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0228 FIVE CORNERS ROAD
tx �1� rf z re ii: f+�{ ` �, m d !Y td.PJ r lYY+( rA. th Y'"yij* * �" t rS .�� x tir4y �i °.Y 4 . t srr�x1 { u� t kt d+ vi ` k 1 4 x1 .. �, �' s+ v "'�' 1� r '� ,,, �, y r.t;5 ..`,.� r +;;'+' .. :a. -ve&, - t 1r. "sstai'.aA'•dJ,. f f Ix .' r::.,�7 S. . .f. ,`1 .�; ...,..° .T• r Ef,. :;4. €.; .t ho71.'tii.�.+ M,:"`a 4t,i ly. },, S¢3 q4' 1i -ar.�4'' °Lip l.,t .....�. -0 r k �' ",-I n ; { '7� f. .!'hF ..{ _ A� t..ilAtlS.'h �,rei. �,. i •��t.. r. 15�,i1. tbh'. r.a {iyeszJ j �& fan g. Y 3s1 t i� a - IS4, YY;�le y+Yr f r'r +'i�,l f'{ —a!f # 19 r" n� S, 6 }' ,Y�,f,Yt ,: y.Yay z«�r J 7ef'B4 ",rlpe p�.,� a. 'r� j ,..i.�°!.'tfe �.. �. �' ar(.: i n:, S7' �-•+4" L�� - c tot- tot- r :{` . I ^ V j1 ° " .. � , .s� q , ° z, t9 1, 4 t • .x '4 4 y; f } 1 JI .Y ` A ,�,'" bi! x o, f f .ri.:.,.: LL ,1f G- R S'' 2 t t W `. ,.t,. •.te a..+ eI - '.a .. ! ,.. ., , i.: ��.. ::1 { --{ j f 6 j kT i ,t' ", i �::: ,s,..' :St h' "� q.. " , h t r K. d, ' ,. . f ;r.:, s.t:. .fix :.:1 ' t.. :'.... p e 1 EI�: , ,.. d, v p;j d. 1, 3 -" t, if,' 1 A :� 4 4 6 T ;4^ + < Y: I i ., 11 t.. 'K t 'p a t E t, r1. f,' 1 r I Y i . 0 a' .: - .. P, 1 Communication Result Report ( May. 22. 2008 3: 24PM ) 2) Date/Time ; .May. 22, 2008 3: 23PM File Page No. Mode Dest i gat io.n Pg (s) Resul t Not Sent 6681 Memory TX 95087789312 P, 3. OK ---------------------------------------------------------------------------------------------------- Reason for error E. 1) Hang up or line fail E. 2) Busy E. 3) No answer E. 4) No facsimile connection E. 5) Exceeded max. E—m a i 1 s i z e nay 2? 08 b02:31p Barn/stahIe Rousing Ruthor 15087789312 P.3 ' /�-tta ��. L�L�(i'✓Yc� %�iGS'� G(-_.fie ZONING VERIFICATION TO: E,inda Edson FROM: Kim M.Gomez-Leased Housing Coordinator RE: .Legal Rental Unit Verification Date: Address: fG YR •'.�i/12 5 NQ tc Ot Village: (zJi'L'`z-Ltrtfr . 1f / Unit Type: �/i i�i i�' _ Bedroom Size: j Map&Parcel No.: d� The owner of the above listed property is entering into a contract with us for the rental or the properly as listed above. _ Please verity by signing below that the unit is legal and meets all zoning requirements for a rental in the two of Barnstable.If it does out,please list reason here: ' .�✓ max, a- iPL � �t 5��.��c d� m.rt Aaf a,00,.off Thank you for your assistance in this matter. . . Signature Print name` . .. Date'. VIAFAX: 79D-6230 MRve swdon8 Rev.8106 3 . 1 May 22, 08 01 : 31p Barnstable Housing Ruthor 15087789312 p. 3 Cj 24, 1 < ZONING VERIFICATION TO Linda Edson FROM: Kim M. Gomez - Leased Housing Coordinator RE: Legal Rental Unit Verification Address: ;r=�� s is ? - < -i - .1 ✓ .ci=e7- Village: Unit Type: %ems `' Bedroom Size: Map & Parcel No.: J(p16 The owner of the above listed property is entering into a contract with us for the rental of the property as listed above. Please verify by signing below that the unit is legal and meets all zoning . requirements for a rental in the town of Barnstable. If it does not, please list reason here: it re 27 i�N►'LS .cam /�-�a� (��D lt��l. Thank you for your assistance in this matter. Signature Print name Date VIA FAX: 79.0-6230 MRVP section 8 Rev. 8/06 R. t, TOWN,OF BARN5TABLE BUILDING PERMIT,APPLICATION Map M Parcel ` o 1�7 Permit# 40 2--7-3 6-3 Health Division Date Issued 8 G ^g Conservation Division Feeo ®� Tax Collector c'!931 Treasurer T '' r Planning Dept. Date Definitive PlanApproved by Planning Board "- Historic-OKH Preservation/Hyannis , `Project Street Address Village% �•F,v�' �0 t I ��e (Y)r9 r Owner 40; S. Address Telephone ` p Permit Request /tom I ,-7 Square feet: 1st floor:existing proposed 2nd floor: existing proposed Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. e 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 A r 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❑ r Commercial ❑Yes ❑No If yes, site plan review# Current Use ` Proposed Use - BUILDER INFORMATION Name nit osZn Telephone Number Address hl 7 69!±SoI C/9 License# rh a Home Improvement Contractor# Worker's Compensation# &�"/�/5 119 a 3 G S6 7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �Lt✓7/l�,ta-cf�tiL. SIGNATURE DATE 6 P5 • 3 r . .` FOR OFFICIAL USE ONLY PERMIT NO. - DATE ISSUED MAP/PARCEL NO. ADDRESS+ VILLAGE OWNER ^ DATE OF INSPECTIO FOUNDATION FRAME INSULATION ;' „. � _°• , i - ,� ;;., _ { ., ;. ' _ _ '. _. + ' L i FIREPLACE .;,-• ` . ..� r• , . ` - _. .. r, f '� -` .. ELECTRICAL: _ ROUGH FINAL; PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ? , FINAL BUILDING,+ ^ J DATE CLOSED OUT t I ASSOCIATION PLAN NO. �TMe rqy� - �: The Town of Barnstable • .