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0038 CENTERVILLE AVENUE
..._ / _: _, _. . � . ;, .. :- ..: ,. , r .. ., y ., x, ,� . r - � ;:. e �, e . _ ,,, , �, :� <: _, . � . z '.� .. ..r , '. - ., �,. � 5 r .. �.r e M .. c � �.' a�.i i .. � '. .. {i� i .. �� .. � ., .s .. n .. �,. ,. � _ '. r, e .. �p r ', - ..' ` t. .-- .+. if n ... .r ,. ., .. .. n �. �. ;, ! . ' .. u K. U � v, r .1 a � ' �- .' � p�, .'- � ,L . �..-.. _ ,. � _ .h � �. .- :: is -.. .''.;� .. 3 �. .. ,' - � �. � � - _ r. .:. N' a,y c .. � .. -, .. .. .. F � ,.. a ',y... _ .. .. i .- � � � .� .. .. ., � T v, r � �+. _ ' c .; a�':. ..., y: �. :, '. .. ,. ,. .�. a ..i v „ ., ;. -. .i �. _ ,.. :. ,. .. ,; .. .. a �.: .,,, ,. . ,., �, '..� . .a�:., ��.,, a .,; t r _ � � �' ., ' . ,. � a. . i a 4 �� .. s e. - � .. ': .� ..r.. .. � .... .' i ..r ,. 'K.. � F�. i �.. � �. �., � -.� .r ,. „y ' .. �� � r ,i ,- - '.,.a. -� - ,f. ,. .�,. ,J.. _:... f. n . '-, � ... ., _ _ .. � .. ., ^� �r a' ..,. ,,. � y i .. r ' ,� .. - �� ' "� u .M- ,, �_ _ . , v � .. _,, - � � ,. o � .. �, .. - +� :_ < ,, ,. c .. - - .. -,. .� � ,. ,_ .. -�. ,. .. ... .. _ ,. .. . ,. _ - � ,... .,. a .. .. .. u _ :. � r :. .. .. ,. e -. _ ., _. ,. � ,. .. Engineering Dept.(3rdfloor) Map ` D L/(o Parcel j�~ Permit# c S I I House# 1:�8- Fos a Date Issued / —9 Board of Health(3rd floor)(8:15 -`9:30/1:00-4:30) Fee Conservation Office(4th floor)(8:30-9.30/ 1:00 2:00) Planning Dep st floor/School Admin. Bldg.) �tNE YSt proved by Planning Board 19 t �; _ BARNSTABLE. ' TOWN OF.BARNSTABLE Building Permit Application ress 0 �J7l��G�� (� -3 .0A Village � �� }����� Owner `��/�1/C .,67igc�I��s'' Address ,Telephone =LS 6 B 7 76 3!Z76 ' Permit Request 12o()F Q1)6sY g�ls7//��5 First Floor � �Q l square feet Second Floor _ / o/y square feet Construction Type J�ay� 'FKA09 E Estimated Project Cost $ 0 0 av Zoning District Flood Plain C/ Water Protection Lot Size Grandfathered ❑Yes ❑No l Dwelling Type: Single Family ar Two Family ❑ Multi-Family(#units) Age of Existing Structure 7 S Historic House ❑Yes L�-<o On Old King's Highway ❑Yes l<o Basement Type: ❑Full ❑Crawl 21'Walkout ❑Other_ C}gpcs e 0,V C, Basement Finished Area(sq.ft.) l00 �SQ4C�r Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing _ New Half: Existing New No.of Bedrooms: Existing �Z- New Total Room Count(not including baths): Existing ZI New First Floor Room Count Heat Type and Fuel: 2�Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes U(No Fireplaces: Existing U New Existing wood/coal stove ❑Yes U�o 4 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) p Barn(size) 9 S,Kone pl)hed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review.,# Current Use Proposed Use Builder Information p Name � (///� �- ��� � Telephone Number 6?) ��Q (�96,V Address 4Ci!!�7 649'A19- License# # `7 O f 0 Z22P. 02MOHome Improvement Contractor# Worker's Compensation# 01)6/41-1 T RIZ7 '?70/// 7 ?T-62_0_� 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 • 16fia,57�� SIGNATUREVX�, DATE e�6— ! 2 &F 7 BUILDING PERMIT DI O I FOLLO Iy�IN®G�yREASON(S) . 4 i " . J'/ 00 f FOR OFFICIAL USE ONLY ir 4 PERMIT NO. - x DATE ISSUED' s MAP/PARCEL NO. ' r •mot= ADDRESS - ', i+ + VILLAGE OWNER 4 _. + DATE OF.INSPECTION: t - , FOUNDATION FRAME _ INSULATION FIREPLACE J` ELECTRICAL: ROUGH FINAL _ - PLUMBING: ROUGH FINAL GAS: f' ° _ ROUGH 'f FINAL _ t FINAL BUILDING f ` •1 t t DATE CLOSED OUT. ASSOCIATION PLAN NO. } ; Tire Cinnnionwealth of Atassachusetts " Department of Industrial Accidents (11 '�' 600 Washingtun Street Burton.Alms. 02111 %1%` Workers' Compensation Insurance Affidavit li :in ini'rm i..n• ------ PG, PRINT -E,&....�.._..�....,.--......a..,..-.. . .,.,,.r. --__- --- - m • lo_cat n; (/t/ J l /"1✓ yj�®l�/VIU �� ! J0 ��� '�v<4!!