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Home My WebLink About0030 PATIENCE LANE Z-17 Town of Barnstable *Permit# Fxpires 6 months from issue date Regulatory Services Fee BARPMAJIs. M039.ASS. Thomas F.Geller,Director Building Division X-PRESS PERMIT Tom Perry,CBO, Building Commissioner , _i!_ p1� 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us . TOWN OF 8ARNST�4IaLE Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Impnnt Map/parcel Number VT/X3 Property Address "30 4e?. 3'Residential Value of Work XOUd Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address � /e � // G L 30 Contractor's Name CONdv-eAlI-c I Telephone Number 7'77''D J b�6-6 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) S ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ the Homeowner I have Worker's Compensation Insurance Insurance Company Name 9PreA4-Adr_ V�w_� Workman's Comp.Policy# 1 (O G 3* 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 ❑Re-roof(hurricane nailed)(not stripping..Going over existing layers of roof) ❑ Re-side #of doors E Replacement Windows/doors/sliders.U-Value 5/ (maximum.35)#of windows "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. co of the ome provement Contractors License&Construction Supervisors License is u SIGNATURE: C:\Users\decollikWA Data\Local\Microsoft\Windows\Te Internet Files\Content.Oudook\DDV87AAZ\EXPRESS.doc Revised 072110 t The Coninionivealth of Massachusetts Department of Indristrial Accidems — _ Office of Investigations _ 600 Washington Street Boston,AL4 02111 tvrvri,Y)mmgov/ilia Workers' Compensation Insurance Affidavit: Builders'C-ontractors/ElectticiansSPlumbers Applicant Information Please Print Le 'b Name(Bess/Orgmizationandividual): V`ei �n'ei_&l I&fxf A &ess: (06 E bw,-•. btkiayllk. 11 city/statef7ip: mome 1. 3 (o- 6 Are.you an employer?Check the appropriate box: Type of project(required): 1.R l am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑N construction2.❑ I am a sole proprietor or partner- listed on the attached sheet 7- [ odeling ship and have no employees Thy sub-contractors have g. Demolition working for me in any capacity. employees and have work ers' 9. Building addition j[No workers'comp.insurance comp.insurance.l required.] 5. ❑ 'tie are a corporation and its 10.❑ELectricaI repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I L❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]i c. 152, §1(4),,and we have,no employees.[No workers' 13.0 Other comp.insurance required.] *Any applicam that checks box#1 most also fill out the section below showing their workers'compensation policy infonnnion i Homeowners who submit this affidavit indicating they are dome all waak and then hire outside contractors must submit a mmew affidavit indicating such. -Contractors that check this box must attached an additional sheet showing the name of the sub-cw=tars and state whether or not those etuitees have employees. If the sub-contractors hax a ermmplooypes,they must provide their workers'comp.policy number- I am a►r employer flint is providing t►rorkers'conrpeecsrrtion irrsnrar:ce for nrY enrpioyPees. Below is the pnliey rind job site information. Insurance.Company Name:_ar Policy#or Self-ins.Lie.#: 1A1D I b 3 Expiration Date: 8/6),2011 Job site Address: .10' �0..�1�.✓�G� N 1 • City/State/zip: Co L7 � t 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 enrol 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 c h;fy�rrr der t r .pains n nahies of pediy that the information pro ded'aboite.is ate a/nrf correct Si tune: WDate: f7 Phone#: Official use only. Do not write in this area,to be.completed by city or tort n 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#: -- 6 try • BAaNSPA M • 3 9. Town of Barnstable Regulatory Services Thomas F.Geder,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder -,as Owner of the subject property S--QLfi�t, hereby authorize �D �6&on my behalf, in all matters relative to work authorized by this building permit application for: t a4rtm e'e (Address of Job) ftSiaof OW&4 Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 IS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED Y THE POLICIES BELOW.THIS CERTIFICATE OF INSUR ANCE DO ES NOT CONSTITUTE A CONTRACT BETWEEN HE ISSUING INSURERS AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. MPORTANT: If the Certificate holder is an ADDITIONAL INSURED,the policy(Ies)must be endorsed. If SUBROGATION S WAIVED, subject to the terms and conditions of the pollcy,certain policies may require and endorsement A statement this certificate does not confer ri hte to the certificate holler