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0108 THISTLE DRIVE
.. � _ . _ . � .. o .. .. , �' ,. 4 z .. .. � � .. s - .. � ... .. .. o ,. ,' � .. - - ..... ,. o ,. .. � � _ .. a - `:: o ,� .. s _ .. .. _, .. - .. ,,� .. .. _p: � a .n �� �. - _ .. _ ..i. - E � rt � � .. ., y � .. �. ,. �. � � o � ii _ '. .n „ o �; ., � G �. ., .. ^. � ,. .� � o � � '� _ � i x o, -. n .. � r tl 4- Application number4x. 7......v............ fee � ......... ............ NKAAW f! � Building Inspectors Initials.. . � I s + ff OCT2 3 2019 Date Issued:. O . N..................... ...................... © p n' G i / �� OFBARNs� Map/Parcel l.?` l s TOWN OF BARNSTABLE '. EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION a PROPERTY INFORMATION y r Address of Project: ER STREET VILLAGE Owner's Name: f-" L' c Phone Number S6. q Email Address:x , ,?' Q2r C'(,f�?C .. , 1111 Phone Number �e 3 01 31� Project cost$ Check one° Residential t Commercial OWNER',S AUTHORIZATION w ^ As owner of the"above propertyy-I hereby authorize>°5 to make application for a building permit in accordance.with 780'CMR' Owner Signature: Date: a TYPE OF WORK' 0 SidingWindows no header char e"# 0 Insulation/Weatherization ,._ Doors(no header change)#. FCommerchil Doors require an inspector's review ED Roof(not applying more than 1 layer of shingles) Construction-Debris will be going to CONTRACTOR'S INFORMATION R Contractor's name Horne Improvement Contr_ actors Registration if applicable)# " (attach copy) r Construction Supervisor's License# —(attach copy)" Email of Contractor t Phone number •ALL'PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY"IS IN 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.r. Purpose of Event 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 Fuel source being used LP tank 20 lbs. or> Yes No ;if yes, a gas permit is required. Natural Gas Yes No if yes,a gas permit is required. 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/COALTELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles:{front back left side right side HOME R OWNS S LICENSE EXEMPTION Homeowners Name: C7�114 2y 6W Q/1 Telephone Number /o � � Cell or Work number 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 the T n o . table. R Signature Date °/�3Agv) °APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information' Please Print Lei ibly Name (Business/Organization/I dividual): tj72EG2y P �/Z- O� Address: City/State/Zip: �.�Y12 i/� 1 t /nr4 Phone#: �� � �� Are you an employer?Check the appropriate box: Type of project(required): 1.El I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner= listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• 9. ❑Building addition [No workers'comp.insurance comp. insurance t ,.Pn��] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.911 am a homeowner doing all.work: officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c.`152,§1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether-or not those entities have' employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 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 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do,hereby ce • un pains and penalties ofperjury that the information provided above is true and correct. SigLiafore: Date: hiz3 2ot Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3:City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C( )states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom . of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like 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 fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Iuvestigations 600 Washington.Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia Town of Barnstable Building Post This Card So Tlat.it is Vis�ble''From the Street-Approved'Plans Must be-Reta�n.ed on Job and,this Gard Must be Kept ! Posted Until Final Inspection Has Been Nlatle ' ° Where a Certificate of Occupancy'is Requretl such Building shall Not'be Occupied until a-Fnal Inspection!has;been made. Permit Permit No. B-19-2675 Applicant Name: Robert Rostocka Approvals Date Issued: .08/20/2019 Current Use: Structure Permit Type: Building Insulation—Residential Expiration Date: 02/20/2020 Foundation: Location: 108 THISTLE DRIVE,CENTERVILLE 'Map/Lot: 148-117 Zoning District: RC Sheathing: 17 Owner on Record: EVERSON,GREGORY P Contractor Name .ROBERT A ROSTOCKA Framing: 1 Address: 108 THISTLE DRIVE Contractor Litense 113252 2 CENTERVILLE, MA 02632 - ,Est Project Cost: $5,706.00 Chimney: Description: Insulation&Air Sealing Permit Fee: $85.00 Insulation: Project Review Req: , Fee Pal " $85.00 -Date.