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0257 MEGAN ROAD
�S9/��yan mac' ACTIVE IMPORTANT MESSAGfA.M. For Day Time M . c2 5'7 0 Of Phone FAX Area a umbe on MOBILE Ar Code Numbe e n Telephoned Returned your call R Came to see you Please call Wants to see you Will call again Caller on hold Message Signed fNERML.48023 MADE IN U.S.A. ' ! ' � � � � i I I ' � � � I � i � i t � � � , � I , � 4 i � i 1 � � � �.�� � � � � � � � � � . ��_� � i � . �: � � I � ALTERNATIVE WEATHER.IZATION Till t 8 1 y .At4 9- 39 ISION Date: , Town of Barnstable ,;:=;•: 200 Main St Hyannis MA 02601 r"';j c-•.:.,t,2;;�. k;'i%fs•..friLo t`•;ru: _J:••;n .. Re:Permit#_ l l `��:,.,;;,..s; ``'ViIlage��::^ rr,jv::nr:yti:.,'3F.'I: i''� ^'•Y�.:•� , :,•�,�,,....,1_�:.r.�!•1 a:The insulation/wea e. u €srk at -. -r•X'. .:,.,;;.• N..s;:� r` •-��,! :"�''.( '.aY 1+,...1...%'^i:�y...� .J 12�s:1a en com let . M � _1��:. :t^" - .3:� •'��}i'�• c�.r-. s::^.,�;, .ac.,. w•.. ,.cT,•''.t: ;1,- is=..-::''�� :'a'Ir•:;'.. - •a".: - _.'"%.: 'fit:'= "i,?_',•..';:•"'.:y,:r,i• +M,.,, ;�;•�. r•;' •�'•�;:.; .,3:i°,• .�i/.,•r';::I•cs'••Ini�'::`:�`:.•' ::<::' aM1"_ :JS,r:ii•'.�:a•l' ':�:�: .:5�• :.:L...?+;:..r ,.���, _ .. ;I.:..MY:.^ ,J...� ^�a:Y.. :i M'"Sir• y��.� 1' ,�•i,'s "i:::.,. !$r'--;1, •<c5 i5:"y"'- :"f,:Z•',.n':;�3°,+, �''N;.Y:, A''•�;.,.a' .i:?tiie:1'��t. ' •''�::;`:i:t3:�.�a<1;�;'j:'•^ �'y:i''.� '•:a•i^:',:1..� '�:+�-, ;,y:;;`'=sr,i'� '''k�"^y-�i+�".'c�i�a,':>':" ;,y?j „':;!yy, ;r,.a;ar1.,:ii��',':7�-�'�; S 2f.;�"a::1::*iii.,�::r,:. -.:r•::::':..,1_.,I,LL, �:�«�t!5,'tt',.-t �,1,;. ::'„ f. ,r•;. - '::i;;:,a)i..:,::`"i'':i'•`r•:^i.:.'i;l,..+:'•i:.:'f':t.:'a•��f-.'.i� tpC.^�j:.�,v"�`a- a.!xr,i_ �'l"pi�A ti'M '.a_:.�1':,..'1.t y" .. .t. y �:r:•'� ' •S,i'ri^.. .ys.;•f,: '%o�?: .y�r,�i4�:"' ;'.i.j'" ;i�•`:x`%�';;;Pier.°r,.:;r.,,,;>' Timothy Cabral, President CSL-105454 58 DIC.KINSON STREET I FALL RIYER,-MBA 02721 � . (508)567-4SA.0 . 1 ALTERNATIVEWMMHERIZATION0. L,CONI•.: f Application nJ6 u e ..... Date Issued: .. .. ... .. Bu lding Inspectors Initials..... .. r V L1J 1 J r aV4ap ParceL-( ! TOWN-OF BARNSTABLE � EXPEDITED=PERT APPLICATION: ROOF/SIDING/WINDOW.S/DOORS/TENTS/STOVES/WEATHERIZATION PROPER -ON Address:of-Project: _ _ NUMBER ' STREET G Owner's Name: 's Phone Number Email Address: r S Peril fry► . I Cell Phone Number e / Project cost$ ���f Check one;. Residential Commercial ^. _ OWNER'Skoi AUTHORIZATION I As owner of the..above property I hereby authorize to make application for a building permit in accordance with 78 MR Y Owner Signature: it&a"a lr A- Date: TYPE OF WORK Siding Wiatlows(no header.change):# t 4 = InsulattonLWeafhenzattQn Doors(no header change)# Commercial Doors•_regrure ari*spector'sTevreiv t 0 Roof(not applying more than l>layer: of shingles) Construction Debris will be going to CONTRACTOR'S INF 4 � , ORMATION ve- Contractor's Home Improvement Contractors Registration(if applicable)# (attach,,copy) Construction Supervisor's License# / y (attach copy) Email of Contractor P,1`4 � &Hl t Lt)Q 1,�c 171�ti, Phone.number . ?07 0 ALL PROPERTIES'THAT,HAVEySTRUCTURES-01/ER;75 YEARS OLD OR:IF THE SUBJECTPROPERTY ISIN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE PERMIT CAN BE ISSUED. APPLICATIONNUMBER............................................................ *For Tents Only* Date Tent(s)will be erected . Removed on number of tents total Does the,tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am--9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval, *WOOD/COAL/PELIJET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APP IC 'S SIGNATURE Signature Date ! All permit applications are subject to a building official's approval prior to issuance. Town o_f Barnstable n Bu•�ld•� g v - Post This.Card oS That rt is Visible From the Street A� rovedPlans Must be Retained on lob and this Card Must be Kept p t .xsai6Posted Until final Inspection Has Been Made pp e3�'YY17 t ct Where a Certificate of Occupancy is Required,such Building shall Not be Occupied unrtil a Final Inspection has been made { 1 llil Permit NO. B-18-4156 Applicant Name: ALTERNATIVE WEATHERIZATION INC. Approvals Date Issued: 12/20/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 06/20/2019 Foundation: Location: 257 MEGAN ROAD, HYANNIS Map/Lot: 291-247 Zoning District: RB Sheathing: Owner on Record: POLANCO, HECTOR&ROSMERY D Contractor Name:..ALTERNATIVE WEATHERIZATION Framing: 1 INC. 2 Address: 257 MEGAN ROAD Contractor License: 175683 HYANNIS, MA 02601 Chimney: Description: Weatherization Est Project Cost: $ 1,009.00 ` Insulation: --Permif ee: $85.00 Project Review Req: a Final: Fee Paid: $85.00 l � . . 12 20 Date 2018/ Plumbing/Gas C.OI:��ClV� Rough Plumbing: r. Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after'issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the;approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoningby-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for'public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by,the Building and Fire Officials areprovided on thispermit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Permit Authorization ass saver Form Site ID: 3566901 Customer: Rosmery Polanco 1, R 0 Sf ,mil r'/ P 6) An(,0 ,owner of the property located at, (owner's Name,printed) 257 Megan Road Hyannis, MA 02601 (Property Street Address) (City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Owner's Signature: /��r'j a ��� 6 Date: FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Participating Contractor Date Name: RISE Engineering Phone: 401-784-3700 Email: Page 1 of 1 For office Uzi ORIY Rev.102015 The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 ,N www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual): ALTERNATIVE WEATHERIZATION, INC. f Address: 2 LARK STREET .City/State/Zip: FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ I am a employer with 16 employees(full and/or part-time).* 7. New construction 2.M I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 3.M I am a homeowner doing all work myself.[No workers'comp.insurance required.] 9. ❑Demolition' 4.F�I am a homeowner and wilt be hiring contractors to conduct all work on my property. I will 10 Q Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.[]Electrical repairs Or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. ROOF repairs These sub-contractors have em ployees and have workers'comp.insurance.' 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑✓ Other INSULATION 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then-hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: LIBERTY MUTUAL INSURANCE Policy#or Self-ins.Lic.#: XWO(19)58867158 Expiration Date:6/8/19 Job Site Address City/State/Zip: f Attach a copy of the workers' co ensation policy declaration page(showing the policy numbeq9nd expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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 S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u d ain a p Iti s f perjury that the information provided above is true and correct: Signature: Date: Phone#:508-567-4240 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#: t.s. Vm' AtagfiiiS d5 Lkens £S-'ifl$44 a €snstrucyn t,€ ti�ia�rr f w FAIJL � �frti�i �tf�t2tflg, ,y .e°a ✓ / J ±l Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Maachusetts 02115 Home lmprovemet�&mtractor Registration Type: Corporation ALTERNATIVE WEATHERIZATION, INC f, Registration: 3756$3 LARK ST �, Expiration: 05/2812019 FALL RIVER,MA 02721 Update Address and return card. Mark reason for change, .._. ..__......____ ..... . ._. ..._ ... ._. .__ __._.._.. . ........._.._ O.-Address. 0 PerewaI D E-mniavmenfi D Legit+. a. ._._.... .. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only ' f TYPE:Oration before the expiration date. If found return to: R29wration 9x2iratian Office of Consumer Affairs and Business Regulation --175683 05M,'2019 10 Park Plaza-Suite 5170 ALTERNATIVE WEATHER!ZATI€JN,INC. n,MA 02116 TIMOTHY CABRAL �t,� -- 2 LARK ST FALL RIVER,MA 02721 Undersecretary Ot V otlt S>' attjre 7 ® DATE(MMIDDIYYYY) �ACORE0 CERTIFICATE OF LIABILITY INSURANCEF06/11/18 THISCERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING.INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). GUNTALA PRODUCER NAME: PHONE 508-677-0407 A C,No): 508-677-0409 Anthony F.Cordeiro Insurance Agency A/C No, o Ext 171 Pleasant Street AIL ADDRESS: HSouza@Cordeirolnsurance.com Fall River MA 02721 ' INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Liberty Mutual INSURED INSURERB: Ohio Security Alternative Weatherization INSURER C: Ohio Casualty 2 Lark St INSURER D: Fall River,MA 02721 INSURER.E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POD CY EFF MI DI EXP LIMITS LTR INSD WVD (MM/DD MMIDDIYYYY x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) S 15,000 A Y Y BKS58867158 06/08/18 06/08/19 PERSONAL BADV INJURY $ 1,000,000 HEN'LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE $ 2,000,000 POLICY❑PRO ❑ PRODUCTS-COMP/OPAGG S 2,000,000 JECT LOC S OTHER: AUTOMOBILE LIABILITY Eaa MBINaccident51NGLE LIMIT g 1,000,000 ANY AUTO BODILY INJURY(Per person) S B OWNED X SCHEDULED Y BAS58867158 06/08/18 06/08/19 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S X AUTOS ONLY x AUTOS ONLY Per accident S X UMBRELLA LIAB x OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE Y Y US058867158 06/08/18 06/08/19 AGGREGATE $ 1,000,000 DED I I RETENTIONS S