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Home My WebLink About0038 GLEN ROAD 3� �� ___ . . � - - . - _ � C i i i i i 1 �� Q� s� =�� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Oa 0 Permit# / I- ��—P l 4 Date Issued o O-�Health Division Conservation Division t11,P1 of All 1Applicatibri Feed® 0 Tax Collector Permit Fee Treasurer. Planning Dept. E 03MING BEM SYS'= Date Definitive Plan Approved by Planning Board LIMITED TO.A,.�(V BEDROOM Historic-OKH Preservation'/Hyannis Project Street Address .3 8 Cr R n K d Village OVqnn '' II 1 Owner G G GO Address -14 e(-,eq� ri () eA e74U1'r_4 Telephone Permit Request —Re—move S .eA co c k (n O&A goo oe", i e7;Su)a 4 4 4-oc )C WA M Q LJ , Gdd ex6u.sl 1;an. Refran�c S�owcr ldoi*- - wed) w 4 h AX LI ?(o on cPn _1_, A�d &J' 4o of Douse. DowhSiu Wi ,k4 , W-1,7dow. Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Sin,ob Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family C( Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes Flo On Old King's Highway: ❑Yes ❑No Basement Type: mull ❑Crawl ❑Walkout Cl Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing i new ` y Half:existing new Number of Bedrooms: existing new 0 Total Room Count(not including baths):existing 5 new 0 First Floor Room Count Heat Type and Fuel: Wrt as ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing yes New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use ne5 tC4,14.'a Proposed Use BUILDER INFORMATION Name Telephone Number -7% Address ' C) License# C 5 OR QQ:7 � N+cwA e I n ''c,- naan� Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 7 tt3 r GGnl t`[aC -(00 SIGNATURE / DATE " Qs- } FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED - MAP/PARCEL NO. ADDRESS VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION FRAME /rr O S N/iT T INSULATION U C)Fc FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH MFINAL ., GAS: ROUGH �_ FINAL ; A FINAL BUILDING co DATE CLOSED OUT ca m /A/ . ASSOCIATION PLAN o NO. f The Commonwealth of Massachusetts Ep Department of Industrial Accidents t 600 Washington Street Boston,Mass. .02111 Workers' Co ensation.Insurance Affidavit-General Businesses m r �+�cyi�•3uR� `Pt'ia:%''e5sSRr.+• •. .t,�rr!wF�r''4.ya. .. � .. .,. y may: � ,:'�bch] name: c G � r �Cl _• ;: address. Citv ��'V%1W G D26 `��1 G ziv: QG 2 Rhone# C,Q7��/3-T wor a location full address): I am a sole proprietor and have no one Business Types 0 Retail❑RestauranVBai/Bating Establishment ' working in any capacity. ❑Office❑ Sales(including Real Estate,Autos etc.) ❑I am an ere toyer with en to es(full& art time ❑Other .��./%%/ %/ %/% /%% I am an employer providing workers, compensation for my employees worldng on this job.: companV.IIafries. -- -- •�' address:' e:M y aihon #•�•' I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: COIDA IIV II .. i5 •i 1.., .4.i. } .y i .. dliotle'#` city .t. �t insurance c c 4. '�� ' ••• company n -,' .. �� '• .! sad3 ass: '. citi'- aihoue:#c insursncegib::,::,:.; - Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of s STOP WORK ORDER and a fine of$100.00 a day against me. I understand that p copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereb ify under the pain and penalties of perjury that the information provided above is true and correct Signature Date Print name /a LVAJ Phone# official use only do not write in this area to be completed by city or town official city or town: permidlicense# ❑BuIlding Department ❑Licensing Board ❑-check ifimmediate response is required ❑Selectmen's Office CHealth Department contact person: — phone#; ❑Other (revised Sept 2003) J Information and Instructions 'd workers ensation for their.. Massachusetts General Laws.chapter 152 section 25 requires all cmPl�yers t�rravi c crir� employees, As quoted from the 4`law", an employee is.defined as every person in the service•of another under any contract of hire; express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in ajoint.enterprise, and including the legal.representatives of a deceased emg)loyer, or the receiver or entity, employing employees. *However the owner of a association or other legal yang emp oy 'victualPartnership, g tY �P trustee of an individual, . 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 ereto shall not because of such.employment.be deemed to be employer. building appurtenant th MGL chapter 152 section 25 also'states that every. state'or local licensing agency.shall withhold the issuance or renewal ermit too operate a business or to construct buildings in the-commonwealth for any applicant who has of a license or P •. not produced acceptable evidence of compliance with the insurance coverage required: Additionally, neither the commonwealth nor.any.of its political subdivisions shall enter into any contract for the p erforniance of public work until ompliance with the insurance requirements of this chapter have been presented to the contracting . acceptable evidence of c authority. Applicants ely,by checking the box that applies to your situation..Please Please fill in the workers' compensation affidavit complet supply company name, address.and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department-of Industrial Accidents for confirination 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 regardii*lhe"law"or if you are' ' ensation oli lease call the D arti ent at the number listed below. . , to obtain a�workers. comp p. cy,p •ep . required City or Towns . Please be sure that the affidavit is complete andprinted 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/licens.e number.which will be used as a reference number. The.affidavits may be returned to the Department bY.mail or FAX,unless otherarrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: . The Commonwealth Of Massachusetts,- Department of Industrial Accidents ON of 1® esuggons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-774.9 phone#: (617) 727-4900 ext.406 yoFIMe roy� Town of Barnstable h Regulatory Services saxNsrasr.E, Thomas F.Geller,Director 4�bp 16119. a`�� Building Division QED MA'S 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: 2�i6G�� Estimated Cost DOa Address of Work: 3 9 Owner's Name: a G rat Date of Application: I hereby certify that: Registration is not required for the following reason(s): []work excluded by law []Job Under$1,000 Building not owner-occupied []owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR ROUNREGISTERED VEMENEALING T WORK DO NOT HAVE CONTRACTORS FOR APPLICAB 'E ID ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDERMGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a perm ofit as the agent a owner: Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffrdav E' : Town of Barnstable °* Regulatory Services ' s Thomas F:Geller,Director 63 .,�� Building Division TomPerry, Building Commissioner 200 Main Street, I�yannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property :hereby authonze�sj j c �c •1 C ��s,AN&) to act on rnybehalf, t ---Q in all matters relative to work authorized by this building permit application for, 36 6-I (Address of Job) Gkc C Signature of Owner Date Print Name a .. '� i 1 C�� W1'�IUC�►-� De C, lumber IS PT girder double 2x6 PT posts 4x4PT rail h6ight 36" a�. residence post spacing45 footing:4 deep W 10"wide l -41.0=A GE iNSPEC TIO IV PIA IV APPLICANT. PACHECO TO WY HYANNIS �a s LOT 8 k 9 (�a rt AS/LOT I LOT 6 1 LOT 7 os NOTE'• AS/LOT 2 / vv, PRE-EXISTING, NONCONFORMING. � �t AS/LOT 6 FLOOD PANEL: 250001 0008 D FLOOD ZONE DATED. 7/2/92 I hereby certify that this mortgage inspection plan Tjas prepared for: Plan is For FIRST HORIZON HOME LOAN CORP. Bank Use Only The location of the building shown does ___ fall within a special flood hazard zone. DEED REF = 6_8P2e 74 Per taped inspection it appears the location of dwelling does ------ conform to the local by—laws PLAN REF. = 861127 in effect at the time of construction with respect to horizontal dimensional setback requirements — ---- or is exempt from violation enforcement action under Mass. General Laws Ch. 40A —Sec. 7 Scale 1 = _ 0' FT. Referenced Deed subject to and with the benefit of all rights rights of way, easements, reservations — and restrictions of record, if any there be and insofar as the same are of legal force and effect. Da te: :HZI PLEASE NOTE.- The structures on this inspection were located by tape not instrument and are approximate only An actual survey is necessary for a precise determination of the building location and encroachments, if any exist, either way across property lines. This inspection must not be used for recording purposes or for use in preparing deed descriptions and must not be used for variance or building plan purposes. This inspection must not be used to locate property lines. Verification of building locations, property line dimensions, fences or lot configuration can only be accomplished by an accurate instrument survey which may reflect different information than what is shown hereon. This inspection is not to be used for any purposes other than mortgage. Yankee Survey accepts no responsibility for damages resulting from said reliance. PHONE 508-428-0055 YANKS SURVEY CONS��TANTS FAx 508-420-5553 UNIT 1, 40 INDUSTRY RD, MARSTONS MILLS, MA 02648 37220 JS Results Page 1 of 1 V t Home Improvement Contractor Look Up Enter Search terms separated by spaces. Search terms can be Town/City, Name, or License number Select Search type: r, AND C OR `S arch Search Results .ry Reg. No. 1 Applicant _,___Street_,___i__. C!tY___.. JState_Zip _ _Name. _ Title ..__€Expiration! DOUGLAS E 296 MARSTON BROWN 143513 COMRMETT MAC 02648; ' ` OWNER( 8/20/2006 A. BROWN ; MILLS � � DOUGLAS I (( Total of 1 Records matched. Back to Home Page BBRS Privacy Statement http://db.state.ma.usibbrs/hic.pl 1/18/2005 Results Page 1 of 1 Licensed Contractor Look Up Select the search method: Uicense Maximum number of matches: _25 Enter Search terms separated by spaces. 187207 Select Search type: r AND G OR Search Search Results Lic. ....... �_.w City/Town Name Lic. +Restrictio7n",',,[Ex tratiow" Street State` Zip T e a ± I � . BROWN ' i PO CENTERVILLE DOUGLAS A CS 87207` 00 11/07/2007; BOX ; MA 02632 145 Total of 1 Records K ... �.....�..�..,.�........-......».� matched. Back_. to._Home Page BBRS Privacy Statement http://db.state.ma.us/bbrs/contract.pl 1/18/2005 oFTME Town of Barnstable *Permit# Expires 6 months from issue date = Regulatory Services Fee 3 ,m� Thomas F.Gefler,Director N1A`� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL OAEyr ' 0.2004 Not Valid without Red X Press Imprint lap/parcelNumber ta?66 Ono TOWN OF BF,R�i�i�,z c roperty Address �� '• Residential Value of Work UOo Minimum fee of.$25.00 for work under$6000.00 )wner's Name&Address Nakk '7"[ ,ontractor's Name Telephone Number SUjY -2VJJ� come Improvement Contractor License#(if applicable) ;onstruction Supervisor's License#(if applicable) ]Workman's Compensation Insurance Check one: V;ym a sole proprietor m the Homeowner ❑ I have Worker's Compensation Insurance asurance Company Name Porkman's Comp.Policy# ;opy of Insurance Compliance Certificate'must be on file. 'ermit Request(check box) �R roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) 2.� side Q Replacement Windows. U-Value 3(4 ( .44) *Where required: lsamnce of this perrDit does not exempt coiriptiance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home t Contractors License is required. ignature !:Forms:expmtrg evise063004