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HomeMy WebLinkAbout0039 TOWER HILL ROAD (31) Lniversal one. www.myuniversalop.com phone:W&76646I6 ULIVIGO03 MAMIMUSA .._.._...�.�..^.J.ter._..� ,-�,... ,r^'t.. /'\._.. ...• ►-. ,� ,s„�i;.., -��sAr[..:. � -._ _ ,....•...n - - -r Y � -� Q K TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel / O 2 O �/ Permit# Health Division W to( I Io 2- Date Issued G o z Conservation Division A/_! . 9/z /�� Application Fee Tax Collector c D i� —� p 710 Permit Fee (/ / oo Treasurer SEPTIC SYSTEM MUST BE INSTALLED IN COMP NCC Planning Dept. WITH TI11E 5 f, OR- ENVIRONMENTAL CO E �► Date Definitive Plan Approved by Planning Board TOWN REGUL An- ON Historic-OKH Preservation/Hyannis Project Street Address 3 /F 06cJ,5_2 I I Z Z R el Vti / t- 7 w- C_ Village 0_3 --,�7-7/e y/ L L / � Owner 0 L 4 /2 K Address / C— .3 7o U/&x Telephone Q Permit Request 2 E1140 v F �C ,�LG�cE Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuationh, O 00, o o Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. vDwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑ No Q Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other 7% Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count 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 Cl Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION / Name n Telephone Numbed` Address 13 License# G 3 Y U Home Improvement Contractor# �>. 3 �d 7 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE :2�" DATE �� • a - o aII FOR OFFICIAL USE ONLY a � PERMIT NO. DATE ISSUED MAP/PARCEL-NO. ADDRESS' VILLAGE - OWNER�� ; DATE OF INSPECTION: FOUNDATION F FRAME INSULATION FIREPLACE kp H; FINAL ` ELECTRICAL: ROUGH, �,� _ PLUMBING: ROUGHI FINAL— GAS: ROUGH r Fx FINAL FINAL BUILDING • � t c,o DATE'CLOSED OUT ASSOCIATION PLAN NO. d The Commonwealth of Massachusetts -- Department of Industrial Accidents ., Office ollnrrestigatlans _ 600 Washington Street Boston,Mass. 02111 V' Workers' Com ensation Insurance Affidavit name: location: , hone# city ❑ am a homeowner performing all work myself. , I am a sole raprietor and have no one workin in ca acity lam ' sation for my em loyees worlring on.n..:th:.:.:i.:.:s.:.r.j:.4o.:.;..bY.}.:... � Pro .$;.;,.};`;;,;,n;:Y?:t.;:;•}:,::.r,:::,;$.�.,.<�>$+•:.,;.:us.r::•}:}:;::!t:>:::;}i;:s.................. ,...:r.r.........:.:..............: ..............::.................... ..... ::..:... ... n.....,..,„:..:.,:.r::::.„.::::::.:::.::.:.:n..:.:.::;:::.Y;..>iii:.:::.::::... .: rat•::' ..;�...'!:4:•}.�:::}$!:%%-:•}k:i.yn.r.$;}:.}}-.�:.}':t:::i•iitt4:i:t+;;4:v:{t.x:::i::::.]v:................... :. a- ................. .;•SY;i:^YY::!:t•r.4:.}:}::A?;•:t:v:t:-:i:•i}::?•:Y•}:!...{•:w::n...vn•.- :::.::::.:.w:n•i}liii}JY:;;::}:{;si:•if•:::::.v::::::nv::nv::.::.............. .....................:YYY•>;i>:Y:•i}::isY:i?:•$•:$$$$':.:$$$$$i$$::$r.:;8s:::$!i::3;}::::.;:•i:::YrY:•ii}:•"::;:i ..........a r ...?:...:.,. 2 . om I,,Uri me:. ............::;...:..::.:..;.:}::.,:.:r.„.:::.::.::.�:.v.,t-:::n.:::.}}..:::n•::::.a.::.,:.::4::<::}::n!.:::.:::.,.:.}:!:.:.:�}..]::::.:4:!.:::.:::.:.•:::.a..!{...:.r:::.:.:..::.:..�<:::..,...:`..:.,••:.:.{:{.. ..}... .. .... .... .. .. .. r...:::'t..:....,w:.:..�:::.•M..r:.r:.:.�.::::.,..,.,.n:..::.i]:;:.;..}::::::::n.::4•«.:;:::;•.,.;.:{.,::.•;:r;•, .. ...... :....... ........ ......... ....................::::::::..:......,.r...............:-::n:.r.....r::....::.:...\-.,.r.:..,.::r:•.,;r:.:.:...::.,-:::•: r...:...}.. ,..,.:.r:::{.Y:;.Y:>•:.•,..,.:.:?:;•:::Y;: ..r....3.. r....... ......... � � ..:v...:..::...:...�.::.....:.:::.:::....rn`;:;:v::::.v::::::::::::.:::':::%$':$$:+:$•}$}}tit?4:^.