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Home My WebLink About0100 STANLEY WAY ez) ay, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ' Map Parcel �b / /' INS`��LLE® Permit# PqJ Health Division 'fl UUITFI TITLE 5 Date Issued.-,-, A ENVIRONMENTAL CODE Conservation Division 'TOWN F3EGlJLATIONeer Tax Collector F , Treasurer ,. Planning Dept Date Definitive Plan Approved by Planning Board Historic=OKH Preservation/Hyannis ,,Project Street•Address t' ' ADD d r A14LY VAP 4 ' Villagei®f, /�dI/6 -Owner �� ai/ r Address Telephone ' S�� P2,6' IL Permit Request co 61-a G � f Square feet: 1st floor:existing proposed 2nd floor: existing proposed Total new Estimated Project Cost Z l4c�0/ Zoning District G Flood Plain ('� Groundwater Overlay x Construction Type a q r 2, r Lot Size Grandfathered: ❑Yes ZNo If yes, attach supporting documentation. Dwelling-Type: Single Family II Two Family ❑ .Multi-Family(#units) ~ Age of Existing Structure Z SYAP. Historic House: ❑Yes n No On Old King's Highway: ❑Yes C�N0 Basement Type: f/Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement UnfinishedArea(sq.ft) .Number of Baths: Full:existing D/I e�. new Half: existing 046 new -Number of Bedrooms: existing 7'&.,I0 new Total Room Count(not including baths): existing U new First Floor Room Count 1 L Heat Type and Fuel: U Ga ❑Oil ❑ Electric '❑Other Central Air: ❑Yes YNo Fireplaces: Existing 0I7e— New ,_ Existing wood/coal stove% ❑Yes ®'No ' Detached garage: ��❑��existing ❑new size d Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:Ildexisting ❑new size Shed:'❑existing ❑new size Other: Zoning Board of Appeals kuutho_rization ❑ Appeal# Recorded❑ s Commercial ❑Yes I/No ' If yes,site plan review# Current Use -Proposed Use ' BUILDER INFORMATION _ x n ' NameZzAol Telephone Number' S`��' e70/ Address % LOa644 A01)'Zly, License# GS o5��6"Z Z8 Home Improvement Contractor ,1- Worker's Compensation#ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOZ*_V/T.�/� SIGNATURE / DATE DZ D� FOR OFFICIAL USE ONLY _ PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: it .FOUNDATION'S FRAME,. INSULATION FIREPLACE-. ELECTRICAL:0 -ROUGH FINAL ro PLUMBING: E %ROUGH FINAL . f GAS: r. ROUGH FINAL FINAL BUILDING ► _ r _ DATE CLOSED OUT a ; ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office 811HY85 i908fts - 600 Washington Street Boston,oston Mass. 02111 Workers' Com ensation Insurance Affidavit %%%%//40y. name: ,/ IiY1e A A IL/1,0 a7 A. 01V-/ location / % dG1GL9/I1/r�✓1 f�l/� city l R?04/ /, 4 / /,A ' phone# ❑ I am a homeowner performing all work myself. I am a sole r netor and have no one worki>1 in any ca achy ❑ I am an employer providing workers'„compensation for my employees working on this job. :company name address::: . city a6one;# ;: insurance co. ❑ 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 tom any name,:::_: address:: . :... .; . ri # :. ...........:.. :::.........:.. :..:......... .:.:: .:: cv iesnrance co :.. cam any name> :;:. :>::, addressr ... in urance co. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I unde:stsnd that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties=_p at the information provided above is true and correct SignatureDate Print name �/G� !� . - Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑selectmen's Office (:]Health Department contact person: phone#; - ❑Other (towed 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the 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 Departmeii's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents office of Imlesugadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 V - °F THE A • '° The Town of Barnstable • snxxsTnat.e. Department of Health Safety and Environmental Services i°c 79' g A`� Buildin Division E 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: r�hs /J'G� Estimated Cost Z O Address of Work: ®/7 (T V� �A� Owner's Name: 441alii e -/mil^t Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 [—]Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date ctor Name Registration No. OR Date Owner's Name q:forms:Affidav t LOT 18 -140 LOT = "__ 3' , ~� o O _ _ • i LQ IF0 00 ' LOT 20 RES ZONE.- "RC" This MORTGAGE INSPECTION Plan is For FLOOD ZOlVE- "C" Bank Use Only TOWN: _CXjYTZ&Y -_ _ REGISTRY OWNER: VRRGffL4__A-_Q_0aJ.SFEZD DEED REF: ._201"5_9_ _ _ _ _BUYER: _L.AUEJZ LET _SCA_ _ DATE: 01 Z92 _ _ _ _ _ _ _ _ PLAN REF: 11811 — _ + ` LE:1"_ _20 FT. I HEREBY CERTIFY TO _F_0_R_SA VIN_G_S 'A_____ ________THAT THE BUILDING q OF SHOWN ON THIS PLAN I ERATED ON THE GROUND AS � . �s9c YA_NKEE SURVEY SHOWN AND THAT ITS POSITION DOES ____ CONFORM � J � CONSULTANTS TO THE ZONING LAW SETBACK REQUIREMENTS OF THE � E: iE1f 143 ROUTE 149 TOWN OF ��4& ABLE-------------AND THAT �� ado. 32{199 >; ' biAFSTONS MILLS, MA. 02648 IT DOES_NO_T_ LIE WITHIN THE SPECIAL FLOOD HAZARD ��` TEL: 428-0055 AREA AS SHOUNI ON THE H.U.D. MAP DATED 61_JJ1_ 5 _ C uni — el 250001 0008 C FAX: 420-5553 ____ THIS PLAN NOT MADE FROM AN INSTRUMENT C �H PLS _— SURVEY NOT TO BE USED FOR FENCES ETC. 8193 FA AUL A. . LOT 18 1V8� 45 4 o. 00 > r LOT 19. 3' SV _� - o� r 00 LOT 20 RES. Zo.14'E.• "RC" This .MORTGAGE INSPECTION Plan is For Bank Use Only FLOOD ZONE- »C" TOWN: _CZTF. 9 _ — - — _ _ REGISTRY OWNER: VIB_GffL __A.._GOODSPE._D DEED - REF: _2011/-259— _ — _ _ _BUYER: L�1�1Z HARD — _ _ _ _ _ DATE: 3/2�92 _ _ — _ _ _. _ _ PLAN REF; JL8,_15U _ _ _ - -SCALE:1"= 00—_FT. I HEREBY CERTIFY TO. IV $FFOFD_ USTITUTION___ ��'f _ T _FOR_SA V_IN_G_S ___------------THAT THE BUILDING � y ��'� �`� Aso YANKEE SURVEY SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS �� c A SHOWN AND THAT ITS POSITION DOES ---_ CONFORM � ,° CONSULTANTS TO THE ZONING LAW SETBACK REQUIREMENTS OF THE I�tEc;�'r� W 143 ROUTE 149 TOWN OF ---HAB ELTABL_L+_'____________—AND THAT a No. 32 MARSTONS MILLS, MA. 02648 IT DOES_N0_T_ LIE WITHIN THE SPECIAL FLOOD HAZARD �`T o h .t ' TEL- 428-0055 AREA AS SHOWN ON THE H,U.D. MAP DATED_6-�9��5 _ �,�';s,,` ^<<p; " FAX; 420-5553 C uni v—Panel 4250001 0008 C THIS PLAN NOT MAIZE FROM AN INSTRUMENT 8193 FA ?AUL A. M—&T2 PLS SURVEY NOT TO BE USED FOR FENCES ETC. �iFe -� q�✓�aaoarlu�oe� �" ' BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR NUm6�6S 058652 Birtldate-Otif 7/1952 Oti17/2002 Tr.no: 22642 a - Restricted Tee t^� � <�' TIMOTHY A WASHBURN� , 177 COACHMAN LRNE W BARNSTABLE, MA 02668 Administrator _7/e HE IHPROVEHENT CONTRACTOR Registration 130798 Expiration:04/24/2002 Type: OBA T. A. YASHBURN CO. TIhOTHY YASHBURN �OACHHAH LN. ADMINISTRATOR V. BARSTABL _ HA 02668 12,d Z,,o„ 4 f l +�ww1 �. } �.rr� •�` fir_ E• � 1 ' i h H 1 i i s • � i r rz to tl \v , sC Q i IF t r _ rr- ! > .: 0 PAW ,