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HomeMy WebLinkAbout0028 GOOSE POINT ROAD _ __ __ ------- -- .. t ' ��l III F Town of Barnstable *Permit# I�— f (0/� ff�' o Expires 6 montlis from issue date °^ Regulatory Services Ste— saatasxaaie ' Mass. i6;& 10$ Richard V.Scali,Director Building Division 0141 �} 8 70, Tom Perry,CBO,Building Commissioner C./� 200 Main Street,Hyannis,MA 02601 ��"'��www.town.bamstable.ma.us /A G Office: 508-862-4038 Fax: 508-790'-6230 EXPRESS PERMT APPLICATION - RESIDENTIAL ONLY n �Z Not Valid without Red X-Press Imprint Map/parcel Number. 6- Properly Address �( C� Ql �-� P-4 - C, Residential Value of Work$ 30M- OCD Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Y\(� �i� ��-� e--7" m S L ` b i Contractor's Name Al i ne Number_g Lt%L- S!i:M Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) 9].Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name k6el U kAo'd Workman's Comp.Policy# L4 7,20 00-�)q G30 Copy of Insurance Compliance Certificate must accompany each permit. Permit Re uest(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to J I ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#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 Home Improvement ra ors License&Construction Supervisors License is requir SIGNATURE: — C:\Users\Decollik\AppData\LocaiuV„cresvrrI",.. -..._..___'files\Content.Outlook\2PIOIDHR\EXPRESS.doc I Revised 040215 I oF� • BnaxSrABIX • 639. h ' Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Paul Roma 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 J'I�i �� , as Owner of the subject property hereby authorize —MOM` '19 l) , _ � t om behalf, in all matters relative to work authorized by this building permit application for: 00&G- Pot (Address of Job) /4 1 � - 6 6 1 ature of caner Dad j 06 kfb Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\L.ocal\Microsoft\Windows\INetCache\Content.Outlook\L7U69LF2\EXPRESS(2).doc 01/25/17 I Massachusetts Department of,Public Safety Board,of:'BU ding Regulations:and Standards License:_:CSFA=055178 Construction Supervisor 1,&2' . F�a`ririly • k°' THOMAS J OROURKE f *, 9-TREASURE LN, MASHPEE MA 02.649 n� lam; Expiration:'. Commissioner 06/02/2018 �e�iom`�ioozr�rcal�:o����iar�aitdeGla Office of ConsumerAffairs'&:Business Regulation HOMP.IM PROVEM ENT°CONTR'ACTOR TYPE:Sunolement Card' Registration Expiration 131597---=02/26/2019 CAPEW IDE OOPfS ,R CFU THOMAS O'ROURKE, f l xk-c- 11,Cl�RNELL4Va� �hs JVAQUOIT.(v1A 053E r Undersecrstkgy The Commonwealth of Massachusetts Department of Industrial Accidents d 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Analicant Information Please Print Leeibly Name (Business/Organization/Individual): Capewide Construction, Inc. Address: 53 Mercantile Way unit#6 City/State/Zip: Mashpee, MA 02649 Phone#: 508-477-0353 Are you an employer?Check the appropriate box: Type of project(required): l.FV1 I am a employer with 8 employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.r�I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 ❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.®I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.2]Roof repairs These sub-contractors have employees and have workers'comp.insurance.* 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[:]Other 152,§1(4),and we have no employees.[No workers'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: Arbella Mutual Insurance Co. Policy#or Self-ins.Lic.