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HomeMy WebLinkAbout0088 GOOSE POINT ROAD 0 a--- =► -�tom(' o . ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map -arcel �Y Permit# Health Division 7S f Date Issued Conservation Division rs �t A �. Fee Tax Collect " (p toll Treasur SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address U7 / - Village Owner IA Q(,q f\jr Address Telephone • Permit Request h L� - f 0- e U y w Cam. L� � J v err, 03 '. d-e S =v e ,5 Coo. 14 Square feet: 1stge: exi ting proposed 2nd floor: existing proposed Total new Q CJJ j ValuatidfR Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) 3 Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑ No O 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:Cl 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 BUILDER INFORMATION Name � C Telephone Number ( 7J 7E Address License# iG~AfS- 1 (f c �1 Home Improvement Contractor# �F �- Worker's Compensation# ViC q d, 0(� q4� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE I t q d® FOR OFFICIAL USE ONLY , IT NO. ` DATE ISSUED k MAP/PARCEL NO:' 1 W ADDRESS �. VILLAGE OWNER . .. DATE OF INSPECTION:` # ` FOUNDATION -- _ FRAME INSULATION s; FIREPLACE t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH" FINAL GAS: ROUGH% ' Y FINAL FINAL BUILDING _: t- DATE CLOSED OUT $ .� C ASSOCIATION PLAN NO. --- � 4n, . ----- The Commonwealth of Massachusetts T Department of Industrial Accidents n _� �. - - ONC-9 of/aYesmoo ions ' _ � 600 Washington Street _ } Boston,Mass. 02111 Workers' Co m ensation Insurance Affidavit name: '� V �f � �h r location: I � ci '1. 2i L hone# `/;,Y—7 —7 ❑ I am a homepowner performing all'Work myself. p ❑ I am an employer providing workers' compensation for my employees working on this job. ,. .: :::.. comaanv name.: address.. :-":; cth^:;. ..:. shoneA ...:...,::;;;:;.:... insurance co:. olicv ❑ I am a sole proprietor, general contractor,or homeowner(circle one)anal have hired the contractors listed below who have the following workers' compensation polices: ::::. ::.:.::.::::.:::::.::::'.:::::::.......... ..................................:::.:.,,,:.:.,.:::.. ;.: ...:..:.::..:.:.: ,comnany name. ... ..: address. :.:.....:. :.. .::,.:.:..::. ... : :::::::::. ....::. ........... ........... .......... .... ........... ::::::::::::::::.. ...: ..,,.:.;. ... .:::::::::::..::::.....:::::.::._::::.:::::.:::.:::..:::.::::.:::::.::.::::::::.:::.... .......................... .w.::::::::._:::::.::::::::::.:.:::..:::::::::::::::::.::...:.::.::::::::::::::.:::::..::.:::.:::::::.::::.:::::::. ... ...........::.........:::::::..::::::.::.::::..:::::.::.::::....................:::::::::.:::,,,:.:::*.....::::.:::................................................:....:....................................................... I. . __ _ . !Y:<: ...... .:::.:.......: . :.. hanrancexo x7: :'::;::: '::;;>;: r...,:.« . ... .. . ::::.;:: :camoanv.,name: .::.::::•:.:::::.::::...::::...:.:.:::.::... . ... .........�............,.Nm."*.�....,*.'*..-�..".'..--..".-"..".."....**.--..'....".'..".....".*'..'.��.,.'*.-.."I . ..,.... -. aaAi;ess. .: ....:...:.. .. dty :::>;::: n ene :::::isj.::; /. F— to aecme 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 form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify under the pains and pen ' of perjury that the information provided above is true.and Corte Signature ." Date 11 ` �( t Print name �Z f Phone# `�/ol-e�`��- c� official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Buffding Department ❑Licensing Board . ❑checicif immediate response is required ❑Selechnen's Office ❑Health Department contact person: phone#; ❑Other (reused 9195 P1A) r 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 contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a Icense 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. t 'Applicants LR -.Jlease 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 