The URL can be used to link to this page

Home My WebLink About0344 ELLIOTT ROAD . o ,- x r. .� .. . , .._ , .:� �. : ,.. -„ ..,. o �;� ,, ,. �; s!1 ilzj�4d Town of Barnstable .°�"'�' Regulatory Services r Thomas F.Geiler,Director TOt' BAR f, LC M+sa Building Division Tom Perry,Building Commissioner" 00 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 fit',= 1, Fax:h8-790-6230 PERAUr# ,)JA2 y 3 FEE: SHED REGISTRATION 200 square feet or less ric Location of shed(address) Village. Property owner's name Telephone number st J L �o Ly Size of Shed Map/Parcel# e Date Hyannis Main Street Waterfront Historic District?; Old King's Highway Historic District Conirnission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITffiN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. TIES FORM MUST BE ACCOMIPANIED BY A PLOT.PLAN, j i Q-forms-sbedreg REV:05201 Town of Barnstable Geographic Information System April 23,201.' 227078 227082 #9 , l{ 227077 #327 A a a y , 227083 #361 , . —".��,,,, '227076 227084 #344 4 Q �> 227085 #330 227103 #377 227086 #316. 227.141 r ° #378 277104 51 2271 #385 #1 50 227152 ". #52 227140 fleet #390 DISCLAIMERS:.This map is for planning purposes only. It is not adequate for legal Map:227 Parcel:084 Selected Parcel' boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:COYLE,JOHN V&DEIRDRE M Total Assessed Value:U50700 1"=100'may not meet established map accuracy standards. The parcel lines on this map are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner. Acreage:0.55 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:344 ELLIOTT ROAD such as building locations. Buffer TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel- 0. Application Health,-Division Date Issued Conservation Division r Application Fe ' Planning Dept. j Permit Fee' x ti f Date Definitive Plan Approved,by Planning Board Historic:- OKH _ Preservation/ Hyannis t s 1 Project Street Address 4 it 11 i ow- 1 -d. Village C LNG�[t � , � Owner ?q-%Tbkq e�W�� Address ��y �I�,'y� . ��Nler, ( / •�. Telephoned Permit Request i 5� 3,0® 51. 0� me"'t 4t a 1611'et OAlt Z In Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new •3 Zoning District Flood Plain Groundwater Overlay p lea 3e.�-�-f w Project Valuation 91600 Construction Type W I F , } =M Lot Size Grandfathered: ❑Yes ❑ No If yes, attaeh'supporting documentation. is Dwelling Type: Single Family-,`` Two Family ❑ Multi-Family(# units) q� Age of Existing Structure �� Historic House: ❑Yes ANo On Old Kin g's Highway: es 'No Basement Type: ;Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 3DD��ew Basement Unfinished Area (sq.ft) 9dD Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas A Oil ❑ Electric ❑Other Central Air: ❑Yes )4 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage:,9 existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review # Current UseS Proposed Use 544-e—. APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name z Z/ a ephone Number Address License# I "l 36 Home Improvement Contractor# 15 R 0 Y Worker's Compensation # WWC 362 120 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Cwuns see �v�S�- SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER ,DATE OF INSPECTION: t FOUNDATION FRAME -� INSULATION •J FIREPLACE ELECTRICAL: ROUGH FINAL A PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING It, a DATE CLOSED OUT ASSOCIATION PLAN NO: f The'Commonwealth of Massachusetts Departinefit of Industrial Accidents Office of Investigations ' 600 Washington Street Boston, MA 02111, www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please,Print Le ibl Name(Business/Organization/Individual): t ��}' �' �eJ/ `� ✓ ° Address: /1 �7 7 D ",' - St City/State/Zip: 05k-1//llc A& o L`� Phone.#: -d a Are you an employer?Check the appropriate box: Type of project(required): 1.Dd I am a employer with 4. 1 am a general contractor and I employees (full and/or part- * have hired the sub-contractors 6. ❑New construction time). 2.