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HomeMy WebLinkAbout0083 FROST LANE g3 �s�- ��.�, �� __ _ _____ f G °FIKE r 'Town of Barnstable *P aY� Expires 6 montfhs from ss ate Regulatory Services Fee * -anaiasrABLE; Thomas F. Geiler,Director MASS.. Building Division Tom Perry,CBO, Building Commissioner .200 Main Street,Hyannis,MA 02601 www.towii.bamstable.ma.us , Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number �� 3 TK sT Property Address )ram L 'ryL /'f�Cr,v,.�,'S� {�7!-� t'r J G� ©'Residential Value of Work �C� Minimum fee of-$25.00 for work under$6000.00 Owner's.Name&Address x�y- Contractor's Name — Telephone Number .Home Improvement Contractor License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑�, I a sole proprietor Lld'l am the Homeowner ❑ I-have Worker's Compensation Insurance Insurance Company Name _ PERMIT, Workman's Comp. Policy# �r—r' 2008 Copy of Insurance Compliance Certificate must be on file. 0E6- Permit Request(check box) TOWN OF BARNSTABLE ❑ Re-roof(stripping old shingles) All consfruction debris will be takg.n to ❑ Re-roof(not stripping..Going over existing layers of roof) ❑ Re-side / f Replacement Windo s/door sliders. -Value , (maximum.44) ' " `''L r" *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permissiegi. ; A copy of the Home Improvement Contractors License is requiree7l— —-- �� �TT SIGNATURE: r¢, Q:\WP.FILES\FORMS\building permit forms\EXPRESS.doc RQvise020108 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly C ENZ e-(Business/Organization/Individual): /�1%L 9�� ��/✓ Address t� r-C�ty/State/Zip; ��d!��� � OPIWI Phone.#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with . 4. ❑ I am a general contractor and I 6. New construction employees(full and/or part-tim.e).* have hired the sub-contractors .2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. .❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No orkers'comp. insurance comp.insurance.$ r fired.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3- - -I am a homeownerdoing all.twork officers have exercised their 11.❑Plumbing repairs or additions myself. o`workers' co right of exemption per MGL ; y [N mp. 12.❑Roof repairs 1--insurance e requtredT]4 c. 152, §1(4),and we have no =-p- employees. [No workers' 13.Ether �l�L�/ � comp.insurance required.] �a 10Ui2 *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 subcontractors and state whether or not those entities have employees. If the subcontractors 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: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: 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 Phone 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#: Z -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 --ofhe foregoing-engage -in-a-jomt enterprise;-and=mclu-drag=the legal-iepr-esentatives-of dec 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." i - 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-contractor(s)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 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. 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 maybe 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 io any business or commercial venture (i.e.a dog license or permit to bum 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 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 wwwrnass.gov/dia (a -i 'THE t Town of Barnstable Regulatory Services t Thomas F.Geiler,Director Mass. Eo 39..A.e� Building Division Tom Perry,Building Commissioner ---200-Main-Streeter Hyannis,-MA 02601 - - - ---- ------ ---- -.__—. www.town.b arnstable-ma.us Office: 508-962-4038 Fax: 508-790-6230 HOA4EOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: FJ y�i�S� ZaN T� �/%!!