Fyy "1'si omitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and Lite 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`Uw"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 permrtllicense mmmber which wM be used as a reference number. The affidavits may be returned 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 8MC0 ofImlesugauOns 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 - oF�rod The Town of Barnstable .nRNscaste. • Regulatory Services 'O�Eo�,�►+°i Thomas F. Geiler, Director Building Division Elbert Ulshoeffer, Building Commissioner 367 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: Estimated Cost Address of Work: // 1 Owner's Name: l J,f ( rn✓✓� p�,lfi Date of Application: 1 c� 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 fo a permit as the agent of the owner: I ( I� C ' Date Contractor Narg Registration No. OR Date Owner's Name q:forms:Affidav 1 - _~ ✓fie �o�nmtairu�ea�c o�,.�uaaacl:uael�a BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR R Number. CS O49825 Birthdate: 01/31/1961 Expires:01/312002 Tr.no: 15920 Restricted To: 1G GREGORY C VARJIAN 98 MOCKINGBIRD LN MARSTONS MILLS, MA 02648 Administrator ,HOME.IMPROVEMENT CONTRACTOR Registration h0023 n� jrPe `DBA Uv Ezplration 10/02/00 f rrll, V GREGORY C. VARJIAN BUILDER 0n/ ti 9�. 6REGORY_C. VARJIAN IOCKINGBIRD LN v ADMINMRATopAARSTONS HILLS MA 02648 C STANDARD LEGEND NOTE:not all symbols will appear on a map MAP If"11 25 � GOLF COURSE FAIRWAY EDGE OF DECIDUOUS TREES EDGE OF BRUSH ORCHARD OR NURSERY 4 v—vw EDGE OF CONIFEROUS TREES — MARSH AREA —_= EDGE OF WATER . DIRT ROAD �, DRIVEWAY { E—PARKING LOT ' ok eG Gc IE PAVED ROAD — — DRAINAGE DITCH ' 1 252 ————— PATH/TRAIL PARCEL LINE MaPno E---MAP# / 21----PARCEL NUMBER #1 #tebo-HOUSE NUMBER 8 2 FOOT CONTOUR LINE }g 10 FOOT CONTOUR LINE , Elevation based on NGVD29 4.9 SPOT ELEVATION STONE WALL -X—X— . FENCE RETAINING WALL RAIL ROAD TRACK 0 STONE JETTY MA � �000"_) SWIMMING POOL (n, PORCH/DECK / 1] ❑ BUILDING/STRUCTURE / V 252 DOCK/PIER / HYDRANT e VALVE O MANHOLE 0 POST 0� FLAG POLE .T O W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M S U N I T a SIGN ® STORM DRAIN r PRINTED SCALE:IN FEET *NOTE:This mop is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetrics(man-made features)were interpreted from 1995 aerial photographs by The James n TOWER 1"=100'scale map and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD o UTILITY POLE w E 0 _ 20 40 National Map Accuracy Standards at this do not represent actual relationships to physical objects Corporation. Plonimetrics,topography,and vegetation were mapped to meet National Map Accuracy Standards s t INCH=40 FEET* enlarged scale. on the map. of a scale of 1"=100'. Parcel lines were digitized from 2000 Town of Barnstable Assessors to maps. - O LIGHT POLE O ELECTRIC BOX \Barn\sitemaps\Pub1ic\m252.dgn 11/14/2000 09:20:27 AM J aj�j - Ir 9 - 1 I— s !' t at �a T,Fl 1�F- � M w �� 6Y . � s3 if 41 qg1 f a g ig �' A-LV, (,A G5 F 4 A! d L L K v<;,C - �eL- k 4), ��PC-AL�✓tt A 1-;s i g Cl uvSC LUG EST/MA TED PROJECT COST WORKSHEET LIVING SPACE Value (high end construction) square feet X$115/sq..foot= ' (above average construction) square feet X$96/sq.foot (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet X.$25/sq. foot= PORCH square feet X$20/sq. foot= DECK square feet X$15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Value For Office Use Only - lnclusionary Affordable Housinc�Fee Residential 0 Commercial" Property Owner's Name Project Location Project Value Permit Number "Existing Sq. Ft. "Proposed New Sq. Ft. Fee $ IAHFORM 1/3/00 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION.SUPERVISOR r Number. CS O49825 Birthdate: 01/31/1961 Expires: 01/31/2002 Tr.no: 15920 Restricted To: 1G GREGORY C VARJIAN 98 MOCKINGBIRD LN ` MARSTONS MILLS, MA 02648 Administrator ' ,HOME IMPROVEMENT,CONTRACiOR ti Re91Stration. 