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HomeMy WebLinkAbout0325 SKUNKNET ROAD �� � � `��t 0 a x „ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1�� Parcel y Application Health Division ! ' J . AIN 1 Date Issued (o Conservation Division Application Fee Planning Dept. � v„ , ��� Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village Owner �A loe lae, ,611de Address Telephone Z 7/ Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type S , 77, Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ld" Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes , 3 o On Old King's Highway: ❑Yes 2-No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new I Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - - - Name � �� �r i, S�a �ol Telephone Number Address / �o'D Ae License # /dam /,!!g o Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO v SIGNATURE DATE FOR OFFICIAL USE ONLY ` APPLICATION# DATE ISSUED MAPJ PARCEL NO. ADDRESS VILLAGE . -OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION s FIREPLACE ELECTRICAL: ROUGH FINAL Y PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL FINAL BUILDING.. DATE,CLOSED OUT A ,OCIATION PLAN NO. _ z f 00,teoioos'Na, 120 PAIMCIPATIH6 mass save CONTRACTOR .uY!?as gxeuari tsnnrgv FI1i52ancV - I PERMIT AUTHORIZATION FORM owner of the property located,at: (Owner's Name, printed), 325 51wn1cx��t- mad Cenjcri 11 e MA 02651 (Property Street Address) (Citylrown) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Owners ignature Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor'to the above referenced project: Participating Contractor Date si Rev.12132011 f C.onser ation CERTIFICATE OF COMPLETION Services Group 50 Washington St.Suite 3000 Westborough,MA 01581 Katherine King Phone(Eve): 508-771-7588 325 Skunknet Rd Phone(Day): . 508-364-4420 Centerville, MA 02632-7117 E-Mail: kathyk0135@comcast.net SitelD: S00002230354 Combustion Safety Test Completed YIN Pre Blower Door# (If applicable) Post Blower Door# (if applicable) Contract ID:20140417_ASEAL Company: Cape Cod Insulation Sub-contractor Work Order#: S30354P35819C222 [Location Descri tion QuantitV Installed Door Sweep 2 Living Space Attic Stair Cover Thermal Barrier with carpentry 1 Living Space Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 10 Exterior Door Weather Stripping 2 Contract ID:20140417 WORK Sub-contractor Work Order#: S30354P35819C222 -Location- Attic Vent bath fan to roof flapper 1 Damming - 46 Attic Propavent 2'or 4' 66 Living Space Attic Floor Open Blow Cellulose 6" 937 Living Space Install 2"Thermal Barrier Polyiso On Kneewall 138 3y PLEASE NOTE:The Inspection of the house is for the purpose of finding CUSTOMER AUTHORIZATION OF CERTIFIED WORK out whether the Contractor completed the work. I confirm that the measures listed above have been completed to my CUSTOMER SHOULD NOT RELY ON THE INSPECTION FOR satisfaction. I have received a copy of the Certificate of Completion and ASSURANCE THAT THE CONTRACTOR'S WORK NECESSARILY hereby authorize the release of any final payments to the Contractor. 1 COMPLIES WITH ALL LAWS AND STANDARDS RELATED TO understand that this Authorization of Completed Work does not in any SAFETY. manner void any warranties provided to me by the Contractor. It was the Contractor's sole responsibilty to assure that the measures were installed properly and safely. In addition, this Post-Installation Inspection does not replace inspections by licensed inspectors where required by state or local law. It is the duty of the Customer to obtain such required inspections. Contractor's Signature Customer's Signature Date Date Conservation Services Group-50 Washington Street Suite 3000-Westborough, MA 01581 -(508)836-9500 The Co,nryrutr'vealth oj*lllassachusetts i laeparrineht of lttdusrrral cGiderrts i' OVICe,of lrtvesligatxorxy' I i 600 Kshington Street Boston, MA 02111 wrvw.1nass.gov/dia 1F ur i;c ra' �uttrliy�c r� tic�r� 111suf once Affidavit: Butilders/Coal racto-rs/:EIect riciakkslPItill, sbex, )l'`Y�=�1st".1�'ri:t.at 1.,e�illly .._. :t �r :)� �/�.:-, ,•1�C( �Yi ,�t Phone#` W- 1 ,wit'k ua-et ployei.? Check the ap'propriatebox:Culployer with. 4 [] I ilnl d�eucral cuatractar acid I . p'Yp� of pro t (r equlred):: _ .LJACJat part-ti.rne).