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0052 CARRIE LEE'S WAY
�. .. _ a .. � � �P o � � _ e �. .. - .. . . - - - .. - � .. f z `t *Permit Town o Barnstable. Expire7oom issue date � ff 8 PERT' egulatory Services Fee �,►xtvsresr�, : ' M"S q q Thomas F. Geiler,Director 9 1639. V♦ _2 20�L prED MA't a ,. Building Division Tom Perry,CBO, Building Commissioner 10A � �!;1-0,.�200 Main Street;Hyannis,MA.02601 www.town.barnstable.ma.us' Office: 508-862-4038 _Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address Ic Residential Value of Worknfo Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address h-we4 L Contractor's Name r Rk''A 0 � (�_l l�IZ �hA)AI t_ Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License'#(if applicable) —{to ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ lam the,Homeowner FA I have Worker's Compensation Insurance Insurance Company Name fm4e(zo- �j rZ.AA/C.i, (!�Ablj P Workman's Comp.Policy# Clt ©b aQ0 - Copy of Insurance Compliance Certificate must accompany each permit. ` Permit Request(check box) r ` Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to I Q/iN IMP 4 o N ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers:ofroof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders:U-Value (maximum::35)#of windows ❑'Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required..' Separate Electrical&Fire Perm_ its'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 ' equired. SIGNATURE: ' The Commonsverdth ofMassac..husetts 13tparhnent of Indusbial Accidents Office of Invesfiga#ons 600 Washington Street Boston,.MA 02111 nw w masmgvv1dian- Workers' Compensation Insurance Affidavit: Builders/Contractors/Etectric ans/Pbimbers Applicant Information Phase Print Lei bly Name(BusinessCTanizationdadividual): A i K,0 Address: `� , -� G 7 Q City/State/Zip *,6N tr4- Wl Phone:# Are you an employer?Check the appropriate boz: Type of project(required): I., I am a employer with 4. ❑ I am,a general contractor and I p � 6_ ❑I+i ex constsxction employees(full andlorpart-time).* have:hired the sub-cmtractoss listed an the a 2_El I am a sole proprietor or partner- These sheet` 7. ❑Remodeling ship.and hime no employees. These stab-contractors have g_ ❑Demolition w forme in a ci employees and have woukers' oriring any capacity. 9: ❑Building addition No workers' comp_insurance comp_insivanr�$ required-] 5. ❑ .We are a corporation and its 1 D.❑Electrical repairs or additions. 3.❑ I am a homeowner doing all work . officers have exercised their 1 I_❑Plumbing repairs or additions myself. [No workers'camp_ right of exemptian per 1bIGL 12.[S Itoofrepairs insurance required.]i C. 152, §1(4),and we have no. employees-[No workers' 13.❑ Other comp.insurance required:}: 'A1Y applicant thar checks box#1.cwst.also fill ost tine section beIaw showing their wwkers'compensation policy info nnatiao I Homeowners who submit this affidavit=&catm9 they are d=g all warms and thm hire autQ&tonftacMrs mast submit anew affidavit indicating such tContracwrs that check this boa must attached am additions!sheet showing the came Of the sub-camn-acenss and state whether ar not those endtks have . emplatrees. If the sub-an=aars have emplapees,they=usi provide&Err Workers'camp.policy number- I am an omplo3it r that isprmi ing worker,mmperisadvii irrsurarrce far or3'employees. Below is the poficy and job s6V inforrrtadon. Insurance Company Name: ':�VjfZ RAJ C IZ- Policy to.5e1€ins_Tic_ C 1�06 ��0 Expiration ate_ 9 13 Jab Site oar : c tylstate/zip 2UIC� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). I Failure to secure coverage