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0161 OXFORD DRIVE
i i tl- , off Igo ' Town of Barnstable O��� *Permit# '/7- 3 S� Building Departure ervires6nroLuhsfromis date '� I Fee saarrer )3rian Florence //toss. 0 0.1 �� .]Building Commissioner n cud" 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma usJU�� Office: 508-862-4038 ' -Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not VaUd without Red X-Press Imprint Map/parcel Number 6 Z/ 6 3 Property Address Ar/ a4ro�� D� G �f r Sri oaG 3 E Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number G;a 0 77/ Home Improvement Contractor License#(if applicable) f�22J�/ _ Email: Construction Supervisor's License#(if applicable) p O �Z !K 5:5 ❑Workman's Compensation Insurance Ch one: I in 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 accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Rroof(hurricane nailed)(not stripping. Going over existing layers of roof) e-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: '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&Construction Supervisors License is required. SIGNATURE: QAWPFIIM\FORMSIbuilding permit forms\EXPRESS.doe 08/16/17 ae omvrnaracuect c accc ccaeC�,a Office of ConsumerAffairs&Business Regulation HOME IMPROVEMENT CONTRACTOR gym, TYPE:Individual Re is1tratio Expiration 06/09/2019 JOHN LOPEZ D/B/A show c �81010N �a JOHN R.LOPEZ _ u 8 HOMEPORT.DR r HYANN.IS,MA 02601 Undersecretary Massachusetts Department of Public Safety � Board of Building Regulations and,Standards � . License: CS-007855 Construction Supervisor JOHN R LOPEZ _ 5 8 HOMEPORT DRIVE Tt HYANNIS MA 02601 Expiration: Cofnmissioner 04/28/2018 r 1 1 Y Registration valid for individual use only before the expiration date. If found return to: Office of.Consumer Affairs and Business Regulation 10 park-Plaza-Suite,5170 Boston,MA 02116 Not validwifh ut s' ature Construction Supervisor .--Restricted to: Unrestricted -Buildings of any use group which contain Tess than 35,000 cubic feet(991 cubic meters)of enclosed,space. Failure to 6ossess a current edition of the Massachusetts State Building Code is cause for revocation.of this license. , DPS Licensing information visit: WWW.MASS.GOV/DPS i r 91, - 17le Commomveaitih ofMassarlitrsetts DeparhmentofrndurtrialAcddenir Offwe o,f 1F tigafiom 600 Washington Street Boston,MA 02111 n%n-v mass gov1dza Workers' Campensatian Insurance Affidavit:Btdlders/Contra brsJEIectricians/Plumbers Appliamt1afm-matign Please Prim Na> e Address: v Ciig/S4atel �1 ®au tY/ mom� �D� - `�7�—9 G Are you an employer?Check the appropriate box: Type of project(required): I.❑ I ant a employer u*h 4. ❑I oat a general contmctor and I �-,I(J�loyees(fu11 andfor par�iime). * have hired the sulr�drat-taas 6. ❑New construction 2. l am a sole proprietor orpartaer- listed as the attached sheet~ 7. ❑Remodeling ship and have no employees These sub-contrac#ars have g.,❑Demolition woAing for me in any Capacity employees and have wodoers' [No wodmrs'comp.insurance comp-insuranm g- El Building addition required-] 5. ❑ We we a corporation and its 10:❑Electrical repairs or additions 3_ of ems have exercised t3:eir El am bameowner doing all work 1L❑Plumbing repairs or aticiitit:ms myself[No wa&='camp. zight of emempfion per MGL 12.❑Roofrt pairs insurance required-]l c.152,§1(4)6 and we have no employees-[No worms' 13_❑Other ' coup-insurance required.) •Ay aFPBc&at that c1Ledm tax 1%l mn also sn oul the soon below shosdag their meets'compensaricuporky infoatzi=. I R.amecrwne6 Who submit this affidavit i g they axe chine all waA and then him auside contncftus—st submit anew affidavit indicsoing sacIL fCasstta�ocsfbat t3sec7�this 6mc nsust ssttad>Ed sm addi6amat sheet sbouiag thenasne of dse sub-cultract am and state whedm ar not fhnse earniesbzve employees.Iftbesub<Gnt ctmsIummpIafee%dLeynm5t'pnmidetheir workers'apP•policy--her_ I am an emplgw flint is pr4aiding warkers"comps salon iantrance forms*enrpli;lwes $etow is ripeptriicy and jab site informafiots Insurance Company Name: 'Policy#cr Self-ins-Lic_ Expiration Dater Job Site Address` Citylstat&z p: Attach a copy of the workers'coaupensatiattpolicy dedaration page(showing the policy number and expiration.date). Failure to secum coverage as required under Section 25A of MGL c-M can lead to the imposition of criminal penalties of a fine up to$00D 00 andfor one-yearimprisonmetd,as well as civil peualties.in 1he form of a STOP WORD ORDER and a fie' of up to$250-00 a day against the violator. Be advised that a copy of this statement maybe forwarded fn the Office of Investigations ofthe DIA for insuraum coverage vow Ida hmbycarbdunderthepains PnIalfies oifpayary"thafthe utforwzafimj-prmided abmv.!s true and correct Date: Phone iF O Oocid we only. De not tsr&r is this area,&be crrinpleted by dfp prtoirn ofic&I City or Town: Permiff kense# Issuing Anthardy(circcle one): L Board of Health 1BuffdingDepartment 3.CiiyYrawn.Clerk 4.Electrical hispector 5.Plumbing Inspector 6.Other " Contact Person: Phone#: 6 laformation and Instructions Massachnsetfs G-e a Laws chapter 152 regoaes all employers ID provide worms'compeosation far ibex employees. f P this fie,an MnPIoyre is defined as.`°.every person in$re smrvicc of another under any contract of hirf-, express or implied,oral or wiftb . .. associsii or�ion or oth�a legal eutiiy,or any two or more Ao employer is defined as an individual,partnership, on, p of the foregoing engaged in joint eoferprise,and inch ding the legal=presentatives of a deceased employer,or the association or other Iegal entity,employing employees. However the receive£'or tmstee of an individual,par�rshzp, - e not more than for ee apartments and who resides therein,our the occopant of the - � owner of a dwelling Irons having; � dvPPT?�g horse of another - employs p who I essans to do maintenance,consirucfion or repair work on such dweltm g house ed do be.an to er." or on the gz�ounds or building appurfena�tbeseta shaIlnotbecanse ofsnrh employm�be deem emp y MGL chapter 152,§25C(6)also sites that¢every state or local licensing agency shall withhold the issuance or renewal of a Iicerse or permit to operate a business or to construct bindings in the commauwealth for airy applicant who has not produced acceptable evidence of c6mpIranee with the iasuraace coverage required." Additionally,MIL chapter 152,§25( (M states-Neither the cone iaawealth nor any ofits political subdivisions shall im Itutu any contract for the performance ofpubho work until acceptable evidence of compliance with the nMU-a rp.- re eats of this chapter have Been pursued to the contra�author ity." Applicants Please fill obt the workers'compensation affidavit completely;by chug the boxes mat apply to your sitnaiion and,if necessary,supply sob�contractar(s)name(s), addresses)and phone numbers)along with their cerfifacate(s)of ir=mce. LimitedLiabi-ayCompaumes(LLC)or Limited Liabffity-Partnerships(LLP)with no employees other.than.