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HomeMy WebLinkAbout0071 TARAGON CIRCLE / ,ewC � i 1 r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map `0q1 ParcelQ$,^-> >C/)G INSTALL � i �� Permit# Health Division — 2- 0 �® Ian ®� 110fisued C04 WITENVIRONMEpiT°�aL TiTLE S Conservation Division G 2V. -- ( CooEF ®U TOIA 'I Tax Collector Treasurer �V_ Ay ` Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address '] 1 T#P 2 WGor� C t r? Village Owner YV E(Z Address Telephone Permit Request 50-n Ravy-n- ► d Q,4-,a, et R eCAA l oUs� - Ala u,, R2 of'- co' 1 CJ 2 tL m i W'eA w 2 W U-Lk M A Ilp o1 5 r+� mil' er.Q 2 aoi►tio t w f o _� "` j L�2c��C ars✓r1 , 1144 Square feet: 1st floor: existing Off/ proposed. 2nd floor: existing — Qin proposed 'v Total new OOP Estimated Project Cost t9O,®00 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size :g_T Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 8 Two Family ❑ Multi-Family(#units) Age of Existing Structure q Yca.o Historic House: ❑Yes ®No On Old King's Highway: ❑Yes �Oo Basement Type: 39Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) -goo Number of Baths: Full: existing new Half: existing _ new it Number of Bedrooms: existing new Total Room Count(not including baths): existing new f I = 1 First Floor Room Count Heat Type and Fuel: XGas ❑Oil ❑Electric ❑Other Central Air: ❑Yes %No Fireplaces: Existing New Existing wood/coal stove: ❑Yes B No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:A existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes k2 No If yes,site plan review# Current Use R-es i ( Proposed Use Ff� gSt-�Qt� BUILDER INFORMATION FRA91R MONS B E�UCTI N Name. Telephone Number Address CO 41 'MA 02205 License# (508) 428-2292 Home Improvement Contractor# Worker's Compensation#�&.tr...It/.S`aa 3630/7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Y K/�n�rn It'►'� , SIGNATURE DATE O FOR OFFICIAL USE ONLY k : PI✓RMIT�NO. DAATE ISSUED MAP/PARCEL NO.. ADDRESS #..`' a VILLAGE OWNER DATE OF INSPECTION. } � FOUNDATION.-t r FRAME INSULATION ` FIREPLACE ELECTRICAL ' r ROUGH FINAL PLUMBING:! ROUGH FINAL ` GAS: k.=ROUGH FINAL FINAL BUILDING _ DATE CLOSED OUT - ASSOCIATION PLAN NO. ' r {.__. The Commonwealth of Massachusetts =- _= Department of Industrial Accidents ` ` = Office ollAresgoodons 600 Washington Street --- Boston,Mass. 02111 � 4 Workers' Com ensation Insurance Affidavit name c•�^ C i=' di-S-P/� location: 2 1 T A LI S are C I k city co+ ,,,& 1-n A. phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole pro rietor and have no one working in any gad I am an employer providing workers' compensation for my employees working on this job.: :............. .......... . .....: '.. ...... ::::: . ........ .... ........ .:.:::....:::: company name .: t dti� 4 r� shone#: cites i 'i1 insurance co. ❑ 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: com anvname. :. ::;:: .;:;<.:::.::::::::'.:...:.. :::::::::::: address: :.. _. :;::>. _...... .............................:.:.:::. :... X. "::..:.: ...... n on ieanran c .. ::....::::. ::::..................... ::.. :.:. . ,Bone . city- p w iacV sarance co_:.... _.. :..:.:....:.:. < " 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 ORDER and a fine of$100.00 a day against me. I understaud that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. I do hereby certify pains and pens perjury that the information provided above is true and coned Sipature Date Print name Gt�vt /�i/l G..�.�1 Phone# -a a5;a official use only do not write in this area to be completed by city or town official city or town: permitllicense# ❑Building Department ❑Leah D Board ❑check ng if immediate response is required ❑Selectmen's Office ❑Health Department contact person• phone#:- __ ❑emu' IN 1111111111 Oevised 9/95 PJA) The Town of Barnstable 9 �'zes� Department of Health Safety and Environmental Services . .o y Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-403 8 Ralph Crossen Fax: 508-790-6230 Building'Commissioner Permit no. Date id av 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: i �7 .M _Estimated Cost d ®vO f Address of Work: 't7/ T/Tfiq 5a Clef Owner's Name: 11 �� -► Date of Application: S 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 00wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. 11 A,0 5 6 /Ili -,X/as � DaX Contractor Name Registration No. OR Date Owner's Name q:fomis:Affidav ' I ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE square feet X $55/sq. foot= GARAGE (UNFINISHED) square feet X $25/sq. foot= PORCH square feet X$20/sq. foot= DECK square feet X$15/sq. foot= OTHER square feet X $??/sq. foot= ® « � �a Total Estimated Project Cost 3 DCD g990915b s 09C-9 N/F TOWN OF BARNSTABLE 'v 00 \ :0) Ln N a 285.83' ► o o' LOT 6 ` 47.161 14 � TOF Elev. = 64.9 ,O ,1 ^ 00 0 rn ;� '-,LOT 5 >, rn , 55,432, sq.ftf o O w , �J 0 276.67' U ' Z LOT 4 Q s . 