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HomeMy WebLinkAbout0025 CAPTAIN LUMBERT LANE ��. �CU r _ _ �° � J Application nu b ... 11............................ KIMa Fee .............. ` .. ..�.5a.� ......... CT 2 1, 2019 Building Inspectors Initials.... ... ..................... O� B.AHNSV ABLE Date Issued.:..®. �.. .�. ........................... Map/Parcel..............:................................................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION = Address of Project: `2 s- Gf}h+0-�N L u✓�ibCr �n CeN iv- le NUMBER STREET VILLAGE Owner's Name: o v A P l� 1 `'t46a`�)Phone Number_ 5o i5- 3;37- a 137- ". Email Address: .T qe ro v J &M le0 .co ryn Cell Phone Number 5-05 -33Z-Si 3Z Project cost$ Z®/0C)C3 Check one Residential V/ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize �# CU S � C �� ti y to make application for a building permit in accordance with 780 CMR Owner Signature: Date: np, I TYPE OF WORK ❑ iding Windows (no header change)# l 2 ❑ Insulation/Weatherization Doors(no header change)#-I— Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to B,�rNs�w bC� +crv1 d y CONTRACTOR'S INFORMATION Contractor's name 3T e o s+om C ft-� Ii f fy Home Improvement Contractors Registration(if applicable) (attach copy) Constriction Supervisor's License # 65 i0 ©yk (attach copy) Email of Contractor `rbe,n 6.0 6-Mal C• C'nrn Phone number. 5O2.3Cop-&gkZ ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY-IS IN • a n�r0%ni,- v0%8 8 u#if r Aftnrw#AI w nnnn2 iw i ntr^nc w nrn&w#r 0-w a sr APPLICATION NUMBER............................................... ............ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 201bs. or> Yes No ,if yes, a gas permit is required. Natural Gas Yes No ,if yes,a gas permit is required. , If food is being served at.your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number 11- I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date - APPLICANT'S SIGNATURE Sigaa e _ Date O 3 All per applications are subject to a building official's approval prior to.,issuance. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 {= www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers., Applicant Information Please Print Legibly`"` Name (Business/Organization/Individual): '` cy5 E-aY» ci+rjacrl Vr,1 Address: 999 T Vlao fr 4-yyC 1- Ir- City/State/Zip: ) 1t N r t.P M(+' 0 Z&crl Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.El am a sole proprietor or partner- ' listed on the attached sheet., . 7. ❑Remodeling. :' t ship and have no employees These sub-contractors have 8.,❑Demolition working for in an capacity. employees and have workers' g Y P tY• 9. ❑Building addition [No workers'comp.insurance comp. insurances required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work; officers have exercised their I I.❑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 W,�rda✓S �oo�—S comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit 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. Insurance Company Name: A55o L�4d-ed `1=;m b121 f rS 1�tg C. w CC S'oo.S6 �17 3 . .'Zo� A- Policy#or Self-ins.Lic.#: 9 Expiration Date: 2 1 �2O ZC� Job Site Address:1.