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0126 DONEGAL CIRCLE
tmot lyvvm-',�To,AS A"�Avul Now e 11—y—A. 0WASNANYMN flj�7f, itloIVN fmq ��" won x I "JIMAN warnuhlon 4y oil URN of Aw"Am"ll!j,,�,,,�,'�Smyw "T.", "Now,%?on MO jjfQ e-v WO Awq A" pay am; TOR ON Iamno-n Von,�'iq" I Raw,tlow, " QQY -my%Lot tag 44 A Cm twx Iyu NQW1 IUD ran M- av"'Quava jfq,BY I ,4i tVAN""-Yom QJ WANT imom, Qn=-a -W, -j MA""a" Nww V 7Z ......if3 Qj,A!,,Q wall;Myn?"y P"yQ"jW Q_Q 'o ____W Dy wnwqxan Known My K"em,, I0 n M,11 2 TIATIA'd R"'Aw Vol imp 00,00 QWQ�w-1QyMW "Mot, it t00 Sao oto -11 nwavin owl I -000 Hsi M54,040% I -HW-5-01="noun gy -PUY Big X"Mi, q vivo-WNFY��.,A-so W14-to Not IjQ-QqgM* WPM SUN-.wow'A Aw"m"low islaym IllIt10 vvy Usti"iiI01 hit � f Town of Barnstable -Buildin aARNsrA$Le ,Post This Card So T.hat.it is Visible from the Street-Approved Plans Must be Retained on Job and this Card Must be Kept MASS, iPosted Until Final Inspection Has Been Made. : t6S4 -Permit ro rxn{" Where a Certificate�of Occupancy is Required,such Building shall Not:be Occupied until a Final Inspection has been made Permit No. B-20-2298 Applicant Name: Armen Safaryan Approvals Date Issued: 08/25/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 02/2S/2021 Foundation:~ Location: 126 DONEGAL CIRCLE,CENTERVILLE Map/Lot: 169-094 Zoning District: RC Sheathing: Owner on Record: LISTER,.CYNTHIA FLOWERS& ROBERT G. Contractor Name: ARMEN SAFARYAN Framing: 1 Address: 126 DONEGAL CIR Contractor.License: CSSL-106102 - 2,. CENTERVILLE, MA 02632 Est. Project Cost: .$7,99S.00 Chimney: Description: Re-roofing! Permit Fee: $40.77 Insulation: Project Review Req: Fee Paid: $40.77 Date: 8/25/2020 Final: '' Plumbing/Gas Rough Plumbing: 4i o Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this.permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) - Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT S'CL'� ter T ' own of Ba - sMe- *. �pFti Permit# . ls.rpires 6 anairlls ro.m issue(late Regulatory Services Fee * I3ARVSfAB[.E, y BASS. 1619- ��� :Thomas F. G.eiler, Director Building Division -,. XBPRES Torn Perry, CBO, $u'ilding Commissioner S PERMIT 200 Main Street, Hyannis, MA 02601 SFP ' www.town.barnstable.ma,Lis OfHc e: 508-862-403 8 �� 1�OF BARW74 t6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Nol Va/Nd roil/rout Red X-Pres.v Ayrinl Map/parcel Number Property Address' r, , ❑ Residential Value of Work �- o+ �y � - Minimum fee of$35.00 for work under$6000.00 Owner's Name& Address 0;14 Ciri.�� :L'�',�s• C%- Contractor's Namew ,.t. Telephone Number '7l,/ 2� Home Improvement Coritractor License#(if applicable) �04t; 42 ' Construction Supervisor's License#(if applicable) CS /5._01q YWorkman's Compensation Iosi.trance Check one; ❑ L,am a sole.proprietor ❑ I am the Plomeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# elf "1 ' �7)L g —/c� Copy of Insurance"Compliance Certificate must accompany each p'crmit. 71 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 rood [iRe-side #of doors VReplacement,Windows/doors/sliders U Value. d�m (i»axi;mum..35) # of.yvindows *Where required; :Issuance"of this permit does not exempt compliance with other toavn,depitrtment regulations;i.e. Hisforic,Conservation,etc, ***Note:' Property Owner must sigh Property Owner Letter of Permission, ..A copy of the Home Improvement Contractors License & Construction Supervisors.License is required: SIGNATURE; Q:1W1?rILESIF0RMS1bui in permit formsTXPRESS.doc Revised.072110 ,. r c .. L , The,'C'r7r unoirwealtlt`of.Massaclttrsetts ---- Departrnernt Of,,]ditstrial Accidents Office Of�IPve'St'lb t7.2'IOTIS � � » 600 Washington Street t