#: 422006346301 Expiration Date:3/9/19 Job Site Address:28 Goose Point Rd. City/State/Zip:Centerville, MA Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure v rage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year m isonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day a 'nst_th vi ator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance cover ge er' tc ion. I do he bW pains andpenalties of perjury that the information provided above is true and correct. Si nature: c Date: S 17 Phone#: -958- 05 Offi al se on y. Do not write in this area,to be completed by city or town official. Ci or own: Permit/License# Iss i Authority(circle one): 1. and of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,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,§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 may be 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 to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia CAPECON-03 CFOGARTY ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 04/17/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER N ACT Orl Rogers&Gray Insurance Agency,Inc. PHONE FAx 434 Rte 134 (A/C,No,Ext): (A/C,No):(877)816-2156 South Dennis,MA 02660 anu"IL .mail@rogersgray.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Arbella Protection Insurance Company,Inc. 41360 INSURED INSURER B: Capewide Construction,Inc. INSURER C: 759 Falmouth Rd. Unit 4 INSURER D: Mashpee,MA 02649 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR 8500067077 03/09/2018 03/09/2019 DAMAGE TO RENTED NTocc D ce $ 100,000 EMISESMED EXP(Any oneperson) $ 6,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 1XI JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY Perperson'. $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED N&rN6gMED P PERTY DAMAGE AUTOS ONLY AUTOS ONLY er accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ A WORKERS COMPENSATION X PER T OETH- AND EMPLOYERS'LIABILITY YIN 4220063463 02 03/09/2018 03/09/2019 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE a N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attachedif more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Z TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 252 049 GEOBASE ID 16372 ADDRESS 28 GOOSE POINT ROAD PHONE (508)362-5315 Hyannis ZIP - LOT 19 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 22968 DESCRIPTION SINGLE FAMILY DWELLING (PMT.#19098) I PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND TIE CONSTRUCTION COSTS $.00 � 756 CERTIFICATE OF OCCUPANCY +► • f * 1ARN3TABLE, MASS. OWNER MEETINGHOUSE TRUST, JOHN J. KENNEFICK,JR 1639. A�� ADDRESS 2350 METT.INGHOUSE WAY'P.O-BOX 350 FD M1►� CENTERVILLE, MA BUILIDING DI/VISION BYia DATE ISSUED 05/08/i997 EXPIRATION DATE TOWN OF BARNSTABLE � CERTIFICATE OF OCCUPANCY PARCEL ID 252 049 GEOBASE ID 16372 'ADDRESS 28 GOOSE POINT ROAD PHONE (508)362-5315 -5 Hyannis ZIP - LOT 19 BLOCK LOT SIZE � DBA DEVELOPMENT DISTRICT HY _ PERMIT 22968 DESCRIPTION SINGLE FAMILY DWELLING (PMT_419098) PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety fet ARCHITECTS: and Environmental Services Ies TOTAL FEES: i BOND $_00 per CONSTRUCTION COSTS <$.00 756 CERTIFICATE OF OCCUPANCY + MASS. OWNER MEETINGHOUSE TRUST, JOHN J_ KENNEFICK,JR s6g9. ADDRESS 2350 METTINGHOUSE WAY D M1� P.O_BOX 350 CENTERVILLE, MA B G ON DATE ISSUED 05/08/1997 EXPIRATION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED APPROVED PLANS MUST BE RETAINED ON JOB AND FOR ALL CONSTRUCTION WORK: WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEI POST-THIS CARDSO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 9�_R7"E 1-3-57;7 alll 2 �8 97 11 2 Pr 3 1 HEATINg INSPECTION APPROVALS ENGINEERIJqG DEPARTMEN ll�v'fq OAT 2 / ;rWY07 F L OTHER: �!