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HomeMy WebLinkAbout1116 CRAIGVILLE BEACH ROAD U i r = ziwk(tv�� �IKE� Town of Barnstable' *Permit# P Expires 6 months from issue date Regulatory Services Fee snxxsrnsr.E A 16 Richard V.Scali Director , a Building Division ' . Tom Perry,CBO,Building Commissioner FEB 200 Main Street,Hyannis,MA 02601TO , 8 2016 www.town.barnstable.ma.us N OF 848 j,�r ��yy Office: 508-862-4038 Fax..AK��/A0-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY %r Map/parcel Number Not Valid without Red X-Press Imprint 1(/ •-' Prop rty Address l �� (0 CotA t/( Residential Value of Work$ �j nL1� Minimum fee.of$35.00 for work under$6000.00 Owner's Name&Address ) 1� Contractor's Name I)OV61 JVt UL LC°N Telephone Number Home Improvement Contractor License#(if applicable) . ' ",j �� 'Email: 7D�)UA. a tV1,�t�t6a,k l L>D1 leyk&#A Cons ction Supervisor's License#(if applicable) 1 � f orkman's Compensation Insurance ` Check one: ❑ I am a sole proprietor ` ❑ I the Homeowner rg-4Cve Worker's Compensation Insurance ' Insurance Company Name Workman's Comp.Policy# Lk C"jQL)s C' r--53 0O Z 0! Copy of Insurance Compliance Certificate must accompany each permit. Permit Reque check box) �,�, Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 4 NN, TVAN ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ' ❑ Re-side ❑ Replacement Windows/doors/sliders:U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. § ' *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. . r SIGNATURE: Q:\WPFILES\FORMS\building permit forms RESS.doc Revised 040215 27w Carr mornveaWt of-Massadrusetfs Department of rndush ial Accidews - ®f,f ace o,f.£imstigations. 600 Washurgton Street Boston,-41A 02111 kl'F!i- nit- gOvIdia Workers' Campensation Insurance Affidavit:B•mldersiContracturs/EIecfricians/Plumbers Appticant InfGnnatian Please Feint Le Iy Name(SusfizmP zmiza ionflaffiyi,d= ,l�l�VA 44 u, Ad&ess CiWStatel N*25=yP0 M I Gt S41t Phan;e sCT 6 D - A�r-�e you an employer?Check the appropriate box: Type of project(required): 1.P am a employes with � 4 ❑I am a general contmetor and I 6_ ❑Ides consiz�iau employees(fish and1br part-time)* have hired the sine-contractors 2.❑ I am a sole propdetor orpartner listed outlte attached sheet, 7. ❑RE Modeling skip and have no employees . These sub-contradors have g_ ❑Demolition w :nQ for me in any capacity employees and have woricers' , [No wokers' Camp.insurance Comp.m¢nranmi �. ❑BIIilr�tIIg addition 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 11.❑Plumbing repairs or additions myself-[No workers'vamp- right of esemp6on per MGL 12.[RIGofrepairs insin-mce required.]Y c.152,§1(4h and we have no employees.(No workers' 13.❑Other comp_insurance required.] •Airy applusatdwt chedm box ft1 nmst also f 0 o=the sectionbeIow--bzwmg th&wa tere compenudag poHcy iu5rmadon_ fi Somemners who submit fix dSdm k huffrat mg they are doing all woxt sail then hire outside contractors mast snhmit a new affidavit indicating suclL ICaatractais that checY this boa must atb died an additional street sliouiag the name of ft sub-cam zaDrs and sta#e whether or not tbase entities lw ecTlayees.Ifthesab-contrectauhive emplagea%they=m pm-ide,their workexs'tomp.policy number- lam art enipInyer that ispr,*riding workers'congwLsaftan irmirancefor my employees Mow is rite pa cy and job sle inforrnatiorz Insurance:Company Nam: A / V�Policy�or Self-ices.Lin. W C,6 GOo So ) 0 f 'Z015 A-Expira nDate: "! 