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HomeMy WebLinkAbout0409 MAIN STREET (COTUIT) �� q � �. _ _ __ .\ i Town of Barnstable *Permit# Expires 6 m onths front issue date Ss. T i Reguyato'r'y Services Fe JAN � Thomas F.Geiler,Director ` �` 200y ®�� - Building Division p v�' Tom Perry,CBO, Building Commissioner OF BAR NSrABLE 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax:-508-790=6230 EXPRESS PERMIT MIT APPLICATION 12ESIDENTIAI. ONLY Not Valid without Red X-Press Imprint Map/parcel Number 0 2 Property Address � �UL S residential Value of Work ? `p Minimum fee of$25.00 for work under,$6000.00 i Owner's Name.&Address Contractor's Name F A a-� Q Yi/J�u c e� o Telephone Number 50 - Q� Home Improvement Contractor License#(if applicable) t! f 'R 3 Construction Supervisor's License#(if applicable) C [:AWorkman's Compensation Insurance Chec one: I am a sole proprietor. I am the Homeowner 0,I have Worker's Compensation Insurance ., Insurance Company Named -@ ��CI> J J. r rv� S�S Warkman's Comp:Policy,# 03 I I � Copy of Insurance Compliance Certificate must be.on file. Permit Request(check box) �Re-rcof(stripping old sh ngtPs) ett construction debris will be taken to 1 t �cJ L- � 0 Re-roof(not stripping. Going toyer ° existing layers of roof) r - ' Re-side p iders ,U-Value (maximum.44) Re lacement Windows/doors/sl *Where required. Issuance of this permit does not exempt compliance with otber"town department regulations;i.e.Historic,CanservatRn,etc: ***Note: Property}Owner must sign Property Owner Letter of Permission A copy of the Home Improvement Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revise061306 The Commonwealth of Massachusetts Department of Industrial Accidents s Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): _/l LC, Address: 1�C City/State/Zip: d6jbj OX35 Phone #: Are you an employer?Check the appropriate box: Type of project(required): l 2Ll am a employer with�D _ 4. ❑ I am a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees . These sub-contractors have g, ❑ Demolition. working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 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. :Contractors 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: 1� Qv 6_Z Policy#or Self-ins.Lic.#: Ll 13 - 0 3 q I m 5,5 6 _ U d Expiration Date: Job Site Address: Al 0 City/State/Zip: co 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cep the nd pe Ides of perjury that the information provided/above is truce-and correct Si ature: Date: / ^O Phone#: UQ�" �� a Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: • � 4 d a® of a d .e b ®-u-Paste R S gozx OM �� e ���•ht���� ®2108 13�l I � str, stiou FRFRASER ASER DEAN CONS-rRUCTION re�tton: 7 T2esB 8 � 02,8,s5 2oos 7a7e2o DPB.C,gy � spM-f19/pg-POB99p - . ` ........... _ muffabdium and ark Mum f Have I Rens"Al El xmv or Chan., "CaML or E$ r re: B BB b the � g , o"rd�� DER C0 ` TV 927820 �d � 8D: � P �EU-r. R , "` fts�ce �B �d SSPo.�v e _ I L. ' I k iBosed.of•Beilding RegulatiOnS/vend S'Gandg'nds gg G6nfftjd6an Super tpe License R 9.7,,668 i Br rdafe .6/ /1:95i7 ZE Cpjra-bn F 6/7/2011• Tr# 9:7668 DEAN FRASER �� :r.. i•., 1.04 TMNNNIEW, :4` EAST FALMOUTH,'MA 02536 Commissioner RightFax C2-2 10/1/2008 1 :00:56 PM PAGE 2/002 Fax Server ISSUE DATE : ��I• CC.. 10/0l/08 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY PRODUCER AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. WISE&QUINN INSURANCE AGENCY CO AFFORDING COVERAGE 449 PLEASANT ST BROCKTON MA 02301 COMPANY A HARTFORD UNDERWRITERS INSURANCE CO LETTER INSURED COMPANY FRASER CONSTRUCTION LLC LETTER PO BOX 1845 COBS C LETTER COTUIT MA 02635 �ARNY ID IET'fE ' .THIS 1S TO CERTITY THAT THE POLICffi OF]NSURANCH LISTED BELOW HAVE BEEN[SSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ' 1ND[CATP.D.NOTWITHSTANDING ANY REQ[IHIEMENC,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W 1lT{RESPHC['TO WHICH THIS CERTD'lCATE MAY BB]SSUED OR MAY PERTAIN,7HE OVSURANCE AFFORDEID BY THE POL[CI[iS DESCRIBIID HER©N[S SUBIHCT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OP SUCH POL[C7HS.LIMITS SHOWN MAY HAVE HEHN RIIDUC®BY PAID CLAIMS CO TYPE OF INSURANCE POLICY NUMBER POLICY POLICY LIMITS LTR EFFECTIVE DATE EXPIRATION DATE MM/DD M/DD/YY GENERALLIABI.ITY GENERAL AGGREGATE PRODUCTS-COMP/OP AGO. $ ❑COMMERCIAL GENERAL LIABILITY PERSONAL&ADV.INJURY $ ❑ CLAIMS MADE ❑ OCCUR. EACH OCCURRENCE $ ❑OWNERS&CONTRACTORS PROT. FIRE DAMAGE(Any One fire) $ . . MED.EXPENSE(Any ons person $ AUTOMOBILE LIABILITY COMBINED SINGLE UNLIT $ ❑ ANY AUTO BODILY INJURY .