�®Vo°N LUW6&—L.1, City/State/Zip: Cen1krd,1I-e ' 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 eerd der the pains and penalties of perju_ry that the information provided above is true and correct Signature: Date: 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 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial.Accidents Office of Investigations 600 Washington Sheet Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-NIASSAFE Fax#617-727-7744 Revised 4-24-07 www.mass.gov/dia BTCUSTO-01 DEATO DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 5/28/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE,DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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 endorsements. PRODUCER k2alACT Rogers&Gray Insurance Agency,Inc. PHONE FAX EM):(800 553-1801 ac,No>:(877 816-2156 434 Rte 134 ( ) South Dennis,MA 02660 AI DRESS:mail@rogersgray.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Main Street America Assurance Company 29939 INSURED " INSURERS:Associated Employers Insurance Company 11104 B T Custom Carpentry,Inc. INSURER C_ 999 Route 132 INSURER D: Hyannis,MA 02601 INSURER E 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ _ 1,000,000 CLAIMS-MADE [XI OCCUR MPT6472F 8/2912018 8/29/2019 DAMAGE TO RENTED 500,000 PREMISES E occurren $ MED EXP(Any oneperson). $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X j�T LOC PRODUCTS-COMPlOP AGG $ POLICY❑ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $, ANY AUTO BODILY INJURY Perperson) $ AIUUTEOS ONLY WNED L AUTOpSULEEDp BODILY INJURY Per accident $ ER AUTOS ONLY AUTOS ONLY PPe'adent AMAGE $ UMBRELLA UAB d OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ B WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN TATUTER ANY PROPRIETOR/PARTNERIEXECUTIVE WCC50050117392019A Z/1/2019 Z/1/2020 600,000 OFFIWMEMgER EXCLUDED? ❑Y N/A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,0 00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Benjamin Thompson is excluded from coverage under the Workers Compensation policy. CERTIFICATE HOLDER CANCELLATION " SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE "FOR INFORMATION ONLY" THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016103) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD . Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Con str ri% rvisor ¢ A CS-106046 r ires: 02r09/2021 13ENJAMIN 9891YAN01116A�Rt y HYANNIS MA 01Qt ° ', '+ Commissioner �� Office of Consumer Affairs and Business Regulation One Ashburton Place- Suite 1301 Boston, Maigachusetts 02108 Home Improve &' 's` , tractor Registration - # .r Type: Corporation ;Xi,5 Registration: 179345 BT CUSTOM CARPENTRY INC. -- 999 IYANNOUGH RD '# Expiration: 07/22/2020 �: -� N, HYANNIS,MA 02601 tN f Update Address and Return Card. SCA 1 E3 20M-05/17 �J/te f0aononanuea`�t a�CJ/�crdurc�euae.C�.� . Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TY.E-•.� on before the expiration date. If found return to: ilildh iration Office of Consumer Affairs and Business Regulation 179345: -= 07/22/2020 One Ashburton Place-Suite 1301 BT CUSTOM CARPENTRY' Boston,MA 02108 BENJAMIN THOMPSOf+I. ;�'' 99J IYANNOUGH HYANNIS,MA 0260i Undersecretary Not valid without signature TOWN OF B RNSTI� LE:' perrnit'•:No. --�4� ------------------ Inspect( Building r Daa1�+Ta/t : _ ,. _ Cash --- - --- ---- -- y. L OCCUPANCY , PERMIT Bond;' ` -- ----y Issued to Bayside Built CO. AddressY Lot 22�q 25.captalfi. Lumber. Ln, CeAervilie Y Wiring'Inspector .r�� j" L Inspection date Plumbing Inspector Irispeotion date 43- Cras Inspector - n Inspection date e. �� Engineering Department Ins ectioii date g r / t d ti I Board of Health Inspection ae �/ / , THIS PERMIT WILT/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.. eli ....................................................... 