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HomeMy WebLinkAbout0145 LAKESIDE DRIVE EAST ���'� �J�• �i � � ...r�_��- �—ram—,. o .� it 1 a i C�0136 6 Ca �,►,E,�, Town of Barnstable *Permit# Expires 6 months from issue date « Regulatory Services Fee �@ l • snRtvsraBls, « Thomas F.Geiler,Director � BuildingDivision PERANIT Tom Per ,CBOf Building Co^:.missioner b SCC P - 5 2013 J 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 TOWN OF 8ARq8Tgg& E`1TRESSPERIVllT AFFILAU11T1Vlr — W►C71DL1\TTiti lQl�\LJL ^^�� Not Valid without Red X--Press Lnprint Map/parcel Number t� S O� � �? Property AddressrJt V e N& [v�Residential Value of Work$ 5fy cc/ + Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address oen✓I r 6)1 �d / Ig f L 4 we.J. J P pr 1�G1 ¢ 6�� �� l►y� oZK32 Contractor's Name%� kec `i',, ei f Telephone Number .So? 7�'c) Z702 Home Improvement Contractor License#(if applicable) & 7 0f 3 Email: f 61 Construction Supervisor's License#(if applicable) F�Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner f I have Worker's Compensation Insurance Workman's Comp.Policy# 22 L(N 312 2 10 Copy of Insurance Compliance Certificate must accompany each permit. Permit Rea4uest(check box){d] Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ��Odit ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is requir d. SIGNATURE: - C:\Users\decolhk\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\8R76BDVA\EXPRESS.doc Revised 061313 ' ( h �Ponvrraoa2caeatIM 01,94&aad,i .Office of Consumer Affairs&Business Regulation "OME IMPROVEMENT CONTRACTOR egistration: ,1.,43053 Type: xpirationc ;_6/.14/2014._1 DBA KEATING CONST. r�4 TIMOTHY KEATING 54 LOWER BROOK SO.YARMOUTH,MA 02664--= ; • z� Undersecretary License or registration valid for indiVMul use only before the expiration date. If found return to. Q>fTce of ConsElner•Affairs and Business: 10 Park Plaza-Suite 5170 Re gulation Boston,MA 02116 Not valid without signature - - Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialtt ' License:-CSSL-099351I Is �. TIMB.KEATING 54 Lower Brook W. South Yarmouth MA 02 F Expiration Commissioner 05/11/2014 dpn�E t . aaRxsTnsLe. MAW 039. Town of Barnstable Regulatory Services Thomas F.V cnlcr,Llr�.\.tor Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 0260, 1 www.town.barnstable.ma.us r Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must r.mmn1m-e anti Sion Thic Sec-tine If Using A Builder � a I, PeAf\ T (d ��/n f ,as Owner of the subject property hereby authorize / i Nl rA��S -6/1 5 to act on my behalf, in all matters relative to work authorized by this building permit application for: 02�32 (Address of Job) .0 iiaiiuc of vwucl L'QlG Tr �Sn 1 Pant�:Tame If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. - C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\8R76BDVA\EXPRESS.doc Revised 061313 The Commonwealth of Massachusetts Department of Industrial Accidents w. 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): ��„1 ) eec f?�, ,S /(/�e_4ce l (0411 t��lr.► Address: SY D � City/State/Zip: (' Y\ 2 y Phone #: Sc) F ' w 2 76-4 Are you an employer? Check the appropriate box: TvnP of nrniPrt lrvmiirPrll . general contractor and I 1. I am a employer with 4 ❑ I am a g 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [gRemodeling 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. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MUM 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' l3.❑ Other comp. insurance required.] 7Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 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 arn an e;player that is pr o vadanb:i'.�r e: t 3 .nS�tr'�i s�duiirTi'ii��j r.'�r"y'c" playcc"i. u?ilv:r sS thu pule y wnd jvb information. Insurance Company Name: Pnlirtir it or CPIf_ing Tie #; O ZZ YA1> 7 2^t U F,,rpirati�n Date; -7/5 ll Y Job Site Address: City/State/Zip: 6Fl lerjr+ir h"(-d&!�? Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). 1a11UrV tV JNl LLLL,%IV V Vr agC aJ rCgU"CU Under Section 25A Vf 1V1VL 152 Cw'I 11..ad tV UA%,1111F%j itlVn Vf 1i111111na1 pci1a14 1NJ Vf 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 a ains and penalties of perjury that the information provided above is true and correct. Si ature: Date: Phone#: ;SU �' ��U G?U 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 C-ntact Pero= Phone#• CERTto mo ,i E v� LIAMILI i Y INSURANCE � DATE 1MMlOGYYYY: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CeRTfFICAOE/HOLDERS THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 7HIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS}, AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPLMIANT: If the certificate holder is an ADDITIONAL INSURED, the oolfcviipgl iile terms and conditions of the Policy, certain SUonviaATiGN iS WgiyED, subject to Y, Policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) rOUCER hlegel 6 Schlegel Insurance Brokers Inc NAME PRONE --_—. — -- —... — JY l'1'11 Pt J'1'IC Y.'1' IAIC,Nu!; EMAIL _. ......_ ... . I NUVHESJ - I west Yarmouth, MA 02673 cusroMERIDx __.. INSURED -- ���� ' I11S1'RER751 AFFORDING COVF.q.AGE - Timothy Beating Oba Keating Canstructi.nn INSURER A COLONY INSURANCE INSURER 8 4 Lower Brook Rd _._ CNA INSURER C __. ... !NSURER D _... .. .. _.. ; .. _. South Yarmouth, MA 02664 LNSURER E-. COVERAGES _ CERTIFICATE NUMBER- - !H!S IS TO F?-T!FY TikT THE POLICIES ;)F !NSURA.NCt: t;ST I% aEL ,, y "EviJIONiviiiNtl[K iNCn rt ED Nt n1AT". ND!NC E` C1Y AVL Bt=1'fd tSSUEir it;t THE tNSUREfJ NAMED ABOVE Fr;u ANY Rtliil;REME ti? TERM OR CONDfTION of AyY 4-ONTRACi OR �liF• '�il:iCt FE N,t ;;y NE I Ut1 t At 11 ?ERTAI J THE INSURANCE .4FF cj ER DOCUMENT h4SN RESPE{ i'r rrC US!0NS NJ CGNL,I 1 NS F - o t ORD D By He ''OL!�'eES .J.E.SCR!BEU HEREty B r C 5 J SUCH.CLIi IES LIMITS SFfOi vN MAY HAVE;BEEN F2EDUCEC Bt J J[C T ALI. T F TE R1.9;, ILTR fIRSR - .. - ._.. P AID Cf.AlMS` WBR TYPE Of�NSIIRAN(`C �, I, ""• INSR WYD POUCY NUMBER IJILICY EFF .-. P60ty0cp - •.. _ __.. S GENERAL UA8ILITY i iMM+OvrrYYYI IMM1OO1n'YYi LIMITS - + GL3594908 03i10/2n1 2 g . ,,,,0,, 2 013 a r0, . DAMGE c P-t r- < 1,v00,000 03/10/201303/10/2014 PREMI ES - ,,e i100,000 MED E rP .... .. $5,0 0 0 t _?SCr 1,000,000 FEry tivtK 1 AG r'EG c 3 L,UUU,UUU 2,000,000 _ AUTOMOBILE COb!e3fr1ED S,aIi,Lr LiMi? -- . $O{llt'Y 3 PvRt UMBRELLA.LIAR EKCESS LiAB - f1:Cf'iflCCURRcNCc .— AGG,:EG B WORKERS COMPENSA T!ON - - - _ - st ewa'LIABIU<Y Ft ` " ;N "-1v U3/U9/2012103/09/2013!X I we sta v- t {�ra taBFP t .I:c f• 'Y- N•A 03/09/20l 03/09/2014 " #; 100,000 <M naln t+n NH, , E E CH a lE�.,. 'e .._ ... .. e1. DIFE?'-- S 100,000 _- eL UISt_,ZSE.t*JL:C.�,.iMi' x, SUU,000 DESCRIPTION OF OPERA HUNS:LOCATIONS.VEHICLES IAft th ACORD It)I.Addmonal Remali,a TIMOTHY BEATING HAS ELECTED NOT Sct,eduie,d mofr"Cc is repurredl 20 BE COVERED ON HIS WORKERS COMPENSATION I CERTIFICATE!-fOLDER CANCELLATION r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES P_F rteurcLLrn o Tir EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED ^I ACCORDANCE NTH THE Pot Iry Panumtnue AU ED REPRESENTATW.E ! (2009109) Ix 1988-ZO09 ACORD CORPORATION. All rights reserved. The ACORD name and lags are registered marks of ACORD i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION qo Map Parcel Application# C;?da 1 Health Division Date Issued 1 0 Conservation Division Application Fee Tax Collector Permit Fee- Treasurer (o/r/?/o8?1— Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address foss-%tmwiALF Ye, mr Village CENPWAr. /1 / Owner Y)A %�/Y4 (7/f%;I S Address_/Zf6--C44F Telephone Permit Request �r Xesfl"WV7 i9�l�la.S5, � �lS/ivy AWNS diP,VVie-' . Ael- A3fL f4-S7P/" W17& '`X 2'L�% l��Cto Sys>5 ��t=/�'�'y h�f G�/tS`�. Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation /Zl� ���� f Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes 2 o On Old King's Highway: ❑Yes O'No Basement Type: ull ❑Crawl Xalkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 16710 SA Number of Baths: Full:existing new �� Half:existing �' new Number of Bedrooms: existing _ new 3 Total Room Count(not including baths):existing new � First Floor Room Cunt v Heat Type and Fuel: Gas ❑Oil ❑Electric ❑Other " :t r`, .- Central Air: 0 Yes ❑No Fireplaces: Existing f p g New � Existing wood/c stove: -®Yeses No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑e fisting 'new maize Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: r� Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes I�IVo If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION name41,;)64 4014Cd Telephone Number Address ik ��*IMUAl /Aof License# CIS Home Improvement Contractor# ///C Worker's Compensation# Ad ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �U�blp�ny y�r�Q -f 'SIGNATURE DATE T/6-7 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED f MAP PARCEL NO. t ADDRESS VILLAGE l OWNER - ' DATE OF INSPECTION: FOUNDATION I FRAME (ZP� v INSULATION ' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING CO `Z? DATE CLOSED OUT ASSOCIATION PLAN NO. y s- } 4 The Commonwealth of Massachusetts Department of Industrial Accidents Of llce of Investigations 600 Washington Street Boston,MA 02111' wtvw.rnassgov/dia ' Workers"Compensation Insurlmce Affidavit: Builders/Contractors/Electricians/Plumbe.rs _Applicant Information Please Print Legibly Nari1e(Business/Organization/Tndividual): �qxm— e iml • •Address: l G 5 ��/2t�tr � , City/State/Zip: eW J Phone.#: - -� Are you an employer?Check the appropriate box: :Type of project(required):. 4..[] I am general contractor and I 1,�T am a employer with._�_�— a 6, ❑New construction . part time).*• have hired the stab-contractors employees(fun a;wor listed on the'attached sheet. 7. [�Remodeling 2.El I am a'sole proprietor or partner- These sub-contractors have • ship and have no employees � 8. ❑Demolition employees and have workers �orldng for me in any capacity. 9..0 Building addition [No workers' comp.insurance comp.insurance.# 5. [] We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 11.0 Plumbing repairs or additions ' '3.❑ I ani a homeowner doing all-work . myself.[No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance.re4 ] e t c, 152, §1(4),and we have no d employees.[No workers' 13.❑Other comp,insurance required.] *My applicant that checks box#l.must also fill out the section below showing their workers'compensation policy information. t H rncowuas-who submit this affidavit indicating they are doing all work and thmi hire outside contractors must submit anew affidavit indicating cvch $Contractors that check this box must attached en additional sheet showing the name of the Sub�ontractvrs and state whether ornot those entities have employees. If the sub--contractors have employees,they must providb their workers'comp.pokey number. X ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. D Insurance Company NaYne: Policy#or Self ins.Lic•`# Uve /Sa7 Expiration Date: s- Job Site Address• City/State/Zip: ���&�I(a' Attach a copy of the workers'compensation policy declaratlon 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 tip 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$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the-Office of' Investi ations of the I)IA for insurance coverage,verification, X'do hereby certify er the ins aisd allies ofperjury that the in provided above is true and correct Si stare: Date: a Phone# Offtcial use only. Do not wrlie in this area; tb be completed by city or town official City or Town: ' Permit/License# Issuing Authority(circle one): J.Board of Health 2•Building Department 3.City/Town Clerk 