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0139 LONGVIEW DRIVE
I TO WIN O CAPECOD INSULATION DEC tun PIRlR GLASS St MLESS SPRATSCAM SUSPENDED EARS GUTTERS INSUTAStGN CEILINGS �- __ 1-800-696.-6611 Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BP-I) inspector. All work preformed meets or exceeds Federal & State Requirements,. Property wner Property Address village Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings Slopes ( ) ( ) ( ) ( ) ( ) Floors u�tfi8 ( ) (x) ('37 ) (X) ( ) Walls ( ) ( ) ( ) ) ) 14, JeA Sincerely HNCodI Jr, President Con, Inc. .Y� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ���', Application # 1 76 Health Division Date Issued ' Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board yoll� Historic - OKH _Preservation /Hyannis Project Street Address /J 9 ..la�V P A r Village. C ' �, P4 y&AA%s Owner j�,� ,��C��i2ca�s Address TelephoneTrPe- �l 01cr 7 Permit Request _A2ZI ,44,� C�G� /1J,�vArl-Da--A-;; Lf Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation D lot,*, 6 Construction Type /Ue- 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/.XLNo On Old King's Highway: ❑Yes X�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 ® w� C c'a 2 Number of Bedrooms: existing _new , s.> p»..g _n Total Room Count (not including bath,): existing new First Floor 9 m Coun J Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other _> `E Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood oal stove ❑Y.�s ❑ No Detached garage: ❑existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑ existing 5-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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name j�� l'o ,�����/�,i� Telephone Number Address License License # Home Improvement Contractor# 3� Email ° Worker's Compensation #Ae.1 'te 1 0/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /V/4 �aA/e�, SIGNATURE DATE �D ✓� F FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE F OWNER r DATE OF INSPECTION: F FOUNDATION, 'r FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING f DATE CLOSED OUT '`' ASSOCIATION PLAN NO. I OWNER AUTHORIZATION FORM . I, a n Ric-HARPS (Owner's Name) owner of the property located at l3 f 4�7� L (Property Address) (Property Address) hereby authorize Caine- Cod h u Xa boli ( ubcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. O ees Signature /611,113 Date , .3 �Ilr.x 11uwlts I)t 1lartn1ct1I ul Puhtic �AcI\ t r liu;lrtl of liuilclill Re'rllaluuu and MaildZild. (;onstru•ption Supervisor License Ll�:cn v c.s.M 10UJ88 1, HENRY CASSIDY8 SHED ROW WEISf- YARMOUTH, MA 02673 �-- Expiration: 11/11/2013 `.- 1 Ti w 7620 - - (�?(:)—M;W101)GIV(rlC`11 V>C1/1/a:JJC4 X11.-jf'1��1 �i Office, of C,onsumr✓.t' Affairs and l3ttstnt.ss Regulation 10 P-irk Plaza - Suite 5170 Boston, Massachusetts 02116 H.onne; Irriprovelnent Contractor Registration Registration: 153567 Typo: Private Curuoratiun Expiration: 12/1 a/?'b 1 rl,r{ 2J;fUJt ,:'Al'F- COD INSULATION, INC HENRY CASSIDY lei REARDON CIRCLE S(-'). YARMOUTH, MA 02664 Update Addros and return card. Mark I"CiIN(m fur chllllgr. Address L-I Relle}V711 l.__I I!:n1t.11uyulcnt I I Lusll:,ud ( uu,uuler nnilirs �� t.tusiness ltegulatiull License,or rebistratiaa valid for individul use unly � bcfurr the expiration date. If tbuutl reltirn tu: JMUMI: IMPROVEMENT CONTRACTOR i U uyistruUun: 153567 Typo; Office of Consumer Affairs and Business Re-gulutiou r.xpu;1uon: 1 21 1 5120 14 Private Corporatir•u LU Park t'I:Iw-Suite�L7U `l Gostuu,MA 02116 Id"t ARI)lil`1l,It�CLF ;ll:i l I i I IIMA 02664 (-111tIcr5r.ePclal')' Amd' Wltho ( IIat re - The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Inf®rmati®n / Please Print Le ibl Name (Businrss/Organizabon/Individual): �V9Ae- Address: City/State/Zip Phone #: 1-7172 1 Z 44 Are you an employ r7 Check t appropriate boz: I. I am a employer with.. ,1� 4. ❑ I am a general contractor and I Type of project(required): employees(full ancVor part-time).* have hired the sub-contractors 6. ❑ New construction i 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 mein any capacity. employees and have.workers' [No workers'comp. insurance comp. insurances 9• ❑ Building addition 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 11.❑ Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL insurance required.] t c. 152, §1(4), and we have no 12.❑ Roof repairs 3a.❑ I am a homeowner acting as a employees.[No workers, 13.9Other/,/�5,� general contractor(refer to#4) comp.insurance required] 'Any applicant that cheeks box#1 must also fill out the section below showing their workers'compensatiod1 Licy information. t Homeowners who submit this affidavit indicating they arc 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 nano 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 oli 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: Polity#or Self-ins. Lic.#:fiC /� �� Expiration Date: Job Site Address:��� � e City/State/Zip: Ai�l zs Z G_j 7i 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 nder the nd penalties of perjury that the information provided above is true and corret� G� Phony#: « l Official use only. Do not write in this area, to be completed by city or town ofciaL City or Town: Permit/LIcense# Issuing Authority(circle one): L Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#; I _- MYOUNG CERTIFICATE OF LIABILITY INSURANCE APEcoD-27 DDffyn F DATE(MMIDUlYYYY) .ATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLD/ERITH c DOES NOT AFFIRMATIVELY OR NEGATIVELY IS HE POLICIES THIS CERTIFICATE OF INSURANCEAMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY T DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED -SENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. ORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to .,Ie terns and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder ill Ik u_of such endorserent s. PRODUCER License 4 PC-514062 NAME: Margaret Young Rogers&Gray Insurance Agency,Inc. _ 434 Rte 134 PHONE FAX South Dennis,MA 02660 A/C o . AIC No E-MAIL ADORESS,myoung@rogersgray.com INSURER S AFFORDING COVERAGE NAIL N uvsuReu INSURER A:PEERLESS INSURANCE CONIPANY^�T INSURERS:COMMERCE INSURANCE COMPANY _ Cape Cod Insulation,Inc. INSURER c:Evanston Insurance Com zany — 18 Reardon Circle INSURERD:ATLANTIC CHARTER INSURANCE-GROU_ P I ----- South Yarmouth,MA 02664 INSURER COVERAGES —_ INSURER F: -- .:-. _. ____._-._..