Loading...
HomeMy WebLinkAbout0237 GREENWOOD AVENUE T i Town of Barnstable *Permit Eo z Z?? Expires 6 mon r m iss a date- ®® ��++ Regulatory Services Fee - X-PRw 1 Thomas F.Geiler,Director APR 112013 Building Division Tom Perry,CBO, Building Commissioner .200 Main Street,Hyannis,MA 02601 TOWN OF OP www.town.bamstable.ma.us O ce: � 6 % Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ,;2$4 - 102 f ' Property Address a3-1 GIV( _nerd_ - jent�.t- -f-Narin t5 f'E M A 61(047 esidential Value of Work 1a0.coc) Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address aZ 31 C-s-i-eQtnWC)D8 AtJkrt.>,.t_ i4p i tool/T ARIA- 02-64 7 Contractor's Name _Je j�t eJ R - 1 6W - Anyydb— Telephone Number �.r�pVo�etmQh#S L.1..E. Home Improvement Contractor License#(if applicable) 1 7 U 7---, Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I-am the Homeowner have Worker's Compensation Insurance Insurance Company Name M ai^ 5E QtyyL} CA_ A-sc Aa y%CA— Q— Lt�� YN&U uU04.,jm. Workman's Comp.Policy# �� Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Ike-side #of doors 1 eplacement Windows/doors/sliders.U-Value (maximum.35)#of windows 14 ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. '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. A copy of the Home Improvement Contractors License&Construction Supervisors License is. quired. SIGNATURE: C:\Users\decollik\AppData al crosoft\Windows\ emporary Internet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doc Revised 053012 03/27/2013 02:57PM 97B4638913 JEFF 'KELLEY CONSTRUC PAGE 02/03 V Massachusetts-Department of Public Safety Board of Building Regulgions and Standards Construction Sunerri.,mr License: 276 N®R�D - Commissioner W101 at ion 02/9t3�16 GTE P, 1 �ea�aoe�lta, •• oface of Consumer AtYsirs&�E ess fitegu99tton I Ho mE wPROVEMEPtTCONFR6&ol ; 1 Registration:,s 970742 ' Type. . 'IEs0iratiotG ?&4l24 13''' LL0 ' 6CE Y HOME IAAi?� • { JEFfREY KELLEY i 276 NORTH END Bta�-ri f,i • �� .- y SAL IS MA 0195��"h�,=..�/ undersecretary =� 4 j y _. A`COR V® CERTIFICATE OF LIABILITY INSURANCE 3A2�2013"' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Sharon Iram West Newbury Insurance Agency - PHONE (976)363-5265 aCNo:(978)363-1228 322 West Main Street ADDRESS•sharon@westnewburyinsurance.net INSURERS AFFORDING COVERAGE NAIC# West Newbury MA 01985 INSURERAMain Street America Assurance 29939 INSURED INSURER B.Liberty Mutual Insurance Co Kelley Home Improvement LLC INSURERC: 276 N END BLVD INSURERD: INSURER E: SALISBURY MA 01952-2107 INSURERF: COVERAGES CERTIFICATE NUMBER-CL1332739540 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE DL R POLICY NUMBER MMIDDY EPf MM`DDI EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE ( RAN D PREMISES Ea occurrence) $ 500,000 A CLAIMS-MADE a OCCUR KPS48242 0/31/2012 0/31/2013 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE Per acei $ AUTOS dent $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION I WC STATU- X OTH- AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? N❑ NIA C2-31S-382982-012 1/1/2012 i/i/2013 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 Y DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED.IN Town Of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Rick Pinciaro/SHAR02 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS02519Mnnfi)m Tho Arnpn nama anti Innn ora ranicfararl morke of annDn Town of Barnstable *Permit# �y� p Expires 6 months from issue date �7 Regulatory Services Fee snnxsrn IX, MAM Thomas F.Geiler,Director 039. Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address ❑Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will betaken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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. A copy of the Home I rovement Contractors License&Construction Supervisors License is req ' SIGNATURE: C:\Users\decollik\AppData\LocaiNi os indows\Tempor Internet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doc Revised 053012 THE. FOLLOWING IS/ARE THE- BEST IMAGES FROM POOR QUALITY ..ORIGINAL (S) , 1 m DATA . in Customer Account Information 0 , - 19270 97517 or, OBRIEN, J WILLIAM&MARY F y T' + 237 GREENWOOD AVE 8. 38 102 HYANNI5PORT, MA 02647 31,7122 . 38+ 3.2 335 • (3+ 003 37 GREENWOOD AVENUE ! Special Conditions jNotes 3tion ad AbtjAdj PmtjCrd Interest Unpaid bal 518,781 � ,00 00 195.60 '�— 714,38 11D2j10518 L0.100 3 177.48 696.25 Utility Acct (� _ _..__... 02 j02 jl 1-d' 951 40 !._.n._.__ ��a 291.94 1,243.34 '.• Customer � I �I 05 j03 j 951.39 i _n__.__ �_- 100 00 < r— a 259 D8 w m 1,21047 FeesjPen 00 �� 15,00 ;� 00- I - 00 15.00 Name - ------- i Totals00 � --- 00 924 10 3,879.44 : ---- - ', Parcel _.-..._ _ __ Prop Code NotesjAlerts - - - Due 04111/2013 3,879,44 ` --... -_ Per Diem 1.13 BIII Dates ]AN 1 Owner; OBRIEN, J WILLIAM& AM HEC CASH 00 BIII Auditsl..'1 1 ... .. .. jPaid UV , 00 View pr irtr unpaid bill.. Bill Events APR 112013 i ' Reprint TOW F RNSTAEI._ Preferences COLLECTOR OF TAXES } Diagnostics LE3 o f 19 L�j LLA] �� Attachments f0} LE _....__.,..._.__....._. Display transaction history for the current bill, 0 �0. +�ewer rto`xncie, OC)0,/-ao w) VAX • anxxsrABLL MASS, Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section- If Using A Builder I, wi LI tct wt, (f) BO-ew ,as Owner of the subject property hereby authorize :Jja V tau (Z• Ve..