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Home My WebLink About4556 FALMOUTH ROAD/RTE 28 t �. ,, .. _ _ . I �I ,i J g �� r.?I �"� � o �/ �� S` G� E �=��- ` � � , LG�'7�/ t ! - � � � � - - - _ �� 1 _ _.>- ��2iG�iG�d LG`-' III Town of BarnstableBuilding Post This Card So'" Z rt is Visible From t42"he Street Approved Plans:Must be Retained ,n,�Job and this Card Must be Kept k W �^� Posted Until Final In"speetion Has Been Made . 6 <° Where a Certificate of Occupancy is Required,such Bwldmg shall Not=be Occupieduntil a Final Inspectiorrhas been made Per �� s•�.,-__,.,.R.fi .,�.9..-h». ,.�-...s ri* Permit NO. B-19-3980 Applicant Name: Dean Fraser Approvals Date'Issued: 11/26/2019 Current Use: Structure Permit Type: Building-Stove Expiration Date: 05/26/2020 Foundation: Location: 4556 FALMOUTH ROAD/RTE 28,COTUIT Map/Lot: 024-005 Zoning District: RF Sheathing: Owner on Record: FRASER, DEAN C& ROBERTA D TRS Contractor'Name:. :,Fraser Construction Company Inc. Framing: 1 Address: 104 TWINNVIEW LANE Contractor License. 194747 2 EAST FALMOUTH, MA 02536 Est Project Cost: $3,500.00 Chimney: Description: installation of wood burning stove Permit Fee: $35.00 Insulation: Fee Project Review Req: Installation manual should be on site for inspection.' Paid $35.00 Date 11/26/2019 Final: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six;mbnths 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 tie in compliance with the local zoning by laws and codes. This permit shall be displayed in a location clearly visible from access street&166�d and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. f .. a Electrical 47'177r 7- The Certificate of Occupancy will not be issued until all applicable signatures byahe Building and Fire Officials are provided on this,Permit. Minimum of Five Call Inspections Required for All Construction Worko r" Service: 1.Foundation or Footing ! Rough: 2.Sheathing Inspection ,. .., x.... ,. ,. 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). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of Barnstable Building Post This Card So That it is Visible From the,Street Approved Plans'Must be Retained onJdb and:this Card Must-be Kept s HAMSrAB1.Er .. _ - e .�� wPosted,.UntilFinal Inspection Has Been Made: .. p�Y�1Yti7* `Where a Certificate of Occupancy is Required, such Building shall Not bbe Occupied until a Final Inspection has been made. 1 1 llil a Permit NO. B-19-3501 Applicant Name: Henry Cassidy Approvals Date Issued: 10/17/2019 Current Use: Structure Permit Type: Building- Insulation-Residential Expiration Date: 04/17/2020 Foundation: Location: 4556 FALMOUTH ROAD/RTE 28,COTUIT Map/Lot 024-005 Zoning District: RIF Sheathing: Owner on Record: FRASER, DEAN C& ROBERTA D TRS Contractor Name`HENRY E CASSIDY Framing: 1 Address: 104 TWINNVIEW LANE i Contractor License: CS=100988 2 EAST FALMOUTH,MA 02536 - - Est Project Cost: $2,000.00 Chimney: Description: Insulation/Weatherization Permit Fee: $85.00 f - Insulation: Fee Paid:, S 85.00 Project Review Req: Date 10/17/2019 Final: Plumbing/Gas -- _ Rough Plumbing: ABuilding Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the'work authorized by thins permit is commenced within's z montt safter"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. Final Gas: This permit shall be displayed in a location clearly visible from access street.or road and shall be maintained'open forpublic inspection for the entire duration of the work until the completion of the same. E_ Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this,permit. Service: Minimum of Five Call Inspections Required for All Construction Work: r 1.foundation or Footing Rough: f 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 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 A— Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT � p TIN Town of Barnstable Building n t PostThi`s'Card So Th"at-it is Visible-From the"Street='Appr6vedGPlaris"M'ustbe Retained on,Job and-this Card Must be Kept~ wa MAHM KAS& Posted Until Final Inspection Has Been Made. Permit Where a Certificate if Occupancy is Required,such Buildmg'shall Not be Occupied until a Finaf Inspection has-been made. Permit No. B-19-1863 Applicant Name: Dean Fraser Approvals Date Issued: 06/06/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 12/06/2019 Foundation: Location: 4556 FALMOUTH ROAD/RTE 28,COTUIT Map/Lot,: 024-005 w Zoning District: RF Sheathing: Owner on Record: FRASER, DEAN C& ROBERTA D TRS Contractor Name: -,,,DEAN C FRASER framing: 1 Address: 104 TWINNVIEW LANE Contractor License: CS,097668 2 EAST FALMOUTH, MA 02536 Est. Project Cost: $ 10,000.00 Chimney:� k y. Description: re-roofing entire house,re-siding entire house Permit Fee: $51.00 f � It Insulation: Project Review Req: / Fee Paid: $51.00 Date. `'{ 6/6/2019 Final: Plumbing/Gas ' G Rough Plumbing: Building Official 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 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. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this'permit. Minimum of Five Call Inspections Required for All Construction Work: °" Service: 1.Foundation or Footing 1 2.Sheathing Inspection 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) 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). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of Barnstable Regulatory Services o Richard V.Scali,Director • Building Division �. * E RNSrAEM +` p hUss Tom Perry,Building.Commissioner °` 200 Main Street,Hyannis,MA 02601 www.tow-n.barnstable.ma.us Office: 508-862-4038 Fax: 5 8-0-6230 Approved: Fee: l Permit#: co2J/S 6 6,' S— HOME OCCUPATION REGISTRATION. _ a Date: j Name: T 1 C A ''Do f �. Phone#: CSOD �A 4L> Address: 4&_ Cn i"/ l_P/lc7 f�T�} �1� Village: Cc I � Name of Business: L L A'(�OUT' V LEAQI PU G OF l;A-PE C—n)> Type ( F. A Nl 1 I Map/Lot_c� n S T e of Business: _• - IN'f N'I•: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is . no outside evidence of such use.No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no stoige or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment • , There are no commercial vehicles related to the Customary Home Occupation,other than.one van or one pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No.sign shall be-displayed indicating the Customary Home Occupation. , If the Customary Home Occupation is listed or advertised as a business,the street address shall not-be. included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the., dwelling unit. . . . . I,the tradPied ve rea4ane ith the ahcke restrictions for my home occupation I am registering. APPlicant Date i Homeocdoc Rev.109113 ` YOU WISH TO OPEN A BUSINESS? ' For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-_it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law.- DATE: 100 Fill in please: APPLICANT'S YOUR NAME/S: B SINFSS O UR HOMEQDDRESS: O► r�� Aft 3 �O�'1 TELEPHONE # Home Telephone Number /Y NAME OF CORPORATION: % 1 NAME OF NEW BUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATION?