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HomeMy WebLinkAbout0567 MARINER CIRCLE I "Wpawqg R i 9 F,gf�.�a Town of Barnstable Final Inspection Affidavit Date: :��iaaO Building Division 200 MairStreet Hyannis, MA 02601 RE: Insulation Permits Dear This affidavit is to certify that all work co plete at: Street: C . Village: t _ _ has been inspected by a certified Building Performance Institute (BPI) Inspector. All work performed meets or exceeds federal and state requirements. Permit applicati n nu ber: A—f — -aJy Issue date: Sincerely, e Francis Sheehan President Frontier Energy Solutions, Inc. 502 Harwich Road Brewster, MA 02631 Office: 774-237-0410 Email: fssfrontierenergy@gmail.com MAY 14 2 �i3 q TOWN OF BARNSTABLE BUILDING PERMIT-APPLICATION Map Parcel_ Application # Health Division DING 1;Ep7. Date Issued Conservation Division JUL 24 201l. Application Fee Planning Dept. TO WIN®� Permit Fee (� V 0 Date Definitive Plan Approved by Planning Board q Historic - OKH _ Preservation/ Hyannis Project Street Address_5(0� Villages►+ Owner WC AA�A,� l e ��, cn��i� Address�_ 4—j NQ 1L (�1(0 Telephone �y 77(o ! O /7 Permit Request � -To Square Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0 Construction Types 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 ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ 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 e(M If yes, site plan review# Current Use� `�,F3 AWL Proposed Use Q1z T Y APPLICANT INFORMATION - (BUILDER OR HOMEOWNER) Na r Telephone Number Addres _,AAr.a r License #fto59 CJ I(Y1A 131 Home Improvement Contractor#r Email „IQ JZki A-dK Compensation#Ub(�nl� s0ol� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE / A 2 f FOR OFFICIAL USE ONLY i . y APPLICATION # DATE ISSUED .4 MAP/ PARCEL NO. ADDRESS VILLAGE ' OWNER } r DATE OF INSPECTION: s F FOUNDATION FRAME INSULATION t FIREPLACE ELECTRICAL: ROUGH FINAL `PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING F i DATE CLOSED OUT ASSOCIATION PLAN NO. t r RISE 5 Dupont Avenue I South Yarmouth,MA 02664 1 508-568-1926 ENGINEERING` www.RISEengineering.com OWNER AUTHORIZATION FORM Michael DiCesare (Owner's Name) owner of the property located at: 567 Mariner Circle Cotuit, MA 02635 (Property Address) (Property Address) hereby authorize Frontier Insulation (Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. This form is only valid with a signed contract. The Permit will be secured by the insulation contractor, at no additional cost. It is the homeowner's responsibility to close out this permit by contacting their municipality at the completion of this•work. E-SIGNED by Michael DiCesare Owner's Signature April 01 , 2017 Date 6.2016 - rl ,'31/r �`�rJ iVr,(,arAr. d✓:!d,a; ;ir<frll3 G € _ . / License or registration valid for individual use only Office of Consumer Affairs&Business Regulation before the eNpiration date. If found return to: HOME IMPROVEMENT CONTRACTOR office of Consumer:affairs anti Business Regulation q "; Registration..:• 160854 Type' tgm 10 Park Plaza-Suite.5170 I Expiration 9/8/2015 LLC Boston.RL4.02116 FRONTIER ENERGY SOLUTIONS'' FRANCIS SHEEHAN 502 HARWICH RD — - BREWSTER,MA 02631 Undersecretary NJVAsignature i a Construction Supervisor Specialty Restricted to: 'Iassachusetts Department ref Public Selfety CSSL-IC- Insulation Contractor Board of Building Regulations and het3nEaa9 S License, CSSL-105941 F . FRANCIS.S SHEEHAN l 502 HARWICH'RD BREWSTER MA 02631 4 i Failure to Possess a current editio State Building Code n of the Massachu setts is cause for revocation of this license. DPS Licensing information visit: WWW.MASS.GOV/DPS I :amiss':e � 02l1712b18 i I j • i i Z — - -- The C'otranumveerlth.q iWassttc husetts r� Departmentvf lttdrestt7ttl,�ccittettts K 1 Congress Street,Suite.100 Boston MA 11 4-2 0.1 �.