Loading...
HomeMy WebLinkAbout0716 PUTNAM AVENUE i78 BIKE Town of Barnstable *Permit Expires 6 months from issue date p Regulatory Services Fee f63¢ Richard V.Scali,Interim Director �� ,�n ,//�� Building Division To ;p of l li'"lNSTAB m Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-8624038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ^ ' Property Address 'z760 a"G1iAPI 6t-w, Residential Value of Work$ 'ST 00 Minimum fee of$35.00 for work'under$.6000:00 Owner's Name&Address R rw-vc'r," A Yl Contractor's Name Telephone Number L316'J "C�`�423 Home Improvement Contractor License#(if.applicable)` L 7`Z2 y ��' Email: Construction Supervisor's License#(if applicable) cC v !as `w Eq*orkman's Compensation Insurance - Cl one: II am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name dt°ik fG!tJ 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 Y49 P,y"- 7f 4 04,4 [�Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ® Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. j Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner st sign Property Owner Letter of Permission. A copy of the H e Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: jV Q:\WPFILES\FORMS\building perm forms doc Revised 061313 2/25/2016 10:42:06 AM PST (GMT-8) FROM: 100005-TO:- 15087901414 Page: 2 of 2 ACO 0DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 2/25/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER BRYDEN&SULLIVAN INS - NAME - 88 FALMOUTH RD PHONEWC,Mo.Evil: FaIAxC No. HYANNIS, MA 02601 EMAIL ADDRESS: r INSURE 3 AFFORDING COVERAGE NAIC ti _ INSURERA: LM Insurance Corporation 33600 INSURED DREI YARMALOVICH - IlvstlRERe: DBABEL ISLAND HOME IMPROVEMENT PISURERC: 204 CINDERELLA TERRACE ILSURERD: MARSTONS MILLS MA 02648 NSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 28713782 REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR POLICY NUMBER MMIDDIYYYY) (MMIDDIYYYYI LIMITS - , COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MADE a OCCUR AI DAMTO RENTFU $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JPERCOT- LOC PRODUCTS-COMP/OPAGG $ OTHER $ AUTOMOBILE LIABILITY SINGLECOMBIWO IT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED - BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ UMBRELLA LA" OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION $ A woRKERs COMPENSATION WC5-31 S-384176-026 2/25/2016 2/25/2017 A Ul E ER AND EMPLOYERS'LIABILITY ANY PROPRIETORiPARTNEREXECUTNE YIN E.L.EACH ACCIDENT $ 100000 OFFICERMEMBER EXCLUDED? ❑N NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEEI$ 100000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached N more space is required) WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. ANDREI YARMOLOVICH IS COVERED BY THE WORKERS'COMPENSATION.POLICY. i CERTIFICATE HOLDER CANCELLATION OWN O SHOULD.ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE T F YARMOUTH r RT THE EXPIRATION• DATE THEREOF, NOTICE WILL BE DELIVERED IN 1116 ACCORDANCE WITH THE POLICY PROVISIONS. SOUTH YARMOUTH MA 02661 AUTHORIZED REPRESENTATIVE "�Z':L / . )+4— � ,, LM Insurance Corporation ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD' 28713782 1-384176 16-17 WC Ashish eorgaonkar. .,2/25/2016.1:38:27 PM (EST) Page 1 of 1 �� } t fAb3sskhW5efts Departt4nt.oP WUtaiic S--.�aty ri Board of Building Regulations,ancl.Stan dards. a r a License. CS=105964 tonstm tip n Super¢.spar _ IVAN V NANIUSHENICO , 174 UPPER COUNTY ROAD APL 1 ` 1.14 DENNIS PORT MA 02639 `� I on, isssoner 01/0112018 i r • i a • i t t i r i _= = c o o mer A OMM(dVusiness j 10 Park Plaza - Suite 5170 Boston Massachusetts 02116 Horne Improvemtfi ntractor Registration l 3 Registration: 172476 Type: Su plement Card r4 } Expiration: 7/2/2018 BEL ISLANDS HOME IMPROVEMEtyT �z IVAN IVANINSHENKO <FF 204 CINDERELLA TER. ! MARSTONS MILLS, MA 02648j, : ` y ems' Update Address and return card.Mark reason SCA 1 0 2OM-05/11 0 Address ❑ Renewal Employment �-'.�17e -�i ayrt�)2fi�z/uC'rzf/�o��C-?