regulations of the Town of Barnstab er.regarding the above - construction. J, 2R.. . Name.... .1 Z ............ ..................D3.79 .f .-.:_ 7� Construction Supervisor's License .......0-379 -21 ...................... PENDERGAST, J. F. A=210-003-000 0-003-000 27029 l/Garage No ... .......... . ........ P -iit for ��..Garage..... .. . .......Accessory to Dwelling......-\........ ........................................... ....... ...... 87 Camp Cpechee Road Location .................................................. . ........... Centerville ............................................................................... Owner .......J.....F.....Pendergas.t......................... . .. . .......... ........ .. Type of Construction ........Frame e........................ ...................... ......................................................... Plot ............................ Lot ................................ Permit Granted September 27, �9 84 ........................................1 Date of Inspection ...................................:19 Date Completed ......................................19 ory Ass s map and lot number ......'.f...a ....4...� '' Sewage Permit numb — �. ` 6�Q y°► ....� .. ........... .. ,.:....., d Z BARNSTABLE, i House number .......; 0,,,�...................................R................, : y� Nb 9 e� �0 MAY Or TOWN OF BARNSTABLE BUILDING INSPECTOR . APPLICATION FOR PERMIT TO ....... TYPE OF CONSTRUCTION .............11le'.( ..:.........':...................................................................................... . ....................... .....................19........ a TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit acccor-dinJg to the following information: Location ... v. y.... . '.......... . yp wiz.... ��t?.. � ........ ProposedUse ...........!� " .... ...... ....... ...*5�..................................................................................... Zoning District Fire District ....�.. .....�....... ........ .... Name of Owne ` i -� � � \ Address ........G... .. .�. Name of Builder Address .. / .,..1-11-1 :... ....`."'..... i. Name of Architect ................ .......... .......... Addre s .............[. .....='�/...!....... :..�.`.. �— Ya O �0 L � Number of Rooms ................ ............................................Foundation ......................... .:....................................... Exterior ...........Roofing, ����`� '��Y :................................• 44 Floors 4:....q ...........Interior .................. .....`?:... . .. �:. • Heating ...:...........7::4Y—.4�: ......................................Plumbing ..................... `...:2............................................... Fireplace ............... ,,/�4- r :.....................................Approximate Cost ....5 5 0c7.......................................... Definitive Plan Approved by Planning Board -----------___—__-----------19_______. Area �..1. ..: . ................. Diagram of Lot and Building with Dimensions 0...� .Fee ...... . .................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH zz- 4- % 2�J OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS " r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ' t r Name .. :........ Construction Supervisor's License .................................... `rrr HYANNIS BUILDING & DEVELOPING ASSOC. ; 25627 Addition ................. Permit for .................................... Sixzgl.e..��mi l . .L1we 1•1•in J. ........... t Location •C-amp••Opeeehe• Rd: .................... ! -^ t n Centerville _ _ t \ At > Own;�-..&annis Building & Develop. Assoc. '; ;, "` 46 Typerof Construction ....,Frame .,.`... ................................ .... ....... ................ f - �` . • ,;,• Y 'S !' F~�3 ii Plot ............................ Lot ................................ Permit G anted .. .Oc•tober...11,.. 9 83 ' Date of Inspection ........................:. ... . 19 Date Completed �U.:., .1............... y!.19 -- i �'.y � �.. •. 7 T S' F. f,... � • ` jai+` X.. "r F �•}.;'1, F �.—• F� •� �. ,/*� ,,. �,•F '.-r� � .ter ,� r �.r .l A: esit map and lot number ....... ....... �..... :..... ... /r`� yof If E rod Sewage Permit numb54r3.,..!j� C......Z... BAMST&BLL i House number ......................................................................... rasa pTE'p Y11Y a. TOWN OF BARNSTABLE BUILDING ' INSPECTOR APPLICATION FOR PERMIT TO exlcu `"' - �-�`�`^, �� •��t t'�-- TYPE OF CONSTRUCTION .............A/49'?14..................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:: Location ........ .................................. ProposedUse ............ ..... ....... .... ... ..............................:................................................ Zoning District ....... ...... ...... .......Fire District .... ........................................ Name of Owne��.... z':.. .� .: 3-z�.tiAddress ........ ... 1 ....... ....�� sa; P•+-- Address �•�: '�''t-y1�c� Name of Builder - ` ............ Name of Architect . . ..... ........4i`'r.`?wk ....` ...Addre s ............/� ? `�...: ...... ........... . . Number of Rooms t` .Foundation t�' ,..-.................................. Exterior •� i� ..........................................Roofing .................. 4-A� -�f' . ...................................... Floors Y .:: ii;. °.r ...........lnterior .....:............. . .............. ` ✓�' Heating ............. ............... .......................................Plumbing ...................... ..........................................Fireplace .................:...��2��..................................................Approximate. Cost ......... .............. �j Definitive Plan Approved by Planning Board -----------____-__-----------19_______: Area ......6..7..�. ................ Diagram of Lot and Building with Dimensions Fee �"�U.:. � l SUBJECT TO APPROVAL OF BOARD OF HEALTH i r 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 . :c:...Coe:................................ ...........a.......... �:.. i Construction Supervisor's License ,::.+............................... r }• .r"�""""' ♦�'�'---+�..--. r1 r� �`, >- r �� .... � �'\Try"' I � �� ��.. 114 > J � i 1 } fJ _y