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HomeMy WebLinkAbout0076 OUTPOST LANE o .�� �' .. .� :, . _ _. � . e t o e . d F .. ;� : _, .� _ Q . . � - - ® � . T n �. .. Y .. ,� .. 1 �. .. 4 + � � ,. . o _ � �� � a L ,- � .. .. �.,, � _ F � • ,. Town of Barnstable e 1 g _ ._ ..._ _.m. rain Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept z $ !Posted Until Final Inspection Has Been Made. • a 'Where . a Certificateof Occupancy is Required,such Budding shall Not be Occupied until a Final Inspection has been made. �� �� � L Permit No. B-19-2216 Applicant Name: Paul Eaton Approvals Date Issued: 07/23/2019 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 01/23/2020 Foundation: Location: 76 OUTPOST LANE,CENTERVILLE Map/Lot 172-115 Zoning District: RC Sheathing: Owner on Record: WATKINS,GAIL A Contractor Name.-,,PAUL A EATON Framing: 1 Address: 76 OUTPOST LN Contractor,License: CS-088720 2 CENTERVILLE, MA 02632 �.. - . Est. Project Cost: $21,000.00 Chimney: Description:' Install 5.355kw solar panels on roof.Will not excee&roof panel, but i Permit Fe: $ 157.10 will add 6" to roof height. 17 total panels. a i Insulation: Fee Paid:` $ 157.10 Project Review Req: Date: r tt 7/23/2019 Final: Plumbing/Gas Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuan �c�a Final Plumbing: All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and str�uctures:shall be in compliance with the local zoning by-laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street oIr-road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures by the Building-and-Fire-Officials areprovided on this permit. Electrical Minimum of five Call Inspections Required for All Construction Work: 1.Foundation or Footing fi�}. Service: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed t Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: 01�•4zN E �iMl4rZ(.. 3�f Town of Barnstable Building -Post This Card So That it is Visible From the Street-,Approved Plans,Must be Retained°on Job and this Card Must be Kept rAasra , I Posted Until Final Inspection Has Been Made. Permit Where a Certificate of Occupanc is Re wired,such Buildin shall Not be Occu ied until a Final Ins ection has been made Permit No. B-19-2216 Applicant Name: Paul Eaton Approvals Date Issued: 07/23/2019 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 01/23/2020 Foundation: Location: 76 OUTPOST LANE,CENTERVILLE Map/Lot: 172-115 - Zoning District: RC Sheathing: Owner on Record: WATKINS,GAIL A -� Contractor Name,�PAUL A EATON framing: 1 Address: 76 OUTPOST LN Contractor License: CS-088720 2 CENTERVILLE,MA 02632 Est. Project Cost: $21,000.00 Chimney: Description: Install 5.355kw solar panels on roof.Will not exceed roof,panel, but I Permit Fee: $ 157.10 will add 6"to roof height. 17 total panels. t Insulation: Fee Paid:! $ 157.10 I i �r r Final: Project Review Req: Date: 7/23/2019 Plumbing/Gas Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by.this permit is'commenced'within six months afte issuan icia Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall;be in compliance with the local zoning by-laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the - work until the completion of the same ; Final Gas: The Certificate of Occupancy will not be issued until all applicable signtures by the Build ing-and,Fire Officials are provided onthis permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: ' 1.Foundation or Footing t` Service: 2.Sheathing Inspection .. , Rough: 3.All Fireplaces must be inspected at the throat level before firest flue'lining isyinstalied g 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Final: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health " "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: QE)40114n a Town of Barnstable *Permit# Expires 6 moo hsfronr issu�ate • Regulatory Services Fee 1ARNSfAAr.�_ MASS F1639. � Thomas F. Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 206 Main Street,Hyannis,MA 02601 www.town.barnstable.