❑ I am a sole proprietor or partner- listed on the attached sheet. „ 7. r171 Remodeling ship and have no employees These sub-contractors have g• 0 Demolition workingfor me in an ca aci employees and have workers' Y p �'• # 9. ❑Building addition [No workers' comp.insurance comp. insurance. required.] 5. E We'are a corporation and its 10.E Electrical repairs or additions' 3.❑ I am a homeowner doing all work officers have exercised their 11.E Plumbing repairs or additions myself, [No workers' comp. right of exemption per MGL 12.0 Roof repairs c. 152 1(4), and we have no insurance required.] t � §. - employe es. o workers' 13.❑ Other � comp. insurance 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. (Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees'. If the sub-contractors have employees,they must provide their workers'comp.policy number. .: 1 n lam an employer that is providing workers'`compensation insurance for my employees. Below is the policy,,and job site" s information. Insurance Company Name: "v�S Co. — L�I&4W C e Policy#or Self-ins. Lic.M W C 30 Z I z 0. I Expiration Date: 3 J-L 3 20 11, Job Site Address: Ll �%�I 1 City/State/Zip: lCeA✓ ✓l/!e ALq: 0Z6 3 Z 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 S 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 S250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un r the pains and penalties of perjury that the in/orniation provided above is true and correct Signature: Date: Phone#: J 0tj' y7i8— 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 F4.Electrical Inspector 5.Plumbing_Inspector 6.Other Contact Person: Phone#:' CERTIFICATE OF LIABILITY INSURANCe DATEp11UpD/r1Y1) 03/2312011. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RK;Im UPON THE CERTIFICATE HOLDER. TH kc CERTIFICATE DOES NOT AFFBWTIVELy OR NEGATIVELY AMEND„ EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIE BELOW. THIS CEFiTMCATE OF INSURANCE DOES NOT CONSTITUTE A.CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE REPRESENTATIVE OR PRODUCER,AND THE CERTIFlCATE HOLDER NPORTANT: If the cefM4te holder Is an ADDITIONAL INSURED,the pollcy(les)must be eridased- It SUBROGATION IS WAIVED,subject the Berms and c:orldMons of the policy,a bin ppiicies rrlpy require sn utdomemenL A statement on this Certltlute does not confer rights 10 the oerMCAW holder in lieu of such endorserrIe P tooucn T Mark Sy!vm Insurance Agency �1rONe 771 Main Street 50A 8-0440 w.�(508N20.9227 Ostervl(e,MA 026S5 q�Rygx_Merk VY.SrM_a _ MAVA ED Pau A' Ct7VgtAG E NA7C/ West Bay Manageent Trust uauaEg A: A�N"US the Co m 77DA MaM Street nraunpc s: W"00 - Osterviwe,MAM55 wuit :Cc: - 4 u�- exeLJREq E: •_ . COVERAGES . CERTIFICATE KUSER: REVISION NUMBER: THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED MWED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVWTHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREJN EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.UNTS SHOvw MAY HAVE BEEN REDUCED BY PAID CLAVS tg SUBJECT TO ALL THE TEAMS, N/ LTV - TYFE OF erSURANCIE !R LJCY LiM�Ta POL1C1'MVMeeR . A OEkERAL UAArlrrV MP0006001005153 12l4/2010 12/4/201] iACH OctuaafNCE t 1.000,000 X CC1�RCul DENEnAL LJAeam ,Q„� 1 100,000 CL/�M11StrtADE aOCCUR NEDEW aroia+�J , s,000 ►EASONAL S AVV INJURY a 1,000,000 GENERALAOOREGnTj • 2,000.000 ML ACGRG(iATE LMITAP�IIES PEA. PROD Te-COUPlOP 00 X POUCY rA0 LOC ACG i 2,000.0 AUTOMOSU UANUTr COmBINED S&GLA 11MIT AMY AUTO Me Now") / ALL OVAdED AUTOS a001LY INJURY CP/r pwom) a -- SCN[OULEDAUTOa eOotLrMJURY(Pyecod") 1 HMO AUTOS PAO►ERTY DAMAGE,� f (Pr Anisr� NOKOV+fIEO AUTOS s UYaetxu LIAN S OCCUR excess wa eACH OCCUNAENCE 1 CLAJ1MsJ1A0E A "GATE / D60UCT1Clf - 1 i B tirDrnrrtla GOrP6MaAT10N _ -AMD t MftoYmr 3D21209 LU,MLIry /N 3f23/2011 3/23r1012 v c s x OTi+ M(Y PROPM TOrwARTI4 ,txECtmve 00FICCOArlAr EmFXCLUD[07 N/A e.L ►1ACGot�Nrt i 500.000 rweaftwy IA 1M) - oE1GR �° gAn0y8 boo. _ E-l.0!SEASE-EA E1.1PLOrp / _ SOO-,C00 !�d>lrJISE•POIA:YUMIT i SOO,D00 cexxirn000 OFO►ERAnOMpILOCAnohs/VEmKLm(1bYtl1 ACORD 101•Aral RMSM Landscape gardening. pSaiMrt mg,Carpentry ecn.wh wnler.