19 ...._ _ ...... ........ ............. .................... y. Building Inspector TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ` 1 1 Map I Parcel 0 0o Permit# 3 7-? 11 yLam, Health Division _ 2�J3 G'ti Date Issued J "g Conservation Division Fee JI Tax Collector f �� Treasurer C ING—CALLED IN COMPLOn% �• WITH TITLE 5 Planning Dept. ENVI§ONMENTAL CODE AN Date Definitive Plan Approved by Planning Board TOXIN REOULA°I ONS � Historic-OKH Preservation/Hyannis Project Street Address5 �t�Ti � 6�'�[ �'� • Village � IZ �(✓,� U)6 3� Owner s f �!�L�2��� 6q g 6q ad Address S 4-,1vt Telephone ��� ` 421 1 5 7 l U Permit Request wq rZo2 a S K/� �►1 r�✓� �aUL Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost /-// PU0 Zoning District Flood Plain Groundwater Overlay Construction Type cSTCel 61-44l/ tJiwYL- Lot Size `'( Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure � 7�S Historic House: ❑Yes X'No On Old King's Highway: ❑Yes qNo Basement Type: ❑Full ❑Crawl &tWalkout O Other Basement Finished Area(sq.ft.) b0 0 Basement Unfinished Area(sq.ft) Number of Baths: Full: existing S new Half:existing 1 new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count 3 Heat Type and Fuel: 0Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes kNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes YrNo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:%Q 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 SC 5�6 Name � �- �� �bJ�i Telephone Number L/ Address ?0-e-e-0 License# O 0 6 3 5 CAA ,(2�t`(� l/ Ub (7 3 Z- Home Improvement Contractor# bG bU Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE r FOR OFFICIAL USE ONLY * PERMIT NO. q-3 DATE ISSUED' x • J MAP/PARCEL NO. ADDRESS ,{F - VILLAGE �e OWNER .�, w, •_' " s - x` . �- '. - 't - .. r f... ; • x J • t w ( DATE OF INSPECTI( i FOUNDATION FRAME INSULATION `a ° FIREPLACE - t ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH FINAL- GAS: ROUGH FINAL 'r Iict FINAL BUILDING —` DATE CLOSED OUT _ 4 ASSOCIATION PLAN NO. k Tile Commonwealth of Massachusetts �� _ ,Cs . T;:__ �:�-_—��� Department of Industrial Accidents ONCe offil yestigatioos 600 Washington Street i A Boston,Mass. 02111 Workers'/ ////„///��/��//�/%� s' Tensation Insurance davit name: / L `— b C ' ► t location /0 ���.>o eo city hone# ❑ I am a homeowner performing all work myself. I am a sole proprietor and have no one tivorid in any ca achy ❑ I am an employer providing workers' compensation for my employees working on this job. comonnv name: address: city: phone#! insurance cn. noiicv# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have . the folloning workers' compensation polices: comvanv name! address! ::....:'•>:;.; ::..: city phone#!. ....... ...... ...... insarnnce en. policy#.. _,..:. .:........ :..:. camnanv name: address: 00 city. phone M . .. :.: >:.... insurance co. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and aline of S100.00 a day against me. I understand that s copy of this statem may be forwarded to the OMce of Investiga ' to of the DIA for coverage verification. I do hereby erti�y ua r the nr an enalti of erj that the information provided above is truce and eomd Si�ature l/ Date Print name ie1(-41UO .