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0068 FERNBROOK LANE
S y u. r , a - o i } 11 �. c <. L TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION A Tflyaaa Q� 7 / �//7 l t1� »,t7 laJC A;�T F�^ a �/�`L./\�� Map Parcel yt.� Application # Health Division '{ Date Issued >` b Conservation Division Application Fe -�. Planning Dept. Permit Fee D li y� Date Definitive Plan Approved by Planning Board �)D//SI/L f*— Historic - OKH _ Preservation / Hyannis Project Street Address �o PfC Q}l 2WV Village �L�L�'eQ�✓t(� Owner—b .. AAv c.e Address Telephone Permit Request 'RewI rive- E 4snw De r k �OARMS QV& 4411 WG s �i�)AGQ G ilk/ Pew Pr I ec e RA-c l�� �� faw. Q&X Ulm i Ext sl-,N c 1-4 x217ecK� spa[I 1ue ck 3aAU 0 cQ 2A41 /,4 mowc Cn�rlxr Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation .690 40 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ 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 Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ 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# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name e Telephone Number c►�3� Address License # CS 5713 4- �II�QS�OI-� iMl d S My- 00-L&$ 8 Home Improvement Contractor# 16X53 Worker's Compensation # V%X 00Q:2 Z74 ALL CONSTRUCTION"DEBRIS >SUL41TIFROM THIS PROJECT WILL BE TAKEN TO �' �oGI� � SIGNATURE DATE FOR OFFICIAL USE ONLY �t F APPLICATION# k , DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER ti DATE OF INSPECTION: r FOUNDATION FRAME J INSULATION FIREPLACE 'z ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL f GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth_of Massachusetts Department oflndustrialAccidents Office of Investigations ' 600 Washington Street Boston, A M 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print L66bly NaIae(Business/Organization/IndMduO): �,L' (�. ,►II ,S j"e ' Address: . 1�10 City/State/Zip: OL114"Phone#: -Sb 6 --IdG-1 S 3 A�Iam employer?Check the appropriate box: Type of project(required); 1. employer with 4. ❑ I am a general contractor and I employees(full.and/or part-time),* have hired the sub-contractors 6. ❑Ne construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. emrodeling shipand have no em to ees These sub-contractors have P Y � 8, ❑Demolition working for me in any capacity, employees and have workers' coin insurance.$. 9. ❑Building addition [No workers' comp.insurance P• 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 l L❑Plumbing.repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t. c, 152, §1(4), and we have no . employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. . I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information Insurance Company Name: 6,yu 5 Policy#or Self ins.Lic.#: Expiration Date:�a 1� Job Site Address: (fir r�Q���� �q� City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one- e ent, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250,00 a day the violator. Be advise that a copy of this statement may be forwarded to the Office of Investigations of IA for insurance coverage ve • ation I do hereby c tify under the pains and penalti of perju ed above is true.and correct Si afore: Date:: /Z� . . Phone# [6. ficial use only. Do not write in this area, to be completed by city or town pfficiaL y or Town: " Permit/License uing Authority(circle one): oard of Health. 2.Building Department.3. City/Town Clerk 4.Electrical Inspector. 5.Plumbing Inspectortherntact Person: Phone#: f .4co CERTIFICATE OF LIABILITY INSURANCE D /2//DD/YYYYi `� 10/2/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must 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 NAME CT Kathy Silvia The Fair Insurance Agency Inc. PHONE (508)975 3131 FAX e.(508)790-1677 619 Main Street E-MAIL kath @thefaira en ADD ES y g cyCOm P.O. BOX 430 INSURERS AFFORDING COVERAGE NAIC 0 Centerville MA 02632 INSURERAMain Street America 29939 INSURED INSURER B:SaVerS Property & Cas..-ARWC 31771 GCI BUILDERS INSURER C: _ PO BOX 509 INSURER D: INSURER E: MARSTONS MILLS MA 02648-0509 INSURERF: COVERAGES CERTIFICATE NUMBER-CL1210200338 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. ILTR TYPE OF INSURANCE POLICY NUMBER ADDLSUBR MM/DDYYEYYY MM/LDDNP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAX COMMERCIAL GENERAL LIABILITY -PREMISES RENTED -PREMISES Ea occurrence) $ 500,000 A I CLAIMS4MDE FX]OCCUR MP143707 /28/2012 /28/2013 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY JFrTPRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acc dent ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS U AB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION I WC STATIU JOTH- AND EMPLOYERS*LIABILITY Y/N FR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? "NIA �0002374 /29/2012 /28/2013(Mandatory in NH) EL.DISEASE-EA EMPLOYE9$ 100,000 If yes,descnbe under -'--- DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER _ CANCELLATION gcibuilders@ comcast.net SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Diane Bellavance ACCORDANCE WITH THE POLICY PROVISIONS. 