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HomeMy WebLinkAbout1216 SANTUIT-NEWTOWN ROAD �"/��� �� :fie � � , - � � � � �- �- N �. as ` 1 r �, J '� � �. � �� w .� L �Cy�--�--- _ R _ .�--- '� �� 'r i TOWN OF BARNSTABLE BUILDING .PERMIT PARCEL ID 026 037 001 GEOfASB ID 1441 ADDRESS 1216 SANTUIT-NEWTOWN ROAD PHONE COTUIT ZIP LOT 1 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CT PERMIT 84606 DESCRIPTION W X 46` OPEN PORCH PERMIT TYPE BADDD TITLE BUILDING PERMIT ADD DECK CONTRACTORS: CAPRA, FRANK Department of ARCHITECTS: Regulatory Services TOTAL FEES: $80 0 BOND $.00 CONSTRUCTION COSTS $7,000.00 434 RESID ADD/ALT/CONV 1 PRIVATE * BARNSTABLE, MASS. i639. BUILDING DIVISION BY DATE ISSUED 06/03/2005 EXPIRATION DATE / //� — _ �'° _ Zvi _ TOWN OF BARNSTABLE l BUILDING PERMIT TARCEL ID 026 037 001 GEOBASE ID - 1441 ADDRESS 1216 SANTUIT—NEWTOWN 'ROAD PHONE COTUIT ZIP — LOT i BLOCK I DLO =-SIZE DBA ,DEVELOOMENT DISTRICT CT PERMIT 84606 DESCRIPTION 8'X 46' OPEN -PORCH '. PERMIT TYPE BADDD TITLE BUILDING' PELT ADD, DCA._ CONTRACTORS: CAPRA; FRANK _ r De '°a"rtment Of ARCHITECTS: j - Regulatory Services TOTAL FEES:_ $80.00 j BOND $.00 �atNE 1� CONSTRUCTION COSTS $7,000.00 "'1• 434 RESID ADD/ALT/CONV 1 PRIVATE P , O * fARNSTABIA • \I MASS. i BUILDING DIVISIO DATE ISSUED 06/03/2005 EXPIRATION DATE, THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS,-THE-ISSUANCE-OF THIS__ • J,.PERMIT-DOES-NOT-RELEASE THE APPLICANT FROM THE-CONDITIONS OF ANY APPLICABLE- - -- SUBDIVISION RESTRICTIONSf MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB.AND THIS CARD KEPT POSTED UNTIL FINAL INSPECTION WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS r PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECH- 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- (READY TO LATH). 'PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE gNICAL INSTALLATIONS 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS-BEEN MADE,i . 4.FINAL INSPECTION BEFORE OCCUPANCY. t- "� 1-, \­- I I Im BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 I I I 2 2 2 I " I I I i 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT I I I 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL 'k WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME4NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTIONVORK IS1N0[:STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- .MONTHS OF,DATE`THEv?ERMIT IS,ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOtEp ABOVE f TION:" f �. jam.. � • � :� - x' �. ., '4 Map Page 1 of 1 Town of Barnstable Geographic Information System Parcel Viewer Custom Map Map Size ® Zoom Out, ( ®'� In L$ 7PG Map: 026 026044 54� 026034 Location: 026024 026030 026003002 # .3' # 1152 # 23 U 60294 }# $ �# 78 026003003 Owner: 026043,t, 026023 ` # 35 4� # 1155 # 1166 f�` '`1 't+irr Location In 026022 0260'28 �° '�ty Map & Parce # 1178 #45 Location 0 005003,026005002 Acreage 026021 0 # 79 # 11�90 0260045001 026005 4 O'6037001 # 95 # 109 Current Ovk 026020 # 1216 Mailing Addi # 0 026042 i2 1215 Et 0261D370132 A raised Extra Featur , �� � ,� Out Building 026041 - _ a Land # 1229 „ � w= f _ Buildings ' wll �sa,t sue. :. PP, 00 Total A rai 02603 p � a dt Mgr R � Assessed V 6040001 : "6 37004 '' t � `� Extra.Featur 2z4 F 54 rf x & Land Out Building a a 'ui� ,: Buildings Set Scale 1" = 234 j' I Aerial Photos Total Assess Copyright 2006 Town of Barnstable,MA All rights reserved.Send questions or comment! BarnstableMA v0.2.7 [Production] http://www.town.bamstable.ma.us/arcims/appgeoapp/map.aspx?propertyID=02603700l 8/16/2006 �° F� -ram RESIDE SEEDS -POOLS -DECKS-OP FEE VALUE ACCESSORY STRUCTURES >120 sq.ft.(Sheds,g >120 sf-500 sf $ 35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf USE NEW BUILDING PERMIT DECKS X (Number) PORCHES X, ' (Number) d W 6 On /l r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ZO 3 -?