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HomeMy WebLinkAbout0011 TIMBER LANE _A.... ._.�._ _ � .._..... T -- - � ._...._.�.. .......�. .______. �. i of1HE Town of Barnstable �;1�6 Ce << 3 Regulatory*Services Expires 6 months from issue date Fee Z� i AAANCT1Af.F. 4 MASS Thomas F. Geiler,Director A Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.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 (550 C)�o Property Address G.A) /residential Value of Work_� r il620 Minimum fee of$35.00 for work under$6000.00 `Owner's Name&Address ��v► �(Z �� Contractor's Name Lb�9 _ `I N !:- Telephone Number .Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 4C17 , _ _ I-�-- ❑Workman's Compensation Insurance ZQ1� Check one: NOV "',d ❑ I am a sole proprietor ! C fi/VI4 El �.� �tST����' I am the Homeowner OF .I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# :opy of Insurance Compliance Certificate must accompany each permit. 'ermit Request(check box) ❑'Re-roof(stripping old shingles) All construction debris will be taken to Re-roof(not stripping. Going over existing layers of roof) XRe-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department'regulations,i.e.Historic,Conservation,etc. ***Note Property Owner must sign Property Owner Letter of Permission. A copy o,j4he Home Improvement Contractors License& Construction Supervisors License is 'requir NATURE: dAl WPFILESIFORIAMbuilding permit s1EXPRESS.doe vised 070110 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 Le�bly Name (Business/Organization/Individual):9 gWA-fZS hUpNS ^` Address: ict `o.� City/State/Zip: 01fZMt POc' Phone #: g^ ©o 7A-reyou employer? Check the appropriate box: employer with '� 4. ❑ I am a general contractor andIF77. E] project(required): yees (full and/or part-time).* have hired the sub-contractors ew construction . am a sole proprietor or partner- listed on the attached sheet. emodeling ship and have no employees These sub-contractors haveworking .for me in any capacity, employees and have workers' emolition [No workers' comp. insurance comp.insurance.# uilding addition required.] 5. [J We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions Myself [No workers' comp. right of exemption per MGL insurance required.] t c. 152, §1(4), and we have no 12.0 Roof repairs 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 thepolicy andjob 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-yeaz 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 maybe forwarded to the Office of Investigations of th IA for insurance coverage verification. I do hereby ce fy nder th ains d enalties of perjury that the information provided above is true and correct. Si ature: Date: Phone Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# L6. Other Authority(circle one): of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector Person: Phone#: THE Town of Barnstable Mato Re • g ry Services . »trrsr.+Hta, MASS g Thomas F. Geiler,Director• i639. �0 � . Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us. Office: 508-862-403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sigh This Section If Usinor A Builder as Owner of the subject property hereby authorize A�j4lLp / s to act on my behalf, in all matters.relative to work authorized by this building permit (Address of Job) c KA p, Pool fences and alarms are the responsibility of the applicant. are not to be filled before fence is installed and pools are not to be Pools utilized until all final inspections are performed and accepted. Signature of O er "AppPrin t Name Print Name Date i Q;FORMS:O WNERPERMIS SIONPOOLS r n, THE Town of Barnstable Regulatory Services aAarrsTAsLA Thomas F. Geiler,Director y Mass. �p i639. ��� Building Division rFD�p Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include OWner-occulijed dwegW s 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;tfiat'fie/she shall be responsible for all such work performed under the building_permit (Section 109.1.1) I i