68 Fernbrook Lane Centerville, MA 02632 AUTHORIZED REPRESENTATIVE Jackie Stewart/FAIMCl � ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025l9t1tr1(151 m Tho ar nPn n2n%a and Innn aro ronicfarod madre of Arnpn .. �/�zdaac �u�eGty e o nzoruuea�th a� e ulatton I _ 4 sa � g'p �, AIatisachusetts= Depurtmentof Puhlre; ttet , Business R g ' CTOR Office of Consumer AfiairCONT� I :,guard°of Buildirig Re!frulations and *a rd" ME IMPROVEMENT 'Type* 9', _ r Gonstrtiction Supervisor License" ? Private Corporatwl F I lVegistration: �52253 .One=and Two-Family Dwellings piration y License CS 57934 { I GCI BUILDERS►NC{ 1 PAULJ MAZZ.OLA PO BOX 509f PAUL MAZZOLA 644 RIVER ROAD K g 1 MARSTONS MI LLS MA.02648 j MA 026148`" Undersecretary 9 MARSTONS MILLS, 1. I ; Expiration 6/t2013 ommnavione`�' Tr# 1813fs~ S r_ r �mE rti Town of Barnstable f °�' Regulatory Services inxxsx�srs, y Mnss $ Thomas F. Geiler,Director �A 1 59 �e A rFn wv.� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 5 08-862-403 8 Fax: 508-799-623 0 Property Ownei Must Complete and Sign This Section If Using A ]Builder , as.Owner of the subject property . hereby authorize �� C" ' � to act on mp behalf, in aIl matters relative to work authorized by this building permit (Address of Job) Pool fences and alarms are the responsibility of the applicant., Pools are not to be filled.or utilized before fence is ' all final inspections are performed and accepte - Signature of Owner Signature of Applicant Print Name Print Name v Dat Q:FORMS:OWNERPERMISSIONPOOLS 62012 i �t r Town of Barnstable " Regulatory Services U. ( : BAMSTAUM : Thomas T.Geiler,Director i Mass. 9� 1639• p Building Division ATFD�� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-40318 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. -- DEFUIUTION 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 procedures 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 form/certification for use in your community. Q:forms:homeexempt . cv , _sT Patrick Sounigo and Diane Beellavance 68 Fernbrook Lane Centerville,MA.02632 December 22,2011 MAIN DECK CONTRACT Description: Demo: -Remove all existing composite 5/4"decking -Clean all existing support joist of nails and fasteners -Remove all existing composite rails and post sleeves -Remove all stair treads and risers -Remove deck skirt board trim board -Remove and store hot tub in garage. -Remove all debris from site Rebuild: -Inspect and repair any flashing against house before construction is started -Install 5/4"I.P.E Brazilian decking with hidden fasteners(NO NAILS WILL BEEN SEEN) -Re-trim deck skirt hard with plastic trim -Install new stair stringers where needed -Install new black plastic post and rail system -Build and install(1)heavy duty gate at top of lower stairs -Frame and deck area where hot tub was -Build new set of stairs as discussed and deck open area " Total Demo labor&Rubbish removal $ 6,284.00 Total Stock and Lahr for I.P.E Decking $19,396.01 Total Stock and Labor for Railing work $17,135.64 TOTAL $42,815.65 DEMO DISCOUNT <$ 500.00> TOTAL CONTRACT $42,815.65 PAYMENT SCHEDULE&ESTIMATED TIME FRAME: - Deposit to start $ 5,500.00 12/23/2011 - Demo completed site clean 15,000.00 01/09/2011 - Decking installed $14,000.00 01/20/2012 - Railings installed S 5,000.00 02/03/2012 - Final upon completion $ 2,815.64 02/17/2012 TOTAL $42,315.64 Paul Mazzola President 4ftellavance G.C.I Builders INC. 1 Assessor's Office(1st floor) Map, of Lot �. 5 •G��S Pe it# �-Conservation Office(4th floor) --- ""`�— '� S�u�y �) Date Issued 4?s- Board of Health(3rd floor)(8:30-9:30/1:00-2:00) t� � �f��Fee .06 Engineering Dept.(3rd floor) House#1 6? LO a pt. or 1 A Bl _ P BAR STABLE. Definitive Plan Approved by Planning Board 19 `®�' g e TOWN OYBARNSTABLE"'.'- :,_1 �} % Building P ermi t Application Project Street Address Village � ��.)<<�,9� r. Owner am% �A Address } Telephone Permit Request 9k Q U Alb �`��ism i it1 1�0� /F Y-- 3 6 Total 1 Story Area(include 1 story.garages-&decks) square feet Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ l .C',CC) Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded r Current Use Proposed Use Construction Type 1 (9.Oy a , Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone Number �Ga AQO S?- Address License# 64 2 8 at ct s o►�5 11�c_� .'< Muo, l Home Improvement Contractor# D�kG 4&- Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS' PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO IGNATURE DATE -7 (� BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. #82.87 DATE ISSUED July 6,. 1995 208.085.015` MAP/•PARCEL NO. ADDRESS 68 Fernbrook Lane VILLAGE Centerville,`MA 0262 OWNER David J. &1:Patxicia Kelly` DATE OF INSPECTION: ='1 FOUNDATION i FRAME ; INSULATION FIREPLACE -ELECTRICAL: ROUGH FINAL i PLUMBING: ROUGH FINAL GAS: ' t ROUGH FINAL + J FINAL BUILDING t • 2,0 , cry ; DATE CLOSED OUT kb ASSOCIATION PLAN NO. 11%02'94 17:02 V6177277122 DEPT IA'D ACCID -y CoijunoiuveQt�t/L Ol Ma6jacha6e& ' ..UaParfinenl o�,S�,�afria��ccict(aft 600 9/UwLyfon sfx�rt James J.Campbell &&n,- ft aaadad sib 02 f f 1 Commissioner Workers' Compensation Insurance Affidavit 1. ✓ � 4 � lncl�� �G k� � (aoen�pamimee) with a principal place of business at: 7 ALL top -C �ccrise�sjo� do hereby certify under the pains and penalties of perjury, that: I am an employer providing workers' compensation coverage for my employees Working 01 this job. / Cie, lnsumnce Company Policy Number O I am a sole proprietor and have no one working for me in any capacity. I am a sole proprietor, neral contractor r homeowner (cirde one) and have hired the contractors listed below who a Tre following workers' compensation policies: Contractor insurance Company/Polity Number Contractor