Loading...
HomeMy WebLinkAbout0596 OLD POST ROAD 0 �9� G/A />osf /�' M Town of Barnstable *Permit#' Q60%,sl (� Expires 6 months from issue date Regulatory Services Fee. , e� -`SS P Thomas F. Geiler, Director OCT 2 3 Building Division r® 2009 Tom Perry, CBO, BuildingCorrunissioner -n �� 200 Main Street, Hyannis,MA 02601 www.town.bamstable.ma.us Office: 8-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address Residential • Value of Work e ❑ Minimum fee of$25.00 for work under$6000. 0 Owner's Name &Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) / ✓J Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance ` Check one; ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. Permit Reques (check box) Re-roof(stripping old shingles) All construction debris will be taken to � �J ��- ❑ Re-roof(not stripping. Going over existing layers of roof) -side _ ❑ Replacement Windows/doors/sliders. U-Value (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 si roperty Owner Letter of Permission. A copy of the Ho rove. t tractors License is required. SIGNATURE; Q:Forms:expmvg Revis--061306 y Massachusetts- Department of Public S.At Board of Building Regulations and Standards ` ,Construction,Supervisor License License: cS 50234 Restric ed to' 00� MICHAEL'"DELUGA . 568 SANTWiT RD COTUIT,MA 02635 --�— �—� Expiration: 7/9/2010 C:'ununissiuncr' Tr#:,3000.3 Board of Building Regulal.ions and Standa6is 1 HOR�IMP�!OVEMENT CONTRACTOR Registration: 105548 ExiratEon; 7%17/2010 Tr# 271970.:' VILLAGE CRAFT i UILbING�f� b DIE LINO 5ANTUIT RD. CQ. .IT, M_02635 Administrator Li&nse or registration valid for indi idul.use only bfothp date: 11 found return to Board of Building Regulations and Standn GIs'' One Ashburton Place Rm 1301 Boston,Ala.02108 .... ............... ...__..._t--.. Not valid Nritltout signalurc - - l The,Commonwealth of Massachusetts Department of Industrial Accidents y Office of Investigations 600 Washington Street Boston, MA 02111 sy www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information. / Please Print Legibly Name (Business/Organization/Individual): Ciyi"l6 .,Address: J City/State/Zip: CC U► Phone#: Aree u an employer? Check the appropriate box: Type of project(required): 1.I� 1 am a employer with_ 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 8. ❑ Demolition I Workingfor me in an capacity. employees and have workers y p �'• 9. ❑Building addition [No workers' comp. insurance comp.insurance.t required.] 5. ❑ Me are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 LE] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 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. tContractors 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: Policy#or Self-ins.`Lic.#:' Expiration Date:�2i , Job Site Address: �eo't� City/State/Zi.p: GLt 1,1 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 certify uncle the s and penaltie f jury that the'information provided above is true a correct. �/ Signature: Date: A� a 6 Phone#: b "` 7�?7 , 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 Linder any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or s renewal of a license or permit too buildings in the commonwealth for an operate a business or to construct g Y P applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-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 complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only.submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia FE3724-2003 (TU'E) 16: 11 MALCOIM & PARSONS INSURANCE (FAM 7313441425 P. 002/003 ---- - DIY I DATE(k1MUCYYY) CERTIFICATE OF, LIABILITY INSURANCE 02/24/2009 y PRODUCER (781)344-3200 FAX (7 B1)344-1425 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Malcolm 81 Parsons Ins. Agcy. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6 Freeman St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 527 Stoughton, MA 02072 INSURERS AFFORDING COVERAGE NAIC q INSURED Ichael De uga INSURERA: Associated Erwloyers Insurance DBA: Village Craft Building & Remodeling INSURER 6: .- 568 Santuit (toadINSURER —�---- --' - Cotuit, MA 02635 INSURER E:- COVERAGES THE POLICIES OF INSURANCE USTEC BELOW HAIL:BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOC iNDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF AN'I CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY TH:POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS;EXCLUSIONS AND CONCiTI0N$OF SUCH PCL0ES.AGGREGATE LIIMTS SHOW N MAY HAVE 3EEN REDUCED BY PAID CLAIMS. INSR TR TYPE OF LNSURIWCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABIUTV EACv4 OCCJRRENCE 5 COMMERCIAL 3ENF.RAL LIABILITY DAN uE TO RENT"cD S LP.U,S3 MADE OC:UP. MEC EXP(AI 9 0.a Pe Cni S -- i — — I - PEr�ShfJAL&ADV't.JJURY i --- --_ - GENERAL AGG BEGAT E S I GENLfi3GREGATEI.I^I'AFhJ=SEER " P?GDJCTs• OMPIOP AGG 5_—__-- - POUCY E T -- AUTOMOBILE LIABILITY COUNNE:1 UNCLE UWT A.N'e AUTO (Fa acaidnnt). S ALL OWNEC AUTOS ..—.— ' iiODILY IhUUP.Y — S:,HEOULEDM_TOSFIRED AUTCS (Per parson) BODILY IN.IURY 5 Y�C'iV-0VJNEC A,�TOS � � (Per ecc dent; PROPERTY DAMAGE § - (Per aw derti) GARAGE LIABILITY - - A'JTOOVLY-EA4CCIDENT S AN I A'JTO OTHER THAN EA ACC -'AUTOOVLY� AGG EXCESSIUNHFIELLALIA9ILIT� - - - EA.CHOCCURREJCE S OCCUR ❑CJWASPA„DE t AGGREGATE S - . S .. OEDv:T&E S RETENTION £ - ---- --- I WORKERS COMPENSATION AND W:C500611401-2008 12/23/2009 12/23/20D9 wco'tATu. ,, ,T A, I AN"PRCPRIETORIPARTtiEREXECUTfVE E L EA-^.I-A=DENT S 100,DO OF, EXGL'JDECT F. DISEASE-EA EMPLOYE S 100,000 :f/Fa aescribe undxr SPEGA!PROVISION$bettyE.I. DISEASE-POLCY LROT,S SOO 00 UTHEP. i I 0E54RIPTI014 PF OPERATIONS I LOCATIONS 1 VEHICLES I EX(LUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS esidential cor,'rzctor. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABCVE DESCRIBED POLICIES BE CANCELLED BEFORE THE — EXPIRATION DATE THEREOF,THE ISSUING IN.SURER'NILL ENDEAVOR TO MAIL .. DAYS WRITTEN NOIICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT .BUT FAILURE TO MAIL SUCH NCT!CE SHALL IMPOSE NO OBLIGATION OR LIABILITY Insured's Copy OFAN�KIND UPONTHEiNSURER,ITSAGENTSORREPRESENTATIVES, Evidence of Insurance, AJTHCRIZ'_DREPRESENTATIVE , ✓� rJ � Irving Parsons 7 ACORD 25(2001/08) I�ACORD CORPORATION 1988 44 ram, O as , C tn' 9L u A5 P, zJ '? I CO-tw%cu ,:� Vaiib- gfw,;vma- �, a' ISFI`�::,'!✓t ._. tea, '. ca Ind CH I � � .� .� _. Rand " ("To, s° z. .' is f 4 4 -9 x t,�i=' y ks ?• �, up I a NOW& aft e U ar:ih , , a � tax �,: agk F? r. AM& FEE% Mot ti, U i.-i ep tj u All Tb ka � p wn a " v 1. m SkI, r 6, 9,4�2, a �. 4'.. h d 'c3 0%0 till"1 Fw OR, � =9 i s r^` -9 -:��,, cam$ ! n r�„X Bui illa�Ad �P_�6�i.,,_..� .._�..�.i� R1.��..� Miami-iA.��11:�ie,�G4Jr7�...�...,:�..�:•....�&l:JLA.....J..•P.1.<.d::.�.0::.:.a.:..._.�.:`..L' G'`mCbe'... .......,_e....:_.d9.':"sFs'a...-....E�.�.N..r...�?4:.... ,. .:":1�.,. r e•......:i:... :,_,:....