__-__ CERTIFICATE NUMBER: REVISION NUMBER:_ _ A IHIS IS TU 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 EXCLUSIONS AND CONDITIONS OF SUCH AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJEC CH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ T 1 O ALL THE TERMS, INSR .— rE3lTR TYPE OF INSURANCEPOLICY EFF POL CY EXPMMIDD/YYYY MMIDDlYYYY LIMITS GENERAL LIABILITYA X COMMERCIAL GENERAL LIABILITY ���-RENTED $__ ^1,000,000 4/1/2013 411,12014 PREMI ES Ea ocW once $ 100,000 ._I CLAIMS-MADE 1-2 J OCCUR --- I MED EXP(Any one Pat son) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: _.____ POLICY PRO- PRODUCTS-COMPlOP AGG $ 2,000,000 AUTOMOBILE LIABILITY C MBINED SIN L LIMI B - ANYAUTO 13MMBCKVMK Ea accident $ 1,000,000 _. ALL OWNED -X 4/1/2013 4/1/2014 BODILY INJURY(Per poison) $ SCHEDULED AUTOS BODILY,INJURY(Per accident) $ -- X HIREUAUTOS X AUTOS ED PROP RRTYDAMACE AUTOS ER ACCIDENT $ X UMBRELLA LIAR �( OCCUR EACH OCCURRENCE $ 1,000,000 C EXCESSLIAB T CLAIMS-MADE XONJ453512 4/1/2013 4/1/2014 ----� AGGREGATE $ 1,000,000 _ DEO X1KEIENTION$ I0,000 WORKERS COMPENSATION - - $ .. - AND EMPLOYERS'LIABILITY WC STAB US OTH-- D ANY PROPRIETOR/PARTNERJEXECUTIVE Y/NI WCA00525904 6/3O/2013 6/30/2014 OFFICER/MEMBERE ER XCLUDED9 (_T� NIA E.L.EACHACCIDENT $ 1,000,OOO (Mandatory In NH) _ _ u}es,describe undar E.L.DISEASE-EA EMPLOYE $ 1,000,000 __... DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 - DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,l(mora space Is required) ---'- Workers Compensation includes Officers or Proprietors. Addtional In status is provided under the General Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION -- I �. SHOULD ANY OF THE A13OVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE — ACORD 25(2010/05) 01980-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD L TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map o7 5 Parcel v Application # Health Division Date Issued c� Conservation Division Application Fee Planning Dept. Permit Fee f �� • 3� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address /.3� o�a��!/y+��t✓ ��' Village _A1V_ PfJ41 S, Owner Rude Z C 6 4 v d 5 Address S.4 m ep Telephone �l7 -�©�✓ a Permit Request tzepkc-e Su-e-eq s m 6�A15 7-j4 j SUb4 AG0g4 eve y o 1�v+Q��s��� .�►�t��►ic�� Cf���'��K e���o��irvs, f-i/� i 6- �i.�� � � � _�G�fS /}S f^�'��tl•�'fGla /�/ � 6�t?it� r.�` -��rC tc4L t Square feet: 1 st floor: existing proposed 2nd floor: existing proposed'`- TI net Zoning District Flood Plain Groundwater Overlay n - W �. Project Valuation �60 AX/Construction Type Lot Size Grandfathered: ❑Yes ❑ 0 No If yes, attach supporting documentation.. Dwelling Type: Single Family Ix Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes a_<0 On Old King's Highway: ❑Yes ralwo Basement Type: PKII ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new -4;�— Half: existing new Number of Bedrooms: 113 existing-A:!!�riew TotalRoom Count (not including baths): existing _rye new -- First Floor Room Count Heat Type and Fuel: AIGas ❑ Oil ❑ Electric ❑ Other Central 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 SC&-e-e#t iL0✓C Proposed Use 3 $P,-sO-Z APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1--ph/4e`P� ����5f 0 Telephone Number SGS ' Address /e3 zoo License # 00 C C 5'3 O;ZG 3 5-- Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Dt, wj9 SIGNATUR /� DATE ���� 11,3 y FOR OFFICIAL USE ONLY 'APPLICATION# DATE ISSUED f MAP/PARCEL NO. f is ADDRESS 'VILLAGE OWNER tf[' f. t Y DATE OF INSPECTION: t � .>t-^FO.UNDATION :� >. �,r,rrr• .rrv�.�r;� s" FRAME } INSULATIONFP..,> ,., . z FIREPLACE p' ELECTRICAL: . ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING'' ' �a DATE CLOSED OUT 1 F, 4 ASSOCIATION PLAN NO. i � The Commonwealth of Massachusetts UFDepartment of IndustrialAccidents Office of Investigations 600 Washington Street c Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Oro nizafion/Individual): �. ��} i��l�S Rce..1 [ ty1 C Q reel ,oOlej /d! Address: l co, -1 C 3 � o a- City/State/Zip: ���-�i�v� �G, �.. Phone#: /0 � -- -7 7/- /4) Are you an employer?Check the appropriate box: Type of project(required): 1.El am a employer with 4. ❑ I am a general contractor and I ployees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.L�_'1 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 workingfor me in an capacity. employees and have workers' y p �'• t 9. ❑Building addition [No workers'comp.insurance comp. insurance. 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its P officers have exercised their 11. Plumbing repairs or additions 3.❑;I am a homeowner doing all work ❑ g p • 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.❑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. .1 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$1,50.0.00 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' ce coverage verification. I do hereby certify u ains an aloes ofperyury that the information provided above is true and correct Si ature: Date: � !5� 13 Pho '� SOS- ?7/fL/fD 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.PIumbing Inspector 6.Other Contact Person: Phone#: e: u 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 bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lice to thank you in advance for your 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 Tel.#617-727-4900 ext 406 or 1-977-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass_gov/dia n o�TMErti . Town of Barnstable Regulatory Services IIAJMIA MASS � Thomas F.Geiler,Director 'tip r�xc 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,_ I� �'�"� � � C' ,as Owner of the subject property hereby authorizeairs, /0 to act on my behalf, in all mattets relative to work authorized by this building pertait (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. t 7s3tute.pof 40we't ' Signature of Applicant iCA'Pft L �ie/ W Print Name Print Name D to Q:F0RMS:0WNERPEPMMSI0NP00LS 62012 I �MAE� Town of Barnstable Regulatory Services t 4 i Aa R1iCf'LAiR � Thomas F.Geller,Director 1.659. .�& 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 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: 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 procedures and requirements and 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 persons)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. C:\Users\demon\AppData\Local\ivliamsoft\Wmdows\Temporary Internet Foes\ContentOutlook\QRE6Z JBN\1 iCPRFSS.doc Revised 053012 f Xe Office of Oft9nConsumeoiz�aeczlCya Affairs&Business R `�e� ='E gM tmMon OVE 4644 CONr�CrOR gulation License Piradon T e e or registration valid 10/8/20 befor C.PgLTSIOS B pB YPe: the expiratio for individul A office of Cons n date If foun se only CGi3l REII4ppELING'3 10 park plat umer Affairs and d return to: gRLES nosto 'Suite 5170 R Re CH 183 LO PALTSIOS e«=_ ,..