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HomeMy WebLinkAbout0019 HOLIDAY LANE ��l' �L :J 9y /�N€ - - T Town of Barnstable *Permit# Expires 6 months from issue date . Regulatory Services Fee Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.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 e:;;� (P77 S Property Address L/�/fr Residential Value of Work 3 %eno s`� Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Tkig S M Contractor's Name �LCt Wet'�C' C�C�/ Telephone Number ©E 3�o`- 7alC-3 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: �am a sole proprietor ® ❑ I am the Homeowner - PERMIT. ❑ I have Worker's Compensation Insurance AUG 15 2007 Insurance Company Name TOWN OF BARNSTABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) [A/Re-side . ,�. l G4 l• 1 ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) 'n ;'l r':,I g *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 7 .r ***Note:. Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. r 1 SIGNATURE: Q:Forms:expmtrg Revise061306 All ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations , ' d 600 Washington Street Boston,M,4 02111 www.mass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information c Please Print Legibly / c / t 'N / Name (Business/Organization/Individual):.�l l l'0 `1 „ �'ee ('L'('rL� Address: 1� �� 49 Z,^r City/State/Zip:� A!� &Z� O Phone.#: 5o Are you an employer? Check the appropriate box: Type of project(required):. 1.❑ I am a 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.Aam 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' #• 9. []Building addition [No workers' comp. insurance comp.insurance. 10. Electrical repairs or additions required.] S. [1 We are a corporation and its ❑ P '3.❑ officers have exercised their I am a homeowner doing all work 11.El Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no a a employees. [No workers' . •13 Other.S'1�9��/ G 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. tContractors 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. lam an employer that is providing workers'compensation insurance for my employees Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M 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 I)IA for insurance coverage verification. I do hereby ee unde7,M" e.4%r-�k enalties of perjury that the information provided above is true and correct: Signature: �` Date: Phone#: 5� Official use only. Do not write in this area,tb be completed by city or town o j tciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building(Department 3.City/Town CIerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M A T Town of Barnstable 0 Regulatory Services Thomas R.Geller,Director �ATF cb1` Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town,b arnstabie.ma.us Office: 508-862-403 8 Fax: 508-790-62.3 0 Property Owner Must Complete and Sign This Section If Using A Builder I, JkRFnn109H T AND ffA7#),,rEh( �OlL-lX-5as Owner of the subject property `! W r�P' ��Ay F� to act on my behalf, hereby authorize r�L a� � g � in all matters relative to work authorized by this Minding permit application for; . W"wPAY .t1wF, 11114 (Address ofjob) Signkare of Owner Da Print Name QF0P MS:OwNERPERMISSION �1 - -� , ✓lie �ooivrn-oouveir,�C� o��//La���ucaef�6 ;1 3 i Board of Building Regulations and Standards i HOME IMPROVEMENT CONTRACTOR ,Q Registra4ion _,100053 s Expiration 6/8/2008 Type Individual a VICTORJ.WIINIKAINEN r Victor Wimikainen 58 CAPE COD LN l BARNSTABLE,.MA 02630 Deputy Administrator' License or registration valid for individul use only before the expiration date. If found return W. { Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,Ma.02108 Not/alidthout signature ! �`+ Town of Barnstable Permit# &7 Expires 6 months fromisue date Regulatory Services Fee 7� Thomas F.Geiler,Director Building Division f Tom Perry,CBO, Building Commissioner �I 200 Main Street,Hyannis,MA 02601 V www.town.barnstable.ma.us fef 384038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - MIDENTIAL ONLY � �7 l Not Valid without Red J►Press Imprint //�� tp/parcel NumberV ` )perry Address / ( /` 4 'RZZ esidential Value of Work 7�� Minimum fee of$25.00 for work under$6000.00 vner's Name&Address .ILREA14-9 X <61.1-14/.6' Sr Cb4L,(dS �E�R77�57l��c/�' DRId�, S��5�3 IsR T�;✓�70 )ntractor's Name Yt /1C 9— IV Telephone Numbee0 a _3 C.2 77l )me Improvement Contractor License#(if applicable) ]Workman's Compensation Insurance eck am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance surance Company Name orkman's Comp.Policy# )py of Insurance Compliance Certificate must be on file. xmit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken toy4e_1414 ❑Re-roof(not stripping. Going over existing layers of roof) ❑ 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. , A copy f th H me Improvement Contractors License is required. [GNATUItE: Forms:expmtrg Mse061306 Board �az�ez!z��„p Of Building Re ` . gulations and Standa HOME IMPROVE rds ME to Registr, NTCONTRACTOR ;. EXpFra n 100053 y f, 08 2 TYAe Individual VICTOR J.WII Vic tor. Nll<AfNEN Vbiir�Wainen S8 CAP e t' E COD LN ABLE,,MA 02630 `..w _J U tY dmi P L� A ,. n - istrator Department of'lndustrial Accidents Office.of Investigations ' d 600 Washington Street Boston,MA 02111 °�M s�•� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers applicant Information Please Print Legibly ,Tame (Business/Organization/Individual): ! ► L e c � (' -address: 'ity/State/ZiP-PXA�,8,C- Z,4,0z ?-6 Phone#: 7s�6 -e you an employer?Check the-appropriate box:. Type of project(required): I am a employer with 4. Lam a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors n'l-am a sole proprietor or partner- listed on the attached sheet 1 7. ❑ Remodeling These;sub-contractors have 8....❑ Demolition ship and have no employees - - working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance._. .. 5. ❑ We area corporation and its required.] . officers have exercised their 10.[] Electrical repairs or additions I am a homeowner doing all work -right of exemption per MGL 11 Plumbing repairs or additions.❑ c._152, 1 4 , and we have no myself. [No workers'. comp. §, O 12: oofrepairs employees. t e to o workers'insurance required.] � Y � k 13.[:1 Other comp. insurance required.] ;y applicant that checks box#I must also fill out the section below showing their workers'compensation policy information: 'r )meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ntractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp.policy information. m an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site prmatlon. urance Company Name: icy#or Self-ins.Lic.#: - - E xpiration Date: Site Address: City/State/Zip: .ach a copy of the workers' compensation policy declaration page(showing.the policy number and expiration date). lure to secure coverage as required under Section 25A of MGL c::1.52 cari lead tn.the imposition of criminal penalties of a up to$1,500,.00.and/or one-year imprisonment; as well-as.-civil penalties fir the form of a STOP WORD-ORDER and a fine .ip to$250.00 a day against the violator. Be advised that a copy of this state maybe forwarded to the Office of -estigations of the DIA for insurance coverage verification. 9 hereby ce under t e pa�in�sd pen s of perjury that the information provided above is true and correct nature: Date: C. 0 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#: °F�► �°,,ti Town of Barnstable Regulatory Services 9" MASS. '8 Thomas F.Geller,Director q7 039' �0 '°lEc►�a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize yy.� f.(J.,L f „ to act on my behalf, in all matters relative to work authorized by this building permit application for: (A ess of J ) 04 i36 ignature f Owner Date c��k'E'�•�N v,Cd�<<Ns l��,�nl s. �,ci�ls Print Name Q:FORM&OWNERPERMISSION R OFINE A Town of Barnstable *Permit# O Expires 6 months from issue date • Regulatory Services Fee Rm BAsrABM v MAss. Thomas F.Geiler,Director �A s639• p�0 lEDN9 Building Division X-PRESS PERM Peter F.DiMatteo, Building Commissioner AUG 2 1 2001 367 Main Street, Hyannis,MA 02601W Office: 508-862-4038 TOWN OF BARNSTABLE Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number .3 _ Property Address //0 C. esidential Value of Work Owner's Name&Address Vs T L ` l5 23�'� �U ts' Contractor's Name��C"lC J` �--�C /+fir I B�/���' Telephone Number Home Improvement Contractor License#(if applicable) /dL9l3 -� Construction Supervisor's