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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 3 O Parcel ``� Application# Qo 7O3 L1-
Health Division
Conservation Division cl ,. Permit# •
Tax Collector Date Issued 1 d
Treasurer Application Fee b
Planning Dept. Permit Fee, /Oo , 50
Date Definitive Plan Approved Pla ning Board /,, e;
s-/07
Historic-OKH r servation/Hyannis 6
Project Street Address 31 S . m ell r' S f 1 I --r. 6A - .
Village Q, ---, 5 -61-
Owner 1,‹G6^1A" t-�TN lie ►' , -E Address S/}nn.
Telephone S o d 3 6 X 01- -g--
Permit Request 6 U et-O . Goa f 6e a co 7
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Square feet: 1 st floor:existing proposed '7190 2nd floor:existing proposed Total new q CO
Zoning District Flood Plain Groundwater Overlay
Project Valuation c;2-.Ji 061 Construction Type
Lot Size 9, S G4.G S Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family ®. Two Family ❑ Multi-Family(#units)
Age of Existing Structure , -51D 'YJt . Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout BOther
Basement Finished Area(sq.ft.) -- _-__ Basement Unfinished Area(sq.ft) —.
Number of Baths: Full:existing new Half:existing ---- new
Number of Bedrooms: existing —mew--
Total Room Count(not including baths):existing new -- First Floor Room Count --:'
._, t
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other =�
IN) Cr
Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/co.,- tore: Clies 0 No
cti x
Detached garage:❑existing mew size 40�74 Pool:0 existing ❑new size Barn:�x`sling' ❑raw size
' A
Attached garage:❑existing ❑new size ----Shed:0 existing ❑new size Other: co
-.., rn
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes $alo If yes, site plan review#
Current Use Proposed Use .
BUILDER INFORMATION
Name .i171"‘4( P tt c-ci Telephone Number 6-0 P 7) / O 9 P 6
Address 7 c -7 %''►'iit'tw S 1: License# 1-3 1626a.
1 iviS j , cis • Home Improvement Contractor# / 03— ''?P
0 g'6,0 / Worker's Compensation# ti./C 431 cli?P)
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -1'o►' - ova- 4 mita-
I3cSNudrq-i _
SIGNATURE 4 g- --. DATE 5)&— -iO
1
FOR OFFICIAL USE ONLY
e -
•
1 PERMIT NO.
DATE ISSUED
f MAP/PARCEL NO. -
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ADDRESS VILLAGE, - ,
OWNER • - , ,
DATE OF INSPECTION: , '
FOUNDATION ®CC- -7" O'43-0-7 PA-- .
FRAME ��' 1 JL /
/4 •�07
INSULATION ,/„-f
FIREPLACE ��
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ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL 1
y GAS: ROUGH FINAL {
., FINAL BUILDING ((.°)4,7, Ir--( _ OI//�O e 7 • _
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DATE CLOSED OUT '
ASSOCIATION PLAN NO. -
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APR 4 [u
TOVUN OF BARNSTABLE
HISTORIC PRESERVATION
7 CC,Vt Y.D TO A.'. O58). 'A/E
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Results Page 1 of 1
Licensed Contractor Look Up
Select the search method: License
Maximum number of matches: 25_11W,
Enter Search terms separated by spaces. 131802
Select Search type: ;, AND OR;,4 erch '
Search Results
City/Town Name Lic. Type Lic. # Restriction Expiration Street State Zip
HYANNIS PACHECO, ARTHUR M CS 31802 00 6/15/2008 26 NANCYS LANE MA 02601
Total of 1 Records matched.
Back to Home Page
BBRS Privacy Statement
httn://dh_State_ma_ns/hhrs/cnntrart_nl 5/7.non 7
Results Page 1 of 1
Home Improvement Contractor Look Up
Enter Search terms separated by spaces. Search terms can be Town/City, Name, or License number
Select Search type: C•, AND C° OR t e.archA
Search Results
Reg. No. Applicant Street City State Zip Name Title Expiration
105488 ARTHUR M. 26 Nancy's Hyannis MA 02601 Pacheco, Owner/contractor 7/17/2008
PACHECO Ln. Arthur
Total of 1 Records
matched.
Back to Home Page
BBRS Privacy Statement
http://db.state.ma.us/bbrs/hic.pl 5/2/2007
m(0,LiLta . r(�
Town of Barnstable,.