� Uf',�j. Phone official use only do not write in this area to be completed by city or town official "city or town: permit/license# Budding Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's OMce ❑Health Department contact person: phone#; ❑Other lte+uea 9,95 PIA) Information and Instructions ti. , Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any con= - of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receive: trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or Iocal licensing agency shall withhold the issuance or renews: of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the . commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. --------------------------- Applicants , Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insnranm coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents 0=8 of lovd0oallons _ 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 OFF The Town of Barnstable 1b 9. Department of Health Safety and Environmental Services rEc N►o�' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 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: U lI SW 114, k,t w(� 000 Z Estimated Cost Address of Work: C9 p� , o.,6 pp-A / - Owner's Name: ��� f � �l,4 p- Date of Application: 3� I hereby certify that: ' Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: -ds A-,4,ao S­eAjo-d 106609 Date Contractor Name Registration No. OR Date Owner's Name q:fbmis:Affdav �oanvnwouueac o� ac�auoetla DEPART ENT OF PUBLIC SAFETY CONSTWH SUPERVISOR LICENSE C Nuaber. Expires: r -- Restr ed , x 00 R IC��D T�ENDSR I � •�••.. 0 ur 0 PEEP'TOAD RD =. c - CENTERVILLE, NA 02632 OME IMPROUEIIENT COfRACTOR T � eq a i,�o� 06009 � pfYPe INDIVIDUAL. 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TYPICAL RT I \'Y �/(.� � /� u TER OCT.CORER M1�.-Lr��...• �J ♦ I t`w/-I ►-- •� �/ •,O,CI, f/ r`-- r' .00 * , RETURN j 4`'G` „O� FLTER AT '3 rN ' �L tzm f. SErE s V kii. PERMLANENTLY J ACHU SiUDED �s �PORTIONS =• I '4 ASAFETY LINE .IIEPRESEW L ATTICIED .1 x,l FLAT AREAS - a '`"•E'w r- FLAT AREAS !HOED PORTIOMaS 1 SHADED PORTION FLAT AREAS e LELAIE►R AREA OR*r AT� sTT O I ARE SUCTWN AI iSALDUYr.- SUE alotnt ALso ItII Ee' af.ass.AREA a Jam.GAL- SF -?° II+DA' aw if. ow YEA a�s�4_SAL-CA f1�00 . j sYIS' sy a!R AREA a -QAL-CAR MSSJEaf 6 L >ls. aEw YEA�orL.CAR e:•.�e' ow AMA a SAL-CAR I' � aoWR ALSO rrx3r A&&"a"AIE la,EMEft' STA/E$ARE OPTDNAL �� WR 411 J13l t-F ass.AR! 916710N �'FRAME AsseMeLr Z/_ LEA z'.Y cR z' SERIES goo$-850-INGROUND S<t.RIES 900 81 950 INGROUND art Sr n44 v a".AM TYPICAL W+ETE sMIDWN� ` : J SERIES 1000 9 1050-I N GR sa sow.LlD mrw as sus. ARLA aaAL w- 1l S, am YEA a ML•CA► Ai.aaAaE Sn aes af.Rss.ASEA C SAL CAP fOIYIE/OOE71a 110 sOSEI Att TE.AIO ARE Y!m I rx3S sin SF.SURVAREA 61H90II_G4_GV. Ot FOOL OVTIi floss TM/S- Y- �I��s AM, IF FYSER . SERIES TOO A T50 INGROUND �--►— — -►—--►--- -►—— LTER MTEA F J —►--- ►—— �—— — — ( ;r -�- -►---ET RN r Q CORNERS AT �. J 1 ruw•MOTOR TYP AT OCT. ,g1 �I I ; • CORER -i-'u-+ - , � I RE'T1111�—\ r � _-1 RET1/M T .�,�.�h$,'(. �'..�� � � e �ITL..T�...++•.r. PUMPMclT AM ATTACEED r,� f «;`ef r V own is numb romm LAT REPRESENTS �? 9MDED PORT70Mg •����`+es�. I '} \fAFETY LIE -> •, a ,y vOR IOMbFLAT AREAS l G'C ITS \ RAT AREAS 1 � c AT TOO {,1 pip ap�� s ll � T�rF�un�9*oWN �, 51CS�R HI S r>c .