HomeMy WebLinkAbout1095 SERVICE ROAD NO. 152 1/3 ORA
0
OF SHE royy Town of Barnstable
Building Department
` B"M'n �'�` Brian Florence, CBQ
t639. �0
ArEp 39.E A Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Date
AMNESTY APARTMENT ELIGIBILITY VERIFICATION
Re:
After reviewing the street file of the above named property;I verify to the best of my
knowledge that the apartment was in existence before January 1, 2000. This property is
now eligible to apply for the Amnesty Program
Brian Florence, CBO
Building Commissioner
q:forms/amnestyaptverification
TO TIME DATE 6
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' W OPERATOR:
7 23-024-400 SETS 23-027-200 SETS
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TOWN OF BARNSTABLE
CERTIFICATE OF OCCUPANCY
, PARCEL ID 000�000 087 ' GEOBASE ID .
ADDRESS 1095 SERVICE ROAD PHONE (508)362-6295
WEST�BARNSTABLE, MA ZIP 02668—
ILOT 1 . BLOCK LOT SIZE
DBA DEVELOPMENT DISTRICT
PERMIT 24934 . DESCRIPTION SINGLE FAMILY DWELLING (PMT_022796)
PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY
CONTRACTORS: Department of Health, Safety
ARCHITECTS:. and Environmental Services
TOTAL FEES:
BOND
ICONSTRUCTION COSTS $.00
756 CERTIFICATE OF OCCUPANCY # s
* BARN31'ABLE, •
MASS.
I OWNER NICKULAS BUILDING, i639" A�O�
ADDRESS Fp�►l
P.0.BOX 567
WEST BARNSTABLE, MA BUILDI• DIVI. O
.BY
DATE ISSUED 08/12/1997 EXPIRATION DATE ;/
TOWN sOF' BARNSTAB E
.�" ' BUILDING PERMIT
PARCEL 10' 000 000 087 GEOBASE ID
ADDRESS ' 3' ,1095 .SERVICE ROAD PHONE (508)362-6295
WEST BARNSTABLE, MA ZIP 02668-
ILOT 1 ' BLOCK LOT SIZE
DBA DEVELOPMENT DISTRICT
''PERMIT 22796 DESCRIPTION NEW 3 BEDROOM SINGLE FAMILY HOUSE
PERMIT TYPE BUILD TITLE NEW RESIDENTIAL BLDG PMT
CONTRACTORS: NICKULAS. BUILDING CO. r Department of Health,,Safety
ARCHITECTS':-, and Environmental Services
TOTAL' FEES: $31,2.70
;BOND ' 00 t
CONSTRUCT-IOM-COSTS - $100:.,870.00
101 SINGLE FAM' BOMB=DETACHED I-_'_._. PRIVATE PBARNIFDOM
MASS.
OWNER NICKULAS BUILDli.NG, n`` i639.
ADDRESS ;wil
P.0.BOX 597
WEST,.,BA ASTABLE - ;CIA BUILD aBY
7-` TE I SSUEE�05/01/k99'7�F. EXPI:EATION
• A '� I
THIS P _'> E ,f, LY.EN-
AROY T 1' P OVR� APPROVED ` ET OR
PERM _OVrN OF �� - P TOWN OF- BARNISTA13LE FTHIS
MI U �.�- [DVIIRING
F _LBINQpSTEL_ `l GAS p BUILDING, ATE
p. � WHERE': ❑ PLUMBING ❑ �fo OR
�� -
� IRED SUCH
`_;r�•1'1 �'�
H-
3. I L FINAL INSP /Z-
4.F
BUILDING INSPECT ON APPROVALS PLUMBING INSPECTION-APPROVALS ELECTRICAL INSPECTION APPROVALS
p
w
o
3 1 HATING INSPECT10111 APPROVALS ENGINEERING DEPARTMENT
2 OARD OF HEAL X- a-
l
OTHER: �)Oa rwt9 SITE 011AN.REVIEW APPROVAL
WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS
THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY
VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA-
TION. NOTED ABOVE. TION.