+ae.w/.qdrJa1 C1.RTIFICAT'E HOLDER CANCELLATION (SOaK26.197A 770A,ca RSbv t Inc SHOULD ANY OF THE;ABOVE O"CROED 7t]LtM3 BE CANCELLEO aEFOAE 770A Main Street THE "PIRATION DATE T?EREOP, NOTICE W1L1 Ere DELIVERED IN OstarvilFt.A4q 02855 ACCORDANCE VWTH THE POLICY PROVLSK)ta. I �T>�0 A9RPSOfTA!1v1< ACORD 25(200IM9 A 1>tB3-200fi ACORD CORPORATION. All rtghtt nservsd. The ACORD name and 1090 Ary Fe91etsrad"rfcs Of ACORD oF1HEr Town of Barnstable Regulatory.Services • BARNSTABLE• v MASS. $ Thomas F. Ceiler,Director 1659.ca�� Building Division' Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, J 6k4 Co as Owner'of the subject property hereby authorize &�M /Iezz— to act on my behalf, in all matters relative to work authorized by this.building permit application for: Cg (Address of Job). Signa re of Owne Date Print Name If Property Owner is applying for permit.please complete the Homeowners License. Exemption Form on the reverse'side. Q:FORM&O WNERPERMISSION Massachusetts- Department of Puhlic Safch ' Board'of'BuildinIg and Standards Construction Supervisor License License: CS 94302 Restricted to: 00 ADAM HOSTETTER �'• a �+ 770 SUITE A MAIN ST - :-PSTERVILLE, MA 02655 ,F'qq Expiration:'I 21=01 1 (I,mmi.—illnrr Tr#: 13857 • ✓/t¢ U4�)LIItOOt!!/C!L![/I ��F�.00JQ•!�(!tW.�d Office of Consumer Affairs S Business Reg ulat:m, HOME IMPROVEMENT CONTRACTOR I'( s Registration: ,152124 Type: t F� Expiration: 8/2/2012 DBA WE5 T BAY MANAGEMENT TRUST r ADAht HOSTETTER 770 A MAIN ST. OSTERVILLE,MA 02655 ..7 I i Undersecretary r aintt:u2is inoy1!m — — p!lee t0N I + 1 1 t 911 ZO Vw uo)sog OLIS 33!ns-ezeld)lagd OI u0!it:ln3all ssaulsng PUB sAeJ)v lawnsuoD,lo 3;)UjO :03 u-Intai punol lI -918P uo!Iendxa aq)ajo}aq �170 asn lnp!Alpu!Joj p!IVA u0!teJisl3aj 10 asuaal-1 L I � ---� - 1 , ��',, 1 ��'� <.`' �- �v-.{ .�-- / � ' �e � � ,J� �� ( �.. 3 yY EU.�oTT .a ............ �tl1 Solrrtiow why of n rc LL4/rY model German Engineered professional series(7.15 and 10.22) motors Features All Imperial products are designed •2 operating modes with high-performance and reliable (Intermittent,Continuous Ventilation) motors for your comfort and peace of `. mind. Factory scealled and dynamically •Variable speed balanced, our motors are maintenance-free •Proportional defrost(Patent Pending) for years to come. •ISFT"6"(dia.)collar system M •10-year limited warranty*on ventilation motors 1SF� _ •Lifetime limited warranty on the heat recovery core 6" (dia.) collar System •5-year limited warranty on all other components Quick and simple to install thanks s. to our revolutionary"Insert Slide _ and Fix " collar system.The "1SF-1"' Why is our system the best? 6'(dia.)collar system by Imperial enables you to manipulate duct within your reach and then insert the collar to the HRV/ERV by sliding it in Selection of controls Operating flexibility place, for a better and quicker installation. Selection of fibers and accessories Better air quality SPMTM Compact installation Maidmizes your space •°DUOTMP'balancing system(patent pending) Silent and economical Sloped drain pan Eliminates bacbeda-produang stagnant water attachment system a •"Pushihmugh`design Silent The entire line of Imperial HRV/ERV 4 Backward inclined motor blades Better performance products is designed for installation Permanent lubrication of PSC motors Maintenance-free bearings by a single person. "Single Person Easy Mountinel"will enable you to save •Door opens upward No obstruction around the drain pan Easy to dean time and effort by offering you a variable Simple electronic control Easy to operate attachment system and maximizing your •Auxiliary conning relays •No relay necessary basement space. 10•year limited warranty on the ventilation motors Reliable and trouble-free lifetime warranty on the heat recovery core Peace of mind DuoTrol"M Easy access to the control connection box Eliminates risks of error balancing system 'ISP 16"(dia.)collar system(patent pending) Quick and simple to install tt. ite^:t YciXiy,� , •'SPM—attachment system Variable settings Silent and economical. By reducing motor speed to balance the unit,you avoid the noise that would be �' �j� - r produced by balancing dampers.In addition,with this echwwgv�1m -=bow— technology the unit will consume less energy. �.