110023 TYPe ,iDBA r <}E><P1ratlon 10/42/44 * � � *' 'k � 6REfi0RY C VARJIAN BUILDER aa�i> �° t 1 6REGORY C, VARJIAN t `�Q o�� - MOCK NGBIRD LN nrwisTaa�R nARSTONS MILISf MA 42648 e` e w jc F iY..i6 y S:t; t 00-35,000 d enclosed space (MGL C.112 S.601L) 1A-Masonry only t, 1 G-1&2 Family Homes Failure to possess a current edition of they Massachusetts State Building Code is cause for revocation of this license. ' 2 ol t DIG SAFE CALL CENTER: (888)344-7233 9� d +* ` f > s t : !License or>re stragon for ind'ieiduaPV�{ ;use only before_„elcpira ion"date.'If found r,f`F return to.One'Ashburt n Place Rm 130 `� ?Boston Ma 02108 N wO jl 577021 EVE The Town of Barnstable Department of Health, Safety and Environmental Services IIA IMAI= Building Division MAM 1059. � 1, 367 Main Street,Hyannis MA 02601 ArFO MA't Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner I Home Occupation Registration Date: � lName: Phone#: Address: G—m,�p PD 1 1�r �2-D village: C ►,tty V 1 VLF Type of Business: Lo Pt w kT-7— Map/Lot: Zs_1 y,y-7, INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. . • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. ' I,the undersigned,have and agree with the above restrictions for my home occupation I am registering. Applicant• c__.= — Date; 4 9 Homcoc.doc TO ALL NEW BUSINESS OWNERS Fill in please: / APPLICANT'S At IfI t% YOUR NAME: BUSINESS YOUR HOME ADDRESS: TELEPHONE Telephone Telephone Number (Home) 710 59 Z NAME OF NEW BUSINESS 't�lc�[�C-�L C��li �. "Deb ►c7�J TYPE OF BUSINESS w3 �EyE�oPr�E, )i IS THIS A HOME OCCUPATION? � � ADDRESS O BUSINESS �E ' 5 . ._ MAP/P FARCEL NUMBERS . .. .. :....... When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below, you may apply-for a business certificate at the Town Clerk's Office (Ist floor-Town Hall). 1. GO TO BUILDING INSPECTOR'S OFFICE (4TH FLOOR TOWN HALL) This individual has been informed of any rmit requirements that pertain to this type of business. Auth ized Signature COMMENTS: 11 a-117k,K2 kaC : 2. GO TO BOARD OF HEALTH (3RD FLOOR TOWN HALL) This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature COMMENTS: 3. GO TO CONSUMER AFFAIRS (LICENSING AUTHORITY) - (3RD FLOOR SCHOOL ADMINISTRATION BUILDING) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature COMMENTS: After obtaining the required signatures you must return to the Town Clerk's Office to obtain your business certificate (cost $20.00 i5br 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. - it does not give you permission to operate - you must get that through completion of the processes from the various departments involved. 44 o The Town of Barnstable Department of Health, Safety and Environmental Services • � ` ; Building Division s639. �e� 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration Date: Name: -�' It-t i Phone#: T70 5 i L l Address: '�56 (--X >-£ %i 1Jr �LD Village: .A ti 2.V I L t-r- . Type of Business: �� D2U�1.0 Pry t.U—I MapA ot: ZS� 4-7 INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4.1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in tragic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right,subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. . • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have and agree with a above restrictions for my home occupation I am registering Applicant: Date: ` Homeoc.doc TOWN OF BARNSTABLE Permit No. 18012 - - VAUVAU Building Inspector Cash rua N/A 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 Michael P. Romano Address lot #14 Goose.point Road, Centerville . tw Wiring Inspector Inspection date c Plumbing e r Inspection da Gas Inspector Inspection date Engineering Department N/A 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. ........................ . .................... . 19_ .. .............. .........:............