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HomeMy WebLinkAbout0029 PATIENCE LANE aq ��rE �£ av � . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �✓.� Parcel. Application # ('1 ��CR Health Division Date Issued L Conservation Division �,1lCi Application Fee Planning Dept. Permit Fee Date Definitive Plan.Approved by Planning Board Historic OKH _ Preservation/HyannisIr Project Street Address C- A Village C®TO I T Owner A M W A T-r Address Telephone 50 -1 1-t, q q l Permit Request C d AJ J TA y-C 1 If a ' X r Y �. rj Cc- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay (Project_ Valuation _SI✓00, Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family :.❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new `4) Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other -�. Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ :­J CD Q Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other'j j S Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ s , Commercial ❑Yes ❑ No If yes, site plan review # a Current Use Proposed Use = ' APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name j A(n e S M O()2 b Telephone Number �� S 2 0 3 0 Address r S 'GO6(-C TJto� Q 2 - License# 9 5 I 1 PA C m p u 7-H Home Improvement Contractor# I a. D J I Worker's Compensation # C '4 6 1 , f ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE l /0 FOR OFFICIAL USE ONLY APPLICATION# { f DATE-ISSUED :"ice `? MAR/PARCEL NO.. ADDRESS. VILLAGE 4 OWNER f DATE OF INSPECTION: f FOUNDATION r FRAME INSULATION.`: FIREPLACE f ELECTRICAL: ROUGH FINAL t i PLUMBING: ROUGH FINAL ` -:GAS: ;a,,,r ROUGH S` FINAL { :.f "FJNAL BUILDINGit_3 � i DATE CLOSED OUT i � ASSOCIATION PLAN NO. � 1 I } The Commonwealth of Massachusetts' I Department of Industrial Accidents s t xi i Office of Investigations t„ f 600.Washington Street \,!IS!% r Boston, MA 02111 c z� www.mass.gov/dia r Workers' Compensation Insurance Affidavit: Builders/Contractors/Elect ricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Indi 'c viduai): Ar C 5 ®�2 C U 8 A M'00 2G c r12 P CAj�Y Address: f G©671-C(_1 14 0.2 ' '? City/State/Zip: � FN SOW Tf-f r)�- Phone #: s AFI an employer?Check the appropriate box: Type of pr 'ect(required): 1. m a employer with 4. ❑ I am a general contractor and I 6. ew construction employees(full and/or part-time).*., have hired the sub-contractors .2.❑ I am a sole proprietor or partner-; listed on the attached sheet. # T. ❑ Remodeling ship and have no employees _ These sub-contractors have 8..❑ Demolition working for mein any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its. required.] �`A officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work - right of exemption per MGL I I.❑ Plumbing repairs or additions myself. [No workers' comp.' c. 152 §1(4),and,we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13,0 Other I J GC 1 comp. insurance required.] "Any applicant that checks box#I must also�fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance jor my employees. Below is the policy and job site information. Insurance Company Name: .. CA Policy#or Self-ins. Lic. #: C Lj . -7 �. Expiration Date: v/6 Job Site Address: 9,q 'D" AT 1 E-V&= ' ( V City/State/Zip: GO1 r 'q Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required "under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.. Be-advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ceraff n ler theyActVand penalties of perjury that the information provided above is true and correct. Signature: 'Date: — Phone#: )�U *> 0 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual, partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that."every state or local licensing agency shall withhold the issuance or .renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers"compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should'you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate he. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in-the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related'to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSA_ FE Revised 5-26-OS Fax# 617-727-7749 www.mass.gov/dia a Date: 1/5/2011 Time: 3: 00 PM To: Braley Wellington Page: 02 ACORD CERTIFICATE.OF LIABILITY INSURANCE oYolioID PRODUCER 508.865.4433 FAX 508.865.4000 THIS CERTIFICATE IS ISSUED AS A MATTER OFINFORMATION C.D. Whitney Ins. Agcy. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 112 Elm Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 271 Millbury_ MA MA 01527 INSURERS AFFORDING COVERAGE NAIC# INSURED James. Moore INSURER A: NGM Insurance Co. - 14788 DBA: Jim Moore Carpentry INSURERB: Ace Complete Insurance 15 Goel etta Drive INSURER C: Falmouth, MA 02540 INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INS TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MMIDD LIMITS GENERAL LIABILITY MPI4S817 05/23/2010 05/23/2011 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO REN ED $. 500,000 CLAIMS MADE OCCUR MED EXP(Any one person) $ "10,000 A _ PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO CT LOC J RO- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ - - ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS - - (Per person) HIREDAUTOS - BODILY INJURY $ NON-OWNED AUTOS, - - (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY _ - - AUTO ONLY-EA ACCIDENT - $ ,ljNY AUTOT .' EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ s OCCUR a CLAIMS MADE AGGREGATE $ 1 $ 47RETENTION'_ EDUCTIBLE L. w $ $ WORKERS OMPENSATIONAND '"t _ - - C46267254 03/08/2010 : 03/08/2011 X I WCSTATU- OTH-. - EMPLOYERS"1LIABILITY* "�- .. I T IMITS B ANY PROP RIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ - 100,000 OFFICER/MEMBER EXCLUDED? If yes,descNbe under e• - E.L.DISEASE-EA EMPLOYEE $ 100,000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT .$ 500,000 OTHER - DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL ._ - - - 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Town of Barnstable OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Barnstable, MA - AUTHORIZED REPRESENTATIVE Gina Bri ham/GINA ACORD 25(2001/08) FAX: 508.790.6230 ©ACORD CORPORATION 1988 THE ri Town. of Barnstable Regulatory Services BARNSfABLE « Thomas F.-Geiler,Director 6.1 Building.Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Ofce: S08-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 'A IT as Owner'of the subject property hereby authorize JA S, /i o U2 to act on my behalf, in all matters relative to work authorized by this building permit application for. "p, (Address of Job) Signature of Owner Date uJA--TT fj Pant Name a If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. O:F0RM5:0 WNERPER MiRS10N •cHt: Town of Barnstable af r� Regulatory Services y � nwtuvsrwst.e, Thomas F. Geiler, Director runs. . Building Division Prfp}Ml A Tom Perry, Building