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Town of Barnstable Building
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L4WP01W
st,;This Card So Tat rt�isUisiblerFrom then5treet _Approved Plans�Must beReiatned on Job and this'Card�M`�u'st�beKept
� a _ ea� ��,x � � � � � �� �..� ` • � : r " F �� " �`. _.n , ; °: :c E 'te ? r2s : pmere a�Certificate of,Oc�cu�pancya Required,such Bwl g shall Not be Oceupie it a Finai lns ct�on has been made.' Permit
1.
Permit NO. B-18-1580 Applicant Name: Jonathan Whipple
Approvals
Date Issued: 06/08/2018 Current Use: Structure
Permit Type: Building,-Insulation-Residential Expiration Date: 12/08/2018 Foundation:
Location: 116 COTTONWOOD LANE,CENTERVILLE Map/Lot. 252 028 Zoning District: RD-1 Sheathing:
1 R �
Owner on Record: DELROSE,CONCENZIO J&LOUISE T TRS ; = Contractor Name ,; JONATHAN N WHIPPLE Framing: 1
Address: 90 WEBSTER ST Contractor License.! CS 078683 2
WATERTOWN, MA 02471 '
�� _ sst Pro�e�ct Cost: $2,574.00 Chimney:
Description: INSULATE ATTIC AND AIR SEALING
PermitFee 85.00
k $ Insulation:
Project Review Re Fee Paid $85.00
J q: r=
6/8/2018 Final:
a
ME
` " j: Plumbing/Gas
Rough Plumbing:
X .
k Building Official
Final Plumbing:
ii;
This permit shall be deemed abandoned and invalid unless the work author�',irzed�'by�this permit is commenced within sixrnonths.after Rough Gas:suance. g
All work authorized by this permit shall conform to the approved appl'caUon and the approved construction documents�fo�whichthis permit has been granted.
All construction,alterations and changes of use of any building and structures shalhbe in compliance with the local zonmgby laws and codes. Final Gas:
g
This permit shall be displayed in a location clearly visible from access Yreet or road and shall be maintained open for publc inspection for the entire duration of the
work until the completion of the same. ;` �` mF g Electrical
z Service:
The Certificate of Occupancy will not be issued until all applicable signaturesM the�Buildmg1and Fire Officials are providSIXh"s permit.
Minimum of Five Call Inspections Required for All Construction Work a Rough:
1.Foundation or Footing ::w _. _ ,. ... �•.� .
2.Sheathing Inspection Final:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation
Low Voltage Final:
7.Final Inspection before Occupancy
Health
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Final:
"Perso s con ra ting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department
Building plans are to be available on site Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
02/1E;,2012 15:08 5087789312 BARNSHOUSAUTHORITY PAGE 01/01
T1 )
ARNSTABLE
t f 2 91
�-1
ZONING VERIFICATION
T0: - J
FROM: Kim M. Gomez - Leased Housing Coordinator
• Rental Unit VerificationRL. Legal R n
Date:
Address: 110 C�0 'Q/� C)OO U 1�17
Village: ( n7�� r V1
Unit Type:, I Bedroom Size:
Map & Parcel No.: 5a
The owner of the above listed property is entering:into a,contract with us for the
rental of the Property as listed above.
Please verify by signing below that the unit is legal and meets all zoning
requirements for a rental in.the town of Barnstable. if it does not,please list reason
U.
i1
S
han you for ur sistance in this matter.
Sign*re. Print name
r-9-
Date
VIA FAX: 790-6230 MRVP Section 8
Rev. 8/0G
I ,
P. 1
Communication Result ReP.or.t ( Feb. 1.5. 2012.` 3:'`02'PM ) . .
µT 2) �
Date/Time : Feb. 15. 2012 3:02PM
F i 1 e
No, Mode Destination Pg (s) Result Not Sent"
----------------------------------------------- -- - -- -- -- - - -- -
6012 Memory TX 95081789312. ` 'P"" 1- WOK qyM-i
M k�
————————————— ——— -- +xe _ —
Reason for error s
E. 1) Hang uo or l i n e f a i l E. 2) Busy
E. 3)- No answer E.: 4) No facsirni:1a co-nnect ion ,
E. 5) Exceeded max. E—ma i l size '•
ty n �encF s
:ZONING VERIFICATION
' - - •.. .,� '". r.µ.+ '.of �b.;�,. �3i �� � f',, � h �.
FROM Yn-k Gomez Leased Htwsing Coordinator
RE: Legal Rental Unit Verification
Dater
Adder 1!G C'o r on GJciod Lira"e h
IIt1ltType: �1/� P Bedroom Size:
Map&.P'.r.'lN.o �So2� 619
1Le owner of the above hated property is entering into a contract witL os for the
1wtal of the property as HAW above.. -
r Pleeae verl4 by aigutng below that the Rob is legal and meets allaonmgIN
,..