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 „ Property-Address 76 Residential Value of Work'L 13s1 6 0Iltinimum fee of$25.00 for work under$6000.00 Owner's Name&Address1 I's -?�/�faaSf onf�t✓l��/ �' O�.1o3�2 Contractor's Name Telephone,Numbers 74/_ Home Improvement Contractor License#(if applicable) /(4 g Construction Supervisor's License#(if applicable) 7 5`1 [ZWorkman's Compensation Insurance. - PERMIT Check one: ❑ I am a sole proprietor OCT I am the Homeowner [�I have Worker's Compensation Insurance '() N ®F BARNS7AL Insurance Company Name 224n 5�. Workman's Comp.Policy# �'(�C " d 2�a`�t✓1 a `� Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles)`All construction debris will be taken' to El Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side P—Replacement-Windows/doors/sliders.U-Value #of doors (maximum.44)#of windows '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:Orvner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required: SIGNATURE: i Q:\WPFI)l✓S\FORMbllii",e permit form-s\F7Cl'RESS.rior • The Commonfveitlth o Massachrrsett f s Department of lntlustrial Accidents Offxce of-Jwvestigations d00 Washington Street y Boston,NJfl 02111 wfvw m4ss.gov/dia Workers' compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individuai); Address: o City/State/Zip S'-7 Phone#,: [3.E] ou an employer?Check the appropriate box: I am a employer with 4: [ m a general contractor and I Type ofproiect(required): employees'(full and/or part-time):* have hired the sub-contractors . 6. ❑New.construction am a sole proprietor or partner- listed.on:the`attached sheet.. 7, ❑Remodeling hip and have no employees These sub-contractors have working .for mein.any capacity. employees and have workers' 8' Demolition No workers'.comp, insurance comp,insura tce.1 9• ❑Building addition equired.] 5 We are a corporation and its 10.0 Electrical repairs or additior. ❑. .. ama homeownerdoing all work officers haveexercised their: self 1.0 Plumbing repairs or addition y [Noworkers comp. right of exemption per MGL surance required.] t c. 152,.§1(4),and we have no 12.,]Roof repairs employees: [No workers' 13.El Other comp insurance required.] 'Any applicant that checks box tl J must also fill out the sect t Homeowners who ion below showing their workers'compensation policy information. submit this affidavit indicating they are doing all work and then hire outside cont 3Contradtors that check this box must attached an.addition ractors must submit a new affidavit indicating such. al sheet showing the name sub-contractors and state whether or not those entities have of the employees. rf the sub-contractors have employees,they.muI t provide their workers'comp,policy number: - I am,an employer that is providing fvorkers compensation insurance for my employees. Below is the policy and job site inform ation. Insurance Company Name: .Sl'1 Policy#or Self-ins.Lic.#: . w C, OvL 6 3 N;:r}SI Expiration Date:_ Job Site Addfess:_.7(=('/� City/State/Zip:( 1 oa 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 fins 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 thepains andpenalties ofperjury that the information provided,above is true and correc> Si ature: Date: /6 • Phone#: 17 N- 4 7 9-6 oB Official use only. Do not write in this area, to be completed by city or town offrcial.. . City or Town: Permit/License# Issuing Authority.(circle one): I.Board ofllealth 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S. Plumbinc Inspector i VP 00 .0. asteg NO s -. + s�hn.S�reet Workeirs. C A hit. o ` atibers Name(�+smes ldrganizatiq� „ Address City/S�t��telZip. es,`yoil aa:eplpl�pCIeC � 1. I an,a ea layer wiz 4_ I am a R f H dre.d): 2. �PloYces(foil aatl/or parte).'� ? a �` mcdm i an4 asolcp�nopf� � r ship and have oa 3 . Fdon working f�r mem 30Y ca ' 11► a sub-ooa�rac °�avi 8 ] [No wor>tets' p mg�Y vvoriCers•coal ice. .1 i soranice w" 9 a r iop addhiou L I am hamernovner doingilk.work toftor.additidus [No w+orlc�irs'"Comp, c52, i & insurance Tom.]fmm Vmp m° � . •p • T3er s�Y eP�1i Jetoa bt�xt" Sto flt �HOMWWD swho eta �'e on ioiv o g > N �a/JIBII.