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0017 EBENEZER ROAD
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Il ' r t 9 ... .F.' h •. - a, M1 - .: rtll� 11 r 1 J J ,�f 1Nro ,1} :,n :,. , ,, ' Ffi [ .. # t u Y< F Town of Barnstable �1ME � Regulatory ServTOR OF BIARNSTABLE Thomas F.Geiler,Director RARMN B` Building Divisio ' r '' �AT i639. ` Tom Perry,Building Commissioner FD N1pV A 200..Main Street, Hyannis,MA 02601 _ www.town.barnstable.m tIVISIO Office: 508-862-4038 Fax: 508-790-6230 ti PERMIT# S�-� FEE: SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less PfJ Location of shed(address) Village Property owner's name Telephone number �- - o Size of Shed Map/Pa cel# Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:052813 � , oF +ergs� Town of .Barnstable Department of Health, Safety, and Environmental Services saxxsTasra, �$ ' ��� Conservation Division '°rFn 3't s 200 Main.Street,Hyannis MA 02601 Office: 508-862-4093 Robert W.Cratewood FAX: 508-778-2412 Conservation Administrator MINOR ACTIVITY REGISTRATION Property Owner Telephone number F Mailing address Y1 10 Project location Map/Parcel# Project description The following minor activities will be reviewed,under Art. 27,by Conservation staff instead of the Conservation Commission, as long as they are constructed at least 60' from a wetland resource area or top of a coastal bank. * Pathways 4' in width * Fencing that does not create a barrier to wildlife movement, 6".above grade * Conversion of lawns to decks, sheds, or patios that are accessory to single family homes, as long as: -house existed prior to August 7, 1996 -alteration within the buffer_zone is less then.250 sq.feet. -sedimentation and erosion controls are used during construction * Stonewalls (this does not include stonewalls for retaining wall purposes, grading and/or fill) z Signature &ate Yr /ZVI3 Re ' d by Date _GIS Plan Attached(fee charged for plan) Q/WPFiles/Form,MinorAct E-8ENEZFR - RoAD 9 0 N tN ' � gTiON FOUNv Z .tom 50 N o o " o 0 Ltl 1 K�/ 4: i/ Hi)ftfRl G � i3UM,K1S Nu.FJ420 cni y / !J F 4IS�.pRtQP �j i . 0 o ,�0 ;o a CERTIFIED PLOT PLAN NEW CONSTRUCTION ONLY l Dr'A F_BENEZEIZ FORD Mogasroms MILL TOP OF FOUNDATION IS I b FEET IN BLOW LOW POINT OF ADJACENT SAgAS f AlLi4AASso ROAD. SCALE: / "_ !+D DATE:0Ay' zz"d LDREDGE ENGINEERING CO./N CLIENTGu�En,aw�r� I CERTIFY THAT THE Fnu1VDATlot`J SHOWN ON THIS PLAN IS LOCATED EGISTERED REGISTERED JOB NO. 91011 ON THE GROUND AS INDICATED AND CIVIL I LAND CONFORMS TO THE ZONING LAWS ENGINEER SURVEYOR DR.BY: SDD OF BARNS A LE MArL,4 '712 MAIN ST. CH.BY: . �- � �o, P, HYANNIS MASS. I _ __ _ � SHEET._1_OF nerF QFA_ I eNe suRVFYnQ Town of Barnstable,.. *Permit# Expires fi-mbnds from Issue date FARM .: Regulatory Services _ Fee 0-) .:e)-0 MS 1163 �� Thomas F.Geiler;Director QED NIA'�0 ,. Building Division J Tom Perry, Building Co loner rt 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 AB > 4 2005 T Fax: 508190 6230 o "N op,_-p". . EXPRESS PERIMTr APPLICATION - RESEDIE LC7©NLY_ � Not Valid without Red X-Press Imprint L[ Map/parcelNumber -7y 2 Property Address d [Residential Value of Work 1�r 00 Minimum fee of•$25.00 for work under$6000.00 Owner's Name&Address �k tc t L✓�vl E�'nZ C? C-wA+C.c yLtic_ 'yu-, o 2-63 2— Contractor's Name�� -cam 5wt, (Y� Telephone Number 5'47 •Z`�C S�.� N, -,5 . Home Improvement Contractor License#(if applicable) t 3 C116 0 Construction Supervisor's License.#(if applicable) ❑Workman's Compensation Insurance Che one: am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance _ N Insurance Company Name -ox ca,5 e8kvLA l•4G �. u' r„ Rl Workman's Comp.Policy# c? Copy of Insurance Compliance Certificate must be on file. F- m Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) 031Re-side Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must si Property Owner Letter'of Permission. Home Impro a actors License is required. Signature Q:Forms:expn*g Revisc063004 } F5� Vrop0� � Page# o 5 yk 335 ?cvct"1AV P—. Z- S709 w72 Z!-1�4r Z.O Gz� 5 0� 3Gd-s'z.v 3 Proposal Submitted To: Job Name 'Job# Address ? Job Location l F lO�c,�-�.z,zc� 2�,� - c W4 ( )M G 2 Date Date of Plans �/ �L q (JS� Phone# ZZo "'lo t(o Fax# Architect We hereby submit specifications and estimates for: We propose hereby to furnish material and labor,complete in accordance with the above specifications for the sum of: $ ® z.. lti s 5 L)evl!tif' with payments to be made as follows:-®w>; fitov �G�-� Zoo TWO [�v��� K,,cr.