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Home My WebLink About0433 LINCOLN ROAD EXTENSION *THE TOWN OF BARNSTABLE BARNSTABLIL OMIA,* BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... ............ ........................................... TYPE OF CONSTRUCTION ................................................................. ....................19'24. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accAding to the following information: Location .....:".............. ............... .......................................... Proposed Use ...4.2. ... ....... ... . .............................................................................. --(' ZoningDistrict .... . ............................. .. .................... ........Fire District .............................................................................. Nameof Owner' Address ................................................................................. Name of Builder, ... ... ...... . ..... ......... Address& ........ . ......... Name of Arch itecT--.?2/>.t--........................ .....................Address ............................................................................. Number of Rooms ..... ....................... 'x�Z'.........Foundation 9L"4, ................... ........ ... ... ........... ........... ..... ... Exterior 411.4. . ..... ....................... ........Roofing ...... ........................................................ Floors ...... .. ........ ....Interior .................................................................................. Heating ... ..... .......................................................................Plumbing .......... ................................................................ Fireplace ........................................................................Approximatp Cost ............................................ Difinitive Plan Approved by Planning Board ------------------------------19--------- 4 /V�/ Diagram of Lot and Building with Dimensions I ITHE PROPOSED ETH D PROVIDING FOR UPP WAGE DISPOSAL SANITARY WATER S11PP PROVED AND D INAGE IS I t N OF BARNSTABLE 13'0A R0 OF HEALTH I hereby agree to conform to all the Rules and Regulations of th Tow Barnstable regarding the above construction. Name ............................ ..... ............. ...................... � _ IiommaI � Bachand, 14522 � add to single No ................. Permit for .................................... l \zemuly ou*ellazg � � ----.—..,.—.--,—,—~---.—...---.-- � � . . 433 Un:o]n Road Zct° Location —.--........--^.-----.-------'- Hyannis | .-.--.—.~—....-~...'.-.-.._--.-----.. ' Lionel Bachand Owner —.---.----.-------'^----''' | frame ' Type of Construction -------------- � ' � —'—`—'—^--~'^'-------^--------- / Plot ............................ Lot ................................ ' November 31 �I Permit Granted .........................................lV ^— ~ Dote of Inspection l� �4 � \ ' - Date Completed .... � ! | � � - ' K ` PERMIT REFUSED y Q- Xj � U , l� ......—~-_---.-..—..—.----. � � ----~---^`^^'—'--^^~--'^--'----'~ ' ^—~--^--'^-^^^^—^—~^^^^^~^'---'---'' ,—.....'......—.-----.........~—,_.—., � / —^—~^^'^^'^—^~'—^^^^^'--^--^'~--~''- App,ovad ................................................. 19 � ' ----~--'------'—^-----^---^^- --------'--------~^--^—^^~^`^`' � L Engineering Dept.(3rd floor) Map Parcel Permit# �g House#, Date Issued J Board of Health(3rd floor)(8:15 -9:30/1:00-•4-39) Fee- Conservation Office (4th floor)(8:30-9:30/1:00.2:00) Planning Dept.(1st floor/School Admin. Bldg.) .4 �1HE rq Definitive P Ap roved by Planning Board 19 � 4 BARNSTABLE. rFO Mph>` TOWN OYBARN5TABLE, ` Building Permit Application Project ddress. . y 33 L-1 p( X I Village Owner 1.eO _9 40141.,I:> Address (.)1UC01JU EX T� Telephone 77,T g(o 7 A ''Permit Request �-- k��C D -Z 7 v _ S�d"P on n e , To rna-7-c h Ex1i77iy r� FT -First Floor square feet Second Floor square feet NConstruction Type (x7 Estimated Project Cost $ O�y aD Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑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: ❑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 i I1,,�9jJ/ Pex)T—_1 (c .1 �� elephone Number 7 7 Address 7?0 (, �aM License# CS O S 7 5 3 L] (e). 4,,ci a?i) f n a 1 0 Z(.7 2 Home Improvement Contractor# 1 Q V 3 a g Worker's Compensation# 6J C 3Sys a U NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTIO EBRIS RES TING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE q' Z J , Ile- BUILDING PERMIT DENIED pF Rj HE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. ^5,. _ ^'- • ; DATE ISSUED MAP/PARCEL NO. . i ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION - .- - FIREPLACE r '. - {.`✓t ,'t 'r' � -- � f _ ! r - t- .. - M1 , ELECTRICAL: ROUGH r Tx.^ FINAL PLUMBING: ROUGH f FINAL' GAS: ROUGH FINAL`t � .