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HomeMy WebLinkAbout0705 OLD STAGE ROAD r7 o6 loll , o u ry 6 ,' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION T '� ar -FAR Map—Map Parcel Application #C2)6 311 hit z. `Health Division E ' Date Issued ( Z e,. G "Z Conservation Division Application F 4_0 Planning Dept. Permit Fee m , Date Definitive Plan Approved by Planning Board o� - Historic - OKH Preservation,/Hyannis " Project Street Address . Gsz C�D�P-r-a s Village Owner it544e47 Address I-J a Y �/..� 66t �l i - d 7-6.?Z, Telephone Permit Request Ife -AM r &/,7r_ .31t7- , � s Square feet: 1 st floor: existing/��proposed 2nd floor: existing��—proposed �� Total new Zoning District ie' Flood Plain G Groundwater Overlay Project Valuation A,201AV Construction Type Lot Size ®-3S Grandfathered: ❑Yes &'No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-FamiZo ,(# units) Age of Existing Struc re �� Historic House: ❑Yes On Old King's Highway: ❑Yes ao Basement Type: ® Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) -S%0 Number of Baths: Full: existing I new Half: existing new _ Number of Bedrooms: 13 existing knew Total Room Count (no2Ga, uding baths): existing _ new First Floor Room Count Heat Type and Fuel: ❑ Oil ❑ Electric ❑ Other �� el - 7� �-, r Central Air: ❑Yes ® No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ®'No Central Air: L3 Yes � $#-Detached garage: Uexisting ❑ new size_Pool: existing ❑ new size Barn: ❑ existing ❑ new size_ 0 ttached g age: V existing ❑ ed new size _Sh • Vexisting ❑ new size Other: Zoning Zoning Board of Appeals Authorization - ❑ Appeal # Recorded ❑ Commercial ❑Yes VINo If yes, site plan review# - Current-Use—— f Proposed Use-- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Sl Z__ _7o91& KJ6— A1C . Telephone Number Address License # 4�11 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO esL� SIGNATURE DATE �� FOR OFFICIAL USE ONLY APPLICATION# ' DATEISSUED + MAP/PARCEL N0. ADDRESS ' f, VILLAGE OWNER - - DATE OF INSPECTION: J f FOUNDATION FRAME INSULATION ' FIREPLACE ELECTRICAL: ROUGH FINAL z PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. I Department of Industrial accidents Office of Investigations 600 Mashington Street Boston,MA 02111 wwlv.tnass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/Individuai): A)IVA'61�" IAIC e Address: t > City/State/Zip:69�lf V 10A 02�3__t7, Plione #: ` 7 Are you an employer?Check the-appropriatri • Type rr-3roject(required): 1.El am a employer with 4. m a general contractor and I 6. L�Iew construction employees (full and/or part-time).* have hired the sub-contractors 7.2.El am a sole proprietor or partner- listed on the attached sheet # Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. workers' comp,insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10. > lectrical repairs or additions required.] officers have exercised their 3.El am a homeowner doing all work' right of exemption per MGL 1 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12 oof repairs insurance required-] t 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 ibis affidavit indicating they are doing all work and then hire outside'eontractors 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 a z employer that is providing workers'compensation insurance far my employees. Below is the policy and job site information. Insurance Company Name: - `�'� eo � �> Policy#or Self-ins. Lie.