Insurance Company/Policy Number Contractor insurance Company/Policy Number O I am a homeowner performing ail the work myself. I Ut+cerstand t`st 2 cot;y of tabs smternent will be forv:arded to the Office of lnvestil;;donS of the DIA for coverage verification and that failure to sec cvverage s ree':ired under Section 25A of MGL 152 wn lead to the Imposition of criminal penalties wttsisdnz of a fine of up cos 1,500.00 andlc years' imprieart ent is well as civil penalties in the four:of a STOP WORK ORDER:nd a fine of S 100.00 a day against me- Signed this day of T Licensee/Permittee Building Department Licensing Board Selectmen Office Health Department T() vl^niFY CovERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 �I tomytk 84'-Or f• 40'•0* Mow. y•'� t 1 •.6 - rTfp1 'O fits % /• -. ,l j. , {�� 'p Z J - LLJ �.D_�•2 Fo.mad 14 Gsy..}td fde.ni..d �. D." - Fo.r...d 14 G.0 .tf•.J Iv..,1t.d •��•d• ' '" CURVFD WALL PANEL DETAIL PLAN STRAIGHT WALL NANAL DETAIL I - - -f H..Y 16{ r- -Sfd ihr•ed.d ,F—S/d- flv.eMd � _ - - \ <... .•r � ) adj...f....n. - edj..•t.w•..f d.44:1 . po.a.fYw) d• .I i L 1# P1.14 { Pool p.orJt •.oL. - "� 9• i7 \ io - �I ELEVATION I — I + 1+ r . - [ `F;� _ ..�7,�I c •�1. 1.- -.r, r,T �'-} -d rpl pr l-' - ;I't'}".1.; SAMPLE —STRAIGHT WALL POOL BRACE r! BRACE RAC Nf)N-A J11S ABI-E U A ADJUSTAtt PLUS L.•. h 2f'o• f. 40-0' 5'.4 AITC.RN41C I " ALTERNATE 2 AN FIOR w PIN rr� ALTERNATE 3 113- u,•Ib S bo 4' i ,o _ - - Sp•r:o1 Y C•.....r A.51.fhn.11 - f-'- c�•, �rl•n I 'er 5;5 114 45•An94 D.... • .«hndt / 111 CORN[R DETAIL CORNFH DETAIL BUTT' SPLICE DETAIL `• I J ALTE RNME .I ALTCRNATE #2 AT CURVED WALL r 8 - F...e.... ,..,.. P L A N N O T E S - --— �.�. 'a..be... DNNIf I. a., a.ef,• .n..0 .- nor nl .b..r....d c..r,•nf 2A00 F.. ...r n. of za d.y. - • .. G•e•..•d n�1 n-n.1 .,•r ti••TTO .r P. .f r.1..�.u....d IIfh1 •. nlfnll.d ond. F,;-id. 9- •.d faulty -_— y J. Tk- A.e,.•.,.� p..pn.e.1 �...-• ...f..•....f�en :a•tpl••d by peel n..n..reel u.•. - A E....... •1.-d and lhoh.aeavoflan to r.yuiftd d•pih 1-1 & De no/ d•o•.. poel w•1h,.uf <o...ulho9 eonl.oele., II I. .n,p>1..4 1k.1 1Mw 1. n• r.•1.• p.nur. b.hi�d w.114 rael p•efib vor..� G. L..., 11..f berkfdl .f ►i e.u.had a/.•.• e. —1 it -.11 --pa.t.d .54-1 bark of F-11 6.4.1. p..I Of CONp .. r:ll.d. Pnnrl. •.ly o� po.... p.tsu.. .. b.<bf111 f•.•ud acf:w p.y.u.• .f r..h. ELEVATION 3 -3 r 1•'A C;`�C� TM.� Z D. na, pl.<. h.e,.f I..d -:Hain 10 f.., .f ,..I .d,.. a A Pool (S m� SAMPLE -CURVED WALL POOL :M1If1f.�,/� / .•� 4 _ _-_----- --- - ------ _y� =- ""`�� t`r 8 DEXTER ROAD • EAST PROVIDENCE,RI 02914 • 401-434-6966 y f Der �'� 0 � � 8 £�p p ry r N ` 410 LA--to l� REQh ot21�D S�TBAGIC. �d �,�� • • . • Yoe 2 , --- CE.2 T/�/EO h,4D7" OLA A/ 'fNAT tN� au���-roiJ ,cacaTioy Ct' "E21!/t1.t 6rrr=7 F SC4 L E- ._ /a -29-B�- I a 91-t-, IS Nor AU-A v .eE�-E.eEwcE loT,. I� n .-L: c•c. 14972 UP T;; 10"2� -� 4WAQ e4 �Qc ac '•- BAxTEO26 TiS//,�° �iCAic/%S .t/OT B.4SEl� tO V AAA L,4A-,o04:> SV�Y6y®C�s �i✓.��',�ti�/. rSueYEY �yE I cksr�2YicL E P IA.$s. �� 1r f= .JeA,4� RzI la iJ DA40Y t av �•�''=r '��.'"s.�=•-`r•' � •�" -COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY, OF ONE ASHBORTON PLACE BOSTON,MA 02108 MASSACHUSETTS-. s > z CAUTION EXPIRATION DATE C O Iy S T R S I!P�E R V I S R V FOR PROTECTION AGAINSY it K/2 2/199 6 EFFECTIVE:DATE* 'LIC-NO. THEFT, PUT RIGHT THUMR RESTRICTIONS I�Z $j'1 4�'-4 42$ $ FM" IN Arr r IA NONE { o � ON LI NSE.. 19641 . WAR.REN . FASCHERER _ °. 224 IpARI :;iE!i CIRCLE BLASTING RAT I m COT, ��: 023�5 . ,.PHOTO(BLASTING OPR ONLY) FEE' O n L%0 NOT VALID UNTIL SIGNED,BY LICENSEE AND OFFICIALLY - r t(lf! HEIGHT: STAMPED-OW-SIGNATURE OF THE COMMISSIONER ± D.�.�. �i tea. J.o4v�.4!14 tki A SIGN NAME IN FULL ABOVE SIGNATURE LINE THIS DOCUMENT M4S1'BE - SIGNATURE OF LICENSEE - �,� ( 1+h '� ti,� r•. CARRIEDONTHEPERS0111OF 'off'-, r + THE HOLDER WHEN:EN- 4. w ONER - ; - OTHERS•R RINT GAGED INTHISOCCUPA1k1NIN . .. M. _ .. - iy,- ,. df� � The TQ'W"n ®f Barnstable i�►raHsr� • peg Department of Health Safety and Environmental Services 6' 16-39- Building Division 367 Main Street,Hyannis MA 02601 Office: 508 790-6227 Ralph Crossen Fax: 508=175-3344 Building Commission For office use only Permit no. Date AFFIDAVIT SOME 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 Type of Work: S(L)i 19 iM 16 Co Q�. Est Cost C3 (D Address of Work: (9. j e f rL� C'(1. i2;t X Owner.Name: i 1 1dat � Date of Permit Application: -i L I I hereby certify that: Registration is not required for the follcming reason(s): Work excluded by law Job under SLOW Building not owner-occupied Owner palling own permit Notice is hereby given that: ' OWNERS PULLING THEIR OWN PERMIT OR DEALING Wrm UNREGISTERED HAVE ACCESS TO THE CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL a 142A SIGNED UNDER PENALTIES OF PERJURY I hcrcby apply for a permit as the agent of the owner6 Date Contractor name Registration No. . OR ate Owner's name t TOWN OF BARNSTABLE Permit No. B,vn.n Building Inspector 1 • Cash -- -- 77 ■61 Q °art OCCUPANCY PERMIT Bond Issued to Address ,r, 1113, e --rnb--,y* r n^. Celt,---4 ,,.- Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 19......_.... ......................................................................................... Building Inspector _ FROM - TOWN OF BARNSTABLE t .-_ ��: ate• -..'��..c ' > BUILDING DEPARTMENT Mr. Francis Ta.hteine ---•---z �fi7 MAIN STREET HYANNIS, MA 02M" . � !'