HomeMy WebLinkAbout0038 OVERLEA ROAD Y
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Town of Barnstable *Permit#
gg
Expires 6 the fro�iso
to
71,Regulatory Services Fee
anRivszesr.e,
v� 1639 hUss. `0$ Richard V.Scali,Director
'0rfo►n�
Building Division
Tom Perry,CBO,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number 2 8 7/1 51
Property Address 38 Overlea Road,Hyanni sport MA M(o yr-1
Residential Value of Work$ 7000. 00 Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address Thomas & Carolyn Odonnell
49 Cliff RoadWellesley MA 02181
Contractor's Name Northern Colony BuKders LLC Telephone Number
Home Improvement Contractor License 4(if applicable) 167739 Email: danwbee@eomcast.net
Construction Supervisor's License#(if applicable) CS—0 5 3 6 3 8
❑Workman's Compensation Insurance
Check one: Kcs?
I am a sole proprietor A c)5 2016
I am the Homeowner F� �i C
❑ I have Worker's Compensation Insurance
TOWN
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
req 're
SIGNATURE:
C:\Users\Decollik\AppDataU ocal\Microsoft\Windows\Tem rary Intemet Files\Content.Outlook\2PIOI DHR\EXPRESS.doc
Revised 040215
�,� �,�' Town of Barnstable=
- ;Regulatory Ser�%ices - -
R�chard Seah,Director
BUII(�iD$'DMSIOIi
Thomas Perry,CBOT.
Bodging Comm>ssioner
'.; �. " 2t10 Mam Street, Hyannis MA 02601
www fovea barnstable.ma os
Offee 508;862-4038 Fax; 508 790-6230
Property Uwner Must
Complete and Sign This Section
Usuig A Builder
I, Thomas & Carolyn q'Donnel l as Owner of the sub�ecr property
hereby authorize Northern Colony :Bui ldinu, Ll lc < to act on my liehalf, ;.
xn all°rnattersrelattve'to work authorized by thus builduig peanut application for
38 Overlea .Road
(Addess of Job)
Si ature
PantName
Tf Property Owner is applying Ior permit,please complete the Homeowners l icense'.Exemption Form on the
reverse side.
z.
C\Uses\Deco11�7cEApppatalLocaltl\9uaosoft\Windows\Temporazy lntemetFdes\CorrtentOutlookl2PIO1DHRTEXPRESS doc
Revised 040215 s
A
The Commonwealth of Massachusetts
_ Department of Industrial Accidents
Office of Investigations
600 Ff"ashington Street
y Boston, JL4 02111
r
st,x7 r.inass.gavldin
Workers' Compensation Insurance Affida-vit: Builders/Contractors/Electilci:tus/Plumbers
Anphcant Information Please Print Lecibl)-
Naine. (Bitsiness'Organization,'Indi%idual): jN[Qc:Ehn;r'n Cojonq' 4��t L
Address: Po
City/State,/Z1p: S —E0.rn5 ( MAoQLGLThone 4:5OR-q Q 0- '7 07
Are you an employer? Check the appropriate.box: Type of project(required):
1.❑ I am a ena loyer with 4. ❑ I am a general contractor and I
p 6. ❑New construction
employees(full and-or part-time).* have hued the sub-contractors
I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
b These sub-contractors have. g.
slop and have no employees Demolition❑ .
employees and have workers'
working, for me in any capacity. 9. ❑ Building addition
[No workers comp. insurance comp. insurance.l
required]
5. ❑ %Ve are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeo,NNmer doing all work officers have exercised their 11.❑Plumbing repau s or additions
myself. [No workers' comp. right of exemption per MGL 12.p§,,Roof repairs
insi=ce required.] t c. 152, y 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 spotting their workers'compensation policy information-
Homeowners who submit this affidavit indicating they are doing all worts and then hire outside contractors must submit a new affidavit iadicatia-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 ant an emplo_rer that is providing Peorkers'compensation iinsitrance for nit'eniployees. Belo"-is rite policy attd job site
information.
Insurance Company Name:
Policy'�or Self-ins. Lic. H: Expiration Date:
r
Job Site Address: JJ o City/State/Zip:
Attach a copy of the workers'compensation policy declarati n page(shoRring 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 S1,500.00 w&,,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. Be advised that a copy of this statement may be forwarded to the Office of
Ins estigatiol-s of the DLs,for insurance coverage verification.