�� n�AlMA 02116 usiness gulation V/Ew�R z CENTERVILLE, MA 02632 undersecretary of v it i - iVlaS.Sachusetts- Department of Public SaferN. .. Board of Building Rea• gulations and Statrtlards Construction Supervisor License License: CS 6653 CHARLES G PALTSIOS 183_:LONGVIEW DR CENTERVILLE, MA 02632 Expiration: 9/22(2p13:. f"i)mm issioner —---------- . --- Tr#: 2797, i p.+^ t I "'+ " =`� •' .� �'..,.,, r+r". a f ��,xi r R* t� .�< T 41 ' � � 'ate � ���' - •3 s^,. 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"y� ,' ar ` nr<L<•,� _� /� �d� I ��`•�+'-q. ��^�� ` '��, ��,� �y �� � E�E "f r' ;� �e#i yn+ #t u., ..,an4,�¢�'+j:�,�a�'.. r� .-. tiT fW4 ts� ;- .t ��..fc��'tti•-< .� -! �`•. tr two§' iVo ,t _ •.e.;,y :�n1. ,ma's Y.`�-•'S =ter _ a � ti• 9 ^ ��/a15 olPIlly/ l 5GS- -771 �y/U SCALE �V90 a'isU �y�U a i c L- cb . 7, ----- _ -------- _� N 03.S1AlG u :.Y �D► (ol oF� r Town of Barnstable *Permit# Py p E rpires 6 mast s from issue Regulatory Services Fee BARNSTABLE, ' MASS. 9� ib3q. �� Thomas F. Geiler,Director A � lfD pgpCl s Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 _ www.town.barnstab le.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �j Not Valid�wiifio�ut Red X-Press Imprint Map/parcel Number. ✓ CJ�/V r. Property Address I V-p A_7J t�)l residential Value of Work r5 Gco Minimum fee of$35.00 for work under$6006.00 Owner's Name &Address Contractor's Name l �Sfli S" Telephone Number j G ' —77/ /y/& Home Improvement Contractor License#(if applicable) / ��r/ 6 f y Construction Supervisor's License#(if applicable) ❑Workrnan's Compensation Insurance 9�E -PRESS PER 19 Che one:m a sole proprietor APR Q ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance 0N OF BARN 7TAME Insurance Company Name Workman's Comp. Policy# 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 [�e-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *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 I Fife mpro em Contractors License & Construction Supervisors License is required: yam' SIGNATURE: , Q:\WPFILEST0RMS\building permit formsTXPRESS.doc Revised 070110 NThe Commonwealth of Massachusetts t >; i Department of Industrial Accidents Office of Investigations 1 E4 r i 600 Washington Street \U 4/ Boston, MA 02111 r- www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: QA. City/State/Zip: �.P%?%,P�'!i,Ile, ,,w , hone #: �G� 7�l l y/6 Are you an employer?Check the appropriate box: Type of project(required): 1. ❑ 1 am a employer with . 4. ❑ I am a general contractor and 1 6. ❑ New construction emVloyees(full and/or part-time).* have hired the sub-contractors 2. am a sole proprietor or partner- listed on the attached sheet. $ ?• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL l 1.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4), and we have no 12.❑ Roof repairs . insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#I 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. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. 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 and -the an Pena- 'e perjury that the information provided above is true and correct Si ature: Date: S �l le- Phone#: O cif lt� 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#: �J 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 Tequired. 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 Iaw 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 Office of Investigations would like to thank you in advance for your 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 Tel. # 617-727-4900 ext 406 or 1-877-NIASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia T r ti Town of Barnstable Regulatory Services s,t.Rrtsrts[.E. Thomas F. Geiler,Director J. Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis,b t,4 02601 www.town.b arnstabI e.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 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. DI (Ad6xess of Job) J Sirnatum of 06ner Date Print Name If Property Owner is applying for permit please co' lete_ the Homeowners License Exemption Form on .the reverse side. i 1 G rho - Town of Barnstable �z� ti Regulatory Services Thomas F. Geiler,Director 16.1p- +� Building Division rfD ley F Tom Perry,Building Commissioner 200 Mairi-Slreet,_Hyannis,MA_02601 www.town-barnstable.ma.us Office: 508-862.4038 Fax:- 508-790-6230 HOAEOWNER LICENSE EXEMFTION Please Print DATE: JOB LACATION: number street village "HOMEOWNER": name homc phone# work.phone# CUR.R1Nf MAILING ADDRESS: eityhown state rip 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 BOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to.reside, an 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 constrgcts more than one home in a two-year period shall not be considered a homeowner. Such "horneownei"shall submit to the Building Official on a farm 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 requirements. Signature of Homeowner Approval ofBuilding-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 homcowaer performing work for which a building pcmvt is required shaA be exempt from the provisions of this secdon.(Section 1 D9.1,1 -Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homcowna shall act as supervisor." 4any homeowners who use this exemption arc unaware that they arc assuming the responsibilities of a supervisor(se=Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness bfL=results in serious problems,particularly on When the homeowner hires unlicensed perss. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The honi cowna acting as Supervisor is ultimately responsible. To crisure that the homeowner is fully aware ofhis/hcrirsponsibilitiec,many communities require,9-s part of the permit application, that the homeowner certify that beshc 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 forrn/ceitifiration for use in your community. ✓pie Vaninu�xu�eceeuz oy✓vlizwc�cru�aeua License or re use on i registration valid for individul l Office of Consumer Affairs&Business Repulatiti;; g Y HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation ' Registration `•114644 ti 10 Park Plaza-Suite 5170 Expiration 10/8/2011 Tr# 288141 Boston,MA 02116 Type C.PALTSIOS BLDG;&REMODELING CHARLES PALTSIOS ` 183 LONGVIEW&0,A1 -":- r CENTERVILLE, MA 02632-.: Undersecretary Not vatwithout signature ,;.. -'� Massachusetts- Department or Puhlir Sa3'�r.