in lieu of such endorsement PRODUCER Southeastern Insurance Agency 641 Main St Hyannis, MA 2601 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY INSURED Roymft&Kushne BuIldem Inc 05 Eban Smkh Road Centerville,MA 02632-0000 THIS 18 TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN 18SUEDTOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING 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 THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS,EXCWBIONS AND CONDITIONS OF SUCH POLICIES.UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, Do OR 'Tyre Or"WRANCe POLMNUMNER FOUCYEPFICM DMe FOLIOYEWMATIDN DME A WORKERSCOMPENSATION D EMPLOYERS'LIABILITY LIMITS E PROPRIETORI PARTNERSIEKECUTIVE OFFICERS ARE: NCL o EXCL o 1261634 8/06/2010 6/00/2011 PA,,TQRYLIMrrB OTHER CawapoApppwloMAOpwe9msONy. CCIDENT S 100.0QSE POLICY LIMIT S 500,SE-EACH EMPLOYEE 100100( DESCRIPTION OF OPERATIONSWHICLOWSPECIAL ITIEMB CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVEOESCRISED POLICIES SECANCELLED BEFORE THE ATTN:BLDG DEPT WIRATKIN DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE 200 MAIN ST WIHTE THE POLICY PROVISIONS. BARNSTABLE.MA 02601 AUTHORIZED REPRESENTATIVE i * Massachusetts- Department of Public Safety Board of Building Re!;ulations and Stanclartls n Construction Supervisor License , License: CS 83280 SEAN J ROYCROFT 65 EBEN SMITH RD CENTERVILLE, MA 02632 Expiration: 11/29/2012 Commissioner Tr#: 5237 .�s ✓�c "lro�fr»re�ru+eall� o`�. lliz�trzc�utelZs � License or registration valid for individul use only h - office of Consumer Affairs&Business Regulation before the expiration date. If Found return to: l HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation 10 Park plaza-Suite 5170 Registration: 141225 Tri 291967 Expiration. 212012 Bosto n,, MA 0211 6 Type: Private Corporation ROYCROFT&KUEHNE BUILDERS,INC. Sean Roycroft 65 Eben Smith Road Centerville,MA 02632 Undersecretary "Not valid witho t - r 7 Assessor's map and lot.number y .""..: . :... ....... Sr` �^ ;,, ✓ F THE T �� =?. G _- " � S S-7 ( Q`� Sewage Permit�humber ........................................................ ^ a Z BARNSTABLE, i House number .............. rasa ....................................... 90� 163 9. �0 • 'Fp Np�p,• .� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..................�cJ% :T�.....1 �,1 l �; ` ......................................................... r" TYPE OF CONSTRUCTION .......................:/ .................................... .................................................. ................1..!c................. .........19... ei TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: q ,i1 Location ................. .... '.. ).. . 1 .!�.` *..... �i f f )....Ft)7 � .... �.!luG Proposed Use ...................1..��..�.��-�:��..!�'.�. ,. ........... ....... . :% ......: .... ..........:...... p .. ........................ ..... ............... .. .......................... Zoning District �r i/ �. !�r? .....................Fire District ............. .. ��J. .................................... Name of Owner ..• ...T'• ,rl ...... � ,,....Address ...................................................try. J /��'��•!l„�............... o Name of Builder ......................... �, ,0. Address W� f r y % te.................................� �J> ; t: .... .... ....... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms `�' /�(.t, l"�1�" .y......................................................Foundation ..................... ..).................................................... Exterior � :�J...`. �� . ........Roofing ��`1��,A� �`. .................................... Floors 1`PY/ ' 1 ....................Interior , ......`.......;,.. .................................... ....... ....................<:.....:.................................... Heating ................ .....................................................Plumbing A' � Fireplace ...............................................Approximate Cost ................. ... .. .t................................... Definitive Plan Approved by Planning Board -----------_-------------------19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH i " i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. r`t , Name ... :r.�^ + !....0 : �..., „.`.... ...................... Lambert, Alfred /A�39-58 21584 one otbry No ................. Permit for .................................... .......... gIe ��II dwaIIib� —'---'---------------'~—^^--'' . 3O ��tieooe �aua Location ---------------------. Cotuit ' ^''' ' ' '— ' ^' — '' P1 /L August 24 g Date Inspection Date Completed ...I......./I.....................19 . . PERMIT . � .. « ........... __.