I do here 3 rtii tide he P tallies ofpeijun that rite information protzded above s true and correct.
Si nature: Date: 't(!g`
Phone 4:
Official use onlY. Do Plot write in this area,to be completed ks,ci,ti�or touts ofciaL
Cite or Town: Permit/License 0
Issuing.-Authority(circle one):
1.Board of Health 2.Building Department 3. CityiTown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
6
�R
Office:of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170.
r.. Boston; Mass&rl
tts02116
Im,rovernent �tor Registration
Registration: 167739
Type: LLC
z w Expiration: 10/25/2016 Trtt 264780
NORTHERN COLONY BUILDERS r _
DANIEL GALLAGHER o
P.O. BOX 278 ;, — --------...----....
WEST BARSTABLE, MA 02668'
Update Address and return card.Mark reason for change.
Address Renewal, Employment Lost Card
SCA 1 0 20M-05/11
' U/ae (pa�itrrreo�racueal�a�C/�ac`etcdel>�4 - '
Office of Consumer Affairs& Business Regulation License.or registration valid for individul use only
PAR
OME IMPROVEMENT CONTRACTOR j ' before the expiration date. If found return to:
— Type:,
Office of Consumer Affairs and Business Regulation
tea= aRegistration: 167739 .
10`Park Plaza-Suite 5170
' - Expiration 10J25/2016 LLC
�- �-• Boston,MA 02116
NORTHERN COLONY BU14D�RS<;L"C
DANIEL GALLAGHER a ter r,
r��-
180 HIGH ST
W. BARN, MA 02668 - Undersecretary Not va witilo. signature
r r
Massachusetts Department of Public Safety
Board of Building Regulations and Standards
License: CS-053638
Construction Supervisor
DANIEL J GALLAGHER
PO BOX 278 'v 9 '�
WEST BARNSTABLE MA 02668
CA Expiration:
Commissioner 10/27/2017
�•'""• TOWN OF BARNSTABLE Permit No.
Building Inspector
• `Cash ----------------
OCCUPANCY PERMIT "� Bond ___N/A______
"No building nor structure shall be erected;"and no land, building or structure shall be
used for a new, different, changed, or enlarged use without a Building Permit therefor
first having been obtained from the Building IInspector. No building shall be occupied until a
certificate of occupancy has been issued by the Building Inspector."
Issued to Kearsage Realty Trust Address 9yannisport
'�R E'�crprlraa ;d%�ae� €7t7�?lrsi_�Zt�ri
Wiring Inspector �� � Inspection date
Plumbing Inspecto r,Sr ! Inspection date
Gas Inspector �, �1 � f' ' Inspection date
Engineering Department 1 -� �f •r 7i,�,r ` Inspection date' ?
THIS PERMIT WILL NOT BE VALID,,AND ,THE BUILDING SHALL NOT,BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS.
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CERTIFIED ..""'-PLOT PLAN
LACATION1f!!5�4 . MASS
EDWARD E. KEL LPf SCALE . .�.��:'� DATE
C'UMMAOU , 1'4 SS. 02"637 �.( S�� PLAN REFERENCE . �7!�!.G. . >•. .'�.`�. . .
G!Up . . .4;v 2 T . .
t'
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Lfi LlY .,f
is ro 231 F:' j t"' /ST/NG ✓•vD per!
I CERTIFY THAT THE .. ...... . .... .....!�T.1.. ....
'c 41'' ` SHOWN ON THIS PLAN IS LOCATED ON THE GROUND
r �_ AS SHOWN HEREON AND THAT IT CONFORMS TO THE
SETBACK REQUIREMENTS OF THE TOWN OF
_ �A' �us779G�44`�. . . . . . . . WHEN CONSTRUCTED.
A SASE-G'E �7Y 77ZOU - DATE 2.8 ef$o
PETITIONER: /�/A/V/V/S�Dp A,40A5S REGISTERED LAND SURVPtR
OF Z 5hk27'5
J
TOP OF FOUNDATION
CONCRETE COVER
CONCRETE COVERS
: 4' CAST IRON " r
PIPE (OREQUIV. 12 MAX. 12"MAX. '°'n�
4"ORANGEBURG(OR EQUIV.)
