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0025 KEEL WAY
Map ` Parcel i- _Permit# /� la Conservation Office-(4th floor)(8:30-9:30/1:00- 2:00) 6 .Z Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) Engineering Dept. (3rd floor) House# INSTALLED g')d 9 DE pND F-ilvai N 1 � r�r,� TOWN OF BARNSTABLE Building Permit Application Project Address �7 Village i/1Y,9wrLiS Owner_ ,'�Chi� Qrl,I/ (n4wl iQ �S6/NOS Address -;Telephone J�©� 7 71 7 Permit Request u3, i First Floor square feet r Second Floor square feet Estimated Project Cost $ Zoning District J Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use ,Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No. of Bedrooms 3 Total Room Count(not including baths) First Floor �o Heat Type and Fuel�0/ wlex lus Central Air Fireplaces Garage: Detached 1 Other Detached Structures: Pool Attached Barn None Sheds Other �� Builder Information Name (/GUYL_CA Telephone Number Address License# Home Improvement Contractor# 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 BUILDING PERMIT DENIED FOR THE FOI WING REASON(S) FOR OFFICIAL USE ONLY _ PItMIT NO. J 7 0Y D TE ISSUED i M P/PARCEL NO. ADDRESS " [ {£' t VILLAGE OWNER _ DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ! t - ELECTRICAL: ROUGH FINAL ' PLUMBING- ;- r;ROUGH FINAL y GAS: ; . -'.'ROUGH, FINAL FINAL BUILDING /�l> G-t ' t DATE CLOSED,'OUTf { { ASSOCIATION PLAJ�;;t0. P t PLOT FOR LOT Indicate location of garage or accessory building Additions with dashed lines --------------- sewerage disposal (cesspool) ED well . I I (Lot.... rear) Abutter's Abuttor1 s Name Name I Lot# Lot# 4�t Rear Yard 5 ........ . .ft. I a If this is a If this is a d d comer lot, corner lot, -1u, write in write in w ` name of name of other street. Sideyard HOUSE Sideyard h• other street. 1 N i Set Back ......a. .......ft. ( I '4 I (Lot.........© ..•••.ft. frontage) __ --- `e=z -- --- --------------------- (Name of meet) Information / Supplied by yW �-� 6 IC!!n7 Mark North Point The Town of Barnstable Department of Health Safety and Environmental Services Ma Building Division 367 Mafia Stand Hyannis MA 0=1 Ralph Crvssen Offices 508-790-6227 Building Comr F= 508 775-33" For office use only Permit no._ Date j � AFFIDAVIT HOME nffROVEMENTCONTRAGTORLAW SUPPLEMENT TO PERMM APPLICATION MGL c 142A requites that the"n=nstruc ion,aitemnorm renovation,rtpaw,modernization,conversion, improvement..lento%-4 demolition. or construction of an addition to any pm casting owner o=xpi ed building containing at least one but not morn thaw fear dwelling units or to sauc=cs which ate ad}aaat to such resideneo or building be done by registered contractors,with certain e�oeptions,along with other mquirzmeats. Type of work: Est Address of Work: /� e / �/�/A-L1 Owner.Name: f 4" Date of Permit Application: (O / 6 �� I heztdly certify that: Registration is not required for the following rrason(s): _ Wane etiduded by law _Job under SI,000 Building not owner-ooarpied Owner palling own permit Notice is hereby ghren that: CONTRACTORS OWNERS PULLING R OWN PERMIT OR DEALING Wth;UNREGISTI FOR APPLICABLE HOME IIMPROVEUENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PEWMY I hereby apply for a permit as the agent of the aw•ner Da a Contractor name Registration No. OR n^,- Owner's name • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE" V ( c( JOB LOCATIONS Number Stree addr1ess Section of town "HOMEOWNER"kIck C? MD 1- 6 7 Name Home phone Work phone PRESENT MAILING ADDRESS ;;Z 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six 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 Stat Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE r APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER' S EXEMPTION The code state that: "Any Home Owner 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 a Home Owner engages a person (s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for . licensing Construction Supervisors, Section 2. 