�C Town Clerk., . �.�. yy�� e 77.5-1 /2+{ .. sy.NM.ylM•iN..M+1W M"P#�-x dP'Wxf.i"N.T- I�I].iti@' l f'�/ "•��+'�/ ` SUBJECT: FOLD HERE ` DATE - -March -18;•• 1985 r t�� ����;�� E'S S A G E Work has _cc r feted r Fe tit w 27283 �Ba side Building CO.�•_�, _s Please se release Bond, - w9,sw!'r°mr.,.xrw+is..;...nvP•..,.e.:..Fya:+p,r v Mt6�arw�+W'4n aeb��.:$?rr sy ea - - SIG ED �-} '•.�' +". P t _DATE - ' REPLY r (j . - � •� SIGNED N87_RM1 _ _- - RECIPIENT: RETAIN WHITE COPY,RETURN PINKCOPY Y • PRINTED iN U.S.A. SENDER: SNAP OUT"YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. JL i i0&0 r-- I� r I 14 � - 0 LATI0 t� QWUIt2,t5D SETBACK 10 AN tot&2 6 T'v AT tw l� F� .� 5 t„o 4-AT G+�ov � /�5 �,�9 Tom'«�/�1 -� ,/r � v�d• :-- BA XTE Epg T.�//. -.�•��.� .voT �:aSEt� o,<l AI MASS e✓t5 K 15 7 A1 . l Assessors•mao and lot number.. ... �`�'?....° .... SewagePermit number ..`... ' s!NI� ALLY , ``a ..............:..... .. s M / � � ' Z =BAHBSTADLE, • (J/ House number F .. ...... ..�'(............................. r s � l�;o� 90 s-Mb l 39'�0� - `' Y, QNPx TOWN OF BARNSTABLE BUILDING INSPECTOR ". r APPLICATION FOR PERMIT TO .�:G?�!���(�..SJ.C.�...�.1.1`ll�:�.'�'....:�.1.-4'.M,,t�..l.. ....�.: .' .. .......1:... ..... ......... !.. 4 12.�' ... .. ... ... ., .TYPE OF CONSTRUCTION ..:....:.��..�..�1.....�....,.I- .. .... ...: ..... ..... ...... .............. . . ....... .... . T } <<. .........1. .............19. .�� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for d permit according to the following information: { , Location ...... ^(�+.. ... ........ ! .�t�i ..�-... ! .,.. .......... : ............................................ ProposedUse ...... .X'�.z.d. � !✓ C..` ........... ................................................. .........................:.....,....:.................... Zoning District ....:.....11. •. ...........Fire District 5, ✓:f, ...... .............................. Name of Owner ...1.?. y.l. ,. ... .i�k�.t�✓1.4. Address ..............�. ....................... ......... Name.of Builder' ........ ...`.: ......................................Address ................. A, .................................. K..:.h..... .tCJ. d'?r ..........Address .............! .!' � o- C.... Name of Architect .......... ................................... Number of Rooms ................./........... ....................................Foundation ................. ...... .. Exterior ...... d hA. . .� . . ..... ........ Roofng ....... . Floors .....6J ...:: E.1L?."! ..{ .� .......!/V � ...Interior ...... ..f..� .../..(��. � .4�.`✓�............. - ll! .........Plumbing I%: `i�. ........ :.. .......... 1 Fireplace ....1 Z, ...4:•k. ...._1� 1-7<.6j.C...K...................Approximate. Cost ........�. .?. v.�'.,v.................. ...... i' f Definitive Plan Approved by Planning.Board ________________________________19________. Area .................:............... .,:..... Diagram of .Lot and Building with Dimensions Fee SUBJECT TO APPROVAL. OF BOARD OF HEALTH �J� � �Q �-"�-day ,�,�'S2 • OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above. construction. Name ...... ..... !'.... ............ Construction Supervisor's License .... ? �!� 11/s. BAy S/� DE BUILDING CO. 1 No z7283 _ Permit.for YY 4t �................ 1 z Sto................... �. Single Fami1Y..P..�Q'I'?,ug..:................... Location .. t..�$,...... .8 .. .... Y�.�1�.�.:Pr.1'ry�.�.�e............. t..................... 77 \44 } r ..r "A.'..•." •,� 1 •� .w} - Owner .B�}y ?�54 $ld �.Gl].T1 ..GA.. .. ........ Type .of� Construction Frame........... ............. .. .........: ' .... . .............. ► r Yi iil 1 f�f.•�!' ` '1 r �' ( �` ..✓ r e..+s. ^^�'� •` ` F � ,f i.^•/'. �(„y -� � .�t�. r� � _ � if � Plot ............................ Lot �. ;,� ,•S t { Permit Granted ......Noveml?e'r 30� .. .19 84 Date of Inspection '.................... "�`.....19 - r #Date Complete . .. 9� �` r its - '1 .r~ ., fit✓ ,G r— - . IQ f _----r___-� 2 � . _ a � � F 2 Assessor's map and lot number:. ... il FIRE Ls/ T . .� o�y Sewage Permit number .................................:........:..I.......... } Z MARNSTADLE. i Huse number .............................. ro rasa p i639 Ar TOWN ' 'OF BARNSTABLE l BUILDING INSPECTOR 7 APPLICATION FOR PERMIT TO'.(./1 E.t1..��r ... .!.A.1.�.`f'... /.0 i,c:.! ....�S itt.. .!.!^a...................:.. TYPE OF CONSTRUCTION ......... ..!.!`a. ...:. ....... -.— ........................V..................................................... 1 ........� ..1'......... . ............I9.R...t� J TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... .( .. ......... :. !�!1.. ' 'F��!?.�`�r... .� . � ..............C`.°^^ ....... ProposedUse ......kR).. .............................................................................................................................. Zoning District ..........4�,,.....`...................................................Fire District ....(.e.—A.•.4..........v. ................................. l �+ Name of Owner ....... .1'.r�:f'......A .....)A.. ..Address .................. Name of Builder ........� ............................................ Address ................ %<.r....- .......... ......................................... Name of Architect .......... wF�e r? . . ..........Address ...� �..K ................