WORKERS COMPENSATION PER OTH- STATUTE ER AND EMPLOYERS'LIABILITY �Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 500,000 C OFFICER/MEMBER EXCLUDED? NIA XW058867158 06/08/18 06/08/19 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Action Inc and NGRID,USA its direct and indirect parents,subsidiaries and affiliates is added as an Additional Insured for General Liability on a Primary Sr Noncontributory basis per the terms and conditions of form CG2001 (04/13),for Ongoing Operations per the terms and conditions of form CG2010(04/13),for Completed Operations per the terms and conditions of form CG2037(04/13)and Waiver of Subrogation applies per the terms and conditions of form MEGL0241-01 (04-11) Additional Insured for Automobile Liability applies per the terms and conditions of form SCA005(02/16) Excess Liabilitv is a following form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. NGRID USA 40 Sylvan Road Waltham,MA 02451 AUTHORIZED REPRESENT 1 f f ©19'k8-2015 ACORD CORPORATION. All rights reserved.1 ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Y TOWN OF BARNSTABLE BUILDING PERMIT.APLIC�TION - _ P Map 1 Parcel NPR f rk �3 OSfp 1� q�r Health Division w,,V.-Datel"ssued /J Conservation Division rtSl Z 301 k/ Fee Tax Collector �/ 0/01 UA - Treasurer 14 SEPT9C SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND ' TOIN"N R'EGULAT6 i Historic-OKH Preservation/Hyannis Project Street Address IA � r -Village S Owner T Address UTAWWfj0b �0�� Telephone _ 51— Z S3- -15.A . -13 i co uk kb 5bl Permit'Request WS kbhk c ICIJ 'To E:)erC -ClOck Square feet: 1st floor: existing proposed 2nd floor:existing proposed Total new V 'Estimated Project Cost Zoning District Flood Plain Groundwater Overlay i Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure �0 ta X Historic House: ❑Yes No On Old King's Highway: ❑Yes Po Basement Type: Full ❑Crawl ❑Walkout 0 Other 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 LF Heat Type and Fuel: /UI Gas . ❑Oil ❑ Electric ❑Other Central Air: ❑Yes �4 No Fireplaces: Existing _ New Existing wood/coal stove: ❑Yes 1W No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:0 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 BUILDER INFORMATION b Name m(= AiiTOF Telephone Number Address a 5q tAmp,nj License# {tJ 1 M Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE O\, FOR OFFICIAL USE ONLY r PERMIT NO. DATE ISSUED' 'MAP. _PARCEL NO: . . •� i ADDRESS r t s' + VILLAGE z ' y OWNER . 1 4� ' 1 j fir, • - ^ _ , DATE OF INSPECTIOI '[ FOUNDATION f ,f ( Y Y• ! ` - * • ,4 Vim^ , . .+- a � 7.-' Y FRAME ; a INSULATION - FIREPLACE ELECTRICAL: ROUGH~ = ` FINAL' PLUMBING: ROUGH, X FINALE _ ~' •r. � Vim. f c _ r GAS: ROUGH; FINAL tF FINAL BUILDING W •�� •� -, �: . . ` + � - .. r - j r - t DATE CLOSED OUT '* ASSOCIATION PLAN NO. e town ot barnstaDie n�axsr�+ar.E. 9�A='&659. � ,Department of health Safety and Environmental Services rEo � Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph,Cressen 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: �J 0j) 'C>ELg= PvNt, f9DwT t cr1 To tE7 g, g.& Estimated Cost r Address of Work: 4�n QJ Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied 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 agent of the owner: Date Contractor Name Registration No. OR1 Date Owner's Name q:forms:Af3idav The Commonwealth of Massachusetts �.�;;-- •;;�:-=�;�t Department of Industrial Accidents • -Tip �� ot�ice atl�sestigations 3 ---p 3 600 Washington Street Boston Mass. 02111 Workers' Comensation Insurance Affidavit name- t �,A ] ( fir location: d,3� 1"\Uk Y2rN city, hone# - I am a homeowner performing all work myself. ❑ I am a sole proDrietorand have no one workin in a�ca acity %/% /%/%////%%%/%%//O///%//%//%////%/G/%%/%%////%%/%%%%/%/%/%/O%%%/%%/%��%%%/%/%/%/��%//%/%//%//%//%%�/%�///%////%/..,,,:.;.: ❑ I am an employer providing workers' compensation for my employees working on this job. comnnnv name: address: city phone#: insurance co. nniicv0 ❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following ivorkers' compensation polices: comnanv name: address: citv.. phone#•. . . . .... oiiev#.. ........... msvrnnce co. comnanv name: ::,...,::•:;.: :... address- city- nhone#i insurance co. polfcv# / -- Failure to secure coverage as required tinder Section 25A of MGL 152 can lead to the imposition of criminal penalties of s fine up to S1.500.00 and/or one years'imprisonment as well as dvd penalties in the form of a STOP WORK ORDER and a fine of 3100.00 a day against me. I understated that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is tr(uv and correct Sicature Date �®� _ Print name , z�� Ph # NN _717-2 2 ` (contact oincial use only do not write in this area to be completed