•
:::.:.,t : Regulatory Services •
�H LE Thomas F.Geller,Director
4ATFD Mp`..... Bulldivag Division
Tom Perry, Building Commissioner •
200 Main Street, Hyannis,MA 02601
wwyv.town.b arnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
•
Complete and Sign This Section
If Using A Builder ,
I,_ / NN r P /{fA ER , as Owner of the subject property
hereby authorize A, 77 eM" /r'.4-c,hif"0to act on my behalf,
•
in all matters relative to work authorized by this building permit application for; ,
-J/-2 /' A/A/ s- 7-7 11,4 47A/cr,4j7
(Address of Job) .
.
•
0„„,, EL,7r- i- ‘_
1.12.-rte ' .(/
�2 007
Signature of Owner �o
• /{-7 >/�771 0 /(?Afl2?? .
Print Name
QFOP MS:OWNERPERRvIISSION
•
•
•
.oFtHEr�� Town of Barnstable •
ypsi
•
P . ,\ -
Regulatory Services
BAarwrAms, Thomas F.Geiler,Director
�
i639'
tED MA'S O Building Division
0 .
• . Tom Perry,Building Commissioner •
200 Main Street, Hyannis,MA 02601
•
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.
Type of Work: ol9 A }0^-. 61446 tom) Estimated Cost a O OO
Address of Work: 3/S c)— , -41"1"" c \ //2_7 .
Owner's Name:"/E rtl 10 (\ Arli ETA-
Date of Application: S-171—>1 6'7
I hereby certify that:
Registration is not required for the following reason(s): •
•
• DWork excluded by law
❑Job Under$1,000
Building not owner-occupied •
• ❑Owner pulling own permit
•
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO'I'Ii.l+'ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent o the owner:
rA,)-- -1 6 1
Date Contractor Name Registration No.
S54 ? /{g/ ''r/� Off
ate Owner's Name
•
•
•
Q:fonns:homeaffidav
it
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. , . ' The Commonwealth of Massachusetts
= Department of Industrial Accidents
ll i— G Office of Investigations
__ �h 600 Washington Street
' 'l lL= Boston,MA 02111
�sq �W www.mass.gov/dia
• Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): j''te 1 Pi tC-0
Address: `2 elq, iw" 5 7-
City/State/Zip: i f '"S fvt4,4-S S Phone.#: CO S / I ° T if
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a y emp to er with 4. IDI am a general contractor and I
6. 0-New construction
employees(full and/or part-time).* have hired the sub-contractors
2. am a sole proprietor or partner- listed on the attached sheet. 7. El Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. employees and have workers' 9. Buildingaddition
[No workers' comp.insurance comp. insurance.$ ❑
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers'comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees. [No workers' 13.0 Other
comp.insurance required.] •
*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.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: G,64... cr-tr. St Y-)'i I n.$v dei4- -G�e
Policy#or Self-ins. Lic.#: '" G if W q/ 8' Expiration Date: /15/ 6
Job Site Address: 3i1-1)' 14" S 1 i1/0.04-1 - City/State/Zip: ,Q/zl2044TM " "043
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 cAI&
- under the pain• 'nd 1 e�/nalties of perjury that the information provided above is true and correct
6-Signature: r .-J``` Date: S____
Phone#: 6-3 J 5 ) / d e S C
Official use only. Do not write in this area,to be completed by city or town official
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
6.Other
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, artnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterpris ., and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnershrn, association or other legal entity,employing employees. However the
owner of a dwelling house having not more tha a three apartments and who resides therein,or the occupa.t'of the
dwelling house of another who employs persons o do maintenance,construction or repair work on s •. dwelling house
or on the grounds or building appurtenant thereto all not because of such employment be deeme. 'o be an employer."
•
MGL chapter 152, §25C(6)also`states that"every st•.te or local licensing.agency shall with• ld the issuance or
renewal of a license or permit to operate a business 'r to construct buildings in the co t i onwealth for any
• applicant who has not produced acceptable evidence of compliance with the insuran s• coverage required."
Additionally,MGL chapter 152;-§25C(7)states"Neither oae commonwealth nor any of's political subdivisions shall
enter into any contract for.the performance of public work ,.til acceptable evidence .. compliance with the insurance
requirements of this chapter have been presented to the con acting authority."
Applicants
Please fill out the workers'compensation affidavit completely,b checking ,e boxes that apply to your situation and,if
necessary,supply sub-contractor(s)name(s),address(es)and phone sumbe 's) along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability artnz ships(LLP)with no employees other than the
members or partners, are not required to carry workers' compensation::urance. If an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit may be bmitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to • g and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit o icen is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding , law or you are required to obtain a workers'
compensation policy,please call the Department at the number.` ted 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 gibly. The Department ,as provided a space at the bottom
of the affidavit for you to fill out in the event the Offic.;of Investigations has to,co• act you regarding the applicant.