1 0/16/911 INITIAL ISSUE elk THIS PLAN IS' NEITHER INTENDED N0,1 DATE I DESCRIPTION BY FOR, NOR SHALL IT BE USED FOR • AS-BUILT FOUNDATION PLAN-LOT 5 MORTGAGE LOAN PURPOSES. TARAGON CIRCLE a BARNSTABLE, MASSACHUSETTS FOR THEO CONSTRUCTION INC. I CERTIFY THAT THE FOUNDATION os� SCALE: 1" = 50' JOB NO.. 1583/1583 SHOWN ON THIS PLAN IS LOCATED PAUL A. yN 0 50 100 ON THE GRO S INDICATE n LEVY �! v 1; No. ic517 LEVY, ELDREDGE & WAGNER ASSOCIATES INC. ENOIEERS LANDSCAPE MCNITECIS PLANNERS LAND SURVEYORS AT FE IST RED LAND SURVEYOR T 1 j 889 WEST MAIN STREET CENTERVILLE, MA 02632 ��_`�`� �. ' I i k', . - - - �Depar nel--' f ::-. t Safety an Environmental Building Division ILAWWARM ' 367 Main Street,Hyannis MA 02601 NAM 1619; 1m$ Office: 508-862-4038 r Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION 11 Please Print DATE: 1 O a , JOB LOCATION: r?t' 7{q tgarwi number stint village "HOMEOWNER": t Aly t �' An`q 1-5J2 — name home phone q work phone CURRENT MAILING ADDRESS: Sr3 � city/town state rip code The current exemption for"homeowners"was extended to include ed 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 sum. DEFEgMON OF HOMEOWNER Perion(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=onsible for all such work performed under the building permit, (Section 109.1.1) The undersi ed"homeowner"assumes responsibility for compliance with the State Building Code and � P tY P 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 7ediff an ts. Signature of Hom er Approval of Buildirig 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 persons)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,marry 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 to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN ' — i . ( �/lo�JC,Srt� - � ' ' � � �: 1 1 j ,.�_ ;.. X S(� - x � �� �`� 5 i-mG-� � �� � . � I �����5 �� s � \ ��.. �6�a9 S-C - .� PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: .10/23/06 TIME: 15:22 -----------------TOTALS------------------ PERMIT $ PAID 25.00 AMT TENDERED: 25.00 ' AMT APPLIED: 25.00 CHANGE: .00 APPLICATION NUMBER: 20064072 PAYMENT METH: CASH PAYMENT REF: • Town of Barnstable ennit:C" 'THE l Regulatory ti Services ate J6b3/� Thomas F. Geiler,Director * BARN 39. E,g+ Building Division �2 ,.QD y MASS. ee: $iDtFo ,�a`� Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 TOWN OF BARNSTABLE Fax: 508-790-6230 SOLID FUEL STOVE PERMIT Owner: Phone: -SOS- 36c) — t av'T Install at: I Village: y�- Map/Parcel: �/_ / ��� �' Date:_ ,0 Stove A. New Used B. Type: Radiant/Circulating C. Manufacturer: `�'�M p woz, c1 D. Model No.: Lab. No. Chimney A. New/Existing (If existing,please note date of last cleaning) B. Flue Size !P C. Are other appliances attached to Flue? D. Pre-fab Type and Manufacturer E. Masonry: �nlined Hearth + A. Materials: uv o'- kZ(" bl v� B. Sub Floor Construction: ' Installer Name: �,S Phone: Address: 71 7 Location of Installation: 4 APPROVED BY: 0' / Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and a Building Inspector PProve d by the Wornwstove Rev 122801 TOWN OF BARNSTABLE Permit No. .. 34665 • BUILDING DEPARTMENT I s.,&a TOWN OFFICE BUILDING Cash ■Ml HYANNIS.MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Theo Construction Co. , Inc. Address Lot #5, 71 Tarragon Circle Cotuit, Mass. USE GROUP FIRE GRADING —: OCCUPANCY:LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL,NOT BE OCCUPIED UNTIL SIGNED BY'THE BUILDING.INSPECTOR. UPON SATISFACTORY:GOMPLIANCE WITH.TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OETHE MASSACHUSETTS STATE BUILDING CODE. January 1.6, 92 Building Inspector a yd —107, 7'ov o/o-1a7 Cov Assessor's office(1 st Floor): - Assessor's map and-rot number d Vl: 01�2-7ay f e) THE� �$ Board of Health(3rdfloor): m �, 4ri, a gfi wo� a o Sewage.Permit nuber �y � �. : 0L� 1 �• INSTAL aLt�¢ C E A Ti ilk i Z DABd9?ODLL i Engineering Department(3rd floor): ENWROWMENTAL C-C)xr)t rrus House number, 039• Definitive Plan'Approved by Planning Board 4> 19 'TOWN REGU ���` ON -7 APPLICATIONS PROCESSED 8:30-9:30 A.M.ak 1: -2:00 P.M.only TOWN OF BARNSTA13 �� � � o BUILDING INSPECT 11 s � o7�ery Q t=o n l v J ! APPLICATION FOR PERMIT TO / �.. //iv � om�=Ss�04 TYPE OF CONSTRUCTION " , ,' Da f i^ // 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 47 414 44 - 7 T ` (20 U/ !r' Proposed Use %ni - Zoning District �IC Fire District Name of OwnerEo �c. Address/78okw70�. Name of Builder S• A,)0, Address 5jaj"i Name of Architect Address / Number of Rooms G Foundation 0,- r, ` S Exterior aiynbo 9 K C -� ►.