$ ❑ ALL OWNED AUTOS - (Per Forsolq ❑ SCHEDULED AUTOS BODILY INJURY $ ❑ HIRED AUTOS (Per Aecldem) ❑ NON-OWNED AUTOS PROPERTY DAMAGE $ ❑ GARAGE LIABILITY 10 EXCESS LIABILITY EACH OCCURRENCE • $ ❑ UMBRELLA FORM AGGREGATE $. ❑ OTHER THAN UMBRELLA FORM STATUTORY LIMITS A A WORKER'S COMPENSATION EACH ACCIDENT $500,000 AND UB- 09/26/08 09/26/09 DISEASEPOLICY LIMIT $500,000 0341M55"8 EMPLOYER'S LIABILITY DISEAS&EACH EMPLOYEE $500,000 OTHER THE PROPRIETORIPARTNERS/EXECUIIVE OFFICERS ARE INCLUDED. DESCRIPTION OF OPISATIONS/L4DCATIONBNEIICLENSPECWL ITEMS THR INSURRD'S MA WORKERS COMPENSATION POLICY AND ITS LIMITED OTHER STATES INSURANCE ENDORSIMU NT AUTHOR12ZS THE PAYMENT OF JI MRFITS FOR CUM IVIADE BYTHR INSURw8 MA w"LOYERS IN STATES OTHER THAN MA.NO AUTHORIZATION IS GIVEN TO PAY CLAJMS FOR BENEFITS IN ANY STATE OTHER THAN MA IF TM VMMM H@GS,OR HAS HWM®LSMpLOyERS OUTSIDE OF MA.THIS POLICY DOES NOT PROVIDE COVERAGE FOR ANY STATE OTHER THAN MA. THIS REPLACES ANY PRIOR CUR771�ICAT E ISSUED 70 7IHB CIsRTIFICATE ItOIDI$t AFFECTING WOIIXBRB COMP COVERAGE }:ii::{{-::•i}: }i:-}%r }r'::v'r'r}::y}::h'r:{i •}'ry'{;}.v::; ::ti::ti :-'r' HE FRASER ENTF,RTERPRIM LLC SHOIDD ANY A THE T ABOVE DESCRIBEDMNG COMPANY BR ILL ENLEDDEAVOR EERIER AI PO BOX I845 EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAR. !0 DAYS WRrrrEN NOTICE TO THE CERTIFICATE HOLDER NAM®TO TNB LEFT, COTUrr MA 02635 BUT FAILURE TO MAILSUCH NOTICE SHALL IVIPOSE NO OBLIGATION OR LIABH=OF ANY RIND UPON THE COMPANY[IS AGIINM OR REPRESENTATIVES XV—nW8ZMDR1ffRESffffATIW .:::...............�........ .....h...ti1...11�..,.... .:1 J:JJ.:..11�::i:1:•::1ti�:Y}•{}'.{.':1:ti:•:rl:�1�:� Fraser Construction LLC CONSTRUCTION 9 Roofing & Siding Specialists REEMM P.O. Box 1845, Cotuit MA. 02635 Email: fraser construction nverizon net 508-428-2292 www.fraserroofmg.com FAX 1-508-428-0123 PARTIAL RUBBER RE-ROOFING PROPOSAL DATE: January 02, 2009 PHONE: 508-428-5855 NAME: Mary Ellen Leonard MAIL ADDRESS: same JOB ADDRESS: 409 Main St. Cotuit, MA 02635 � FRASER CONSTRUCTION hereby proposes to perform the following services in a neat and professional like manner and in accordance with the manufacturer's specifications and local building code. -�1 -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. SUPPLY & INSTALL - .060 EPDM Rubber Roofing OVER Y211 FIBERBOARD on back low pitched dormer only l SUPPLY & INSTALL - .32 White Aluminum Termination Clean & Remove- Debris from work area daily. TOTAL INVESTMENT: EPDM RUBBER ROOF Partial rubber re-roofing on back low pitched dormer only. asphalt PRICE- $3,495 Initial AU& Payable immediately upon completion _J ?0 NO MONEY DOWN—NO Payment at the start or part way thru Payments accepted are: -- CASH — CHECK— MASTERCARD —VISA—AMERICAN EXPRESS *Any payments not made within 30 days of completion will be charged 1 '%2%for every 30 days the payment is late. Possible Extra—Any rotted or otherwise deteriorated trim boards,plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$55.00 per hour,plus 15% markup materials. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION: Carries Workman's Compensation and Public Liability Insurance on the above work. DATE OF ACCEPTANCE: Home ner Fraser Constructi Assessor's offioe (1st floor): Assessor's map and lot number ..... ' ............ � "'' Board of Health (3rd floor): < Sewage Permit number ..... ... yEngineering Department (3rd floor): Housenumber ..............................................1......................... APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE T'O� BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....TZ;'*.vt!t 19.. ..�...................................................................................... TYPE OF CONSTRUCTION W...C9.P0.............Y� � .............. w� v1� ....;>...19..¢..�1. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the fall wing information: Location ....4f Ct............ ."1(! -).. ..........J.. .............. '. . ?. .................................................................................. ProposedUse ......kr��t ............................................ ..................................................... Zoning District ..........................................................Fire District .....Cv�v .............. ........................................................ ........ Name of Owner ....CnAA.L.ES......L:�0WARD......Address .....�.V.. 3...... f N t.!'t ......4 PAO.�..... ....... ......... . 1 < < � t , I` Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ....................... ..............................................Address ................................... ............................................ Number of Rooms ...................Foundation .......� y.�.V� ` .. Exterior L(,/.CZC� ...... .�!.!.... ..!..............................Roofing .......... � I ............. ............................................................... I \' n O 'f ...� ...........................Interior ......... �... ....W...J �.4.Floors �A„(..Q.��............�.1�✓.�. `(. ........................................... Heating C ........ ................Plumbing � //� tom^ Fireplace ..........`f.1. ............................................................Approximate Cost A.—ZY Definitive Plan Approved by Planning Board -------------19-------- • Area !ll.Ll..A.............idp. Diagram of Lot and Building with Dimensions Fee :.. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of thegTowBarnstab a egarding the above construction. Name ..... . ........ Construction Supervisor's License .................................... LEONARD, CHARLES No .....Ukfi.8 Permit for ....Remodel .............. ` � ' n le Famil Dwellin Location ....4Q9...M 1?...Street..................... ................c t.uit,............................................... Owner ......Qkja.1;.je.s...Leonard..................... Type of Construction ...FXa>: Q.......................... ............................................................................... Plot ............................ Lot ................................ Permit Granted .....March 9 , .............19 88 Date of Inspection ............ ..........19 Date Completed ........... .........J.............19 i� r Assessor's offioe (1st floor): a � > /� � PyoFTHEto Assessor's map and lot number .............. .................,..... eW e� Board of Health (3rd floor): Sewage Permit number ............ yj ......c.... o } t BASdSTA.M. . Engineering Department (3rd floor): '�T L/6 House number / } APPLICATIONS PROCESSED '8:30-9:30 A.M. and 1:00-2:00 P.M. only; , TOWN OF BARNSTABLE BUILDING INSPECTOR , _ S� APPLICATION FOR PERMIT TO .....�.\.Y.� "� TYPE OF CONSTRUCTION ........... ..C7.! .. .........V..:.ar t/l ac...`.. . .. ............................................................... ..................... ....19J�&7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... 9.�.............{� /i� 1 e. � C.........J.... ........................................................................................ d- Proposed Use ............................................................................................................................................................................ �L'�� Zoning District ....................................................Fire District .............................................................................. .................... //�� II '' N e 1 � V`'1 U�u Name of Owner ....4T7 .R.L.F.S.......... O.....A.r�. ......Address .....:`?.�. i Nameof Builder ....................................................................Address ...................................................................'( Nameof Architect ..................................................................Address ...................................... ............................... Number of Rooms ......................f............................................Foundation .......C„fivt e �.