#:_� �°� ' ®6C?7.�� / 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 flue 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 c fz under ih and penalties of perjury that the hTormadon provided above is true a d correct. Si ature: 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 COLLtact Person: Phone#: Client#: 15273 2BAYSIDEBU ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/16/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Dowling&O'Neil PHONE 508 775-1620 FAX 5087781218 A/C No Ext: A/C No Insurance Agency -A/C, E-MAIL ADDRESS: 973 lyannough Rd., PO BOX 1990 INSURER(S)AFFORDING COVERAGE NAIC/t Hyannis,MA 02601 INSURER A:Acadia Insurance INSURED INSURER B Bayside Building, Inc.and Bayside Design&Remodeling, Inc. INSURER C PO Box 95 INSURER D: Centerville, MA 02632 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD A GENERAL LIABILITY CPA007340920 1/01/2012 01/0112013 EACH OCCURRENCE $1 000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $250 000 CLAIMS-MADE 51 OCCUR MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1 000,000 X OCP GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 F_IPOLICY M PROJECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION WCA007340621 1/01/2012 01/01/201 X WCSTATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $500 OOO OFFICERIMEMBER EXCLUDED? � N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500 OOO If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town of Barnstable, Building SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S96172/M96171 LS1 The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 1 of 2 The Commonwealth of Massachusetts William Francis Galvin Secretary of the Commonwealth, Corporations Division One Ashburton Place, 17th floor Boston,MA 02108-1512 ty +( Telephone: (617)727-9640 EMERALD DEVELOPMENT CORPORATION Summary Screen Help with this form ®� Request Certiftcatez The exact name of the Domestic Profit Corporation: EMERALD DEVELOPMENT CORPORATION Entity Type: Domestic Profit Corporation Identification Number: 043109866 Old Federal Employer Identification Number(Old FEIN): 000353998 Date of Organization in Massachusetts: 01/31/1991 Current Fiscal Month/Day: 12/31 Previous Fiscal Month/Day:00/00 The location of its principal office: No. and Street: 3 BAYBERRY SQUARE,ROUTE 28 City or Town: CENTERVILLE State: MA Zip: 02632 Country: USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: City or Town: State: Zip:. Country: Name and address of the Registered Agent: Name: BRIAN T.DACEY No. and Street: 1645 ROUTE 28 PO BOX 95 City or Town: CENTERVILLE State: MA Zip: 02632 Country: USA The officers and all of the directors of the corporation: Title Individual Name Address(no PO Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT BRIAN T.DACEY 62 FERNBROOK LANE; CENTERVILLE,MA USA 62 FERNBROOK LANE, CENTERVILLE,MA USA TREASURER BRIAN T.DACEY 62 FERNBROOK LANE, CENTERVILLE,MA USA 62 FERNBROOK LANE, CENTERVILLE,MA USA SECRETARY BRIAN T.DACEY 62 FERNBROOK LANE, CENTERVILLE,MA USA 62 FERNBROOK LANE, CENTERVILLE,MA USA -business entity stock is publicly traded: http://corp.sec.state.ma.us/core/corpsearch/CorpS.earchSummary.asp?ReadFromDB=True... 8/29/2012 The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 