� \` Board of Building �T Rey uliltiOns and Standards Construction Supervisor License License: CS 6653 Restricted to:, 00 CHARLES G PALTSIOS. 183 LONGVIEW DR CENTERVILLE, MA-02632 Expiration: 9/22/2011 ' ('umniissiuncr ; Tr#: 2790 1 _ r 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 257 Parcel �l " J Permit# " �359 4, Health Division Date Issued sepINSTALLED SYSTEM Conservation�Division ALLED IN COMP Tax Collector • TITLE SLIgIV WIT}I CIE T- DENTAL CODE AI!! Treasur r I-I ""lf �. p +;Planning Dept. �- Date Definitive Plan Approved by Planning Board ' Historic-OKH Preservation/Hyannis - 3 / s r Project Street Addres Village Owner °� Address t ` Telephone - h Permit Requ st - All Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 4/'Two Family ❑ Multi-Family(#units) - Age of Existing Structure 1 2 Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type:, Off-uu ❑Cra 1 ., ❑Walkout ❑Other t Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other t Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ;❑new size Barn:O existing ❑new"size Attached garage: 'existing ❑new size Shed:b existing ❑new size Other: ` Zoning Board of Appeals Authoo tion ❑ Appeal# Recorded❑ Commercial ❑Yes es,site plan review# y - Current Use Proposed Use BUILDER INFORMATION P i Name �^ Telephone NumberIt Address - License# 6 Home Improvement Contractor Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE l /" FOR OFFICIAL USE ONLY �- PERMIT NO. ' •.) � - + t , DATE ISSUED MAP/PARCEL NO.? ADDRESS VILLAGE - r OWNER DATE OF INSPECTION 7 FOUNDATION FRAME ts INSULATION tr K FIREPLACEto A i ELECTRICAL: FINAL' FINAL` C) --� ` p PLUMBING: -~ROUGH FINAL GAS: ROQGHt e FINAL 5 , FINAL BUILDINGc - ,�! / � ,• �' • !; . 1 f DATE CLOSED OUT J3 r ASSOCIATION PLAN NO. „ k . ' The Town of .Barnstable a,►aivsrwst� 9 .1 Department of Health Safety and Environmental Services Fo►�o3' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 ' Building'Commissioner 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 construction 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 requirements. , Type of Work: Estimated Cost ozev Address of Work:�/7 Owner's Name: Date of Application: / 3 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law E]Job Under$1,000 Building not owner-occupied E]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 a ent weer. ate Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav The Commonwealth of Massachusetts =- W- _ Department of Industrial Accidents . ` vNee of/oresfflatmas 600 Washington Street -"�- , Boston,Mass. 02111 — Workers' Compensation Insurance Affidavit c .; / name: Z&- .""� ,'1-L64'e--" ..., . -- location: - city hone# Q ❑ I am.a weer performing all work myself. a sole Xz,etor and have no one workili in aclty ZZ ZZZ ❑ I am an employer providing workers' compensation for my employees working on this job. i. anv.name ........::.:::::.;:....:.. :.. .......... ............. ......... adore ::.::<:::::.:;::::;:: ::: ty Qhone#: ;:;.>.::::';`::.;::::.:.......;:-... % %..:.: "^iC�ClTiii#3iyi?i?2'' 'tiiii2i %i4 2 `i!i}iisi?i %i''i222> <`iii' ?[� i <' i >isii'' < ii::%<:::�:i:i tisura nc o .:. lice# `<:' :>'><< '`'' > <: .`< > »` > Ellcontractor, I am a sole proprietor,generar, or homeowner(circle one)and have hired the contractom listed below who have `- the following workers'compensation polices: an name. ...::::::::>::::::::,.:: ::::::::::..::::..:<.;::::::::::::.::::::<>::>::;. :: comQ v :..:. .. .... :.;:.;:. .:::.::.::::::..:. :::<:is>:'>::<: address:::..::.:;:;.:: :>::::>::.:.x: :.;::...;;: s::... ff :..:.:::.::..:.:: -:...:::.:;.....:, ::.,::::;;::::;;:;:;. .:,.........:........::..:.....:::::::.;;:.;:.:;:.;;;:.:;:.:......:::::::::::..:::::::::.::.::...:.:....:............ ....:................... ................... ............... ........ ,:.;::I:::,::::... ::::::::.:.. :. :.. ..... :.. n,:.::::.::.;.I.I. »:::;:::::: :...:.................:.......:::................................'..:..,........,...... t F.. ...., ................ ... ..:. :.. ,. ..::.::.>..::.::::::: ._ .. r >> <> aav name: <«:<:<<:> :.....:<:.....:.....:.........:.... <::;:.:fi::.::..:..:.::.:.:..:. ::. ..... ... s >< And,die3 . :... ::«.:•. > tiitine# .................................. . ............. ...:..:..... ... :::::::::..:::: :..;. :......... ........... ..... :::::..:::::::::::. ..................... .............................................. .................... ...................................... .....................................:: .....;a::::.....:... :•..;:..;. ..............................:.:,.....:.::::::::::.: :::::::::.:::::::::.:::::.:::.::.:::::::.:::::y;.;:.:...:..;;:...:..:;•;::.:::::::::::.:F-.':..,.;.:::.:::;.::.;:..;;:..:.:;:.;:..:.;:;..:..:..:..:;.;:;;;;:•::.::::.:....:..;;:.: ::.:...:.;;;::;:.;..:..».;:..:::::::::..::.....::.:::.::.:........ :::.:.......:.....-..-.-......:r.......:.................. ............... b7Ur911CC.CQ... _....... ...... Olicv#. :;• .x ::,.....:... 11 Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a am up to 51,500.00 and/or one years'imprisonment as weR as civil penalties in the form of a STOP WORK ORDER and a fine of SI00.00 a day against me. I understand that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby Cad the pen ' of perjury that the information provided above is trw.mid correct 77 Sigaatur DateJ - / - �� 2�7 �— Z� I Print name L&LC-L Phone# official use only do not write in this area to be completed by city or town otfidd • city or town: permimeense q ❑Building Departrnmt ❑cheekif immedi=*e response is re4ID OLicensing Board ❑Selec6nen's Office OHealth Department contact person• phone#; _ ❑Other Ormed 9195 PJA) 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 coau-.- . 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 receive: c: 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 renew&: 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 imo 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 of 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 is the permit/license number which will be used as a reference number. The affidavits may be returned fo the Department by mail or FAX unless other an 3gements 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 0mce of Ilwasugatlons 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 f ' ,. r.'_ .' _ ti..�_.. � �J� L/00)LI)t0'�tUICGAI/L I a�✓!