License#(if applicable) ( ' ❑Workman's Compensation Insurance gck one: am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Co Workman's Co Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify).4 U �01<( i + ere requved: Issuance of this permit dos not exe pt complrance with of er town depa ent regu at ns, .e.Historic,Conservation,etc. Signature Q:Forms:expmtrg:rev-070601 i v .. .. �\ ✓i4e oetu�ea`QE o�✓`+asuscvYt�e!!s i C NONE INPROVERIMT CONTRACTOR a Registration: 100053 ` Expiration: 06/08/2002 TrPe: Individual 3 VICTOR J. VIINIKAIMEN Victor Iiioikainen ;! ��CAPE COD LN ADMINISTRATOR t BARNSTABLE MA 02630 Jh. _ ^��,✓1e�e{po�ca�tsoea� �✓�.aaaac�iude� ,r BOARD OF BUILDING REGULATIONS License::CONSTRUCTION SUPERVISOR f Number ES3 000998 T 13141i ate:09/29/1940 Expmes 09/29/2001 Tr.no: 4330 --- Restricted To: 00 VICTOR J WIINIKAINEN- PO BOX 69 W BARNSTABLE, MA 02668 Administrator gg ti Assessor's map and lot number ............................................. . -7 �7/r/ -rNE Sewage Permit number ... ................................ BARNSTABLE, House number .......re.............................................................. MAG& 2639 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ................................. ..............................�ts .........I......I..................................... TYPE OF CONSTRUCTION ..........( I./— ............................................................................. .............................. ......197? TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information a4-2 Location ...7-;. ....... C................... ... ProposedUse ... ....... ...9� ................................................................ Zoning District ........Rti. ......................................................Fire District ......//Y- .................................................................... Name of Owner .........Address A.t.�!Ili�n2... Name of Builder ...filn )Se.. ........Address ........... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..................................................................Foundation' s Exterior ...........................................................Roofing y..... ............I....................... 4-_ Floors .....................................................................Interior ... ...................................................... ---- / J Heating )46 Plumbing ..... ................ ................ ............................................................................. Fireplace ......... ..................................Approximate Cost .... ...................................................... Definitive Plan Approved by Planning Board --------------------------------19--------- Area .......�.r-�.............................. Diagram of Lot and Building with Dimensions Fee ..........Z-- ................. . .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH Ali I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ................. .................................................. Nelson, WillLao ` &=267~183 � No 2—I235Ponnit for . 1/2..§ULqPY....... ..............oiogIe.. . _____. Location ...... —..I4. ................. __------.--..�qqt.. ---' w� � Owner ................��l1���..����Cv�................... � � Type of Construction ---..J�.aoue.................... � .. -- -----. Permit Granted Date of —`-_-� . � ~~'~ ~~ ^r~ ' � . � . � PERMIT R-FUSED ' ----' � .......... . .. ' — ' ` .� . — --. --���� « --'^~' | Appro 19 --------'-------'~---^-----'' ................ —........................................................... � � �C �/� sessor's map and lot num r ....................... l,3—��yOSTRE ro Sewage Permit number ...........41 z:................................. SEPTIC SYSTEM N119ST B� d p IN COMPLIANC = BABa9TABLE, i House number .....:: .............._ � Mb a WITH A„TIke"LE II STATE 39 S \e AN —'Y CODE AND TOM '°�awar r, TOWN OF BARNS., BUILDING -.INSPECTOR APPLICATION FOR PERMIT TO ..................... ......................................... a. ,.n..,.