���7J;1�lcY/frJlllJ Office of Consumer Affairs&Business Regulation f License or registration valid for individual use only ME IMPROVEMENT CONTRACTOR " before the expiration date. If found return to: r5 a istration ! Office of Consumer Affairs and Business Regulation 9 T72476 Type. 4 F> 10 Park Plaza-Suite 5170 Expirat+on ., 0{ Supplement Card s Boston,MA 02116 BEL ISLANDS HOME�INIPROVE'MENI s IVAN IVANINSHENKO: 204 CINDERELLA TERr MARSTONS MILLS,MA 02648 Undersecretary Not ali w' t tur I rt The Commonwealth of asrackusetts Deparment of Industrial Acciden& _. Office oflnvestigations . 600 Washington Street Boston,MA 02111 nmv.mass gov1dia Workers' Compensation Insurance Affidavit: Blalders/Coni -Achws/Electricians/Plulnbers Applicant Information Please Print Legibly Name(Budues&10rni tiondadhldaal): Wo 7V&k4csSlC�5 mess: - CitylSta&Zip: 4' PC bone#_ .�0�'=��y- 6. ®c Are you an employer"Check the appropriate boa: Type of project(required): 1.❑ I am a employer with 4- ❑ I am a general contractor and i _,/6WIoyees(full andlor part-time).* have hired the sub-com'tractors 6- ❑New construction2.LJ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling P ship and have no employees These sub-contractors have g- ❑Demolition w far the Y� ty-in an ci employees and have workers' °`�� t 9_ �Building addition [No workers' comp.insurance comp_insurance_ required.] 5_ ❑ We are a corporation and its 10..❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their ILL]Plumbing repairs or additions myself [No wcukers'comp- tit of exemption per MGL 12..❑Roof repairs insurance required.]F c. 152, §1(4X and we have no employees [No workers' 13.❑Other comp.insurance required-], •Any app&mot that checks boa#1 mast also fill out the section below showing they worketa'compensation policy information Homeowners who submit this affidavit indicating they are doing all war}sad then hire ontsibe contractors omct submit a new affidavit indicating such. 'Contractors that check this boa must attached an additional sheet showing the nee of the sub-contrw=and state whetbet or not those Mies have employees. If the sub-coa=ctots have employees,they nnm pmvide their workers'comp.policy number. I arts an ernpioyer that isprm idhW workers'congwisafion insurance for irty employees. Below is the policy and job.site information. Insiwmce Company Name: -6 Policy#or Self-ins-Uc.#: W e r,-41J" 6 fJ�� EXpuationDate: Job Site Address: 06- 0141<4 . CitylStateiZip: 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 andlor one-year imprisonment,as well as ciial penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the ' lator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for ce coverage verification. Ida hereby certify and the is and penalties ofpwrjuty tdtat the ittforwmtion prmi ded aboi a is true and correct Si Date: LoZ'2t>/4 Phone#: Official use onry. Do not write in this area,to be completed by city or town aficial City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cit3Trown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#. 6 THE T Town of Barnstable Regulatory Services &MWSTABM Richard V.Scali,Interim Director ''�EON,;,r►�`� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize 6c( /14t-1'4(5 0 � .� id r to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) *Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections a performed and accepted. . atut of Owner S' Applic J Print Name Print Name Date r I -. n.rnv�,rc.nttn.taonaD�noern*ronnr0 inll� ._ � M V Town of Barnstable r Regulatory Services , pF'THE rOk� Richard V.Scali,Interim Director Building Division sexivsr,�sr a Tom Perry,Building Commissioner , 9� M6 13% `��. 200 Main Street, Hyannis,MA 02601 Al fD ,I www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6250 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB.LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town 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 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 t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 C� Parcel 113 Application:# e Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee A&&. e_-)o Date Definitive Plan Approved by Planning Board C Historic - OKH _ Preservation/ Hyannis Lam ` SE: Project Street Address Ale-, Village C-&a c-f- Owner _ 14 an e�' Address Telephone 1,2>$ - aq- D®kD Permit Request /X /t/ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District. Flood Plain Groundwater Overlay Project Valuation `� 8' y 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 BlilLj) Total Room Count (not including baths): existing new First Floor Room �U� 1 Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Taw/�! 