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HomeMy WebLinkAbout0593 OLD STRAWBERRY HILL ROAD Old Th24vbel r cS+o,P wo Town of Barnstable Building - - Post This Card So That it Is Visible From the�Stceet ,Approved Plans,Must be Retained on Jobr�and;thisCard Must beKept Posted Until Final Inspection Has:Been Made ` � a Whe,"re;a Cert�ficateof Occupancy is Req;u�red,such 8u�ldmgshall Not be Oceupietl until a Final Inspection has been made Permit x ..�:...�..:,.: �. Permit No. B-18-3484 Applicant Name: DEUTSCHE BANK TRUST CO AMERICAS,TR Approvals Date Issued: 10/25/2018 Current Use: Structure Permit Type: Building-Restore to Single Family Expiration Date: 04/25/2019 Foundation: Location: 593 OLD STRAWBERRY HILL ROAD, HYANNIS Map/Lot:., 273-007 Zoning District: RC-1 Sheathing: Owner on Record: DEUTSCHE BANK TRUST CO AMERICAS,TR Contractor Name: Framing: 1 Address: 32 GORDON LANE Contractor License. 2 YARMOUTH PORT, MA 02675 Est Project Cost: $200.00 Chimney: Description: Restore to Single Family. Remove Partial Walls(halff and,debris Permit Fee: $85.00 existing on site.Take out Kitchen Cabinets and Old`Appliances• Fee Paid:` $85.00 Insulation: Project Review Req: ' Date 10/25/2018 Final: Plumbing/Gas y h •.' Rough Plumbing: Building Official Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorii d 6y this permit is commenced within siz'cnonths after, issuance. All work authorized by this permit shall conform to the approved application and the'approved construction documents`for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures sh4IFbe in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for inspection for the entire duration of the work until the completion of the same. Electrical e Service: The Certificate of Occupancy will not be issued until all applicable signatures'by the Building and Fire Officials ace provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:' Rough: 1.foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Person contrac with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT s i - ~� .J.. . �... .4 ............ uasay�r._serer +; XAst3. Permit Fee..........................:............Other Fee........................ Total Fee Paid............V ..... ..... ................ TOWN OF BARNSTABLE Permit by...,s .......On... BUIELDINO PERMIT map...._... .....f.......................Pa=....... ..................... APPLICATION Section I — Owner's Information and Project Location Owners Name Owners Legal Address City C State~ WF,4,. C. Owners Cell# Q, (-\RO--)-1 C S rFrm`all-Sy 6ZLC�l_��L� oC 1RO� ��\L• �� Section 2—Use of Structare Use Group---BUILDING ®EPT. ❑ Commercial Structure over 35,000 cubic feet i ��❑ OCT j.9 ZD�� . � Structure 35,000 cubic feet TOWN OF BA�RNSTA13LE Single/Two Family Dwelling Section 3—Type of Permit. ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ElDeck Apartment ❑ -;Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ,{ ❑ Renovation ❑ Pool ❑ hm ation other Spy , s � S► k �t 6 Section 4 -Work Description V I —AIM! '�e �®�� Paz' — cv T Act nndaimd:219201 S _______ _ ..._ . .. ...... Application Number...........................................:.,. ... Section 5—Detail Cost of Proposed Construction A L�,� Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms F,xisting� Total#Of Bedrooms(proposed). t 110 MPH Wmd Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wince T ❑ Oil Tank Storage ❑ Smoke Detectors [] Plumbing ❑ Gas .❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom i Water Supply ❑ Public _ ❑ Private a Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No . l Section 7—Flood Zone i Flood Zone Designation i Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information 1 Zoning District Proposed Use Lot Area Sq.Ft i Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site) Setbacks Front Yard Required Proposed Rear Yard - r Required Proposed Side Yard Required = Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last wanted 219=19 Application Number........................................... Section 9—.Construction Supervisor Name Telephone Number Address City State Tap License Number License Type Expiration Date Contractors Email Cell# 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 contraction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section-10 —Home Improvement Contractor Name Telephone Number Address City State Tap Registration Number Expiration Date I understand my responsibilities under the rules and regulation for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Budding Code. I understand the construction inspection procedures,specific inspection and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your EUC... Signature Date Section 11—Home Owners License Exemption Home Owners Name: Telephone Number 5 O'R (o RG- 6 5 Cell or Work Number O I understand my responsibilities under the rules and regulation for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the contraction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE ignattte7 fDate ', r0 CPrinf N me Telephone Number f 4 O_ E-mail peifflit to: l f� LC T e..r.. A,w A.Hln/MM0 r' Section 12—Department Sign-Offs Health Department © Zoning Board Cif required) ❑ Historic District ❑ Site Plan Review Cif required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire deparbnent for approvab Section 13-Owner's Authorization L , 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: (Address of job) Signature of Owner daze Print Name Last wdated:219/2018 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 Information Please Print Let?ibly Name(Business/Organization/Individual):_ �Q� � Address: ':�k F_- sU e,3 City/State/Zip: V.WPhone#: Q — 02.� 6,5 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2 sole r ri t r listed on the attached sheet. 7. ❑Remodeling .❑ I am a o e o e o or artner- P P P ship and have no employees These sub-contractors have g, ❑Demolition working for mein any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance.: 10.❑Electrical repairs or additions required.] 5. El We are a corporation and its ep 3. I am a homeowner doing all work officers have exercised their 1 L❑Plumbing repairs or additions 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. 