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HomeMy WebLinkAbout0039 TOWER HILL ROAD (14) �3 � ��.ve�c- l-� � I I �'ot, �� . ..._ . ..A,... ..�,..�� . .... ..-.m�,..a. . . ,..,.---� i 3 + , �� i - - �_ i I I� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map - Parcel.. � Permit# �2_ 153. ,. . - TOW11 OF EARNS TABLE Health Division h' Date Issued Z Conservation Divisioncpk ��' ;�j-j-8_- Nn 2AIJ cation Fee Tax Collector O I l.- p� Permit Fee Treasurer — �. _..Lji v'iSIO Planning Dept. r , Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 3 9 Villages fr2 U ! L C E Owner U �L 0.9,V 5,5U14- y"Address3 /OG� IZ ecl V Telephone OC.A3 4 a ze,_ Permit Request 2 c 'i� ow � Square feet: 1st floor: existing _pro osed 2nd floor: existing proposed Total new Zoning Distric0_(�, _ Flood Plain Groundwater Overlay © Project Valuatio Construction Type �J Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new 2 Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Z Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# Current Use Proposed Use '-E UILDER INFORMATION Name 5 �. /` 040 Telephone Number( . Da Add"re, s (` License# �rJ A,/ 2j21,nLS Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO � . SIGNATURE DATE / t FOR OFFICIAL USE ONLY PERMIT NO. � DATE-ISSUED a e, i MAP/PARCEL NO. ADDRESS'` "' VILLAGE OWNER _ DATE OF INSPECTION FOUNDATION 1. FRAME i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. s The Commonwealth of Massachusetts f Department of Industrial Accidents office oflnsestigations . Washington Street Boston,Mass. 02111 Workers Compensation Insurance Affidavit i O I '" name: r location 1 City hone# MEL fa am a homeowner performing all work myself. am a sole r netor and have no one=122%AM in an ca achy /% � ////%%/%/%/%%/%%%%/%%//G%%%/%%//%/%%%O��%�%%�%%/%�%�%/%/�/G%/�%%%%/ m an em to r providing workers' compensation for my employees working:on this job. :rom 'sn n m .......... dNINE aL am a sole proprietor, general contractor, or homeowner(circle one and have hired the contractors listed below who have nsatlo n ohces: come thefollowin workers P P..... g.........................:.:::.::.:::::::::::::.::::.:.::: :.::.::::..::::::..:::::::::..:................................................. tc� ``. 'am 01 .... ............. ................................:.:.�.�::......................:::::::::;::.;;.; y� ..:.Jj.�:.�:::::::::::::::.�::::::::.:�:::v:::i:?ii•:vii:�::::?r�:�iiiiii)i:ti�:!.i::i:•:i�ii:vti: :<r;;,>::<:«;::>;::;»>:;;::>:::<;;:::.::.;:.,.;:;.;::;.:::.;;;::<.;:.;:.;:.;:::::.::::::::::::::::::::::.:::::::::.::... /�.iy�Jj... c ah ::::? >::::::::>::>:::::>:;::?<::>::»::>::::>:>::>:<:<:.:><::»;:::::...... .. . .............. ....... .......... .................. 'NMI 1 addr -: ...eh: : : : ... :'E<" �i. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a the up to$1400.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that s copy of this s tatement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify under the pains and p alties o perjury that the information provided above is true correct. signature Date Print name /� esz t Phone# 6 g 7 official use only do not write in this area to be completed by.,cityo r town official ^. permit/license# city or town: ❑Building Department +r=� ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (devised 9195 PJA) 1 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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 section 25 also states that every state or local licensing agency shall withhold the issuance or'Yenewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance*ith the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required.to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of die 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 affidavits may be rerurened the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. _ The Department's address,telephone and fax number: The Commonwealth Of Massachusetts ..Department of Industrial Accidents Dince OI InvestIgau011s 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 °F`VE A Town of Barnstable Regulatory Services BA 'STAB Thomas F.Geiler,Director 9 Mass. �pr 039, A`0 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 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: ��C Estimated Cost ey000. 