_ ES NO ADDRESS OF BUSINES MAP/PARCEL NUMBER ®A T— OP' (Assessing). When starting a new busine ss there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth . Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE a - This individual has been i formed of nj permit requirements that pertain to this type of business. BUST COMPLY WITH HOME OCCUPATION ULES AND REGULATIONS. FAILURE TO Author ignature* :''rVIP 11-Y MAY RESULT IN FINES. COMM ENT e S :2. BOARD F ALTH This individual has been informed of the permit requirements that pertain to this type of business. Ti Authorized Signature 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business.' = x Authorized Signature** COMMENTS: 4. r Town of Barnstable *Permit# X � XPR FvW 6months•from issue date ' T Regulatory Services MASS - - i N m� Thomas F.Geiler,Director s" Building Division ToWN O Tom Perry,CBO,.Building Commissioner F 13ARNSTAB�E 200 Maiu.Street,Hyannis;MA 02601 wovw.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ' Property Address ;r�; A9 f lox< 0.Residential Value of Work Minimum fee of$25.00 for work under$6000.00 y Owner's Name&Address ,rj�} Contractor's Name s Se w �n",,�k;r t K.. nn, `L C C T elephone Number 5_081_2 _* Home Improvement Contractor License#,(if applicable) Construction Supervisor's License#(if applicable) �O 8 4workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have.Worker's.Compensation Insurance , Insurance Company Name iVa'�ro»a Un i Or, ":i ir e- Co. Workman's Comp.Policy# V j C,d b e c �go(0 C)f Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) y ; XRe-roof(stnppmgg of ) All construction debris will be taken to -, A �S ❑Re-roof(not stripping.�G++oing.over existing layers of roof) ; �Re-side �x pe�v1 02 wJ tie10 #of do orsi .� ® Replacement Windows/doors/sliders..U-Value- (rraaximum.44)#of windows *Where required: Issuance of this pemut does not exempt compliance with other town department regulations;i.e.Historic,Conservation etc. a - ***Note:' Property Owner must sign]Property Owner Letter-of Permission, e Home en Con rs License&Construction Supervisors License is ' required. SIGNATURE: Q:\WPFMES\FORMS\b0dingpermit formsEURESS. Revised 090809 i p • w -., [Laissachu'setts-Depa�tEnent of Publec`S:>fet} Board of-Building Regulations and Standards a . CbnSttucf'['tsn Supervisor Lricense , ` License: 'CS 97668 vDEAN F51 R v 4 } 109 TW1NNrNE �IEW LA w n " F:A57 FALAII©Ul"Ea=iuw 02536 ; ;Expiration.,6I712093 'C'onunissionir 7r#• 96692 s .... . - . - µ , a FRASCON-01 MOSU CERTIFICATE F LIABILITY., INSURANCE DATDIYYY1l) 9126122s12o11 PRODUCER (508)676-0309 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Viveiros Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 375 Airport Road HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Fall River,MA 02720 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. _ INSURERS AFFORDING COVERAGE NAIL# INSURED Fraser Construction LLC INSURER A:National Union Fire Insurance Company P.O.SOX 1845 INSURERB: Cotuit,MA 02635�` INSURERC: INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL POLICY NUMBER CY EFFECTIVEMMIDDIYYYYI POLICY EXPIRATION LIMITS GENERAL LIABILITY - EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY - PREMISES Eaoccurence $ CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ ' GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGO S POLICY PRO- LOC AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILYINJURY $ SCHEDULED AUTOS (Per person) HIREDAUTOS BODILY INJURY NON-OW NED AUTOS (Per accidenU S PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY - EACH OCCURRENCE $ - OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE RETENTION $ S WORKERS COMPENSATION - - WC STATU- OTH- AND l3IIPLOYERS'LIABILITY YIN RY LIMITS ER A ANY PROPRIETORlPARTNERsxECUTIVE M09930601 - 9/26/2011 9/2612012 E.L.EACH.ACCIDENT $ 500,00 OF ICER(MENBER EXCLUDED? YY 5fl0,00(Mandatory In NH) - _ E.L.DISEASE-EA EMPLOYE S Des describe under 5flD,00 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER - - " DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Fraser Construction,LLC DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAR 30 DAYS WRITTEN PO Box 1 S45 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL COtUit,MA 02635- IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE L 1 ACORD 25(2009101) 91988-2009 ACORD CORPORATION. All Tights reserved. The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and usiriess Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contncptor Registration _...........__.____.__. Registration: 112536 .� Type: DBA Expiration: 3/23/2013 Tr# 209024 FRASER CONSTRUCTION CO. _ DEAN FRASER P.O. BOX 1845 COTUIT, MA 62635 Update Address and return card.Mark reason for change. Address n Renewal ❑ Employment Lost Card 0PS-CA1 0 50M-04/04Q101216 ��,/�,��/�� ,�� Officea firmer airs&Bltsin`eesss e�i License or registration valid for individul use only -- HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 112536 Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5110 Expiration: 31231,2913 DBA Boston,MA 02116 F R CONSTRQCTION CO. DEAN FRASER 104TWINN VIEW LANE E FALMOUTH,MA 02536 Undersecretary of Val] wit ut si re u „a. _ i The COMMOnweaith o,fMassachuse f Department ofIndugridAccidentts Qfj17Ce gflnvestigadons i 600 Waylft n Sleet Boston,MA 02711 Woaters' Compensation Insurance davit.3 ptg Co>nfracto>t A Brant Information WElectrxciam/gl,.hers Please Print L Name(sosiaesglQrgsuizatiowIndividuat): 1 'b 1 Y Ca its-4f' - Address: c'$�o —L --� City/Staxe/Zip: �, S i� 4 �63 5 Phone AVeoa sa employer'!Check the appropriate box: am a employer with 4 [)I am a general contractor and I Type of project(required). i 2 ❑ employees(f ill and/or part time) have hired the sirb-co 6. i am a sole n �acbars Q New construction Pr prietm or partner- listed on the attached sheet. Ship and have no employees Them sub-contractors have 7. ❑Remodeling ! working for me in any capacity employees and have workers' 8 ❑Demolition [No workers'comp_insurance camp insurance t 9. ❑Building addition j 1equired.•1 5.❑ We ate a corporation and its 3.Q 1 am a homeowner doing all work officers have exercised their 10.[]Electrical repairs or,additions I myself[No workers'comp. right of exemption!per MGI i 1.D Plumbing repairs or additions insurance required.l t c 152,§1(4),and we have no 12-[]Roof repairs employees.[No workers' 13.[]Other eaanp.msutance required,) `Az13'aPPlicmi that chocks bog#I roast also SIl out the section berow sh 4 Homeowners who submit this affidavit ittdicatm o vAg their Co policy infnrmatioa rCoabractors that eheekthis boot mraR t; doing all work and him outside 1*11=must submit a new affidavit indicating MP1oYees Iftlteb=aactors have an$ddiCoaar sheetshowiag the aea�of the sub-cbntracEors and state whet6eror not those mtitf ve h emPleYees,they nncst Provide their workers'comp pp)icy number. I am an employer tbatis pmvift workers'con cation insurance or j infonnation, f my Inployeex.