4.Electrical Inspector 5•Plumbing Inspector 6. Other . '• Prescriptire}*sckt$d fcT flue iwd�'tro-F'tsa 'Rcsldaatix!Ba1IdlbV 71rstt3 nftll'8'r �`Prle , ' � MIiYIMi71� I�fAXf111VM Slab 'S�ting/CoolUng t3lsarcg Glazing Ceiling 1�VaI1 Floor $isetrtrzst T gttlprffrntdcrsc Arm'r~!,) U-Ynln�t R-Yakut ' l owducl R•yalua° w"u . • • . R-v�uef F�-rn1c�e� , P= tea 5701 to•6500 grxNag JjgT0 33270 Plarsasl 38 15 19 14 Izys o-sZ 34 19 + 19 14. R 12f. p.54 31 . • i3 19 ID .6 "13y�f'Z 5 ' NIA. Normxt •r IiY. Q.38 38 13 2s 1UA Normal ISfi Q,48 38 I9 19 I tl 6' u �, . u AFUS y I5'r 4.44 38 I3 ZS NIA 15 AFM �y ISY. 4,i2 34 l9 I9 74 6 . l8/. a.�x 38 • • l3 2� NIA NiA Normal ?C . NIA' Normal y 13 . 0.41 33 19 9 rld 90 AnE x l8t 644� 38. 13 l9 10 6 IV a.3a 34 I4 I9 ro S�sAFitR i. D 1�E5 OF YROI'ER,'I'1': .�Ji� AD SQUARE FOOTAGE OF ALL.BXIEWOIi.`WALLS; g, SQUARE FOOTAGE OF ALL ULA_IN °jo (3LAZINQ ARLA 4#3 DNIDED AY•92): '? © ' SELECT PACKAGE(Q AA",sea cbac! 0 OTHER MORE IIY-VOLVEh METHODS OF DB TNG EN 'rI�I REQUIREVhI S ARE AVAILABLE. AM US FOR THIS WOR.MATION6 DING-L74SPECTORAFFR.OVAL:: YES,,. N0; q�s-©aG343a , i °FTHEr° Town of Barnstable ' Regulatory Services EAM� ABLX MASS. Thomas F.'Geiler,Director Fo;q,:�A 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, D9A- //y S atllly< , as Owner of the,subject property hereby authorize -��A/ fS� O�of Ball ti / 7 fo act on my behalf, in all matters relative to work authorized by this building permit application for. c (Address of Job) Signature of Owner Date PC'Z rint If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. i ZHE Tp Town of Barnstable Regulatory Services " BARNSTABr.E. Thomas F.Geilerf Director � •r v MAss 0.39. Ilk Building Division rFn 1MA� ,Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city//ched state zip code The current exemption for"homeownertended to ' clude owner-occupied dwellings of six units or less and to allow homeowners to engage an indiv hire w does not possess a license,provided that the owner acts as supervisor. ITI N OF HOMEOWNER Person(s)who owns a parcel of land on / a resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attachched structures accessory to such use and/or farm structures.- A person who constructs more than one howo-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Buildinal on a form acceptable to the Building Offcial, that he/she shall be res onsible for all such work erformede buildin ermit. (Section 109.1.1) The undersigned"homeowner"ass s responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and egulations. The undersigned"homeowner" ertifies that he/she understands the Town of Barnstable Building,D"apartment minimum inspection proced sand requirements and that he/she will comply with said procedures and requirements. / / Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hiresunlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of.a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a forrr✓certifrcation for use in your community. I ' ��►(fjffjJ� VL-IN a /VAI L. VY aw1■—io■ ■ • ••svv•'—w— BAYST-1 1 05/24 07 mueXR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION tdrew 0. Gordon, Inc. ONLY AND CONFERS NO RMM UPON THE CERTIRCATE 10 Main street HOLDER TM CERTINCATE DOES NOT AMEND.EXTEND OR I Box 299 ALTER THE COVERAGE AFFORDED BY THE POL=3 BELOW. swell MA 02061 3one:781-659-2262 Fax:781-659-4725 INSURERS AFFORDING COVERAGE KAIC8 Bay State Basement Kstest a Renaissance Ciro dba Owens Coining Finished G Basement systemOSUFM Canton Ht0 021 °' WSURER e wERAGES ngpoLK=GFIIsU.#NMLMMeBa K%VES IM TO'PEflSFWUUMJ VERRUEPM=PEMW ANYrea 7MORCOND OMOFMKCMPJ fOROi MOOCUMENrWRNIUWWiTO%%"MIMCERTFICNEWYBEISam(R WAY FeUW-FE BIMXVNCEAFFCFDEDBYWPOUCES OESCRI3: IFAE7J MOSECf7O/ILLlM7MAr,,F)OL11>MMAADCOADQIOMS OFS" pawA EMIELIMSS"OIMaMMYW VE8ffi1RMC®BYPADClM6. 