$a�'� fILL "I•u:�iF 3'}a s''• OD SUCTION 'A'F OAL M�K-'f •x• f�sow Ir.La►se svn gLSE —--—► ze AM AREA A ROM GAL-CM. -►-- -- 0� �A AT OW SIZE SHMN LIY.FW•S4 tj SkW A1EA A '�. GaL.CA SERlES 0 /=SIMON LO•.4Y EL&EFT Olt-MT MAID) a aM-AEA a j7�SAL CAD. SC. =B' �' � ° �°�� G�CAPo' iArRE Ltt A SERIES 600 6 850.USGROIM7E�Jrl SEES SERIES 600 9 650 INGROUP a SERIES TOO 9 T50 INGROUND Ar Pos ools x*. r oR•z' • FILTE P{AiP✓l�YOICIR 1 �_-. �- - FETIIaI F><TEw _ T z 4- ' � - RETURNP � Tm EAL PUMP 6� ♦1 ,fin. LSUCTION TTT tE]IE>> �� ut 144 AasETf tAR a I FOO COINER ) nT ..'a. \'[ (swam.ono. PERMANEN lT-f*lC ErtnY FM #, • ATTAGJED sz \ ®• SAFETY LJEE s L _. Sl1ADED POFZ•C1E11'C$ ) AREASFLAT ^ :.`. LFLAT AREAS i` -. �'�`rl ° \•I°` I - S 1R IOso nRETVRM`.. Y,Qp00 I I RE'T11ISi ` yR �_ i _- _► _ --►J RE TURN AL y'FRAME ASSEMBLY TYPICAL WHM 94CPWN •A'FRAME ASSOELr �„J __ a /YA00 ML W SQE SIArt'N WX34'4 SF SURF.AREA TTPKJLL.tE1EJt£ 910WNJ >lff!W�ADO lt.S=' ,57 31. fad ALA SF. ASS.AREA j1BSm cam' �- r W•.Sr S0.S, =ARM. a L3TC0_SAL W AL50 AVYLASLE WX30'410 7RI Jr.{C EL!town mm) Im Sy, ww ARE! a�jm SAL CAR � Ld.40'-Tar 3J. APR AREA L' _GAL.CAr AVALAALK ALTERNATE. 600..E 650,.. SEP r�r,.,. •rpnl IIJn SERIF, 1000 8 �[a fMY-liL Iwijlewiz L L t3 _inoiisi pO �Al ILti'•0 -r.�C1rOA O OM1i. aDa1►IOi A PlrlOr 1M it CAIY{Stt1. 1 uaPlnr r►r ai)AL►s rar w rs..elua r11..1Q 1 `I ra•ti0l►��1YRGu -�+••- n u°�ao r raw.a � a, -Lf t.1YO15 . ~/AT atLK 37Rt •--Lr r►cAw. e�af•KMaT•-..fie \ - -- t M 511RLAItf� I MD!1YLlET=t,`/■ I . 1 - s� V►•IR t,. �... 1_ _'�—IL _ M M war s7m � y 4 is.wri'l ,r wrn as.oa i■M.la1aY s,a� d 1 KQ [yrllr �I M�Wir O• s �!I ` r<Tioofa! fo UIL ifldOid!of so In-"moms a7►R al _ a l""" unn won>,a .cir�►r 61Q60 �- s� `� 9ooe950�gp►Co>wNfaR� cr�tE5-nO a 050190r 940-- - •" GONA 9 7 CbRNER_�i a �. r�w frm� /r Lu iiri��'wrs N ■acac. a_ � ��' a M M�Y N p.Wi � \ I /fJ` .ri10�s ra P IMl1 1Q QR. i.-\1 / �` j A.IYO.OO J !Ab 2 �. an f j� I _ 111 M J rr •Wo oo�_ _ ] w. ^�- - 3 Y__ / �i ' 1 � Iw CA.WtH fib �01 AM a 'l rLiNme74 i C) PM c n06� . ra1�10 P0A tG�■iP�s , pq,p�'wrtM KaA[[ v 00-STAN COMER s_ W o � SIE TOO 0 50 F-t7D 11 • ! SERIES loo0 a 1050 EL • ss wo►.ti� 7 1, ivasifmrw I roWtr f O ` C Y : a n' :adr =g aE a°7R� ) r �1oR aQ swev er! I I wom ro, F 1001% se X,.I\ 'v'T''�` awn.tee yr . / ...:•._:�.';.r::: [1 OQ I --J� ffco o 1l� rvtf - lleL T Ka �3 �m �, e�Y r frAJl. 'T► � -. ._ � xis / AIO!a►asOs .•' � ��. +•••Ir�aa•Ari - e. v O /IDSS IO' :a. ][C' Z,R ` _ ►ML1►efJO •ALKAre p O o m J a ° eat Aw Naw►• Is r.ML¢low �. ,e �j� wra fi`•. • wla tifiAla z K�[esws�►� �- �w bQ �rxxK� r nwoi� M►s�Sb TTe __ �_ _ rsrc E lY�1a1 W�" } C w // �r T-!r, ..xl+.Ifrrs� aN 0111" f J4Y rKV!-ffYlf °'°�"atJr�9r1� LjM�I.L'JF�tfSLT7 Rt p" ��s w. I T,� fi. Oo ��A CG M al.QLLY.S1Ql Tnr !AAd f' 13M 171aC� i'1■►CM fA�7► p ft&"vow .w[�..i.lr► wrn aw GINlLA•l.fti.� �. ,� ..00� 9 = SF3tstS 600 g KIW R CORNER _ _ 1 AYY.w1p rlus`— G r�r ra _ �iarnm rw. !oo o.o�•v.� WOO, mrraoir=wYK'o I�so. w A a11r*f) ' � ti LI frfiva��wl�suw.rnro■►rr io ■Fs•�Ila fwa■. r►r A-•r Kto IrMO s f' rrt RA. [ ws.►.•a�lw►w+.eet u Tewrr..►e`"Atnw :Jer'r'�t 41 `r[►'w°'■.v:'ra[.`. sA' J- F w..rM;wroo►°�i.°►.► ul1' a .. i[.•.a � a ,^,• wy •orM>�.°•• wnK ro�tve. �� Kld7�•�i [> ItnJR�l1 oft w_�•�to� .irw �'�i v n"io• .'now at ra►■o.•rove- ey� �tnu aer s wsma rows �qLAW &Wx � OlL7r 7✓•L�� �r�KL W=ffi 11J 1Mr r�laa.1. .�+ iwitivi°rim ai eu�s�wna N _s,rwi,Ivr■n n t No ■^A A�r�a���s'�le�w►e iarA mr■.►.a o r.rewrr►w.