�aNar�su. - ' ��' Department of Health Safety and Environmental Services 1"9.Moss Building Division 367 Main Street,Hyannis MA 02601 r ' Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date ' AFFIDAVIT HOME E"ROVEMENT 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: we_-g Estimated Cost 00 Address of Work: C �ilrY ClZ/I-v� Owner's Name: 09/t/ 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 MWROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. to Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav ine commonweaun oi xiassacnuxeux Department of Industrial Accidents 600 Washington Street Boston,Mast 02111 Workers' Coinvensation Insurance Affidavit name:- "')I j 14 rT 4-K city M phone# 0 1 am a homeowner performing all work myself 0 1 am a sole *etor and have no one working acitV ME MA am an employer providing workers,compensation for my employees working on this job. .. • . ...................................... ...................... .4 .. ..... . ...- ..................... . ...... . ......... 4. ........................... ........ ..... ......... . .... .......... . ......... . ......... ....... ......... .. .......... ........ . ........... ......... ......... . ....... .. .................... .................. Cilh. ..................... .... .........xx . ............................... ............. JA Insurance-ca; ............;`-- am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors fisted below who have the following workers'compensation polices: .............................. ............. .......... ............... .... .... .. .......... M. ..... ..... .......... ......... COM111111*4iini e .......... ............ 'x. -X -... ..... .... ..................................................... ... ........................................ re ............ ....... .. . ................ ....... .................. ..................................... .......... ............... ...................... ... . ......... . ..... ... ................. ......... ......... .City" ....................... ....... ........ XX ........ .......... ......... .......... .............. .................. ........ ................ .............. ....... ..... ................. .. ............. FE/11111 ------------ ........ .. ..... ...... ...... .............. 8, campanv name: ........... ........... g* ..................... ................................... .,.>...... ... . . ........ ........ ...... ... ............. ............ .... ........... .. ............. .... ... .......... .................... ... . .. .................... .. ... . ............... ....................... ..... . . . ..... . .. ...... ...... ............ . ...... ...... ......... ',.*,.*... ............ .... ...... .. .. ............... ... .. ..... .................................... ........ .......... .......... ....................— ....... ......... ........... si . . ....... ............ d x, onej ......................................... ............... I.M. . ............................ ..... ... . ...... ..... .. .....no i'M Fujim to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criodual,penalties of a&a up to$1,500.00 and/or one years,imprisonment as won as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the 0111ce of Investigations of the DIA for coverage verifta" I do hereby ce rrn the ai* enaldex of perjury that theinformation provided above Lift,and correct Signature Date -Nn Print name 4�>.eA•VA �44 ce--S::S& Phone# —0,3,7-4 ------------------- - ------ ---------- offinvaRaw official use only do not write in this am to be completed by city or town official official city or town. permimcense# OBuildingiDepartment [3LIcenstagBoard C3 Ccheck if Immediate response is required Oseiechnens oface e C311egJaMDepuftent con contact person: ----------- (revised 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 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 contL= 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 m 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,neid erthe 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 and supplying company names,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 peimit/license number which will be used as a reference member. The affidavits may be rctu riR to the Department by mail or FAX unless other arrangements 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'call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Imlesdoadoas 600 Washington street • Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 = HOME IMPROVEMENT ,CONTRACTORS REGISTRAT'IONtr Imo" a .°Board of Building Regulations ,arid Standards Jf`` {` One Ashburton Place — Room 1301 � 4 Boston . Massachusetts 021.08 - HOME IMPROVEMENT CONTRACTOR -Registration 112536 -Expiration 04/06/01 .a— -- ---------- ------ Type — DBA � �. �S rJ m �i{e�noet�¢`G� ✓�[amae/euaelr HOME IMPROVEMENT CONTRACTOR * Registration 112536 FRASER CONSTRUCTION co fr R Type - DBA DEAN C . FRASER -Expiration 04/06/01 71 TARRAGON CIR COTUIT MA 02635 ` . FRASER CONSTRUCTION co DEAN C. FRASER 1 TARRAGON CIR �CO TUIT MA 02635 ADMINISTRATOR Engineering Dept.