by city or torn oMcial Icity or town: permit/Ucense tl ❑Building Depart atent - C3Licensing Board ❑ check if immediate response is required ❑Selectmen's OMce ❑Health Department person: phone d; ❑Other (mNu c 9,95 PJA1 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for thcz" employees. As quoted from the "law", an employee is defined as every person in the service of another under any cow of hire, express or implied, oral or written. An employer is defined as an individual partnership, association, corporation or other le entity, r o or more o=. P P � rp gal lily, o an tw the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer', or the receive: 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 main =nce , 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 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,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 tb.insurance requirem= 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 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 Departnreat 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 permitllicense number which will be used as a reference number. The affidavits may be rctumed fo the Dep.,==by mail or FAX unless other anzagements 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. i The Commonwealth Of Massachusetts Department of Industrial Accidents Me of myesduatlons 600 Washington street Boston'Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 " The Town of Barnstable ttear►srnet.t: Mess 9q, 159. .e� Regulatory Services Thomas F. Geiler, Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-62:0 HOMEOWNER LICENSE EXEMPTION t�'1 Please Print DATE: JOB LOCATION: number street Iv village^� ..HOMEOWNER": ��C �1C� t©F ��=1��'Z�20 e home phone# work phone# CURRENT MAILING ADDRESS; J WO ON\ I Jj Cy N(J\flp p �J N ILi Q�' 6rk-a (D\ 6 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 faun 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 BuiIding 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 person(s)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 pace of this issue is a form currently used by several towns. You may care t amend and adopt such a formicertification for use in your community. Q:FORMS:EXEMFM COLLECTOR OF TAXES TOWN OF BARNSTABLE L4 Issue Date: 04/25/2001 MAUREEN J.MCPHEE FISCAL YEAR 2001 REAL ESTATE TAX BILL Due Date: 05/25/2001 Commitment: 2001-01 P.O. BOX 1360 TC Bill Number: 202 HYANNIS, MA 02601-1360 'Please return this'section�0f theBill with payment _ Parcel ID: 291-247 Fire District: HYANNIS AmountjDue sj $642'S9, Voluntary Scholarship Payment: AHTOF,ISAAC&JENNY Voluntary Elderly/Disabled Payment: 3 LYNNWOOD LANE WORCESTER MA 01609 Total Amount Paid: 02082082001600000202200000642595 4 + 4 4 4 4- P ease tzar aiong the perforation ar^d indi.;de the above section r,.th payment. 8 8 S 4 4 4 Tax Rate Per$1000 FISCAL YEAR 2001 REAL ESTATE TAX BILL Issue Date: 04/25/2001 Class 1 ' Class 2 Class 3 Class a Due Date: 05/25/2001 Residential Open SpaceCommercial Industrial Notice of Real Estate Tax for Fiscal Year 2001 General $8.99 $8.99 $8.99 $8.99 Based upon assessments as of January 1,2000 your Bill Number: 202 Real Estate Tax for the fiscal year beginning July 1, Parcel ID: 291-247 2000 and ending June 30,2001 on the following District $2.52 $2.52 $2.52 $2 52 described parcel of Real Estate is as follows: Fire District: HYANNIS Oalirner1nformatian a Info AHTOF,ISAAC&JENNY Parcel ID: 291-247 3 LYNNWOOD LANE Location: 257 MEGAN ROAD WORCESTER MA 01609 _ Class: 1010 Acres: 0.280 Valuations ;; . Special Assessments jS/A) Tax In oration - Land Value for Class 1: 29,800 S/A 1: 0.00 General Tax: 1,000.59 Land Value for Class 2: 0 S/A 2: 0.00 District Tax: 280.48 Land Value for Class 3: 0- S/A 3: 0.00 Land Bank Tax: 30.02 Land Value for Class 4: 0,. S/A 4: 0.00 Total Tax: 1,311.09 Total Value for Land: 29,800 S/A 5: 0.00 Total S/A: 0.00 Bldg.Value for Class 1: 81,500 Total S/A Int: 0.00 Total Tax+S/A: 1,311.09. 'Bldg.Value for Class 2: 0 Total S/A: 0.00 ,Bldg.Value for Class 3: 0 First Installment: 668.50 Bldg.Value for Class 4: 0 g Adfustm Second Installment: 642.59 Total Value for Bldgs: 81,500 Adjustment 1: 0.00 Net Actual Tax: 642.59 Total Bldg./Land Value: 111,300 Adjustment 2: 0.00 Amount Paid:' 668.50 Residential Exemption: Adjustment 3: 0.00 0 Interest: 0.00 Adjustment 4: 0.00 Adjusted Total: 111,300 Adjustment 5: 0.00 Fees 0.00 Total Taxable Valuation: 111,300 Total Adjustments: 0.00 Amount Due t :$642.59 Please put your Bill Number on your check. To obtain a receipted bill,enclose a self Office Hours: addressed,stamped envelope and both sections of the bill with your payment. If no receipt is Mail Payments to: desired,please DETACH TOP SECTION and forward with remittance. If not paid when due, Town of Barnstable 8:30 AM to 4:30 PM your tax amount is subject to penalties of interest,demand and fees. Collector of Taxes Monday through Friday Interest at 14 percent per annum will be charged from the date of issue P.O.Box 1360 TC 367 Main Street Hyannis,MA 02601-1360 Hyannis,MA to the date payment was received in the Tax Collector's Office. 