&5 members or partners,are not requited to carry workers'compensation fnsormm If an LLC or LLP does have employees,a policy is required. B e advised that this afftdayk may be suhmifted to the Department of Industrial Accidents for confumation of msui-ance coverage Also be sure to sign and date the affidavit The affidavit should bez et>mmed to the city or town that the application for the pccmit or license is being requested,not the Department of . h2dusf-mil,A_ccidmfs. Tuyuld you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Deparmm ent at the number listed below. Self-msma ed companies should entcr their self-insa=c,5 license number on the apprapriefe Ime. City or Town Officials Please be sure that the affidavit is completer and pried legibly. The Department has provided a space at the bottom the affidavit for you to fill out in the event the Office of Inver cns has to contact you ecru ding ib e applicant- of Please be sure to fill in the permiillicrose number which will be used as a reference number. In addition,au applicant that must sabnut multiple peemWHcense applications m any given year,need only submit one affidavit mdicatmg runt policy kf6rmation(if necessary)and under'Job 5ife Address"the applicant should write"all locations (city or e, - or town be Provided to the f, or marked th �' o the-affidavitthathas been officially stamped by �3' P to A co f �) PY applicant as proof that a valid affidavit is on file for futoreperm#R or licenses. A new affidavit must be filled out each year.Whew a home owner or citizen`is obtaining a license or permit not related to any business or commercial-Venture (Le. a dogen licse or permit: m to burn leaves efe.)said person is NOT required to comple#e this affidavit The Of of Investiga ions would like to thank you in.advartce for your cooperafian and should you have any quesfions, please do not heshate to give us a call The Department's address,telephone and fax number: The Co w�attJE of Massachmsi-,M Department of li&6gUa Accidents mere of �4 T�ashin Bwbw.,MA 0�111 Tc,-L 4 617'27-49W cit 4-06 Q.r 1-.977-MA&iAFE Fax#61"-72'-7M Revised¢24-07 nug gpV/dia. r . `s Town of Barnstable Building Department Services ` s" ' ` Brian Florence,CBO &639- Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.ns • 1 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section if Using ABuilder I, 4E/ft-e-'/L- 6 `e QQ/ ,as Owner of the subject property hereby authorize s v0 Lv CO-L S T to act on my behalf, in all matters relative to work authorized by this building permit application for. . 161 oXr—®1242 Dk Ccrtu/7--VA. o2a 35 (Address of Job) **Pool fences and alarms are the responsibility o e onsibili f the Pools a are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:F0RW:0WNERPERWSSI0NP00Ls Rev:09/16/17 Town of Barnstable Building Department Services Brian Florence,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 z ARL � www.town.barnstable.ms.us i"9. A1� Nth Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAnJNG ADDRESS: citykown 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. DEFINITION 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 responsible for 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 Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner - 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 permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming 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 actin as Supervisor is P g P P g P ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q :\WPFII.ES\FORMS%uilding permit fotms\0TRESS.doc 08/16/17 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 0 Parcel d 3& Permit# 4.+ 7 Health Division Date Issued Conservation Division cis Fee '50_0 Tax Collect Treasurer d 6G SYSTEM MUS Planning Lpt. INSTAL LED IN COMPLIANCE WITH TITLE� Date Definitive Plan Approved by Planning Board ENVIRONJOWjlI AL ANp 'fofth Historic-OKH Preservation/Hyannis ,, IONS Project Street Address. a x wo2® A01C Village ~� } Owner ���'yPi✓ f K -T� 60V C'e-` S Address 161 Telephone 5_0� y0 0 _ -3 6 3 Co Permit Request /�C 14 7I 2— Square feet: 1 st floor: existingproposed 2nd floor:existing proposed Total new 9 P P Gd Estimated Project Cost' �SOoU Zoning District Flood Plain Groundwater Overlay Construction Type S/ L y,� o� old© � , Lot Size r��� Grandfathered: O Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 4 Two Family ❑ Multi-Family(#units) Age of Existing Structure I q Historic House: ❑Yes k(No On Old King's Highway: ❑Yes #No Basement Type: §kFull ❑Crawl ❑Walkout ❑Other �y Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /0 L90 ) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing hew T Total Room Count(not including baths): existing new First Floor Room Count • (� Heat Type and Fuel: ❑Gas WOil ❑Electric ❑Other Central Air: ❑Yes allo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:4existing ❑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 a BUILDER INFORMATION Name P1C1t119_,g0 Servo S�C% Telephone Number `J D 3 6 2' cP 7 7 Address_3�(/3 A,41A) S/� License# 0 D 9 6 3-6 0,42,)ST%?6A-9 01� b 3 Home Improvement Contractor# Worker's Compensation#f'1,�X-` cX3S5_ 7b( 91 CD ALL CONSTRUCTION DEBRIS RE�sULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ` ADDRESS VILLAGE ~ OWNER DATE OF INSPECTIQI_ : FOUNDATION R I FRAME c INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH M FINAL i GAS: ROUGH =t tC FINAL FINAL BUILDING nF awzlsh ^ DATE CLOSED OUT - 'a,ft% _ ASSOCIATION PLAN NO. VE The Town of Barnstable eaaxsr�u.E, 9� , ,0�' Department of Health Safety and Environmental Services -- ArFO c, Building.Division ; 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date _;,? ^ 00 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: �GU /'� Sb(/`Affit.11/C.� �� Estimated Cost Address of Work: j (V 96ec,0 C 6Fyl Owner's Name: �/Cy�� 6 e—JGf/ Date of Application: 2 "2o o O I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law Job Under$1,000 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 a of the owner: Date Contractor Name Registration No. OR Date Owner's Name x q:forms:Affidav --- - - _ The Commonweaffiz of Massacizuserrs Department of Industrial Accidents ENTOlfice oflnyestigsuons 600 Washington Street Boston,Mass. .02111 Workers' Compensation Insurance davit name: location city C�0 TJ! tM�- phone# '�6 3 b s� - 9 7 2 2 I am a homeowner performing all work myself. - ronrietor and have no one worldrig in any capacity O/----- -///%/%%%/%////MEME%%////ME///%/%%%/%/%%/// (®"I am an employer providing workers' compensation for my employees working on this job. comnnnv name• - address: 2 � � .:.: .... .:..:. city If�IS� M,U ®�(0 �U phone#- UItX insurance cn. (WtujJ ,� wk C.& V1 nolicv# ta"C i///i////io///////%�iii/////act//ia/io////////a/�iZ�/////r/ii///ari/ ///////////i//////�//////i//r%i/////////////////////////////%//o//////�'�'�//l%//�//,�//.�//////////,%////////////.%//////////a///%/////////aD///// �aii/• ❑ I am a sole proprietor, general contractor. or homeowner(circle one} and have hired the contractors listed belotiv who have the following workers' compensation polices: comuanv name, address• city phone insarnnce cn. i ///////////////////////////////////.�l%//////�l6%/,�/�///////////////////.!�//////////////////////.G%/////,�//!�/�!�///%/'%/; camnanv name' ::.::..... address- HtN- phone#r insurance co. Failure to secure coverage as required under Section 15A of MGL 152 can lead to the imposition of criminal penalties of a Me up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a titre of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification 1 do herebv c i nder t pains ?enalties of perjury that the information provided above is trup,,annd correct Si�ature Date 3 Print name ptc- -421J ��Osc� __Phone 7 01mcisl use only do not write in this area to be completed by city or town official city or town: permitfUcense 0 ❑Building Department QLicensing Board check if immediate response is required ❑Selectmen's OMce ❑Health Department contact person: phone#-, ❑Other��� ;trnam 9;95 P1AJ - - Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for th.