3C� Job Site Address: G7 y l L-'� City/Stzfel7.sp: �L('�C /li✓� C��.6 �Z Attach a copy of the workers'comppensationpolicy declaration page((showing the policy number and expiration date). Failure to serum coverage as required.under Section 25A of MGL cL 157 can lead to the imposition of criminal penalges of a fine up to$1,540:OU ar d for oue-3 ear rmprxsonzamd.as well as civil penalties.in the form of a STOP WORK ORDER and a free of hp to SO.00 a day against the violator. Be ad%ised that a copy of this statement xaaybe forwarded to the Office of Investigations ofthe DIA for insurance coverage yerifica ion. I do hereby cwtcf}r under the peeing andpenahies vfpetfur}r diatthe informadwi prot--feIerl a bare and camect sip: Date: Phone 07 t3,okfi L use anti. Da not writs in flats area,ter be completed by dty artonn offf aaL City or Town: PernritUcense# Lssuing?y.nthority(drde one): 1.Board of Realth 2.BuMiing Department 3.City1rown.Clerk 4.Electrical Inspector S.Plumbing ng Inspector 6.Other Contact Person: Phone#: Laformation and Instruefions W Massachusetts General Laws chapter M req[ius all employers to provide WWII-, as'compensation for their employees_ p -tD this staft±-,,an enpkyee is dewed as."—every person in the service of another under any contract ofhire, express or implied,oral or writte:o" An employer is dewed as"an incrrvidnA pm-ter= ip,association,corporation or other Iegal entihy,or any two or more of the foregoing engaged in a Job enterprise,and mchidmg the legal represeniafives of a deceased employer,or t3ie receiver or trastee of an individual,parfnersbip,association or other Iegal entity,employing employees. However the owner of a.dwelling house having not more than three apartments and who resides therein,or the occ.-apant of the - dwelling house of another who employs persons to do mainiunance,construction or repair work on such dwelling house or on the grounds or building apprsrte th,--mto shall not becanse of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local'Iiceusing agency shall withhold ffie issuance or renewal of a license or permit to operate a b�isskess or to construct Vnildings in the commonwealth for any applica twho has notproduced acceptable evidence of compliance Wirth the bl5urance.coveragerequired." Additionally.MGL chapt-r 152,§25C(7)states-Neither the commerawealth nor a'ay of its political subdivisions shall enter inb any contract for the performance ofpublic work until acceptable evidence of compliance with the nmurance.. requirements of this chapter havu been presented to the contracting MfhD,*" d App4carrts PIease fill oil the workers'compensation affidavit completely,by checkinge boxes mat apply fA your situation and,if necessary,supply sub-coniraetor(s)name(s), address(es)and phone numbers) along with their=t[Facatr,(s)of insurance- Lfinite;dLiability Companies(LLC)orLmritedLiability Partnerships(LLP)with no employees other than.ffio members or parta�are not required to carry woilcros'compensation insurance. If an LLC or LLP does have employees,apolicy is requamd. Be advised that this affidayit may be snbmifir--d to