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2917 MAIN STREET
Jj \ �t �` � �� � . ;, k i 1 � i R, yY � 2J y QD UPC 12434 No. 2V $�°c7oT.CONSJ� HASTIN©S. MN ' r. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Map 'I Application 9 Parcel. D` /C V Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee # Date Definitive Plan Approved by Planning Board Ple 2--Z'7—f 3 Historic OKH _ Preservation / Hyannis Project Street Address aQ eA n Village Vocc-n-fab i c Owner z c n L C ✓l U-21 e, Address aq(-7 C 1 un St &m Telephone � (�� l Permit Request + l.(i�,`l I� +(,,i O l' 1 L G i W I C QJL v�0�L anA (Ayr SU) W hnYnG Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District - Flood Plain Groundwater Overlay Project Valuation aOO'3.00 Construction Type ;[n G �-►�m. Lot Size Q (4y S Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure 1150 Historic House: ❑Yes 2FNo 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 Type',and Fuel: ❑ Gas Oil ❑ Electric ❑ Other ' Central Air: ❑Yes ❑ No Fireplaces: Existing New _ Existing woo loal stov;Q ❑ s ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: 0)&isting Unevzosize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ V Commercial ❑Yes ❑ No If yes, site plan review # Current Use _ Proposed Use _ APPLICANT INFORMATION �G11 `1 / V�Gr �J �4t(B SILDER OR HOMEOWNER) Name �` S I> 1�'� Telephone Number 'W a3 7- 014 10 Address _/�,J ���y�I G� License # 5 Home Improvement Contractor# 16o c6 Sq Worker's Compensation # 6 0153r 5DI ao 11a ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A-Yn( A UY)J C7a6y 5 SIGNATURE DATE 3 5 a01 1 : r FOR OFFICIAL USE ONLY b � APPLICATION# '`F s -DATE ISSUED.,.kut�r } oMAP-/PARCEL N0_1 E, 'y .ADDRESS„ VILLAGE OWNER F DATE OF INSPECTION: FOUNDATION FRAME INSULATION' FIREPLACE ELECTRICAL: ROUGH FINAL s PLUMBING: ROUGH FINAL K GAS:-I E;a�,.. ROUGH.--.- -, FINAL h r FINAL BUILDING�_ • , _ _ __. _ `i k 4 DATE CLOSED OUT, 3 ASSOCIATION PLAN NO. s The Commonwealth of Massachusetts Department of Industrial Accidents O,fj`ice.of Invesstigadons, 600 Washington Street Boston,MA 02111 . www.mas&gev/tlia Workers' Compensation Insurance Affidavit::Builders/Contractors/Electricians/Plumbers Aanlit ant Information Please Print LeAbly Name Musinesdorgaatzatiodlndividnap: t Ci �X)UZA��l Address: 50 ::� J, City/State/Zi9(-ZS"5kZ"' ,�MA OA((3 Phone#: �4 — Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer, with 4. Q I am a general contractor and I employees(full and/or part-time).* have hirers the sub-contractors 6. 0 New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. Q Remodeling strip and have no employees These sub-contractors have g. 0 Demolition working for me in any capacity. employees and have workers' g Q Building addition [No workers'comp.insurance comp.insurance: i required;] S. Q We are a corporation and its 10.Q Electrical repairs or additions - officers have exercised their - I 3. I am a homeowner doing all work. _ 11:Q Phnnbiag repairs oradditions myself.[No workers'camp. right of exemption per MGL I2Q Roof regains insurance . .]t c. 152, §1(4),and we have no �t 3a.❑ I am a homeowner acting as a employees.