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HomeMy WebLinkAbout0382 MARINER CIRCLE �� `� t r 0 b P- " Barnstable 'I' own or= Building ;PostThis Card So Th"at rt�s Visible"From the Street Approved Plans Must be',Reta�ned on Job and this Card Must be Kept v Mn ,Posted Until Final,7nspection Has Been-.Made Permit Where a'Certificate of Occupancy is Required;such Bu�ldmg shall Notbe Occupied until a Final Inspection'has been made Permit No. B-19-4019 Applicant Name: William Callahan Approvals Date Issued: 12/02/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration.Date: 06/02/2020 Foundation: Location: 382 MARINER CIRCLE,COTUIT _ Map/Lot: 024-085 Zoning District:• RF Sheathing: Owner on Record: MOZZI,JENNIFER Contractor Name: EFFICIENT BUILDINGS LLC Framing: 1 Address: 382 Mariner Circle Contractor License; 169944 2 Cotuit, MA.02536 E PoCost: 3,600.00 Chimney: Description: Install insulation Permif Fee: $85.00 Insulation: Project Review Req: ;. Fee Paid: $85.00 Date_ ,f 12/2/2019 Final: Plumbing/Gas x g Rough Plumbing: s, 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 bythe Building and Fire Officials arAe,provided on this�permit. Minimum of Five Call Inspections Required for All Construction Work Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 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 All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: t oFtHE rot,, Town of Barnstable *P'ermr� # / L tips Expires 6 month .from issue date Regulatory Services Fee BARNSTABLE, Thomas F.Geiler,Director y crass `bA i639• ��� Building Division rEo �s dw Tom Perry,CBO; Building Commissioner ` 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: .508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT.APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number r D 5 Property Address VResidential Value of Work 41, ED( Minimum fee of$25.00 for work under$6000.00 Owner's Name&Addressr 5 = Contractor's Name 1� A Telephone NumberAL Home Improvement Contractor License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor am the Homeowner ❑ I have Worker's Compensation Insurance ra Insurance Company Name j a Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. "' Permit Request(check box) a` ❑ Re-roof(stripping old shingles) All construction debris will be taken to -- r> ❑ Re-roof(not stripping. Going over existing layers of roof) t ti ❑ Re-side Replacement Windows/doors/sliders.U-Value t c>?-I (maximum.44) *Where required: Issuance'of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. ® �'"PERMIT SIGNATURE: JAN 14 ZOOS TOWN OF BARNSTABLE Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street 105 Boston,MA 02111 s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 1 Please Print Legibly Name(Business/Organization/Individual): ��/lA Address: OVV�KW cj CL L. City/State/Zip: `� M Phone.#: © 5 Are you an employer?Check the appr ate x: Type of project(required): 1.❑ I am a employer with 4. I am a eneral contractor and I employees(full and/or part-time). hired the sub-contractors 6. ❑New construction 2:0 I am a sole proprietor or partner- listed on the attached sheet. 7. .❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers'comp.insurance comp. insurance.$ 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 11.0 Plumbing repairs or additions myself. [No workers' camp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside wntractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip 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. a I do hereby cerlWift under the pains and penalties ofperjury that the information provided above is true and correct Si tune: Date: i 0 Phone#: -JC,) ` Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their.employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in atom -enterprise—a mclg the legalrepresen�ative �fdec�ased empiayer;vrhe-- — - --- 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 insmance 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-contractor(s)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 completeand printed legibly._The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The' Commonwealth o€Massachusetts Department o€Industrial Accidents Office of Investigatlans 60f1 Washington Street , a - `Boston;MA.62111 - Tel. #617-727-4900 ext406 or 1-977-MASSAFE Fax#617-727-7749 Revised 11-22-06 www.rnass.gov/dia DATE(MM/DD/YYYY) ACORD,M CERTIFICATE OF LIABILITY INSURANCE 05/13/2008 PRODUCER (978)922-2288 FAX (978)922-2731 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Appleby & Wyman Insurance Agency Inc.' ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 152 Conant St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Beverly, MA 01915 INSURERS AFFORDING COVERAGE NAIC# INSURED Statewide Incorporated ,_. INSURERA: Hanover Insurance Company •22292 - DBA,Penguin Windows iNSURERB: American International Group 12303 Cyrus Way INSURERC: Mukilteo, WA 98275 INSURERD: Attn: .Gordon Williams INSURERE: 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 D' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MM1DDtYY) GENERAL LIABILITY OHN694845404 -05/05/2008 05/05/2009 EACH OCCURRENCE $ . 