�............. ........... .G .. ..... ....................................... Number of Rooms .............. ....................................:..........Foundation ...... �t v?-P,............ .. :, Exierior O Roofing Floors .....6,6-;........al.!V.. .......... �...L. ...............f1 + ....Interior .....?.!..' ....!..0 ..�..F?5c1 in Heating �.� . Y.`' �!�. ... ....Plumbirig �r3-f. .. f?.1 ... ......:.......: �. .............. � . ...... Fireplace ... ......;�..... .�....d.l,..j ...................Approximate Cost-.--.. ...�2... ...... � �.................. - Definitive Plan Approved by Planning Board ________________________________19________. Area .................................j........ Diagram of Lot and Building with Dimensions A.. . g 9 `+ Fee• ...........:...... .............. ..... SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam ........ Construction Supervisor's License ..,.ti...(.:......................... BAYSIDE BUILDING CO. A=208-85-15 's:: 27283 , ., No ..........:...... Permit for ...J.a..S.�Qx�......... ...... ..........Single Fam �,y..pW�11zn ......... <` Location .IPjL.1a r.....68.. d................ ................ Owner .....�?Yaide..Bui.lding..CQ ................ `x . , 4 a: Type of Construction ...Exam....... ............... L ............................ ... ....... .... } Plot ... ................ Lot .................................. " Permit Granted . `NOVenber 3Q.........19 84 Date of Inspection 19 Date Completed .........19 wv A '. #tom a- r Town of Barnstable Regulatory Services oF1HE Thomas F.Geiler,Director Building Division" sARNSTABM « Tom Perry,Building Commissioner 9 MAS S. A 200 Main Street,Hyannis,MA 02601 Arf�MA'S Office: 508-862-4038 Fax: 508-790-6230 January 21, 2009 Kenneth Perry 19 Guildford Rd. Centerville, MA 02632 RE: 68 Fernbrook Lane, Centerville, Map: 208 Parcel: 085-015 Dear Mr. Perry: This letter is to notify you that a final inspection was conducted at the above referenced address for permits (79909,83266) and the following deficiencies were found: 1) Guardrails in accordance with 780 CMR 3603.14.2 were not installed as required. 2) No record of final electric inspection. You must correct the above deficiencies and arrange for a reinspection by February 18, 2009 or be subject to further action by this office. Thank you for your immediate attention in this matter. I may be reached at (508) 862-4034 with any questions. Respectfully, ��f re L Lauzon Local Inspector Qzoning5 i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel S Permit# 9� 9 Health Division 84 4-q `Q 1/f Q /�14 Date Issued /D�It510 Y`1•�.A L`E W61/04 Conservation Division � (( Application Fee Tax Collector j i `, I L j Permit FeeEpp 7� . Treasurer SPr,TAr1 Ml i R BE Planning Dept. — -i c i ��--- INS a AU.= _ rF Date Definitive Plan Approved by Planning Board ENVIRONMEN`f'JaL CGOE AND TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address bf) F� CAKb Village Cup� J 1 LLE Owner PP40 UL I—ELLX Address =Fy� Telephone (966) --7 !0 - �01)7 Permit Request f 60JUD A IUD, X A(o ADO [ I - 'f— MAS-j e AOD " UJ CL StT Wffl+ LALAJPKY enb Square feet: 1st floor: existing 1 proposed 2nd floor: existing proposed 1 ( Total new ILA Zoning District Flood Plain Groundwater Overlay Project Valuatio 1 Construction Type RAMC) Lot Size Grandfathered: ❑Yes >(�o If yes, attach supporting documentation. Dwelling Type: Single Family COY Two Family ❑ Multi-Family(#units) Age of Existing Structure X) Historic House: ❑Yes >� o On Old King's Highway: 0 Yes o Basement Type: 0 Full ❑Crawl XWalkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing I new Number of Bedrooms: existing_ new Total Room Count(not including baths): existing Z new First Floor Room Count Heat Type and Fuel: NLXGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes *o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ',-M�No Detached garage:O existing ❑new size Pool). <existing ❑new size Barn:❑existing 0 new size Attached garage existing ❑new size Shed:Xexisting 0 new size Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded❑ Commercial 0 Yes �No ,If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION °3 fOj Name d �� �� Telephone Number ��� 4)b r Address 1 0 LD- 1ZP_0 AC U�S0 License# rannut I"l f Home Improvement Contractor# I Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �( MAL SIGNATURE DATE r �— ' r ' FOR OFFICIAL USE ONLY - PERMIT NO. DATE ISSUED MAP/PARCEL'NO. -. - ADDRESS -}- VILLAGE -- OWNER r r DATE OF INSPECTION: r FOUNDATION FRAME t I� INSULATION ', �• FIREPLACE ELECTRICAL: ROUGH FINAL- PLUMBING: ROUGH rn FINAL GAS: ROUGH a FINAL•'• FINAL BUILDING ' R '`6t i - irk l- , DATE CLOSED OUT- ASSOCIATION PLAN NO. .., �' ,' The Commonwealth of Massachusetts t Department of Industrial Accidents 600 Washington Street Boston,Mass., 02111 . Workers', Com ensation.Insurance Affidavit-General Businesses �i name: i 731 ` address: 64 .`Y •. ` bf r57, state: hone# l 1�� work site location full address): � � J • I am'a sole proprietor and have no one Business Type: []Retail❑RestaurantBai/Eating'EstAfis ent -working in any capacity. ❑of [] Sales(mcludmg-Real Estate,Autos etc.) an em toyer with 'em to es full& art time: ❑Other to er rovidin - M MIN irorkers' compensation form employees worlang on this job.. ; am an ein y P '• I P . - T Coll/ an •II .. address: :l'• ;1.1; honeKx .