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Massachusetts 02108 Home Improvement Contractor Registration Registration:, 137943 Type: Supplement Card Expiration: 1/29/2009 OWENS CORNING BASEMENT FINISHING DANIEL WALSH 60 SHAWMUT PARK CANTON ILIA 02021 Update Address and return card.Mark reason for change. Address "'` Renewal Employment Lost Card CAI O SOM-OSM6•PC8490 ding U ati an tan ar s Construction supervisor License Limas: CS 79893 B i rdU l attt: 10/5/1962 t > i�lb/2009 Tr# 4794 DANIEL F Wvnku i 488 KENDALL RD:_: TEWKSBURY.MA 01s Commissioner . x 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION MIp Parcel U w Permit# Y4 3 9 €riB!_E Health Divisionts�"L$ ( �iu�9 � �"�"'� Date Issued 2 D Conservation Division Application Fee �— Tax Collector Permit Fee � (� Treasurer SEP'9'EC Planning Dept. IIy AMAW jJ4 Date Definitive Plan Approved by Planning Board IMES EWRONMWALMEMD Historic-OKH Preservation/Hyannis TOWN REGULA110tdS Project Street Address Za k e S I e. 3i-! V e_ -er s� Village cph. ek'\/I /j 61 Owner P?e Mr3- D Lonm Ps' r. I'll Yr_5 Address 6 069- Otlf7ler, eP• 13&-f40_5elo IQ e0,?4' Telephone 0 J — a�_e 5;14 Permit Request n 9� re l 4 i VY S V,\r, Vtj h eon Nd w a 7�Gj/h . 4 l rt 7fL� eJede_� driio Y.1rebt4;1J wallyl-Lail n/,,\ 4elrOokh deck, re,014( e slde /A 1/y/114 e0nkA a`Te-. �h�$�v,s�°� ����/z�Y� �b C on!6,e jh Square feet: 1st floor: existing I,530 proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation q?y Qom''' Construction Type WOW) -1�. ►C_ Lot Size ® a Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes �R No On Old King's Highway: ❑Yes ,X No Basement Type: RFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) h oh d Basement Unfinished Area(sq.ft) %S' 3 0 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: X Gas ❑Oil Cl Electric ❑Other Central Air: W.Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes All No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:Cl existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes J`No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name-___ ,t/ A aehf 5 �, M0 Telephone Number CDCY`7-'41— I A O Address 2,03 Un /D h License# qi SS 3 Ja ryhov;�A ek+ I 0 O �L6_75' Home Improvement Contractor# /5/ 7, Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO c�G)ycs,�G, ��st"er Ffrz�/6h SIGNATURE ii ,, /%�� DATE 67 FOR OFFICIAL USE ONLY PERMIT NO k DATE ISSUED tt MAP/PARCEL NO. . ADDRESS VILLAGE OWNER DATE OF INSPECTION: ► FOUNDATION 4 FRAME � *� INSULATION O l0Y FIREPLACE ELECTRICAL: in ROUGH FINAL PLUMBING: ROUGii-vlg'� FINAL GAS: ROUG FINAL FINAL BUILDING Q H DATE CLOSED OUT cl ® Q co ASSOCIATION PLAN NO.�A} rSs r sa Z The Commonwealth of Massachusetts Department of Industrial Accidents ' F 600 Washington Street' Boston,Mass. 02111 y Workers' Com ensation Insurance Affidavit,General Businesses name address city LJ0,Y-YK0 RJh P G� state: zip: ®o16 7 phone# t/tP / 76— work site location(full address): A/S_ 4.—a ke 5-d 6 .L ri yiy ' - Pg ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑Restaurant/Bar/Eating Establishment working in any capacity. ❑Office❑Sales(including Real Estate,Autos etc.) ❑I am an em to e r with employees(full& art time). ❑Other dI am an employer providing workers' compensation for my employees working on this job. company name: address: city phone#• w. .insurance co;. . . olio # I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: / coinUanV name: address: t/• c t�' J�A city: phone#: 3 C/ insurance � ta olic' # comoanV name: address city::. phone it insurance eo. olicv# Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of crimiaal 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 fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify undd r the p 'ns annd pennaaltt* otf perjury that the information provided abov"is true and correct Signature `I�_9!