✓�,/E 66 CIA le- 5�; /6Aoofing I-VrAg j/ �-- i—z 16 Floors �11 z � d Interior G ,.,-. f�Q�,�. - 4a- L—Ag�6 Heating /V, Plumbing 2 Sig 2Ki Fireplace 4 f'�ifl�n�ro� Approximate Cost 7 Q62 , OCR I-o L r�-e PAC /l Co✓� d f'v► v�:� "-u�- Area M7..2 .S. F. Diagram of Lot and Building with Dimensions (s Fee -76 ®� v fad arz 6C> J . E-b�Z, f z 7 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 constructi Name Construction Supervisor's License Boa S� THEO CONSTRUCTION CO. , INC. - 7 No 34665 Permit For 1, stor4z Single Family DwPI 1 ; vTrY 'Location, Lot #5, 71 Tarragr)n Ci rcle, - Cotuit �wne s --Inc. ". Type of yConstruction Frame { Plot Lot s ` Wit. � r ,_ .. ", � i *' 'i -..� + i � ' .. •_ - �'• =F' Permit Granted Octeb6rr 2 5 , .19 31 r Date of Inspection/2'�-FZ I 19 t Co pl ted �`�P� �y19 ,A .JAMUS ARE SHIMMED AND PLUMHED:­2. INSIDE US ARE APPLIED• T0 REM f TOWN OF BARNSTABLE, MASSACHUSETTS tSV1LUImu rt1'Cmi 1 A=041-025 DATE OCtOber 25, 5t1g -��-1-�- PERMIT NO. S t��6.5 APPLICANT Owner ADDRESS 1Cu jt%Iow IH0.1 (STREET) (CONTR'S LICENSE) F PERMIT TO Bulls;( Dwelling �1� ) STORY Single Family Dwelling NUMBER OF (TYPE OF IMPROVEMENT) N0, (PROPOSEO USE( DWELLING UNITS AT (LOCATION) Lot #5, 71 Tarrayon Circle, CUtult ZONING j INO.) (STREET) DISTRICT '.� BETWEEN AND (CROSS STREET) (CROSS.STREET) SUBDIVISION LOT BLOCK SLOT IZE BUILDING IS TO BE FT, WIDE BY FT, LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION Sewage #91-280 (TYPE) REMARKS: r f , bond AREA OR11 /2 sq. rt. VOLUMEE It75 000. 00 PEREEMIT $ 76. 00 (CU91C/SO DARE FEET) ESTIMATED COST Theo Con5tructiotl Co. , Inc. OWNER -;. ADDRESS 178 Thornton Drive, s BUILDING DEPT.BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,.ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED 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 PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND 1, FOUNDATIONS OR FOOTINGS. MADE. WyERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2, PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS p PLUM81NG INSPECTION APPR VALS ELECTRICAL INSPECTION VALS PIS, �v 2 2 27 , 77n 3 HEATING INSPECTIO APPROVALS ENGINEERING DEPARTMENT 1 2 B(?,AgD OF HEALTH OTHER SITE PLAN REVIEW APPROVAL WO ALL NOT PROCEED UNTIL THE iNSPEC PERMIT 'x!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR A APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR By TELEPHONE OR WRITTEN CON$ CTION. I PERMIT iS ISSUED AS NOTED ABOVE. NOTIFICATION. WP .... � �.Q�� �,,�7�L,.� `' ,.,�:.r+^E5w:�;:,FAr`":f`:' "I:fA.�9.3,i1�:Yx:lM'.SLk. N/F TOWN OF BARNSTABLE 0) \ J fn 42 285.83' LO CD I �' I SU a� 1 �11� LOT 6 47.161 1 TOF Elev. = 64.9 � h lb \ rn LOT 5 _j \ rn \ 55,432 sq.ft± "o \ 1 0. 0 w ` \ u . v \ Q 1 1 m � m 276.67' m Q , 1 1 ' � \ 1 Z 1 I � 1 1 \ LOT 4 1 , ^ 1 1 \ 1 ' 1 1 1 I elk THIS PLAN IS NEITHER INTENDED 1 110/16/911 INITIAL ISSUE NO.1 DATE I DESCRIPTION BY FOR, NOR SHALL IT BE USED FOR AS-BUILT FOUNDATION PLAN-LOT 5 MORTGAGE LOAN PURPOSES. TARAGON CIRCLE IN BARNSTABLE, MASSACHUSETTS ^ FOR THEO CONSTRUCTION INC. @�Rttdsn�`P SCALE: 1" = 50'1 JOB NO. 1583/1583 I CERTIFY THAT THE FOUNDATION SHOWN ON THIS PLAN IS LOCATED � � PAULA. ticyN 0 50 100 ON THE GRO S INDICATE LwY1, �l No. 10617 zo///1_4 ro,/.ti LEVY, ELDREDGE & WAGNER ASSOCIATES INC. — -- ` '�• S T ENGINEERS LANDSCAPE ARCHITEM PLANNERS LAND SURVEYORS ATE RE IST RED LAND SURVEYOR, ',_ ' ' S tl Ii ti 1889 REST MAIN STREET CENTERVILLE, MA 02632 �:,�5 f � F ��r5 �+: na, t ,� ,w�N <t' i,k�n ,: r � ti,s•, ,x ,,;, + r,�'r'a ' "°� ?r', r „I s� :'r, G .,Y„�: t �': ,,, ,''u,: � ..- w ..,A ,:`• { r.':;'�.. a � a. 4 .� .t a �.� "i yw .F .F rq 1 cs, L,. ;1, ir.. > .!s�.. { �{ �' .5.e �',s `. �.r6.P�= � ,*E'se LJ. .'ter 3• !._� '.la:.hY'(,,i 4�:t� `2.a P ....,,`tx;. �,7j�:= •:.3;T` :;,�'^., t,•t.:.,. t&ccT:.r.. �a y�a�¢ �!.r:`.,,�" .t� g.. 1."� .�.> - _ �. .n✓J. 4`., -':R. 1 i -T.t'iFs 'Ya A;,:,M .,+ r'^4 .: -i•Y +t 3�a- R�: .,t, f�� FS: -fit#px iy'. ,, :x?.i^ fM'<c..,�,F:n,. �'S:3y*+, .,s.,...A- ..r a; a.^ ,..:1+ ".',ux- `rSn,,.. .F,. - r;s :.,.. .�'�-z;�8.r:",v V... ,t��`:-, X," .,, .+'tr ....,7--,'�.ls,� yr et, � r: *,�" �' 4�. ti�"7 A.: 6!r= [u. - .1... and S'S`+ Cp .ey � „ 1 'f, ":-: �s:.. ,.r ..., ,....,.. +..:. 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'�� �,v ��.as,a�_�•vi',�'`�,�3u ,�. a.. .�e __ -..,,�>,•.-:-- -"J THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A , m / �C(�`J IL DATA r^ 1 � � xr.. �i 4 .a .vim F �}•3y�r.s'k�'�d�sny C�Y� � � < "..,% - � ' 4 yy�4r3si 4 t� r LNT,CF _.GCS c�Y s k5, MONW ALTH A IL ENCLOSE_ CHECK U I GDcR i LICENSE �? COni$TR. $UPERVI$OR . FORREOIt cDF' �aTION LATE r A I ! 043 I - MADE PAYABLE I ; RES EFFECTIVE DATE LIC-NO. c Y "COMMISSIONER OF PUBLIC SAFETY" 991 182 o ,r 47 Hl :_:`SMAN DR. ARMG I MA 72675 SSE NOT - `.I v OPR ONO .. �' S FICTIv Li, I NOT VALID UNTIL SIGNED BY LIC[' ICIALLY 1 •)� _ . �_A.?ED OR SIGNATURE C. .::TONER t �-.•% - LI--.. Nv ;tH L _.--NSc STUB .Is SIGNATUr:E OF LICENSEE I; � IN FULLABOVc SIGN:....,.. L<. a TI,. .. <""HT THUMS;'R:NT =.. - ..