✓��- SIT LAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. Zv 1 I } e i • � ��o �� - . � � C�� �Q�,�� - . � �-_ � ��. �r � � 1� l� )q � I _ TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 252 049 GEOBASE ID 16372 ADDRESS, 28 GOOSE POINT ROAD PHONE. (508)362-5315 Hyannis ZIP - ,LOT 19 BLOCK LOT SIZE ,.DBA DEVELOPMENT DISTRICT HY PERMIT 22968 DESCRIPTION SINGLE FAMILY DWELLING (PMT_#].9098) PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANG CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: HE BOND $_00 Ox� CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY * ; + BAMSTABM MASS. OWNER METTINGHOUSE TRUST, JOHN J_ KENNEFICK,JR i639' �1�� ADDRESS 2350 METTINGHOUSE WAY ED MA'S P-.0_BOX 350 ���,,,%� CENTERVI DLE, MA BUILDINQ.41V BY � DATE ISSUED 05/08/1997 EXPIRATION DATE �'" -F t r TOWN "Ob'"rSi�_ a ---- BUILDING_-f - PARCEL ID 252 049 ' GEOBASE ID r' 16372 ADDRESS 28 GOOSE POINT ROAD ' �'� Pi{' '362-5315 Hyannis `LOT 19 BLOCK iOT SIZE _. `DBA `r DEVELOPMENT DISTRICT HY PERMIT 19098 DESCRIPTION SINGLE,. FmmI DWELLING (96­565) PERMIT TYPE BUILD TITLE NEW RESIDENTIAL BLDG PMT CONTRACTORS: KENNEFICK, JOHN "J_ JR. Department of Health, Safety ARCHITECTS: Y and Environmental Services TOTAL FEES: BOND �TNE CONSTRUCTION COSTS 101 SINGLE FAM HOME DETACHED 1 PRIVATE PI- IAMSTABIM • MASS.- , OWNER OWNER METTINGHO SE :TRUST, JOHN J ' XENNEFI.CK,,JR 9. ADDRESS 2350 METT' HOUSE WAY P.O u,BOX" 350 , CENTERVILLE, MA BUILD . VISION BY DATE ISSUED 11/06/1996, EXPIRATION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION-STREET OR. ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS"MUST BE,RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN.MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. O BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMEN 2 FH H � 2 OTHER: / SITE PLAN REVIEW APPROVAL I li 2 `d 97 WORK SHALL NOT ROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TI N. NOTED ABOVE. TION. I � ` I I I � I I I I ' I I Ul, .�. Engineering Dept. (3rd floor) Map Parcel Permit# ( 1 0-1 House# Da Issued ' W ' -Ito Board of Health (3rd floor)(8:15 -9:30/ 1:00-4:30) e 690�2 2 ,00 Conservation Office(4th floor)(8:30-9:30/1:00,- 2:00) J S q b Plannin ept. (1st floor/School Admin. Bldg.) tTB� S0, S BE gec an Approved by Planning Board 19 � P CE gp �NBLE. TOWN OF BA1tNSTAB ,7�-"j � � ND Building Permit Ap lication tnAddre/Iss �iQ aodSG Po/NT o j JIlO. Village tfCn �e ,V; t✓ ''F' 1.:' JJ Owner ee .n oule �uS a ►1 J• nhe c ✓ �us eEAddress��• BMX o��Sv F�l,7 •Q1t Telephone .3t'o` - urh et2,G6� Permit Request ohs iAc Si h c; L �Si e-j,Ge-- First Floor AM9 square feet Second Floor ��2 square feet .'Construction Type Estimated Project Cost $ /0, 0 J Zoning District c Flood Plain da Water Protection Lot Size ��� s/ Grandfathered es ❑No 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: YFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /00 Number of Baths: Full: Existing New 2 Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New _�First Floor Room Count Heat Type and Fuel: I$Gas ❑Oil ❑.Electric ❑Other Central Air ❑Yes 2i0 Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) ``�/ Other Detached Structures: ❑Pool(size). M' ?ttached(size) � X 22 ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes/ UlKo If yes, site plan review# Current Use VLcCA1JT L� Proposed Use '7kveLLp',/6 ,rBuilder Information Name keq AP C i( e4Vo^U . l�C- Telephone Number . A00Z Address • 'o License# WPJ ­,0f/ U24 Home Improvement Contractor# Worker's Compensation# A WC 7Q 6�2-(o 3 eZ O 1716 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTIZUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO L. &tH4UW1 SIGNATURE I( DATE I BUILDING PER I DEN DOOR THUFLI,04I�G REASON(S) R FOR OFFICIAL USE ONLY'''''PERMIT NO. �' _ p-- ,� ''--; - r .: "• �d: . . ' " ._ .