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HomeMy WebLinkAbout0018 VALLEY BROOK ROAD "Ig UI,'�;4 k4 I"WAL Ar"),g c J�140 WMIANW1 long of "w A lei 01 Ng OWN, MIN of mvwl""Px� TJX 10 I if MIJ WIN j WA .jv. Mot—w-1 V iq Rf`4` Ing RA a IRV synxImmr swww1w I`W f �qp I"TI, "1 111"'., q mU jg 'A. 4 low wavgp M�&G, a KV tl�"'ru" Mow p1m, VAN mow oil.� gy, F" 11� A;-Swu 4-1- 'INV MOW, �,py M -xm CAR QQ"Ii lot out -1 Alf L31!URGY, P ,mylki, is 31f 15%syp"My boom -0 OZ. t� sk Emu 14100 M,!Z71"W": T�B wf v ic M All �mg- 111KA 4,jal Mks sfi�l TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map77 6 P-ar s Application# Health Division 014 Conservation Division Permit# Tax Collector Date Issued Treasurer Application Fee co Planning Dept. Permit Fee 430.00XZ. Date Definitive Plan Approved by Planning Board WR.k 43S ea Historic-OKH Preservation/Hyannis Project Street Address 11 truok fao.A Village _Lee,,,�fir,li Owner kA V een� Address R 14dl f,A j .Telephone Permit Request�� Ace-4 xmz> etk.,,z> S/ ®f "ioth 04, FX j 4;-q, �F � Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project ValuationA C ®00 O0 Construction Type rL-ot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ® Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑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 Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat TypeJGas and Fuel: ❑ ❑ ❑Oil Electric Other J Central Air: ❑Yes ❑No Fireplaces: Existing 1 New Existing wood/coal stove: ❑Yes 0 No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size d Attached garage:O existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization -❑ .-Appeal# ---<= Recorded-❑ TCo Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use +� C.BUILDER-INFORMATION f Name i tCi re Telephone Number 5-D Y- -17 l— 7 V Address 1% License# �9M�r rtnlle, IaA &cp 3 2 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE�.. � J DATE b(f1�.�oto C ' � FOR OFFICIAL USE ONLY , r PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: , FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. �\ iI1Y VVIIIII/VI/IiVN/N/ � �/J I/r�wr.-Nrr//r 1 Department oflndustrid Accidents Office of Investigations 600 Washington Street • Boston, MA 02II1 www mass gov/dia, Workers' Compensation Insurance Affidavit;Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly. `Name pushess/0rpnizationandividup: l �- Address: �:� U City/State/Zip: • V DI Z Phone M. 5 6 7� 1 '3 21 t a Are you an employer? Check the'appropriate ox: Type of project'(regnirecl): 1,❑ I am a employer with 44 -=Z am-a general'contractnr snd I- 6, ❑New construction employees(fall and/or part time)* havch�rcd,tho sub=contract i� 2.❑ I am a sole proprietor or Partner- listed on the attached sheet t 7. ❑ Remodeling ship and have no employees f t` These sub-cautractors have SR ❑ De Hdon working forme in any capacity. workers' comp.insurance. 9. ❑ Building addition Mo workers' Comp.in=mce• 5. ❑We are a corpgsation and its trl q= officers have exercised their 10.❑ Elccical repairs or additions 3. -I-am`a-ho tom g-aU work At of exemption per MGL 11.0 Pb=bmg repass or additions '-myself:[Nonworkers'c0* e. 152,§1(4),and we Iwo no 12.❑Roaf tepeesZ. insnrancc=cquue&]41`: employees.[Nowo&M, MED O@ier camp,aisuiance required.] *Any applicant that checha box#1 amst also fill out the section below showing thair work='oompensatioa policyinfcrmatioV t H=eowncn who submit this a&davh mdicatiag they are doing an work andthen}rite outside coatmctors mot submit anew a$davit indicstiag such tcoatractvss that check this box sent attached as additional sheet showing the acme of the sub•c ontrai t m and their workers'camp,policy b fornuficrn. r am an employer that is providing workers'compensation insurance for.my employee& Below is the.Policy an4.t0b site. information. In&Eco Company Name: Policy;or�lf�a.Lic.