Bloston, ALI.02111 `�'� tG�at�rt�.mass got�,�dia Workers' Campensation Insurance Affida-vit: Bt ilders/Con:tr-zctoi s&/Ele.ctricians/Plumbe-rs App-licant Information �-- Please Print Legibly Nam6 (BusinesslOrgatlizatiau!Lndividc�al): �.l et.,w-►-e d cc—&Iiz> Address, CltyfSta'telZlp: ✓vlD J�}' 1 FI1O11Ci A; rr 1.7i employer?Check the appropriate boa: Type of project(required):' 1- I am a employer with_ _ ' 4• ❑ I am.a general contractor and I * have hired the sub-contractors 6 ❑New construction employees(fu11 amdlur part-tizue). _ 2.,El am a sole proprietor or partner-- listed on the attached sheet: . y ❑:Remodeling These sub-contractors have slop and have no emplo}^ees 8- 0.Demolition F working :for me in any capacity. empluyTps and have workers' comp-insuran'ce..1 9. 0 Building addition [No'workers' comp,insuurance p 10.❑Electrical repairs or additions required.] 5. 0 We are.a coaparation and:.its 3.❑ .1 am a.homemtmex doing all work of3�.ce.rs have exercised their I LE]Plumbing repair's or additions myself. [No ivorlmrs'coot p. right of exemption per NfGL 12.❑ oofrepa.irs insurance:requurd.]T c: 152, §1(4), and.use have no q employees. [No workers' 1 .. Other a eJ 1)6�✓ comp. insurance regtuired-] '� *Any appficaut that checks box#1`.n7ust also 511 flit the section belau,sbowing Their wwXeis'compensation policy inforiwtim T Homeowners who submit this affidavit indicating they are.doing atl'wcrk and then hire outside contractors must submit,a anew:effida�it itidicsting such- = Gwractors that check:this:box must sttached m additional sheet showing the naive of the sub-coutmctars and state wheth-er or not those entities have emplayee:s. If the mb-c.onisactors:have employEes,ihey.wust provide their workers'comp.pohq number. : I tint an emiploy er that is providing hsurance for tiny eiltployees. :Below is trite policy and jab site injormationi insurance Company Naive: G cc 1 Cvyy L'L C_ y� U /'ey J'` Policy#of Self-ins:,Lic.#:_ �.7 d . °'y.i 11)' O E:xpirationDate: . a 1 v .2 v Job Site Address: City/State/Zip: : �',-► e® y J`i l(�.: (7 ,LZ Attach a copy of the woi-kers'compeirsatioon polky'de.claration'page(sho►iing-the;policy rluuiber and espiradon date). Failure to secure coverage as required under Section ZjtL 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 M1. Investigations of the D.IA for insurance cosmrage vetcation. I do hawby 1if txnrder tPtepaitls r:lid rw1ties of p,e ury that the infortnation provided a ove is true and correct Si ore: Date: �V G Phone#: tO Lf•— 7 3 L O -r-Yal tise one y. Do not i0iko in i this area,io be completed by city or toavtt o�cial . r Cytr or Town: Pei met/License#. LssuingAutholity(circle one): 1.Board of Health 3.Building Department.3.Cit. oti�M Clerk 4, Electrical Inspector S.Plumbing Inspector t . Other Contact Person: Phone N. of THE r HARNSPABLE; Ass. 1679. Town of Barnstable 1� prf�MAC h ReguIatory.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 1 Complete and .Sign This Section If Using A Builder -- - I CV in J-4 o Gl t ,S 1r✓ as Owner of the subject property hereby authorize S to act:on my behalf, in all matters relative to work authorized by this btulding'permit application for: C. (Address of Job) Si na re of Owner Date Print Name If Property Owner is applying fo.r permit, please complete the"Homeowners License Exemption.Form on-the. reverse side. QAWPFILESW0RMSlbui1ding permit formslEXPRESS.doc Revised 072110 lHr,- ti Town of Barnstable ' Regulatory Services .l v LASS. $ Thomas F. Geiler, Director � a679. ♦�'-°r ,,,�rb Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.ba rnsta ble.ma,us Office: 548-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street // village "HOMEOWNER" 4 1' + "� G'a� til`"�'�.