'74mires aunts fora rental in the'tuwn of Aarnatsbla u it does not,pleats list eeasoa t - �' - -
as
le how i
5 ¢
qpun for nr aistence aft Hatt
v6n Hm' Print aamo
Date
VIA PAX: 790•6230 MuP seam t
Rev 6/06 Y, t a .
:� ,,
BARYSTALB
NABL
0 MAX
TOWN OF BARNSTABLE
BUILDING
� �� � � �� � �� INSPECTOR
�� ��
��00 � �-00 � ���� � ���������� � �0 ��
�� �� � ���� � ���� � ����� ���� � �� ��
APPLICATION FOR PERMIT TO .-^\ ..................................................................
.
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TYPE OF CONSTRUCTION ...��]�513 -~���' --^--^`-~^^-^'^~'`-^'~-~`-^~^~~^-'-'----'~^---'''' '
C1, -cr�� '
-:=���J�.---- ...-..--.-l�����
TO THE INSPECTOR OF BUILDINGS: '
The undersigned hereby applies for o permit according to the following information: �
Location ..\ "r�—.\L�--.{�J�.4.[�\[l.\�\m(}r� ,..\ ��,,.. [J.�. ,,,.,. _______,_____
Use — — ------^--'--'` '' '
. ..r~... ..^—..~.---..^._~. . .�....—~...—......---- —.. - . . .. ----..
. .` --�
� {.
| Zoning District —������ .~----'.---..-------..Rne District —^_�'��l. .....................................................
�
n0
Nome of Owner ..[-�u«-Y'k�\��—.. ��-----A66reu ..u���.. ..Y/x=V �»V�—J�"��.-----
'
0
Name of Builder .�»\� ..y^ .--Y\�� .A66res —\4x�'—/�' '' —'[� �»^----
�
Nome of Architect .� - �~�����—. del-
......................A66res —[�-�—(-�1 '—' ----
' '
Number of Room \
. ..-------
8\�
Ex|erior —.--.---.QooGng —���� ��{�~—'`—^--'—'---------'—
» .�
�~�-
<~ �
Floors —'=�!� —..----------.---.....|n�ericv ..��������..—.�!��Y�^—...--.—.------- `
`
Heating .�"-.. +4��—. �r+�-..-�...—..---..~p|umb�g .��` ~+`^�_��.\~_+............................... _
_ � - `
��
Fireplace —.:�`.\�,���-----------------.--..Approx|mote �oo —. ....................................... ,
Definitive Plan Approved by Planning 8mor6 lR----. Area —i?A�30-------.. '
Diagram of Lot and Building with CUmanohonu Fee _______________
SUBJECT TO APPROVAL Of BOARD OF HEALTH
61 �
`
'
^
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'
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS _
| hereby agree to conform to all the Rules and Regulations nftheTown of Barnstable regarding the above
construction. .
~ '
' Nune . �~�--.----_.~
� \
�-�
' Construction Supervisor's License —\ ...................
MCKEON, CYNTHIA A=252-28 '
}
No. . 5.98�... Permit for .One.. Story,...,,,.,,
........... ingle„Family,,,Dwelling,.,.,,,,,,,
Location _...Lot162,, 116, Cottonwood :Ln.
................... Q.1q.tQx'.V.Ua.,P................................
Owner ........Cynthia,,,McKeon,,,,,,,,,,,,,,,,,,,,,
9
Type of Construction ,
................................................................................
Plot ............................ Lot ..........................
Permit Granted ... January 18, 19 84
Date of Inspection ....................................19
Date Completed ......................................19
I
l
N.
7 Assessoi's map and lot number .... ....... P %TrE
T
Sewage Permit number .........................11?�::.. .:,..... ' .....:
SEPTIC SYSSTEM MUST 8"
�. ..................... I��STALLED IN �:OP .LI, ''` 2 BasasTllDLa
House number ......:............................ . . s �� rasa
Al TP' a f 6 9.
a 5 �0
�a MIN
TOWN OF B A-R =S�T-A
BUILDING INSPECTOR
f
APPLICATION FOR PERMIT TO ....QtrW..... �( �I C� b►f1.............................................................
TYPE OF CONSTRUCTION ... i`.A,M ..........................................................:......................
.........................
..J iNn%.........1.....................I
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies
'i for a permit according to the following information:
Location ..L 14a - �-t'C�3 ®OC l_ � `J .��.i M
................................... .........
ProposedUse .. .... W. �.!. .4. . ........................................................................................................................
pp "I C l,
s -Zoning District ... 1 .......................................................... Fire District .......k..... .. ?. ...........................................