•//lWk it clean&s mpke:OTdf Range of controls ,. _&rgpptiytm�al1Pyyfffi�i�= e6wrHRV/ERVsy GGG/G l!✓N'GGG/ m mc)deZ The entire range of"GreenThinkeil model"controls is offered with features making your ventilation system simple,easy to operate and backed by a 5-year limited warranty. a Choose from: RD-1,RD-2,RD-3P RDAP and T-3 _. (Push-Button Timer) 0 1111 I:II 11jj1 - _ l USER-FRIENDLY CONTROLS - - - RDAP and T.3 inoWs gx m above .. emu Also akeilable: PE(Energy Recovery Corel DOF a r,rl 93mgm Push Through Easy Access Door Sikint opera on for �. operation system removable better home co� o�"C:..T°f The side air p show thegth operation at a imperial swhich top hinge door //Di� Outside air is pushed Through the heat exchanger,which acts as ---^�� a sound attenuator.This process is very silent and provides you vrith better home comfort. -_ Proportions! Defrost Freshr Ewa f __X��r Zt� operation system ISF"' The defrost energy is controlled by .."J / Colj Systerria.) 1 the outdoor air temperature.The ��fa Heat ,'r'�,,. .�� motor speed essentially increases as recovery Fresh <� �• i outdoor temperature drops to provide Maud air `�,,- ,r � -� increased defrost capacity.For instance,at to outside PN7-is tts `� -�•`�236 -5°C the defrost mode will function at lour speed. pit ton" This technology reduces energy usage by ` • '' eliminating unnecessary defrost energy during )ndays and offers a more silent operation. o Pa mH.[ us tFU I/d ou IA 0 175 25 01 02 174 83 175 109 231 150 50 02 17 163 17 164 98 207 —3 325 Drain Pan 75 0s .73 154 n 154 88 97 yas 100 0.4 61 142 67 143 n 163 _ looge system Eeh51 122 52 731 61 128 50 HRVfERV units are equipped fOb 57 172 58 111 W 1280.7 52 110 52 111 56 us d u easy-access sloped drain pan, �,,r+'.•20 40 60 80 10D 12xcess condensation that might .a" H1/1�Tesiedbr.BodyMUaedatTesftCamdabn (Oftch) GmssMDoe-l/s accumulate inside the'unitgdes to the centre of the drain pan to be evacuated. P- tME VS 0 Us CFO of 11111 175 FMA u 25 0.1 91 206 98 209 115 244 150 50 02 92 195 93 197 103 218 u 3 5 maintenance system 75 03 11 114 88 186 98 208 y_^ 100 In order to improve air quality and ` 125 U 13 159 13 19 90 174 — 125 05 li 159 75 159 82 174 �� 75 offer the best possible air environment 50 150 1.6 a 146 fib 146 14 157 in your home, Imperial has developed 175 0.1 64 136 64 136 Ba 136 05 one of the first maintenance service, 20 40 60 80 100 120 systems in the industry.The`'Filter, MV I'Tested by.Boayme m to w Testing c ads tw(ortKh) rang Abaon-t/s l Maintenance Adviser""'will remind you by f e-mail when the filter of your fiRV/ERV system tfl� must be replaced,to maximize its performance A A W, and efficiency. °6 -f Ud 0 1iiiih UN&M t1� °C I us am wane oficiem fHectiveorx yip 0 R 32 61 11 6' 15 0 32 56 159 158 60 74 Imperial Peace of Mind z 0 32 46 98 112 fil TS ,� 0 Tl 15 159 158 W 68. 2 0 32 55 116 122 59 72 F 0 32 86 -182 172_. 59 66 All Imperial products are backed b x •25 -13 29 fit 118 61 15 -25 -13 52 110 147 61 - 15 P p Y 1 antersaaara,�asdONat HIM Die,d—We ed 2w r s- aarm.ateroai v�-tcne the best limited warranty in the *„ ` f ( industry,for your peace of mind.[mom GM size 237 a 21A°111$° 2YP x 21H°E 1W -All Imperial pmdams are baled by the best Bm�d You benefit from a lifetime warranty J HmIabW(UHzW) 12%12%101 12%1?115" °a..q Wft na*n on the core,a 10-year warranty on our -bnp d.IAtrTKM.t.r;Ie5inenrsensded0ftW ventilation motors and a 5-year warranty - CFE1 30111160 50to220 modayapwbmwtowowamke..DetwM on all other components.So you can 4 deskm atom m sperd�as.In amer to alter at p y Type efitate>hage M-ft(Potypmotu) M-Bm"poem) a0dmmagtmftpmd=diatIshW yampeifim breathe easy. Eai`wokm 104 111 weweansunmalamhadastofiaeom.deaw Y80age 110VAC @ 60 Hz 120YAC @ 60 Ht to ina11atmn of etecWv pmdans mquin s the serum of cert ied welwidan or elecobdam Ao>p V 1.5A 15A DefimttlFe Evulffi06n EYdiali011 CefI1601188 HYI,dSA3 HYI,dSAs ..