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Home My WebLink About0127 THANKFUL LANE ia � ,�"k� � � Parcel a� nr # Conservation Office(4th floor)(8:30- 9:30/1:00 2*0) �9m Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) 'A e ' 9�. Engineering Dept. (3rd floor) House# � ,pp ;, i SErilc sy, - IH�T'ALLED I T 19NVI WITH TOWN OF 1BARNSTABLE®'VN RE ULATICv 6 Building Permit Application ro -trees Address �Z I ( i 0 � Village. OwnerCLA Address Telephorie ' 4 I: Permit Request l• First Floor square feet Second Floor square feet Estimated Project Cost $ Zoning District Fl od Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded ii Current Use 4MA1 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 's Telephone Number Address License# O Home Improvement Contractor# Worker's Compensation# st�sc_l `I-b�5�1•� ,� ► NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTIN FRO THIS PROJECT WILL BE TAKEN TO 4- Z SIGNATUREtjJ4LU PATE '"I -1 BUILDING PERMIT DEWED FOR THE FOLLOWING REASON(S) r. FOR OFFICIAL USE ONLY _ P MIT NO. _ TE'ISSUED 1' . P/PARCEL NO. --------------- S ' \ •t CRESS "' + + VILLAGE : f ! +t NER E OF INSPECTION: . FOUND"ATION FRAME " ,r .. _ . �_ � _ 4 _ .' a ' ••--, '� INSULATION FIREPLACE ELECTRICAL: ROUGH - t FINAL ` PLUMBING: ROUGH/ `'" FINAL "'D� 40- GAS: c-ROH'� :. FINALi FINAL BUILDINGell DATE CLOSED OUT' ASSOCIATION PLAIN NO. THE Sewage Permit number TOWN OF BARNSTABLE BUILDING INSPECTOR TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Nome of Builder .� ../-^.Ll��T��------------.A66nsss _ ...... � Name of Architect ----------------------Ad6res ---------------------------- Number of Rooms -----'\---------------'Foundation ' �`�` ' ��.��—..��.\ P \~ ---------. `| x/erior 'Z}7��......4-_.c��~��!��l��.............................Roofing ....7` � / Floors —. ....................................................... -----------.-------.---------. � _�- ` ~ He6�nd ------:-------------'.-------.P1um6ing -----.------------.-----,--- _— � n c ...FireplaceApproximate � Definitive 6v Planning Board lV ' L'�� 7l ^ � ' ,pp ",=" . ----^ - '°=" —''`'`°'^—'—^----- / Diagram of Lot and Building with Dimensions ^- Foe _______________ SUBJECT TO APPROVAL Of BOARD Of.HEALTH | � `^ �. . | � . . ^ � � ^ � OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ' | hereby agree to conform to all the Rules and Regulations of the Town cfBarnstable regarding the above construction. ' Name — ��-..�—`..1�........................ Construction Supervisor's License -- —'~--~---' | BLASENAK, GROVER/ A=39-26 rr s 24784 ADDITION No ................. Permit for .................................... Single Family Dwel.linq............. Location ....127...Thankful Lane ........... ..................A ............ Cotuit ......... ..... . . ......... . .. .... Grover Blasenak Owner .................................................................. Type of Construction Frame ................................................................................ Plot ............................ Lot ................................ r e 4 x Permit Granted ....February 8, 1983 " Date of Inspection 19 4 r� Date Completed ......................................19 1 o® d/ /- F INSTALLED IN COMPLIANCE 0*THE TOWN OF BARNSTABLE 1639- BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......... ....... '--^^^^^-^^^''~^^----^^^^-^^-- TYPEOFCONSTRWCTVON ----..---l��.(��r\ ~�._...................................................................................... J 7J --..--��a ------.l��.�I TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for o permit according to the following information: Location ....�~`. -/. - .��.�r. /�..' -1��.y}.�......... (n «»_��. ..1_.............................................................................. Proposed Use -..�\�� \ v[ -----------.------------------------________. / ' ZoningDistrict ............. ..........................................Fire District ............... ...............k----.--------- Name of of Owner . .f.