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 under the pa' and penalties ofperjury that the information provided above is true and correct. Signature: Date: (C� A '" Phone#: '(5 [[6, fficial use only. Do not write in this area,to be completed by city or town official ity or Town: Permit/License# suing Authority(circle one): Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector Issuing ontact Person: Phone#: 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-contractors)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 cant'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 permittlicense 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-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia d 1 F` c . r N C� P LW Q:.Cslo VA., Q\, _ i Anderson, Robin From: Thomas Lanman <tlanman@hyannisfire.org> Sent: Thursday, June 14, 2018 5:10 PM To: Anderson, Robin Cc: Lauzon, Jeffrey; Bill Rex; Melanson, Dean; Kelly Foley Subject: 593 Old Strawberry Hill Road Robin: Regarding our conversation earlier this afternoon regarding this property. I checked the property look-up for this address prior to my scheduled 26F Inspection this afternoon. It is listed as a three bedroom single family residence with an un-finished basement. During my inspection, I observed that the basement was fully finished with evidence of two bedrooms and a full kitchen consisting of a sink, refrigerator and an electric 4 burner stove with oven.The bulkhead had a full door in the opening leading up a set of covered stairs to the exterior.The first floor consisted of two bedrooms, a living room and full kitchen. I did not go to the second floor. I asked the real estate representative if this was a town permitted two family property and she replied that it was being bought following a bank auction, and their plan was to return it to a single family residence. I told her that given what I had seen that I could not approve the 26F Inspection due to the situation in the basement and that it needed to be resolved before an inspection could be completed. Lieutenant Tim Lanman Fire Prevention Officer I Hyannis Fire Department Tel. 508-775-1300 Fax 508-778-6448 tlanman@hyannisfire.org 1 Date: June 14, 2018 To: Building File RE: Un-permitted Apartment Address: 593 Old Strawberry Hill Rd, Hyannis Originator: Lt.Tim Lanman, HFD Complaint: During 26F inspection, Lt.observed a 2 bedroom apartment in the basement contrary to previous records on file. Enforcement Process Steps ® 1. Initiate local investigation: RA ® 2. ' Document/enter into system Yes 13 3. Contact ® 4. Property Owner Residential Accredit Loans, Inc./Deutsche Bank 5. Seek access to subject property 6. Seek administrative warrant (if necessary) NA 7. Notify state authorities of findings NA 8. Document conclusion OPEN ® 9. Referred Jeff Property—273-007 i Property is developed with a 1 1/2 story single family dwelling(1984)containing 3 bedrooms and 2 full baths on 0.25 acre located in the RC-1 district. History Property is a vacant foreclosure. 06/14/2018 Lt. Lanman performed a 26F pre-sale inspection and noted a full apartment in the basement contrary to the property history on file. Lt. Lanman notified the Building Dept. accordingly. He did not complete the inspection (did not inspect the 2"d floor) and advised the RE agent to un-permitted work must be resolved first. Notified Jeff to check site. O� GApplication 13imm1er.......................................................... . � . MA88. Peffiit Fee..........................:............ Fee.................:...... s639� MIS TotalFee Paid..................................................................... TOWN OF BARNSTABLE PemiftApgnNal>y.................................On........................_. BUILDING PERMIT — Map........................................Paned............................................. r APPLICATION Section I— Owner's Information and Project Location Project Address Village 0, I Owners Name h � — �' Owners Legal Address �` City State zip Owners Cell# E-mail Section 2—Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3—Type of Permit I ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire struct=) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 -Work Description a 1.nct mwLgted:2J9=19 Application Number.................................................... Section 5—Detail Cost of Proposed Construction Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal '❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7-Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last imdated M01 8 Application Number............................................ Section 9—.Construction Supervisor Name Telephone Number Address City State zip License Number License Type Expiration Date Contractors Email Cell# I understand my responsibilities under the rules and regulations for Licensed Constriction 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.Attach a copy of your license. Signature Date Section-10—Home Improvement Contractor Name Telephone Number Address City State zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors 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.Attach a copy of your H.LC... Signature Date Section 11—Home Owners License]Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Constriction 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 APPLICANT SIGNATURE Signature Date Print Name Telephone Number E-mail permit to: Section 12—Department Sign-Offs Health Department ® Zoning Board(if required) ❑ i Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ i Conservation ❑ For commercial work,please take your plans directly to the fire deparbnent for approval Section 13—Owner's Authorization L , 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: (Address of job) ' Signature of Owner daze is Print Name 1 i Last nnaetmh 2/92018 TOWN OF BARNSTABLE • PERMIT CHECKLIST Sign off hours for Health and Conservation are 8-9:30 a.m. and 3:30 4:30 p.m* A complete permit application includes filling all sections .1-13 1. NEW STRUCTURES/REMODELING/RENOVATION/ADDITIONS ❑ Site Plan showing setbacks of proposed and existing structures ❑ Commercial—One complete set of full sized plans one reduced 11"x17" (plans may require a stamp by an architect or engineer). Residential - 5 Sets of floor plans no larger than 11"x 17" smoke/co detectors marked ❑ Worker's Comp. Affidavit and policy(if required) ❑ Res Check or COM check from the 2015 International Energy Cod Council (IECC) ❑Letter of financial Interest for new houses only(not required for rebuild after teardown) ❑ Performance bond made out for$4.00/foot of road frontage(new construction only) 2. DEMOLTION OF A BUILDING (NOT PARITIAL) ❑ Everything above plus shut off letters from following utility companies: ❑ Gas El Electrical ❑ Water ❑ Sewer(if required) 3.