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HomeMy WebLinkAbout0089 CAP'N CROSBY ROAD �a Cc��`n Crams Io c�(o�,�- 0 a a � . .� . a o � o r. w =%► TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0q5 �.�f,,= ail Map Parcel TOWN OF BARNSTABLE Application # �/ Health Division Date Issued tiR l6 111!G PIN, 2. r Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board D I V I ! a! Historic - OKH _ Preservation / Hyannis Project Street Address t�d_ Village{ ,� ,�►�� Owner �Tc Address Telephone L1-1 6 -c(3,1 3, Permit Request _ �., 1=f.�,,L ,. .,. Y�' �5 1���ti }. s Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation . Construction Type 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 ❑ No Basement Type: ❑ Full 0 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: ❑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 Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - (BUILDER OR HOMEOWNER) Mike McCarthy Construction Name Telephone Number PO Box 52 Address West Dennis, MA 02670 License # e280-6964 CSL-5S633 HIC-169393 Home Improvement Contractor# Email Worker's.Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 3� 1 i fi FOR OFFICIAL USE ONLY APPLICATION # it DATE-ISSUED VAP/PARCEL NO. t ADDRESS VILLAGE OWNER s DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 3 ' DATE CLOSED OUT ASSOCIATION PLAN NO. �' �9 'f �.^t� S/e,�c �z l � 1C,�- C ra•r" / � k y � �-�_ y2�'��/3�3 r..ti • T ti r omi'of Barnstable R --latDtt y Senriees WAS& Scali,:Director A �y ���qA�m AT�111f6�1il�g•I�n�r��avla Town Perry,Building Commissioner .200 Main S&eet,II)vwis,:ivlA 02601 .K•ww.to�vn.barnst�[e.ma.us Office: 508=8624038 Fax: 508-790-6230 PropeAVOWne,17 MUSt Complete. Sign.Tlis Seet on 1f Us .g;;�.A_%61d-r 01, ✓ ��' ���� .___� ,as Ownernof tl�e sul�ject.propeztyr hereby au,diorize� w acti,ou n I*half, in all maum relative to work authorized by this building peniit application,for. 0 CosLY h _(Addieess d.f ).' "Pool fences. and alaro s ait the responsibik oft e:applicant. Poolq are not.t o be'filled'or'tit lined before fence ;s'izastalled and all final inspections are�perforined-and accepted 4 ,S of Owner Signatore of Applicant O �W Px nt.Name Print Name . . .0 Q,FORI�1S:0�17JF:��;U.f ISSIONPOOLS � Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvementtr'�ctor Registration Registration: 169393 �- �71 Type: Individual =� ;�,w Expiration: 6/16/2017 Tr# 264961 MICHAEL MCCARTHY icy �i-�:-'_'•--..^.�".,...e.."�"4 �'\,� MICHAEL MCCARTHY P.O. BOX 52 A` " ,.�- E� w WEST DENNIS, MA 02670 .; Update Address and return card.Mark reason for change. sCA1 as 20rn-05/11 [� Address ❑ Renewal ❑ Employment ❑ Lost Card t�Jhe�pa7»n�2ao21vealCl o��iraaac�iateGta 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: Registration: ; TB9393 Type: Office of Consumer Affairs and Business Regulation Ex iratio :=.fi0h1>7 Individual . 10 Park Plaza-Suite 5170 Boston,MA 02116 MICHAEL MCCARt MICHAEL MCCARtlW XNoN�afid 6 RANGLEY LN. SOUTH DENNIS,MA 02t80' Undersecretary ith t signature Massachusetts Department of Public Safety r Board of Building Regulations and Standards License: CS-058633 Construction Supervisor MICHAEL J MCCARTHY P.O.BOX 52 - 2 on WEST DENNIS MA 026T0 (-1j^^� vim-- Expiration: Commissioner 04/10/2018 The Commonwealth of Massachusetts Department oflndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 wwwmnss.gov/dia Aforkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE.PERMMING AUTRORITY..: ApplicantInformation Please Print Leeibly Name (Business/Organization/Individual) MikeMCCarthy COUstruction- PO Box 52 Address: West Dennis, MA 02670 City/State/Zip: Cell 08)#280-696 393 ��'- Are you an employer?Check the appropriate box: Type of project(required): l,[glam a employer with 5— employees(full and/orpart-lime),+ 7. ❑New construction sole a I 2. am se proprietor or partnership h p and no employees working for me in ❑ 8. Remodeling any capacity.(No workers'comp.insurance required.) 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.)t 9. El Demolition ' 4. 