the Department of Industrial Accidents for confamation of fn eirrance coverage. Also be sure to sign and date the of dap-L The affidavit should be retnmed to the city or town that the application for the peunit or license is being requested,not the Depar meat of n , Accidea-ts. Should you have any questions regarding the law or if you E ee requited to obtain a workers' compensation policy,please call the Department at the number listed below. Self-ins r-ed companies should enter their self-mete license number on the appropriate Ime. City or Town Officials Please be sure that the affidavit is complete and pried legibly. The Department has provided a space at fbe bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Pleas e b e sure t4 fill in the pen it cease number which will be used as a reference number. In addition,an applicant en ear need o submit one affidavit indicating current '�mul� Ie emLitllicense Iicafions in nay given y alY, that mast sabmY' fry p aPP - policy information(if necessary)and under"Job Site Ad press"the applicant should write"all locations ni (city or town)-"A copy of—the—affidavit that has be--a of cially.stampDd or marked by the city,or towi maybe provided to the applicant as proof that a valid affidavit is on file for future penazts or licenses. A new affidavit must be filled out each = ear.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venom Y - affidavit ete this Le% a dog license orpemiit to bum leaves etc_)said person is NOT compl The Of of Investigations would at to thank you is advance for your cooperation and should you have any questions. P lease do not hesitate to give us a call. The De arfinenfs address,telephone and fax number k ; DegarEment cif 1olusizial Aocdents 1• Off jca Qf)aLvesr�tio= 1504-Washingtan t.) ' M&obi II Tf,-1.4 617-727-4900=t406 or 1-M-MASSA� Fa.#617-727-7M Revised 4-24-D7 mg� , to aft'iJ,Am rat min Jor XW 4 To to Cr if fq Qt" ggk iyt T. aa. a... . rk Jf 3� �#t It ' ' � �po DATE(MM/DDNYYYY) CERTIFICATE OF LIABILITY INSURANCE 11/24/2015 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 pollcy(les) 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 Lora FitzGerald NAME: Southeastern Insurance Agency, Inc. PHONE 508 997-6061 FAX N E t: ) A/C. /C No:(508)990-2731 439 State Rd. E-MAIL lfitz@southeasternins.com ADDRESS: P.O. BOX 79398 INSURERS AFFORDING COVERAGE NAIC# North Dartmouth MA 02747 INSURER AArbella Protection Insurance 41360 INSURED INSURER B AEIC Mullen Building & Remodeling LLC INSURER C: PO BOX 1274 INSURER D: INSURER E: Marstons Mills MA 02648 INSURER F: COVERAGES CERTIFICATE NUMBER:2015-16-1 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE WVD POLICY NUMBER MM/DD/YY MM/DD/Y LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE a OCCUR DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ 9520043214 9/8/2015 9/8/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑PECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 A ANY AUTO BODILY INJURY(Per person) $ ALL AUTOS NED X AUTOSSCHEDULED 1020024224 11/12/2015 11/12/2016 BODILY INJURY(Per accident) $ $ HIRED AUTOS R NON-OWNED PROPERTY AUTOS Per accident)DAMAGE $ Uninsured motorist BI split limit $ 250,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- ERAND EMPLOYERS'LIABILITY Y/N X STATUTE X ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 B OFFICER/MEMBER EXCLUDED? a N/A (Mandatory In NH) WCC50050133082015A 4/30/2015 4/30/2016 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I I I E.L.DISEASE-POLICY LIMIT 1 $ 11000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION doug@mullenbuilding.