2 of 2 The total number of shares and par value, if any,of each class of stock which the business entity is authorized to issue: Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Num of Shares Total Par Value Num of Shares No Stock Information available online. Prior to August 27, 2001, records can be obtained on microfilm. Consent _ Manufacturer _ Confidential Data Does Not Require Annual Report Partnership _ Resident Agent _ For Profit Merger Allowed Select a type of filing from below to view this business entity filings: ALL FILINGS Administrative Dissolution Annual Report �! _ Application For Revival Articles of Amendment � I! � j Ulew Filings � ' New Search 1 Comments O 2001-2012 Commonwealth of Massachusetts All Rights Reserved Help http://corp.sec.state.ma.us/corp/corpsearch/C orpSearchSummary.asp?ReadFromDB=True... 8/29/2012 `F�riE r TWn of Bar .stable. Regulatory Services B usss '$ Thomas F. Geiler,Director 'OreDtA� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Tmv-town.b arnstab le.ma.us Office: 508-862-4038 Fax: 508=790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder ds Owner of the subject property hereby authorize to act on my behalf, in all matters relative to.work authorized bythis building permit application for: . (Adch-ess of Job) '— OV;k 2�, Sign e of Owner ate Print Name Q:F0RvIS:0WNERPERMIS S 10N r t L At Tf `� ,`, _. q. do'' v D W: Till � r:.4 .y� W N M 'C" in eG N- 00 ON Cs �:. � � LO .� Qq:' � N N N N CA N N. Subcontractor's Insurance Updated 1/31/2012 , b GLPohcy� WG Sub Contractor.. : rExpirafion Expiration., tlnsuranceAgent All Cape Garage Door 10/7/12 6/1/12 Dowling&O'Neil Aluminum Products of Cape 8/15/12 8/15/12 Rogers&Gray Plymouth Anthony Averinos 4/6/12 7/25/1 William Palumbo Cape Cod Marble&Granite 7/1/12 8/16/12 Southeastern Insurance Cape Concrete Forms 9/29/12 12/7/12 Almeida&Carlson Chaves, Robert 8/13/12 12/17 1 Marshall Lovelette Ins Cornerstone dba Tony Arede 10/22/12 2/1/12 Sylvia&Company Ins Coy's Brook, Inc 4/24/12 10/1/12 HUB International D.P. Fuccillo Construction Inc. 10/20/12 10/23/12 Almeida&Carlson Govoni Land Services 6/22/12 6 12 Southeastern Insurance Hill Construction 4/29/12 8/14/ AXIA East Insurance Kitchen Appliance Mart 8/12/12 8/12/12 USDI MAP Insulation 10/1/12 10/1/12 Willis of Tennessee Meagher Bros.Construction(Decks/Michael) 3/24/12 11/9/12 Olde Cape Cod Insurance Meagher Construction(ROOFER) 3/13/12 6/23/12 Dowling&O'Neil Insurance Morse's Masonry 3/10/12 9/29/12 GH Dunn Insurance Reed, Mel 7/21/12 7/21/12 Kerry Insurance W.Vernon Whiteley Plumbing Heating 10/1/12 10/1/12 HUB International Wood Floor Specialists 2/3/13 2/3/13 Dowling&O'Neil 11SBS20081RedirectedFolderslwhitneylDesktoplSubs for John 1 67- Office of Consumer Affairs and usiness Regulation 10 Park Plaza - Suite 5170 w Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 113786 Type: Private Corporation Expiration:_ 7/16/2013 Tr# 213797 BAYSIDE BUILDING INC BRIAN DACEY PO BOX 95/ 3 BAYBERRY SQ CENTERVILLE, MA 02632 Update Address and return card.Mark reason for change. Address Renewal R.Employment 0 Lost Card IS-CA1 c'S 50M-04/04-G101�216 — Office O` A- M aMON- A�W.