- 00 Map 3-7- 1 Parcel Application# fJ 2�5 Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application Fee-4_v c7 Planning Dept. Permit Fee 3 a 0 0 Date Definitive Plan Approved by Planning Board Historic- KH Preservation/HyannisI" TV 0 Project Street Address to / V., I A,,,-Xitl j t) Village ]"uJ Owner T11' (i � � A ' � /�� �� Address Telephoned Permit Request no it 1940 1 jz�( �} ',G�-�J� E 42 V AC4 1 , 0TA:i*I 4;- Aged` Square feet: 1 st floor:existing a proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 14-0 0 Construction Type 00 L , Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure I Historic House: ❑Yes 50o On Old King's Highway: O Yes 'A No Basement Type: .'Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 4//4 Basement Unfinished Area(sq.ft) f7&0 Number of Baths: Full:existing 42.. new Half:existing of/, new Number of Bedrooms: existing new / Total Room Count(not including baths):existing new— First Floor Room Count Heat Type and Fuel: ❑Gas id Oil ❑Electric ❑Other Central Air: XYes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 2 No Detached garage:❑existing ❑new size Pool:❑existing ❑new size, f Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:W existing ❑new size LM Other: Zoning Board of Appeals Authorization ❑ Appeal,# - -°` ` - Recorded❑ - Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Ahie Telephone Number Address !!�jP 4 &A* License# / y� AG,yx�l0 Home Improvement Contractor# 1101f2. 1 r Worker's Compensation# 6�'�`�a—�� i'�o ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE '.�3-�' S G {" FOR OFFICIAL USE ONLY i' i • . .l PERMIT NO. � 1 DATE ISSUED ' MAP/PARCEL NO. t —s ADDRESS VILLAGE, Y OWNER i DATE OF INSPECTION: I�f FOUNDATION i FRAME INSULATION ,r FIREPLACE ' r i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL _ GAS: ROUGH FINAL v FINAL BUILDING t . DATE CLOSED OUT ' -- - ASSOCIATION PLAN NO,. r — 1ne t,ommunweatrn ujlvlua�acnu�e�w Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 • www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pluir>ibers Applicant Information Please Print Legibly Name (Business/Ora nizationUdividual): Address: City/State/Zip PIMY r-M C P's �, � Phone M ?®a) Are you an employer? Check the-appropriate box: Type of project(required): 1. I am a employer with 3 4• ❑ 1 am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2. : 'r I am a sole proprietor or patner- listed on the attached sheet $ [1 Remodeling - ship and have no employees These sub-contractors.have S. ❑ Demolition working for mein any capacity. workers' comp.insurance. g, ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am homeowner doing all works. right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. r ' C. 152, §1(4),and we have no 12.0 Roof repairs insurance required.] t . employees. (No workers' comp.insurance required.] 13 Other_ - 4 *Any applicant that checks box#1 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. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers corrrp,policy information. I am an employer that is providing workers'compensation insurance . r m em toes. Below is h P 8 p fo y p y e the pokey and,y®b site information. Insurance Company Name: �� /Y��_ i t® r��c/�a t..C i Policy#or Self-ins.Lie, #: 64,C z ud k—/.X SU 6 P� o Expiration Date: 1- --� Job Site Address:12/G ..;�ir;i R City/State/Zip: -1. 02- 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 certify und pains and penalties of perjury that the information provided above is true and correct. Phone#: ,/ E-0 v 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): I.Board of health 2.Building Department.3.City/Town Clerk 4.Electrical Inspector S.Plumbina Inspector ll 6.Other Contact Person: Phone#: °1114E,°� Town of Barnstable Regulatory Services BARNSrABL& ' Thomas F.Geller,Director v •Mass. $ `bA,fo i9. a`0 Building Division Tom.Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 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. e-Type of Work:-�L�� _Estimated:Cost_�% Address-o f� Work- / Z % cOwne_ r!s N me: , �F� Date-of-Application:__ --,,r�21 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 fi 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 PENALTIE OF PERJURY I hereby apply for a permit as the agent of the owner: �`r l Date Contractor Signature Registration No. R Date Owner's ture Q:wpfi]es.forms:homeaffidav Rev: 060606 Town of Barnstable ► ` regulatory Services . t y, MAN, m Thoas F.Geller Director ' Building Division. �fD Mt+'� r • Tom Perry, Building Commissioner 200 Maier Street; 15yaunis,MA b2601 www.town.b arnstab l e.ma.us Dffice: 508-862-403 8 Fax: 508.790-6230 Property Owner Must Complete and Sign This Scction• -If Using ABuilder -1-'I &AXI C." ,as.Owner of the subject property hereby authorize %QA w � ��, to act on mp behalf, in all matters relative to work authorized bythis building permit application for. QWJV(. (Addres'i of Job) Signature of Owner at Print Name Q:FOgZy15:OWNERPERMLS5I0N ' VDAC WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CHANGE DOCUMENT WC 89 06 00(Q0) POLICY NUMBER: (6S59U6-861 X751-6-06) CHANGE EFFECTIVE DATE; 03-22-06 NCCI CO CODE: 80381 INSURER: CONTINENTAL CASUALTY COMPANY INSUREDS NAIVE: CAPRA, FRANK G DBA CAPRA HOPE IMPROVEMENTS This change is issued by the Company or_Cosnpanies that issued the agreed that the policy is amended as follows: cK�d-forms a part of.the policy. It is An absence of an entry in the premium spaces blow means that the premium adjustment,at time of audit, justment, N any,will be made ADDITIONAL PREMIUM $ NI ADDITIONAL NON-PREMIUM $ NIL RETURN PREMIUM RETURN NON-PREMIUM $ 3 THE STATE. CHANGEI L THIS POLICY ENDORSEMENT WAS PROCESSED DUE TD A CHANGE MANDATED BY i THE FOLLOWING ENDORSEMENT(S) IS ADDED: .�. tdC89040600-01 POLICY INFORMATION PAGE E -EXP WC89060000-01 POLICY INFORMATION PACE ENDORSEMENT WC89061400-01 _ POLICY INFORMATION PAGE ENDORSEMENT THE INFO PAGE SCHEDULE(S) ATTACHED REPLACE THOSE ON '-= THE POLICY. C - DATE OF ISSUE:04-24-06 Ate CHANGE NO:o0i POL. EFF: DATE:03-22-06 POL EXP. DATE: 03-22-07AGE oo1 OF LAST OFFICE:CNA 04%J PRODUCER:FLAGSHIP INSURANCE INC 26" a - ' i. e�/ ' I + I I tires I S� i I i I��-i I Y L I �i I i' ro jr 00 i i t � I +� ` � 8 .DUI v• � "i t �,,, i I � I ,1 3 � 6 �t r , � - I I i i v _............. _........ 00 I ���� 6 Ste ✓ � � 4 io -. CoTv j 2 � r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION s Map , 2 6 37 001 Parcel G 67- � Permit# ao Health Division Date Issued Conservation Division Application Fee Tax Collector Permit Fee *30, Treasurer Planning Dept. EXITING Date Definitive Plan Approved by Planning Board umnw To. OR MROM Historic-OKH Preservation/Hyannis k Project Street Address Village Owner � �� ��� l ��� L Address ] Telephone Permit Request 2IV — , r Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood'Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family M/ Two Family ❑ Multi-Family(#units) Age of Existing Structure _1 6 Historic House: ❑Yes No' On Old King's Highway: O,Yes ;2(No Basement Type: 67 Full ❑Crawl ❑Walkout 0 Other . Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new o 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 _VOil ❑ Electric ❑Other Central Air: ❑Yes UNo Fireplaces: Existing _ New Existing wood/coal stove: ❑Yes Jlo . Detached garage: ❑existing ❑new size Pool: 0 existing ❑new size Barn:0 existing ❑new size Attached garage:❑existing 0 new size Shed:Yexisting.O new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes VNo If yes, site plan review# Current Use - - - - Proposed Use r BUILDER INFORMATION Name �� Telephone Number 34— 2 — 3A? Address _B 6_12 ��} �� ` License# VV V M"q 3 O L Home Improvement Contractor# J J b 3 a Worker's Compensation# Ma I ALL CONSTRUCTION DEBRIS RESQL1ING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE / DATE FOR OFFICIAL USE ONLY PERMIT NO. PATE ISSUED MAP/PARCEL NO. ' ADDRESS VILLAGE OWNER r I ' DATE OF INSPECTION: r FOUNDATION FRAME INSULATION FIREPLACE ` ELECTRICAL: ROUGH N FINAL S PLUMBING: ROUGH tJ FINAL GAS: ROUGH _FINAL x' FINAL BUILDING ' 1 DATE CLOSED OUT ASSOCIATION PLAN NO. s r• r Town of Barnstable • � i . Regulatory Services ' anxNsrnB Thomas F.Geller,Director s M,►sa g Building Division Tom Perry, Building Commissioner 200 Main Street, Ijyannis,MA 02601 www.town.barustable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize T Q -r C 0� to act on my behalf; in