� ;/ 3t�Y'rlr./11Q56.,y Ub/ttr(t't Workers't omiiensat oo Insurance Affidavit:Ruiltlees'£'.Derr.srtar;r'FicctrlciinstPltrtitbcrs. -ro 6r IALED WITH ['F;Ft�ll 11'l�tt: -�t°tiit)t2t`t�'. 1ppjicanl Information I'{e:a5i Print. l.e.ri4i{v — _ Name f'Business!. rantLa..c�ri•'ltilsalJuat •'' "t Lt f__ �L {^ q l '4's, Address `::,U F Cil)-1 tit /I ip: � w _ ' o.:. •! `' { Phone�� � � c �> 7 - t-)L 1,1 C Are-you an enipioyer cht k the_,4pprupritit!ox Typet of project(required): 10 t Q l am 3 c,^.iFin,Lr 1++rfa ��rz F,pa ¢, f it;lE 3nt4,crr�a..?irr).' s D A; w,,,or1swuctFQt} ?.E]I sole proprietor o I iint slat t; 1 have.no empio z, 4'grur Ei t_ 'Of mu is . � 12t t tt�zlt link any ttpaCity,(11\10 w<;rtl(Cr ctr,rap insufawcc requirell'.]�.� ('� !8rn ahoineoNm rdc� �all+tiiir su f:.{\n mu.k..r cr> T- iaaur.nCe re<p ite�I` 9. Q jjemoliliklrl ill Q Building:tciciititan 1.01 am t htfrn lwxt aid 1 wilt h #arra t,ttrnT:etc ra to ccJrau>nY r r work on mj��m iFx,.;e t wilt enstrc Oat,ail c6ntracto oiA javc-work .. ..omi.'ewanort„stuarrce o;am soic ISCkCil3�,repairs or additions, ftztsrn.t�w.wrtl t:..cirtic}rr•,: I 12.©Plumbira,repairs or additions j I.�€ t t a pneml cunt to t>r to I have hires!'he>ut C)nt tct n t ,ted,on the at.ached sit ei wbconi xiorrha na4 4 are av wort^ n nut t I 3.E]Roofrepairs. T �. '< otllct VIC- I^.El cL rn a Cori a r Jt;on ar {its C is:6tC5 Ir l'C C etc i5eu.try r n t�t �t iilt:ir per vtul.: — 152,,1.1(4).and we nwive nu ctephy..s rNo Aofkrrs'vo nn nsuranCa reiituh d] ;Vny applicant that the:k's tx n"it nwst As")till put the sec.itrer hein•.v eh,vink rdieir wu,i,c,A"et7mner>,acion,J�u eo infnrnratinn t Hcnw mrr:;%YM,irbnti€efts:.C:..fi.i: h y . do mg dvi wo s anc'ihpr,hies ou,-sidv cuntracton;m stst tun.t a new u:idnrit inflicwing silch- :r oz'ra 7 tha::car,Ck.llus box taws:a,,-ac cj ac'ci ate iaaE,h,,t, w'niSy,tv n:untk oi'dit sub;col"11 xtvrs and state whether or,Iot,"hfjse 3 utieS,hare emplovee& If"thc:t'b-wf't ctam,ras,_ci rrloyct"s.they freest:rr vir e,hnr workets want.pofir number, I am an enTlay=err rhat is prof=idukg workers'compensation insurance for tray eltydnyees. Below is the policy and joh site information_ 1 insurance Company ° Y l�u'ti�i� L i Pol#cy 9 or Self-ii15. Lie,�: � 1..,.,.�C' . �, ID art _ / /��7 t 1 J� � ` A Job Site Addres��G _/ �•� �i..� t tylScit���.t(y� ��LI M l_ Aitacb a copy of the workers cam pciisatioct palicv clot ldration p.ti(sllo+vstl #hc policy numbs aryl!csiiratton_ua��,..1a� Failure to secuie ct3verao�g;._( ltiired undo €NIGL.c, 152;§25 rt is a crimi.nai violation pUbishable by a ifine tip to$1.,500 0' BP,Cltor one-t'G1t 1.r1p"sc1mnient.,as-well s civu pe anies it ..,e fo, rl olfa`�l OIL u'f.RK£)I�,i)I_It and a r'Ite of'up to$ Y:(€,0(3 H i if€3.'C,—,-1frt St the tiof a(or 1 i'C,Ypv ofthis statei?leni,mx- be `r J,'r4andVd to t1'sC:`t;� Iit..,t)?'`f 1 ..�t.x?,;1?.on;Cyf1he DIA—For insuraiwe cuveraae verialcacion. f do lierebr rer2ifi:urerlrr the IJairas.<<rr r zres nfirecrjcary thrkt the.ixrfttrrrtrztirrrt prm irlad abnve' true nftrf correct Stgnature� C7ate: Phone 4, 1. r�ol�' L. / ! {,' '� 1 L✓ j OWicial u-a+tftr. Do not write in this area;to he rtampteted ley ritf'or sus;gin nffrid City or`rotva: Fermat'Lic,Fnsc - _.. -.._......___ --- ...... Issuing Authbrity(circle oncl: L Board of Health. 2. Buildiag Departmetif 3.Glyfrow•n Clark 4. Electrical Inspector S. Numbing,.tnspector i G.Other C.o.ntact Ferwn.: i Phone 4: i �►co D® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) `.• 03/16/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - NAME:C Rogers and Gray Processing ROGERS & GRAY INSURANCE AGENCY INC PHONE, 508 398-7980 _( ac __........._-.__....__._._ A-fC.._NoEA): ( )------.—.._....