�] a._:::'.....2_.,.-. �..•;.::.._ yr�r.ra a•s e�sae �,o roe am mr aa�aw. rvieira as a�waµea-a tra;aoww`Yaa nwnsw�.�ws a,ab=Ian�ar.waemomar we oa�n u+.ce,sa�.,..a w,a w.;M,ne � .. _.�,r z�,>i..,-.a � r To no longer receive these r quested prom otiGi ii"!th :ttA rur-j<�il?�E����,1- ��3�7 6772_.�1�t:� O O 4-! . Town of Barnstable. y Regul.a tory Services v ��'$ Thomas F. Geller,Director o05P.�a Building Division Tom Perry, Building Commissioner 200 Main.Sheet, Hyannis,MA 02601 wptwv.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1.Ca4 I, ✓ ��-t�j leH , as Owner of the subject property herebyauthorize 171) ,- to act on my behalf, in all matters relative-to work authorized by building permit application for: 7�1 '00�`� (Addxess of Job) Signature o Owner nate Print Name Q:FOR.M S:OWNERPERMIS S ION I-�• '�VRIR-C10rLB_' � �� , FIE J. LI LOF ' \ - --•--�_�--.Cr`_I_ ___t--'1. I i _ . �� 617.428.9213 _=1 •T-=: u.RuwEu'6_�t sror-tau�u:. custom Qesigns -- =� ✓ \ ... ~' I copyright®1980 .. '--Glyl..... _ ♦ e ,,. s All Rights ReserveQ mat-- " �siwl�e.tQ7ttl: _ i. 4�'1:WU Lo! ew+dtr_ I SSf 4-4 ncc.Qtsna-_ !. W.,.s ee.rac:2w:a� II i-' Preliminary plans and layouts by O.C.D.are tor the use of their customers only.Any other use is strictly prohioite 1'i -. ,. w,,....w...,,,.«..:.w�.rn4..u...>...>..w..x,...�nan.,«n..a...,..r.,e,,. _., ..=,a.....,,......,u._.. - — Ell _-CASE=: J i. >., ,,,re- � �='\Vtiss•J.CdIXIB.Sk11014L'L-S,_____. �. P 617.428.9213 �evl i n . I :;l:AT_TllM�1RLtNl:3titNGCES— __ ' i i ust m o " . t ► a�:a°**� - designs --_ copyright®1980 ,,II .. I All Rights ! Reserved 4] i t '74ux:G:/Ztt74-- i I u IIAA � rs LWG{ 6.D:oln fs! Preliminary plans and layouts by D.e,D.are for the use of their customers only.Any.other use is strictly prohioite { Kiwi,..,�,,. ..,„.,.,,,,,.,.a...,r�-.....,rM.,-•-••,�.-.-...-,........�--+...-,..,.,.,�,w,....:...�..,-•.+-�.•�•.,.,.-,.�..�-_.._...-....._... _,.......---�..__.-.�.�.....---+,.., ti.. , 4 ' 'S' -•i. _ '�' of � . I _ E ..,PAT10 r q } . { I! •t. 77 w s L' v Tun f- K'TCHEN G UU4>e _ r ♦ aook'asit{LY orNSIIY 0..s 5 otN[/C tat' - .-SvtK Oe YL4TlQ; - '�UItT'IN':L1Qt4iA44WS.. 'uI I O ..•.•-.••-.- _�_f6C":' ` aN1.9�OMi BOI Ff00 g.p+-. a •�'" -*.6 0'-.11 e-0 �-E' ._p;0• Y'.4" ♦ � ti �,`. 72.1: Tr 9 ,. :_sla aM+I& - IN'IN�ROO—M ;r04_R �.1]•at4°'op��• "''e 1� 7• —•._ .as s• - ,r . . a• ,o � V 7.428.9 213 faecec rast+cnRg4ssrT_. e o �" �� @UstOm designs copyright©1980 Alls Rights R t , erved s t --p NN CON L.-SLAG�ii�6la arD4A.�v.M. 1 — 6'.O' 4 4` AO^ G O• 8,•p,. � I l .Q... . _ ._. ... . _wsLo:yssY[G9L.AM._V.AL MLQLUAA cc V girl 9.A,y �.. 9 'C p^ ♦ ,.. � ' , � U , (1A ' I 1a,4 a-,o•, �EL94.�F.GO"DEi P1�lAC" :ra:j� � fi • Preliminary plans and layouts by D.C.D.are for the use of their Customers only.Ahy,o[her use is strictly Profti Dite .•. o rnar na xrwuxa.mese mmavro. - ,.. _. .. ,.;..,.. -w+.. ...w...•....«.,..,,-...,-.�*+•d�w--- .-.. "'""'.••'."*"'u'.n""•°".r.»e,♦+,w,°*»•gnrw.a..«»,»,wr..m.x-•...+a*:rvns♦hw• -,1 a.:s.k.,.x a::�,.,s�Nm.;Ms*+^n..�n>aw_o- «}:t«..,,».,.•aw., .,,. ....r ;Tww sr...+.;..;ra..m,+m•w.�...�a;�,._..,,..»,.w... ,.,.......,...M_. ....•. •,,.w«+...-ew»ar+.,-+enF. f i . 1 i e n � / ` - I"' �.nlz.lo.a.aunza nowt _ I -QPLAI:BEIOYiC-T � . _Ir..loymtwRrit �' _.. •5 j i n., L i46 4+ G. -�tA1 v eu unc ""_'JL 617.428.9213 �eviin it rsnr_tww @UStOm aSeSign5 copyright 1990 �I I• All Rights Reserved i d; .o!