- 8/20/2019 Final: Plumbing/Gas j Rough Plumbing: � Buildin Official g Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months.-after issuance. 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 gmad and shall be maintained open for.public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are,provided on thispermit. Minimum of Five Call Inspections Required for All Construction Work: _ Service: 1.Foundation or Footing Rough: 2.Sheathing Inspectionw ter- 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) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health 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 }�1 r N41- it 7-42. ®E e .. 1 vp�f'bT+EDI f V f�,, { t r� .- _ //� ��.,.' • F '' '/ ice"'r*'� D `i. p y �. •.d3�'�L�: -/"= w�e�' ,atgT_@.. / S' —i�©o G��. s�.vr-ic T.��t/•� �,� .7% 37 -- F'!_/'?i'✓ 8C��,�. ct/' •`�/T d'✓/Ts� /' d.c s�/AgNO .�TG�d./ ` P _ Sf�Oi4/.V O.V TI-1/.S PL F�V /S LOCATED O.t/ TL/E j T 4, r E�.OtI.VD .6T5 SNOW.V HE�Eo�t/ iU.VD 7-.yF97' /T Q E S CO.VFO a it�1 T O F T</E 7->W.v t ate ' i�Vi-/E.V •CONST+�C./C 7'E D. ! ��� �y1;�� '� ek `���+ FRNE. Gn - '$'f'3wQ °*�'Out7'E 6�4^-Y'�3f�MOUTN, MASS. a� cam- ,�E�. L - .�✓��� ���, �F ,�. G r — ssessor s,map and lot number 1.?.. l%.7........ SEPTICYSTfI r INSTALLED IN CORL I NE sewage Permit number 74...................................... WITH APTI ' C SAiITAY C r THE TOWN OF BARNS' fffift'�k . ... SS � i EAHB9TADLE, i "b 9 d* BUILDING IRSPECTOR O'FO YPY ' L k APPLICATION FOR PERMIT TO ................... .........................V................................... TYPEOF CONSTRUCTION`.................. '." ................................y........................................ ............?/J z ..............19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby appliesfor a permit according to the following information: Location ....... ...... vl.l.C� T�:. ..................... ................................................................ ProposedUse ....................................... ..................................... ......................................................... �j Zoning District ....Fire District rn.......................................... ..� '................ .�......... Name of Owners .�. .rr... ���/.... /� .Address...... ............ ....... ... ..1.�-..... ... ................... r Name of Builder �� .!�v`:...�...�!I�......... . Address .........�...................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .......5.......`..........3.... '.......................Foundation .............................................................................. Exterior ... .:.. .d- ...... ........ ................ ..............Roofing ....... ..... '... ...................................................... Floors ..a.......Interio ................................................ a Heating L .. ... M...................................................Plumbing .....�::... .. Fireplace .........t�o�/ ...........................Approximate Cost .... .......................... ........... .............. Definitive Plan Approved by Planning Board ---------------_---------------19_______. Area ........ f..Z`. ! �.............. Diagram of Lot and Building with Dimensions Fee ...... '..d..�. ................. SUBJECT TO APPROVAL OF BOARD OF HEALTH c � 4/k/ I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..... ..... �.... .. .......... .......................... ,-,'-'ape Wide Development Corp. 7N Permit for .......PRItA�P:UA....... Location pleted PERMIT REFUSED ^^^`''^`'^^^^^''^`'`—^^^^^^^'``''—^`^'—^^^^^'^'' � ----~----'^-----'—'—^--'^--^~—' ~ ~ � ^ ' Approved ................................................. 19 � . ' . --------------------------' --------------------~^'^^'~'— ' Assessor's map:and lot number ...�.`... /.. 7 Sewage Permit number "".�l- 7..... .....}... 6.°,ll LLU M ((�Q�Ja WITH TITLE 5 ,�/ Z BlHH9TADLE, i House number ................... ....�.1�:fJ..:... :......L-MVIRONMENTAL CODE I�9�: 900 039 u T®19VPe REGULATIONS �0 MPY aye TOWN OF BARNSTABLE. BUILDING ANSPECTOR APPLICATION FOR PERMIT TO ...............:..................... ................. .. �Z��.�.�?... ........................... "TYPE OF CONSTRUCTION .............. cn!.... .... !.....� -..................................................................... ...............g/ ...................19.. 1 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora Permit �according to the �informa :Location .........../...D .U...... ......