�-c�1� Dollars N Any alteration or deviation from above'specifications involving extra costs will be executed only upon written order,and•will bebome an extra charge over and Respectfully above the estimate.All agreements contingent upon strikes,accidents,or delays submitted beyond our control Note—this proposal may be.withdrawn by us if not accepted within days. I. RCUP'tance of Vropogal t The above prices,specifications and conditions are satisfactory and are ' Signature hereby accepted.You are authorized to do the work as specified. Payments will be made as outlined above. Date of Acceptance Signature NC3819 MADE IN USA 1 •��-� The Commonwealth of Massachusetts • 04 Department of Industrial Accidents .s 600 Washington Street /r Boston,Mass. 02111 Workers' Co m ensation Insurance Affidavit-General Businesses ti name: Z address: cityLz Vl ► t V state:' zi-p:02-6.3Z- phone#5d d` 3 t7D-� �.UJ work site location(full address): [4 am a sole proprietor and have no one Business Type: El Retail❑Restaurant/Bar/Batmg Estabhsh. ent working in any capacity. ❑Office❑Sales(including Real Estate,Autos etc.) ❑I am an em to er with em loyees(full& art time). ❑Other // %///�%%�//////%� //////// AMW /%�///%%Z% �I am an employer providing-workers' compensation for my employees working on this job, coal an name: address: city phone#! 00 instirance.co:•: I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: com'-en addresed :' city phone .".I .. \ ..P..; insurance co. = oh / // / .. comp iii Deriiee" address city phone#i ' Insurance le ":,.. : ., ".oliev# Fallure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well a,civil penalties is the form of a STOP WORK ORDER and a fine of$100.D0 a day against me. I understand that R copy of this ptatemeat may be forwarded to the Office of Investigation of the DIA for coverage verification I do hereby cert' and r the pains a penalties o perjury that the information provided above is true and correct Signature 1 Date Print name Phone# S U -3 6 U—.5-2-0.3 ra `official use only do not write in this area to be completed by city or town official city or town: permitflicense# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑selectmen's Office E []Health Department contact person: phone#; ❑Other (revised Sept 1043) f1E�' Information and Instructions Massachusetts General Laws chapter 152 section 25 requires ail 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 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 section 25 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,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. Please supply company name, 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 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. 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 b'e used as a reference number. The affidavits may be retumed to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would hike 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 BMW of wesng;adons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-774.9 phone#: (617) 727-4900 ext.406 Results Page 1 of 1 Home Improvement Contractor Look Up Enter Search terms separated by spaces. Search terms can be Town/City, Name, or License number Select Search type: C_ AND C OR arch Search Results Reg. No. 11 Applicant Street City State Zip Name Title Expiration 134160 VICTORY P3ARK CENTERVILLE MA 02632 SMITH, OWNER 10/2/2005 ROOFING AVE STEPHEN Total of 1 Records matched. Back to Home Pa&e BBRS_Privagy-Statement http://db.state.ma.usibbrs/hic.pl 3/24/2005 oFtHE, Town of Barnstable *Permit# A 0 Expires 6 months from issue date T Y Reg ulator Services Fee na �� (f . atvsTABLE. 9� MAW. ��$ Thomas F.Geiler,Director 1639. Building Division Y AlE n.Pj?jFoSS PE 141 Building Commissioner JUN 17 Tom Perry, g 200 Main Street, Hyannis,MA 02601 T 2 3 ?Op3 Office: 508-862-4038 Ow1V OF BARNS IPv Fax: 508-790-6230 TABLE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY `. l /' -7 Not Valid witliout Red X-Press Imprint ,7 Map/parcel Number [ 7 l/ 7 Property Address �G Residential Value of Work Owner's Name&Address C,1n-t-5f T-4Z- LAA 1A�Z" 17 Contractor's Name Sfi �L,2 C Telephone Number Spa'360-- S-24!511 Home Improvement Contractor License#(if applicable) 3 Construction Supervisor's License#(if applicable) f ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name /l/ �LL Workman's Comp.Policy# Permit Request(check box) , 02"ke-roof(stripping old shingles) G h S 1 Y t ❑Re-roof(not stripping. Going over . existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature Q:Forms:expmtrg -..