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0036 FARM HILL ROAD
. ,� o a .. o � ,. , ❑ � ,� - - r Application number...BsZ.�."3��g................. Fee....... 35:c�........................................................ KAM Building Inspectors Initials....................................... , DateIssued.....................................I........................... Map/Parcel...... ............ 9............................ TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOW S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 34 F,4R j yje-C RD C kZ-Q 11/LLF ,q-�}- O2G32 - NUMBER STREET `' 'VILLAGE' Owner's Name: R 16 J jW Phone Number j 7 - 309- _3 2 Z Email Address: 401-•Gv,4-4 Cell Phone Number Project cost$ Check one Residential_� Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK Siding ® Windows(no header change)# Insulation/Weatherization Doors(no header change)# Commercial Doors require an inspector's review ® Roof(not applying'more than 1 layer of shingles) Construction Debris will be going toAipjylpy CONTRACTOR'S INFORMATION Contractor's Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# C SR 10617 y (attach copy) Email of Contractor # GA EA CR EiF i 1"S GLC Phone number 77 LI-3S3-7 S0� i APPLICATION NUMBER ............................................................ *For Tents Orily* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X , - X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a for profit non-profit event Check one: Food served Yes No . Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approvaL i *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNEA'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature .. Date_4D Zo —26 All permit applications are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department 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 Legibly Name (Business/Organization/Individual): 19 4 EA CRe4Ti[I A)S LL K Address: City/State/Zip: O 66 Phone#: — 3 — Sa- Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2� 1 am a sole proprietor or partner- listed on the attached sheet. ,/ Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' � 9. Building addition [No workers' comp.insurance comp.insurance. 10. Electrical repairs or additions required.] 5. We are a corporation and its P 3. 1 am a homeowner doing all work officers have exercised their 11. . Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12. Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No 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. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolky and job site information. Insurance Company Name:___ Lq�/C CAS�/ 75/ Policy#or Self-ins.Lic.#: L ' �D� � Q Expiration Date: Job Site Address: fft(Zy1 141 LL PP, City/State/Zip: C cm4ri y/(1_ 114A 01632, 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. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: r �L_ A— Date: 7—d —2ej Phone#: 7 1 —j 5 T — 7 Sa"7 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/Ucense# 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#: i • e is '�iv i✓ Gaea Cteations j { - 'G.AI.A. Creations Owner& Contractor Agreement Michael Meyer 774-353-7507 Jonathan Bolinder 508-776-3588 V ,E..L.N. 83-1643211, - ; gaeacreationsllc@gmail corn This agreement between � G.A.E.A.'Creations L.L.C. `-Z and Richard Faulkner 36 Farm hill Rd, Centerville MA 02632 Effective on date signed Whereas owner(Richard Faulkner) finds that the contractors (Michael Meyer&Jonathan\ Bolinder) are qualified to perform the work requested, all relevant factors considered, and that such a performance will be in furtherance of owners'business. Now, therefore, in consideration of all the mutual covenants set forth herein and intending to be legally bound, the parties hereto agree*as follows. a.) The owner agrees to pay for all materials required to complete job correctly. The contractor is expected to use proper materials and only new good quality products agreed upon by owner. b.) The owner agrees to pay for all labor and materials performed to get the job done ($5,685.10). (See payment arrangement for labor costs). If any additional hours are performed after payment arrangement is completed they are to be compensated for this separately. This should also be agreed upon with the owner and contractor before hand. c.) The payments are arranged in a schedule. One deposit to be paid before work starts (due at start of project in the amount of$2,842.55). This is a non refundable deposit that the client agrees to pay and not receive back if they decide to cancel the job part way through. The second payment (due at completion of$2,842.55) Work is to be completed in a timely manner, unless an unexpected obstacle is faced that is no fault of the contractor. d.) The contractor agrees to pick up materials, replace 650 square feet of white cedar shingle siding, replace 20' of PVC trim, repair chimney flashing leak, replace 1121nft of deck boards, clean up/disposal of debris. The owner and contractor both agree to the aforesaid terms. Both will sign below signifying their understanding and consent. Please sign name and date. Owners:' �zl Date: r Contractors Date: TYPE:Supplement Card Registration Expiration 196093 06/30/2021 ,,q AEA CREATIONS LLC - MICHAEL W-MEYER f 39 CRANBERRY LANEfG�.tr�dGfu�ti' SOUTH YARMOUTH,MA 02664 Undersecretary Commonwealth of Massachusetts Division of Professional Licensurc Board of Building Regulations and Standards CSSL-106179 Expires:05128/2023 MICHAEL W MEYER 416 CEDAR STREET WEST BARNSTABLE MA 02668 Commissioner nfia.�c_,dl. r 1 t t t F S 3{ i a f } I z` s i a' 3 s f Assessor's offioe (1st floor): I , OFTNEtO ,Assessor's map and lot number .`�.�� .... o.�..�..0 0`' �♦ � � B.o''ard of Health (3rd floor): � �f Sewacr Permit number �l.X"-OIR A ��m.. Engineering Department (3rd floor): 'oo rb 9 House number } �e �Fp YPY y' APPLICATIONS PROCESSED 8:30:9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE r � BUILDING INSPECTOR APPLICATION FOR PERMIT To All: .. 