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HomeMy WebLinkAbout0340 OLD STAGE ROAD e r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel A � a E R � AB pplication V ZZ Health Division r Date Issued C) )15 Conservation Division ��P Application Fe SO Planning Dept. Permit Fee }' Date Definitive Plan Approved by Planning Board 4 Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner Address JIM al 4- 10 Telephone l Per it Request l6 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District & Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure2qda- Historic House: ❑Yes Cd No On Old King's Highway: ❑Yes 2No Basement Type: W 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: UGas ❑ Oil ❑ Electric ❑ Other Central Air: 0 Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: A"'existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size — Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT-INFORMATION- .- (BUILDER OR HOMEOWNER) Name Telephone Number AAd ress / 74 License # S Home Improvement Contractor# Email .Worker's Compensation # (dS/0 ALL C NSTRUCTION DEBRIS R LILTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE � r � FOR-OFFICIAL USE ONLY ° APPLICATION# DATE ISSUED MAP/PARCELNO. z , r ADDRESS VILLAGE OWNER t DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL s GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. -� The Corr;mornivealth of-V as_sachusetts` ; Department of Ixrrlrrstrial Accidents �.. - Of•free of In—stigations 600 Washington Street E Baston,MA 02111 y wfVty ma Y-..gt)v1dia Wurkei<s' Campensatian Insurance Affidavit;B:mlders/Contrac-turs/EIecfricianslPlumhers Applicant Infarmatian Al A ZI Please.Print Legibly NaMe(Business, anizatio 1Y ' Address: 6KI City/State(Zip Phone Are you an employer. C6 e ek the appropriate bar: TAe of project(required),:I.0 a employer with 4. I am a general contractor and I e�xployees(full andlor part-time}* have hired.the sub-cont 6. 0 New consiructioa 2.211 am a sole proprietor orpartner- listed onthe attached sheet: 7_ 5��odelmg These snub--contractors have' slug and have no employees. $_ ❑Demolition pr w gcapacity- employees and have workers' 1 lrfnD for me in any 9- 0 Building addition [No Workers' comp.insurance comp_imurance f rewired_] 5_ We.are a corporation and its lb'-0 Electri al repairs'or addiCions 3_❑ I am.a homemme r doing all work officers have exercised their li_Q Plumbing repairs or additions. m)%el£[No workm'comp- right of exemption per MGL 12_ Roofr insurance regaimd]i c.152, §1(4j andwe have no employees-[N"a workers' 13-0 other ' comp.imurance required-] *-ny spp€icaatdist check-s box rl west also fillcutthe sectionbciowsho7mg The'¢woaere compensation policy inforinstdcaL Mmeuwners who submit this afiidavu i&cating they are dGmg all wcA and"then hire outside contractors amst submit anew affidavit mdicaun-,sorb IC'ontractors tbst cbeck This bock must attached as siditianal sheet shovgng the nay of the sub-cau=ckFa and state whether or not these Eaddes Dave employees.If thesub-couto3ctors have employees,dleymustprosvidetheir workers'c"oip.policy n—bet_ , I am art employer float is provUb4-warkers'c ngw!satiort irtrurauce for my enzpIoy-ees HeNv is iliepaUcy and job site hiformatiom (+ Insurance Company.Mame: J. Policy 4i or-Relf ins.Lic_4 �Q 7 7'=- 0- xpiratioa Ihte: lZLl Job Site Address: Q. CityJStat&2p: r Attach a copy of the workers'compensation policy declaration page(showing the policy inimbe r and expiration date). Failure to serum coverage as required under Section 25A of MGL c 152 can lead to the imposition,of criminal pe n"Iti s of a fine up to$1,500 00 andfor one-yearimprisonment as well as civil ppenalties.in the form of a STOP WOR ORDERand a fine of up to$250.00 a day against the k olator- Be adcased that a copy of this statement mn y be forwarded to the Office of Investigations of the DIA for insurance-coverage y etification- I rJa ltt?retiy cerfi iAcdcrr tlt prunis air *11abYes of`pedfuty fl jatthe incforazagorrprat ded ahmv U- ' $and rrect Sionature:. i ' Bate: Phone lk t7, Zdd use only. Dv not ovate in this area,to be catripL jad by city ar town official ; City or 'own.: PerrmitUcense# Issuing kuthority(drde one): „ 