15) . This lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "Owner actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, man communities require, as- part of the permit application, that the Home Owner 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 to amend and adopt such a form/certification for use in your community. r. Tire Cunimmnwealtlr of Alassachme is .iv Department of Industrial Accidents • � ,. _:1� OIIIceallalvest/gatlo�s ' 600 Misbia;tun Sircel -•` Bu+7on.Marx 0.�,111 Workers' Compensation Insurance.AfIrldavit Anniica�nformat//ion -_•. . • •�� • Please PRiNT`le�rbly•�,�,__�, name -fi 7 11-, e /e 0lyos Sim- /4,4 1* .; /W 771 I am a homeowner performing all work:myself. ❑ I am a sole proprietor and have no one working in any capacity ❑ 1 am an employer providing workers' compensation for my employees working on this job. cemp•tnt•name• asidress• - tih•• phone#t insure nice co neiicv# - ❑ I am a sole proprietor,general contractor, r homeowner circle one)and have hired the contractors listed below who have the following workers' compensation polices camniny name: address ,apX 70? ' phone insurnncece Cee �,��pd� .. Roiie,•�! ... • f.:�.:u::=- `«---^:-•- --.:_ .s,.'tr:-.4..•aa�..4*er,%z•�r-�''''��'!�+�= - -- - - �'0°�°0'°r'•'�r�`'+� 'v��5••_7,'_'_yr.."y*�!'+�'!�_ trim Inv name• address: - city- Rhone#: - in'tUrflnee co. policy# ..__.*M.��sf�.{-Jf•t•;ipfillSF.•�:. ?•'�L:i .:.IP.��rMy '_�!X.- - - - - _ .�.ir�.q ��� :Attach additionai'abeet i[tiec�;,r,� -y � '—�•�'�°"� Failure to secure eoyerare as required under section 25A of MGL 15Z an lead to the imposition of criminal pensides of a fine up to 51.500.09 and/or one pears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a line of S100.00 a day song me. I understand that a coin,of this statement may be forwarded to the Ogee of Investigations of the DIA for corersp vai ieation. I do lterebr certifj•under the pains and penalties ojpetyur}•that the information pmWded above is true and correct ienatu 4 � Ste ., Print name /1 ��r e �i��,s -'- one#�S°�> 7?/�l/� will official use only do not write in this area to be completed by city or town ofticial city or town: permit/lieense 0 r1tluilding DepartmOMccent �Lieeusing Board p OMcr cheek if immediate response is required OSeleetmeap rtmen Otiealth Department contact person: phone #; rtOther ` Information and Instructions Massachusetts General Jaws chapter 152 section 25 requires all employers to provide workers' compensation for thci employees. As quoted from the"law".an emplgree is defined as every person in the,crvicc Of another under any contract of hire.express or implied, oral or written. 1 al An entpinrer is defined as an individual, partnership,association.corporation or other :.� cntit y. or any two or more the foregoin 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 rein. or the occupant of the .• apartments and who resides the P owner of a dt��ellin, house having not more than three dwelling !rouse of another who employs persons to do maintenance,construction or repair work on such dwellin, hoc or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer F. MGL chapter 1'52 section_'5 also states that ewer}•state.or local licensing agency shall witlihold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonn eaith for any applicant who itas 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 E been presented to the contracting authority. `'• '...w•��.�w e.- �./i. �al �. '�^I .; ice!^rti:�Y:^��Y.v ]+^�:I.�.:: . ,a v� .� }I .,ii-:. F1 •I,... .� 'f•• �. f'•• w:t .{ fir. .� :�• .... i I•. 'L.• Ina.S'!>.•!. •VF�.i .dam I•y.. /1•i' •i'� 1:.LI4 A: �' 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 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. : 77 7 ::77-77. •'��t:. .y La _T:nS1'i �E7J��'.. •'f�!sr:•�'.i'�~'il• �:• i�i`:i.,;.5lf.Mt. •�,!'!1.3Z7?