Commissioner 200 Maiu.Streett_Hyannis,MA..02601 Rrwv.town.b arnstable.ma.us 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 MAILING ADDRESS: city/tovro state zip code ed to include owner-occupied dwellings of six units or less and The current exemption for"homeowners"was extend to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as_ SuperyiSOL. p DEF77 MON OF HOMEOWNER' Persons) 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 constrycts 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.be/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 perrnit is required shall be exempt from the provisions of this scctign,(section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that s�ufch 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 pmcccd against the unlieenscd person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully swans of his/her responsbilitics,many communities require,as part of the permit application, that the homeowner certify that he/she understands the msponsibilides of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/ccrtification for use in your Community. Q:fonru:homccxcmpt Ph 7 Y .. , n v . I t.. • a , F y -- - ems. f r i : _ v r t e Y , j ypA� � ' a .j i I LfTO GJ pus�- �, D 3 0 LA t , L p 7 63 1 � �,• 24, ` 11i 75 Z _V ` -�--"47" Q �1 a � 0 r \ \ .L 0 7- 6< . SD S F U U Lv7 N b bJ"J 43 Y c CERTIFIED PLOT PLAN GUT 64 .PA7 IVC.e A/�/E j -CO TO / T 4 E LDF,��c;� �r IN ido. 8CALE� DATES 4lZ�BS-" mckw/J ove/��I Teo it l EE W CLIENT I CERTIF'y THAT THE , -- SHOWN OW, THIS PLAN is LOOAT90 GIST REGISTERED 9-S 0 63 ON THE GKOUND AS INDICATED MO.. CIVIL LAND Joe MO. .___._.._.. ENGINEER SURVEYOR �i. CONFORMS �O THE ZONING LAWS a OF _AARNSTASLE, MASS. .7 12' M A I N STREET i�ATE HYANR 1S, MASS-. SHEET OF!_ REG. LAND SURVEYOR i ✓tze (�o�.irr�oriuieczl a� aaaar�ivaet7a License or registration valid for individul use only Office of Consumer Affairs&Business Regulat ou. before the expiration date. If found return to: �. HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs.and Business Regulation ` Registration�t 1420592 10 Park Plaza-Suite 5170 Expiration- �2/5L2012 Tr# 291 33 Boston,MA 02116 i Type Citlivitlga `F I (. MOORE CARPENTRY JAMES MOORE t 15 GOELETTA DR,,. �-WEMF EAST FALMOUTH 'MA 0253.6 Undersecreta.� 1 _ Not valid.without signa re ` tar-t III cnt of Public Sufct� i assuchutictts Board of Builditi!�Rc!:ulati0ns and Standards v1 or License Construction Supervis Family One-and Two.. Dwellings License: CS 45959 . JAMES S MOORE 15 GOELETTA MA 02536 - E FALMOUTH, Expiration, 1.1/24/2012 ��- �♦ Tr#: 6209 ('um�»issi,rner i TOWN OF BARNSTABLE Permit No. ______27805 { ; Building Inspector ITAU cash ------------ • OCCUPANCY PERMIT Bond ________X Issued to 'Cynthia McKeon Address d lot #l64 29 Patience Way. Cot-ixi r Wiring Inspector � �— Inspection date �i' Plumbing nmectorr� Inspection date _ ` "N `1 Gas Inspector Inspection date /�v ✓Engineering Department 7" i%' ! Inspection date Board of Health ,....�, ��'r- Inspection date ] U � r 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 BUILDINGG_CODE. ................ . .. N... Bu lding Inspector q r r` �'fy •�'. TOWN OF BARNSTABLE BUILDING DEPARTMENT 2 BARNSTAU : TOWN OFFICE BUILDING t639. �� HYANNIS, MASS. 02601 \ i MEMO TO: Town Clerk FROM: Building Department ��... DATE: a An Occupancy Permit has been issued for, the building authorized by Building Permit #... . .» .