�✓!S —�� number/ / street village / "HOMEOWNER"", ✓i�%dw& 0���N I�^-2.1.0 name f, home phone# work phone# CURRENT MAILIN.G_ADDRESS:, Oq ity/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-family dwelling,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. Signatim of Hoine wner 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()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 person as 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 permit 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 fortn/certifrcation.for use in your community. Q:forms:homeexempt r. j rti Town of Barn-stable Regulatory Services �sexrA s Mg« Thomas F.Geller,Director 4'iOr16 19. 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 Property Owner Must - Complete and Sign This Sections, If Using ABuilder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name .4 If Property Owner is applying for permit please complete�the Homeowners License Exemption Form on the" -6 side:- Q:FORMS:O VJNERPERMISSION Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services F Thomas F.Geiler,Director � i l " uilidi g Division DEC ' 2006.Tom Perry,CBO, Building Commissioner_ WIV�F gAR 200 Main Street,Hyannis,MA 02601 kSTAI www.town.barnstable.ma.us Office: 50.8-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY. Not Valid without Red X-Press Imprint Map/parcel Number r- Property Address 3 a-0 00 Minimum fee of S25.'00 for work_under$6000.00 ®..Residential Value of Work nn frl Owner's Name&Address � C �61&L. or C),j uj Contractor's Name c `�t'D6 C—L C s�� Telephone Number �U 7 2� �` L Home Improvement Contractor License#(if applicable) l y 3 -J Construction Supervisor's License#(if applicable) 2Porkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name 11 (� t /'� 5 s V �`/` C C Workman's Comp.Policy# A O' Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Q Re-roof(stripping old shingles) All construction debris will be taken to_ ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. 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. A copy of the Home Improvement Contractors License is required. SIGNATURE: t�__ Q:Iforms:expmtrg Revise061306 The Commonwealth of Massachusetts Department of Industrial Accidents Office oflnvestigations 600 Washington Street Boston,Mrs 02111' �M www.mass.govldia ' Workers' Compensation Insurance Affidavit: Builders/Coiitractors/Electricians/Plulmbers Applicant Information Please Print Le!Z1h Name(Business/Organization/Individual): . CAP G4O l to C Lf C-1 'C-C C_ •Address: b City/State/Zip: e ® f /-Y-v;�- Phone.: 0r8 T3 Z . Are you an employer? Check the appropriate bog: .Type of pioject(required):. 1, I am a employer with 12 4. [] I am a general contractor and I employees (full.and/or part-time).* . have hired the sub-contractors 6 ❑New construction . 2.❑ I am a'sole proprietor or partner- listed on the'attachied sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, []Demolition 'working for me in any capacity. employees and have workers' g �Building addition [No workers' comp,insurance comp,insurance,t' required.] 5, [] We are a corporation and its 10.[•Electrical repairs or additions 3,❑ I am a homeowner doing ill-work . officers have exercised their 11.❑Plumbing repairs or additions ' myself.[No workers' comp, right bf exemption per MGL 12,0 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 boz#1 must also fill out the section below showing their workers`compensation policy i*,formation. t Homeowoers,who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. #Contractors that check this box must attached an additional sheet sbowing the name of the Sub-contractors and state whether ornotthose 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: Policy#or S elf-ins.Lic,#: Expiration Date: S Job Site Address: S 3 �`� CArf C City/State/Zip:WAA-&V t J Attach a copy of the workers' compensation policy.declaration page'(shoming the policy number and expiration date). Mlure.to secure coverage as.required under Section 25A of-MGL c. 152 can lead to the imposition of criminal penalties of a nne lip to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK•ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investisatiors of DIA for insurance coves e verification. ' 74idthe pains and penalises of perjury that the infbrrr�at on provided abov2isrue and crrect. Date: to 0 not write in this area, to.be completed by,ciry or town offzciaL City or Town: ' .Permit/?