� .�ai�: Job Site Address: City/5tate/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secvre-coverage as required under Section 25A of MGL c. 152 uai lead to the imposition of criminal penalties of a fine up to$1,500,.00 and/or one-year Ituprismanmt as well as civD penalties is the.fum 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 statemmt maybe forwarded to the Office of Investigations of the DIA for fiance coverage verification. I do hereby cet under the pains and penalties of pedury that the information provided ab a is a and correct �z G� Phone#: Ioffici,4,1 use VM4. Do i htlft tea,to cat City orTowm: I'ernft/License# Dsuing AuthoM(circle one)., 1..Bozrd of B.e0th 2.Building Department 3.City/Town Clerk a.Electrical inspector 5,Plumbing Inspector 6.¢ther Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to providevmrkeW compensationforlbeir employees. Pursuant to this statute, an employee is defined as"...every parson in the service of another under any contract of hire, express or implied,.6w or written." ; An employer is defined as 'an individual,partnership,association,corporation or other legal entity,or any two or zaore of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,dr the . receiver or trustee of an individual,parm,ership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartvneirts and who resides therein, or the occupant of the ' dwellinghouse of another who employs persons to do maintenance, construction or-repair work=mch ftelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed tobe an employer.-- MGL chapter 152, 125C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license.or permit to operate it business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coYerage required" Additionally,MGL Chapter 152,125C(7)states-Neither The commonwealth nor any of its political subdivisions shall cater into any contract for the performance of public work until acceptable evidence of conliance with the insurance requir=errts of this chapter have been presented to the contracting authority." Applicants Pima IM out the workers'compensation affidavit completely,by chediing the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone numiber(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or-Limited Liability PartaerAips(LLP)with no employees other than the members or partaws, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign Cad date the affidavit. The•affidavit should be riimned to the*or.town that the application for the permit or license is being requested,'not the-Departmea-of Industrial Accidents. Should you have say questions regarding the law or if you are required to obtain it workers' Compensatimpolicy,•please can the Department at the number End below. Self-insured eompauiesaoffida;aber their self ice license number on•the appropriate line. City or Town 0171dals . Please be sure that the aidavit is complete and printed legibly: The Department has provided a space at The bottom. ofti davit for you to fill ont.in,ft eve the Office of Invesd a ti has to contact you mgnding-the.applicant - Please be sure to Min fhe pmn itTlccme atmiber which wM be used as a reference amber. In addition,'an applicant thatrrmst submitmuttiple Permit/liccnse applications in any given year,need only submit one affidavit indicating current " e lieaut should write"all locations in sty or oli information(if necessary)and under Jah 5�te Address the app �..,._( F cy town)."A copy of The affidavit that has been olficiaIly stamped or marked by the city or town maybe provided to the applieantas proof tbat•a yalid 4davit is on file for future permits or licenses. Anew affidavit mustbe filled out each ' year.