�_'� . f� � I- - _ - �' DATE ISSUED ISSUED := MAP/PARCEL NO. '' :"' ' -� � - ,_,. - _ ->• � . 't , "1 .. � - J r' ADDRESSVILLAGE ' r (OWNER t, •rsp. 'J_ - ` .�_,�. 1•'- �"1 !1 'C *'� -! .` '� V � 1- 1•+ � Y•1 , � ✓j 1 .} +'ei Arl � i.^'v. ' .dti DE OF INSPEC IO4 N AT FOUNDATIONS 1 ., FRAM E} �, r ;I,) ! f I t i _ INSULATION a FIREPLACE: '(� t? ,-- IREP ,F - - -ELECTRICAL: F1NAL PL'iJIvIBING: r ROUGH `FINAL Nw FINAL GAS: L I�R(3YJGH _ •yE > ram•]` _. .F -t. I' i •,.� t 1 - _. - i 1 - t .r. - -� 1 r _ y 1 FINAL >^� 7 -.' r ({ DATE CLOSED'OU3� t , -,:ASSOCIAnON PLAI is - - r 19 , �7, sF v 23 t ZZ�t 6-ayr�Qr�oN N �o o SE �i✓r AC ae" MA/' Z52 PcL p LaC4-rlol/ f G'E.2T/.c?Y TNAT -rl E roaA10A TON S L E- '�-0, 0.4�"E Sf/OWN 1�E�2E0.C/COS-1OL YS l-r// h' /_ Na✓ /�LPL A/-1,47 SETBA ClG ,�EQU/,2E/yE�c/7rS O.� TNT' 7Z�N/it/DF A.vo /s Nod- i ,Goc.4 TES Lri/Ty/N TyE �LoaaPG4//! / $G ZG f R6• /2/ 0,4TE% ��! et__� f3AXTEiE�6 it/YE /it/C. Tf✓/S �.C.4.�t//S�(/aT B�.SEO dv,4�f/ �2EG/STE.�2EO L.4�/O SU.2li6'��c /9.4Ss. O�,�SET.S Syoy✓y Sfrov�� //oT LAW OFFICES OF JOHN R. ALGER, P.C. ATTORNEY AT LAW 886 MAIN STREET P. 0. BOX 449 OSTERVILLE, MA 02655-0449 TELEPHONE(508)428-8594 FAX (508) 420-3162 October 18, 1996 Mr. Ralph Crossen Building Commissioner Town of Barnstable 367 Main Street Hyannis, MA 02601 Re: 28 Goose Point Road, Centerville Dear Mr. Crossen: I am writing on behalf of John J. Kennefick, Jr. who individually or in the name of a nominee is obtaining title to Lot 19 on a plan in Plan Book 249 Page 121, being a parcel of vacant land at 28 Goose Point Road, Centerville and being shown as Parcel 49 on Assessor's Map 252. As a result of my examination of the title I find that by deed recorded in Book 1903 Page 318 the property was conveyed to Henry A. Dapkus; that since that deed the property has been in the Dapkus family until the recent transfer; that at no time did the Dapkus own or control any adjoining property; that the property contains 17,000 square feet and until 1985 the zoning requirement was 15,000 square feet, which was raised to an acre in 1985. It is therefore my opinion that this is a buildable lot under the zoning requirements of the Town of Barnstable and it is entitled to a foundation and/or building permit. Very tru y yours, JRA/db y x 3 E° e° 7'�}�1CF•s. R1R'rN'vE�'>I' q Cr Me4C .cti1Ma IC-`( >- t;7-(VJ�5tIIr.tSL£GAP %+.°l �. 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'I y.G yI� All _ Y t aj ill ,•���',L�i4��"•h I � .� +�- ," l�r I�N� 4 L �i -i ?_I Li..".='=`� i .�,;...., � tM I! { � �.) a a u _�✓�. . ��l N� I J ..9 i � r � .. � 1�_n 1 �'_cx'+Tr _ -� �1 _ "_ � �i.- !l 47 i ___. I ,1 I � (,1�,,,1, I G''i)" I a, I 9'•d' .. i ,�� 1 i W W I IOF a II nt u i -. 41f4 S 4t'flf l' IL .:1* � •^� I._I / ' 10 7 A • -�. ., f•. :d n.qk,NC.4taM1 m. G QU W N N s,a fir- q Iwo Ib , 11 � LJ W I��•t°. .� , W t s� - ,1�it Id .(1r,f IiECY011 j1 Ifil tt:.xr Jro-ilry an la tPx O 1A N 0 i ql qu i 2 •A;�I cur �n Y } z„ �y� _o FULL Q��elii''� �M p ( - 1 �1,1 I�f.lTl oV Cn�p,�G1ir ul+� it i s�rc•z�r3 c. �Y In' Vo M j H O ` ow::,u. n ce raP.._t IL 14'.y11 + (,.�4n I:a 1'y -�,•� a Q at i tit r �i- d u I FI.J r{�".._'. m�_:� ). ! "�,"'1 - w I. i•-� N —'l•'clfl V.HII in N1 n [LIN Wy ,'77 J 42-:VYJ 12"'��r,l�, ' I +O I i ;f � ,�. 1 Y-S���✓ 1 I 7z, .I _..I, I ; +• �J gn ._-,�t1°Gp GX•�NG�,} I ( 1 �-,� �'�'�S' i(FED I'I�:+M�'� j l .j ^^ j . '_ � t~t y Iy'1 Si2I�is 6 '�• '(0'"!ri�%Y�1'��t 1 :.I I x Q lI 17�. } ' 6 71`fn✓'IN �'v.