' PITCH )- MIN. PIPE- MIN. LEACH.
• ' PITCH I/4"PER. PITCH 1/4"PER.FT. PIT e,° PRECAST
e' NVERT o a LEACHING
e EL..$2..L.�r... INVERT INVERT p� w PIT OR
e , SEPTIC TANK EL. . . . DIST. EL33,�Z >_ EQUIV.
,•e INVERT BOX '
o; ... . . . /000 GAL. INVERT INVERT ;•' V ww o: ::�. 3/4"TO IV2,
� EL,3 t3� 3o,Bo ;• �o o' WASHED
�•
• W STONE
DI
PROR LE OF GROUND WATER TABLE
SEWAGE DISPOSAL SYSTEM
NO SCALE
PIRELIARINAR"Wo
SOIL LOG WITNESSED BY :
DATE �'!� .���BQ. TIME. �•.30. !�'` 4 !0- !' �"Ze-4y. . BOARD OF HEALTH
TEST HOLE i TEST HOLE 2 TfsRS �,�J /��-, ENGINEER
ELEV. . 33f3o _ ELEV. .. .. . . .
Gbh le
s�8-sc,c. DESIGN DATA :
30" 3
NUMBER OF BEDROOMS
TOTAL ESTIMATED FLOW 33o GALLONS/DAY
BOTTOM LEACHING AREA �8.''��a. . SQ.FT. /PIT
SAID
SIDE LEACHING AREA . . �BB,.To SO.FT./ PIT
GARBAGE DISPOSAL .Nf?Ne.(50% AREA INCREASE)
FiN&- TOTAL LEACHING AREA . .7�7 d�?. SQ.FT
SA+va PERCOLATION RATE �ds?.?A! �??^!4. MIN/INCH
/SZ"
LEACHING AREA PER PERCOLATION RATE Via.. SQ.FT.
No WATER ENCOUNTERED
NUMBER OF LEACHING PITS .1 !p!T,W/?1�/•TI�1/o �-�-
APPROVED . . . . . . . . . . BOARD OF HEALTH a!�.57n!VE oti ' r= /.S;G yan/s of.srat,+E
pine P.r . . . . . . . . . . . . . . . . . .
DATE . . . . . � MAS E.KELLEY CO
� .
AGENT OR INSPECTOR xRS SURVEY
30 G PONDORS
DRIVE
aH*ARMOUTH,MASS. {OF Alas
`,r t+f!� k?A.*•y '02664 ��TNOMAS S9�y
SOT�!. v Ep EARD
KELLFY
Z=v No i2 D='' �o Fr,/ST f`Q►w���
E�?4Z�jY. ?Izt/ST NAI. ��d
PETITIONER / /L)T//�//s;fb�2T /�f!9SS �" =��='?•'
- i
July 30 , 1980
Engineering Department
Town of Barnstable
Town Hall Building
I Robert F. Horan as trustee of �Overlea Realty Trust
and owner in fee of Overlea Hyannisport do herewith
agree not to petition the own of Barnstable for any repairs
to Overlea Road or appurte ant dr 'nag a peri d of five
years.
Robert F. Horan, Trustee
i
3d r—d
Assessor's map and lot number 1 .... ." OF THE t0
SYSTEM MU
it S
Sewage Perm number ...... SEPT�C.
_ INSTALLED Au.Eo COMPu
3TODLE, i
House number .:..... ............ � ... ...........; WITH TITLE 5 9 M�a
ENVIRONMENTAL CODE �� 16 9-ArAl
�
TOWN OF- 'B A'R.N�S TtXt r--1V, IONS
BUILDING INSPECTOR
M
APPLICATION FOR PERMIT TO :.........21.+9.1.. �..�.( ..,.:.5►. ................................ .............:..
TYPE OF CONSTRUCTION ..........:....... .................................... ....... ............................... '
.................... ....... 9.�.�
TO THE INSPECTOR OF BUILDINGS:
he undersigned hereby applies for a permit- according to the following information:
V�i+.a 1C44........ ...s
�i4,kA.%A A .V .IL............Location ......�....p. ...:: ,.......... .. .. .. ........