//. ice / �SlE+ Date IR Print name A/a t/IV's � �0 (A Phone# 63 G' official use only do not write in this area to be completed by city or town official cityermit/license#or town: p []Building Department check if immediate response is required ❑Licensing Board +. ❑ P 9 [:]Selectmen's Office ❑Health Department contact person: phone#; ❑Other (mdsed Sept 2003) 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 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 dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such.employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pern it/license number which will b�e 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 life to thank you in advance for you 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 BMW of hinsugoons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext. 406 oFTMEras. Town of Barnstable Regulatory Services $ SWILE, s Thomas F. Geiler,Director 'gyp 1b39• �,�� Building Division rFD►r1P� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 • Fax: 508-790-6230 Permit no. 1 Date AFFIDAVIT HOME Z2ROVEMENT 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. Estimated Cost Type of Work: 1-p�Jci& �Grl" - T— - Address of Work ���,� � 'rlcQe �/ Y- �/: f ,� l en Ap/ V//l d `� S /tS owner's Name: � / Date of Application: �� d�7`Q I hereby certify that: Registration is not required for the following reason(s): nWork excluded by law ❑Job Under S 1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERIT M OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PRO GRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: '1_6�7_-09e 71, 140, lei Date Contractor Name Registration No. OR Date Owner's Name Asa cMK ApP �h! Time J3.2.1b(coattaued) jh yom lrue$ tzye Parktgei far Qan sad Two-Fx='1y Resideatill grtildiap Sated rrl Pmr�P . IKINIMifiI Hcadng/Cooling MAX#MUM Colling Wdi Fioar USCMI perimcw Equipment Wci=c ' Mcdnty�� V�y UO3 R-t4uzl R.ys(uet R-tralues R-veudf A v�lue� Pig° 3101 to 6900 Hefting D rre 1011T' 6 Nanasl 38 13 19 10 6 Nonvid 0.40 70 19 19 t4 6 I5 AFVE . OSZ 10 R . 0.50 13 19 NIA NOrrn-A 9 1Z/. 39 13 25 NIA I . q36 Namul 31 6 T 19 19 10 15 AM u I5'/. 0.46 78 13 25 NIA N1A Y 15Y 0.44 31 6 15 ARM 19 19 10 NIA Normal `sr 15'/. Osx ]a 13 V NIA X 19% 032 Normal 2S NIA N/A Y 1Sy. 0,42 31 19 6 90AFtlE 13% 0.42 3s 13 19 10 6 gO.AFLM x 1'9 19 10 AA 18/• 1, ADDRESS OF PROPERTY: ran room 30� 2. SQUARE FOOTAGE OF ALL EXTERLOR WALLS: f b 3. SQUARE FOOTAGE OF ALL GLAZING: v 4. % GLAZING AREA(#3 DNIDED BY 12): 5, SELECT PACKAGE(Q--INA.see chart above): S OF G ENERGY REQUIREMENTS NOT: OTHER MORE n VOLVED EO HOI) INFORMA . ARE AVAILABLE. ASK US -BUTIDING INSPECTOR APPROVAL: NO: YE5; oorm5•580303a of r Town of Barnstable .,. � yP °^ Regulatory Services 3 SAMSTAIL& ' Thomas F.GelIer,Director XAn 1659. 1k Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 office: 508.862 4038 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as.,Ownet..of the.subject p-topertp. ._......._... .: hereby authorize «� /►Df�. a �h'�h't .� / �/ o;act ontny.behalf,. Ca,��rA�cF� ' gull-Del? in all matters relative to work authorized.by.this building.pe it•application for: Z 3=2— (Address of Job) ; Signature of Owner Date l .vis .vs Print Name oFtHEr�ti The Town of Barnstable BARNSTABLE. ' Department of Health Safety and Environmental Services 9 MASS. 0a i639' �0 "rEO Mpi Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection h-� �rci m-e Location al !n kP s c�,( 0, E..G 5�- Permit Number 7 0 Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: ►�c �,,�,.s'� �� Cu� r�cxc,e br)1 �tUG f r Ck J J Lib31r Please call: 508-862n-4038-for re-inspection. Inspected by �,!L i fJG Date f ` �`� I I _ i i � � eP�6�.Cf Ehc/oxol. Pc►c►,, Soc,�b i sash 1 � I''I►. J 0'�r 1 . �Y v► h ►S cc) y 1 S - V�. Gs -- . evahovj i 1 is rRF��r PL w,ua0 Aspia _ `i l { to � 1 � J-, -3 0 C ro SS S�G��/o h � o scale, i ® zX 10 ►}jade rs i i i } I x N i i i j Zk�0 C 16 2- 30 - ----- -_ AA. �or irca wsea o�✓�Craaaclzuaetis BOARD w BUIL©.IN@ REG,II��ATIOt 4 •`' Lrcense: oN"STRUCTPON SUP'Ef,RWN R Number.: 042539 _,. +tp 04 Tr.no: 26205 jj QHARLES J MAL)AG5 14,- 203 U ON ST L ��, RJi�/Y®UTkUPORT, MAy 92675 v Administrator • � �fe -Varivnt�yu� _ —�-� �. Board of Building Regu ti% acid Standac`u�ae�l.ards HOME IMPROVEMENT CONTRACTOR Registrat ob: 114718 r E. vatlon 40/19/2005 Ype individual CHARLES J.MAURO_ CHARLES MAUO==q 203 UNION ST. YARMOUTHPORT,9A'026'A -Administrator t -•-'r•'•--;-19 4 .40 7:7 j 5 � S- 5` ski � � ,. , i �. � 1 .