- _ __ 02 Page# of pages I AXZ36?- 6 f - Y5X , �> Proposal Submittedfio. Job Name Job# Address Job Location Date Date of Plans 11 Phone# Fax# Architect rrftherebysubmit specifications and estimates for: z 7FW hereby to furnish material and labor—complete.in accordance with the above specifications for the sum of:. . .� -- ��?fJ`LtI�Q/t1�. .,P,(S�Z�- Y 1�%b•a(,l��.C� �Il� Dollars with payments to be made as.follows: J r SCJ G� tJQ' _ S"Q Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only upon.written order, and will become an extra charge over and above the estimate.All agreements contingent upon strikes,accidents,,or delays SUbmltted beyond-our control. Note—this proposal may withdrawn by.us if not accepted within days. acceptance of VroponY ed The above prices,specifications and conditions are satisfactory and are G&�x� hereby accepted.You are authorized to do the work as specified. Signature Paymentswill.be made as i d above. Date of Acceptance�� �G. �-3 Signature ' � ✓�Ze:-Pahvrn.�ruoea� a�,�aaoaa�ucaella Board of,BuIlding Regulations and Standards HOME IN&QVEMENT CONTRACTOR 4} 11 Regioraiatt 4160 .P N 4 �j�i►8�igtf ��F' 03 Ayp �— VICTORY POOFl - - - STEPHEN SMITH`'; ii 33 PARK AVE CENTERVILLE,MA 02632 Administrator TOWN OF BARNSTABLE' 'i�er dt No ------ Buildr i D ing:-Inspector s Cash � °"'• OCCUPANCY PERMIT :Bond '`--= "No building nor structure shalr'Ve erected, and no land-,'tibuilding or structure shall be' used for a new, different, changed, or enlarged; use without'�a Building Permit therefdr first having been obtained"from the Building Inspector.No.building shall be occupied untii w certificate of occupancy has been'issued by-the building Inspector.",. Issued to kj d " �rahbrier Corp,, Address Lott 04,0 i7 Ebenezer Ro�.d dills Wiring-Inspector Inspection.date Plumbing Ihspector _ 1 _ Irispection'date Gas Inspector f . . F�� Inspection date p } t. Engineering Department , , Inspection date'2 i ✓�• 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. -• (� 3, Fr�Is9''iCJ�CJY-. Y e f. /t} `,�:.. ....................................»................j 19».».�... - ......-------------- I ».....»..... ....... ..... ��`v - Building/Inspeetor M t CBENEZ ER go AD H 1/5. 00 i +11 3,9 N � 5� Fo�NpgT'ION tJ Z N o C) o Q _ tT1 n �+ r Lar 40 dUNWIS `"'OO Nu.0420 � yJ C cyy� �dSl'E�{QP / , 0 . Q CERTIFIED PLOT PLAN NEW CONSTRUCTION ONLY = I-°r Ao aE:"EZtv2 RoRD /Agasroms M TOP OF FOUNDATION IS I - b FEET IN BILLOW LOW POINT OF ADJACENT AA Jlll,S',tA J J ASS* ROAD. „a A SCALE: I _ �+D DATE 1 MR/ 22 $I LDREDGE ENGINEERING CO./NCJ I CERTIFY THAT THE F�u,unAT,n�, CLIENTGaE►.�awEa SHOWN ON THIS PLAN IS LOCATED- EGISTERED REGISTERED JOB NO. 91O21 ON THE GROUND AS INDICATED AND CIVIL I LAND CONFORMS TO THE ZONING LAWS ENGINEER SURVEYOR DR.BY= S22 OF BARNS A LE MA S. 712 MAIN ST. CH.BY: 5/-1 HYANNIS, MASS. OF I 1v SHEET DATE REG, LAND SURVEYOR ... Assessors-mna and lot number - �� p,c ... ..............�.......... Sewage Permit number w............................................. SEPTIC SYSTEM MUST o INSTALLED IN comPUA House nu.mber: .......L7....... ..I,f. ............. ..................:..... r E ST11DL Q 4 WITH TITLE 5 1od. /TSSQ 5so�s G OS¢ o 2639. \•� C reTOWN 'OF BAR �NVIQONIVIENTAL S t DUILDING,"�. INSPECTOR APPLICATION :FOR PERMIT TO .... ...... ....� I....... .. ... ,. :.y.. TYPE OF CONSTRUCTION ........... ®�4. .' � ....... .....:................... TO THE INSPECTOR OF' BUILDINGS: The undersign d hereby applies for a permit according to the following information: r. Location ....... �!........iCf ". :% �........ - 1. .. ProposedUse .............`... ........................ .............................................................. ... Zoning District ....... ��.,,.........................:........:.............Fire District L� ........ .... .. . . .... .. . . ..... .......................... t Name of Owner ............ . ...... .......... ........ .:��.........Address ......jo...... .. ....64.&. Name of Builder ............:.......�°`f..�................................Address ..............�.. ��„r............................................... Name of Architect .................. .!..".........r..................................Address ........... -rr................. ........................................ Number of Rooms ............... .......... ..................................:Foundation .:............. lldl!!.