`!.. .. ......... ....................................................... ProposedUse ..... ..... ....... . ............................................................................................................................................... ZoningDistrict .............i..........................................................Fire District .............................................................................. Name of Owner /.!` ....... .. ..:...... ...........................Address /.. . ....�% GG .....0.`.'J?.c^!`�� / tC2� / t.cp Name of Builder .... ... ..... ..... ....... % .....` ..r......Address Nameof Architect ....... .....................................Address .................................................................................... Number of Rooms .......&.YkA............................................Foundation .............................. ........................... Exierior .......k�............ . ..................Roofing Floors ..............................................................Interior ........l..JS................................................................. Pleating /� '.'.. .........................................................Plumbing ... . ..�f..r....................................................... Fireplace ..................... ... ........ .........................................Approximate. Cost ........./.�.i..�a.a:. j.0........................ Q p Definitive Plan Approved by Planning Board ________________________________19________. Area ...................... . . . Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 9 o� � RCGf 15TI aW�L�/R1�r b OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS / I hereby agree to conform to all the Rules and Regulations of ;thew.,n of Barnstable regarding the above construction. Name ... .............. ...C (/ Construction Supervisor's License ....�1..�.. .�1..f`...A... _ Tapuell, C. F. 3l0�� � to single Nofof�—.----------. ^ . ____familv..dwelliog_______.____. . Location ..........l08..Tki�tle...Drive ______ ^ CenterviIIe_______,__.. . . . - C � lI Owner --_—..�--�—�����--________. frame Type of Construction. .......................................... . . . ' -------------------------- \ ' ' Plot ............................ Lot ----------' , Permit G,onua] ---- —.lp 87 � [��� Date of |n --'��--�^�/��._—.lV o- . Dote Comple+e6............. ..........................lP � . . . . . - . � . . . . ` . � ^ L� L . ' Assessor's map and lot number .... .......P`7'"�--- 7N E Sewage Permit number ........... ............................. ....... EARSSTAXE. Aouse number ...................... ........... ........ .. .... 9O MAGL pow 1639- TOWN OF, BARNSTABLE BUILDING INSPECTOR f APPLICATION FOR PERMIT TO ......I.................. .I.e.1.1........ ....4)(7............................. .. .... ...... TYPE OF CONSTRUCTION ...............lv....,6.4.............. ... .. .......................................... ..................... .. .. ..... .............. .. .... ... ................................ /, ... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a ermit according to the following informs ion:.............. Location ............ ..... ....IF...... ... ..... L...q ....... ....... ................................................................................ ProposedUse ........ ........... ... ............................................................................................................................................. Zoning District .... ......******"**'Fire District ......... .................................................................... 4 J ...... ...... Name of Owner ........... ........I'll.............Address ............................................................................... Name of Builder yoav ... ......(.�e. ..... . ......Address ................................ ............................................... Nameof Architect ........ .....................................................Address ............................................................................. Number of Rooms ..................................................................Foundation X...................................41 ................. Exterior ......G04�-^....... ... ......... ....... ...................Roofing ........ .....i............................................................... . /D Floors ........ ................................................Interior ..................................................................................... Heating .......1-.K.... .........................................................Plumbing ....... ............................................................ Fireplace ..................0(-yN1!9,P- ,t4c�.........................................Approximate Cost ......... ....................... Definitive Plan Approved by Planning Board --------------------------------19--------- Area .................. Diagram of Lot and Building with Dimensions Fee ....... ................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH i `J+ Coos i P AGE rh Ow • OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and. Regulations of the 71wn of Barnstable regarding, the above construction. Name ........ ...................... Construction Supervisor's License .... Tapsell, C'. F. !#A=148-117 1' t 31043 - add `to single No ............... Permit for .......,............. ............. famil dwellin .............. ..................... .�.... ....................... Location 108 Thistle Drive .............................................. Centerville u ....................................:....................................... Ta sell. Owner ............C. F. .................�........................... frame Type of Construction ......................................... .............................. ..............................................•. Plot ............................ Lot ................................ r Permit Granted ........Aug.w;. ..4..............19 87 Date of Inspection ...... .............................19 Date Completed ......................................19 ,.1 • F' 38./i 1 ;• o-T- - � ?a 11c_ .SEWAGE .TYC'�'TE/q L7.ES/ SCq.C.E ZPigTLy: / 5' ---/ooe--> ;L Qe SgE.oT/C 6.4OEPT/�� �.E�.ECAST �Ef1i QA�E i.c7/2 aL 0 T 7--- �'!_�?/✓ BOO.e :4/� q/'• s�✓iTN. !' O� H/ASNEO sTc�✓.fE ;yy T. NE'.E'Es6� C�,e'T/FY TNgT T/,/E 6C//LD�.Vrr` - fi t s,�Ow.v O.v 71iW S .011.s:)A-1 /s L.00.gTEo OA/ TL/E f- 60u.VD AS SHOWN NG3.eBOA1 q.VD 7"f/gT /T I>OES CO.vF'O.L�M TO 7�N� zo.c/it/G OF Y—I—sQWZ OF z•.NE 7' �/WN OF G'R.e/JSTQ C��LE ^IG ;�•C ARi:E arcin cam �n in�rir� � of u c•/ViL E.VGi.VE�e S UTE GA^-Y�.eMOUTH, iL1gS5. 2:).49 F-Si r• '�. ssessor's map and lot number 1............. ~...1.....7........ SYST1,�ej M',IST 8£ � ��.,'d INSTALLED' I<� G ':,�I A N Sewage Permit number 7� \;f Tl I +'•�'e '`1- II K,�TE SAN TOWN OF BARNSrAlff' I' P. O Z ISTA BARDL i 9�o M6 9 , � UILI Nffi G ISPECTOR APPLICATION FOR PERMIT TO ...................6A.... ..................................................................... TYPEOF CONSTRUCTION .................. ......................................................................... ............ /.....✓.l...7.: ...19........ TO THE INSPECTOR OF BUILDINGS: The-undersigned hereby applies for a permit according to the following information: Location .....: ... .. .-7 �!(.C.s..7Z.T............ .................... ......................................................... ProposedUse .. ............................... ................................... . . ......................................................... rj .. Zoning District Fire Districts .................../ .......................................... ........... .......... ....................�......... CAA Name of Owner .... ,1�.......L.�.Cr...!/ l!:.....f�G.�,l7Addres ... .... ..... .... �y . ....! ' ... .'Z!1�:......... . .......Address ......... ............... Name of Builder 4.T`"'d. .....:................................_ Nameof Architect .................................. ............................Address .................:............. ............ ............................... Numberof Rooms ...........S...................3.... r r.. .............Foundation .............................................................................. , ....... ... .. .. �Exterior ... f . L1..1.1...�....................................... sU! t .......Interior ....... °.................... ............................................... Pteaiiny � L..���..: N .:..... Plumbing ..... ......�%s .................... .................. FirepFace ..... ...............................................................` Approximate Cost .............. .. ......................................... Definitive Plan Approved by Planning Board ---------------____-----------19_______. Area ........1:r.Z`.7... .............. Diagram of Lot and Building with Dimensions Fee ...... .................... SUBJECT TO APPROVAL OF.BOARD OF HEALTH -- /�- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above - construction. Name .( ...��.... . ......................... .. . ..... Cape Wide Development Corp. A=148-117 Permit #17897 Build one story, sing family dwelling Thistle Drive lot #3 Centerville t 6 a August 20, 1975 1