Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0054 LONGBOAT DRIVE
c) c �FT- " t • y$py, f� 0 A J �d I IIII �RECYC(Fo�O UPC 12143 a �� No.5�G HASTINGS,MN r Town of Barnstable — Building Post This`Card So That it is Visible From the-Street-Approved Plans Must be Retained on Job and this Card.Must be Kept � MAS& $' JPosted Until Final Inspection Has Been.Made. � � �er��'1111 �. 1639 HYII� uc° Where a`,Certificate of Occupancy is Required,such Building''shall Not be Occupied until a-Final Inspection has been made. Permit NO. B-19-3618 Applicant Name: SIEKMAN, NANCY MARIAN Approvals Date Issued: 10/29/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 04/29/2020 Foundation: Residential Map/Lot: 193-152 _Zoning District: RC Sheathing: Location:, 54 LONGBOAT DRIVE,CENTERVILLE F Contractor Name: Framing: 1 Owner on Record: SIEKMAN, NANCY MARIAN Contractor Licenser 2 Address: 54 LONGBOAT DRIVE Y Est..Project Cost: $ 150.00 Chimney:, CENTERVILLE, MA 02632 Permit Fee: $85.00 Description: Finish Basement into.(3) rooms with 1/2 Bath need to create Fee Paid:,' $85.00 Insulation: bedroom,entertainment room-and office spa,,ce �., Date: 10/29/2019 Final: Update Smoke Plumbing/Gas.. Project Review Req: 3 Rough Plumbing: s Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced"within six months afte'r,issuance. Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officialsare provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing Af- 2.Sheathing Inspection f` Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed,—. 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall.not proceed until the Inspector has approved the various stages of construction. Health "Persons tracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: n� Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-,ISSUED RECIPIENT Final: IKE Application Number. _ ".... I to .................... Suklo//VG ......... 11MUMAJ3140 PIP MASS. Permit Fee.......................................IMer Feci....................... 1659. ► OCT 2 8, TOW/V OF R Total Fee Paid...............i............................................... ...... 1 R111,- TOWN OF BARNSTABIt Permit Approval by. . ............................on........................... BUILDINGPERMIT f Map....................................... ............... . ...................... APPLICATION Section 1 —.Owner's Information and Project Location Project Address go&-r Village Owners Name— Owners Legal Address City Ck4Q, State A14- zip o Owners Cell# E-mail Section 2 —Use of Structure Use Group_ ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,060 cubic feet Single/Two Family Dwelling Section 3 — Type of Permit -1 F❑ New Construction ❑ Move/Relocate E] Accessory Structure Ej Chdnge of use D Demo/(entire structure)., Finish Basement El Family/Amnesty El Fire Alarm Rebuild El. Deck Apartment Sprinkler System ❑ Addition ❑ Retaining wall Solar ❑ Renovation ❑ Pool El Insulation Other—Specify Section 4 - Work Description 7— ec cluk be ftow +,ftdw&S T.P.qt iminted- 11115/71)1 R Application Number..................................................... Section 5—Detail > Cost of Proposed Construction SZ) Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics Wiring ❑ Oil Tank Storage ] Smoke Detectors Ft Plumbing ['� Gas ❑ Fire Suppression El Heating System 'Masonry Chimney❑ f ❑ Add/relocate bedroom j Water Supply Public El Private Sewage Disposal ❑ Municipal On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage # of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes No Last updated: 11/15/2018 Application Number........................................... Section 9- Construction Supervisor Name Telephone Number Address City . State Zip License Number License Type Expiration Date Contractors Email Cell # I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and a Town of Barnstable.Attach a copy,of your license.. .,. . Signature Dated Section 10—Home Improvement Contractor Name Telephone Number �- fiA Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documenta'on required by 780 CMR and Town of Barnstable.Attach a copy of your H.I.C... Signature Date �19, Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Mas chusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentatio required by 780 CMR and tye Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date ,D 4 / Print Name elephone Number C. a 7 E-mail permit to: Last updated: 11/15/2018 i Section 12 —Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approvab Section 13 — Owner's Authorization I, , as Owner of the subject property hereby ! r authorize , . to act on my behalf, in all matters relative to work authorize y this building permit application for: (Address of job) Sign a e f Owner date Print e Last updated: 11/15/2018 Won Levd, o j� . 04 SMOKE DETECTORS REVIEWED B RNSTABL DI EPT. D E FIRE c A TM NT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING L.�v��- ��e�� �k �.�r�s s _ �� �,I� ���t'�' i 'Aps i f I i E I I, cac - at. N a oAn f--oo I r Town of Barnstable Building Post'Th�s:Card SoihatF�t;�s Visible Fr`om;thgS.treet-ApprouedPlansMust;be Retained onJobyanduthis Card Must be,Kept tA1tNl3r7►61:C.:' �c - b Posted�Unt�l .e° Where a:CertificateyofOccupancy is Required;such Bulld�ng shallsNot;be Occupied untilFnallnspectionhas beenma. y Permit, Permit No. B-18-1870 Applicant Name: Oliver Kelly Approvals a Date Issued: 06/15/2018 Current Use: Structure . Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 12/15/2018 Foundation: Location: 54 LONGBOAT DRIVE,CENTERVILLE Map/Lot 193 152 Zoning District: RC Sheathing: r Owner on Record: SIEKMAN, NANCY MARIAN Contactor Name. Oliver Kelly Framing: 1 Address: 54 LONGBOAT DRIVE Contractor License . 128957 2 x CENTERVILLE, MA 02632 Est Project Cost: $5,900.00 Chimney: d k Description: ROOF(NOT APPLYING MORE THAN 1 LAYER OF SHINGLES) Permit Fee: $35.00 Insulation: Project Review Req: s FeePaidf $35.00 Date k 6/15/2018 Final: Plumbing/Gas A� Rough Plumbing: x Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonied�by this permit is commenced within siz months after�issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local g bylaws;and codes. Final Gas: This permit shall be displayed in a location clearly visible from access stteet or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical ' Service: The Certificate of Occupancy will not be issued until all applicable signatures bythe Bwldmg and Fire Offi gals aresprouided,on this permit. Minimum of Five Call Inspections Required for All Construction Work: y Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Application number. ................................... DateIssued................... ............................. Building Inspectors Initials .te. �► �� � � ..... ................ VN12 20�� Map/Parcel.........lg....... . .. .... ....l................ Tod/n��F TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO W S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of �tw Ad NUMBER STREET VILLAGE Owner's Name: ���� Phone Number Email Addres s: A -)� �'v Cell Phone Number Project cost$ Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK F Siding F-1 Windows(no header change)# Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) w, Construction Debris will be going to �� e1 i -,,r3 CONTRACTOR'S INFORMATION F_ Contractor's name- , . S- r' ., .9n Home Improvement Contractors Registration(if applicable)# 1��q (attach copy) / rr Construction Supervisor's License# ( KJ (attach copy) r Q (I Email of Contractor�,�U L�LEI �C�� Phone number c0�S / -T 6 Y-0 ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN ___ .._.. __....