-,.. I j •''j, t'J�`aic._ COb1MISSIONER I .f n 7/ A�-roksm C'y role;CJ)W o : - .sumo oMs 7 �3r �,,�. ' aches � bteB` ding�Go et�180 pendia� echo lx 1 t The Massachusetts State Building Code (780 CAM) includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, constructing/installing a house addition with very large percentage of glass to opaque wall, seeks to utilize a special energy conservation exemption option for "sunroom" additions to' an existing house (780 CMR, Appendix J, Section J1.1.2.3.1). This FORM is not intended to prevent a homeowner from selecting a "sunroom"of any size, configuration,orientation, form of construction or percent glazing, but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations involved in selecting and utilizing a"sunroom"addition. The connection of "sunroom" structures to residential buildings may create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and construction/installation of"sunrooms", included below is a non-required, open-ended list of product and design considerations that a homeowner may wish to consider before actually constructing/installing a"sunroom". It is recommended that consumers carefully review these options with their designer, builder, or contractor, in order to minimize potential energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO"SUNROOMS" • Solar Orientation and Natural Shading • Type of Glazing • Insulating value • Solar heat gain • Frame materials • Glazing to frame sealing and gasketing materials/seal durability and/or weather tightness of the sunroom • Adequate ventilation-Operable windows and fans • Applied Shading Systems • Insulation level in floors,walls,and ceilings • Possible Sunroom isolation from the main house via a wall and/or door or slider • Heating and Cooling Methods: Efficiency,Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Section J1.1.23.1, requires that the actual property owner(not the owner's agent or representative)acknowledge receipt of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read the information in this document concerning sunroom comfort and energy conservation. Signature of Actual Building Owner Date r✓i 0 Print Name Address of Permitted Project Owner Address(if different than project location) Owner's telephone number i 0 n'?6tT C-4 oG/ V k QC6,rdi „,...Y�„l+i�r.1•�Sw;f?+.•#�:ie iT+"n'1w''.,i�'1'�,{t' ^,�;. .�'S.^.4�._F,�.-��7p...�.".`r,,._..�. K•.m..�-wa. .,,-�.•.,+.-.- a,.-r.rN^�1'ti►t.9 +..^.i�'+',ni'^ir...-C'•.-..+.�*..'y�t""(r'lr:.n rrr'r f y..*i<Yrf�i7',,; .�x,, i Assessor's office(1st Floor)- ,L O Assessor's map and lot number Board of Health(3rd floor): r e�P ♦w Sewage Permit number '. Engineering Department(3rd floor). r ?` t; asaHAS& c �J }�. � rus 'l House number / F °o�o639- ,Definitive Plan.Approved by Planning Board 77 Ls 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.a d 1: -2:00 P.M.only TOWN OF : BARNSTABLE BUILDING IHSPECTOf %-�- ,r APPLICATION FOR PERMIT TO / lv /��✓ tr 1 TYPE OF CONSTRUCTION 5- , Fw / 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Z, '- 7 !” Proposed Use Zoning District Fire District 9� ' Name of Owner Address/78- 740 K-�-4t- Et-, Name of Builder Address FX*21S, Name of Architect Address / Number of Rooms 6 Foundation �ucte� �„�r_A lE on �o o Tin,`js Exterior CIA42 o.v K C -� I.�✓� 6 C6 da-c 5�,A, l oofing ��✓J�.� �7 SG. ����G S Floors c uog 7 Interior �,W N-. Ed,dk - &--I I Ao Heating f✓o V4 7ex— d+y Gad. '. Plumbing .Z /fro 7L � Fireplace �� c -d i'�iq.5dry�"/ h Approximate Cost 7 f, Oyd , 00 d -�/t?n UJ✓� ^-. fill- L�'`��...�o �^'u� n� Area Cvt tJ G✓i t. D'� a C" ' C-% ram- t I.S S w Diagram of Lot And Building with Dimensions n( l 3C A � � Fee roa-A, Yrz Go J . E-7t)Te� sx . , OCCUPANCY PERMITS REQUIRED FOR NEW`DWELLINGS t . I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above constructio . • Name Construction Supervisor's License 0 S� 1�THEO CONSTRUCTION CO, INC. c7y� ova x o,s A=041-025 No 34665 Permit For 1 z Story Single Family Dwel1inq Location Lot #5 , 71 Tarragon chi rcle Cotuit c- Owner. Theo Con. f-rnct i nn rn Tnc. Type of Construction Frame Plot Lot Permit Granted October 25, 19 9. Date of Inspection 19 Date Completed 19 r i • - v Assessor's office(1st Floor): Assessor's map and lot number J e-11 Conservation `�P ♦w Board of Health(3rd floor): • k � Sewage Permit number t ssa ST'LUZ rku• Engineering Department(3rd floor): oo i670. House number �o Y1iY Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only ` TOWN I OF BARNSTABLE BUILDING DIVISION APPLICATION FOR PERMIT TO - )• ����$ TYPE OF CONSTRUCTION _ Yr_ S 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Ifzyq !� CY) Proposed Use Zoning District �C�'t .C, Fire District �'U Name of Owner —�P _�(l 64�E 1r{ Address Name of Builder t-2�9S'E'.