Proposed Use ........:.S.I.K. ..r— .. �t'S: 4 .........................:..............................:......
..
Zoning District .......... '�...... ...............�........................are District ......... ... ��.�!1.IA..�..�. ........
Name of Owner ... . ddress ...�dci �.... . . A!lL ..Y..!!.lw�2Gc471
Name of Builder ................. .: !!" t...............................Address �►' - ... l.............. .... , ................
Name of Architect ..Y. .45...�44 � t 1�jQlC.o..r�...Address ....... .. . .....GiC'.�ft.�....�. .
V
Number of Rooms ....:......... e ........................ .Foundation . . a. . ..`
_',-A .. 04�1�,A�G,
Exierior ....l��G�r.W......,� \R!► ...(<4. . M/d. . .Roofing .....\, . O..GA....pm ..,.S.�L�r,. ..��.........
i
Floors ^-. _ :.... ........�.1.1/1C,......................Interior ....................................................................................
Heating• ...4 ,LC ILG.r.. Plumbing ...... . ..W.Q.......C�.. ..IR
Q,✓
Fireplace .......... s.............................................................Approximate Cost ........ . ..........................
Definitive Plan Approved by Planning Board --------------------------------19________. Area �. ®. .....
Diagram of Lot and Building with Dimensions Fee �'�'
SUBJECT TO APPROVAL OF BOARD OF HEALTH
5d _ �U
f I
I hereby agree'to conform to all the Rules and Regulations o the To of B nstable rding the above
construction:
Name ..... ........... . ... ..........%....
Kearsage Realty Trust
22388 � �
No Permit for
:..........single family..dwelling...................
Location
38 Overlea R -
.. ......................Hy . ....................... �-
Owner ........K..e..arsa a. Ra
ty...TrwaC...... Y i
Type of Construction .....frame...............
................................. .............. .......... - -
Plot :f...r 1.........:..... Lot .............. ............. 1
Jul
Permit .Granted .......... y 30..:;.,:. 19
t
s
-Date of Inspection za %Zl..T9
Date Complet .... ............ 19�/
PERMIT REFUSED ...... . �..:
`
ri r^....... .. ..............................:.................tv
033
APPrt.................................... 19
l _ ' SD � ��
Assessor's map and lot number ..... --s. 1........ ..... �: .;� � ) a� K....
�� Q�Of 7NE
Sewa g ....a Permit number 0cr"U�...3�.,� �' r,W R ye
Y..................................
li BARNSTABLE. i
House number ....... ......1. ..s*:................. r�......... r Mae&
..
1639. \0�
MAI or,
TOWN OF BARNSTABLE
BUILDING INSPECTOR
1
APPLICATION FOR PERMIT TO ......... d.._
TYPE OF CONSTRUCTION .............. ............................................. , ...... ................. _
1 TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
_ I n /
Location �a. .........�.. ............. ) C ::.�"<R; :... X,...1.... �.J� .!.'.?�.�... U :�.. :� /,.0 . ............... .....
�. .. - �.
,Proposed Use .......... t!........ ........................................ .........................
Zoning District I ......................I.Fire District ......................
Name of Owner ... C Fri„r C .�t�,j 1 t'G�,(+, .t.4 j `�....�. t 9�/G!!i( � (k!?:}^ ,l/,..;��...... ,' a
... ... . . �. , U Address
`Name of Builder .................... ..............................Address .............. ........................................................
Name of Architect �/ ; lln�-�- \ ac.n. ....Address ..... ....,��,�,• f;:�:,.,......� lr �.... c __
.�....:................... ......
i
u � �
Number of Rooms'''.!. .! +.............................Foundation
(
Exierior .... �, .�,1.��'.....CA..:.^. Sl 1 .w.. `:...�'::u!� :�t:�:.: �.Roofing .....�r �.....���.c>5„�v ::...� f'.!� . It^ ........
Floors r f. k ' Interior .........
And
. . . .........................................
Heating ( g
Fireplace ........ J. "..c ...........................................................Approximate Cost .......... .� : �?.f?.! !�.. `..........................
Definitive Plan Approved by Planning Board --------------------------------19--------. Are ..... . -...:'t".................