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE FOR DISPLAY PURPOSES ONLY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Mullen Building & Remodeling LLC ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1274 Marstons Mills, MA 02648 AUTHORIZED REPRESENTATIVE Lora FitzGerald/LHL p�'O c �} o` vC ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025r9m4011 L _ Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-081995 Construction Supervisor , DOUGLAS W MULLEN 87 HICKORY HILL CIR OSTERVILLE MA 02666 Expiration: Commissioner 01/23/2018 ` _ c�/�ee �panvrnd�ccuna�z n�C�'laaa Office of Consumer Affairs si Bez,ness Regu'; f �OME IMPROVEMENT CONTRACTOR. ` egistration.. (A 5317 Exp'iration:�� 2(k7 LLCilk MULLEN BUILDING`�8 R I. DOUGLAS MULLEN i Z , 87 HICKORY HILL OSTERVILt_E,MA 02655 r�3erec ' Construction Supervisor Restricted to: Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit: WWW.MASS.GOV/DPS / icense or registration valid for individul.nse only efore the expiration date. If found return to: yNj c2iee of Consumer Affairs and Business*Regulation �)l'ark Plaza-Suite 5170 Elton,MA ,2116 . �: T _ ature ot valid ithout sign 1N' 1 i a • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map go Parcel 96 , Permit# 0 �w Health Division Date Issued Z Conservation Division d S 6 Fee ' 2 A�9, Tax Collector r Treasurer �;E � i Planning Dept. VA H TITLE' LANCE Date Definitive Plan Approved by Planning Board ` II IRCNMEN.. ff Er Ng TOWN ; Historic-OKH Preservation/Hyannis � Project Street Address `//b C Kow,y 44 Village ( ,P_!'71�ery*if/e_ Owner MOIR, 1171anV151107 O Address //y M-r/6&,1 �2 (�C/�/► j�� Telephone 7 0 Permit Request i 0 Of s a C,_0oA1_:1, 77 v _ sy Square feet: 1st floor: existing proposed / S 2nd floor: existing U_tr proposed 0 6 Total new Valuation fl Zoning District RP_1�3)_Flood Plain Groundwater Overlay Construction Type �6n Genf-ions Lot Size it U­e_ Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family �d/ Two Family Cl Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes • .dNo On Old King's Highway: ❑Yes U' o Basement Type: ❑Full R(Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) /1 Basement Unfinished'Area(sq.ft) Number of Baths: Full: existing o`z new Half: existing / new Number of Bedrooms: existing new D Total Room Count(not including baths): existing `�f new U First Floor Room Count i Heat Type and Fuel: of Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes O'No Fireplaces: Existing O New Existing wood/coal stove: ❑Yes vlo Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes O No If yes, site plan review# Current Use Proposed Use tell de//7; BUILDER INFORMATION Name (0111—ad 6L1_Z< ��',D Telephone Number Address�oA-7 License# r Home Improvement Contractor# /��,3�dC Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOl¢ SIGNATURE DATE %� FOR OFFICIAL USE ONLY PEtMIT NO. F DATE ISSUED MAP/PARCEL NO. ADDRESS ._$. VILLAGE ' OWNER was DATE OF INSPECTION r FOUNDATION s - FRAMErw - INSULATION l-ao/of , FIREPLACE - ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - GAS: ROUGH FINAL, FINAL BUILDING r�`� l ' DATE CLOSED OUT, s.