all matters relative to work authorized by this building permit application for. t(Address of Job) afore of Owner Date f Print Name aK FIwe tqy Town of Barnstable w h °�^ Regulatory Services saFuvsras Thomas F.Geller,Director Mass. 9 Ma q, 039. Building Division ABED MA'S A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-962-4038 Fax: 508-790-6230 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: 0 Estimated C s o . Address of Work: Owner's Name: Date of Application: t� / /'0/ ;zoo 6 I hereby certify that: Registration is not required for the following reason(s): QWork excluded by law ❑lob 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 PROGRAI`A OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERMRY I hereby apply for a permit as the agent of the er: Date ontractor Name Registration No. OR Date Owner's Name ' Q:forms.homeaffidav The Commonwealth of Massachusetts Department of Industrial Accidents 600 Washington Street Boston,Mass. .02111 Workers' Co m ensation.•Insurance Affidavit-General Businesses address: city state: zip: phone# work site location full address): I am.a sole proprietor and have no one Business Type: ❑Retail -RestaurantBar/Eating Establishment working in any capacity. ❑ ce❑ Sales(including Real Estate,.Autos etc.) ❑I am an em to er with em to ees(full& art time. ` Other % / i� � I am an employer providing workers' compensation for my employees working on this job. e_:e: eOlil .Ilm^an ' 6>' � :. city: t 5�,�1 �:�D��y. phone:#:,.L�f):�. :`�.�` .._ :� •, , ..... .- 4. , V11711/ �/ I am a sole proprietor and have hired the independent contractors listed below who have the following workers, compensation polices: T addressi. incur nc com' V an `uea�ei A address:. • �-`. " ' . - - ' ' c3ty::. ,. .; - :'tiltone:# t' �:. 8 a: .:..::: .:::> .- OIie 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$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK OP.DER and a fine of$100.00 a day against me. I understand that 0 copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify ands pains andpenalties of perjury that the information provided above is true and correct Signature Dates 'V"V1= Z. 21,9 Print name ��a�^-v G tjp a a Phone# 1 �✓ L ' Ing official use only do not write in this area to be completed by city or town official city or town: permidlicense# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department - contact person: phone#; ❑Other (revised Sept 2003) za Information and Instructions Massachusetts General Laws chapter 152 section 25.requires all employers.to provide workers' compensation for their.. employees. As quoted from the f`law", 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 dw g g . , 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 section 25 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, 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 in the workers' compensation affidavit completely,by checking the box that applies to your situation..Please supply company name, 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. 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. . 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 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 life to thank you in advance for you 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 e m of 1® sugawns 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext.406 AS(JI�I�' S i3 col) cox a.arL , x,F c-14 o r -71 ` a { _ { _""!-.-^.®_-a-' :r.'..�'.�""•:t:1 3 � .,� Y �� i �� ) { .� � } � � � d.H.:.d.. .z � r i�' ,� �. � 3 �.'. ? .i.�_ ._I i !p _ ji 77 71 7-7 :1 ..,.{� ....,.,-•I..:....T...,�:-,rT-..,a fr...... f}s.--..k�.-., -�"^ ,l j os-.,.;.�- �� '` i �. - 3 1 ;• Z .,,,._�t°L t 7717, jl x `, IL ;1 7 ! !gym1' ;1 .1.,...,�.. "..�...,:,,....1-- ! ',«• .�...- k�.w:. 1 ��A- 1 'r'.�,`.; }$. JV"� 7 •l: 'v .' 9 i• e �� f { ��3. ,i i� '.{.._ +.. ..�..�;.;-•.-R.1 ..� F'''-.'A t*�.tr�.:.'»��. S. 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'__ .�__�'--b•-''-- �. ...I . .. ..iw��-_;• �•I,.._. . I -i-• -F 'i_.J__J.. � _ -1. _i_"'._ 1. - i -.; .i•-1 � � , I• I .