-Where a home owner or citizen is obtaining a license w permit notrelated to any business or commercial ventage (!.a, a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Imrestigations would like to thank you in advance for your cooperation and should you have,any questions, please do notbesitate to give us a call. The Department's address,telephone and fax=Mber: 'Ile Commonwealth of Massachusetts Depzrrtmmt of Ihdustrial.Accidents wfice nf In 600 Washington Street Boston,IviA 02111 Tel.#617-727-4900 ad 406 os 1 077 MASSAFL ' Fax#617-727-7749 Revised 5-26-05 wwv.azss.gov/dia °FTMETpy, Town of Barnstable ti Regulatory Services • snxxsTnaLE, « MASS. $ Thomas F.Geiler,Director �ArF1 MA.Sa10 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 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. _10 ype of Work: l X+� ��'�c ;a _Estimated Cost. `!j`d dd_ Address;of;Tork IS 1/,4Ar'i T?rv® k ROA?� f!'�,.��-es-u;�L Owner's Name: � CJ Tate_o`"f A p ication: I hereby,cent fy-hat: 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 rz 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 Contractor Signature Registration No. -0�o ►l Date �.- Owner s_Signa e Q:wpfiles.forms:homeaffidav Rev: 060606 Town of Barnstable Regulatory Services sAxtasTABr E, ; Thomas F.Geiler,Director 9 MASS. g 59. A�� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 • www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 6°4�,°9 006 JOB LOCATION: M CFA4erVi 1�' number street village "HOMEOWNER": jj'%jQ irll V j ere c_ S '111-527k 5b8"7"71"S`lOv name �d home phone#\ work phone# CURRENT MAILING ADDRESS: ec4,tXe,4-jitic 04A o2t-3 z_ city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units.or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-familydwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. —94a�m V. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner'performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons.-In this case,our Board cannot proceed against the unlicensed personas it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the pen-nit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt 0 V l 9 16, y n/�v,I V r � , yP �► 2.2 � N % c! 1y. , 'vp. . 790 5o"38G --� oe 57. 59 N 79°5 "0'3a v 07 tq s � 97 `r l yLnkus CERTIFIED P,! t IN �7N 3 y° 7 w"rq • tr - ' SCALE$ �o- .l of �`� I CERTIFY THAT ENG1 �' Gl.1NT k�o ,� ROBER7 �s SHOWN ON THIS -I � Tf�tED 'fin. ,i L01gTER , ' 5'/0 � ELDRIDG[ y ON THE GROUND A; LAND 1 };, `, � No. �sau7 �a CONFORMS TO THE E 41NE{ER b ; SURVEYOR QR,OY!;` �E♦CrStEp,4 � OF 84s7Mc,6 �. N 'STRE9T, Y:e,N'Il lS�< MASS. -- The Commonwealth of'Massachusetts Department of Industrial Accidents A W Office of Investigations 600 Washington Street Boston, M4 02111 www rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibly Name (Business/Organization/Individual): Address: - 3600 RT 0M —7 - City/State/Zip: 71- /VfA iw4 Phone#: 508 190-06 iQ Are you an employer? Check the-appropriate box: Type of project(required): 1.❑ 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 sale proprietor or partner- listed on the attached sheet t ❑ Remodeling ship and have no employees These sub-contractors have 8: ❑ Demolition working for me in any capacity. workers' comp.insurance. 