% /Z- L5 city phone I am a homeowner performing all work mvself. �am a sole proprietor and have no one workina in anv capacity ���/G/l //'�/s• VT 7LO / Ci I am an emplover providing workers' compensation for my employees working on this job. cointian • name: address• city: phone#- insurance co, nolicv# 1 am a sole proprietor, general contractor, or homeowner(circle are) and have hired the contractors listed below who have the followin_workers' compensation polices: comnanv nnine- address• city: phone#- insurance co. nolicv# comnanv name: address e city: phone#• insurance co. policy# Attach additional sheet if neccssa =. + -=+ - +: ~ "�• %'��' •+ --�' ' yit•?.ti�iL.war�:q. - Failurc to secure coverage as required under Section 25A of AIGL 152 can lead to the imposition of criminal penalties of a line.-'up— so S1.500.UU andiur unc wears imprisonment as we as civil penalties in the form 0172 STOP 1yORK ORDER and a fine of S100.00 a day against me. I understand that a cope of this statcn►cut may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 tlo hereb►•certijr rat cr t •ptri r and a is ojprrjur►•that the information provided above is true and correct. Si=nature Date Print name Phone>* official use on iv do not write in this area to be completed by city or town official city or tmwn: permit/license# MBuilding Department Licensing guard 1]check if immediate response is required selectmen's Office 1: [311calth Department contact person:• P hone#: rnOthcr Anformati'on and Instructions Massachusetts General Laws chapter 152 section`25 requires all employers to provide workers* compensation for tile.' employees. As quoted from the "law". an !�nrph ree is defined as every person in the service of another underanv '-contract of hire, express or implied, oral or written., An rnrph rer is defined 1.as an individual, partnership,association. corporation or other legal entity, or any two or more ahc fore�soimz cnLa�=ed in a joint enterprise,and including the le-al represcntativc_s of a deceased employer, or the receiver or tnistee of an individual , partnership. association or other 16gal 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 d%velling house of another who employs persons to do maintenance , construction or repair work on such dwelling_ hog or on the arounds or building appurtenant thereto shall not because of such employment be deemed to be an employer MGL chapter 152 section 25 also states that even state or local licensing agency shall withhold the issuance or rencival of a license or permit to operate a business or to construct buildings in the commonwealth 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 perforniance of public wort: until acceptable evidence of compliance with the insurance requirements of this chapter 11, been presented to the contracting authority. e Applicants Please fill in the workers' cotnpensation'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,rowns _. ,...... .. _ ... .. . ..... .. _. 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/iicense number which will be used as a reference number. The affidavits may be returned t' the Department by mail or FAX unless other arrangements have been made. The Office of Invest.'=ations mould like to thank you in advance for you cooperation and should you have any question 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 �.., Office of investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 The Town of Barnstable • nAaivsr,+si,E, • 9�&6 Department of Health Safety and Environmental Services Eo ' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only 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• Est.Cost A Address of Work: Owner's Name LLc-e�C�e-Qo Date of Permit Application: —1 7 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the age the owner: Date Contractor Name Registration No. OR Date Owner's Name � I 26P-4 , p�� �clC Foe I , SG�CTi�7lJL� t f I 111 r• — I A�S � ln _ Ik$ ._I.