1 I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition ensure[bat all contractors eilher have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.D Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 1 .❑Roof repairs These sub-contractors have employees and have workers'comp.Insurance, �-�/ 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.LJ Other 1/✓e.f 152,§I(4),and we have no employees.[No workers'comp.insurance required.) "Any applicant that checks box fill must also fill out the.seclion.below showing their workers'.compensation policy information. t Homeowners wlio submit this affidavit indicating they are doing all work and then hire outside contractors mush submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contraclors and slate whether or not those entities have employees. If the sub•contraclors have employees,they must provide their workers'comp.policy number. I ant an employer that is providing workers'compensation.insurance for my employees. Below is the policy and job site information. Insurance Company.Name: Policy#or Self-ins.Lie.#: Expiration Date: )2 �Is I1( Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a fine up to$1,500.00 1 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under? a" s enaIdes it/perjury that the information provided above is true and correct Signature: Date: Phone#: 5(, abc.-6 S C r, 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 Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ,4cor a } CERTIFICATE OF LIABILITY INSURANCE DATE(M 201'S"r) 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,.."pol cy(les)must.be:endorsed. If SUBROGATION IS WANED,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). �p�T PRODUCER 01962-001 NAME Bryden&Sullivan Ins Agcy of Dennis Inc (508)398-6060 NQ; (506)394-2267 PO Box 1497 : So Dennis,MA 02660 INSURER AFFORDING COVERAGE C Y INSURER . A.LM.Mutual Insurance Company INSURED INSURER B Michael McCarthy Construction Inc INSURER P O Box 52 INSURER West Dennis, MA 02670 IN R RE- INSURER F, COVERAGES CERTIFICATE NUMBER: 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. INCTYPE OF INSURANCE POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES ETO RENTED rice) $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ ENI AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ OLICY ECT OC AUTOMOBILE LIABILITY I aMBINED SINGLE LIMIT $ c e ANY AUTO BODILY INJURY(Per person) $' ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PPROPERTY DAMAGE $ AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB I CLAIMS MADE AGGREGATE $ yDED RETENTION $ ApRMRO A X TORY LA�S OER YIN E.L.EACH ACCIDENT $ 1,000,000.00 A pglgp=OR/PARTCC�L�USWE UT IV CE� NIA VWC-100-6017656-2015A 12116/2015 12/16/2016 (Mandatory 16 NH) EXX E.L.DISEASE-EA EMPLOYEE $ 1,000,000.00 WsCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION Cape Light Compact PO Box 427 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Barnstable,MA 02630 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD (0 �tME Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services g Iy S )t`V1CeS Fee `TLj g2BARNsrAB 'j Thomas F.Geiler,Director i639- Building Division r Tom Perry,CBQ, Building Commissioner (✓ F 200 Main Street,.Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY of Valid without Red X:Press Imprint Map/parcel Number I C) Iql r Property Address Z CkeC, e - a-a`U.. gL Residential Value of Work �� 1 j Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 0 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor MAY .3 0 2012 iI am the Homeowner. t have Worker's Compensation Insurance 1 TQWN.OF BARNSTABLE Insurance Company Name��TU.E'_\"e-S Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ' NRe-side #of doors IFNIReplacement Windows/doors/sliders.U-Value (maximum.35)#of windows *Where required`. Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of t me I rovement Contractors License&Construction Supervisors License is required SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.d Revised 051811 ?die Commontveslt3i o Mussachusetts I rrrhnent of 1ndustria1 Accidents QjOke of Investigations 600 Washington Street Boston,A4 02111 nmvm&mgvv1dia Workers' Compensation Insnrmce Affidavit:Buiklers/Contr2ctursfflect6ciansfPhunbers licant Information Please Print Legib Name(Busoa�ess��Orgauiz$Gwhdividnao: a Address ll ,.. VA Cit#State/Zip_ t r Are you an employer?Check the appropriate bom Type of project(required): 1.2-I am a employer;with v'— 4• ❑ I am a general contractor and I employees(full sudlorpirt-time). have hired the sate-conrs 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 S_ ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp. a comp.instuanae.Y 9. ❑Building addition mod] 5. ❑ We are a corporation and its 14.❑Electrical repairs or additions 3.❑ I am a homeowner doing all:work officers have exercised their 11_❑Plumbing repairs or additions myself[No workers camp- tight of exemption per MGL 12.❑Roof repairs insurance require&]1 c,152,§1(4},and we have no employees.[No workers'- 13..❑ Other comp.msazanm required_] `may appbcaIIt ibat cl ects box#1 mast also fill oat the section below showing their workers'compensation policy 1nformz&m- Fiomoeowaerswho submit this affidavit indicating they ne doing alp yr+o*and dLen hire outside contractors most submit a new affidavit indicating sack IContiaetors that check thus box must attached an additional sheet showing the name of the sab-connxtors and state whedw oraot&use entities ham employees. If the 6ub4oretractoes base employees,they most provide dmdr worker;'comp policir nUMber. -Tam an employ r that is prot�i ' wrkers'co Q1i�n.iprance jbr my eng7loyaee& l3e�ow is t�hepo icy and job site informaturrt. Insurance Company Namme: t Policy#or Self--ins.Lic.#: � � b \ Expiration Dtte: Job Site Address: City/State zip: Attach a copy of the workers'compensation policy d r .tion page(showing the policy number.and expiration date). Failure to secure coverage as required under Section 25A of MGL tw 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 cavil penalties in the form of.a STOP WORK ORDEII and a tine 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 iimi trance coverage.verificatioa I do hereby under th s pert ofpedkty that the information Prow above is and correctSi hate: Aw Phone#: Official use only.. Do not orrice is this area,to be completed by city or town official City or Town: PermitUcense Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/rown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• 6 + BARNSTAB14 MAM Town of Barnstable 9A i63� rFDMA�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 I , as Owner of the subject property - h reby authorize Uto act on my behalf, in all matters relative to work authorized by this boil g permit application for: Sot C� (Addless of Job) C1 ZT3v / S' ature of O ner Date P ' t Name If Property Owner is applying for permit,-please complete the Homeowners License Exemption Form on the reverse side. j Q:\WHILESTORMS\building permit forms\ENPRESS.doc Revised 051811 �1HE Town of Barnstable ffJJ � - Regulatory Services - na s i E' " Thomas F. Geiler,Director s63q. � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB 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 homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINMON 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 wbo 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. '4 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 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. Q:\WPFILES\FORMS\building permit forms\EXPRESS.dbc Revised 051811 TE ISSUE DA THIS CERTIFICATE IS ISSUED AS 4MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE-))OES NOT AFFIRMATIVELY OR NEGATIVELY Ar JEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTIIORIZEII 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 CONTACT NORTHWOOD ESHBAUGH INSURANCE AGENCY- NAME: PHONE FAX INC (A/C,No,'Ext): (A/C,No): 540 MAIN STREET E-t7Wl- . ADDRESS: HYANNIS,MA 02601 PRODUCER CUSTOMER ID t. INSURED INSURER(S)?AFFORDING COVERAGE NAIC DEAN F STANLEY BUILDING CONTRACTOR INC INSURER A TRAVELERS PROPERTY CASUALTY 359 C APT LIJ AHS ROAD COMPANY OF AMERIC A CENTERVILLE,MA 02632 INSURER B INSURER C INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY-THAT TBE