0 Address of Work: 3 c7 ZD cu 6-72 Owner's Name: Vl/ S (10Z,66 S Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied El 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. i SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as a agent of the owner: � 3v 7 Date Contractor Name Registration No. OR Date Owner's Name Q:fbr ms:homeaffidav �I 1 � 1 i - , 71 i w J01ejjs1u1wpy L09ZO VIN 'SINNVAH 1S ON1NdS SCI• J � Ria13 S SVVYOHI 6Z09Z :ou SVE690 S-a3oa4wnN ��QQ asuaal UOSIAU3df1S Nouo 12ilSN = l SNOIlY°1f1J321 ONIU91117,113 d0 U111\1013 Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Can,tractor Registration Home Improvement Registration: 123067 Type: DBA Expiration: 12/02/2002 THOMAS EDLDRIDGE CONSTRUCTIOON=N THOMAS ELDRIDGE y.. . :.,r 138 SPRING ST. HYANNIS, MA 02601 Update Address and return card.Mark reason for change Address ❑ Renewal Employment Lost Card - ---- ,per �/ze �omvinovzcueall/ a�✓�aaaac/auaella �-\ Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Regisj Board of BuildingRegulations and Standards tration123067 __ __ g z Expiratipn 12/02/2002 One Ashburton Place Rm 1301 }.. •.:, 'J Boston,Ma.02108 •:Tiype.;_,INDIVIDUAL� THOMAS EDLDRID,GECONSTRU THOMAS ELDRIDGE _'; 138 SPRING ST: "� HYANNIS,MA 02601 Administrator Not valid without sienature ■ ■MINE ■ONE■■■■S■■ ■■■ EEE ME■■E■i■■■■■■■■■mo■ ESE ■■ ■■MEN■■■■■■■■ ■ MEMO ME ■MBEs ■■■■E■■E■M■ME M MEN ME MEN ME Er ME OEM ■■■■MEN ■■■�®■■■FEE _ � ■■■■MEMO■■■■mom ■ 5 ■ ■■■■■■■■■■■■■■■■ r MEMIMMEN No ME ■■■■■■■■■®■■ ■ MEMEMME No MMEMEMEMME ■■■■■■■■■iE - MINE �■ EM■■■■®■■EEE:.._ ■■■■■ n ■ EM■■■■E■E■ii it E iiE ■■ so 0 No 0 OEM No ME MENNOMMEMEME 0 MEEMMEMMEM MEMEMEME No MENEM MOEN ®®■SEEM■ , I SMEMO E il> liE MINE■ EMOM ■I�I�E ■1E ,� EEEE '''"' E1 ■1■11E ■ ■SIB iMEN No No SENSE IMMENSE MENNEEEME.E■ NEONiiEME■EMINME■E■EME�■E ■FINE■ME■ ■■■■■■■■■■■■■■r■m■ m NOTE:not all symbols will appear on a map / GOLF COURSE FAIRWAY 43 . 2 fY .' EDGE OF DECIDUOUS TREES EDGE OF BRUSH ORCHARD OR NURSERY 1 `',77 v--V EDGE OF CONIFEROUS TREES t � --•` ,... MARSH AREA + / EDGE OF WATER ! � -- p DIRT ROAD DRIVEWAY \ / a 2 �—PARKING LOT 43 , 6 / I �PAVED ROAD / \ - DRAINAGE DITCH i ----- PATH/TRAIL PARCEL LINE MAP Ito -< --MAP# 21 -c PARCEL NUMBER #1860 —HOUSE NUMBER 2 FOOT CONTOUR LINE L� 4 3 . 8 ----- ►® 10 FOOT CONTOUR TINE ' --' '• Elevation based on NGVD29 4.9 SPOT ELEVATION 43 STONE WALL ---- --- ---- -- ----------��--...—._.—.__. �� -X—X- FENCE RETAINING WALL -1 t 1-f- RAIL ROAD TRACK STONE JETTY SWIMMING POOL ' > > PORCH/DECK i ] 0 BUILDING/STRUCTURE c DOCK/PIER ' HYDRANT 80 � � i •. ------.--.- •• E) VALVE O MANHOLE _a 01 0 n - o POST O�' FLAG POLE T O- W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M S U N I T 0 SIGN ® STORM DRAIN 1 N PRINTED SCAIE:IN FEET *NOTE:This mop is an enlargement of o **NOTE:The parcel lines are only graphic representation DATA SOURCES:Planimetrics(man-made features)were interpreted from 1995 aerial photographs by The James ❑ TOWER 1°=100'scale map and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0 UTILITY POLE w ` 0 20 40 National Mop Accuracy Standards at this do not represent actual relationshi to h ical objects Cor oration. Planimetrics,topography,and vegetation were map ad to meet Nation!Map Accuracy Standards fAdgn\conservation.dgn 06/14/02 04:22:20 PM i P�O�tME f�'Y The Town of Barnstable RARN.gl;.- .0 NPASS. ' Department of Health Safety and Environmental Services 9 t63q. �0 prFo Mai wilding Division 367 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 IT PLAN REVIEW Owner: `� ' ' � � P, Map/Parcel: o Z ' Project Address: 09 -'M ILL( LL4_ Builder: The following items were noted on reviewing: U • f� Lcs- i3 C-i2 6Y-� DOT l?a•kv 0 t51NJ 0 17 S� _tom 0 ,, ��p�oV-Telo �- " M1 Reviewed by: " Y Date: q:buildinglormsxeview V_. - -