HomeMy WebLinkAbout0132 RALYN ROAD �3a
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Assessor's Office(1st floor) Map . Parcel Permit#:
Conservation Office(4th floor)(8:30-9:30/1:00- 2:00) Date Issued
Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) Fels IQ^
Engineering Dept;(3rd floor) House# IKE
Planning Dept.(1st floor/School Admin. Bldg.)
Definitive an pproved by Planning Board 19rZ
�` � a 8
TOWN OF BARNSTABLE `~'n `
Building Permit`Application "
Projc t Stree ddress , f.�.2 �L y$i✓ /��
Village Te/iT
--Owner Address ' /3z 4-
Telephone
Permit Request ,� �„�� Li L,1*-1lam A//,4 1_ gAgp,Az�,•vp" by/WZOW
y First Floor square feet
Second Floor square feet
Estimated Project Cost $ /"6
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ?
Zoning Board of Appeals Authorization Recorded
P/ Current Use Proposed Use
Construction Type
Commercial Residential
Dwelling Type: Single Family Two Family Multi-Family
Age of Existing Structure Basement Type: Finished
Historic House Unfinished
Old King's Highway
Number of Baths No. of Bedrooms
Total Room Count(not including baths) First Floor
Heat Type and Fuel Central Air Fireplaces
Garage: Detached Other Detached Structures: Pool
Attached Barn
None Sheds
Other
Builder Information
Name Telephone Number 5Ff/,r—
Address License# 4�1 3G 1CY9
- wo-19_ Home Improvement Contractor# /00 7�d
Worker's Compensation# . O 8 !lo—OW �ZJ
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT).SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE es DATE /a
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY
IT NO.
PERM �
DATE ISSUED ►
MAP/PARCEL NO.
ADDRESS VILLAGE f w
OWNER
DATE OF INSPECTION: `
FOUNDATION i
FRAME
INSULATION. av
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING- TROUGH FINAL
GAS: + �"'� ROUGH FINAL ,
•
y f f
FINAL BUILDING.-
DATE CLOSED OUT
t r
ASS OCIATION PLAN NO ; +
arnstable .
The Town of B . .
P Department of Health Safety and Environmental Services
` Building Division
367 Main Stroet,HYatmis MA 02601
Ralph Ctossen
OM= SOSMO-6227 Building commission
Fauc 508-775 3344
For office use only .
permit no.
AFFIDAVIT
HOME DWROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERwr APPLICATION
MGL a 142A requires that the"rteonstruction.alterations,renovation,repai4 on,
improvement,. conversion►
on of an addition to any pm a fisting owner wed
improvement,.renrotial. demolition. or construction which a'"-adjacent
building containing at least one but not more than four dwelling units or to structures
to such residence or building be done by registered oaauaaors,with certain=epdons,along with other
uequircracum
P ' Est.Cost _3 020
Type of Work:
Address of Work: /���r✓ �
Owner.Namc:
Date of Permit Application: /o---/
I hereby certify that:
Registration is not required for the following ream(s):
Work ceduded by law
Job under SI.000
Building not owner-occupied
palling own permit
Notice is hereby gh-crt thy: WITHCONTRACTORS
OWNERS PULLING THEIR OWN P DEALING
DO NOTEH�►H TO THE
FOR APPLICABLE MEMeR
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:
lee7,*
Date Contra Registration Na
ctor name
OR
The Commonwealth-of Massachusetts
Department of Industrial Accidents
' 0/I/Cd Ol/Oi�AS�OOS
600 Washington Street
Boston,Mass. 02111 _
Workers' Compensation Insurance Affidavit
City C /T /!21�24' d Z4?�3�J phone
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.
::...
Company namer .:... ::
address:
city:
1z one#
insurance co. „
am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have
the following workers' compensation polices:
company name:
address:
city: • . ::.
insurance co, Qol ��5Ge1
company name:
address:
city phone#-
insurance co.
A�tac �a Itrona c _n
t»_
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or
one years'imprisonment as well as civil penaities in the form of a STOP WORK 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.
I do hereby certify under t sax penalties rjury that the information provided above is true and correct
Signature Date /D—/2 — -Y
Print name Phone it
+: otricial use only do not write in this area to be completed by city or town official 4
L: city or town: permit/license fit r•t8uilding Department
' OLicewing Board
check if immediate response is required Selectmen's Office i.
t, E3Heaith Department i
! contact person: phone N; r10ther _.
f
(remcd JMe PIA) -
_ �\ ✓� VLL�Y►i,�iiG4'IZIUP,CI.GUL O� Z!!Q�
: HOME IMPROVEMENT CONTRACTORS REGISTRATION
oard of Building Regulations and Standards
One Ashburton Place Room .1301
Boston, Massachusetts :021.08
I .
HOME IMPROVEMENT CONTRACTOR
-Registration 100740 Expiration 06/23/96 r
Type — QRIVATE CORPORATION I C\ _qL 9!�
1 HOME INPROVENENT CONTRACTOR...
' Y j"istratioa 100140
Capizzi Home -Improvement , Inc. i Type -.•PRIVATE CORPORATION-
Thomas -Capizzi , Sr . -Expiration - --06/23/96
1645 Newton Rd.
Cotuit MA 02635- i Capizzi Nose Improvement, Inc ++I
Thomas Capizzi, Sr. I
-iV o,r" Newton id.
AD"pN1 wmn •Cotuit NA 02635 j
Restricted to: 10
1EPARTNE11 1F ►UBLIC WEFT
ug CONSTRUCTION SUPERVISOR LICENSE I 10 - Noet
l
' Irobtr: . Expires: lirlldele: IA - Nssoorr oily
CS 146119 10/21/1196 10/29/1148 16 - 1 1 2 Fjoilr Nous
Restricted io: 10
• Vp IAVID N 1E8B
Ca" MSM#MR 100 PLUN NOLLON RDcd
ti
` I E FALNOUIN, NA 12S36