�"Ywlcouftwbu .1� .4: f arr7:�" Ofl r1¢ ev YWli - .. ------------- forneotiaeR. at��wR Insareuoe N +a ;�ob ComAap3+ n v� PONCy#or S046S.Lit#' 001 Attub 8 � copy Of the Wort es Fad �� p'��de+�ra e�sh`o` >o segue coves as a, fine aP ffi1;�00 Oo apd/ot. w A. 25A bfMGz .w o AP M alties ofa Of up to$250.00 a day aftaaOr r i gnORK :aad arm: of the DIA for msuraHcehem eov wa Q 's slatay.} .� ffic Q ce of �do.. bY repaus ap ,PeKI the rn h: M. furl we o�1J= Do nail wr&e�lids City or Town: , + �'erriuh! �use# �g Anthortity(cir'cle one): i..la of Heatth 7. 0 � 4 6.Other reoor; Plrsmbin=inspector Contact Person: t • �tHET _ i Town of Barnstable Regulatory Services + BAMSTABLE, +' 9MAM Thomas F. Geller,Director Building Division Tom Perry,Buildi4g Commissioner 200 Main Street,H}annis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6231 Property Owner Must COMPlete and Sign This Section If Using A Builder r; • �i, as Owrlerof the s ubject property hereby authorize • �' e Can S to act on my behalf, izl all matters relative to work authorized by this building permit application for 6k4 Address of Job) Sig ature of er Date . �l f / s Pnnt Name If Property . pe Owner><s applying for perxntt please complete the Homeowners;License Exemption Fthrm on the reverse side. -Town ©-P Aa ,,,SKU c- I h i S IS 40 'U1-rerm /- �(a 4a- LoL xe.'.S +Lo,vc- ce,4vv on s��- �� �-we�5 ;ns}all�,tian Jobs bv� /R�eYcr'.5 1 x • i r e x CONTRACT# �03906 5a INSTALLED SALES SPECIALIST - NUMBER C t CUSTOM�FR 4,4, �%a t1 T ??7l0 02 ( �i(� l TX//ii,5 STORE NO ST EET ADDRE t �' STREET ADDRESS I CITY _ ... STATE ZIP ~CnY STATE 1 ��PHONE /�/7 � — • - • /j �/ Lf/G �� �4(� - TELEPHONE LOWE'S HOME CENTERS.INC.'S MA HIC NO.:148688 CASH ggNlc LCr; �O - miSs FEIN.56-0748358 D ✓ GURGE 'Y��IPBItF ijlB'6� i'S � � aver 3^ d INSTALLATION STREET ADDRESS CITY ' •" STATE ZIP ..5Tgll /6- ,e id �i,re 104,4fo 1411 — O, Tii /1 e 7-Fee ' , 21,511AC9 Fvoz 6ro � Co i N It �D A.l 2.�S /e 7H P/f Y&e/V i i Contract Total C�a j Are permits required for this installation?:IX Yes [ ]No *applicable tax included I i NOTICE TO CUSTOMER:Federal law requires Lowe's to provide you with the pamplet Renovate Right.,Important Lead Hazard Information for Famil- ies,Child Care Providers and Schools.By signing this Contract,Customer acknowledges having received a copy ofthis pamphlet before work began informing Customer of the potential risk of the lead hazard exposure.from renovation activity to be performed in Customer's dwelling uniL Work is to co mence u on reasonable availability of Contractor and/or availability of any speclaforder o custom made Goods which is anticipated to be /�" 02 —/Q [fill in date]. Estimated completion date Is /O [fill In date]. essence. Contingencies that Said estimated substantial completion date is not of the es may materially change said estimated completion date follow: ' Y (If applicable,insert a statement of such contingencies). IF THE CONTRACT TOTAL IS$1,060.00 OR LESS Customer must pay in full. COMPLETE THIS SECTION ONLY WHEN THE-CONTRACT TOTAL EXCEEDS$1.000.00. [Customer to Pay in Full; OR [ j Customer to use the following payment schedule:. (1)Deposit $ to be paid upon siging contract.Deposit should be 1/3 the total contract price;and (2)Payment of$ to be.paid anytime after this Contract is signed and before commencement of installation,I/We authorize Lowe's to do one of the following(check appropriate box below): [ ]Charge my/our credit card for the amount of the payment indicated above anytime after the date this Contract is signed; or [ I Deposit my/our check for the amount of the payment indicated above anytime after the'date this Contract is signed;and , (3)Final payment of$100.00 to be paid upon completion of the installation and both parties'satisfaction. . NOTICE REGARDING ARBIT Anna AGREEMENT FOR CLAIMS COVERED BY M.G.L.c.142A LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT,THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUT- IVE OFFICE OF CONSUMER AFFAIRS AND BUISNESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION AS PROVIDED IN M.G.L.c.142A. By'L Date: Lowe's y, a Centers,Inch By. ✓ r Date: C. -7f Owne Signature " THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWE'S PURSUANT TO M.G.L.c.142A.THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE SECTION ABOVE IS NOT SEPERATELY SIGNED'BYTHE PARTIES. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE.READ THE TERMS AND CONDITIONS CONTAINED ON THE REVERSE'SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CONTRACT BY SIGNING BELOW,YOU ARE ACKNOWLEDGING THAT YOU HAVE:READ;UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE-OF THIS PAGE AND.THE FOLLOWING PAGES OF THIS` CONTRACT.YOU ARE ENTITLED TO A COPY OF THIS CONTRACT AT THE'TIME.OF SIGNATURE. ` WITNESS OUR HAND(S)AND SEAL(S)BELOW THIS.DAY OF Lowe's Home Centers,Inc. �� Spec la or bo er spouse' custoWer acknowledges receipt of a true copy of this contract which.was completely filled in prior to Customer's execution hereof.You,the buyer,may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.See the attached notice of cancellation form for an explanation of this right. EXTERIOR SOLUTION GENERIC (Rev.12/09) ®2004 by Lowe s.®Lowe's and tlIe gable design ' areregLSteredbademaksatLFcoporetion. I'll!'lit 75153 00 KENNETH D- KENDALL 5 WEEDEN PLACE FAIRHAVEN, MA 02719 - ----� 1/12/2011 10058 f ,sue ✓fze �omv�noouuea`l� o�✓�c�aaac�ivaeCla \ Office of Consumer Affairs&Business Regulation- License or registration valid for individuI use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration�-148688 10 Park Plaza-Suite 5170 Expirati�t� f18f2011 Boston,MA 02116 is Y ,S�il�m`ent Card LOWE'S HOMES E--N-TEkS�IC C` JAYMI RODRIGUELk� 136 TURNPIKE RQ S.WTE 100 7 a , SOUTH BOROUGH MA 01'772 Undersecretary P�MeVvalid without signature 07/30/2010 15:52 50e9973324 HC&C INSURANCE PAGE 02 CERTIFICATE OF LIABILITY INSURANCE" 7HI3 CERTIFICATE IS ISSUED AS A MATTER pF INFORMATION ONLY AND CONFCRs NO RIGHTg OP Ib I'G DATE{MrvuDD1YYYYI CERTIFICATE ppE$NOT AFFIRMATIVELY OR NEGATtyELy AMEND,EXTEND OR ALTER THE COV UPONERAGE AFFORDED BY THE PO 7 30 14 DELOW THIS CERTIFICATE OF INSURANCE DOES NOT CON3TITt1TE q CONTRACT BETWEEN THE ISSUING IN URER AHOPOLI THIS REPRIESEIVTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. POLICIES h RCert cote 110 der s an a O UTHoRIZED the terms and conditions of the policy,c L U D, a Pfl cy ss must a en ors® . l p Y rl n policies may require an endorsement. A Statement on this certlfl certificate not confer Ashes t to— PRODUCER the certificate holder in Ileu of such endorgement(s), I AI D,su ject 1�ulaphrey, Covill & Coleman. Insurance AgencME; 195 R yr Inc.rx1c St. P.O. Dox 1901 , l New Bedford ADDRESS; NA 02741 —' A/C.No)-, phons:508-997-3327 F` cusroMeRrD I+` INSURED .DKE3, INSURER{3)AFPORDING COW;l XCennet D. Kendall d/b/A INSURER A: ClonMe Ce ZIl9Z1X8IIQe Co. NAICp Clea:rv?ew Xiotne INsuReRB: Norfolk & 34754 5 Well Place zmPzovemeat Fairhaven MA 02719 X)edhaat 23965 INSURER C: FNSURERD: - INSURER E COVERAGES CERTIFICATE NUMBER: INSURE F THIS IS TO CERTIFY THAT 7HE pQLICIE,g OF INSURANCE LISTED BEt,QyV WAyE BEEN rS$uEp TO THE INSUREQ NAMED ABOVE FOR T INpICATEp. NOTWTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANYCONTRAC7 OR REVISION NUMBER: CERTIFICATE MAY BE LSSUED OR MAY PERTAIN,THE INSURANCE AFFORD IF T Y O HE POLICY PERI00 EXCLUSION$AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE Sy BEEN REDUCED AY PAID CLAIMS IN IS WITH RESPECT TO YJH)QH THIS UCED DESCRIEIED HEREIN IS SUB IECT TO ALL THE TERMS, LTR TYPE DF INSURANCE - GENERAL LIABILITY INSR POLICY NUMBER $ X {atMlrD UWT3 cOMMERCrnI GENERAL LEABILITY $1,000 R0652279A EACH OCCURRENCE CLAIMS-MADE �OCCUR a�JO�Jia o3/oa/11 /pD0 PREMISES a oeaurrentx $5 0,0 0 0 g Al EXP(Any one person) a 5,0 0 0 PERSONAL&ADV INJURY GEN'L AGGREGATE LlE 1,0 0 0,O 0 D Iva APPLIES PER; $ POLICY PRO. GENENALAGGREGATE JET LOC $2,000,000 pRQDUCTS-CQMPIOPAGG AUTOMOBILELIAB►LITY - 8 2,00p.0p() ANYAUTQ - g COMBINED SINGLE LIMIT ALL QyVl1Fb AUTOS {Ea acddenl) II X SCHEDULED AUTOS - .BODILY INJURY(Per Dn S p� I 100000 A X HIRED AUTOS BODILY INJURY(Per eocrdel f 3 0 0 0 O 0 X NON-OWNED AUTOS RYLT3 92 PROPERTY DAMAGE 0?