508-862-4054 Taxes will be delinquent on 05/26/2001. Abatement applications must be postmarked and mailed to the Assessor's Office no later than 05/25/2001. For more information regarding the Land Bank Tax,the Voluntary Elderly/Disabled Fund,and the Scholarship Fund,refer to the enclosed sheet. -Visit our Town Web site at http://town.barnstable.ma.us SEE REVERSE SIDE OF BILL FOR IMPORTANT INFORMATION! �i 0 LOT 18 3 SOY' 17 f(J •z. PROPOSED DECK lq.X V ;w. g12 � LOT 1 Tt?P 1?T.i" 11tts Ivt I�`IC, INSPECTION P2arz is For CY INSPI:rC TION FS,00D ZO F O'r h 77,M'r L.__ ...:. _ YT ISTRY OT+7TdJN,RF isAtl t:`��/`I._. M_ I>LA`d I{ER-,?i ��? ff. �Z? 7,�?_. _. C it a g -- i. _� �.. .. YANK SURVEY :iigt�i f ON Till i'L,t'v IS LOCATED ON THE GROUND A4 �� q� -• SHOWN AND HAT ITS POSMON DOES CONFORM s� PAUL �� CONSULTANTS TO THELONUNG LAW SETBACK g EQUIREM;~�T`x Of THE - MERTHZ-W �. 40B t5u1:1 Sl f n� O r'�A���1 �i� Atai� THAT 4lt No 3 g�rDts�r�Y ROAD LIE. WITHIN 'EH SPECIA3 FLOOD HA7biI� �,� 3t4 t? . MA tSTOtiS Alitg:S MA. 02643 € AS 'SHOWN ON THE 11 111), MAP eA" /LI° ^`r � Tip t. E-£�r THiS PLAN wr �t;j!'gM NOT TO HE USED FOR FENCES, 1 C.. 1.155,94 .DP f tj re OVERALL SIZE: 1 '-0 LONG 14'-0 WIDE 1'-2"HIGH A , hh y ,� .. • } F _ e r Y t 5 Y } S K s Qty Size Material Part 5 2X8"5(14' TRTD LUMBER LEDGER(A)&BEAM BDS(B) 2 2X8"Xio' TRTD LUMBER END JOISTS(C) -a 2X8"X�' TRDT LUMBER JOISTS (D) 2X4"X8' TRDT LUMBER STEP SUPPORT SPACERS(E) 2 2X6"X8' TRDT LUMBER INTERIOR STEP SUPPORTS(F) I 2X6"X6' CEDAR END STEP SUPPORTS(G) i. 2X6"X6' CEDAR STEP RISER(H)&TREAD(LO y6 2X6"X f 4" TRDT LUMBER DECKING I 2X I 0"X 14' TRDT LUMBER FRONT FACE BD (J) 2 2X 10"X 10' TRDT LUMBER SIDE FACE BDS(K) --__i_�_i Q -�-- 2"ABOVE GROUND { ! IIIi � IIj GER 4 FT BELOW GROUND 'X14' FOUNDATION SCHEDULE -�- '- iBER 6"DIAMETER FOOTINGS ACHED TO ;TING DECK { i f i , , y EXISTING 12X12 DECK GNU 257 MEGAN ROAD, 12' i i ' i y 12' U[uu -j -i REPLACE FLOOR BOARDS Qty Size Material Part 26 2X6"XM: TRDT LUMBER FLOORBOARD -�• v ��• 61uVo 440 0000 bUhiULUili 1.U1N51 id002 t u TOWN OF BARNSTABLE LOCATIONet t2lE .- AZ SEWAGE # 'VILLAGE I-S ASSESSOR'S MAP & LO'TCpr INSTALLER'S NAME & PHONE NO. Ova--7'rLyal-I e,'J J f_ SEPTIC TANK CAPACITY LEACHING FACILITYc(cype) .!;E>J%� H LIC ATE OOM � PRIVATE WELL OR NO. O , F BEDkt S _ BUILDER O OWN L.),4 We '4177!J.444J4S S DATE PERMIT ISSUED: Z-0122 —DATE COMPLIANCE ISSUED, ,�`�/ VARIANCE GRANTED: Yes CNO -7-Jr7 ,.. fyr ;,:10/21/93 11 52':- ,,, $508 428 9399 BORTOLOTTI CONST 001 ' � ti"• -ri.r !.A r.11•.Jt..y.-).Fr, "!r,'i--. ryNry.��IJ:�.r�r.u�.....J4.•�.•�•r!.-Mr. r�'_• .. .. � �- ..r r wu r. r♦ � (Jr Mmuaai����ara�wae�in.,�rjwnC�gcfµ[L�:tpasp•t�le' '.- 1 •. - 1 a� r� �':ir;'��I s..r'p rl: .•4a• ..N;i••' •:r�.�. .•;}+.�.7• r.l� / t i• r BORTOL:OTI. i bONST,RUCTION;';; • `;:�•... '.:T65`iWakeb 'Road"..,; ',: ,,• •r:• pp CC MARST0N9 MILLS.Mi4°:�0264$"';:`: :(504:77i-'9399 ' :; :y :4 :.:4Of cog? 110-3.0mv .zz -TO •��.�7.jtJf�,�,y;'r�>:., ::�.�:� f r'•' `•.:'i I .. • i� N. '��7; ;'!r%�,'• _ .:r, C ' ,'Q OAY WORK NTRACT ��^n!'!;(�LC.l� .:: `:/;�;•! {:•, .'t ''' (.EXTRA' , .01 ,r TGTAC�1LT�t" '.n �'':. •..a• w':•' T4YAL ABOR. . � _ Aw7e CaMPI„pTGP. .: W K.DRD R16D Y- ). ..• �` .t.. � �' •-,.. . roiaiumdu T. L ►n l_ COLLECTOR OF TAXES TOWN OF BARN STABLE `�1" Issue Date: 04/25/2001 �i MAUREEN J.MCPHEE FISCAL YEAR 2001 REAL ESTATE TAX BILL Due Date: 05/25/2001 r Commitment:.2001-01 P.O. BOX 1360 TIC Bill Number: 202 HYANNIS, MA 02601-1360 .:Please return thtssecfion of the,`Blll with payment ' Parcel ID: 291-247 Fire District: HYANNIS Amount Due ��, $64259 Voluntary Scholarship Payment: AHTOF,ISAAC&JENNY 3 LYNNWOOD LANE Voluntary Elderly/Disabled Payment: WORCESTER MA 01609 Total Amount Paid: 02082082001600000202200000642595 Pease tear aeon n 8 Yt 4r $ $ $g i.e p�r'craian and incude the above s�tlon v.