-Below is the policy mid fob sate Insrance Company Name: i pYl( J U hip ire '/+AsUt'7G'E� Policy#or Self-ins.Lic.#- iN C O 8- ! JExpivation Daze: 0201 Job Site Address: OL City/State/Zip: F Attach a copy oi"fire worfters'compensation policy declaration • Failure to secure coverage as required tinder (showing the policy number.and expiration date), Section ZSA ofMGL,c 152 can lead to the imposition of'criminal penalties ofa s fine up to$1,500.00 and/or one-year ilnprisonmeat,as well as civil penalties in the form of SIOP WORK ORDER and a fine of'up to$250.00 a day against the violator. Be advised that a c f Investigations of the DU for copy of this statement may forwarded to the Office of >ostrance coverage veri$cation .flue itsrd penahhes of perjury g6at the informrmon provided above is true and correct Si ' _ Date: �17 a. E Phone#: { Offzdal use only.. Do not w.,*in this area,to be conrplet by e4 or town o eial City or-rows: PermitEicense# Issuing Authority(drele one): I..Board of'Healtb 2-Building Department 3. ? 6.Other C�tyfTown Clerk 4-Mectrlml Inspector 5.Plumbing Inspector—�_ i Contact Person: Phone#r i { u oFIME Town of Barnstable *Permit Expires 6 manta rom issue date * Regulatory Services Fee ', + tnaxsrABLE, MASS. Thomas F. Geiler,Director r��rED Building Division �—PRESS P R I Tom Perry, CBO, Building Commissioner API.C� i1 ?f11 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us 'FOVV } OF,BARN.STABLE Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid wil/roul Red X-Press Imprint Map/parcel Number, U Property Address _,6 0T 110 CC,k,�• KResidential Value of Work Zj _ Minimum fee of$35.00 for work under$6006.00 Owner's Name&Address ��2Gw� C (=✓�uS C f� 10 4 T l�� 9 rc�r ram- �' ✓��'-'t "" X Contractor's Name Srr � ~ Telephone Number Home Improvement Contractor License#(if applicable) Q 6`3 Construction Supervisor's License#(if applicable) 7 �� ZWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ lam the Homeowner [� I have Worker's Compensation Insurance Insurance Company Name wA.4-1 � ) in 1"yvN 10'—' /Le Workman's Comp. Policy# we 009`7 :S1060 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_ ,.jelt�`L �L ❑ Re-roof(not stripping. Going over existing layers of roof) �. Re-side #of doors ®. Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improve ontractors License& Construction Supervisors License is d. SIGNATURE: QAWPFILESIF0RMSlbui1ding permit formsTXPRESS.doc Revised 070110 I , N The Commonwealth of Massachusetts - i ^; I Department of Industrial Accidents i L Office of Investigations fir 1, i 600 Washington Street . Boston, MA 02111 r www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly NaMe (Business/Organization/Individual):• IF-A U,.M - Address: a City/State/Zip: M- i4. Phone Are you an employer?Check the appropriate box-.., -Type of project(required): 1. [ -1 am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction ' employees(full and/or part-time).* have hired the sub-contractors 2. ❑ 1 am a sole proprietor or partner listed on the attached sheet. t ?• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp:insurance." 9. ❑ Building additionA .N [No workers' comp. insurance 5 ❑ We are a corporation and its' required.] officers have exercised their ]0.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11;❑ Plumbing repairs or additions,. myself.[No workers' comp. c:152, §](4),and we have no 12•❑ Roof'repairs insurance required.) t 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. (Contractors 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.#: C CC) 41" _f Expiratioti Date: O Job Site Address: R !/C!� 27 21 City/State/Zip: rt Attach a copy of the workers'compensation policy declaration page (showingthe'policy,number and expiration date). Failure to.secure coverage as required under Section 25A of MGL c;A 52 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 certi der the s an en ' s o rjury that the information provided above is true and correct Si ature: Date: �P 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): ,:I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: V t 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(7)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 certificate(s)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 tor 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 burn 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 Investigations' 600 Washington Street Boston,.M.A 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE -727-7749 Fax # 617 Revised 5-26-05 F www.mass.gov/dia 7 THE jr, ti ToWn of Barn-stable ` 'Regulatory Services A� • 7A.Et1i5TABI.F. • r- ` rs�as Thomas F. Geiler,Director i639 �Q' �fo � Building Division Tom Perry,Building Conunissioner 200 Main Street,Hyannis,IvfA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owrier Must Complete and SignXhis Section If Using ABuilder as Owner of the-subject•ProPe� hereby authorize to act on my behaff, in all T-ri, Is relative to work authorized by this building permit application for.. (Address.of Job) . Signature of Da Print Name If a Pro e Owner is`-a 1 'n for errr it please' coin fete. the P � PPX1 g P _ P Homeowners License-Exem Lion Form on :the reverse side. P I ♦ yj/ I � / �J T� Town of Barnstable ray y� o Regulatory Services MAY rrsrw M Thomas F. Geiler,Director . 1L1 QC 1619. Building Division Prfp {A. Tom Perry, Building Commissioner 200 Mairi.Street, Hyannis,MA_02601 Rrww.to wn-b arnstabl e.ma.us Office_ 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: eiryhown state up 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 supervisor. ` DEFINITION OF BOMEOWNER Person(s)who owns a parcel of land on whi6 he/she resides or intends to reside, on which.thcre 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 bomeowner. 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 building 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.hcAbe,understands the Town of Bamstable Building Department minimum inspoction procedures and rtsquiremcnts and that he/she will comply with said procedures and requirements. Signatbre of Homeowncr Approval of Building,Official 1, e co 35 000 cubic feet or lar`cr will be rc &d for comply with the Note: Three-family dw Ilmgs containing g quir mp y State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The code states that: "Any botmowmcr perfomvng work for which a building permit is required shall be exempt from the provisions of this section.(Section 1 D9.1.1 -Licensing of unnuruction Supervisors);provided that if the homcowne engages a person(s)for hire to do such w orlr,that such Homcowncr shall act as supervisor." hfany homeowners who use this exemption are unaware that they arc assuming the responsibilities of a supervisor(set Appendix Q, Rules&Rcgblations for Licensing Construction Supervisorz,Scctioa 2.15) This lack of awanmess bftm results in serious problaas,particularly when the homeowner hires unlicensed persons. In this ease,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. Thc homeowner acting as Supervisor is ultimately responsible. 