+}'�{"'�'cl�'�-�^IS�wt�na� I . 't j I W � ' I � ' . - NOTP; PfilI) TO rpN; HII PION CON717AC1'f3h7 ii r "_'HI'! ALI. - F•• .'.rder !lw N TO Vv, a The Commonwealth ojAfassachusetts Department of Industrial Accidents -' ,c.: `'•-; 600 11 a.vIrington Street Boston, Alas. 02111 ' Workers' Compensation Insurance Affidavit An�lic ant mfor1.matton• Please PRINT Iebt�y—:,, name Ice nnet;c eS1a��'t-taN� l�tJ C- • PO • �Br,� 3s-a a 3 61404e wA ylk 0.2-64&' nhonc# I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity r lam an emplover-providing workers' compensation for my employees working on this job. 1 cnmP tn} n•tmc• -J �J Ice- �4e t�c I c -Tes 7`a R•i4T1 00 •tddr s . c7. 3 2 3 Sa /r'I'c e-?7k)6/,4 uk G,/ city NST*,o L c-- /`T� • �-L C� �lthonc fs• 3 2— .f'3 - in urince co. fllSoG'd� l /qd�� �+'/•J /���SGG(�uc�//J rtoiicv# Ak/C / PO02.`•.J QC'/ 7J, I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below H•ho ha.: the following workers' compensation polices: cominny name- address: cit- phone#• insurance co nnlicv# cnm :tnv name: addre s: city• phone#• insurance co noiicv# _ 'Attach additional she t it neeessarx� t'T" �. '^Ffr sf 'Si ir►i�ii'.��{`.�� r..•'• � • a � �+%!��y •"zi`' Failure to secure coverage as required under Section 25A of 11GL 152 can lead to the imposition of criminal penalties of s fine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. I understand that a cope of this statement may be forwarded to the Once of investigations of the D1A for coverage verification. 1 do hereh.r certi f•under tlr• ar s and penalties of perjun-Mai the information provided above is true and co rec Si=nature / Date �� , Print name ol I �c �� �J v Phone# official use only do not write in this area to be completed by city or town ofrrciai city or town: permitAicense# P111uilding Department ❑Licensing hoard check if immediate response is required 13Selectmen's Office 011calth Department contact person: phone#- rJOthcr ' Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers* crnilpensation for thci the "law". aft un lnt ee is defined as every person m the service of another under anv employees. As c uoted i Qom p D P , 1 contract of hire, express or implied, oral or written. An enrplt tver is defined as an individual, partnership, association. corporation or other legal entity. or any two or more the foregoing enLagcd in a joint enterprise, and including the legal representatives of a deccasctl employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the apartments and who resides therein, or the occupant of the owner of a dwelling house hay m� not more than three ap P dwclling house of another who employs persons to do maintenance , construction or repair work on such dwelling hoL or on the arounds 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 li:fs not produced acceptable evidence of compliance with ;lie insurance coverage required. Additionaliv, 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 h been presented to die contracting authority. • ._ sic . . .. - i'.. - .... _ _ .o-�.'. — '.rM.. � .. 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 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 cite 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 require:: to obtain a workers compensation police, please call the Department at the number listed below . ..-.•.._ _..- ..,w...;..._v-,...�..--�.ww.•rr�—arc•,-+� - - _ City or 'towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom o the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pie. be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned the Department by mail or FAX unless other arrangements have been made. 