[No workers' 13.t@ Other��ccA, kc i-L,4-\ general coaorat torArefer to#4} comp. ce ] 'may wlio"'t mat checks box#1 must also fill ant the section below showing their wodm&ell tio�I)Oiicy icon. t Homeown=who submit this affidavit indicating they are doing all wo&and then him outside cm=ctm must submit a new affidavit indrating such. tConmu=n that duck this box must attached as additional sheet showing tux name of thee,sWN=m ton sud state whether or not those entities have employees. If&e sub-eantaeta rs have employees,dicy smut provide dues wod=W comp,pommy u I am an employer that is provMW workers'eoerpensaaon imurmwe for my employees. Below is the po&7 and job site information �. Insurance company Name: 9 1 n V�(,h - co . Policy#or Self-ins.Lice EStpiration Date: (. �,D j J Job Site Address: � � �' I Gt lYl �1- City/StateJZp: L� �,�,3 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date)_ Failure to sechue coverage as regtmed under Section 25A of MGL c. l52 can lead to the inipositioa of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment;as well as cm penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofperIiY that the information provided above is inure and correct Sign Da a S Phone IO,flcial use only. Do not write in this area,to be completed by city or town official L City or Town: Permit/I,icense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: 9/1.0/2012 3 :58 :44 PM 8740 9 02/02 CERTIFICATE OF J"ILUTY INSURANCE D MO TOIs Connie=Is ISSO® As A M"M or IHYORHATIOs Mir AM COMM HO-RISns OeOs ROB CIMPICATE EOLOEB. THIS COMMIChm Bus E04 AMMIUM'SYBLI 00 OBHARIYRLY MM. MEND oft man us COWMAOB MFOUM By THE POLICIES HIMOV. THIS COMMICUS 0Y IHSOHAiCE now OOT CGN6MM A COORSACY MMUM TOE I63OIH6 IHBOHSRM. WTHORIaw IO: muff TIM OR PAOSOCSR, Aw I= CIMUICUR HOEOBR. 1 I HONER: If the eertifiests holder is an AOn1TIOHAL Xms=D, the poliayties) out be endorsed. If sconamno0 re VA M, subject to the tams and conditions of the policy, certain policies may require an andorsemeut. A statement on this certificate doss not confer rights to the certificate holder in lieu of such andorsemutts). amosata oasrer - "er8 & emy xnausanre agency 'x'n`I We.X..s s)= 424 Route 134 Aa°1L4'= South Dennis, tL 02660 eauam no. _ mini alt MWM eansass sale e Haontisr Energy Solutions Inc �"'li.I.M. liatual Insurance, Co33758 na,M al502 Hazw:Lch Road - nwace a Brewster, m& 02631 met a�sarA:. �n - COVEUGss CERTIFICATE Ao)f M RVISio$ Htl MM: Ton Is To CWwr low M reaw=or MWM=Sono MUM IMM now us=To"Is UMM WWW awn POR us"Mr nU0V Zo=W o. AaY T.I=OR or An conglM=OR olmta oeammur Rrwt 22"Mp Te MUCH Mw Cearl MM tn►Y m usom OR an RRRfaa,am saw ATl UM Hs wn Qo==Vnemw IRRI7Y U soap To a&sae SEW.IOIeIaslalrs aOs coaaMMors or SM PDXM=.IM=SHOW HAY aA4E H®RRDO®Er I=cry. - _.._ ter lot=IS! ttam=ow II. TWO oY IesORaSes asAw/tan artfmJmn GEMWMJMrzesaaTr aa«eeaa,Aacr a 11ada0•ItM am ananas , DRUM n to ROM peel s •- F NIUM L asv INEW a ab&Sam m DOW AMUS U. Gomm AiiaaAAl[ a 8trrm�vs IrARs►.a�r �n smas imu a • t••�_ � - to+oeLima AV167 Dub 4 D " SPUT now G.s VU-4 e. aIa aae ' ❑6LmD3a0 AUNG - aINCI IlOe V Qw amdmll • 01=Aoms a--add d ❑amFa M ARNIM. a ❑ _ ®na=sA SM — sate ataaucc� a ❑eels Tam ❑cam Ism G7G1[YB:t a omxaera � s MM ❑csEaaaa t a ulnal=VM H MM noncoms g aRonRlsco/nAR[Irzas/ Z.A.uetaceffiar a 1,000,000 A axscurM QUICEM us D 1=1 ® excl 6015315012012 °I�D MMU :� a 1,000,000 03j14/2d1Z 03JI8J2013 a.A.eamsc-wsssssc a 1,000,000 s f erstatslcoa of ss cot IOMMMI tBANcis SNMMM IS HOT t g4 TH6, I COMIMBATION 80I,ICSf CWIFICM HOLDER C.VM:ETAMION HOOSING ASSITABC6 CM. a000I.0 w OF in Soon am==POMIoS ED CBCMM=M"M 460 REST liAIH s'P zXVIUMN DUE 'OAP, 00'PDCH SUL RE OEiIma IN=9011M YNH Ht� troaz�Qaovarocs. )l MMS, HA 02601 Issaarras aec 6094 OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at (Property Address) (Property Address) hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering,to act on mybehalf to obtain a building permit and to perform work on my property. ' Owner's Signature Date MassAchusetts-Department of Public Safetyiea�,anaa�arr�rtlllc_ C��a�sailFrue Board of Building Regulations and Standards �. -Offiee of ConsumerAffdrs& ewltegulation o st. - ,ME IMPROVEMENT CONTRACTOR ar. C n ruction Supery isior.Specialt•.. ration 160854 Time- License CSSL 105941 _ Iration• :•9l8f?A14.:,: LLC of i ES FRANCISS, T � _ FROT�fIER=ENERGY_SOONS 7 502 HAJM4&. ;. �$ Brewster 02631� � FRJ4NCIS $MEEHAN � SW =HA-W -H RD. '4• ,a �•_ BREWSTER,MA 04631 Undersecretarq t Expiration - commwssidor 01 02/7726 :. -. 