%aeJlo oa/se/al (PtracNyenl) $100000 UMBRELLA LIAR S EXCE9S LIA6 OCCUR S CL4rMt;MAOE DEDUCTIBLE EACl1 OCCURRENCE � $ ~• RETENTION g AGGREGATE S WORKERS COMPENSATION S — AND EMPLOYERS'LIABILITY ANY PROPWETORIPARTN YIN S OFF?CEPJMEMBER DW? TIVEL TpRYLEMRS Inundatory In NH) ©ECLUDED� /q ER' yet deeatbeunft - EL.IZAC14ACCIDENT g DESCRIPTION OF OPERATIONS below - E.L_DrgEti,E_EA EMPLOYEE g E.L.DISEASE-POLICY LIMIT ri ESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES;(Attach ACORD'"AddlUonat Rarnap<s Schedulo mae apaco Is ro9v +Q�t'9'9 C&s re pe 2nc, acid any and all subsidiaries are named a Additional Insured as respect to the General Liability & O�ercial Auto pa Add, ERTIFICATE HOLDER CANCELLATION LOI s 1 SHOULD ANY OF THE ABOVE DESCRI12ED POLICIEB BE CANCELLED BEFORE THE EXPIRATION DATe THEREOF,NOTICE WIC,BE DGWERED IN Lowill Com3parii9E3, Inc, ACCORDANCE WITH THE POLICY PROVISIONS. Attn: 29 Insurance PO Box, 1111 AUrHORl2®REPRESENTATIVE N. Wilkeabpro NC 2B656 :pRD 25(2009l09) CORD CORPORATION. All rights reserved,. The ACORD name and logo are registered marks of ACORD ( F ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel i/J-" Application Health Division Conservation Division Permit# Tax Collector Date Issued = G Treasurer Application Fee Planning Dept. ` Permit Fee t>2Z5 Date Definitive Plan Approved by Planning Board ®K Historic-OKH Preservation/Hyannis Project Street Address x © o Village 2 �//e r �. Owner Gia, Z 4, Address Telephone 3a - — s Permit Request Square feet: 1 st floor:existing posed Pmlol existing proposed Total new Zoning District Floo lain Groundwater Overlay Project Valuation °�A/ 00 Cons r tion a r Lot Size ac randfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0' Two Family ❑ Multi-Family(#units) -> Ci -' E Age of Existing Structure 12 77 Historic House: ❑Yes ail No On Old King's High�ay: ❑Yes ❑No BaAent Type: ❑Full ❑Crawl ❑Walkout ❑Other P Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) I Number of Baths: Full:existing o 2 new Half:existing new Number of Bedrooms: existing .? new Total Room Count(not including baths):existing 7 new .4' First Floor Room Count 7 Heat Type and Fuel: 14 Gas ❑Oil ❑ Electric ❑Other Central Air: A Yes ❑No Fireplaces: Existing New Existing wood/coal stove: Ad Yes ❑No Detached garage:0 existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage-4existing ❑new size Shed.Q�existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name, , Telephone Number _SW - Address ; o� License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE �`,��,� DATE 9 —�-off t M1 s FOR OFFICIAL USE ONLY S R PERMIT NO. " s DATE ISSUED MAP/PARCEL NO. -ADDRESS VILLAGEf ' f j F OWNER DATE OF INSPECTION: FOUNDATION, c I FRAME INSULATION 1 u CG ._ ,,"Is FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH —FINAL GAS: ROUGH �MwL t FINAL BUILDING ®�lgeb a/"�fist DATE CLOSED OUT ASSOCIATION PLAN NO. Towle of BarnstablePermit: =H �? ' ?'�� `c �OfTNE 2 36 Regulatory Services Date: Thomas F.Geiler,Director Building Division ee:� p0 ►,,�=`ib ��� Tom Perry, Building Commissioner TEo � 200 Main Street, Hyannis,MA 02601 www-town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: r l� �,���.s Phone•-,�"vim - Install at: Village: Map/Parcel' - d /lJ Date:— C?//S/ r 4 " Stove r E ��iew/'t7sed B. Type: adian Circulating 1i c-n u, C. Manufacturer: 0,41ap S�0� Lab.No. Model No.: .moo Chimney A. New/ xistin f existing,please note date of last cleaning B. Flue Size . C. Are other.appliances attached to Flue? Qco D. Pre-fab Type and Manufacturer E. Masonry. ine alined Hearth A. Materials: B. Sub Floor Construction. Installer Name: Address: �5- �D►�aon S�, Phone: i- L+'79� Location of Installation: APPROVED BY: Please make checks payable to the Town of Barnstable R *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Town of Barnstable *Permit#,:�?, 6a6oaya Expires 6 months from issue date X-PRESS PERMIT Regulatory Services Fee MAY O 5 2006 Thomas F.Geiler,Director Building Division TOWN OF BARNSTABLff om Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.