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,000 SF CLAIMS MADE Fq OCCUR MED EXP(Anyone person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 ° - GENERAL AGGREGATE $ 2,000.,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY JE a LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNEDAUTOS (Peraccident) $ PROPERTY DAMAGE $ - (Per accident) GARAGE LIABILITY , AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC9879592 05/05/2008 05/05/2009 X I WCSTATU- OTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 500,00( B ANY PROPRIETOR/PARTNERIEXECUTTVE ' .. OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,00( If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,DOC OTHER DESCRIPTION OF OPERATIONS 14OCATIONS/VEHICLE$I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS orkers Compensation applies in MA. nsured's MA location: 3 Electronics Avenue, Danvers MA 01923 CERTIFICATE HOLDER CANCELLATION " SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE r EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL' • - ' _ 10: DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ------- -- -- --' -- —BUT-FAILURE'TO MAILSUCH-NOTICE-SHALL—IMPOSE-NO OBLIGATION-OR-LIABILITY— OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. For Informational Purposes Only AUTHORIZED REPRESENTATIVE Lisa Marciano/AIESI ACORD 25(2001/08) ©ACORD CORPORATION 1988 PDF created with pdfFactory trial version www.pdffactory.com L Town of Barnstable Regulatory Services Thomas F.Geiler,Director RAxxs-rnsLe, u,►sa g Building Division A Tom Perry,Building Commissioner 200 Main.-Street,-Hyammis:MA 02601 www.tovvn.b arnstable.ma.us Office: 50 8-862-403 8 t Fax: 508-790-6230 H0112EOWNER LICENSE EXEMMON l / Please Print DATE JOB LOCATION: 3( m QVU G r c� i�7 Uu number / ,�- street village ..HOMEOWNER"' F/�AUtl►► ire S� s O . 1"I SO .1 L name �f,��ihome phone 1 work phone# CURRENT MAILING ADDRESS: 3 8 2 �t y�/�1 O u KW G W Go+-w} IU 02-6 3.s cityhown state zip 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. DEFINTI'ION OF HOMEOWNER - Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there 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 homeowner. Such "homeowner shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be re�onsible for all such work performed under the building permitfor 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-he/she understands the.Town of.Ba.rnstable,B.uildjpg Departmant minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. ` Signature of Hoineowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that "Any homeowner performing work for which a building pmmit is required shall be exempt from the provisions if this section(Suction 109.1.1 -licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such ' work,that such Homeowner shall ad as supervisor." Many homeowners who use this exemption are unaware that they are assurning the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction`Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware ofhis/her respon.nbilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the rapons;ibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may caret amend and adopt such a form/certification.for use in your community. Q:forms:homoexempt tTa,�,ti Town of Barnstable Regulatory Services • • • BAR.NSIARM • y MAM $ Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 iy Property Owner Must T 1 R 3 Complete and Sign This•'Section If Using ABuilder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION ` t'1s_5essor'S_1`map and lot nu m b r { / .......... C, V *THE TOE a/ 'l 1 -S wage Permit number .... ..............................................�'L 'NM C SYSTEM -- �EO IN • ttHouse number .......... .....� ............................................., W1711 TJ L 1639. e00 ENVIRONMENTAL c0 0�aY a\ TOWN OF B A R N S T A YEGULATIONS BUILDING INSPECTOR APPLICATION FOR PERMIT TO ................... ............................................................................... TYPE OF CONSTRUCTION ......(NL ... K -.. .. . . ............. .................. .......f0 .�.....................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following ' formation: Location .. ��....... //�....................... ............. . ......... ............................................................... ...................... ....................Proposed Use .....�...................... :.............. ........................................................................,......................... ZoningDistrict ...............?-.........................................Fire District .............................................................................. Nameof Owner a*: ........................Address ...............................................................I.................... Name of Builder .� .....................................'.......Address Nameof Architect .......... .......................................................Address ................ .. ............................................................... Numberof Rooms ...................�..............................................Foundation ...... ............... ..................................................... L.�t�4�`'`' f!�" ....Roofing _ Exterior .. ................................ ........... ............................ ........... . . .......,...................................................... llJ Floors .........:.........:..............Interior ....................... ..................................... ..................... -Heating- --�� :::..Gld.....................:....Plumbing ............................./....�/d'?w/..�:......-'. Fireplace .........:... ........................................................Approximate Cost ......7,5P�.!/.z rO........................ . ...... /3 7P Definitive Plan Approved by Planning Board __ ___ ___________________19________. Area ...... .....:....... Diagram of Lot and Building with Dimensio s Fee ^ ....... 1. . .............. SUBJECT TO APPROVAL OF BOARD OF HEALTH I SSA l K tad - � �LI I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable ra above construction. N ......... ................. | � Theo Construction � / l 03 Single K��..�.�--.. Permkfor --.��-------- ' ~ Famill' Dw ellin9 '--------.--------.--~----- - Lot �66 382 2�a��i�oe�� {�i l� Locohon --__----------------.�o s ----.-----cotuJt.-----------'' ' ' ~ Owner .......TheD...CDns.tzzuaticxo.----. . ` Type ofConstruction ..VraMe--------- . . . . --.---------------------- ~), ^^ Plot Lot ,----.----. ----------.. JPermit Granted '��5........ PD0 rb-^~ of Inspection .....................' --..lq ~ } ^ ` Dote Completed .!..��.���/�..�..��---]V ' � . / - / . ^ ' - ` ' ^ PERMIT REFUSED _----.,-------_-------. lV , . . ~ . _ ................................................ . � ............................................... ^ ^ o» --'�—' ' . � �� ... .---....—..---~.. � .! ---- lV ' ','r~ ^ �_�--. �' ------ . .� ................ ............................................................. -1 ' � ------^----.-----.----...--... ` | ! | / e Ass ssor's map and lot number ............................................. I E 2- !�ewage Permit number ....(.. . ........................................ 33A"STABLE, mum iHouse number ........................................................................ t639- D mp"I TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .................... ........................................................................................................ .... ........................ ........... TYPE OF CONSTRUCTION ...... I llq���_ ,,Z'�, ................... .......Ir.7. .........................19. ...... ........ ....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: X0. Location ...................................... ................................... .........!..................................................................... ............. Proposed Use .... ................................................................................................................................................... ZoningDis trict .........2, ........................................................Fire District .............................................................................. Nameof Owner ..........................................................;...........Address .................................................................................... .......Address .................................................................................... Name of Builder ......................................... Nameof Architect ..................................................................Address .................... ............................................................... Numberof Rooms ..................................................................Foundation ............................................................................... Exierior Z��z,,6 ......... .......................Roofing ........... ................................................................ Floors ..................Interior ............................................ ..................................... Heating ............................ ........:� .........................Plumbing ....................... .... ......:................... Fireplace ....... ...........................................................................Approximate Cost ........t�; ....t.................................................. ................ Definitive Plan Approved by Planning Board -------19 Area ...... Diagram of Lot and Building with Dimensions Fee ..........:7� .................. .SUBJECT TO APPROVAL OF BOARD OF HEALTH 77� __j I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable the above construction. Namef:�................................................. ............................. 1 Theo Construction A=24-85 No 22003:.... Permit -4)r ... �ngle.................. Fami.ly..Dwelling............................ Location Lot #66 382 Mariner Circle ................................................ Coui .............................t........t .......................................... Owner ...Theo Constr. . . ..ution. .................... .... .. .... Ic.. ....... Type of Construction ....F.......rame �.............................. 3 .............................................. ............................ , Plot ............................ Lot A .......................... Permit Granted .....Fe.b:1ary. ...25.,....19 8 0 Date of Inspection ............................. ....19 Date Completed .....I/............................19 PERT REFUSED .................. .I. ........ 19 .................................... ......................................... .............................. . .................................... ...........................'