-DECKS/PORCHES/GAZEEBOS/INSULATION/SOLAR/POOLS/SHEDS ❑ Site Plan showing proposed location ❑ Construction plans showing framing detail (if new framing), Pools—Barrier details,pool specs (engineers design) ❑ Workman's Comp Affidavit and policy (if required) FAMILY APARTMENTS ❑ Section 1 Plus: ❑Family Apartments are subject to approval from the Building Commissioner. Agreement must be signed, notarized and recorded at the Registry of Deeds and returned to the Building Department. The Commonwealth of Massachusetts Department of IndushrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Naive(Business/Organization/Individual): Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 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 workingfor me in an capacity. employees and have workers' Y aP tY• $ 9. ❑Building addition [No workers'comp.insurance comp.insurance. 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ ep 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 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. 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. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: Phone#: fficial use only. Do not write in this area,to be completed by city or town official L[[6.1 ty or Town: Permit/License# suing Authority(circle one): Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector Other ontact Person: Phone#: 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-contractors)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 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 1-8 77-MASSAFE Revised 4-24-07 Fax#617-727-7'749 www.maw.gov/dia n. 't TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map z13 Parcel Permit# Health Division D-A a) 0L/ �'., �b„ ,4.t �i A I.� Date Issued d 2 / () h A y rl Conservation Division 2 0 u FEe, I F";� Application Fee —a Tax Collector J Permit Feeo® .....__�.----SEPTIC 8Y DUST 88 Treasurer +i INSTAUEDItsCOMPUANCE Planning Dept. ENMRO TMEG TALCODEAN Date Definitive Plan Approved by Planning Board TOM REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address Sf3 old sTeR l b6P—Q—V AL& A2& Village GC1vAn2 Owner C&16�A�& leap-4 Address :5 3 ���Y �1 &4,r,P :v // ,j Telephone !;a& z Permit Request -T ® CLO a ul k 9-mil Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Qssid ly-ItWL Flood Plain Groundwater Overlay i Project Valuation_4Kv Construction Type t= Lot Size Da 25 A C►26S Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family �4 Two Family ❑ Multi-Family(#units) Age of Existing Structure 7,o,YeQe!-,-_ Historic House: ❑Yes %JNo On Old King's Highway: ❑Yes 4 No Basement Type: ®Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) _ �, Basement Unfinished Area(sq.ft) R2C>S9.jr r Number of Baths: Full: existing ay6 new Half:existing zva new Number of Bedrooms: existing ?Wo new Total Room Count(not including baths): existing F,oc g new First Floor Room Count �o y 2 Heat Type and Fuel: W Gas ❑Oil 5Q Electric ❑Other Central Air: ❑Yes W No Fireplaces: Existing rya New Existing wood/coal stove: 4 Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size y Barn:❑existing ❑new size Attached garage:®existing ❑new size Shed:A existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes I&I No If yes,site plan review# Current Use _ Proposed Use BUILDER INFORMATION Name_�` e-Zas � �/�' ,c► Telephone Number <o& 04� Addresk��3 ®1 ���,�1.t�6 PTV"je,6J License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY C , l PERMIT NO. ` w DATE ISSUED y 4 ' MAP/PARCEL NO. ` s ADDRESS = VILLAGE % OWNER DATE OF INSPECTION: ` r FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL { PLUMBING: RO FINAL GAS: RON FINAL Q FINAL BUILDING m �NN go DATE CLOSED OUT in w ASSOCIATION PLAN NO.m r __ The Commonwealth of Massachusetts _ -- Department of Industrial Accidents' — 600 Washington Street _ Boston,Mass. 02111 Workers'..Com ens ation.Insurance Affidavit-General Businesses +� kr.. ,xk4y'p�m. �•,.r4ya�r�•'/"gt�A.r�g'"" �� �.C.-L� i ` � —,� ' i''1' . • 71a1ne � � •(� t _address S L ct ate: vhone work site location fu11 address I am.a sole proprietor and have no one $psiness Type: 0 Retail[]Restaurant/Bar/Eating Establishment working in any capacity. Of Sales(including Real Estate,Autos etc.)' an em to er with . etn to ees full& art time)... I am % //%%//G///%%//�%/�/%////%�//�/�%////%%%/ I am an employer providing vtorkers' compensation for my employees working on this job. companine $tli3re s '` t f{:; 3' :i+' 1+. at :: "�� .Rorie:#:��•"•�' .:.� . 4{• r)� •ol� iiisiirance.co: T am a sole proprietor and'have hired the independent contractors listed belwho have the following workers' .compensation polices: :{* :;Cn t4'i" 'i°' +r:•+ '�•�,.•.. .< i: t..:.y:�,:ti• :::;Y, v>• .�. CID ax address:. 4• �:r - ,., , ,i .. ,• 'one`#i. "•' ''Y:;••'' . V. —•'•t l.•. ,.'ir •i' >.::;� Y.e.,.. •,:d r.^tri >� 'F:' •'�iC :7f., ..tt... �yY.'. �� . insurance co. ;x %%%/////////%//% _ Y.�: .fy. ';'(:.:'f';i fit'.• ;Yy.•' _ cum an. na�eayo .. .;_ .• . address:. h0ci #: i f,' '�-iry.' Y... •.:fy.�.t.1 e:4:i :::�. !.. y. ' :•?i.• n. .>. i}. iffsurance:c Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK O12DER and a fine of$100.00 a day against me. I understand that p copy of this statement maybe forwarded to the Office of Investigations of the DlAfor coverage verification. I do hereby certify under the ins andpenalties ofperjury that the information provided above is true and correct Signature Date Print name� ��2- F�°�o ��J2�`t�i A Phone#sS®�- �i�— 7� c+�• [.ontact nly do not write in this area to be completed by city or town official permit/licenE.# : ❑BuilDb ❑Lic mmediate response is required ❑Sele❑Heaon: phone#; ❑Oth ) r Information and Instructions Massachusetts General haws chapter�152 section 25 requires all employers to provide workers' compensation for their. ernpioyees: As quoted from the law', an employee is.defined as every person in the serviee'of another under arty 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 enferprise, 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.ernploys.persons to do.maintenance, construction or repair work on such dwelling house 6r on the grounds or urenant thereto shall not because of such.employment.be deemedtobe.an employer. binding.appurtenant .. •• . MGL chapter 152 section 25 also•states that•e' ve'r 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 1. 