The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that "Any homeowner performing work for which a'building permit is required shall be exempt from the provisions r 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 From:JanetFaxlD:Philbinlrance Page2of2 L)ate:1lrzrdu11 lu:bbAmragerotz OP ID: JD ACt'�RO" DATE(MM/DDA'YYY) CERTIFICATE OF LIABILITY INSURANCE 11/02/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement s PRODUCER 617-389-9400 REACT Philbin Insurance Agency Inc 617-389-6948 PHONE FAX C No E:t: A/C No): PHILBIN INSURANCE GROUP E-MAIL ADDRESS: 629 Broadway PRODUCER LYONS-1 Everett, MA 02149 CUSTOMER to*. INSURER(S)AFFORDING COVERAGE NAIC 0 INSURED Lenny Lyons INSURER A:Atlantic Casualty Ins Co 61 Court Road INSURERB:Granite State Insurance Com an Braintree, MA 02184 INSURER C INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE D S B POLICY EFF POLICY EXP - LIMITS LTR INS POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY OCCURRENCE $ 1,000,000 EACH A X COMMERCIAL GENERAL LIABILITY L117000929 10/01/11 10/01/12 PREMISES Ea occurrence $ 100,000 CLAIMS-MADE I OCCUR MED EXP(Any one person) $ 5,000 PERSONAL•&AD•,V INJURY Q 1,000,000 GENERAL AGGREGATE $ ^2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OPAGG .$"j 2,000,000 POLICY jRo LOC � r �$f _ 1 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ; (Ea accident) ANYAUTO BODILY IN.IIRYIPerperson) $,a,. ALL OWNED AUTOS BODILY INJURY(Per accident) $! SCHEDULED AUTOS C-) PROPERTY DAMAGE $„ CIO HIRED AUTOS (Per accident)NON-OWNED AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATL) OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ N/A 2253366 11/02/11 11/02/12 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE •THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. Town Hall Barnstable, MA AUrHO�RIZEDREEPRREESENTATIVE O 1988-2009 ACORD CORPORATION.•All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD n r�,l.l�Il11llIlq Id11 t o ICI It VI f uuul .7 dl Cl 0 Board of Building Rculations and St:uul:u Standards . . Construction Supervisor License OfficeCA taiBCgh'upo HOME 1MPROVEMENT C0 i License: CS 80035 t Registration: �138477 Type: i — o. DBA — : Expiration:, 41-7,12013 . LEONARD G LYONS L ARD LYON '„-.= tF €1O ,N 61 COURT RD a•— BRAINTREE, MA 02184 LEONARD LYON �. 61GOURT RD'. =I !s BRAINTREE,'MA 021 UuBeesecretary Expiration: 6/16/20i3. ('unnni,�iuncr Tr#: 20199 1• j 'License or registration valid for•individul use only before the expiration date. If found return to:. Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 j Boston,MA 02116 - i I i Not valid wit t signature i 00 .�pric TK woo G.a� G 4 Rr ry� L oT 2 (Z 4 7744,43,s-e- G A A4Z- FOCHARD c� B TER ��ej����� CEQTIF 1 ED p L.bT F�t_.,G.►..1 LOCATto" MAesTv►�S M��s ,�- GALS rr= Qv bAT� �,/3�-,-1 G6RTlt=14 T"AT' TNtr rWOVATtOIJ S14owU Pt-A1J Q�FciZc►�GE NEZGo" COAAPLYS W ITN THE StDtt_l i►-IE Auto SET�ACiG t?E4vtcZE�titE�.tTS OP THE r."-oT 2� ZoWU o� 7BAetJsT4BLr-- - TaLL tr i �s DATE G 3 �� BAXTCt2 " REGISt�c.� LAIJ� 5u2vc�foczs T"t'S is uoT aASErl> 064 Aw 05TE2V1LLE o MA545, ! t1.lS'MUAAEtJT S0GZVC--"I' 1� TIAE-- et4oWLX> APPLI GA►JT• tibT 6E u5C-D To C>�TG2Mt%4t: LO'r LlWES pI CENTUQ-t �r'�+--_., .-.. �,+.-_-e..,�._ _,..,�.,1ti„�:_a..�. ,y.,� ...,.tt�.=..i;,,L'^`^""tea ��:y :.yr- ,. -�.. ,- �+r�.ram.:..??`;'%ih+•,-_Y. � ... -.,.--•`-.' : ` • ,�' `'. TOWN OF BARNSTABLE Permit No. __19275 5/7/77 Building Inspector Cash __ OCCUPANCY PERMIT Bond "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 Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to David Tellegen Address lot #2R Race & Timber Lanes, Marstons Mills Wiring Inspector � "`—� Inspection date e-1,12 Plumbing Inspector ' j Vy / Inspection date Gas Inspector Y Inspection date Engineering Department N/A 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. 19 Z9 �� ` ................... .�. .. , ..._, � ...............�J...Building Inspector •-• .