1 Ftestricted To:CSSt-1C-Insulation Contractor Lioeose or registration valid for individai use only befare-the expiration-date. If found-return-to: _. Office of Consumer Affairs and Business Regulation 10 FarL Plaza-Suite 5170 Boston,MA 02116 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. ` t: hfigV at signature For DPS UceraingWbrmatioavWvt: wwwA&w.Gov/DP5 : f P F v� �s r Date: L( Thomas Perry, CBO Building Division 200 Main Street Hyannis, MA 02601 RE: Insulation Permits ` Dear Mr. Perry, This affidavit is to certify that all work completed at: .21 1 i � � Q ! 7 lei l a n r� � � � � has been inspected by a certified Building Performance Institute (BPI) Inspector. All work performed meets or exceeds federal and state requirements. Permit application number: '70( 361 .I S_O z Issue date: 2- 22 - 13 Sincerely, Francis e President Frontier Energy Solutions, Inc. Office: 774-237-0410 + Email: fssfrontierenrgy@gmail.com u" C) :. ,.F^n � P a4 • 4! 11W •1 1" 9 2006 Town of Barnstab *Permit# R I G, q i, Expires 6 mon from. date JU FdNSTABhE Regulatory Services a Fee *tans $ . Thomas F.Geiler,Director . . Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint •.qq Map/parcel Number c` 7 Property Address 09dResidential Value of Work' 1 _7 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �V 15. �Q.r 5 Telephone NumberV � Contractor's Name p Home Improvement Contractor License#(if applicable) I oV Id D Construction Supervisor's License#(if applicable) C� fTWorkman's Compensation Insurance . Check one: ❑ I am a sole proprietor ❑ I am the Homeowner have Worker's Compensation Insurance Insurance Company Name CUGA I n3QUO YO Workman's Comp.Policy# A f P 23 1056 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) 'p r Kau �f ISRe-roof stri in old shin les All construction debris will betaken to tN f�W l�lJl,4� f ❑ (stripping g shingles) (S ❑Re-roof(not stripping. Going over existing layers of roof) bag 610sf ❑ 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:Forms:expmtrg Revise071405 r qv CAPIZZI HOME IMPROVEMENT INC . SPECIFICATIONS AND ESTI MATES PAGE 7 OF 7 STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I A/A 4R Ga OWN THE PROPERTY LOCATED AT - ti? v, IN _ V tAl(w 5/6k- MASSACHUSETTS. I HAVE AUTHORIZED—... CAPIZ7,1..,,HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. A I GIVE MY PERMISSION TO l r 1 `,-t.t I/' r LESSEE TO APPLY FOR A BUILDI G PERMIT IN ACCORDA CE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: OWNER'S ADDRESS: 5 � OWNER'S TELEPHONE: .Z ^' 2 3 C LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 NEWTOWN RD. , COTUIT, MA 02635 APPLICANT'S TELEPHONE: 508/428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: ACCEPTED BY I lr oboto DATE THIS PAGE IS P OF AND IN CONFORMANCE WITH PROPOSAL # C� �,"9AMi,J(I]- R.(',,(21S3.T-all ") + t Repisi{aiion: 1007.4D -• : . ,•. lyilr:: T'rivaic Corl�Uralion E>:piraiiorl: 8/23J2DUG CAP=] HOME IMPROVEMENT, INC. .` ThOmaS Capizzi, jr. ---___—.