* have.hired the sub-contractors 6. [] Now consta-ttutiau ' proprtctor ol;- PZLM-tier- listed on the attached sheet, 7. [] lit rx odelirab ;I11i)Gild 114vG tlU Cll]plUyC:CGs- These sub-contractors have -pc:CClQl.lt30[1 . . � wutl�utg fur 111c iu. iuly ,capacity, employees tend have workrs e ' �• ' i camp. insu,rance.i `� ❑ Building addition (^ru WUrltcrl'9 t J111 P. t.nJllrarlL'C yulr�d.J .5. 'We ar�a corporation and its l(y.❑ Electrical rcptttrs(it addltlut]y din a humc.owner dcaing all `vork officers have exercised than l 0 Pliunbulg repairs or uddtt,ons [No workers' comp, right of exc,nptiou per.NiGL „surut,�c rcquirdd.) .t c. 152, §1(4),and wC have no 12 (� RuUf repztirs ;.-�� I u:n u hatrtcowucr acre]Y t]_Y aOther.,,/ ' 1, employees. [No workers' i 3.� ,�� �cnctul t'unuactc�r (t'�icsr tO �4) k t comp,instuance requircd,j . jl)1)I,i.t111 Ulat L:hCr l A WX t#'1 MUSS alb{) till Ottt ChC 9CCR0n below Showing[tictrwotkcn,cou,pcDU40dpolicy infamlation, :,Uu,wl�u1-,]why sut,ruit tttix uffut4vit 61weating they ure doing all work,ittd then hire outside conwracton must submit a new 11014Lavit iuilicatir_,g.yucb.thin box roust urtachcd au uckiitiuuul sheet showlny the name of the xttbK outr,utaa suet Stew whatttcr qc u«t those enlitica tiavc rpI VCCN Il u,c jutr:wnruCrurs havc Crntat0ycc5, thcy must provide their workrrs'comp:policy uumbcr. i .-m urn r,rtployer that is pro viding'workers compensation insurance fur my employeax is axe policy until jab a'itc - nsu,aucc lrXpit`drlgll Date; ,,n .`ilr CityfStatezip: cupy of rite ►vurkcry' corxrpeusation policy dMaration,page(showing the polley'number amid expiration date). w jC%tLUQ I"Ycrztg;c as rcgUirtd ilmler Section 25A of MGL e. 152 can lead to the unp'Qsitiotj of cLisl blal picUalti�3 of a it ul;to S 1,00.00 and/or cane-year imprisonment,, as well as civil pcaaltica'iu the form of a STOP WOPK ORllLR and a tine ,i.,p,u +,2i0.00 a Clay abaInst the violator. Bc advised that a copy of this statement may be forwarded to the Office of t«�sn'Satious of tic QIA, for i.mILa ncc cover-age Verification. tlu ncrcby t'criiv�ana`er tine ixir (xrru'pertltx of perjury that the infarttrattarr provided above is;truc and correct: i `, s` tfIt"6c/arc wily. Do ixo[ write in this area, to be compleietl'by city or torvn official, r - fi , t irti',,, i" r.rr: .-._.....___- « Perruit/Liceme# Imaj,g.-rutlrurlry (Circ le oue): y — - --- l. xN of lieulrft 2, Bulildirrg Depurtment 3. City o'w' u Clerk a. EIectrical Inspector 5. Plumbing fimpect0f, o. 'Other r Phone : Massachusetts -Depaftn4rit of Public Safety hoard of Building Regulaf oris�0 Standards Construction Supervisor License: CS-100.988 � HENRY E CASSIDY' 8 SHED ROW , WEST YARMOiFI'H MA 02 >I ni _ Expiration Commissioner 11/11/2015 ` s Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 n Boston, Massachusetts 02116 d Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation . Expiration: 12/15/2014 Tr# 233831 CAPE COD INSULATION, INC t � HENRY CASSIDY ¢�i _ f 18 REARDON CIRCLE , ` $ �" WE SO. YARMOUTH MA 02664 `Update Address and"return card.Mark reason for change. SCA 1 Co 20M-05/11 Address 0 Renewal. Employment Lost Card Vhe�po�rr�rndretuetcCCl o��lczadac�uAeC�" � Office of Consumer Affairs&Business Regulation License or registration valid for individul Use only Ox'VOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: gistration le 53567 Type:_ Office of Consumer Affairs and Business Regulation piration 1211t 01-4 Private Corporation' 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATI,QN 311-1 SING tcx £ i HENRY CASSIDY 18 REARDON CIRCLE ' SO.YARMOUTH,MA 026i 4. Undersecretary of val witho t sifnat&e ` i j CAPECOD-27 CVANGELDER DATE(MWDDIYYYY) �.