____. � o i TOWN OF BARNSTABLE 19275 6/7/77 � e Permit No. ______—_ . Building Inspector Cash �YL } �'10 YPY►'� I:/� OCCUPANCY PERMIT Bond "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 Inspector. No building shall be occupied until a certificate.of occupancy has been issued by the Building Inspector." Issued to David Tel?a;en Address lot �2R Race & Timber Lanes, Flarstons l sills Wiring Inspector � '` I ` ff�.f� Inspection date Plumbing Inspector f t `_~ Inspection date Gas Inspector Inspection date Engineering Department 11A , 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. /A y 19 77 _ _... _, �,_.cBuilding Inspector __ Assessor's map and lot number ....... J�... ." !/•��' 7- 7' 4 , > L ? �1�• Sewage;=Permit number � n 41 WITH R,RTiCLE I I STATE TOWN OF BARNSN � D TO WN y�F THET M. BAH39TO33L$ 9� a Ya��� BVILDIHG INOECTOR APPLICATION FOR PERMIT TO ... .....E /„ , ,,/.�..WE /... lv(/c�CJ2) / 0 TYPE OF CONSTRUCTION ................................ nJ�.=............... ................................................................... t•: R ....................�l..�..................19.. � TO THE INSPECTOR OF BUILDINGS: The undersigned herfik e applies for a permit according to the following information: Location .la7 .. . ..... ..�:�..C?�✓�.2....��9�t�............................................................�..... ProposedUse ......A5....................................................................... ................................................................................. Zoning District .../toZ)..-. ............................................... District ...CG/1J7�. 4�ST.............................. ..... ... .. Name of Owner .1orl— ...-,c;.!v!Z. . ..! ...........Address �����... ....... �T ��S/ 1 /hO rlTi .. ..... ....... ......J. ...............T� ✓91�7f-= Name of Builder ........... 45 .............................................. .................................................................................... Nameof Architect ..........1/VV..�F...........................................Address .................................................................................... Number of Rooms .......... ..................................Foundation ..../.K.9��............................................................. Exterior I/.....f .............................Roofing ......... l��S�!5��94T.................................................. Floors .......llw2.waUD....................................................Interior S�L�riQOC� Heating ...........!......1/.�..........d�L-..........................................Plumbing ........... v .................................... Fireplace ....... �.�!-............................................... ..........Approximate Cost ©0 �i7,,....°.................... Definitive Plan Approved by Planning Board -------___!�___-----------19 Area ....... ....Q. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH l � i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable garding the above construction. Name ..... . ............................................. First Century Corp. No Permit'for .............one.....tor s...... .X....... .. (-single family dwelling ......................................................................... Location ........... "`—� Timber Lane .. o..................... Marstons Mills ............................................................................. Owner ...........First Century Corp...........................I...... Type of Construction .....................frame.:................... ................................................................................ Plot ...................... Lot ...........:#2R ........ .................... Permit Granted ..........June 7 ........19 77 Date of Inspection ........7701/4........19 Date Completed .........19 V f 9,Y 0,f I/Z PERMIT REFUSED ............. ...................... .................. 19 ......................................................:................... ............................................................................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ........................................................... ................... A / � 18 L,OCR /ocb GaL � s�vric TK Gj:wC4 Rr j M+ti L oT Z-A NE A. BAXTER Z2 No 2t(46 &©� 4 CE{ZTIFIED pl.bT" PL:./S►�l su LOCATION 1�AQ51_00S M�tis SC.ALt I ►r 4o Tj.AT� /3�`t-I G6•iZTl;=,4 T"-AT TNE. YivQbAT(olJ 5"owl.l PL-AIJ R FcR�►�1GE %-iF�EOW GQMPLVS WIT" THE 5t17G-UW& oT 2 A►Ja SET$AC-4 VGQUl'ZS E:WTS bF ' l4C- -to W U OF -BAP_ '5T4-Bt. __— -FALL- GATE G 3 "1'1 ' u s(1= • REGISt��D LAl..lp SU�vcYo�ZS T"tS" Vt-Aw IS LIO'Y 'BASE'(7 oiJ A'" OSTE2V1L16 a /1iCASS. It.l�'(TzG9MENT 'iv2VEY �TIIL- C�F�S�TS SI�OLJW` APPt_1 GQ.t�iT - -` tJpT 6E USC-tom TO 0e:TGV_M%%4& LO-r t_t►1�5 t'125T CE►JTU� � • 7 Assessor's map and lot number ....... ...................'..`!...,..... Sewage Permit number 7 � �Q�OFTNEtp�o TOWN Of BARNStTABLE i BARNSTABLE, ; 9� 0"Y.a.O� BUILDING INSPECTOR ,e. APPLICATION :FOR PERMIT TO .,./...-........�.................................................................. ................................. ' TYPE OF CONSTRUCTION .........GVOOI.......�i/19rm,:^ .................................................................................... ...................... ..................19 .77 TO THE INSPECTOR OF BUILDINGS: , The undersig/nedJ hereby, fora permit according to the followingrmation::,.. • Location /�1 7'... ./ ................................................ / .. ` ........... /!'?�� L.........v ... STOr!.......;• �. ProposedUse ......-4 ........................................................... ...................... .. ..... Zoning District ... ...............................................Fire District ...0 l/U7�"'...{ ...... Name of Owner .l"/..I�ST.ar!!TL ...........Address ..... �I•••• -/.�`!/••••••�T (NF'ST 421h0 tljil` .......J. ......................... ... Name of Builder ............. . ?.: .........................................Address .........✓..?lh............................................ s Nameof Architect .......... ./a u%...........................................Address .............. ...............................................................::... NumberTQuaQc� i; ofRooms ..........�...................................................Foundation ................................... Exterior ../-III...:.s '—<.!9P&Q19•2••4. .............................Roofing ......... J,SG���!9cr ................................................. Floors wc�U3) Interior .........J�..��T�OGc� ...... ........................... Heating .....✓ /� 1�v.....— 0/L•..................................:..... Plumbing ...........Pv�...........................:::......................... Fireplace I�5..................... ............................................ .............................................Approximate Cost ......... v�S�........ ..... .. r.. Definitive Plan Approved by Planning Board -----------19.73. Area ' Uv Diagram of Lot and Building with Dimensions Fee " SUBJECT TO APPROVAL OF BOARD OF HEALTH n 4 , r. ( oo ,(f I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction S Name ............. ............................................. ..................... First C Corp. �=l�0-69 --- ' ^ .tory � '`" — �Ksipgzfamily dwelling ............./............................................................ Reeel & Timber Lane Location —....----_______________. i / Marotona Mills ----.~---.,-----.----------.. First Century Corp. ^ Owner ------________________ frame Typo of Construction ....................................... � —~--------------— ' � inn � . � � � Permit Granted -- ' Date o* Inspection, Dote Completed « � � ` ^ PEmmoo � � lQ ���'��� ^ — _ ......................... � . ..........' -------. " � / . ---.'�—.����... /�.~--.—_--. ^ .—.—.—.—.—.—...-----..—....—.---~—. � � � Approved ................................................. lg . ' -----'----------^--``~'----'— ' � ............... ......'......,'.....................`...`',,,......,` � �