`. � L c` `�-er- name home phone N / work phone# CURRENT MAILNG ADDRESS: XL 04.J�a�,�.! 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- farnily 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 t�e//she will comply with said procedures and requirements. Signa e f 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.:' Licensing ofconstruction 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 oRen 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:\WPFILESIFORMS\building permit forms\EXPRESS.doe Revised 072110 ✓�ze '�n-rjrnxarrueczf�z f�iks�ivarlta ` License or registration valid for individul use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration'..,, 1.58718 10 Park Plaza-Suite 5170 Expiration.:: 2/26/2Q12 Tr# 292852 Boston MA 02116 TYPe Individual'.:,. , JAMES A. MILANO JAMES MILANO f 38 WINTER ST YARMOUTHPORT,"MA 02675 Undersecretary Not valid without signature i NI ass - i9cpar'tn,tnt �rl'�ul�li� �atl'cti $ Iiapatrtl of £34stltltn�: R '�tal.itit9n, alld St$tj'ti tt tl, ConstructiOn St ervisor License License: CS 15046 Restricted to: 00 JAMES A MILANO 38 WINTER ST _; - YARMOUTH, MA 02675 Expiration: 1115/2011 %-G-- -� -fr#: 9337 a. - ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/08/2010 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(fes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER `" CONTACT '� (— �="'-.,."'-..."•_• �,� NAME: PHONE' rAt! EASTERN INS GROUP LLC IN L ! i 233 WEST CENTRAL ST E-MAIL 1%?i �"� ADDRESS: PRODUCER NATICK,MA 017C� CUSTOMER ID - B:Y--- 2132KY INSURER(S)AFFORDING COVERAGE INSURED INSURER A: TRAVELERS INDEMNITY COMPANY INSURER B. MILANO JAMES A INSURER C: INSURER D: 38 WINTER STREET INSURER E: YARMOUTHPORT,MA 02675 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 ADDLSUBR POLICY EFF DATE POLICY EXP DATE- TYPE OF INSURANCE - POLICY NUMBER (MMQD\YYYY) (MM\DDIYYVY) - LIMITS LTR INSR WVD - - GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY_ DAMAGE TO RENTED $ CLAIMS MADE OCCUR. PREMISES(Ea occurrence) MED EXP(Any one person) _ $ , GEN'L AGGREGATE LIMIT APPLIES PER: PERSONAL&&ADV INJURY $GENERAL AGGREGATE $ POLICY PROJECT LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS 'BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY. $ ` • ' NON-OWNED AUTOS (Pei accident)PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $, WC STATUTORY LIMITS OTHER WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY YIN UB-0072N728.10 02/20/2010 02/20/2011 E.L.EACH ACCIDENT, $ 100,000 ANY PROPERITORIPARTNERIEXECUTIVE Y E.L.DISEASE-EA EMPLOYEE $ 100,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-POLICY LIMIT If yes,describe under $ 500,000 DESCRIPTION OF OPERATIONS below - DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/RESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFRCT[NG WORKERS COMP COVERAGE. THE WORKERS'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR MILANO JAMES A. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE - _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE . ATT:BUILDING DEPT WITH THE POLICY PROVISIONS. 200 MAIN ST AUTHORIZED REPRESENTATIVE HYANNIS,MA 02601 Charles J Clark ACORD 25(2009/09) 1988-2009 ACORD CORPORATION. All rights reserved. 4 (} i TOWN OF BARNST ABLE BUILDING PERMIT APPLICATION SEPTIC S"181 ,, Map �o�( Parcel Pw INSTiALLED IN C0 Lit?L Permit# WITH TITLE 5 Health Division Jt 7 ENVIRONMENTAL CG!i'm �r` Date Issued lL 6 Conservation Division /v 060 o�— TOWN REDIJLy "e ^. _ Fee Tax Collector- ! f Treasurer x Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address A \ `T � i 6-7 ) --,CJJ Village Ce -*,�e IC v Owner ,A C \_,. ke Address F� Telephone �C)— \ Permit Request O h �\OSe� , .