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IBUI . L. DING
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PERMIT
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000 -000 08�
I Dept. (3rd floor) a Parcel Permit# 7-1�
;. .
House# Date Issued
Board of Health(3rd floor)(8:15 -9:30/1:00- 4:30) Fee �� /o?, 10
Conservation Office(4th floor)(8:30- 9:30/1:00-2:00 . , �,
PlanningDept. 1st floor/School Admin. Bldg.) 0, JvxlCS�
P ( g)
Definitive Plan Approved by Planning Board _ u 14 19
TOWN OF BARNSTABLIE
Building Permit Ap lication
S
Project Street Address 'tz AA y 1'� Z a I p
Village
Owner A. - Address _7
Telephone two ^? G 7 9��—
Permit Request
" , ,
2�
First Floor CI square feet Second Floor square feet
Construction Type 41 O.%k a
Estimated Project Cost A=03M /oo, Flo
Zoning District Flood Plain /(� Water Protection
Lot Size `�—lf ro r9 in Grandfathered ❑Yes ❑No
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 Xull ❑Crawl Xalkout ❑Other
Basement Finished Area(sq.ft.) .� Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing New
Half: Existing New
No. of Bedrooms: Existing New _ G,
Total Room Count(not including baths): Existing New 7 First Floor Room Count
Heat Type and Fuel:XG'-as ❑Oil ❑Electric ❑Other
Central Air ❑Yes �kNo Fireplaces: Existing New Existing wood/coal stove ❑Yes/ o
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
one ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes � 10 If yes, site plan review#
Current Use Proposed Use
Builder Information
Name za Telephone Number
Address License
Home Improvement Contractor# SIC �t�hc
i
Worker's Compensation# .5ee Q�
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RE ULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE 'L
BUILDING PERMIT DEN fED FOR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO. t �.
ADDRESS VILLAGE - � -
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
e
v
PLUMBING: ROUGH FINAL "
GAS:,-'o ROUGH FINAL ' --
FINAL N,D-,jq [� t
s P
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OAT CLOSED OLJ r
ASSOCIATION PLAN,r4b '�' '
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``N OF Mqs� C6,eT/G/E!J F641A10gT/ON /Q19V
god JOHN
g P.
C-3 OOYLE,III
N0.33589 " ffICKlJLf/S BU/LD/NG CO .
�q 9FC/ ERE Q- Lo T ONE SE.eV/CF R04.6
SURV�y�
B<1RtiCsTfl BLE, MA.
BOX 59S !�/F.gLMDU7h; M54.
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a- Department of lndiistria' lAcchlents
Office 011flyestly.711017S
6110 Ilushin-ton Street
Boston, Afas.v. 02111
Workers' Compensation Insurance Affidavit
pliiiie PRINT;iaiJG1j_____`�__'_
namen
10 ation* C
A
0hone#
CHN,
am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity
I am an employer providing workers' compensation for my employees working on this job.
company name-
.1
phone
insurance co, # 6
general contractor omeowner(circle one) and have hired the contractors listed below who have
the compensation
t
following workers comjS�ensMation contractor
company name—
address:
ci 11hone -Z z 01
in urprice co. policy N
_T7 Tn
• coiiininv rinme:
iddress-
Ill
citN*: phone N: 12
1
insurince co,
'Attach additi6nal'slicit'if "eC_C3_3-L_rY___�__
Volicy IL1
Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the impositio
n of criminal penalties of a fine up to 51.500.00 and/or
unc%cars'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of 5100.00 a day against me. I understand that a
copy of this statcniciii may be forwarded in the office or Investigations of the DIA for coverage verification.
I do hereby certify under the pains a liahies of perjury thp-the ipformation provided above is true and co/ect.
'N Sienature Date Z
Print name �c _ 1_J_ Phone#
official use only -n official
do not write in this area to be completed by city or to"
permitAicense riBuilding Department
city or town:
oLicensing Board
0 check if immediate response is required CIScicctmen's Office
U .. olicalth Department
-contact person-.
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