�... ---A66neso Nome of Builder �Lk*��l� / 60{~��M Address .+-------=--^--^---^---' ~ —.-..". .. ��......~..~---.....�.....-- Name of Architect --.-------..-.----------A66n*ss --------------..-----.--.----.. � Number of Rooms ..... ^ /.........................................................Foundation ........................... ]� Emer�, '� L \`� ------------.Roofing -. &o -----------' � . �� L d�u� Floors ..��.]��0.��.x�-,��~�.��..�..�� |nte,ior ---.�� .��%� ��-.. --------. ' . ' / ~ Heating ......... .�.......--��.-��:----P|vm6ing -----..�-,,2-. .--------' � � Fireplace ------'. -_..........................................Approximate Cost ........ ....................................... Definitive Plan Approved by Planning Board --------------------------------- V-------- ' .. ------ Diog,om of Lot and Building with Dimensions �_________ -7- - -� � SUBJECT TO APPROVAL OF BOARD OF HEALTH \ | | hereby agree to conform to all the Rules and Regulations nf the Town of Barnstable regarding the above construction. Nomev��'��3��^. ��.�..�`�� -�--. sewap;e 624 Grniver F. Bl_asQnak No ..17.3:'R.... Pe it for ....psi t in................. .......... �......................................... Location T Rfi..1.�.....mR'Ar�,�.,1 T ann ......................rp.t~.01............................................ a Owner ...C- ^�*""..F.: Rl asQrg'' ............................................ Type of Construction F''ar'p ............................................................................... Plot .....3Q....... .......... Lot ................................ Permit Granted lh r 19' 74 nct�h Date of Inspection 19 Date Completed .�l�.S/��:`........,�..19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... Assessor's map and lot number .............. N Sewage Permit number ........! ........ ..................................... Q�o*7HETo�♦ TOWN OF BARNSTABLE •8A$H9TSDLS, i "6 9 BUILDING INSPECTOR o am a• APPLICATION FOR PERMIT TO ........................... - ?... ..!t!t,`J................................................................ TYPEOF CONSTRUCTION .......... . ter ? ...,..................... ................................................................. .............4.. `:�:................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: r Location � ............................................................................ .........................:..,:..1....�:. n..,..........,c>..:.U.�..;.. �.:..a .. '...�..t. �1'1� ?� K ProposedUse ..... . ......................................................................................................................................... ZoningDistrict ............. ?........................................Fire District ...............' C- !. f........................................... p _ . Name of Owner �� Isr)rl.. v (`ti . 11 �<a S A.?�.:!..}L.........Address f....P. I 1�..!..:� 1_ .� v.'�.�.......� ...........'.I.f J�... ..... .. .... Name of Builder ' ....................... A� Address 17Sc7 � tit) Nameof Architect ..................................................................Address .................................................................................... Foundation .�r).`.. P .. .. 4. Number of Rooms .... C�......................................................... .... .. ........:....................................... Roofing �'� ..... Exterior .... .. .!..!}...:..`. ..................................................... g ........,............................................................................ Floors t.:,J 1 �,P-f �} j`P!� S�t 11!. .5/�{..v!.�;)y. .Interior ........... r ...... ........................... t i ! Heating ..................................... ....................Plumbing .................. Fireplace .................... -l'?! .. ._.........................................Approximate Cost ........`k�....8.�.,:UZTZ) ............................................ Definitive Plan Approved by Planning Board __________________________ 19 ---. Areo ..'.:`..:....::.......................