•icense Issuing Authority(circle one): :1.Board of Health 2,Building Depa tment 3.City/To-rn Clerk e.Electrical Inspector 5.Plumbing—Spector 6. Other Contact Person: Phone#: I + I I S �. II y j I FROM :CPP5-WIDE ! j ! ADC ,NCI.j i 5�Sa2s3928 D(go. 02 20@IS 11:35F,M Pt #! Ir 11[#,1.Wn91E.LbiJ].lr ow V ri B s 7l k Re 1R Ory'Serv�CeS MAPS,� � � � iri .�Oeiaez•, Bu i m 'vas-on i ��•' I J i i otrr Peir^►,'I Wldtng Cox'ambsi6 I j Zj D Main trr,�t,� I�yannse,'k. 0260 i �+w:.to n;barnisiabxfe.ma a8 'i � i �: . 1 Coma plct� �hd Sign Tlis�S cdbxr � { ' if . g i i A J��.i,�d'�r � I - � I I F 1{ �.er of to subjecti prope f hereby Aurho f A i^_l t.� I �r tO art i]p asly be�al it in ill rriatt�:rs ela iti rx�ar �aix aox d bythi.s �i L&ng 'eMmt a� 3icatxnx�it) i I f job) � 1 it rl I i 3, 5i� Of , a ( is i, e � tl i I i I i it U0 35,000cf enclosed spare 1;A Masonry only iG 1 Z Family Iom;es "=1` Fa'lureto oss! ess a current.e z P. . .:,. . . di'honaofahe: Massachusetts State�$u $an t:ode• isea�use for:.re�ocatou�o'f tlui5lieense: License orreg�strmtron veagd for IndaWidul>use only t' before the ipiratibA date. If'found.return fio Board of Build�gg=Regulations and Standards One Ashburton Place Rm 1301 Boston,Ma.02108 alidzwithbut i nature w , Joa�s�u� 5£&ZOf1t(30 JOdJO �311�ti1�? B§.t t 4yy �� xal6aa; a47 � I 1 N0�`fN`IN"/IIcIW13fiIIQ1 spaepr�uat��pus�unpeln;tal�.�af�tmgdo,p�eog . �;' d'l?"� t�Yiv�iuo�r -Y' aaua►mwtuo , � x I � 1�1�021d�H04 M tL 060bx1 #�!� 6007�/r7�Z�/:l Q,g EEE fp eWIVIS p� s� ! nag�niMITCH[' p��og i ". T6 _ Client#: 51439 CAPEENT ACORD- CERTIFICATE OF LIABILITY INSURANCE 5D4AT,,E Z,M,/D DffYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers &Gray Ins. Plymouth ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE J,U1 Court Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ). Box 3700 Plymouth, MA 02361-3700 INSURERS AFFORDING COVERAGE NAIC# INSURED 7 INSURER A: Firemen's Ins. Company of Washington Capewi Enterprises LLC INSURER B: Acadia Insurance PO Box 63 � INSURER C: Centerville, MA 02632 INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS MM/ D A GENERAL LIABILITY CPA0215624 04/30/08 04/30/09 EACH OCCURRENCE $1 000 000 n2clom MERCIAL GENERAL LIABILITY DAMAGE TO RENTED $250,000 CLAIMS MADE Q ny one person) OCCUR MED EXP(A $5 000 PERSONAL&AD V INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY MjE PRO- LOC B AUTOMOBILE LIABILITY MAA021562510 04/20/08 04/20/09 COMBINED SINGLE LIMIT $1,000,000 ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY � X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ B EXCESS/UMBRELLA LIABILITY CUA021562710 04/20/08 04/20/09 EACH OCCURRENCE s2,000,000 X OCCUR CLAIMS MADE AGGREGATE s2,000,000 HDEDUCTIBLE $ X RETENTION $10000 $ B WORKERS COMPENSATION AND WCA025019610 04/14/08 04/14/09 X TORY WC LIMIT OTH- EMPLOYERS'LIABILITY E.L.EACH ACCIDENT s500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT s500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis, MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE e� ACORD 25(2001/08)1 of 2 #S35389/M35379 DAC © ACORD CORPORATION 1988 11 0 12/02/2008 09:55 9143777484 TRAFFIC DIV. PAGE 01/01 [a% 13 FROM :CAP&I]DE FAX NO. :5084283928 Dec. 02 2008 11:35RM P2 f Town of Barnstable p�YY Regulatory Services � �1 iTAl1LIfl, f 'Thornm F.Geller,Director l RaUdhig Tam Terry, Building Comraimioner 200 Wit Sr;9et, Ilyantvo,M,q 0260 i 'PPr'V1� town,blrnRt�ble;ms�,us Ofce; 508-862-4038 Fax; 50-8-790-6230 Property der Must Complete and Sign This Section If Using A Builder z� tha6 0 6�le, a ms 'Abject upropy he.re.by ral'60 i2e �(gyp 1.t,�1 (� (� am �eS io act on my behalf, in all mAttixs elatin to'cw'ork authorized bythia bi ldulg pc.mut applicc>ti,on for: r7c• - ern, �- , mf� oa(oo I (Address of Job) cr; ,igna ,7acr Da e ate, Pnc1.t N'a.n.e Q�AOP.MS:O�IPt bRiv1ISSIDN ty{s �-n,*�.trk---a�A.r.-"r ..�;Y "r'�.'¢,T�s.�.