--------- ADDRE mail r0 erS ra C ADDRESS: g 9 Y• Dm 434 ROUTE 134 INSURER(S)AFFORDING COVERAGE NAIC N SOUTH DENNIS MA 02660 INSURERA: AIM MUTUAL INS CO 33758 INSURED - INSURER B FRONTIER ENERGY SOLUTIONS INC INSURERC: INSURER D: - 502 HARWICH ROAD INSURER E: BREWSTER MA 02631 INSURERF: COVERAGES CERTIFICATE NUMBER: 134675 REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD SUER' ( POLICY EFF POLICY EXP LTR TYPE OF INSURANCE WVDI POLICY NUMBER MM/DD/YYYY MM/DD/Y LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES(Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _$ POLICY C p LOG PRODUCTS-COMP/OP AGG $ OTHER: � $ AUTOMOBILE LIABILITY I i COMBINED SINGLE LIMIT $ Ea accident ANY AUTO I BODILY INJURY(Per person) $ ALL OWNED F—il", SCHEDULED N/A i BODILY INJURY(Per accident) $ AUTOS AUTOS ......_..._......._.......__..._........----.--..__..._ ._......_.._.._._......---__.....----.._....._ NON-OWNED PROPERTY DAMAGE HIRED AUTOS - I $ ..___.. AUTOS _(Per_accineng I $ UMBRELLA LIAB OCCUR EACH OCCURRENCE - $ EXCESS LIAB CLAIMS-MADE _ NIA AGGREGATE $ DED RETENTION$ j $ WORKERS COMPENSATION I i X I STATUTE j OERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETORIPARTNEWEXECUTIVE I E.L.EACH ACCIDENT S 1,000,000 A OFFICER/MEMBEREXCLUDED? N/A N/A N/A j VWC10060153152017A 03/14/2017 03/14/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes,describe under L.....-------------- PT N OF OPERATIONS below I j - E.L.DISEASE-POLICY LIMIT S 1,000,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Frontier Energy Solutions Inc. 502 Harwich Road AUTHORIZED REPRESENTATIVE •. .. Lay Brewster MA 02631 Daniel M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Assessor's map and lot number TH E i � - P Sewage Permit number ....,��. ...........�.:...........:.................... -• Z EAR35TADLE, i House number ..v�� .I v rAea . ......................................... �p t 63.9. \00� G �D YpY a' , t TOWN OF BARNSTABLE --� BUILDING INSPECTOR APPLICATION FOR PERMIT TO ,? ...................... ....... .......................... .................................................. TYPEOF CONSTRUCTION ............:.........:...........................:....................:............r .............................................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �!t ... ! : ' f .. ..... lx......Location ... ...... ProposedUse .... �....... ...... ............................................. Zoning District ............. Fire District ........ !►. ................................................. af.l.l) �11��•^ �"'tt............Address /.......................:.f Name of Owner .......................... ........... Name of Builder ✓7t'I�,�..'1....� � ........Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ................... .........................................Foundation .......Lt..............`:..::.....:.....`.................................. Exterior .+�f::!'fir :( ..... Q 'L`�-C. 3 ,k f f ,ffl: .............Roofing ....: � ? :ZG'............. . ... 4 �iFloors ........... ..........................................Interior .....�i,6.............. ..................................... r �>> ,U ....4 Heating ��....................r..... '..., Plumbing .......:..........�,< ............................... Fireplace ....................... ...........� ......................................Approximate Cost ............ G ............ Definitive Plan Approved by Planning Board � ' ___ ________19 Area f. .................................. U 7) Diagram of Lot and Building with Dimensions Fee ..�'� . ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH l� v I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. { f� i Name ... 1::-::82 , THEO CONSTRUCTION No 22.7.5.6.... Permit for ......Qae...5.t;.Qr.y....... ......S.in g.le..F am i ly. ..Duelliag............... Location .Lot #24 567 Mariner Circle ............................!.................................. Cotuit ............................................................................... Owner ....Theo, Con .....................struc ion................. Type of Construction Fraf/nee ...... .................................. ....................................... ........................................ Plot......................... Lot ................................ z Z 'Permit Granted .....Decembr 12,...19 80 ............................... Date of Inspection ................... ................19 .................. ........... .................19 Date Completed PERMIT RE USED ........................................... ..................... 19 /I�/......... ................................................................. ................... ...... .. ............ ............ ................. ........... .......... . M............................ Approved .................\..... ...N.... ...r 1/9 ............................................ ........6....................... ............................................................................... AS*s--map and lot numbe J2 ................;.......................... CF THE Sewage Permit number ... . . ............................ ISEMSMEM WTAL,so IN co LE, XASL ................... .......................................House number WN TITLE ENVIRONMENTAL C 163 , ,10k TOWN OF BARNSTA G I.11,A T 10 IMLr BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....................34C414................................................................................... Z�Vey�..... ..............................................I TYPE OF CONSTRUCTION ........... ... ...... ......... ..............19.R ------TO-THE-INSPECTOR-'OF_ "BUILDINGS :� The undersigned hereby applies for a permit according to the following information: tell/................... ........................Location ..... . ......I` ... ...... ...... ............. ProposedUse ............ ............................................................................................................................. .... Zoning District .. . ........ ........................................................ ....... .....................:.........Fire District Name of Owner . . .... ............Address ........... ..................... Nameof Builder ........Address ...................................................................................... .Name of Architect ..................................................................Address ..................................................................................... Numberof Rooms ...................f�.........................................Foundation .. .. .......................................................... Exierior ..cJ. ... ..... ..... :.............Roofing ....... ....................... ........... .................................... Floors ... .././,4) -.6..Y.IC-1 ..................................Interior ..... 9.01 44C..a&.................................................. ................................................ Heating ................. .., Plumbing .................. Fireplace ......................./.......................................................Approximate Cost ............z/Rfc z 97"V. ....... ............ ... ............... - 13,64 Definitive Plan Approved by Planning Board --------19 Area .......................................... 7-P Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH L> 14 A14 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. N. Name ..... .. ... .... .. . ............................................f..... rt THEO CQNSTRUCTION .2.2.7..5.6. Permit for One....Story.............. .... .... .. .... Single Famil Dwelli.n g...... ..................................1 . ...... . Location ..Lot #4 Mariner Circle .............................................................. ..................C.9.tu-i-t.............................................. .. .... .. .. Owner ....Theo....Construction:............... .. .. .... .... .. .... .. .... .. .... .. Type-of Construction .............................. ................................................................................ A Plot/............................ Lot ................................ Permit Granted ...pe.c.em.ber....1.2.......vjq 80 .. .. .... .. .... Date of Inspection ........................ ............19 Date Completed .................. 9 PERMIT REFUSED ..................... ........................................ .19 ...... .....1$.................................................. S.. .................................................. . M ............................................ sa. t;................................................... en 'Appr.eve� ..... ......................................... 19 .......... ......... .................................................. v ..... .... 1 N E gal-9 . • o n=o PLAN SHOWING o 5 . 13 aaO:) 10, W ' FOUNDATION LOCATION 2 .•o � viz zr :a jar caD GOT (;�1 T, MASSACHUSE T T S z w"}'i-0w Q as OWNED BY: z, w a� �a SCALE i ''= ,30 DATE /!/G�/ 4 c NO.RMAN GROSSMAN,----- —..REGis,rEREO LAND SURVEYOR " u Z� HW 'Q 0"o IL I HEREBY CERTIFY THAT•, THIS FOUNDATION IS LOCATED F MAS ON'THE LOT AS :SHOWAI AND CONFORMS TO THE TOWN OF BARNSTABLE': ZONING REGULATIONS REGARDING °� NoRMAN SETBACKS FROM STREET LINES AND LOT LINES . GROSSMAN • 12775 �Q MOPMAN , GROSSMAN R.L. S. DATE �No SUR4 v TOWN OF BARNSTABLE Permit No. -----------_---------- �� Building Inspector n.0 Cash ---------------------- 'o `OVA-16 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 j.neo C.onst2"uctior; Address 567 M.--trinf- Wiring Inspector '/ y Inspection date Plumbing Inspector i� .,, � Inspection date / M 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. ................................................... .. 19......_ ......................:................................................................................. Building Inspector Assessor's office(1st or): Assessor's map and t num — 0�� o�THE To SEPTIC SYSTEM I'atU�°K"EE Conservation II ��°�LLEC I �O� a �9�� 0 . Board of Heal d floor): P g WITH TI to 6 saav anc Sewage Perm mbar �� Engineering Department 3rd floor): _ ENVIR i,.,' Selo• off' House number TOWN 7�!�� Definitive Plan Approved by Planning and 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 Lzz�X z C rejeL Po rC i, TYPE OF CONSTRUCTION _ / 0 3 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: J Location rb-7 AIQ V' int C G 6- C QZL— U j Proposed Use S C ir e e G') �p ►`'C l�'1 Zoning District Fire District - Name of Owner / ' rs Sep L v q cc f Address -5,-"6 / Aoe; lier C.j trC1e cot. ' .39 6 " e3 R4. Name of Builder� !J►� U�li1 Cf G �� Address �. Name of Architect Address Number of Rooms Foundation cD ti e p-e-+,e— 0 b SAS Exterior `S h ►h_� �L-� SL� r e� `� Roofing Floors `/t� J� C� J ��ki M� Interior V V1 'T" 1 h S A e rl Heating Plumbing /1 Fireplace Approximate Cost V© � , o � Area -- Diagram of Lot and Building with Dimensions Feecs-�, D o SCVee►t Pve'(`c� sq me Location al.s O )d deck ,a Sc ra e �` "GP 0 =r r Ci rcle OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name , , Al, L Construction Supervisor's License © � 0 f SALVOCCI, MRS s No- -PORCH Permit For BUILD SCREENED ,4 -PORCH - Location ' 567 Mariner Circle L '.COtult Owner. ' Mrs a` Salvocci Type of Construction" ,- Plot`' + Lot , Permit Granted August 2 3 , 1 Ste —'9 4 Date of Inspection 1 19v Date Completed 19 t �, + r-�� -- i �z yI ,-7 1 • al r 4. COMMONWEALTH OF MASSACHUSETTSy, r — � DEI'AM 1`iFINr OF INDUSTRIAL ACCIDENTS �"" 600 WASHINGTON STR�� l `�V�� games C2�' 130STON, ,�LASSACHUSLI-I-S 02111 .. � c--t ss ne WORKERS' COMPENSATION INSURANCE AFFIDAVIT \J (licensee/permincc) with a principal place of business/residence at: a (CITY/State/Zip) do hereby certify, under the pains and penalties of perjury, that. j ) I am an employer providing the following workers' compensation coverage for my employees working on this job. Ins uranc ompany Policy Number 1 am a sole proprietor and have no one working for me. O 1 am a sole proprietor, gcneraj contractor or homeowner (circle one) and have hired the contractors listed bclow who have the following workers' compensation insurance policies: Name of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number 0 1 am a homeo,;,-ncr performing all the work myself. NOTE: Plcasc be a-zrc Lbzt while bomeov'ncrs wb'o employ persons to do maintenance,construction or repair work on : dwelling of not more than three units in which the bomcowner also resides or on the grounds appurtenant thereto arc not general)- considered to be employers under the Workers' Compcnsauon Act (GL C. 152,sea. 1(5)), application by a bomeowner for a IICCn Sc or permit may evidcoce the legal gurus of an employer undcr the Workers' Compensation Act I understand that a copy of this statement will be forwarded to the Deputment of Industrial Aeodenu'Ofiiee of Insurance for coves=c vcrifuaion and tha; failure to secure Covcr-iCc as required undcr Scc ion 25A of MGL 152 can lead to the imposition of_rtiminal pcnatics Co of: fine of.up to S1500.00 and/or imnday one ye.;.:and ei.:i,pcnatics in the form of a Stop Work Order and fmc of 5 J U0.00 ains; mc. Signed this f , 19 _ Licensee/Pcrmittcc Licensor/Pcrmittor --- - , of o `ll 1 �o.q3 . x _ 0 in io 4 W 1l22 PLAN SHOWING oil a4l6 /J aao:1 10z FOUNDATION . LOCATION aw GQ� y COTUI T, MASSACHUSE TTS z;> o OWNED 8Y CO�YJ`TiB Co �� ° of O.Z. W 0. Qa SCALE i ''" .34 CATS �- 19614 !' NORMAN GROSStdAN----- - REGISTERED LAND SURVEYOR ► +� Z� < Z Z:iFw 'Q O I HEREBY CERTIFY THAT, THIS FOUNDATION IS LOCATED ON THE LOT AS SHOWN AND CONFORMS TO THE TOWN ' V cyG OF BARNSTABLE ZONING REGULATIONS REGARDING ° OsMan SETBACKS FROM STREET LINES AND LOT LINES . GROSSMAN N 12775 Q NORI!/AN GROSSMAN R.L. S. DATE �y� SUR"` • BAMSzABIA The Town of Barnstable ' Department of Health Safety and Environmental Services " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair, modernization,conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: S rl! EA F)Or(f Est. Cost 06)0 .90 Address of Work: 7 M `I r1 h-e ll— C j (/ GL C D-�v Owner Name: l Y S a 1/0 C-C / Date of Permit Application: CJ 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 Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby a ply fora rmit as the agent of the owner: L ( v Dat Contractor n me Registration No. OR Date Owner's name - I I HOME IMPROVEMENT CONTRACTOR Registration 110880 .7 e - PRIVATE CORPORATiCN Expiration O9/� I, CU ll REMODE'Iii'C HUINAULL ADMINISTRATOR MASHPEE MA 0,260, _ I `-� COMMONWEALTH '. t.DEPARTMENT OF PUBLIC SAFETY . 1. OF ONE ASHBORTON PLACE _V MASSACHUSETTS BOSTON,MA02108 r^. - 1 LICENSE CAUTION EXPIRATION DATE '� 1= CONSTR. SUPERVISOR _�8 } 4:14 06/22/1996 EFFECTIVE DATE LIC-NO. �i FOR PROTECTION AGAINST ' THEFT, PUT RIGHT THUMB RESTRICTIONS 16 a 03/31 /1994 050096 PRINT INAPPROPRIATE 1 9 2 FAMILY HOME BOXO D`DAVID G HUFNAGEL 38 J ONES RD . 1 BLASTING OPERATORS z NASHPEE MA 02649 I M(y$ 1NC [ P1AaT0: f PHOTO(BLFSTING OPR ONLY) F �00 00 - - FEB NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY ti HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER ` : 1 THIS DOCUMENT MUST B- ■ SIGN I �ftlf•C�/lB9149h't0lI2f�E LIlIE CARRIED ON THE PERSON 0.444444L SIGNATURE OF LICENSEE THE HOLDER WHEN Et' n R OTHE=S-=,GAT THUMBPRINT GAGED IN THIS OCCUPATIO. ��J�- COMly11SilONER aw�&ro .. ra4�-tefs Poo tr i -- i pew -- Screers s i pet t � 1r , cohC re i �ee� f 0 rem o v 2 L d olec< ahC� reT 4.a Sk�"� Scree-A LIN