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO .APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. l Name .......................:.......................................................... -J sewage 424 Grover E. Blasenak /�9 - 26 No .17378..... Permit forte Yellin .......................:............. ............................................................................... Location .. Lot. 11 Thankful Lane ............................................... Cotuf t Owner .....Grover E. Blasenak ................................................. Type of Construction ...................Frame.................. ................................................................................ 39 26 Plot ........................ . Lot ................................ Permit Granted .....October 16........1974 ............... Date of Inspection ....................................19 Date Completed. ......................................19 PERMIT REFUSED ...................................... ....................... 19 ............................................................................... ............................................................................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... FEE TOWN OF BARNSTABLE, MASS. is 0 M q bo 04) THIS IS TO CERTIFY THA �PERMIT IS HEREBY GRANTED TO o M Sri Om nr .............(PROPERTY OWNER) _.........................................................................................IADDRE531.................»...._...._..._.._._ g re,a TO ...................................... ....................._........................ [y`^1 (BUILD) 'o/ LTERI (REPAIR) 04 a)_2 0 a O O (TYPE OF BUILDING) (APPROXIMATE SIZE) w op LOCATION ....................................................._..............................................._..._ ..._............................................................................................................ _-___»._.��_. y (STREET AND NUMBER) (VILLAGE) NAME OF BUILDER O R CONTRACTOR _»................_.._..._........_......-_..........._......._.......................-..»._.......-.......___.._....._......__._........__ A APPROXIMATE Copt T ............ mot I HERE Y AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN y I OF BARN ABLE, REGARDING THE ABOVE CONSTRUCTION. oPOo4 / ' V.. a _ _...__.................................................. _....................._.........................................................._..._........................................................... A N (OWNER) (CONTRACTOR) daq � � o O U _.._—........................._.....-_.-_............................................................................ ya BUILDING INSPECTOR Subject to Approval of Board of Health. 43 .??,7,/��G'�.`Ci�i oC.3��i�'ti,G y'" �t Fl,t ,.' "•"ti� �`,two:*,$ 1-7 M� r - a i • •� 4.. 1, :r x ar _ The Commonwealth of Massachusetts rD — �:__ Department of Industrial Accidents _ _ OfI/CB 0//OYBSU 8U0 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit Ca Ar �L �Q city y � rhone# L-Q I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 77 1 am an employer providing workers' com ensation for my employees working on this job. a cow any n I C r �_ Id,dres phone#• fY� �'SP,SF�lt3�t:aA��f? ►*�.+�. iw. *�A�F''rssld � t''� - �� + o -26 -- inrance so — S policy ZU � i+ ArCExciR �rsrr.stsrenaag+'}grys�ny 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 city: phone# insurance co. 7. companename: �1�/L;�Y'e �a t^ �Pvv1 ' p \�tnc;�ttrC address-(.�� .�'� . /•1—�f)�� '� Z � � S ��'wLl e �(J Alt—Y Y� ,Ca 1 L J�OS 39&.S' hone N, i I y „k3�] � _" ��C✓V e -s VOY ! 1 W CC.... . ....... 'ILY ��tla'ch�addltionalBlt'tet-12':n_ec a"" 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 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. 1 understand that a copy of this scat ent may he forwarded to c Office of Investigations of the DIA for coverage verification. /do her ►'c n and r to ain a p aloes ojperjury that the information provided above is true and correct. �n Signatur ( Date So— �`dG Print name Phone# "�f✓ official use only do not write in this area to be completed by city or town official `'rV' city or town: �s permit/license# []Building Department !