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Home My WebLink About0025 GOAT FIELD LANE 01J �Oct7 P��C/ ew. II WE A t The Town of Barnstable • s�ttvsr,�ai.E, • " ' •• Department of Health Safety and Environmental Services 'biro rya'+" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner SHED REGISTRATION GR F64,t> LtiNC I :c- Location of shed(address) Maur,W) Lye 7 79-,r6yl Property owner's name Telephone number i BXId " Size of Shed Map/Parcel# Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? q Conservation Commission(signature required) N1- 100 yl THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg -lieo on_ N PO '�\. �(a.� �i ) `,' �\ ? a ry.D � Q n q.. ..•� � � � �� _ � .. D n 1 0 7 f n ~�n t n 14 it 'it la A i u A lop 10, o� i. . •a o P flop+i 14 - � S ft � �I P. : ,O" 016• o-4 - rY`d . n 3- R •' �I: f,e•i� „ i 14u� 3 •'m � ,.�``, .° . � md' `O ��. p Y" p � J;�eye e� . o i s� R Z .. '� ..� -\,O t� � � Or�y� �.� p. .p`ti• ��r�e. �� -.. �.� pt.1• � W � �,d. w iN . iM' 'b: ' ••.:A� .� �y.\:..,�. 4 a , e n. 9� o�l'04 Y�`r�n7 a•,o �. . P4 �yA ', 4 '��O'I�• p.( t ,' �t.jf R i •• �•. 11�°. .90 ^ Ir." w ,;rr• ail od. n to y L 1' • F �� a 1. �a(f °s: q••:.�i 2 to _ W � > U r, . a � ri?. O » •ice. fry' ��' +•. � all ri fb 1:.` C 0 .4ds a GTq� / 0 �j1�i,t+ op pa kA A 3 PINE Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fee L-3-el , • BnxxsraBM 9� ,"S. ,0$ Richard V.Scali,Interim Director ArED��p Building Division Tom Perry,CBO,Building Commissioner X-`Wss 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us SEfp 0 4 2014 Office: 508-862-4038 8- 30 EXPRESS PERMIT APPLICATION - RESIDENTIAT �7 �NWABLE Not Valid without Red X-Press Imprint Map/parcel Number a L 21 ii Property Address lJw ' C1 Q l� ( .I-, (� 56'Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 95 G{tad- TWA Ln Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email, j nl Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor �] I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name U5A* Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders.U-Value )n n/) (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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 Ho a Improvement Contractors License&Construction Supervisors License is r quired. SIGNATURE: ail T:\KEVIN D\Building Changes\EXPRESS PERMIT\EXPRESS.doc Revised 061313 the Cointrionlvealth of Massachusetts Department of Industrial Accident O f`ace of Inuestigadono 600 Washington.Street Boston,H4 02111 ivrvly-mass govldia Workers' Compensation Insurances Affidavit:Bnilders/Cnntractors/E=t-cta-icians/Plumbers Applicant Information ( la Please Print Legil Name giugineworgan zatioi di6t a1)_ L() ` Address_ City/state/Ztp: Phone 5�8-108� 5 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 constuctiou employees(full and/or part-time).s have lured the sub-contractors 6. ❑New 2_❑ I am a sole proprietor or partner listed on the attached street_ 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance co-op.insuranct".7 - ❑Building addition required.] 5. ❑ We are a corporation and its 10-0 Electrical repairs or additions IN I am a homeowner doing all work officers.have exercised diek 11.❑Plumbing repairs or additions myself[No Workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required,]1 c-152,§1(4.X and we have no employees-[No workers' 13.