- 1645 NG'V40n Pd. —_ CO1uii, 1AA 0263:5 — irJpftic Address and return rard.)142rlt rf:.ason for dianj, Address R Rtne-wA ❑ Employment ❑ Lost C Board of BuildinE 7tcduiafions and Standards Ucense orrecistration valid for individul use on)y HOME IMPROVEMENT CONTRACTOR before fteex iraiion date.. 1f found return to: ?' )' 3;egisiration: $Hard of i ding Re uiations and Siandards - 1 DD7A D � � E,Piration: 6/23/2006 OneAshlwrion PlaceRm 130) Type: Private Corporation Boston,W-02109 CAPIM HDMIE IMPROVEMENT,I 'T'iiomas Capri,jr. 1645 I4e,Adon Rd. _ Cotuil,i>AA D2635 . f i Administrator N— . —:��ot valid wi2hou b lur ✓lae-�'anvno7uoeall!o�,:ii' ic�es�,a { BOARD OF BUILDING REGULATIONS J License:'•CONSTRUCTION S _ Number;;Cg 057032; B%rtfidate:,3j912611963 Exp.ires�'i)9 612bD7 THOMAS X CAPIZI�}� �• r .. ! 1�1i 1645 NEWTOWN COTUIT, 'MA 02635 CO MISSi6ndr . _ j ,4 As ssor's map and lot number 7� el q � /- 'THE 3Q� Sewage Permit number ............... v Z BARNSTABLE, i House number ....................... .......f 1�7.............. y MAM �p 039. 9� TOWN . OF BARNSTABLE r BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..&Ila....AO.1.A!AQ...........:..... ...f�'.:...1.... �1............... TYPEOF CONSTRUCTION ....4��....�M....................................................................................................... ..................19.Q.3 TO THE INSPECTOR OF BUILDINGS: ` The undersigned hereby applies for a permit according to the following information: .....©!d Al.. � !�x��.....a:...�. 1 r. zz.. ProposedUse .... .......... .. .....: . ............................................I...................: Zoning District ......................................................................Fire District ................OAR<l!. .\............................ Name of Owner�Q.�1. 12 4 . .�� .C`0 �.!�1:�...........Address ..� ..... Name of Builder .n'.�.� . .. : :.. .'.�.t.n..�'1:�....A .�r. ...Address .. ... .............. Name of Architect pp�� ..........................Address ........ Number of Rooms ................L.................................................Foundation .!.D-( ... . ...:...4:.W..Cvl-e........................... Exterior .........6A.a).n* [x.�6. ...........................................Roofing ....3.J..IU....� - .....f � .!l. ! ......................... Floors .......('+'P7 ... \JQ�.�!1...............................................Interior .... ................................................ Heating .....1`K?'4........ .......................................Plumbing .................................................................................. Fireplace ................................................................................:..Approximate. Cost ......��.f.`���.:..Q. ,1....................,............... t Definitive Plan Approved by Planning Board ---------------____-----------19_______. Area ............................... ,r Diagram of Lot and Building with Dimensions Fee � ! � SUBJECT TO APPROVAL OF BOARD OF HEALTH l 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. 14 Nam ......................... ... ...................... Construction Supervisor's License .................................... r CO_LLINS, ROBERT & JUDY i 25-08 Addition io ................. Permit for .................................... SSngle.:Fa ? I)wella.n _ k g. ......... .J _ Location ...Q.�,4�..�7��L..I,r�11e.,....&...I3t�••b1� -.....Bar , k21. ...................................... A . Owner ..... Qb-PV.f•...L&..jlud. Cnl.lins...... ;3 Type of, Construction .F'ramp..............;,,,,•,,,,,,, -, f • t r , ........... .......................................... 1 _ ,Plot ........... .. Lot ................................. Permit Granted .........uly...13......................19 83 « w Date of Inspection- .....19 Date Completed ................