•ith payment. Tax Rate Per$1000 FISCAL YEAR 2001 REAL ESTATE TAX BILL Issue Date: 04/25/2001 Class 1 Class 2 Class 3 Class a Due Date: 05/25/2001 Residential Open Spacecommercial Industrial Notice of Real Estate Tax for Fiscal Year 2001 General Bill Number: 202 $8.99 _ $8.99 $8.99 $8.99 Based upon assessments as of January 1,2000 your Real Estate Tax for the fiscal year beginning July 1, Parcel ID: 291-247 2000 and ending June 30,2001 on the following District $2.52 $2.52 $2.52 $2.52 described parcel of Real Estate is as follows: Fire District: HYANNIS Owner ormatto f ,. � Prope: InfarmattaraG; AHTOF,ISAAC&JENNY Parcel ID: 291-247 3 LYNNWOOD LANE Location: 257 MEGAN ROAD WORCESTER 1MA 01609 Class: 1010 Acres: 6.280 -ti -a� rep^'° u -�� '� �l/attaa#ions °= Spectal.Assessments(S/A}-- T Information , � k.. ��� Land Value for Class 1: 29,800 S/A 1: 0.00 General Tax: 1,000.59 Land Value for Class 2: 0 S/A 2: 0.00 District Tax: 280:48 Land Value for Class 3: 0 S/A 3: 0.00 Land Bank Tax: 30.02 Land Value for Class 4: 0 S/A 4: 0.00 Total Tax: 1,311.09 _ Total Value for Land: 29,800 S/A 5: 0.00 Total S/A: 0.00 Bldg.Value for Class 1: 81,500 Total S/A Int: 0.00 Total Tax+S/A: 1,311.09 Bldg.Value for Class 2: 0 Total S/A: 0.00 -Bldg.Value for Class 3: 0 First Installment: 668.50 Bldg.Value for Class 4: 0 Atljustments. '' .r Second Installment: 642.59 Total Value for Bldgs: 81,500 Adjustment 1: 0.00 Net Actual Tax: 642.59 Total Bldg./Land Value: 111,300 Adjustment 2: 0.00 Amount Paid: 668.50 Residential Exemption: 0 Adjustment 3: 0.00 Interest: 0.00 Adjustment 4: 0.00 Adjusted Total: 111,300 - Adjustment 5: 0.00 Fees 0.00 Total Taxable Valuation: 111,300 $642 59 Total Adjustments: 0.00 aAmOunt DUe ��� �„ Please put your Bill Number on your check. To obtain a receipted bill,enclose a self- Mail Payments to: Office Hours: addressed,stamped envelope and both sections of the bill with your payment. If no receipt is desired,please DETACH TOP SECTION and forward with remittance. If not paid when due, Town of Barnstable 8:30 AM to 4:30 PM your tax amount is subject to penalties of interest,demand and fees. Collector of Taxes Monday through Friday Interest at 14 percent,per annum will be charged from the date of issue P.O.Box 1360 TC 367 Main Street MA to the date payment was received in the Tax Collector's Office. Hyannis,MA 02601 1360 Hyannis, p y 508-862-4054 Taxes will be delinquent on 05/26/2001. 'Abatement applications must be postmarked and mailed to the Assessor's Office no later than 05/25/2001. For more information regarding the Land Bank Tax,the Voluntary Elderly/Disabled Fund,and the Scholarship Fund,refer to the enclosed sheet. Visit our Town Web site at http://town.barnstable.ma.us SEE REVERSE SIDE OF BILL FOR IMPORTANT INFORMATION! LOT 18 { tisF r o �- LOT 17 � PROPOSED ,`i°'�— � L -`y DECK lq.'x v AIR =DrTro LOT 16 x< zt?✓r J" r,i MORTG AAGE INSPECTION Pirm iv 'or P"�;oD zoNF, "c" OlLh Use (} i4 t0l,h 11 A + Ian _ .._----REGISTRY OWNER: ,ffZ"rfz�l ----- lt E:'D 'f ": . .... T3 t.)'ER- J S ,k J,6 X K..ALlT& 1A i:t.I<..�,1 C.f= s 7. � � �t�'ce.� •`�...���1.�,..,<`�d�:1L!' ��;Vli....ff_�' Mr THAT HC BUILDINGster# . YA:oiKEE S[ RV Y 6CATED ON TH GROUND Ati t7 �-SHOWN AND THAT ITS POSITION DOES ...........— CONFORM PAUL 10 H ZONI'�C LAW SETBACK REQUIREMENTS OF THEr � 40D (SUITE 51 HiTHEW aty !ti¢ ... AND THAT %� S INUI1 TRY ROAD Lit WITHIN to SP C IAI L£;OL HAZARD r * *c c v S s xr r r ` ;rE tct M RS"?Os MIL MA 0°254i RE , r #taw t C)t� T sL FI L.C). LA I��AIL91 �.....,.. T"L. 4 c3—£7f a TMS III-AN NOT MADE: N'FtOU RtJ 1hfiTPUbfi ti't ate A 1TFI `'I IS Sl RtTY, NOT TO HE USED FOR FF:NG`;CS, FTC. 11 194 DP i OVERALL SIZE: 1 '-0 LONG 14'-0 WIDE V-2"HIGH f 4 4, d' ( r F G t ♦ 3 S � i /' v' ✓O : Qty Size Material Part 5 2X8"X 14' TRTD LUMBER LEDGER(A)& BEAM BDS(B) 2 2X8"X TRTD LUMBER END JOISTS(C) 'C 0 2X8"X�' TRDT LUMBER JOISTS (D) 3 2X4"X8' TRDT LUMBER STEP SUPPORT SPACERS(E) 2 2X6"X8' TRDT LUMBER INTERIOR STEP SUPPORTS(F) 2X6"X6' CEDAR END STEP SUPPORTS(G) 3 2X6"X6' CEDAR STEP RISER(H)&TREAD(LO 'o 2X6"X 141 TRDT LUMBER DECKING 1 2X10"X14' TRDT LUMBER FRONT FACE BD (J) 2 2X10"XIO' TRDT LUMBER SIDE FACE BDS(K) f s ❑ O O 2"ABOVE GROUND w z � O O W ❑ LEDGER 4 FT BELOW GROUND 2X8"X 14' FOUNDATION SCHEDULE LUMBER 6" DIAMETER FOOTINGS ATTACHED TO EXISTING DECK .ti EXISTING 12X12 DECK F}NU '��"`�F orJ aX\'X' 257 MEGAN ROAD, 12' 12' / I REPLACE FLOOR BOARDS Qty Size Material Part 26 2X6"XM' TRDT LUMBER FLOOR BOARD �'�Xt'L' TRI)T, L vV`l f. ? �,. - -- --. -. m �v au DVAI VLU111 LUiV71 wi002 ' } • 3 TOWN OF BARNSTABLE LOCATION,;, , /'h 'r,4 SEWAGE # .13-'r��U F -VILLAGE Xllq4L^w4s ASSESSOR'S MAP INSTALLER'S NAME PHONE NO. / >l C � r 'SEPTIC TANK CAPACITY �DG LEACHING FACILITY-Atgpe) (size) X/0 NO. OF BEDROOMS v PRIVATE WELL OR BL1C 'SATE BUILDER O OWN yo) DATE PERMIT ISSUED: Z-oz?-. DATE COMPLLANCE ISSUED: VARIANCE GRANTED: Yes No may.. .. -. ' • _ J. y7-Jr 7 IItGI� 0 3/ 30 r: 10/21/93 11 52 $5081428 9399 BORTOLOTTI CONST 001 '., -•� h .•.._1.,w...ardfx••Y••t.p.-...•r•1'.:.....;.�N .. u.,.. +Iwv J:�-M...,•. , .. ... !/-'T'y:!.. Purr,.. y.• ,.�.�,.•...,.•.. Y.. � _ - `Y', 1 mU a2'44 nor wii�uir e.l [la!,l f+goo y}e, BQRTOLOTl'1 GONSTRU.CTCON;:INC:' OG,3a:ggEnD i.c, j �.. ....,;..