� _�� /q^) Address Name of Architect o1 J/5t Address Number of Rooms i2/oJ' Foundation Exterior Roofing17 CGcJ Floors Interior Heating Plumbing Fireplace Approximate Cost Area ®o Diagram of Lot and Building with Dimensions FeeD rl 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 Home Imrpovement Contractor Registration#- l ���� Construction Supervisor's License# FRASER, DEAN r 71 TARAGON CIRCLE, COTUIT r _3 Nog Permit For RESHINGLE ROOF ; S. F. D. Location ` Owner I Type of Construction - - r Plot Lot } Permit Granted - Sept. 15 , 19 194 f , Date.of Inspection 19 Date Completed 19 r 1 r r L�igineering Dept. (3rd floor) Map Parcel (Ilo�—,��� Permit# �' t House# �/ Date Issued?—J`- g 7 Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30) Fee o?�S ,0-� Conservation Office(4th floor)(8:36-9:30/1:00-2:00) Planning Dept.(1st floor/School Admin. Bldg.) THE rq Definitive Plan Approved by Planning Board 19 • BARNSTABLE. MA �pt 6 9 TOWN OF BARNSTABLE i Building Permit Application Project Stree ddrreerss '7/ 17k7 :ia -1 oz or-i Village Owner Address Telephone Permit Request First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ �5wZTZ7 Zoning,District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Builder Information Name i��f ��e,-a � Telephone Number Address �4�.4� ,�s �¢o�r�.�..P License# Home Improvement Contractor# 11.�)$-3 C Worker's Compensation#a a/�k=3og-3 old 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 DATE BUILDING IF T E FO OWING REASON(S) 'N FOR OFFICIAL USE ONLY ` PERMIT NO. DATE ISSUED - ' MAP/PARCEL NO. ! , ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME - .INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH G FINAL FINAL BUILDING b l r , DATE CLOSED OUT ASSOCIATION PLAN NO. Eaginepring Dept. (3rd floor) Map Parcel -M-Permit# aLQ I q House# 3 Date Issued v 48 Board of Health,(3rd floor)(8:15 -'9:30[1:00-4:30) Fee. 45, Conservation Office(4th floor)(8:30- 9:30/1:00"_..2:00) - Planning Dept. (1st floor/School Admin. Bldg.) IKE►p Definitive Plan Approved by Planning Board t 19 =F { t�eAnnsrnaLe, { TOWN OF:BARNSTABLE Building Permit Application t :1 Project Street Address —7/ ,%t��G��c�✓�? C'//z Village' Owner 1��r.M. C �,/t Ge�Q� Address lk-( Telephone 'Permit Request t First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ � � Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: p Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use C Builder Information Name rjAlpl /--/(G.�2 dl Telephone Number Address 7/ �f9lL.Cc G erg �'/mil License# r� Home Improvement Contractor# //O S Worker's Compensation#4ee_/-jS %S� . �6­3- 6-/6 NEW CONSTRUCTION ORAADDITIONS 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 JA4,We 6/717 SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOW RE SONS) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED. iM a MAP/PARCEL NO. z a €. - y - ► f • ; ADDRESS i .VILLAGE ; .., OWNER - r •. � , - . i A, r_r ,, i DATE OF INSPECTION: FOUNDATION - FRAME INSULATION • -. � _ . , a - �r '.. FIREPLACE i y ELECTRICAL: ROUGH FINAL ; PLUMBING: ROUGH FINAL F GAS: ROUGH FINAL FINAL BUILDING -, � `a t• DATE CLOSED OUT. _ . S r ASSOCIATION PLAN NO. a tab 'The Town ofBarnIre r • •� - ICPS $� Department of gealth Safety and Environmental Sere Building Division 367 Main Stan,Hymmis MA 02601 Raion C. : Office: 508-790-6227 Building Cot Fax: 508=90-6Z 0 i For office use only Permit no. Date AFFIDAVIT HOME McROVEII�IENT CONTRACTOR LAW SUPPLEM —NT TO PERMIT APPLICATION MGL c. 142A requires that the ureconstructfon, alterations, renovation, repair, modernization. conversion, improvement, removal, demolition, or construction of an foam dwelling onen to any -oring to owner occupied building containing at test one but not more thany tared contractors, with structures which are adjacent to such residence or buildia be done b registered certain exceptions,along with other requirements Est Cost �— Type of Work: �v Address of Work: Owner's Name Date of Permit Application: l hereby certify that: Registration is not required for the following re:uon(s): Work excluded by faw Jots under 5I,000. _Building not owner-accnpied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THM OWN PERMIT OR DEALT NG WITH UNREGISTERED CONTRACTORS FOR APPLICAB GRAM OR GiJARAN FUND UNDER MGNo I42a tZ ACSS TO 'I gl' ATION PRO SIG- UNDER PENALTIES OF PERJURY 1 hereby apply for n permit as the agent of the owner. -A Cunzraczor Namegjrarioa No. D ze ' � T�IL' (!/11111U1111'Ctl I! U lLT.S(IL' IIISC S prllurtllrrrrt of Industrial Accidents 600 !f ushbigtulr Street Bttstutt..'Mass. 03111 «'orl:crs' Compensation insurance Affidavit •`1JiPiic�nrinfiirmatinri • -- Plc'tsePRfNTIeb;iiiv'�'�—�-�-���—Y_-._- nnrnc �©�iL�✓\ � ��G�f� • r _ _ Inc inn• 1 '221 Q- �^ city �p l'�'z�— nftnnC l am a homeowner performing all wort:myself. I am a sole proprietor and have no one working in any capacity FK I am an empiover providing Nvori:ers' compensation for my employees working on this job. cnmwinv nnmv- atirl tree• cirv- n . nhnne 0- inKiirnyirr rn [ I am a soic proprie:or. general contractor. or homeowner tcsrdc olrej and have hired the contractors listed bexw wrc the "oilowin_ workers compensation police: cmmTI°tnc rinmr• ati rt rr«• in<irr^nrr rn cnmr.