Diagram of Lot and Building with Dimensions Fee �
SUBJECT TO APPROVAL OF BOARD OF HEALTH
1
I hereby agree to conform to all the Rules and Regulations off the Town of Barnstablere°garding the above
construction.
' Name .... .............:................... ::::::. .....:......
Kearsage Realty Trust- A=287-15I
No ... ... Permit for ....I...1Vst ......
.......s.img1e..�ami..ly..dwelling ......
Location ...3.8..Overlea.Road.. ......
..................Hyanrisport....................................
Owner .....Kearsage..l3ea1>ty..Trus.t..............
Type of Construction ..........frame.....................
................................ . ............................................
Plot ..................... I.. Lot ......... ...................
Permit Granted .......... TulY..30..............19 80
Date of Inspection .......-.1......................19
Date Completed ......................................19
PERMIT REFUSED
................................... .... .... n... 19
..... .. �. .........................
V � -
.. ....l.......................
................................. .........................................
Approved ................................................ 19
...............................................................................
...............................................................................
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Dennis Mc Williams, Builder
Box I5
West Barnstable,MA 02668
(508)362-8383
July 27,1995
Town of Barnstable.
Building Inspector
Hyannis,Ma 02660
re.
Building Permit#37481
O'Donnell Residence
38 Overlea Road
Hyannisport,Me
Due to unforseen circumstances I,Dennis McWilliams,rrequest that you
withdraw my status as construction supervisor at 38 Overlea Road
Hyannisport,Ma
Sincerely,
Dennis McWilliams
Supervisor#009685
i
• TOWN OF BARNSTABLE
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
P ase print.
DATE
X_ 0B. LOCATION
Number Str et ddress Sectio of town
�
"HOMEOWNER" 6/f 'c;.3 � S77 0 , ..
ame e
Home phone Work phone -
RESENT MAILING ADDRESS
City town State T 3o LS
Zip code
The current exemption for "homeowners" was extended to include owner-occupied
dwellings of six units or less and to allow such homeowners to engage an in-
dividual for hire who does not possess a license, provided that the owner
acts as supervisor.
DEFINITION OF HOMEOWNER:
Person(sY who owns a parcel of land on which he/she resides or intends to re-
side, on which there is, or is intended to be, a one to six 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 Stat
Building Code and other applicable codes, by-laws, 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.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Note: Three family dwellings 35, 000 cubic feet, or larger, will be required
to comply with State Building Code Section 127. 0, Construction Control.
HOME OWNER'S EXEMPTION
The code state that: "Any Home Owner performing work for which albuilding
permit is required shall be exempt from the provisions of this section
(Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that. if
Home Owner engages a person (s) for hire to do such work, that such Home Owner
shall act as supervisor. "
Many Home Owners who use this exemption are unaware that they are assuming
the responsibilities of a supervisor (see Appendix Q, Rules and Regulations
for . licensing Construction Supervisors, Section 2. 15) . This lack of awarenes
often results in serious problems, particularly when the Home Owner hires
unlicensed persons. In this case our Board cannot proceed against the
inlicensed person as it would with licensed. Supervisor. The Home "dwner- actin
as supervisor is ultimately responsible.
To ensure that the Home Owner is fully aware of his/her responsibilities,. man
communities require, as part of the permit application, that the Home Owner
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 to amend and adopt such a form/certification for use in your community.
I�
4
COB
FND.
/ 3 68' L=151.41 ' \
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PRIVATE WAY o
C.B.
FND.
/ 0
I / SHED
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ca C�
o LOT 9
� T,.
LOT 10
pfv,3050� DECK 147.2'
LOT 8 �__---_------
J !a .414.0 0
' _-__
4 'HSE-..B'4
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w_- 14.5' 18-�
2 }14..0'