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 respansibilitics of a Superysor. On the last page of this issue is a,farm cirn eriUy usr�by several towns. You may care t amend and adopt such a forrri/certification for use in your eornmunity. } Ne Office of Consumer Affairs and Efusiness Regulation 10 Park Plaza - Suite 5170. Boston, Massacyh setts 02116 Home Improvement'Cqtor Registration Registration: 112536 Type: DBA = Expiration: 3/23/2013 Tr# 209024 FRASER CONSTRUCTION CO. DEAN FRASER P.O. BOX 1845 r � / COTUIT, MA 02635 t _ rs �!� Update Address and return card.Mark reason for change. -�� Address n Renewal ❑ Employment Lost Card DPS-CAI 0 50M-04/04-G101216 ,�� OfficeT0f/6J e��tfa-rT l;usri en ss egu a on License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: :;112536 Type: Office of Consumer Affairs and Business Regulation Registration: >: 10 Park Plaza-Suite 5170 Expiration: ,3623'013 DBA Boston,MA 02116 F R CONSTRUCTION CO ,?, :t 'F DEAN FRASER 104 TWINN VIEW E FALMOUTH,MA 02536s `v;."' Undersecretary' of Vail wit ut si re t . s i e 07 �iyr �urea�/ o .�f�avaac ivaelta:'. Board of Budding)tggulat�ons asd 8[sndards ConstructimnSuiservis©r License License .CS ! r 97668 Birth,litii` 6/7/1,9.7 M E Cpiration V7,2041 Tr# 97668 _ Fife§triatlon.,.. 0 DEAN FRASER 104 iVHINN VIEW LANE � _ �✓�� EAST FALMOUTH,MA 02536 Commissioner':' . I Cm CERTIFICATE OF LIABILITY INSU Fw►scoN.o1 Mosu RA N C E DATE(MMIDDfy" PRODUCER CERTIFICATE 676-0309 10/21/2010 Viveiros Insurance Agency,Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 375 Airport Road HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Fall River,AAA 02720 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INsuREo Fraser Construction LLC INSURERS AFFORDING COVERAGE P.O.Box 1845 INsuRERa Nahlonal Union Fire Insurance Compan NAIL III Cotult,AAA 02635- INSURER Et INSURER 0 INSURER D- COVERAGES INSURER E 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 ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.INSR ' TYPE OFPOLICY NUMBER POLICY EFFECTIVE PO CY EXP RATION GENERAL LIABILITY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MADE OCCUR PREMISES Ea occurence $ MED EXP(Any one person) $ ' PERSONAL&ADV INJURY $ GENL AGGREGATE LIMIT APPLIES PEF;t GENERAL AGGREGATE $ POLICY PRO- LOC _CTI PRODUCTS-COMP/OPAGG $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT ( ALL OWNED AUTOS Ea accident) $ SCHEDULEDAUTOS BODILY ILLY INJURY $ HIRED AUTOS NON-OWNEDAUTOS (BODILYer INJURY) $ PRO(Per PE accident) $ GARAGELUUBRITY ANY AUTO AUTO ONLY-EA ACGDENT $. OTHER THAN. EA ACC $ AUTO ONLY: AGG $EXCESS/UMBRELLA LIABILnY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION g AND EMPLOYERS LIABILITY X. WC STAITJ OTH. A ANY PROPwETORrPARTNER/EXECunvE Y C009930601 . 9/26J2010 9/26/2011 OFFICERIMEMBER EXCLUDED? E.L.EACH ACCIDENT $ 500,00 S(Myaensdabory In NH) E.L.DISEASE-EA EMPLOYE 3, 500,00 PECIALL PROV SIONS below OTHER EL DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION I SHOULDANYOF THEABOVE DESCRIBED POLICIES BE CANCELLED Fraser Construction,LLC BEFORE THE EXPIRATION AAA DATE THEREOP,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 . DAYS,WRnm Cotuit, C Box A 02635- NOTICE TO THE CERTIFICATE HOLDER NAMED To THE LEFT,Bur FAILURE 70 Do so SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY I ND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES, AUTHORED REPRESENTATIVE ACORD 25(2009/01) ©I BW2009 ACORD CORPORATION. All right reserved, The ACORD name and logo are registered marks of ACORD { J r-- ft. Z. �_ . :-: ,..• .. • ` _ .. ,'fit $� � •�. y �•+ J.� }ram .. _,•- �'� � �A t� .✓.��ar� j fI - _ � -�''.^,.ray"' - �� -mow •6 y• ,�, F .�s �.�' '« 'i+V iEr�.i .+r J� �"'�X ::.` ..��-... `..ti a -' � -. ram• ...._ � ...lye"" � '�� ,-R"�'�. .+-- -.p�'`a:;f� +,+ ,_ .: .��`.� _ �' � �$' as .6 ��_� •""` + '' ' ` •: J• v ` ¢ 'f• .,.. 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'l.ifF,\.;�.+. .l, ti F TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION• ,• , Map Parcel �� y Permit# _ R Health Division Date Issued a� Conservation Division ` - Fee Tax Collector Treasurer a ..Planning II . 9 'Date Definitive Plan Approved by Planning Board 'Historic-OKH Preservation/Hyannis a ` i Project Street Address �S O F Village 1i»yz,4 'Owner Z-0-04 w Address Telephone -Permit Request (ale r fig �.c�i��oG�orc2s C Ot ,. C Square feet: 1 st floor: existi g propos d 2nd floor:existing proposed Total new Estimated Project Cost 9000 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 ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(§q.ft) Number of Baths: • Full: existing new Half:existing new Number of Bedrooms: existing` new, e Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other .F Central Air: •❑Yes ❑ No -Fireplaces: Existing New,. Existing wood/coal stove: ❑Yes ❑No Detached garage:O existing ❑new size Pool: ❑existing ❑new size' Barn:❑"existing ❑new` size Attached garage:0 existing ❑new `size. Shed:❑existing ❑new size Other: i Zoning Board of Appeals Authorization ❑ Appeal# Recorded.❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use `_ -- Proposed Use P ... BUILDER INFORMATION Name F RASER CONSTRUCTION Telephone Number Address 71 T'ARAGON CIR. License# COTUIT IAA 02635 . Home Improvement Contractor# `36 5 ) 428-2292 Worker's Compensation,#. 60 a ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE `� ' M a. FOR OFFICIAL USE ONLY PEigMIT�NO. DATE ISSUED e MAP/PARCEL NO ADDRESS {:" VILLAGEr + r' OWNER DATE OF INSPECTION: t FOUNDATION 1 g s E � FRAME 'f f i INSULATION . N FIREPLACE w '� ELECTRICAL: ROUGH FINAL r - , - PLUMBING: ROUGH FINAL GAS: ROUGH, FINAL FINAL BUILDING a>' r7 i r r DATE CLOSED OUT ASSOCIATION PLAN NO. oFTME�o The Town of Barnstable • IARNSfABL& • Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 _ Office: 508-862-4038 Ralph Crossen Fax:, 508-790-6230 Building Commissioner Permit no. Date a0 ; 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 onto structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: e S/ c3zJCSl Kl CW Estimated Cost Address of Work: Owner's Name: !9 r.�) �✓lc�Q.fi) ' Date of Application: (A-,),z I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under S1,000 Building not owner-occupied gOwner 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: h�O la / a-s D6116 Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav The Commonwealth of Massachusetts - Department of Inthatrial Accidents ,o -- - office 0f/"es089oos _ 600 Washington Street Boston,Mass 02111 Workers' Compensation Insurance davit name ' P,A location- C/-�z city (fo U/ In g , phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole netor and have no one working in any capacity %% //////J/////'//��%%/%%/G/%%/%//%//////////////�%////%�%/%%/%�i, I am an employerroviding workers' compensation for my employees working on this job.::: :: . : ........ ....::;:;: ;;;;; P.................:.::::..:,::::::. :::.:::..:.: :..:,:...::::::::::::..:::::::::::.:.......:::.:; co - ; r�I 'K � mpany name cadre ss G �city ..: � ....� ... phone#. � insuLV ON F1111-1111111111-1111111-111A rance co. ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have e following workers' compensation polices: the com any name: :....:...... . address. :..::::. .:.::::: �t 'L!;: {s {:j;:�i'ii:{::?i:;:;-1,.isii:isr�iii'iiiii::iYiisv::j•iY.•iiiiii:•i»ii:•::+.h}i}iii:^i:: :. j:?:::`:: :::::.::i::::::-'ii;;:::;;:ii:i rii$;i?i:<:::::i::i::::::i;.;j:.}}::ii:;;:;'::!r;:!�ii}::<;::;:;:;iiiY.ii•.:i::{i?�i:i;:•::;:.;:•::i:::;::::•i:?:'r.;:.;':: :::. ::;':>;:;.:::;::;>;:::'::;:.;::::::.: <::;..>:.::;>: one:#,: ... .. city d :::: .....::<:<;::< k. 'v'):j:?::;:;:;:;:?}i;::::�:�:�i`?:iT:�%i?:iF�l�ii:'ii!�F<�i>:;ii!; is }j i ii::{:i::i;ri::'�:i:is:y}i;ii:;:;i:� �:$isiCit'::i:;i::�::::�:i�iy;::;:;i:%i?{^YLi?i:iyni:•i:•:i:iii:; address: :'> . >:<;ho ne clb* ........... ..........._ Fanure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,900.00 and/or one yam,imprisonment as wen as dva.penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Ofilce of Investigations of the DIA for coverage veriflratlon.. I do hereby certi er t and pen of perjury that the information provided above is trw amd correct Signature Date Print name � �=2�5 Phone# ofiidal use only do not write in this area to be completed by city or town official City or town: permit/llcense# ❑Building Department (]Licensing Board ❑check tif immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; - ❑Other- Umsed 9/95 PJA) C r 4 HOME 114PROVEMENT CONTRACTORS REGISTRATION and of Building Regulations and Standards One Ashburton Place - Roos 1301 Boston, Me achusetts 02108 HOME IMPROVEMENT CONTRACTOR __-- _ -- -- -- r - - stration i.22536; Expi ati" 04/O 01 r % ' r x , Reg _ Type atrAW - 1h�n 1OR \ r. �. ��.�- �i>+�:.♦�� 1. �•� 'p—:,. .�.z..:T�'.�t,i'2�xn�Xar:�$�t a�"h$R;��'";ixF>X",ura.rv'0�t`'ain".�iu'�u'�J`t,. 'P�N';,p."'s ` „� $3F�Y}rt`.�` 'ini .:1. ,14";,rn•bF ,h,4rfikfiMcP t �"A%�'Sg';i<npibP,V„m.�34hd�'a�' et1Ra ..,�•+: ..n i,A"•1: ": :iai Y41!i a..I•'4i'i 4:tlb i"-,'4 ?fa al.r,a{1+•_ �xy.k� t ,:.., F l .. �.:;gail;Xt.dA.4 IN.�A:N C.0 pT.�NJ4'H ,w.. �. �`...�. . .. FM a.-�1u!..".'n-�h'`�...,`A:d,k.,:sV..""fh>L'�1k'�W,"MAAN!"k�i:�P�:�•r 4,;!T.' ."' 7K9!'°�•fh'�dV;.1.++9ibn�ir- t� 'k•+.'�l^',.;1�i�+v"• +n„K.a:-: r,:« e•N S.s f'N 3p.,.xm +d µ'.P.F^"<:ri...R4 �... � 1. 1-.,. ,l..t�ti.,..sa.• n,in„ ..,� �`.i. ..r .,mY/,ri.- �IUr:$,5 '::itlT.ns.s.lr vt,w 'r`ms,.tru-:. .,Y:' .w+:ekn• .fir, e-.� -ER, ASER" CO.:... ;....,.NSTRUCTION. '�".'..a,,.. ..... ,.. ,.,,.. \ �• .. ,v, a ,, ".<�r°: '%,�,� .c.m ,� �9 a os• ,B r�a«nw r a r,;;, �.�„a�»�• co DEAN' C. ,FRASER i TARRAGON` CIR. _ic ,a.,, 'K. 4�tab l r COTUIT MA 02635 1l1N co. wbaw*K MAN C. FRASM r .'+.,m- �;pw .. ,. s !:. ,?c:">;°,°'rn .'ssmiAJ>k�� dtU6 -`" '"• •�. . :�` � e'- . ,s, ?�4 ... . w MA R tIR j Engineering Dept.(3rd floor) Map 6 ;? q Parcel 6 ,0 Permit# c House# SSh 6 Date Issued a SPQR Board of Health,(3rd floor)(8:15 -9:30 0:00-4:30) "- Fee' d� Conservation Office(4th floor)(8:30-9:30/1:00-2:00) 4 Planning Dept. (1st floor/School Admin. Bldg.) THE Definitive Plan Approved by Planning Board 19 ^") BARNSTABLE. MMM TOWN OF.BARNSTABLE , ' Building Permit Application Project Street Address 'IS_S_"A /L74- 0- '9 Village v Cc� ,f /77/9 Owner �f�pG,,y� {'✓ Address '2 CG2 C� Telephone Permit Request vd First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ 5-000 �. Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 No.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 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# Current Use Proposed Use Builder Information Name Ceevvt r A)e, 1 Telephone Number r Address / J;�9/6:i<g m C11Z License# Home Improvement Contractor# Worker's Compensation#��'j3/� f/g�363 O/,/ 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 ��✓�f� SIGNATURE DATE as-b g' BUILDING PERMIT DENIED FOR THE F LLOWING EASON(S) r t. r i 1a - FOR OFFICIAL USE ONLY s PERMIT,NO. DATE ISSUED MAP/PARCEL NO. � i _ - • - _ 'mot ADDRESS i VILLAGE ' OWNER DATE OF INSPECTION: FOUNDATION FRAME - INSULATION FIREPLACE ' ELECTRICAL: ' ROUGH FINAL, PLUMBING: ROUGH FINAL GAS: ROUGH FINAL `. FINAL BUILDING (3 )-/ /W' , . , . DATE CLOSED OUT ' ASSOCIATION PLAN NO. ' The Town of Barnstable 9ARtvsrn U& 9q� 'e� Department of Health Safety and Environmental Services 'OrEc " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only i 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: Est. Cost 167®DZ,7 Address of Work: Owner's Namel Date of Permit Application: a� 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 hereb apply for a permit as the agent of the owner: Dat4 Contractor Name Registration No. OR Date Owner's Name ' Thc• Cot inalllt'CUlth of Afassuchusem liw; Dc partllunt njludilrtrial.4ccidcnts _i ;i' 600 Washing-ton Strcct �, •.,-,: .':• Bostutr.�11uss. 0�111 Workers' Compensation Insurance Affidavit aliltlic tnt information• Please PRINT Z. nmc• CiAA location• 1 T1 il!LIS.^ `'/;? Cit.,- (gin la&t. /f ,/9 nhnne 0 I am a homeowner performing all work myself. 1 am a sole proprietor and have no one workings in any capacity I am an empiover�providing workers' compensation for my emplovees working on this jab. emmmant•n• rne, 1 ✓i�i�i?/L f adrlresr. city: nhnnc#• in-mr•tnce cn. 1 Lit 1hot-leu—P nalicv# r % fS qr,:5�5G, ig .._.._..— ...... _.._......... ��.- _.—..._. -. G 1 am a sole proprietor. general contractor, or homeowner(circle arc)and have hired the contractors listed below who ha% the following workers' compensation polices: comnant, name: adri resc: cirv: shone 0, incnranrc rn nniict d cmmnanc name: adclresr rite- nhnne#• insurance co,- Attach additional sheet if necessary -�wSec Failure to secure cover-ice as required under Se cr ion:-9A of IN GL 152 can lead to the imposition of criminal penalties of a line up to S1.500.UU ndiur uric years*imprisonment:is%tell as civii penalties in the form of a STOP NVORK.ORDER and a fine of S100.00 a dad•against me. 1 understand that a cope of this statement mat be furtcarded to ttte office of Investigations of the D1A for coverage verification. 