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HomeMy WebLinkAbout0103 FIFTH AVENUE (HYANNIS) Ave. x of ram, Town of Barnstable *Permit# 00016 Expires 6 mniiths.from issue date egulatory Services Fee BAD ESQ PER 9 MASS. 0K v s6gq. Thomas F. Geller,Director. FGM !/ �ti0 A� APR 2 3 2000 ]Building Division TOWN OF SARN STAG h- Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 w1n-Ar.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red t Press Imprint Map/parcel Numbere� Property Address 3 F�Fv\A P�U UJ EST k Y4 N v 1S?d h T rn f\, b (o l a Residential Value of Work�aq 0 O , COO Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �j 1`� /��^?SV S ?/= I C q L is /03 F' IET>-1 AVE L E51 HYap"lSP6,Q7 Contractor's Name N-�AT 1kN J i Y L E R / Telephone Number 52 9_ -7 75'7 2 55 Home Improvement Contractor License#(if applicable) Construction Supendsor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner t� I have Worker's Compensation Insurance IF Insurance Company Name 1}V L Workman's Comp.Policy# P 0 c)Lb Cope of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will betaken to / U t-j;U O' 1 112 t-)S T A E-_�LC ❑Re-roof(not stripping. Going over ng la<Prs cf rcci; ❑ Re-side ❑ Replacement Windows/doors/sliders.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. c p f e ome Improvement Contractors License is required. SIGNATURE: C:\Users\decollik\Ap D kLocal\Microsoft\Windows\Temporary Internet Files\Content.Outlook\MY7NB4IL\EXPRESS.doc Revised 100608 BnBxsrnBLF- ,� Town of Barnstable Regulatory Services Thomas F. Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I,"h oLu n Sp e 1 dei' as Owner of the subject property hereby authorize :y6 y\oMr a�) to act on my behalf, in all matters relative to work authorized by this building_permit application for: iO3 E4 Ahf, West Nyarm�mc m� oa��a (Address of Job) �I 1 a31og Signature of Owner Date �n r f Print Name If Property Owner is applying for-pumit,please complete the Homeowners License Exemption Form on the reverse side C:\Users\decol&-\AppData\Local\Microsoft\wnidows\Temporary Intemet Files\Content.Outlook\MY7NB4IL\EXPRESS.doc Revised 100608 ,1 The Commonwealth of Massachusetts Department of Industrial.Accidents Office ofInvestigations 600 Washington Street Boston, MA 02111 g www.mass:gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information t'Please Print Legibly Name(Business/Orsanization/Individual): J O A-Tq V ', Address YA) X VoLm CTr City/State/Zip: M1h AnJ1_5 /n 19. OQ�O f Phone 9: �o y Are you an employer?Check-the:appropriate boa: Type of project(required): 1.❑ 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 2.41 am a sole proprietor or partner- listed on the attached sheet. $ 7. '❑Remodeling 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 required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.] t employees. [No.workers' comp.insurance required.] 13.❑-Other *Any applicantthat checks box#1 must also fill out the section below showing their workers'compensation policy information. 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 their workers comp.policy information. I am an employer that is providing workers'compensation insurance for mJ employees. Below is the policy and job 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 year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for ins�ance coverage verification. - I do her by c fy u i tallies of perjury that the information provided above is true and correct Si ture: Date: L/ Phone#: SC �` �j(0 7 ��?S 7 Official use only. Do not write in this area,to be completed by city or town official. City-or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: .._.......... ---. t3 41114WVctfi(yitv"� License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR ( before the expiration date. If found return to: Registrati$.r 106627 i` Board of Building Regulations and Standards I:. One Ashburton Place m 1301 Expiratlun____7/24/2010 Tr# . 0 Boston, Ala.02108 to iy1dual [j JONATHAN M Al�I RP Jonathan Tyler I'4 67 Cranberry _.._..- W Hyannisport, MA� fi7 s j Administrator Not valid Without signature � `4 t� i i�aii �4 ' t GtStws luv ii a'1 5il'�r , I tii:Li6i1n§ j 00'-35,000 of enclosed space IA-Masonry only ;. LId@h§e CS 72579 , I 1G- 1 .2 F9'niily Homes ftCh 1U412010 T1=# 14112 It 1 p� j h IFailure to possess a curr ent edit on of the C, © J Massachusetts State.Building♦✓' de - 7 i is cause fdr revocation of this license. ') 1( JONA fFIAN M 2 LYNXHOLM CT` HYANNIS,MA 0260fi4 ) b Cdtiiliis`sibfifr n I A Assessor's map and lot number .... 5.` ..... `5�./' 1 ..:. 7ME .. �oF toy Sewage Permit number �� �:... �P o ............ :.. !!........1.(.,. w Z BARNSTABLE, i ;House number ......................................................................... V MU&1639. m� �e ''71r0 gay a. TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........c ....................................................... TYPE OF CONSTRUCTION .............L✓ ... :.................................................................................... ... .................19.. y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information- Location .............. . . .....................: ... .V. ... .......A✓e4 . ./../ , oV �t.. 41f......................... f. ProposedUse ......... M„!. .....�.q14.................................................................. M s Zoning District IRK .. Fire District ....................7�0........................................... ;..:: ,r Name of Owner ..!