(U-61 {Le t l a,. to act on my behalf, �mp�a�emQ„v►iS LI..C.. in all matters relative to work authorized by this building permit application for: a3"1 �R-eh�nd ���.2..; ��J4y►ntS-P�,-�,wl� (Address of Job) SigiGire of Owner Date C),ff)Yke✓L Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doc Revised 053012 03/27/2013 02:57RM 9784638913 J&F KELLEY CCNSTRUC PAGE 03/03 Unrestricted-Buildings of any use group which conWn less dm 35,OW cubic feed(991m)of enclosed space_ b ' failure to poam a current edition of the Massachusetts Stag BulMing Code is cam for revocation of this license. For UPS Ucasinz Information vhit: www.Mass.Gov/DPS J i z is The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street s Boston,ALL 02111 www.mass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address:_Z1 - ( P✓ a City/State/ ip: W Phone #: ' Z 1 U 5 Ar�yon employer? Check the appropria a box: Type of project(required): 1. employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I'am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.$ 9. Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof airs rep insurance required.] t c. 152, §1(4),and we have no 13.❑ Other p - ' employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: t/X C Policy#or Self-ins.Lic.#: AA Expiration Date: 10 I Job Site Address: _ 23 I �fcnnu=4 A Ve City/State/Zip: 7� 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$1,50.0.00 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 r Investigations of the DIA for insurance coverage verification. I do hereby certi er the pains an a 'es of perjury that the information provided above is true and correct. J Signature: Date: Phone#: 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- #.Other Contact Person: Phone#: T"El°�°� TOWN OF BARNSTABLE BARBSTAHLB, i "6 9 DUILDIN I SPECTOR o ynr a' /- C, / DIV APPLICATION � leq FOR PERMIT TO .................... . .................................k����..�i. 1.�............................................... TYPE OF CONSTRUCTION ® ........ ... ..................... .. . ........................ TO THE INSPECTOR OVBUILDINGS: The undersigned here applies for a permit according to the following information: Location ......'.'��.. .:... .....:..........°.. ? '1..... . .... ............................................................ Proposed Use ........ ... . ........ .. .... .................................................................................................................................... Zoning District .... ... . .. .. ....'� � ............................................Fire District ......L.. .......................................................... Name of Owner . .. ... e ............Address .... .�:.... ..... /.. Name of Builder . . .... ...... Address 1 Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..... .. ...................... . ..........................Foundation ... ....... � Exterior ... .. . .'` :lfO. V� !K !...........ROOfIn • g ............ . ...... .... ......................... ..... Floors ....Interior .... ...... . . ..... .. .... Heating UG ^ ..........................................Plumbing �" .. G Al `� / Q Fireplace ................:...............?/09 W....-e...7..........................Approximate Cost ......1...2...................................................... Difinitive Plan Approved by Planning Board --------------------------------19--------, R , Diagram of Lot and Building with Dimensions � I t hereby agree to conform to all the Rules and Regulations of t wn of Barnstable regarding the,above construction. Name / , ...................... O'Brien, William qY1 197 No Permit for add to & . remodel dwelling ............................................................................... Location ......237 ...Greenwood Avenue ................................ .............If ..................... .xf!R] isport................................. Owner ........William 0•Brien. ........................ . Type of Construction . frame I .............. . ........... ................................................................................ Plot ............................ Lot ................................ r i I Permit Granted ......DE comber..16.........19 70 s Date of Inspection .... ...e...LL ` Date Completed ......................................19 + t d PERMIT REFUSED ................................................................ 19 A� 1 ............................................................................... ► �l f ................................................................................ E ............................................. .............................. ............................ .............................................. a Approved ................ 19 1 ` ............................................................................... .................... ......................................................... 4 Sewage Permit number Xno..—tVA,:�.. Ar 'TOWN OF BARNSTABLE BUILDING 11SPECTOR TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a perm.it according to the following information: Location .......... ......... ........ ...........gle'lL .................... Name of Owner Aq,/ ..Address Z.317 Name of Builder -----------------^ --- -A66rex -------------.---~.--.------- ` .Name of Architect ..................................................................Address -------.