'Tile Office of Investigations would like to thank you in advance for you cooperation and should you have any question please do not hesitate to give us a call. r-•tau.....�• -.....-._-.�.rv....+. ..-.wwr •rn� - - - - - - :7•,-, ....t' The Department's address. telephone and fax number: The Commonwealth Of Massachusetts •Department of Industrial Accidents Office of investigations 600 Washinaton Street _ Boston, Ma. 02111 fax #: (617) 727-7749 nhone #: (617) 77" -`100 ext. 406, 409 or 3 7S C L-I X s i j' i.r O m © 1 S H r-y hw"H 70 p V DO 7 W , Do rri m o m m r-1 r Z O O, <A v O OD O cp. Soo r_ H o r rz O` CD 7D Z ! ?D Sa q1 a m O O Z _ O ! w p d r d f Y W. estern Surety -Companyd d 0 i d LICENSE AND PERMIT BOND KNOW ALL MEN BY THESE PRESENTS: BOND No. 68544906 ; That we,. J. J. Kennefick Restorations, Inc. ' , d . of the City of Barnstable , State of Massachusetts , as Principal,, . and .WESTERN SURETY COMPANY, a .corporation duly licensed to do business in the State of i U d Massachusetts as Surety, are held and firmly bound unto the d TO' n of Barnstable State of Massachusetts Obligee, in the penal sum of Five Thousand_and no/100 _ DOLhARS($5,000.00 )� lawful money of the United States, to be paid to the said Obligee, for which payment well and truly to be made, we bind ourselves and our legal representatives, jointly and severally by these presents. THE CONDITION OF THE .ABOVE OBLIGATION IS SUCH, That whereas, the said Principal has been)jicensed Street Opening Y by the said Obligee. �� ( W TERRE, if the said Principal shall faithfully perform the duties and in all things comftgi ' ath hie lvs and ordinances, including all amendments thereto, pertaining to the license or pw*•< Pei its applied d"r hen this obligation to be void, otherwise to remain in full force and effect until nctber 25 1997 , unless renewed by Continuation Certificate. his bon ma�bbe Terminated at anytime by the Surety upon sending notice in writing, by certified mail, to thelef ,of,thecitcal Subdivision with whom this bond is filed and to the Principal, addressed to them at the Political®XbdisFon named herein, and at the expiration of thirty-five(35)days from the mailing of said notice, this bond sliall ipso facto terminate and the Surety shall thereupon be relieved from any liability for any acts or omissions of the Principal subsequent to said date. Dated this. 24th day of October 1996 J. J. nMEFICK RESTORATIONS, INC. Princi al BY Principal Countersigned W E S E R S R E C A N. Y By By / F Resident Agent St hen T. Pate, President ACKNOWLEDGMENT OF SURETY ; (Corporate Officer) STATE OF SOUTH DAKOTA County of Minnehaha ss o J p On this 24th, day of October 1996 ,before me, R the undersigned officer, personally appeared Stephen T. Pate who acknowledged himself to be the aforesaid officer of WESTERN SURETY COMPANY, a corporation, ; and that he as such officer,being authorized so to do,executed the foregoing instrument for the purposes therein contained, by signing the name of the corporation by himself as such officer. ' IN WITNESS WHEREOF, I have hereunto set my hand and official seal. d d I +`J.''4C;4V�j4i;C�C�C:^sC_:e�eV:q:ni4GGC:{, g B. THOMAS a NOTARY PUBLIC SEAL SOUTH DAROTA SEAL , Notary Public — South Dakota Y Form 532—9.95 My Commission Expires 6-2-2003 'ACKNOWLEDGMENT OF PRINCIPAL F (Individual'or Partners) ; 4 � 9 F STATE-OF, n F il G - ss G ! F County of R 9 A il Fi il On this day of ,'before.me personally appeared G ! F ! p il 6 il G known -to me to be the individual_ described in and