# : D M: S / -MM FEEMEMMOMM/1-1-10 I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: com an 'n'alft ;e ',:X:. �,... •}• t.�:•,,•t. ::5.•::fr •'i�<1 1' ' .., , E,..,.r,r .•�>. � •y}. ''v.i•��.. .. . &one cl. ance co. •.y v9r.,:•Y c �,��: ,•s•;,,, ••iJS i •�'..'. -.�,.�r:r r•••• , �~T'. •::;% ,s.Y i ..t..'f;c .F' '•W:: ?:' .+:.• r'O-11C :.#.•'• ••Ji':2•,. .•nts•'. :�':•.. '•a::`{•`•T.•:�•' Plie : ' ..Y:, •=r•: :'S�• 'i. i:i. '.t` if'T�:St.,d.,. i,r. insiireNMI 15 ac Failure 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 as civil penalties in the f6im of a STOP WORK ORDER and a fine of Simoo a day against me. I understand that It copy of this statement may be forwarded a Office of Investigations of the DIA for coverage verification. I do hereby ce ify nder the pai s :dp alties perju hat the information provided above is true and correct Signature Date Print name 4 ' ' Phone# official use only do not write in this area to be completed by city or town official city or town: pgrmittlicense# 7OBullding Department _ DLicensing Board ❑-check If immediate response is required ❑Selectmen's Office ❑Realth Department contact person: phone#; ❑Other (revised Sept 2003) i Information and Instructions. Massachusetts General Laws ghapter�152 section 25.requires all employers to provide workers' compensation for their. employees.. As quoted from the 'law", an employee is.defined as every person in the service of another under any 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 mare 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.oceupant,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 is 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 sitdation..-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. Alsobe sure to sign and date the affidavit. The affidavit should be retumed 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 regardin*1he"law"or if you are required to obtain&: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 umber.which will be used as a reference number. The.affidavits:may.be.returned to be sure to fill.in the perrimt/license n the Department by mail or FAX unless other'ariangements have been made. : The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a calla The Departrrient's..address,telephone and fax number: :_ . . . . The Commonwealth Of Massachusetts• Department of Industrial Accidents Me of Wmgugaffens 600 Washington Street Boston,Ma. 02111 fax M. (617)727-7749 phone#: (617) 7274900 exL 406 �oFtHE l°�ti Town of Barnstable Regulatory Services B"WrABLE. " Thomas F.Geiler,Director 3;�a``� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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: ANWAV 1116Q Estimated Cost Address of Work: Lo� � ,�, Cr� � 144 A. - Owner's Name:_- Date of Application: 1lJ r I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that:. OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: �b_PE 4,cW4" Kglkff-� 6 , 6W=4 IVR Date Contractor Name Registration No. OR Date Owner's Name Q Iorms:homeaffidav L- RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $ 50.00 Alterations/Renovations $ 50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE J�square feet x$96/sq. foot= 0;'LL/ 7� x .0041= 100,76 plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 - >1500 sf-Same as new building.pemut: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee /o� 7� Projcost Rev:063004 i _r Town of Barnstable p�'SNE TpKH . Regulatory Services .�� Thomas F.Geiler,Director . � Building Division s6g9• A,� _ pTfD � Tom Perry, Building commissioner 200 Main Street, Hyannis,MA 02601 _. Www.town.barnstable.ma.us - r Fax; 508-790-6230 Office: 509-862-4038 w T Trope-rty Owner Must Si o �plete and � This Secti n - = z -if Using A Builder - asowner of the subject property hereby �auth , .'to act on my behalf, orize in all matters relative to work bytliis building permit application for; _ (Address of J'ob) Signature of Owner . � � l Print Name (Val Z S, g y ' 4 - O � • /� ,�;�. 3 ✓gyp, �8 �I p LA-rJO O \ F%C*iAFE) " � A. ' (ru 24L Ar e� CE.e T A A/_ Gay rUAT t46 rc)o z::,Ariow r,.o�nT�D A SCAI-� /'� .Oto' /a -z9-$� . I�®u.�c� l��lzt3o�1 Aar 15 NoT' PLAti .2-=— E E.c/CE OG A'fEA V l rg 113 PLAIM, Ior t -TE: A06-2 7 -84 AA1 .2EGiSTE.eEp 444-/O ✓.��.er��s �-,Su e✓EY �yE 0,,s7 aZ;,z. E— MA.ss. lCs�`r ��lia/J I�AG�y` -y IB'-d , .. � EXISTING DECK - - 1L .. .. Ul Circe )cv a ft O 'EXISTING RESIDENCE - f W jug z z wg Am }z z ul _. J ul F 74 LL d m Y CO s . SWEET 2 OF 3 . 24'-O' 34'-0' 4'-0' . 7W-O' FIRST FLOOR PLAN srsaEvc.ro .,oe, care . arxAww er. Icw A / !� N .I MN SIDE SET BArK a veer V�H'lT dY CDX SNBATRNG _ � p. ." [•VE.,Iy - r_aewi COAIC_ I`I M •, VAPOR BARRIHR 4 I MATOJ OOETviG ROOK RTt71 Q p s - ' _ ' • .. �,.I I. - .v of 16 a �s r may, i 1 Rae F.G. o HBITED L , - ru.,sR DnssNi,run 5 Wr 90 'A' PADAD i.. I RIB ur weuL m QtEATH-. ow MTCTCW TCP 6 WLL I I ai W.2. Pfty a (S1✓gA7MwNc� R.C.CLAPSMRDS W. ...I RIGNT SIor Q 0 Yt.C.9HtNQ.F9 RGR L RT4AOiOD RN PA INWL- 2.0%1 K'o.C. - *,-O' 3$1O QRT CRAWL SPA - EARRM z crao5s s6cnow t�°-, S N a Z wtL a Y FOUNDATION PLAN m i; . scxev<.io . sygg 3 CP 3 ' JDB. OAIB - ; DRAWN BTU KW ' V IMPORTANT _ ANY CONSTRUCTION THAT INCREASES LIVING-SPACE _ BEYOND 1200 SQ.FT.PER LEVEL MAY REQUIRE THE �R INSTALLATION OF ADDITIONAL SMOKE DETECTORS: V O - NOTE A SEPARATE PERMIT IS REQUIRED FOR THE INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL. PERMIT DOES NOT SATISFY THIS REQUIREMENT. ` W u� W u s-n la-a ADDITION Fxle-11 Z .. p(19TIN4 ADDITION p(1971NG AmTWN - W V. 2d•-Ir 0 2T-0 . .. _ -��m REAR ELEVATION FRONT fVAIM RIGHT EMVAMN B . Z r $rN�V4•T4 a �Cit2 v6=T4 •,Gl�VC.EV - J W J _ to tL W v- . _ " • N MET 1 OF 3 Al . .. .. ,YJB• - DATE. 16/Od IiL s TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map. Parcel 0 ���— Permit# R 3 02 Health Division . 