� CERTIFICATE OF LIABILITY INSURANCE 4/1/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS j 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 Rogers&Gray insurance Agency,Inc. PHONE Cape Cod Commercial 434 Rte 134 fAIC,No.Exn: (/uc�No):(877)816-2156 South Dennis,MA 02660 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC A INSURER A:Peerless Insurance Company INSURED - INSURER 8:COMMERCE INSURANCE COMPANY Cape Cod Insulation Inc INSURER C:Evanston Insurance Company 18 Reardon Circle INSURERD:ATLANTIC CHARTER INSURANCE GROUP _ South Yarmouth,MA 02664 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 CONTRACT OR 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. POLICY EFFFF POLICY EXP — — LTR I TYPE OF INSURANCE INSQ POLICY NUMBER iMMIDDIYYYY MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE ��OCCUR CBP8263063 04/0112014 04/01/2015 TVAGFTOhERTED 100,000 PREMISES Ea occurrence $ -- �..... MED EXP(Any one person) $ 5,000 - PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE__ $_ 2,000,000 X POLICY(( PRO- _ t ^I JECT 0 LOC PRODUCTS-COMP/OP AGG $ _ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident) B ( ANY AU10 _ 14MMBCKVMK 04/01/2014 04/01/2015 BODILY INJURY(Per person) $ ALL OWNED _X SCHEDULED AUTOS AUTOS BODILY INJURY(Par accident) $ 1,000,00 _ C NON-OWNED PROPERTY DAMAGE I X HIRED AUTOS X AUTOS Per accident) $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 C EXCESS LIAB CLAIMS-MADE R/O XONJ453512 04/0112014 04/01/2015 AGGREGATE _ $ DED X I'RE r`ENTION$ 10,000 Aggregate $ 1,000,00 WORKERS COMPENSATION STATUTE PER _ER _____ AND EMPLOYERS'LIABILITY - D ANY PROPRIETOR/PARTNER/EXECUTIVE YIN WCA00525904 06/30/2013 06/30/2014 E.L.EACH ACCIDENT ^ $ 1,000,00 N� OFFICER/MEMBER EXCLUDED? NIA --- --------- ' (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 It as,aesariba under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000. . I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Workers Compensation includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EVIDENCE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved'.' ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 21131oY, �ppTME Town of Barnstable *Permit# Fxpireonths from issue date BARNSrABLE, : Regulatory Services Fee MASS Thomas F.Geiler,Director t 3 FD MA't Building Division Peter F.DiMatteo, Building Commissioner *1JPRESS PERMIT 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 , 4; Fax: 508-790-6230 � � E EXPRESS PERMIT APPLICATION RESIDENTIAL j Not Valid without Red X-Press imprint Map/parcel NumberCIO WN Property Address n J ('L(A yik'in k c�a ��-liL �(U L 0?_(va 2. Residential Value of Work 40 an an Owner's Name&Address a KGB_ I r/ A ! S e r 771 ° :Z5MA 32.5 `73 kCCta`2G a_ R0. C,0_u e%-V L(\e OIL&J 2— Contractor's Name � C� I� A V1l'a= Telephone Number Sb A 3 7& Home Improvement Contractor License#(if applicable) (LL—Zq 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 NameU�rJ�� `� ��C>l/st�✓t. �`(,L Gt C 1 �, , Workman's Comp.Policy# Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows. U-Value ®• 28 (maximum.44) �►"� 4 S/-�e / �e�Cvl ctobh BT �3Cl�rt "WC, 1�t61�►1.fG. ©ulvbiir ❑ Other(specify) 1 c,,n J6. o$- Q a t Cd . *where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature Q:Forms:expmtrg Revised121901 • 19: . VASCO NUNEZ CARPENTRY 79 Mayfair d.it-R _ SOUTH DENNIS, MA 02660 MA Lic. #069680 H.I.C..#124793 (866)398-1511 • Toll Free (508) 3984511 • Dennis, MA PHONE DATE_- TO: Ms. Kathy King . 508-771-75.88`. 