9• ❑ Building addition [No workers' comp. insurance 5• ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 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. rOther Ex a � RSeAp comp.insurance requird] l *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContractcrs that cbeck this box must attached an additional sheet showing the name of the sub-contractors and their wormers'comp.policy information. I am an employer that is providing workers'compensatdon litsurance for my employees. Below is the policy andjob site information. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: l8 ald llF y �Vo X 9D . City/State/Zip: Cei14C1_V1__r 0 R 63ve 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 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 the pains and penalties of perjury that the information provided above is true and correct Sienature: �� ®�� Date: Phone#: od Official use only. Do not write in this area,to be completed by city or town officinal. I 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 I 6.Other 1 Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, 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, §25C(6)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,MGL chapter 152, §25C(7)states"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 out the workers' compensation affidavit-completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit 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 retained 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials . 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. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your 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 off ce of Investigations 600 Washington Street Boston, IAA 02111 Tel. `617-727-4900 ext 406 or 1-877-MASSAFE Fax #617-727-7749 Revised 5-26-05 www.mass.gov/cia On■■■■ ■■■MMMMMMMMM■■■■■■■■■■■■OMEN■■■) ■MO■■■■E■■■■■■ NMn■■1 ME MEMO MOM NMI MENOMONEE ME] ME O■ME■ ■■MENE■■m!67morm.... ■ ii MOM! mom Ill NMI MMMM■■■■ IN ■■; ■■ ■ N■ M■MM ■ n ` ■■ ■■■ ■■■ illm No ■■ ■ ■ ■■ ■■ ►=� ■■■ 4�. mom NNE M ION ME MMME ME ■■■■■ ■ ■ ■ boa ■■■ ON ME MEN ME ■■MEN ONE ME ME ■ ■■ ■■■N Ill ■■N - M■0 NNE ME 01 ■■ ■ J■■■■■■n No mm ME NN■■■■■■OO ,IIMMMMM , ME MOM N MONO ■NOM■ MON mmmm so ■■ONM■■■■■■■O mm1!� �OPi N■ ■■■■■■■ ■■■■■ i ■ ■■N NNE MEN ■ ■ ■M ■ - � ■ ON _ NoNNE ■M MMEM ■OMMN■ No NMI ■MOON ■ME■■E■Ill ■M■■■■■■■■■■■■■■■■I ■■■■■■Mn■■■■■■■N■■■ mom MEMO No mom ommoom Ill ENO Ill ■■■EO N■ � ■■■■■ N■■■■■N■■■N■■■M■■N.I MOON i■ n ■ ■■■■E M■■M v N■ MOON - ■■■ � ..� o - ■■ONO ■ ■■ ■■NNE ME■■■ ■■ M■M■■NM Ill NMI NMI f t. 1, } r 3� - r f - 1 r �I ,Assessor's office(1st Floor): r Q Assessor's map and lot number ✓ V poi tM[ I Conservation(4th Floor): Board of Health(3rd floor): r t • � �a C 2 sea»r►nr Sewage Permit number S 7 pEouc SySTEPAj PADS 'BE .o rua Engineering Department(3rd floor): ' /� �� INSTALLED �` �° MPLI'`NC House number ' '. C$' WITH THE 5 Definitive Plan Approved by Planning Board Y EMAAWft TAL CODS,AND APPLICATIONS PROCESSED 8:30-9:30 A.M':and 1:00-2:00 P.M.only TOW�$ , �y��� TOWN . OF BARN!— XWLE , BUILDING ' INSP"EC=TOR • APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION V-5 19 _ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ! \ A Proposed Use *�� �' V�, '`CADO fy%\ Zoning District — \ Fire District Name of Owner layia C-e— yy�4t�e�' Address \& VA \ e Name of Builder �A\,A\r-`,l Address SSy Name of Architect IA Address Number of Rooms Foundation _ �d �m u �{' Cow Exterior '�' G� V1 r e— Roofing Floors Interior Heating V �N Plumbing Fireplace 11 Approximate Cost Area \G C, Diagram of Lot and Buil ing with Dimensions Fee ci L'O-f 4 �0/./9� o O b 72�i a e O a 0e OCCUPANCY PERMITS REQUIRED F EW DWELLINGS I hereby agree to conform to all the Rules and Regulation the Town of Barnsta ring the abov ti'uc ion. Name Construction Si ipervisor's License ..BUCKLER, BRUCE No 3 9 8 Permit For ADD TO DWELLING SINGLE FAMILY DWELLING Location 18 Valley Brook Rd. 1 . � •. _ Centerville Owner Bruce Buckler ~`• ~ ' `j ' Type of Construction �• ``s Plot � Lot #3 4 Permit Granted June 15 , 1 g 94 Da#e of Inspection: , �4 Frame _ 19 Insulation' " `- ; 19 ^� Fireplace i 19 . Date Completed. . 