82818 Central Air: ❑Yes ❑ No Fireplaces: Existing New Existirt�Gc®,' ''`gal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size Pool: ❑ existing ❑ new size Barn: ❑ existin b n w size g g g _ g _ g e s e_ 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 4 Name � c Q� �m`' Telephone Number ` -7 7G Address Z P License # CS 105-530 Z Home Improvement Contractor# 1?10/ T3 Email c6aef2i. 1i.ue4u9c9r(L `4 ehon Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 5+J s[�c�o SIGNATURE C\ DATE , y FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED 'J MAP/ PARCEL NO. ADDRESS VILLAGE t OWNER J DATE OF INSPECTION: FOUNDATION FRAME t f INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ` FINAL BUILDING ,F DATE CLOSED OUT ASSOCIATION PLAN NO. r s s Dovetail Woodworks � �.n ` v 1 w� ( Estimate 2 Maple Street I)OVII TAIL Mashpee,MA 02649 Date Estimate# WVOOIDWVORKS Phone# 508-776-5426 dovetailwoodworking@yahoo.com 6/8/2016 302 Name/Address I Brendan Annett 716 Putnam Avenue Cotuit,MA 02635 Project Description Qty Rate Total Build custom deck approximately 8'x 14 in alcove on front of house. Deck would have one full length step on the front 14 wide. Deck would be supported by two(2)12"Bona tubes too code. This estimate allows for 1"x 4'mahogany decking in the cost of material. c Install Azek 1"x T skirt and riser boards. Materials 1,300.00 1,300.00 Labor 44 75.00 3,300.00 Plans and Permits 200.00 200.00 This estimate does not included the cost of demolition and removal of the front steps. Cost of demo and removal provided by Be[Islands Home improvement. Work to be done in conjunction Bel Islands. A$1500 deposit is required. Any work done outside this estimate would be at time and materials. 4 4 f Total $4,8W.oD } • 27ie Commorriveakh ojfMassachusetts Depcar&nent o,fIndustrialAccidents - - Offw.e ofInvestigations 600 Washutgion Street Boston, M4 02111 _ wivtn rnasmgovldia Workers' Campensafian Insurance Affidavit BtnilderslContractars/EIectr eianslPlumbers Applicant Information Please Feint 1,M- ly Name(SusinessADiganiraationfladividoal}. y� c� Wad � k r addre Z Met-Ole Sf-: City/StatP.f _ / 4 0Z(, 3ne u, '7 Are you an employer?Check the appropriate box: ' Type of project(required): 1.❑ I am a employer with 4. ❑I am a general contractor and I employees(full and1br part-time)-* have hired.the sub-contractors 6. New construction 2.D�I am a sole proprietor orpartner- listed on the attached sheet. 7-❑Remodeling ship and have no employees These sub-comtractors have 8: ❑Demolition wodcing for me in any capacity. employees and have warkers' g. ❑Building addition. LNa w.orkm' comp.insurance cop-insurance-1 required-] 5.❑ We are a corporation and its 10_❑Electrical repairs,or. .diti +e 3.❑ I am.a homeommer doing all worlr officers have exercised their 11_❑Plumbing repairs or additions tr y&-I€[No worlmrs'camp- right of exemption per MGL 12_❑loaf repairs i nsm=— a required.]s c.152,§1(4)6 and we have no employees.[No wodoers' 13.❑Other comp.insurance required.] *Any WHcsuf that cheda box is1 mast also fill out the:section below showing&&wo&ere compensatiaa poriiey informzda Homeowners who submnt this dfidacft inet eating they axe doing all waoic and,rhea hiss outside cantzactoes nmst submit a new afdavbt MdieWng-sach- ZCdn =ct=that cbe is this boot must attached sa additional sheet dwwiag the nine of the sub-co=zctxs and state whether or not those entities have emphryees.If the s ibtontxactnes have employeee%they lmst pmuide their workers'comp.policy number- I ani au euplgvr€lent is prenadircg workers'contponsatioii iamirance for arty?oniploj ees Below is$te policy twd job site iuformathm Insurance Company Name: Policy 4 or Serf--ins.Lic.9: Expiration Date: Job Site Address City/Stat&2 p: 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 1572 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 peaalties.in the form of a STOP WORK ORDERand a fine of up to$250_00 a day against the-violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification- I do hereby cet fyy nstdcrtha palms ands pajal€ifess flat fir ofveduiy e info rmafion provi&d abmw r`s hire and correct SiMature: Y Jam t&� .