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HomeMy WebLinkAbout0043 GREENBRIER LANE A LVI= �» = ; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 79 " d 0 Permit# Health Division Date Issued 1. 0-- Conservation Division Fee ' �� o Tax r II t `�� U Co ec or Treasurer ' 1 c)) t Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis ,Project Street Address 7; f env �r i e a . Village o Owner Address Telephone _Permit Requestr,� Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation �' Zoning District Flood Plain Groundwater Overlay Construction Type coo Lot Size J 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: 0 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 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❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use /� BUILD R INFORMATION Name �� c �o /// Telephone Number %S —%e)- V Address /i e � � License# Al, A..)/ 5 � /�o2�n I Home Improvement Contractor# 3 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 4 SIGNATURE DATE F FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUEDf MAP/PARCEL NO. ADDRESS, i�*,`��a, I VILLAGE ` OWNER '' r s DATE OF INSPECTION FOUNDATION FRAME INSULATION FIREPLACE _ ELECTRICAL: ROUGH FINAL '} PLUMBING: ROUGH FINAL F GAS: ROUGH FINAL FINAL BUILDING x; i DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office oj/fiffiestigatieos r 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: location: 7 / � cityhone# ZY 6 G c ❑ I a homeowner performing all work myself. I am a sole r rietor and have no one workin in ca acity I am an em to er rounding workers' compensation for my employees working on this job.O ......P Y P: com an name: n dress:. r> ;::>:.:..,. X. cites phony#: insurance co. o IM: : ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation.:.p..oi:c.::e:.s:::: . : .... :. :. .......... . . : : :: : : com an ;name: . .. :..... address:: v ,one.#r�` dtv .....................................:. .......................................:..........................,................................... ............................................................................................................................................................. .. : .>: c as :rouse ,. adtli ess. e#: .:..::.: ....... tiara - <> to�nrance co.:: Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine uP to$1,500.00 and/or one years'Imprisonment as welt as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under,$t0e'PqiW and penalties of perjury that the in ation provided above is true and correct j Date �Q// 41e Signature (' Print name � � ✓� Phone# 7?S'—Ze O official use only do not write in this area to be completed by city or town official city or town: perndt/license# ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office [-]Health Department contact person: phone#; - ❑Other (revised 9/95 PIA) 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 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 an names,address and hone numbers along with a certificate of insurance as all affidavits maybe suPP1Y�g company p submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and G`y 4 V 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 munber 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 peimit/license number which will be used as a reference number. The affidavits may be reruriE 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 fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents oince of Investloatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 of tHE rqy� BAMSTABM The Town of Barnstable - v� 1659. �, Regulatory Services Thomas F. Geiler, Director Building Division Ralph Crossen, Building Commissioner 367 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 thanfour dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other 1 requirements. ov Type of Work: / w Estimated Cost C;2,�Fn0 Address of Work: �J �r°e CA�, e✓C �j c;A-",C. Owner's Name: /z b� A /G Date of Application: /, h l i ,Ago oe) I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law E]Job Under$1,000 []Building not owner-occupied []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 hereby apply for a permit as the agent of the owner: 115Zo60 /9 9 Date Contractor a Registration No. OR Date Owner's Name g1orms:Affidav INhOVENENTAOIRR CTOM aPitoi�` /1742OU1 ON A S NOFIEL ON MAIN. b .LNQFia s - ��tt`�ANPSMINE 9VE t��� :. 4 j 1 J ' TOWN OF-BARNSTABLE �i842 Permit No.' t �n ;Bmlduigv-Inspector , Cash OCCUPANCY PERMIT -- - Bond - - ` "No building structure-'shall be'erected, and�no land, building or structure shall be . -_ used-fof a-new, different, changed, .or: enlargedl use witliout -a;Building. Permit"therefor _ -first having been obtained'from the Building:Inspector. No building shall-be occupied until a certificate of occupancy has been issued by-the�Building Inspector.', Issued to. . Greenbrier Dev: CorpY AadreS Bo�-51( Centerville, MA ]:ot tifl 43 Greenbrier ane, hest Hyannisport . wiring Inspector C » Inspection date Plumbing Inspecror �s� �l . a , Inspection!date f -C Gas Inspector `1 tlt� � 2f :.F Inspection date'7a3 +i Cr Engineering Department 'j si> [} 'mot ••flFr i% 7 btion date ` THIS-PERMIT_ WILL NOT BE';oALD)„ 'AND'sTHE BUILDING SHALL NOT. BE OCCUPIED UNTIL -SIGNED BY THE•BUILDING,INSPECTOR UPON SATISFACTORYF-COMPLIANCE WITB_'TOWN REQUIREMENTS A_ - f/ Building Inspector ` - OAK Assessor's map and, lot•number .:.. �... J .......;r5� THE �o Sewage Permit number ....... ..... 1,. DA"ST&BLE• i - House number., ................ ..... ...: ...... 'a rasa TOWN OF BARNSTABLE RUILDING 1 INSPECTOR ' P t �"/�i� 4�/ �ir��. ..... . /1f APPLICATION FOR PERMIT TO ............... .. : .....:........ TYPE OF. CONSTRUCTION �x•�a. i?1�. .i:n,y .•:��r .>>' . .......................................................... ...... ..... ... r„ 19 ....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora permit according to the following information: Location .........::f...... ....... ...................................................i✓ 1 %`',//'C�•�% �..'.11i ... .r f................. �....:�..... Proposed Use Zoning District ......,.........1`~ ' . ..:..::......................................Fire District ..