- employees. As quoted from the "law", an employee is defined as every person in the service of another under any cam- 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 cf the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the rece-n- 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 c. building appurtenant thereto shall not because of such employment be deemed to be as employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renew of a Icense or permit to operate a business or to construct buildings is the commonweaIth'for any applicant who 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 fbi the performance of public work,� 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 along with a certificate of insurance 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. 'Ile 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 u 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 wif1 be used as a reference number. The affidavits may be retunnid io the Department by mail or FAX unless other anangemeats have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have nay questions. Please do not hesitate to give us a call. WI The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents r 0MCC of Imlesugatlons 600 Washinlrt on Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 OHE=5IlIP Ou E T t ,f CTOR , y_� w C 0 I. . '' ' l F ' MIN.r. TC3R�.� �.. �s�., �,.k4, �•� , . f.MO{I[ilm As A.YIAC a mrtunAs n[aAMA.a: _ P�nT Sham.[a WE ml—s a®m a AAIARIIID. ea PUMP ORSJH--�\OCT. \�' TWMAL"we S 3{RETT�LIE � Y PRJUE ASSEMBLY ATf� nr AA..�� Y FRAME w3`.�7�Lr JAY TJR - 7rPICAL AT 1 f'--� PLOT AP1 TYRCAL MERE SHOWN SAFETY LAW {MOTOR �] W FRAM WHERE 5LY ry ..a- •IOIOI ¢CORH� T.177[JIL AT MOTOR TVTIC^L E FLJEA I I IETIAI Aram .. T— •—— ►1 1 CORNER ..g s�� z aEREs �-� RETIAI s!D� ♦ -® � S .�.• so� AlJ l {�uEpOs_(jJ.�/, ♦ F�rEx t y FLTERJATT Pp ACHED I 9NOED ? .sHAOEo �� 'IPQfIlON3 z.> PE T TACHED r -EAFET7 LINE.PORTION L. ITS ":LTEglITS i .. ,�SAFETY E �? e , tSNAOED f � FLAT AREAS 111 6 ITyNN I.SKNGMER AM FUT AfEAS SUCTION orr 3 ♦ a�aew ALAO IY.t.• Sr.a.s.. aAL u► �{p AL 1 9�� L— f-`V YA..AiE �. s. l iyL CiR aAJ1 L aW i66 A llis A�6 WALL.fJR '• A FO7 BE OL YFOR ` I { Sill to'.Ao'_olio v.f1E rWA a is�pw.rx a-e�aA SLAW.AREA L cr..us L— �J n�33 OAR AT X aRY' Suc, �L —�--� FOR mY 3T•a lT.AI' TI FROM MSE 7 OR Wr BE LOCATED >a sa.w ALfo n'+aS 1!i sJt a.W:MWA aL104 CY.CA►. a TrIxAL MIH61E aHOMIHA `a� AT FostTnNs•x:•roR•z'� -SERIES 800 8 850 INGROI�ID SERIES 900 9 950 INGROUND AVULANA W- MA uiv AARLA L { CAA . _ �✓ lyl lHoml�^"�'' S''I °A" ` L �'F SERIES 1000 9 1050 INGROUP!D{F.�t 1—� V.SUR AR A t a.L_Ty {EM.IE Aovnle AYIe sew AIE APIWEIr.r{,Alo AIE{ATm !IYn3S 3l0_ S.F.SURF YEA aII90p_GAL.GP- w POQ OVTw Sw{ Atp i Ls tlp 7!{ylpp•K_ - • SERIES TOO 8 750.INGROUND cF++w.Lsrn.eYc.a„om TL �� � La rn°C� I,TH'{'i TYPrAL cCORM1.RSQ awa sm"m s , K�M.ME1 / _, ,� L J I aACTTON. ► aETua S r lcfpk �RETIsa I I d� �Puw AM ` PMS Awl 1 REru� I `� MOTOR - AT GOO AP HED YOIOR J'('j APWM L7 AF{OT1A"CAN"EOpflL' Z ERI SAFETY LOW °'�- SAFETY LINE I fAFLT7 LJN[ 3 t AT 650 i I\ Y .rs 9YOED PORTIONSI FkAREPMT AREAS I 'SERIESDIAUM POSITION �. wm FLAT AREAS O3MMMOSSES 1 + r .� 7 ♦� AT 700 �I _Y OPTIOIARE a O sOlaEli aT3o TYPICJIL WHERE mNHWN _ _ I • 3 n SI/CT10// {EJ00 T I RETSII{I FHLME A53E1 r -1 f� { MERE � o m TYPICAL WIOIE s+IOWN � �.' S»ew �mSatHvngEsr 1 � mOs aME AMuaal�wl..ae ^.: L—►— --►----►� O Met IAI- Mo'.AIr n La r M IOLIIf WUXI J�u R.s AAMu►_�tAM_er - 1T►{M{AHt . O ID AL{D wWMI[W.M'LL E"Y'M I..IIf MNOI A31 SF all AllfA►�1App RAi.d1. CPTIONAI INES iew ad.3W e.MF YFA AJ Q QN_Cy.O W.rA RmEST rA.NWT ww0l iaT—sr sour.A.TA•33rr A11L ty. STARS ARE OPTIONAL . o m a SERIES 700 81 750 INGROUND AT��'ICw OR_ RIES 800 8 850.pIM"D grow gElata SERIES 600 8 650 INGROUND 1 Cl m FLTE '_ m — --►�—.►--.�--.►— RETURN iLTFR —�—��♦� �— Pow a♦roTaw ♦_2 "�--.—►"'—' RETURN $� 7 ' TR ► ® I MMOIORPUWJ . i-^"+Bs•'IV,.c,ITLlEwPERA M :. � sAIo� L ..>•...am• FRAME Lr T».uo NP MERE LAFXTLY Em OONRR F - d �' AT-T.oED �' �. T•�- MesJ ...aTnAAM I ..�' 3APErr LNE I f I eASEnr�i{E t o2� W ,c� i .i. .., ... I. . : -5MOEV PORTIONS T AT Boo SHADED PORTDa SERIES�/�5 IEPRESE7/T5 `%:• N 2 also FLAT MEAS ii' Y `► I 1 AT sw } I '. 1000 I ti I T RETURN O FGA Ep/ s 1 3 SERIES ��• cAp00 I RE7l1W " � NAI F.NG�? �' T I • �—— --•—J - 1'FRAME ASSBWBIT RETURN I AT7PKJIL WIERE SHOWN ..FRAMES. TrPMJAL WHERE 910{71 AIRS ARE (. TIpYL ' fII S SI.Fw Y.3) Ifi m r I51 SA!wt AMA a N—K) GAL- SHOWN CAR 5� HCAMSA•}�'J S.F.SURF.AREA j,'IgQ GAL CAR ' AYAIA<L 9.aI n tgRfl IMiol J�L.fw[YWI1 {jj$�M.AL.TY A..HLARA W.{I u HaE AREA aAL TAR ALSO AVYLABLE GAL-CAR LOI.W Aa MANS Al"a ALAI-cm 16F30•AIQ SF.SVi.AREA SERIES 1000 a 1050 INGROUND SERIES M INGROUND ALTERNATE 600 8 650 SHAPE ppe --se-0 {goo of a i t 1 � 67 � .38- .]'o YjILIiAM ��GJ� W M 1�TT IN .•1 C. 11YE H ,p No. 19334 p suR�/s+ CE,2T/.c/EO ` ' FLOT GL4.t/ �'E.2T/.may 7;41.47 .GaC�1T/O�C/r.. � I. S�/o!-t�it,r yE.2EO.t/Cos-fb.G YS Wjry � 7-7J/7� 7 3 :oCq Wiry/N . 1. T.yE F.Loaa 1 BASLc- ;aAXT.E�28 �NS7-,2Uiy� l-v,7- '�/.4.t/ i2E6/STE,2E1� 1.q c/O SU.eYES2�c� 4,6: .SEQ '7'-p OET�,�ii�/.t/E .LG�T�./�t/ES AOG,C./C,•Qi�/7'�' {�� �''c \ ' Town 0f B rllstable *Permit# 2Q6- 6— F.xplres 6 months from issue date ]regulatory Services Fee -12 3 1, /�;z PERMITThomas F.Geiler,Director 0 C T 2 3.2008 Building Division �� v Tom Perry,CBO, Building Commissioner TOWN OF BARNSTABLE , 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 . . Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTL&L ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address �--T Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name 7 ,, Telephone Number; .10 Home"Improvement Contractor License#(if applicable) —_jg — Construction Supervisor's License#(if applicable) _ ❑Workman's Compensation Insurance Check one: ti ❑ I am a sole proprietor ❑ the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workmaa's Comp.Policy# Copy of Insurance Compliance Ce cate must be on file. .. Permit Request(check box) �C roof(stripping old shingles) All construction debris will be taken to existing layers of roof) � ❑Re-roof(not stripping. Going over g aY [] Re-side ❑ Replacement Windows/doors/sliders. U Value (mum•'4) *Where Tcquired: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. P�7e Impro meat Contractors License is required. SIGNATURE: 0:F0rms:exprntrB r 'eni of P.utilte SI tgt, 1lrlatisachusetts - Dc dil .. Box;rd tit'Building;Reaulatioias and �t indar,,s ' Construe'n Supervisor' License Ucense: CS 8267 _ Restncted to 00. F• '' -JAMES D DANFORTH, , PO.BOX 973 COTUIT; MA_02635' Expiration "5720/20 10 T rA 27541 - (onumsrune.r. V -— ri !3o u d of Building Reaul,troirs au ROME IMPROVE44ENT CONTRACTOR PegistrMio`n,: 114813 Expiration 10/27/2009 Tr# )�08�, tr t t a JAMES D DANFORTffl E IOD I t JAMES DANFORTH '� { t 1105 OLD POST COTUIT MA 02635 1 1rmn+ `i +tor f y y . ,y� The Commonwealth of Massachusetts ' �-\ . Deparimettt of Industrial Acciderits , Offcce of Investigations 600 Washington Street Y Boston,MA 02111 ` www.mass.gov/die Workers} Compensation 14sur$nce_A.ffidavitc Builders/Contractors/Electridans/Plumbers Please Print Le 'bl • A, licant Information - - . Nagle(Business/Orgmintion/Individual): �J Address: AV _ City/State/Zip: Phone.#' AEa3m an employer? Check the appropriate box: . Type of project(required):. to er with e '4.❑ I am a general contractor and I 6. ❑New construction 1. a emp y have hired the sub-contractorsployees(full and/or part time). '7, Remodeling listed on the-attached sheet. ❑ 2.Q I am a•sole proprietor or partner- These sub-contractors have . 