1� � ` _`4, '•mod ;.°, �� *� 3� 'N . ) 1 - . . ..... .... _ ~ (100 V :IS17IT'CTOJN STkLt`T �amcs- Ga`a��e� OSTO,\, )\4ASS.AC1-3USLT3-S 02111 ` -WORKERS'COMPENSATION INSURANCE AFIDAVIT (licensee/permia<c) with a principal phccofbusincsslresidmocao Ceram eT v�\ ASS O-,;�- ' ` (GrylStacclZip) do hereby eerti6-. under the pains snd penzltics ofperjury. than. j I I mm an cmplovcr providing the followingworkcrs compensation coverage for mycmployccs working or, his job CLMM�,41 \0.\ VN \ o t� _ faoa Insurance Company Policy Nu.mbcr j) ) am z sole proprietor and have no onc working for mc- () 3 2m 2 sole proprietor,gems-mil contmaoror homeowner(eircic onc)and h:vc hued the eonmaors listed below -who h2vc the follovaagworkcn compcimdon insurancr-poliaer- T,--o -,r r-, 1mme of Conrmcror Inure=Comp=y/Folier Number .` Name ofContraaor Insunncc Compan licy Number (Y\mtrr. � 1\12mcofContmaoi Inn=riccComp=y/BolkyNumbu — \ D 1 am a homeo.rncr performing 211 the work mysd£ NOTE Plc_sc be:Msc t!:t.��<le�co..�<rs w3o etaploy persoos to 10 rasietetaoec,toartrvetioa or tcps;t�otJc ors a Z—ClUnb of not=or<dzm Lrc<tsa;v ie e<boraco•.Mcr also r<s;des of oa t5<�rouals apptsrseeaat t5acto aK oot�eoer—17�' 1 o,p<r-; to b<er-plor<rs or a�Lcr 6<vae:<ri Ccrrpcns:t,oa Act(GL C 152,seen.1(5)),appl;at;oo by:bor m-mcr for a Jie<v%< rr„t r..:y c"idccc< L^c 1<tJ st:tvt c!:z<r- Icycc t:act 6c Gor1crr'Cocm1x]t2t;*Q Act- i t ac<rst:nc tn:t: copy of tics st_t<incrc.ii iz is �zdcL to tic Dcp: --cnt of Jnduscr;J Accd<nv'Orc<oflasv::ncc f0r.co-cr:4c ��crifict;on:.nd th-t f:-ilt:r<to sccvc<corcr�<s:aSuircd undcr Sccvon_'SA of MGL 152 c:n kad co cbc irrpouuon oJ�irsinaJ p<r.:Jcics coasisons of a fine of up eo SJ 500.00:-.dlet i- � ri onrnatt cf du ;! then 't7 d foc ofS J 00.00 a day againstr v Jt;c is p sa v I to - Zn.,C-c-/Pcrm d2yof (`u , 19Liccirzcc Licensor/Purniaor j -`-------------rT! • 1. M _ J . Y � . . 1 w z l Imo , j i C Ij fl 1 —.3 • J �s � I NNNNNN _ 4 Y ] F_ , , F 2 i 1 X4 3oCo ve-\-Y- �to�S� wPR� �CDY. Zito pTs.\O +S�\\Se4al. 6p�e B�� venaT f.X S A AI Ix IV _ 4 - y S 00 ell 0 X O gg e� j �. n Ia SA ------ � {f � J / v \ U � r( h h i U o ' 9 OT ,F � . - J 5� s )a S 7 9 5-0'3 6 C Bo. so 57 -9 k Y 1 t ° � 3S {�� �� HE'D � •\ ybti' , �� �IQO T,f�G 7•./d.�/�o,G'/Q/9 RT.�. ��0� 9 Y Y 'sG, Town fy T S ko AE p4, rfi �y �o© K ���( CERTIFIED PLOT ,Jry�` 07 3 y LL Ey , �-4AAJ �CL ,r IN N SS -4 -�•r S .i SCALE+ / 10-3 DATEAH OF Maw ' s J� GI.I�NT I CERTIFY THAT THE �#TRED °'< RLOISTEFtEO ' , �•^1.. ar ROSERT �r � Sao p SHOWN ON THIS PLAN IS w 1,Yll. =LAND`; �04 Not, ON THE GROUND A grENO "' e°�� y S INOICi INEER SURVEYOR oY� `Y, � rdo. 1S3ti7 o CONFORMS TO THE ZONING !►STEP s E O F 8�i�er � M A S S ��•��r J ,f.,�•�!�JY�;+�.ettt M�1S.Sti, ' - �lA���"�'`.s �R:' � / I + ,.-...- _ . - -..+-..-.-�Z,,— rox•—s.� s,x+,.-rt�..,:,;,,.�••�*-,r i� • TOWN OF BARNSTABLE Permit No. --_28316 - - _ Building Inspector cash wa - --- ----}- / 1639. OCCUPANCY PERMIT Bond __X______— r Issued to Bruce Buckler Address Lot 34, 18, Valley Brook Road, Centerville - Wiring Inspector +— F �� Inspection date ( -�C Plumbing Inspector { � !4 Inspection date Gas Inspector ; v �,� Inspection date � f xjEngineering Department"—/,;-,," G Inspection dateA .r/v. � Board of Health Inspection date' r 10 aS 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. rY... .....` .......... 19 �' , __. �� . ..._.M Building Inspector i e�..