^...........................: TYPE OF CONSTRUCTION / / (..... ................................................................... .............................:.M3......19 777- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information, f � ,[.,� / Location .......Q.................. .......f..l...b.1. ..��...:.C`... ..4r......... ....... ... .................. ................................. ... ProposedUse ...`�.�.. .�� `'Q ... r'-'..�/.... .... . ..:...:. dl................................................................ Zoning District ........ �..............................................:.......Fire District .....�`.Y Name of Owner "v.!..dI.'./.'7"?'�... L�..1.Sb. Address Name of Builder .f/.!611M.�Y.....!�!�/!5�.:�......Address �'1.�.L..'Y�'.?�..��......�.�.5!�.�?�.J/.../..// ! i of ff Nameof Architect ..................................................................Address. .................................................................................... Number of Rooms ..................................................................Foundation Z" o.. , �. .� .... ......... ....... ........... Exterior C .C� �? ...................................:................:......Roofing s : �.. ..........`.l..I.......L p. l'es .................. / C.`� J' ......Interior ...` O C Floors ............ .. ... ........................................................... e.�........... ........ ............................:............... Heating.'!. "...:�v .ems- .....Plumbing / .......................................................... Fireplace ......... .....................................................................Approximate Cost ...��!' do..®............................... !� .... . , '.. Definitive Plan Approved by Planning Board ________________________________19_______. Area ... . ..- ...s.................. Diagram of Lot and Building with Dimensions Fe ..............1...'�...... ....... SUBJECT TO APPROVAL OF BOARD OF HEALTH 1P' Y 1� y I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .....: /- ' ?. .,�.... ................................... � Nelson, William 21235 I I/2 story No ................... Permit for .................................... I9� � single family dwelling -----------.—~'----.--.----.. lg Holiday Lane ` Location .......a°.................................................. — West . t_____. .—.--.—'. �----- ..-------.. ` . . William Nelson - Owner -------_.^--___________ ' . frame Type of Construction .......................................... ' ~ ' ..�----.---~------------:----. � #3 � ` Plot ............................ Lot ................................ ^ ' r ' April 25 79 Permit Granted ----...--------.lP ' Date of Inspection ----.� —.'l9 . � ^ Dote Completed -----� ';�z—..lq8 �� ' . � - - . PERMIT REFUSED // . . � ____,,____------.. lA ' ' - - ' ~ - --.-----------------. .------ —.---.---.----.-------------.. ..—l------''�—~---^---'—'—''--^'' . . .. --.----..---..—...—.—.�.~----- —.. �. - - . ~ ^ ' ' ' ^ Approve6 19 ~ ' » ''r------------^---^--^— .— ...., . , -------------.---- .. ---.. �r | l� 2I23� o o`""'e ' TOWN OF BARIVSTABLE y yPermit-No _ se B - _ ulding'3nspector • :Cash xx OCCUPANCY PERMIT Bond ``No building nor structure-shall -be erected, and no,land-, building-or structure shall be for, a new, different,",changed, 'or-enlarged' use Iwithout ,a' Buildings.Permit therefor :. first•having been obtained fiom the Building.-Tnspector:1No'*building shall be_o.ccupied until a,• ' •certificate of occupancy has: been issued 'br'.the 'Building,Inspector."•' Issued to _ ,Will lam Nelson- o ;Address � l3 Holiday Lahti a.., 6]est �Hyann�ispq Wiir'ing Inspector 1G_£/� - �Z4, CaAj-( C Inspection date Plumbing Inspector �4 Inspection date -Gas Inspector: 3N, n �. ���`7 Inspection:date r f:�Jo'r!r.�y "'Engineering Department -1 i�t � � k'- Inspection aate f ' THIS PERMIT WILL NOT BE VALID,,AND' THE-BUILDING SHALL_ NOT BE OCCUPIED UNTIL SIGNED BY; THE ".BUILDING INSPECTOR: UPON SATISFACTORY COMPLIANCE.tWITH:TOWN REQUIREMENTS__. -,. / Building Insp ctoor ^w• i> :r«v£�., 5 :. ° �- t t ,' +� + . - n F fr^rf 7'a' ;y. i t f t s„$ s ' :' + ' y ':: o Ac' .� a,t,r b .. ,r_,- w?'.w.s .1,d. t I .al t...._�: *.�.g v_.,°""�.`,.-bd�a J II ,,,�,,.:1,�I,_i�i�­1,�"_­,1..,.'-�,_.-�,.1����,,1.�.,/_,.-,­, - . j. 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