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Home My WebLink About0136 LOCUST STREET __ r------ -- - _�_...� 1 - __ � .r �, Engineering Dept. (3rd floor) Map -MO Parcel 22% Permit# 7 �6S House# 134a f�Date Issued O — -96 Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) N-&_/Q? Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) r �1NE 19 _ BARNSTARLE. TOWN OF BARNSTABLE APPLIaw E ITNASEM C CONNECTION PERMIT FROM THE Building Permit Application ENGINEMG DIMON PBIOR TO CONSTIiUGTtOI�Freet Projdress IL h L oC u s 4- St =:� Village _�Jklgwrvie, " Owner: 1,_J R,-Hive Address 1 Z4 LAG oSfi` 4 t H jzAr4wil Telephone Permit Request d Ro o r VI x 1,6 G 1k rlZ_ + Ce v✓-e"-r SC A-3 *-CLnW 1�/ S L i d Q/WA �L lw)5 ?tom fast rL 2 4YV S;a e.. .y First Floor square feet,'- Second Floor square feet Construction Type 10&1 G YA Wig, Q Estimated Project Cost $ Zoning District Flood Plain. Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure `5 5 Historic House ❑Yes qNo On Old King's Highway ❑Yes 4No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other &Eb xioat-L 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 N,4V 19V CZ l4. P,4�,:1, Telephone Number 7 Zs 3Jd7 i G Address 106 14 �/,'/I 2cL— License#CS 017357 T/ jvw(S /Y► A. t_1 t%!V) 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 y,Ys-t4 6a2 lAwd I t SIGNATURE DATE BUILDING PERMI DENIED FOR THE FOLL WING REASON(S) FO OFFICIAL USE ONLY PERMIT NO. v DATE ISSUED MAP/PARCEL F ADDRESS VILLAGE s' OWNER ' DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL i T PLUMBING: ROUGH FINAL GAS: ROUGH' FINAL FINAL BUILDING ZRl .� DATE CLOSED OUT c ASSOCIATION PLAN NO �x 1 ' �-� I n C The Townn of Barnstable . ntal Services UAM Department of Health Safety and Environme A Building Division " 367 Main Street,Hyannis MA 02601 Ralph Crossen Building Commissione- Office: 508-790-6227 Fax: 508-790-6230 For office use only Permit ao. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SiJPPLE ME TO PERMIT APPLICATION that the "reconstruction, alterations, renovation, repair, modernization, MGL c. 142A requires re-existing conversion, improvement, removal, demolition, one but not more than four o dwelling units or to owner occupied building containing at by registered contractors, with structures which are adjacent to such reside ats r building be done certain exceptions,along with other req are Type of Work. O Qc�. 11 eas Est.Cost 3 Z S — Address of Work: LaC, U T S T • ""� ' Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own Permit Notice is hereby given that: PEST OR DEALING WITH UNREGISTERED OWNED PULLING THEIR OWN HOME IMPROVEMENT woRx DO NOT HAVE FOR APPLICAB FUND UNDER MGL c.142A CONTRACTORS GUARANTY NESS OR CO ARBITRATION PROGRAM ACCESS TO THE AItB . SIGNED UNDER PENALTIES OF PERJURY 1 for permit as the agent of the owner. I hereby app Y a Q v SS 23 eye / Registration No. C utractor ame Date OR. Owner's Name Mara The Commonwealth of Afassachusetts .«:i Department of Indusrrial Accidents i i Officeo/lasestlgalloas \ ';#': r;�' 6111111asbittg-tonStreet Boston,Alas. 02111 F4.:r•- �'' Workers' Compensation Insurance Affidavit I .�._. _ innt_ information Please('R(N('le i Jy,_ Incz-itinn- city �l ydtiw�� nhone>Y 77,E I am a homeowner performing all work myself. ® 1 am a sole proprietor and have no one working in any capacity _ __.ra.:•�.....ZY....+--^"'-'-,C—^.a--.-. .��.a-n..RTlc ..�•--`...m.-f1.�-....,n-* -- - - ='-"�'.''"•""•...�+,.......,x---•—..e L....+ir.....�waLrr-ar..r.�..rw�•Ia..r — .. ..:�^..... .-... :.: ..'.. .... '. ..�.... _.:'.. .••..w.�..::_ _� __ r� 1 am an employer providing workers' compensation for my employees working on this job. company n•tne• address: city- - nhone#• insurance co Itnficv# II a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: compiny name: - address: cin•• nhone#• insurance co nofier# �-- , ... - _.. :.e:..fc:. :71•o'ti-=--+•-s••:-�-i�-�'K-T^ei..'= ----'Aer•.-.n.�"A;-�':. s+:_r,�..:..�7.:v-a...��:�!F^A,-.--t:----r - i LL.1.•Swi company name: - — address- — City nhone#• insurance co noficv# Attach additional sheet if necessary '�'�-t =: irr:i�i.� +�yNiiai.�i.1Y •' - �8+"i .Nic air lti Failure to secure coverage as required under Sectionf25A of 1%1GL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 andiur une years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine ofS100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. ' 1 do hereby certift•under the pairs and penalties of petjun•that the information provided above is true and correct. Si:nature l- -I_Q�� Date Print name A, Mo nfc-1 �i4 viv r cT�y, Phone tr;7 7S— �/6-7 'o(Tcial use only do not write in this area to be completed by city or town official city or town: permitilicense Al r1Building Department C3Uccnsing Hoard I7 check if immediate response is required Selectmen's Office r [311ealth Department contact person: phone#; r'tUthcr f;. (revised 