14 CIF 'pFchSiA Issued 00 Conservation Division ` / AN jo:_ Ap lication Fee f � f� Tax Collector Permit Fee c�o Oo U . Treasurer o ... 01 Viol SEPTIC SYSTEM MUST BE Planning Dept. fi Viol I S IN COMPIJANCE • . � V1flT�TITLE$ Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND TOM REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address DP �ftb� Uwe Village Owner \- Address Telephone 1 Permit Request z) LY 1 r a9g PL74N Z ////0 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new !�� Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes �(No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure `0 Historic House: ❑Yes *0 On Old King's Highway: ❑Yes Xlo Basement Type: ull ❑Crawl ❑Walkout ❑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 Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel:)Gas ❑Oil ❑ Electric ❑Other _Central Air:_XYes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:O existing ❑new size Poollxxisting ❑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# Current Use Proposed Use BUILDER INFORMATION Name If0K2PN Telephone Number ns`4 0(0 �.�(0 3 Address &O[L O C" J2k J License# 0 Home Improvement Contractor# Worker's Compensation# WC al 5 31101 l©zV ' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L TIC. CTIn SIGNATURE DATE a4 A FOR OFFICIAL USE ONLY PERK41T NO. F DATE ISSUED , MAP/PARCEL NO. ADDRESS VILLAGE - r OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE r_ . ELECTRICAL: ROUGH FINAL j PLUMBING: ROU&Hcco j FINAL-' ' GAS: ROUgh J FINAL r FINAL BUILDING /- y2 -q� e ■ iop u 0.%W- F - DATE CLOSED OUT � � �• - ASSOCIATION PLAN NO. The Commonwealth of Massachusetts ; Department of industrial Accidents 600 Washington Street r� Boston,Mass. 02111 ' ,., workers' Cam ens on Insurance Affidavit General Businesses address: UJ zi hone# 1�� • state: work site location full address. [] I am a sole proprietor'and have no one `Business Tylpe: [�Retail[]Restaurant/gar/Eating Establishment working in any capacity. ❑Office[]Sales(including Real Estate,Autos etc,) I am an em loyer with eiz to es(full& art time. ❑Other e�y��ary�MEMNO.J ko et ro 'din -Workers' compensation for my employees working on this job. i .f am an emp Y P cam 11211 name: ,t•j.: < .. i": ,.. :. '„:. . address: bone#• city: .;, . .. ,:,. .":(¢ 'ra•" : 77t 113sdrance.eb;,r'.:: .:'.. •i:�., ..% , ' // // / / /may/ proprietor and have hired the independent contractors listed Below who have the following workers' . I am a sole compensation polices: ;'q 1i aII DSII1 I,.,:..�: ✓•' 'r; ..n•.I'.�tie::;i: o: .C•' 'u: r'•'t:: ',. :� ;=•r.: .r' :?:f 1 1:tN••a'•.G.". ��..;• hone For., Clty:. ,r+: ,':i,"(` '�'�'' '��{• •a: :. :�:.�.r;f .ti; 1��y���y ������ ICY insurance co /////% /l/ •• eii�'name:•a•: �i'r-a:g',i '•:'' ..,' .;,. '�'•'. address: 'hone 0- - 30 0.00 al Fallure to secure coverage as require nnaltle�Sla the form of ee STOP V4'ORK OGL 152 cat-lead to tbLe RDER and a Fine ofi520�0 achy ageia+tmeI andatand;that gr one years'imprisonment as well P copy of this statement may be forvarded to the Office of Investlgatioas of the DIAfor coverage verlficatian I do hereby ify der thepains an penaltie erJu that theinformation provided above is sum and owed, Date Signature '® � I Phone# o Print gam ofBeial use only do not wrtte in this area to be completed by city or town o clal pertnit/license# ❑Bullding Department city or town: Qlicensiag Board ❑Selectmen§Office ❑check if immediate response is required ❑Health Department , phone#; ❑other contactperson (revised Sept 10M) •'•���.�-x—�,���{"'�'�£'s`-hex `_"'�e...s �'�.�� �w ' ..saw�;a,.. ...w.-.,.,...-....._,. „r ,.'wm•-,..,....,.... ....». ...+...,,«.:e,yw...a.+•.r..—.•+.e...ww•.*.. ..••+.....*s.....-... ...s-•-....,........... . ..,r•...w,. Information and Instructions Massachusetts General Laws chapter 152 section 25 requires an 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 Iegal 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 Iocal 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 d to the city or town that the application for the permit or license is being affidavit. The affidavit shouldbe returne 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 D.epartrnent at the number listedbelow. City or Towns Please be sure.that the affidavit is complete and printed legibly. The Department bas 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... cense number which wdl be used as a reference number. The affidavits maybe returned to be sure to fill in the p�rrnt/li the Department by mail or FAX unless other airarigements have been made. The Office of Investigations would&e 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 M of Imstigatlons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617)727-4900 ext.406 r o�t�e roe Town of Barnstable • Regulatory Services snares LA Thomas F.Geiler,Director 1639. c 3�A � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4039 Permit no. Date ' AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142Arequires 