> ,. LL f ASSOCIATION PLAN NO. The Town of Barnstable s� MAM Department of Health Safety and Environmental Services rEo 5 Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038= ; ' Ralph Crossen Fax: 508-790-6230 Building Commissicn° Permit no. Date AFFD)AVTT 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 orto structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. bow'a Type of Work: Estimated Cost 3 Address of Work: !I/G r�a,o y/11e- tf a-e l 2a0 Owner's Name: A i Date of Application: / �- I hereby certify that: Registration is not required for the following reason(s): Work excluded by law OJob Under S 1,000 [3Building 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 MWROVEMENT 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. Date Contractor Name Registration No. OR Date Owner's Name q:fbnns:Affidav The Commonwealth of massacizuseas Department of Industrial Accidents O�cr uads et 600 wasl:uigon Street Boston,Mass- 021 Workers Compensation InsaraIICe davit .zOr sn narrie: • location' hone� city �g aII=*myself r I am a homeowner P �tv . o= m anv a sole provrietor have 'ob. jmfarm workers ....:..:........ '.vh::hKi:}i;:::i::::3;i4:t+{i?,:y:i:{•,{?{;�{iii:r'i:i:::?j^i'vi?:{?i;•C•:'i•.::::i::•.:�i?::-: ::...�:;:iii:.::;:::.. !.v Y�:^..'�.ram•.:•?.+. .•..:••:x.•.y....:vr':}.. :.. .:..... .. r..::Y:•}:4••}::::.nv:•.:::::r?:.i:}:is i}::.::v:::.:...'..::...,-..... am an CMPIOYW.... .x. w„+.:t4!•.M.- ..n ....... n..v �:•}Y:-Y.?}.�hv.,;. .vv:•..r•;:'r 4Yiiij$t$•}$.:.' ..:: lT� �... ..........:.....:•........-............. .. {%. 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F(.'{fi �L.wClL• ............. :..n4::....:vrnY :•:• to s .500.00 maror tn�Qranct:-•co:;:';: ,.,�:;.::::::;-::.,..,. . ���tothnofatmimalPmaltie'°t��I�;�dthaca FROnre to secure covemp se u�foam of �P�theMDIA s�_�e of S100A0•dq IIY nsomnmt sus Wa IIs d�Pew for covM9e ' one years'imp be fotwsa�ded to�OIDoe°i copy of this statementmsy above it true eoReet . mid asawa of P���information prow I do hereby certify under the pair P _ � Date Signature Phtme# print name - v ite to this arts to be wmpkud by shy or toen otSdal do not wr ofudal use only ❑Bunding Department pew �e ❑Licensing B--rd dry or town: ❑Selectmen's OMce onse required ❑Health Deps�mt check if immediate111p - ❑Other---- — Phone#; contact person: i Information and Instracfions �satiop for achusetts General Laws chapter 152 section 25 requ�s all employers to provide workers' comp -- Mass � em to ee is defined as every person in the service of another under and' cc— �mplorees. As quoted from the"lave, an P Y o f hire. e%press or implied,oral or written- 'corporation association, corporation or other legal entity, or any two or rno, loti er is defined as an individual,p of a deceased empiorer, or the rec •fin emp rise, and including the legal represeS - he foregoing engaged in a joint entm? Io iove•.s. However the oRzz-r or a association or other legal entity, emP �P dv•eiiin_ wee of an individual, partnership, who resides therein, or the occupant of the dwelling house hazing not more than three ap �or repair work on such dwelling house or on the group another who employs Persons to do maintenance , tabe an empio r shall not because building'appurtenant thereto sha of such etnploymest be deemed Ye state or local licensing agency shall withhold the issuance ar 11GL chapter 152 section 25.also states that every is the commomvealth for any applicant wnc :- or to construct buildings required. Additionally, n.