� �.� nrrno►r n BODMIe► RFMRF d PFRMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s),will'be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval; *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CAM the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date _ t APPLIC SIGNATURE Signa Date i g All permit applications are subject to a building official's approval prior to issuance. r f Payment schedule: balance upon completion. Respectfully Submitted, Oliver Kelly.- Proposal accepted by; u'�Date / /20i 7 If acceptable please sign and rem' one copy to the address above, keeping a copy for your records, this proposal is vali for 45 days from date above, please call to verify thereafter. 'l A& Office ofiPonsumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Masla usetts 02116 Home ImproverrI :Contractor Registration _ Type: Individual s, OLIVER KELLY + Registration: 128957 8 RHINE RD Expiration: 06/13/2019 _ YARMOUTHPORT,MA 02675 ; Update Address and return card. Mark reason for chan-:' sc a e: zoM os 1i ___ _ C7.Aetdre r'1 Q�he+!!at r'i a.,�DtQrt►pnt.C7 I_nct 1 _ ��e�a»r'9�ranrrre�r/f�c�bllm.:.-rrc�u�elld Office of Consumer Affairs&Business Regulation . . HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only ' TYPE:Individual before the expiration date. If found return to: <.- E lration Office of Consumer Affairs and Business Regulation' -T - 1L6957 06/13/2019 10 Park Plaza-Suite 5170 L3"dn;MA 02116 OLD.M.iC=i LY' 8 RHINE RD. U 1L�5 YARMOUTHPORT,MA 02675 Undersecretai Not valid without signature V f Commonwealth of Massachusetts s � Division of Professional Licensure Board of.Ovilding Regulations and Standards ConstructioSZtp'eFvi qr Specialty r ' CSSL-099167 yPplres 09/28/2019 OLIVER M KELLY =y r 8 RHINE ROAD YARMOUTH PORT_MA 0267 f's 7 o. .. .j 2 I Commissioner V" DATE AC ® ' CERTIFICATE OF LIABILITY INSURANCE (N9MIDD/YYYY) `/" 05/18/2018 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 endorsements . PRODUCER CONTJoanna Bednark CT PHO NAME:ME: DOWLING&O'NEIL INSURANCE AGENCY (A(CNe I.t: (508)775-1620 No): ADDRE EaeAIL SS: jbednark@doins.com 9731YANNOUGH RD INSURERS AFFORDING COVERAGE NAICt< HYANNIS MA 02601 INSURERA: ACE AMERICAN INSURANCE CO 22667 INSURED INSURER B: KELLY ROOFING INC INSURERC: INSURER D: 8 RHINE RD INSURERE: YARMOUTHPORT MA 02675 INSURER F: COVERAGES CERTIFICATE NUMBER: 270693 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF IN8URANCE ADDL UBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DDIYYYY MIDDIYYYY COMMERCIAL GENERALLIABILrTY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person $ NIA PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 0 PER`OT LOC PRODUCTS-COMPIOPAGG $ OTHER: $ AUTOMOBILE LIABILITY COEa aMBINED SINGLE LIMITcddant $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS NIA BODILY INJURY(Par accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Par acddent UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE NIA AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X PER OTH- STATUTE ER AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ 500,000 A OFFICERIMEMBEREXCLUDED? WA wA NIA 6S62UB8H08580918 05/10/2018 05/10/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 NIA DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensationrinvestgations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of MBSIIpe@ ACCORDANCE WITH THE POLICY PROVISIONS. 16 Great Neck Road North AUTHORIZED REPRESENTATIVE Mashpee MA 02649 �wf. C.� Daniel,M.CroHu�y,CPCU,Vice President—Residual Market—WCRIBMA 01988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATIONO Map 19 3 Parcel Jr 1�';, , NSTA&BLE Application # Health Division `, E, Date Issued 5 /S ,41 Conservation Division Application Fee Planning Dept. xm� � Permit Fee v� Date Definitive Plan'Approved by Planning Board Historic - OKH _ Preservation/ Hyannis 4 L d R Project Street Address 5OB w 0 A�' r;r 1 rr__ , � 6 Village C2nTefYi lie v Owner n ;e k moan Address S-km.e, Telephone Permit Request 3 0 �0se -t-0 -f-�t �- F�ir sea e &Vc otne, w T nJInc - p am , Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation b300 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) Namewl,11114M C1C1 4 C t c5,R-c Zn.c. Telephone Number 508 3 48 0 � 4 Address '' I-�u n+�fti-h n Are, License # Z L T-1t-b S o N A' 0 M 6 1 Home Improvement Contractor# I -"Fl A Email Worker's Compensation # W W L 3 13 b a 4L1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Y�rmou�� SIGNATURE DATE 6 AS FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ` ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. F The Commonwealth of Massachusetts Department of Industrial Accidents, 1 Congress Street,Suite 100 Boston,MA 02114-2017 - www.massgov/dia R'orkers'Compensation:Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH T.HE PERMITTING:AUTHORITY. Applicant Information _ Please Print. Legibly Name(Business/organization/Individual):Cape Save Inc Address:7-D Huntington Avenue City/State/Zip:South Yarmouth, MA 02664 Phone#:508-398-0398 Are you an employer?Check the appropriate box: Type Of Project(required): L ✓ I am a employer with.20 employees_full and/orpart-time).* ( 7. []New construction 2. I am a sole.proprietor or partnership and:have no employees working for in ❑ 8. 0 Remodeling any capacity.{No workers'comp.insurance required.] ' 3.01 am a homeowner doing all 9. El Demolition work myself.lNo workers'comp,insurance required.1 t 10❑Building:addition , 4.01 am a homeowner and will be hiring contractors to.conduct all work on my property. I will ensure that all contractors either.have workers'compensation insurance or are sole I Ln Electrical repairs or additions proprietors with no employees. = 12.❑Plumbing,repairs or additions 5.D I am a general contractor and I;have hired the sub-contractors.`listed on the attached sheet. . 13 D Roof. epairs These sub-contractors have employees and have workers'Corp..insurance.; , 6.D Ware a corporation.and its officers have exercised their right of exemption.per MGL.c, 14. Other Insulation 152,§1(4),,and we have no empioyem.[No workers'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 ofthe 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;Wesco Insurance Company Policy#or Self-ins.tic.#:VVWC3136274 Expiration, 04/09/2016 Job Site Address: 54 Longboat Drive City/State/Zip.- Centerville Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under.MGL e..152,§25A is a criminal violation punishable by a fine up to$1„500.00 and/or one-year imprisonment,as vt%ell:as civihpenalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of.this statement may be.forwarded to the Office of Investigations-of.the DIA for insurance coverage verification. 1 do hereby certify under th pains and penalties of perjury that information provided above is true and correct Si ature:. . Date: 5/6/2015 Phone#:508-398-0398 Official use only. Do not write in this area,to'be completed by city or townofftciaG . s City orTown; Permitlicense Issuing Authority(circle,one)! 1.Board of Health 2 Building Department 3.City/Town Clerk k Electrical;Inspector 5.1Plumbing;Inspector 6.Other Contact Person: Phone#: I .aCORc.