� *� . ................................................................. Exterior ............. ....... �. .�. .... .........................Roofing ............... ? . H .............................................................. rJc� \ 'C IR✓ Interior �. Floors !:� �........ ......... .....,.....v` . '..1............................................. .... ...Heating .........1._.,. !.................I........................... .. .............Plumbing .................6�( ......................................................... .. Fireplace ............/`°.` ..........................................................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 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town o'f Barnstable- regarding the above construction. Name ... ........ � ,,� .......................... Construction Supervisor's License .................................... 1 , LEONARD, CHARLES A=22_25 No 31668 Permit for Remodel Single' Family Dwelling ......................................................................... Location 4 ........09........Main...............Street................................. Cotuit - .....................................................................I......... Owner ....Charles Leonard ..................................................... Type of Construction Frame- .......................................... ............................................................................... Plot ............................ Lot ................................ - Permit Granted ....March 9, 19 88 Date of Inspection ....................................19 Date Completed ......................................19 �.,j�.J'tafi'v.�.�..}-"i:f.;x...+•: lar' !1?w.�.V�..�`�.�i�?"M: s,�.�..r.�A.eb-."o...,..✓,'Pd:.:_hfrait4'�iti'.�nsy:. 1>. «:4e+gblr. "•.�.�..�31'S�C"WG YyF,1y::,�5;f�t1_�!Y.°."r^.:�:h+:, �.«y,.c' .w . _ Assessor's office `(1st floor): Q >� Assessor's map and lot number .... ......... :r...0...l.... Board of Health (3rd floor): Sewage Permit number ........yt.':....�..........��..:....................... Z B9Bd4TADLE, Engineering Department (3rd floor): 1639- \0�' '.......{. � .4 House number DMA a Definitive Plan Approved by Planning Board --------------------------------19-------- , APPLICATIONS PROCESSED 8:30 9:30 A.M. and 1:00-2:00 P.M. only TOWN. OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..:....�.J.:;a ! ......'. ��fv.............................................................. 11 TYPE OF CONSTRUCTION ...............1�.. ...../.,y,� 1! .......................................................................... .....................�1/. .'� ..........19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..:. .tF'"� 9'.01A.1.E�:...�'.�`. ......... ................................................................................................................. ... ProposedUse f'`Y a,�F�r� w !�... .. ?.A��. ....................................................................................................... Zoning District ...............1...,, ....Fire District .............................. ..................................... Name of Owner �I l P I ....Address ......l��� .............Nome of Builder .�-............................................ ........ ......Address ........�.......................................,...........//.................... Nameof Architect ..................................................................Address ......................................................................... Number of Rooms .......... .......................................................Foundation ..(.. ?,fir.. ✓.e_ '� ................................................................. Exterior .....1............ ...................(.��.......... �*� �a�# r t `.. Roofing ......... � . ............. . I Floors ......................................................................................Interior .........(..,`:...t.Y...Y......T.............C.'..J..C.......i... ............................. Heating ry .................................................................................. ........X .A. ............................................................... Fireplace ..... .. ...................................................................Approximate Cost ..4 ... s.G ........................................ Area ...s..�a � l Diagram of Lot and Building with Dimensions Fee �� .� ............................................. - 1 c L,j 4 [ OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding he/a'bo e� construction. Name ... /%7�t;C;1 .�,. > ..,f/�/,,,. - i�- ................. Construction Supervisor's license .... ............. LEONARD, MARY ELLEN A=022-025 No .3.2.4 3.6... Permit for ....ABD...M.-BARN... ......Ar-CeSS4)r.y...to...Dwel-llng........... Location ...4-0-9L.-Ma-in...Street..................... ..................co tu.i t............................................. Owner .......Mary...E.11en...L.eo.nztr.d........... Type of Construction Frame.............................. ............................................................................... Plot ............................ Lot ................................ Permit Granted .......November 1.5.,..I9 88 ...................... .. .. . Date of Inspection ....................................19 Date Completed ......................................19 0- „''�""�+"�r.sadgff"t:�A.y��`."{,k,p"”. x•:.:;�a.,s:'^ta-•mot+:;-�...�_. a � -,."�'4}'J�9rx�9�v�!'mF*`1"""-`r..��"_'n.c�---""+�"�.a' - .-..�—..-.rya>e�<'^.,.�r, �•�i'� ,. Fro TOWN OF BARNSTABLE 31668 � Permit No. ................ BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash FYI N/A. �Eai,,rk HYANNIS,MASS.02601. Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Charles Leonard Address 409 Main Street Cotuit, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. June 8$ � ............ ..........., 19......:.......... ........................................:.. Building Inspector w - _ ..-. ;.. .�ea �.c•+- ear..::t� a.;h,-..e.:,.::. '' i"'"Zt''h�'�ti'... 'd� '#e^.+�++fic ;�.�'�"�f4+�cY�<:w'�'�'�s"'S. � ��'�1?f•"#+e'a'y�kx�eaiat6it�*n . z i�r'�a+gt6a4a:'•+�aq 'it s3�F y�r`{ ,*TOE>, TOWN OF BARNSTABLE 31668 Permit No. .............:.. BUILDING DEPARTMENT 4 a�un TOWN OFFICE BUILDING Cash 7 aNl R7 .6,9• N/A HYANNIS,MASS.02601 Bond tV CERTIFICATE OF USE AND OCCUPANCY Issued to Charms Leonard Address 409 Main Street Cotuit, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD ' THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN 'REQUIREMENTS AND.IN ACCORDANCE WITH SECTION.119.0 OF THE MASSACHUSETTS STATE i BUILDING CODE. ;F n June 15, .......... . ................. 19......$ ....... I.............. Building Inspector i X Map o� Parcel� �j, �� ' Permit# r - Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) S�U� raP Fee- Jt25-.d ` hhWilt oe Engineering Dept.(3rd floor) House# T° U g y gar Get IKE • RARNSTARLE. 19 ti ^. MA6aSS. _ TOWN OF BA,RNSTABLE Building Permit Application , f Pro' t Stree�t�^Address. Village Owner Address SCI � Telephone Permit Request �� V11 First Floor square feet ova Second Floor square feet Estimated Project Cost $ 06,ao Zoning District Flood Plain Water Protection Lot Size .4e� Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family ✓ Two Family Multi-Family ` Age of Existing Structure Basement Type: Finished X Historic House Unfinished X Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) 9 First Floor Heat Type and Fuel k Central Air Fireplaces / Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Aame �4114AILla�� _ � Telephone Number �12f ddress License# l� 1�Uil f' 1 /A 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 DATE 7-,6Z2 BUILDING PERMIT ENIED FOR THE FOLLOWING REASON(S) + <FOR OFFICIAL USE ONLY r PERMIT NO. 74 DAcTE ISSUED _ M ►P/;PARCEL NO. _ rt ADDRESS . - VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ' FRAME _ INSULATION t + FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - < a GAS: ROUGH FINAL - FINAL BUILDING � ► ` +�f1a7 a ' s DATE CLOSED OUT ASSOCIATION PLAN NO. + • . TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE .. �. .