�lwj;f;r^^F� k'3••�b' -a+d"'A =vni..., „`4rp�` ^E i^S e.S;.fg s. y ..y.`� ''ry,,.��'" ry ..,, r , J�ofTxero` TOWN OF BARNSTABLE Permit No. ..3.9625 BUILDING DEPARTMENT NAM{ ' 1 TOWN OFFICE BUILDING Cash {$3 6 Q. .99) e�Q iuv HYANNIS,MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Charles Hughes Address Lot #11, 83 Frost Lane Hyannis, Kass. 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. October 20, 19 87 /. .......................... �.............. Building Inspector i4 a y I K(�i1•r, t,.,,'YAS�r"'A.�'T,. "' ' '� c x;•.� x7 ,:.i '+t"y..' ` TQWN C�F BARNSTABLE, MASSACHUSETTS ``j �.: #zs� o1z DATE MIT "J , PER11�i��1 APPIICANTWd�G�3' ADDRESS ... > (NO.f'r STREET ,:, �rinosn • CONTR LICENSE) - PERMIT TO , �. NUMBER OF STORY ''" 7 - WELLING UNfTS '(LOCATION) 1 _ { P SE1 ZONfNG NO ), STREET) — DISTRICT b�f BETWEEN �' AND I'. (CROSS'STREET) - (CROSS, STREET).,` i' SUBDIVISION LOT, i,. LOT BLOCK SIZE BUILrD NCe IS TO BE FT. 'WIDE BY FT. LONG BY FT IN HEIGHT AND SHALL CONFORM IN:CONSTRUCTION:.' 1 .o :a . .. TO TYPE USE GROUP. BASEMENT WALLS FOUNDATION. .:. ...;'(TYPE). Owiie,r " ($360. 00) AREA"OR yw VOLUME 1040 'SCE ft. ' ESTIMATED COST 5O O.O'O O.O FERM.T 5.2 OO # (.CUBIC/SO UARE FEET) OWN Ea C'h Nt, ps ADDRESS QQ R17+ 1 far AVPt117i� [AI �a�Ynlr�{,,.:, BUILDING DE PT e e f BY..' ( iiw f ;. tr'tiyT.f, rp� f S�rt�{`ft1•+:t9`�v 1 7 l I a ^:THIS:PERMIT CONVEYS NO RIGHT TO 'rREET�fLT��}2� 3` rPEOVANENTLY.- ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY.'PERM ITTED UNDER THE BUILDING CODE, MUST BE(! �., PROV°ED..BY.THE..JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAIN r FROM THE'DEPARTMENT OF PUBLIC WORKS.. THE ISSUANCE OF THIS PERMIT DOES'NOTRELEASE THE APPLICANT FROM THE,CONDITIC '- oF-e�•v'eoo,',r•,A,o,LE.SUBDIVIS)OK.RES.T_R!CTIONS. -•.:_.,- __ - " } - .. y. �` < `��MINIMUM2:OF=::'THREE CALL ¢ ti'INSPECTIONS REQUIRED FOR APPROVED PLANS MUST BE RETAINED\ON,JOB AND.THIS WHERE APPLICABLE SEPARATE ,f r71LL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS . ARE REQUIRED' FOR FOUNDATIONS OR FOOTINGS. ELECTRICAL, PLUMBING, AND MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.- TO f1+2' PRIOR COVERING STRUCTURAL QUIRED,SUCH BUILDING.SHALL NOT BE OCCUPIED.UNTIL yI MEMBERS(READY TO LATH). 9 FINAL INSPECTION BEFORE FINAL INSPECTION HAS'BEEN MADE. �C r ` .!OCCUPANCY. . : �. POST THIS CARD SO-IT IS VISIBLE FROM STREET { UILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS.. J =r 2 Y ^/ OVAL! HEATING INSPECTING APP OVALS REFRIGERATION INSPECTION APPROVAL! aJ )li G EERiG O T H E R -2 - ,° z �BOARa �F HEALTH ' WORK SHALL NOT 'PROCEED UNTIL 1.HE PERMIT WILL$E 9ME NULL'AND VOID IF CONSTRUCTION INSPECTIONS INO.fATED ON THIS Ct t a ' LNSPECTOR"HAS APPROVED THE VARIOUS WORK IS NOT 7TTE'D WITHIN SIX MONTHS OF'DATE THE CAN BE ARRANGED FOR BY TECEPH! STAGES OF CONSTRUCTION. PERMIT IS ISSUER AS NOTED ABOVE. OR'^ITTEN NOTIFICATION::. r L.. 2 i a th. I ICO- l 0 Seale I "-20 iqa Cap e yet sae 10-5-86 . 49 Ra�bo,t road l o26ar 1- : 1 i lane l-6: I x � ' pit � 1 i 4 .i.de 0 w !U/2 ?9¢� '' I C 61 ind I I=204 �OUG� n l 000 O.£Leu: 32.:5 .41 /009 ........... - -. v ._ l I I M s _.. o..__-w.a 3 0.o i 'pot' 12 36.4G; i i , �9 7 -:� nd s= p%u.�-i.,`e No Sca e i Cg 1000 r i ,. ,. wctshe -, �.�S.�. i y p ea ato N `1' , ; �'' 1-6 l<4 l '�'ii 2 l wash I__ t i r ed i : !.+J/2 atone i«<' B/ 1II/2" 23.E I•,,r„ ,:�:1. ' atone I .::Sketch P� ;ot .fend � /dgcuwl 9: �"a• �i 9o, Chai t e1 Pucd l-cep. 13e c� tot.1%.. aa:._ahown on a.pin".�cecoaded hook 164 page 57 £levat i o" �sJwwn�:ata on an aa�uscecl d4 t ,*. :_: . -•-- �c�te"-----Ac�Pnt o l ea�;tFi - A''ade, 9-22-86 9. t`""rckean P��o wa te�i encorivr tehed l vu G.%i on whown on l�.i� p)-rut ate, tocu ted on .('e�,than 2 min. peh. I'r the c�icound as a{wwn he�ceon and Kiezt.� -th.e a.et- beck �ie�yu iaencent� of the Jow#a of 6atmt. b e,. 9./�./ z9.7 9.l0.2 z5".k date .4-L0-87 __ .�-... - _ i _ _ .._ -:Yl/ .or-' 29-7 naed�4x nredircnL 4 sand nand i 4pNL SA 4tonen dtonei �o�' j M �^ Co �E ` yi o IV o.324 p �®081 �fG/ TEa �4 ��A41 LA9fl S� ; i .L'Ot to s Scc�1.e 1��-20 �j � :�+ e / G Date f 0-5-86 . 