/GQ.ddQ�LCUJP,�S � - - i OEPARTNENT OF PUBLIC SAFETY 4. CONSTRkTION`SUPERVISOR LICENSE f Number Expires: =— RestrteCed�T►= 08 01CNAEt OiNOIR i32 OUST"IN Y.I. CENTERVILLE, NA 02632 - .. ^Y.. dry.-,�. Y-'d-tyw Yyns.T.arvN•,�s-lsC /--F r - . _`} v-. � ..... � :.ftX # �� •��-aJ�N+av'�Ys��(&z4' a>x P" r .r . t ...�'rax�•k i 4 W 6 ,.t .nK'�. q .. ^"�'�''>.L •4t't a• je w �a�3.`";c'3m=�- 4• •-wT a9- �- ,a �q. �' lrf, ti'a''``'iht �.+ -�xp•o-.�s .k y ;� r $ a t _ HOME IMPROVEMENT .'CONTRACTORS REGISTRATION ' $ Board of. Building Regulations and Standards u , �0ne -Ashburton Place Room 1301 r k n ,�.,,R,!.. .A... ,,,,,a .a' 0 n ��� Boston, Massachusetts 02108r „ a � 'Fry } z MA i, k `f. ,:� a •. :ti... .n ,j....�.� -edk s#Y P ,4.� V'4 - Yy i S A .R,. � .-' HOME IMPROVEMENT .CONTRACTOR ` '` kI� - ---- Registration 1i3239 f=Expiration 05/27/V, 9- Type - INDItIIDUAL. r a g , j f ca,z-s dK ,Y..a F. t ra+tr . - #g-'}'as+•��"-mac:k- 3k�::e ,. Ye��.`�' xHOME IMPROVEMENT CONTRACTOR 9 stration 113239 Type - ' INDIVIDUAL .MIC`HAEL *J DINOIA x Ezplratlon 05/21/99 32 OUTPOST LN `pFdtS f 'CENTERVILLE MA 02632 =„ J,� r� ei r MICHAEL J.yDINOIA UTPOST LN ENTERVILLE MA 02632 ��ADMINISTR, n M _._t tam / / '.��i/ Cam.,.' ► ��� ti is S' e` sit � y i k i E 4 r;— TOWN OF BARNSTAB3 "Fir BUILDING DEPARTMENT- COMPLAINT/INQUIRY rePORT r Date Rec'd B Assessor's No. Last Name First Name ORIGINATOR �� Village State Telephone: Home Work Description- COMPLAINT INQUIRY Requestor's Signature Gj — COMPLAINT Street Address LOCATION OFFICE VSE ONLY INSPECTOR'S Date W.5; ACTION/ Ins ector - COMMENTS FOLLOW-Up ACTIO14 ADDITIOi:AL INFO. ATTACHED COPY DISTRIBUTION: WHITE - DEPhRTf—'NT FILE YELLOW - INSPECTOR , PINK - INSPECTOR (RETURN TO OFFICE FGR.) ►czscz R251 088. LOC 0139 LONGVIEW DRIVE CTY 07 TDS 400 HY KEY 161737 - ---MAILING ADDRESS------- PCA •1.011 PCs 00 YR 00 PARENT . - .. C.I., H RNI MP A 50 k; MT GALL, ONEL A REAACji 2 CC)I 139 LONGVIEW DR Spi - SP2 U T I UT2 27 SQ FT •.17 2 0 CTERLE M2 B 96 , EY 17OBS CO '1_ENVIL A 0632 AY17 B95 NS 0000 LAND 28800 imp 68400 OTHER 700 ----LEGAL DESCRIPTION—" TRUE MKT 97900 REA CLASSIFIE..D #LAND 1 28, 800 ASD LNO 28800 ASD •IMP 68400 ASD OTH 700 OBLDG(S) -CARD-1 1 68,400 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE •1 700 TAX EXEMPT O 39 ONGVEW D HYANIS REIDENT' 979 979 9790PL1L IR N S L 00 00 0 *DL LOT 31 OPEN SPACE ORR 09 19 0100 COMMERCIAL INDUSTRIAL EXEMPTIONS SALE 00/00 PRICE ORB C79146 AFD LAST ACTIVITY 08/01/91 PCR Y R2Ci iii:��:, r� r• R M T T r•MT AC"rsO('�R! R CARD :0 t `.iEv 161737 I li:.•Jl _ i� L I�\ f�i 1 1 I�i 11 ACTION 1 J.LJ14 i�l Lr rl��l L+ - PERMIT—NO MIT—NO O Y R TYPE VALUE CK"B Y NO Y R Ji Pa NEW/DEMO COMMENT • T•'� ��3 n /i s" i� Ire _ i •7 i i+lE i CE r.f'11"•�C 1 L'�•_("I.�. : _ 11 'r_'.�� pZ7 � � �•..� w...... �?3. � w�_t�_� 3"'z'L=YH V:... i vi.�.i 5'�.-��'�'0 n tit ",�i ♦ r i i '�i i h,NEW y nr OD:•1 n • RAR�rsrasM • The Town of Barnstable 059�- � Department of Health Safety and Environmental Services " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner TO: Health Inspector FROM: Gloria Urenas, Zoning Enforcement Officer v l" DATE: August 29, 1994 RE: 139 Longview Drive, Centerville, MA A=228.004 On August 19, 1994, I made a site visit to the above referenced address. I observed a common kitchen and facility for two (2)roomers. I found no violation. cc: Ms Ronnie Hall 1 r SENDER: I also wish to receive the H • Complete items 1 and/or 2 for additional services. d m Complete items 3,and 4a&b. following services (for an extra 9aJ rn • Print your name and address on the reverse of this form so that we can fee): > N return this card to you. y � > • Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address N d does not permit. r t • Write"Return Receipt Requested"on the mailpiece below the article number. 2 ❑ Restricted Delivery 2. " • The Return Receipt will show to whom the article was delivered and the date V cm delivered. Consult postmaster for fee. l 3. Article Addressed to: 4a. Article Number Q a Ronald Hall 4b. Service Typ e, c ❑ Registered M. V 139 Longview Drive .A c I �Certified Jred ❑ Ex ress Mai RetY Re M.,for i I Center v' le, MA 0 p c-, M� �e c 7. Date of Deliv 0 5. Sig re (Addresseei 8. Addressee's Address (Only if requested x j and fee is paid) LU 6. Signature (Agent) ~ L 0 PS Form 3811, December 1991 *U.S.GPO:1993--352-714 DOMESTIC RETURN RECEIPT UNITED STATES POSTAL SERV CAGE R/ P Official Business O o P -3 U! f PENALTY FOR PRIVATE USE TO AVOID PAYMENT OF POSTAGE,$300 E] I P 1 M Y `I f Print your name, address and ZIP Code here ATTN: Gloria Urenas Town of Barnstable 367 Main Street Hyannis, Ma 02601 L i !1!lie1I1!!i!f!ii:!IIlIII!!III'.lit!!I41I!!it!!1111!11 P 015 493 801- Receipt for Certified Mail No Insurance Coverage Provided Do not use for International Mail PosT"sERM ISee Reverse) Sent to Ronald Hall Street and No. 13 9 Lon view Dr.- P.O.,State and ZIP Code . Centerville, MA 0263 Postage 2 . 29 Certified Fee Special Delivery Fee T Restricted Delivery Fee C- Return Receipt Showing 0) to Whom&Date Delivered m Return Receipt Showing to Whom, C Date,and Addressee's Address 7 TOTAL Postage. _ c &Fees $2. 2 9 0 Postmark or Date M E 0 U. to a STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR AUY SELECTED OPTIONAL SERVICES lase front). I, 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address y . leaving the receipt attachbd and present the article at a post office service window or hand it to your rural carrier(no extra charge). 4) 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of the article,date,detach and retain the receipt,and mail the article. 3. If you want a return receipt,write the certified mail number and your name and address on a C. return receipt card,Form 3811,and attach it to the front of the article by means of the gummed' .� ends R space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT j REQUESTED adjacent to the number. O ` O 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M endorse RESTRICTED DELIVERY on the front of the article. E 0 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If aL return receipt is requested,check the applicable blocks in item 1 of Form 3811. a 6. Save this receipt and present it if you make inquiry. t 02595-93-z-0478 a�itxsrnsi�, The 'Town of Barnstable ' �m� Department of Health Safety and Environmental Services 39. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner August 11, 1994 Mr. Ronald Hall 139 Longview Drive Centerville, MA 02632 RE: 139 Longview Drive Centerville .Ma A=228 004 Mr. Hall: This office is in receipt of a complaint alleging that there are three(3) apartments located at 139 Longview Drive, Centerville, MA. The area is zoned Residence D1, and only single-family dwellings are permitted. There is no record of a building permit to convert the single-family dwelling to apartments Please contact this office immediately regarding the above matter Respectfully, Gloria Urenas Zoning Enforcement Officer 4 GMU:dee Certified mail �i . .��. �i � � _.� �� L zJ �-�. �� ' � ��=� ��- .�.. 1 �- �- ( f � I i� � t E t P,Y � n ._ i _. �) � � i ii i � I .wL 0.1 �`� E ` r _ � ' � ' i � �`, I � .� . ! 1 1 �' �1 } � i r�, . � � : ; �. - � , ; �4 � , M�'+C1�'1"Y'�►111Y''#W 1= Io►GE ol A.M FOR DATE TIME T M ' OF PHONE i `, RETLlRNE� PHONE ;1'QLti�CALL A CODE NUMBER- EXTENSION ' n PL1 A5E CALL: M.�SSAGEC7> cCC:L P_ car UIiLL CALL brzDCAME T0, S......, Q WANTS TO SIGNED TOPS FORM 4006 ���_ �- �- 1 : , r _ �� I s. ' --� - -f-� . . , a. —� <Jar rGorn 11�7A �'l'�`� GJQ/Vl� fU kn el.J o �feome a-� Annie N:l() THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA • __r.,.. ,{,.^ft _.may..y' .:i+s 4�1.� `..p� �. ` i ..'.Z� - 'Tl'-_. tx��+�.+ts+Y�' vS,;9.r..�i1+$�}` '�L-eP.w�l.r+�ara�x`- R� � TA - t I ..T J_�? nDD,:,�gc ti— G -_ r 7 t _ rc. `l;'9 - f .... F,T LOi:r r AN 13 Y ) ,. LOT ZE F .._.. ---------- ,.. S y..---- ----.I i. 'HEG,si _. 17 M N, _ 1 TO TYPE � - u<E !;,RC:.'..__: - �_� � - ..-----..._..__., .--'--'--'--r,S:�-eVE:NT q'k � OR FOUNUA7!ON ------------------�----.._--._ _ a M REMARKS: `S ErG1�Csti--G.Fi R —' --- — - -- PER _ VOAREALUME IVC Area- C.17C�iic�e _ _ _-- ESTIh1RTEU 1..O5Tf / /OOO OO .. FEE MIT r—��J o L�O_ (CUBt!C LSO UAR[ FE'cii - -- _-- - - - - OWNER.'- .. Ronnie hall. _- S.J7 )T'.t'J ZJ�.C-'E'1 Ceriterville BUILDING DEPT. ADDRESS F3v -- - I , — �� Z_� � TOE OF BAR NSTABLE,-MASSACHUSETTS' t: ®WILDING P 1 .93'7*4 DATE_ �19 PERMIT NOr - -'_-� g , APPLICANT - ADDRESS _ IN0.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO ( ;` STORY DWELL'NG UNITS _ (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING AT (LOCATION) DISTRICT (NO.) (STREET) ' BETWEEN AND (CROSSSTREET) (CROSS STREET) J'' LOT r SUBDIVISION LOT BLOCK SIZE _ BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONlSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: AREA OR .PERMIT VOLUME ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) 41 r: OWNER BUILDING DEPT. ADDRESS BY THIS PERMIT CONVEYS NO RIGHT- TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE., MUST BE AP- PROVED 3Y THE JURISDICTION. STREE`� OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINEDf' FROM T1'iE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS O.F ANY.APPLICABLE SUBDIVISION RESTRICTIONS. i . MI yMUM.. OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE ' PECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN r {ALL CONSTRUCTION WORK: PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING AND o U ri'D :T i O N 5'Ok ;GAT CGS MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. �2. F )] OR TO ::OVERING STRUCTURAL QUIRED,SUCH BUILLit `v-b ---_c �c ^rriIPI F.^. ''N-T11_ _ Mg RS(REAOY TO LATH). FINAL INSPECTION HAS BEEN MADE, I - 3. I A� INSPECTION BEFORE O CjI-NPANCY. ' POST THIS CARD SO-IT -1S.-VISIIBLE FROM STREET _ BUILDING INSPECTION APPROVALS PLUMBING INSPECTION.APP.ROVALS ELECTRICAL INSPECTION APPROVALS 1 1 7 z 1 z - z• � y HEATING INSPECTION APPROVALS t ENGINEERING DEPARTMENT I OTHER 2 BOARD OF HEALTH t PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION !C 'a \NO'K SHAD NOT PROCEED UNTIL THE,INSPEC= INSPECTIONS Ih!D.`'ATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIOOUS STAGES OF i WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN COW._TRUCTION. '�� 1 tl PERMIT iS ISSUED AS NOTED ABOVE. NOTIFICATION. :E } ' I I 1 BUILDING PERMIT i/ now APPROVED TOWN OF BARNSTABLE Wire Inspector J ' a ' � J 1 Assessor's office lst Floor Assessors map and lot number ,2 / Ion S rO� Board of Health(3rd floor):ArI,4 41ii 4 Sewage'Permit number /ate? • Engineering Department(3rd floor): ALwT LE House number Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDIN/0 INSPECTOR APPLICATION FOR PERMIT TO LZ�"Q G1C CO hee"o TYPE OF CONSTRUCTION 19 �U TO THE INSPECTOR•OF BUILDINGS: The undersigned hereby applies for a•permit ac ing to the following information: l Location 3�! .t.�rr�c � � L.��a ��'��• Proposed Use Zoning District to Fire-District C.�a /Ll "7 Name of Owner Address/� i2L CX�G�� dCC� CeiCCP� Name of Builder �/ Address ' rr •r Name of Architect r� Address Number of Rooms Foundation �OzCLa� Exteriorr �` �` Roofing Floors Interior A.' Heating Aar Plumbing Fireplace ��LP Approximate Cost ��� Area /Uo ;�r eAs- 6Lw4-,s C . Diagram of Lot and Building with Dimensions . Fee b'2' ` OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnst ble r'garding the above"const i Name Construction Supervisor's Licensee r _ HALL, RONNIE No 33784 permit For Remodel Gar acre Music Studio Location! 139 Long View Drive reeixter Owner Ronnie Hall Type of Construction Frame Plot Lot Permit Granted May 30, 19 90 Date of Inspection 19 Date Completed f�f /�� 19 40 In 0 tU e ,. .. ,s`.,..:., 4�. ,Sr.P?t "w *F, F=:.ih ..� .: "�"" �,..ea.e'-rt',L•�..d} 1 r,`it. 4}' i +Y o +f'? ;�y;�tF;Nt�!''""`.c.'5�.,+'%,r„�'^�i"1,r'`"'�.'`�''F`3'y��`�5";""���'rr fib'*' 1M �- ! :h tirti...w4w'�'Nt.:. • Y'}'.r�`tx M�' Nti•�'FY.M"i+m.�.lilaixk f.,I Y' ., Assessor's office(1st Floor): Assessor's map and lot number / 1+ o�THE to Board of Health(3rd floor): Sewage Permit numberj/�yj�r1�'1' •� � � �, Engineering Department(3rd floor): v = �ese9isntc �rAss House number °° 1639• Definitive Plan.Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only C -i TOWN OF BARNSTABLE =; _. BUILDING INSPECTOR / � APPLICATION FOR PERMIT TO r•/ C` �l-`'��/� G!f (`' ��(`�-✓l�` /J` � <<�C � TYPE OF CONSTRUCTION t Cc -r /tom 7�(<� 2� 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 3�� Proposed Use � ��'�' Zoning District Fire District sue' 0 Name of Owner Address Z 7�c�C lc% G Grp l ' ter` v Name of,BuilderGIL�'lU Address Name of Architect Address Number of Rooms Foundation ��� Exterior �� `!L l` ,'��`"` �- Roofing Floors / Interior �C(v' 6,�'�d�f�C'T Heating Plumbing Fireplace Approximate Cosh C�� Area Diagram of Lot and Building with Dimensions Fee • I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of�Barnstab�egarding the above construction. Name �G/G/G Construction Supervisor's License HALF, RONNIE A=251--088 No 33784 Permit For Remodel Gar ge Music Studio Location 139 Long View Drivc C jet exar�l e A04AI16 Owner Ronnie Hall_ ---1I Type of Construction Frame Plot Lot Permit Granted May 30, 19 %0 Date of Inspection 19 Date Completed 19 PERMIT COMPLETED 1/1/- Assessor's offioe-(1st floor): 16 Assessor's map-and lot number ..g-�............0 ... 