as required under Sect iiort 25A of MGL c_ 152 can lead to the imposition of criminal penalties of a f ne up to$1,500-00 andl`or one-year unpnsonment;as well as civil penalties in the form of a STOP ©lII�.flRllIlt and a fne 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 versfficatic n I do hereby c render the pains dPena at the In:ortraa#irrn ptfirrtt!idad nbova is true ntrri rnnrrert 5i tare: / f �. Date: v Phone M 3a 7 QBkniffl use only.. Do not smite irr this area,to be a7mpUted by taty or telvii o .ciat (pity or Town: Permit./Ucense# 1[ssn.' Authority(circle one) 1'..Boaard,of Heakh y. m Bu Department 3.CityiTown Cleric d.Electrical Inspector 55.1''lumbing Inspector 6.Other. PATRONS MUTUAL INSURANCE COMPANY OF CONNECTICUT xONS GLASTONBURY, CONNECTICUT ARTISAN CONTRACTORS POLICY DECLARATIONS Policy Number: CTR0002906 RENEWAL Effective date: 07/08/12 . NAMED INSURED . AGENT 6770 . .. i , CHRISTOPHER PAINE EASTERN INSURANCE GROUP, LLC. 22 DRIFTWOOD LN . 233 W CENTRAL ST SOUTH YARMOUTH, MA 02664 NATICK, MA 01760-3757 (508)651-7700 Policy Period: from 07/08/12 to 07/08/13 12:01 a.m. Standard Time at_your mailing address shown above. Insured is: INDIVIDUAL Business Classification: CARPENTRY- RESIDENTIAL Code: 10030 LIABILITY COVERAGE; COVERAGES LIMITS OF INSURANCE L. Bodily Injury and Property Damage Liability. $1,000,060 Per Occurrence $2,000,000 Aggregate M. Medical Payments $5,000 Per Person N. Products/Completed Work $1,000,000 Per Occurrence $2,000,000 Aggregate 0. Fire Legal Liability $50,000 Per Occurrence. P. .Personal,and Advertising Injury Liability $1,000,000 Per Occurrence .. PROPERTY_. _... COVERAGE: DESCRIPTION AND LOCATION OF PROPERTY Loc. 1: 22 DRIFTWOOD LN SOUTH YARMOUTH, MA 02664 COVERAGES LIMITS OF INSURANCE . Loc. # Building# Limit ACV A. Building B. Business Personal Property 1 1. $2,500 t C. Loss of Income ACTUAL LOSS SUSTAINED, NOT TO EXCEED 12 MONTHS. .WAITING PERIOD: 72 HOURS Increased.Property Off Premises: Automatic Increase-Coverages A&B:. 0% ANNUALLY Property Deductible: $500 .. .. SUBJECT TO THE FOLLOWINGTORNIS AND ENDORSEMENTS AP-100 Ed. 2.0 AP 0611 01 99 AP 0643 12 99 AP 0432 12 03 AP-222 Ed. 2.0 GL-841 Ed. 2.0 GL-895 Ed. 2.0 PG 5521 06 05 AP 0700 01.08 AP 0688 06 02 AP 0690 06 02 AP'0692 06 02, AP 0365 10 06 AP 0233 01 08 . jPREMIUI, AND BILLING INFORMATION ANNUAL.POLICY PREMIUM: $1,128 $650 Minimum Earned Premiurri,Regardless of Term M: ENDORSEMENT PREMIU BILL TO: Direct Bill To The Insured TERRORISM PREMIUM: $25 MORTGAGEES PRINTED: 05/24/12 INSURED COPY THIS'IS NOT A BILL Office of Consumer Affairs and usiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contfactor Re istration r' Registration: 139223 Type: DBA e ; _ 1211 Expiration:- 6/24/2013 Tr# 214149 PAINE BUIDERS ` - CHRISTOPHER PAINE im+ 22 DRIFTWOOD LN 0 S. YARMOUTH, MA_02664 �w . f �� Update Address and return card.Mark reason for change ' ` Q Address Renewal 0 Employment Q Lost Card DPS-CA1 0 50M-04/04-G101216 _. Office of Consumer Affairs&B siness Regulation g ✓fie UiarirriaizureaCC�i a���cwaac�ruaetGc License or registration valid for mdividul use only g before the expiration date. If found return to: _ P HOME IMPROVEMENT CONTRACTOR. , . . Registration::,�39223 Type: _ Office of Consumer Affairs and Business Regulation. Expiration. 6/24/2013 DBA 10 Park Plaza-Suite 5170 -- Boston,MA-02116 . PA E BUIDERSI-1— * CHRISTOPHER PAINE . 