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Home My WebLink About1166 OLD POST ROAD b i l� f Assessor's map and lot number� �N :�.... .: ...............' � Sewage Permit number :..�. .. � �QyoFfHEra�o TOWN OF BARNSTABLE i • i MASH9TLU i "6 BUILDING INSPECTOR A?E p MpY APPLICATION FOR PERMIT TO .....' �................... ............................................................ TYPEOF CONSTRUCTION ..................................................................................................................................... ....................... .....................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: (3h).......P.o. '..............1�.�t......................Co ..l. ........................................................ Location ..... ,.................... ProposedUse ...............0 CL I—Cti. ..................................................................................................................................... .......Fire District ... s.r`G.ti Zoning District ................................................................. ....................................................... Name of Owner .....I..!'1l.C.!1G! ./......... $9A ..............Address .................................................................................... Nameof Builder ...A 1.C.!1 Ad..........AACARW................Address .................................................................................... Nameof Architect ..................................................................Address ............+....................�.++..................................................... ...Foundation ..`.YNX�`:T ....Q./PS-K............................. Number of Rooms ............�.................................................. Exterior: .......>n. ...........................................:..Roofing ..... �h ;t.t........................................................... Floors ......�-.:tk!,*NA ........ ...............................................:.....Interior .................................................................................... Heating ..................................................................................Plumbing ..............:........•.........`.. ... ............................... Fireplace --- ........................Approximate Cost .... ...."��t..O��.Q......................... ........... Definitive Plan Approved by Planning Board _______________________________19________. Areac�` ... .t ....:......... Diagram of Lot and Building with Dimensions o Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH \ �a I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ^......:............. Bean, Michael No J §��.... Permit for ....garage.................. . .........I...................................................................... Location 'Old Post Road ..................................................... Cotuit ................................................................................ Owner ..................Michael...........Bean............................. Type of Construction ..........f..rame...................... ................................................................................ Plot ...................... ..... Lot ................................ Permit Granted .......JU.17-9....................19 75 1i Date of Inspection ....................................19 Date Completed ... ,/��. .. s ........ .... PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ................................................................. ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... Assessor's map and lot number .�. ........ Le-,c �� ''' •' �� '��- Sewage Permit number ...:..! i' • TIN ET TOWN OF BARNSTABLE , Z BAUSTABLE, i "b .•� BUILDING INSPECTOR �F wi• APPLICATION FOR PERMIT TO ............................................. --- 0. TYPEOF CONSTRUCTION .........................................................................................................................:........... ................................................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location1 r C C 1 t't I�..... ..... �.o.�:�............. .�..:.'......................... ........... ............................................................................ . Prop r ................................................................................................................................ Proposed Use `. C' .'CA '. Zoning District Fire District ... ..... .4:.t ........................................................................ ............................................................. Name of Owner i 1 r �fw -0 t ...............Address .........................:...... Name of Builder lffl t c t�!r'P.I..........;�i1?r t.�...............Address .................................................................................... ............... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....................................................Foundation ......t'.•tn r R a Tn r; e .............. ................................................................... Exterior .... .... .............................................Roofing .....I!:` .I ..+ ..... ...... _ Floors l s �.., ..................................................Interior ..................... Heating ..................................................................................Plumbing ...................r�............................................................. Fireplace Approximate. Cost ....F}....�r C?C.. ... .......................................... . : .................................................. Definitive Plan Approved by Planning Board __________________ ___________19________ . Area ..4.....:"....% ......................... Diagram of Lot and Building with Dimensions Fee ............. ............