Name of Owner .....�..19 ..............Address ................
S1�.....P. .................
Name of Builder .M� � C:,STCM a J�^�1. .Address......f. . .. ... ...M ....2
Name of Architect .Go.( Apn �-,n` `< .................Address �?A �f3C P��!!l.P#lt ............
........ .. ........ ................ ........
e'nNumber. of Rooms ...F'..f4#.1...............................................Foundation .... ......... ` C'-M .
Exterior ... 1.es...f.... f j. wq nC.d'.......................Roofing � .......................................................
i
Floors P>T. ..........................................................Interior .. .!^e „[`...C
.....................................................
Heating F.R.W......b.l..... A',-->................................Plumbing � I V C-1 ..........................
Fireplace ... d`i ............................................................Approximate Cost ....,. {.. Q.0......................................
Definitive Plan Approved by Planning Board -----------_______------------19________. Area
Diagram of Lot and Building with Dimensions Fee .............. ... .........................
SUBJECT O APPROVAL OF BOARD OF HEALTH '
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Tow_n of Barnstable regarding the above
construction.
Nam ..... \.:.� ..........................
Construction Supervisor's License ... ..................
M0KEON, CYNTHIA
Sory
No ... Permit for ......t..........
. .....Single ...Dwelling................
.. . .. .... .. .. ....... ..... ............. ..
Location ...Lot 162, 116 Cottonwood Ln.
...............................................
Centerville
........................................................................
Owner .....Cynthia McKeon
................................................
T Y'pesof Construction, ............Frame..............................
....................................................................
Plot,............................ Lot ... .......
Perm-it Granted .. January 18.............................f.........19 84
Date Insp of? ection .....................................19
Date Completed 19
N/p A
i^V 7- v,Z-.. t .'
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N L tJ 7�
46 ' '� •• r. .. � - �
+� 4-1v
o
CERTIFIED PLOT PLAN
r� 10 L D T /6
�' v� RUJERT ,��>
NEW CONSTRUCTION ONLY E3Rvc� Yr CzEIV`7 Ef/ALE
a.oREav
TOP OF FOUNDATION IS FEE t IN
ABOVE LOW POINT OF ADJACENT ,:..- '°
ROAD. Rai, sy.�vw
-- 10
SCALE, I rr =30' DATE
(A-DREDGE ENGINEERING COIN 14 CLIENT. c K,..._,_,...,V I CERTIFY THAT THE
E®ISTERED RE015TERED SHOINM ON THIS PLAN IS LOCATEp
CIVIL LAND JOB N0. ��' ON THE GROUND AS INDICATED AN,O:
ENGINEER SURVEYOR '. DR.BY A"�� CONFORMS TO THE ZONING LAWS
/fi
OF BARNSTABLE MASS.
712 MAIN STREET CN.BY, ' 4
HYANNIS, MASS. SNEET_,,` OF
i�Ak REG. LAND SURViYOA
FROM
TOM OF BARNSTABLE.e.
s ,�-**'. -mod BUILDING DEPARTMENT
Tom Mr. Francis Lahteine ,
Clerk , 367 MAIN STREET HYANNIS, MA 028M . .
Phone: 775-1120
SUBJECT:'
FOLD HERE '
DATE
ril `3a,"`1984-
Wdrk has been &np;g under Penlit- R4984 1G, thia'A a-K'e-9Q) y
Please release Bid.
1
• - SIGGNNEEbc -
t Y
DATE f -
REPLY c
SIGNED - -
N87-RMI - RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY
PRINTED IN'U.S.A.
SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND,PINK COPIES WITH CARBON INTACT.
-Y
a TOWN OF BARNSTABLE Permit No. -----------25990-------
�
Building Inspector s�assrm Cash
--------------------
e 9.DUO
OCCUPANCY PERMIT Bond ----------------X_- -
Issued to Cynthia McKeon Address
.Pn�` t�1�I /1'1�! �('a�'fa�a7����snr� �1 n�zo - �n_�►,�'n i,R��',9�n_
Wiring Inspector {� C1 f, ' -- Inspection date
Plumbing Inspector ► Inspection date
Gas Inspector `'K. ,, `� o� � Inspection date ! w&
:Engineering Department Inspection date -t>-)77 t
Board of Health .. Inspection datey///fA y
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE •,
BUILDING CODE. �+
Building Inspector
oft Town of Barnstable *Permit# _ R,
Expires 6 ntowk from Issue date
„„JWA" : Regulatory Services Fee ,
v X" Thomas F.Geflery Director
Building Division
Tom Perry, Building Commissioner
200 Main Street,.Hyannis,MA 02601 X.PRESS PER
`:'
Office: 508-862-4038
Fax: 508-790-6230 AUG 1 5 209,
" EXPRESS PERMIT APPLICATION - RESIDEM9A1j_0NLY
Not Valid without Red X Presslmprint I„UVVN QF BARNSTABL.