POLICIES OF INSURANCE LISTED BELOW HAVEBEEN ISSUED TO THE INSURED N.04ED ABOVE FOR THE POLICY PERIOD I IDICATED. NOTRTfHSTAND7.NG ANY REQUIREMENT,TERM OR CONDITION OF ANY-'CONTRACT OR OTHER DOCUMENT WPIH RESPECT TO WHICH THIS CERTIFICATE 1,LAY BE ISSUED OR MAY PERTAIN,THE NSURANCE AFFORDED BY THE POLICIES DESCRBED HEREIN tS SUBJECT TO ALL THE TER2•JS,EXCLUSIONS.AND CONDITIONS OF SLiCH POLICIES.LUMTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIALS. INSR TYPE OF INSIIR4NCE ADAL SiJBR POLICY NUAIBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (AINf/DD/Y YYY) (h'IIvf DD/YYIY) EACH OCCURRENCE S GENERAL LIABILITY DAIJAGETOP..MI D S O COI&kEp,CL.L GENERAL LIABILITY PPMZSES sa %,MD.E:sENSE(Anyone S G CL_Il.1.S1AADE 0 OCCUF.. .' - person .. PERSONAL&ADV. S - 0 INJURY GETIERiJ,AGGREGATE S p GEITL AGGREGATE LNUT APPLIES PER: - - PRGDU'TS-CONF(GP S - 0 POLICY 0 PROJECT 0 LOC AGO AUTOMOBILE LIABILITY COMBIREED SINGLE S LILIlT Ea accident) BODILY INJURY S' 0 A1•rYAUTG - - (ParPeis06 `. BODILY INJURY S O ALLv47vF?"TiOS (Far Accident) PROPERTY DALMAGE S 0 SCHEDULED AUTOS (pe:accident) 0 mRF-D AUTOS 5 0 NON-OWl•IED AUTOS 0 0 UMBP,ELLALLAB 0 OCCUP. - - - \ FA-CH OCCURRENCE S - 0 EXCESS LLaR 0 CLAI&-,,LADE AGGREGATE. . S 0 DEDU=L;P-. $ 0 EETEI•ITION$ S WORKERS'COMPENSATION W C A AND EMPLOYERS LIABILITY. NIA S1:4TUTORY YIN L11-an ANY PROPRI TORIPARTIa-6R! - - - E.L.EACH ACCIDENT $100,000 ESD:CUTBIEOFHCER/1vMffiZR Y N/A 4369POSI 10105f2011 - 10i05/2012 (1WNDATOFYINNS3) - E.L.U15EAb`E—EACH S500;000 { . Ivr�LOYEE - E.L.DISEASE-POLICY If yes,describe under DESCRIPTION OF E.L.D S1001000 OPERATIONS below - - DESCRIPTION OF OPER4TIONVI-OCATIONS.-VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) THIS REPI-4CES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS CORD C0117,R4GE - f ERTICATE H¢I DER. �NElLAT�©I I TOWN OF BARNSTABLE BUILDING DEPT 20O v1A III STREET SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE .THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN HYANNIS,MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. kM.ORI7.ED REPREMrATNE Office of Consumer Affairs&Business Regulation License or registration valid for individul use only a e.HOME IMPROVEMENT CONTRACTOR 1 before the expiration date: If found return to: Registration, 32149 Type: Office of Consumer Affairs and Business Regulation j Expiration 1�1i/28/2012. Individual 10 Park Plaza-Suite 5170 'Boston,MA 02116 DEAN F. STANLEY` � ;1 1 DEAN STANLEYs r / 359 CAPT. LIJAH RD s. ;^ CENTERVILLE, MA 02632 Undersecretary Not valid without signature. M Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Superj iti,ir License:CS-035037 - r:rT'ti DEAN F STA1�JY = <� 359 CAPTAILY'LIJAIIRD CENTERVIIIyLE MA 02632 t s Expiration .. Commissioner 01/19/2014 T HE FOLLOWING IS/ARE THE. BE ST IMAGES FROM POOR ', QUALITY ORIGINAL (S) I m DATA Town of Barnstable *Permit# (c, k Eaplrea ti mb from Issue date s i .Regulatory Services Fee Thomas F.Gellert Director Building Division . Tom Perry, Building Commissioner 200 Main Street,.Hyannis,MA 02601 office: 508-862-4038 i:. ' Fax: 508-7904230 EXPRESS PERWr APPLICATION - RESIDENTIAL ON&6 1 6 2005 Not Valid w&Aout Red X-Press Imprint Map/parcelNum1wPAY cl 3 9 ,� TOWN OF BARnlSTk�B E U Pro Address ,Residential Value of Work 1:3-id Q Minimum fee of•$25.00 for work under$6000.00 owner's Name&Address @ \ 6 -CwN, AAS 1:� Contractor's Name `e.. Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ® ❑Workman's.Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I an the Homeowner s; I have Worker's Comp ation e Insurance Company Name Workman's Comp.Policy# ©C O 4 Copy of-Insurance Compliance Certificate must be on file. Permit Request(check box) 0.Pe-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing.layers of roof) . ❑ Re-side 0 Replacement Windows. U Value (maximum..44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.- , ***P( Prope a must 'ga Property Owner Letter of o t tractors License is required "'m 1 I. Board of Building Regulations and Standards Signature HOME IM OVEMfNT CONTRACTOR Re ist 2149 /2006 QFarms:expmtrg dual Revisc063004 lugr - — c ival 'v I DEAN F.STANL qj - %ii DEAN STANLEY c 6`0a � oA.