��.»» ....._ ....... ............... »_ ............_................»......_.................. „.. f issuedto ............................ �' ) C.. » ................................ .................»..»».»»»...................... .»»».... Please release the performance bond. 5,}S. 10"N' S r { 1 �v 7 63 62." 40 " 20 ' �- ! .v Lu gN �. ...--47t77IN o 4.7 077 1 - i y, zU, /.So S,F .50 y o S G Z 44 z.v �ONE'�Is' ram. . 2.7 CERTIFIED PLOT PLAN T CO TO 7- ELDRE f No. SCALES /F;?-4�- DATES 4/Z��.S' jt a NQ M7 kwN , I CERT1 THAT. THE . T.. .r ,r, a L►1ENT,...:'.,..._.., SHOWN 'ON� THIS PLAN IS 1.0401� Fe? btu RE RE01ST4RED E 8- �v ON THE GROUND AS INDICATED AM�1 r a y JO NYC 71 0 0 w......�_...w 4 LAND CONFORMS 0 THE ZONING LAWS ENGINEER SURVEYOR OR,.®Y� OF DARNS SLE MA88. T 12'MAIN 1 N 9 T R E.E.T 4 y 5 z r.1 H YA N R i S MASS SHEET.�.OF, ATE LAMO SURVLYOA ' f, Assessor's map and lot number ........... ......+r ...... �TNF PTIC s Y STEM Yt _� T°``♦ Sewage Permit. number ................... ..� ...�� liV pq� y�dda�.�..ED CO p �� o� y,•;,= 9 BAHHSTABLE, i I TITLE 5 House number ......... ...... ..9...................... EN �� � 9° Mw OF• �BA�RNSTABLE TOWNE TAU' DE .. - s=� BUILDING t 1-HS•PECTOR �r APPLICATION FOR PERMIT TO. ..... .. ......... .............................................................................................. -,TYPE. OF CONSTRUCTION .....: ... ............................................................. ......... ~ ......... ..........191S. TO,THE INSPECTOR OF BUILDINGS: The, undersigned herebypapplies"for a permit ��ac��cording to the following information: Location .........F-r'••1• .....6 ........:. . ,�541�r ......WA�.......... i. ......... ProposedUse .... ......�. tV:�l.�. .... ................... .............. ....................... ......... Zoning .District .....A�Zv6th J .... e: ............:Fire District ...... .� .�S ... :..........:.:... ....:...... L Name of Owner . �? � Z..r �. 711 . 1���............... .........� �t............... . .......\...............Address ........ .......... ,. Name of BuilderG!' ..41.�t.5. � 7�?p. �' �..Address ..............< ..........:...................... . f ....... . d , Name of Architect ... 0A7%1jr�.C�..� I��..........Address ... :.,.�o?�... :Q:1��[ :P�r .l..Y."�.t.. ii Number of Rooms ........... ......................:............................Foundation .. ; . t�.... ... .... � � ............: Exier for ... ` ................................................Roofng . :: SP.H ....... Floors. ...Interior . . -... ............:. Heating ......F. I.C1: .............................................. Plumbing : ......................................................... Fireplace ., ...?�..�.we... ......I..hwnt—rl- 4 ...............Approximate.•Cost ... ©�.Sg �c� Pp Y g - --- 191,, �/ Area ........... ... ...../ SAO' Definitive Plan Approved b Planning Board =_z / ______ �E .. . .. . Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH . Y. OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ......... . ©® �� Consiruetion Supervisor's License ..................................... to f YtKEON, CYNTHIA N,- ..,. 05. ,. ....................................One Story Permit for _ Single Family Dwelling ..........y .... ............. . fi ..... -....... 6 4 Patience Way Location .......Lot........... JCotuit r•-t— its -•1' ,i j ;--,. 1.i- ✓ ............ .......................................... . ........ - �.. 1 'w.. .�.