�r the of a license or permit to operate a busines with the insurance coverage not produced acceptable evidence of Complianceshall eaior into any contract forthe performance of public work uy—i commonwealth nor any of its political subdivisions of this chapter have been preserved to the cow:=- acceptable evidence of compliance With the ins :applicants Lion and � � �by��ng the box that applies to Yrour shun Pease fill in the workers comp with a�of insurance as all azIIda�•its maybe supplying ompanY names,address numb of insaraace coverage• Also be sure to si=n c ' e i< artment ad. Induuaial Acadezzts n=o: tic s submitted to the Dep � ��be retttmed m the crt3'or town that the application for the p.. •__ ^.. The af�avit gaming the "'law" or date the affidavit. ©dew. Sb° you b ve any questions re c eing requested,not the Department Of Industrial the Depattmeat at the munber listed below. red to obtain a workers' compeasatzon.polrcy,Pb /iiin,......... are reQul � / / ' � i/{.;. �/ j//i%///.%/� SEEM City or Towns - and p�holy, The Department has provided a sp ace at the bottom c:the please be sure that the af$davrt a complete has to contact You regarding the appli please arndavit for you to 0 out in the event the Office of m=mber. The affidavits may be zed TO be sure to fill in the petmrt�iC=number which wi71be used as a refer :.e Department mail or FAX unless other arraagammts have been made. Y=c A - of Investi 'ons would MW to thank you in advance for' o — operation and should you have and,gt; pans• i n.. Offic- g� o�cc do not hesitate to aye us a caII. y,ya„y 1107 me The Department's address,telephone.and Iax M=ber: The Commonwealth Of Massachusetts Department of Industrial Accidents amce of Invesilgatlons 600 Washington street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 77.74900 ext. 406, 409 or 375 ` ' 14 ESTINA TED PROJECT COST WORKSHEET Value LIVING SPACE (high end construction) square feet X$115/sq. foot= (above average construction) square feet X$96/sq. foot= (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet X$25/sq. foot= PORCH square feet X$20/sq. foot= DECK square feet X$15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Cost ,31�6M L , ..,:,.. -„-.,e.•• edmuao-:�+Y�:�a i.:: �9e,.e•.tssna w.! .�= ._.-.;'._.,, -..�.�� _ _�.. r'.C ..•' , I • (ZLcl7S� RE vS� � , �_ • T . r i Ex _ T r IrL s 1 k n c• r , 2& On 0 A39W a44a V.x REu5E /Yxh6GL &E.t,5C R4x/G L� 0ao13 G N6.R S OWZQ 4 n A)EW I/d WALL * r �\ d •, LNlu�t \ A` 10 6L�11Hab�To .\0 �t $�D 4?-OppA I l i lb r I It�vSE 94xl(o/&L ME a44 7uI a4xl6&L G�6 yEGC)A) tGo02 PLAN - XALE a'=l-v" FX•gT, C,HIMal-6y BRICK i' OVE12 �a"GDX PLY l'AI'>� I — kiD&IE a COw7T. S0FTIT UL^JT RA Y-E = ALUAA. b LrVT+" 4-5 100 LITf 9 Q �la , &JA FTf12t FA5 C/A DSO a , I x G 50FT IT Ix Y FP,1EL�E t- 3p oLXV 77)P PLATEf — SIDIIJG- WIG 514IaGLCf y'TTW,t- MATCN � JAW JVeKC OVER �A"CLDC PLr 'L�iV1 I A U 1 x 5 CDD' EX'STI 'ti NO T2/M 10/,'1oowf V/NVL WIn100W OJT- 2 l\ cJ�LL 5 °o dx4 y e/&"0(. 