22 DRIFTWOOD LNG` S.YARMOUTH,MA 02664 Undersecretary Not valid without signature Massachusetts Deiiar'tment of Public Siifet� Board of Building Regulations and Standards Construction Supervisor License License: CS 58296 CHRISTOPHER PAINE 22 DRIFTWOOD LN ;. SO YARMOUTH, MA 02664 Expiration`: 8/15/2013 Commissioner Tr#` 21371 OF THE r0� * BARNSTABLE 6'9 ,�� Town of Barnstable prfD Mp2l A Regulatory:Services Thomas F. Geiler,Director. Building Division` Thomas Perry,CBO Building Commissioner 260 Main.Street, Hyannis,MA 02:601 www.towfi.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize ^L �/y( to act on my behalf,.V. : in all matters relative to work authorized by this building permit application for: (Address.of Job) S$ature of Own DateY4 6 .. 2 Print Name` If Property Owner is applying.for.permit,please complete the Homeowners License Exemption Form on,the reverse side. :. QViTFILESTORWbuilding permit forms\EXPRESS.doc �oFtlr Town of Barnstable P O Regulatory Services BMWSTABLE Thomas F. Geiler, Director 9 MASS. F16:)9. 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. 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 procedure's'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 fom)/certification for use in your community., f1•\WPPT1 P1,\TY)RUQ\hnildina nermit forms\FXPRFSS"doC AN TOW Permit No. N OF BARNSTABLE 20379 ------------------------------- i Building Inspector snsrua� Cash 'o esv. OCCUPANCY PERMIT Bond ---------X--- No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to James K. Smith Address Routo 132, Hyannis, MA lot 022 52 Carrie Leo's Way, Centerville Wiring Inspector Inspection date �� , Plumbing Insp ctd t L� Inspection date Gras Inspector Inspection date "'f Engineering Department f,., .r `t f" r+� ,� :�/�� Inspection date THIS PERMIT WILL NOT BE VALID,.AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL ' SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ............../,Db/ f ( X 19.. a441� ...._ ......:...... ........................................._...............__.... ._ Building Inspector t Assessor's map and lot number . . , .... ................... .. g I SEPTIC SYSTEM MUST BE r •- `� INSTALL `= IN CO Se"wage1Permit number ....................' ,.. ....................................... � WITH NCE tiARTICLE II STATE � - �jR /� R SANITARY CODECODE TOWN THETD' r O ♦�j Y O 1' '`•L AR11vCmT111- � 1 t BBSBSTAliz. i I 'i639• i639 _, BUILDING INSPECTOR 90p ,�� '� M tn '1 r Co�s� c 1 w�LLf'! AIaPLICATION FOR PERMIT TO .......................�..4?•...••..... .................:.......................,........: t; C ra TYPE OF CONSTOCTION ................... .....:f..Q. M£................................................................... ..................... '-' ..........19.13 ` TO THE INSPECTOR OF BUILDINGS:_ .. The undersigned hereby applies for a permit according to the followi information:. t E ,zWhaCE kl+e2ltLLELocation ..... ................................................ . y. ... . 'Sr, EWT Proposed Use ......�:....:Q...........1.�1�•...................................................................................................................:...................... t, IJT 2 1 LL . Zoning District ........................................................................Fire District ...�.4�'.. ....�•....�?........ ........................................ Nameof Owner ..........:...........................................................Address .....................................:...........:.................................. J A�1 S �M i t�1.....................................Address �ARLSST� •?4 ......................... Name of Builder ............. ......... Nameof Architect ..................:...............................................Address .