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 t�e insurance requirements of this chapter have been presented to the contracting . authority. Applicants Please fill is the workers' compensafm affidavit completely,by checking the box that applies to your situation.. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits maybe submitted cidents-for confirmation of insurance coverage. Also be sure to sign and date the to the Department of Industrial Ac 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 regardin�`th6`law"or if you are required to obtain a.Workers.'compensation policy,please call the Department at the number liste,d.:below. City or Towns . Please be sure that the affidavit is complete andprinted 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. The.afl'idavits,may be returned to :FAX unless othei� ements have been made. t mail or arrang .. . the Deparmmen.•by. . The Office of Investigations would like to thank you in advance for you cooperation and sliould you have any questions, please do not hesitate to give us a call. address,telephone and fax number: . t s addr ep , The Departmen •- . The Commonwealth Of Massachusetts Department.of Industrial Accidents elate of Mvesflgatlens 600 Washington Street ' Boston,Ma. 02111 fax#: (617)727-7749 nhnnP#- f6171 727-49f1(1 ext:ao6 +Er Town of Barnstable of °�.y o� Regulatory Services Thomas F.Geiler,Director 99, 1659. Building Division. ''TFD►dA'� Tom ferry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. Date . A"IDAVIT jOMZ jMyRoVZraNT CONTRACTOR SUPPLMENT TO PEMYRT w CATION E MGL c.142A requites that the"on,or onstraction of an addition to n,repair,anyPre-existing OvAler-o,c pied conversion, •improvement,removal,demohtion, binding containing at Least one but not more than four dwelling units oz to structures which are adjacent to suc residence or building be done by registered contractors,with certain exceptigns,along with other h requirements. j Estimated Cost Type of Work: Address of Wor - � �y s ;��/S 7`,P.o��r��9/ .Sly l/ 2 • k• Owner's Name: ' Date of Application: i. '-,Y hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []lob Tinder$1,000 []Building not owner-occupied ROwner pulling own permit Notice is hereby given that: OyyHERS PULLING TEEIRLO ABLE HOME IMPROVEMENT yyORKI}OSNOT HAVE CONTRACTORS FOR ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDERPENALTIES OF PER3URY Ihereby apply for apermit as the agent of the owXLer: Contractor Name Registrationl�Io• Date 0 Owner's Name r rj a Town of Barnstable , ' do Regulatory Services BAENSTASM ; Thomas F.Geiler,Director 9 MAW. q,A 039. AN. Building Division rED fMA't 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: 5 53 Q� —S T 0A G l k e-,e QV A/J Ze' A CiC/ l 11& number street village "HOMEOWNER":4521� F 6&_ r'reA VVD ZSg�Z .S96�el4e name n home ph e# work phone# CURRENT MAILING ADDRESS: 215 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 Sign re of eowner 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 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. Q:forms:homeexempt — LOT 21 O 1�313' LOT 20 � „ � 116 03, LOT 19 � ���tt� tERpp GDP STEPHEN J. �y NV.3 559 ES OAP NOTE. HOUSE APPEARS TO BE y�y® PRE—EXISTING, NONCONFORMING --------- -------- ------------------- FLOOD PANEL. 250001 0005 C FLOOD ZONE. C DATED- 81-19185 ------------ -- I hereby certify that this mortgage inspection plan was prepared for- Plan is For OPTION ONE MORTGAGE CORP. Bank Use Only The location of the building shoovn does _MT_ fall within a special flood hazard zone. PLAN REF. = 32849A-2 Per taped inspection it appears the location of dwelling does _____ conform to the local by-laws Scale 1" FT. in effect at the time of construction rvith respect to horizontal dimensional setback requirements — or is exempt.from violation enforcement action under Mass. General Laws Ch. 40A -Sec. 7. Date: 1211L03 PLEASE NOTE.` The structures on this inspection were located by tape not instrument and are approximate only. An actual survey is necessary for a precise determination of the building location and encroachments, if any exist, either way across property lines. This inspection must not be used for recording purposes or for use in preparing deed descriptions and must not be used for variance or building plan purposes This inspection must not be used to locate property lines. Verification of building locations, property line dimensions, fences or lot configuration can only be accomplished by an accurate instrument survey irhich may reflect different information than what is shown hereon. This inspection is not to be used for any purposes other than mortgage. Yankee Survey accepts no responsibility j for damages resulting from said reliance. PHPHONY508-428-0055 1 .J E/NK S Uf T N E/ Y COl 'N S UL T A l W TTS FAx 508-420-5553 UNIT 1, 40 INDUSTRY RD, MARSTONS,MILLS, MA 02648 36185 JS - r TOWN OF BARNSTABLE BUILDING PERMIT'APPLICATION Map Parcel ,rs,,,t Permit# t �� Health Division t 1 i --�1 Date Issued (U 7—T 115,6 Conservation Division Q 4 i P: , Application Fee Tax Collector �.. Permit Fee Treasurer EXISTING SEPTIC SYSTEM Planning Dept. LIMITED TO 3 #OF BEDROOMS Date Definitive Plan Approved by Planning Board vF44"i ('Duel �Avle S C v.� Historic-OKH Preservation/Hyannis ,bLP%^y vim,CIA f A 164"&k. Project Street Addressi�L° A?d Village C_6- ,2.Te7 C, Ali ,-'Owner C AQ Low C'2''o !?6��.0 i�t� Address 14W RA Telephone X2 7 e,- keM116 — Sk2if- 3kV_-k1 Permit Request TO A dcd a Jma4,oE& 1 ti A q ck a � �2 W i b I c1Q v6 Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District - � . r- A Flood Plain Groundwater Overlay Project Valuation .$5•CCQ CQ Construction Type AQ A/�� Lot Size 40 2 s R C Re-5 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family W Two Family ❑ Multi-Family(#units) Age of Existing Structure / FAps Historic House: ❑Yes A No On Old King's Highway: ❑Yes No Basement Type: V Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: ' Full: existing i new , Half:existing new Number of Bedrooms: existing 2 new i Total Room Count(not including baths): existing new 2 First Floor Room Count y Heat Type and Fuel: Gas ❑Oil ❑yp [>� Electric ❑Other Central Air: ❑Yes ®No Fireplaces: Existing /vp New Existing wood/coal stove: WYes ❑No Detached garage:❑existing ❑new size Pool: LI existing ❑new size Barn:❑existing ❑new size Attached garage:N existing ❑new size Shed:A 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 Name E- C Vr-PS -Telephone Number _'S%26- Address :5,�-3 a1� e-'r-P_.X141Z' e 11 License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE / _ , FOR OFFICIAL USE ONLY 1 PERMIT NO. DAT', SSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME , n INSULATION r FIREPLACE ELECTRICAL: ROUGH FINALI- PLUMBING: ROUGHm FINAL-'r+ �f GAS: ROUGH ©, FINAL, r CJ � vim,` ....