8. Q Demolition ship and have no employees employees and have workers' working for me in any capacity. 9. Q Building addition, comp.insurance.$ [No workers' comp.insurance 5• We are a corporation and its 10.Q Electrical repairs or additions Q required.] officers have exercised their I l.Q Plumbing repairs or additions 3.❑ I am a homeowner doing ell work - amyse]£[No workers' comp. „ right of exemption per MGL � 12.[�Roof repairs insurance required.]t c. 152, §1(4),and we have no ,.13.Q Otlier . employees.[No workers' " comp.insurance required.]'. applicant that checks box#1 must also tall out the section below showing their workers'compensation policy information, t homeowners who suhrpit this affidavit indicating they arc ' *Any aPP doing all work and lbc n hire outside contractors must submit a new affidavit indicating such. #Contractors ttrat check this box must attached so additional sheet showing the name of sub c�hectors end state whether.or not those entities have employees. If the sub-,contractors Lave employees,they must provido their workers'co policy number. ; Iam an employer that is providing workers'compensation insurance for my employees`Below is the policy and f ob site information. Insurance Company Name 'Expiration Date: Policy#or Self-ins.Lie.M ' Job Site Address: City/Statelzip: Attach a copy of the workers' compensation policy declaration page(shoving 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 lip to$1,500.00 and/or one-year imprisomnent,as.well as civilpenalties in the form of a STOP WORK ORDER and a fine ofup to$250.00 a day against the violator. Be advised that,a copy of this statement maybe forwarded to the Office of Investi of the MA for ins a coverage verification I do hereby ce the our •and pen 'es of perjure that the information provided above,is true and colrea Si el ate, one I.ffzcial use only. Dn.not write in this area,Yb be completed by city or town official `Permit/License City or Town: # ' Issuing Anthority.(circle one): c 1.Board of Health 2.Buulding DepartYnent'3.City/Town Clerk'4.Electrical Inspector 5.Plumbing Inspector 6.Other - rontact Person:__ Phoiie M , f _ �.� r AI TRAVG LGc RS" WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (GKUB-8027AO5-1 -08) RENEWAL OF (GKUB-8027AO5-1 -07) INSURER: THE TRAVELERS INDEMNITY COMPANY 1. NCCI CO CODE: 11347 INSURED: PRODUCER: DANFORTH, JAMES D. CHILD GENOVESE INS AGCY P .O.BOX 973 60 TEMPLE PLACE COTUIT MA 02635 BOSTON MA 02111 Insured is AN INDIVIDUAL Other work places and identification numbers are shown in the schedule(s) attached.:. 2. The policy period is from 08-28-08 to 08-28-09 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s) listed here: MA B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in �— item 3.A. The limits of our liability under Part Two are: o_ Bodily Injury by Accident: $ 100000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit Bodily Injury by Disease: $ 100000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A a� D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS EXTENSION OF INFO PAGE 0 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating W= Plans. All required information is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 08-13-08 DS ST ASSIGN: MA OFFICE: ORLANDO INDUS AFF 161 PRODUCER: CHILD GENOVESE INS AGCY 75FSL nnnaon i C c AW& TRA`,Y ELERS J WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (6KUB-8027AO5-1 -08) CLASSIFICATION SCHEDULE: PREMIUM BASIS ESTIMATED RATES ESTIMATED TOTAL ANNUAL PER $100 OF ANNUAL CLASSIFICATIONS CODE NO REMUNERATION REMUNERATION PREMIUM SEE EXTENSION OF INFORMATION PAGE - SCHEDULE(S) SIC-CODE: 1521 ---------------------_----_-.- ------------------------------------------------------- STANDARD TOTAL ESTIMATED ANNUAL STANDARD PREMIUM $ 341 PREMIUM DISCOUNT NONE 0900-20 EXPENSE CONSTANT 159 TOTAL ESTIMATED PREMIUM 500 DEPOSIT AMOUNT DUE 500MP t A/R (WCIP) # Minimum Premium: $ 500 ST ASSIGN: MA DATE OF ISSUE: 08-13-08 DS OFFICE: ORLANDO INDUS AFF 161 PRODUCER: CHILD GENOVESE INS AGCY 75FSL L r ESTIMATE James Danforth P.O. BOX 973 COTUIT, MA. 02635 (508) 420-5131 Kathy Gettis 161 Oxford Drive Cotuit, MA. October 2, 2008 Roofing work to be completed on entire house and garage roofs, as follows. Remove the existing wood shingles. Install an 8" aluminum drip edge on the overhangs. Install ice and water shield 3ft. up onto the roof, also in valleys. Install 151b. felt paper over the roof sheathing. Install a 30-year Architectural type roof shingle, using Certainteed Woodscape, which is an algae resistant shingle. Install new vent pipe flashing. Install a ridge vent across all roof peaks. House and shrubs will be covered with tarps while work is in progress. Removal of rubbish. Material and labor $7,670.00 Acceptance of Proposal: Signature: Date of Acceptance: Zo 51 lo P Signature: c Sep 10 08 07: 34p - p. 2 Construction Supervisor Home Improvement License Number:#008267 Contractor Registration:#114813 Home Phone#50S 420-5131 Cell Phone#508 280-0802 STATEMENT JAMES DANFORTH PO.BOX 973 COTUIT, MA 02635 Thank you for your business. It has been a pleasure working for you. Respectfully Submitted Thank you for your business. It has been a pleasure working for you. Respectfully Submitted TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t SEPTIC SYSTEM MUST 6= // �vf D Map_ J Parcel U43 o INSTALLED IN COMPLIANGib e Health Division WITH TITLE 5 O ENVIRONMENTAL'CODLQINffued Conservation Division LO TOWN REGULATI01 7t Tax Collector 3 - / Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board ij 1,or Historic-OKH Preservation/Hyannis Project StreetaAddre'ss 4L-X / ;72jAfrp- w ' Village Owner r.an 04V Address X1-06,22A-) 7, 63.1-L/�' Telephone 7l -3 G _5 D 77ae-, vow -J" Permit Request Square feet: 1st floor: existing qs� proposed 2nd floor: existing proposed Total'new Estimated Project Cost o2f% ao Zoning DistricV=gSi&Aoo'l�/�-1rFlood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes 210 If yes, attach supporting documentation. Dwelling Type: Single Family 'Two Family ❑ Multi-Family(#units) Age of Existing Structure 00ZX Historic House: ❑Yes d<oo On Old King's Highway: ❑Yes @-No Basement Type: I<u11 ❑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 3 new Total Room Count(not including baths) existing `� ' new First Floor Room Count Heat Type and Fuel:. ❑Gas it ❑ Electric ❑Other Central Air: ❑Yes 4wo Fireplaces: Existing Z New Existing wood/coal stove: ❑Yes LR46- . Detached garage:❑existing ❑new size Pool:0existing ❑new size/7e33 Barn:❑existing ❑new size Attached garage:21xisting ❑new size -��.o._ Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded O Commercial ❑Yes Q4K If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name r c w Telephone Number -55-cr 721 S- --Go Address License# Home Improvement Contractor# JG 5?-,? 75' Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO. if/,vz�_ C2 SIGNATURE DATE .�®�v- • �r t FOR OFFICIAL USE ONLY PERMIT NO. x s DATE ISSUED r i MAP/PARCEL NO. a414 '. . . f ADDRESS ti ' ' t VILLAGE OWNER . �'�."`�• `� .; •; ' ! .. r: _. ;-- t t � - DATE OF INSPECT[ ; FOUNDATION, • is ;� ` . _ . FRAME2 '' t _ INSULI1 0 FIREPLACE Iai r ! " n44 � •� t ELECTRR 07% ROUGH FINAL _ ` PLUMBING:CT 0 ROUGH FINAL , X GAS: _ ROUGH FINAL ` •FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. , The Commonwealth of Massachusetts Department of Industrial Accidents .,_ ,�= - Offrce af/m�estigallnos 600 Washington Street - - Boston,Mass. 02111 Workers' Compensation Insurance Affidavit ' location: city � �T �r 36 ❑ I am a homeowner performing all work myself. , ❑ I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. ❑ ............................. ...................... ........................ : ::::::.:::::::.::: cone any name. address. - ..:.... :.::.:::.:::::::.. .. ..... city ........ ohoae#i :..: >::: insurance co. oiicv ❑ I am a sole proprietor,general contractor, omeowner circle one)and have hired the contractors listed below who have the following workers' compensation polices: comDanvname•Ll .:::: /�^:+ d/Fib .............................. address . ... ... ......:......................................................::::•::::i:::.�:::::::::::::::::•:•.::::::::.::.............................. ::•:::::v::::::::•::.�:: ..: ":i:�:::.i:!.;.::.:::.:i:ii:�::�:�i::::•: :.. ..;:v :..:.. .:':.�.�::iii}iii:�:::i": ri::::.:i::.:::.:i:i•::v.�:::::viii::.i:ir:::i:i6:•:i::'>i:.i:.: ...............:...::: .... ".i'.:'•: :ii:.iii'i.i:is :::�7��wi::� i':is�i}i:•iiii:<.i:.i:J::.:i.i:::.i:�::::.;:" ;:.;:;.;;< �?:� ::.;• ;:.;:!.;;::Rhone#. �� insurance ca _... .. . ... .. oTicv# c anv name: address:" > h one t1tP insurance co:.: :•: Failure to secure coverage as requited under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to s1,Sooxo and/or one yam)imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Offlce of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is im,and correct Signature a6ii�� Date —7 < Print name � 1C'3Z� UI If Phone oincial we only do not write in this area to be completed by city or town ofiiciai City or town: permittlicennse# Building Department ❑Licensing Board ❑check if immediate response is required . ❑Selecimen's O®ce ❑Health Department contact person: Phone#; - ❑emu (tevaed 9/95 PIA) The Town of Barnstable * BARNSrABLE, ' 6�. Department of Health Safety and Environmental Services rEn r„p+' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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: ��sfit`T/7�I� /'�1�l S/lPi� Estimated Cost y�U CtJ Address of Work: Q& 40-2'201 Z'__ZnA 6L�l0 7 Sr Owner's Name: Date of Application: ,20 - I hereby certify that: Registration is not required for the following reason(s): ' ❑Work excluded by law ❑Job Under$1,000 []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: y Date Contractor Name Registration No. nD Date Owner's Name q:forms:Affidav � B'C'Y. r��`C���i�dPlft'1'G`�'✓Y." 'Li1/ i/SG' �,.- P/' uPi� •. r 67 Board of Building a ulations One Ashburton Place, Rm 1301 ` r' Boston,, Ma 02108-1618 ` License: CONSTRUCTION SUPERVISOR LICENSE' ' Number: CS 073865 Expires:03/14/2002 a Restricted To I JAMES R MCGRATH , 50 WINTERGREEN LANE R BREWSTER. MA 02631 ` t` Tr.no: " 73865 « Keep top for receipt and change of address notification. " G P �tx o/�aQ e x y HOME IMPROVEMENT.CONTRACTORS REGISTRATION Board of Building Regulations and Standards One Ashburton Plac® - Room 1301 Boston, Massachusetts 0210E HOME IMPROVEMENT CONTRACTOR ' Registration 109374 Expiration 091I1%00+ TYPe - PRIVATE CORPORATION PINE HARBOR BUILDING CO JNC. y " .TAMES D_ MCGRATH 259 GUEENANNE RD.' a S HARWICH MA 02645 J Suggested Affidavit for Home Improvement Contractor Permit Application ' For Office Use only NAME OF CITY/TOWN,. Permit No. Date 'AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGLc.142Arequires that the"reconstruction.alteration.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. /��,� -}�,y Type of Work: C_ Ist ' GfiOn � ee- pmi t " Est. Cost Address of Work v / l��Iii%� rz� erl7y/7"` Owner Name'✓ Date of Permit Application: 3- tpG 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 _Other (specify) 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 r7- ,;p G—60 / Date CantractorllNa a Registration No. OR: i'll�-Q�IU� Notwithstanding the above notice, I hereby apply for a permit as the owner.of the above property: Date Owner Namc OWNER: Map Lot _ ,.•�. DATE: .The Com1nonwealth ofMassachusetts Deparmwaft of Industrial Accidents . nr � . — Ofllcaol/o�rs�lAa�loas ' 60(I Washington-Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name, ---- locntion- city nhone 0 I am a homeowner performing all work myself. rl I am a sole proprietor and have no one working in any capacity ri I am an employer providing workers' compensation for my employees working on this job�81� "CID A 0 4 address: ��l Ll r 0 1 d d � i � �c�dc,�� Ch MrV! / #-�t�rL' `�w t ll. 141 30 1 am a sole proprietor.general contractor,or homeowner(circle one) and have hired the contractors listed below who havt the following workers' compensation polices: slLn- addr «' nhoneingurn #: - --- -- eolicv# nddress- city nhone#: insurance-- nolicv# - Failure to secure coverage as required under Section 25A of MGl.152 can lead to the imposition of criminal penalties,.(.fine p ioS1300.00 sod one yeah'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a line ofS100.00 a day against me. l understand that a copy of this statement be forwarded to the Office of lavestigations of the DIA for coverage verification. 1 do hereby crnijy u r p d es of perjury that the information provided above is true and correct Signature /� - Date Print name i Gm9 S c�• C(bra Phone# y3o-awn official use only do not write in this area to be completed by city or town otrcisl city or town - permit/license p nBuilding Department C3Ucensing Board CONSTRUCTION SUPERVISOR FORM . PLEASE PRINT: DATE JOB LOCATION PROPERTY OWNER CONSTRUCTION SUPERVISOR e-S U. c(e)r LICENSE NUMBER �CJ I PHONr. -760-y ADDRESS ef_A f 5k CnS•. �flt'1 LS LICENSED DESIGNEE (IF ANY) 2 . 15 Responsibility of each license holder. 2 . 15 . 1 The license holder'' shall be fully and comniete V responsible for all work for which he is surer islna. He shall be responsible for seeing that all work is done pursuant to the St:.te Buildinc Code and the drawings as approved by ;the Buildinc . 0f_icial . - - - 2 . 15 . 2 The license holder shall_ be responsible to supervise the const.raction, reconstruction, alteration, repair; removal or de-ol i ti on involving the structural elements of buildings and su=:ic zures only pursuant to the State Building Code and all of her aco1ica•D1e Laws of the Commonwealth even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the pe=it holder . 2 . 15 . 3 The license holder shall immediately notify the bui ldi nc 0==;cia1 in writing of the discovery of any violations which are covered by the building permit. 2 . 15 . 4 Any licensee who shall willfully violate Subsections 2 . 15 . 1, 2 . 15 . 2 or 2 . 15 . 3 or any other seczions of theses rules and rec-.slations ar_d any procedures as arne^ded, shall be ssbjecp to revocation or suspension of the license by the Board. 2 . 16 All building permit applications shall contain the name, S_cnature and license number of the construction Supervisor who 1s for suzerviSe those engaged in Construction, reconstruct_on,. alteration, repair, removal or demolition as regulated by Secr_on 109 . 1 . 1 of the Code an these rules and regulations . In the event that such licensee is no longer super-.rising said persons , the work . shall immediately cease until a `successor license holder is sustituted on the records . of the building depart-ment. I have read and understand my res-ponsibilities under the rules and regulations for licensing .construct_on supervisors in accordance wilt Section 109 . 1 . 1 of the State` Building Code . I understand t:_e consursction insnec.tion procedures and e specifi'c insb_ eczior:s as ca±led for by the. bui ldinc official . LICENSED CONSTRUCTION SUPERVISOR A PLOT PLAN FOR LOT '7 Indicate location of garage or acccssory building, Additions with dashed lines------------- Sewerage disposal(cesspool) Well I I (L ot.. /. S.