1.Soard of Health 2.Bu€Ring Department 3.Qtyf own Clerk 4.Electrical Inspector 5.Pht¢nbmg Inspector ` 6.Other Contact Person: Phone it: r• Information and lns&ue oas Massachusetts General Laws chapieir 152 requires all employers to provide workers'compensation for their employees; p �this she,as errrplayr�is defined as_"_.every Person i a the service of another under any contract ofhi m express or implied,oral or wfi ten." An errr�Ioyer is defined as"an individzlal,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged is a1 mt enterprise,and including the Ie&I representatives of a deceased employer,ar the receiver or t ustee of an.in partamship,association or o er legal entity,employing employees. However the des these" or the occupant of the - ouse of more�three apartments and who rest m, cQp owner of a.dvrelimg h having � dwelling house of another who emp persons_to do mamtenan ,conshuddon or repair work.on such dwelling house or on the grounds or building appurEe thereto shall not beca�e of such employment be deemed to be an employer." MGL chapter''I52,§25C(6)also sues "every state or IoµcaIi`'tensing agency shall wifihhold the issuance or renewal of a license or permit to operate busiuessor td,cd ct buildings in the Commonwealth'for any applicant-who has not produced acceptable evidence of comp ante with the h snrance•coveragerequirech" Additionally;MGL chapter 152,§25C(7) 'Neither the co onwelalth nor iay of its political subdivisions shall enter into any contract for theperfomiaaw ofp lic woncuntJl fable evidence of compliancevlith the inmmance._ requirements of this chapter have been presented the conirac auflioity_" Applicants Please fill out the workers' compensation affidavit co Ietely, y checIdag the boxes that apply to your situation and,if necessary,supply sub--contractor(s)name(s), address(es) dp nenumber(s) along with theircertificate(s) of innzance. Limited Liability Companies(LLC)or L" 'Partnerships(LLP)with no employees other than the members or partners,are not rbgzm ed to cau-y workers' co e anon ins2sance_ Ir`an LLC or LLP do es have employees, a policy is required B e advised that this afE ay be submf�ed to the DepaL"iment of Industrial Accidents for confirmation of insmace coverage. Also be re to sign.and date the affidavit The affidavit should be,refimmed to the cd3` ted,or town that the application for the p or license is being reques not the Department of n i Accidents. Should you have any questions a law or if you are required to obtain a workers' comen psation policy,please call the Department at the m.= below. Self-rosined companies should enter their self-i sarance license number on the appropriate line. City or Town Otdcials t - PIease be sore that the affidavit is complete and pried I ly 'Ibe D (--at has provided a.space at the bottom of the affidavit for you to f M out in the event the Office o vestigations to contact you regarding the applicant Pleas e be sure to fill in the pemutllicease mrL ber which be used as are en.ce number..Ia_addition, an.applicant that must submit multiple p(-_ffiiVHcense applications in giveayear,need submit one7affidavit iadira�current policy infb=ation.Cif necessary)and under"Job Site A ess"the applica t'sh d'�l trite all lacativns n (�'Gz town)_"A co of the•affidavit that has beta officially ed or maimed by t3.e or tour may be provided to the applicant as proofthat a valid affidavit is on file for fntrre omits or licenses_ An affidavit must be.filled out each_ year.Where a home owner or citizen is obtaining a license r permit not related tQ an business or commercial venture (ire. a dog license or permit to bum leaves etc.)said person NOT reqaired to complet this affidavit The Office of Investlgatims would hke to thank you is advert for your cooperation and Dull you have any questions, please do not hesitate to give us a mll- The Department's address,telephone and fax number. CG=M t th of a acl�u tts ' 't Df--gaitnMt of xndusirz cckd its ,; r t Qf ce Of j)1,vC&tF9ati o Bastou,MA E2111 ` f,14 617' 7-49R0 cxt 406 or 1-977-MIASaAFE Fax:ff 617-727 7M Revised 4-24-07 . w W g.mass-gogf din r wry Town of Barnstable ` Regulatory Services 9� 1MASS * Richard V.Scab,Director Building Division Tom Perry,BinT.di ag CommisAoner 200 Main Street,Hyannis,MA 02601 W W W.town.b arnstablema_us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section if Us ink` AA Builder r' as Owner of the subject prope hereby aurho ' -6P to act on my bebalf, in all matters relative to work authorized bythis binding permit application for. (Ad s of ob) '`Pool fences and alarms are the responsibilityof the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are perfo� ed and accepted. S , S e of Owner s' Signature of Applicant P. Name AtN D F QF0RMS.OTNERPERMmsIO2qP0OLS • `lT ` VX/ W t!