° '°•.ew TOWN OF BARNSTABLE BUILDING DEPARTMENT = seas : TOWN OFFICE BUILDING �. rm i639' HYANNIS MASS. 02601 MEMO TO: Town Clerk FROM: Building Department *^'" `- DATE: f ~ 1 A w An Occupancy Permit has been issued for the building authorized,by BuildingPermit .... ...................................................... .... ...... ... .. »... issued .to ?f ;C'-P— c�, Please release the performance bond. 0 '49 ,0vV ©eP— 1 1>L 1 p Assessor's• map and lot f�umbfr .... .A...Y..:-.11.!/.............�'K SEPTIC SYSTEM MUST BE CF TXE TO Sewage Permit number ..........<��r�..:. . z INSTALLED IN COMPLIANCe�P� row WITH TITLE 5 , House numberf� -NVIRONMENTAL CODE aaasrence .AS�►S oo i6}9• `� r TMC^ n vlitTI S MO d' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..............11A%. >............................................................................................... TYPE OF CONSTRUCTION ....... ............ ......................................................................... ........... ..................19.25.5 TO THE INSPECTOR OF BUILDINGS: I The undersigned hereby applies for a permit according to the following information: Location ......Loa.........31 .4............ A.U-PY�.............��...R�.c K......f. ..................C'.��R,�.1.p................... Proposed Use .... A(( .1 ...... .1. . ........I` .4. ...................n............... ....c . ...T....................................... .....Zoning District ..........`.�Q.�.�................................................Fire District ... .. .. .. tJ l �3�T,............I....................... ,r... Name of Owner .T�,.LIV44k.....0n..\?':��.I.�K�.................rr11Address ... ... . .............��.��.11 ........Q. \.... .\�C�....... Name of Builder ..I ....4.. -101 ...,,,.-.�.r. lcldress ... oX...s .s.....t gpo....�P—Nllf!�i........ Name of Architect `..QL�. .(Q .......k .....4... ....... PtMQ.....1...........r J� wl ..............Address r.... �T��a�'. —� z.......... ... Number of Rooms .......51. Foundation . !:r4D C0r 'Ci2E`� Exterior / ...,:.. .......0 ..........................Roofng �......TfSa .. ..�.....t.G.....s......w.gk.,.R..® ...�........... Floors ... n!.A JE-J, ! \h6YL -...................................Interior � `4 ..... ....................................... ..Heating Plbig4 ....2_. . ..... .Fireplace .x�......e.,. ...........................................Approximate Cost .........1FJlO..r Ba.n......................... Definitive Plan Approved by Planning Board _fir-`-='-'-'-=-'�-=`-��19gz- Area .../1��. ../�� , Diagram of Lot and Building with Dimensions Fee .........49... ..1..... SUBJECT TO APPROVAL OF BOARD OF HEALTH I�\ OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ,,�/r .Name ......... ... "".. ........NGk`e� .. ............... Construction upervisor's License .....4v. 34 ........ I + BUCKLER, BRUCE \ rt • 28316 One Stor . No ................. Permit for .....,............. 9Y........... i : Single Family Dwelling,•,,,•.-.-„-,-,.._-,- i Location ....Lot 34t 18,•Ya4u..AKogXJ, Qad Centerville Bruce Buckler Owner .......... ..................................................... Y _ - Type of Construction ....Frame 5 ` � r i Plot ............................ Lot .................... ........... �. ,. \• rt 7 Permit Granted .......August 12, :, ..19 85 - TM Date of Inspection .../................................19 {' Date Completed / �! ....'1'9 -.. .............. rlh y CC iQ � - r M !� ` 0 -1 c f. �gmc t.t _ _ Assessor's map and lot n' umbe"r k �,`� � •, - Bpi TM E Sewage Permit number ............ ?. .......... : .�? /.. d ♦� Z BAHBSTADLE, i House number ......:.:..................... rasa 9 0 r �p 039. \00 Ar t TOWN OF BARNSTABLE F �6 6 BUILDING :INSPECTOR . 