• - Cynthia McKeon Owner ........ } t yt• - Type of Construction ........Framer .....y.......... 71 9 ,`.......... 4 _.. ...... ...... ................. Lr ..�"'�w y \• .. c . ,Plot ....................... Lot ..... ::... ....... �. April 25 -,t 85 Permit Granted ......................................... 119 if! t Date o"f'lnspectioneP, .. -19 71 Date,.'Completed ...... . :`:19- s t IT �a/ � . . h_ � � ti • ' TOWN.OFBARNSTABLE BUILDING PERMIT APPLICATION Map 3 Parcel eZ Permit# •� Health Division - Date Issued �� 1 Conservation Division Feev�s Tax Collector Off 9 Treasurer I I t f Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis y` • i Project Street Address Village /, n Owner Address Telephone — r d Permit Request IIA& Square feet: 1st floor:existi _ proposed 2nd floor:existing proposed Total new Estimated Project Cos �m Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)' Age of Existing Structure Historic House: ❑Yes ❑No On.0ld King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor.Room_Count Heat Type and Fuel: ❑Gas ❑Oil' ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing. ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use k BUILDER INFORMATION , Nam Telephone Number Address License# (a) Home Improvement Contractor# Worker's Compensation# , ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE 'e FOR OFFICIAL USE ONLY ,� - � •- � - - ,ice • -'. ` ;• T - t '._ PERMIT NO. _ DATE ISSUED •MAP/PARCEL NO. JL ADDRESS 'VILLAGE OWNER 4. i DATE OF INSPECTION: A. i FOUNDATION FRAME _ t INSULATION { ' FIREPLACE t r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL . a FINALBUILDINGIa �'a1i - ke i t d DATE CLOSED OUTS lotto* ' ASSOCIATION PLAN NO. '' • ' - f T 4 r al Accidents Department of Industri A. -:�- = Ol�ca ol/oyestfgatloas 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance davitif F1 jname: location: 0 hone# city ❑ I am a homeowner Performing all work myseiL ❑ I am a sole Droprietor and have no one worldn in env acity �///// ' ' I am an lover' . workers ' ensatioa for my employees working on this job.::::::.:::::.?.:::.;•.}...::::::?::: comoan .... ..... . ................. .............. ...... are '::}:•;;}>}•<?{::{.;::>:.;:.:...�.:;:.r:.:}•:}::•.;:;:;• �.:.::.:.:...:iiiii:i::::... ....:..,... ::...:.......... µh::?{?4}}:•i::{::n}::;•}:,}'r:i:•il::}••::::::}}:i:!?4}4::• .: iry::i,'••v:Zvi:�:V{i�:;:��:;:Y:��::.cif; tins,•::::::.:;-:� v}"'ti::{.}::::..... ::::. .. citv�• . ':•}:iiiii::ii:•i:.T:.'v,:i}:i:v':}:i:;{::::'r,':;Y::;i;;:y:•;i: ;• ::y):! . : {.;I•,:$•<:j:ri'ri?:::'i<{}ii�:?C i:•' '::ii}:i:;}.n::;'}'::i}:i'::'}i::ii}i:4i'•::� <:.x..:.}:%:nisi:: .. :.; . -.:. 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'nv•.::.v.•....::>}.•:;{::.}:•::;::::.......... . ... ..:......::�:::..:...............................::::iiii:i::::nv:::::::::::....:':}:::i vi:::�:•:•v.{a•.................4x.},•.v v%•:4i insurance co.. ..........:,.,.,...... ..... FaIInre w secure coverage as required under Section 25A of MGL 152 can lead to the imps of crhoind peaaifles of a Sae up to SI's and/or o�yam,itnprisortrttent as wa as civa pmaides in the form of a STOP WORK ORDER and a Sae of 5100.00 a day against me. I that copy ea this statement may be forwarded to the OMce of Investigations of the DIA for coverage vedffcatloa. 