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH t � 1 FL Y wou SC- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name 'r.::'..........`::`.... ..:..!';.;a c..^.,.....6.................. Deeu^ Michael A=56-9 No _l7805_.. pe,n� . for __�ara8e_____. � -----~-- -------'' uv C= - . Location ' --- -~ - —~ ~~^~^^ Owner =^c"°= .1/Be.a.n......................... Type of Construction Plot ........................./ ' l 75 Permit Granted -----. ' ..................lg bate of Inspection ----- -----..lg Dote Completed -----.....------l9 / � / PERMIT REF USED � . lq | � --------------- -------' ...^.............^^^''....................................................' ................ —. I ^�---'� —�' �—�,. _. .. ._` _ ................ Approved ................................................. lQ � ' -----------------`--------'' -------`--------------^^'^-- � ` | | Engineering Dept. (3rd floor) Map Parcel MQ r-JJ Permit# d / House# C,U=,, &VL �A,ccsrqke Issued Board of Health(3rd floor)(8:15 =9:30/1:00-4:30) Fee r Conservation Office(4th floor)(8:30- 9:30/1:00 2:00) Planning Dept. (1st floor/School Admin. Bldg.) �THe,p Def' fie- an Approved by Planning Board 19 • BA RNSTABLE.�` MASS f TOWN OF BARNSTABLE rF159. LW .1166 Building Permit Application 00 - Project StreetAddress (��T � C`�11 [� L r Village Owner Address Telephone Permit Request ae First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ A6S-0 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) mil\ Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information r Name tq-(& C3�JCLa 0� Telephone Number Address '71I1 (/X License# Home Improvement Contractor# J�a � Worker's Compensation#&�(' 151,55 f e 3 o/�e NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE /Q BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED " MAP/PARCEL NO. ADDRESS VILLAGE � ^y OWNER DATE OF INSPECTION: FOUNDATION FRAME t ` INSULATION ' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH ' —FINAL FINAL FINAL BUILDING Z' b e 1 i DATE CLOSED OUT ASSOCIATION PLAN NO. °Fiae?4 . The Town of Barnstable • L►arrsrasr� • 9�A � Department of Health Safety and Environmental Services TFo ` Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 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: Ale Est.Cost Address of Work: `� /�4/ZCc�E� 00 C 4c.c,LC MA Owner's Name 12. IC.(Ad" Date of Permit Application: /fJ 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 apply for a permit as the agent of the owner: Dat Contractor Name Registration No. OR Date Owner's Name r The Commonwealth of Afassachusetts Department of Industrial Accidents l office ollnvestigallons 600 11'a0in-ton Street Boston, A1uss. 02111 Workers' Compensation Insurance Affidavit A,.�nitcant information: Please PRINT Ie� v �— �- ' name• location: `7 7/$/Zn,5lY-N �Ji2 city Co MW 40d 3,5— nhonc 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity .vim. Ar. .^�, s �„"'yramer._z: s.T's+.+ F+ ?'w-''8`r e*x roen39..`.�.^+37i��"*r*r^�"d^ 7w.,a'..-A4 w+^ r.,n•Prr....,...•.,,P. ....._._ -....:....,... -- ._.r«...ws,>.ar,•..c..»u<sv�.srfs.�.:.:'1.:ei...r:.- _ .s:�.r'C-tis...'�� .ai.aa,� ._�,�..';�,`;-,�„:;.� .:. --�w^a.?ad. -...-_, ._a....:..r.:.,.:W......._�.�.....�. I am an employer providing workers' compennsat�io,n for my employees working on this job. company name: �� t�i>✓LS7ywc��Y� add ress• cite: ,�/� 1 J phnne#• -y insurance co. G� ��1� ,�"/1 ka k policy#zoc 131a y�� e 3 Ql� �. t.. ._: .. .�.; > •':.,r,ny-..^+!'�'f`]fj . hp tree S .yycn>ist,:e.. zw . 1.,.�.�.�..:iw«.s(..'_.......raa�r.u_..-�.w._l-��....: - ....:�._.:. i r..�3 .�i. :... r.�.rud.ii .•_..- ____._c... :-:'.A". .�,y.. .f �W - .a.. 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: company name- address: cite: phone#• insurance co policy# t ._.. :+[:Fi'« ?1R`^_ ..y.':"S '�' t ♦.. iT •C'T'AV >1"jam r�wrr-8- r 1F" ./` :.-y..T6a�..�l��.-.-..-'_:t.: :ta5 a' 6a :iu1;' �+i.,�buC' 't''..'r:r..:aor:�iCr• .L:r.:us. company name: address: city: phone#• insurance co policy# .Attach additional sheet if n--- ---tj..-'�`r r% ,,�;e�r'_;' Y—'. *F = L{•:" �' ,`y ^'" '�"zy' "'z� F'M r7 Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of 5100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby rti y ands t ,pain• it enalties of perjun'that the information provided above is true and correct. / Si_nature Date Print name Qe ayN C U.aa,vt Phone# r.- officiii use only do not write in this area to be completed by city or town official ty or town: permit/license# rlBuilding Department Licensing Board (]check if immediate response is required [3Selectmen's Office t C]llealth Department ` contact person: phone#; I"Other (re%ised 319;PJA) . 4, d" Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an enrploree is defined as every person in the service of another wider anv contract of hire, express or implied, oral or written. An enipl( rer 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 chajiter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or rencival of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant Nvho has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. -_. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the 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. City or Towns 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. Tile affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. .. - .: ... ...er, ,......+es+.tnsa.?prf'•wsaor.a.+fTnriw.rc�..,c3v.nr.+:w-.sro,•. e�+►�" n�+.T►+v:K+rR..a'*o*.'w.F_F!CY`��nr •�*M,x7'+miws....^.�..s.9, Tile Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 NVashington Street Boston,Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) M A I �C&L DAmA . q i r�'•Ll�t C - ,�! _.'e� � ,� �� '.ice._ '.�! _ * ✓ v sly � ' I �I �`�n � - .F YY'_, IY }. r1.`C ��. 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