__................... _... _� _.. Building Inspector TOWN OF BARNSTABLE permit'�No. 18012 w •Building Inspector v 1 „un.a , Cash, ---—_ ' /J F ___ NIA S f d r OCCUPANCY ,PERMIT Bond __ No building nor structure shall a 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 Michael P. Romano > Address - lot #14, Goosepoint Road, Centerville Wiring Inspector ' � i1 Inspection date `"? Plumbing Ihspee, r Inspection date . f sr , Gas Inspector y Inspection date Engineering Department N/A 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 'J......._... ..................................... .........................«............__..«.............._._._ Building Inspector TOWN OF BARNSTABLE 18012 Permit No. ------.-_—_-._--.-- t »n.0 Building Inspector Cash t �Y� ----NIA , '��° � OCCUPANCY PERMIT ' r 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 Michael P. Romano Address lot #14, Goosepoint Road, Centerville Wiring Inspector �` ~ �f. f1 �"'f Tr.► y Inspection date Plumbing Inspector Inspection date { Gas Inspector Inspection date Engineering Department N/A 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. ..................................................», 19»»: ...................................................... .....»».......».».».».»..» Building Inspector r � 1 L-T LoT /3.9 �oT � r t , V00SC- ROIA17- ��cri�i�`o �Lo T �G•9/�/ o� A PLAN Fo,� W/-�GCo7T AM63 ANC .2eZ�4COGD /N �,�,.•=x-�,'�' � /�G. /,s'/ �,�i�s. �o�..vey ,ems. o.�'��:v„5 TH,97 THE dui Z),9r1aA1 f` E S.Sio W N oN T5i'/S PL.�}N /S Lo CATS p I rrr f ory TiS�� C�o�..v0 As ,5./a /��PEO✓�/ A�✓a Jl�/.S�T /T C'aN,GoQMS t r� 1 -_ - T 7"NE ZoN//✓G G191.vS of TyE Tow/v ©F 1�.9evs7�cQt� I Asses',gor's Crrtap and lot 'number .... r. V SEPTIC .SYSTFA 1V4US- T BE r Sew IN STALL[ age Permit number .................... .............................. .... . WITH A ma's l-E 11 STATE SANITARY CC! ANP TOWN T"Er°� TON O F BARN W S `T' Z BASBSTA11L S Gi i " 9 .e BVItLD•ING� � INSS-RECTOR c MPY Ar 751 y , -FOR PERMIT TO :••.••w.APPLICATION.a . ...•Y• TYPE OF CONSTRUCTION .......... .(.N. t L ... �'�.:....... A ............. ... ........... ...................... ...0) .......19�5 TO THE INSPECTOR OF BUILDINGS: ti The undersigned hereby.applies for a permit according to the following information: Location ........kz-.,. ......... ........C2Q.{?:5e- ....... I y.......' .............. ProposedUse ........ f.N..fa 4,. ........ ......:.................:..................................:....................................I......................... Zoning District :....... .............................................................Fire District Name of Owner .�r.,:.....P. ._O DIY!A(V..i�.....Address.I•z..R!49.-; nfl(?��...��c Name of Builder ...........S.Awr��.......................................Address ....54 7Ya:I.................................................................. Nameof Architect `..........................................:.......................Address .................................................:.................................. Numberof Rooms ............?....................................................Foundation Cp.N!� .....................:.................:........................ Exterior .......—11.1............................................................".....Roofing ..�.aP.`........ 1:V1. .......................................... Floors .....t `�..iV!? C:L....S.(. .............................Interior ... .............................. Heating ....{':...14.(:<.�.........!" !15..............................................Plumbing ..Cy.�!?e.. :............................................................- Fireplace ........2...•......................................................................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 F I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 1 Name .......... ........... � ` . . � / | ; ^ ~ � ^ . Romano, Michael P. 18012 one story single family dwelling '20' Goosepoint Road ' Centerville .............................................................. Owner ..........Micbael..P�_Bmmuanp______ frame Type of Construction -------------- ' r .. . ~ _----................................................................ Plot ----.'—... Lot �g/4 —.. ' ----------' - ���' �� �� Parmk �ron*a6 ^ e- lV ' ---- ........ob-----' - | � Date of Inspection .1~^ V -/14 7-6 . - . . _ Date Completed —. /,l9 ^ ^ � lg . ~—..~---.'�`---._---.-�—.�—.--. ^ ' - � -'.=,--.--...^ z'�..~ ' 2 '. ' . �----. . .... -----~— .—�—�.—..—��.---''--------....--- -_ ����, ''� ' ',,,' ',` ' ' ' � . Approved -------------.n-- lV � . ' ^ --_--.�-------------�---.--'.. . . . / . . . ------------------------~—. ~ / ~ � / . . _ Assessor's map and .lot number t / /� Sewage Permit number .................................. ....................... °`T"ET TOWN OF BARNSTABLE BARNSTABLE, i '6 9. BUI-LDING INSPECTOR oo�1MFYaO APPLICATION`FOR PERMIT TO .... ............................. c i ..............................................d '1 �4 Q TYPE OF CONSTRUCTION ...........`. l......f:... .....i."Aen,.......F-PP. ............................................ YN ...... ...............Lp.)...... .192A TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the_following information: :T. r .. 17r2r fLocation I.. ..... . ........ r ...........................................(..r..-^..i.�.i..i....Y..?....�.�.a....-.�..k.-................ ........ ProposedUse ........`:'.!.n!.�?.:.. �:........... .. =..:........................................................................................................................... Zoning District .....................Fire District Ngme of Owner .........�7 .�Lc x�rs iv .�.....Address��-a �L( �1?► Lct= ( t. Nameof Builder ..........�. .........................................Address ................................................................. Name of Architect ...................................................Address Number- of Rooms ..........7:...................................................Foundation ..........................:.......... Exterior ...... ..............:......................................:.............Roofing f i. ...................... .�.. Floors ....s..r! foc�........................�..(l.fa .............................Interior ���t.S'f`�(r ............................ Heating ... ....1 {.J 7A5 ..........................:Plumbing s��r� ' . ........................................ ..................................................................................... Fireplace ........ :-.....................................................................Approximate Cost ................................................. Definitive Plan Approved by Planning Board --------------------------------1'9--------. Area t{.7 5............-................... Diagram of Lot and Building -with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH i t /095 O I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name / ...�''..c !....?.f�.. .,................... --- -" - --_- -___'--" ^^^~~~^^ P. ~~252-4' 18012 one sto No ~----- Permit for .................... l� family o ,�l� �aoul ly ��el1 -----------^------=—~ ' �f-- '' . V . Location ..S gQomoepmint..Bmad.............................. _. / ^ ' _________ . . Cmo�arv1lle_________ . . . . ^ ' Owner ....... Michael P. Bmmaoo------------------' . ` ^ ' Typo of Construction .........f.r.ame.............. ' . . . ' . . = X . . rerm't Granted � ` . Pate of ' ^ . , uo/e Completed PERMe ^ . . ` - ' ` : . ' . . . . ~ ` . ' . . ................��� - � � ..................................`- -- .. . - ' Approved �� lQ - ---------./------...—.---.---. ^ - . -----------.----------~—.—.— . . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a Parcel 1-7 Application # o a Health Division Date Issued 3 Conservation Division .,Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address G o0Se ��A Village CEN MK_ I C Owner W,1 k.