'SnPLA� �0�7MFt0� I�oard of Health (3rd floor): f1 /�. 101 ,� . Sewage Permit number /.�..;... .. .............. YSTE S 4� Engineering: Department .(3rd floor) _ 3 .[_. I 7"ALLEI� �� Q f House number ................. ..... ...�,3j. ..... .. ( WITH 1nTLe�pra •APPLICATIONS PROCESSED 8 30�-9 30?A.M: and 1:00-2:00' P.M. only; CODS AN.D TOWN REGULATIONS p TOWN- ,- :OF - IIAII' N STABLE { BUILDING ' INSPECTOR APPLICATION FOR .PERMIT TO �.�S�OL�CT SGi&EA/EQ /�OdZI�► e6/.o��0 �o �1�1 oT o e ............ .... ..... . . .:............... ................!........................................ .... a . TYPE OF CONSTRUCTION ......... �JUQA . « ... .... ..`. .............................................................. ................................. t .. i ..— 6.._.........19. 6. TO THE INSPECTOR OF"BUILDINGS: The undersigned hereby applies for a permit according to the following informatiori: ALI Location .....I3..1... �!/ G/� �Y Vtl��� A�....................... y. ................... ........... ...................... ........................ , ... Proposed Use .......... .EE�I' O Yt h � v'�i'✓�(IL l t S. :........ :. f.. ............................. /�1/ ....................... . ... ...... . ZoningDistrict .... .......................................:............................Fire District .... .. ..... .........e...........:..................................... Name of Owner /LONNI,��;.:.L, f?'��I .. Address ......�....... . ......... .:....... ........... �3 �ti .. ...... Name of Builder /�cf6�14�L �� '.� �6Ct74p/ Gc�G�/o/si �S �fj/11�. ................... .............. .'.`�.... .............Address /` . Nameof Architect ..........•......................................................:.Address ..................:...... ...................:............................:......... Number of Rooms .G..�...SG.I.. t7J!sv��./.G.Y..P %tjr►�+ . � Foundation tion .. AGE .�.......:�y.- ` fJJ Exierior (/A/,/0,jv4 oofing fi �............ Floors . ........ ......�1.............................:......................Interior .....`' /.'. ......:,rl................... ..........................: Heating /VD�✓�. "....Plumbing (/Cr/t ................ ..... ... .......................... ..................:,................................... ............. .. Fireplace .... .....................................................:..................Approximdte Cost (O Gy /.... .................................................. ti .Definitive Plan Approved by Planning Board ____ __________________ __19 ______ Area l y����.. ...... .............. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH �Q SCt�EN@D aev Ll m P /8 = / ' F LOIV�rVII��. . RdSFj -SC� IN�J PORCH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS •- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. .. .......... ........ ........................ Construction Supervisor's License- .............6............ HAt,L, RONNIE L. i \� 30193 rT i a s No ....... ......... Permit for ..,3u...1 ... C�.k�:iec, Porch r Sing'1e Family , . .............. ....................x. Dwel.I�n�....... 139 location ........ Loncjview..1D. .�.V .. ......... ' �► r ~ ...................... Owner .................onnie...L• ..h .�l.. 4.'........ i , .t. TYPe of-Corstruction ........ F'XAMe..................... I- • ............................................................ .................. Plot .......... Y .... • Lot ...... ....... ..... _ r • 3. �' _n Permit Granted ....... 1.7.,.:19 8 - + I Date of Inspection . :19 i ��• `- .' Date Completed ..... .............. .......19 --.� -- its •� epedP ,yn S� r.' /'1 !� i 'I. I !�.� 1 I CV CM Z. `ate' �F •ANY. ''rS: :' ,, �— , ( "•2"a �'1 F- _ - •d„ Y6 a !I L ' � tr1.. v l gyp,. .Y _ w ` y v , 4 v . • - ' �F� .. � .. .. .. F r-- - ( t �4 Assessor's offioe (1st floor); ,p �� Ali 4; oFTHEro Assessor's map and lot number �:'.. !!�� . ........... ` }Sewage Permit number .......Q.,�:..... ............a....:. , Z Basa9Tsnteo Board of Health (3rd floor): Engineering Department (3rd floor): / NAM \0�° House number ........................:......... ....... ........................... '°rt c war a APPLICATIONS PROCESSED 8:30-9:30 A.M. 'and 1:00-2:00 P.M. only TOWN OF BARNSTABLE r BUILDING INSPECTOR 'APPLICATION FOR PERMIT TO .. ......................5.. �/ O /? i0//AC� D °- ... ............ ...... ....................................... �a Z TYPEOF CONSTRUCTION ......... .......................................................................................... r f ................ ..`...� ......19.TO THE INSPECTOR OF BUILDINGS: / The undersigned hereby applies for a permit according to the following information: Location ...... .�7......... Cv/Fwr......C�w/�vVi EA ............. ................................................. Sct'�o ��►'fay�Z...0 s '�-:................... /........................................................... Proposed Use ............ .. ....... .....................�... ................... .... :..... Zoning District ....................Fire District. ,. :.. a,v�vi� L. ,gip// �3 ����� Nameof Owner .......................... ....................................Address .......1/.......... ............../.......a..........................j.............. Name of Builder �������� /✓( �(�.� � 3. 6ergf .it/G[ ...................................................................Address ..... ......... Nameof Architect .....:............................................................Address .................................................................................... Number of Rooms .................................. ..... - .�� ...: Foundation `r..................... ,i .F ?......././.... c`..Firs /N� �ii / �Q,�1Q- .//.. ��JJ 4 ' Exterior '/� ...0�/dhLE ... . ....� ,.... .... .�- !... . ` Roofing ..!!!.S/�f7..G ............................................................... Floors ..(..... `'.L.r. ,�Y..1.a. 0....:'............................................Interior .....&.7 .....Srl � iGC� a Heating :: Y /.• _ t .!1.............................. Plumbing ... Fireplace ....N�'v� ...............................Approximate Cost .. /�.f�`�D�� ........................................ .......................................................... Definitive Plan Approved by Planning Board ------------------------_-------19-------- . Area ... fir. ! ' Diagram of L'ot and Building with Dimensions Fee ...