® y. Square feet: 1 st floor: existing . proposed \�\o 2nd floor: existing proposed Total new Estimated Project Cost cs Zoning District Flood Plain Groundwater Overlay Construction Type 15 o F MCA me- Lot Size \�'��\ Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 1( Two Family ❑ Multi-Family(#units) Age of Existing Structure \14L" Historic House: ❑Yes kNo On Old King's Highway: ElYes No Basement Type: `U Full ElCrawl ❑Walkout 0 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 (7) Total Room Count(not including baths) existing new First Floor Room Count (o Heat Type and Fuel: 14 Gas ❑Oil ❑ Electric ❑`Other Central Air: ❑Yes 54 No Fireplaces: 02EExis inng New_ Existing wood/coal stove: ❑Yes �No Detached garage:❑existing )knew size' aCe, Pool:0 existing 0 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# , f Current Use QM Proposed Use �3 rl\-Q— BUILDER INFORMATION Name avA tA Telephone Number Ha�" `Sj-�(04 J�V_ � A Address � License# (25Z�S a Home Improvement Contractor# n KL A�AV ��e� S Worker's Compensation# .AA Q' —`sd`�Co ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE �-®cam t FOR OFFICIAL USE ONLY OERMIT NO. V DATE ISSUED w 4 MAP/PARCEL NO. rt ADDRESS,. . i VILLAGE OWNER y�"� - _ � • - �+ _ - �`•- •f _ . DATE QF Ir5fECTION:' a, 2: €" FOUNDAATION FRAME J Z-�� ' INSULATION f FIREPLACE_ ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ; DATE CLOSED OUT — 1 ASSOCIATION PLAN NO. 1 r ' ti K 1 O, 1 . 11 • \1.,.�11. .11111\-11 +:11 \11 IU 11 - 1/ 1 it l l . . �l . 1 • _ ,.:.. 11 1 .�}£Cy41 .11 1 , • 1 LI 1 . 11. � / � ql J roll/ 111 Il 1 1 • 1 • •. 11 . •u.,�-lw .Ion.wl .:n .n \ • ... • .. 4•.,V ....fib;+.>.^'n.;....:::i,, � .,{;b,. •':u..6•J.'.'?;;;Sr::`xµi:: x�:%; 3?r .:i%�'aw'Sr $J.i. }.: •:A, , v ..5• .l"^}}.r.'S•`:.^G;{T<?:j':�•':2�1:`�:rr �?'i.�;YS.):•i::•.;^.$i:}'.:....;,v..;:. .i . 11 v}'11 : " C}+F 1+i4•S�il{i`S{,...i'i:i `5:: .,:vn• •p<:::}i;.... •..: 4.. i Kn : : 4i{fp„ ~" ..�..., >)::•y>;Sri:duJcs::3.`;`,fit:`'^�;•';:::'?'�xio:�' i.w. \ .. ?`:..r:??<.�:"?:��i.;';vim;.,::..;. :.:::T:�.: ••:'} 1 1 jj�//jj��j�j���j��j� ////j��/�• I 1 _ • 1 Il 1 • 1�. ' ..ti COU4&"by city artown to be I r only do not write in this arm use ■___j--)Buading Department [3IAcensingBoard . OMvL city or [3HeslthDepartment e is required . • Phonst contact �pwVPCOCCI 1 wJ%dM'.\\OC`MPwS'�h'�••[a.C6�••1..�••/�Y:.t..A+(AtW'C'�.1� 7 Information and Instructions loy ers to provide workers' comp�auon fort:eir ' �sachusetts General Laws chapter 152 section 25 requues���ery person in the service of another under any coins quoted from, haw ,an employee is defined ]lo�e-s. As 4u - .. ure, express or implies oral or written' oration or other legal entity, or any two or more of employer is defined as an individual,Pam'association,g representatives of a deceased emplorez, or the re:=i�er Cr ed is a joint enterprise,and including l employees. However the oR•n..�r of a foregoing er �association or other legal entity, employing�P g house of ;Lee of an individual,�arta� P who resit��ia,or the occupant of the dwelling. not more than three aP house or on the grounds or tilling house having or repair work as such dwelling ether who employs Persons to do roaintenan not becausef be de.Med td be an employer. lding appurtenant thereto shah state or local licensing agency shall withhold the issuance or renewal M chapter.152 section 25 also states that every construct bwldings in the commomvealth for any applicant who has crate a business or to c coverage required. Additionally, neither the a license or permit to op public Rork umil t produced acceptable evidence of compliance with the � �,�forthe perfo�aace of p . of its political iasivaace �of thus chapter have been presented to the cones.