-------------.------.. � Number of Rooms --------.-------------.Foundohun ..........................____ (. y_ Exle,io, -- —.. �`/�/�/ /�/ {,.{`--.—.--.Roofing — .��.......�/�'7-/.A/.L/_—_' _- Floors .............. ............................%------------------. Heating ---------.,-------------,—'—'Mumbing -----.--- ......................................................... /�c� =�' Fireplace '----------------_----.----'Approxim ate Co» --�.��~.,.— �^4 Definitive Plan Approved by Planning 800nJ 19--------. Area z/. — .....L'�-��� � -� 7 -0_- ~' Diagram of Lot and Building with Dimensions Fee _____ _________ � SUBJECT TO APPROVAL OF BOARD Of HEALTH � � . | ' � � | � ` � ` � � | hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. .'� ... � U �' ^� � /�/ � �O'Bri�� J.- William No2,IZ34........ Permit for ....EnCj.0,Se--Bje�e!2i�VTay ............................................................................... Location ..... 91rP9AWQ0.d..AVe...................... . ....................�ygnnisp.o.r.t ......... ................................... J. Willigtjn..Q.1Brjerj................. Owner ......... .... . . Type of Construction ....framp........................... .................................................................................. Plot ............ Lot ................................ Nov. 19 79 Permit Granted ........................................19 Date of Inspection ........................1-1........19 Date Completed ......................................19 PERMIT REFUSED ....... ............................ ......................... 19 ............................................................................... ............................................................................... ................................................................................ ............................................................................... Approved ...........................................I,..... 19 ............................................................................... .............. ........................................................... Assessor's map and lot number ..��.g.��..^...I!5.. .. 1.;1 .... �oFTHEro Sewage Permit number ......:X.......71,n.....Ane.:.. . Z BARNSTULE. i Housenumber ..:..................................................................... r raes iF °psi 039. 9� U-1 a\ TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... / OSC...... �................ TYPEOF CONSTRUCTION ..................................................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..........{��..a ....... r . �a ...... f........ .,7 /s9.✓N/5.. ...:X�.T.................... ProposedUse ........................................................................... ................................................................................................. ZoningDistrict ........................ ...............................................Fire District ............................................. ............................... Name of Owner A. .:'/... L //`�1�'�.....���`) ,'/. .!i�..Address ..Z..��'... G�.E�/!/ 0��... Nameof Builder ....................................................................Address .................................................................................... .Name of Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .....,............................... ......................................... Exterior ..................................... ........................Roofing ........ ,'// G l`�.. .......... Floors ...........................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. G� Fireplace ..:..............................................................:................Approximate Cost .......z-��. ✓"�� i.......!/....................... Definitive Plan Approved by Planning Board ________________________________19________. Area S Diagram of Lot<and Building with Dimensions Fee ......... ........... ............. SUBJECT TO APPROVAL OF BOARD OF HEALTH k _..N hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the,above construction. " Name � .. t William 21834 ....... Permit for J�AQI. $.P-..B No .. ....... , B ezeway ae.-B eezew�, ...................................................... ....... ................ Location ...237 Gree .. ................. .................PAQQ�...&V .. ................... ........... .............................................. J Owner .......... ..... ............. Type of Coni;ltruction ........f ran'"ie...................... ...................................I............................................. P Plot ........... Lot ... ...............; ............................. X 1,1 Nbv. 19 79 $4 Permit Granted .... ..................................19 Date of 114pection I.. ............)....................19 Date Completed . ............... ...................19 PERMIT REFUSED 19 ................... ................................................................................ ............)................................................................... I .............i............ i............... ............................... Approv d .......... .................. 19 ............................................................................... ...............................................................................