1 do lrerehr cerrijt• the pit•is and praait'cs ojperjun•that the information prodded above is true and correc. Si^_nature Date a _ Print name Phone# ntliciai use only do not write in this area to be completed by city or town official city or town: permit/license# riiluilding Department Licensing Board Selectmen's offtcr t �check if immediate response is required• ❑ ' 01lcatth Ucpartmcnt EE t. phone it: rj01hcr contact person: — r n } Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' contpens:ution for employees. As quoted loom the an enzplt{vee is defined as every person in the service of :tnt)thcr under am• contract of hire, express or implied. oral or written. An cirrplt rer is defined as an individual, partnership, association. corporation or other legal entity, or any two or me 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 : owner of a dwelling_ house haying not more than three apartments and who resides therein. or the occupant of the dweliing, house of another%rtto employs persons to do maintenance , construction or repair work on such dwcllinu or out the _arounds or building appurtenant thereto shall not because of such employment be deemed to be an empio.,. MGL chapter 152 section 25 also states that every state or local licensing agency shall ivitltltuld the issuance or rencival of a license or permit to operate a business or to construct buildings in the commonwealth for any . pplicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chaptcr been presented to the contracting authority. Applicants Please full in the workers' compensation affidavit completely, by checking the bog: that applies to your situation anc 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 tite 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 anv questions regarding the "law" or if you are recuire to obtain a workers' compensation policy. please call the Department at the number listed below. City or'ro-yns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at tite bottom the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. P! be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returnee the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questic please do not hesitate to _give us a CZ11. The Department's address. telephone and fax number: The Commomv ealth Of Massachusetts Department of Industrtal Ac cidents -'Office of Investigations 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone =`: (6I7) ":--—9()() eat. 406, 409 or 37S •5, � �$q"j V� �1.l,•. f.': � � . _HOME aIMP eoa teIM,a'. rohr �,yyASbu� A #�Fs �8.neY s _.. w x y °ry �. tl ars ME ° 21 Qoom *' HO I > {,,� MP,ROVEMEN �a �: ' 8 �r RrYPestraton�`2�2536N ,., ft.� /06 ' �...RA SER :F E N RU I RA r � SER 1 TARRAGON � ■ 0 rUZT, MA :IV 2635 'ygg }xpE� j .i'' x Engineering Dept_(3rd floor) Map - Parcel - �Q S �' Permit# Q9 / z w„ House# Date Issued Board of Health(3rd floor)(8:15 9:30/1:00-•4:30) Fee Conservation Office(4th floor)(8:30-9:30/1:00-2:00) Planning Dept.(1st floor/School Admin. Bldg.) BIKE t * Definitive Plan Approved by Planning Board - F 19 • • BARNSTABMARR LE, i .., JED TOWN OF BARNSTABLE Building Permit Application Project Street Address Yy q q I m D U4 Village Owner l2l4 C '�✓t Gye-� Address 4so� Telephone Permit Request 4 RrJJ-?_1n mana�;6 au f 1411t Sala , First Floor square feet Second Floor square feet •Construction Type Estimated Project Cost $ jQ,UE1C? Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes _ ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No ' 1 R 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 No.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 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# Current Use Proposed Use Builder Information Name 0 Telephone Number Address 71 7-t+9c�Srz1 Q ti License#112)S-3 , Cc��-cc Home Improvement Contracto LC)C./27/ 3/S y�r363c7/>S Worker's Compensation IF 0 5 , 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 DATE BU DING PERMIT DENIED FO E FOL WING REASON(S) - FOR OFFICIAL USE ONLY _ PERMIT NO. DATE ISSUED MAP/PARCEL NO: ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION = '' FIREPLACE 1 ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH 'FINAL GAS: ROUGH FINAL ► 1 I i FINAL.BUILDING DATE CLOSED OUT- ASSOCIATION PLAN NO. The Tomm ®f Barnstable Department of Health and EnvironmeIIttl Services Building Division 367 Main Strut,Hyannis MA 02601 Raiph Office: 508-;90-6Z7 r Building Coe Fax: 508-"►90-6=0 r' For office use only Permit no. Date o�� ' AFFIDAVIT HOME MOROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION ` MGL c. 142A requires that the "Teconstruction, alterations, renovadon, repair, moderni=ion. conversion, improvement, removal+ demolition, or construction of than four°n to any dwelling preuni-existing to owner occupied building containing at least one but not more structures which arc adjacent to such residence r building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: Est. Cost Y Address of Work: �-/ Owner's Name eAj C Date of Permit Application: `r hi i I hereby certify that: Registration is not required for the following re=on(s): Work excluded by haw _Job under 5I,000. Building not owner-occupied Owner puiling awn permit Notice is hereby given that: OWNERS PULLING THEIR ®WY PERMIT OR DEALING WITH (AYREGIS'rERF.D CONTRACTORS FOR APPLI NP GRAM OR GUARANTY FUND UNDER MGLO 142A ACCESSrr TO THE ARBATION PRO SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owaer. / C�atractor Name No., Date I - T11C• clinniumstwum olmassaamserry Depurf"Ielr1 of hidustrial Accideirts 4" Y OfticZ SMyesugatlons .. . .h(1(1 !f•uslrin�,turr Strcu Wurk-em' Compensation Insurance AlMda •it 1AyCh",nrinfornintinn Plc'tse 1'R1NT leb;�yiv"�-- Inc•- inn `� ( 'rA(zk<—z \ Cin• 61 6— nhont' I 1 am a homeowner periormin_all work myself. 1 am a sole proprietor and have no one workings in any capacity - LIR—I am an employer providin_�workers' compensation for m% empioyees working on this job. cnfml rnn n tmt ltirl tree• nhnne H• - iwmr^nrr n 1y'-:. JFlr �Vi� �C nnlic� f! "-p-/n/ z sole proprietor. general contractor, or homeowner(circle atre) and have hired the contractors listed beiow 'xhc -c the "oilowing workers' compensation polices: cnmr'rrn nninr- 1611 rrcc• )ncur-nrr rn cnm .,n%. nnrnr- J(Irlrrcc• tin•• nhnnc*�• incur-nrc rn Holier ,Attach additional sheet if necessary --- ;ram._ _.,. •:c..Y� -_:�_�r•. __......... _.,.:...,�..� r.. F:fnurc ra secure cuvernce as required under Jtetton_SA of t11GL 152 can lead to the imposition of Cnmtnai penalaes of a line up to S1.SDU.UU anutur unc ,,cars' imprisonment a.s %%cil as civil penalties in the form of a STOP WORK ORDER and a fine ofS100.00 a dad•against me. I understand th=t copN of This Statenfcnt mas be furs.'arded to the Once of im•estitstions of the DIA fur coverage verificatt.on. I eio hercnt• cc ruin t rile mitts anti pcttailles of perjun•that the information prorided above is true wid correct. S'IQnaIur Primnzmc Phone# •• otTiciai afse unly do not«•rite in this area to be completed b�•gin•or tott•n otTiciai ` city ar tnvn: permit/licensc d r-muildin_Department C:uccnsinc board k Jc 's r :heel:itimfncdiatc respunsc is rrquircd Orrcc Qlcctmen ,. [tllcalth Department phone#: r-Uthcr E contact nersnn: Information and Instructions Massa:.'tutictts Gencr:tl La++s chap tcr 15= section 25 requires all employers to provide workers' ct�nhpensa..ioll emrtim•ees. As queued firom the "la++'".an enipI01'Cr is defined as e1•e.