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. ® �.J Estimated Cost Type of Work: Address of Work: 0 �� 4 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 QBuilding not owner-occupied []Owner pulling own permit Notice is hereby given that: . OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED LE ROME IMPROVEMENT WORK DO NOT HAVE CONTRACTORS AORBITRATIAPPLIC�N PROGRAM OR GUARANTY FUND UNDER cc.142A. ACCESS TO TEE . SIGNED UNDER PENALTIES OF PERJURY I her by ply for a permit as a agent of the o. er, /,6 iN �5� Date Contractor Name Registration No. OR Date Owner's Name Q:fo=-.homeaffidav I f Town of Barnstable Regulatory Services saiuvsrrnss , x Thomas F.Geller,Director OM fb a�•� Building Division Tom Perry, Building Commissioner 200 Main Street, $yannis,MA 02601 www.town,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. �� � fi Cc` si�2eaW t on my behalf, in all rriatters relative to work authorized by this building permit application for. to wo- (Address of Job) c�_ Si ature of Owner /te l� Prurt ame Q:FORMS:OWNMERMMSION l � ✓fae C�amipt47ru�eai o�✓l GaadaGltuGe�1`6` r i -BOARD O,E BUILDING R+EGIhL-ATI,, License ONSTR'U.CTI s,N SU!PE'RVI1SO'IR ({� Nurnbe 076820 �j r e OY A 5 Y.no: W1,5 KENNE 0 PE. .I� _ 19 GUILDF 4 5.``� ( o b� _,f C€NTERVILLE, MA 2632 AtlminFstiator Board of Building Regulations and Standards HOME IMI OVEMENT CONTRACTOR Fa1 2282 / j/2006 _ 146 K.P.REMODELIN; KENNETH 'PERR 1:9 GUILDFORD RD. � I. Centerville,MA 02632 �. Administrator R r , t v_ \00 Psp ' 0 . r Gp Z8 5 �I O LA`r10 IJ `x 1 p % 2n ��e c►�7�._ CE.2 T/� EO OGDT p A/. TN AT "s Fo wkJ ,A ri o N ZOCA7 i0AI t`.o��Tt�D d Ttf G G��DY►�D /�5 SCA L /�� ,�o /a -29 ocATEA:. WIT* 10 'tf(S FL OD ILA,N. Xr n ' 1• c•C. /4972 o ram. 10-- et A•y7c`'.._ .BAxrE�e6,v rE / •y/S �.C.4.vlS it/OT B:4SE.r� O,c/.4it/ .2EGiSTE.eEO L�/p 51[/[/.eY6ye�e�'► 0s�Ts'ueYEy RZ,14 iJ DA40$1, . oftMEl�,, The Town -of Barnstable BARNSTABL6 Department of Health Safety and Environmental Services "MASS 0 ' Building Division plfo�y> 367 Main Street,Hyannis,MA 02601 )ffice: 508-8624038 pax: 508-790-6230 1 PLAN REVIEW Owner: min Map/Parcel: C)1 Pro ecf'Address' o Builder: KQ The following items were noted on reviewing: r� Y, U U 2• d v er C) Yl 04Ub J y— ` Y►'l of -� yon r � Y. 1 1 Reviewed by: Date: _ 7 v 11 4'-10• 4`2 4'-10• 1' .. �//jjam�•�' —^ea__� _� o LSc2G0 GROER - _ T. .. P.T.POST QA METAL 6ALV.METAL P!0@f ANCIICR SUNRQOTT RN7fd?VBlr ann rncr�»MRu I A8RM1.T BNINGA I WW CLOC ONCATUM ' �-) r1ATCN OflSnlG ROW Plrot \ @ - I, I Y 240'. I ..� - Rm F.O.I - a 4 Qs CRAINl qPA/F 1 1 — VBRlD BWFIT 26'.Y Wax- . VAPOR 9ARRIER I I MATOI Bft6TItiG TAM - l�[ - comrlmuv� I� Z •. "..w IODrING 1 1 - m F.G.INBUL O 35 V2'.W fUW poI NG TOP W YI/LL n! T 2M C PLr.Bm S•IP o.C. .. t I TYvu 1 caR mTMun� ADDITIONL) A DDIrION tlBSa2C1 o (2)) � 2.4 snm FKTSvmr Q anb RG.asreanRos FRaN'r• �u ————— -- --1' I RIG7T ow F LAT Mf oasnm --------------- BI4•PLTYiO® BASEMENT .. >w F.G.INLUL. 240'. mro.t. P.T.20 .• 3 GRco, CRAWLL SPACEPOST r�"eiv rwrrn PowT mom T PIER W ap = VAMR MRRIER I I 'WAD IW-- T1P. J - I I W I F,\ ,C-U� U at u _Y b_u• U q tact cmoss secnON w u scnev4.ro �^ Z Y Z 0. tl FOUNDAMON PLAN co SC:aAW.To s -ICB. 0410 . ORAMN BY. Ibl • H OS t 4'-O'OOMIEGTPY B�l197YNG DEGC BIAIROC!'10B:1C (fI - as IA4 60'BTOpI'1 DOORS ro) ScTre.\Dco�tS Z I o SUNROOM G Qt, EXISTING DECK S L ADDITION yN' a 3. - W STROM DOORS Kr � Om DEMUR DOORS 7rP v m Z CLOSET CA2 L \\ 11 O ADDITION 6 EXISTING RESIDENCE o A fi LU J Lij - F9 V � d n v pL w i w I . I SHEET 2 OF 3 24-O' r 34'-0' 4-0' 76'-0' DGT - , FLOM PLAN ' SCALr-VV.1.0 JOB. D4N) + y DRAWN BY. KN v . DAT 3 / v IJ c� Q ac) lu 00 m J � u-o• - Tfir F TFI. „ nnsTmw AODinaw suiaRDon Aownow - I I I I I ILij Z H Ll Z - u u u I I i w � § F- II . GE RGMT ELEVATION REAR ELEVAMON u sru�vs.ro 5rsa�vr.ra Y z w U- SMENT 1 OF 3 Al . DA E 3/iV05 �oFIHETO The Town of Barnstable BA MASS.LE. ` Department of Health Safety and Environmental Services MASS. i639, `0� � pTE039. Building Division j 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection _��.1 (2 i14 Location 1-p r Y �^i r ,<9� L r1 Permit Number f f Owner Builder One notice to remain on job site,one notice on file in Building Department. The following items need correcting: Q vt u 1 `r c In � ve Ui4 CA ! �`: 0 t r N �. Please call: ��508-862-4058 for re-ins/p�e/ctiioon. Inspected by `I� C-1/9 a,,, 0(2 SLY Date ��� /Z' v ,>r December 12«1984 Mr.Brian Dacey 62 Fembrook Lane Centerville,HA.02632 Res lot #18j,Fembrook Lane»Centerville Dear Mr.Dacey: I have reviewed the foundation as shown on a plan certified by Baxter & Nye dated October 29p 1984. After your presentation as to the topography of the lot and the fact that a ten foot easement abuts the property line I have made a decision.Because only one comer of the building is only six (6)inches less than the requirement and because it is "too small to notice",I have granted a pemmit for the constmction of the dwelling unit on lot #18. Peace, JDD/gr Joseph D.DaLuz Building Commissioner Vl £>l-ATIC?'-1 \ZeQUIIZl5D 'iE^OL lo RICHAFD 24046 :7b— 6It^'Y TUAT "tv4i5 FocpOiiAT'®'^ i-p '^^ATBD TH^A^ l4lsiZBVf^\6 M(?r wi7^ATe>Wir»4i»4 '^•yyg'/Ci -r^/s /</4c>7^^ASS'ZP ^:>^y AyS71^6//^£-A/r f 7-^^ j I—AnJ £• rf^.j?.'r//=/^s^7^2-0'^ ^etrr£B.\/it^ SCAl-Sr /"'^O /o'Z^-s4- /PjLA/y loT ^ l-^.C./^972 SAKT£^4 je^s/sr^^E/:^-<:>^^sc^i<syo& A/='^/./£'A/^Bz/ai-j Pa^^V