� _�.1 t S --T• _�..i�l •.�._..' _i. .i...J• 1 T I }I �':�:��� I I. ..t._s. •yo "' ' .J. r I, �?� •;' -�..-� .�.�_�..-�—s- �_� . 1 JD ' i• ' r ; I ; t f FF r L ` _ ' I , ' r .A - I c. • I IT�ff •{i-� r - i f License `QSTRjUCIiOM E` �CTaCO'I • - lulu is � ��'��R�lS®R� 01,2430. _ x 06 Tr.no: 25926 FRANNW 0Aype ago CEfi1T,���I�LLE; o_ 5 ' 1N 6 = Board of Bu' ing �gulat ns an tan ar�s� One Ashburton Place'- Room 1301 Boston. Mass4ghusetts, 02108 Home Improvement, _ tractor Registration io n Registration: 110321 ` A Type: DBA W Expiration: 10/20/2006 CAPRA HOME IMPROVEMENTS FRANK CAPRA 40 COPPER LANE W CENTERVILLE, MA 02632 - Update Address and return card.Mark reason for chang Ej Address Renewal ❑ Employment El Lost Card DPS-CA1 0 50M-04/04-G101216 • Town of Barnstable �pFTME Tp� Regulatory Services Thomas F.Geller,Director • 1AMSTABLE, • MASS' — f Building Division 039. �0 Tom Perry,Building Commissioner ,�.>200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERNHT# FEE: $ lJ' SHED REGISTRATION 1 120 square feet or less Location of shed(address) Village Property owner's name Telephone number Size of Shed Map/P cel Lea Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEES PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A pG�� PLOT PLAN . Q-forms-shedreg REV:121901 — _ r I : t • : f .. I _ I ' ; I __ I I , 4 I . . i- i _ • r r , ' L 1 — ' ! _ —i — - Y Tr , I , : • r� I ' I I I l 1 1 i 1 44 —`.3'A il_ !19''� I^— F-' —1• ._a... _ I I _'•�i. —t- '•i--•t--t., . 1 - TT _ I ��7ll�ti r��- rL,l'1F�'11f1"�I�I lJ I�3 �i ; _'• -�._'� -;.._,.. � `�. .L � .,. ,. .�, � _ ,� _T-^i• � t � •r -.'1._.'_. ._�__y.��-� ..� - .1_ 1 • � T I TTT'__ .mot_..___.. t ' �_ ' ...}.. 1 } r _ C �..... ..i.. 1 I. TOWN OF BARNSTABLE permit No. ____27542 . :. Building Inspector seaan�a i Cash ------------------------- °'"Y' OCCUPANCY PERMIT Bona Issued to Robert Glover Address 1216 Newtown Road, Cotuit Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date XEngineering Departm t Inspection date G Board of Health Inspection date THIS PERMIT WILL T BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUI DING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ...................................................... 19......_.... .................... .................._......... ............ .... ...:..........................._ Building Inspector TOWN OF BARNSTABLE permit No. _27542 su.n i -Building Inspector cash - '��` OCCUPANCY PERMIT Bond _ ___ -` — -- �J 3 . Issued to Robert Glover Address 1216 Newtown Road, Cotuit Wiring Inspector Inspection-date Plumbing Inspector Inspection date { ",N Gras Inspector J ': Inspection date XEngineering Department`"- rs f Inspection date Board of Health �� n, �� �l \ ! Inspection date , 4THIS 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. ' .±......... ......... 19..._ _ :................:.................. ................................:.... ...._...... �... .__ Building Inspector '>. TOWN OF BARNSTABLE 27542 � Permit No. ------------------------- �� i Building Inspector cash ------------------- 1619. ` x OCCUPANCY PERMIT Bond ------------------_------------ i a Issued to Robert Glover Address 1216 Newtown Road, Cotuit Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector / Inspection date Engineering Department f r.,.,�� Inspection date .1 } Board of Health ;w,. "�� 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. •h ............................."...................... 19 . . ..... ............................................................................................. 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I'�r_i.-.F_.:_ r I �i (• I I;�� � I � LT l t ` + t• _J-_ �+ 7 J I--1_J--�. '. + r'~I - I 7 + , r 1� f.� t + i.,�,i. 1 F ' Iu' ' t + - � I I -�li ' I I� i f1. 4_i-•� I i r , _. �II G P. • z I I Witt3AM M, i 1 r I ' � - J I , I : i ' Lic _.- - 17,7+' + _ I .-.__��._s..__1...J_�.-...... _..�.-._...,::.t.-+ ..!_ .J._:..-t.. ....a...t..,i 1,........:4.«+.-..c•-�,,.l...t.,.__�.�� .I:...l....+__.....4 J L_._._-:��....i.-L-_L':�_r.......