•Please be sure to fill in the permit/license number w i h will be used as a reference ber. In addition,an applicant
that must submit.multiple permit/license application-in any given year,need only sub 't one affidavit indicating current
policy information(if necessary)and under"Job S' e Address"the applicant should wri,: "all locations h (city or
town)."A copy of the affidavit that has been offic ally stamped or marked by the city or `iwn may be provided to the
applicant as proof that a valid affidavit is on file or future permits or licenses. A new affi avit must be filled out each
year.Where a home owner or citizen is obta' g a license or permit not related to any bus' ess or commercial venture
(i.e. a dog license or permit to burn leaves etc said person is NOT required to complete this :ffidavit.
The Office of Investigations would like to ank you in advance for your cooperation and shou d you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone an ax number:. /
e Commonwealth of Massachusetts •
(Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. #617-727-4900 ext 406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 11-22-06
www.mass.gov/dia
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Town 'of Barnstable
Regulatory Services iLAVN UARNSTABLE
• BARNSrAB7;7 Thomas F.Geiler,Director 2001 ,P{1L 20 PM 12: 10
MAS�p 1659 Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
G11r'IS10P!
Office: 508-862-4038 Fax: 508-790-6230
AGREEMENT FOR ACCESSORY USE OF RESIDENTIAL BUILDINGS ASSOCIATED
WITH RESIDENCE
I( ; the undersigned, Kenneth Kramer, being the owner of property situated at 3152 Main Street/Rte
6A, in Barnstable, MA, holding title under a deed recorded with the Barnstable County Registry of Deeds or
Barnstable County District Registry of the Land Court in Book 6371, Page 305, or as Document No.
, being shown on Assessors' Map 300 as Parcel 046, hereby agree, certify, warrant and
represent to the Town of Barnstable that the accessory building to the residence located on the same parcel as above-
described, which contains .a loft above, is not intended for and shall not be used as a permanent, separate apartment
for year-round or summer occupancy,for rent in any fashion.
The intended and authorized use is for storage with the residential use on the same premises. This separate
unit shall not be used for a"Family Apartment" (as defined in Zoning Ordinances)which would require application
and approval of a special permit and compliance with the Family Apartment Rules and Regulations. This separate
unit shall not be rented as an apartment or as a single room, or in any fashion, which rental would be a violation of
the Town of Barnstable's rules,regulations,and zoning ordinances.
This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land
Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use
of the property as herein stated,which shall run with the land and binding future owners.
The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by
the Town of Barnstable Building Department.
WITNESS our hands and seals thisc:„Oh day of 00 .
TOWN OF BARNSTABLE 0 NER
By:
Building Commissioner /y
THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY, SS Date 7�O -0 7
Then personally appeared the above-named (owner), ��f`e tAttriv c9 A and
made oath as to the truth of the foregoing instrument,bef e m .
Notary u tc
My Com ission Expires:
MIRIAM E.SPRAT UE
' ' :,ommo ealth of ubMassachusetts
NotaCommission Expires Feb
Q:word/accessoryagreement '••-e_.._... February 13 2009
1
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f Assessor's map and lot number .E/la... ... ..: '
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TOWN OF BARNSTABLE
BUILDINGINSPECTOR
APPLICATION FOR PERMIT TO move barn
TYPE OF CONSTRUCTION wood
•
28 November 1984
•
TO THE INSPECTOR OF BUILDINGS: •
The undersigned hereby applies for a permit according to the following information:
Location 3152 Main Streets Barnstable
Proposed Use storage (no livestock):
Zoning District R F 2 Fire District ..Barnstable Village
Name of Owner Kenneth. D. Kramer Address 3152...Main...Street,....Barnstable
Name of Builder(mover)Glenn avenn.ing.SeCl Address Cap.t...DO:ane.!.s...Way.,....Orleans
Name of Architect N Address
Number of Rooms 2 Foundation ..cement..slab
Exierior white cedar shingles Roofing asphalt shingloP
Floors X 2 Interior ...11n .7,n ..She
Heating none Plumbing none
Fireplace ...n4 ? Approximate Cost ..$.8.QO.Q...Q.Q
Definitive Plan Approved by Planning Board 19 Area 0
Diagram of.Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
O r(
,
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.
Name
Construction Supervisor's License
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'' •KIRLIMER,, KFNNETH D. ,
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Nat. 27327� Permit for Move Barn
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