❑Other comp.insurance required.] ;Any applicant that checks loos#1 must also fill out the section below drawing their workers'compensation policy information. lfnmeowners who submit this affidavit indicating they are doing all aaak and thenhsre outside contractors mnst snbmit a new affidavit indicating such. (Contractors that check this box must attached an additional sheet showing-the name of the sorb-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their markers'comp.policy number. I ant an employer that isproviding workers'compeensadmi insurance far my enipivymL BdVw is tire.policy surd job site iq formation. Insurance Company Name: U Policy#or Self-ins.Inc-#: Expiration Date: Job Site Address: City/State/Zip- Attach a;copy of the;corkers'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$1,50U.i10 andlor 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 J:et`atr},ce under�theah'&s a.�`,Perl'ury that the infarm�ionpt�ot�ided abors is Gate maid correct Bate: Phone Ofjrrciad use only, to not write in this area,to be completed by city or tmvn of civet City or Tower: Permit/License# Issuing Authority(circle one): ..Board of Health 2.Building Department 3.Citp Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: - 6 Town of Barnstable Regulatory Services Richard V.Scali,Interim Director Building Division SARNSTABLE. ' Tom Perry,Building Commissioner 9� 1639. �� 200 Main Street, Hyannis,MA 02601 RFD MA't a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: 1 (F-0 1 e�w. �i(f➢f111) number //q��,//�� street village- "HOMEOWNER": ((�aumoI4 �OO'@ 0� r��7 ✓Utz�S IDS '1`1�1I name home.phone# work phone# CURRENT MAILING ADDRESS: _ �i06a Il I2 f Oki 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- 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 procedure d requireme4 an4 that he/she will comply with said procedures and requirements. 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 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 form/certification for.use in your community. T:�KEVIN_D\Building Changes\EXPRESS PERMIT\EXPRESS.doc Revised 061313 a, _ oF1 r Town of Barnstable *Permit# d! /0,1�0 Expires 6 month fro sue d Regulatory Services Fee * snxxsznai.E, p 1MASS Thomas F. Geiler,Director rFD Mp'1 a P/2- Building Division Tom Perry,CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.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 '�4 y 7 l Property Address Z-5— ,q-f,4-Z C-Ldz LA-0-6 , 77'7i4N/.XJ1 S f (,, --, �w- hip Residential Value of Work%6, 62)C) Minimum fee of$35.00 for work under$6000.00 Owner's Name& Address 4L14-, V rV LAC U Eve i 64 ftt tr., L6v �— C 47t-&-- AAN —U ryp4- O Z(O 1 Telephone Contractor's Name hone Number T p Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) PS 7 3 o ❑Workman's Compensation Insurance Check one: I am a sole proprietor ❑ lam the Homeowner A P ES S PERM ❑ I have Worker's Compensation Insurance e9/I� Insurance Company Namc 6 9 �11? Workman's Comp. Policy# JWN OF SARNSTABLE Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side 3 U ' #of doors 3 Q Replacement Windows/doors/sliders. U-Value " (J (maximum .44)#of windows__s- *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 & Construction Supervisors License is require SIGNATURE: f Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 070110 OF THE r Town of Barnstable Regulatory Services BARNSTABLE, + Mass. Thomas F. Geiler,Director i639• ��'� ArFo �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 Section If Using A Builder I, �- -tl l��'L��'�— �� , 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 If Property Owner is applying for permit please complete the . Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMISSION SHE Town of Barnstable �pF Tp�� yip Regulatory Services BARNSTABLE, Thomas F.Geiler,Director q MASS. 16.39. A,0 Building Division rED � 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: EU-? / JOB LOCATION: �—J �Dl�}T C, �—�T/L ��'r number �/� street p village Q .,HOMEOWNER": h/ '4n �I /E�U G—t�L6*f_ name //11 home phone# work phone# CURRENT MAILING ADDRESS: (364 y'cZ CL_A L&9 6 fT city/town state zip'code The current exemption for"homeowners"was extended to include owner-occupieddwellings 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. ` i, ' ; ''�: t I • , 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 re ire ents. 1 ' lzd� su'L G� Signature of omeowner 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 person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. C 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 forn-/certification for use in your community. Q:forms:homeexempt The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations kil 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leuibly Name (Business/Organization/Individual): RV Q VI S /��(pvI — �� (/C) V1 f Address: l O✓6A a City/State/Zip: -4�4 r i d l y t cat Phone #: f U IP qde-7 6 )-6 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 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 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 workers' comp. insurance comp.insurance. � required.] 5• ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE]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: Policy#or Self-ins.Lic.#: 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 ofperjury that the information provided above is true and correct Signature: Date: &-9 b ¢ / Phone#: Sd O y DJ (7 a(---3 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#: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Z7 Parcel J 9 /� Permit# 4,4e ` Health Division - Date Issued 4 Conservation Division - Feeir S Tax Collector Treasures Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address D576Mar X'elo .Village��>✓a,�,�Y T Owner d / 4hae-,. Address Joni, Telephone 778RS-ST,( Permit Request oc Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Lot 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) NNumber of Baths: Full: existing new Half: existing new umber of Bedrooms: existing- new Total Room Count(not including baths): existing new First Floor Room Count ' Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Ce6tral Air: ❑Yes ❑ No Fireplaces: Existing 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 Proposed Use BUILDER INFORMATION Name Jdtiry Q,6e!.1"r-Q402 Telephone Number "771Q 9` ?/ Address 3s (41*ht� eke License# 022 / lFt »a.rho Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Av•;p SIGNATURE DATE P/13�®a S. FOR OFFICIAL USE ONLY r i PERMIT NO. + DATE ISSUED MAP/PARCEL NO. t y y,. 1 w L ADDRESS ,. -VILLAGE . OWNER,- DATE OF INSPECTION: 4 _ FOUNDATION : r FRAME INSULATION FIREPLACE - - ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r s FINAL BUILDING - DATECL'OSED'OUT i ASSOCIATION PLAN NO. t Department o n 01�ca ot/�yestigauoas it 600 Washington Street Boston,Mass- 02111 ,y� v davit -_ �/�/ /�' Workers C�yo�m ensationInsnran ce :'-�i37 F1 t 1:-r•••E�{T�I tIL'�Ti"3 nn•ne� �ocation� � hone# cin• A I am a hozueowne1 PCrf=n'n9 all work mys is aav caaacity . I am a sole DzoDrietor and have no one�voikinn :...: employees woliang on this lob. :..:.: emD P ...... .... .nrn ......... }/........ . .....:::.......... ..... ... .-. ...:............................. ... .:v fir v,.,r.,....n};•:•::.:,,.:::::•..::::•:::::.::....... n:•.:::}r::::;:�:?:.:....�:::::::..:.:;:<::... .. ......... .. ..:::.v..:•::.�.....:::.� ....,h.:.• .,......,....5•• Y,rCw�n'".,�.�;... ..:n. vh :.::::v::S4i?iii:?.}:4?:j;:iC>}:?;i:?::..... .. ......... .. ::::•.}Yi.:S•}ii{4 •A :. }N. v:::v:::::w::.: ..{{n,.. .. ..........::::...... .. .. .,... A^.. addre .......::•::n .. �a x$:.......�:..:Win,:+:.......:.:.....:::::. ..:..�........:::.,•.<.:.}•:,.:.,,,,,.:: . .... ............. ... .. . .. �::..:....... ......... .......urn . . ...}•:::::::.....;:.-.:..... ...... insurance co. have hired the Contractors listed below who I am a sole PrOP ��c�trador, or homeowner(circle one)and &'�, the workers comp p easatton win :-:: :n....:.:4pcties'.:.x:} .;:. .�.:::::::::::.:. o .....:.....:::.v•.}:{:}}y:.,......:..h Ka r:nvM4+ .,Wj^^.,C}M.. ..• ..A .4.:.an;{a$:•}?:?.y,,v::? ::............,.;.,...,.:..:..x.v:..}}}}i}•i•;:$:}}:?•: -� ..::. :• ....y'•v:•...... .,-..,.,.;..}.vY.,,r, :. Sfiavv:yv-•• ......v::....:w. ... .....nr..4. ..n:n ..:...}'r4ti,..{r�n. 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' _ f Y r 1 11 � �••r 11•11^r1 .t r1 /11111 •.• ram• • • • •• 1 �• • • • Y.111 11•.•�•.- r•II/1•�•IAY.1/ •11 1 • 1 1 .t •/ .. . •IIt • • • ,• 1• .• to i1 •% 1 l .••un1 -•• •lr t •WWII-/ -••� 1 ' --}} r •1 1 ..Y• •I:1■ •III /V. 1• Y•iit Y. « • t 1 w•RI •111 • t/ .0 1 wul • lop • t11 • 11 // a -.0 11 11 t• _ - _ yy•• • 11 ••1 I 1- 1 v�1 -•1-• ^1 Y Mutt •^ 11 .f•• • • IA IIY. . / .INH•�• • • .,1 11 11 •�••1111 ^•AV lull/ 1 ^ 1 � ' • •t•w01 1 ' t1 111 �M •1/1 �• _ yy .11 • • 1 11 1 .11 r 1•I • 1 Y•• •�• .1• •11 .0• 1• 1 • •• 1 1 . .11 • 1 w ••• •• •• t:.vlr.1 u u 1 «: I ��jjj jjj�jjj/�----- ease wool 1 1 11 11 1 1 1 • 1 �• t all 1 1 1 1 • 1 1 1.' r l l � t l ' . 1 • , 1 1 1 - • • 1 1 • 1 ' 1 1 1 1 1 TThe Town of Barnstable MAM Department of Health Safety and Environmental Services t6,jg. Building Division 367 Main Street,Hyannis,MA 02601 Ralph Crossen Office: 508-8624038 Building Commissioner Fax: 508-790-6230 - Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW 1 SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of as 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. Estimated Cost Type of Work: 3_ Address of Work: Z''v Owner's Name: '+-��N �7e Date of Application: 8�3/On I hereby certify that: Registration is not required for the following reason(s): Work excluded by law 01ob Under S1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that:OWNERS PULLING THEIR OWN PERMIT OR DEALING W UNREGISTERED K UNRE GIGI DO NOT HAVE CONTRACTORS FOR APPLICABLE HOME IMPROVEMEN•T WORK UND UNDER MGL c. 142A. ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY F SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav I F • i s vCAM 1 mCD rn co E. 3 � czoao o ry v S CDrrn a CD � z v c .a z a ry c a It a z °O �+ m z a mm � CO o `e o A a e-� j j or) Map 1,9 il Parcel /?9 a Permit# ✓ �� House4 .' - Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00- )? 7443 Fee �kP ✓`` D v Conservation Office (4th floor)(8:30- 9:30/1:00-2:00) ff 2e yam_ 444 Sri Planning Dept.(1st floor/School Admin. Bldg.) FNV�AO �r Defi ' ive lan Approved by Planning Board 19 _ ® d� &C a TOWN OF BARNSTABLE Building Permit Application Pr QS &147-Re lb 1,v Village Owner �/3e;r2 eel✓ LnveTT Address „Sit .Telephone Permit Request Peoloi.,e a " Dec 4r — (J ' PT Gvv�e tvi'Th � �` -r•9►.,,. 3 ` �r Dec y ii,.c% � s 1z�- e? ^t'36 •� a1. C! JL ` C. First Floor square feet Second Floor square feet Construction Type Eawniy,e i Estimated Project Cost $ S206.0, o0 Zoning District r Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family g Two Family ❑ Multi-Family(#units) Age of Existing Structure �76y�_ 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 No.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 wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Builder Information Name (0,/eaIn•-�e�2 Co,�csrnrx n�,..� Telephone Number 3D8 -7 t7Y 0 3610 Address /4'3 Ce--,pw Sr License# 936 D's°' 4,�t3 026,32 Home Improvement Contractor# //33 00,2 Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �., � . � � DATE 7-2 /-9T r BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) �v va "G l L C. ' FOR OFFICIAL USE ONLY _ PERMIT NO. DATE ISSUED _ MAP/PARCEL NO. - • _ADDRESS ,VILLAGE t r - OWNER DATE OF INSPECTION:, _ FOUNDATION FRAME r- - 6 INSULATION - .• - � '� �` ; - - • ' . . •- FIREPLACE ' y f ELECTRICAL: ROUGH FINAL R , PLUMBING: ttA ROUGH FINAL GAS: 0 .ROUGH FINAL d,.� ��,pay + - - � o .,, .. - - :•' . , ° FINAL'BUILEilM. ';a DATE CLOSEDOUTi° Cx. ASSOCIATION PLAN' NO�� a` The Town of Barnstable I lip 9� �' Department of Health Safety and Environmental Services � 6 9, . BuiIding Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 BuiIding Commissions For office use only 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 constivction 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 rre-equirements. Type of Work: �.e -L ee �a Est.Cost_ Q-e- . r ` Address of Work: Owner's Nam V-C, , Date of Permit Application: I hereby certify that: Registration is not required for the following reasons): Work excluded by law Job under S1,000. BuiIding 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 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 Name Registration No. OR Date Owners Name The Commonwealthof Massachusetts Department of Industrial Accidents #XCe 911ffY8S/gatio,7s 600 Washington Street - Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: n r location city 1-4YC►ti k i S 4k C. phone# rc 3' I am a homeowner performing all work myself. 9mm. I am a sole proprietor and have no one working in any capacity ,,,,,, ❑ I am an emplover providing workers' compensation for my employees working on this job. com nnv name: address: city phone#: insurance ca. olicv# ❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: tom anv name: address: city phone#- insurnnce ca. :. olicv# cam anv name: address: phone#r city- insurance co oiicv# _. % ///%/ %//%%//%G. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a One up to SI.500.00 and/or one years'imprisonment as wen as civil penalties in the form of a STOP WORK ORDER and a line of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. 