� JOB. LOCATION 7��1 J2i S� j -Number Street address Section of town "HOMEOWNER" Name Home phone Work phone PRESENT MAILING ADDRESS Vin - City town State Zip cc The current exemption for "homeowners" was extended to include owner-occi dwellings of six units or less and to allow such homeowners to engage an dividual for hire who does not possess a license, provided that the owner acts as supervisor'. DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends tc side, on which there is, or is intended to be, a one to six family dwelli attached or detached structures accessory to such use and/or farm struct-L A person who constructs more than one home in a two-year period shall not considered a homeowner. Such "homeowner"' shall submit to the Building Of on a form acceptable to the Building Official, that he/she shall be resno for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the Building Code •aad other applicable codes, by-laws, rulesJ. and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and re #emic and that he/she will comply with said �. ,p y procedures and requirements. HOMEOWNER"S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be requir to comply with State Building Code Section 127. 01 Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for w ch� blik permit is required shall be exempt from the provisions of this sectior. (Section 109. 1.1 - Licensing of Construction Supervisors) ; provided th Home Owner engages a persons) for hire to do such work, that such Hon shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assu the responsibilities of a supervisor (see Appendix Q, Rules and Regula for .licensing Construction Supervisors, Section 2.15) . This lack of a often results in serious problems, particularly when the Home Owner hi unlicensed persons. In this case our Board cannot proceed against the _ inlicensed person as it would with licensed Supervisor. The Home"Ovine as supervisor is ultimately responsible. �. ... To ensure that the Home Owner is fully aware of his/her responsibiliti communities require, as part of the permit application, that the Home c certify that he/she understands the responsibilities of a supervisor. last page of this issue is a form currently used by several towns. Yoe care to amend and adopt such a form/certification for use in your commi The Cu»r»ru»H•calt/r uj!I tassachinetts Depart»u•»t of Industrial Accidents z ` i1E' -�;54 - '60011 asbilIgI »Street 4r•� '`+•~�- ' Bnstn,r.Aficss. 02111 �• Workers Compensation Insurance Affidavit ---------•—'—'� Alestse l'RINT'1e tbly• � � L2rn2�Gj'd location 40 y �'l`"�-�✓1 fit' �/ cttt 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an emplover providing workers' compensation for my employees working on this job. addresse city: phone#t sorince co. •. r � mow... '7„' - .... .. -.__._ �.. _._ ._._ 1 am a sole proprietor.general contractor,or homeowner(c,rcle one)and have hired the contractors listed below who i the following workers' compensation polices: m• add re phone#- nolicv# curnnce Co nt 1nv na e- address- 't, phone#• noiicv# imur.117ce CO. s •eM .aw.e it . �.� -tea �w.+�r. :Attach additi'dasi'shtiei if necessary_.?� r'"' • Failure to secure coverage as required under Section 25A of IifGL 153 can lead to the imposition of erimiad Penalties of a line Up to SISOOAO any one years•imprisonment as well as civil penalties in the form of SPOT R•ORK ORDMt and a.Qne ofS100.00 a day against me. 1 understand tha copy of this statement may be forwarded to the once of Investigations of the D1A for coverage verification. I do lrerebr cenifj•u,rdcr die pains b,id penalties ojperju,;r that the information pnnided above is true and c rneecL 2(p 1 '�Sianmurc _ ,�� hone • . Print nameQ Fcheck nly do not write in tbfs area to be completed by city or town oBicial perntit/Ilcense# Inguiiding Department city Board r F .. CUeeastng • Osdeetmen's office mmediate response is required C311eaith Department on• phone#: rtOtber�_ information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' eompettsatio►► for employees. As quoted irom the "iaw", an emphtree is defined as every person in the service ofanather under an, contract of hire, express or implied. oral or written. An c mplt rer is defined as an individual. partnership, association. corporation or other legal entity, or any two or r. the fore�:oin-, 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. Howe:•e; owner of a dweiIinL house having not more than three apartments and who resides therein. or the occupant of the dwc1ling house of another who employs persons to do maintenance, construction or repair wort: on such dwelling or on the ,rounds or buiiding appurtenant thereto shall not because of such employment be deemed to be an empic MGL chapter 152 �.ction ''S also states that even•state or local licensing agency shall withhold the issuance or reneival 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. Additionalr•. 