��..,.1.._-. � 1 'Jz MUST BE 7- SEPTIC SYSTEM Assessor's map and lot number ............................... mIL &`AL�.E�► IN COI�: LI I C c OsTNE tCfr �} WITH TITLE E Sewage Permit number .............���.�.a.�2...4............!.:�'1 � S ENVIRONMENTAL r� House number ... ................Z....... ro roseCb C qpY TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............ ��„�� � ...... / f�✓ ..... TYPE OF CONSTRUCTION ..........1� d ...........: ,i .................................................................. ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............................................. - .0 .. .................................................... / �/ ProposedUse .....-5� ......./"/s��:y�...........................................................................................I......................... ZoningDistrict ......................`.................................................Fire District ....(2 7........�................................................ Name of Owner .. f% � �...... a d/�/-1 .....Address ......... ...../o.!. �-�.k).... .//J'd..�l.... t � Name of Builder lJ�� �.�e..... ....Address ...�l�� f�� i! .r�� ✓.................... � Nameof Architect ................../..............................................Address .................................................................................... Number of Rooms .! .. ........................................Foundation Ql-/ �'.........CZl/L�C'� ................... .. ...................................... Exterior llli-eW......... ...................Roofing .....��t �2�/� T................................................ Floors ...........lo/..�...................................................................Interior ......5!!?l .K..�! .................................. Heating ...........6k...........:.......................Plumbing ........ �...... �'/ ��..�%1................. Fireplace ............................................................Approximate Cost ...............4. .................................... Definitive Plan Approved by Planning Board ________________________________19________. Area 7361 S /....................... ........' Diagram of Lot and Building with Dimensions Fee �j ........ .7.P....-""_"--........ SUBJECT TO APPROVAL OF BOARD OF HEALTH zO Q� µ 1 q0 �c ZD1 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'................... r . ........................... .. Construction Supervisor's License .................................... aDVER, RDBERT a No .. 7542.... Permit for ...l.Story.................. .........::;Singlet 1y 1 17.ir ................. Location 1216.11--vitown..Road.......................... COtuit Owner ...Robert Glover .............................................................. , Frame Type of Construction .......................................... • R ............................................................................... 1 , Plot .........................:.. Lot .......................... Permit Granted ......Fy..2. ...:......19 85 ( ` Date of Inspection�l�-. ::. ....................19 a r ^ .e. Date Completed ..... ..............................19 ' • f . Assessor's map and lot number . ...`........... � _ N Sewage Permit number ......... -..... ..........................t..r.rl d EAWSTADLE. i House number rasa 1639- TOWN OF BARNSTABYLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............................ e ....................................................... .. ��d0 � � TYPEOF CONSTRUCTION ................. ....................: ........,::...................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: r . Location ! J , f i._-� r....................:.,...:.?..:...:!..... .................................................... ......... .............................:...'. Proposed Use ......:SfJ�i�%'�Jy �1:.�t' .................. Zoning District ........ ............. Fire District .. ...... ....... 11:............ .....Address Name of Owner .. {?! ....:. , r .. !i?� ✓,., ./ w Name of,.BuilderJr .... . ✓ .. ' •••�—!� ......'... .........Address ...1.