\ �.___.| ...}--�...L----- O— —' �—' T . ............................... .. ........................................ � Approved ---------------- lA � ---------------...-----.—.-- � �---------------.---.....--.—. � - �"' ` Y`yam"'�R5 r rre�M,:'wsn+tYt �`•'�.� e`ar 4" 's - '?^, rf - Si "' , e re ••aa=- t. `,* < t5 �� * r� V ,ti^ g t s.. s .ry„z t 4�. r w-+.+ -:.w k .seq.� � v, ,�•p s.':.,r �v ,.t7. ..roC 't••, n a. �� L4'-.r , r..- t - rp4 je *Y i t_. "Prat.Y { � i ..J:� h1F' .j.+ e� "t`'�'� _ R.�.,iJ„r �„v'�4l. +r'+ •`e' ° A - � PD oy • _ - t-.. Al -1`� j {, .1 r 4-1 O LAT • .- !�.{yam � ." - �LtVATrolal oF:roP aF` y : - T TIFY THp-. , E. okAy oONSNOT G nGULU1Tf0 OF776 _ A' • •+r- V _ 1 -s4- r C.__.._`tS.�.w k tr . y.....4i k1.a. ♦ '1' ..tn '� y kSf :a - . i 9� ,��kj 2k..C.^' "'�. i rf -T x;z Asn'Mor's map and lot number A il--n'6.. ........... THE 7 Sewage Permit number ............ ..................... . . ................... ... STEM M COM "LADLE, fO .. ..0.................................House number ................ ........4j & WITH TITLE 6 "M TOWN OF BARNS TAL CODE AKIO T�fttULATIOJYS BUILDING INSPECTOR APPLICATION FOR. PERMIT TO .............. ......................................................... TYPE OF CONSTRUCTION ...................... ............................................................................................. ................................................19.X? T E P G R OF BUILDINGS: x2jg INSPECTOR '4 The undersigned hereby applies for a/6!rmit according to the following . . [n f)rmation: Location ..... .. ....... . el. .. ...... e�g -. - ... . . . . .... . . . ProposedUse ...................a.amr2e .............................................................................................I.......................... Zoning District ................. ...................Fire District ............. .................................... t4� t�� - C% S' 14:AYS 3y Name of Owner .... ......e." :90�.....Address ........../ .&....9/....................... � 0 R ....... n n *......I.........................Name of Builder .....(e Z?)"�A.....4��dclress Name of Architect ..................................................................Address ........... ......***"***"*.....-Foundation .....��.!gw Number of Rooms .... ex. ....................................... ...................... .... .... ................................Exierior ......... ....... ..........................Roofing ... . ..... ............. ........................... Floors ........................... ......... ..........................Interior ....... ....... A Heating ................ ........ ........................................................Plumbing ...............................% ........................... ................ Fireplace .......................V�S...............................................Approximate Cost ................. .................... .. ... .. Definitive Plan Approved by Planning Board ------------------------------19--------- Area ...... 7 Diagram of Lot and Building with Dimensions Fee .......... ............... SUBJECT TO APPROVAL OF BOARD OF HEALTH 0\)D I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...e,00....04!9.c.y.....41 ..................... Lambert, Alfred It 21584 one story -,,N6 ................. Permit for ..................................... single family dwelling ............................................................................... 30 Patience. Lane—, Lbcation ................................................................ 41 Cotuit 4, ............................................................................... Owner Alfred Lambert ....... Type of Construction frame ........................................ ................................................................................. #68 Plot ............................ Lot ................................. f e August, 24 i 79 Permit Granted ..............................ii..........119 Date of Inspection .......................................19 Date Completed ........................ PERMIT REFUSED .........................M, .................................... 19 =. .................................................. ..........U. IRS.. ............................................ . ........... .............. ............................ . ........... ...... Approved ---f:�........ ................................. 19 ....................................................... .............................................................................