� _ =, •, -_ r _ •r . _ ' FINAL,BUILDING ,- - - i eic •`f r r - f - ' •• i i r4� - +_t wtiJ- ' i .; DATE CLOSED OUT. -. ASSOCIATION PLAN NO. p .v - p8 The Town of Barnstable M �$ Department of Health Safety and Environmental Services Building Dlvmlon 367 Main SUMO Hyannis MA 02601 Ralph Crosson Office: 509-790.6n7 Building Commission: Fax: SOS-790-4MO For office use only Permit no.------� Date AFFIDAVIT, HOME nUROVEMENT'CONTRACI'ORZAW SUPPLEMENT TO PERMIT APPLICATION MGL a. 142A requires that the "reconstruction, alterations+ renovation, repair, modre-exi i n. conversion. improvement, removal+ demolition, or construction of as addition to any pst�g Omer occupied building containing at least one but not more than four dwelling units structures which are adjacent to such residence or building be done by registered contractors, with certain czccptions.along with other requirementL J:TQ; ;� '��007-7- Est.Cost- �2 y20 L Type of work:__ Address of Work:_ Owner's Name &A Date of Permit Application: I hereby certify that: Registration is not required for the following rensonisj: Work ezciuded by law _Job under S1.000. Building not owner-occupied Owner pulling overt permit Notice is hereby given that:OWNERS PULLING THEIR OWN PERMIT OR DEALIIYG WrM UNREGISTERED CONTRACTORS FOR APPLICABLE HObtE IMPROVEMENT WORK DO NOT HAVE ACCESS TO TM ARBITRATION PROGRA&I OR GUARANTY FUND UNDER JMGL c. 142A SIG.-= UNDER PENALTIES OF I hereby appiy for a.permit as a agent of e o er: Date Contractor Name Registration Na OR Date Owners Name The Commonwealth of Massachusetts ' IRK j Department of Industrial Accidents a ��=° � � Orrice ol/olreslfgalloos .. 600 Washington Street Boston,Mass. 02111 " f•-* Workers' Com ensation Insurance Affidavit name: location: city phone# ❑ II�a homeowner performing all work myself* U ZZ 1 am an employer providing workers' compensation for my employees working on this job. comanv name• t L. -7 address: :::. 1-�yc' i�1 dtv- CkA/)c A A 6,a t, 7 %Z phone#- (� �' '� L]5�.2 b Insurance co. Rolicv# pd-3j�o q:a ❑ 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: comoanv namIJ e• ` fi address• t; city :• t phone#• ....... Insurance cm ////// . a c6my3nv name address- phone#: insurance co oiitww# Fallure to secure coverage as required under section 25A of NIGL 152 can lead to the imposition of criminal penalties of a Me up to$1,500.00 and/or one years'imprisonmea well as ties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of ails statem y be forwarded to a Office of Investigations of the DIA for coverage verification. i do hereby c jy under the yarns d penalties ojper' that the injornrari ded above is trw and correct Signature Date J 76 _ Print name 7 4U L 6V A—Z ,A—A^ Phone# 7� ` 0 CJd [G i/�7 (C3 :dteckifinunediate, se only do not write in this area to be completed by city or town official wn• permit/license# (]Building Department • ❑Licensmg Board response is required ❑seleeanen's Office (Health Departrnent erson• phone#; ❑Other (mmea 9/95 P1A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for the.": employees. As quoted from the "law", an employee is defined as every person in the service of another under any coat 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 c: the foregoing engaged in a joint enterprise, and including the legal repres e:i entatives of a deceased employer, or the rece: 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 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 renew of a license or permit to operate a business or to construct.buildings in the commonwealth for any applicant who h-c not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions ihall`eater into anyfcontract for the performance of public work until accep*le 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 yoL are required to obtain a workers' compensation policy,please call the Department at the munber listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the'bbt=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 retuned 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. FINE The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Invesduadons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or 375 F 4 z 03 cD N O F••� !T O r 1• No .- 3 N �, ZO = rn . L7 ►�+ y �o t./s P N O N a' C 3 co o_ m N -� o •'~ r r w o co o � RE-ROOFING ❑ If located in OKH or Hyannis Historic District-Certificate of Appropriateness required unless same color/same materials specified on application Map/parcel number Sign-offs from: �- ❑ Tax Collector `'� ❑ Treasurer EY(of squares of shingles or square footage of roof to be shingled 13S/Pecify stripping old shingles or going over old roof. If going over ❑how many roof layers existing now ❑what size are rafters? What is span? ❑ Complete dwelling information for the Assessor's Dept. -if known Workman's Comp. form [v]� Home Improvement Contractor Affidavit(RESIDENTIAL ONLY) Home Improvement Contractor's License OR ❑ Homeowner's License Exemption(RESIDENTIAL ONLY) [� Check expiration date on license COMMERCIAL WORK-No License is required. Fee q-forms-PERMITS I Rev 6/2/98