�"A6 � 2 ; - + - r CLs'lL /ri Fs 06 T pOc/r3c `/t D.0 — — 1 k Del Po _ 1= PT I126 s T ON ' Fy&OT C©i2n` iz a y f [ ! 4 l a f I 1 i I fJ v t 4 I I! < ere- ...y' f � . _• —'_ - i � _.', ` r V*Av T" ! i f - t 2X i' 14V CA � C.B. Ito LaT ICD-) •• � CLOT 18� 1 � pips d I � (,J.I � �t�Ts METAL_ n 5►.16'D 0 9, 1g, 4 59,A 18, 3 1 ZS.-F: 3 Q (r placing existing shed) . N Q SHowR_2 Co . to v �o. a v1 - � EIGISTIN[r -� D w M I_1_1 �I y: � v 86-'17' _ G E IJ T E 1Z.V 1 L-L-F- 64c' w 1 d E o I� ►J r_Rs : Mt2. �. M>Zs. STA 1J SAL-TA L1 SL AS . PR£PAFf v FOR• soc. ^�`t-�n.:�t__� '� CER rlf'!£O PL O r PL AN :volt= F=e c l&.IT`e&,m o SI T54e-G 3 zo' LOCATION, WEST H"{ANMISPo,CrII"Ass. CS1VCY.�.�ZD ScT�3t�uGtG+ tC' SCALE: II"� DATE I1- 11- 19a7 R£F,£R£NCE: LOTS 9,9 J=s oNQ6) P.B. Ito P. G' u� L.C.P. FL0OD ZONE FORGE G / H£R£BY CERT/f Y THAT THE BUILDING o LOW. SHOWN ON THIS PLAN IS LOCATED ON THE 27807 y GROUND AS SHOWN HEREON AND THAT IT 1p w° Q' 'Do E •S CONFORM TO THE ZONING 4 01S t� BY•LAWS OF THE TOWN OF BArtNST�►g�-E ����sUR��` WHEN CONS TRUC TED,ExC E 1r 4.S MOIT--0 LOW A WELL ER, INC. 714 MAIN STREET MRMOUTH, MASS. DATE .. . . �, • , .,.. .it�..�umMUNW�ALTli Ur� Iy1A,JAt:tlu,i�1TS. � ,,, ,,,.,,. .,,. ..... . . .. .....: . . . . Board of Building Regulations and Standards Transaction No. One Ashburton Place-Room 1301 Boston, Massachusetts 02108 Registration No. Application for Registration as a Rome Improvement Contractor or Subcontractor Effective Date MGL Chapter 142.46, CMR 780-6 Expiation Date FOR OFFICE USE ONLY Date L Name Print the name of the individual oorr�business saapplying 'for th/e�registration(not both) I. Mailing Address ;/--7 3. City, /��v"G ��/ state 23D � (�� Area Code Bt Telephone Number 4. Street Address(if different) Print street and Number(P.O.Box not aaxptable) ary State Tip S. Applicant type: Individual ❑ DBA ❑ Partnership ❑Trust ❑ Private Corporation ❑ Public Corporation (See instructions on back: .-d-hig endesing a only or/town registration under the DBA or Rictitious name"law-MGL c 110,ss S&6) 6. � (see instructions) !/ 7. Number of Employes & Individual responsible for Home Improvement Contracts Last Fast Mi 9. Title of individual responsible for Home Improvement Contracts 10. Does the applicant or responsible individual hold any other construction related state,city,town licenses or registrations? L�' ❑ If yes,complete the table below. Use additional paper if necessary. Yes No Type license or registration Issued By L{oense or E*ration Name of License Holder registration number Date CONS , Yes No include two separate eeniGed checks or money oiydeis-one marred"Registration Fee';one marked"Guaranty Fund'. ALL APPLICANT'S MUST INCLUDE A GUARANTY FUND FEE EVEN IF EXEMPT FROM THE REGISTRATION FEE.See instructions on back for amount of fees. Make all certified checks or money orders payable to"Commonwealth of MassachusetW Pussaant to Massachusetts General Lbws Chapter 62C section 49A,I cMW under the penalties of perjury that 1, lmow ballet,have Ned all state tax returns and paid all state lawn required under law. /Z"/y/77 Si cure of appli t or applicant's representative Title held with applicant ':C• .. _ a , , r per.. b L SA. k°t r- off•'i �.. . i�'� 1 t ' ;`' ��t s x Q✓1�e'[Oom�n�a�+�uea� o�,/[�Cva0ac�tudP,ll6 •S' r 'DEPARTHENT OF PUBLIC SAFETY (:< 4 CONSIRF-TION SUPERVISOR LICENSE Expires: t •• :] KELLEHER } $ SQ,OTH WAIN ST t =4-{�IFORD, WA 01757 Parcel J &erMit It -Conservation Office(4th floor)(8:_M-9:30/1:00-,2:00) Date Issued -0 Board of Health(3rd floor)(8:15 -9:30/4:00-4:45) Fee engineering Dept.'(3rd floor) House# J _ ` 116 RARE. PP Y 19a .