+,.... - ;- '.:765:t,Watieb �Roail•:'�;; :;" �•: , IIIIARSTbfV3:MILC:S :•:IIIIR°:;0264$':.`' Q 4 0 J . . 89 ••'• .' ' .r ORDER TAW"DY u, :''/•O'•�Y��'�i `�r!r::h�. �:.:�'•" '';:-;• ��' ,'i i! "iO DAY WORK 0,EJCTRA' , I �a T AL LABOR` 'fir•. :`�., •.i •;��-.,�:•'• •s . .. !" ,,•�•. `-TAX ' ' AAU COFAP"T4P. W K CPC A6C ��r,. ..•, t � ;• ,-•.. v %tS./G: :=. rorAidu T. Gamin L r s 1 ELM PARK AUTO BODY 234 PARK AVE. WORCESTER, MA 01609 J FAX COVER SHEET DATE' TE%IE : , j J TO OF FAX: #-9x NUMBER OF PAGES : (Including Cover Sheet) FROM: �OF ELM PARK AUTO BODY FAX 509-752.306O IF NOT RECEIVE)CORRECTLY PLEASE CALL 503-757-2256 TO 3Jd6 Aacq einv >I�Nd H73 0906zSZ809 60:6T T00Z/bZ/00 LOT 18 w LOT DECK 14?X14' n'flJ fib';�D`jy 155 61' r LOT .1fi RED ZONE, 'We- Tills MORTGAGE,, INSPECTION 1'Inn to or FLOGfJ t°ONB 'C" DEED REP: .Ji7 --_..__It ISTRY , ER: DATA: $�27>�__� -- BUYTR: -isze-&��'t�'lt'Y_�/� �3 _- -_ - P I RED`; e E HEREBY CERTIFY TO 60, r'j �r THAT THP BUILDING 0f NOYJN Tilt GROUND AS U` w YAN.KC,E SURVEY 4HOAN AND THAT m pO$ITION DOES �-_ CONFORM PAUL CONSULTANTS TO THE ZONING LAM SETUCk REQUIRiiiNTS OF THE r MCRIA7liEVy or 40B (SUEiP :al Ton OF --_ -...-AND THAT 2 No,12opy INDUSTRY ItO.AD )T DOE8_�9,,T_ LIE WITHIN THE SPECIAL FIAOD Jig7,AR0 s;. rr ip AREA AS SHOWN ON THE H.U.D. MAP D(TEft- ,�ql ^ '�. rsi� ,,• MAP-MDNS ]WILLS, iik 026c3s - ' :5J70U1 C TEL 4?E4--OG5$ ?HIS PLAN Not u4D1 iRUM ATRUW901' F.4?C 4 0 5 5-53 SURVEY, NEST TO BE LKED FOR FPiNrE3. £SC. J15A4 PPP, LQ 3E)Vd AQ08 CinV :iLSV6 W73 0906ZSL809 60:6T T00Z/bZ/b0 OVERALL SIZE : 14'-0 LONG 14'-0 WIDE V-2"NIGH w k 1 � ••�i t't Al � 51` 't y ytS yl� � 'yl ,� 5 /t r ��_;� — _ �. ', t .�t ' �'t •'1 i 't t, � r t ;�1�t1,Ia y 1 t , t. IA ` � '' ,5 5` � l5 t` A �•.t 'S Y �, se � `r M1/ �r—� =- 'f �.� � q t � � , S` t •, 1 y} ',t t 'It t •.t 1 tl yt .,;, l ; .i�'y t M1M1 A 1 `'t ll y 7 5 ,'A M1 .�'S 5' A � 'i �• •�- to y r ,t 't t 5t ,r ''yr •t �/� / %} •� •'t t i 1 1 1, �M '� l Size Matedw Patt 5 2X8"Xi4' TRTD LUNMER LEDGER(A) BEAM BIDS(5) 2 2X8"X14' TRTD LUNZER END YOTSTS(C) 40 2X8"X7' 'IRDT LUhMER 3OISTS (D) 3 2X4"X8' TRDT LUMBER STEP SUPPORT SPACERS(E) 2 2X6"X8' TRDT LUMBER 12f MRIOR STEP SUPPORTS(F) I 2X6"X6' CEDAR .END STEP SUPPORTS(G) 3 2X6"X6' CEDAR STEP RISER(H)&TREAD(LO 70 2X6"X8' TRDT LUMS1 R DECKING I 2Xi0"XI4' TRDT LUNMER FRONT PACE BD (3) 2 2XI0"X14' TRDT LUMBER SIDE FACIE 13DS(K) 60 39Vd AG08 OirV >16Vd H73 @906z9L8@5 60:61 Q 2"ABOVE GROUND u O c: LEDGER 4 FT BELOW GROUND 2X10 LUMBER FOLMATION SCHEDULE ATTACHED TO 6"DIANIETER FOOTINGS EXISTING DECK POSTS b© 3Ek7d Delos oinv 71 V6 N73 0906zsLs99 60:ET TooZ/bZ/tie t { 4 1 Z- orb 1,6 a . a ME.G9N RORD C. ER I FIE . ® PLOT PLAN . LOCATION: /`� SCALE: " �6 D A T E. . „� / T �-4 l R E F E R, E N C E i'/D vv•v D A T E I H ER EBY C E R T I F Y T H AT T H E ' 6 U I L D `I N G R E G. L A N D S U R V E Y O R SHOWN ON THIS PLAN IS LOCATED O N �..tq; THE GROUND A S : SHOWN HEREON A N D THAT I P D o a*nr' CONFORM ..,,1 _O --T .: ,.H..-E Z O N I N G ® Y - L A W S...:__-O F:-T..H..E T O W N OF ,6A-r1yS -/-A®L jC W H E N C O N S T R U C T E D BARN5TABLE S. UR .VEY CO`NS'ULTA 'NTSo INC . W EST Y A R M tO U Y H, IAA /a ' q J y j .aT ---�....�..�.1�+'ww---•--v-+-•�.�...vr.-,�...��.w^'-..�..�_-.-�.-,r �'1-.-ram^..-.,��-..� ..`. As�sessor� map,=and lot number gg�� j;,L . D IN IrVFVLi�I I�SB SSG �s� A IRT3 i E 11 STNT Sewage Permit number .�..5 a ... ............ ........... ai;T1 Y '3 AND, TOM R LALTf:QMS. ` y�F7NET��♦ TOWN OF BA::RNSTABLE G Z BARNSTABLE. M6 B 1-LDINS , INSPECTOR O ful . APPLICATION'FOR PERMIT TO ... . ...........................J ....I+--a-..c ..... ..................... TYPE OF CONSTRUCTION ........��-z�t.. ........ . ...: .. .....19 7 TO.-THE INSPECTOR OF BUILDINGS: ) The undersigned hereby applies for a permit according to the following information: Location .......... .:../ ...... 1�d1 .... ........ ...... .................... Proposed Use ......... � .... . . ....... 4��� -� ................................... Zoning District . ..... �............................................. .....Fire District ......//Y,. z!% Name of Owner;.4!�LP�%�:.'� .....Address to Or Name of Builder '� �� �( ........Address �� Name of Architect ..................................................................Address ...................1/.. Number of Rooms ........... .............................:.......................Foundation ..l..Q...... SGG W t�!!d .Roofing ... ..to/. d.A Exterior ............................. . -............................... Floors ..... .... .. ... ... .. . ........61T'�►,�-................................Interior .... �..... .. . ....... ....................:. Heating ...............