�,..... ` Name of Architect ......... '.. ... ✓� :F .....Address �..:`..r" ....... ......`. ... .. Number of Rooms ...................................................................Foundation .............r .. .... Exterior /,,ez S` //I'�J .....................Roofin ti�� �%LT Floors .Interior .....a � z �/ ' Heating...........,> �T���/''...,.^..f .... . " ........... Plumbing ................... . .. . .? �e.. . . .......................... Fireplace ........ i .f�..............................................................Approximate. Cost .................................................................... Definitive Plan Approved by Planning Board ________________________________19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TOLAPPROVAL OF BOARD OF HEALTH 1 f f ,'J ... b 4l 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. f ,Name ............ ........ ..: l � !� .......................... Co nstruction Supervisor's License .................................... GLOVER, ROBERT A=26-37-1 .... Permit for ...L�qry................. No .. Single Family........................... .................... Location J2j§-M.WtQ .2oad........................ .......... ................................................. Owner J Xt..91.Wer................................... Type of Construction Fxam............................. ............................................................................... Plot ............................ Lot ................................ Permit Granted .... .�r.........19 85 Date of Inspection ....................................19 Date Completed ......................................19 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map3 40P;� Parcel 43-2 00 0 " � Permit Health Division Date Issued Conservation Division Feet Tax Collecto w Treasurer ��- - Planning Dept. i Date Definitive Plan Approved by Planning''Board Historic-OKH Preservation/Hyannis Project Street Address Village i Owner Address Telephone Permit Request V� - Square feet: 1st floor:existing proposed 2nd floor:existing.. proposed Total new 0 Estimated Project Cost L Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yesf ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family 0 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 Total Room Count(not including baths):existing new First Floor Room Count e - Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing . New Existing wood/coal stove: ❑Yes 0 No Detached garage:0 existing ❑new size Pool:❑existing- ❑new size Barn:0 existing ❑new size Attached garage:❑existing ❑new' size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ "Appeal# Recorded 0 Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION - �, 47 Name Telephone NumberJ( Addreis P0 V License# Home Improvement Contractor# /40 C � Worker's Compensation# ©0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOlay SIGNATURE Q DATE d` ` — 3 r, - FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. �'r a 1` _� • o �Y''r , .., _ _ ' - - • l• - -� ..a-. r ADDRESS :-VILLAGE OWNER DATE OF INSPECTION: , _ •_,, FOUNDATION FRAME q INSULATION FIREPLACE '" + r` • - ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL - • GAS: 'ROUGH FINAL � `. - __ .. r* - •' - • � f � `�', . ,. w �> FINAL BUILDING " DATE CLOSED OUT ASSOCIATION PLAN NO. c required unless same color/same materials specified on application Map/ arcel number Sign-offs m: Tax Collector Treasurer of squares of shingles or square footage of roof to be shingled Ospecify stripping old shingles or going over old roof. If going over Ohow many roof layers existing now Owhat size are rafters? What is span? Complete dwelling information for the Assessor's Dept. -if known Workman's Comp, form [Home Improvement Contractor Affidavit(RESIDENTIAL ONLY) [Home Improvement Contractor's License O ���Homeowner's License Exemption(RESIDENTIAL ONL �eck expiration date on license COMMERCIAL WORK-No License is required. L Fee ,.' 