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HomeMy WebLinkAbout0046 TOMAHAWK DRIVE * ',s1��T'yt�'cl A', N�M,�, " ,i- J�#°, ,,' X j�ia� 'a-Y y ;d'S,:;E �1f fi, r`rr. + r,'. v�k !F�x " M1.� }I ,4, f� I � � s I1,r.t��2.3",',�,7f ro fA, Y f't, k ,rry�{ vF � ` B 1 9 .r 3 .s e3.rn �ry'yr.�x Y s ra: 74j " 'Illm'SP'l � YF � W �� 11�.�T�Az 'Ti : `d [��"xF'` Z6 t'• � ' ,� T f ;. „a; .,fir �, TY', n "4,,,y ,{-e, •rr i` , eo:7,'.',! a .�{: Y II {..., ,f,j� . 43; ='f ♦ ,.,'}! ,, x.�.. ?. ,b ' ,' .�'i�`.„"r, Ck. h.., ,., , f. Ixotj. 4 ar ,i! - k" '.. 9a�t'' ✓r'�"L "! ,a. ,.hi.s. .�:I7l,at.F' P.. ;.in, -A,*e,: l �, ! ;, 4.`i try -~.- y . t JEY , r :' ,,sl � ' f f' w r r`, ,� nw',4 +� ;` n a 3F L,. •s ,• ; , jT'f3H t3, j 1 #a U,,�`'71 r,,a( #r` i �o1.It I j '� , ,�: 1. x I ,., �; ` �'r e ',I f a �':i31 E 9 It. - ., i v- ` , }1' I^ }1 9 4 t ,. ,., - ' Yf . , t - �` ��. t ;4 ., - .. 'r i "`� r. r 7 P 4 .::+, ,,r >~•, p '# 1 �. .., , .. A 4kt, `F''. ,r., ;_ „!_ t a f r f.. » .... �s4 f.: p l ", ..i ,..- 1. a ,-,:. 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(3rd floor) Map //Parcel Zpermit# House# lD Date Issued —�7 - ..)CBoard of Health-(3 d floor)-(8:15 -9:30/1100-4:30) _ "Fee g) SEP'17®RI ST BE LANCE Definiti ,p pl Dt ,�■�DLvdld 19 ENVIRODE AND TOWN OF BARNSTABLE TOWCNS �_ 6 Building Permit Application Project Street Address -Tv fy f)rhi4 tc9 2 Village e E7�T U �-L �'1 e Owner 1[[/A PA io JUS/' Address aA �d o� h141*0k Telephone � � oc- Permit Request � P�/Q-C� r3, UPIP DD 40 S AP ) L3 r5 �o Cep f 17K C°.FD iQ f First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ `700 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 4 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 0 Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Meat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Ventral Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - r Current Use Proposed Use Builder Information / Name t Telephone Number Address License# 6"A " He 44 9,',4da` l AA / Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE !�4L� DATE c3 7 9 BUILDING PERMIT DENIED FOR TH FOLLOWING REASON(S) A VA l/ r �/ � ka-�. Y FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED; r: MAP/PARCEL NO. f ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION 1 i - FRAME - INSULATION J FIREPLACE -� ELECTRICAL: ROUGH FINAL PLUMBING: ©UG, FINAL GAS: Uy.• FINAL too FINAL BUILDIrt kit DATE CLOSED BUJ i T 4. ; ASSOCIATION 1 NO '• r oFTME . . ; The Town of Barnstable • snRxsrnBzs. • 9� "9 ,m�' Department of Health Safety and Environmental Services ArEoteo't' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date_ AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one.but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: RE P444-r 14 ' Est.Cost 7 ep o to Address of Work: Owner's Name Ipgl s� LEA PFi2Xi� S Date of Permit Application: ` 9 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent the owner: A5�v Date Contractor Name Registration No. OR Date Owner's Name The Continotrwcaltlr of Massachusetts Depart»unt of Industrial Accidents oficeollnvestigallons 600 !iT•uslii►r,tun Street Bostoll. Mass. 02111 Workers' Compensation Insurance Affidavit A licant information: Please PRINT lebi """~"��'" ���•��� name• l 67/44/4 P6#?K/,V -S locition- 5�4 7-©1YAA4id OA city L°l��TFR �J�L C /`'1!� / fhonc I am a homeowner performing all work myself. —1 am a sole proprietor and have no one working in any capacity ;,•..... .•..•....,..-..�-+s............._...w.+._..n.r•s...�sr?:r•�.M+�'.�r'r`*•.wr�rw.aw!!^:a....� ,...,r.+..... .+...ti..�-...a�,.,..�....._.. ... ......�. /". '' .:..