� FINAL BUILDING C ,L (� 9 ?0/o; ^ _ it - 0 O DATE CLOSED OUT. rn ASSOCIATION PLAN NO. O A) i+ s P The Commonwealth of 1Vlassachusetts •. , Department of Industrial Accidents' — 660'Washington Street S j J Boston,Mass. 02111 :t > Affidavit-General Businesses anon In ance Affid vrt Workers; Com ens sur • �iiia�iirrrrii�,�rrl%iiiirF� �� WINA,� ��r �����������������������������������������•. address: - • �,.,t ' ' , state: zip: 02,63 phone# work site location fall address : [] I am•a sole proprietor,and have no one Business Type: []Retail❑RestaurantBai/Eating Establishment i working in any capacity. Office"[] Sales(including Real F.sfate,Autos etc.)' ❑I am an em to er with eta bloyees(full& art time Other an ei�G�///�l%%%%/O� aa�/� �/O/%%%%/%/% /%//%%%% ..;:.%%%////%%/%/ I am an employer providing vzorkers' compensation for my employees working on this fob. \1 :.ti.�r.f:i:{•; ..':.Y:'!:' SP•J• .,5..::','�.:ii•♦ .v x- "tom t�,.Ki '.7.f:.•x ,L:•.:, t 'xl',:,t' 'J ti +h�f' •�f ,t` ��:./.:1.: xt.fx•'•{i�5 S•' �' .ti�y''Y.j' colt an •I18IIIe1. .,i', .4, !J, ::J. :u':.:it h, r x•„ T`- ' �1: •r •:� •wd a '.i:••S: ,:t•�1.Ji�^.:::•'.'{.:.. .:;FJ,X i•.I'rr' .. f ._ .,i-it•ft,�,.- ;� itx,.,,a:7,n t.ia+i'' r<y};: ..a;•� r..x,.'::S..n :1°'.• •n r„ MSi.... :C� ^ii.... L 't n.i•:'.V r.,� !..t=' �t:f�.;.:•' 'i:" hon :`{ ',i t."::•i: k4.t•t�+�:::"LLi• 4 J'. t.• F' + r i 7' e:.#• Ci .4^•'z�, ;1�,�ryt •11. t � ,jj ^�t' :t;' J't. •,;i+' ,.t.j4..tt�• •t.• .. •I: i 11.. M'•�.1.i�t••;L''j:,• it '. . OlIC`.# } :.�}i .:[','S. I am a sole proprietor and-have hired the independent contractors listed belowwho have the following workers' compensation polices: COID 812 t]'aIQ' f.:..:_ y:•a;F:;% '.: f., J:� :a '•' _ 0�,3 •;er�pa:''�.. .{.i ;.f. y� ;. t•.,r.u:.;-i1: J,i,.t, % •:t: .1' {J•.�i'7�.f•,: .:'i':'f'`•Y:'`pr i."+`t 'x`}.;r: "f, •}' Jr}•. 5 'i '" r' ,+, •''' :� :aAdJy :a t'• '.Y:. r0-fib* :4 ;A r:.:'Y.t.t:'• ftiv.pi.t i, .;•".:r,': t•.'t+ Fws;t �+:a•'ti,"'ric", .r,.'' .a.w�y, .i.r':.. ;i: 'r.}� �!i .:� '<'. '. :*:�• �':r,• •: •.}•.1' 0. •:C.,'f�'':t;� ir.•. �'4.• �f ."r: :{i �Y: •,. 1.+•.,., Af!i'•s--' .�•` ''f.' :J•. Jill`� 'L''.t,. `•14 Y.-��t J'C�+4+f; ',`L.:�r,', yt\:"'.t' J'y�YY+'.,x• �:i...:.. 'J :s.`r:'i `i' !,1 - COIn 8D• 'IIBII i ..t:.. �°f' •• ', • �• � /tick .r• ' .r4..x 'fir•i.. �•t �;' b:'.�! 'rTiLL Sti .•+ y Cl' _T: ,:�` .ri,!.,, •.i•G .:r..:��:.i`..:., f �.l�u •Li>'.•x. "' .:1••.' t::h• . . Failure to secure coverage as required Under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as wen as civil penalties In the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that 0 copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certi ttke. ins and penalties of perjury that the information provided above is true and correct Signature . . 14 Date � � �+� Phone# Print name V—� � =� �'� ? official use only do not write in this area to be completed by city or town MENEM official city or town: permit/license# ❑Btnlding Department _ ❑Licensing Board L(=,-%edSqpL2M) eck if immediate response is required ❑Selectmen's Office Health Department ct person• phone#; ❑Other �FShIETip� Town of Barnstable Regulatory Services anRx stE.$ Thomas F.Geller,Director XAM A 1639. a1m Building Division TED M� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town,barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 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: 1) �61 �-�i�� Estimated Cost .� Address of Work: 67 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 i t own r-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. OR C Date wner's Name Q:forms:homeaffidav RESIDENTIAL BUILDING PERMT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WO XSHEET NEW LIVING SPACE square feet x$96/sq,foot= x.0041= �5� plus from below(if applicable) ALTERATIONSMENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= 0 0 x.0041= —Al l plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 " >1500 sf-Same as new building permit: x.0041= square feet x$96/sq.foot= STAND ALONE PERMITS Open Porch x$30A0= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00 (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation(Moving $150.00 (plus above if applicable) Permit Fee Projcost Rev:063004 I T"E Town of Barnstable oF TWA: Regulatory Services BARNSTABM « Thomas F.Geiler,Director 9 MASS. q,A 1639. A,� Building Division RFD MA't 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 1 / Please Print DATE: ��' — y j JOB LOCATION:_ T� , ►�J -5�e4 W bzjz K ikL.� Al — nu m er streetsn� ` village .HOMEOWNER":_c-�0-L-0 S name ``home phone# work phone# CURRENT MAILING ADDRESS: I�� cityhown 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 requireme ts. Signature of Hom eAner 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.L l-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 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. Qiforms:homeexempt r• a. 1 I r � 1 1 1 `-------- ---- 29, ------------ ------- ---------- ---- ---------- 1 p 6 ' IFFf i CARLOS ROBERTO PEREIRA 593 OLD STRAWBERRY HILL RD, CENTERVILLE,MA General Specifications for materials. SMOKE DETECTORS REVIEWED Windows with screens and grilles,trim will be primed. Walls and ceiling will be drywall with taped joints. BUILDING DEPT. DATE Siding is clear R&R white cedar shingles with tyvek vapor b Insulation RI in Walls,R30 Ceilings and R30 in floors. Roofing is 25 year Shingles with ice and water at all eaves. FIRE DEPARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING FRAMING %" Plywood subfloor. 2"x 4"flamed bearing wall 2"x 8"flat or shed roof. IMPORTANT - UPGRADE REQUIRED 2"x 6"ceiling joists. STATE BUILDING. CODE REQUIRES THE UPGRADING OF 1/2"Plywood roof SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN 1/2"Plywood bearing Wall. ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. NOTE' A SERMTE PMI T IS REQUIRED FOR THE INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL PERMIT DOES NOT SATISFY THIS REQUIREMENT. I 593 Old Strawberry Hill rd, Centerville, Ma 02601 New Look inside of 2°nd Floor -------------------------------------- -------- 39'.5-------------------- ------------------- - 1 I p p, 1, I I 1 I 1 I I1----------------- - 1 - 1 1 1 -- ----------------------------4---------------1 -------------------------, T---- 1 1 •\ i 1 I i�K•\ 1 1 CE > 1 I •\ 1 O 1 1 I 1 1 , S Bedroo 5 ft Exist windows 1 ;® 18 i W 8 26•.3 f � 1 ® 1 1 1 1 15' A 12' ; A 1 I 1 I I ♦ j , 1 ♦ / I I ♦ / 1 1 ♦ / 1 1 `♦% 1 I 1 1 / ♦ I 1 1 4 Exist step ; / ♦ > 1 162 UP 1 , ---------------- ------------------ ' -------------------------------------------------------- 593 Old Strawberry Hill rd, Centerville,Ma 02601 Look inside of 1°nd Floor ----------------------------------------------------------------------------------.---------------; EL Kitchen 01 II II Bedro& I II Living room Bedroom i I Exist step , Down/Basement steps Up a Floor steps d FC -: 1 \ � /�/1�� )f..,. +.'`..ice' • � Yi+y � l r � _ +' �� �-• tom} .� ,! 'L➢,ti - `� y _ i° K; _ tt • w - Qw ._ } DSCF0356 DSCF0357 OSCF0358 I LOT ?l LOT 20 __=./ . "r" (I j Y / - "'i`�`'' `/ram\/ .•A.:^�.w'_-.�m.. 1+ STD PHEt�t DOl'LE iVOTL'• HOUSE APPEARS TO L1L' ; g�p� �s va Ph'l'—C.IISTING. _1LO/1jCON1O12�U/IVG PIOOD PANEL: 250001 OOO 5 C 1;%OOD ZONE C__ D_sJILD v3 I her eh} eel lily that this mortgage inspection plan was prepared for — Plan is For _ OPTION ONE AIORTGAGA- CORD Baryk use Only 77re location of the building shown does _ QL_ t�// rriLhin a s�ecia/ flood hazard zone. T / T LAl1 REF = 32849A Per taped inspection it appears the location of dwelling does ._ conform to the local by-lams if] effect at the Lime of construction mith respect to horizontal dimensional setback requirements ,Scale I" _- _ =�O FT or is eccrnpi.from violation enforcement action under A/uss. General tdrnrs Ch. -10.4 -.Src. 7. fJc?�e.• __ r PLEAS",NO%f` Me sLrrrclwrs on this inspection were located by tape not instrument and are approximate onh: an actual survey is necessary—_ for a precise determination of the brnlding Location and encroachments if arw ecisl. either nay across property lines. Mis inspection trust not be used for recording purposes or for use in preparirr- deer/ descriptions and nznst. not be used for rur-iancc or hrrildin:,, plan pruposesr 9Yjis inspectiun must not be used to local.- property liar... terificalion of building lncalions, property Line dimensions, Aencrs or lot r.rrnfiguration can only be accompfished In• as arcurale instrument sur vti y which ma_y reflect different information than what is shown. herzorr. This inspection is not to be used for any purposes other [Harr rnor•l�•nee. )'n We Surrey- accepts no respunsibdit�- for damages resulting• from said reliance. T: fll• l r/—1 r /1 r r ri rl^l P/{DA'L.` 5flf!--l2li-a05:> 1I, 1 F:a.V .5oe-=ISO-55s3 u U(V17' 1. 40 INDU.SIRY RD, LIL<IRS'I'OIV.S AIIL1oS A/f1 026zl8 36185 J.S r REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY Thank you for registering in accordance with Town of Barnstable,Code chapter 224 sections 224-3 and 224-4. Please complete one form for each property in foreclosure (section 224-3) or already foreclosed for which possession has been taken(section 224- 4). Please file the original with the Building Commissioner and a copy with the Chief of the Fire District in which the property is located. If you claim you are exempt from registering under Massachusetts law, please state the reason(s) and complete section 1 (property information) and the first paragraph of section 2 (foreclosing party, court, etc. and foreclosing party representative, but not other representatives and attorney) so that the Town can review the exemption and update its records: Section 1 —Property Information Property Address: 593 Old Strwbry HI Rd,CENTERVILLE,MA 02632 Assessors Map #: Map/Block/Lot: 273/007/ Parcel #: 273007 Land area and description Lot Size(Acres) 0.25 Building(s) description and contents Single Family,Year Built: 1984 Occupied: Occupant(s)(if borrowers so state and include name(s)) Carlos Roberto Pereira c/o Ocwen Loan Servicing LLC-Judy Credit Zz_ PropertyRegistration@ocwen.com/ -d Phone: 1-800-746-2936 email: Property.Preservation@ocwen.com other: VacaIccupant(s) t: Date: Anticipated Length of Vacancy: Qz Last )(if borrowers so state and include name(s)) rn Phone email: other: Has possession been taken If so, please explain and complete and file the maintenance and security plan form(unless exempt as stated above) Section 2—Foreclosing_Party Information Foreclosing Party (full name/title) Korde and Associates P C-Foreclosure Attorney \ Foreclosure Case Court: n/a Docket# n/a sti Date filed: Current Status: Foreclosing Parry's representative(s) for property (entry, management, repair, etc.)(name,title,): Company (if different from foreclosing party): Address: Phone: email: other: If an exemption is claimed, please do not complete the remainder. Other representative(s) (if foregoing representative is primarily responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and/or foreclosure,please so state and do not complete contact information(i. e. "none"or"see above")). Deutsche Bank Trust Company Americas,as Trustee for Residential Accredit Loans,Inc.,Mortgage Asset-Backe( Name,title, other: Pass-Through Certificates,Series 2005-QA10 c/o Ocwen Loan Servicing, LLC-Judy Credit Company (if different from foreclosing party): Address: 1661 Worthington Rd.Suite 100,West Palm Beach, FL 33409 PropertyRegistration@ocwen.com Phone(s): 1-800-746-2936 email(s): other: Name,title, other: Company(if different from foreclosing party): Altisource Solutions,Inc-Darren Wisniewski(Waltham Resident) Address: 1000 Abernathy Road Northpark Town Center Building 400,Suite 200,Atlanta,GA 30328 617 728 6130 Phone: 407 739 3930 email: Darren.Wisniewski@altisource.com other: Please mail correspondence to Atlanta office,Darren is local to address property conditions and emergency matters. Attorney representing foreclosing party Korde and.Associates P C-Foreclosure Attorney Firm name (if different from attorney's name): Address: Phone(s): email(s): other: I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of ' chapter 224 of the Code of the Town of Barnstable. QA Date: (to'a Name: Alma Emery Title: Assistant Manager I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-3 of chapter 224 of the Code of the Town of Barnstable. Date: Building Commissioner, Town of Barnstable REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY Thank you for registering in accordance with Town of Barnstable Code chapt r224 sections 224-3 and 224-4. Please complete one form for each property in foreclosure ca. (section 224-3) or already foreclosed for which possession has been taken (section 224- 4). Please file the original with the Building Commissioner and a copy with the Chief 6 the Fire District in which the property is located. `3 CD If you claim you are exempt from registering under Massachusetts law, please state the reason(s) and complete section 1 (property information) and the first paragraph of section 2 (foreclosing party, court, etc. and foreclosing party representative, but not other representatives and attorney) so that the Town can review the exemption and update its records: Section 1 —Property Information N� Property,Address: 593 Old Strwbry HI Rd,CE++TEfF*t�,MA 02632 Assessors Map #: Map/Block/Lot: 273/000/007 Parcel #: 273 007 Land area and description Lot Size(Acres) 10,890 sq ft/0.25 acres Building(s) description and contents Single Family,Year Built: 1984 Occupied: Occupant(s)(if borrowers so state and include name(s)) Phone: email: other: Vacant: Date: 10/31/2017 Anticipated Length of Vacancy: Property remain vacant Last occupant(s) )(if borrowers so state and include name(s)) Deutsche Bank Trust Company Americas,as Trustee for Residential Accredit Loans,Inc.,Mortgage Asset-Backed Pass-Through Certificates,Series 2005-QA10 c/o Altisource Solutions,Inc.-Samir Shaikh Phone: (866)952-6514 email: VPR@altisource.com other: Has possession been taken If so, please explain and complete and file the maintenance and security plan form (unless exempt as stated above) Section 2—Foreclosing Party Information Foreclosing Party (full name/title) N/A Foreclosure Case Court: N/A Docket# N/A l r Date filed: Current Status: Foreclosing Party's representative(s) for property (entry, management, repair, etc.)(name, title,): Company (if different from foreclosing party): Address: Phone: email: other: If an exemption is claimed, please do not complete the remainder. Other representative(s) (if foregoing representative is primarily responsible for property and/or foreclosure and is most likely to be able to address town matters concerning the property and/or foreclosure, please so state and do not complete contact information (i. e. "none" or"see above")). Deutsche Bank Trust Company Americas,as Trustee for Residential Accredit Loans,Inc.,Mortgage Name, title, other: Asset-Backed Pass-Through Certificates,Series 2005-QA10 c/o Altisource Solutions, Inc.-Samir Shaikh Company (if different from foreclosing party): i Address: 1000 Abernathy Road Northpark Town Center Building 400, Suite 200,Atlanta, GA 30328 Phone(s): (866)952-6514 email(s): VPR@altisource.com other: Name, title, other: Company (if different from foreclosing party): Altisource Solutions, Inc-Darren Wisniewski(Waltham Resident) Address: 1000 Abernathy Road Northpark Town Center Building 400,Suite 200,Atlanta,GA 30328 617 728 6130/ Phone: 407 739 3930 email: Darren.Wisniewski@altisource.com other: Please mail correspondence to Atlanta office,Darren is local to address property conditions and emergency matters. Attorney representing foreclosing party N/A Firm name (if different from attorney's name): Address: Phone(s): email(s): other: I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the of the Town of Barnstable. Date: Name: Alma Emery Title: Assistant Manager f k I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-3 of chapter 224 of the Code of the Town of Barnstable. Date: Building Commissioner, Town of Barnstable 9 'y`oFTHETp The Town of Barnstable BA LE,MASS. • Department of Health Safety and Environmental Services 9 MASS. f639'AT N. to.MAr Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection nci I Location 573 old S�n,w�<�r„.�/�3 � Permit Number g0)6 2 Owner Builder One notice to remain on job site,one notice on file in Building Department. s of following items need correcting: (- of ��,i�S '� 2A1 -�)b ( i�� ✓1�� C/��a � ���� ���fj� � e+1Crn 1 I tQ_Q�Q a 03 Y\4 Ve-k QS Der- C O e bu 5l 1 t Please call: �508-862-4038 for re-inspection. Inspected by /-- Date IRY)I\ �ppiHETp��� The Town of Barnstable BARE.MASS. Department y artment of Health Safety and Environmental Services %639• �0� prFD MAy A Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location 5 i Permit Number Owner Builder ,��tAj/I r One notice to remain on job site,one notice on file in Building Department. The following items need correcting: QJ � � I J Please call: 508-862-4038 for re-inspection. Inspected by r r r Date //-v Assessor's map{and lot number/ 0 7 ............................................ THE ra yoF Sewage,,Permit number .........cq.3n... .................1 31AWSTABLE House number ................'4 `-...................................................... MU& os�.b39. I?MIR TOWN OF, BARNSTABLE .BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......1 91!Atruct .................. ........................ ........... ... ................. 'W TYPE OF CONSTRUCTION ...................o..o...................d Frame............................................................................................. September 1...........19. .................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the foll6wing-infor,motion: Location .......... r-rX 9A 13mmAsi M A,............................................ ProposedUse ................................................................................I...............................................................i............................. Zoning District .......... ....................................................Fire District .....HVPLMUqj%...M4 A P�.%.................................. Name of Owner ......K-1.ab.a laws...On ne-.T.ahn......................Address ......601....()I d...Str�XM!?.=...ELI)....Rd.,.�.... Center-%jd11e-,'-4Ass-. Name of Builder .............................................................. ....Address ..................... ...................... ...................................... Nameof Architect ..................................................................Address .................................................................................... -Number of Rooms .......;a.:?