1 do herebv certify under the pains and/penalties of perjury that the information provided above is truo and correct Signature Print name w Q L in t �,¢i✓� �r Phone#.5��—��'—D�3 � official use only do not write in this area to be completed by city or town official city or town• pertnitlllcense ri OQIB,iecensmg Board eat ❑checkifimmediate response is required ❑selectmen's Office Qffealih Department contact person: phone# ❑Other�,� .... :::... ..... .. (revises 9,95 P1A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "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 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 section 25 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns 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. The affidavits may be returned io the Department by mail or FAX unless other arrangements 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 Office of Investigations 600 Washington Street ,_; Boston, Ma. 02111 fax#: (617) 727-7749 fit" phone#: (617) 727-4900 ext. 406, 409 or 375 GEOGRAPHIC INFORMATION, SYSTEMS UNIT 43.3 X 43.3 �i4 . }�41.9 1 42. i 5 4 - -- 44.6 E 41.4 4 f O r l ` \4 �... .4 X9.7 O - i f ned, �1 i r i -56No Tv�?Y8 ' Deep 1 Rs�l Ila „ X00 Ar I f' � 1 �� • _ _ , . .. _ _ J ' t • „r t r 4 ' :+ r r f 7 - hey 09, lyy --Deep RAW b,9,wljxe�lr 0. C. N �\ 4-3 LOCATION SEWAGE PERMIT N0. VILLAGE � d 3_ -;>63 Ly 4\ 4��- I_NSTA LLER'S NAME s ADDRESS e^U I L D E R OR OWNER '6 l�, xj e� - v , II DATE PERMIT ISSUED DATE COMPLIANCE ISSUED DECKS If located in OKH or Hyannis Historic District-Certificate of Appropriateness is needed Map/parcel number Sign-offs from: i/ Health Conservation Tax Collector Owner's name&address Deck Dimensions Estimated Cost Complete dwelling information for the Assessor's dept. Applicant's telephone number Plot Plan i Two sets of plans with cross section Workman's Comp. form Home Improvement Contractor's Affidavit Construction Super's License AND Home Improvement Specialist's License OR Homeowner's License Exemption form. Check expiration date on license(s) Check expiration date on license Fee q-forms-PERMITS 1 Rev 6/2/98 ' ✓7GG �V/ !$IAGIiLIG !./��'VKAIV (�u.{Ir/GL4• , � �F r3,�� aig r J, 1 y t"�� i 2f r.}• ��,+3 +r r rt X� tq-s'i mr 't r t F.W 1 °;}';�°7"'Ic W'�� C :E�tIM' J k a ' r {•T y 'y.,. 7 ..� �4.�fr*N'tkh. }� �� Vi l�_� N� i f',3 4,',tr i!'Fye}I.✓� i �r3.��'- .�{i i.. ri•:- (.+� ! .4. .N 4.. .,/. .�+ " t A: HOME= 'IMPROVEMENTyCONTRACTORS?REG:IS j �,;�, Boar.d., of °Bui'1di,ns Regulatt ;ons-Aand.AS �" 7_ !•„ 1,,. ..;. -', 8 f� r Fs_�`jy ORI '.1':3 j"• ': I" �4 r'" h � -e7�'i?ry.;<"G' •,ss�s��!",�.,�4`E r ';' r. j One Ashburton�P 'ac Y '' !',."�`.,}' ' �.:• a w�f��r:h�e taQ R� +��,F.�J� J� � �' a" °'„��cs" skr � � •� t��X #�..'�>•+ro.� 'g ��3fi� :e�e S4 �st`��%.Y' z�o.4�k!e;. �� '{-..).�T.MJ; 1.4-�t ZZr1� s�"9.a�y-�•.�.nt�h "fi^a�:%v�,.h.�•+rj ,:��.�tt*'�t 1 r .,-,.4. , -J., 3' �; .+Y ,..,`' .fi'�r° n;,;'."''� ...r. ..."Kr :: .. '�trr's,n r•F.' �_t ��°� X.�r�`"z� -��.�'br .lhe �e;a�vd s"CS .T',,,b'� ,:,A�'�, �. ,.f:;. y�T ; rqt I�a,�.c:+ri�A J -.�. '¢Amp, na�`�`'� ;� w+"r �'.h`.t-a�le> �8.,, �}.��h.,.� L" wayF.�( •�; . �4 ..nv't c•�`�r„..`�"'�`><.�`t�r}� i7?,-'•..fi"� Y,,yy�r ?'. '. .;r :3ai.t.ais + IKON ,�P HOME:�IMPROVEMENTr=CONTRA,Ci;OR : , �.; •.��' �; �� t � .�� .��:� r� �� -:: ��n��. ��>;�� ,��.�•.;�.r�.�,�.�� ;.; Ex -r r •. Registration.``Z1'3387 _:`Typo INDI1JIiDUAL x� '� �� , � �� 'I �� i(✓j/��" �aky��/��K1[��a , 4 S M �+ { I �� 1 e �� tm ,:x, •'ter .i",+ +4 M Yy. � y r�, u �,r •�,�,r� � , �, �� _ N � � HONE,'IMPROVEbEt#T:CONTRACT.OL,,.� ,� � .d t�.:..a. ; ��!� •`�tY��`tf`<�'�� a'}� � r�K�ta � ='��r � '` �' �,:�- J `Re9.lStrSl.iuD �113387 :��;��, � .OBERLANDE:RONS�TRUC-'klflM ` txm�'� PTrPehIDIV�DUAL ; tip a a� s :.x .s q y 2,5 � 3� ,{ EDWARD ;A OBERLANQEr.., E pirakLa 06119 r R c 8 z y 183"CENTER ST� DENNISP6RT MA 0263 ., t ! OBER ANDER CONSTRUCTION f F . is ':.v 'ry % 1411 ' . EDYARD A` OB}ER�ANDER, �} 7lD �, w DENNISPORT J... D2639 � .. _ ' ��'�;. -t; :�""S,�kt �vr � �1,.,c_:.2,.,• e:.