`.......it re ar) i — — -� Abuttor's Abettor's Naase Name/ f Lot/ 2� Rear Yard '� / / Lot M O e� •d. . . .ft- If this is a `�.. if this is G u ccraer lot, caner lot, 'Write in write in J nee of `: rarne c! othcst:ee2. Sic'e�•arc' HOUSE Sideyrd other r-c,:t. Set Back fT- I • (Lot......f.01:�. ft h-=Age) \ / (Name of street) / \ Information / \ Supplied byTi��/v r�LpeQ�� _ Mark No-h Point Department ofHealth Safety ann Environmental 6ervices Building Division IMMS 'xerX ' 367 Main Street,Hyannis MA 02601 suns.& s639• .o Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commis&; HOMEOWNER LICENSE EXEMPTION Please Print DATE: 3 JOB LOCATION: / �x�/>�� , �G7 Z number street village "HOMEOWNER": `>T�[/$�!/v /�/��%L�eK1 1 �tf Sf�O 3Gr �lU D name home phone# work phone# CURRENT MAILING ADDRESS: ��l Q,�ti/LZ) city,/town state rip code The current exemption for"homeowners"was extended to include owner-occuviied 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. DEFINITION 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 responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned`.`homeowner'asses 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 Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. r o Signature of Homeo er� Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger wiil 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 permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors):provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming 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 of his/her responsibilities.many communities require.as part of the permit application.that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this'issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEM PTN I 'C o► � --�3��Joe -70 c K CSO L 1 t)) I I I I • to / t�o'RDI I I I SHEDS 4AvE j G,qecc ENo Lou rl�a-.s a x y" 'GOLL-49- Lf x y T"v P PLA-rE CNU-r S►t-pw N, i � � I 6LOLKI�Cr I s77S i I I I I I \... GG 32' \ 2Q C13 ,cy./l�• V41LLIAM d; C. R.,• to flYE No. 19334 4 p. ti J S 7 ,C 'Y�'E'.eTicy 7T�AT `,LaC.4T/O,C/ snow C /�y�ieEO.1/�p/s'Jid.G YS SCAL. � A ETBAC E'QUi,�F�yE�"s OF T•Si6' T w//aF f- • , Wiry/�t/ TyE .c.LoaaoG4��f! /.,v N .4i!/ � .eE 6/SrE,2E0 ,L,�c�p SU.eYE�r� if�p 7"p it/OT B� /C�ic/; /D I p — 1 I 16 jOLIC_ Cc�1[_RLiE �'>LOLI` . a RA I<cs FAA-I 177_0 +- 3nrJ S� D�NCs ohEry ,U U- w 1 ►., r>ovi-5 �v�Ti�tv�1 C ASPHAt.i SIIIr.IGLES j6 ' /Engineering Dept. (3rd floor) Map Parcel OS 9 Permit# l 9 6 7 7 House# �.(© ISr Date Issu d / g /)hoard of Health(3rd floor)(8:15 -9:3011:00- 4.30) �Fee 0-6c. q�V*`a3 .q ,Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) IJc d y IF( � �". 7� �`4'a("'0 Ctt� THE►q;_ q a� RNSTABLE_• �Q ni'A$5.� 11 TOWN OF BARNSTABLE � Building Permit Application :, ;, 7e �ddress /6 I okFC DC! Village COT y..t I Owner 5_( eykZ 0 t- C/M4)/ CDD U Address Telephone St'S c/`Z o 3 C 3 Permit Request E l=-XiST 1 by yc26w I" �o�'N - 12C►hnyL Alli10 C.7- u-ems FYZti L'i 1- Pr-'2C l First Floor 6 (. _ square feet Second Floor So Sk fl' square feet Construction Type (f0KJ e AT t 6/v.4/L- POz-ct4 C:v\cusv-(L - !U tkD Q_CO Estimated Project Cost $ /6 ,a1r)n, � Zoning District Flood Plain Water Protection Lot Size 'Zo 0-1710 S1- f�• Grandfathered ❑Yes ❑No Dwelling Type: Single Family (j Two Family ❑ Multi-Family(#units) Age of Existing Structure , Historic House ❑Yes (�J Flo On Old King's Highway ❑Yes 4No Basement Type: 18 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) . Number of Baths: Full: Existing 2 New Half: Existing New No.of Bedrooms: Existing 3 New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas )d Oil ❑Electric ❑Other Central Air ❑Yes 1t4 No Fireplaces:Existing ' New Existing wood/coal stove ❑Yes No Garage: ❑Detached(size) 2 Other Detached Structures: ❑Pool(size) 14 o ❑Attached(size) ❑Barn(size) W C> ❑None ❑Shed(size) K c::) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 1n No If yes, site plan review# Current Use Proposed Use Builder Information Name C NV57O Q(f-OL 5A4U g S Telephone Number .-o ' ' C - l B S Address �(, ��k �S C)P 11 i S fL D , License# O J 3 7 6 y D�L re lQ_ V-\ O Z6 3 1 Home Improvement Contractor# )2 Z 0 3 Z- Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L0CA-A- SIGNATURE / `z DATE f� — y - 74 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) r. FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCE.. 0 r `t NN ON ADDRESS VILLAGE g OWNER a DATE OF INSPECTI ,N: FOUNDATION ` FRAME �` • INSULATION FIREPLACE ELECTRICAL: UGH FINAL PLUMBING: ROUGH FINAL. r •4 GAS:'.' ROUGH / FINAL FINAL BUILDING DATE CLOSED OUT P ASSOCIATION PLAN NO. ' ,.- _ a; ..,....•.«..w. ,....i..;, .u,xa .>�s....«. .2 �i�.�.:t.:.. ....,�-tomx va Oil : .::.:.; :.:..:....`':"...:'.•..'':r DATE MID K..D/YY) ;.; CE 1211A410 :: ........................,...... .-. ..... .- ....... -......... -.. ...THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM. PRODUCER a N E.S 0 8-3 9 4-0 9 4 6 COMPANY BIDER! NORCROSS & LEIGHTON INC MARYLAND HOMEBUILDERS ON HTTP: //WWW.NLINS.COM DATE c TIME DATE P°�n 1 TIME 437 STATION AVE X AM X 12AI AM S YARMOUTH MA 02664 09 04 9612 : 01 PM 11 04 96 NooN THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY CODE: 0 2 0 9 5 8 3 4 N&L 2 SUB CODE: X PER EXPIRING POLICY t: ON ORDER CAGENCY USTOMER ID: CBARH 5 O—1 DESCRIPTION OF OPERATIONSNEHICLESIPROPERTY(InChWMg Loeatlon) INSURED HOME IMPROVEMENT CONTRACTOR i CHRIS BARNES DBA BARNES HOME CONSTRUCTION 76 AUNT SOPHIES ROAD REWSTER MA 02631 TYPE OF INSURANCE COVERAGEMORMS AMOUNT DEDUCTIBLE COINS% PROPERTY CAUSES OF LOSS BASIC BROAD D SPEC N r GENERAL LIABILITY GENERAL AGGREGATE $ 600, 000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 600, 000 CLAIMS MADE X]OCCUR PERSONAL&ADV INJURY $ 300, 000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 300, 000 FIRE DAMAGE(Any one fire) $ RETRO DATE FOR CLAIMS MADE: MED EXP(Any one person) $ 10, 000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS MEDICAL PAYMENTS $ NON-OWNED AUTOS PERSONAL INJURY PROT $ UNINSURED MOTORIST $ AUTO PHYSICAL DAMAGE DEDUCTIBLE ALL VEHICLES SCHEDULED VEHICLES ACTUAL CASH VALUE COLLISION: STATED AMOUNT $ OTHER THAN COL OTHER GARAGE LIABILITY ti PA:UTOONLY-EA ACCIDENT $ANY AUTO R THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE: SELF-INSURED RETENTION $ STATUTORY LIMITS WORKER'S COMPENSATION EACH ACCIDENT $ AND EMPLOYER'S LIABILITY DISEASE-POLICY LIMIT $ DISEASE-EACH EMPLOYEE $ SPECIAL CONDITIONS/ ER COVERAGES NAM ...: .: ....................... :2 ......... �:: :s ... .... . r........ '. ..... : : :; : :Y: : ADDITIONAL INSUREDMOGGEE ...:.�.;.�i....i.:.:.:.:H" 4 LOSS PAYEE LOAN s �. AUTHOR RESENTATIVE Ma: be........::.:::::::.:1.::son:.:.::. MC:(C) :<:: ::�:: <>: .. : �:�: • :ERSE:<:51tH:•::>:«:»:»>:'�:>:':�14GORD>CI�RP#'�RA'F101KE'.>A99 <:»;»::>;»:<::<:»::NQ']'E:» #3Ft�'A�slg.:x's'TA .:INFF�N�I'�iO�:fli>E.:F>EEt�............................................................... :................................................................... ✓�ie i0anvnzareusea� a� ac/zu6eG�i D UPlul uF Alk-ETY , n CONSTRUCTION SUPERVISOR LICENSE Nu®bery = Expires: Restricted To 1G .;:rCHRISTOPHER D BARNES �` 16 AUNT SOPHIES RD BREWSTER, MA 02631 HOME. IMPROVEMENT CONTRACTOR Registration 122032 Type — INDIVIDUAL . Expiration 07/12/98 CHRISTOPHER BARNES G�io�na o�i f!