✓ 359 CAPT.LIJAH R "" 5 Administrator CENTERVILLE,MA 0263 Town of Barnstable ti °�. Regulatory Services valliz. Thomas F.Geller,Director NAM Building Division Tom Perry, Building Commissioner 200 Main Street, Iiyauuis,MA 02601 www.town.barnstable.ma.us 01fice: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder 6 N& ,as Owner of the subject property hereby authorize k �. to act on my behalf, in all matters relative to work authorized by this b g permit application for: (Ad ss of Job) Signa e" f Owner Da Print Name l j Assessor's map and lot number �C /`'�G — G'!J '7 7y SEPTIC Sewage Permit number ......... ... 5 .............. "' �QyoFT"ET TOWN OF BARNSTABLE BAUSTAU i out 1k, BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........ ................................:......:.... .. ............................ TYPE OF CONSTRUCTION ................Zt ler.e-'.0,,. .... .: ................................................................ ....... ...........19.7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following'T information: Location .............. .. ......... .......`C!; ./�.. .... .... ��.!.►... `'4..1... f�L/........... JJ ProposedUse ......../..��'�'` ..:.............................................................................................................................................. ZoningDistrict ........................................................................Fire District ...... 1... Y--...Q, : 1........................................... Name of Owner ...... ..L.l. . ...........................Address .....le( ....�Y�.�E�,.J4�!i..... ........ Nameof Builder ....................................................................Address .................................................................................... r 1P Nameof Architect .....................................................•............Address .................................................................................... Numberof Rooms ................�...............................................Foundation ...... .................................................... &A— Exterior ..........l .... .... �..................................Roofing ......... A�............................................... Floors CD a k ......................................................Interior " ...u � -q Q .......................: .... ..... :...`.... Heating �'C�....�C�... .j.o,.C..�...........................Plumbing ............ ... rf�. +.o.............................................. Fireplace .................. ..............................................................Approximate Cost ......I � �0 4 .......................... .......... .. Definitive Plan Approved by Planning Board ---19 Area Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH cc ,fg - a� C 3"l z 37 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re or ding the above construction. Name ...... .......... .. . ................ ... Stanley, C. F. 1C3 _ 0 w 6 17984 1 1/2 story, No ................. Permit for .................................... • single family dwelling ............................................................................... I Location �7/ CapW Crosby Road 1�......... .... ......................................... Centerville ............................................................................... Owner C. F. anley ..........................St........................................ Type of Construction frame .......................................... ................................................................................ Plot ............................ Lot ..........#6.................. October 9 75 Permit Granted ........................................19 Date of Inspection Date Completed ..,� .. .1.. .........19 PERMIT REFUSED ................................................................ 19 ................................................................................ ............................................................................... Approved ................................................ 