/%C/fir//'!I 2:1 LJ F 2k�,•. Office of Consumer Affairs and Business Regulation r 10 Park Plaza - Suite 5170 Le Boston, Massachusetts 02.116 a ! _ Home Improvement Contractor Registration ° U) •,,1, Registration: 132560 m ` Type: Individual ' o I f Expiration: 2/27/2015, Tray 236532 Q. - 1 ROGER E. BYAM rn - , All ROGER BYAM ,;;` ' .�' _ a ,, 4 Cn a - to o P.O. BOX 1793 ��_, s �, c� = a r _ ,; w m c; o };a HYANNIS, MA 02601 _'; ._, .__. 3 W 'n WKz E , Update Address and return card.Mark reason for change. o _j r_ a m a Address Renewal Employment Lost Card a) v Ix a= SCA 1 it 20M-05111 - - C lsu er Afairuaecr Business ion License or registration valid for individul use only - � Office of Consumer Affairs&Business Regulation g y ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: c gistration: 1.3$560 Type: Office of Consumer Affairs and Business Regulation xpiration: ,;2/27I201.5;.. Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 ROGER E. BYAM Sri ROGER BYAM ; 504 PITCHERS WAY HYANNIS,MA 02601 Undersecretary Not valid without sign ture F truction Supervisoricted to:tricted-Buildings of any use group which contain han 35,000 cubic feet(991 cubic meters)of enclosed . I Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit: WWW.MASS.GOV/DPS Details Page 1 of 1 Licensee Details Demographic Information Full Name: ROGER E BYAM Gender: Owner Name: License Address Information Address: Address 2: City: HYANNIS State: MA ipcode: 02601 Country: United States License Information License No: CS-075376 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 8/7/2015 Issue Date: Expiration Date: 7/3/2017 License Status: Active Today's Date: 11/9/2015 Secondary License: Doing Business As: Status Change: License Renewal Prerequisite Information No Prerequisite Information Discipline No Discipline Information Documentum http:Helicense.chs.state.ma.usNerification/Details.aspx?agency_id=1&license_id=264326& 11/9/2015 Office of Consumer Affairs &Business Regulation- Mass.Gov Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Consumer Affairs and Business Regulation Home Consumer Rights and Resources Home Improvement Contracting HIC Registration Complaints Registration# 132560 Home Improvement Contractor Registrant Registration Home Page Name ROGER BYAM Address 504 PITCHERS WAY City, State Zip HYANNIS, MA 02601 Expiration Date 02/27/2017 Complaints Details No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Back To Search https:Hservices.oca.state.ma.us/hic/licdetails.aspx?txtSearchLN=32786 11/9/2015 O)o i X-PR RMIT ` own of Barnstable *Permit# y �s Expires 6 mo s e Regulatory SemeeS Pee Thomas F.Geiler,Director 0K 10'L�ol l2. Building Division (� TOWN OF BARNSTABLE Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.batnstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXP SS PEItNM APPLICATION - R+SEDENTIAL ONLY Not Yatid without Red X=Press Imprixt Map/parcel Number Property Address ® tZ 0� L AResidential Value of Work Z Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address_ S�y"7��.(� 5 rn 1th 3�1 UI '?ems ov�A C. Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) dWorkmaa's Compensation Insurance Check one: ❑ I am a sole proprietor. I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name a�ror�a l (, n 0n E 1 rfo �nS0r6Y1 C2 �o Workman's Comp.Policy �!C aaq Gl `g74 b I Copy of Insurance Compliance Certificate must accompany each permit Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to SGYxC(Ai\C ❑Re-zoof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors' ❑ Replacemenr Windows/doors/sliders:U-Value (maximum.44)#of windows `Where required: Issuance of this pemzitdoes not ezampt compliance with other town depaT=mt regulations;i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Em ment Contractors License&Construction Supervisors License is required SIGNA / Q71WPMES\F0RMSIbm1ding permit forms\02RESS.do Revised.090809' i f nunonweaft ofMassachrr,Seft I DepwMrerrd of'&&I'strial-4c1idents Office of�revesiaga i 600 washington Svc Boston,j1022111 wwx.stras�govldia i Workers'co a . . A Iicau �fot°m t ,ation Hoag arfce �rb vA ersleontractorsfElecttic' ioa .All ians&Iumbexs Name(,�USi--/organ w0nIhLdMdW): r Pie Print L Address: �1S City/State/Zip: Lrf L-,T+ Are-yen as em to er? 7b� Pie#: S0� y2B `�� P Y Check the a r I I. PF QFaiate]no$: employees Toyer wft T e El lam a gme al mac"aid E Typ of praje0(req�d f P Y (fa arxl(05ai`etJm bave )' i 2• I am a sole pr'oprietor�°r partner? tiered o atEac- Om 6 Ej New consfxttction Ship and have ao to hed sheet 7. 0 Remodeling i F Yes These sub-contractors have working for me co is any capes, employees and have workers, 8 ❑Demolition 7 [No workers'comp-i nmance camp insurance x 9, required J ❑Building addition 3 I our a homeowner do 5 'We are a c°rporaiion and its I Q, i mg a l work officers bane exercised their D Electical repairs or additions iosnrauce r°� 'COmP right of exemption per MGI i I'�Plumbing repairs or addifsorrs dl t ' c 152,§1(4),and we have no i2 Roof repairs i employ.two workers' 13.0 othez ° YaPPlicanrtkaCcteckshoxi�srai;o Comp-Imsurancerezlujred) t tHomeowaen;arhosabmirthisafi�i���ffiesertioabclowshowingth�• •� oa ti � 'Cbahac -tbW checkihis b= g�-e dohtg aII Mrk and then bite outside w Po cy Mfy=atfon i =*Oyees Ifthesub cantac�� ab�danaddiIIo>ffiTskeershowiggthaammeofthesuh c6ut:a � shsnbmitaneruaffidavirindicatmgsuch. Po �eYm"stP-14Dtheirworkers•co statewbcUherornot those entikeshave 1 '�A PolicpnumBcr. inf n.l fkatircp omViduigroerAers'cangmsatiorrb"Iffance or i r>strance Co f my loyeen 8elory is thepoAcy and job site r I mpanyName: - �os'1Q/ Ut��� %Y-E. •1�k5�v>" /� 1 Policy�or Self-ins.IiG#: W C O���8 1 Job Site Address: EViratioa Date: D q Z-6 0"2 e, ® O� • i , A#aeb a copy of the worlrers'coa�pensarioa citAft e/Zrp: l) Failure to secure coverage as re uar 3'declaration Page�(Sjtowjng fire policy rrtiarber and q under.Secixon?SA ofMGL c 152 can Iead rn the imposition ercrnmin�al iration date). Erne up to$I,SQQ.QO aad/or one-year anprisomnant;as well as OM penalties in the form of a STOP of WORK ORDER and a fire of up to S2SQ.QQ a da penalties oft Y against the violator. Be advised•that a copy of this s Investig��of ire DIA for in ce�,e�verirf�catiosL y fmwmded to lire Office of !do hereby cerff dpettnfiies ofPe?7tjy Char the rnformaffort rovid 1 P ed tabQve is true and corr�eCt. i Phone 9- _. 0.W41 use only.. Do not wlAe in tft arery to be completed by city ortolan offlzw City or Town: i k'ermiMieense g A atbority(eirrje one): L Board ofRealth 2,Railding Depmtruent 3. flows Cler 5.Other �' k �Efleetxicai Inspector,S.PImmbin g Inspector Contact Person: Phone : i " 1 , z AC 0" FRASCON-01 MOSU CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER DER 1 HIS 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 Viveiros Insurance Agency,Inc. (508)676-0309 NAME: Suzette Moniz. 375 Airport Road PHONE Ara No Ext:508-676-0309 FAX No):508-324-9147 Fall River,MA o272o ADD a S:SMDniZ@Viveiro nsurance.com INSURER(S)AFFORDING COVERAGE NAIC INSURED - INSURER A:National Union Fire Insurance Com an Fraser Construction LLC P.O.BOX 1845 INSURER B: Cotuit, MA 02635- INSURERC: INSURER D: . - INSURERE: COVERAGES msuRER F CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREDNISION AMED NUMBER: FOR THE POLICY PERIOD NOTWI INDICATED. THSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT NTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OFINSURANCE ADDL UBR I R wvD POLICY NUMBER POLICY F POLICY EXP GENERAL LIABILITY MMIDD/YYYYI fmmIDDI - LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE DOCCUR PREMISES Ea occurrence 5 MED EXP(Any one person) S PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY PRO' I PRODUCTS-COMPIOPAGG S J CT LOC AUTOMOBILE LIABILITY S _ COMBINED SINGLE LIMIT ANY AUTO - - Ea accident $ ALL OWNED 171 SCHEDULED , - BODILY INJURY(Per person) S AUTOS AUTOS HIREDAUTOS A NUTOSON's"I BODILY INJURY(Per accident) S PROPERTY DAMAGE Per accident S UMBRELLA LIAB S OCCUR EXCESS U L CLAIMS-MADE EACH OCCURRENCE $ DED RETENTION S - - - AGGREGATE -S WORKERSC am—PENS ATION AND EMPLOYERS'LIABILITY X WC STATU- OTH- A ANY PROPRIE70RlPARTNER7EXECUTIVE YIN WCO099306D1 TORY LIMITS ER T OFFiCERlMEMBEREXCLUDED9 ❑ NIA 9/2612012 9/26/2013' E.L.EACH ACCIDENT S 500,000 ER (Mandatory in NH) If yes,describe under elow SCRIPTION OF OPERATIONS % E.L.DISEASE-EA EMPLOYE $ 500,000 DE b E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTON OF OPERATIONS LOCATIONS I VEHICLES.(Attach ACORD 101,_Additional Remarks Schedule,if more space 11 is required) - - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Fraser Construction LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE IN IN 31 BOWdoin Rd ACCORDANCE WITH THE POLICY PROVISIONS. Mashpee,MA 02649- AUTHORIZED REPRESENTATIVE - ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. ' The ACORD name and logo are registered marks of ACORD rZ Office of Consumer Affairs and usiness Regulation - 10 Park Plaza- Suite 5170j Boston, Massachusetts 02116f. Home Improvement Contractor Registration Registration: 112536 f Type: DBA Expiration: 3/23/2013 Tr# 209024 ' FRASER-CONSTRUCTION CO. DEAN FRASER P.O. BOX 1845 COTUIT, NIA 02635 Update Address and return card.Mark reason for change. ED Address ❑ Renewal Employment Lost Card 9PS-CAI 0 SW-04104-GIO1216 Office-Ro i mer airs�c'$u"slnes as License or registration valid for indlividul use only. q HOME IMPROVEMENT CONTRACTOR before the expiration date. Ufound return to: Registration: 112536 Type Office of Consumer Affairs and Business Regulation Expiration: 3I�3%013 DBA 10 Park Plaza-Suite 5170 Boston,irlA 02116 O— R CONSTR�ICTION.C�. DEAN FRASER 104'TWNN VIEW LANE E FALMOUTH,MA 6 53o" Undersecretary 'Not vali wrt utsi re t}![:issachusetts-ilel)aty trnent.of Public"Safety Board of,Buildiny Regulations and Stiindat-ds Coh6tructibn Supervisor License -License: -CS 97668 - 'i. DEAN i`RA51R cr! 104 TNJII�(�� 111� ;NE ' EAST�ALRi10UTFl;'1�AA�2536 Expiration: 617/2013 f:nmmissin,tor` Tr#: .16692 . I Any deviation or alteration from above specification will be executeda upon written orders and will become an extra charge over and above`the estimate.' All agreements cofitingent upon strikes, accidents or delays are beyond our control: Owner should carry fire, tornado and other necessary insurance upon.the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: f omeowner Fraser Con Ction, LLC For coMpagy awe only:. Date Received Date Started: Date Completed Job estimate: Dean/Mike # of squares: Billed Material ordered Extras Paid -Available Discounts k { .i4mPhdo,Roof Jcgb• . j per customer.Not':t)be combined r discount Exp re /31112"NRG Al r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map / ® ._Parcel Permit# .Health Division e_�CAD - #0 9, Date Issued O S O Conservation Division 0 G Application Fee «Tax Collector �i2 �D�/��0 Z- Permit Feed Treasurer� � Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 3 oyo Q Village Owner , TCAX e-4 Ry e �r7i%_ Address kZXd O/o/ �'/�9� �%��✓ Telephone d 7-7 / 3 / y � Permit Request o�y �C, �r /� e.4 e j Square feet: 1st floor: existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay ixRroject Valuation _Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. DwellingType: Single Family � Two Family 0 Multi-Family #units YP 9 Y Y Y( ) Age of Existing Structure �G jQs Historic House: ❑Yes teNo On Old King's Highway: ❑Y-es 'No Basement Type: ❑Full ❑Crawl alkout ❑Other U; CD Basement Finished Area(sq.ft.) 7 ��'✓ Basement Unfinished Area(sq.ft) � `. Number of Baths: Full: existing new Half:existing new' w Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: AGas O Oil ❑ Electric ❑Other Central Air: �Yes ❑No Fireplaces: Existing _� New Existing wood/coal stove: ❑Yes )(No Detached garage:0 existing new size aDDV Pool:O existing ❑new size Barn:O existing ❑new size Attached garage:O existing ❑new size Shed:D existing ❑new size Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use /�/ �b l BUILDER INFORMATION Name lr/�y� c / of 