� Date: Phone i�- -5,0e- '7-7 6 Oj icial use only. ,Do riot write in this area,to be campletesd by city ortonm official City or Town: PermitUcense 4- ---Issuing Authority(circle one): I 1.Board of Health 2.Building Department 3.City/rown Clerk 4.Electrical Inspector S.Plumbing Inspector b.Other Contact Person: Phone#: Information and Instructions Massachusetts G&amnl Laws chapira 152 requires all employers'to provide workers'compensation for fhea employees. Pmsuant•to this sttute,an anpLvee is defined as."—every person in the service of another under any contract of hire, t express or implied,oral or watinm" An e77p£oya is df--$ned as"an individual,partnership,association,corporation or other legal entfty,or any two or more of the foregoing engaged is a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individnal,pa tammhip,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 - dwelIing house of another who employs persons to do mainte ce,construction or repair work on such dwelling house ' or on the grounds or building appr>r[enmt thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also signs 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 airy applicant who has not produced acceptable evidence of edmpliance with the insurance.coverrage required_" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor a'ay of its political subdivisions shall enter into any contract for the perfon mm ofpublio work until acceptable evidence of compliance with the inset-ance.. requi ements of this chapter have been presented in the contracting anfizoiityf Applic-auts Please fill out the workers'compensation affidavit completely,by checkiag the boxes that apply to your sitnation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s) along witli their certificates) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not requited to cant'workers'compensation insurance If an LLC or UP does have employees,a policy is requited. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insmaance coverage. Also be sure to sign and date-he affidavit The affidavit should beretnmed to the city or town that the application for the permit or license is being requested,not the Department of hoalstial Accidents. Should you have any questions regarding the law or if you are req¢ to obtain a workers' compensation P olic3`�P lease call the DeP artment at the number listed below. self-insured companies should enter their mP self-i asura ce license number on the appropriate line. City or Town Officials f e e that the affidavit is lete and rued legibly. The De arfinent has provided a space of the bottom Pleas b sure comp p gbly p of the affidavit for you to fill out is the event the Office of lavestigafions has to contact you regarding the applicant Please be sure to fill in the pennithicense number which will be used as a reference number. In addition,an applicant that must submit multiple pennitllicense applications in any given year,need only submit one affidavit indicating current policy inforaation(if necessary)and under"Job Site Address"the applicant should W ate"all locations in (cty 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 f itaic 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 venrse (Le.. a dog license or permit to bum leaves eta.)said person is NOT requ>red 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 cal The Department's address,telephone and fax number 'Ihe Cammmweajth of Massachus,,etts Dep2xfm tit of laclusIdal Agent% tl�-rtce�f�tvestig�t�o� ' ���asbingtan Size Bostau�MA G2111 Tf,-L:#617` 27-4900 Q�- 4M or I-M-MA-9SAIE Fax#�617-727 7749 3evised 4-24-07 is s c^a c @cgs e.x12 Q T,rs 't , _ coQ .