-u aeona License or registration valid for indi idul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: WDzE Registration: :113786 Type: Office of Consumer Affairs and Business RegulationExpiration 7/16/2013 Private Corporation 10 Park Plaza-Sutte 5170 Boston MA 02116 BUILDING I(�IC .. .. P.O BOX 95/3 BAYBERRY SC2 CENTERVILLE,MA 02632 Undersecretary ... off id ith ut signature i Construction Suren i.ur Ll=n=CS-005645 • 4 F'i.S BRIAN T DACEY =� Y PO.BOX 95 CEI�TTERVII�LE 02632, Y r v, 3 Cetss� U'4t19/201'4 U'nrestnctedi=Bu>ldings of is y use fgr�upwliich conta Mess than 355_,',00 cubi4c f et}(99jl.n)of enct'99edi 9 Pac0;: F5n'WFq.to possess a,ftrrent ed'i€,on of the'fUla ass chusett`s v x f .h Mate Buoldtng..Code is cause forrevocatto.nrof this rib ,wnse: far DRS Liee'nsi'ng:informaion,visi't- wvuwnMass:Gou/.DPS. X Iq Ct J16f6f: N 00 ON - tef v--f 00 G1 O ri NN M tt' to IGN Lam.tV. - l0N .. I 5 � - t r� Ll 6' Dl j Ll rv� : r ri N Cl) It 1!] to N. 00 a\ rcz 'V4 N : m w-i. � Lf) � .H m : � +�: � CV N ..N � N N. m -- � c � o c, Town of Barnstable Permit# Expires 6 months from issue date Regulatory ServicesMAM Fee • sexrraznBi.i. Thomas F.Geiler,Director O ��163� '�� Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERART APPLICATION RESIDENTIAL ONLY f Not Valid without Red X-Press Imprint Map/parcel Number t Property'AddressIle Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address FD I-fCl 00 Dq co Contractor's Name ly P� od t j s l y d_T t 6`1\i Telephone Number J VC)o d Home Improvement Contractor License#(if applicable) NT Construction Supervisor's License#(if applicable) I®� P E R korkman's Compensation Insurance: AUG 2 3 2012 - Check one: ❑ I am a sole proprietor ❑ I am the Homeowner rj'j I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name Workman's Comp.Policy# ��s T ( �� Copy of Insurance Compliance Certificate must accompany each permit Permit Request(check box) Re-roof(hurricane nailed)(stripping old shingles),All construction debris will be taken to ❑Re-roof(hurricane.nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders:U-Value (maximum.35)#of windows 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Xreuired. Owner must sign Property Owner Letter of Permission. of the ome mprovement Contractors License&Construction Supervisors License is SIGNATURE: C:\Users\decollik\AppData cal\Microsoft\WindowsUemporary Internet Files\ContentOutlook\DDV87AAZ\EXPRESS.doc Revised 072110 The Commonweakh ofMassachuse#ts Dewhnait of Indusbzal Accidents LV O we of Invesfigadom 600 Washington Shwt Bostord,AL4 021.11 wwry rnamgvtVdia Workers' Compensation Insurance Affidavit B>Anders/ContrachwsMectrkians/Plambers Apli"cant Information Please Print Lemb Name(HasmeaslO ahonlfn�ritmal): Address: City/State av �-'�.�/� Phone n an employer?Check the appropriate box: Type of project(required): 1. am a employer with 4- ❑ I am a general contractor and 1 s, have hired the nab-contrwtors 6- ❑3�e�,v construction employees(full adrd/o � )- e 2.❑ I am a sole proprietor or parer- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sob-cofactors have 8. F1 Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.msuradnee.I �- ❑Building addition required] 5_ ❑ We.are a corporation and its 10.0 Electrical iepairs or additions 3.❑ 1 am a homeowner doing all work ohs have exercised their 11_❑Plumbing repairs or additions myself[No workers'camp. right of exemption per MGL 12.0 goof repaaim insurance ]l c.152,§1(41 and we have no employees_[No works'. 