-nv nntnr• - . • atirirr<<• riTt•• ni'1nnC#• In,mr^nrC M '11tach additional sheet if necessary t ;: - �. .•:... .::, ..•... �...•..r. •.... ,.......�.._._.. -'� ' F:u,ure n,sect,rc cnvcrat c as regwred under tecuon SSA of UGL 152 can lead to the imposition of crtmtnal penalttes ota lineup to 51.50U.UU anurcr une ears' imprisonment as %%Cil :u cicii penalties in the form 0172 STOP WORK ORDER and a fine ufS100.00 a day against me. 1 understand th=t- cop) of this .st:ttentent nta%.bc furs nrded to the orrice of In%•estis:ations of the DIA for coverage s•erification. I do herenr crniit to r/re prrirrs and roltics of pe • �rltart/te information provided above is trur mid correct. cif ccu.:` Datc ��1/� ('r Phone ' otTiciai uac only do not s�-ritc in this area to be completed.by cin•or tot�'n otlicial ` [ city or tnwn• permit/license tt rtluildine Department C:Uccnsinr hoard Scicctmcn's orrice cheek if immediate response is required +' V icnith Department phone 9: �Uther contact ncrsan: Information and Instructions Massachusetu General Laws chanter 152 section 25 requires all employers to provide workers' compe:ts:;Non :;. - "la�� mt enrploree is dcf mcd as ever},person in the service of another undLr:::: en;nim ces. As quoted from the co►;:rct of lore. =press or implied. oral or writtest. .. ' An rnrplm•er is dcf mcd as an indix•idual. partnership. association. corporation or other imml entity-, or any ttc�) cr tltc !ore_oinu en_nucd ill a joint enterprisc. and including the le=l representatives of a dcce cJ emplover. or rec^i%•er or tntstce of an individual . pannership. association-or other legal entity, employing employees. Ho«•e-.•: 01Vrc-of a dwelling, house Davin_ not more than three apartments and who resides therein. or the occupant of the dN%clline house of another�yho employs persons to do maintenance;construction orrepair wort: on such diveili;:__ or on the __rounds or building appune^ant thereto shalt not because of such employment be deemed to be an er:: . 1tGi_ Jmnicr 15? section ,S also state that eti•erz• state or local licensing agency shall withhold the issuance e. »:►1 of a license or permit to operite a business or to construct buildings in the common',calth far::ny ic::nt who has not produced acceptable evidence of compliance iiith the insurance coi cm-c required. IN.. ►tcitlter the commonwe:ith nor att}• of its political subdivisions shall enter into any contract for.tie per:'j7n:.::ce of public wort: until acceptable evidence of compliance with the insurance requirements of this c::cc: ;tee to the contr:c.&irtg authorin•. • ... .ram.« . al)�)iic::nts Pl��se :ill in the work-e-s' compensation affidavit completely, by checking the box that applies to your situaion, c: su;.pi\-in_ company names. address and phone numbers as all affidavits may be submitted to the Departmc^t of 'nc :s;riai .-accidents for confirmation of insurance covem_e. Also be sure to si;n and date the zfridaviL The - ::vit :i:ould be returned to the cin or:own that the applicztion for the permit or license is being res{uest.d. r J�:c �cra;toe::t of�Industrial accidents. Should you have atn questions re_arding the "law-or if you � repc: c \%ari:c-s compcnszuon poke':. please call the Department at the number listed beiow- C:ty )r : wins P!e��_ : e _ure :ha: the.affida%.'t is compie:e and printed legibly. The Department has provided a space at die 'a=::7 FF tl;e �•- ;a�it for you to fail out in the event the Ofl= of Investigations ltas to contact you re_ rding the applic:rt:. be _ _ :o fill in the permit/license number which will be used as a rerr-rcnee number. The affidaviu may be re:ut; -tie DL=mnent by mail or FAX unless othc-arrangements have been made. Tile _1ffice of Investigations would like :o thank you in advance for you cooperation and should you have any que_:: piersz! -o not hesitate :o __ive us a =11• Z. .�. . i l:e Depar-,ment`s address. teie-hane and fax number: The Commonwealth Of Massachusetts Department of Industrial :accidents -• office lit Investigations 600 Washinbton Street Boston,:Via. 0=11 fax R: (617) 727-7,749 61-'j -="- '900 c-:t. 106. 109 or _—c � Oa o - Va r �r `. V, W� Nit a ${ Q 01 HOME .r R�9ist M$ROVEMEN {� '' $ = r Tye tion2�2536 PDBA . 04/ ERASE R CONS T ' e 91 , �p RUCTTO �r ,. 71 AN � TARRAG01y OTUIT MA r} -02635 W7h 4 H AM - i I c a r IME The Town of Barnstable'* arnstable �. Department of Health Safety and Environmental Services 1659.Eo " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 �. Ralph Crossen io_ Commissioner Fax: Building Com 508-790 6230 i g For office use only Permit no. i k 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: / Est.Cost Address of Work: Owner's Name Date of Permit Application: ? S' 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 Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the of the owner: Da a Contractor Name Registration No. OR i Date Owner's Name The Commonwealth o,f Massacliusetts �a -•-. 