19 . ............................................................................... ............................................................................... l/q,,,.,r...�.�. ,,;.. �,-.�}'."r.�„'"�^rvsd'�"�...�n...�it f�"""'t^}-1•".'r"r'�r t y�i_ Y r,�,y,��,Yfy„��.�1} �..r"� ��,/i!�'/�/y+i� � //y //�.-,,�.`..'�u�p� f ��v"".f``Tl`�aR4'..-f�' `... .'.F%-.1........`) ...... j �N//" M•.it.r„ L ��` �� �� Assessor's map and 'f lot number .. t J 3 `' Sewage Permit number ........................................................... { C) OFTHE'T��ye TOWN OF BARNSTABLE t MAR33 AZLE. i NAM BUILDING INSPECTOR �0 MPY a' APPLICATION-"FOR PERMIT TO .......................................,j..`................................................................................... • TYPE OF CONSTRUCTION,) / �� - • �.�.�fd 4- 't............................................. ................................................................................ r _ .........` .... ...................................1 .s TO THE INSPECTOR OF BUILDINGS:, The undersigned hereby applie's for a permit according to the following information: fr Location ! (n/ F/ (+ �"1 �,:j e, ,.n ........I...................... !.................................... ProposedUse ............................................................................................................................................................................. Zoning District Fire District �I' ........................................................................ ................... ......................................................... r Name of Owner r r ...............................Address .. /'- f r n Nameof Builder ....................................................................Address ...............................................t.................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ............................................Foundation ....................... .............................................................................. / Lf Exterior s ` Roofing .' ...................................................... Floors ..........:............................................................................Interior .............:.. f f Heating .... .................................................... ...Plu}nbing ....?. " ..................................... ............................... Fireplace ..................................................................................Approximate. Cost ........ .. !Definitive Plan Approved by Planning Board ________________________________19________. Area Diagram of Lot and Building with Dimensions Fee ................ SUBJECT TO APPROVAL OF BOARD OF HEALTH 11/I F1I� 1 -AP 1 , y 7 v I L � f c 37 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...................................................... ' r I Stanley, C. F. '.A=1-931;r5 17984 1 1/2 sCor No ................. Permit for ... st�........................ ........ ) q3 2 -r single family dwelling .....................................*"**........... ........ ............. Location !�. sp ...!#I.' Grpsby R ad ... ................... .... ................. Centerville ................................................................................ Owner .........C. F.I.....S.......................................... tan 1 ey frame Type of Construction .......................................... ............................. . . ............ #6 Plot ............................ Lot ...... • Permit Granted ........P..C..........ober t ...9.............19 75 Date of Inspection i...............................19 Date Completed/.....................................19 PERMIT REFUSED .......................P........................................ 19 ............................................................................... .....................I......................................................... ................../- ............... ............................................................................... �- 7 Approved ................................................ 