who executed the. foregoing instrument and y G 9 F 9 acknowledged to me that_he_executed the same. My commission expires Notary Public ACKNOWLEDGMENT OF PRINCIPAL (Corporate Officer) STATE OF ss County of . On this day of ,before me, -personally appeared , who acknowledged himself to be the of , a corporation, and that he as such officer being authorized so to.do, executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself as such officer. My commission expires Notary Public - - - - - - ---- - - - p � f p (^) G F U fr p /ate •� � p G U A A z O w e O a 1�4 N �' F W ce i L O r Z - j G 4W H ! G i ! G a O U1 G4 'C G f i 2 I. a5iW&Ls FAMIU� PLA" 01J BACK- u�zEt Pl o GA W 3A`r- 17M Ly FT.Ow = 3 x I I o = 33 O LDT �`� SEYnG TANL t 33o X?OO = GC)6 u5s 15o0 GAL. ---- ---- --- - - -... - -- L. ;AC41" 5`(6TMA Vv-' CV-.1 4 Ar-FU CATION A¢EA 2E1Q'D, 33b GPD s .7j vn/SF= A4 s F APPO"-noH AVZA Drk5I6W '51te-WALL A21,-A= (O8 X 2)k Z = 2 7 2 F. I7E'�'At�. OF LEAGf�Iu� T 1G�4 t2oTT-OM A ZMA = 6 01r A = ?A 0 S.F• 98.S t -rML A4 s 5 1 Z we ,�, MIU 1�1C�ZtASE9faPR-F >`L95.3 Mix . PE¢CoLATIN ME LS sra►.IETakaET3 ' /s-Yz �01� SOIL. �.I�Sj..I MA,X 2EC�• n _ -- 4• H OF 9.4.S �; 3�4-I'�z sTo►1� s�of 0 e PEPER al +nacl $ NO.29'133:. 4 A. v clvl�. y � - loN or %G 240 (; . Tg- 1b 1, O .01111� 9g.v A •�-�" EL54,75 INS[ 14J 9?.0 ,. 9 2 e 5 Qd 6 T1►►�. 45 n�. r0 ✓ 1.7 C e T C Z � . A EL W? 2 8 &C -ss tFo l t-ry Izp A.c7 a16 vi AIRE►2 1 nG,4T I cal C.c�.�-1-� 1 L� M P'.5 5 p 8 7 gg V$M 10. 9 `3 1S6ALE- AS W7TL=-C> VA7S N o V.A �zo�oslr� I GFzT1 r-`f rPAT 1"I I E �w c-';-`'�C* SI Io�uN 12L&.k 1 IZGFEZEKIGE- I} vN CtMpLy5 wITS E SIDELIN AISD "FL„" , 2y 9 �3,6•G \Z 5IrIB v- zWUi EMEW'TT 9)1= TIAE TOWN OF /rr(,1S,P 2SZ PAECt-;1- 049 13,&e"S-rPreLEAQV 15 uOr LOCATED VV I T-I.1.1 N -Rcu t� z AJ- FLzcV HAZAn1-M. BA Q g NyE I,JG ' ) I.{lI,ID SUQVE'1�LZS r 6ddGl t`.tEE?�f tJod. g-, 1 qq& t G �S G - oSTEeVII.L MAsti. of-"F52t'S 1-7�oM $V I LD1 N( SF�OI NOT E >s Q�,�caNT: J E►.3 t�l E�1 L1L 1l�C. USED Tb gl,iTA5w-s1k FT20p -rl/ LIWV,5. Y� 1�1I t'f�uSE hlo' 2u '�Ao.\9 A'ss c-5 so es MAP ZSZ PRe- 049 OF 1pS,p s rPETER SULLIVANS �. Qj NO.297 :1 CIVIL Farm , goo �ooyou_�_xY s�bu 71 C101 L SAX- VZE.jLN T , 1b _ 9 K 4- ► of T;4 `Z 4� � 4tCFwfu+ ' 1 36�*" %9 5 1.10. 2e loo oo —lee ..N -�.� ..._.--...v...... �o s IT-C-- A,N,.l � vt a�3 �oosE ?o►NT°MIZv Ll-Z M sS asTE> ! L L C 1�,aS5 a LAW OFFICES OF JOHN R. ALGER, P.C. ATTORNEY AT LAW 886 MAIN STREET P. 0. BOX 449 OSTERVILLE, MA 02 6 5 5-044 9 TELEPHONE(508)428-8594 FAX (508) 420-3162 October 18, 1996 Mr. Ralph Crossen Building Commissioner Town of Barnstable 367 Main Street Hyannis, MAIL __ e: 28 Goose Point Road, Centerville Dear Mr. Crossen: I am writing on behalf of John J. Kennefick, Jr. who individually or in the name of a nominee is obtaining title to Lot 19 on a plan in Plan Book 249 Page 121, being a parcel of vacant land at 28 Goose Point Road, Centerville and being shown as Parcel 49 on Assessor's Map 252. As a result of my examination of the title I find that by deed recorded in Book 1903 Page 318 the property was conveyed to Henry A. Dapkus; that since that deed the property has been in the Dapkus family until the recent transfer; that at no time did the Dapkus own or control any adjoining property; that the property contains 17,000 square feet and until 1985 the zoning requirement was 15,000 square feet, which was raised to an acre in 1985. it is therefore my opinion that this is a buildable lot under the zoning requirements of the Town of Barnstable and it is entitled to a foundation and/or building permit. a , Very truly yours, -JRA/db