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 /7s ,i,s-0 Property Address 7 ('y do04 S LL [Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address ,g ' /� j,.����ir•J 26 �� s ,ZZ Dez 63ai. e, - Contractor's Name zro c 40e.4 Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping, Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. SIGNATURE: Q:Fomis:expmtrg Revise071405 The Commonwealth ofMassachusetts Department oflndustrial Accidents ,) Office of Investigations 600 Washington Street •` Boston, MA 02111 y ' www.mass.gov/dia, Workers' Compensation Insdrance,Affidavit; Builders/Contractors/Electriaans/Plumbers Applicant Iaformation,, Please Print Legibly Name Q3usiaess/Org?nization/Ina�idu4: Address: d b� City/State/Zip: 70-/�a�1� Phone Are you an employer? Check the-approprlate box; Type of project(required): 1.❑ I am a employer with `_4. ❑ I am a general contractor and I,° 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,t' 7. ❑ Remodeling ship and have no employees These sub-contractors have` 8. ❑ Demolition working forme in any capacity. workers' camp,insurance, 9. ❑ Building addition [No workers' Camp.insurance S, ❑We are a corporation and its required.] �offcers have exercised their 10,❑ Blectricalrepairs or additions 3.9 I am a homeowner doing all work right of exemption per MGL ME] Plumbing repairs or additions myself.(No workers' comp, c. 152, §1(4),and we have no 12,❑Roof 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 infonnedow ' t Homeowners who submitthis affidavit indicating they are doing an work andthenhire outside contractors must submit anew afdavit iadi=tbag such tcontractvrs that check this box•mnst attached an additional sheet showing the name of the subcontractors cad ibeir•workers'comp.policy iafotmatioa. ram an employer that is providing workers'compensation insurance for.my employees. Below is thepollcy andjob site lnformaddon. '� -: Insm•ance CompanyName policy I or Sei4i.Lic.#: B Ilan: Job Site Address' City/State/*.- Attach a copy of the workers' compensation policy declarWon page(showing the policy number and W.1rataton date). Failure to secvrc coverage as required under Section 25A of MGL c. 152 rmlead to the imposition of criminal penalties of a tine up to$1,500A0 and/or one-year imprisonmen�as well as civil penalties in the.fann 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 veriEcation. i I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. S Date. Phone#' S?> - /mod- vffii:akl usE or.y. Dv r M*E ir.ift ama,to U compleftd by C4 of tPM oJitie C`rf orTown: Permit/License# Issul4a Authorial(circle one)., l 1.Board of Health 3.Building Department 3.City/T1 owa Clerk 4.Electrical inspector 5.Plumbing Inspector 6. Other Con�ctPersota: Phone#: Information. and Instructions . Managhus neral Laws chapter 152 requires all employers to provide wbrkers' cornpensatimfor-their employees. #. Pursuant to this tote, an employee is defined as"...every person in the service of another under any contract of hire, ' express or impli or written." An employer is defin s-"on individual,partnership,association,corporation or other legal entity, any two or more of the foregoing engag ' a joint enterprise, and including the legal representatives of a dece employer,or the . receiver or trustee of an k ' 'dual,partnersbip, association or other legal entity, employing loyees. However the owner of a dwelling house h wing not more than three apartments and who resides therein, r the occupant of the dwelling house of another wh employs persons to do maintenance, construction ar rep ' orkm such dwelling house or on the grounds Or building enant thereto shall not because