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 chaptf been presented to the contracting authority. . ..�-.w..+--• .. •.•w�, - .. t::L•.: . .��:�:� • '.y...r e`li:r IN�:V;•:,7' :a .y.'ri.. 4M•:rii� .r��,.�..'.v� 'c.•ey u...- Applicants Please `ill in the workers' compensation affidavit completer•, by checking the box that applies to your situation ar. 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 affdavit. 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 requi to obtain a workers' compensation policy, please call the Department at the number listed below. �. _..w+.�.ss...+Yr� .a••!•.v�'��' �. - :.. .. :. .. - .w.•:...y�r�.:: •tea• ... •.. -.S,`.,.. >: ':—'+a.'-• . . . :�,;.:''••""�'.w��.•�~�::"•'I`Yv;.'fs :+::�' :isii.�..:3'a•.•r'''t�t.i�''.. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant I be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be rettunL 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 quest please do not hesitate to `ive 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,Ma. 02111 fax#: (617) 727-7749 nhone -9- (617) 727-4900 ext. 406, 409 or 375 • b O e Town of Barnstable . es T�1 .~ mental Sere � S Department of Health Safety and Environ zeTv. ,' Building Division � a 367 Main Street,Hyannis MA 02601 .R Ralph Cross= Commissi Office: 508-790-6n7 Building Faye 508-775-3344 For office use only • h f Permit no. Date AFFIDAVIT r SOME IMPROVEMENT CONT'i LTO 1 w SUPPLEMENT TO PERMIT APPLICATIO ction,alterations,'renovation,rqx&,modernization,comrerSIOn, MGL c 142A requires that the-reconstruction, ed demolition. or eonstttraron of an addition to any pre-c:asting o� obi improvement,.remo%4 units or to sttn�which are adjacent building containing at least one but not more than four dwelling with met to Bach residence or building be done by registered conurac Lois,with certainmoons, along mequi=CIILS a Type of Work: r�. Address of.Work: —" ,- S� �-0�Z ' k - � �� OR•ner.Nam a Date of Perim Apo Iicauon: I herein certify that: Registration is not regWrzd for the following rrason(s): f Work eoduded by law Job under S10Q0 a Building nat,awner-0ocupied Owner palling oar permit Notice is hereby gn�en that: CONIRAC'rORS OWNERS PULLING TI�iR OWN PERMIT OR DEALING DO NOT HAVE ACCESS TO ME FOR APPLICABLE .;HOME BeROVENIENT WORK OR GUARANTY FUND UNDER MQ-c 142A ., ARBTFRATION PROGRAM • DER PENALTIES OF PERIURY : SIGNED UN ,. f k for:a rinit as the agent of the ovener• f A I hcrcbyapply R - x , Date - ntractor name Registration No. k 4 //�� •�y'Yiiii:vii:::v: •'•'•4:F •.•••v'•'•' HAM ::w:::::::::;.................................::::::::::::v:::::::::::w::::::w::::::::::::::::w:::::::::::::::::x:iit8iiiii'>iii»}:•iv iii'is3:6:^::Q::;:;y;:J:•is6:i%L::}{..........•..........: y�•�':\ RENAS 13 ik'f`.•` :•':':''.: :.' :�':':'.':<; ,'•``,•:•'•'::'r'a' ; .:5>:.::..:::'< %".'`''' ? .% ................................................ ` . .... ` .... ''E#'3#< ``y ?'2 's:::; r:;::.::;:::i:;:;;:::ii::.>•: Kil >::.t:•> RY ELLEN LE ...........:::A ONARD MAIN THE..�€'�x:.. S ET.'. :.::: ......::.::.;:.::.;:::::::.:< ::< .. :.>::::::.... ....... III 'T N...............:..:..::::::::.:::..:::::::::....:. ...... M:......::........:..::.. .................::...:...:::.... .:::.:.::::.:::: NEIGHBOR .::::;::. .. .::::...:.......................:::..:..::.:.:.....................: BARN BEING G RESHIN L G ED -NO PERMIT >: X. 7 2 396ABW ENT T SITE ..,,,,....I�; r..;..; l l O S AND TOLD THE YOUNG G MAN T O HAVE THE OWNE R CALL xx >' THE GA COMMISSI NER (G AVE E A C RD . 