� _.. CERTIFICATE OF LIABILITY INSURANCE bATE(mmwfY" . �1z4f2o15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATWELY AMIEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY'THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A'CONTRACT BETWEEN THE It INSUREI? AUTHORIZED` REPRESENTATIVE.OR PRODUCER,AND THE CERTIFICATE HOLDER. jmPORTANT If the certificate holder Is an ADDITIONAL.INSURED,the poNcw"I must be endorsed. If SUBROGATION IS WAIVED;subject to the teens and conditions of the policy,certain policies may require an'endorsement. A:statement on this certificate does not.confer rights to the certiticate holder in lieu of such endorsemen s PRODUCER NAme. CCONTACT olleen Crowley Risk Strategies Company PHONE (781)986-4400 Fax !C 0.(781)963-4420 15 Patella Park Drive I .ccrowleyfarisk-strateges.com Suite 240 - INSU S}AFFORDINGCOVERAGE NAIC�. . IksuRof llT i32"�$8 INSURERA:Se7.ective Ins.. OF .America tNSLrRED �,� INSURERSjU11I=ica Fiaauaiai 14133ance 0212 Cape Save, Inc INSURER C:-WeSco..YASUraIICe an . 7 D) Huntington Ave - INSURER D i�. i� g to !� /s�}t INSURERE: S6uth yinso 1tl!` iJli U 604 INSURERF COVERAGES CERTIFICATE NUMBER.CL153249150I REVISION NIJNIBER: TtikS:IS TO CERTIfY THAT i?iE POLICIES Of*WSUftAIVCE'LISTED3 KtOW'HAVE BEEN ISSUED TO THE1NSU RED'IVAMED A6017E E.OR 1 FIE POLfGY7PERIOD (Rt=ATED. 1+tf)TWtTHSTANDING ANY REQUIREMENT,TERM.OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT Wn'K RESPECT'TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE.AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS; EXCLUSIONS AND CONDITIONSOF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF-INSURANCE AwnPOLICY NUMBER POLICY- �ICY EFF POLICY IXP LIMITS GENERALtIABILITY EACH OCCURRENCE $' 1,000,000 X COMMFJ2CIN GENERAL LIABILITY �I ED' PREMISES Ee occurrence) $ 100,000 A CLAIMS-MADE.a OCCUR 1994480 O/16/2014 0/16/2015 'pn£D E)(P(Any one person} $ 10,000 .:.PERSONAL&ADM INJI.fRY 5 1,000,000: GENERAL AGGREGATE $ " 2;.:000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS:-COMPAOP AGG $ 2 Door,000 POLICY X PXCTRO }( LOG $ AUfOMOBILELIA IL1TY Ee a n# `; 1 000 000 • j B ANY AUTO BODILY INJURY(Per persony $ ALL OWNED SCHEDULED 679fifi00 1/6/2014 1/6l2o1s AUTOS AUTOS BODILY INJURY(Pei accident):$ x HIRED AUTOS X, NON-OWNED AUTOS Pertl YY MF €,. $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,:000,060' A EXCESSLIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED IRE[ENTION 01 1994480 o/i�/2oia o/16/20i5 WORtta'RSCQMPENRTIQN f1!SCYS Ff1ClLlt�e<]. £or T. ..X \AGSTATU- .AND EMPLOYERS'LIA13IITY OTH- AN/PROPRIEFOR1Pl{{TNERIEXECUfi1VE YIN OY6e3g9 OFFlCEPJM£tt$ER EXS1 CCtED? NIA E:L:EACH ACCIDENT $ 500 000 (Mendafory in NH) 1Z62 74 /9/201"5 %9/201b Ifyyees,aescnbeunder E.L.DISEASE-EAEMFLOY DESCRIPTION OF OPERATION Sbw E L.DISEASE-POLICY LIMIT 500 O00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Aftach ACORD IR9,AddiElonal Remarks.Schedule;if more space is requ7red)Issued as evidence of.ansurance. Thielsch Engineering, Inc_ is listed as additional ins- ,-ed ,as respects General Liabila Ly: .as"r gtyyred ,}sy writes so>�t ract, CERTIt=1CATE HOLDER CANCELLATION t SHOULD A1VY OP THE iA8OVE'DESCIg(8ED#OLICIEt BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Light Compact ACCORDANCE bVIiTN THE POLICY PROVISIONS. Attn: Margaret Song ?O DOX 427/3CH AUTHORIZEDREPRESENrAnve 3195 Main Street B3rIIS': x}ie.i Mid 02630 chael Chrstian/CLC_ ACORD, 2:�20 t0105 Q-3988.2(IM1tI dtC01aD CORRORAT60_N. Aft IglTts rsses�ed. tN3025(2otoos},o The ACORD name and logo are registered marks of ACORD _ f Building Permit Authorization I, Nancy Siekman , as owner - - hereby give my permission to Cape Save, Inc. 7-D Huntington Avenue . South Yarmouth, MA 02664 Office:508-398-0398 to take all necessary steps to obtain a building permit to perform work at my property located at 54 Longboat Drive Centerville, MA 02632 Signed Date ,,�� Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration w w• Registration: 171380 Type: Corporation Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. . WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE ' SOUTH YARMOUTH, MA 02664 —.__•_____..__-,____�__ �u Update Address and return card.Mark reason for change. sca i 20M-OS/71 Address Renewal Employment (� Lost Card n'f�! �cvnirru ruaeal,/,/r r��'^l/��ia:;nc/nJet/r ' Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 47.1380 Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Expiration 3/14/201.6, Corporation Boston,MA 02116 CAPE SAVE INC. ���. WILLIAM McCLUSKEY' 7-D HUNTINGTON AVENUE` SOUTH YARMOUTH,MA 02664 Undersecretary Not vali Tt signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialty License: CSSL-102776 9i WILLIAM J MC C-LU 37 NAUSET ROAD �- West Yarmouth MA Expiration Commissioner 06/28/2015 hl . .na..,,,,LAdir.►LL5 .• . —0 N � cc 0FFICIAL _: r- "i O Postage $ Ln Certified Fee C3 ostmark O Return Receipt Fee "P1 q� (Endorsement Required) ��/ 1 O Restricted Delivery Fee O (Endorsement Required) o Total Postage&Fees rO Sent To � Street,Apt.No.; or PO Box No. `y-- City-fate,ZIP --•�+'----- ------ - - `-- �---------------- Do`s 3 oZ l Certified Mail Provides: o A mailing receipt n A unique identifier for your mailpiece o A signature upon delivery o A record of delivery kept by the Postal Service for two years Important Reminders. o Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return . Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece 'Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,April 2002(Reverse) 102595-02-M-1133 j • SECTION e Complete items 1,2,and 3..Also complete A. ature item 4 if Restricted-Delivery is desired. t ® Print your name and address on the reverse X �a&'dAtdressee so that we can return the card to you. B,)Received b tinted a e) C. Date f Delivery is Attach this card to the back of the mailpiece, ah or on the front if space permits. 1. Article Addressed to: D. Is de very a r ss different from item 1? ElYes If YES,enter delivery address below: ❑ No 3. Service Type ;E!rCertified Mail ❑ Express Mail ❑ Registered 18fftturn Receipt for Merchandise ❑ Insured Mail ❑C.O.D. w�- 4. Restricted Delivery?(Extra Fee) ❑Yes 2:. Article Number ;; ; 70021 f],0 GO° 0 0 0 5 £ 0 7.81 (transfer from service label) + t i PS Form 3811,August 2001 ` Domestic Return Receipt 102595-02-M-1540 s15w nn,, UNITED STATES POSTAL SERVIC ', -First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • TOWN OF BAR NSTABLE BUILDING DIVISION 200 MAIN ST. HYANNIS,MA 02601 E I C.r1�"G l�Fti?Ff�:Ifi1FF�3fkfkF?1S?k!tl�Ikfkfltilitifkl{f?!�flfi?kktti '`"' i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel /J o-7 Permit# R` 2 7 6 Health Division 11 7 Date Issued / / — Conservation Division I , Fee Tax Collector 0o S A Treasurer I pp Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address Village C��Iv`T 2c91LL� Owner �94019 NO /I/A4 M Address � Telephone SiE �rt 4 Permit Request p� D Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Ovrlay _s Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documen n. r C6 -•i Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Z Age of Existing Structure Historic House: ❑Yes �Oo On Old King's Highway: ❑ es Basement Type: Vull ❑Crawl UWalkout Cl 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: IdGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes �No Fireplaces: Existing O New Existing wood/coal stove: ❑Yes *0 Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:Vxisting ❑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 113 Telephone Numb Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY a PERMIT NO. DATE ISSUED 4 MAP%PARCEL NO. { ADDRESS VILLAGE OWNER < a DATE OF INSPECTION:- FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 5 DATE CLOSED OUT ASSOCIATION PLAN NO. 1 The Commonwealth of Massachusefts Department of Iridtrstiial Accidents vi4ffice.of Investigations` . 