-.......a -•- b.y�y;, c�..:zv - I am an empIover providing workers' compensation for my employees working on this job. +� r corimarn•name: A,)yL=L address: ley 614,sCO4�Ss57` 40ke P, Oe 640x city: isA Ind /YORR Oil*dy'/ "A / phone#: k5-6 t insurance co. �olicv 1 am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers compensation polices: comnatn• name: address: city: nhonc i1• insurance co. policy 0 -_..._._.... .._ ..-.�.—._..._. _I.C..✓i i...r_.__- _ _ _ .�1.�:aw''.rr..Jr'__ __ -_.�1• __ _ _ _ 1•` _ -- .��a�iO�Y`_• _ __� comnnnv name- address: rite: nhonc tJ• insurance co policy 4 Attach additional sheet if necessary `- - __ r"�%'"' '^"~�" �"•'"'z ^R 1 •.= 77 •a .r_���i _..,li' � _ r -- - _ ra.r.�r�:i.:�`iiti'R�r- ••�:__••• �••�+5 - 5il�ltl:L��i!•.Y�:c;:�:sL F:rilurc to secure coverage as required under Section Z'A of 111GL 152 can lead to the imposition of criminal penalties of a tine up to S1.500.00 andior unc cars' imprisonment as mcll as civil penalties in the form of a STOP NyORK ORDER and a fine of S100.00 a day against me. 1 understand that a cope of this statement may be forwarded to the Office of investigations of the DIA for coverage verification. I do hereht•cerrift•under the p tit and penalties of p f)un•that the information prorided above is true and correct. ignature Date Print name Phone# .Z"'.wrr •official use only do not write in this area to be completed by city or town official ' r F city or town': permit/license# r'ttluilding Department ClUcensing hoard O check if iniNediate response is required selectmen's Office I C3I1calth Department contact person: P hone#. r•IOthcr r i reanui 3. VIA information and Instructions Massachusetts General Laws chapter 152 section 25 requires all emplovers to provide workers* compensation for their employees. As quoted from the "law", an cmpinree is defined as every person in the service of :mother under an• contract of hire, express or implied. oral or written. An enyplorer is defined as an individual, partnership, association. corporation or other legal entity, or anv two or more the foregoing engaged in a joint enterprise,and including the legal representatives of a deceasedemployer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the mvncr of a dwelling, house having not more than three apartments and who resides therein, or the occupant of the dwellin-, house of another who employs persons to do maintenance , construction or repair work on such dwelling hour or on the ,rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of license or permit to operate a business or to construct buildings in the commoni•ealth for any applicant m.•ho has not produced acceptable evidence of compliance with the insurance coverage required. Additionaliv. neither the commonwealth nor any of its political subdivisions shall enter into anv contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying_ company names. address and phone numbers as all affidavits may be submitted to the Department of industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers* compensation policy. please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regardin, the applicant. Pleas be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. Tile Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address. telephone and fax number: The Commonwealth Of Massachusetts r Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 7.t - � HomE IMPROVEMENT CONTRACTOR �"�� �`Registration��110541 "` i YPeINDIVIDUAI � ' r 0/20/98 .F,Ezpira.A0n 1 f MANUEL.1 RODRIGUES x ' '1> 47 rJ . MANUEL J RODRIGUESx �r; aDMiNisi R �SAGAMORE BEAgC�Hs. MA 02562 f` 3