-��person in the service of another unac- of hire. express or implied. oral or written. -•- An entpiarer is dct;ncd as an indi+•iduai. partnership. association. corporation or other legal entity. or any Iwo or the �urc_cin__ cn__ascd in a joint criterprise. and including tic le'- representatives of a decc:sc- employer. or a:c recc or mistee. of an individual . pannership. association-or other legal entity. employing employees. Ho++e•. c o+N'rcr of a d%vellin__ house itati•inc not more than three apartments and who resides therein. or the occupant of d%%chin_ house of another who emplo?'s persons to do maintenance .construction or repair work on such or an the __rounds or building appurtenant thereto shall not because of such employment be deemed to be cn e:np N 11G;_ _harncr !5= section 25 also states that e,%•cr•}• state or local licensing ngencv shall withhold the issuance c; ti+::l of a license or permit to upernte a business or to construct buildings in tic commonivenith for un�- c::ttt ivho leas not produced acceptable evidence of compliance with the insurance col-erase require•?. �c Iv. :tcither the coin monweatt nor any of its political subdivisions shall enter into any contract for ,,,. of public N ork until acceptable evidence of compliance with the insurance requirements of tlhis chcc:. hce:: _-rc=,ted to the contracting authorin•. �Pl�iicartu ('!case :iii in ;he %vorkers' coinpe:hsation affidavit completely, by checking:he box that applies to your situa:i= su�c:� :ne _otncan+• names. address and phone numbers as all at�idavits may be submitted to the Department of `n� .Accidc::ts ror confirmation of insurance ccV=!e- Also be sure to si;n and date the sflidaviL Tite zVit sitouid be returned to the cin• or town that the application for the permit or {icense is being reque=tec- r J;:c Jcca.::;te::t of Industriai .-accidents. Should you have any questions re_arding the "law-or if you are compensation policy. alense call the Department at the number listed below. Cin• it ;osm P!e 7e urc :ha: :he affida+•it is comp{e:e and printed legibly. The Department has provided a space at the bott:;r- the •- ,a+it for you to fill out in the event the Office of Investi`ations has to contact you regarding the appiic:.•h:. F be _ _ ;o 5il in the permit/license number which will be used as a reference number. The affidavits may be re::r: nt ,:Ie D:ca,;;neat by mail or FAX unless other arran^e:neau have been made. i h_- of Investi_ztions would like :o thank you in advance for you cooperation and should you have art}• quest: pies: -;o not liesitz:e :o _•ive us a cell. Tit Jeczmm�enf s address. teie-ihone and fax number. TIhe Commonwealth Of Massachusetts Department of Industrial :accidents - o fin sf Investigations 600 Washington Street Boston, :YIa. O2111 fax T: (61, 7-7-7;49 ni une =. 6 i-) -- --'900 c -06. 109 P/ w ) /,- _;� .A 0 • y'�. jF.,. �.qt�t �' r �p 1�i,. ^S+t� �w,� � �' ..7� '" r '- • • ;�`'r }� +a r A h ,. � .:9 .,. ems".$ � • „; • • Ft I _ yyyy��tt��Tu �:�T y: e�' r��rr ..t11~< •��a'r-%;,_ ,,ter a 0 0 I r Al" 2. . R�f M�i sH�h nX•T� r. 3tf f �7 p Im f Ati - *Permit R- OF THE Tp� Town of Barnst0l , Expires 6'nondis from issue date Fee Regulatory Services es o� Director I�eirr'vli� .�7'1 1 HAss. Thomas F.Geiier, ��pTF16!%9. AvO�j Building Division -PRESS PERMIT Peter F.DiMatteo, Building Commissioner DEC 4 2001, 367 Main Street, Hyannis,MA 02601w Office: 508-862 '038 TOWN OF BARNSTABLE Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Bed X--Pros Imprint Map,parcel Number Property Address Value of Work yov LEResidenrial Owner's Name 3 Address �•�" Telephone Number ' $ Contractor's Name Home Improvement Contractor License 4(if applicable) r Construction Supervisor's License (if sppiicable) ' ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor 0—I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name _ Worianan's Comp- Policy permit Request(check box) w ❑ Re-roof(stripping old shingles) _ ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-sideoGc �G�la�✓� 4 Replacement«Windows_ U-Value gy( ' m'44 ❑ Other,(specify) ' depanment regulations.i.e.Historic.Conservation..... *Where required: Issuance of this permit does not exempt compliance with other town Sienatur ��Q:Forms:expmtrc:re� 070601 • !.�"�;"'*• rrt«, ..•,. � :.. � .+'` '�,.., �" 1 ��" ? q1.• 2��F �:r.1 !� ♦�,� f'`�;`", �-•�''. c C.t � ✓ 4 • •Y.,T,J • ♦ did J'^ sss .y 1 �Gh t•,k i T. i `e ...� �, • a 7 4 _ • i• •. }D k" r, f J7` r;ems° w'•t ? 4A.s av'«+ ^3 ' .t��1'} ,•�y.. -'+"'�,'p,--aM�e iT`; �«��9"c}� .y7�,,1.� ., {��'A'.., G - a1 _3- ^i'Y'�ir.s r`� `11 � Y« 'iri.'YF „ww'F r. 4trf>S,r a�.•.. 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'�r4, s.�...�,�•. ., Zara•:' .'d+ 'y ", C`.�'".T'�t' :,.;��`L�i��'��,�7'Z�,��„.�-,s'e:'�an.`".�i.. t,t�: x�'".� x�. ->t� _�»` .a ,.=s 4556 Falmouth Road, Cotuit ? 7/10/06 G w� pp ........... il? �5i... ..... �<? ......:..:: � ;,:>::;::>:<:>�::fraser rooIll fm T no OUR BE >>` ................... —PLANNING DEPT. :aaiy .........:: <z' ...NV �.::::::::::::::::::::::.:fix::::;:::;:;:::: .::::::.:::.:.::.:�.:.:::::..:.:: .::..............??????RUNNING BUSINESS FROM • PROPERTY O ERTY WI THOUT OUT APPRO VAL.VAL. to owi .. .......... .��:��::::: FRASER HAS MET WITH ANNA B RE: P. -HS AL L LL PAP E —RS AND I S WAITING G FO R O EN .G STAMPE D PL ANS. . S '{ .fix... 0 ,3 1 Willi /c f ��- J r � r✓ r 1 � GARAGE � r r � t o�f r � k I E TOWN OF , BARNSTABLE NARIFSTAELE, 1639' BUILDING INSPECTOR 0 Jul APPLICATION FOR PERMIT TO ......-1� ........ a..... ................................................... TYPEOF CONSTRUCTION ...................................................................................................................................... CX................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....4.,e .,Lx....... .........�I-�- , ........................... ProposedUse .,g' ............3................................................................................................................ Zoning Di9trict ....Zoni .1...................................................Fire District .i................................................. Adclressfatl�lt�.��...... ...CA.M- Name of'OwneKa-49-t t-14-: ................ Name of Build r lLa2 ),,, -GL-�� „^�� .. Nameof Architect ...................................................................Address .................................................................................... Number of Rooms .........../.....:.............................................Foundation ......rmy--�-- ...... Exterior ... ......................... ....................................Roofing ... ..................................................... V" Floors ..............................................................Interior .................................................................................... Heating ................. Plumbing ....................................................................... ............................................................................ Fireplace .....................4.......................................................Approximate Cost 0.0...................................... ........ ......... ... ... Definitive Plcin Approved by Planning Board ------------------------------19--------- Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH 0 er a-,,�Cz SEPTIC SYSTEM MUST BE NIISTALLED IN COMPLIANCE Vi']MH A-�T- !CLE 11 SIATIE , SANITARY CODE AND TOWN REGULATIONS,,/,—*--, I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. N=4 .................. ............. Curtis, Othal E. 16145 garage No ................. Permit for .................................... (demolish existing garage) ............................................................................... Falmouth Ave. Location ii- t ................................................................................. Owner .................Othal.E. Curtis.................. ............ ..................... Type of Construction frame .......................................... ................................................................................ Plot ............................ Lot ................................ \.I r Permit Grant 1 23 Granted ........... ............................19 73 Date of Inspection .............. ...... ..............19 Date Completed .... ..... ..... ...........19 PERMIT REFUSED f .................................................................. 19 ............................................................................... hl ................................................................................ ............................................................................... it ............................................................................... Approved ................................................. 19 ............................................................................... ................... ........................................................... i 1Q I l�yl,)--1 MA riS.r.. . i i • RESIDENTIAL PROPERTY. FIRE DISTRICT MAP NO. LOT NO. SUMMARY STREET 4556 Route. 28 Santuit 24 � - -7 3 LAND / J.S J C BLDGS. p o U OWNER c'.�.:_•-r:.. _:.,. ... roraL LAND S C ti RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: 7S BLDGS. �1 7 OO at Curtis, Othal . 11/7/50 768 303' B TOTAL 1•70a LAND 1 BLDGS. 0) j TOTAL LAND BLDGS. m TOTAL LAND BLDGS. —� TOTAL LAND BLDGS. at TOTAL LAND BLDGS. Q1 i _ TOTAL LAND BLDGS. ' INTERIOR INSPECTED: . - 3 341 � TOTAL - DATE: ✓.. �._ LAND ACREAGE COMPUTATIONS BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE_ —^ TOTAL HOUSE LOT _U7c3 y. - - -- �� _ } LAND CLEARED FRONT �S (/5�,� !-(,,; PP .cry-(7cE r 0) BLDGS. REAR TOTAL 4 WOODS&SPROUT FRONT LU OUo `A /Z S / HLANDREAR 7p �,SG�)' / 75U /'7 S 0 WASTE FRONT REAR BLDGS. TOTAL LAN D // 7 >j BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH % FRONT FT. PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND c\AinceoV r.in on 4 BI-DGS. ;onc. Slab Bsmt.Garage St. Shower Ext. Walls PURCH. PRICE . Brick Walls Attic Fl. &Stairs Toilet Room Roof RENT hone Walls Fin.Attic Two Fixt. Bath � Floors 'iers INTERIOR FINISH Lavatory Extra 3smt. F 1 2 3 Sink Plaster Water Clo. Extra Attic '/ /� t EXTERIOR IOR WALLS Knotty Pine Water Only 7 )ouble Siding ;Wr+:eed e?i.,.:'" R No Plumbing Bsmt. Fin. Tingle Siding Plasterboard Int. Fin. .� !p ±D ,Shingles (,t//1:'L �.�/:", TILING�'r/Z, :onc_Blk_ _ G F P Bath Fl. Heat -� ,_% ,o2 , "ace Brk. On Int. Layout Bath Fl. &Wains. Auto Ht. Unit - O to Veneer Int. Cond. Bath I'L &Walls Fireplace -� .om. Brk. On HEATING Toilet Rm. Fl. - /7 -- Plumbing ._.__. . Solid Com. Brk. Hot Air E., J Toilet Rm. Fl. &Wains. -- ._ -- -- -- ----- --- ----- Tiling / /, .� Steam Toilet Rm. Fl. &Walls , Blanket Ins V�,y Hot Water St. Shower - �� •` o�Y , *. , Roof Ins. Air Cond. Tub Area Total Floor Furn. �• /� ROOFING COMPUTATIONS Asph. Shingle Ppeless Furn. S. F. Wood Shingle------ _-- No Heat �� S. F. Asbs. Shingle Oil Burner 11 S. F. Slate Coal Stoker S. F. File Gas S. F. OUTBUILDINGS ROOF TYPE Electric Gable � flat S. F. 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED Hip Mansard FIREPLACES S. F. Pier Found. Floor/lI � Gambrel Fireplace Stack / � Wall Found. R 0. H. Door LISTED FLOOR Fireplace Sgle. Sdg. Roll Roofing Conc. LIGHTING Dble.Sdg. Shingle Roof Earth No Elect. DATE Shingle Walls Plumbing ��Y� Pine Hardwood ROOMS Cement Blk, r/' Electric z TOTAL - Brick Int. Finish PRICED Asph.Tile Bsmt. 1st Jr-f-(/, _ J Single 2nd 3rd FACTOR -- ^ 0`.x., G. REPLACEMENT 1 r-J S j_3 OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOO. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. DWLG. .533 , 7,P 7-5- 3 c. 13 t; �: 2JK3? 4 5 6 t3 9 10 '"s'¢U TOTAL �jsT� J HOPERTY ADDRESS ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CSTATE LASS PCS NERD KEY No 4556 ROUTE 28 01 RF 20C 01CT 07/09/95 1011 00 OaCC R024 005. T LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS T 12211 L anc By/Date Size os,on Y UNIT ADJ'D.UNIT ACRES/UNITS VALUE Description CURTIS. ALICE F $ PELLS.D MAP- I CD. S" '-/Acres LOC./YR.SPEC.CLASS ADJ. COND. PE PRICE PRICE ;#LAND 1 35.100 C ARDS ACCOUNT - 10 1BLOG.SIT 1 x 1I =i0 100 29999.9 29999.99 1.00 30000 ##8LDG(S)-CARD-1 1 34.800F 01 11 iRESIDUAL 1 X .70 =10 121 6000.0 7260.00 .70 .5100 i1PL 4556 ROUTE 28 COTUIT 6990C J #RR 1388 01.56 70000 iBATHS 1 .0 U X C= 100 3500.0 3500.0 1.00 3.500 8 t#CL22 NOW CL4LC-DENIED 95 1- 1/2 BSMT S X C= 100 3.6 3.6 824 3000-8 USE A !FIREPIACE U X C= 100 3100.0 3100.0 1.00 3100 8 D VALUE D J 69.900 T U MMARY S ' 35100 T 34800 M ! Eli ITOTAL 69900 CNST T �. oEEDREFERENCTy� DATE-TOI•- aecq,o.a PRIOR YEAR VALUE Book Page I.- MO.-�D1 $ales P:io. LAND 35100 S ' 92fi5/056JTI,07/94 A 1 IBLDGS 34800 P1430AD1TEI,'12/93 A 1 OTAL 69900 7600/177TEIb7/91 A 1 I BUILDING PERMIT Type Amount Dete LAND LAND-ADJ INCOME SE SP-SLDS I FEATURES BLD-ADJS UNITS Number 35100 1 3600 C a ss Const. TOt al Year Built Norm. Obsv. Units Units Base Rate Atll Rale A i Age Depr. Contl. CND Loc urp R G Repl Cost New A01 ReDt Value $tortes Heig nl Rppms Rms B.I�s •-Fis. Pertywsll FK. I01C- 000 100 100 53.95 53.95 40 60 34 56 100 56 62137 .34800 1.0 3 2 1.0 4-.0 IDescnplion Rate Square Feet Repl:Cost MKT.INDEX: 1 D Q IMP.BY/DATE. / SCALE: 1/D 0.82 ELEMENTS TODERUCTION DETAIL BAS 100 53.95 824 44455 INGLE FAMILY : DWELLING CNST GP:00 FSF 90 48.56 90 4370 *----- FSF 90 48.56 200 9712 � --IO------* "TYLE 0.0 FSF ! -- -- -- ------------' DESIGN ADJM7 0.0 10 10 XTER-WALLS AME----------------- D.0 EATlAC TYPE 7--- ------* Ih'TEFINISH ------------_ D.NTEQ.LAYOUT 0i ! ;INTE9 abACtY 02 AKE AS EXTER. D.D - -- TER ! LOOR STRUCT -00 - - - -- 0.0 W E F LOo9 LOVER 00 ---- 0.0 ----- - E Total Area Base s 1 1 14 22 ! 0 OT T Y P E - 00 --- _0 BUILOINGDIMEN$IONS *'�-9---* BASE 24 LECTAICAL DD 0_0 T 8AS W16 N08 W11 S06 W12 FSF W09 t - ---- - -- --- - _ _ A 0U-NDATION ti0 qq=q N10 E09 S10 .. 8AS N22 E02 FSF 10 10 *---11---* ! -- - --- ---------------------- N10 E20 S10 W20 .. BAS E37 S24 ! 6 ____ L FSF i NEIGH80RHOOD owe It COTUIT 8 LAND TOTAL MARKET *--9---*----12---* PARCEL - - 35100 69900 *-----16-----X AREA 85456 VARIANCE +0 _18 STANDARD 25