600 Washington Street Boston,MA 02111'w ww mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pluilnbers ADplicant Information Please Print Legibly Name (Businesslorganizationadividu� an: 1�'1� / AA) Address: n&���- City/State/Zip:: �= ✓yV�- Phone '3Z4 Are you an employer?Check the•appropriate box:. Type of project(required),.:- 1.❑ I am a=vloyer with 4. ❑ I am a general contractor and I 6.. New construction employees(full'and/or part-time).* have hired the sub-contractors listed on the attached sheet# [] Remodeling2.[� I am a sole proprietor or par�uer- . ship and have no employees These sub-contractors have ,8. .❑ Demolition worworkers' comp.insurance. "capacity. mP 9. Building addition forme in an c g No worke& comp. insurance 5. ❑ We are a corporation and its ❑ [N � 10.❑ Electrical repairs or.additions � required.] officers have exercised their 3. I am a homeowner dojAg all work • right of exemption per MGL 1Y.❑ Plumbing repairs or additions myself (No workers' comp. c. 152,§1(4), and we have no 12.❑ Roof repairs insurance r uired. t employees. [No workers' eq ], 13:0 Other camp.insurance required.] *Any applicant thatchecks 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 anew 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. ' _ Insurance.Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 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 cari 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 STOPVORK ORDER and a line of u.p to$250.00 a day against the violator. Be advised that a copy of this statement may a forwarded to.the Office of . Investigations of the DIA for insurance coverage verification. I do hereby rti under the pains an ena ies of perjury he in" rmation provided above is true and correct. Si atare: Date: Phone#: Official use only. 13o not write in this area,to be completed by city or town of City or Town: PermitUcense# 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#: Information and Ins Massachusetts General Laws chapter 152 requires all employers to Provide workers' compensation for their employees. purr-fit to this statute, an employee is defined as every person in the service of another under any contract of hire, z express or implied,oral or written." • , association,�rporation or other legal entity,or any two or more An employer is defined aS.: in �n�,•,PP . representatives of a deceased employer,or the of the foregoing engaged in a joint enterprise, and including the legal rep to employees- HoRteY.er:the receiver or trustee of an individual,partnership,association or other legal entity,employing e1� Y o . ant of the owner of a dwelling house having not more thanons fb do apartments and who or repair wo Y on such dwelling house dwelling house of another employs or on the grounds or building appurtenant thereto.shall not because of such employment be deemed to be an employer." MGL chapter 152, §25 C(6)also states that"every state,or local licensing agen the cy shall withhold issuance or Tenewal of a license or pew to operate a business or to construct buildings in the commonwealth for any a plicant who has not produced acceptable evidence-of compliance with he insurance coverageg ebe�ions shall P ter 152, 25C states `Neither�e commo Y of Additionally,MGL chap .. § (� until enter into any contract for the performance of public work acceptable.'evidence of compliance with the insurance 1equirements of-this chapter have been presented to the contracting authority. 11 Applicants '. .. • ation affidavit` f. completely,by checking the boxes that apply to your situation and,i Please fill out the workers' compens necessary,supply sub-contractor(s)name(s),address(es) and phone numbers) along with their certificates)other insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(Ltion insurance. If.LP)with no employees other than the or LLP does have members or partners; are not required to carry workers' compa be submitted to the Depan Cartment of Industrial employees, a policy is required. Be advised that this affidavit y Accidents for confirmation of insurance coverage..application for�thebeuror licensto sign e nis being requd date the ested,not the Department of should.t. The affidavit b e returned to the city or town that the app permit Industrial Accidents. if you are required to obtain.a wo*ers' Should you have any qu w or tio regarding er��below.. Self-insured companies should�r their iumb compensationpolicy,please call the Department self-insurance license number on the appropriate line. City or Town Officials . e bottom Please be sure that the affidavit is complete and printed legibly. The Departmto c two you regarding thvided a space ate aP . C t t the Office of Investigations h Y u to fill out in the even davit for o an licant• e aft Y. additio f the In applicant* ° number which will be used as a reference number. n, in the errnit/hcense Please b t sure'to fill P en year,need only submit one affidavit indicating current that rmist submitmultiple permit/license applications in any given y Y policy information(if necessary)and under"Job Site Address" ie applicant should or marked by the city orte"all town locations bProvided to the or town)."A copy of the•affidavit that has been officially tamp is�on fde for;future permits•or�licenses..Anew affidavit must be filled out each applicant as prdof that•a valid affidavit year,Where a home owner or citizen is obtaining a license or permit no��related anyusiness�a�mmercial venture 't to burn leaves etc.)said person is NOT required complete erml . license or • i.e. a do P . . The Office of Investigations would h'ke to thank You in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and.faxmumber: The Commonwealth of Massachusetts . Department of Industrial.Accidents� ..Office of Itivestigati.ons f 600•Washingfon•Street V 'Boston,MA 02.111.- Tel. #617-727-4900 ext 406 or•1-877-MASSAFE Fax#617-727-7749 Revised 5-26705 wwwmiass.gov/dia E Town of Barnstable Regulatory Services vg Thomas F.Geiler,Director FQ,,9,i Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601' www.town.barnstable.ma.us 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. `y, Type of Work: X Y U.�/7 eD/ Estimated Cost —i Address of Work: 1��� OT 41e. �� 17/l�lstC Owner's Name: �/�5eolzlj 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 JAOwner 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: Date Contractor ame Registration No. Da Owner's Name Q:forms1omeaffidav rq ` i Town of Barnstable PypFtNE soy�o Regulatory Services Thomas F.Geiler,Director r ' XAM Building Division i63q. �0 ATE p►u`'� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.townb arnstable.ma.us Ece: 508-862-4038 _ Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print r v� DATE: ?