4 APPLICATION FOR PERMIT TO .............E.�,) %�>.................................................................:;.............................. TYPE OF CONSTRUCTION ...... .C�s .u' ............ .+PaC 1.��.......:................................................................. .......... �. ���..................I 91�>5 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for\a�permit according to the following information:(' Location ......LT..........3.. \(.�L.L-�=.� .... wo.K �..t.....................`�-..........��.� .................. Proposed Use ....swgh:........ .,Ly,........4sm., IMsC .................................. ................................................ Zoning District ..........(��.-A...........................................","Fire District ... . ... 0�...................................... Name of Owner ....�.\1.iq (KIr-0...............Address ... .. . .. .......���C��1.��CG Name of Builder . ....... �. ` vJs�—?.!1..... �,�.t'. ddress ......`..: ° :... .`�.....l . l l 'd� �. ........ .I -`env............ � � > Name of Architect 1t ��.1. ��.I.�T ..............Address .. ...�a ....... Pst'14 .1�f ��`�'.(� I`fti4.. Number of Rooms ........�..�'�. ..Foundation Ca�C*4 .............................................. .. ..............: .,............................... Exterior eo.. .,N.N.1 ............. ! ,.. 45. 'f�:.......l............. C.�-..�-� .� �lAi4 .........................Roofing ... .. ��-- ...�. .. ................... C> V (N.1.�- ...................................Interior ?t i z i.Nt.....�...... �� ................... Floors ..................... '`..... ... ................................ . . Heating . .. .1 -' ...................................................:..Plumbing ... (2........��-............. A Fireplace .. ..... .. ...........................................Approximate. CostrJ l9 Definitive Plan Approved by Planning Board A Area f.. X....... Diagram of Lot and Building with Dimensions Fee `�"l '.. .J.................. .. . ...... ..... r SUBJECT TO APPROVAL OF BOARD OF 'HEALTH t ti } OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regtirding the above construction. Name ......... ....'�........... ............................................... Construction u ervisor's License p v...... .�............. BUCKLER, BRUCE A=4-&8—E}91► & 1`y9'164 No ..283.16 .. Permit for ,.ONe Stor.y ........... ... Single Family Dwelling Location ......Lot 34, 1.8..Valley. . ...Brook. . . ..Road . .. .. ........ . .... . . .. .. Centerville ............................................................................... ' Owner ....Bruce. . ...B.uckler. . . ............................ . .. . ...... . ...... . . .. Type of Construction .....Frame . . .......................... . ................................................................................ Plot ............................ Lot ................................ Permit Granted August 12, 85 Date of-Inspection ....................................19 Date Completed ......................................19 y i tip v d IV f 441 . � Y*; ' �^ h 22�f aT: 577, s? y T t. A MIS ri}` ar ` 1 h ;.'Rb - ` N rer e.�-io, p,� �R'r, lIZ � I W 97 CERTIFIED PLOT PLAN MA . Y 4F� E Y SC ALE, — DATE, Sw OF } ��. A"�:��: I. CERTIFY THAT THE �o�NDi9�✓oL✓ E R D E ENG1 1 l3 •1 GLINT Q� s�.�� s�oE��a�r' �� SHOWN ON THIS PLAN IS LOCATED 759 6-4 a kFt$T{ IEDh Rr01.STEREID r!o Mn ;D�� ON THE GROUND AS INDICATED AND :- . LAND rQ4 No IS367 � CONRORUS TO THE ZONING .LAW S ENOtPtEER ,: SURYEYOR x. OA.sY� ors^ ''frsTEe4" ��� OF MASS ti z � n ✓, S< oe 1 Me ►I N -�3 T H E rT _ } kItYAJ �S;yMAS'S*t $M( TQF,�„ DATE REG. LAND SURVEYOR