13_❑Other comp insuranm required-] •Any appli t that checks boa#1 must also fill ant the section below showing their waakets'ca¢apensatum policy infimnsu a 1 Ela�aa+�s who submit d us af6tlavit i b icating theyare doing all wank and then hire outsides canuwiors m svhmit a new afiidavit indicatige,such - 1 that check this brie must amched an additional sheet showing the name of flLe and state whets of aw those eutanis bay employees.If the sub-cantractors have employees,they roust provide their waders'comp.policy,number. d Ann an employer that is providing workers'compensation insnranca for my effgdA aes. Below is the policy wd job site injor manor. Insurance Company Name: I Fa V e-(� Policy#or Self-ins.Lic.it. - � / Expiration Date: Job Site : -7tn—d I� City/State/Zap: ► C'/ b' 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 rip to$250.00 a day the violator. Be advised that a copy of this statement may be forwarded to the Office of . Investigations of the D for insurance coverage verification. I do heredfy rider the sand addles o.fpejttry that due injo ati�n provided7�av r`s and correct re Bate: Phone#: ��'. L/a (T--0 exs Official use only. Do not wrrto in this area,to be completed by cdty or town,officiaL City or Town: PermitfLi,cense B ning Authority(circle one): I.Board of Health 2.Building Department 3.Cityf Town Clerk 4.Electrical Inspector S.Plumbing L&spector 6.Other Contact Person: Phone#•, m tssachusctts- DeI),ti•tment of Public Safctc Board of Building Regulations and Standards Construction Supervisor License License: CS 102260 Restricted to: 00 MICHAEL' MEAGHER JR 97 EMERALD LANE MARSTONS,MILLS, MA 02648 "--�- —.. _Expiration: 11/5/2012 ('ouunissiuncr Tr#: 102260 ✓�' C 04mf7q)2040Z LI/CrB�sin�ess Regulation OffceoGod � & d, HOME I.MPROVEfi11ENT CONTRACTOR Registration162938 Type: Expiration 4/27/2013: DBA -,n* M HER BROTHERS�CQNSTRUCTION, MICHAEL MEAGI-lRJR� k 97 EMERALD LN o-0t r� ," Undersecretary MAP.STONSMILL,Mks 48 "f Restricted to: 00' 00- Unrestricted 1G-1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license: Refer to: WWW.Mass.Gov/DPS ' r , License or registration v§id fovindividul use only E before the expiration date. If found return to:. Office of Consumer Affairs and Business Regulation - ite 70 ,•. lO Park Plaza Su f Boston,MA 0211 r Not vMfd without signature• f * snxivsrna�, • MAM , 'Town of Barnstable � A Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO 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 1 as Owner of the'subject property hereby authorize r"� r'� ��iV 7 t U % /o to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) S a e of Owner I6ate Print Name } x - If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\UseTs\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 OF INPORMAamt LIED AS A MATTER GA7IVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFOR AUTFIORI/ED REPRESENTA'11VE NOT AFFIRUA•DVELY OR NE CONTRACT BETWEEN THE)5$UING INSURER(S), OF WSURANCE DOES NOT CONSTITUTE'A GDUCERA ND iNE CERTIf�CA7E HOLDER , ANT;N t eertri holder is,R 16 'ADDITIONAL INSURED,the PQr'DK'a=)nnust be endorsed N SUBitcate dosTION IS WAIVED,2V*Fsub) o'h the oNc cn'fein poNelea'aey req:dre and ppdorsmnom A sta"YnOnt on thisIMPORT ooNtloete does not confer rlAhtg W the 61 ft p Y. xrtl4ade holtler n lieu cd eUeh endareemsrd(4 CONTACT PRODUCER NAME' FAX PHONE FAX (AIC,No,Eat? OLDS CAFES COD IN5.1�C,CY ' E-MAIL " S mT .. pDDRE33: iPRODUCER ' CI TOMER ID m NA10 9 HYANNIS. 