�e?E^ +��a,w.caeaunq.co - Preliminary plans and layouts by DC.D,are for the use of their customers only.Any other use is strictly Prohibite ' ' � � - �,•.^^.,*............,...m.,,..,.�wo-,...<.w.,,c .e..,wn,.....:..R,,,...__..;...«.-,.yy.•xw,.ri.w��ea..�z,w�., ..nr..u:,.w,..u,.;.....+,+wsv-R:Ww�..N..�..w.......,«:_....,..��:,...,.�..._.__ • lssrtssnePlN4 .= __. � it .l2HF.1N[4Hs!n' � u • I � II +�cn-.rt.Y+v000=�-- - ,�. � _. --_--. - , �+s�+nc:�rttr.N:ww�=_._° p r ' ^ _ _ I�IN�:B1�6d. _-Y_R-r y:ldSLt"_CT4P..� a3'S26APPItJe,. _ __... � 1 � r, 1 •' q - p _._. _ r _ 4. , I cuts - � rc::►ctaYQon:,_-`='•— --- .. l } 4_Rat�S— - � _ R•iO:INEll41't10N_-� ..s,,.�' � --tD +* ..;; ,r�/ tsTRAPPttiy 'r + —tom�-s�kxin__ f 6NUTI iN , IL. 1 "MTN _ :'..C)PPER.FC_{E0. "....F<,._ �.�:': e--• :-'. , < a 617.4]8.9]13 . v I _��n P_L4S[IZQD - S$.HIGs[vvML?; a " •., •i r 3 fN�LiIfGG4i- (geVi 1 n , s f @UstO m s f { 113'STQAP.FINr., TorsX,N�va YINY�Q.`. k „.--_ - -� o esIgns LZ Copyright©19B0 t ITK.HC -' i I ,f All Rights Reserved • � � ��C�HALF_=_.. _ a ;� ., - --- - 1 � t jM r ?rlSRynj Wlllel4':IRK4L I t - i- _ } I!' -114'�1�-0" •� - In"_P..W�voOD__ : pR1Us.Og.!"TNss cCtwoo - - - --YR=I°rImew-sC•CTr019 ' F ,.YnTCR:P.IiDQi!INY�=CI`tG� t•. 4 '.,; t<� � , - ��...�..)) t rrssexmEtxr, _— 'f�' � '�1•. ...-_' _ `,.INK:GDMC.:4sAA_.- • „ � • ,.N. . �[ .�,..-�=yff—ep._ __ _ __ �'. ,,._... _SECTION_C='�_ -- .>-�:-'--•;• . � � '`' �: �-�'TTf�17-off tP I � Preliminary plans and layouts:by DE.D.aie for the Use of their customers only Any ocher use is strictly prohlbile , ...++,-w,.w.�-• ...r v ,,._.n.v.....vw....,.,...,..+,.,-.•nw..•v.e+.....rt;+•�•+ .aw.rv,.!+a*r:•• .••+_ra ��.,.•.w•,4+-..r+w.r•.wwar.. <"C�'S�"!M"'�'`"� -®A�Y_.T:akf Y+:,. _n.. . _ ._. n.+w_.'?,YJ1kKJVw;n.Mr �.h.. .r4.rk.•N.mcn�k - W+• +n+!cyak '^;4+�b�matis,u�TM;PhY�,nw.^`%-ti-i•F,:•w�+� INS cv, a=y-c-Wce Gt� am iti ��ka�.�boo� �w &�'us�lole 7�� � ��� . I 1.a1� �a`�ty a VAIT,� fie. kaA&A owl. A� Pad Noon `.. i i PLAN BOOK 373 PAGE 25 SH DH \ Fdn. N 03'59'00"E 702.55 \tn\ 1 Z o PARCEL 8 o \A 40 1 . 57 ACRES o \ r ti O `camo a. F M 17• 'O S 03'59'00"W 709. 15 $B DH O LYI I Fdn. Ln Fdn. "A I O i 0 REF.' TOWN ASSESSOR 'S MAP 54 PARCEL 8 E i PLAN REFERENCE: BA RNS TABL\E REGISTRY OF DEEDS PLAN BOOK 373 PAGE 2� DEED REFERENCE: BOOK 956 PAGE 398 PLOT PLAN OF LAND TO THE BEST OF MY KNOWLEDGE, THE FOUNDA TION L OCA TED, IN SHOWN ON THIS PLAN IS AS IT ACTUALLY EXISTS. � � BARNS TABL E —CO TUI T— MASS. . ON THE GROUND. " �1� Lr" 4U . , I 4 �`` PREPARED FOR DA TE.• ✓UNE 26, 1989 }rlx� RICHARG` ?• .0 FEFIREI A MC SHA NE CONSTRUCTION CO. crn. �v�g I R.L.S. ` %''-,�y� O g. DATE. ✓UNE 26, 1989 SCALE.' 1 "a80FT. �j FLOOD LONE C rc�wn'�ir !/J CAPE 6 ISLANDS SURVEYING j `. �>._ D-✓ MC F ALMOU TH MASS. L - — BUILDING PERMIT N0. 3 5 DhTE J�gti? 41 ASSESSORS PARCEL NO. CONTINUATION OF ROAD BOND The undersigned owner/contractor hereby, agree to maintain their road bond in e `force until the following work items are.completed to the satisfaction of the Engineering Section of the Depar=ent of Public works: v V loan and seed shoulders as soon as c weather permits: c other (explain) lkf 37,91-L._ n:. e LOCATION:: l l—�T 1 S I� ��U� ���T l�i�. �o7Z-;'7 —T' '�n /a'S SIGNED (O;vi;ER/CO\ CTOR) (print name ) Eir 1NEE , '.G AUTHOREZATION t M T OF BARNSTABLE, MASSACHUSETTS BUI DIN G /�(�. AnO54-UO8 DATE July 14 19 89 PERMIT NO. �'� 330, 5 John McShsue 