�; p check if immediate response is required OLicensing Board Selectmen's Office .` OHealth Department contact person: phone#; nether �s• Yms d 30� PIA) . Information and Instructions Massachusetts General Laws chapter 152 section 25.requires all employers to provide workers' P compensation for their employees: As quoted from the"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,jassociation, corpoTati on,or other legal entity, or any two or more of the foregoing engaged,m a joint enterprise,and including g g . � J rP g the legal representatives of a deceased employer,or the receiver or trustee of aff individual , partnership,association or other legal entity,employing`e'r loyees. 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 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. ;t_:-..e�rdi„rid:r+�, �g��3'.,a.�''.e"�•n�h;Y� ..: .c. �tA`�&��.,_:�`'a"��+�ag.. ",;, :�a,.,�;JM1aa7'�,�:�au '�?e_..;� "`_�: _ _.s 'F;�.._ V?�: 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. 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 like to thank you in advance for you cooperation and should you have any questions, please do not.liesitate to give us a call. ` ,.a- ._yx. The Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 Suggestei Affidavit for Home Improvement Contractor Permit Application Fa►r olnce u&e owy NAUE OF CITY/ O V Vernau No. e,,341�'� `Q Date AFFIDAVIT llunte Improwcrme:nt Cuistmctor Luw Supplement to Permit Application MGLe.142Arcquirea that the"reconstruction nheralinn renawnlinn remit mrlalerninitinn mnvef%ion.inlinwement.removul deinolition, ':nnaln^lion of un udi ilion 14)u..V hrera1%liny-..wncr-.w-i•ua.ic.l buil:hue au.an.ininr I.I Icusl like hul n.n nuna•Ihun f.u.r U%velhnr unils....ur In au uauraea e.hit'll Cis diucenl III,ua•h Ia%l.lfn.'e.0 buildup•'be aluaae 4Y IegI31cow wuU.aa;auts,caul►axrtiem,;a.Caa,uuNa,•lung w1411 0111er IC11a11rc0cUla.-- f \ 1ypc of Work: �1 \` Est. Cost P Address of Work Owner Name: Date of Permit Application: I hereby certify that: Registration is not required for the following rcason(s): _Work exclude4l by law _Job under S 1,000 —Building not owner-occupied —owner !lulling own permit _Other (;peciiy) 4 Nutice is hereby given that: OWNERS PULLING TI IE IR OWN PERMIT Olt DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICAULL I IOME IMPROVEMENT WORK UO NOT HAVE ACCESS TO 11-11 ARlil• l%". TION PROGRAM Olt GUAN.ANTY FUND UNIA.l: lvtGL c. Signed under penalties of perjury: I hereby apply for a permit as the agent of the: owner: at ! 1tcl.imratiun No. l.11atc Cuntrlculr IV ttt. Olt: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above Property: Date Uwncr Name � t.,'t� r• __-' ' 't f 4•L f � y a.. • • .'. � �r/ie �anvnaaizcuea�,�i a�./�aaaac�ivaeCla Resiricied fa: G2 UL • r CGNSiRIGiiOt! ;_;Q� L - i Nu�bz : cXcir : Fiithdate:; iR - hasom oai> r� Ana,- ilii'%i9?' 01!17l1953 ; iG i & 2 Fa®iiy Homes Rzs r�cizd ;f, QG t. Rff.YY HTi RID of 'yilrT•, kX ? [ Yj S nK ', },{HOME_lIHPROVEHENT CONTRACTOR� Registration 400502 h Type fi PRIVAIEMCORPORATION„ 1 h{R E iZ zpIratron 2,06/18/96 ` AMERICAREMOtlElIN6 INC [�lL�✓! -'Char!'4s�Cock L'4 /7.' � 14585 NORTH STEHMQNS iS52 ADMINISTRATOR OALLAS TX 75247 - > i - �. r I t i. rir�rl p'1• "•1�a - fc r � � r.t j t v d v { a -'t I Fq ? t t't � ti"- ;+ s:•-? t � ,. r '. ..�< ,,,� t`'�k r .< s ��+'� ,j rt•:, n :.,� �.� f " q:t�j 3 t:k. � t a r'�T'�r ��• ,•� « s : r �a: ��Qa a i'+l;;:» +�r:,7�.?r{yE+�y-AN`�� In�ly �l3fd"r� �S�"4`1 �to7t�'+,��g •r ' tc � ��yy�.1��+�y�. As �'"s`�� t} � ff htl t��t�;jw i��l��.�`irT ni t yt t.� t t� r!'� .�Y `i }. t`?�. A iw'.=� t' �^��Y!'Gj.Y4'1"�, �i•• ,'S�. I �Iq (� �-''"{P� �i�� ;i":.+ f��;-r,;,i+.. �. � .;+ i a�'� �. i.M.•,y, 1 Z.i..IT:s '?�,t'Z it4L .�;�� < 1 r�x.�+i�a �_'ay 1 «''� f:, e } j r, {��,5 � it .ytJsy"�+i �+.. � ;r.,... ��t:.. � s:l a