{ �"t'• � ... IS f y I� � f' i ''„..F t' � � F Ot r i{ .+ ` m.ti $P_ c 1 ., ,3 ,� ,. • 1�' _ t ',+ ,. a.. • f �- ; r ~ .e'—�— .�. _ �."��� � _-mot •..r.•W..�__.,r..��� � _ y _, a ��'� � R �, ,. t .. i • _ r ,• :,,,e ___.__.� ___ _.�—_..� *Ft ..._.�y__� ,�..33E�e., r ..•. .. � _ __ ate_ Q �._ _......�:._._k _ ._ _ �.1.�, � ___.� �_ �� _ _ ___•__..��..a iP �q Asse'2Mfs-r�ap and lot number . . ��.. .:� r ��� r� 3 k"I ��F rN E Tyr ewage Permit number..................................................... Cfa1��� K1i3�F ?'i��EJ ' y Z BA"STABLE, i House number ............. ..............................: Towss L C ,90' .r. e� Nrb`39� \0� �I'Apa. D MAC p' �, . TOWN ;OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO J UAL ... PoI C hi 0/V EX/S � v � TYPEOF CONSTRUCTION ..................................................................................................................................... a + ........................ ...........3.........191.a TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..�..1..���.. � ES/dJ�' Pl? ��9 5�`' C,6E /J�RI/I L.�' ......... ........ ...................................................... ........................................... Proposed Use ✓.. C/ ................................................. ............/..... `............................. . ................................. I c Zoning District .....1.).. .(...................................................Fire District ... E T.I..OJ. ..1................................ Name of Owner ...E.... ..�.......�°....L �/.��................Address ...; M? .. .......................................................... Name of Builder Q w ..............Address........................ .. . ............... Nameof Architect ......... (.. ................................:.........Address .............................................................................. Number of Rooms � ' ..................Foundation s©.vvT-vi3 E 4'- Exterior ....��-L�7 5.5...577.I,We.e". .............Roofing .... 7 5 /.l�L%...................:............................... Floors Dec /1/ �9SS (�d 0/J................ ....... ........�.f......�^. ....................................................Interior ..... L. Heating r�� NF ..............................Plumbing ov N.................. .......................................................... ' � ov ' Fireplace �/�h/E ...Approximate Cost .......1.0.........:..... ............................................:.................................. .................................... Definitive Plan Approved by Planning Board _______________________________19--------. Area .'!......................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH "! t �5 . l Imo--- OR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. f %/�� Name .... ..... ...................... Lurie, Celia S. " 23827 ' No ............ Permit for ...PtllClose..poxaion ......of exipUug..smock................................. Location .....:.....1.45..Lakes ide—Dries••East ..........................Cmtervil le. ..............:............ k Owner ..........Cel ia...S....Lurie. ....................... i ' `Type of Construction` .............fr.aMe.................. ............... Plot ..... Lot ................................ Permit Granted ......FeOn `ry..23.........19 82 Date of Inspection ....................................19 Date Completed ....................: J9 Assesidors�4bp and lot number ........ /,,- Z. THE TO 07 Sewage Permit number ................................................... V 33ARN9TAXLE, Housenumber ......................................................................... r VAG& 1639*101 Mix TOWN OF BARNSTABLE BUILDING INSPECTOR /L/ /V, 7- P 6: Df- APPLICATION FOR PERMIT TO .0 --, PcIR-C , C)1UFX15, )" C 5.................................................................................................... TYPE OF CONSTRUCTION �fd ss ..................................................................................................................................... ........................ .. .. ............ .. ... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...................................................................................................................................................................... Proposed Use ... V C ...................................................................................................................................................................... (-' F -7-- - b-- / - _ /L,/ T, Zoning District ..... ...................................:.............: ...........Fire District ...........................)Q5....................................... C,c,//9 -5. /, o/o, jc 5/9M Az Nameof Owner .............................. .......................................Address .................................................................................... Name of Builder' .........J(.0 \) ..9 ................. .......................................Address .................................................................................... Name of Architect ........./P/..119 ..........................................Address .................................................................................... ........ ..... 3 s 50 X,�V Number of Room ............................................Foundation .............. /Ve 1��a19 7— Exterior .... ..........................................................................Roofing .../5)........................................................................... Floors ....... ......................................................Interior .....C /........................................... . .... .... Heating ...... ........ ..........................!....................... .....;.......Plumbing ................................................................................... Fireplace ...... 3 ......................................................................Approximate Cost ........ol.,!......................................................... Definitive Plan Approved by Planning Board -------------------------------19---------- Area 1�.0.0...................... Diagram of Lot and Building with Dimensions Fee ........ ................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH NV, J/z-: C /T 7- L 7' 76 -OCCUPANCY PERM ITS-REQU.1 RED-F.O.R_NEW I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. Lurie, Celia S. A=252-90 No ...23827.... Permit for ......eaQ1Q5.e..PQr.t.:h9n .......Qf-existing..de.ck.................................. Location ...............145-Lakesi-de..Dmive...Ea s P-, . ..............................Centerville......................... Owner ..........Celia..S....Luzie......................... Type of Construction ...............frame................. ................................................................................ Plot ............................ Lot ................................ Permit Granted ..........Egl rY..D......19 82 Date of Inspection ....................................19 Date Completed ......................................19 66'o 7o o. ell,