4464Falmouth Rd., Cotuit 001608 APPLICANT ADDRESS (NO.) (STREET) (CONTR'S LICENSE) Build dwellin 2 Single famil tl dwelling NUMBER of . PERMIT TO (TYPE of IMPR OVEM�TI ( N0, ) STORY (PROPOSED USE) DWELLING UNITS lot 596 Old Post Road, Cotuit ZONING RF , AT (LOCATION) DISTRICT_ (NO.) (STREET) - 8[V BETWEEN AND. Cs'. - (CROSS STREET) (CROSS STREET) Ue LOT $UBDWISION LOT BLOCK SIZE CI .'"BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT.AND SHALL CONFORM IN CONSTRUCTION ti hi to TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION' (TYPE) N 'REMARKS: Sewage #89-286 ii e BOND isle an AREA OR 2981 sq. ft. 200,000 PERMIT 208.00 ei ' VOLUME ESTIMATED COST $ FEE IO (CUBIC/SQUARE FEET) Helen Picard &.Sean Kelly +�) OWNER C O John McSfiane 44b4 kalmouth . , Otuit. BUILDING'DEPT. i ID ADDRESS BY IIC C FROM THE DEPARTMENT OF PUBLIC WORKS. THE.ISSUANCE OF THIS PERMIT DOES NOT RELEASE"THE APPLICANT FROM THE CONDITIONS a' OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. - �, MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE 9! INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUC-H BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH). FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING ,J INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 zJ'� 2 / O 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT OTHER 2 BOARD OF UEALTH WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT 'W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITT CONSTRUCTION., I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. .,..:;a+(...-� �.:,"—:,�,.,�,.�. �.__.. ,.�n9+�.iatr? r.�-,;�r t�rt:��+�a3•:��R' :r^8K"�`rr".�.N'+F:"2'!'y,�R„e�,Pra!".. ,..'P!�a.+�.o'rn's..ik.?a.,...rig.'4Py�R}r'��+=.,.�.."rfim+twtt o..,,,,,..-.n, -,. ,.q..�.. „cr. n. �:.�.. , ..�.i H ofTxs TOWN OF BARNSTABLE Permit No. .. 3Q95 BUILDING DEPARTMENT } D°$:E. I TOWN OFFICE BUILDING Cash 7 i6}q "�teuv HYANNIS,MASS.02601 Bond ...........A CERTIFICATE OF USE AND OCCUPANCY Issued to Helen Picard & Sean Kelly Address Lot #8 , 596 01d Past Road 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. Jaxiva- rill G` sl'G "Gy ............. .1....®...... , 19...Q............ ,.......... ,Building Inspector 1 FMtassessa* offioe (1st floor): SE Assessor's map and lot number .. ... — d v �. .° � iF Q�OFTHETO�♦ Board of Health (3rd floor): Sewage ..Pe mat pumber ...... .. ................. V� � � '; 2 BAflII9TLBLt, .Y ............. f W jf' jnt (3rd floor):�� G �J S,. TOXY Y,I �-.'-i w.ATI0� j '00�16 9-Engmeen�+ �t. ;'.................................... ............................... o�a� House n ° r APPLICATIONS IpObCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ................................................S:nr��� �A!vf�y ...........Q �`:Y� TYPE OF CONSTRUCTION ........ - o.o�......F( ftn.t.......................................t...............................•................... ............... . ........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby appliiees� for a ermit according to the following information: Location �� t.. ..�v Sri1�A �ipin. /7 �.�e1-gyp ProposedUse / ........ .................../............................................................................................. •4- Zoning District ....... ................................Fire District ......�0�!J.......................................................... ...................... Name of Owner lYClcq /,j,' / >!