�EtX AUNT SOPHIES RD ADMINISTRATOR BREWSTER MA 02631, I , �FIME la,_ � arnstable' The Town of B ' KAM Department of Health Safety and Environmental Services 19. p Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-790-6227 Building Commissioner Fax: 508-790-6230 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 t not more than four owner occupied building containing r to such residence or building d ng be done by registered icontractling o owith structures which are adjacent to certain exceptions,along with other requirements. 6�N tZ1)r-LtSe2-� cro Type of Work• i 00 e.n l i 6 O AL $ A uv M-C r4 Est.Cost Address of Work: Owner's Name S l Date of Permit Application: " 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 VE CONTRACTORS FOR APPLICABLE OR GUPRO ARANTY FUND UNDER MGL c 14VEMENT WORK DO NOT 2A ACCESS TO THE ARBITRATION GRAM SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. _ "i o P��� CNei s >3 Date Contractor Name Registration No. OR r The Commonwealth of.4fassachusetts Department of industrial Accidents r t y Office oflliFestigallons 600 N'a.vhine►tun Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Apallcant Information Please PRINT lebibl�a,� , name CH-(L{ c city phone# I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity .._.F:..s-..aw`R;-^.^" .•�....rw...,..ytru��ss �_ ,r.s3�►":+�+� ....�'; ''�. - .. _'.-:�.-..�. - -r�:.�r'-...+..�►.��......� I am an employer providing workers' compensation for my employees working on this job. _s. comliany name: y� it Q-� TL VL,1�- 6 hop J� insurance co policy# 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 Cf-{Q(� ►(J�1T�� U QQ�U S address AL.)L`l 30� f+(If 3 -R 40 ULL--)SML AAA b•Z� '� 1 nhone#. �h p insurinceco 're.�t':f- <.a.?tR.-_.._...�•• --Tl:t. -T 4"ryc��....?�-S'.F..f� .:.ar.►fr.T �� �.i.:� �� .LY�3�+5 company name V�"/t`t LAt-IIJO tfi2"`-C G U 1 t r 1p UL S address 3 S T-ls41- 1 1tJ � city �t2 i�-c�v - �•1 Phone#• s ins wr•tnce co .-� .,..,...,._..—,.._.........._.. ...._...�...,.- J-- ..-,�,.. Attach addittio_nal sheet if necessarX.�:,,�.,Y r'`f y�`�®` = : { Failure to secure coverage as required under Section 25A of AtGL 152 can lead to the imposition of criminal penalties of a fine up to St,SOU.UU and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement,may be forwarded to the Office of investigations of the DIA for coverage verification. 1 do hereht•certif a Jcr the pr ins and penalties of perjun•that the information provided above is true and correct 7/ Si_naturc � Date �o _ 30 cl ra Print name c H e _5 B AOV C�s Phone# ��(5 'official use only do not write in this area to be completed by city or town official city or town: permittlicense# riBuilding Department OLicensing Board O check if immediate response is required OSelcctmen's Office ►` =. E]llcallh Department contact person: phone#; MOthcr (mised;(gc P1A) 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 emplirnee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An einphover 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 dwcllin�,, house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on tiie grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that even, state or local licensing agency shall -,vithhuld the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonvealth for any evidence of compliance applicant licant who has not produced acceptableIliance with the insurance coverage required. 1 p. . contract for the subdivisions shall enter ►nt.o an co G � neither the commonwealth nor any of its political subdiv►s►o y Additionally. nc . . of this chapter ha;,e ' acceptable evidence of compliance with the insurance requirements P erformance of ublic work until P - P P been presented to the contracting authority. 7777► ��.. ..++.w .".'�:'-'t'� `;y .J i i - -etc ..l�Mfw .... .1 i,r.. = ar _. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying com any names. address and phone numbers as all affidavits may be submitted to the Department of . P R o be sure to sign and date the affidavit. The ce covers e. Also' n of insurance b Industrial Accidents for confirma tion 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 compensation olicv, lease call the Department at the number listed below. obtain a workers' come p P to ob p r Cit.- or Towns ` Please be sure that the affidavit is complete and printed legibly. The Department lips 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. The 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, lease do not hesitate to P 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 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 i Assessor's map and lot n � . (.:......o3..Q..... ! 3 i�¢ -SEPTIC SYSTEM THE ro py Sewage Permit number ........... �?�.7 ..�................... . INSTALLED IN i BAUSTADLE, i ... ..1.....:�...��9 � � WITH TITL$ M�a Hodse number --, ENVIRONMENTAL C�®� q���9�'°rt�oMava�� � i639' 9 T®IIMILE"'� TOWN OF . BARNS � BUILDING- INSPECTOR APPLICATION FOR PERMIT TO ......................CcJ 4......5....!t �'C CU \y .W.{.... { f 5 TYPE OF CONSTRUCTION ....... o o C(........Ft. Me ........................................................................................................ t ....................... 1 ...........19..5' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....!'-6%./...... .X .. ...................... ................................... Proposed Use ...Sim .... aY.V..Lt .y... . n ...................................................... ......................... Zoning District ......... . .i.. :....................................................Fire District ........� c ►.1..................................................... s.6t.� .lVEhVic, ����` . .D� Name of Owner �� Name of Builder .... ............ 1 (( �� � /IC�.F�.t:�......VI.JC.(..I!'�-.. 1.U!'�..Address ..........................��.!!.✓.��C..................................... 3 Name of Architect ..........................................°' ...............Address Number of Rooms .................... . -C. ..........Foundation 14�.......... ...U.1!i C C::4:.A..:C............................... r r Exterior ........ ' .rt . ...V�.(�':0.: ..........Roofing n ..... Floors .Interior .....� `..`4,�.�. r ...... ..U -: VO `r4 LAJ Heating �7.........................................................................Plumbing ....... p. .�:...Y.C............�.& Fireplace .................-..............:........ .... ..... ...... pp 1.......0 Ljc�clC V �.$A roximate Cost ........ . �5� .o.a �r.. ..Q.. . Definitive Plan Approved by Planning Board _ � _ ______1913— ,,,jc Area .........`..4-C.?`jr.......;:.!r' Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH oltl D s 9�O /A 1� 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. 1 Name ... r / p.. .. . . G.. ......... Construction Supervisor's License .001.. ky. '146 WELLINGTON, CHARLES 0. & NANCY "No `29677� Permit for .Two„Story•.••••,.,,••_, a• in le Famil Dwellin Location .......161,.Dx.fo1;d..Ar;Lve.... CO.tuit �• _ r-, Charles 0 & Nancy We *'Owner •...............y....... .h�ngt.ox� , ......................... ... Type of Construction .....F.r.aWQ.................:........ .............................................................................. - AF-. Plot ............................ Lot :..:............................ ` 1 Permit Granted ..:......July...-2.1........... .......19 86 -- Date.of Inspection`/744--- ... ...... .19 Date C zu, -��..! ........ :19 N, r' 1 Assessor's .map and lot number, ......0.�.A.... r '•- .:... .....Sewage Permit number ............ ........P..................... t Z BAR33TAME. S Hooke number ...... .......M...jo.....