-rind mmonweatthnor any � cmmble evidence of compliance with the ,Plicaats ourlion and eosatiOn.affidavit.=Opletely,by checlang the boxthatapp affidavits may be -ease fill in the aroma numbers acng,with act of msuraace as all names,address dad finsoranceAlso be sure to sign and PPlymg ' o f Industrial for th„penult or license is :omitted to the Department or tea that the application for the • The should be returned to the regarding the 'Uw"or if you ae the afndav� artaie�of Industrial Accidents• Should�bave�9 4�m ;mg not the Dep Deport at the member listed below. . a workers' �mpeosatumpobcy�P� , required to obtain " �, 'ity or Towns :. - _ . 1 D-partzaeat has provided a spat"at the b ottom of the davit is complete and printed 11Y has to contact you regarding the applicant. please_ rase be sure that the the Ofli�of Iuvestz8at� • e to ndavit for you to fiIl out is the event unmber. The affidavits may o reumzed sure to fillinthe pce nuaiberwbichwdlbe usid have�bemmade• Department by man or FAX unless athar eratian dad should you have any questions. would lie to thank you in advance for you coop Office of Investigation _ :ease do not hesitate to ginus a ca3L 0/10 FAWN telephone and foxmmnber: �e Department's address, of Mwsachusetts The Commonwealth trz dents Department of Me of imrestigatians 600 Washington Street - r Boston,Ma. 02111 " fax#: (617) 727-7749 phone#: (617).7274900, ezL 406, 409 or 375 THE. The Town of Barnstable anar,srAOM - 9�A Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissione- 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:G Estimated Cos O eo© Address of Work: 'i e A' Owner's Name: Date of Application: 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 IMPROVEMENTG ��DER HAVE ACCESS 142A. ACCESS TO THE ARBITRATION PROGRAM SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: CN,- 200 0 44 4 s Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE (high end construction) square feet X$115Isq. foot= (above average construction) square feet X$96/sq. foot= \ � � _ - (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) C, square feet X$25Isq. 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 t IAHFORM 1/3/00 BOARD OF BUILDING REGULATIONS . License: CONSTRUCTION SUPERVISOR Nurni�er.:.CS 035037 Expires:,01/192002 Tr.no: 15179 A - Restiicted To: OQ DEAN F STANLEY 359 CAPTAIN LIJAH RD. —, 1 CENTERVILLE, MA 02632 Administrator HOME IMPROVEMENT CONTRACTOR . S Registratio '108672 v �,- T � yPe�BA ` Expiration 08/21/00 q 4 DEAN-F STANLEY HOME IMPROVEM M ° # Dean F Stanley Cept l jah Rd" ADMINISTRATOR =' k ,Centerville 'MA 02632 I L-O i 37,`09 1 �7 �- �- Jc� 9�1 00 .� 1 sla��r' t Ir.loo v I �� ; _._ gam. �-� ..___,�___._• : �jE61AL. Cf (�CeL.F- , LI -5-r-r-R GY�•1T � I,4' t ��I✓�zT- MORTGAGE INSPEC71ON PLAN BUYER: .�.r.� a, LMAW IN ' AM I1�.11TLE 1N . MASSACHUSETTS O� 'THAT F9A11E IA_ 7HC PRRI:SWY . L 111E BUILDINGS >�4iL-# 0a� T� I NkOd1iEN _o REAR YARD.SM NAYAW AREA. Y11SY '� PROpEim IS �r Lt3CAPE� �1 11�IE�E$1ABUs1i� ADD DEED, COMMUNITY PANEL NO.:Zeoe>o 1 0013G DATE: t5- IcY--fig" MAM19PiA1101 OF IM It MIAK MY WMWWT TO THE REODRDED DATE OF THE . S2 I.AMT DEW AND D= NOT IN03M VERII Mgr THE ACCURACY Of 719E DEED W=IPTION PACE PRE OUS TO ITi DATE OF RECORD. CERT. NO. IRS OOM MANY IR NOT REPO OLE I"OR ANY INDENYURES MADE SUBSEQUENT TO 1199E RECORD® DATE Of.THE LATEST DEED OF REODRDED. 