@PsNV� *VAV�nc ��U C U CERTIFIED 1//11Ma . I Al rwlogl hT II i dand T ucwifmdlnfmdmdw,%6rg7ur>itypm*&at&efo&uingdi wbram Vl��" ZS Cep ^��I ►► o Imperial Air Technologies Inc. '�} ff c 500 Ferdinand Blvd. rV aSSt1 f o Dieppe,NB Canada a E1A 669 o Toll free:1888 724-52U expert t�y r� #' Fax:1(506)388 4633 o;For a4JLCG3 "] I Ask for a brochure on/other Imperial IndoorAir Quality Products at a distributor near you. Uk t ArW`' ° ' _Ij --- ,- - ?1 yls- I-H - F I -�- ! -ry - ! l 1 � #-- - - --I �---- - , ®: r. { ( Y � i I ' � i Ili I i i � � it i � ' i � i III i i � ! I � I � . I I i I � i { I� � � I � i � ; � � � � i � I� � � � � � I � � � ii � I i � I i I I I� i t I i t l j ! I' i I i I � � I �I I i I �� Z �. . I � � I � � � � I . I V f Town of Barnstable *Permit# 00 Expires 6 months from issue date Regulatory Services Fee . Thomas F. Geiler,Director Building Division �� '� Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - .,RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number (uJ Pro erty Address �� 1 �d Qv� Residential Value of Work " I DDminimum fee of$25.00 for work under$6000.00 Owner's Name&Address -3 ` va U_ `n n Contractor's Name C��tr ��K�1 I Telephone Number ! Home Improvement Contractor License#(if applt le} I e �1,� ( 0 Con;itruction Supervisor's License#(if applicable) ❑Workman' Compensation Insurance Vr n y fir. C ck one: s�`;: ,� F't HIT I am a sole proprietor ❑ I am the Homeowner APR 1 0 2007 ❑ I have Worker's Compensation Insurance ti �,�f. TOWN 'r' ��a�ZIPTf��L� Insurance Company Name _ Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) T.• ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑R -roof(not stripping. Going over existing layers of roof) 1 Re-side ❑ Replacement Windows. U-Value (maximum.44) '"Where required: Issuance of this permit does not exempt compliance with other,town department regulations,i.e.Historic,Conservation,etc. ***Note: Prope weer must sign Property Owner Letter of Permission. Hol inf Imppoveme Co actors License is required. 3IGNATUM: �:Forms:expmtrg 2evise071405 f WET Town of Barnstable Regulatory at® g ry Service's 9MRNSZABLE, Thomas F.Geller,Director MASS. Bi1Rding Division. Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, �`" re ,as Owner of the subject ro P Pe rtY hereby authorize � to act on my behalf, in all matters relative to work authorized building permit application for: (Address of Job) SigA, ture of Own r Date Diu Print Name QTORMS:OWNERPERMISSION j 1he Gommonwealth of'Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston, NIA 02111 www-mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legjbly Name (Business/OrganizationUdividual): Address: P. O . 60 k �3 City/State/Zip: M ' �0(phone#: - �J� Are you an employer. heck the appropriate box: Type of project(required): 1.❑ I 2MA a employer with 4. ❑ I am a general contractor and I 2.�tloyees(full and/or part-time).* have hired the sub-contractors 6. New construction tmv a sole proprietor or partner- listed on the attached sheet. 1 7• ❑ Remodeling ship and have no employees These sub-contractors have St. ❑ Demolition working for me in any capacity. workers' comp, insurance. g, ❑ Building addition [No workers' pomp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ �00f repairs insurance required.] t employees. (No workers' ,-,/Other �d�� comp.insurance required.] 13 [g *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. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un a paia d penalties of perjury that the information provide abo a is tripe and correct Si ature: Date: Phone#: Q `� Official use only. Do not write in this area,to be completed by city or town offtciaL City or Town: Permit/License# Issuing Authority(circle ogee): 1.Board of Health ?.Building Department 3.City/Town Clerk 4.Electrical I®spector 5.Plumbing laaspei Jor 6. Other Contact Person: Phone#�: 07� �o'rrirrcoizure�i Board of Building Regulations and Standards HOME IrROVEME License or registration valid for NT CONTRACTORWj before the expiration date. If founds etul use only 24310 RTr�tion Board of Building Regulations and Standards Ids 007 w` �- . One Ashburton Place — lY''e" r4idual Rm 1301 I ames Curley +��-"�r = ,! I Boston,Ma.02108 Imes Curley 17 Rd. ,zaz l~ Fuller �s�l mterville,MA 02632 �-- Administrator Not valid without signa ure i I i Assessor's map and lot number .......C .....tJ "�" '."