................................................... Approved................................................. 19 i TOWN OF BARNSTABLE Permit No. ---------- 1n� ; Building Inspector Cash -------------- ---- rYL -- ' OCCUPANCY PERMIT Bond ----—_-_-.--- "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. .....................................................1 19...... ....................................... .... ........................_........................._.»..»._.» Building Inspector r " " _ "Ns.1 ',_ L 11 f yt ! �m I, -' �'� n s •w Y ^�A � ?!, f ' r rr • J n ����� . . 9 dr. 1 a D Fes. K 'a `2.- • lt G/.e c r PLAN SHOWING FOUNDATION LOCATION C O T UI T,: MASSACHUSE T T S OWNED BY Ti� 'i� �'�aJ��'7"�• 7p. SCALE : / " = 4d DATE: y.r•C• ! 4 1979 NORMAN GROSSA?AN------ REGISTERED LAND SURVEYOR I HEREBY CERTIFY THAT THIS FOUNDATION IS LOCATED ON 77HE LOT AS SHOWN AND CONFORMS TO .THE TOWN OF BARNSTABLE ZONING REGULATIONS REGARDING v= i. SETBACKS FROM STREET LINES AND LOT LINES 73 NORMAN GROSSMAN R.L.S. DATE C I at TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# D-20 3 Health Division C, `6 Date Issued Conservation Division r Fee `� ���-- Tax Collector Treasurer �/- � 5' 7 41C SYSTEM MUST My INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address VillageZt 7 ii Owner � � ��S'7� Address Telephone 4/aQ,�-I— Permit Request /Tyo 0 Ue-- 196 Gc 2-4YLK Square feet: 1 st floor: exjsting proposed 2nd floor:existing proposed Total new Estimated Project Cost -:�sdea• 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(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric Cl Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:Cl existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# - Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name�''1clti �r l��� ^� Telephone Number T Address_ 4 ^d � Ic=��� C� License# 0���/�J Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Oxon 12 SIGNATURE DATE / S J �l FOR OFFICIAL USE ONLY ERMIT NO. } DATE ISSUED' MAP/PARCEL NO. 4 ADDRESS VILLAGE OWNER t' DATE OF INSPECTION: FOUNDATION } FRAME INSULATION - s - 4 FIREPLACE ELECTRICAL: ROUGH -' - FINAL PLUMBING: ROUGH FINAL -GAS: ROUGH + ,. FINAL FINAL BUILDING `y DATE CLOSED OUT YN ASSOCIATION PLAN NO. I ' M Department of Health Safety and Environmental Services `tee Building Division 367 Main Street,Hyannis MA 02601 n Office: 508-862-4039 Ralph Crossen Fax: 508-790-6230 Building'Cornmissioner 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: yci®/ Estimated Cost ;OS-Ye) c/Q 04/ Address of Work: 2- te- a-G/ Owner's Nae• / I �m Date of Application: A I hereby certify that: Registration is not required for the following reason(s): Work excluded by law r]Job Under$1,000 Building not owner-occupied. [30wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME nvlpROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby appl for a permit as the agent of the owner. y `'� Datd Contractor Name Registration No. OR Date Owner's Name q:fomu:Affidav The Commonwealth of Massachusetts Department of Industrial Accidents "Fl::�::' • .— OIfICrOf/oYBSI%get/OQS — 600 Washington Street - , Boston,Mass. 02111 - } Workers' Compensation Insurance davit — name c location cityU�' [,� k hone# 0,�&.3� ❑ I am a homeowner performing all work myself. ® I am a sole etor and have no one wo in anv opacity I am an em 1 providing workers' compensation for my employees worldng on this job. address.: ::::.. ......:: insurance co. : :. ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: com anv n address.. .:.�.;'.:;::::::::::.. :::;:?:::.;:::.:::....... ....... .................................................:..................................... ........ ... .. .. ...... 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I understand that a copy of this statement may he forwarded to the Office of Investigations of the DIA for coverage verification 1 do hereby certify under the pains and penalties of perjury that the information provided above is trw and correct: Signature Date Print name Phone# official use only do not write in this area to be completed by city or town official city or town: - permit/llcense# ❑Building Department QUcensing Board ❑checkff immediate response is required ❑Se alth Department Office ❑Health Departmen ent contact person. phone#C _ o�eT (revved 9/95 PJA) r r> t r y } d ° :e.. :., :d � �•�g . -..�t� 4 1"6'�., 'Fr �, •; t t �' ? '---. v.lV. byxF. rf,,,?ka'4�z=:y y�,tgi �//�� j/.}���.(^Y,c ry ���� i 7.k'9f 4sd. g, lfi r. .:•3 I �,Y .pice?. 'v. '%'"�+a; t` �' 5�__.a J'tr k kF i. '�1. .« ..�ViiVii.Wi...y t' . <k`i.� ^� kt•a s'� �•s '�' '1. rei:. ���y � ,x, 3- ��� '� �'cr U. .il,`^• t '➢.'C p ±,,. 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' �fl.z .V I�UALt '� i?r' 7=p�Y� sda'rrsiw �' � '?. . eINDI ,i .;,t• �, � :. yA x� �.� r.Registration106566 T J P 16,i " ' 4 Type, NO.IV.IDUAI it: s ;�•�,�� ;'x " IY3�7.. -' t� ration F•07/24/00 t typ ram' FEXr.. CLIFF/ORD t w x t� t' .� �I i `,i� BRIAN' � „ ,�f rr a I Brian `D, `Clifford 4 �� ' ' Y rath ' , t} * i, ;. * wx �a 4 BRIAN CLIFFORD t •� ` y + 10 Goff Ter 'r02632 t 5a I , g; ° ' ' Brian D. Clifford Center v i 1 le MA j `� v{i ,, , , ;~ 'i L2 ~ off Ter, x �o cen�er.yille HA 02632 w a• " a ;4 i a' t? ADMINISrRA .e 3• r