� JOB LOCATION. number street villagejg man f7e "AOMEOWNEr: 'v`/ ho c pb e# work phone# CURRENT MAII.ING ADDRES x ci� state zip code ityTown The current exemption for"homeowners"was extended to include owner-occupied dwellings Of six units or less and to allow homeowners_to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor_. DEFINITION OF HOMEOWNER person(s)who owns.a parcel of land on which he/she resides or intends to reside,on which there is,Or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more thaw 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 buildint.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 h she will comply with said procedures and 5paturce ements. of 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. HONZO1'VNER'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 parson(s)for hire to do such work,that such Homeowner shall act as supervisor:' Many homeowners who use this exemption an unaware that they are assuring 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 wbe4 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 ensue that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the n cur application, that the hoareowaer 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. 4.. �... 77 JS" T/.�' 1 3A ' /6,690 sa 4., ti90 F. pTE aj a �o w , ,o Fouy,pq ftay �83 o:a 0� iy AcK op � a tar CERTIFIED: . PLAN IT AM CON3TRUCTIODd ONLY 0�—FOUNDATION. 18 .:.FEET ,A�� A�OUE C1a?IW R01AlT of AD AcENT t �f �e -:� �` to L `U;h1�, ► y, 1 r- --' 3 C A l E f."= cs'' D A T E . E''E'IVG EE ING ��: ,�•° 1 CERTIFY THAT THE GDIW Ld _- L_�-- i I i ci e I P / - i � I I °FIME T Town of Barnstable Regulatory Services �snieMAn xas�'� Thomas F. Geiler,Director �A i63 . �0 yen�9 Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax. 508-790-6230 Notice of Building code Violation and Order to Cease, Desist and Abate: Nancy S.Papp and all persons having notice of this order: As owner/occupant of the premises/structure located at S� gboat Dr:Centerville 1VIA 02632, Map 193 Parcel 152, you are hereby notified that you are in violation of the Massachusetts State Building Code 780 CMR Article(s) 110.0, Section(s) 110.1, and Barnstable General Ordince Article IV para. 2,working without a permit(constructing a deck).You are ORDERED this date to Nov.2, 2005 to: 1. CEASE AND DESIST IMMEDIATELY, all functions connected with.this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: 780 CMR Article 110.0 Section 110.1 Barnstable General Ordinance ArticleIV.Para. 2 Permit Application. 2. COMMENCE immediately,action to abate this violation. SUMMARY OF ACTION TO ABATE: File a written application for a building permit for work that will be done. Dismantle deck and return structure to original configuration. And,if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the State Building Code Appeals Board(as specified in Article 1, Section 122 of 780 CMR State Building Code)within forty-five(45)days after the service of this notice.. By order, Jack itzgerald Local Inspector F TOWN-OF BARNSTABLE BUILDING PERMIT APPLICATION a Map Parcel Permit# Health Division S--1 :S�Z f` Date Issued Conservatio .D' 's i2p M Fee �s'.�� Tax Collector - SEPTIC SYSTEM MUST BE INSTALLED{IV COMPLIANCE Treasure g w ENTALCODE AND Planning Dept. ENVIRONM TOWN REGULATIONS Date Definitive Plan Approved by Planning Board t • m Historic-OKH Preservation/Hyannis Project Street Address Village I le- Owner Ct�u Cc A Address S4 m, Telephone �lS" S D Permit Request L -^A j2dd 1 Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Estimated Project Cost7 600 100 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) Age of Existing Structure Historic House: ❑Yes f qIU ' On Old King's Highway: ❑Yes O-le- Basement Type: "O-Fact' ❑Crawl , 0-ftlkout ❑Other Basement Finished Area(sq.ft.) 35 0 O Basement Unfinished Area(sq.ft) 1. 00 Number of Baths: Full:existing new Half: existing new Number of Bedrooms: existing_c2 new Total Room Count(not including baths):existing new First Floor Room Count S Heat Type and Fuel: 56as ❑Oil ❑ Electric ❑Other Central Air: ❑Yes &N_0 1 Fireplaces: Existing 'Al 0R-C New Existing wood/coal stove: U_Yes-' ❑No Detached garage:❑existing ❑new size Pool:❑existing CwWew size- —Barn:❑existing ❑new size Attached garage:De<sting ❑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 Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE C DATE _��) 7 l S a r _ FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED r �! MAP/PARCEL NO> ADDRESS - VILLAGE # r OWNER DATE OF INSPECTIO FOUNDATION FRAME - r INSULATION , FIREPLACE. ELECTRICAL: ROUGH FINAL •` r PLUMBING: ROUGH_ FINAL � s► ' GAS: ROUGJ� i-• FINAL f FINAL BUILDING !' " ` DATE CLOSED OUTt ;• `" r ASSOCIATION PLAgg N _ s^ • a j d f - CAPRI 04 i.,>8•""t' .:..� ... .' -t ...�"-. :-`•.i �-s.,. °::.=:�a? _...-,F •...-,- .,»:...,g�t•'t.-� wr s'�`,-��- �:w",�°'�s` �� �' �.`�.t { �x .J,.. .a„ / -.:,+' ...,. ,...ttbe i - .a "�:Y'x �:i. i.-"} �rv. .�..h +Sa.-x'•Y. .. �. '.._' 4. F 1 ! �f lt,•� //f t, � r`�• a r �ls. /. /' /r -.A'...-. "..k" .w x�' _ -r �`T'.:._ r "Te;,, er- e.s.i: _ f- .'F''d :f I 'r :.-r,•- s 1 `�Qy+.�`E� -�, F.f .� 3.•..v- v- � r. r p., :-r c l :'4 / :f, 1 ./,� !: -?TJ e _ ,o. x Y ,c.•,3 t ¢J r t> a vo-3 ° F4�RL�S x Js; r7st��r. met � w .•.. .. r �-`•= i �� .✓.ti i1 ti+f :5_.. -�iF t.. -..ri4....r` -... .-. ! ,,�• �IN$ �.. .' `Y_s�=- - -a- k•'t g'`- '�c."x.'Fri RIM ,a.`" '�"'i�' s«^.�.- ,� x+ ,,:i. �.. k. '� Y- , "� - '�% _�+'':'� i:�d� ,.�.:-,art i:"..,.,. r � '' - -�� '3� ".at.:,. K #..y �j•"` • ',ems ..:<.� _,. : �: �... '�:':'.. . .#''.,e.... _;t -".:.r: ;•� �.ry'� 9x ., s. , '�'e 3,:.'. .. .�, � _.R,n: YY :, � "c .A,S �+�. _is.. '-: :_� =''.., «3....._ .'4` i-, q" s+; ". �'..•"^,.sa': s'� .5;. +s _ .f - I �r � N � IJ 4 i.,... ,j- ;P. - -.i rTi ".-.:1- !h 3 1• w@=Y�'ry}.F _ -.- -; .. i,�- A x >,�,. y "� .1-. ,',. ,..m .:.:: .• L- rt;' .,tea. t", y .1;4r � ,.3: a. `i c�' �._ .� �._ #, - rc °" '3 .56'-3 '�,.• � � �," .�-..r, j,_� -_ � a - sK^*. �4 'TV t, tZ d c 'Dig o , — .r-r. -"�s- '`=3;4r '� t r -�, i ��y�.'t[ .a'•h� rc "- At °'s� =r,-<: .1 rr,�.:r � �r ��°� i.-�s�•€.� F y r ;3 _ =f. a y £; �', `4 rai rir v � •® ® ® _., ��3� sg2 .E I��t}�� r7-t to -., � � ;�; s a � f » # �3� ..�: f ��c`-L�'ws"��;�. -�p:. A d e - _. '. .: ... `. a •... _ '%.+t( "CAPR/" BY 15tJNS1Fi1NE FEATURES: • Virtually Maintenance-Free FE• AT'URES�' 4 � ; , Krystol Koted Frame and Wall for longer lasting life <� r � ��" 54. E fPermanentMed a` Sand Fi tern° � • Simulated Woodgrain Steel Side Walls • �• F�ngertC�ontrol ,�61?osition; Top In-Wall Automatic Skimmer and Returnsk Moun200.allti-Flo, Multi PortlSelf-Lockin -Swin u Deck Ladder � g9 9- P H�P. ,400 g p.h ) 9 20 Gauge Virgin Vinyl Beaded Liner Corrosion proof UnitizedFilter Swirl Design Bottom, Tile Border Tank *GAF �rTM '• Steel Plated Fasteners � InfectionMoldedABSSupport ; 25 Year Transferrable Factory Warranty I •' Easy to Clean StrainerPotfor • Painted on Both Sides, Inside and Outside x 7 �M:aximurn Um Protection • Exclusive 5052-H34 Aluminum Alloy Deck , • Advancetl�Techn:ologyto�Provide r' •Attractive Extruded Aluminum Coping Covers '� Supe for Fiftratioia" Free-Standing Patio Deck i • Large 3f' x 5' Pre-welded Deck FULLY AUTOMATIC Prepainted Slip-Resistant Cool PRO SERIES White SAND-FILTER SYSTEMS • Deluxe Swing-up Ladder ALL ABOVE GROUND POOLS ARE NON-DIVING POOLS - ' • Welded Picket Fence • Aluminum and Stainless Assuring the pool owner of Fasteners season after season of a sparkling, • Hardware to Secure to Pool p g, • Has Base for Stability clear pool, automatically. Specifications Subject to Change Without Notice o `MBASS'ADOR �ilXX'LGl 0�'4 161 Morse Street, Norwood, Massachusetts 02062/Telephone: (781) 440-0420 1-800-752-9000 Buyer(s)_90 Z/-7el .4.r?7W Phonec5Z;e— ,. —671/07 Address LO. 1r4 !n47— City 4 !