� 16 .. .:. . .. _. . . !EFt'CC.VGltr B E/Al6, 1.07- S NOCtQY CL�Lr/FY rtIAT 77WAP AVJO .O.L/ N/S PL Ate/ /d LOGHT�a Ori/ 77N A.1 r �►o�..va w.v lsbcuv A,vD rxr Or /T ,• �,; f, l�0 E 5 COA/f'06A•�1 TO 7�/ OAJ/ ''.. T �r c <w�4�� OF TEG HAY/GAL - . .. ... �A.ST OENNlS , ILIA a a. —' �+rr .raw: A. ,va sWAr+e+roe. uj ca P, x LLJ C�4 ley CC> cc < co - .......... Olt. C�1ze rpb7rvma�zcuec�cCo�c/�cra�acLuc�e� _._ . . _,. Q\ Office of Consumer Affairs&Business Regulation License or registration valid for individul'use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration::;-.,j70173 Type: Office of Consumer Affairs and Business W ulation Expiration:==9/23(2017 DBA 10 Park Plaza-Suite 5170 `- Boston,MA 02116 DOVETAIL WOODWORKS.-7�. •`=_`_ .=.:J' - DAVID SMITH 2 MAPLE ST MASHPEE,MA 02649 — Undersecretary Not valid without signature Construction Supervisor Restricted to: Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to Possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DIPS Licensing information visit: WWW.MASS.GOV/DPS Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-105530 Construction Supervisor DAVID M SMITH 2 MAPLE STREET r gel t MASHPEE MA 02649 a 4 CIA-- Expiration: Commissioner 04/05/2018 I J i r Y r ' �'� ���� _ - �� � � :i r � `fix r ttl I S ��� �• _ t ! ��eI�3` � 1♦ is .. ^� -" +. q r .`E::fit... t:�;�. .Y b ..,ci..T rya ./... '� R,e ry F 2 G:•,.a ,xSS 4 s_r #� �� 1. „f 't � V • e�7ctrayr� '- - -�_ K �.. -07 ,eeFte�►,vice�:_ ��, owner PNEiE'. LAY r"' i`t #Yg.rrt s.�,bry v o,v rNAa PA.A�✓ 'if rrr w� '7-" a ; 2 NtCdQ1� C�dT-/FY �'/ LOt�:TE�D at/ 77y& "r: �i � � � �, , iR Nd OoES corv�+•oen.t; ro rS.TR�L -;M �s�-G�frVa o� rat �ttlwsti Off' �, a q TECHA//GAL f L 9A/NII /6 ./g55OG/�9T�S E/9.ST OENN z Aft". wa aur�wley-+�a 5 Assessor's map and lot number ....' . .....�....t...l.:' f THE r Sewage Permit number 9 BAB33TABLE, i House number / ""sIL .................................................................... �p 2639 0� am w. TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO �!/. lpl r �/..� Q��y TYPE OF CONSTRUCTION ............... ........ .....�1,+ . , . ................................................ � r / .......................� 19�7r ................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: -J Location ...,..,............................................................................................................. ProposedUse ..............J '11, ...1e W IAl-........................................................................................................................... Zoning District ............ i:`::'........................... ..... Fire District ............... {. '., ........................................... Name of Owner .. ! �....i... .-, i'..... ..�'�-" - v f ....�..:...t'.Address ....:! 7n...t�r..F1 I,r....................................... ..J 1tr. Name of Builder ......... J eF.................................Address ...Lan.....Z�—Q C. ....�.�7r►.I�J' Nameof Architect .....................:............................................Address ..........................................................,......................... Number of Rooms ..............Foundation .........�?`?�... t C�' 7`► '-n e. Exterior .....C. ,AD1,nrAQ rlt f1� t�� tih!O,n C+�.... Roofing ....... �1 .................................................. ............. ........ ... ...... .f .... Floors Q'-.. ": Interior .................................................................................... -T .. ..................................... - r Heating._ "~.:.?ct'?�. .�7 �! ?... ;1 f .......Plumbing ............................................................-...................... __._ .. _ Fireplace .............. ................................................................Approximate Cost ............... ~fit^}.. ...®.................. Definitive Plan Approved by Planning Board -----------_________---------19_______. Area 1 59'-i^:�. ...f:.::.:..:..:........ Diagram of Lot and Building with Dimensions i Fee `.�'........... ......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree,to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....t r ��;�....If ........... .,.. .. ... - G� Day; Christoph r. A=39-113/ No w.......2095Permit for ......one story._........ singl. ... ... e family dwellin. . . �....................... .. ............ ...... . . .... Location .........716. . .,.A.tnam. ...Avenue„•.............. .. . .. . ... . ...... ........ Cotuit ............................................................................... Owner Christopher. . ..G.....Day, ................. . .. .. . .... Type of Construction . ..........frame.................. Plot ...................:... Lot .........ll................ Permit Granted .....Jan ry...a...............19 79 Date of Inspection .. .................................19 Date Completed ......................................19 PERMIT REFUSED .................................... .... ... .... 19 wi6� I / ' .... .'`�........... Approved ................................................ 19 ............................................................................... i I t ��o TOWN OF BARNSTABLE Permit'No. Building, Inspector saurr.0 Cash -----� OCCUPANCY ' PERMIT Bona _ X (Okqt� No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Christopher G• Day Address lot 411 _ 716 Putnam Avenue. Cotu t Wiring Inspector fl C/ ` //JJ�e ++��� Inspection Plumbing Inspectoi K, v t l Inspection date Gas Inspector r r! / Inspection date Engineering Departmentl� r� �!cGt t-�lt�� Inspection date 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. / f ................... ...�.. ......., r <....... .%Building..Inspector .._ ..._...... G s@ssor'S map and lot num ..,,,.,..�,.,.�..L. .,. _ yO6TNEr� _ . � .� SEPTIC-SYSTEM MUST BE �y 7 . INSTALLED IN COMPLlANC Sewage Permit number .. �. .�� WITH ARTICLE 11 STATE = 33ASa4TO11LE, House number ...... ,,� SANITARY ,CODE AND TOW :9 SAM «. �p 6 REGUL4TION'S. ,�' 39a�e 0 YPY TOWN. OF . BARNSTAB;LE BUILDING-- 11SsPECTO-R =} f APPLICATION FOR PERMIT TO ............................ 1 .. : .... . .......................................... TYPE OF CONSTRUCTION ................ 'ltl�F� ..`�� �1.. .../../00..e.................................................. J.l °.... J�................19 TO THE INSPECTOR OF BUILDINGS: . The undersigned hereby applies fo�ra permit accord,iinng� to the following information: Location ........I (.,� 1(,�/ i .....'.Q pe.....n.. /Ld/..7....ew!5.5............. .. .�........ ................................. Proposed Use ............... .................................................................... ..........................................:...... Zoning District ..............� =............................. ..........Fire District ..........k.l .:�::........................................... Name of Owner ....� !� . ...... . .. ...... .... . . .......Address /.2.0...004,, "-^lA1,C...41.�". Name of Builder ..............�T!A"`. ........ ..........Address / A.O ��ner1,!,V...... ..... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .......... '.. ,C...' -... .. ..............Foundation .........!17....PEAQ .....&4C................. Exterior ......cl.14 0 ...4... ........Ape.k ,.Lr.................................................. Floors 1qi ? 4 ..................................................Interior ...................... Heating .......' L.......Plumbing .................................................................................. Fireplace �. .....Approximate Cost ..............:.3�.j ®.� ,•,•„•,•••„......•„ ..:............ ........................................................... Definitive Plan Approved by Planning Board ________________________________19_ . Area ........�. �� .... �d.` Diagram of Lot and Building with Dimensions Fee ' �S............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 -/C/7 Sob I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 4 ' Name .....<. ..`..... .t .. .�...:� ......... . | . -_ - ' ` ' . . . ` � . ^ ' ' ' - ~ _ ' ' - , ~ . . " ' . . . ` . ' . ` . Day, Christopher G. 20951 one story Cotuit Christopher G. Day frame Date Completed :..19 PERMIT REFUSED Pe —.--.----- ...................... ............................ . --------------.--.—.--------. Approved . ` __—_------------. lV � ` ' `^ ' ..�-----�—�-----.,.--.--.--~.—... . . . -------'--------'---.---':'�' '�� ` � �