�,�.� ��/ ..Address ........C/v......au, '?.`.. ............................. ... �........... ........... ..... .... Name of Builder �D ^'� /' " "...t................Address .yY�e �'ylMv��l► "� U/,• / ................................... ........ •............................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ...........-7...................................................Foundation ..?0o4 > 2 e .k ..f�!•..�.............................................. EXlerior `Z / / y� ../ ���!P...C!..................................................Roofing ........... .IV...?...�!...`................................................ Floors .......... 'rZe. ©�/4......................................Interior ..........�. .•c. o�14........................................... .................... rr`j` (// Heating ( �.'.4.�......................................Plumbing ..........> ./ ..... !3......5....................................... I�Y Fireplace !�S�� ................Approximate Cost ........ .lJ C7z ......... ............ .�. .f. .................................... Definitive Plan Approved by Planning Board ________________________________19-------- . Area .... ... . .. ......... Diagram of Lot and Building with Dimensions Fee o��.. SUBJECT TO APPROVAL OF BOARD OF HEALTH ob OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding t above construction. Name ..... .. ...... ........ ........... ..... ............... ................ Construction Supervisor's License ..00 1 ?0 PICARD, HELEN & SEAN KELLY No ...DU. Permit for ...Two Story......... j# Single._,Family, Dwelling Location ..IAQ.t...#.$........5,96,.O1d,,,POSt...Road Cotuit ............................................................................... Owner .Helen Picard & Sean Ke11X .................................................. Type of Construction ..Frame . ............................ ............................................................................... Plot ............................ .Lot ................................ Permit Granted ......JulY.. 24.1.............19 89 Date of Inspection ....................................19 T''i lt� C pleted .A...A ... .............19 4 i .•1 Assessor's offioe .(1st floor,): r-- �, fJ f M E T = Assessor's magi ,pnd, lot number .. ...... .:. ., ....................... oho Board of H�alot� (arc} floor): fO Sewage,:.P,ecmt dumber ,.� ............... i BAHJ9TODLE, S Engineeriii a��,t�nnt (3rd floor): ��� 1 °oo YA°9. 0� House nV r?' ............`.......... . ............................. O v a� MP ri'I r'ii .. APPLICATION!S''`PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR Con 5A a o- N e_3 S./�c� i c ,`F?n�t S��Q :r� APPLICATIONFOR PERMIT TO ................................................... ........................... ................ TYPE OF CONSTRUCTION .. ..O 0�...... ft M. ...................................................................................:.. ............... . `..t.... ........ .1 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a ermit according to the following information: ���- s Location ...................................a........lb �...........>............................... ...... .............................................................'........................ ' ProposedUse ............................................................ ............................................................................:.............. � ZoningDistrict �......................................................Fire District .......C,..0....v.......................................................... I-1 Name of Owner r...Address ' Name of Builder S ... t................Address . /y6.Y...../C!tlMv��L►..?d....... �. �.: .............. .......................................... .r Nameof Architect .................................................. ...............Address .................................................................................... Number of Rooms .......,...7...................................................Foundation0�� 2 G' ..tc,..�l..0.......................................... Exterior ......:f Dd ./ � R 2al................................................Roofing ...,....... S��l� �/ ................................................. Floors t ...`�....l'.. 14,/Z 0"4/t x, ..........Interior ...........1•=.. .�.e 00%.... ................................................ ............................................... ilia , Heafing �.'�.�f .:.:....:..0... ...:..........:; _:.... .......Plumbing .........: ./ .... ::.,".? .........`,' ......:. `...........: ' D4 K �Dv op�...................................................Approximate Cost ........ .. ..............................Fireplace ..... Definitive Plan Approved by Planning Board _______________________________19________ . Area Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH t y r OCCUPANCY PERMITS REQUIRED. FOR NEW DWELLINGS I hereby agree to conform to oil the Rules and Regulations of the Town of Barnstable regarding the above construction. r Name ....... ...... ..... .... ...........M...... ................................. 4 Construction Supervisor's License .. .'�?.� ............. PICARD, HELEN & SEAN KELLY 0�.��� �� 8A=054-008 No 33095 Permit for „Two Story . ................ Single Family Dwelling Location -....Lot...#81......596 Old...Post. . . Road - . ... .. .. . ...................Cotuit... .............................................. Owner .Helen Picard & Sean Kelly Type of Construction ...Frame ............................................................................... Plot ............................. Lot ................................ Permit Granted ....JulY...24.r................19 89 Date of Inspection ....................................19 Date Completed .......................................19 �e z 4/b Assessor's office(1st Floor): L I G SEPTIC SYSTEM M E Assessor's map and lot number "7 D D D INSTALLED IN CO Board of Health(3rd floor): �,�� 1 WITH TIT ° L� •' w Sewage Permit number ENVIRONMENTA Engineering Department(3rd floor): (o � TOWN HEGU House number 66 Definitive Plan Approved by Planning Board 19 o�►r 4, APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only A: ;TOWN OF ' BARNSTABLE BUILDING INSPECTOR A, GATi N FOR RN1 LARGE FOYER r TYPE OF CONSTRUCTION WOOD FRAME. Ill t October 25, 19 q3. I ' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: , Location 596 Old Post Road, Cotuit, Ma. Proposeef%i dense Zoning District Fire District Cotuit NameofOwner Helen Picard Address 596 Old Post Road, Cotuit, Ma_ NameofBuilder S. J. Bishopric Address . Box 687 Osterville, Ma- Name of Architect N/A Address N/A / Number of Rooms 1 Foundation,----8" Block Exterior Wood Shingle Roofing MPmhrane Floors Wood Interior Drywall Heating F H W Plumbing N/A