//I_CF State Zip G,6��� who covenant that they are the owners of the above property,agree to purchase according to specifications: -1�.vsTi¢LG94 F/Z-TiA4T/y4) S'VSTF. /7-7 Payable$ d - r month ��installments, beginning_ da s after Y completion. SCHEDULE.OF PAYMENTS In the event that this contract is to be paid in more than(4)installments,or is to be financed,the Seller shall have 1 PfICB the right to arrange for financing in which case the Buyer(s)agree(s)to execute all instruments required.If the �f Buyer(s) fail(s) to execute and/or deliver said instruments required for financing, then the full amount of this contract price shall forthwith become due upon completion.The terms of this contract and of any instrument 2 Paid with f�fder $ LJ referred to above shall be cummulative and not exclusive and together shall constitute one contract. The Buyer shall be soley responsible for pool location,including,without limitation,compliance with all zoning a Payable Olt StBtt requirements,set-back requirements or other restrictions,and location of pool within property lines.Buyer will provide access to the pool site for delivery,and Seller shall not be responsible forany damage caused by ingress 4. AayaHle oft.COfnpli3tlon $ > or egress of equipment,supplies or motor vehicles. The Seller shall not be responsible for any delays occasioned by reason of weather conditions,accidents,act of god or any other contingencies beyond its control. 801/o DOWN REQUIRED ON CASH ORDERS Buyer shall supply suffcient water to fill pool.Buyer will also provide for electricity to the filter,and will provide all proper electrical appliances as required by all codes.Buyer warrants that he owns the premises where the pool is to be installed and that there are no zoning limitations or restrictions preventing the performances of this agreement.Buyer agrees to supply for and obtain and deliver any necessary building permits. The following items shall be supplied by and/or shall be the sole responsibility of the Buyer,and the Seller shall have no responsibility for:grading,fill,change of grade,landslide,setting of land or landscaping,concrete work,sidewalks,fences,lawns,shubbery,driveways or patios,any part of the electrical system,drainage around the pool area,and building permits zoning and zoning changes.Buyer shall grade the area around the pool so that the surface and subsurface water and drainage shall pitch and flow away from pool,construct any necessary or desirable retaining walls,and shall.comply fully with the instruction manual. The credit of the Buyer shall be subject to review and consideration,and if the opinion of the Seller or any financing institution,the Buyers credit shall be found to be inadequate,then and in that event the Seller shall have the option of cancelling this contract. DAMAGES:It,after we accept your offer to buy your pool,you cancel this agreement,you refuse delivery of your pool or we are unable,through your fault to assemble your pool,you will pay us for our loss and our expenses.Our loss will be equal to 20%of the total price of the pool,unless a lesser amount is stipulated by law. Upon completion,Buyer,at Sellers request,will sign a completion certificate which will be conclusive evidence that the pool and/or'other installationis in all respects satisfactory and that the work has been fully and satisfactorily completed.Use of the pool by the Buyer or his family or guest shall constitute evidence that the pool is in all respects satisfactorily completed.This contract and agreement contains the entire agreement between the parties hereto,and all prior negotations,representations,agreements and understanding of every name, nature and description have been merged into or superceded by this contract. Seller warrants the pool against defective parts for one season at no charge for labor and materials.The pool carries a 30 year transferable pro rated replacment policy in addition to the limited warranty. YOU MAY CANCEL THIS AGREEMENT WITHOUT ANY LIABILITY TO YOU, PROVIDED THAT YOU SEND A WRITTEN NOTICE TO THE CONTRACTOR BY MIDNIGHT OF THE THIRD BUSINESS DAY FOLLOWING YOUR SIGNING OF THIS AGREEMENT, BY ORDINARY MAIL, POSTED, BY TELEGRAM, OR SENT BY DELIVERY. ATTACHED TO THIS AGREEMENT IN DUPLICATE IS A DOCUMENT ENTITLED "NOTICE OF CANCELLATION" WHICH EXPLAINS THIS RIGHT.OF CANCELLATION TO YOU AND A COPY OF THAT DOCUMENT MAY BE USED FOR SAID PURPOSE. ALL MATERIALS SUBJECT TO MASSACHUSETTS SALES TAX ` Witness our hands and seal this =;Vm.T day of By REPRESENTATIVE Accepted: ` Signed y OWN Signed Contractor may assign this,agreement OWNER e Town of Barnstable E ° Department of Health Safety and Environmental Services Building Division 9BAMSTABM MASS, ' 367.Main Street,Hyannis MA 02601 i639. 1� prED MA't� Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: ¢ JOB LOCATION: 0 num er street village �/j� "HOMEOWNER": Uu A—) f`YI C L O rLy /�-1 5-6d rS yy 27 -6 l O name home P101ne# f work phone# CURRENT MAILING ADDRESS: ;f 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 su ems. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-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 • 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 buildixl permit '(Section 10.9.1.1): 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. S�gn ure 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. 11 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 to amend and adopt such a form/certification for use in your community. ID a Q:FORMS:EXEMPT l Proposal Expires on: Wip Number: 9721 100 02/24/99 Version Number: 00001 QUOTE WORKSHEET Insurer GRANITE STATE INSURANCE CO Underwriter ANGELA MAN I SA Branch ASSIGNED .RISK Broker SCIARRATTA & DOUCETTE INSURANC Insured AMBASSADOR POOL DISTRIBUTORS INC. Effective Date 02/24/99 Expiration Date 02/24/00 Anniversary Rate Date 02/24 Rating Plan 3 COVERAGE A: YES EMPLOYERS LIABILITY 100,000/ 1001000/ 500,000 N CAUTION: This quotation is an estimate based on the representations of the named insured, and is subject to all policy terms and conditions, rates and underwriting rules in effect during the coverage period, In conformity to applicable laws. LW0997 it (Ed. 9-91) ' The Commonwealth of Massachusetts ; '*'. - —=: Department of Industrial Accidents M ' �' '.�� Offrce atl�yesti0at�ons �s: ---d 600 Washington Street lh Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: location � _() tti S h U el city celr✓4n-ij t I I e phone# ❑ I am a homcaivner performing all work myself. ❑ I am a sole roprietor and have no one workin in aan rd achy ' '%/%%////%/�//�/�/// '///D ❑ I am an employer providing workers' compensation for my employees working on this job. comnnnv name: address: city: phone#: 5 insurance ca. nnliev# rR-1 am a sole proprietor, general contractor, o homeowner( cle one) and have hired the contractors listed below who bare , the foIloning workers' compensation polices: Comvanvname! l'l✓n brt,,5/-Y do,L ?U/14, iid I /h arcs ?.