-k v-,', R���=>z�-S Address 3 y s.3 4A a01 50f- Vf Telephone `i 13 (95 6o1`� �vRwS'roN' =1, sooao l° Permit Request Fort D;`w V466r V-ra.m.Twr_E p�r-rt.��Ls f S tl�R.o�l< ��,5•.C.+�C' �N �z� � C ooat.�N Square feet: 1 st floor: existing proposed _ 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ao Construction Type Lot Size 908(-sc2 ems' Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure (o Y rz Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ' ❑ No Basement Type: 0,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: a existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: I 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: A 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 UJ A A L.crj Telephone Number '716 h / I Address a;, Avv e5RkCi*ty y s. J�Nm!S, License # -7 q 9 ZR! i,U�d I iMWl Rnj .� /iome Improvement Contractor# a-9 01 Sl Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ` - bwN o i L. PUs� SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# , DATE ISSUED MAP PARCEL NO. ADDRESS VILLAGE I ' OWNER F DATE OF INSPECTION: t FOUNDATION FRAME INSULATION i FIREPLACE I ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL F GAS: ROUGH FINAL FINAL BUILDING `I F DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth ofMassachusetts . Department of Industrial Accidents `Office of Investigations t 600`Washington,Street ' Boston, MA 02111 ' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information - Please Print Legibly Name (Business/Organization/Individuai} `,Whalen-Restoration Services - Address: 22 American Way City/State/Zip: South Dennis, MA 02'660 Thone#: 508 760 1911 Are you an employer?Check the appropriate box: c'Type of project(required): I.U I am a-employer with 4. ❑ 'I am a general contractor and I ,. �T 6. ❑, ew construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner listed on the attached�sheet. $ 7. 0 Remodeling ship and have no employees # These sub-contractors have 8. ❑ Demolition working for me in any capacity. w workers' comp. insurance. 9. ❑ Building addition [No workers' comp.insurance 5. ❑`We area coiporation'and its officers have exercised their* 10.❑ Electrical repairs or additions required.] . . 3.❑ I am a homeowner doing all'work right of exemption per MGL 11-❑ Plumbing repairs or additions myself. [No workers' comp, c. 152,§1(4),and we have no "' 12.❑`Roof repairs insurance required.] t ` , employees.,[No,workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#i must also fill'outthe 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. tContractors that check this box must attached an additional'sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. a Insurance Company Name: Arlella Protection Co. Policy#or Self--.ins.Lic ,#: 9091320408 ' Expiration Date:` 4/1/11 Job Site Address- City/State/Zip: Attach a copy of the workers',.compensation policy declaration page(showing the policy number and8expiration date). Failure to secure coverage`as required under Section 25A ofMGL c. 152 can lead to-the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains,-anJdpenalties,ofperjury that the information provided above is true and correct .Signature: cy Date 3- 1 W Phone#: 6-0 y E y G Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Datet 3/8/2011 Time: 4t16 PM Tot 9,1508-760.9995 Rogers & Gray Ins. Paget 001 Client#:32193 WHALRES ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYYI 3108/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 CONTACT NAME: Rogers&Gray Ins.