�:i�.�..>.� ,w"+� �...a:% s.m:v_ "�r..� � �x��i,��'i ;i�'�s`,4v:�'�",�� Alm �omemwxcuealt� a�✓v( c tuaeCCa It' I . DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION`SUPERVISOR LICENSE Nuttier Expires: Res0,i-q W ffio 68 ' EWARD A 6BERLANDER �83 CENTER St DENNISPORT, NA 02639 �`' ,• TOWN OF BARNSTABLE ___ _ 1 _ Permit No. 2704 ___-----___--- `` Building Inspector s.unm Cash ------- --_— -- sYL ,e,o• °- OCCUPANCY PERMIT Bond --__-- -(� Issued to F'ayS?de Buildin q Co. Inc. Address Tot. 27. 25 C',cxAtfield Tar!-. r r t uvanni c;- rf- Wiring Inspector / fin ° Inspection date �f i7s ��1 %J .c.-a ._. Plumbing inspect or4 � Inspection date Gas inspector Inspection date7,4 ` � r ;4Engineering Department-�`f ;.f+'� f � f�� t C,/, pt,4 Inspection datet-r; r' i Board of Health - �' r`t Inspection date/L 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. .....�.......:`.:1........�.�.......... 7.9 .................................................. Buildinc, Inspector FROM Y vow of BARNSTABLEa Mr. Francis Iakiteine� .».�.a BUILDING DEPARTMENT txan Clerk ' _ � � ""`" 7 MAIN STREET HYANNiS,� i�A Q�1 � , �� g�. Phone*,775-1120 j � I 1 SUBJFCT: FOLD HERE s? ..DATEJanuary 17, 1985 MESSAGE [fork has �� o=ieted. ♦ �e t #"Is 2.704l and 27043. �i3a ide �a ld nc�- ,4n,b.'3 �%?^� 9E'�'t'.^Np•P.M^h.3k�•��+"+a:+r �Ye.-J[•h�A€w�p�R'*..lee?w n`a.p'.,f•3ae-•It`+rMi •S�Tb rs�i� t �c r+r' N Co. Inc..) -f--Pease-release-Bonds. - - SIGNED DATE - �•) ! "'f ! ` REPLY Ne7•RM1 RECIPIENT:RETAIN WHITE COPY,RETURN PINK COPY ' f • - y PRINTED IN L.S.A. SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. UOABAvns ®NV I 193H 3jjvq, "rip✓"l� kid . . '5 Sid W `S I�1 N dIt H 13�3HIS. N I�/W .ZIE C VW `31OVIONUVII J® SAWR ®NINOZ 3H1 01 SWVOJN0O QN�1 '1iAB0 0wv 03.1niam S'y ®NP10ve 3Hl wo ON 'SIB 031VO01 SI NVId SIHI N0 NMOHS 03t$31S103N 03 31SII .3H1 IVHI AJI1N33 @ �a is.cMAN VNIM33MIS .��ns ati NI �, �nas� L 1✓Ocl.S1-A1/V VIH 51-:W/Y7 a,'. 12't3Fa02S / `•' Coln, '. NV-1 d .10-ld IF7.Cl t - j+ ry E N, C7 Z 1-�' 7 Assessor's map and lot number ... ... - /�v�-- I Z`.� �� OF THE Sewage Permit number � .:. G.� i' w Q., 'N ";" g�, g��,iy t�a.�/'�'"'"�Vt� 7;y� = BASHSTADLE, House number ........................... .... ........... .... Y, "ALLI 71tl C3 �Ld� la 9� 16 9 dd� TLE 5 A. r. TOWN OF -- BARN�ST�A�BLE � d A., CD BUILDING ' INSPECTOR C..:. OO i.ne '.. f a APPLICATION FOR PERMIT TO, ....:.... v .. ...... ... -.. . .. ...... ....... .. .. ........ .. w y ' TYPE OF CONSTRUCTION ........... :....................................................... .................... '� t ..........`........ "" ". .......19.. J TO THE. INSPECTOR OF BUILDINGS: The undersigne r y applies for p it according to .the Flowing informatio ..`.a ^1 r Location .............. .... ..... � 1 .�,�".J... ....�... ... .V.�. ... ... .., .................................... ProposedUse .... ...... ...... . .. ..Ct.....................:.................................................................. Zoning District ....... ... ......1..... �' ?,.....................................Fire District ....�'i.. ..,G��,��. ...................................... Name of Owner ..24, ..` , ..C.....Address .....OL:. ..f� . Name of Builder ......... ......:...................................Address ........ a-1 .................................................... Name of Architect ....... ��. s........:.......Address ..... .�� .. .................. Number of Rooms ..................................................................Foundation ......... Exterior ... � .. :. �1 .........4.......................Roofing .......................................... Floors .... .........�.......... .....Interior ... ,,....//..... Heating ......... .. .........:...............................Plumbing .......:... ... ........................ Fireplace ........... :. Approximate. Cost C. .................... Definitive Plan Approved by,Planning-Board _____ _______________19-- Area 5.�"1�................. ,.� ' Diagram of Lot and Building with Dimensions Fee �}......:/../..P............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH j • Y OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of'Barnstab Bard* g e above construction. ''}} Name .................. .. .... .. j Construction Supervisor's License EKT- nDE BUILDING CO. INC. No .27.Q44..... Permit for ...Lh Story................. ..' .....Uag e..Fazni1Y...nwea-ung.... .......... Location ...Pt.27 ......U..QQAt i6.1d..Tane... .................... t<. Yt.. Owner .....BaySide .BL??7, ,g..Gs�....lnc........ vl Type of Construction .Fr ........ r .... ......... ................ ..... .. .............. Plot ..................... Lot 4. ` ................. sPermit Granted ... October 1,� ° t 19 84 Date of Inspecti lGt.... 9 Date Completedlcti4. ,�. ....f.. 19 c.'. ; - Y• 1r f r l d y �° � fa /� � ,` �,�. • � � �,�, � of "" "� "t Assessor's mW *THE NABIL 039. TOWN OF ` BARNSTABLE BUILDING tl | TO THE /morcC/vu OF pv/u//wuS: TheUndersigne! hereby applies for "a permit according to the f 11 nformation .' . Proposed Use ' ^ ` ' ...-._---� --....--,---.,---,------. -. ' , � \ Zoning District --.,�.�f!.../� ------------Rne D�h�� -_-,..��. ------------.. � _ . � Name of Owner .!�� . A66rmo -..�.........................�/ .............................. ��.^�y / Nome of Builder ��/�/�� Address `��. --� --------r--'r- ~~ --',^^� --__~,~________~_, Floors ---------7--�� ' ,y /,/ � Heating ' ��~�l. --�---.�� . .. ---'num�ng ---.��-��-.. .��='.:-----_.. /----- —'----� . s�� ' � 7~ `�'��` -- ' ' Fioep|oco ---' -.�.....................................................ApproximoheCoo ........ ....��---_,.~_,,____ � Definitive Plan Approved by Planning Board lR--�-� - Area -.^��.[��-----. ^^� Diagram of -Lot and Bui|6ing with Dimensions Fee .......~�'�' -�� ______ � SUBJECT OF BOARD OF HEALTH " '4 \ ' ! ` \ - ` ^7 �7 ,l '� _ / . OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ^ | hereby agree to conform to all the Quks and Regulations of the Town of construction. -�Name ...... / � / [ Construction Supervisor's License j/.... .......... .�/� ---- BAYSIDE BUILDING CO. A=247-199 .r No 27041 Permit~for ... 1 z Story Single Family Dwelling .... ................................................. ........ .. Location . Lot 27, 25 Goatfield .................................. .... ....... West HXannisport ............ Owner ......Bayside Building Co. Inc. Type of Construction ....Frame ............................ ........................:............................................4......... Plot ............................ lot .................. .......... Permit Granted .Qctobex:.1..................19 84 Date of Inspection ....................................19 _ 1 Date Completed ......................................19