6e, . ......t� �! TYPEOF CONSTRUCTION ..(!�� �.............................................................................................................. ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location . y ..z.• ..........:................/...... I....... VA Proposed Use .... ...A& L�trra•%,>l?^••�...5...-(, Wi1.1,n..r.r��`..�o�..!�,... ;,k�G,fa� J....................... ........ Zoning District Ate` ...........Fire District 1-- "' Q -' P ' ,� . /Name of Owner l.C. .�+.s . ...4°L.�. . !r.� s--'................Address ..... �?.!�!2.� l./ /''/et Name of Builder ✓/��/,,.� o •/r5"rOC , 1 C . I/,/y�;�,,,� 110 I f/ , ..............................Address ....... ............................... e J 9 Name of Architect ...... r-�. •.Address .. ./.../:. /✓Gb.is /�/.. /-�.................................. / iJC1. . .�.... 01cL ......................../............... Number of Rooms Foundation v (��!!.�f'e. r-2' EXlerior �//l.Lr G/e 1................................................Roofing Floors ..... A.Y'��e. .....................................................Interior .` ....:...............................................................:.:..... g g .> , rieatin .....1. !'................................................Plumbin . _. Fireplace ..................................................................................Approximate Cost ............. +. CJ(J(� ............................................... Definitive Plan Approved by Planning Board _______________________________19________ . Area Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH f 514 1711L-Z- O-14 D - 1 4 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of th Town of Barnstable regarding the above construction. Name ..`.... ............. Jf q Construction Supervisor's License FAUI,KNEr�A BLZ �&=247-OO ' ` _3l4OI penni� �v Build Addition - No . ���--- ------------ * ' ��I--.. ' �J^��, ^ Location - � a ----' (,8 //� �e ^ ' ................... ---~----'^-- ...... ................ Owner .......Di/�b���d.�F�olk�����______Type of C»»m'»,ti»n _.�������________ --------------------------. Plot ............................ Lot ----------' ' . / November lO 87 Permit Granted -----------�-'lV ' Dote of Insl5ection ------------lV ' Dooa Completed ------------'lP ' � 5 ' , 0/99 , � . ' ' � ' .. . / . .' . ` PIP- �-] --�-- i ; �y� �o,S.G� p-ion,• - _� . f t �: i I i I • i I � i , , 1 _ t iI ` 1 1 i I M- 4. _.._;-i i : : fFI. 7 1 IF I i I U; 1 - ,Assessor's offioe (1st floor): / f 80 Assessor's map and lot number . z� �i oFtMETO �?... .. V� SYSTEM E Board of Health (3rd floor): � fO o� Sewage Permit number ............./.� .� �../.... ......� ..., rr i 1��LLED IN COMPLIAIZ# Z B9Sd9TSDLL TITLE 5 MAX& Engineering Department (3rd floor): WITH a ggaa p� E iL � T�L b00 G ,�.gF_,i �p 1639. \e� House number ........................................................................ Ly;�;@ �`.. 'FDYAYd' APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00'P.M. only h , �� Mau 9�, .���`;' TOWN_ ®F BARNSTABLE ' BUILDING INSPECTOR APPLICATION FOR PERMIT 7080/1'o... ) TYPE OF CONSTRUCTION .. .D.. ............................................................................................................... ...............--................. .............19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... �Ghlvr �d - �n�17 V h ................................................................................. Proposed Use .. �1?.Cl(/R.. .....� gd�....L. �l.Lc?.1.?-1�" .5.: ffi.h�1.�!� 6P.. ...� it �G Zoning District ...... iC,1........................................................Fire District .......... 0 '—. ..' ...... Name of Owner ...............Address ..... ..?!!?�ey j//� /'"/� .... ...... . . .................................. Name of Builder y!t?. a /ZS�GC C- X 7`� /7`t�4.oi�s� P.. a V .'Y.:�Z.�`7 Z' Address .......... .. ��..... Name of Architect Address.. . /x' ....... ................................................................ Number of Rooms .... ...:... .....................Foundation �' Exterior ..5//!.f'l.�r . r................................................Roofing i/..../T..S 4.....�............................................. FloorsC<��.......a.? .........................................................Interior .` ... ...................................................................... / �v� /� Heating .........................Plumbing ..... .. . .... .... .......................... Fireplace ..................................................................................Approximate Cost ............. .�....................................I.......... Definitive Plan Approved by Planning Board ________________________________19________ . Area ......�2.60.. ............ 40 Diagram of Lot and Building with Dimensions Fee ............--emu SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....•. Construction Supervisor's License .°!..:.©. .1.. ./...... '7 FAULKNER, RICHARD/ No ..3.1-40.1.. P6rmit for .....uild Additich ............................... .. ....... .. ...D.w.e 1.I...i.n.g.......... LocatJ� Farm Hill Road on ..... .......................................................... C �' e T 1-,( 1 vc2 T rt ............................��A...... .............. ........ . ........... Owner .......R.i.c.h.ar.d...F-au.l.kn.e.r................. .. .... .. .... .. .. Type of Construction ....Frame ...................................... ............................................................................. Plof ............................ Lot ................... Permit G ... .................... . ranted ....1�pvember 10.,.....19 87 Date 6f Inspection ....................................19 Date Completed ............................-!.........19 211