-- ............................................................................. Number of Rooms ...........:.....Foundation � .....C® ................ Exterior � f. RI> ...................Roofing ...... ..............................:...................... Floors L 3�11 L...7?.... -�H.l 4............................. �� WALIT Interior .................................................................................... Heating F.KW.....b.y......................................................Plumbing ......�:.....�. -'1�5.................................................. ... 1 Fireplace ii ...............Approximate Cost ..... Definitive Plan Approved by Planning Board --------------------------------19________. Area ........� O...Sc ..:...... ®v Diagram of Lot and Building with Dimensions Fee . .�. �.... ... ..................... 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 ...... ............................. ...................... Smith, James K. No .. 20379.. Permit for .......one ......... ....... ....... single* family--dwelling . ............................................................................... 52 Carrie Lee's Way Location ................................................................ ...................Centerville............................................................ Owner ......James K. Smith ............................................................ Type of Construction f rame .......................................... ............................................................................. Plot ............................ Lot ..........#22 ...................... Permit Granted ...........July 10.............................-19 78 Date of Inspection ...... ...19 -Date Completed P ................19 . ........................ .... 19 ... ......................... ...........................;............ ................................... ....................... ........................................................ ez Approved ................................................ 19 lr ............................................................................... ................. ................................................... . Assessor's mop and |o* number ��F ��� �� 4 9 .--� 4 ` Sewage Permit number ........................... -. - � ����� �� � � � �� � � � � � ' TOWN�� |� ��]� BARN STABLE �� �������� ' . ' '. ^ BUILDING � 0N0N �� 0 �� � �� ���� �� �� 1639. ^ ��0NUUN�N0 � ���� � �������=0� � NN �� ' MASL �� �� ����� � ���� � ��~�w ���r � �� =� ' - ~ �� APPLI�P��U�� ^PER ���LLw�l CATION ��� 8&0[ ---.---..��.�.L--..'-. ----_-----------------. �(,� ' TYPE OF CONSTRUCTION ....� L......T±..x-..:..n':....r....................................................................................... ' __,.____'T�| ................--..lg........ -/�� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for o permit according to the following information: ' ' Location .........................--......`..........-.L .� '�_., . . .�/L[��_____________._______. Proposed Use .-------.,----.---------------.--..----.---------. u �~ Zoning District ............... ........................................................Fire District .�..`........\7.........l !.......------------- Nome of Owner -----------------------.A66reos -------.-.-------..----------.. Nome of Builder ....................... &/—. ------.Address ..-� 'F-----------...---.. ` Nome of Architect ..~.........................................................Address -------------------------.. -7 � � �C�FT�Number of Rooms .�--------------.