7 24 96 >> OWNER CALLE D D AND SHE WAS »> INFORMED INF T HAT SHE WOULD L NEED A ...... U L ING PERMIT. " < > '` Town of Barnstable Building Department Compkint/Inqui y Report Date: — 9G — Rec'd br. Assessor's Complaint Name: F—aa— ::7--A—®`y� Location 'Ile Originator Name: Street: village: State: ZiP: Telephone: D/L Complaint Description: Inquiry 0 Descriptiou: For Office Use Only Inspector's ector Ins . Acu rr on/Counents Date• A�� P Follow-up Action 7/ /AIL Additional Info. Attached ffo Date Time HILE Y U WER OUT M r of Phone Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL Message J Operator AMPAD 23-021-200 SETS EFFICIENCY® 23-421-400 SETS CARBONLESS I MUST BE Assessor's office (1st floor):. I THE ' Assessor's map:'and lot number'.....4020 /�4,� °� /ff r �. Board of Health (3rd floor)i Sewage Permit number ......... �z.i.T'.8.��.. ........ �.�K��.�• 1 BaaasTsnLt, . Engineering Department (3rd floor) yo 9 1�isd .N� ULJ�► ( ♦° 01%S' nsa r House number °o i639• 6 Definitive Plan Approved,by Planning Board --------------------------------1.9__ ___ APPLICATIONS PROCESSED. 8:30-9:30 A.M, and 1:00-2:00 P.M.'�only TOWN OF BARNSTABLF BUILDING.,- INSPECTOR ... • APPLICATION FOR PERMIT TO .......... . /�,,/ . .................. .....................•••,,. TYPE.OF CONSTRUCTION •,............:.� : J�..... ... . .>�7/.:/. .............................. ..... ./. ..:/� ......19 "..0 TO. THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a •permit,according to the following' information: Location ....... .. . m ..... . ..... ............................ ..:..::.. ProposedUse N �: ....... ..... .. .............................................. ........ ..................... Zoning District ...... ..... . . ............................... ...................Fire .District• .............. ©G v� Name of Owner .L�1� .... W........... ......Address ......K.�.l ....!•."l.�T �y..5 . a�� b�...... ch. L t Name of Builder .. . .. ...... .:....... .......... .......... .......Address Name of Architect ......... .........::....:..........:... .....:.........:Address ........,............ Number of Rooms ......... :.......... .... .... ......... Foundation .. .M.[.r _-:.. ......... ....... . 1 Exie for .....C�:. !'� .. ...�1, JN�.. ..�. Roofing n. !9!.r ....... _.. .. /" .k , `Floors ..... ........:Interior Y.'!r%.......... dG.......................... Heating ....,! :....Plumbing '........ ........ Fireplace ..... .Q. ......... ....:, :... ......... ........ .......Approximate Cost ..... .0 `r ....... Area Diagram.of Lot-and Building: with Dimensions Fee 1 OCCUPANCY PERMITS REQIM D FOR NEW DWELLINGS¢. I hereby-agree to conform' to all the. Rules and Regulations of the Town of Ba stable.regardi the o construction. Name ...... :..................... 3 - 1.31 Corist�uction' Supervisor's License .. . ........ • a - LEONARD, MARY ELLEN 6 3, No ..32:4-:37&, Permit for ..Add...T.o...Barn..... , N - 1 ....Ar-c,e s.s.o ry...t.o...D,we 1.1 ing.......... _ Location .4.09...,.Maim...S.tr.eet. ................ r}'' r` ..................Ccatuit........... ........... .............. ; Owner ......Mary...El.len...Le � . . f - •w c...: ° � ` � „�. e.� ram.' - J.a ! , f - , '� � •} - , Type of Construction .......Frame.... .. r ...... ................................ �. r y_•• S ;. Plot Lot ... . ......................... Permit Granted . November :15.r..19 88 k1 Date of Inspection ..:... �......'1.9 _ S. tt n i• • _ "•fir (Date Completed '. ....... 19 i ok /0 r1 t 1/ - -- --_-- _ r;,��•�'L PAfC�2 - a:.:�`a'' yjD K q': � Gt �� f� � va+. � Lj�`^"Il"' � C 54 x I lot NN vl- .� w + F=-�"`3'SG'� � I ���_ - --� tt ��• � I '• .}, � �, ::� "3��J�"� /� — _� vcl G �' �� �,r. -'�' � I _ - -- _- _ -.— � f a �G; li•�"� r l I �/p ff*-� A► �'r �. -71 �/ 1 1 ` I 1. I 4r--- AL - - i "i 1 1 i ti L A ! t AT ff .- _ r . .� ._. _... Y . , r r I w L_!L -- exu j� r� .#''I�-1 i ����i���•1. v-K'. �� !^% '� '��9-�- < j �••- � - _ - t'_"} "I�{;«.� �.r �� !��{ j— _f 9 i � ��_�y--�� � f t.%�I 1f�" I y----y 1 I f ( _ f i , ! _ or f_ IL , t { _ r - _ _. �'-1�1�`ate' WI4-� -�`�' '`f -- _.--• -. � _ _ _ _ _ _ . ,, t,�r,•� I t , ,- ..-" � . :'i i .__ __—. _ _ _ _ _ _._._ � ...w __ - Hsi�:• , - --__ .: _. '- .. — r i ___--aL t - - - _ SCALE. ' I" y APPROVED By DRAWN SY I V DATE. DRAWING NUMBER