9 Telephone Number 771 ie-?s— Address 37 G/V S-r /es-) 3i-1Qtvi License# Go 6 9 F6 Home Improvement Contractor# Worker's Compensation# /Y//) ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO wti P �A/Z/I 1� SIGNATURE DATE /'d e r p FOR OFFICIAL USE ONLY u PERMIT NO. DATE ISSUED J, y`-`MAP/PARCEL'NO. ter Ir(i IN ADDRESS it 'f VILLAGE r' OWNER DATE OF INSPECTION: (V , FOUNDATION FRAME 'l-f C� (tij/ ^ Z 7 ^6 3 INSULATION L� (`j t FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH; FINAL FINAL BUILDING DATE CLOSED OUT r ' ASSOCIATION PLAN NO. r r tr °FINE ram, Town of Barnstable Regulatory Services BAMSTnsLE, * Thomas F.Geller,Director 9 MASS g i639. A�� Building Division lFD MA'S - Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modemization, 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: 4 Estimated Cost ' 0 Address of Work: -7`/d 0 Z� Silo Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reasou(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED ACCESS TOT TEE AR ITRATAPPLI ABLE HOME IMPROVEMENT WORK DO NOT ON PROGRAM OR GUARANTY FUND UNDER MGL c 142A. ACCESS SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: A Date Contra or Name RegistrationNo. OR Date 0Yzer s_,;ar_e The Commonwealth of Massachusetts _- - Department of Industrial Accidents _-_ office Of/nyestig�tfo�s ' 600 Washington Street Boston, Mass. O2111 `j Workers' Co m ensation Insurance Affidavit / 7. ,3 n, 7 ?C1 location• _ -• - hone# s ?7 /•/�;71 Cl In I P.l!•.! e - ❑ •I am a homeowner performing all work myself. ® I am-a sole r rietor and have no one workin in ca achy/%//o�%/G//%%%%%�%/�///%/%%�///%/////%///%%%�/%//�/�%///�//%///e//%///i%///%%S%//w%/o/%%%///////%n�//�////51//jQb////G///%%�%%//%%%%//////�%//%/�///%%/%%%%/G%///�,. • ///%///%/r//// ensation for my ay •r • om � •;r,;;•n.,'f•?:�Yv:$;:y,; .y..3, v�Y;nYF>,'.'•.$`}r^,,.^•,"i::,:k�?_ Ikers c {.:Y:r{ �.�:::,�;:;2><}v�:$£$^.:jin};$:}:{:;r•'• ::5:4:... ::',�;±$;i?rh4£:};:Y?'i •:n+�ii;:S::S::ivvv: ovidin wo P, }.?.<4:J:•< 5f�:,: •$:~_,; ::},Y�Y::. „�.. y h•2.. '}y�. 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Iles oI a 9nenp to 51,50U.Q0 mcUor Faflure to secure cover>;e is required under Section 25A'of MGL 3.52 cari]ead to the imposition of criminalp one years,imprisonment as well as dvfl penalties in the form of atipnP the fiLKOor coverage���tion.00 a dap against me. I mtders{smd t}iat a' cope o WO f this etateznentauy be forwarded to the Office of Investig , _ that-the-in ormatian-provtdedabvave-isscr an_d coirect - I as hereby-�ertifyuncier•the�ains-and penalties-of-perjury- f r . Date _ % - Signature :Phone '•print name� � offlcialwe only do not write in this area to b e completed by city or town official pertnit/ticease# [i mgDepartment city or town: ❑LJensi cng Board . ❑Sale=trnen's Office contact person: � ' J formation and Instructions heir Massachusetts General Laws chapter�152 section 25 requires ally 1oy e=5 a m10t�he servi eeof another under contract employees. As quoted from the"law", an employee is everyP . .of hire,'express or implied, oral or written. yer is defined as an individual, partnership, associ artners ation, corporation or other legal entity, or any two or more of An emplo _ the foregoing engaged in a]off 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 ... dweller house having not more thanthree apartments and who resides therein; or the occupant of the dwelling house.of g persons to do maintenance, construction or repair work on such dwelling house or on the grounds or another who employs p P yer. building app� errant thereto'shall not because of such employment be deemed to be an ern to L chapter 152 section 25 also states that every state or local licensing agency shall for old an a he ulicant who has of a license or pertnit.to operate a MG ' business or to construct buildings in the commonwealth not produced acceptable evidence of compliance shall enter into any contract for the the insurance coverage iperformAdditionally, ance o public workimtrl commonwealth-nor any of its political subdivisions acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority ,j,'.,;././�, MEN Applicants your situation ailcf Please fill in, the workers' compensation affidavit completely,by chefldng thte of insurane box that ce as lies all affidavits may be along with a addr ess s and hone numbers g . ,._... companYnames, a P Also be sure to si ' and '. subsupplyingartment•of Industrial Accidents for confirmation of insurance coverage. En submitted to the Dep _ theapplication `" date the affidavit. The affidavit should be returned 3� Should ca have any questions regarding the"law'.o=if.YQu being requested., not the Department of Industrial Accidents. Y. bt�vn a workers cpmpensatioispolicy,please cali.