�l wa..aw► ?YP MICQN71-WM1Rf1�LLL S rr 10t cwp. ■jiTYfILA. � tf IMrn wA F : UAT wvr % FANi ■ T Yti _ Ie . rt. VJ C' l PF 612,FF1TY-1 , `) 3 r LET n\n�•. a I, 1� Foy � sE�B�� b A�,uA:I .E �,E- ` 11 _ IA.5 IUELsT : SEE t2e�Fifl l-' PQcPItE GFkDrr4,ti� _�_n fxD I_uw6e-c-T L.4rsaa _ sr K 1+ STIL �1r1� Fs.f3. V,-n �r M s CERTIFIED PLOT PLAN P7 L I11.113Co� NEW . CONSTRUCTION ONLY x y "— TOP OF FOUNDATION IS y `- FEE 2es74�c IN . ABOVE LOW POINT OF ADJACENT ' No suR ROAD. SCALE, /''=4eo DATE , 4-6z D f G EE CLILNT I CERTIFY THAT THE FauN�at�iL E®ISTERED REOISTEREO SHOWN ON THIS PLAN IS LOCATED JO® NO. ����3 ON THE GROUND AS INDICATED AND CIVIL LAND CONFORMS TO THE ZONING LAWS ENGINEER SURVEYOR DR. ®Y� OF eARNSTa E , ss. .712 MAIN STREET CH'®Yl H YA N N I S, MASS. SHEET Of DATE — 0.- L AND SURVEYOR ,' - s�ssoF's'map and lot number c 1 " • 2.-...7... �.. r Q Sew��ge Permit number ........: ..... p DZIiHj� G� - _ �'� o� ABBSTLUt House number 2 ; $ Mb a 0............................. B 9 t�6 -gyp���* r �� ' 3 q' 9 M 3v'9la s�)Y J8 aa?.3 0 MPY a\ TOWN OF .:BAR:N T1 � �.. .PP DRrP -- LE 5 BUILDING INSPECTOR E " T103V`' ° �� APPLICATION FOR PERMIT TO ... /!?l..! .. . !�...yf .... ....... ....................... TYPE OF CONSTRUCTION ...........:1JQOA..... /7fQl ............... :.........:.................................. 19.& TO THE INSPECTOR OF BUILDINGS: The undersi ne reby ap lies r a pe it a ord'ng t the followi in rmatio Location ... . ' �D�C ... ��.��:.................. . .....:...... ProposedUse (%/.��.FIV,04-i. r. ....... ..................................................... ....................................... Zoning District .. .. ......:....... . ...............Fire District Name of Owner .. c' ..� .... ...........Address x a..�'✓....::..L-1/L..................... Name of Builder" ....... .....................................Address .......'.......-�i /I` r .....................................0........ Name of Architect ...,. ., .;.. ........i ��!-.f ......Address .�..?� / .ya.,�`�',��. �..................... ............ Number of Rooms ........ ......................................................Foundation ... ................. ............... Exterior .!�1 '.?:.." .:�.. ...:..�/..:. ±,,.� , .,_..............Roofing ........ ...,1.xr/,,,V.Z—t7..6............................ �. �. L � �c.. Interior ...�-. �`'u� <T..1!:�... .. .. .....�!f.. Floors ............ ...,.{.�........ ... ... .... � ............ . .... Fiea`ting ..... . ..............................Plu Bing ....... ..... Fireplace .......... ............................................................Approximate Cost .... —. ... ..................... .. .?2- -- Definitive Plan Approved by Planning Board -- -------19 Area ,.. ................. .... Diagram of Lot and Building with Dimensions Fee auk ............................................. 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 T wn of Barnstable regardinglhe above construction. �y,��,�✓ �� Name ......... ..... . ........... . .... .. ............ ................... (SIDE BUILDING CO. 2 4.;/ Nb .....9...2 ... Permit for I2..Story.. .... ..... ........S.i.nq.1e...F.ami.ly..Dw.e.1.1.in.g............. ...... .. ....... .. ..... .. . .. .... Location 22,......25. .Captain. L.umberts •Lii: ... .. .. .. .... ................!�pX4tgA�yi.11.e.................................. r ........`.......Bay side aide Build.i.ng..!