` Sf! .........19 l "17� r _ i ' 4-a tti a• B,4 vsrAQSLIF rIA 36Z Zag9 is 9 X a _ , I i `i' I i I i An�re�cav CoyTRAc.Ti�vS CL�Fn.om�LlyO y�F7NET��y TOWN OF BARNSTABLE i •BAflHSTAItLS, i a 1 MPV BUILDING INSPECTOR �F� a' APPLICATION FOR PERMIT TO .. .....� 't T ..........�LJ•..?.................................................................. TYPE OF CONSTRUCTION .......... �°.�, r.......... ?'. ...... °".'•........................................ �i�/� i� p ............................................19�r..... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: / Location 7'-- 4 fi a ✓�q/ �. N ........................................................................................................................... i Proposed Use .................. ........................��.�............................................................................................................................... ZoningDistrict ......................../..c............�..................,.................Fire District ..............:............................................................... Name of Owner 'fi ..." :....' �T..F !�.............Address `.!! i. .... d►..... `,�'I 7 Name of Builder, .�/ •S. '�7'...........Address /. .!p7®v Y�`f !iT.....'"?..!45.:........ Name of A rem,-... !y4 ........Address .....� ..' !�'''✓.. .f...... ! :....... Number of Rooms ....... ` - . //'T..4.. .'�/..�.F........................................Foundation �L.....d.`".'�..�1.�.p...��.��!�c'/ Exterior 'l..'..e� � o�f�.................. ..............................................Roofing ............................ ....................................................... Floors 44ly o0 Interior ............................................................................. Heating 7- '�� '� �/X ��! ... .................................................. g .�..............�....�..'E.............................................Plumbing 7' S Fireplace ® ®p O................................................................................Approximate Cost ................r...................................................... Difinitive Plan Approved by Planning Board ________________________________19 Diagram of Lot and Building with Dimensions '��„ --71 p4 >� - 60 -71 i e1(1-7 ' 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name �... .. ,' Sheaffer, Peter G. l �7�--0 9 DEC 31 19710 i No ....12�39. Permit for ...... two story, s single family dwelling,ogarage ............................................................. # o?9i� oute 6A & Old Jail Lane Location .....R Barnstable t Owner .........Peter G. Sheaffer ......................................................... i Type of Construction .....fsame.......................... ; i ................................................................................ + Plot ........................ Lot ................................ I . Permit Granted .........January. 2.0.........19 70 ' I Date of Inspection ............. .................19 Date Completed ......................................19 4 � PERMIT REFUSED I ................................................................ 19 ............................................................................... " ............................................................................... e ............................................................................... t • t Approved .............................................. 19 ............................................................................... ..................... .........................................................