`ttie Depaitfii atthe number•listed belo*...: are required,to o City or Towns ottom Please be sure that the affidavit is complete and printed legibly. The Department has provided the ace li antat theb Please affidavit for you to fill out in the event the Office of Investigations has to contact you regarding PP �r� r' bei wliichwilLbe used as a refeieace num�,er. Tlie'affc�avrts may"f?e'r t�+•,. be sure.to fill in tlie.p ezmztljxcense riven - :; . - eIItb `fnzail or FAX unless other arraiigeiaents Have been made. ti the Dep .. Y, artlll � y,4;r., •.,: •5. ••: Olx have an estiOnS, ations would like to thank you in advance for you cooperation and should y • y . The Office of Investig. ., plee do not hesitate to give us a call. as _ 's address,telephone and fax number. :.,,... .. The Department The•Commonwealth Of Massachusetts _Department of Industrial Accidents pace at tnyestlgattcns . 609 Washington Street ;'=y Boston,Ma. 02111 far ff: (617) 727-7749 ii. (.117) 727-4900 ext. 406, 409 or 375 '; F r OiIY�//ItO02[({�2G�ry p��,ivLCL000LClcLI.f1GGLp � ��. . ' 92. BOARD OF BUILDING REGULATIONS J! r t , P License:\-CONSTRUCTION SUPERVISOR lt� , I{ Number CS 006980_ ; is F Birthdate-04/04/1947 yI - I ! Expires 04/04/2004 Tr.no: 20121I m :3 Restricted 00 r �s GLENN B CLOUGH JR; h 37 OLD STAGE RD <s ,r' C. •«e y CENTERVILLE, MA -�.02632 Administrator �. ami gums .l9A'O P [�l;no �!m l -- --- — — — -- 4--- Z£9Z0�✓W'3�lInb31N30 Jb'1 MJ 3S al0 L£ ,Y �Jr HOf1m0 NN3lJ �Jf Hono-io 8 NN31J IenpIAIpUI :adAj- ;. 80IZ0-EN u04sog ui. aag uo;an s as t,00Z/96/6 :uol;e,idx3 TO£I -H ld qq V O spagpag;g pug suougln8ag 8ulplmg;o p nog ti0ti601 :uol ei;sltiaa :o;u.injaa puno3;j •alup uollgaldxa aqj aropq U013VUIN00 1N3W3AOUdWI 3WOH XIuo.asn lnp►Alpal.ao;pileA u011ga;s12aa 10 asaaalZ 11. spaepue;s pue suopelnta21 2ulpl11ng;o paeog > � G 0 b � X • I / Lj /Lb -- — / 01,/t db L.P o-d, _.. f Jyn i 0/./ .fi Fs. /„ rgila 1 I FIeC f�.C/�i./i4f Cj i1•ZA-C 7 �`�' 6CALE: ePPPOwo BY CP�WN BY o.Ye: ' BPAWINO HUMBfiP T yC' t ( /,,/A ' - y .e w n ♦ y Y' . .1 ,P .. .*'i-..4L- .'s Y0:- i .n.-_n . . .; _ 7 TOWN OF BARNSTABLE Permit No. _____M812 Building Inspector Cash ($109.00) �2 C -- i 7aezrr : - wa 1639. OCCUPANCY PERMIT Bond __—____________—___ Issued to Stephen A. Smith Address Lot #3, 340 Old Stage Road, Centerville Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department �l�.. 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 OF THE MASSACWSETTS STATE BUILDING CODE. 1 f Building Inspector TOWN OF BARNSTABLE, MASSACHUSETTS PERMIT ,.-_; A-190-236 JOB :WEATHER CARD • DATE, January 6' 19 86 ,PERMIT NO.��- ,:- APPLICANT Owner - ADDRESS - oumer IND.) (STREET) (CONTR'S IJI CENSE) PERMIT TO Build dwelling � 1} ) STORY Single family dwelling NUMBER N OF G UNITS 1' (TYPE OF.IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) lot T3 340 Old Stage Road. Centerville ZONING RC DISTRICT IN0.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT �. SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) c REMARKS: " Sewage'Sewage #'185-1108 (owner) 109.00 AREA OR 2181 sq. ft. 80,000 PERMIT 120.75 -� VOLUME ESTIMATED COST $ FEE , (CUBIC/SQUARE FEET) Stephen a. Smith OWNER - 3�4 aid age Roaa, Gentervilit, FIR U2632BUILDING DEPT. / ADDRESS By - , c r — ik. THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR 1, PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDERtTHE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OP-PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. _ _y MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND A I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. - POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS - PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 Q 1 1 .01 3 HEATING INSPECTING AP ROVAILS REFRIGERATION INSPECTION APPROVALS 3NI10IN3 11 dc"n-e ;1!