�qr........... ....................... .. .. Type.of Construction ...E-KATRO.......................... or id :A .......... .................................................................... Plot ............... ........................ Lot ............. Permit'Giranted ..Japuary 3, 9 8 3 .1 ............... 9 Date Completed ...............1-o-3 4 Assessor's map and lot number ............................................. ..........................................- FT� H - f ETO SS, Permit number ........................................ !`11:�...�"+tr 2 Z 33ARIS8TA LE. • House number ..................................... IL ................................... C ` 9�p 1639• \0�� a M TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... './ ....................... TYPE OF CONSTRUCTION ............. ,/0. ..I ..... r ?. r�................f r.......................... 17 19.d .................. ....... p TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to' the following information: Location / ......................) 1�� �� //1!? i. �A.�........ ........................................................ Proposed Use (/�! "��n� 1 f,fin„ ;.. ..... ...... ....................... Zoning District fT75"?a .............Fire District c... ..-"" Name of Owner! x-.4.1...... .......Address � �1 7; ��'..(:s?^ !-.:.J�`?......................... �,. / .......................................... Name of Builder' ...... 11.w........... .........................................Address ................ ............ Name of Arc hitect .....................................' �,.!. - ......Address t .CJ w,9 , !+4x/ C ..................................... .......y.... .._.......................�............, N Numberof Rooms ........ .....................................................Foundation r7if a�cam'+.................................................t! ...,...�..............Roofin . ..................................... Exterior ....1 ........ .....::.�. A rinterio�r 9 . •L .��r ,l,,,1 „rt f/C. !, � Floors ......:. .... ........ ...._. r ��, Heating ....... .... . .. .. . ........ .. ........................:... .................Plumbing ........ ......... ....:;._ . .... .:-'' �. Fireplace .. ...........................................................Appr�ate Cost .. ; .ya?�' .................................. ,..Definitive Plan Approved by Planning Board _______1_��!��'___________19___ ...... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ' 1 1 . � ✓ tt i Zt 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. i�-d / f�+� ✓E y Name .........y..... BAYSIDE BUILDING CO. A=147-11.2 No ..2�6 9 2 Permit for 1 2 Story ,. .......... .................................... Single Family Dwelling ............................................................................... Location Lot #22, 25 Captain Lumberts Ln. ................................................................ Centerville ............................................................................... Ownrr ...Bay. side. ....Buildi. . ...ng Co............. ..... ....... .... ....... .... ....... ..... . Type of Construction F.rame .. ................................. ................................................................................ Plot ............................ Lot ................................ January 3, 83 Permit Granted .................:......................19 M Date of Inspection 19 ` Date Completed 19 s ti Y ' i i s r` 1