(3rd floor) Map Parcel t 0-7 ^ Permit# J /� i House# avZ$ F�vz- Date Issued Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30) 27 Fee S�::0 Conservation Office.(4th floor)(8:30- 9:30/1:00-2:00) _ s fw-4 SEPTIC' BE 19 CB TOWN OF BARNSTAWN : W���ti Building Permit Application O Project Address // �� Ve l�,i h k o Ct_�/1i Village r �/j Q.,== E Owner -rwl � ddress Telephone ' 5 b K" Permit Request &&--dmeun Shed x ( (�� First Floor square feet Second Floor /y J -- square feet Construction Type ry-a M e--> Estimated Project Cost $ Olt • `tS Zoning District Flood Plain Water Protection Lot Size [u`.�?.(l® 'PCs. ,�- , Grandfathered ❑Yes ❑No Dwelling Type: Single Family I K Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes Vo On Old King's Highway ❑Yes 19rNo Basement Type: Wull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) A� (f) Number of Baths: Full: Existing¢ New Half: Existing �_ New No. of Bedrooms: Existing —:3 New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas N(Oil ❑Electric ❑Other Central Air ❑Yes KNo Fireplaces: Existing New Existing wood/coal stove ❑Yes Wo Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) (None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes *qo If yes, site plan review# - Current Use Proposed Use Builder Information Name 5 Q Laa-5:ed Bq&J i Telephone Number © Address PC). CO�j,Q�( G22 ' . License# q qt,/ P.0 213PV LIi �14 o k U2 Home Improvement Contractor# 9 7` 3 Worker's Compensation#3) 1 Z.'J_5r0 /to L/ 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 BETAKEN TO SIGNATURE�i �1✓/ / I S.4 9,DATE IMP61l 2) / BUILDING PERMIT dENIED FOR THE FOLLOWING REASON(S) ' P FOR OFFICIAL USE ONLY J s . i PERMIT NO. ' DATE ISSUED t .z MAP/PARCEL N. '4. ADDRESS VILLAGE i OWNER DATE OF INSPECTION: - FOUNDATION FRAME . INSULATION s` FIREPLACE t - Ot ELECTRICAL: Ni GH FINAL PLUMBING:' . H cl FINAL 3 GAS: , _FINAL - FINAL BUILDING �Or�ie y DATE CLOSED OL� ASSOCIATION PLC r Qi) Assessor's map and lot number �.. .. - DOe_CU 1V() MPTIC4SYS -f�I�JY U TNETp�4 Sewage Permit number .- Tt f 1................... �.. 13 £� r� AL� � fl ' �lP o L 5 WITH TITLE 5 Z BAREST LE, House number .....�.. ..... ..................................... --- '` . 7'NVIRONMENTAL CO Ma,•�r�vtNa TOWN REfaUL.ATIOB T F OWN O BARNS TABLE BUILDING INSPECTOR-, � y Y APPLICATION FOR PERMIT TO ........4....,(4•.....� ...to.v>:!'... ...............................y................................ TYPE OF CONSTRUCTION ........ ....... ................................................................................... e ...... ............. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following �information: Location .......... Q........ f J.L°...Co.(r .L V 5........ ...............�`...... ... .............................................. Proposed Use ............... ......... ... ............................................... `...... ................................................................... ..... .... /',,�� Fl� /lr CY f� l c —�S Zoning District ...L4F...{'R . .... ....... .. . '.......r� ............Fire District .................r1 .!�f..V..6......1`............ ..................... Name of Owner ...........�4 �ir!'� e.G.....V CL. .ttot Z$" . .................Address .......e�.................. ..............................5...........r.......... Name of Builder ......... LG:G� 4 R /.....................Address .......a. .. .... s.P..�n s:.R(.:�r..Wes.....Qlte! k b Nameof Architect ...............5\� ....................................Address .................................................................................... Number of Rooms ................ ...........................................Foundation ......f?..®o&.�g:d......la r( CCv� ........ Exierior ........Roofing .........a 5. .�............................................... Floors �f It �d h.a A.tev#..Y..4......Interior .4) ... GK Heating .............©.f..1....... .......................Plumbing .........I...... .L.�................................................... Fireplace pP ........ ........................................................A roximate. Cost Q.o t�.................................... Definitive Plan Approved by Planning Board ______3�7_l_�________19.77. Area ���T.SY � .......... ........ .. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH GO � C �6 OCCUPANCY PERMITS REQUIRED FOR W DWELLINGS I hereby agree to conform to all the Rules d Regulations of the Town of Barnstable regarding the above construction. Name ........ Construction Supervisor's License .................................... JASON, MANUEL 28412 No ................. Permit for ............ .............Single,. . ..Fam.i.l.v.. ...... . . . ,Dwelling....................... .... Location ....... Road .................... ........Q.P'.I3tgxx.UI�................................ ............. Owner .........Mqiq!4gj..Ja.s.o.n.............................. Type of Construction ............FKAiN................... ................................................................................ Plot ............................ Lot ................................. September 11, 85 Permit Granted ........................................19 Date of Inspection ... ..19 PS Date Completed ....................... ... W .......19 VD Assessor's map and 'lot number � ..�.�.:��.. .. �� ;....0 L1,1I�2ZL IQeSr641c T j �7HE TOf� a a Sewage Permit number ...�40 s ; �t t �E� r3�C� t as 5 roe' 4� BA"SSi LE. i House number ....s��..�...Ld.:.... ....^`......� 1639: .� AM 'EO MaY a' TOWN OF BARNSTABLE ' .,! - BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... . a......� ........................... ...I : .... ........................................ TYPE OF CONSTRUCTION ........ �` "L.l�.:....................:. .... ........................................ ......... P `= .... .............19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location a .® t d. ...1..•�. r�;•� V 5............. ...•..............Cr! K.�.!�" �.l..f.�'...............::...::........................ . . �la 5 f Gt Lcc c ! Proposed Use. .............. .......... tl � _ , Zoning District ... . ....... .. ....... "........ ................... ....,.........Fire District ...........L.-v.c.rr..V..�.C... �5... .................:... Name of Owner .........ov... .!�.G1..K:d..... .................Address .......?:: .t?:..... ........ ....�a v �..�. ...!.'i?�......... Name of Builder ..........rt1.4-C. q.�'u....�!a .........Address ....... .... <.JtR;vn•S:. c1•�..!!�1C'.S.,I,...tet.Y.�!S!� Nameof Architect ....:..........5� °1.:....................................Address-7i...........................................,..................................... \ f. Number of Rooms w., Foundation ..... 0' E G l0 _..... F :.....f�.lt..'......................................................... Exierior .......... 1.7-..r.t..........................................,..........Roofing .........Q.S. ........................ Floors .......... Y.. .....a.K.(....1?a vc(.W..O.5ikA......Interior ........0 .-ck............... ............................. Heating .............4 P...I ..jn!a..I....r:........................Plumbing .........L........4t ..........:.............................:.......... Fireplace .................{l!1-i1.."...................................................Approximate. Cost .....:.......... f..{.��......................�.....,..... Definitive Plan Approved by Planning Board -------- ---------19__-7-7. Area .......f 1, .s�c :......... Diagram of Lot And Building with Dimensions Fee �`' ....�..V. .............. SUBJECT TO APPROVAL OF BOARD OF HEALTH �` 2G • V - C�ov B y OCCUPANCY PERMITSrREQUI RED FOR W,DWELLINGS I hereby agree to 'conform to all the Rules Regulations of the Town of Barnstable regarding the above construction. _4 Name ....... `- .. i ,J' f n N Construction Supervisor's�icense fJ . ...... :y. .......F................. � JA300, D&AgDEL A~168-107 . 28412 ADDITION No ................. Permit for .................................... ___Siugle_Family..DwelIio8 ______.. _ 228 Five Corners Dou6 Location ................................................................ - Centerville ----.----.-----------------. Ovvne, --. .J@���----------. ^' ^ Type ofConstruction .........�����-------. . -------------------------` � ' Plot ............................ Lot ................................ ^ | ^ . ' ' t Se �eo��er ll ^ Permit Granted ---.R����---'�--lg 8� _ ^ ' � Date of | ------------lV . � � Dote Completed ------------..lV . ' \ � � ^ ' - ' ' '. � « - ~ - ' ` - - � ' °F'WE Tom, f t . . °: The Town of Barnstable • sTABM • 9eb 116J� ,0� Department of Health Safety and Environmental Services ArfD " Building Division 367 Main Street,Hyannis MA 02601 c� Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner 'For office use only 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: � �-✓ �,.� _C ) Est.Cost, Address of Work: A Op Y 0 Pc)ck C ( nt .vv� I Ie Owner's Name L I 's 7 �'� J�� I ►'l G!� Date of Permit 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 owq 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: dRCU 2 ) , I g 9 r7 s0<OS a EA. Date Contractor Name Registration No. OR Date Owner's Name The Commonwealth of Massacbusettt Department of Industrial Accidents ` Office o1/11vestf9at/ons 600 1Vashhq,ton Street Bactun. A1uas. 02111 Workers' Compensation Insurance Affidavit Appltc•tnt tnformattori. Please PRIIVTIebjl�j�--"�'� 7 name location: city rhone# 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity • = re.............