—...................., MAM'� 90o 1639. ti I la? a�9 ' TOWN OF BARNSTABLE �t BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...� :: .'..'..c c'` '. ?.� ,� � ..1 ,,, � 0 ,,.. .........` ..................r: ...... . TYPE OF CONSTRUCTION ...... :'� r`'k '� .......................�..'......... ....19. i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: k l '`� r C �t U J r l Location ... ...��............ ...k.f�. ...........r........... .................,........................................................................:..................... i�fG ' C an i1 Proposed Use ...,� ......... .... ..............4....�3..c.�....!....... ��.,. . .!. ,......................................................,......................... Zoning District .........). .r.. :....................................................Fire District .......l,,.......J 1 I .........4.................. rt/C�M Name of Owner 1...,.::�!(�T (.,.5.�.:. .. ". ��! ....!.��.. .:... Address �,G. � X......(G.�.� ................................. �' �.. ' � ..:. .... ............................. ... Name of Builder Lice C t_ S W Address ..........................a��.t!!�?. ...........:......................... Nameof Architect ..........................................:: �: .............Address ............:....................................................................... .... f c�. ;. ,. Number of Rooms ......)).......... ....... ........ '.EE........... ::............Foundation .�G..........�,..U .r..(..t... .. ................................ Exterior Vl yi j l�C l.......� 'a ...............................r g Cf ..... Roofin ..............,...... ....... 1.....1........................................... Floors ............................. .........................................Interior I � 0C r ... .. .. ..... Heating Plumbing ................ ?.. t y ' Fireplace ........�.. ' zd.....J'�..`... :..! .....�...r�........�.. . 5 Approximate. Cost . . . ?�.. �{.Q.0.:.0..n..................... ..... . . ....... . .. Definitive Plan Approved`-by Planning Board ________,�_�Q--- 7_____197 _ . r jArea Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH r 1 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. (11, Namel., e, ............. ................... ,7 ; Construction Supervisor's License 0o �.�,Al........... .WEIELINGTOR, CHARLES 0. & NANCY A=021-038 No . 9677:° Permit for Two Stor .r Single Fam.i.ly Dwelling ...... . . Location ., 16. ... 1 Oxford. . ..Drive. . ....... . ...... . .... .. . ...... Cotuit ........................................ t Owner ,.,.,Charles 0. & NancyWellington .........................I................$.... Type of Construction .....Frame ............................................................................... Plot ............................ Lot ................................ Permit Granted July , ...............21.....................19 86 Date of Inspection ....................................19 Date Completed .......................................19 16o /�� ;;, .:. _ w�� ., � _� rti-r.. �„ � xq„ w• :fi { sY�y"r#" .rl'�rw.a• s. . .'ar`=:�sam^;.. ...,......,a,g .,,.,y,...�,. �'+''` '4�. �.T � _,_ ,� .s..;p�:,...:#7iR`1tk..�'1c'S ;.a "....[�'=?'r .ry;r.."•_ .. ..� ... Z., A ,.TMET, TOWN OF BARNSTABLE Permit No. ...296.77.... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash rYa HYANNIS,MASS.02601 Bond ..........a/. CERTIFICATE OF USE AND OCCUPANCY Issued to Charles 0. & Nancy Wellington Address Lot #21, 161 Oxford Drive 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. `Gy ......Aprz1..11......... 19..8............. .... a..../........................ Building Inspector TOWN OF BARNSTABLE BUILDING DEPARTMENT _ RAITIT ' TOWN OFFICE BUILDING rug HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: //—//20s> An Occupancy Permit has been issued for the building authorized by BuildingPermit #.... ..........................................._................................»»... issuedto ,, / 2 ..1..��...Y . ..........................»....» .........................»»..» Please release the performance bond. { :"� a .:9.vv°"+.. SHia n �.•.�'�/•" .�'.+i. ti .,.....,..., .ro. I,,, v �.I :T it �..;�gC7k� SYi-'r7`N r �•� :�yi s V. I i PINK='DEPT. FILE COPY,/WHITE-EIELD`COPY/YELLOW APPLICANT COPY TOWN OF:BARNSTABLE,.MASSACHUSETTS PERMIT ',VALIDATION., A=021-038 D.ATE.,_.' .filly ,,21 19 86 PERMIT`NO: •N aP 2967 APPLICANT Charles Welli. ngton ADDRESS Box. 1021 Cotuit, ' Mel. 001394 INO.) (STREET) (CONTR,'.S LICENSE) TO :Build _2 NUM BER OFPERMIT STORY- n eamilywelin� ,DWECLING U NITS1. (TYPE OF'IMPROVEMENT). NO. (PROPOSED USE) 4(` lot #21 161 Oxford :Drive, Cotuit ZONING AT (LOCATION) DISTRICT ' (NO.) - `-:(STREET), BETWEEN' AND a' - ACROS.S�%STR�EET) (CROSS STREET) SUBDIVISION LOT LOT_ BLOCK SIZE i BUILDING IS-TO FT. WIDE BY. FT. LONG BY FT. IN HEIGHT AND,SHALL CONFORM IN CONSTRUCTION •' TO TYPE USE GROUP BASEMENT.WALLS OR FOUNDATION '.::. ... ..�:.. (TYPE) REMARKS Sewage #86-701 il BOND AREA OR Ft PERMIT VOLUME'71 �28 Rf= ESTIMATED COST 75,000 FEE' 83.00" (CUBIC/SQUARE FEET). OWNER Charles '0 & Nan y Wellington �`T ADDRESS BOX 1,027 , O l A A'. a BUILDING DEPT. , i t 1?x, •i. ?�y,.,..,'i(, t./.h.J..s--,' 1 1 L1 tl S 4 �� y / i . y -y., .e " ..'{. F'>• ... .. '.. ,.' ..a .... :: l 1. FOUNDATIONS OR FOOTINGS. - 2. PRIOR TO COVERING STRtiC-ul< L�QUIREO,SUCH 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 INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS { a Y a 2 2 Z L 3 HEATING lNSPECTiNG APPROVALS REFRIGERATION INSPECTION APPROVALS I� 11 .! I HER 2 2 I ) VJGRK SnA.L_ NCT PROCEED UN?!L THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD - NSPECTCR AS APPROVED -HE VARI1-US I WORK IS NOT STARTED WITHIN.SIX.MON THS•OF DATE THE CAN BE ARRANGED FOR BY TELEPHONE STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION. r• --- -7771- 3220 1 y ' ` 4. o WILL cG�\ C; a to FdYE p No. 19334 SV su y CE,2T/.GIEO �,L,OT f�l_.4A/ 9 4� 1. tb� ,L0CQT/O/L/ X' CE.27-/,�Y T.U,4T �Cai ZJ/T S.�/OWit/;yE,eEO.C/'CO�lOL YS 11//Ty SCE,L G- ' I = O_ -_3 �EQU/.2E�1ENYs O.�' T.Y�'{7ow�v.:: '",C.A�t/ �2E�-EA2EiC/CC- : W17-,,VloV 7-yE AAA ,BAXT.E,es k/YE 1,,/C. AV .2EG/STE.2F� !-�,C/O SU.eY6y2�,c . 11V- T.eU�I��t/l",S'U.21/E'Y ism p 7a OE TAP l///E 44�T �S/��/n�Gi ATTORNEY AT LAW 10 MAIN STREET, P.O. BOX 1420 (Corner of Route 28 and Main Street) COTU IT, MA 02635 ' OFFICE (617) 428-3656 July 15 , 1986 Mr . Joseph DaLuz Building Inspector Town of Barnstable South Street Hyannis , MA 02601 RE : Lot 21 , Oxford Drive, Cotuit , MA Subdivision Plan of "KING ' S GRANT" , recorded Barnstable County Registry of Deeds in Plan Book 271 , Page 56 Dear Sir : ' Please be advised that this office represents Mr . Charles 0. Wellington, owner of the above captioned premises . This is • to inform you that this property has been held -in individual and non-contiguous ownership since at least August 22 , 1978 . Accordingly , it is .the opinion of this office that the. premises qualify as buildable under the Town of Barnstable Zoning By-Laws as currently in force and effect . Please contact me if you have any questions or comments regarding this matter . Very truly yours , WARREN W. SCOTT WWS/fmd i 4 t ------ --- 10 17 1 f SCALE:Yy f , APPROVED BY: DRAWN BY i Q DATE: REVISED N Z fA • N a „1 DRAWING NUMBER f 'QAo� f f s I 82. t � f t �F I f 9 � V , i 015TIrj w%N.Qv%.? I � I I SCALE: APPROVED BY: DRAWN SY ce a DATE: REVISED u z a N Vl Q a k' DRAWING NUMBER It k.rr llllin?.-F Clicp; t.••�.r• .-•-�.�,,.vim.�.v`. -, ;.:.., -_—, }��¢r