< ..:� :. address: S'� :.,<,...;•.:,..: cites ,/,� IL-u,u o J .. phone* insvrnnce cn. k eitev# j ......... .... ...:,. .. .... comnanv name: address. phone#? ... .. .......... . >>.. . insurance co. Polkv Fanure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of erbninal penalties of a Me up to s1.500.00 and/or one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a One of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage vetiIIcation. I do hereby certify under the pains and penalties of perjury that Me information provided above is true and correct Si`ffiature 1 C Date 5 �j�7/y�i _ � ?:iat name Phone# ' ofncizi use only do not write in this area to be completed by city or town oM-iai dtv or town: petmitillcense# QBuilding Department l]Lkensing Board check if immediate response is required ❑Seleennen's OMce QHealth Department contact person: phone#; ❑Other�� ;craven 9%95 PIA) 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 cam- 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 o: the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the recery 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 Iicensing agency shall withhold the issuance or renews: 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 requires of this chapter have been presented to the contracting arrthorit3. , 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 A►ccideats_for_confimmation of in��� -coverage:—Also-be sure to ign.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 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 Y 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 Iavestigatioms has to cm=you regarding the applicant. Please be sure to fill in the permitll use number which will be used as a reference number. The affidavits may be rctzaned io the Department by mail or FAX unless other arrangements have bees made. The Office of Investigations would lice to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a cal The Deparaneat's address,telephone and fax mrmber: The Commonwealth Of Massachusetts Department of Industrial Accidents OQIce of Inesduad ans , 600 Washington Street. Boston;Ma 02111 far#: (617) 727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 � � � ,�:- , ` ._y.� i The Town of Barnstable MASS Department of Health Safety and Environmental Services 639. �,� Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner TOWN OF BARNSTABLE Permit: 3-70s-(( SOLID FUEL STOVE PERMIT Date: 3�lZl� _ —--- /-� Fee: ate' Owner: O'Gl 1 I C �✓�` r Phone: of 0 . A9 Address: 5 `/ o ty, .. �(v) Village: e. ,,emu , f. Map/Parcel: Date: .o Stove A. New Used B. Type: Radian /Circulating C. Manufacturer: Lab. No. D. Model No.: ChimneL�Exi:sting)afexisting, A. New please note date of last cleaning B. Flue Size C. Are other appliances attached to Flue? 1V'0 D. Pre-fab Type and Manufacturer t (N cE Masonry Lined/Unlined Hearth A. Materials: B. Sub Floor Construction: b t�i 1�, Cg instalier Name: Address: Phone: Location of Installation: APPROVED BY: j Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the - Buildin In ector ' g sP Stove.doc i TOWN OF BARNSTABLE Permit No. _ Building Inspector s,urrw Cash -- ----- OCCUPANCY PERMIT Bond ___-_______ 12 Issued to Address 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 TOWN OF BARNSTABLE BUILDING DEPARTMENT . BAR STABL TOWN OFFICE BUILDING 639 HYANNIS, MASS. 02601 . �o root►` 'r MEMO TO: Town Clerk - FROM: Building Department _ DATE: An Occupancy Permit has been issued for the building authorized by Building Permit #.. p U„ / ............... . ........_................ ._.................. .......... issued to .........�»/ �......... / 'G � �l .:! :?. .................. _.. .. f Please release the performance bond. Assessors map and lot number - THE t SEPTIC SYSTtIM, Sewage Permit:number .......�.......... .�............. •- INSTALLED 1-14,COO ' WITH TITLE BJHB�SBTABLE, i House number. .Jr 7 ........................y...................... �. Sao ENVIRONM N SAL �:.(� ,�i6 xl a� TOWN ,. OFF BARN!- L LE BUILDING "INSPECTOR :. APPLICATION FOR PERMIT TO ....... . ............................:...................................... ........... TYPE,OF CONSTRUCTION iw.rr. ...... ............................ , nn ... ....................19.,C�',� TO THE INSPECTOR OF BUILDINGS: I' The undersigned hereby applies for a permit accordin to the following info rma on: Location ............ s!1.1...::........�........�......... dlL . ..L9.Glf�l. ........ ..�..1vG......... .....�?C�!C!/i.. . Proposed Use ....... �l.ft!�....:....L..�i/f�G ..................................... .......................... Zoning District ...........1�-. ............. . ���t. Fire District .............. .—................ ... -77//A4 y � /�a eR A�e� Name.of Owner . ..�'f..A........ !`//ViO... (li /ll.......Address �.��� ....(�.-.. ..... Name of BuilderA/ LG���4:. :.♦!..Address ../P� �...........�y ...�:... �`�lf.!•+.j, ' Name of Architect ..... .!Q�✓!0�..... �, ..`Ov,..3.......Address ......4-Q...4: / / .........^ ....................................... Number of Rooms ........... , ............:............'..........................Foundation ..... D !Q........ orlG2G.C. .., .. Exterior ..GJ'........ .� .! U.¢.4%(..........................Roofing :...... .h4:..... . 1.�. /� .�:....... Floors ......41e ... ./..... 244. &. ........ .tN. G,.Interior...... ........C/ `j .......... ; ....�.��C7iG Plumbing .....:..� 4. Heating .............................................. .............: ... ..: ................................. Fireplace ....... a.>!+006...........................................................Approximate Cost 2 lJl�G * ........................... . ............... ................................................... Definitive Plan Approved by Planning Board ----_------------------------___19-------- . Area .....�J.sA.4.............:..... Diagram of Lot and Building with Dimensions = Fee y............................................. SUBJECT. TO APPROVAL OF BOARD OF HEALTH 7AI 4 ♦ • "r e OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstab re arding the above construction. ame .. Al . (,Y.. . . v..D .� Construction Supervisor's License � Q-3: ........ P "ITOUKALIS, TIKA & MARINA i No Permit for ...Qti..Story............. ' ........SJi 1919�L FaillUy..11azellizig Location ..LQt..3A...... Spit.1?xzv�.. .....: . .G.g5at;e villp....................................... } Owner ....AAA..&.. Type of Construction ....Forte........................... - ................................ ........ ...... Plot .. ........'........ Lot Permit Granted ..... .1` ? k�:.21�,�.., 1.'9 85 Date of Inspecti ..C. 19d� - ? Date'.Completed .. 4:.......191R6 a A - !•� ��''�, � is � - . d • . .,..'+",'^ .-•t T♦ . _ ' - , �^ s Assessor's map and lot number ` ./ .....:. r?� r z ac; P�oF ropy THE Sewage Permit -number ......... ...................................... • �`' ���C.—� Z BABHSTADLE, • House number .,.,.�*r.. .................................................. 9�O N039, 6 e� IL 9- f+ • L�.,'" 0 MPy a. TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO +'1! .' �' .. TYPE OF CONSTRUCTION ..... /l ra ......' �',,? � ,. ...................................................................... .. / ....................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accord to the (following information: f f• J (�4 +'bra, /'� > / /G/ C'c �o°�t Location ...... ...:....'...�..........................................,......... .. .......... ' .!