^:•::G'.:$Y$�::v•{L:.:ti}i{{yii-fti4{?�•:?:i}:iii}ti .. .. • n•�::.M1;;..;...x.{ v::::::.v::{x::..i........:x:::n::v:'- MUM v, .}ti,J.•}: �tOII Ste{! ............ ..:::::.�::r.,...::.:.�:;::•}}i:+-i:.�:$$:J:$:`:r:;;:k<?:::'i:;;:$�;:::.:::::....... :.:.n'v:::FYc'r.•:t•:{t;•3::Y:!4:-3}::::>:�Y:�itJ:;;.>::.::?:: :: ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have thework..e..r..s....c...o.............................o.r....h.....c....e....s....:ensatio .........:.:...:...:....................:..:...:..:.....:..:..............:..:.........:....:..:.:................:...:....:.r.:.:.:.:.:....::r.::::::.:n::.:.:.:.:.:.:.:.:.:.::.:..::.:.n...:.:..:.:..:.:::.:.::.:..:'..::.ra:.:.n:.;..;: }.4:. {ri. :::• :::::n•:::::{:rnr{�;4;t•; ................v.. .:.:v::::.v:•:x:::nv::.:....:::n}}}':n:•. ... .. n•::w:::t.n:K:;dvt{:nv:::::::...:::::. •.::.n:n•.:.;xy}}:•i:^::::N:{?::::..;.;:.:....... .. ... ...........n.. n•!::...n:•n:•,:n:.:.v ....... ......::::::.:::::.v. .r w.r:C•�':.iJ:4}YJnw:.n .. ........... ........ ................ .... ......::::::................::3"i:v}YYYY]i}}::.........n:•.::..::.x.;,$,;i`:?;}r{;:$$'L:$?:{ti•4i:;j$<}r?i $Y}%;:Y`:${:i}' tom ......... ......... ....::.:......., :.....„.::.v.:.,...:::::::.�....,n.:4>}Y:::::::::::::::::::}.w:::::.-:.�::.:::•:n:.v..x,:nYf.-:::;$=':4:�J. k:< .. ....... ......, r......v n...... ..... nv:nv:................•• ....w:::::::::vx•}:•:o]y:::Yx:;:•••.v'"::.'::r•'.,•v..h.}..::•:Yx::n,:v:vr•]' :?;4Yv.•Y:.::Y]•rY^{•: ....Y...n. n...A. .:........ ......... ......... ..... ... ...............:n•v..... :.... r!•::::;:x::iv:::'n,C;{ni'•J:t4f:v.»;vn;{:.:v.\,tit]:;�}:?:�;tiJ(Li:4:;}:K:$$�\R?�::'r,:$Y.J.{n•.•.'r$Y\ n... ...rr.«..:.. r..n..r....n• ,..n..nr•• ...........: ..r........:...:•J.......n....,, ,...'L'4:;r,`:•}'}v:: ....}:nv::nv}{.:r.:•}:N:n:•$:n]v;... .r..,.:.:.:.:n}:Y:..;...:r.Y:•}YY:'Y;., ... .v::niY.t•.:,::v:n:.:................v:.. t•:t::•}y:;::n.•t::0:!?•Y:}:::{- .:xnvn r...:•n•w•.v}.4;i•;j$:Y<:4}}}:n•w;•x::„.;f{$::•i';$$$i;:i%:}LS?:::v;.. ::: .... invxn.........,., ........... ..... :..:.r.............n....•..:]:•.:Y......;r.•........ v;•..::.:............: :.+}Y;v::{;}`::t ...,.-. 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I do hereby certi the pains and penalties of perjury that the information provided above is truo and correct Sipatue Date Print name155 / offidal use only do not write in this area to be completed by city or town official permit/license# ❑Building Department dty or town: ❑Licensing Board []selectmen's Office ❑checkif immediate response is required Ogealth Department contact person: phone#; ❑Other oemed 9/95 PUO 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, constriction 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 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,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 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 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 perniit/license number which will be used as a reference number. The affidavits may bb retained to 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 faxnumber: The Commonwealth Of Massachusetts Department of Industrial Accidents amce of Iovesagatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900, ext. 406, 409 or 375 °FVE Tp Town of Barnstable Regulatory Services * saxHszns . ' Thomas F.Geiler,Director Mass. 9 1b39' °� g Building Division �AlFD MAC A 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' � O d O © � r Address of Work: a 7' / C1 Owner's Name: L A 2 C Date of Application: 2 Z Z 0 D Z-- 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. SIGNED UNDER PENALTIES OF PERJURY I reby apply for a p 't as the a ent of the owner: 11a o (-7 t Contracto ame Registration No. OR Date Owner's Name Q:forms:homeaffidav S T • S s _ I v � 19 Vc cal Pd S p s - � a ■ MEW-0�• ■ �: �� ■■■■■.