7:VI"VVOf axy 'SNUE 15r xley a jv"ac J NEt,1 �y" Pie£ tiA�/SNf 0 zrooR (WOOD) AMP �w5t, h 506 F[000z rQ441- �"© .- >, � */lEMOVr= TaONT ..ROOF OUt411�1A t>Elow yxrJ'7 Ls' FIOp/Z' 1 , Cx15T, Ex1 Exl I;X 15 CRAUX S P.AOC -- - f fAM/Al SEcnot3 - G.G-ACC WI0Dow 5GNFDUI,f i NV/N BE(Z gyp. GLaf h ITE OTHER —. q a 030L c 13 ayya 6 D - _. ..i - • a �, �f V6E EXi -77 s f I H7 LtyAno r .. ' - SCALE: APPROVED BY: _ DRAWN BY y/�7 i .. - DATE: REVISED 51la�r�A) _M,atonl�^ Tn}�So�J 778;l,67Y DRAWING NUMBER I /OPd - R IT EHI t !f I LH Ld I I ao3? R�� RusE M-1 LLU FM T11 ►�— avva -a • PEA f- yA-ty w 4 t A LF Z rr _ rl r 4i --�{ \y ij v •L J � I .o �9 . 21B F nay�y I V{ '69e<et 1 Gam/6�✓lL'..'1�� -�---�'�- �1'^}Ic /�• y'/� / CcattATC'G•+aS d VATlL^?,Lk tM �/ ay 413 rstZs,� aAu. ri•i-ups i /p LG9 � GCyySX�O�D�1 fd 1A� v/45e.so vre,�royi, Lry� � �� Mtar/rC'O^ � � _ .... Z. '�-.•f1L .4.A "S?AGL"' 4, ly !I ^st(.�t��'4.:c»..a•Tto�t `�w.t Iu'�-.cG+a la.t2MIuu'T 5 E-Z, 10� 6:n� Olfns�9E d�4uG . - WhTk A,WAC@C PZ.d'u1s - ��Y i L h1 o Scae.,E. �bC.H 1 iJ E++ Iei /zdT j7.Cwf PTTIM 6GCRi/Oi./ CE 7 l//LCE' i SuurvAN 1 [i J k,sto No.29T3a No Gac..-a+.e�� G--¢i+xoF.Z '$�•*•o, �°c•. �� lur✓. �=r.�-jb i t �JE.�TI C.�TAA1'l—I._ISE �O�JJ 'SALI.O�..tT.EIL "T L p' S+OCwaaL�Ga7nLl'CY :z`1.3OrID�r,D.S k Z•� ° mo Ga f Tt6Grr"TEVEG L4�.?7 Si12./E/e^.� $JY'TD 1-�Gti?ALIY`( ! 9DK l0 r. 1.p - S'JO 4'� I d'YYc.2✓ILLL- -. N1dJ. -T'S?��•T7a.i 4_�!F�J ��c�E?C' �r^•�!/�ai L:��i•�.-�� � r..r IT L i V,5 fag 1 1 j Fx� s x HOME.IMPROVENENT CONTRACTOR Registration',3112332 ' TYPO - PRIVATE CORPORATION F Expiration `03/16/01 ROBERT J. BULLOCK CONSTRUCTI' ROBERT J. BULLOCK JR # BOX 563/ 6t_WINTER ST j �ADMINISTRATOR •. WRENTHAM MA 02093 5 ♦JIFF: ...-.�. k3,u. -- 6Te �auvmazu�ea�i a�✓�aaaac�ivaP(z BOARD OF BUILDING REGULATION. License: CONSTRUCTION SUPERVISOR Number: CS O42006 . Birthdate: 03/30/1959 Expires: 03/30/2001 Tr.no: 8000 Restricted To: 00 ROBERT J BULLOCK JR. 64 WINTER ST WRENTHAM, MA 02093 Administrator V)VED t�-- - . ._ } r.19 e:` NOTE C ANGES --- - --' 1 � L�.r,.r• rr r� I � � t _ TO OF BMMSTMLE Building Inspection Depeeo iI I 'O I .• I 1 L�' � 411 -��I►1�� �n'.Wr tial.:µ r.. - I I I l - r t r+enor�Ir't •T� !ram. .. •\.-..__ �L.IIY.oWs CamM i e',, lNi `__C'•'"'I+1•iYJ.tl' G�.r4 P..1.1:1(•./KIMI I I� � {�♦ WA�r1W i 3, � I � .. � .�t!.� �INIF-I Li }� , ._�r` 1 .LLB• Looll Gi nl wlr_c slu- ICI I I el.cra.�L:Iy1 I 1� r 5�G7-IJI77 7. .......... _ rr♦/ r ' �. _ t 7 . M D FTfJ � .t.9ticJ�I P.r GFYlIG•/ILL.E N�... `.. • (�•.�►-K';�>GcTIaN,eh�ficY'to�-t w_.��� ' /9 Z, �. $ ? .� �/ •IX/��Y II -EX IST LF_Hc..K�Li C.,c�,6lD i _ \ ✓�SaA 5�it,�T¢A�l���+CN AZ .5 1/Y K il--�a�tTE•i =e VILL T J'L{tLF� /'- SJ// .. ��iKf-TG'G4SQ 1/hTEL L��ASS 1 7E-G. �--/� /`j85 '- 4S U6<EY-,ttL�t ZO 14u-0W'�PL6hc�<a - _. _ • <..,.—..— S.Z__ .. _.__._r=-S.Q:�..--�?.-s----ELS. GtEdn/ - MFJ�ru••Q - Me-Rt+y ' 4.:- .,.. '. .' - S SA.JO. SGn�D •. SGw�b - ... n GCtiSNG t�'S�J E •, `i.��E¢ ,...- �L G 9 1!( v1F1/>•/S�F 9 1.D' �W45NEO P6n 4rouE 'F�14(i•C'. 1 ZL ly " .4 ?1C-sAvb 2 -mac 16,.r.l�LA'101.1 `�1.1•E I���O?Iwl ZMIUtiTSs - � 3A$ -_ . I - W TN A WATE2 PiLOCWGc - f( 41" ?E�2 FpPATEb - Ni 5� ! o� P(TFA [mac i/o�I SULLIVAN I N..29733 >\I o CTAza.c,r_ G—¢1•A DEZ � o f�o,s.cF`��'•. •�✓. 