° ..........r,...... . ............................... ProposedUse ........!'�. '..! .........•f �',• !'e +'.�' •-';" ................................................................................................ \ Zoning District ..... ..... .... ......Fire District .............. ..... ......... ........... . ',. • I of 0,'tAge" g Name of Owner�µ ✓..l.'` •'44 //�`� 9!+ o.......Address �. 'r3. -�'�0'7 °r.......t `Y ....... ..... Name of Builderr`.!� fG r....... nr":.5.... ..Adclress ...! ....� .... f '✓ ,,... ..7;,f . , �j Name of Architect ....... �' .. ....... i......Address ...... ` Number of 'Rooms ........................................,.. .................Foundation .......°�.. a J et .'; .!a.*°.��� f ,rA}........... Exlerior � J( �` 1'�1 r+/ g '� �% !„1,,,,,....,,:r •; � '"`�' �". ......... ............. .. ......::...... ..... .. ....... Roofs n ' . . Floors t '�`� ' r'" ....... �:, �,� ._�'Plnterior ' ... ......... .. ......max ......... ...... . .'n. "' r Heating .... ✓";.fe ao€........................................... .......Plumbing ......... ............................................................. r".... x ..................Approximate Cost . ^'1�.� Fireplace .........:........:....-.........\....;.....::................... ......... Definitive Plan Approved by Planning Board --------__-----------------------19________ . Area ....... `. z) .^............... r Diagram of Lot and Building with Dimensions Fee ............ ..... SUBJECT TO APPROVAL OF BOARD OF HEALTH 01 1 �4 • 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.. r ... .................................. ...:.. ...................... oet ,� Construction�`Supervisor's License f�.4` : '.. .... ........ t` ! r f � 3-153-000 . * �.0 �� � /��/ uue Permit - -------. ~` .......... m ' Location ....I���..3�.__54.. - ' � ------��uw�+��+�n�-----` .�------ ' Owner ....:.1� .h�. �___. r ^ ~ . Type of Construction —.zv.�=...... . . . � --------------------------' ' ' . . Plot ............................ Lot ----------.. . ' D&arob 2I^ 85 ' Permit Granted -------------]V . ' ^ / Dote of Inspection ............................. ......lQ . . Date Completed ------------..lg . . Of ~ ^ - \\. . . , ' ` . � . . . ^ . ` 'r ^ ' N N , __ x /Fl7NOR 7XE S�PT/G TA�tI�,` DR K �.4 cis/�rG P17 .4 Arm' �9caRE T'I4t i4'N /t"B 0 3aJ L A ?4'A0/aaM E7',=& Co VCRe�T.= CGMER � s1dALl ®'. �IPZO�+GNT' T'® J�A®o : CONCf�E�E 'Q~/DYC ®!Pr hi 64NAX7,TA E.4 Y C^S 7 / 'O/V C O Y4 SA1,4 BONJ/M. PITCN � SE_ a, �y 9s.: CO►/E/�.S j�'°R��Fr If/JV .CAR/VIE JIVA Cc)YER CLAN SAA1,0 ,+ L/QCJID L.EWFILSCH = AER / 67 d J►9/N. /�Cld �8A L. m a r a • ® • s e • p ®mom o ®�T. o WA SHIED S�Nto �� .P�f� PT." .����/C �i�/v� O s D.i ® • e ,e'• e • s o a •� $ e r e�FECT7V� • r � � - 3�4�— / �2 t ° c q D�PYtI ° a o • 0 WA5lYA=P STONC ► o -- a' i c o • • f f • ® r a o p P,4&.CAS T SE.MAAGE �'L VA?YON S �i T Cif T' c/� C��a G �.v y '. . o m • e • •. ° • o • e e o P/7 OR �V/V., • . e � EL,73_ �,. 1NYEf2T.AT AgU/tDING F7.0 Act' < 3 /itilL E '. 'RT/C 7".4.-VK :n F T /Z F7 D/i4 A9. C(5EE�ABut..4 rJON _ OU3'LE�`'.S�PT/C TAN/'C.. 3,9 FT. �1 !A&,FT 4pvsr'!4'za#T10N sO $�•� , SECT'/®N OF GROUMD WA'rEty XAME _ Ot/�LETb/ST�d'/e�l/t'/®!Y�!A' ..�/,S FT. . - "J.`;• - - ZIV41C ' �ACNlVers ®/ 9 0: FT 'EWAG& VI S'PDSA k SYST'WM L�A��!/80�: POT �i���l..��'1®/N,- Dffs1G s'CALE f. " / ®„ D/I►pEN.S/®J!/ A 8 I�7: CRITE-RMIA GAR43AG_4W'a/5,A70sAt dovir NONE ®!Lo L®G TOTAL J=LOai/ 3.3 © G.�St.�DA�'. s0/.L 7.ES7' / SD/L 7"ES7 � �'�/z �''�$ ' aEU & A aF t, AClra .oirs- l , `�'c=8! &a; i -Art&r1! 0A7 OA:®/4 rES"7: ? °Via' SID.=4a-_ACHlA/Gev _ iv)reN Nfgwlc2�. T �Ss2 ®07 P'ofs9 L�9Cf�lNG AteR/SIT �t�� Y5.Ear NE D �Y 't AWMCCLA?40N RArJF / Gc-ss A'//J1rVl14/C 6 E{ TOTA4 1, 4CN//YCr ARR-A. . .3 3'9 S� F7: . o L4 } I�PC0�7'/0j'V R, � T 4�✓MIJV. INCH 32 s� FT s v r3 50 t:.. ohs � OF ��` Mgss9 ;gin/` �p7 3� GvNc - l) T Jet✓E A B cL/V' 0951�O _ - -No.1 t, �..,•. .ate -<'J�s :..: S♦/' 1.F..- .F ,.,... .,.::: 'A,>� - �..�3, �{`,t:5.r�-3' #°'�. f., 3 f ,`-'�. is er._ .-::_ ..p_. ..,- ;: .. ..,- ay. - -. a .. ...:, x o...• f ,: .-- ......�, +� N ,..... .., .,.,.�.-. , t,. +`,...... -�..N_,.._, .....-.., 'fir:,.... _.,.x.,. ��a'�. �a r... ,.:*r. r-_ '�? �_ 3• � --�. _�,� ,.r. �.. �.» xz........: .. .:...._. :,.a .,. .: _ ,-<_,. i- ...._.. ,. �..,. i ��.n �r,�v:. �.. nc•_?t .�;i',:�*"n"qh=: ✓a�Sm,Y'"a�=�,.�u +:'�-.,v- _ � h;u �- .. __-> , -. r. ..�..t 4.., -� ..�3.:a,.- .s. ,. .... _ =a„-z'. -. sr.. F, ..,._ ,: -r .>r,: �,�•� w�+rf. - -a F" �_xc r�". ..x. ..� t�+'-,,:. .v :_ „ram f :b s•: : �.,,, - r, .. _,. _ _.. ...,,. -^�.�,.,�;�<�, .� � �"�� t '� ,�. s:-•a., t..-�a4.,a.. .,: r .....€ a .,•.�'�-+, o!r� _. ...:.. �.'±t _ ` zr. ...-._ �`..�,,.FT+ :1: ��7'T+ '%'t '�- ,? �"q�. - ,�+�--K��•`, y�w�a �.a ..tea �. .r.--r h��F'.-x. � <;S,m. �s. t�,.-, �"��- z:,�a� .e-�.,�.�"�'•X _ �a' ur s ,�ruN.: � _ .,« -.':' ur.+ '"W.._.-•t'`l,+ '._ ,,.'�a,.31..e+K:h"G.. �. -.; r.;x'-=.r .• .r,:•' � - .y�� � ..�,:�,.. �'.i� CteP :..,�." .}.. >.». ...., � .. -.. t.-c_"s+>��-r< - .,".^�*,�L';�fa...v�,` �«i5,;k...a��. :�:3 -�c •, ,` ,,r;;�5v4 � �:.a:-. �--'k"Y.•`� 'r- .ten :�-v:.k�eut*' -�f��. `�:.' n.�,- - ss �n�k,S�:. .,Y --^-�.R -,�*v.:�`",�..�r::..�"sYa,•,`.�r:..�^^�•..e:,.. :.r'.3.,..�•'. .... .,..r- ^.-.;* �" '��`���.<. ��'.,+ra: n e,'.��i ;_�£�i+:. ,,r''h':.., .� M^�� .. _ .?au:, ����i�,'•�����is �r.:,�''..a,.F..� .. f / • - • , pp d A. r(,:!3 / t. -90 5 , Al . ' A/ -7 N �-^10 L6 le,g-0.s F w J L T4, r V hOF M r '(�i �prc►r 7 or N ` g7,5 L- a ' _ �h � ALE Grp 4y J � G1NfORSE � 3r ,.,. ,' < .. � w ^ .N �,:.. .I— .:� Nu.10951�O w'P c.,Ji SGom poi A7 /ST ���`' s 33 =-9 --1 --( ¢ ^i FrS10NAL�� i sti" as ,a r G �..1���-'7: :. ��.s7' I� �J..�i '•'1.. — . `L..a rj[- C, f r EP �3G: . II-3 S-3 00 l o v ` w i T ROBERf , ����y. ' . � S S�°I� 33 �36 r� ul 20 / /V L E G E N AG r �EXJIOTINS, SPOT ELEVATION OAQ I. 'PIN® CONTOUR O —_ _ C.ERTIFI,EO PILOT PLAN .` ; '$ $ffEV LL SPOT ELEVATION � � Z-0IV6l;v .7- �R"v� ,P SSE® - CONTOUR , O CkwT4EP✓ 1� �..�- NITE The ,location of any existing underground sewerage, wells, or ;other utilities shown .on :this plan is approx- I N' 1x111a e only as determined,,from,records and/or verbal : e ormat:L_on.',The .contractor is responsible for the er -on of the existing 'locations in °the field. gCALE� /'' �/L7 DATE l 3 - -- xrnrar� sc �'11�G0�lEE'RAIYG. CO ON �r��.,,� VI CLIE1�4,.�-0-- --- I CERTIFY THAT THE PROPOSED: E01ST.IrRE REGISTERED J06 .{gyp, �' ..r BUILDING SHOWN ON THIS . PLAN st IN tCd9lll LAN® �. ,4 �"1, CONFORMS TO THE ZONING LAWS 1 „ER R1/ ®Ii,dY� _._._„_......,... OF BARNSTABLE , MASS. T12 MAtN STREET Cm;..®Y� p , i3 ;� �. 4AT MASS,. Z;SHEET-L OF EG. LAND SURVEYOR Y CAA'+.ji•:" Y V. �. n'.�. S. .15 - k 5T9 6� � p Al 109 L°T 3AZIA TH H f> irS N •F O. - .. r'1 � Nb't�.' ��fh-'4e'D 7o t _ IAwn, A4 _ 10 1 Pf?r JIA7, RJR dt j CERTIFIED " PLOT PLAN NEV: CONSTRUCTION ONLY `s=T®I� OF .FOUNDATION ISM FEET :` �� � � ; IN. j, ,ABOVf'-m,'LOW' POINT of ADJACENT h to L .� . SCALE' ��fr',V ' DATE i -112 .: ` PKIM E ENV EE ING CO. �s��fv k r.�,� CLIENT„h f 1 CERTIFY THAT THE - SHOWN ON THIS .PLAN 13 LOCATEQ LIEE ISTERE. REf ISTEREOf 3aCIILLAND JOB NO. . : _. ON THE GROUND AS INDICATED AND®lNEER SURdEYOR DR.BYE � r CONFORMS TO THE - ZONIN LAWS ' OF BARNSTA®LE, MASS M . . CH.BY* TI2 MAIN STRE.E.T 3 HYANrI St MASS. SHEET 0f ATE RES. LAND SURVEYOR *