4A.0206 INSUREIt(s)AFfORDINO COVERAGE i 2.36RC I - •• INSURER A: TRAV�[.11'itS INDE1 VUI CCWANY INSURED INSURER B. . RJSURER C: . 3yIF SCAR M1C[�AELDB/L MF_kG BR CONSTRUCT IDN INSURER D: 97 D - INSURER E INSURER F: MA&5'CC�N� MiLIS.MA p2Cr1•A '. REVISION NUMBER: COVERAGES • CrURAM0ATEFDOPLO: TH{4ISTO CERRIFM�/�TFIAT.THE PoUdEA OF INCURAKCE.UBT ED @2LOr►NAVF BEEN 19SUtOTO THE DOCUMENT INSURED NAMED ResD ABDVt WHICH TM FORTHE POLICY PE MATE MDICBE ISSUED . Ai ED NR Ik�ar PERTAW.TANYNSURANOfE AFFORDED R CONDTHE ITION OF ANY CONTRACT OR DESCR DER HERON 19�dECT 0 ALLTHE rsMs,FXOLu ONB AND CONDRIONSEOFA9UcH P UabS 0 UKT3 SHOWN Y HAVE BEEN REDUGFO BY PAID CLAIMS, POLICY EFF DATE P.OUCY EXP GATE ' U18R ADDLCUDR rypv�OtA p DFI LIMITS TYPEDFINSURANCE POUCYNUNBER [m ADDtYYYY) I LTR' IN9R ww EACH bcCURREJCE $ GENERAL I IAB,LTTY COM ERCIALGENERALLIABILITY DAMAGR TO RENTED y. I PREMISES(Ea OccuRP -) Ci NS MADE DCCl1R.. MED EXP(AyV ono P—Ort 9 PERSONAL A&AbV INJURY S GENERAL AGGREGATE -GEN'L AGS MATE LIMIT APPLIES PER PRODUCT%-COMPIOP AGO G POyr_{I,'• PROJECT LOC COMBINED SRJGLE AUTOMOBI LIABILITY• LIMIT(Ea suddent) ' ANY AUTO BODILY INJURY ALL NED AUTOS (Par pnraon) SCHE ULE AUTOS .. BODILY INJURY' S HIRE I AUTOS : (Par ar6kkinl) I PROPERTY DAMAGE S NON-IYWNED AUTOS '` (Per swldend { EAOH OCCURRENCE UMS LLALIAR• OCCUR • AGGREGATE EXCE LIA19 CLAIMS-MADE DED TIBLE S " RF, �. ION F WO SiAT1TORYIJMiT9 OTHER WORK COMPENSATION AND S 'IOO,ODO A EMPLOYE S.I.IA1AUTY YIN . U8 4R 'ASA-i t 1IlOno11 11imnal2 . E.L DISEASE EA EMPLOYEE 9 10Q,000 ANY PR ITORmARTNERVAEGUII& 14 OFFICEIt7NC .ERExra,ImED?., EL,DLst ASP•POLtCY.LUIT S 500,000 pAnndmary) NH). 11 yes,d99cdt' kn44r DESCa1PT10 or OPERATIONS blew DESCRIPTION OPERAMONSILOCATIONSNEHICLESIRES[RICTIONS/SPECIAL►TEMS T=FM IA ANY PRIOR CFATOCA'EIsso=TO THE CP.RT[KrA.TE HOLDER APFB77 4G WOWM&• COW.COvL?f hca NMAGPD'R NII I ISCOVerEDBYTMWORKERS'COW-8NSAT.[ONPOLTCY. " CERTIFICATE HOLDER . CANCEI.L:ATION TOWN OF SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATETHCREOF,NOTICE WILL BE DELIVERED IN `36 zC'LF' .AT CK PD ACCORDANCE WPM THE POLICY PROVl510NS 'AUTHORIZED REPRESENTATIVE MASt MA 02649 Charles I Clark ACORD 25{20 9/69) 19weDD9 ACORD CORPORATION. ATLligltts reserved Town of.Barnstable Regulatory Services ti Thomas F.Geiler,Director . uu r e Building Division s s�rn i.E. v n AS& Tom Perry,Building Commissioner Ea Hai IN 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Approved: Pee: Permit#• HOME OCCUPATION REGISTRATION Date: q 16 C/ /' Bl] Name: v C.� (_c_12ve Phone#: r�l —�-��•���J Address: 705 J� ST�Cr ��fJ �f '1�Village: 6 4- 4e u�l (- Name of Business:B-f 6AS Type of Business: 6t,vAO 0r::nC,V)C t Map/Lot- INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space, • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,' odors,electrical disturbance,heat,glare,humidity or other objectionable effects. , r There is no-storage-or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met-on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment • There is no commercial vehicles related to the Customary Home Occupation, other than one van or one ity,and one trailer not to exceed 20 feet in length and not to pickAlp-truek•notto•exceed•one ton.capac '6*cced 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included.. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling I,the undersigned, and agree a above restrictions for my home occupation I am registering. Applicant: Date: G Assessor's map and lot number .. /,....... ./...,1.. . . - �; vo Sewage Permit number 8d.-:Zz—d .............................. �� f7£AL7lf SEPTIC INSTALLED SN L M Housenumber ............................... ............................. WITH TITL �•MaY ' TOWN OF B AfR N S T A%` k4ENTAL CODE AND l� �-I.;I_..�TIONS BUILDING INSPECTOR / APPLICATION FOR PERMIT TO .......... C 7. ......................... ... ........ .................................... TYPE OF CONSTRUCTION GC ' �............ ........................................................... .............................................................. .......�.1.U/1)�..............:........19 G a. TO THE INSPECTOR OF BUILDINGS: z The undersigned hereby applies for a permit according to the following information: Location ...........�.C �Yt - .......... �..................... [` ............ l.ITT ....:...... .................................... ProposedUse .............../PM. 6s ................................................................................................................................................ Zoning District .....Fire District `fT Name of Owner ......kC acua........... � -............Address ........,V.IJ](f d OV?a /mil S.s................................. Name of Builder ........9T.A&L?5..........C�9AV( s............Addres .........Q S.Q.........M(!'q/ .....�6....1.1y ( .Name of Architect ..........6.A(.�.............DA �...................Address .................................................................................... Number of Rooms tt ........................Foundation ......... �v < d�.. CC.?!` TCT.�1......... .. ............... Exterior wt1.�T ....... D �2 Roofing / .5P�� L. ............ .1 .�/1/CL:���........................................ . ..................... ....... h Floors c,......... ...... ...Interior ........:.! ?. .. ✓..! .� ........................................... Heating ............ (C...............................................Plumbing ..:......... A/................................................................ Fireplace ..............A/0...........................................................Approximate Cost ........ .....`7. .� o��1�............... . Definitive Plan Approved by Planning Board ---------------_---------------19________. Area Diagram of Lot and Building with .Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH O' 0`0 rJ e0s Iq I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re rd g the above construction. Name .... .. . :—:..... .. . .. ....................................... ",,DePAUL, j No 22.233.... Permit for ...One...S-tory......... fI.-SIn-gle...F-ami.1-y..Dwelling.............. Loq,qtion ... ...0.1.d...Stage...RqAd............ Centerville ............................................................................... Owner Kenneth DePaul ................................................................. Type of Construction .........F.r.ame.................... . .............................I.................................................. Plot ............................ Lot ................................ Permit Granted ...........June....2 ...19 80 Date of Inspection .............. 19 '03e) Date mpleted ................ 19 PERMIT REFUSED ................................................................ 19 ................... ..... .. ............. ............ . .. . .......... ........... ......... .... ............. . .... ....... ...... ............. ....... .. ............. .. . . ..... .. ..... 7- ............... ...... ... .... ...... Approved ........................................... 19 ....... . . ................... .................. .................................... TOWN OF BARNSTABLE Permit No. ----------_-----------\-1� I BuildingInspector `�" s 0"S. Cash ' �'r0 Y►Y 1'� OCCUPANCY PERMIT Bond ----___------____---_--__ "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to r-e'tebi DePaid Address 01 Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. .....................................................1 19......__ .................................................................._........................................ ._ Building Inspector J - zt� ti Pbm u4 - 3 �t�ec>oM v t_10 GArcgAr-G 6;-�t+,tbE:%z o r>.dt Lam( FLvw _ I Ibl-c S G•Rt?• TA+•tK = 33G>.r (SC.% * 4--r7 6.P.D. 1�ISPDSAL PIT- .USE (OeX=) GAe.-,. , C�4VAL-L AZEA tSG� S•F. i SF g2.S = 3 TS G.P.tD. Up i3c rrom S Sri. t .o -:. ' _ Sv e.R:p. •- ..Tdr,&L -vv Sl6Q = .425 G.Rom- Low F ToTQ L A t L�f FC.vti c� = 330 6.` ..'D. l5 C4 67 `) 7 " Pmrdc0L Tto CIO. �L�4titJ `OtZ L�S_S. -A)` At isi,, f• ' k. �, T o 1OW ¢ ' L Fir z TOT V�IO`100.0 T -TeST 4. i tJ V7-0 S 4 ppFs 'DrT. tW. 6AL. .q�• S�r�c ,� - INV. TAWw. 000 i FIT � �,.� �� Wert-1 .. _ •i � - WAfi41�0 ' i QY- + C -_QTtPIED PLC) Ptzo'F--t L L o C.A•T I O" `�4 AT' -Tk1{~ PQ ;DWF St low+.l. Pt.A 1-1 1-1F;ti?twra+,t. �c.���f�t-�lS" �+t/ t'T'4,i Tt�i= 5{DE t_t►�lE: Awb SETi�'>hCtG L"CQU{9ZE� :uTS of �r-NC G•Z ``71 i i tZCGIS (L-i��D t �.i-tG iUZVaYvQXC I 05'CE V-VlLtG c.> Il A5� i, tt�tsre� �c��.,4. ,Uc�,�tti�, ,� -���r-w• c. F�:,�c-�. �ik•�Gt:1L.D AF�{�-.mot cn,�.��r J<,�•�J ��1�AUi.� t U-Lt-. TO. tS� t e►�M►►�i= It�,C: t_t W _ __ ���IGN �QTA. •? T�d1 t�f V=Law = %10 - 3 = 33o G.p-D. �t_P T-i C 1r7 C•% • A-9 5 6.F?o. :o USA- t oOb 6Q.t_. �ISPoSAt__..PIT - y5E low GAi SW61AVALL AZEA = (50 st=. Iso SF 2.S = 3 7S To-r,&L T7 ESIG►J = 425 G.P.D. c. ` \ ,jL -roT4L- Ft ra 6tD. PEf--GDL&TtOLJ V&TL IIQ 2•MIQ, oIZ �SS. ,�} J�'A)L �`"WILLIAM j r dta 193 su -r sT (o•�� ( Tot F•+v a ioo.o ...,,.. P/ . 776 tur9M "�Pd` 4'p,�� IW- -z.o sv� ,►r4 --r -Box 9 sEvrtc I o Situ p yI Wv. , T'Q N K A' logo G.0 IWV• tuv.94,' F-T t N� . w�ru .•, la/4't��Z • WAf"aO IlQ.OfZ:7-t L_EL - -LtaGAT1 ot-J -/`Z:o 1 ,(� ►.�o Sc Aa-t=- SG A I_t` (i ►- GUt AT C— "Z 15, UC t�i t P I! T F4 A-r T N G Peps. D W R.!-. 5"aru�7 Pt to t,1 TZ t F�. E►__.1 G C; Nt'��cJ GeatilC�t-�(S W tT1-i TIa; StU� c_t►-lE: �--GT� E AA!t 'SET VIA C - t~r Cr U t M c ►-iTS o f T t�t G �C� �J 1C Z ") Z, -To w tJ c), R adz t fo�i'A t . vA.-rt G•Z$'-75 W L� �^" 8l5.i:TCtiZ. �. u�t; t�-1G_ � tZCGtSfv--r-7 an LA,1-tG iUevaYoIZ;I 1W�CG'_J,✓tiC=w;' ��ut�•lt==�'c' fit. -Y►ate c:F"�,�["<, SI•lae:�t� A.F�ta�t GAI-J"T'_ ��,�.�.1.� �E Cl�.ut,.... � t �;,t Wit_ u-�trF-, t"�;, t�r__t't:►=MI►JL 1._a-'C l_1 W��� ._. ._.._ ______.._ __ ...�.. ..._..._..