10/11/20fl.4 325 5kunknet Rd. . ,J68 NAME,l=O ATJQN Centerville MA 02632 Replacement.windoias JOB NUMt3ER JPB PRONE 7588 508-7 60 7111 , 1.Remove one aluminum 6'slider from kitchen dining area, and install: one Andersen 6' - "" frenchwood gliding door in same location. New door will have white exterior with white interior, white hardware, white screen, and prefinished white grilles. 2.Remove six wooden double -hung windows, ( 1 picture window, 1 double mullion window, and 4 single double hung windows ) . Replace with Andersen double hung and picture windows. New windows will have white vinyl exterior with prefinished white interior, white hardware, white screens, and 6/6 preLfinished grilles. -. 3.Supply interior/exterior trim and framing materials where needed, per conversation of description of interior/exterior trims to be used. 4.Supply town building permit. 5.Take all old windows and debris from this job to town landfill. �- ( Cal!( tQ,(_ 6.Make arrangeme4 for delivery of new Andersen products described above. * This proposal does not include any painting or staining. * All Andersen products described above 'will be prepaid by owner. . ** If this proposal is satisfactory, please sign the YELLOW copy and 'return with payment schedule. i 'WE PRO POSE hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: Four Thousand Two Hundred Eighty and 00/100 Dollars dollars($ 4,280.00 ). Payment to be made as follows: 50% Down payment to start, at time of start. . . . . . . . . . . .. . . . . . . . . . . . . . . . ... .$2140.00 50% Upon completion, at time of completion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$2140.00 All material is guaranteed to be as specified.AH work to be completed in a professional manner according to standard practices_Any alteration or deviation from above speafications Authorizedell <,�involving extra costs will be executed only upon written orders,and will become an extra Signature /a zi charge up M cha over and above the estimate.All agreements contingent on stnlm%accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.our Note:This proposal may be workers are fully covered by workers Compensation insurance. withdrawn by us if not accepted within 30 days ACCEPTANCE OF PROPOSAL—The above prices. specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the�work as specified.Payment will be made as outlined above. )l(.9nature Kateof A tance: 04-O ber (7 • Zoo+ ---, Signature PRODUCT 13128T FOLD AT Id TO Fr COMPAtdiON 771 OU{?YUE BVELOPE. PRINTED iN U.SA B Q --- - The Commonwealth of Massachuseta _ Department of Industrial Accidents ' -, OBiCBOf►08dOB8 600 Washington Street, 7M Floor Boston,Mass 02111 Workers'Co m nsation Insurance Affidavit:Boil lumbin lectrical Contractors name A address✓`-.i!Y I f f t/' Rr� city C9 . state• (n�— zi 1 p -Z(d{p� � Rhone 4A ` 0 /5 v , work site location(full addrees)• ❑.I am a homeowner performing all work myself. Project Type: ❑New Construction[]Remodel Dir I aim a sole proprietor and have no one working in any capacity. D Building Addition ❑ I am an employer providing workers'oompatsation for my employees working on this job. Join eotn ra'n`i� 14 Add[a 4 _I.Y 1 C(J-& (d( /g Cfity: %1�11 m - 7(11 f d niione#• �`��� � Y> �l nrance.4�0. I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers'compensation polices: a - - cdty phone#• Di mpaiiv mate• - _ •Av '•1 i' 1Fi387f1'L'` m .a° �•irireas ".• CIS�:v. .'r*aa,,:..::»,�+i•q,o-'ri::,,`-:,�-,n:.•,.