< �. Y <'..!t�./.1/y�`.............. ..Name of Owner r " i/pFn�s �l ZZ, �,96C�:.. �'� � Address 75/ f;L.s4:*fC:.Jri1 T Name of Builder "....�J.� ....... ................ .: .: . � .................................. Address .:........... ................................... Nameof Architect .....................:.:.....:.................:..................Address :....................................:...............................:. Number of Rooms C :.... :....:......'...:.............Foundation . /�t7Gw� tf'/r ( Nt !'( /r} .....:........... . ............:........... r.G �r�V/l� ........Rcof`In ............/�)..//......h�....` ............................Exterior ..................r.......... ✓...... : g Floors �),q�,y9(" / ,� L. •//i f.. ...................Interior ........ a...'t,f. ...... :..... �j.........:.............:.......... Heating ........ ..!f........... r ....� ....... ........: ........Plumbing a........:::...:... ........ ...... , Fireplace ...............Approximate Cost ................c':. .......................... ..... .,;. /, •--) .� % yr. Definitive Plan Approved by Planning Board _____._ 19_!__ Area ... . f' !� Diagram of Lot and Building with ,Dimensions Fee ...... + x, 7.. .. .................. SUBJECT TO 'APPROVAL OF BOARD .OF HEALTH Koo, a/3i%71 r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. .r Name ..................... Greenbrier Development' Corp. A=268-78 -(7 ® r No.........21802Permit for ......1„1/2„story :single„family, dwelling„...„.,,,.;, Location ....43 Gree.nbrier. . . ...Lane. ........ ........ . ...... . . ...... . _ West Hyannis�ort............ Owner Greenbrier Development Corp. Type of Construction frame ............................................... ............................ K-ff Plot ............................ Lot ...... ....1�....... ......... November 5 79 Permit Granted .............«t..........................19 r Date of Inspection ...... ..........................19 Date Completed .. ................................19 PRMIT REFUSED �.............. tK ....... .................... 19 . ! /............... ..................................... 0 ..... _ ,.... ._ {� . ....................................... .. ....... ........ .... ............... V ,Approved ................................................ 19 ........ .................... ...................................... .. ..... ..... .................... ......................................................... �� sses is ok J3/` 7 map and lot numbL-7 1. ..p... .GP........ fl C — �oFTHETo� � o 4 Q Sewage, Permit number ....... G .... SEPTIC SYSTEM MUST 2 INSTALLED IN COMPLIAN 33m9TODLE, House number ..............................13.................................... 9 Mae& WITH TITLE 5 �0�01 6w3ar9• R MEMAL C05 AN - TOWN OF BAR 0IONS ' BUILDING INSPECTOR r . APPLICATION FOR PERMIT TO � . •�lyl� TYPE OF CONSTRUCTION ................ ..............................................'%°........................... ............. ..........:` ° ................19 TO THE INSPECTOR.OF BUILDINGS: The undersigned hereby applies for a permit according to the following in rmation: Location ....... ( �......... .E �'' '.... .:. °S/...�.17 ��tL��� l � , �� Proposed Use ........ r ............................................................................................................................................ .... . . Zoning District . ......Fire District r....�`.�.................................................. s�Name of Owner �: '�" ��� ...I�.u�`.. `�lP ...:....Address .....1! .: ................. Nameof Builder ...... ...................................... ......... ...... �<. .................................................. -------- � .Name of Architect ............... .............................................Address .................................................................................... Number of Rooms ..........:. /...................................................Foundation .. �S � �✓ �.... ........ ........ ........................................... ........Roofing .......Exterior .......L.. ... . ... .................................... ,t., ...1.1. ............:......... /I !✓ Floors � .... �.� .............................Interior ....... i/1�. ''..... .. .................................. Heating 1....../!.�`'.... ...........................................Plumbing ....... �lr .... v..4 .......................,. . Fireplace Approximate Cost -........................................................................... ................... y 9 -yam ------1 9�__/___. Definitive Plan Approved b Planning Board __�`©__!�_________ __ Area ......................... Diagram of Lot and Building with Dimensions Fee ... .of ......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I . I hereby agree to conform to all the Rules and Regulations of the Tow of-Barnstable regarding the above construction. Name ...... ... .... ... .... ... ........... ......... Greenbrier Development Corp. W .......21.802 Permit for .....1„1/2 story...... . e . sing]e..faota.�Y..�IWe ?� g....................... ; i ` 43 Greenbrier Lane Location ................................................................. :................We ..HY•annisport..`........:............ reenbrier Develo ment Corp. 4+ Owner ........ ................................. .P...... -44 ............. 9 1 r _ Type of Construction `.................frame.............. '� � I` •- • ............................ ......... ................................... . - ��10 ' Plot ......................... . Lot ................................ ' Permit Granted November 5 �, ` 79 ( " ' Date of Inspection .............. ..19 Date Completed ......................................19 A {' PERMIT REFUSED' .......... . 1. y _ F ....................... ....... ............................................................ f F S e �. ........ . ............................................................ T� •�.� A� F� S � t Approved ................................................ 19 { t ............................................................................. .................... ............................ E }'