of such employmen a deemed tone an employer." MGL chapter 152, §25C(6)also es that"every state or local licensing agency sh I wfthhold the issuance or renewal of a license or permit to o prate a business or to construct buildings in a commonwealth for any applicant who has not produced ace le evidence of compliance with the In ranee coverage required. Additionally,MGL chapter 152, §25C( states"Neither the commonwealth nor of its political subdivisions shall eater into any contract for the performan ofpublic work until acceptable eviden a of comliance with the fiW=;nee requirements of this chapter have been pr ted to the contracting authority." Applicants Please IM out the workers' compensation affid completely,by chec ' the boxes That apply to your situation and, if necessary,supply sub-contractor(s)name(s),addr (es)and phone n (s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or.L 'ted Liability P ershipa(LLP)with no employees other than the members or partners,are not required to carry work compensati insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this avit c submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also a sur to sign and date the affidavit. The•affidavit should be returned to the city or.town that the application for the or license is being requested;not the Department of Industrial Accidents. Should you have any questions regar ' the law or if you are required to obtain a workers' compensation policy,please call the Department at the listed below. Self-insured compmf=thould tarter their self-insurance license number on-the appropriate line. City or Town Offiudals . Please be sure that the affidavit is complete and printed egibly: The epartment has provided a space at the bottom •of�sffidaYat for you to fill out in the event the Offic of Ir vestli ` has to contact you regarding the applicant Please be sure to fill in the per�ieemc auumberwhi WM used as efereace number. Tn addition,an applicant that must submit multiple permit/license applications any given year,n only submit one affidavit indicating cuaent policy information(if necessary)and under"Job.Si Address"the applicantIto write"all locations in_T(city or town)."A copy,of the affidavit that has been o� ' stamped or marked byy or town may be provided to the applicant as proof that.a valid affidavit is on file future permits or liceusosw affdavit must be filled out each year.Where a biome owner a citizen is obtainin, license or permit notielaty business or commercial ventare (i.e. a dog license or permit to burn leaves etc.) 'd person is NOT required to comp a this affidavit The Office of Investigations would hike to you in.advance for your cooperation an. hould you have any questions, please do not hesitate to give us a call. The Department's address,telep and fax manber: Tie Commonweal of Massachusetts Department of Industrial Accidents Office of IRMftadw 600 Washiugtou Street Boston, MA 02111 Tel, #617-727-4900 ext 406 os 1-M-MASSAFE ' Fay.L 617-727-7749 R,vued 5-26-0S - — cowl 'a www.i`aass. d1 Town of Barnstable Pv°F TNE'�ti yw °T Regulatory Services Thomas F.Geiler,Director �pTfDMA�N. ,f Building]Division. Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner bust Complete and Sign This Section, If Using ABuilder 1, Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. J, 11011/ Address of Job) Sig ature of Owner Date Print Name Q:F0RMS:0WNERPEPdV MSION Town of Barnstable ptHE Regulatory Services Thomas F.Geiler,Director RASNSTABM • 9$ MAC Building Division 16;9. �0 'OIEv►�'�° 'Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PERMIT# Z Z FEE: $ SHED REGISTRATION 120 square feet or less 76" DL 7 ?OS-r- L 1v C—=�:cv Location of shed(address) Village OWK- GYlL rvfl F&IAl e? Le Z d' ST cc� L Property owner's name Telephone number Size of Shed Map/Parcel# Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 J M/ . � � 1 f f f ! MAP 172 � --_ f % _ T 116 66 7 1171( MAP 2 - 1 15A 17 E # 7 1 t f- J 15 �- # c:\conservation.dgn 3/28/2006 3:36:33 PM d�?... '�� �- /s - Assessor's map and lot:number ..: .... . 