�c';�; Failure to secure coverage as required under Section 25A of muL 152 can lead to the imposition of criminal penalties of a tine ail to$1,500.00 and/or one years'imprisonment as wen 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 stat6inent may be forwarded to the Office of Investigations of the DIA for coverage vertlication. I do hereby cert fy under the pains n, enalties ofperjirry that the information provided above is true and correct. Signature Date f2�10� Print name 0-3 ,rt OtA(A Phone# Him r[01 7checkff do not write in this area to be completed by city or town oflldal town: permit/license# []Building Department ediate response is required (]Licensing Board Selectmen s Oilice []Health Department contact person: phone#; []Om (revised sort zoo3l Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their q employees. As uoted 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 engagedin 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;havmg not mor e than three apartments and who resides therein,or the occupant of the dwelling house of another who er#ploys 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. lion 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 � p 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. 011111 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 permit/license number which will be 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 like 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 Office of Invesugotlens 600 Washington Street,7`h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617)727-4900 ext. 406 i ✓fie -�omvrreoruve¢�i-�./�aaac�cc�ivaelta BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 069680 Birthdate::10/03/1948 Expires: 10/03/2006 Tr.no: 2545.0 - Restricted:. 1 G VASCO E NUNU ill 79 MAYFAIR RD G S DENNIS, MA 02660 Commissioner ✓tze �a�n�rwruue.��tl� cj�.flar:r:«•�r.,:elta Board of Building Regulations and Standards r- gj HOME IMPROVEMENT CONTRACTOR � Registration: 124793 Expiration: 8/25/2005 Type: Individual Vasco E.Nunez,III Vasco Nunez,III 79 Mayfair Rd. � S.Dennis,VA 02660 Administrator h I Assessor's map and-lot number ..... ..9�........1.,,��/...... ��- } t y FTHETO� Sewage ;Permit number . f Z EAU9'T"1IILE. i House number ....................................................................... 9 I$"& �p 039. \00 'Ep yAY f►• TOWN OF BARN.STABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........................... �,........ t ....... ...................................................... TYPE OF CONSTRUCTION ............................G�Od .............. iF'f1 .......................................................... . t �-p `• Ci ..... ............19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the' following information: Location ...... ., � l-• 7 ..... i!� 1. '��". !.................................................. ................................... ProposedUse ................ �� /if/G/................................................................................................................................ Zoning District .................1 ............................................Fire District ...................C___0 ..................................................... Name of Owner SLS ��Q(�5 •.• .Address �Q��.ra....�! �T S........................ ... ..... ......................... ................. . ........................................................ Name of Builder ...... (566L /SQLlaws 00r(leL•Address:.......................5� A� Name of Architect .......... . .:..........Address Number of Rooms ........�..... ... --TR�....Foundation .................... !. �.......................... Exterior ........................5 .� 9�s.....................................Roofing ............................... Floors ......................�..... (Jr..............................................Interior .S .TA{Ilr.t i'Heating- -.. ............. .�.................... .................. ` ......:Plumbing'..-..',... ...... ... %c /�QP r�z:..:..:..a...:/' Fireplace .................... ..rl...................... ...............................Approximate. Cost ..................... . ................................. Definitive Plan Approved by Planning Board -------------19E -. Area .......................................... Diagram of Lot and Building with Dimensions Fee. ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable r garding he above construction. Name . ...:. .... .. .. �...�.,,,.............`.. .. ' Construction Su rvisor's License S L S TRUST A=171 22 No ... Permit for ......One...StM.......... ...........5.ingle...Fqmi.1v..Dw.e.11iP.&................... ........ ........ ... .... . ...... Location .....LP.t..it 2.7........32��...$ku.nkne.t...Road C..................... .Q.0 P.K.V.:L I 1-.P................................... Owner ........S...L...S.....Tru.s.t................................. Type of Construction Fr.4jftq-,.............................. ................................................................................ Plot 'at June . ..............19 86 Permit Granted ....................11...... Date of Inspection ....................................19 Date Completed ......................................19 111197 Assessor's map and lot HumberTV IN E SYSTEM TIC Sewage Permit number .................. LLE® ICI COMPLI ♦�I`� STA WITH TITLE � STABLE. House number ........ 3 z ........A, a, /p papa (��y� /y 5 rasa f 1R0A116*EN 1 AL ccor D� 9O t639. � s '�119�1f. 9 OYPYa' TOWN OF; BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO //L� ........................... ...............:.......... TYPE OF CONSTRUCTION GOQ ............ ......................................................... 4�.��.�1 f��`1�.....1 ...........19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... � ...:. ........................................ ................................... ProposedUse ............... ..�.. .7......................................................................................................I......................... Zoning District .................j � .............................................Fire District C-0 Name of Owner 5 .L.eQr �.............................Address .............. .Q�Q...teDI ..t!R.....�!. �N&�5........... ....... Name of Builder ...... cQ�L/SQGIs A� �L6�(r�E / .. ...... ..... ......Address .................................................................................... Name of Architect .. 5 f`� � L Address r�� 19A....... Uy"�/P�� Number of Rooms .... � rb .`. Foundation / �die� ...C. ! ,.. �6.J_�x.. �„_���•�...-hl'�L 1 ..................................... w Exierior � Roofingr�..... ........................ Floors ....................../.;�/..XY.GI`-!........................................Interior ................ ....���Q��.................... g Plumbing ,Heatin '...`. �/ 4 QP�C l�................................. Fireplace ................. .....................................................Approximate Cost ....................: . .... ................ Definitive Plan Approved by Planning Board --, G ------- r----19 C. Area/....... ................................ o Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of 41B,,arnstable r arding he above construction. Name ....................... Construction Supervisor's License Cam'/..�1.�... „�.... ��S L S TRUST- No ....29.4.8.9.. Permit for ..jgne... .............. % Single Family Dwelline.................... Single .................... A Location ......3.2.5....Sk.u.nkn.e.t...Road _ Centerville ................................................................................. Owner .......S L S Trust Type of Construction .............Frame............................. .......................................................................... Plot ............................ Lot ................................ P4rmit.Granted ... ................19 86 (� Inspection Date of ..... .. .........:)'9 Dot Completed ...... .........19&� r ti SP ofYxE�. TOWN OF BARNSTABLE Permit No. ..29489....... BUILDING DEPARTMENT :a. I TOWN OFFICE BUILDING Cash HYANNIS,MASS.02601 Bond X.. �t%��Iv CERTIFICATE OF USE AND OCCUPANCY Issued to S L S Trust Address Lot #27, 325 Skunknet Road Centerville, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. September 29, 19 86 � ^- •- . ............ .... Building Inspector `�..�•.� TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING ' rya HYANNIS, MASS. 02601 �o r�r►' MEMO TO: Town Clerk FROM: Building Department DATE: ✓ G� ��d An Occupancy Permit has been issued for the building authorized by BuildingPermit #............°��.....2. /..................................................................................................................................................... _. issued to `4� ......_ S o� ..... �a �...� .` . ,.¢i�.�.r��/....9-c Please release the performance bond. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M A�C(, I DATA t .. .. �!��«.�••,- 'sue +'� €4.'.- ,iks:.. 1.4��C�fr^ n�, a '�'+ �«3'.�. �^- y:q".. ' .x • UILD: NG d TOWN OF BARNSTABLE, MASSACHUSETTS ERMIT Eti 17i-:'? 1 JOB WEATHER CARD s,V 9 DATE _..1. 19 t;0 PERMIT NO s `� ta` 2¢ 4 89. . .�.. Fa .`..' T(.� .I.t ws :I%V t'10.!`eI / s.l i 11y ...1 [ APPLICANT ADDRESS JZ: l�l)U L< 1 . ,i, .s..l+, l ( (NO.) (STREET) - (CONTR'S LICENSE) PERMIT TO LSu id dwe' I:1[?S' i �1±'i �_E; ieilIlll� l"� ' v NUMBER OF 7 j. STORY g DWELLING UNITS " j - (TYPE OF IMPROVEMENT) NO. - (PROPOSED USE) - 4 ZONING AT (LOCATION) !or ffc 7 �1_S EJ{ilF Iti 1 r.J:7C�s Vi Iti E�`•li; '... DISTRICT IN0.) (STREET) € at BETWEEN AND (CROSS STREET) (CROSS STREET) " I LOT j SUBDIVISION LOT BLOCK SIZE f BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION I I TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION j . (TYPE) REMARKS: { is AREA OR ].464 `..,i7 VOLUME x. f t. 5[3; �Cill PERMIT �f. .<.)(; ' ESTIMATED COST FEE (CUBIC/SQUARE FEET) { i OWNER S S Trust i I •koute 2 i:{ �i BUILDING DEPT. I 'ADDRESSBY f f c`1P[a15 r a".q ✓ ,' r .. THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE"BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THISPERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF.YANY APPLICABLE SUBDIVISION RESTRICTIONS. - MINIMUM OF THREE CALL INSPECTIONS APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE NSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ALL CONSTRUCTION WORK: PERMITS ARE REQUIRED FORELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANC Y IS RE- MECHANICAL INSTAL LATIONS. ' 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL• MEMBERS(READY TO LATH 3. FINAL INSPECTION BEFOREE FINAL INSPECTION HAS BEEN MADE. � OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET ` BUILDING INSPECTI N 0P,ROVALS PLUMBING INSPECTjqN APPROVALS ELECTRICAL INSPECTION APPROVALS ti? e � U 1 cG 2 ... 2 2 � — j 3 Cj HEATING 'NSPECTING APPR VALS RE I LS / 1 I i RING ..- de i 2 RD OF HEALTH x 612 � 86 { i ''WCRK SnALL NCT PROCEED UNTIL THE PERMIT WILL BECOME NULL AND`YOID IF CONSTRUCTION iNSPECTIJNS IN.NCATED ON TH!S CARD NSPECTCR -iAS APPROVED 'HE 'iAR'OUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEI E STAGES OF CONSTRUCTION. - OR WRITTEN pE.RMI T.IS ISSUED AS NOTED ABOVE.- NOTIFICATION. .Lot 2 ps /LOT -Z e; .99 e . e - �� ti� SOT 2lL •6t N p41. ... A JOB # 85-420 CEP TIFIED PLOT PLAN PREPARED -FOR: - _ Loca_TION:_-` -_LO-T-.27__.SKUNKNET-- RD_ _CV-I-LLE - ___ _--. __- - -_---------- .---- -_ - - SCALE: I =40 ' DATE: 06/02/86 REFERENCE: - - _ - PB 403 PG 27 --_. -- - LEBEL-SOL lS OF MAs� RN I HEREBY CERTIFY THAT THE• BUILDING A Er SHOWN ON THIS PLAN IS LOCATED ON THE OJALA y GROUND- AS SHOWN HEREON- - -_...-... - -. - _ . _ o No:26348.. . Q 90�� 9FCISTER�� J� down cape engineering t LAND SJ0 n---CIVIL--ENGINEERS LAND SURVEYORS #�� t '` ROUTE 6A YARMOUTH MA DATE PEG. LAND S VEYOR i