19 ............................................................................... ............................................................................... Assessor's map and lot number ...�EL. ..-:.�� :. :....... of THE To Sewage Permit number :� .. ,a •�� i d f Z EAUSTAZLL i House number ............... 9 MAOa G� i639 - 'TOWN OF BAR.NSTABLE } RILING INSPECTOR APPLICATION FOR PERMIT TO ....F—FEC.'..L............FAm..l..l.y/....... ........................................... TYPEOF CONSTRUCTION ........ .ei.................................................. ............................ ........ ........:. .7. ..................19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location-..<J.f... .......aa ss.�l........ ................. ............................. Proposed Use ....... ...... Q ..................................................................................:........... - ........................ ZoningDistrict ..............� r'....................................... .Fire District .............................................................................. Name of Owner d.QY� e��.............J>..)A-4--Q/v.........Address ......51../....... ......CAQ! aVV .ty�'... 4..,... Name of Builder :...Address ��. ...... �. ! ............... «I Name of Architect .................................................... ......Address ....f..............................................f r Number of Rooms ..................................................................Foundation ......poll. .......CV .n......................... Exterior .....f 77..,' 1. ...Roofing ....... 4 Floors .......C.1q-t.T.(2.� .....................................................Interior .......19;e*Xe5 !—.&<C1.. � e, .............. . ... ...... Heating Plumbin �k. ,� y . . g ..... k..........:......... .... 9 �srQ.. .: ' Fireplace ..................11/.,pG.11/...�........................................Approximate Cost ........ r5 ...................................... Definitive Plan Approved by Planning Board ---------------____-----------19________. Area .................... ................ Diagram of Lot and Building with Dimensions b Fee ............. �.........:.... fqI XI`1 SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ........ �. .` Dillon, Jeffrey ' kw-7o ` No.22^0.11... . Permit for S.j.eoj.e------' Fa � . . - ---`'=`�=�a''~ .............................. ' Location ..8.9...qap.'Jl..Q�:r3Jobv..Jl0.ad---. ~ ------.!���t ��---------- ^ Owner —. Di]`lDA......................... / ~ Type^of Construction —I'��P��--------� . . ' ' ' | - .----.--.-----------------` . . Plot ............................ Lot ----------' -� , ' ` ~~ Permit Granted ..��l���oa�l�..2O�x—�jV 80 Date of Inspection ---.--------.lQ ~� «��� Dote Completed ��.-~��—.-/�J�� ...........lg } ^ _ .' - ' PERMIT REFUSED . . ^ --.�--,'—....---.-..----. lV . ' - ..--.--~—.�----....~.-----........... — . _—~-------.~.-.^—.---... ................... . , .--.—,--..---.-..,..--..—.,'—.—..—.~.. ---..—.—.-------'...---.~~~...�—�. . Approved .................................................. 19 . ° . ' . . . —_---'�—''. .................................. ^ ^ ' --� ' —'— ' ^~^^^'-- ..............� '--------'' '' ' | Y Assessor's map and lot number ... .:�z..�....�.1% .............. PyO%TN E l��y Sewage Permit number 1....:...r:...:.v:............... ..:::.:...... �'_� Z e r?8G7 rows �� S BAHHSTADLE, i 00 M63I \00 OUSe numbeC ................................................... 9 �F0 MPY a'e TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...4f�.-:r f �....�'1 1I -�! 0 /"I!) TYPE OF CONSTRUCTION ........r / l ?l `•:................................................................................................ ............�.................................... 19.. TO THE INSPECTOR OF BUILDINGS: �I The undersigned hereby applies for a permit according to the following information: Location .: ��� .. �� f':117�.`r�1 ! ! 4�/1�'i f� ?,it/i �! P ....:.......... .............. .......... .......... ProposedUse ...... ..,tl_Y..........