1� J
R=5,,E>
2378' L= 600
0 00
R=18
0 VERLEA RD.
Rl'S. ZONE.- 'RF1 This MORTGAGE INSPECTION Plan is For FLOOD ZO.,'E.- "C"
Bank Use Only I
TOWN: Y�VIVISL01_ — _ REGISTRY OWNER:. JOHN F CONNORS. JR. — —
L EED. REF: �`T�13 40� — _BUYER: 1tI Q 4S_F_7 300DATE: � 8_Z—O�� L�JI>'12 -Z— - - : LC _ —
— SCALE: 40 T-
1 HEREBY CERTIFY TO y����LFQ1>?IZ1�'�TZ73[TIQL'�'Qg��y1Lv ---
_&_ITS_S_UC_CE_S_S_O_RS AND/_O_R_A_S_SIC_N_s___THAT THE BUILDING �H OF y YANKEE SURVEY
SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS .�� � CONSULTANTS
SHOWN AND THAT ITS POSITION DOES CONFORM PAUL
I'0 THE ZONING LAW SETBACK REQUIREMENTS OF THE 2 A. 40B (SUITE 1)
1'0WN OF _ 3 MERiTHEW INDUSTRY ROAD
�c"��N��.�'_____________AND THAT' No. �2098 e
IT DOES_ NOT — LIE WITHIN THE SPECIAL FLOOD HAZARD �o MARSTONS MILLS, MA. 02648
\k:EA A5 SHOWN ON THE H.U.D. MAP DATED_7iZ/JZ__ d�9F��SlOt'; oQ�� TEL: 428-0055
C0m snit —Pane :4 250001 0008 D �HAI1AN05 FAX: 420-5553
_ THIS PLAN NOT MADE FROM A UMENT 16047 BJS
PAUL A. MER[THE�V-PLS ------ SURVEY. NOT TO BE USED FOR FENCES. ETC.
�TtiE T�
o
e
• SARtiSi'Ag(E•
The Town of Barnstable °
MASS. peg Department of Health Safety and Environmental Services
► ' Building Division
367 Main Street,Hyannis MA 02601
Office 508 790-6227
.Fax: :508-775 3344
For office use only
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•eadsting owner occupied
building containing at least one but not more than four dwelling units or to structues which are adjacent
to such residence or building be done by registered contractors,arith certain exceptions,along with other
requirements.
Type of Work: Est.Cost
r
Address of Work: 6W Oy s6L 7
Owner Name: r��L
Date of Permit Application: �� J
I hereby certify that: ;
Registration is not required for the following reason(s):
Work excluded by law
Job under S 1,000
Building not owner-occupied ;
Owner pulling own permit
Notice is hereby given that:
OWNTERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS
FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE
ARBITRATION PROGRAM OR GUARANr Y FUND UNDER MGL c_ 142A
SIGNED UNDER PENALTIES OF PERJURY
I hcrcbN-apple for a pe the agent of the owncr:
Date Contractor name Registration No.
OR
Date Owner's name
The e.00u." �/QooaaE«aeua
HOME IMPROVEMENT CONTRACTOR
Registration 116599
Type - INDIVIDUAL
Expiration 06/28/96
DENNIS M MCWILLIAMS
M. MCWILLIAMS ` .
DENNIS �.
r- w
G�ceMeo7!� f± D A R ST
ADM(N(sTF+nroR W BARNSTABLE MA 02668
I
COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY k
OF ONE ASHBORTON PLACE
MASSACHUSETTS BOSTON,MA 02108
LICENSE CAUTION
EXPIRATION DATE ( ( CO ISTR. SUPERVISOR pit 7a .b
RE / / 9 5 EFFECTIVE DATE LIC-NO. 1. FOR PROTECTION AGAINST
STRICTIONS ' THEFT, PUT RIGHT THUMB
NUINE r 00/30/1903 009695 PRINT IN APPROPRIATE
O O rE�"E
BOX ON L�..��..,�.
g DENNIS M MCWILLIAMS P ; bb�
45 CEDAR ST � ' BL/��TIFF CUS
SS 015-40-4449 W titiRIVSTABLE MA O2hb$ m ; 9T INCLUDE PHOTO.
PHOTO(BLASTING OPR ONLY) FEE: n -J 14 11 ti J!w
1 U n. l l J NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY'
HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER L
THIS DOCUMENT MUST BE « SIGN NAME IN FULL ABOVE SIGNATURE LINE
CARRIED ON THE PERSON OF SIGNATURE OF LICENSEE .