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 3 Vic a w A PROPOSED SCRI NCO P69CH OCCUPANCY PERMITS REQUIRED FOR NEW�--DWELLINGS I hereby agree to conform to all�tthe\Rules and Regulations of the Town of Barnstable regarding the above construction. t_ Name ...... ... � ' ��'�'�............ .�. `. #�i/Id/e Construction Supervisor's Lice`nse_< ......:........................ HALL, _P�NNIIE L. / A=251-088 No 30193 permit for Build Screened Porch ..................... Single Family Dwelling ' .......................................................................... r Longview Drive Location ........139........................................................ ....................CST.-�v .......... .Y1{'1.tS Owner ......Ronnie L. Hall ........................................................... Type of Construction .......Frame ................................... ............................................................................... Plot ............................ Lot ................................ November 17, 86 Permit Granted .......................................19 Date of Inspection ....................................19 Date Completed ......................................19 � 4 Q Assessors map and lot'numbe a .1... i..�o........... of NE ;... — 2 Sen4e• Permit number .. ....0.;............. ..... ♦� o ......r........H use number ............... .:..... o �a \e0a 7 M 039. .•` TOWN OF BARsNSTABLE . BUILDING -INSPECTOR "APPLICATION FOR PERMIT TO ..........4.i�p..:.. ' .9......; ftT�f .................... !l 0 C/<!�. ". :.. TYPE OF CONSTRUCTION .......:.................................................................................................I ............................. ............................ .. .!•... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for, a permit acco�rding.tothe -following informatSion: ........E&it��......: � V ...... X.LLocation ...._.................. T)�V .....................................� Proposed Use ............ .. .l.y:t!..... V1.....................................:. Zoning District ..............l�G�...+............................................Fire •District ...................G/r�:/U�L�.I.,. ....... .............. Address I Q ^�/� Q 1 J Name of Owner lt) � ...h.:..../..�J.!..!..!..... 1 ./...�'l. ll��U� �/JIC,.- . Name of Builder ..Wl�!.�... ���.W/.�........Address Nameof Architect ....... .. .......h: ........J .Address ................................................................:................... Numberof Rooms ......... .......................................................Foundation .......!�`:..... .......................................................... Exterior r+ �T 9 t� � ..Roofing .. RrT Floors ..........................Interior .... .H z CT Cc'K Heating ...L...�2.... �a ��........... :`.":.Plumbing �......ff ✓ .... . i_-,-':a...,.�.,lk.�.<..:....;.. Fireplace r11 t; ri S ..........Approximate Cost ........: y..V...Y...."........... ........ ............... Definitive Plan.Approved by Planning Board ---------------- ----- 19 --• Area -Diagram of Lot and Building with Dimensions Fee /�! `-.................. .....m.p............. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the To -n-of arnstable regarding the above construction. 1 ' Name, ���'df/��rr ... .... .........1 ..... Construction Supervisor's License ... Y.. ... f HALL, RONNIE L. 25755 ADD BATHROOM ' No .....y„x•:...:.:. Permit for ct ,_ f .� a• Y ` ................ ...D.We lling............. s Location` ...13.9...L.QIagvIew...Drive............. r i a Hyannis - Owner. ...Ronnie' L..........Hall....................... Type Construction .....rame........................... t ' y Plot ............................ Lot ...:............................ ,.✓ Xe Permit Granted November 8, - 19 83 v ........................................ 'F fi�Date of/Inspection ;.. Date` Completed ................ 7t Assess'or's map;and dot num7e) ` aJ"��Zcc ..... c. 1 ..�, ... Sewcoe, Permit,=number .. ,[- 1 " ABB9 E. • H use number .......• /. ..� .. rb L a en a ,........... 9�0 9- �0 'F0 mo a' TOWN OF BARNSTABLE BUIBIN:& INSPECTOR :APPLICATION. FOR PERMIT TO .... v. ..�.... ..................... 4.2 .�1/l.(.t.. ./. :TYPE OF CONSTRUCTION ......................v .......rr? ►nr................................................... ................... /.. ....,.., TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:- Location .:..................:..ra�.� :........ ......../1[JQ 05. 6.. ...... .......� .......:....:........ Proposed Use .............. ..:. .i��.l.................... ................. Zoning District .. .G, �............................................Fire District ...... �'/�ctJnJf. .... Name of Owner ....P��O- i.f.j.I.E...Y1...:j. 1.!..�! .......Address./.J�..l.../'1.t!! g.U1. � !�a.-...0A).�- fe(2�/'/� Name of Builder Add(ess.! ... ..(.)........S� �J�N!�,?. ...S���IOV Name f Architect .......Shm.e........n 5........ �Address . Numberof Rooms ..................................................................Foundation .......... .............................:::................: Exterior. ........(.`)H ,r.�...:1.f 0.A.P.......................................Roofing ........�s�a�!�++.T...:...:.... ' Floors . ........................................................... ...... ...... ....... ..........Interior Plumbing S/a[ w{' .� ' Heating f.U`Cf...... .�aT .. ?.T f�. ... °�, i7X. ... .... Fireplace ... Af�� !,r.5 , �... ...............................................Approximate. Cost ..`.... ��� ' >. ' •p ............ . . . .. .�. ..... ... .. ... Definitive Plan Approved by Planning Board -------------------------------1 9-------- . Area Diagram of Lot and Building with Dimensions Fee /] O� SUBJECT TO APPROVAL OF BOARD OF HEALTH k j r r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Tin-of-Barnstable regarding the,above construction. Name ...... ... ............... Construction Supervisor's. License �Dv � HALL; RONNIEL, A=25.1-$;8 No ? 55.... Permit'for_...ADD BATHROOM Single Family Dwelling _ Location 139--Long� ew. .QrlY.�...:.. - vannis.. Owner r Ronnie 'LHall .. .. . ......... f Type of Construction Frame _ ............................... ; ........................_ _ ..... .. ................... a.- Plot _ .. Lot ......................._ Permit Granted. November 8. .......19 .83 Date of Inspection ..............................19 i { Date Completed ......... .... ...... ......1.9_