� Fo rAn+�' 7 TOWN OVBARNSTABLE Building Permit�Alicat!'on r Project Stree Village Owner `f�./�S LC Address Telephone Permit Request First Floor square feet Second Floor square feet Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure -f— D Basement Type: Finished Historic House AJO Unfinished Old King's Highway IJO Number of Baths a� No.of Bedrooms Total Room Count(not including baths) '� First Floor Heat Type and Fuel Central Air Fireplaces 1, Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# 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 PERMIT DENIED FOR THE FOLLOWING REASON(S) r.' FOR OFFICIAL USE ONLY _ PERMIT NO. t i DATE ISSUED MAP/PARCEL NO. ADDRESS - VILLAGE ; OWNER f DATE OF INSPECTION: FOUNDATION FRAME ; INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL - - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING t DATE CLOSED OUT , ASSOCIATION PLAN NO. i .The Commonwealth of Massachusetts Department of Industrial Accidents Z- _ ;i , .;:. � Olnceollo��st/galloas *4 L'i: 60011 asbiigpon Strcer 10 46 =/ e Boston,Mass. 02111 max.,}�• `_ Workers' Compensation Insurance ARdavit lip name ? � am a homeow er performing all work myself. 1 am a sole proprietor and have no one working in any capacity _ ❑ I am an employer providing workers' compensation for my employees working on this job. comnnnt•nnmc- �+ddress• • •• nhone#- . insurnnee rn_ U nlicy# ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired=e contractors listed below who have the following workers' compensation polices: company n•nme. address: call: phone#: insurnnee co nnticv# trwiJr-- .N':�!•�'; � K�.y_�r a�wt�7t�!"/':.'1'•�eKT•rSG1C•l� _ _ _ --___ •'77RF ?1�'i`�.i��rti�F�T�'���Y-"�':A�l �nam•name• address- • nhone#: insurance co nolicv# _ Atiach additional'sheet i[neeeis :•+�:- rt :�=`w^H"'K'a.rxw- ; :•� ��� ,' r Failure to secure coverage as required under Section 25A of h1GL 152 can lad 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 line of SI00.00 a day against me. I understand that a copy of this statement may be forwarded to the Once of Investigations of the D1A for ctnerage verification. I do hereht•7:3, der thepains andpenalties of perjuq•that the infomwdonpA ded above is trae and correctSignatu tent name Econtact do not write is this area to be completed by city or town official permit/license# raBuiiding Department ❑Licensing Board ` diate response is required OSeleetmen's Office C311ealtb Department phone#; r'IOther (rmsedIV5 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' 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 emplimer is defined as an individual, partnership,association, corporation or other ;,-gal entity, or any two or more o the force=oinst 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 tite dwcllin41 -- 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 1'S2 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 I av been presented to the contracting authority. (` - P.S•';' .e.` i•n::1..'a v ''Y:•` ..}+ �•:a y 1►:�R��'_✓'Cy�,�.•.._..r;, •ry .i 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 affida�•it. 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. ..7 777 ..-..:.' .. � ..:i:" .`,':v-'� r•�.3 Mqt "r..'.9i�! �'� .rwuFt',•�.. - +. 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 hesitate to `ive us a call. 77-7 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) 7274900 ext. 406, 409 or 375 ° The Town of Barnstable KMM ,S Department of Health Safety and Environmental Services 1 Building Division 367 Main Strut,Hy=:ds MA 02601 Office: 508-790-6227 Ralph Crosser F= 508 775-3344 Building Commiss For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the-n=nstruaron,alterations,•renovation,repair,modernization,conversion, improvement,.remo%al, demolition. or construction of an addition to any pre-Wasting owner ooarpied building containing at least one but not mots than four dandling units or to SWICtUres which are adjaft to such residence or building be done by registered contractors.with