__...,.._.,;7rovs....Y..�Rf�,r,T--..-..n-,.7f's+'..:.�....-..•7......qn!.4,,,,.,.�.+�..y.,...�._......,...,..._....,.r.�-...,w....._...,...,__....__....... I am an emploo`vyer providing workers' compensation for my employees working on this job. coma nnv name:--✓l I�,z Q_S OSt address- P® dZ A to l_72 2 �I�,�c7� A�{,� .J.�, A , G � 1 ¢ citv:�91C 1 /"'��'� /'/ 1V• � �.�0 �� Rhone#: 100 �L/ p p� U I yA k _rt►lic� # 3 1 )23 -V r V .._ ...,. .. Cj 1 am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: companv natne: address: city: nhonc#: insurance co. noiiev a ., .�+"_ _... yw_ _ _ ,'�.:Y.. .. ._- - _1r�_^.�::�.:•ZL iT"I!7w_-:S �Tr._._. - .R.�...�....._...-.-r_ _.._-.-.... .._ ._.�__....... r_l �i..i_.._ ..i_�ivlr...Jr'--- - :t.. _ ,.1-� ___ .�.:�:OrY`-• -.a.--�. companv nninc: address: cin: nhonc#: insurance co. Attach additional sheet if neccssa :�^- ,-w-r. ��'�"•��'�— ..-�.....a.:..r.�r.:i..`.ti�:Si.• ---1���.s- ---'ro•� - Y'yie•T.s:�ir.•.w.:�.:n. Failure io secure coverage as required under Section 25A of AIGL 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 andiur unc%cars• imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. 1 understand that a cope of this statement mac be forwarded to the Offcc of Investigations of the DIA for coverage verification. 1 do hereht-cc fv undcr 7�r_ tins and penaitics of perjun-that the information provided above is true and correct � Si_natur• ,'Nr �6%l 1715 /19 j Date Print name �n��/T �o l C ��1�/"/ �l/ ��D�� Phone# ' official use only do not writc in this area to be compacted by city or town official r� city or town: permit/license# r7Building Department C3Uccnsing hoard O check if immediate response is required selectmen's Office I C311ealth Department . contact person: phone#: rnOthcr t: J j 508-775-3818 508-790-1903 FAX ILL . STOR Q a Unfinished Furniture,Woodenware,Crafts ROUTE 28 GEOFF PORT W.YARMOUTH,MA 02673 f SCREEKNOUSES D3000d MGM 00mynno e Sheds USA will acknowledge BY , , ' : vs MAIL the receipt of your order. 1 , / ' ❑ e e O lovely additi/ on to any cyaral! D Sheds USA will schedule delivery by � � ' ' I UNFINISHED FURNITURE • WOODENWARE • CRAFTS Contacting customer one week in UNSURPASSED CUSTOMER SERVICE! DENNISNEW BEDFORD-CANTON - FALL RIVER,PjyLjgMOUTH _ advance. NASHUA,NH • SCARBOROUGH,ME D Please know in advance any important // details (location of nearest electrical _)4 ere -4 w4at our cuitomepJ Ja- y: outlet, directions, etc.) "Outstanding... (the crew) went out of � ,� ' D Skilled craftsmen completely their way to show the utmost courtesy, o _ assemble shed on site. respect and consideration." j R.T., Nashua, NH - - "Many thanks... the quality of your - product will be brought to the attention of ! , WIMMIMC401M neighbors and others..."shed —R.C., Pembroke, MA �I �•"..�i "(The office staf was very helpful and ( Ha� MR(I friendly. WALLS —V.N., Tiverton, RI • 2x4 construction,24"on center When selecting your site please consider `Your construction crew left the yard k ' i -- • Pine&Cedar:1"tongue&groove the following factors: immaculate." (horizontal) - CLEARMCE -E.P., Plymouth, MA ! • Texture-ill:exterior siding(vertical) i Remove tree branches or other obstacles "•..very competent, neat, polite and ROOF friendly." 5/8"plywood 3' around perimeter of shed and 9' above. — R.P., Franklin Square, NY • 2x4 construction,24"on center • Self-sealing asphalt shingles w/15 year LAND GRADE "Thanks again for your follow-through Q warty Land must be less than a 6" slope,with and diligence." O ❑ • Heights—8'wide standard=8'3" —L.R., Nashua, NH —s'wise L3 no protruding rocks or stumps in the gambrel=9' area "...courteous, efficient and professional." t -10'wide standard=8'11" —10'wide gambrel=9'5" ACCESS —J.M., Ocean Bluff, MA FLOOR Shed is delivered in prefab sections; clear ; • 5/8"plywood access to site is necessary—stairs, nar- UNIQUE 1 o-YEAR WARRAWTV / • 2x4 construction,16"on center for row walkways,fences,gates, shrubs, etc. Sheds USA, Inc.warranties labor, materials 10'wide units are difficult to maneuver and should be and structural soundness for 10 years with 3actopy di rect t0 ou • Pressure treated floor joists optional noted. proper maintenance. This warranty does not t WINDOWS windows w/flowWINDOWS include fire,flood,windstorm or neglect. ���� ��� LAID QUALITq Customer must stain or preserve building • F ° boxes and shutters Consider other factors when choosing within 60 days of delivery. • 8x8,sx10 and 10x10 units include one your site, including proper drainage, No other warranty is expressed or implied P.O, Box 6622 window.All others include two. by any employee or sales agent. DOORS firmness of earth, etc. FINANCING Portsmouth, NH 03802 40"double door,standard PERMITS (603) 431-8489 • d 10096 financing available at selected Locations. • Optional single and double doors up to 78" Permits are the sole responsibility of the Low interest rates, 90 days same as cash with homeowner. credit approval. See salesperson for details. *psft about our I Do% financing! D - Custom Placement of doors) and window Vans at no charge F —Shown in 8x10— —Shown in 8x12— —Shown in 8x14— D Choice of siding. Texture-111, Pine or Cedar D Choice of roof styles: Peak or Gambrel -�-_ � -• --- ---L - -- _ '; at no additional charge Asphalt shingles-choice of 3 colors 7�c Functional windows- 12'wide sheds and (` ( _ --, I/1p i larger have two windows with flower %/ i r I i �pl 1 I _ I,. ' - I _ ! I !