•`�•... ...... Exierior / .:. .......... ..114, ................Roofing ..........��.. .,►� /? ............... Floors .... .... et/ Interior ............. ...... ............. . . ............................ Heating ...... .....f..`....... ......... Plumbing .......16�!„".... ......................... i Fireplace ... � �rN. :.Approximate Cost .... .......... ............................... ....... ..... Definitive Plan Approved by Planning Board ---A)_______ ------ 19_-1__ . Areo � `..... 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 ofBarnstabl, regarding the above ' construction. ` Name .........4 ........ ............ . ... ... ............... --j T HF GREENBRIER CORP. 2314k One 1/2 Story No-%................ Permit for .................................. Single Family Dwelling X................ .......... Lot #40 17 Ebenezer Rd. ZZ Location ................ S ............................. ............................ 7 Owner ,Tha...Greenbr-iar..CQrp........... Type Of Co'n struction ...Frame.......................... I.......................................... ................................... 'Plot ............................ A Lot ................................ Permit Granted ...... 4Y......Tc.......... . ,119 81 f � Aj Date of Inspection ..... Date Completed .................... ;1 9 k1 L PERMIT REFUSED > .............. ...... ........ ................. 19 ;4 ...........�; ..... .............................................. Go /41 ................... .. ......... .......... ........................ . ............ ... . ..... ....... ..................... ...................... . ......... Approved .... ..................... ....... . . 9 AI ....................... ............................... ....................... .............. ............................................. .... J Assessor's map and lot number ... .......`. r � — '� �� y'— of To w a:�"� , Ac,. s56' THE Sewage Permit number /y ..`x �' ................................. d`` �� Z 33>BB9TAXE, i House number 9 NAB& y.T. ..................................... �p 03 ,per 79• !�` :4r.Ce� JK1i:;P'�, �<�f.`_. C..✓t JC'.<'�• �FQMPY p'� TOWN OF BARNSTABLE BUILDING INSPECTOR ,-�---� � - 1 ... .....::................: ....:, :...l APPLICATION FOR PERMIT TO ............................. ....:: .: �'" G''. � ` .. ............. TYPE OF CONSTRUCTION ........... �� .... '° ' *' ::............................. ............................................. �Z .... �r ..!................ .............19.... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the' following information: %f Location... �'?. ........ r'{v`� ..... ................................ A .?. mac f .. ProposedUse .....: .'..'' ?'<.1h....FX10).�. .................... ...................................... ...................................................... i �:�..Zoning District .......�..,. .;.......................................................Fire District ....,........... ................................... Name of Owner ..................................� � ^ �:.....`� ?'' .........Address ......f1 ..£ ,t. ...: .... Nameof Builder ....................... ............................Address ............... ............................................... Name of Architect .. " ................................Address Number of Rooms ...............fir?„ Foundation................. fir'.:.!....:....... - ......:....:.......................Roofing .................�.�... ...... /. Exterior:r4 ..,...... .� ... f `�' � ..... .........................................�.." r ,. Floors .....,....1F, -�f.!� Y.....................Interior ............ ........L?...r� 1 .......... ...............� ... ..... Heating ...........................Plumbing .......... ......... ......................... ......................�....�.... .l.�.dry........................................ Fireplace ... .,!� ° fa!i.l.. ............................Approximate Cost ..... ? r'.................................... Definitive Plan Approved by Planning Board ___ 1 f�'"`_ 19_ �/> `��; ........... Z ______ Area .Diagram of Lot and Building with Dimensions �' 9 Fee �............ :......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH r f T I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ' Name ..............,;. J � . ' ^ � , ^ ' � ' - � ~ ' ' / ' . ` ^ . ' . � � � . ' ' x ' ^ ' ' - � . ' . ' . � . THE 9REENBRIER CORP. Marstons Mills 19 PERM' IT REFUSED lg -------'--^^^^^—^'—^^'~^- --------^----^^^'----- ..