3l95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers'- npe-nsation for the employees. As quoted from the "law", an empl( ree is defined as every person in the service of another under anv contract of hire, express or implied, oral or written. An entpl( rer is defined as an individual, partnership, association. corporation or other legal entity, or anv two or *tor the foregoing enLaged in a joint enterprise, and including the legal representatives of a deceased employer, or they` recerver or trustee of an individual , partnership, association or other legal entity, employing employees. However tlt 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 ho or on the ,rounds or building appurtenant thereto shall not because of such employment be deemed to be an employe MGL chapter 152 section 25 also states that even• state or local licensing agency shall withhold the issuance or renei%-al of a license or permit to operate a business or to construct buildings in the commonwealth for anv applicant ��ho 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 1-. 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 suppiying 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 vdtt have any questions regarding the "law'or if you are requires to obtain a workers' compensafo i polic), 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 o: the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Ple: be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned t.. bn 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 question. please do not hesitate to give us a call. I v...a a.asa ...`.. The Department's address. telephone and fax number. R� The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax #: (617) 727-7749 nhnne #- (617) 727-4900 ext. 406. 409 or 375 I G I � . A 1 s r 1 1 yr- , • Xa S GUIi.• Q W 1 V� OFFICE AND MODEL HOMES: - ASHLEY DRIVE, CENTERVILLE, MASS. ael W&w&~A- TEL. (617) 775-6812 (617) 428-9101 ^^v1l .-Air' J tr r s �� Syr l/ IMP • Tne ille One of the most beautiful and practical homes designed to provide every convenience. Large foyer with WOOD DECK WITH SEATS guest closet leads to spacious living room-dining room combination. The magnificently treed outside is seen through sliding glass doors opening to a.large wooden deck. 2 full baths and 3 bedrooms with large closets (one bedroom is beautifully wood panelled for'use as a den). Wall-to-wall carpeting throughout. Intriguing o w Fa 8 SLIDER kitchen features Whirlpool appliances, including self-cleaning range. Oversize garage and full basement. DEN 1z Professionally landscaped for easy maintenance. , = .9 x 10' BEDROOM Q KITCHEN 12'6"x 11'9" 11'-9"x 12' DINING vocREr DooR LANDING 11 9 x 12 GY�RAGE HALL 26' Builder on premises daily (including Sundays) 9 a.m. 6 P.M. � C' BATH 1 EATH MASTER BEDROOM LIVINGROOM O '9"x12'DIRECTIONS: 23 x 13-9"Cross Sagamore Bridge, follow Rt. 6 to Rt. 132. Right on Rt. 132 for 1'/2 miles to right at traffic 9OVERHEAD — FOVER light (Phinney's Lane) 2 miles on Phinney's Lane to right on Rt. 28. 1/4 mile on Rt. 28 to right at �� 68 Old Stage Rd. (Howard Johnson's and Mobil station at traffic light) 11/2 miles on Old Stage Rd. to PINERIDGE on left. J QQ -z , Cl 0 c S: N z O Q � � 2,6 ' 12 OFFICE AND MODEL HOMES: ASHLEY DRIVE, CENTERVILLE, MASS. Y - avl TEL. (617) 775-6812 (617) 428-9101 1 � I o0 00 R e er V ' le One of the most beautiful and practical homes designed to provide every convenience. Large foyer with WOOD DECK WITH SEATS guest closet leads to spacious living room-dining room combination. The magnificently treed outside is seen through sliding glass doors opening to a large wooden deck. 2 full baths and 3 bedrooms with large closets (one bedroom is beautifully wood panelled for use as a den). Wall-to-wall carpeting throughout. Intriguing pyHw E 8 SLIDER kitchen features Whirlpool appliances, including self-cleaning range. Oversize garage and full basement. I L2 :Nx 10' BEDROOM Professionally landscaped for easy maintenance. = KITCHEN �- I BEDROOM 11M 11'-9"x 12' DINING DooR LANDING 11.9"x 12' HALL 26' Builder on premises daily (including Sundays) 9 a.m. —6 p.m. GARAGE BATH o ��5 LIVING ROOM - MASTER BEDROOM 23'x 13'-9" O �� 15'9"x 12' DIRECTIONS: FOYER C BATH Cross Sagamore Bridge, follow Rt. 6 to Rt..132. Right on Rt. 132 for 11/2 miles to right at traffic 9OVERHEAD H light (Phinney's Lane) 2 miles on Phinney's Lane to right on Rt. 28. 1/4 mile on Rt. 28 to right at 68' Old Stage Rd. (Howard Johnson's and Mobil station at traffic light) 11/2 miles on Old Stage Rd. to PINERIDGE on left. e , R ;HONE�,IMPRGVEME CONTRACTOR Regtstr ti0110652 ' ' ;r TrpeINDIVIDUAI d aX,rond=A DPayne��Jr & � , s - : �� •_ 0�8 ue r<Y1��11111 xitd ��,� E�� . 10 1„�be - t ✓fie �ammw7uaea�.lfc a�,/�voac�ivaeCta DEPARTMENT OF PUBLIC SAFETY , CONSTRUCTION SUPERVISOR LICENSE Expires: ' - Restricted To� : 00 - yn„ A PAYNE JR w C0 MNll6sto a =BLUEBERRY HILL RD HYANNIS, MA 02601