�`; boxes and shutters 5/8" exterior plywood floor, 16" on center . , � � it • , �- � �' - -� , �_. 1 i � ��. ; I , _ - ; � � _ �''• _ ',. S•.� -_ .� -- _- _ -_ ---- - � '1 k I�+ -- ' D 5/8" exterior plywood roof D Heavy-duty 40" double door , I _ ,_ i I' - - D All galvanized nails &hardware included i ` D Concrete blocks used for foundation // / / D D D Free delivery&setup to most areas D Vertical exterior plywood siding D Most popular material. A~ unit ahown WA cgamAre/l-4ty e opams rooland O tional 26"jingle door. D Durable D Withstands all types of weather ! P g Upgrade to 54" Double Door....................$50.00 D Same quality features as cedar D Classic tongue-and-groove Upgrade to 66" Double Door....................$95.00 and pine models construction D Durable and weather-resistant Upgrade to 78" Double Door..................$125.00 D Economical D Affordably priced D Pleasant aroma naturally repels insects 26" Single Door ...........................................$70.00 and resists rotting Extra Window..............................................$60.00 (includes window box and shutters) D Ages beautifully Vents air $30.00 �� D Excellent base for stains and paint / Screens....................................................ea. $15.00 You need a � c . . . `�i G� ` '�; •, ;;fit• •I � _ D One of the most stable types of lumber, Extra 40" Door.............................................$90.00 • � �._ _ _ - - resists warping and buckling Extra 54" Door...........................................$115.00 ...your car has never seen the inside I'" , I ' A I ' ' Extra 66" Door...........................................$145.00 of your garage. Extra 78" Door...........................................$155.00 ...passers-by look at your lawn and = t II �_ i•''', !�; _ _ - __ Ramp (4' pressure-treated) .......................$50.00 ask if you're having a yard sale. I ?�I, : ( - - Custom Pool Filter Hole (in-house)........$75.00 your basement's storage capacity ,� ��lJ WJ �NJI�JV Zar Exterior Stain............................... . $24.99 ' �,, ; , , it ends at the last step. (We're proud to carry Zar stainfor the treatment of our, Ll ' — b sheds-available in clear,cedar,gray,brown&redwood ...the condition of your workshop/ p/� / / //� t craft room is affecting your marriage. cc77 DD DD I �Do/o[ l/.�aaba/na, �arct�]ener'e KeEreQat, p J�ii� i�One o�our molt popular lar�out� Child'e l.Lu�houae, .�trti�E'S cul rEor.� Pressure-Treated Floor Joists ' ...you've been injured tripping over / / //�� P children's toys. / Lail,dO 6� Studio quedt "( abin or 8x8 ...............$30.00 10x10...........$60.00 WA or on th/e ga a en an an c7, 8x10 .............$30.00 10xi2...........$60.00 ...opening the garage door = avalanche. optional 26 "jingle door in front... ea.4 y J for garage 8x12 .............$40.00 10x14...........$70.00 / a / / rac 8x14 .............$40.00 10x16...........$75.00 acceje/Or riding lawnmower and ild owner! 8x16 .............$50.00 �� ♦ I vv v iill i CRAqGERRY IiiQiii�O r 1 0 16.4 PI WK WIN vim',► � ���. J � � � �� �1 (. ! ♦. s:. -- sheds TSA - � _ P.O. Box 6622 Portsmouth, NH 03802 (6031)431-8489 Customer L<<:- S,Ps.����r Date 3/.i t /4 '7 Street Address ers PJ Dealer W:W'r �A t'-� Mailing Address P.O. # City C e���.��.i t C- State e-Ap� Zip 2a-�� Salesperson sc otit` County (if needed for tax rate) t Order Information Home# G(�$ - 3 W l Work# B a Item Item # Quantity Price . (if applic.) Size/type: k I l7 T:. I I�_ qC? Roof style: peak 0 gambrel bother N/A N/C Shingle color: [::]black [?�]brown EJ gray .N/A N/C P.T.joists 30 Vents (pair) '' 3 Exchange 40"double door for 54"double door 26" single door ?O Extra door(indicate size) Extra window (inc. shutters&window box) Ramp `^G Screens - Stain Miscellaneous Credit Subtotal 717.7 Please diagram top view of shed, noting position of Tax G t N S doors and windows. Total Ia90. +tS 4 Deposit 71 Delivery Charge :1 6 iv JTC�I "- Balance Due , 1 1.to R D ,,. Finance Amount T/ C.O.D.1777� X._ '} 11� 'Please nole the follorning: Delivery noles: 1. Review brochure thoroughly and/or speak w/salesperson for delivery requirements. 2. Above balance is collected upon delivery. 