certain W=Ptiotts,along with other requireme= Type of Work: ESL Cost Address of Work:-` 4L 0%mer.Name• Date of Permit Applicatio I herd cenifp that: Registration is not required for the following reason(s): _Work cmduded by law _ob under S1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING TFOR OWN PERMIT OR DEALING WI'IHUNREG15T1�ED 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. Date Contractor name Registration No. OR 9- Lro n,,A Owner's name !' �v CLCT 18� •• l'n CLCT lo� t� 19 Colo15 it II,�.DO' mod_-. %•► 01 1 f 18, 3 1 Z 3 Q - Q SHowF_2 N00 n 4 co �15ED Y' j PA.-r PAT o EsCI5TIA1Cr J DWELL) n �4 v C.9.IC; 1 ez: 0�J r_Rs : M c2. . Mlzs. STA IJ LAY 5ALTA U SK AS PREPARED FOR: SNG'QV=r_Z1NG Assoc. cos= C5TER2v11_Lc r CERTIF IE'D PL 0 r PLAN F2ti&1TYA2 D VET54-c ld � Zo' LOCATION• WEST h1YAwkilspnorT, MASS. �SI�EYA�Z►� sETt3t ,�c+ Ic'� SCALE: 111 •30' DATE 1I- 1z- Ige,7 R£F£R£NC£: LOT �9, Zo CAS cNr-.J P. B. 'l b P. 01 Mu L.C. P. a4e " FLOOD ZONE / HEREBY CERTIFY THAT THE BUILDING :o EORGE ip- SHOWN ON THIS PLAN IS LOCATED ON THE 27807 1 GROUND AS SHOWN HEREON AND THAT IT � 278 ° H w � 'moo E5 * CONFORM TO THE ZONING ��9E c1Si� BY-LAWS OF THE TOWN OF BA�.t�sT�►PsL-E '��,�0 sl jR`� WHEN CONS TRUCTED.►F-xc E PT LDS No'Tp-0 LOW A WELLER, INC. , 714 MAIN STREET YARMOUTH, MASS. DA T£ Town of Barnstable Building Department Complaint/Inquiry Report : `� —�—�� Rec'd by: _ Assessor's No.: Date Complaint Natne: Location Address: �r M/P l�ii�l Originator Naine: Village: State: Zip: Telephone: D/E Complaint . Description: �p Inquiry 0 Description: For Office Use Only Inspector's Inspector. Action/Comments Date: ` V Follow-up Action Additional Info. Attaclied Copy Disaibuaon: 111ke-Depan=ent File 1 P1101V.&Spector �nd. T•, fed. to p1pol Col. f � 9 I q >E � S►-I EV Q SNOW F-12_ co Q ZAJ5 E'7 gt.0cW- L 1 N , Q � EICISTIAIC, y'' :7 Vvr_Nv� o I� IJ �Rs : M R. �. MRS. STD� LAY SaLTA v S K AS PREPARED FOR : �fMG'Qr=r_Z,NJG Assoc. col= c:2TEo2v1L-L-r CERTIFIED PLOT PLAN -. * LOCATION WEST h1YAtJ ti1IS pc� LT IVIQSS. F2o1uTYp2 D SrTF3,�,G1G 3 7�p' 1 (;SI pL�A�ZD SETc3t �f:+ Ip SCALE: 1" - 5n' DATE I►- 1 Z- 19e,7 REFERENCE: LOTS 19 ZO(AS ONG0 P.B. '1.b P. o L.C. P. FLOOD ZONE E I HEREBY CERTIf Y THAT THE BUILDING :o EORG ow. Jp- SHOWN ON THIS PLAN /S LOCATED ON THE - 127807 on GROUND AS SHOWN HEREON AND THAT/T 278 �° a. -Dc Ms _ CONFORM TO THE ZONING 9�. q` -Az BY-LAWS OF THE TOWN OF$AIZNSTaP'L-E ���0 SIiRJF. WHEN CONS TRUCTED.-F-xr-Ep i h,S Qorr-D0 LOW a W£LLER, INC. 714 MAIN STREET �c YARMOUTH, MASS. DA TE - - I � I TT IT I f LLL I ;'t A - _ ICI f _ � i f I � I-C- - - I I 1 M FR, 1 I �,- - -- -- - L -- I 1_ rl I I I I I -- ! � I 1 ! li I I I i I TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. ; DATE JOB LOCATION 3f Number Street address Section of town "HOMEOWNER" l 5,� S ,75-- 3 7 Name Home phone Work phone PRESENT MAILING ADDRESS City town State Zip code The current exemption for "homeowners" was extended to include owner-occupil dwellings of six units or less and to allow such homeowners to engage an in dividual for hire who does not possess a license, provided that the owner acts as supervisor DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to r( ' side, - on which there is, or is intended to be, a one to six family dwelling. attached or detached structures accessory to such use and/or farm structure: 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 Offic on a form acCaptable to the Building Official, that he/she shall be res ons=for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes .responsibility for compliance with the Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirement and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet,. or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. I 11%02•194 17:02 'C6177277122 DEPT IND ACCID �-- r. All n Tyr LOI;UnolUtlealtlL of j111/aejachaietb oUa'PartaxAl o��iu�u�tria��ccu�en� 600 .Ju-n# n Slma l James J.Campbell &ton, V macfwdA 02f f f Commissioner Workers' Compensation Ittsura>tice davit with a principal place of business at: (QLY/s zfa) do hereby certify under the pains and penalties of perjury, that: () I am an employer providing workers' compensation coverage for my employees working c this Job. insurance Company Policy Humber () [ am a sole proprietor and have no one working for me in any capacity. () l am a sole proprietor, general contractor or homeowner (circle one) and have [tired the contractors Iisted below who have the following workers' compensation policies: Contractor Insurance Company/Policy Plumber Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Plumber �am a homeowner performing all the work myself. 1 ineer<trrc: co;y of iL is stenent will be forv:arCed to tre Of ice of imesdgzdons of(fie DIA for coverage verification and that failure to sec ccve!age as ree-;red under Season 25A of MGL 152 caa lead to the Imposition of criminal penalties eonsisdn¢of a fine of up to s 1,500.00 aricic yea:s' imprisc-ment as well as civil penalties in the form..of 3 ST P WORK ORDER and a tine of S 100.00 a day against me. Signed this day of , 19 �t5 Licensee/Permittee Building Department Licensing Board Selectmens Office Health Department _-�r6 9 TO VERIF`r COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 37S - The Town of Barnstable . ,A,M.,MZKAM peg Department of Health Safety and Environmental Services + " BuiIding Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax- 508-775-37A Fu:.j,+:_,t.^c�*_- �« For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERM1TAPPLICA1ION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modetniratian,conversion, improvement, removal, demolition, or construction of an addition to any preexisting 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 O 00 , cad Address of Work: _ �� � �/ - e:/,, OKner Name: Date of Permit Application: I hereby certifv that: Registration is not required for the follcming reason(s): Work excluded by law Job under S1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICAELE H01v� IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION FROGRA.1;OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor name _ Registration No. OR . Date Owner's name Assessor's Office 1st floor Map Lot Permit# Conservation Office 4th floor) Date Issued / 9 Board of Health Ord floor r17e �AW o � 55 -ICEngineering Dept. (Ord floor) House# r� f 1�t - .avaawa r�wua��wr i 1ARNBrAB1d' _ NAM cin ►v flTan Nff rove - 19 s6 )Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.) , SEPTIC MUSTINSTALLED I COMPLIANCE VATH TITLE 5 AND TOWN OF BARNSTABL ���® �� �Ct�® EE Building Permit Application Project Street Address 38 64 V e zv r /k- Village Gy "o AI A" /d Fire District (honer Address Telc hone 7J 3 Permit Request: Zoning District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Existing Information Dwelling Type: Single Family Two family Multi-family Age of structure Basement tyre Historic House Finished Old King's Highway Unfinished Number of Baths No.of Bedrooms Total Room Count not including baths First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone number Address License# Home Improvement Contractor# Worker's Compensation # 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 Pro'ect Cost Fee SIGNATURE ` 0' � DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T 1 T7 FOR OFFICE USE ONLY 5/1/9 5 a*613" _ cAf 246.012 ADDRESS 38 Centerville Ave. , vII.LAGE W. Hyannisport Stanley. Baltauskas OWNER DATE OTSPECTION: FOUNDATION - FRANIE .ti INSULATION' ¢ a ' . 1 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: s 1 DATE CLOSED OUT: —3 ASSOCIATE PLAN NO. cu h< t �a-:O F�•.�if1y v . }R C t