- !"a/t.1.................................................................................................................:...... ZoningDistrict .................!.. ... ..........................................Fire District ...............`..... ... .............................................. Name of Owner .............. l l-l: : ........Address .....�.'"7.......C-49,'0"T.....CRK�--t•;'.... ........ Name of Builder .:....Ln) �' �� .a....Address �., ...L� 7,PE.' /t/1S ......... .... . . ........... .... ...................... ................................... Nameof Architect << `........................................................`. .......Address ....!................................................................................ Number of Rooms .....................Foundation f?nA,,r ,......................... Exterior ... ...........................................................Roofing ....... :.. s' ir .:�.................................................. Floors .......<. e.?: .....................................................Interior ......: i F�'. ........................................................ . Heating ......`��. r '� 1..................................................Plumbing �?)F1/1�� ............ ...............................::................................................. Fireplace �Ye2! /.(.............................................Approximate Cost � �/i!'.J — Definitive Plan Approved by Planning Board ________________________________19________ Area .....��` .. ................. Diagram of Lot and Building with Dimensions �tt f Fee ............................:................ SUBJECT TO APPROVAL OF BOARD OF HEALTH 43 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ^ Name, f ��...'.i r(.. /V Cc f'` ................................ �=l93-85 Dillon, Jeffrey . i ' No �320l0-�Parmh for .................... ' ' . ---Ir��d.l�Z..I�y��.l ' --��.«��. ---.. ' � ' Location Jl..CX Sky..IlQad......... ' Centerville ' ' ''�� ......' ...............' - � ~ °=."= Z=ff re* ( � ' Type of Construction ncx � � Permit /ted ... ...2.8........19 80 ^ ~' ~~'~ of ^ ispection ....................................19 � Dote [om � PERMIT RE)SED � ................................ 19 ----T-.. ../-' --'T''T--7"------'' . . -'-`-'' '..4^-~'-^------^^'-'--' . .~..-'.......-.--...-----~..-.-_--- * i ---------'''^-'--~'^^-^'`'^'-'--~'- � \ , Approved ................................................ lg -------'--^---'-~^~~^-'--^'--^'' � ' -------------~-~-^'----^-^^^^ � � ' THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) MC C DATA J '�Z'�7a•'J ails �eL� '?r �'"� � ��irl�il� GO lti:.r.lm M1\P?AL C oR. FI.�tM'I ©�T iZ � !i'„ 4X6 ::ocLga7les M.tT =.1 I.. YF;aNc''Ci Jli!.1�. i•CeAY TAt� �•. 3RlCK k A to ;� - � - �2�4L7r d unu. PAti'ltfi.e Y,i7f.2s'� .IN'Sf n.riP1.1,. }ST9 L'm. 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Asr a�� �r, #� ,�''- S � •r�+ r.,,s �' :r '�" yu1->,ci i7 A y r V - � 'x! r,�K�"• Est.� '"l��k!,� g j rVi '� @t¢t d,'�!, `� wil �ta6v`'"L111 U., � � Scale ,1 ZL 0� 'Yix su dirJ- vision plan entitled� d ,- ,.R !'Crosby .Hill F.ast`P i�� CeriGer {r Gz J :fix x3 rs „ Ville 9 ' by Charles .No SaverY�y��,� s � t, Ince Hyarin�.s9-`I•,as,sa dated L { rA z ('r7 9 '^Ar'�I 1 Aug21v 1y (3 and recorded �� �•. C a -• 'y a:',:'r ✓j a.. �e, t h Ytir' # rat c�r'K).�"� ;c��J� P. Registry 'C� *CjeeC�s'r ' y� ] . - n E.1�QCi. �� 1,c. C�i- gC3 i ,aw'wi w -.q. ®ol o '2 lCj 75 nln0/Ry16/8�a, tp 3R •; I. L�"1ACK$ON IA m 'j Builder o S �YfY 43 YCy,A�) No.8937 Char] ea F o Stanley tt v 5 For a�° t I Cc Iv, r 9� STE 8 p �. U�d�� r d_4 , r i Sit 3 `' y y i f. 4 � Y71;•':'�. +�s`�� All 3r 45 r i C1 Fe.4Z !+1 co v/ 36' ILI V N 3G 2/ 3 - - A` 1 ct f PPIV Scale 1.14 - F? 0' BUILDING LUCATiva rLAA Being lot -b ad shown on a subdivision plan entitled Tr.osby Hill Bast" in Center- ville, by Charles N. Savery r Inc. , Hyannis, Mass. , dated Aug. 21, 1973 and recorded g Barnstable Registry of deeds s in book 277 Page 9$ j" N6 I Oct. 2, 1975 Thoanoa IL JACKSON Builder • • NO.8937 Charles F. Stanley Q/STEfk"�°oa- I Centerville , Mass. SURd0 Q ,�r1