-So.Dennis PHONE 508 398-7980 FAX A/C,No,Ext: (AIC,No): 434 Route 134 E-MAIL ADDRESS: P.O. BOX 1601 PRODUCER CUSTOMER ID#: South Dennis, MA 02660-1601 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:Arbella Protection CO 17000 Whalen Restoration Services Inc INSURER B 22 American Way - INSURER C South Dennis, MA 02660 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR 7YpE OF INSURANCE DDl UBR IOLICY EFF POLICY EXP LIMITS POLICY NUMBER MMIDDIYYYY MMIDDIYYYY A GENERAL LIABILITY 8500040398 4/01/2010 0410112011 EACH OCCURRENCE $1 OOO 000 X COMMERCIAL GENERAL LIABILITY - PREMISES Ea occur rranca $100,000 CLAIMS-MADE FRI OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO- LOC $ A AUTOMOBILE LIABILITY 74917400001 9/25/2010 09/25/2011 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ - ' X SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS $ $ A UMBRELLA LIAR IV I X OCCUR 4600021586 4/01/2010 04/01/2011 EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $1 00,0000 DEDUCTIBLE $ X RETENTION S 10000 1 $ A WORKERS COMPENSATION YIN Y l 9091320410 4/0112010 04/01/2011 X WC STATU- OTH- AND EMPLOYERS'LIABILITY OFFIC ER/ME BERPROPRIETOR/EXCLUDED?ECUTIVE�ANY NIA E.L.EACH ACCIDENT $500,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) - Project location: 88 Goose Point Road,Centerville,MA 02632 CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN William H Roberts ACCORDANCE WITH THE POLICY PROVISIONS. 3453 Harrison Street Evanston,IL 60201 AUTHORIZED REPRESENTATIVE 0 198 -2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S64403/M61439 - AMP MAR-07-2011 04 :38 PM MassParanormalInst 508 362 2846 P. 01 i I Restoration Services Inc. vAa®rtt e,9oot,%W Dameeo a mow laemsdisdoa somas odeRwWan • Reamtmotiw Specialising in Fin Reetomdon -All Work Guaranteed Accam, Authorixation and Direct Payment Request Form (we) authorize WHALEN RESTORATION sI11RVICE8 to perform work Emergency SeMc es at property located at 88 Goose Point Road, Centerville, MA tD repair damage caused by Freeze p on /11 . As owner(s) of this property, I (we) understand that I (we) must authorize this work. I (we) hereby authorize WHALEN RESTORATION SERVICES to perform this work and accept Mponsibllity for ' payment upon completion. •--- 1 (we) authorize and divot my Insurance Company A�4� &4ACJ�&e �Ld Policy No. f_s 5 D —/o , to make payments directly to ALEN RUTOMRhON SERVICES, Insurance Claim Specialists, for doing this work and to that extent I (we)Assign the benefits applicable to this lose to WHALEN RESTORATION SERVICES. I (we)acknowledge receipt of a copy hereof DAMD SIGNED WNUaNRIMTORMONREP. OWNERGIONIM �^ 22 American Way,South Dennis,MA 02660 Pbam:(308)M60.1911 • Fax:(308)M60.999S • I-NO.244•2608•E-MCI:ro wn %web Pope:htlpJlwww whA4enstmdons,eom OFFICE COPY i r ✓lie Pelt! o�✓�aaa«elu aetta �\ Office of Consumer Affairs&Business Regula6cn License or registration valid for-individul use only HOME IMPROVEMENT CONTRACTOR ' before the expiration date. If found return to: Registration:$ 129244 � . Office of Consumer Affairs and Business`Regulation Expiration: .7/30/2011 Tr# 287004 10 Park Plaza-Suite 5.170 Type: Private Corporation Boston,MA 02116 Whalen Restoration.Services Inc." # William Whalen 'L 22 American Way South Dennis,MA 02660 Undersecretary Not valid without signature t a• r s �lits site hus'etts.- (Department of Public SafetN Board of Buildin- Re--ulations and Standard. Construction,Supervisor License s , License: CS 74928 WILLIAM WHALEN 122 POND STREET ; BREWSTER, MA 02631 Expiration- 8/10/2012 C'�mniissiuicr Tr#: 70 ,. o I _ �� �..w.{.... �,- `i ( , � -�--�+•. �-----•„t.._ }._,. �, ' .._ �.. �..,_.-_r-_.-1 j rl� -.� _ )_._._...�._._-... _, - .,.- !- _ .t--• -�._-_ _9---._ -�.-v;.� .. - - -",'-_. �- I ._ I.. _ ' _ _""-�._. . ._- 1 --+--._ __- " _ -�-- i_--_ _ _I �.1. .... __,. i I J _ I , ------------- I r r I � I ' } l1/i N6Yuooea.` ' _ 7 � p¢� , me I �a I - jh. la�' , , I i �� I I i ,- I } r fi 1 I , �- - r I 1 � , I -�'-_ . 7-- L- - -- - - -- -- - - - - - - -- - - -- a-- ^--�r— i t Y— '(� T r --- - i•---,--+ - - I ---`t---- -i--- �- - i•I6�lNl.w�i-y ;-'Th l3�-\"�iVv� } -._ ..._.,._,__� _,- , -�- -' - _ __ _ �.�. , _ I _I — —+ _t.r 1 , I —fr -T— 171 ......... T-F 1 F F-71__T-1 �ai . lT I f f I I _- _-.�..- ..� - 1 , }� 1- � �- k --^'{ '^•N-^ " - ;-� 1 , ._._ _.� - - - 1 f 14