1: Dcprrrtttzent of Inthrstrial Accidents A Y � t iiw office athlyest/917t/offs 600 Washington Street Boston. Ma.yx 02111 Workers' Compensation Insurance Affidavit A i I 61ot information: Please PRINT .......... ...-.__.. __ ._ .. _..b� r ......._........ ..... I - name: toC � location: _=?/' 6 Cli✓t l/7 city a 4r44..� nhonc# I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity .._.....�. - --- - ....:..........rc.n�..:,..�.}.....�- -- y�'-- '- - - ,.c�..��... �.•-�ie'� - - ----.ter,' .—_—._.ram I am an emplover providing workers' compensation for my employees working on this job. comnan.• name: .eeL]d/1 Ces address- city: /f [!hone#• / insurance co •�. ���1—C.��l�t �i� !�7`e' GLI/ �olics !t/iC.C'/S3/� v �O d��7 1 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: cirv: „11hone#: insurance co. nolicv# . - _ .-.ir:.'_.... .y..+,-�._....� .. �T':t".i"•-r--:"-- .__ fir"-�":V-:�� -iT"l��w•S.'♦ —T�':•-.:: ..._ .......ti..:_�....._...- company name: address• cots: phone#- insurance co. policy# Attach additional sheet if necessa7�.:.:... :,. ' ,-:, -�,,•• 'r. =-'" T'"�C• %.••.'.. .r:. ..•� T-"v ►,_•,i__'".�.-�... _� -- . --LT.. .__Y...__._ =rar.��iJ.3 fir.... _s��-. -- -•-•=� ai`c tr: e:iwi �� Failure to secure coverage as required under Section 25A of AIGL 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 andiur. .x. unc wears' imprisonment as.well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a cope of this statement ma% be forwarded to the Of17cc of Investigations of the DIA for coverage verification. 1 do herehr cerrift• r er the rr'm'7 nd penaltie f perlun•that the information provided above is true and correct. Si_nature Date Print name Q?,'1 1 Phone# official use only do not write in this area to be compacted by city or town official city or town: permit/liccnsc# r'llluiiding Department C3Liccnsing hoard O check if immediate response is required 0sclectmen's Office t [31lcalth Department contact person: P hone#: rJOther , vn sm 3? NM information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the an eniplt{ree is defined as every person in the service of anuth�r,undcr an} contract of hire, express or implied. oral or written. An employer is defined as an individual. partnership, association, corporation or other legal entity, or at», two or more the foregoing engaged in -,,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 g than three apartments and who resides therein, or the occupant of the owner of-, d����llui� house having not more tl p dwclling house of another who employs persons to do maintenance , construction or repair work on such dwelling, hou_ or on the `_rounds or buiiding appurtenant thereto shall not because of such employment be deemed to be an empioy er. MGL chapter i52 section :5 also states that even 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 commonyrealth for an} 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 ha been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers 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. Tlie 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 rown5 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. Plea: be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned tc the Department by mail or FAX unless other arrangements have been made. Tile Office of Investigations would like to thank you in advance for;you cooperation and should you have any questions please do not hesitate to �unve us a call. �.,.,,.,..,..,.,..... �....-,..�,.o.,...._� - Tile Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 1. fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 ,eCLAi.�.w+rrur�ria�' a..y`.r-gin_ �r - -""-"•4..,. ^.'Lrv�:�. — .0 ..�.3=c s^"' :�... ,.-7�;r:-, .,'en:....i'. ,`�t. '^V'eY�f'"`.� �5� •f `+st'vv.'tir�r•fia.cac l ' r �•" ,,.', ...; t<:. 3 h s.':'� '�k �:.�. Z az r'�ua fi'.�iaAe si r�r'"j k a-y ��,� '..�h �i r k (i•,, U, 3oar.d HOME IMPROVEMENT. CONTRACTORS ;REGISTRA of. Building "Regulations`and, Standards'y ! One Ashburton Place — Room13013r3 az rrp 4 k t Boston , Massachusetts 02108L,� ' ' yt .J "Y 7 5 yl'C5.1� .'x4.��.t`./" ,� .s`�'`�-p a } +� ��` ; t 5� i 40, s�ac fi ,ab+._.� } a �� o it HOME: IMPROVEMENT*CONTRACTOR ;' t- I, �E�c n r�� t 4 yt•�. z a }. '� • ',11�... .r t�•°d�.Registration xpiratina04/06i ` 9a2536 9ti t�.1�.T�}�F'ir�Y�'43��•h�A�.,�t��� ��,�'�.... .kN�¢Jgs„�7 4- Type # E r iz "' "to,- ' ' ' NONE`�INPROVENENT'CONTRACTOR aU%4 K 1 ] Jt, �q ',' +§ f �Yi ` Y � � �° . Reg istrationwi12536 x , 'µXi;"�i t+' `.' v =F'•13.° 1 FRASER .CONSTRUCTION.; r #ate OBA�, �3 ir'e e E °+:E slir,(,r ,'.` ;�5ri +i '�"^� J"r R K' -43`��Q� •r.q.. .. 4 .DEAN C'. ` FRASERi � ��`ra�' ` �t � � � �Ezpiratlon. 04/06I99x «' s'T�.';, t rt. 77 >. ♦ -cs, f'+ ', '?M9 "n+`,5. 