■. �.■ MEN E � MME■MMM MM.■E SOME MEMEMEME .ESE■■■ ■S MMEEMO■ a� ■. ■■moss SEE■rMEMMMOMOMEMMMEME =®� SOME ON ®a� MOMMEMEMMEM ME No MEN MOMMEMMEMEM EME■■■M■MEEMEMMEN ■ EE MEMO■EEEE ■■■■■■MEMO M ONE E E M■Mm ■SEE ` EMEEMO OE■■ME MEREON SEEM 00 EEESEE �. o. E■■M■■ME■ . h _ I I t _ - - is �� $ ,ti I S � •ti � �, I � ( I � , I 1 I I I 1 I r --- - ----t---r- -t--f--,---r---r--j-t7-�--i-r--r--t --y- �__ I ( I , T ^�- I I I I I 1 ' I I I I 1 ....... 1 ' ............. - I I I I � , r -r r --t -_}- � -i--t- T �-• I I I I � I a� � 4 I � j i J I I I s ME SEEM ■ IMMENEMom I LE AAIAY !ACC ,A-1FE STANDARD LEGEND _ MA 117 N i a symbols willappear on o map -- GOLF COURSE FAIRWAY l NOTE:na t / \ ) , � � �-�����-•�-:"� EDGE OF DECIDUOUS TREES MAP \ ;� �.,,%_..........^.`�-_--•_______------�__ EDGE OF BRUSH ORCHARD OR NURSERY :._.V...._. EDGE OF CONIFEROUS TREES `° 23 MARSH AREA EDGE OF WATER DIRT ROAD \ DRIVEWAY PARKING LOT PAVED ROAD 1 DRAINAGE DITCH . 4 1 . t --_� PATH/TRAIL 1! 1 ( _� `,'•i 1 PARCEL LINE MAP I to- MAP# 4 �� 21 -< PARCEL NUMBER E---- t. -- #1860 —HOUSE NUMBER �r-,� � 1 ; 2 FOOT CONTOUR LINE _r 1 ; �} Q— � --kt�— 10 FOOT CONTOUR LINE L4 � ° [ 1 Elevation based on NGVD29 r �\ / `/4.9 SPOT ELEVATION A-� i 4 4 c�—� STONE WALL ° -X—X FENCE i ; I RETAINING WALL J ram— RAIL ROAD TRACK \ / 4 \•� 4 r STONE JETTY / 64 \ P0° SWIMMING POOL Ir '. PORCH/DECK r \`,_ i\✓� ?, IU ❑ BUILDING/STRUCTURE 4 1 _�•� r r,,N DOCK/PIER .Q� HYDRANT 1 B VALVE O MANHOLE 1 + ; 4 4 ° o POST p� 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 .o SIGN ® STORM DRAIN q PRINTED SCALE:IN FEET . *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetrirs(man-made features)were interpreted from 1995 aerial photographs by The James ❑ TOWER w *a 1"=100'wale mop and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company. Topography and vegetaton were interpreted from 1989 aerial photographs by GEOD UTILITY POLE "� 0 20 x� 40 National Map Accuracy Standards at this do not represent actual relationships to physical objects Corporation. Planimetrics,topography,and vegetation were mapped to meet National Map Accuracy Standards LIGHT POLE O ELECTRIC BOX i 1 INCH=40 FEET* enlarged scale. on the map. at a scale of V=100'. Parcel lines were digitized from FY2002 Town of Barnstable Assessor's tax maps. `,� Board of Building Regulations One Ashburton Place, Rm 1301 Boston, Mal;`��108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 06/03/1958 Number: CS 059348 - --=_== _ Expires:06/03/ 4 _`- _i Restricted To: 1G THOMAS S ELDRIDGE 138 SPRING ST w HYANNIS; MA 02601 Tr.no: 26029 Keep top for receipt and change of address notification. Clx 91te Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvemeri,'-C.- ractor Registration Registration: 123067 Type: DBA Expiration: 12/02/2002 THOMAS EDLDRIDGE CONSTRUCTI:O'N THOMAS ELDRIDGE 138 SPRING ST. M HYANNIS, MA 02601 Update Address and return card.Mark reason for change _ • ❑ dress ❑ Renewal ❑ Employment ❑ Lost Card _ � ✓`ce 'C000r�nzanwea�.� a�./�.cwoac�ivaeCla 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: Registration: 123067 Board of Building Regulations and Standards �Expiraf i'10:.,'.12/02/2002 One Ashburton Place Rm 1301 TypINDIVIDUAL Boston,Ma.02108 THOMAS EDLDRIRGE CgNSTRU' THOMAS ELDRIDGE 138 SPRING ST: � HYANNIS,MA 02601 Administrator Not valid without signature