..."'. oA/- P<�-4f,Lo 7ja�/7-3 SEMC SYSTEM MUST BE ' INSTALLED IN COMPLIANCE Sewage Permit number WITH ARTICLE II STATE SANITARY CODE AND TOWN TOWN OF BAR AUM E yDi 7M E TO i BJBBSTL�ILE, "bICb 0 NPY BUILDING INSPECTOR a' APPLICATION FOR PERMIT TO ........... ....... ...... ............... ........ .............: .............................................. TYPEOF CONSTRUCTION'!........ . .... .................................................................... ...................:..:.................... ....... .. .. .... ..... ...1.. .........,9 TO THE INSPECTOR'OF BUILDINGS. The undersigned ..hereby applies for a permit according to the following information: Location .... .1 .........1..11.�?.t..... ........ .......................... ................................... ProposedUse ................ .. .. .. ....... ................................................................................................................ Zoning District ...... '. t... Fire District ... �°..`..........�`.................................................. Nameof Owner . . . .................. ..............................Address ......... ......................................................................... Nameof Builder .. .............. . .........:..... . ...............Address ......... .......................................... .. ............ Nameof Archit . ....... ... .. . .............................:............Address .... .. ...,. ...................................,......................... Numberof Room.......................................................Foundation ....Gh? .............. .......................................... Exterior ..... ..... ..................... .............................................Roofing ............ .................................... Interior .. .................... Floors ........................... . ............................................................. .............................................. hHeating .. ................................ .............. .............................Plumbing .... .... ................................................................... Fireplace ........../....................................................................Approximate Cost .... . ................................ . . Axe- /04, D Definitive Plan Approved by Planning Board -----------____---------------19________. Area Cre......... 6 �o.. &).... .. .. 52, Diagram of Lot and Building with Dimensions 1 4 Fee ............................................. SUBJECT TO APPROVAL OF'BOARD OF HEALTH 4 (P13 Y r S60 I hereby agree to conform to all the Rules and Regulations o e Town of Barnstable regarding the above construction. Name. ................. ...................... � ` . Coyle, Dr. John � � 1644JO twoat�z�r ,No ---.--. Permit for ---.--..� �-~ single family dwelling —'---'----------------' .`.."--'' c^ ~ [ �� Ubt Road Loconon �'�.------------------- � Centerville � ^--------.—^---_----------- � Owner ..............I}r._6o}n. le_______ �m � Type of Construction -----.�.��____.. . . ----..---------------------. #1n � Plot ............................ Lot ................................ � 7 � � . ( / Permit Granted Dote of Inspection lV �~ ��' � Dote Completed ...... lg PERMIT REFUSED ------.----. ------.. lA ~�� ---' .................................................. / � _._-----.------------------.. , } / .-------------------------- ......................... Approved ................................................. lg IC A, ---------------^'----------' ----------------------.—,—.. ` 1 ' |