`/.�C1' .�b...I...ct.joh./..4.9.17.....................Address .......................................................................:............ _ r Name of Builder ...... k?:% a./.7.....0.L.R ......Address ......Z./....L.Z.n* .5 .Al.................:. Nameof Architect ........................7���.........................Address .................................................................................... Numberof Rooms ..................... .................:....................Foundation .......COY�C........................................................... Exierior ........ &.1p. :...................................Roofing ............ ................................................. C 4/' e ..I......................................Interior .......... Floors ................... P.. ........... cL.` .!"'. .................................... Heating ...........................................Plumbing ..............."................................................ Fireplace .................../"•. ---:.........................................Approximate Cost ..........15.. ............................1........... Definitive Plan Approved by Planning Board -------------------_-----------19________ . Area .......3�0 4 Diagram of Lot and Building with Dimensions .� Fee ....... .!. ............... SUBJECT TO APPROVAL OF BOARD OF HEALTH 3 L ------------------- a 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. Name ............ �....� :!^ ........................... ............. Construction Supervisor's License .... .......... PAPAZIAN, HAROLD A=245-93 No 26098 Permit for ..Addition ............... Single Family Dwelling ............................................................................... Location /,,�� 5th Avenue West Hyannisport ............................................................................... Owner ....Harold..Papazian........................................... ................. Type of Construction ..Frame ................................................................................ Plot ............................ Lot ................................ Permit Granted Feb.ruary`23............19 84 ...... ........ Date of Inspection ....................................19 Date Completed ......................................19 / - �� �O-Z Asses'sor's map and lot number ....ca .1�4 ....... FTNe Sewage Permit number .... ...(.. . ..::..: r 11 BAWSTADLE, i 7House number .................................................a.........:,......::... V Ulan �e 0� :A TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....."..:C !� ✓ 7 ... .. .� f�.U?')....................................................... TYPE OF CONSTRUCTION ........................ ...... ...��:..-::......................................................................... ........ ...FAel.........................19..8,� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...............J�.V........................5 ........ At! ./......k!J f .../7 ....... 5 °N' f.. �f......................... ��i ProposedUse ........: i�.!/ l!.. .! ..... .�1 ............................................................................................................. Zoning District :.................� 11..7..........:................................Fire District ............. (./...................................... Nameof Owner .....................Address .................................................................................... _ e Name of Builder ...... . ..�G lr�.�l....Ql-.�?n.®?I .....Address . 7./..... ........ Name of Architect ........................: �' -. .......................Address ..........................:....................................... .................. Number of Rooms /f ...Foundation .......�qnjq............................................................ / .0is ka /r Exterior ........C .i`..... !7�!`R ��...................................Roofing ............ ...*................................................................ Floors C�?ViT. ....Interior 'UfZ `� ..................... ......... ............................... 1 - _Heating ................. .�Q.�.1 !.�...........................................Plumbing ...............Ive..................................................................... Fireplace ...................rv..{!N .- .........................................Approximate. Cost ..........Z:,Ke......�............................... ........... Definitive Plan Approved by Planning Board ________________________________19________. Area ....... .©.................. Diagram of Lot and Building with Dimensions Fee ..:... 1?l�..s5�� SUBJECT TO APPROVAL OF BOARD OF HEALTH S � 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. Name ................................... q Construction Supervisor's License ...a � �, ........... -----�- - | IAPAZZ]QN, BAIX]LD � No -26098—. Permit for ..�dditioo_____. � ' ^ Farni ' ---.~--------.—_..----------. , 5th J�xezuae--- . -- ---------------------' � ot —�-----—e—.—..~---_----------. 0wv�ar —BazxoId. ___'______ ` ' . � Type, of Construction ..Frame.......... ` . ---------------.----------` . . Plot ............................ Lot -------'--- ^ . . ' . . ^ Permit Granted - .�23,---.]V 84 ' Date of Inspection ---------.—.—lA ' . ^� Dote Completed : -- 19 �~ ' ' ' ^AP. � / � , ^ ^ ' ^ . . . . � . . . ' � . ' . . . . . - . . � , ' ' -