�..................................................Foundation ...........:P.. ......................................................... Exterior .j,4 pkqard and shingles Roofing ... Asrihalt shinkyles .. .................................................................... ............I........................... ......................................... Floors AP.9.4...and...Li.npleum ......Interior .........Sbe.e.tro.ck ck.................................................... .. .... ..... .... .. ....... .. .... .. ....... .... Heating .....F.10.0tr.1C...................... .................................Plumbing .............mo... C.O.9p.Qr...................................... Fireplace ....A0.P.Q-..S.t0.Ye.......... .......................... . .......Approximate. Cost ... .............................I......... Definitive Plan Approved by Planning Board ----------------------------19--------- Area ..'.AP56...P—A... -�Ji Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH r#IDS 4) v �ev , Y�j % 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 A ...r, ....... Construction Supervisor's License .................................... ONNEMBO, NICHOLAS A=273-007 No ..263...... �rmit for Cme Story y ................. Single Fail.y...D..w..el ling . . L .. ..... ................ otm 1Sr Location ................ ... ..... .... tawbe.r '.. Hi'- l Rd- .. .. ............... ... ................. ? ........... ................... Owner ... Nicholas Onnembo ........................................... t Type of Construction „Frame r .............. ......... ................ ........................... Plot ........................ Lot ................................ ril 17, E Permit Granted�....................................19 84 Date of Inspection ....................................19 Date Completed ......................................19 t-1 TOWN OF BARNSTABLE 2i3 ; Permit •No — ` - Banding. Inspector S360 I sau,r�m" F e (. tja OCCUPANCY 'PERMIT Bond, — -- -- - :Issued to Nicholas O,RneiAlm r:� Address; .lot t4k20 583 Old Strawberry Hill Road, Hyannis l� f`J' _ _ wiring-inspectorF f1 � 17 Inspection.date 1 Plumbing Inspector's '< t Inspection,date. Gas Inspector ( � `V , - a Inspection,date Engineering Department <4 �. Inspection date Board :of.'Health "; n Inspection;date C �� THIS PERMIT WILL NOT BE VALID,, AND THE BUILDING` SHALL NOT, 'BED OCCUPIED ,UNTIL _SIGNED 'BY THE BUILDING. INSPECTOR ,UPO`N SATISFACTORY •COMPLIANCE 'WITH' TOWN REQUIREMENTS AND IN .ACCORDANCE ''WITS.SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING .CODE:, t 9 ,; '•/%-mac ' ;; Building Inspector,�� _ -- - { -wnk Oz-v c,� Y / 7 ALL tc I `J t 17 0 ~ M' r.�2 p 19•S7 a 11_ . N f {. C 2 7, o. M Y R Ova K 90',ti O ; ` S, r 5 %Z5 ram, r11�C-g ` �►� v� t F (BUT:/3/ y. 1 it Iv N` (rrT cif a TZ;z.7e.J /f+-r, C/ Cam: j yv 4 1.. r , CERTIFIED PLOT St 177, �. E aF w� F�/cA+� 11i (If � _ 1 o� ROBERT NEW ; CONSTRUCTION ONLY eriucE ' ✓�.y�� / /1//eS' ' TOP'.( OF FOUNDATION IS "FEET 8 E:DR.E ► " �N ix LOW POINT , OF ADJACENT' �:�� ROAbo W CAL' / —3o OATEN . 4 Yak OR DQE E Q/NEE lNQ INCv K�rE•�4 u CLIENT . 1 CERTIFY THAT '.TNEovoi/ Eet9TERE0 RE®18TERED "`""L"''""'. 'SHOWN ON THIS'' P4AN 18": 4000 �f 408 NO. ' 3 2- " ON '-THE THE GROUND='A! `INDICATEW�jg v:, CIVIL �.' LAND �--- � n ENGINEER 8URVEYOR DR.8Y� A. _ CONFORMS TO THE ::ZONING- I:AWB F 'OF 13ARNSTA13 MA88 �. 712 MAIN S T RE E7 CH.BYE 3.E; y/ RIS MA 1 I �+ HEE .3 �" GF ti..� • . _. . .,,, .I. D TE REG. LAND. URVEYOR 4: •;, D 1'e- /Z A 4-- *�Asssessar�'nGap and lot number ....';,?,3.�.�.� ...:......:.:C�� oFTNEto ,Sewage Permit number .. :...1 l� -SYSTEM MUST ��, °+►....... ... D IN ppscOM q A ., ��BABd9TAD Huse number ..............,.a� ....X�..........:.................::..:., ' WITH TITLE 5 �� „�9 L �r �y �,pp,� E • ENTAL Coo TO ce •G , . is TOWN OF BARNSTBL - -K � BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....,Construct Single Family,, Dwelling,, ,, ,. TYPE OF CONSTRUCTION Wood Frame ...................................................................................................................................... September..:l.,...........19.D.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .........La.t...#2Q.....Qld..StrA30.9,vu...?.111... .,............................................. ProposedUse ................................................................................................... ......................................................................... Zoning District .......... .�.Qr.r....................................................Fire District ..... �a .7..Sa... la. S....................................... Name of Owner ......Rich:al.a.s...Onnemho......................Address ......6.Q1....01.d..S.txawbarx�y...Hill...R.d........ Centerville, Mass . Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ........5.1.X.....................................................Foundation ........... .►.C, ......................................................... Exterior .Cla�.g.Q.A r.d...and• shingles........................Roofing ........asphalt...shingles................................. Floors ...Woodand...Li.noleu ......................................Interior ......... k.......................................................... ..... ..Heating l e.Cx J.0.... ...................... 9 �P• ...Plumbin ............ Ws7....-...D.A. J:...................................... Fireplace .....WOO. ...S.tO.zl. ...................................................Approximate. Cost ... ............ ....... --- 19 -----. Area f t.!...� Definitive Plan Approved by Planning Board -----------____________ "sg.:.... . . Diagram of Lot and Building with Dimensions Fee 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 Town of Barnstable regarding the above construction. r/ Name ..,. :.. . ........... Construction Supervisor's License .................................... ,r ONNEMBO, NICHOLAS `s..�lo 26303 Permit for ..One Sto � S wp l.a xlg......................... k Location W. .. bsrsy..all Rd. ............. yarmi.s................................................. r rf Owner .... icholas. Onnembo........................... , Frame Type of Construction ........................................... �I,f - i Plot Lot . .. ..................... w t ' April -17; 84 r Permit Granted .........................................19 F P Date of Inspection ....................................19 Date Completed :....Z �:..........1,9�" r t r w p ` -