THE HOLDER WHEN EN-
OTHERS �e��
-RIGHT THUMB PRINT GAGEDINTHISOCCUPATION. COMMISSIONER
11/02'P4 17:02 $61 i i.°i i 122 DEPT INTD ACCID - 001
C..n1 *W,/nr7i✓;nnfl{1fr7Clitt�!?tb
2apartmeni o1JnLJt i. ✓4.ca.,b
600 Wukj&.Sh,n f
James J.Campbell &ton, Mw-d-uld 02 f f f ,
Commissioner
Workers' Compensation Insurance AKidavit -
I, H 14
(aaesscdpamcrce)
with a principal place of business at:
(Gty/st"J7So)
do hereby certify under the pains and penalties of perjury, that:
() I am an employer providing workers' compensation coverage for my employees working on
this job.
Insurance Company Policy Number
! am a cnip nronriarnr nnrf have tin nnP wnrieinv for the in A","
t) l am a sole proprietor, general contraaor or homeowner (circle one) and have hired the
contractors listed below who have the following workers' compensation policies:
Contractor Insurance Company/Policy Plumber
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
O I am a homeowner performing all the work myself.
et£turC .CCCj'G`C`;5 s-iG-%E'1t x'l:to(Q.^r.�i;.f�LC V:a 0,ice cf{r,vtmzr2tors of&e DTA for eoxTrage verifiution and.n4--,':iiu.e iL r�eccre
CC E`;ce;_c rEG:i:EC L'.ccr SCCLOr 2EA of MGM 152 C..,ivaC to Lhe impCSition 6 cnminal perzlt es ronsisdne of a fine of up to S 1,500.00 and/or cn:-
yEa's. im�rLC ^En; WEN as Crvil pcnzltiE:in tte foT ef,STOP WORK ORDER and a fine of S 100.00 a day against me.
Signed this 5� day of 19 9U
Li eel ermittee Building Department
Licensing Board
SeIectmens Office
Health Department
TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375
TOWN (r BA.`NST.-LE Bt ILDE G PED2,11T f f7 yd'/
jAssessor's
Office 1st floor Ma / Lot ��� t�, Permit# -? �/�
Conservation Office Oth floor �' Date Issued S—
Board of Health Ord floor
Engineering Dept. (Ord floor) House#
Planning Dept. (1st floor/School Admin.Bldg.): SE P UST BE
Definitive Plan Approved by Planning Board' 19 tNSTA PLIANCS
5
(Applications processed 8:30-9:30 a.m.& 1:00-2;00 p.m.) ENVIRONMENTAL CODE AND
TOWN REGULATI"
TOWN OF BARNSTABLE,,,
Building Permit Application
Proiect Street Address
Village 1j�A6✓IWs look% Fire District
(honer —Y IU 0'bQ/VN—L Address
Telephone 7 " S-7 7 /
Permit Rcauest: X72 'y i9 l / t1'/D11,�
i
Zoning District Flood Plain Water Protection
LotrSize Grandfathered
`q
Zoning Board of Appeals Authorization Recorded
Chrrent Use Proposed Use
Construction Type
Eaistin2 Information
Dwelling Type: Single Family Two family Multi-family
Age of structure / Basement a (07,vtxr,Tt.
Historic House lr1V 4 - Finished
Old King's Highway t/Q Unfinished P1
13
Number of Baths o22 No of Bedrooms
Total Room Count(not including baths) First Floor
Heat Type and Fuel 0,05 /&'64 , Central Air ti jA Fireplaces r�e
Garage: Detached Other Detached Structures: Pool
Attar/ Barn
None Sheds
Other
Builder Information
Name �ti�S / — �G� —� Telephone number
Address License# (09 6ff�
Gt,), ga&ys lk24, Home Improvement Contractor# �1 S
Worker's Compensation # I'VA
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
r Prb'ect Cost 0'600
Fee Y`j 0•CIO
SIGNATURE DATE
I
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
�� �� BPERM T
$
FOR OFFICE USE ONLY
3/8/95 —3-7
y 287. 151
ADDRESS 38 Overlea Road VILLAGE Hyannisport
Carolyn O'Donnell
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME l
INSULATION 1
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH -s Y FINAL
t
GAS: ROUGH FINAL
S
FINAL BUILDING: �,,.:, � •
DATE CLOSED Oily
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