�q(5 6 I? HIMN g0ftvj 5 ,Z v-6 R NCRK S,+AL_ IN $per PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED VN TM!S CARD NSPECTJh:!As'a??ROVED.'HE vAalc;)s, WORK t5 NOT STARTED WITHIN SIX MONTHS OF DATE THE LAN BE ARRANGED FOR By TELEPHONE £TAGF� '?F L^515?4UCT LDN - OR WRITTEN NOTIFICATION, PERMIT IS ISSUED AS NOTED ABOVE. _ w � e- _�...,.....,.-•f........-".�..�.�.►4�+.- M+�-_ __ — ..--t•r--..ter �Sr. �t � y.r :: .__'- _ �.�-.ccA-_�"� _ O ; t� 2-a M p�,:'1'• !:mot t CH Ra A. �;tr BAXTER �31 No.24048 Poo5 IN GE.2T%.�/EO PLOT �,C.q,t/ 7-1-IAT T.-/c- /`Ut��tJc�i�T�01J LaG.4T10AI SHOWiV/HE.2E0�C/COiyyvL YS l-1//rH iL .CE'QU/.2E�gENTS Ooi::- Th/,E- 73 a) 12 A)-S7-A.B LG A�c/o /s /✓a 7` 40 Tye .c.LOGi�PG4/�/ :�:�s� BAXT.E.2s /NST,eUiy,c�t/T,s'U.2Y6'Y�. Tye O��SE'Ts Syof,�/yS.�v�r.� �ST.E21i/.Gl�a Hl�4SS. 7'2:5) l• - x,H' Asse�or's asap and lot number..../.../..5�.-...41 ..... ... STALLED IN COMPLIANCE ��o%THE Toy Sewage Permit number ........ ..:.. f. ... .::. �j WITH TITLE 5 t N10"IRCM1IENTAL CODE AND t EAR33TAXE, 2 House number ........:........ a•••F,TS. p� 9 MAna .......................... "��� I _Q�...l �7 4p i639. 0� } " - 6 f� 0 YPY h•. TOWN OF BARNSTABLE BUILDING , INSPECTOR APPLICATION FOR PERMIT TO ..................... ............................ .. . . .. TYPE OF CONSTRUCTION ......... .............�... ........:..%.............................................. ................. .. .... 19.rlJJ� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information Location ......h.0 ....�........*........yO...... `'.1.4 ..... .. ........... .�'�a` �!i ��Z ..................... Proposed Use .............................. c'-�`-�l/w Zoning District ......... 4..4ff...x ...................................................Fire District Name of Owner ........... .....�. ........ :Address ................................................� .. .. ....... C Name of Builder ....... ... .................................. Address ............. .y ., � `:�:�..................... ........ Nameof Architect ..................................................................Address ......... ...................................................................... ' Number of Rooms ..............`� .........,...................................Foundation ��'®✓ ��, 0 7`%✓ C/�✓ Oosrr� .� Jai/✓�� ,�......................... g ......,.......................... ....... ........................ Exterior ............ ..........:..................... Roofing ' Fo �j� ��v `4�. Floors -, ��/VL, ............................ Interior ..... .... l/, ' .a.... ."umbi-g ��t� ` 7rjearng .... .............................................................................PI .. ! ................. Fireplace ....... r .`4.3......../.......................................................Approximate Cost ........ `.....�!........................................ Definitive Plan Approved by Planning Board ----------19________. Area .....AK 41(......... '............. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH Z. r ry I� OCCUP Y PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town,of Barnstable regar 'n the above construction. Name ..... .......:....... ..... ...................................... Construction Supervisor's License ........ SMITH, STEPHEN A. 11 28812 11 Story ISM ................. Permit for .................................... j- Single Family Dwelling ......................................................................... Location ....Lo.t...3........3.40...0.1d...Stage...Road ....... .. . . . .... . .... . . ...... ... .... Centerville ................ ............................................................ Owner .......Stephen......tep.......hen ....A........Smith.................... ........... Frame Type of Construction .............................. ........... ................................................................................ Plot .............re....... Lot ................................. 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