4[^ t i :-_' t x c.,' 1 `;"•" 71` TARRAGON ',CIR`:kwv xs, y ,, r yfH FRASER_ CONSTRUCTION i a COT UIT MA 02635 RYA rt. . t. ` t •; r� �r �4 � �i CH'FRASER r � ADMINISTRATOR a i t s ate" r ,a COTUIT,;HA,02635 I f Ox .Aa : The Town of Barnstable Inspection Department 161 r �, +► 367 Main Street, Hyannis, MA 02601 508-790-6227 Joseph D.DaLuz Building Commissioner March 19, 1992 t Mr. Dean Fraser 71 Taragon Circle c Cotuit, MA 02635 RE: A=041 012 .X06 71 Taragon Circle, Cotuit k r Dear Mr. Fraser• This office is in receiptkof an anonymous telephone complaint alleging that you are operating a business from your home located at 71 Taragon Circle, Cotuit. Please contact this office immediately re the above matter. Very truly yours, *Alred E. in Building Inspector AEM/gr ti } • �f . f f t LOC710000 CURTIS ROAD CTYj00 TDSJ 300 co KEY 421038 ----MAILING ADDRESS------- PCAJ1301 PCSJ00 YR791 PARENT] 25635 THEO CONSTRUCTION CO IN MAP AREA JIIAC JVJ MTGJOOOO 24 GREAT POND RD SPI , SP2] S P!3l 7 1 - UTI] L17-2] .09 SQ FT S YARMOUTH MA 02664 AYB-1 EYBJ OBS] COnST] 0000 LAND 3400 IMF OTHER ----LEGAL DESCRIPTION---- TRUE MKT 3400 REA CLASSIFIED #LARD 1 3,400 ASD LNG? 3400 ASD IMP ASO OTH #PT. 71 TARPGON CIRCLE DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #DL. LOT 5 TAX EXEMPT #RR 0000 RESIDENT'L 3400 3400 OPEN SPACE COMMERCIAL INDUSTRIAL SPLIT 82891 EX"EMPTIONS SALE J02191 PRICE 48000 ORE.174361001 AFDJ v N LAST ACTIVITYJ09118191 PCR..jN TOWN OF BARNSTABLE -� BUILDING DEPARTMENT COMPLAINT/INQUIRY REPORT L T1 d \ Date Rec'd B Assessor's Last Name AM1First Name ORIGINATOR Street Village State Zip Tele hone: Home Work Descri tion: COMPLAINT . '7/ Zx�, ` INQUIRY Requestor's Signature COMPLAINT Street Address LOCATION A= OFFICE USE ONLY INSPECTOR'S Date ��-� Inspector ACTION/ COMMENTS zj FOLLOW-UP ACTION - C ADDITIONAL ' INFO. ATTACHED COPY DISTRIBUTION: WHITE - DEPARTMENT FILE YELLOW - INSPECTOR PINK - INSPECTOR (RETURN TO OFFICE MGR.) NISC1 _ x .T .. ., 5. '',. �.'. .. _.., : WNS �•{ :ram .a rn,?a:•,-+u •,,.. .: .._ .: , __,.^ '.:. _ - - r - } t , X y�t f , - + t lie r 1 �,...: 1 L{a'Y �..r-.-� ..':..fit ' { 1 { S•- � u J r } i DECK I; � t � � , ., ? - �;. fir.-.# , 1 ra ` ,+.I...�G l,b"•-.-�,_ '�- r , , } • I r^ � t+ r + Y 1 _ . rto i',. �a._�y'e.-trr_ 1_. Wit--, �,�r- �yr.f�1"t;�, � a.- ,s. 1'Ws�• ._--j � I :r•1�-,_�., , P"-G>�� !��"r:i",.t�' st•-t _. j y �...is � � � w ' n t i r 1 , L a , _.�.__..._., - _ -. -- - - - - �---- -•'ir � }•-'-• — F �$ L'•S�c's•ir�,.>ts.'� C_-%r' -, � c" � { I i y •+� p ar+srisa�,a�.a, ��a.re�-... ,.._.�,_. ..� .•f,,,. pF._ ..,..I�_ _ _.....,.:.i: � 1 ^ �� '�� 1 pp tp S , ATIPLAN FLOOR PLAN _ o�� i- �; .iA _. _.... � j � �v--,lam.. ✓>..i.: '-r:,fE�i�= --..... L � � 3 V a � U - C .. .F-SIr.+:i . , .'�:,n+r�. r :.r !r r rr r r r !r C}! 114 1 9 � r v SECTION -t �- ,Sl, U - Q'' iL = l� vU N <A C d O N u � 3 _ -t- _ 4.:._.,_...,.•�arw...,...•i.. ,._._,.-,.._.._ .,___... __._._ ,...,��.. ».•...•.�..�..\,..,.»..,,.. "...•,.. ..s..,._,w....w..,r.:.-,..,a,__...,..r...,,-.,�.......w-......s-,......r-�.�.,-.._...y.....<...,..,.r..:.,..---•,.-..,..•_�..._.,.____,...m..__....._•.-,,. _.. •I��rc:., 'C{i I I r 1 Sryyr• .�. ., y,�� ( _ M f�`t. Pi,,Ky u�• {�_- y'{ ,F`c:.r4"'A /jam ` +_ F "^a`M �"� ..,� !•"^'�. ,C?.w:+- - M�-,y,,.�✓✓�'�,i"..' �,... __._ ... �_ _ .. .._,.:�" �•�.�.T _ 'gW:u'��C�`•,+Tw4�. ';is..+"�"��`:•!+�T':m�%.`x;Mw,."..�:.• •��iA•,..:..,� _ �" _,r � � ' .^,Vb+f+gep. ". ''S�s.Y\Sw-,OmMYa�kycC. �1101eaMM1 ,�d1Yt2.�aR'.'l�F.�P'�Mf'n'i1l.s.'v/I?It�.WtuY•Y^','#': u•?' �rt/P9?� t'-� 04 NO , Lu : w N } _ 4 - Cie w a. - Y i r - ' -w—Wiz:`..d':w"'�'�w4�' =:cam-�'... ., j �y��Fayy, --.-.,.-__•-- ��AA LLJ CY V LU i ,, - ._. r •' .... , , -. .._._-_ ._-......._ ....: ".. yam,,. � p".\' .._ .. __._-... ..1: ;y` 1 .. � � 1 s. ,, y 1 t �' Y'-- - � J r kC.• Gcr4.. ,_.,. � y za r._. ,� r f i r t... 1 p - r--', � � CLi F 11 V- p qq tt q y i I } + I G 1 j t K(e, _. :� +''.. •,u;,,.e __ ._ _ Z i } l job no. . , s , .fit -- •r .a �t i _ t _ ` Y t S � ¢ � 2_...L_�....;j �_ ._-_i' � �_. i �... .} -__ _. j x<.- T:.�_..._.•:'r` �"� -_ � l� � t � _i r,_i _1...�_. 1. _i,� $: .t Ii _ 1 1 ' `fit'"•..-• -_.......,_----_-_ I -z:a,. A.�..-,�.-:�.-�"�,�,,.,.,�.,�,,.�,:r.,,..•.�,..-:,�:y> .e....�. �,._ rr , + i._ _.,-r.,,r•�y,>'S�-�<....,.-..�_<�.__.�Wit. r - ! Scale ! drawn , . - ._ .. Ae.. +n,.. � .•-4>:- ... ... . .*s:-:: ,�s"r�..: •sws*:�r:��s�r»rv.,.,•�e�:^^.ra..... _. ...,... _ M.:,,..>.- .....x+^•�r.^.x,... sx�:.,'.- .,�•�>-z:.::. .�_-:.,,x,.:_';---.-- _:.�a:.- .,,:�. .:•+pnw. . ..a..�..•c,.�'' .,,. �+•e.-�..r.'�e•�.e^*r,......,;..,,...•p,....._x-,.."..p.�,.....,,,,,s ',•swv,.�e +..�,+5�, ,.. ... rev. 1 i f rev. j rev. N R'6RELLYATI.Qt! SIDE ELEVATION A� l Ie Slt � I t j't!! , "twOFYr ight 199 J k -. :r .. ...�--, " ..,e:a. '. ..-e a-_� '.. ,:. ,'. .�•:.ems- :i. Sy'"'.': r 1 . .- _,}b)-Yn",L'