,Iap/parcel Number ,5 2 o J b
'roperty Address Wo OrAotA w wd
Residential Value of Work ( ���6 Minimum fee of•$25.00 for work under$6000.00
)wner's Name&Address L,o n can z t n I Rose, ILL r i 1*nod l a l c.,
rp e vyi l l e,i mck, - oaO a
ontractors_Name owlArkes mQ;n(�S(1an TelephoneNumber-_SCR-- aaj-s�3�
Home Improvement Contractor License#(if applicable) ` "1
Construction Supervisor's License#(if applicable)
t I
4wolkman, Compensation Insurance
ck one. '
I am a•sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name ST- -Paji 1pms
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must be on file. 14
Permit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
[replacement Windows. U-Value (maximum.44)-
*Where required: Issuance of this permit does not exempt compliance with other Iowa depa 01- � �
***Note: Property Owner must sign Property Owner Letter of Pj' ward of Building Regulations and Standards
Home Improvement Contractors License is required. HOME IMTOVEMEtiT CONTRACTOR
Registr-zln\ 144823
Signature
,�- 2006
' Kidual
QForms. PB CHARLES MEN t
Revise063004 i
!i CHARLES MENE
37 VILLAGE LANE
SOLITHWELLFLEET,MA 02663
Administrator
•" 4
Town of Barnstable
Regulatory Services
Thomas F.GeUer,Director ,
��b,�f ��•'� Building Division
Tom Perry, Building Commissioner ,
200 Main Street, $yanais,MA 02601
wwwAown barnstable;ma.us
dice: 508-862-4038 Fax: 508 790-6230
Property owner Must
Complete and Sign This Section
If Using ABuilder
as Owner of the subject property
C
:hereby authorize , to-act on my behalf;
in all matters relative to work authorized by this building permit application for:
(Address of job)
Signature er Da ;
ese
print Name
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute, an employee is defined as ...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership, association,corporation or other legal entity;or any two or more
of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
do maintenance, construction'or repair work-on such dwelling house
dwelling house of another who employs persons to
or on the grounds or building appurtenant thereto shall not because of such employment be diaYe1
6 also states that"every state or local licensing agency shall withhold the issuance or
MGL,chapter 152;§25CO g
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."
9
Additionally,onally,MGL chapter 152, §25C(7)states"Neither the commonwealthi 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
er have been resented to the contracting authonty.
requirements of this chapter . P .
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary;supply sub-contractor(s)narne(s), address(es)and phone number(s)along with their certificate(s) of
insurance. Limited Liability Companies(LLC)-or Limited Liability Partnerships(LLP)with no employees other than the
members or partners, are not required to carry workers compensation insurance: If an LLC orLLP does have
employees;a policy is required. Be advised that this affidavit 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 tlie-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'
ease call the Department at the number listed below. Self-insured companies:should enter their
compensation policy,pl
self-insurance license number on the appropriate line.
City or Town Officials
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. In addition, an applicant
that moist submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
Please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial.Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
Tel.#617-727-4900 ext 406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 5-26-05 www.mass.gov/dia
- The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Invesdgations
600 Washington Street
Boston,MA 02111
c www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Orp=ation/Individual): N. j �2L mP nencrQs
Address: P O ZOX '-304
City/State/Zip: 5 UJe_I!c 12e_k MCk Phone#: SO 1377 3 a
Are you an employer? Check the,appropriate box: Type of project(required):.. .
1.❑ I am a to er with 4. ❑ I am a general contractor and I
ems y 6. ❑New construction
employees(fall and/or part-time).* have hired the sub-contractors
2.�am a sole,proprietor or partner- listed on the attached sheet $ ? Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
workingfor mein any capacity. workers' comp. insurance. 9 p ty ❑ Building addition
[No workers'comp. insurance 5. ❑ We area corporation and its
required.]
officers have exercised their 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions
- and we have no
myself.'[No workers' comp. C.-152
,
§1(4), 12.[:1 Roof repairs
insurance required.]t employees. [No workers'
l3.❑ Other
comp.msurance required]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy-information
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating.such.
tcontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp-policy-information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the pokey and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic. #: Expiration Date:
Job Site Address: ' City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500,.00 and/or one-year imprisonment, as well as.civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
Tdo hereby certify u er he pains a penalties of perjury that the information provided above is t e and correct:
Signature: i,„ Date:"
Phone#:
Official use only. Do not write in this area,to be completed by city.or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#: