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HomeMy WebLinkAbout0107 WOODSIDE ROAD /evic '` Qob(p y y7 114E Z Town of Barnstable *Permit# � Expires 6 months rom issue dateOD s Regulatory Services Fee -MA­IM0 Thomas F.Geiler,Director ZOL) Building Division Tom Perry,CBO, Building Commissioner ®� 200 Main Street,Hyannis,MA 02601 - 'less www.town.barnstable.ma.us n e Office: 508-862-4038 Fax: 508-790'C2902 6 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY TO��O�c B ?446 Not Valid without Red X-Press Imprint AR�S'�'q L vlap/parcel Number 1 (9 — L-.� 3F ffif 1115 l s ?roperty Address L.!/d-r72�iJ d' � =ti =Z Residential Value of Work 1 ,�0 0 Minimum fee of$25.00 for work under$6000.00 Dwner's Name&Address ' O 7 azjw� f Contractor's Name ,���.'� Telephone Number T/.�/S 47 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ' ❑ I am a sole proprietor ® I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit 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) ❑ Re-side ❑ Replacement Windows. U-Value (maximum .44) *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. Home Improvement Contractors License is required. SIGNATURE: Q:Forms:expmtr Revise071405 ` r M The Commonwealth of Massachusetts e Department of Industrial Accidents ° Office of Investigations 600 Washington Street a1°; ` k ff Boston, MA 02111 �t www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): S -A-Z-cQ Address: e1-4, ZV, 13aA -,_-7'��214 City/State/Zip: ,4 o n,66 F _ Phone#:- . 5 D Y_— kXS_' Ire you an employer? Check the appropriate box: Type of project(required): ❑ 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 ❑ ng I am a sole proprietor or parer- listed on the attached sheet. t ? ❑Remodelipartner- ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its equired.] officers have exercised their 10.❑Electrical repairs or additions am a homeowner doing all work right of exemption per MGL I I.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.Q Roof repairs insurance required.]t employees. [No workers' 13.❑ Other comp.insurance required.] .ny applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. iomeowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such. ontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. :m an employer that is providing workers'compensation insurance for my-employees. Below.is the policy and job site formation. surance Company Name: )licy#or Self-ins.Lic.#: Expiration Date: b Site Address: City/State/Zip: ttach a copy of the workers' compensation policy declaration page(showing the.policy number and expiration date). tilure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ie 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 up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of .vestigations of the DIA for insurance coverage verification.. do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. ature: Date: lb 6 :tone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M l— t 1 . �> 27850 TOWN OF B'tRIdSTABLE permit No. ________—___ Building Inspector Cash � -------------- a - 'palm" OCCUPANCY PERMIT Bond ------- Issued to James H Burlingame _Addre s i,ot 38 107 Woodside Dr, ,- wiring Inspector C- Inspection date s` Plumbing Inspector Inspection date >1� Gas Inspector Inspection date S Engineering Department f Inspection date Board of Health 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ' .................................................... . 19 � � _:...---------.-- Building Inspector ��--...�---ter,- �ttJ!"�P'+'�'®'.".cwr •:. ... '1 e,Q'�n7�'Y'r-�V6''`C �s-1��.r,.:ri't, i � �i. i �Wf�o '�•�w TOWN OF BARNSTABLE BUILDING DEPARTMENT t ssaasr TOWN OFFICE BUILDING ,. out HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE An Occupancy Permit has been issued for the building authorized by BuildingPermit #._... .. .. ✓_ ._�r. ......_................................................. .. .........._.. 04 issued to—Zem-.e°.; ......I�3'.Q � �!t� �.... .� s ...... . .. .... r Please release the performance bond. D SEPT TEM Assjsspr's map and lot -number ...... R_2.—....�. ......... Il�US`T D INSTALLED IN COMPLI�,'Q�£TNE,o� Sewage Permit number .......:........... :3� WITH TITLE 5.. oNol ENTAL CO jt WADLE, i y House number /� 07.......................... 'IOVVM, .FjcrU AAy� ro era a ♦� C ypV TOWN OF 'BARNSTABLE •BUILDING • INSPECTOR " APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION .., ' a ..(3.....................19..�t J ! %TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ' Location .. .... .1(4tS`? ... .. ! 7... !IA�.Q/ ............................................... ProposedUse ..... c Cet... ...................................................... ............ ................................... .. ......, ..... 10 � Q ...........Fire District:'.' .f tS.. Zoning District .. . .......:...........................................:... ......................................:........ Name of Owner..,. � �Ar lY�➢s?.. .. ;........Address .....21_... N .,7 A . . . . . . . .Address 'arre of Builder .... ..... Name_ of .Architect ...... ...1. ..(c).2,0���...Addres�lf � .... ....�/.��� ....... ... .. Number of Rooms ............. Pa."..........Foundation ..... lr�11 . .. . .'.... .. ../1,...�......... ..... Exterior .., .:.......:...............:............:. ::...Roofing .... . . . . ........ ... .. YA Floors : :...................Interior ...... . �z7ZX�. ..............................d � .. Heating .... •...................................................Plumbing ..../�. fiJ . i Fireplace .....o .. . ............:..........Approximate. Cost ....' ..................... r i Definitive Plan Approved by Planning Board ____19.1 .. Area ........�7v�..................... Diagram of Lot and Building with Dimensions Fee ...... ... ' SUBJECT 10 APPROVAL OF BOARD OF HEALTH i �"I: J, 1, - •..1 ' .A ..... OCCUPANCY_ PERMITS REQ`UIRED..FOR NEW DWELLINGS I hereby agree to, onform tosall the,.R'ules and Regulations of.the Town of Barnstable regarding the above construction. Name 1 .;.,/c) . . .... ................................ Q�.�1...-� �. �Construction Supervisor's License LE.... BURLINGAME, JAMES H. 27850 p f , 1�2......tory. Permit or ......... .......... ........... Location .....Wt...3.8..........I.Q.7...Wo.od5 de..0-rive ...................... .................... Owner .......JJAMe5..1i......BUrlin.game.......... Type of Construction ....FX-"I M ......................... ................................................................................ Plot .......... Lot ................................. Permit Granted ...... ....................19 85 Date of Inspection .................19 Date 'Completed / AJ 00.......................... YV.�ni'V 1 (i4.�N•J� .(',? A.�i..n.�fL1.'1.-t" c,S::S..:...": .. ..1.�'.:.+. .. .... Existing Well Lot .3.7 T40TE : _;• t ` 1�6 xL� Pit ill, unsuitable rratcria 1•( r a �� Q 3 :WJ31 atone J. to be removed 10T i '' _63 - iirecti,)ns around 'Qp.r:F' :D .. leach pit M e t ion j;6• ♦� V -'S O O.Z �a�4, %i.,.'GI -' 1A� . rp'�•t��a�r Via.:.' �: . _.. _ y s EXrsrin�y. : Lot 38 p� FaE, of �Er,b � FauA/UATIOAI 42,9$$ S.F. 0 y 4 IZ'7 Lot 39: Lot 40 SCALE 111- ;OI• Iyi os;_ DATE 6-20-84 Rev., " 4/11/$5 N — N G s r o, o I . x 4' A„— ',01 JJ PROFILE : i „✓/3• sra� , ; • I I NO SCALE 16.7 i •;i, • �•, I SKETCH FLAN OF LAND IN MARSTONS MILLS,N,A. for J JAM S BURLIATGAI•E Being lot 3$ •as shown on a plan for Holly ! Realty Trust by Charles N. Savery Inc. , dated March 24,1970 and recorded plan book '239. pa-e 137. CD Elevations shown are in feet above an assu:iied datum.. -------------------------------------------=---- ':i;'..: date Agent : Barnstable Boarci of Health 1 4' SOIL LOG:.P-3045 All Cape Lngineerin DATE,' 3=.7-$4 P. 0. Box 1533 }L f WIT.. J:Jacobi Hyannis, MA. - I Tel. : ?7s -00 No' water Encountered 5$ Test Pits Z�'7 2 24 G TOP `� ` ' `' zz•� I CEkTIFY i -iA'i• 'i"1-II- NL.AN ,C.'HOW:': ccAy r t THE ACTUAL LOCATION OF THE STRUCTURE ON THE LAND AND ' M t 4, F� M� THAT IT CONFORMS-WITH THE SAue BY-LAWS OF THE TOWN 1 S AMA ESN Of Mks �,CN OF 44 r ` FRAM( M FRANKS 6239 .7 /Z.4 . 'CONERY 'do. 0 p CONERY No. 6.513 G�Q 0�Ft Assessor's map and lot number ...... R..(......... cFTNEro Sewage Permit number ....................� ....................... SAWSTABLE, House number ................................ ........................ *AS& O 1639 00 - D OR TOWN OF BARNSTABLE BUILDING INSPECTOR ' APPLICATION FOR PERMIT TO ...eR ...... TYPE OF CONSTRUCTION .... 1i ln'� .U n__ , o;,Ql�„�� ,.. ... �.�, ®....Can'/ .f? ................................ ..................I TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location . ............................................... .. .......... ............ Proposed Use ..... .......... Zoning District ..... .................Fire District ....(.5za- 4xu., ............................................... ........................................ '_7 �` Name of Owner .:............Address ..... ....... ... ....A.......... .................... Name of Builder. Address 4x...... Name of Architect ....... ..... Add ress/,4,........... Number of Rooms ...............................Foundation ..... "A."s.. .............. . Exterior (V ....... Roofing ....0 ..4.,". ..... ........................................... ....Al Floors . .................................. .........Interior ......... 7r, ...k�... ......I....................... ....... Heating ....Eae..Yl� r..........................................................Plumbing ....A aA... ....................................... Fireplace ..... Cost x:,_IX252.........................4.............. ......... ......................Approximate Definitive Plan; Approved by Planning Board. ---------19:z Area .......................................... Diagram of ,Lot and Building with Dimensions Fee ....... ..................................... SUBJECT TO APPROVAL OF—BOARD OF HEALTH 1 . 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. .nf, 1Aj Name . .e-4, ....... .... .............. ...... ........................ Construction Supervisors License ..... .... BURLINGAME, JAMES H. A=127-26 No 27850 Permit for .... Stor ........... ............... ..... # ... Location .........107 Woqdside--;R!5. .................................... .................. .................... Owner .q ?�I.in.gArrie.............. Type of Construction .....FV.4J.nQ......................... ................................................................................. Plot ............................ Lot ................................. Permit Granted ......May....6...,....... ...... ......19 85 ........ . Date of Inspection ....................................19 Date Completed ........................................19