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G_..cL_ / 0.,: neovever: wh.n �_ l.4%, THE y T TOWN OF BARNSTABLE SS BLE, � Q i BARNSTA i "b 9 M Y BUILDING ' INSPECTOR AY h APPLICATION FOR PERMIT TO ............................................SINGLE FAMLIY...DWELLING...`.....................TYPE OF CONSTRUCTION .....................ERAXE.................................................................................................... ......AP RI L..25.....................19.72.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: /°26 CENTERVILLE MASS Location ........Z�T..67......DOIVTEGAL CIRCLE .................................................................................................. ......................................... Proposed Use .................DWELLI. . . NG ....... . .. ............................................................................................................................................... .. Zoning District ..................RQ..................................................Fire District ... ............... Name of Owner .....JAMES...K'...SMITH.............................Address .3..A3N.2.TABX4 ...MA5.S....................................... Name of Builder JAMES K.....SMITH SAME .................... .......................................Address .................................................................................... Name of Architect JAMES K ST ................MI.......H........................Address ...............:...SAME................................................................_ Number of Rooms ..............5..................................................Foundation ...PDURED...!✓.QAICRET'E.,...F.TJLL.................... Exterior ..W.SIT.Ea...UDAR...SUN.GIE.5.............................Roofing .........Aj9.IIILT...8J1IXGZ,ES.................................. Floors ... HARDwOQD & RUG i"�SHEETROCK ...................................................................Interior .........2...:..................................................................... Heating ......EA.$...HQ.T...AIR...............................................Plumbing .......CO.P.rFR........B.ATR AX)...HALF.................. Fireplace ........qAe..................................................................Approximate Cost ... ......................... "3 Difinitive Plan Approved by Planning Board ---------------____-----------19--------. �e Diagram of Lot and Building with Dimensions a s % I (D I a `C � w �- Ll oo ® z > LIJ R W > d � O LL Illy) � 0 ® aw in Lt! S-I h-.l-- UJ co (n f� W Q © ' < 0 w � wr J � W}- in ( Q4� C� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. �.'r...+�-. . ............................................................................. Bodtb° Jazuao K. _ ` \ , �raa 'otar� / No ..�.�.�.�.�-- Pernnh �ur ----..�..�'�.�---- ' single family ���'�^_��''�'''^�����''������.��...''.....'...'......_ � ----' ��z�I�— --'---'--'----^^-'—'-----' ' ' Centerville ' ^ ........................ —^^^—^—` ........................ '' f Owner .......Jazmao..K�_Sorith_._._______ ` < Type of Construction ..............frame / ` —..,--..---.—.-----.---,—,------ � � ��� . Plot ---------. Lot --..��....------ . _ April 26 / Permit Granted --.����..��-----]ADate of Inspection '� ^�~^�' | ~�| � Dote Completed lq PERMIT REFUSED ' - - � .---.—_—,.--.—.---------. 19 —.--.---..---.--------.~------- ---'--'---------'—'--'---~----- ' ^m���� ` ~- ' —..—.----.-------.--.—.--.—.----.. .-------,...............--.----....~. -� � - Approved ................................................... lA � . . ^ ---------------'-----~—~—'—'- � . , ----'---`---^---'—``—~—^^^~—'—^` � . � � ` _