` 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 foryou to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pler be sure to fill in the permittlicense number which will be used as a reference number. The affidavits may be returned t 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 questior please do not hesitate to give us a call. �...,.r�...._1�..�a.1�.. •• � .���. _ :li _�..�.;.s• i.r•..«��w%•...a1..r�'if..�i aiw••.w :�,_�: The Department's address.telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents - _�. Office of hwastigations 600 Washington Streets. _ — Boston,Ma. 02111 fax#: (617)727-7749 ' phone#: (617) 7274900 ext. 406, 409 or 375 t 5 s, :f7immONWEALTH DEPARTMENT OF PUBLIC SAFETY OF • ONE ASHBORTON PUKE AgSSACHUSEITS BOSTON,IAA 02106 L z I_E t•d'3. EXPIRH - c r � ) EFFECTIVE DATE LIC-NO. RESTH 03/31./1.9Y4 045135 JAMES D MCGRATH Po BW 708 jNOT J[S 1�W CQ6L0 •� : :. :.ic pq(k+lh FEE:. ! - - rtlL SpNED B+'L1CFi6EE HEIGHT: A-s)GrHTts+E of TIE�R ..... ngS DOCUMEM MUST BE yLyr,AT OF LICENSEE T THERHOON THE PEitSQV OF �T•- ��•ti:i• 4SSIONEN L!. THE MOLDER WHEN EN' .:-IMT C.AGE9WT150CCAIPAT)ON. _ V 7 7. lugHOME IMPROVEMENT CONTRACTOR Registration 109374 Type - INDIVIDUAL Expiration 09/11/96 PINE HARBOR BUILDING CO.,INC.! JAMES D. McGRATH ��O 80X 708/120 G1 WESTERN.RD A00" Kii 02660- f�J 1 4 k ip Nn t EMMA \ a f Wtz f.Q ® 00 CD w+ y„ n M n Y co Aj En En c #ltii Even Pitch Design 6' X 8' $ 840 8' X 8' 880 8' X 10' 1 ,080 . m 8' X 12' 1 ,220 10' X 12' 1 ,460 .T. 10' X 14' 1 ,700 10' X 16' 1 ,950 ,® 12' X 12' 1 ,680 060 12' X 16' 2,380 F Custom styles and other sizes are available, " Payments are due IN FULL the day of delivery. 'Credit card sales must be processed before delivery. -No exceptions- (standard 10'X 12'Even Pact,Desii3n) Please check with your' �al building All sheds come in natural pine. We recommend staining after construction to preserve the wood. department r _duig permit , requirements�egarsett acid'�cmd other - regulatioizs'that may;upply _ Because we recut all We csOhat�you`please prepare the _ - lumber at the shop, site loCatibrr on wYucYi tlie3 shed is to iT11 ,;. installation time is usually be constructed,Trees shrubs,-and x #moth ry FJj } \ only one day at the sight. miscellaneous rtems should be ' R 1 4 . removed before we amve to do the l q'Pi r I� (8'X 12'Salt Box Design) builduig ' Ii Please ndtify us in advance if the site you have chosen is not accessible by truck, or is in excess of a 50 foot distance. Sheds are built on location for your convenience. Salt Box Design :y. x.. - r 6' X8' $ 770 n 8' X 8' 810 8' X 10' 1 ,000 8' X 12' 1 , 120 - J 10' X 12' 1 ,360 10 X 14' 1 ,610 10' X 16' 1 ,840 12' X 12' 1 ,570 12' X 14' 1 ,890 (8'X 12'Salt Box Design with optional extra window and cupola) 12' X 16' 2,200 With your own landscaping, your shed will start to take on your personality. So q i o ka:7' 1A AR K ;p g T?s , I Lt.1- 1-It ems; 1 Fzn a� �► O 'Elk A s o W Sli3s�� ^ ' LL 1639. BUILDING INSPECTOR TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Definitive Plan Approved by Planninc Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH Lq LLj LA ly� LLJ Lij Lu Lij � I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above ''~--'-------�r—''---^~—'—''~ � - ^�^���^"c� Co.ezozisnor� C" -=-- - 15842 one story No ................. Permit for .................................... az:dgle family dwelling ~ ----~------'---'----^—'--'---' Keel Way ` Location .----.--------~-------.. .� . West Hyannisport ' . -------------'------.—.----- Owner __.IerunioD_rt,_�urxcitzzre..Co^_.. . .~ frame Type of Construction -------------- —.—.------------------.-----.. Plot ............................ Lot ----��-----. —' 22 � 73 Permit Granted --..�.���.�----'—.]A xv ' Date of Inspection ' lg . ~~'~ Completed ^^ Cb ' w � PERMIT REFUSED . ` ----_----..—_-------... 19 -----'--'—~^—'-------.---.---. —.~—.--------------'....------ .—.—.—.~..—.---.~....—.--~—.~.....—. / '—~—^^--'—^~—^--------`^^---'—^' . ' ^ Approved ................................................. lA ' -------'--------^'^^'--''~—^^—`- -------------------~—^'--'—'`~' / | | `