3-�s-� j 2, %w o= zsc2 -G?D c/,/'� srro i;'•` �ti� �FEJZ��•/G� It '✓c7TL�-nel�—LASE loco �ALIJ>�.1 IAn2�L - '1 �oT LZf O Z 1-ED.L+i l&4 = EL-D so.X10,k0.. ) ✓3'[..a4,n - S,pE\../ALL�h7hL1TY ;?N+10)XO.S x 2.'9 10o G-cP-j- TLE�ST-EKED Lq.✓b SL2 �2.lL 1601-IOTA L Wy to>L I.C) = •SOD Ecti 17 1-7 ioTp,L Cn.�.,c ITS/ 400 ��-p rr7� Assessor's office(1st AssAssor's map and lot lnumber (J /6 9 SEPTIC SYSTEM MUST BE FTMET INSTALLED IN COMPLIANC o Board of Health(3rd floor): WITH TITLE 5 d� Sewage Permit number • s AND • Engineering Department(3rd floor): ENVIRONMENTAL C®I) t Dsae9r&nLL House number °o r T®WN REGULATIONS ay .p Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only A P P R G v o is 1A OF BARNSTABLE St a Co servatio 17" I -DING INSPECTOR s gaed APPLICATION FOR PERMITIT TO TO TYPE OF CONSTRUCTION GU(7® /� /�f�A/ s i G (� 19 —[ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location o I cP A f o d le Od Proposed Use I U Iti zG/y Zoning District P Fire District Name of Owner IPA 11 1 u 0 S /G Address 2y11'5� eLi?��/�/t!D ✓bye Name of Builder s be�� Address � f 0/C1 Z`6C��rPY w/�Y 1 Name of Architect Address 1�jr�'UiU/S e Number of Rooms cl/1 / Q k f��1 Foundation �c' rr GLIY�� Exterior �� �L'/i e?e tom 1 Roofing P�xz •ly' x " y Floors Interior Heating /i i Plumbing Fireplace �� Approximate Cost Area Diagram of Lot and Building with Dimensions Fees J Qr OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding th above construction. Name Q4Lonstruction Supervisor's License, � _ DUBINSKY, PHYLLIS f �3 , ri No 33830 Permit r Build Addition Fo r } Single Family Dw,,(4111ing ' 0 42 Location 1116 Cr�aigville Beach Road Cente?rvill d, Owner. Phyllis_, D`abinsky - Type of Construction Fram Plot l Lot _ Permit Granted June 27, 19 ?0 Date of Inspection 19 i Date-Conkje ted 19 r , rr 0 , " < Mr W C r a _ F - T , �w Asse`ssor's office(1st Floor): Assessor's map and lot number/ G d ,y • �p�THE toy WQ e Board of Health(3rd floor): Sewage Permit number l 2f /C� _ • )� ILL33TADCL Engineering Department(3rd floor): rua" . ,House number °o 1639• Definitive Plan Approved by Planning Board 19 �0 V10 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BAR.NSTABLE f PAPPLICATION 4O�UILD. ING INSPECTOR FOR PERMIT TO /7 �� / 7--)O TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 1) 16 C IC. Proposed Use Zoning District Fire District " Name of Owner f?-1 IS )U 0 Address ) 6,e S%/v. Ay c� J 'fi ,� / r I o/c/ ��0A)r-Py 'WXy Name of Builder �� ��� y ��Cy S y/L, Address �49h a Address �T ����S /4 Name of Architect /Number of Rooms �l� l�4�Z I N fit' F'k f��t Foundation /V o v 6't e e > C1St�/2��1� Exterior 4r d,4 S�i^v /ill Roofing /TcJ,�r�/ ) -Sk/ v v Floors Interior Heating i sPlumbing = AlFwTGI Fireplace ~-�"� Approximate Cost _ Area Oct y 2 Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS it I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name } Q-.-Construction Supervisor's License /v,� V.+ DABINSK.Y, PHYLLIS_ A=206--090 `3 p?O�-OQD A �No 33830 Permit For Build Addition Single Family Dwelling Location 1116 Craigville Beach I-oad Centerville Owner Phyllis Dabinsky Type of Construction Frame Plot Lot Permit Granted June 27 , 19 0 Date of Inspection 19 Date Completed 19 PERMIT COMPLETED 1 IL&