Fireplace N/A Approximate Cost 17,000.00 Area Z? Ctn ET. Diagram of Lot and Building with Dimensions Fee 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 E. • Construction Supervisor's License ,� i�61 PICARD, HELEN _ - la No 3 6-2.5 8 Permit For AD I T I ON ' Single Famil we n' A Location 596 O l d t o a d i. Cotuit Owner Helen Pica _ - - Type of Construction Fra 4 P Plot Lot _ 1 - 1 ' Permit Granted October 26 , 19 93 ' Date of Inspection 11 a 3 19 i Date Completed �� - 19 1 S fig . >rq _ a5 ' -. S� • 4 in v� f ` 'jE COMMoNwEALTH OF MASSACHUSETTS E DEI'AI�MENI'OF r TDUSTRiAL ACCIDENTS .t 600 WASHrNGTON STRE�r .lames.: Canooei' BOSTON, MASSACHUS=S 02111 -woRKERS' COMPENSATION INSURANCE AFFIDAVIT (l icc n scc/perm i rtcc) with a principal place of business/residence at: ! ( iry/State/Zip) do hereby certify, under the pains and penalties of perjury, that: i I l 1 am an tiIIpICYCr t rG'✓ltjinb t}It iG1iGWU^•b:' ,iitCSS CG1i�pCnS :lon covcragc fCi 1Ty Ci �1K3jCt5 working on th't: job. �A-1500 0(703,6� Insurance Company Policy Number O I am a sole proprietor and have no one working for me. f J I am a sole proprietor,general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation insurance politics: Name of Contractor Insurance Company/Policy Number .F l-amc of Contractor Insurance Company/Policy Number Name of Contraaor Insurance Company/Poiicy Number Q I am a homeowner performing all the work myself NOTE: PIcasc be aware that while bomcowacrs wbo employ persons to do-maintenance,eoostructioc or repair work on a dwelling of not more than three units in wbicb the homeowner also ruidu or on the grounds appuruaaat thereto arc pot geaera ). considered to 6c employers under the workers'Compensation Act(GL C. 152,sect 1(5)),application by a bomcowncr for a license I or permit msy evidence the legal sutus of 2m cr•ployer undcr the Workers'Com PIC asation Act. E i cnocrstanti that a copy of ties statement will ix forwarded to the Dcpa:=.cnt of Industrial Acadcnu'Oricc orinsorancc for.covcratc verification and that failure to secure coverage as required undcr Seecion 25A of MGL 152 can lead to the imposition ol_ttiminal pcnaJ(ics consisdng of a fine of up to S)500.00 and/or imprisonment of up to one year and evil pcnaltiu in the form of;Stop Work Order and a fine of S 100.00 a day against me. Signed this day of 19 LLlf t a, � Y Licensee/Pcrmitt Liccrisor/Pcrmittor I , I .c' _Ky �X1s�NG- 3����n�N�- � � ,� - �v� 1— HOME IMPROVEMENT. CONTRACTOR j "i Registration 10614,1. -Type - PRIVATE CORPORATION Expiration 07/22/94 Steven 3•. Nisliopric Inc. tLlAorGe 3te'verl ;. �iSilGpi iG E 67 Higillpoint Road a noM(NISTRArOR Marstons Mills MA 02646 G , COMMONWEALTH r DEPARTMENT OF PUBLIC SAFETY OF ONE ASHBORTON PLACE MASSACHUSETTS BOSTON,MA 02108 CAUTION EXPIRATION DATE FOR PROTECTION AGAINST ' .r?A' EFFECTIVE DATE LIC-NO. THEFT, PUT RIGHT THUMB RESTRICTIONS - PRINT IN APPROPRIATE 10 BOX ON LICENSE. 5 � BLASTING OPERATORS ,} ;tylU N U I;!:•'.r•..:. 'i,"i...... Fry 1 , ::, -, r..,, �.)✓ !: j.';, ..i r.--•_ i� ._._ MUST DE RHOTq:} PHOTO(BLASTING OPR ONLY) FEE: NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY •, ' HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER , DOB: THIS DOCUMENT MUST BE « SIGN NAME Iy ULL ABOVE Slq�ATURE LINE SIGNATURE OF LICENSEE b_U_LL l_' CARRIEDON THE PERSON OF THE HOLDER WHEN EN- 6/!' COMMISSIONER OTHERS-RIGHT THUMB PRINT GAGEDINTHISOCCUPATION. L