11"I f. Sy_E� b JIUS J: 3sq t; 3a_ 77- O �� ; � ./�', i INVALL ED IN COMOLIANCE WITHAR'- v c. fLESewage Permit pumber r, S iATE.UN � R CODE ANDTOWN ri p..i, All C,.:p r� i �F E-,G I.ATI( - - - - 'Q�o�TMEro�a: �r 7 TOWN, OF {BAR.'NSTABLE t o i 33ARISTSDLB, • g• .. raga c? �- DING INS PECT' PE T' R BUfL fl i > APPLICATION.FOR .PERMIT TO y ............................................ . ................. TYPE OF CONSTRUCTION ..............tm,a4r94!................. .......... ............. ................................. I . . ...... . .............19. TO THE INSPECTOR OF BUILDINGS: The. undersigne ereb '-applies for a permi cordi t the followin i for atiori: . _ _ _ . .. Locatio .� � . ProposedUse ... .. ....... .. . ........................................ .......... .... :.............................:....... ZoningDistrict .......................................... .......................Fire, District .......................... • ........................................... Name of Owner .. ... .... .....� . . ... ...... .........Address ....... Z. .......� .................... Name of Builder ..........r ............................ . ...................Address ............. .. .. ...... . ................ Nameof Architect ..................................................................Address .................................................................................... Numberof Ro s ...... ........ :...........................................Foundation ......loat ... t.... ,................................... Exterior. ..... :.... :. . ....y................................. .......ReoflrTg ......... j.... L �.�:...... ..::uc.ouwyioc. Floors ............... ...Interior .......... . &,... .... ............................................. -art Heating ..............................................Plumbing ......................... .... :............_. . ........................... Fireplace ......... ` ... . ......................Approximate Cost ...... .... ........ ............ ... .. Definitive Plan Approved by- Planning Board _______________________________1974 Area S' ............ . ......... Diagram of Lot and Building with Dimensions Fee !_ SUBJECT TO APPROVAL OF BOARD OF HEALTH f A q I hereby agree to conform to all the Rules and Regulations of the Town of Barnstz- z:; construction. Name ..... .... a I .,F A-172-115 Ajan,E. Small Mo .......�-g36, Permit;for;.: ie�ling. ................ ............................. . ....... L,$cation-....Loz.,, 2 I&............. Yuzpaat.La«,..Centesv111e.... . .•.. Owner ................Alan...E I.Small.'..................... , Type of Construction .......wood.........:....:........... Plot ...,A 17.2-315. ... Lot ................................ Permit Granted . . J.q1 .........11. Date of Inspection ... .. .... J.19 Date Completed ................19 ~PERMIT REFUSED .......................................x .................... 19 ............................................................................... .......................... ..................................... ....................... ...... ................................................ ............................................................................... Approved ................................................ 19 .................... .................................... ................. r I` 4 O 00 ' •�r M L G T zG © L- Mew Q WOOD 0 C- Al - O U T Po S-1` L P,,N t '� f} Cl={ZTlF1�D PLOT P�.lSt`1 C6iZTl1=-4 T14AT T141= ovhiDF.��oN Staawl i PL-A�► R�.�EiZ��JGE wr--eQoi,4 COMPLYS W 1TP THE 51DE.I.i►-�� 1_ T L-G Q.ua SETBACK VE-QUiiZENAE►-►TS bF TNT L . C.• 3 a 8, l � how►.l o� �3������` ��A�i_-G �,,J _ DATE B,a.XTEjZ � 1J�lE 1�►.iG.. REGISi'' -V-SD LA,Wr> SU?VC`(OV4g TW5 V L..AW IS LJOT BASED 01-4 AN " USTE9.VV IG- c� t/-1r+fASS� 114-5-re JA^ckJT SU2VE�{ THE OF�S�`S" S�aowW APPL.1 GANT A 1. /HIV C , rjM�,� �... t,JC>T eS USCo T-o De:TEZMrW& LoT LINES