49 /dc-�bo t lZ ad ldya►tyti ; Na. '02601 9-tod t 1-6 1X L pit 40 wide -204 a V �000 -kc PC s r d •t. /.2,2 eS M Vi 129�G /00% ; 30:0 _ l.�J ��laZe2 to b �. ind tad,Led D. j ' I i _pot, 12 i i j nd At i ji)e No S,cate a r 1000 �; -6 144.1pit •••;1 I,�s ,.U�� d.tone u _... _ . j sketcA 1.Can o .ccwld •i n ld yana ti., ?ci, 9o)t ChaU to /duck/ 6e�ing. tot..l f aa...hhown.on.a.ptan %eco�tded !in. book 164 pie 57.! _.... Et wa�.t on.i ilwaln i a ie on an auu ned dattm. lam•----79—. :t.7T W9oaicZ-o - - - 9e4 t Pit �p-6 L 9 I ..... _ ' Nade 9-22-86 • No` wa' t eat enco un to ted e .tl►cwc 2 nui. peg. 1 A i nl .01 . 1 -4 0 4A i 29.7 z�:S• i IrInIct ncedirrnc . ' is�;dtiu►�i I . I . ; 'z �\ON P Nil L 'L. JA�o�9 a14 4 oo���of�IWEA1.•���� L7.7 1.7.5 FROM TOWN OF BARNSTABLE Mr. Thomas S. Burns BUILDING DEPARTMENT P. 0. Box 394 367 MAIN STREET HYANNIS, MA 02601 Menlo Park, CA 94026 Phone: 775-1120 L SUBJECT: A=289-12 Frost Lane, Hyannis, MA FOLD HERE DATE October 17, 1985 MESSAGE Please be advised that as per our telephone conversation your lot was separately owned prior to the increased lot size requirement and would be buildable subject to the approval of the Board of Health. SIGN oseph D. DaLuz, Building Commissioner DATE REPLY, SIGNED N 87•RMI RECIPIENT: RETAtN WHITE COPY,RETURN FINK COPY V Assessor's office'(1st floor): Q(J SEPTIC SYSTEM MUST F'THE t Assessors lmap and lot number I., Board of Health (3rd floor): c INSTALLED IN COMPLI b l 3 .`.., WITH TITLE 5 Sewage Permit number .. ........................ ...................... „} �N 9TODLE, . IL Engineering Department (3rd:floor): ` �I 63 R M A D House number 1 `�..�1. 3...............: .... .� TOWN REGULATION ��DyAYa� .................................. .. . APPLICATIONS PROCESSED ;8:30-9:30 A.M. 'A' 1:00-'2:00 P.M.:only; 3L SIGNIIJC ENGINEER MUST SUPERVISE t NSTDLLTA�T�E, N AND CERTIFY IN WRITING TOWN ;OF B rA"R N S TA�.J, ;,i WAS INSTALLED IN STRICT M riC,.()RDANCE TO PLAN. B'UILDIHG ' INSPECTOR .� U APPLICATION FOR PERMIT TO ......................................:.................................... ........ ..... ................................ TYPEOF;CONSTRUCTION ...........................LAIOar .......................................................................................................... ....... ............ � a`............................19........ �0 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ ..... ............................................................................................ i ProposedUse ............................................................................................................................................................................. Zoning District .............! �..`!-�..............................................Fire District .......... .... ............................ Name of Owner .... n Q://"e .........l(..vy f�?......�..............Address ... •-- v y _'„ > � '��'�. .... Name of Builder .........J....Q....................................................Address .......... Nameof Architect ..........................:.......................................Address .................................................................................... Number of Rooms ......................................................... Foundation ail r'e j - G of/I G 44 / ......p.......... .p�.lt. . ......5....Exterior .....W.ved s/1 ��� Roofing ....... a./..................................................... Floors 74..��.�G....a,Y.�......C.fl�p'G! Interior ..... r<y..r,V �Qll Heating ' .... n / �a -5.............Plumbirig .... oE. ! ........................................ f4� � Fireplace ....: .©..............:.......................................................Approximate Cost ..... ..°r�................. ........................... XU__93 r / Definitive Plan Approved *by Planning Bcard /�� Y 19________ . Area � ..7.P..................... T-------------- Diagram of Lot and Building with Dimensions Fee • SUBJECT TO APPROVAL OF BOARD OF HEALTH C4?6f4 6� i 2- anf rdv n0� + 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 A.0.01. e............ HUGHES, CHARLES A 30625 One Story-.a ................ Permit for ................;.................... 'Single Family Dwelling 11I4 ng ...............::;....................................................... Location Lot #11 , 83 Frost Lane Hyannis .............. ................................................................ Owner .....Charles Hughes Type'of C6n�truction Frame ..................................... ......................... .......................... .......................... Plot .............................. Lot ................................. 87 Permit Granted 'Apr-1 1- 14,.....:..................... ...............19 Date-of Inspection ................. ...................19 Date"Completed .......... ..............11§?y M M tov z M I-- Q M M tr ro 0� (r -1 m owl. Assessor's office (1st floor): l �/ n `�I �pFTHETo� Assessor's map and lot number ............./. o� ��1. .A. P � Board of Health (3rd floor): � I � � fO� Sewage Permit number ..........., t B9BaSTODLE 3................................. Engineering Department (3rd floor): ' 'ov "639• House number 2 .. �0 hh YP APPLICATIONS PROCESSED 8:30-9:30 A.M. aiid//1':00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....... v:t....... ..� /.... , .......... .............................. TYPE OF CONSTRUCTION Wo�� ' f-gni.�. .......................................................... ................................. _/_ 01-'-6_a ..... 1941 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... ,f. ...� .... :S': ..` 9!1. ..!. .... ! ">..........`.............:...... ................................................. .j.. fit4 C_t ProposedUse ....................:............................................................................................ ZoningDistrict ............t....... ................... a ........... ........ ...... .. .............................. Name of Owner `A•:i...?.......::.:...... ..........................Addressr....................:...}............... ....:...........:.... ......s Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... y `1 Number of Rooms ..............................................................:...Foundation .... v ;.......vre� Cd ............................ Exterior ......a^!..i� `. ......`-�fls.n A-. ........:... ................:...Roofin g ........ f� s,0 �+O // :............ .......`.................................... Floors c:.........................:...Interior ..........r ttJC1 ,. ,. I)., ...... Heating /,i�f r_ -e!;5,1 �` - ;f 5............Plumbing � �. . 1...?/ / !-" /:........................................ -......................................... .... E i4/ �......................................................................Approximate Cost .....fir. ; °'ram Fireplace ............ ..................................................... Definitive Plan Approved by Planning Board _t _______________________19________ . Area Diagram of. Lot and Building with Dimensions Fee SUBJECT PTO APPROVAL OF BOARD OF HEALTH } � - -7 i '. 3 8 r'u f r i 9a 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 �~ HUGHES, CHARLES A=289-012 / R No .306.25 permit for .................................... Story .............. Single Family Dwelling .................................................................... Location ,,.Lot #11 , 83 Frost Lane ............................................. ..................HXannis..................... ..................... Owner .,...Charles H.ughes. ... .... .. ............................ Type of Construction Frame ................................ i ................................................................................ Plot ............................ Lot ................................ Permit Granted .......Agri 1 .1.4 , 19 87 Date of Inspection ....................................19 Date Completed ......................................19