1 do hereby c OY undo the pains and penalties of perjury that the information pro►Rded above is true and correct Date �,' — Sima # UL4�1 Print name: CofficiWaiuseonly do not write in this area to be completed by city or town offfcial pers diftense �$uiidin;Department : QLicensmt Board �g�etmen's Diffce cimmediate response is required _ QQ$eelth Department phone ii; Others contact person: tensed 05 PJA) • - • :1/�1 .. • :.1 • •II .• 1 1 �+ I }/•u • �/ • . • . - • •IIII•. • .1 .1� •- �•1./ . • • • �• . •111 /. 1 I / / •�,•11 �• • :� • N •'Il 1, 11 :/ • 1• 1�1 1••�1 .1• .1 • 1 :.•y• • IIII• :•• • • • ter• • / / :. • . •�• .11 11 • • • •../ • • •N • •11mWelf• • • 1.• • • ••11 • il. • • / • •1 :+•1 .:r • lpMm'w-Wasi 81044 • 11• N - �•K • :••.1 Y.1/ • •�.•.s }• :•,•1• • �1 •1 II • • •• /1 • •/�/ 1 1• •M .11 •11 •I • 11 a w•% :+,111 �•-- • 11 :..11• • • • .• II • •• /a •1 . • . • •. 1 11 • 1• II • skis ad 1 v.t tilt qq11f.qja1Fi1 I# 1 • V • II -• -I 1194I qh 1, • ,I. .111 • 11 I • 111 ' 1• /• 1 i•1 • 1• :.•11• • •�./ •1, I• •(as I 1/ 11 ■ , .a(*,i •1 w• ./1 •' •I.. •11 1 were • I so . • • •1 •11 /1 '1 ••1. • • •• • .• M• /1 /1�•1 • 1 I / • •�✓•1 • 1 1 :.,11• • 1r w.l I . �w.l �• /• 1 .11 ...11• . •:1 1 • �1 ► • •11 • Y.1/.� 11 .1 1 1 r•= Y}1 VII ::l t ( II 1 1 1 1 1 1 r' 1 1 1 1 1 11 1 1 1 , 1 1 1 1 rl 1 / l r 1 11 1 1 J. 1 11 MI 11111 1 1 1 1 1 1 1 1 1 1 1 1 1 • . 1 1 1 / 1 11 1 1 1 11 1 11 .11 Y' YI :., 11 :.1 • • 19 •11 Y. i • 1 -•/.•.w I. •11 •••II • 1 I• .11 • 1/. • . 1• K 1 •• Y •1/ 1 .•tllw IIII• .11 • r•111■ M 1/ 11 • 1.1.11 .11 r' •1 • 1 . •••I.. • " •Y. • •il• •I Y•1•I1. .11 • 1•/ •1 11 1. .11 Y �. 111 -..r w,l•. •1 /11 NI .1• /ti IV. •-.w. • w.1/�. I. /1 r•1,1• • eeee�/�eee%/eeeee�e�eee/O�eee�ee�eeeeee�eee�eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee��eeeeee��e�eeeeeeee/// ' 1 • y1 I .,I 1 II '•1.• �1 r.N/l of-♦ `Y.*a late IV.i i■ •i, 1 r•IIt1. }, ■ • «• 4 .•11 • /1 • •/ /1 .t 1• • � 1• •. 1/ Y1■1 J■ •1• .1.• •. II • .IIII•./1 IV.11•�. . • .t1 • I I •11 III111 •./ ■il ' (/1 rw •1/ t✓•11- •1 II 11 .t1 r I - .• 1 1/. /1 • • 11 11 �• • 11 � .+.. ■11 w,l .1 1 111 •• « •...Il 1•I r•iU U.n✓•U •11 U 11/. IIr.t1 r r• ..•; •. 1 1 I 11 '1 1/ 1 1 -1 1 1 - •U1 . • 1 `II • 1 1 . w.11.1 }. 1• II _ MI • •1 i• •• 1 /1 .1 t1 .1, . Ira1 •�1 1.1 11 •-•.IIII •t ••'^• . 11 • �•• 1 w �• 1 1 11 , • .1 .11 w/l •I 1 /11 ■• « .-.11.. III • 1 . • . 1 1 .11 • , 1 .. ■(•1, w•GI •111 • All •) �• 1 �•9-Me . ✓• 11 '•1..•-• •'•IIII•.+/ `Y.1■ •11 I • • ✓• I I, / -...:1to1117-11 .1 11 ..IIII .773 1-,1.77• ' 1 1 •" 1 ■ i•t . 1 •1 •1 1• :. . • 1 .•.11110 w•, .11 .Itooil IIL. _.•. / 1 , -•.Y•1 I11 -•.I 1 •) . 1 • L• . r .1 // I . / .1.1 . i�• . •) • • III • 11 1. F1 •- I r.1■ .It kff I,ffeesIt1 V. « •• 1 w•Y.1 •111 • 11 .1• 1 troll • r< 1 I • .,I 11 /• •••t.Itll Mw• ..IIII •./ • 1 / 1 I_ 1 Vim. _11�t _'. •' ..IIII 1-. 11 i1 • ' 1►- 11 I .t611199�. 11 It •. I11:1.1 . • 11 •1 111 . 11 a .1.•:1, • w•,w,1►. 1 . �. • I .� • •I:1• •11 . I . • 11 .11 • 11 1U.18 jj.t1 r 1.1 . , r•• 1 -t .1• UI .1, • 1 • 1froIL . 1 .11 1 :rI •• 1• 1:..vlr.1 • L ••: I e���� '!.�%/%/ee%�ee�e�eee�eeeeeeeeeeeeeeeeeeeee�eeeeeee��eeeee�eeeeeeeeeeeeeeee�e�eeeeeeeeeeee�e�eeeeeeee� 1 - •. ••1�111 •. .� 1 • 1 •11 .11 • .:V 111Y/1 •�1 1 1 11 11 1 1 1 • I �� 1 1 else ' 1 1 1 1 . I " 1 w' 1 1 1 ` 1 1 ' 1 1 • 1 1 t I t . 