367 Main Street,Hyannis MA 02601 ` Y MCC, SE8-8o1-4038 Ralph Crossen ax: 508-790-6230 HuiIding'Commissio::er Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERWr 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, Estimate Y! d Celt � I t Address of Work: vl 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 E30wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IOROVEMENT 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 th owner: JIA Date Con ame Registration No. OR Date Owner's Name g1orms:Affidav t ric. t—UMMU11wealill Uj massucuusells Department of Industrial Accidents ?t -_ Office 011HY050alfOOS 600 Washington Street Boston,Mass. 02111 i, Workers' Com ensation Insurance Affidavit city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one workin in am'ca acity �am an emplo er providing workers' compensation for my employees working on this job :company name.. k address. hone#. insurance co. olicv { l ' ❑ 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: companv name. .: - address. .ems Ci phone# .. ...... :::::::.., :::....: comany name: ::.::::.:..::::..:. .. ...::::.:...:::..• .:.:. ..: ,:;:;:::>:::>:`::.c:> 4:% i:?E<:<: «<ii .: y; ;' ::':::. amp address. city ,. _ A) one# e w X. :........................ olicv# Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to SI,5mo0 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 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 the p penalties of perjury that the information provided above is tr�u`:an#corre Signatures : L Date T r Print name 1 Phone# IN- official use only do not write in this area to be completed by city or town official city or town permit/license 0 ❑Building Department ❑check if immediate response is requited ❑Licensing Board ❑Selectmen s Oiflce contact person: hone tt _ ❑Health Department P ❑Other Ur ued 9195 PJt) ' Jae &44xonwea" 0 , HOME IMPROVEMENT CONTRACTORS REGISTRATION . Board of Building Regulations and Standards I � . One Ashburton Place Room 1301 I Boston , Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR 1 ------- ---------- Registration 103714 Expiration 07/09/00 I Type PARTNERSHIP I 07. o lad yl,�laa� ! HOME IMPROVEMENT CONTRACTOR I Registration 103714 PAUL J . CAZEAULT & SONS ROOFING Type - PARTNERSHIP Paul J . Cazeault ! Expiration 07/09/00 22 Giddialt 'Rd . P .G. Box 2781 Orleans MA 02653 PAUL,J. CAZEAULT & SONS ROOFI Paul J. Cazeault &�iddialt Rd. P.O. Box 278 I ADMINISTRATOR Orleans MA 02653 70 Il i tl�l 'il. r!I Ill i'Ll il,.l, I i 4 a 1'(IN ! ;_ I r(li! ,.Lli'L_i?d.l,•` Oir. L I I,'I�jc i; t a"� ` h!u l I lb y y !f T J X IQ .. 1'.I I.i.:1, ,1 lip,• d4�.1 r1 ' 4, i +„f i st . �J M fa a i. i I 1 :? - s K'.z •• :l1tC Vd!)L!)LOOLIlM.OU+� O�a.l��JJI.LC�UJG'!!J'� � .. E 4 DEPARTMENT OF PUR IC SAFFTy I (ONSTRUCTTN, SUPERVISOR 110ENSE Number: FzPil'es: Firl;,rlrlP: CS 026325' 10120(i9)9 B 41 95y ., :` Resrrie`led Toi NB r•'Wf�UI-J''CAZEAUET . i ISM;MAIN 5T QUERVIL11, MA 01655 t CB g (FND) SAAMIT POND fill - 6 /6) `\\ ' —, ; 61 _ co vscrs POND If / ; — fit, G LOCUS LOT 1 SHED SKETCH OF LOT � NOT TO SCALE Lo MIS POND ASSESSORS -;'�� f 613 MAP 26-37-1 - 5�9 4 ' -_— LOCUS MAP PLAN REF 331—93 L LOT 2 "1 1 ASSESSORS MAP. 26-37-1 �o ,, ,, ,,,,,,,,,,,,,,,,,,, n ,,,,,,, ZONING. ..RI,,. \\ --- ASSESSORS � ,—_ _ -;;;;;;; �1216;;;;;;; SETBACKS: 30'-15 -15 C F p """ . """' - DEED REF 8659-225 MAP 26-37-2 �P SN if PLOT PLAN OF LAND ef4,0 r' __- LOCATED AT.• s6 'ECK ;�— �- 1216 NEWTOWN ROAD BENCHMARK '° MARSTONS MILLS �Q ? OP CORNER OF �JP P ATFORM, ELEVATION = 54 `\ PROPOSED 52 FROM CIS DATUM O� oo= ----— \4 ' STONE' PREPARED FOR- WALL WALL ,- ° "-; o .' PA=TRICK CA TALANO . O Q�y (FND) FEEVARY 20, 2005 0P 0 \ C.B. PGATFt7RM REV J O -�-—- dr STAIRS l- ►►►►�� , 7t7 WATER ► �N OF�LGSS � REV FLAGGED BY -- - s \ _ -- :!r1J�P�G�stEgF��hG�`► TAVARES WETLAND — — '46 -' S __— ' '-- _ �— REV- STEP REV 44 -_- ---- Ik - - c DOYL N YANKEE LAND SURVEYORS SER VICES — _ . _. ' s z ti, =3,- 42 — WATER LOCATEJ� GRAPHIC SCALE EDGE :� �� F�; & CONSULTANTS OF oz E ,• P.O. BOX 265 30 0 +s 30 60 f4_05 UNIT 1, 40 INDUSTRY ROAD MARSTONS MILLS, MA 02648 L O VE'LLS' POND TEL• 508—4,28—0055 FAX 508—420—5553 1 inch = 30 ft. SHEET 1 OF 1 JOB f- 53819 ✓F D2 � 3 � �{ 1 I f i CQUALITY PARK Mo 10 x 13