-----Foun6oiion -' � -- ____._ Exterior � �'�� .....................................................Roofing ...... ..................................................... Floors .........�����..-7/�-.|��f���..........................................Interior -- ----_.___________ Heo�ng -��A �|-.�L�u-..{~�\i------------..F1um6ng --��-' ~_--_-__________.. Fireplace ....... ...........................................................................Approximate Cost -- r)c~*~`,__,~__~_,___^_ r^ DefnhveF1on Approved by Planning Board l9-------- . Area ........ .................................. Diagram of Lot and Building with Dimensions Foe ......... .�� 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. � Noma ��� z����3�� `' —.. Smith, James K. Aa168-8 (no plotted)' e No ....99M.. Permit for ..one„story .. ............... .....................single family dwelling................ Location ........52„Carrie Lee's Way ................................................ ............................. Owner ..........James K•..Smi;�h......................... Type of Construction ......,..A/r4me.................... ...............................I .............................................. Plot ..................:......... Lot ..............i22............ Permit Granted Jul 0 78 19 Date of Inspectio ....................................19 Date Completed .... .................................19 PERMIT REFUSED ...... .................. .. 19 �. .�y .... ...........J. .................... ............................................:.................................. ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... "+7t�•w.,�P.4'y� _s.......� _._,,.,„.„ ....y. ..,: .,_'.,. .-.�., - •;r'rt 3�.. ?g,,..�.. -.+e.w�, x,?tn.:.-.,s.., a - ,...r".y; .:^r ..;wn r-xe+ra-'-:*.a � „ �7n. pv+pe�7a�rn��s+>n�q'.'�•=si.'"t+T`-„'"R.,;':SR:t.°.,T"•�,`:�°•y'.13�""!" 9 TEST HOLES �! MARCH d97 /976 PA(JL MURRAY - SNSPEC.TOR L0`f LI ELEV, /a : 7 LORM 2-4 LOT J-9- a4 144 AND t NO LJiq T'6R ENC fOC1N,T S P E C LOT 9-3 TbE5 r 0/5, Box _ a HOLES LEACh P!T ` � 'Y- Oti 51M.LAA SO14 CONDITIONS Gi O IN DoT// TE5T HOL65 �' TOWN L-i..IATER AYAla:A.3L6 ', {</ 5 u/L.D/nrG S ETOAC/c 2�- CJ I2 E MFiI/T!5 ;` \V .S G A 4- I �. 9 0 C� F/00N T Tom' SE P T/C 5 y5 TEM CONS T2 UG T/ON 5A4A L.L C0NF02M TO MASS • ODE S/G N F'L O[.V , (? GAL100A Y ENV/eONMEn/T�}L COOS TITLE Q M /V. ///�/Gy ,�. . ` ✓; r - .'- 7 7(f QAI?N,5 LA.8-L� R Fp,C'�/ 2, 4 TE G�j TOP OF HE.�ILTH TEE 6,UL.AT/OHS a ( a ^I AA/N OLE �Co✓E.4-2 TO &X TE n/1D Tp 7MPC�✓/OUS CO VE2 TO ,a2E.✓EA/T �/n/E-5 W/ T/-//N /' OF F//�//SHE [7 C�12ADE ,�2oM /n./F/LT2AT/AA5 5.6 0 _ 21 4"co✓r_/zs _ _ n/s T. 4 c� � SOX Sr/20n/ ,c G,m �., 4„pj a/A rF z MTC�� �-F�.Ow LiN,E '�- M/N di TCF/ D/A. /O".N/N Z" M/n/ I=o ✓_ �2 �4" FOOT /¢ )4 �FooT rc�� A /'f - �4 Foo A r. '•r' O j000M/M W 5 H6 . ci� ` GALLON/ /A/VFer /A/VEP-T CA T-:1:4 G/ Ty ELEV. AR0UA/O Z �T/c 7-A V& /3.3 / , 5 48o770m OF (WA TGIZ T/G HT) /�V VER7- p/ram/ //VVE,er (9. 5 r- /VO GA)e,5A6E G,LI/VDE.P. C r( r � ZO' M/n//MUM L0CA7`/0/`/ 2EFE2EnfCE QE1NG LOT .5Ep77/C TANS 0/S7-.Q/4!3U77/0N 80X OUTLETS �1NU LEA CAI/NG P/7-T :TO ,8, OFCO.�JClzGTE COAJC2ETE S7;24e---A-107?y 3000 Psi M/n/. J/q�I S K, SMITH jS TEFL >0000 „ "- /O LOAD/AJG av D,o/VE vV4Y ^YoT To BE LoGA ED l' f� , E2 SYSTEM U/vLE.s5 /-/- 20 Y.4 �?M P�T7� .�T� M��.� d OV � _ I CERTIFY THAT THE FOUNDATION 13Ivo€IL)P` ()N r�;� OF S/6n/ LOAD/�vG TNIS PLAN /5 LOCAT,60 ON THE C'r-P,'5L.1t+Ip I � f35 5,1:?0/v HERE'ON A/v L IT DOE-- CL� TO .? /a= �7-1 fLi11'I, SETQRC /? CtU�i' �wry fit' F v c �b �v�'�� IAA TE /•-/E..4 L 7'74 4 oz5 /T L?Fa 7- 5 :-r(IAII ,.17�' p,�,eo✓