1 ,. The Town of Barnstable • n�►errgresrE. - 9� Department of Health Safety and Environmental Services 1659. '�i��„�►y" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph C rossen 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. _ 6L- Type of Wor : �- � i C� _ ,l.) s ' Estimated Cost Address of Work: Owner's Name: Date of Application: % I hereby certify that: Registration is not required for the following reason(s): Work excluded by law oJob 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 o r ) Date Contraqbr Name Registration No. OR Date Owner's Name q:forms:Affidav Board of Building Regulations and Standards One Ashburton Place - Room 1301 BOst:On Massachusetts 02108 h-lome Improvement Contractor Registration Registration: 103714 Expiration : 7/9/02 Type : Private Corporation To l c,nntc->u,eta/C/e c`.l(aaracl,., •/l HOME IMPROVEMENT CONTRACTOR 17 Registration: 1037N PAUL .3 . CAZEAUI T & SONS , INC . js e r� Expiration: 1/4/02 Paul. Cazeault 22 Giddiah Rd . P .O . Box 2781yj Type Private Corporatic Orleans MA 02653 PAUL J. CREAULT & SONS, I Paul Cazeault 7f 22 Giddiah Rd. P.O. Box 2 A.o„V;r,iSraaroa Orleans MA O2653 V Assessor's map and lot number............................................ T E TO Sewage Permit number. ............................. ...... 339RNSTAMLE. House number .........i4........... .......... ............................. 1639- TOWN OF BARNSTABLE_ BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...........�S)A. >............................................................................................ TYPE OF CONSTRUCTION ......� ........Fk .................................................................................. .......... ............WIS.— TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: .. ............Location ........��. j........ ......WA.. .......... ...7 ....................................................... ............................... Proposed Use ...4;. ........ Zoning District ..... . ........ ... Fire District ...... 6 N:T0.S C T.............................................. A A .............Name of Owner 5@t .....pap . .........Address ....... a 7 Nameof Builder ............... ................................................. P. Name of Architect ... ..........Address ... ........ Number of Rooms ........... ...................................................Foundation U. 6....00...116 ..R rA 10�16................. Exterior ... ........................:.......................Roofing ....#136i .P.Hif)%L T. .......................................................... Floors ...WW1}......s ................Interior .............. Heating ......F.K.W/�01;5........................ .....................Plumbing .-c1-5AW- -6>......................................................... Fireplace ........ ..............Approximate Cost ...6.009.ae-=.)............................................. Definitive Plan Approved by Planning Board - //9------------ 7-----7-- Area ..... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town,of Barnstable regarding the above construction. Name ..........A.A4in'...zt�.... .....................Construction Supervisor's-License9.(9-1.....� ................. MCKEON, CYNTHIA A=39-48 , 2.7805 One Stor No ................. Permit for �:�QKY........... Single Family, Dwellij F Location .....Lot ...................QQt.U;Lt........................................ ' • Owner .......... .......:........... �. Type of Construction ....Fxame......................... Plot ............................ Lot ......... � f. .Permit Granted ...•. ............19 35 Date of Inspection' 19 Y Date Completed s .....................................19 .