3. Any permits necessary are the sole CArec oms from a major roule): responsibility of the customer. � 7_�F2 4. Once delivery is scheduled, cancellation or postponement will result in a minimal 2 �) 4 rZ�, G F Off✓ 2 4c e e " $100.60 charge. 5. All information contained in this order is P 7- G^/ /�7' 2 accurate and understood_. csignature: tom' /�• "'' 9/ v C r vF 6S 12D, orl 2 NO r'6�S O n/ • a _F TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE I tq JOB LOCATION v�C�✓� � � '� .-.. Zer," Street address Section of town . "HOMEOWNER" ame Home phone Work phone - - PRESENT MAILING ADDRESS City town State Zip code The current exemption for "homeowners" was extended to include owner-occup ied dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does. not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re- side, 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 Officia on a form acceptable to the Building Official, that he/she shall be responsibl for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes ..responsibility for compliance with the Sta Building Code and other applicable codes, by-laws, 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 comp airho_s 9dures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 01 Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a person (s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction' Supervisors, Section 2.15) . This lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home ''Owner� actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, man communities require, as part of the permit application, that the Home Owner 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 to amend and adopt such a form/certification for use in your community. Sent by: SHEDS USA 6034367320 03/21 !97 16:52 Job 174 Page 2/2 NI A.56 �cWT 4 Ur6 ll l' + 05635 I v 0f BOSTON BCA R11,0 F;EXAMINCR3 (.Hilt Ft •;1?u> hfce;rin Nll rd t+l'll 17 + - SLI I t t Sent by: SHEDS USA 6034367320 03/21 /97 16:52 Job 174 Page 1 /2 Sheds USA Storage sheds delivered. P.O. Box 6622 Portsmouth,NH 03802 (603)431-8489 Phone (603)436-7320 Fax TO: FROM: DATE: k OF PAGES: o'd Comments: tit �. t ` TOWN OF BARNSTABLE yam. w Permit No. ____ Building Inspector Cash -----------------------oY . OCCUPANCY --- PERMIT Bond ------------------- "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Jason Address :iyannI r�)) Corner: enter- Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department 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. ...................................................... 1.9......_.... ................................................................................................................. Building Inspector V �r 1 1 � 1 � � r 00 � � f _l 1 f � -_� . in" i yi i ✓.. . .`�.-_ A-Aes 4CoV4 X"AD /—Z- 0 / Pl— AIV L 0CC,4 T/O/1.' S^CL1 L,6 _ �_ �i _. 00.4 Tom' ©LAN �2�F'�.e�NC� : /3F/�✓�- (-6,?,'/FY' TA-VA T THE EXiST- . .� /N r6ri FOUNDA r1ON L OC4 TiO,v. /.5 C2 F 'F, 4.5 SNOWAI ANL7,Q U�_,�_E'ONFO�Q�!PV/rN " O'u7WA'OE A14. ssessa%s' map and lot number SEPTIC LEAST INSTA ry { L Tf M MUST BE, Sewage Permit number ......... ......:....�. °.... ......r, �WITH An CLE OMPLIANCE C SAPVITAny C0 1! STATE *THE TD�o ; TOWN ' OF ,BARN-S-'tA-3B]LtTO " i BAHEST&BLE, • i 9� r6 9 w BUILDING 11SPECTOR �o ar a• - - , APPLICATION FOR PERMIT TO ..:�r1St rci-fa% i2el i uG ... TYPE OF CONSTRUCTION ...........W.99• ....FQr�M ....... ..�. .'/2 .....: TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to. the following information: Location .... T.. ..1.......r=t.Ue....CQQK)C-,QS..:... 4 H1D..1.....(Z.EP!E.�L)�.LLe....................................... ProposedUse ..... L.E.K.T.I.f3L.........................................:.................................:............................................a............ Zoning District 1 (, !ox i 1k)..T ). �- ..Fire District .. ................................ .................:............................................................ Nameof Owner. ...Aft}: n.:�. ....................................................... Name of Builder ...............Address ... � �� r: l�?.L .......................................... Nameof Architect ..................................................... .........Address. .... .................................................................................... Number of Rooms ....... .....Foundation .. QU2El� �`oNC.QC 1.0.............................. ....................... ...................... P...................... ................ Exterior .�NGLC... .. L P (��CS�R�� ' Roofing ....... ........................... Floors ...W A L .L.-TO.. .P� ...................................Interior ....�� y.w�k L- .......................................................... -... ........ Heating ..N. ......b.......................................................Plumbing .................................................................................. Fireplace .....00E................................................................Approximate Cost .......... ................................. . .. Definitive Plan Approved by Planning Board -----------___ __------------19________. Area ........./... ........ Diagram of Lot and Building with Dimensions Fee �!�� ............ .... ... . ......... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. . Name .... ^. ........ ............. d Jason, Mr. & Mrs . Manuel =No ...20.1Q4. Permit for ....?�..1. .s• o-ry- r" P� .......s.xng.le....£a.�.i1,y...dwe1.1• ng........ ..... _ Location ........... 22.8...Fiv&..Gorrr •rs• -Read .........................GEnte•rvi.11e......... ............... - Mr. & Mrs . Manuel Jaeon ........... Owner ....................................................... „ - Type of'Construction ...............frame ........................... ~ Plot ............................ Lot .......... ................. z b` April 14 78 , Permit Granted ......... ..:..........................19 Date of Inspection Date Completed .1.Q....� ?fl..............19 -4 e " PERMIT REFUSED - ................ 19 R _ ................................................ - ........................................... ............... . •............. Approved ......:........... .... 19 T• .......................................................................... a , 1 � 7 14- Assessor's map and lot number .. Sewage Permit number ....... 7�......... . ............................ TOWN OF BARNSTABLE i 8AHB9TADLE. "6 9 o waYa'' BUILDING INSPECTOR � r APPLICATION FOR PERMIT TO ... 41")wc_LL_e c, TYPE OF CONSTRUCTION .......... 1 ...........y...'f?...... } ?r .......................................... Q �. ................................................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies-for a permit according to the following information: Location ............................................................1 U E C ^�; #.1C S t')f C F ►.�1 E ProposedUse ... �.?....: T..'.i .! ..................................................................................................................................... Zoning. District .. ,F. ....:: :.?..... ..!�.):...................................Fire District .............................................................................. ` J Name of Owner ......................1............... �A..............................F }Address -� �A I►��S Name of Builder §�lir, k ` Address ......................... ........ '..........I...r...I....�.,..�.................. Nameof Architect ...... ....Address.............................................................. .................................................................................... Number of Rooms ....!..........................................................Foundation ..�t`��)P... �.......C:..`?.N.. T(.............. Exierior . ..�,�.!t l*JC t _C .._.A..... t�,C�A(cj.�.............Roofing ....... ............... ... 1 � ................................................... Floors �L.L- F0 - I . f)t I .....................................Interior .......I 1?,YI-0v4L-.4::................................................. ........... Heating t....V\ b ? ( is t tL_ Plumbing Fireplace ....... �.`,r ..................................................................Approximate Cost ..........................i� -............................... :. ..... .... ..... Definitive Plan Approved by Planning Board ________________________________19________. Area ................ .......................... r-) r 't Diagram of Lot and Building with Dimensions Fee . '`"# � SUBJECT TO APPROVAL OF BOARD OF HEALTH �t I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............................................ r j Jason, Mr. & Mr;; . Manuel .- F6L-r6i No ...2.0.104 Permit for .....1... 1.f.�...& .......... ami-1-y..4w-e•1.1•ing........... Location ...2.2g...p.iv�e•••Go-rne-rs•••Road..... Centervill Owner ..........Mr. & Mrs . Manuel Jason ........................................................ Type of Construction frame ............ ................... /LF1107 , Plot ........................... �Lot .....#i...................... Permit Gran ed ..............A..pr.....il........14........19 78 Date of Inspecti n ....................................19 Date Completed.......:.........................19 PERMIT R FUSED ............................. 19 . .... ...... .. . .. ..................... ...................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... p tji 'Q 0 1 IriA moo, ,p Orn % � 39 52 ! 1� � jbp 5.360 i R!v V .p 4,b ' Iri 0 � S43 °32o0E LA os GIN -Al 1441 .SAD rri vi 6Z 044\6 d0000 GOND 00 382, 60 ' 47Z P.46E 20S � O $