(...............j�. ........................................Plumbing .................................................................................. Fireplace ......................................................Approximate Cost ......P�.. ......................................... Definitive Plan Approved by Planning Board _12___ 0- !__________19 _. Area ./.n..�ZJ�..�h`f.......... Diagram of Lot and Building with Dimensions Fee � � • e SUBJECT TO APPROVAL OF BOARD OF HEALTH TPI lk I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name:...'......... ..... ... ... ........ Dacey, William E, Jr. . t k P 17319 permit`#or one story, F r� ...................... 7 single family dwelling lo Location egan Road................................. ' Hyannis ................................................................................ SfJ Owner William E. Dacey, Jr. , ►, !,S�,� `w Tye of Construction frame t _ .............................. C ........... ...................................................... ..... P - Plot Lot ................................ r y September 8 74 ; r '- Permit Granted .................:...................t)19 `1 Date of Inspection ........................rr.........19 -41 A Date Completed .,/� '...-.�.:.!..: 1 PERMIT REFUSED, 46A ` 19 ' ....................................................�........... ... r') • j ...................................... ................... .. i ....................:................................ .............. ............................................... . ........................ ` Approved .................................................. 19 .. .................... .................................................... �� 1 Ya'4 Yob E 8 f 1 d is f. 1 �®o� FR�4iarle' c �— S o8© Z3` 30, W 80.00 m E 3 N RO R D I: CERTI EIED PLOT PLAN LOCATION: 1 SCALE: / "= 30 ' DATT.E .� / 7 74 R E F E R E N C E : /.a' .4 s s ©'vv.y o"v I- F,/- A'A/ .2 7 0 9 DATE I HEREBY CERTIFY THAT THE BUILDING REG. LAND 5URVEY0 SHOWN ON THIS PLAN IS LOCATED ON wa THE G ROUND AS S. H O W N HEREON AND THAT it ®'® '.i CON FORM TO THE ZONING BY —LAWS OF THE TOWN. OF ," utS' eA f1y TAA91_ ,C WHEN C. O N S T R U C T E D. �I� J %. 2.,•72$ � ��, 13'ARNSTA13L1r SURVEY CONSULTANTS, INC . �• � �; WEST YARMOUTH, MASS . �,. �tt�!'� � � � his_ w�..<.�.�►'�.._�r► _ - TOWN OF: BARNSTABLE BUILDING INSPECTOR - APPLICATION FOR PERMIT T 0. ....................... ` TYPE OF CONSTRUCTION ........ --- ...—_-------'-------------- ............l ..`°.~ TD THE INSPECTOR OF BUILDINGS. ` The undersigned hereby applies for o permit according to the following. information: . �~~ '��p - Location ��—��pJ �---..��—�..--. x����...���������.---'� ���--- .................... Proposed0/ ..................................r---- ......................... Zoning District .� —..Fi"e District —' ........... , �/ � /�� Nome of C)vvne, � ��.�.. ���--Add�mx �---=-- �—. Nome of Builder ......./,.............. ...........................................Address -----.---------.------------.. � Nome of Architect ----------------------A66nes» ---------------------------- � �� ~ Number of Rooms ---��-----------------.�Foundo/i — ` ' _- Exierior —' ..................................R a a fi . ------------ / �� � Floors —' —..��Jj��----------..Interior ._�~�,—' � ____________.. . . � � Heofing ----'i----����e-------------.�umbinQ --'�---------------_________. ' � �� Fireplace -----.xz/~*.------------------.Approximate [os —..m.�*..y ��.��----________,_ Def ��veF1on Approved by Planning Board lQ —� � ^' Diagram of Lot and Building with Dimensions ' Fee __���Z~7�_______ SUBJECT TO APPROVAL OF BOARD Of HEALTH °~ � � ` | � ' ` , | hereby ogn*o to conform to all the Rubs and Regulations of the Town of Barnstable regarding the above ' ^� Nam .................. ^~~- �/---... ' `' William l73l9 one storyff single family dwelling .......................................................... -- � � Megan Road Location ...----------------.....--- Byannia --------------'-----------'' William E. Dacey' Jr. "=.=. ---------~------------ . . . frame � Type of Construction .......................................... | � -------------'------------'' , Plot ............................ Lot —. _______ ' Permit Granted ---Se—�--tem—b—er-- ........l8 7� lV ' Dote of Inspection ----------.--lA — Dote Completed ...................................... PERMIT REFUSED ' l�........................................ . ' ----^-------------^-------- ^ ` ' � ^—_--~---.--------.--------. � - ` —^----------~^—^'^^----^----- � � --------'—~----------^—^---- � ' Approved ................................................ lV � ' -------------------------~' ` / ---------------------^----^ � _ ]