HomeMy WebLinkAbout0040 MURRAY WAY
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' ���• TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION .•-
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Map Parcel O ;! Permit# s
Of
Health Division CX)o� � Date Issued � ar s
r111 e7
Conservation Division o ® " � 20 _ 8: t L Application Fee ��t
Tax Collector Permit Fee 3(�). 6w
,
Treasurer i?f--V 151 N,
Planning Dept. ""'i"C SYSTEM'
fA
� A
L T'Date Definitive,Plan Approved by Planning Board P D Idq COAOPLIANI
QV ITH TITLE.5
Historic-OKH Preservation/Hyannis 1," "1 " NMIbTL
NY`v�E9,R rNa-aq..
Project Street Address 40 0 y\ y
Village z-f 't S.
Owner EGA , Ac.s �n, 2, ! c&22�A Address V ALA k AC_J_�
Telephonec1,
Permit Request ��� �SGIS"�[�(s �Tc tc �
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Sbcyo- Construction Type
Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family. O Multi-Family(#units)
Age of Existing Structure .ga Historic House: ❑Yes Q'No On Old King's Highway: ❑Yes w'I�Jo
Basement Type: ❑Full ❑Crawl 0 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 0 Other
Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0 No
Detached garage:❑existing ❑new size Pool:❑existing O new size Barn:❑existing O new size
Attached garage:O existing ❑new size Shed:0 existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded O
Commercial ❑Yes 41(0 If yes,site plan review#
Current Use t r? `4., c 4 Proposed Use
BUILDER INFORMATION //
Name ALP I,J�JAr1�L Telephone Number ` � ��
Address License# b S
4A.-IL oy\ �A _ Home Improvement Contractor# A_L K 4 0 9
"2.Q&tJ Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
03
SIGNAT DATE
k
FOR OFFICIAL USE ONLY
S
RMIT NO. _
DATE ISSUED r
MAP/PARCEL NO. '
ADDRESS T VILLAGE `
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
• I
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
- Town of Barnstable
' J
oFTMe ion
Regulatory Services
HSrASTA, Thomas F.Geiler,Director
Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Fax: 508-790-6230
Office: 508-862-4038
Permit no.
Date
AFFIDAVIT
HOME IMTROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142Arequires that the"reconstruction,alterations,renovation,'repair,modernization,e c conversion,
n ion,
improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not Moro than four dwelling units or to structures which are'adj acent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements. �
t Estimated Cost
Type of Work:
Address of Work:
A A' •ram EL �J l(`-
Owner's Name:
Date of Application:
certify I hereby that'.
Registration is not required for the following reason(s):
[]Work excluded by law
[]Sob Under$1,000
[]Building not owner-occupied
O mer pulling own Permit
Notice is hereby given that: GISTERED
• OWNERS PULLING THEIR O'oV1Y PERMIT�ORDEALING INIPROYEMENT�WOItKDO NOT HAVE .
CONTRACTORS FOR APPLICABLE H N
. OR GUARANTY FUND uNDERMGL c.142A.
ACCESS TO Tt�.`E ARBITRATION PR
OGRAM
SIGNED UNDERPENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
Date
Co actor ame Registration No.
OR
Date Owner's Name
Q:focros:homeaffidav
` The Commonwealth of Massachusetts
•z _i Department of Industrial Accidents
- = Office of Investigations
600 Washington Street, 7*Floor
Boston,Mass. 02111
L Workers'Compensation Insurance Affidavit:Buildin lumbom /Electrical Contractors s
name: / �✓
address
city 4-Vl...rytiof state: ziRQL(,g "( phone#I
work site location(full address):
❑ I am a homeowner performing all work myself. Project Type: ❑New Construction Rtemodel
2-1 am a sole proprietor and have no one working in any capacity. ❑Building Addition
"',� stS-:j'h'a'`�'�-�!�.'+�"*i. .ie�'i,���L • 'r!S 'SJaw.�,��r..tin e.;,. :. ...a..l....�. ..:a�fi�'�. .i...,.�..� ..__T ..t -, ._ _"�3.,. . .);y'?,_"
❑ I am an employ providing workers'compensation for my employees working on this job.
comoanv name: P$2 . ` M-' 4 Vt— L>�
address:
city: .....�°_���.�'yti�>cwC.� _ ;--- '.. .-9hone#• �K9 a '_.��,��. .
insurance co. Icl#
❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have
the following workers' compensation polices:
company name: --
address:
city: uhone#•
insurance co. IDOlig# h
comoanv name:
address:
city: phone#•
insurance co. . ON#
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 31,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. 1 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 the pains and penalties of perjury that the information provided above is true and correct
Signature Date
Print name �- c C' ��� Phone# 7 60 " 4 I '�2
official use only' do not write in this area to be completed by city or town official f
city or town:. permit/license# ❑Building Department
❑Licensing Board
❑check if immediate response is required ❑Selectmen's Office
' ❑Health Department
contact person: phone#, ❑Other
(revised Sept.2003) -
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 ima 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. Please
supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be
submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and
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 number 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 permit/license number which will be used as a reference number. The affidavits may be returned 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.
' X i
The Department's.address,.telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street,7t6 Floor
Boston,Ma. 02111
fax#: (617)727-7749
phone#: (617) 727-4900 ext. 406 .
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Town of Barnstable g
Reglatory Services
Thomas F.Geller,Director
g Division
Bu�lthn � 1
EDPM'� Tom Terry, Building Commissioner
200 Main Street, Iiyaanis,MA 02601
www.town barnstable.ma.us
Fax: 548-790-6230
Office: 508-862-4038
property owner Must
Complete and Sign This Section
If Using ABuilder .
7F_le ��� ,as Qwner of the subject property
hereby
authorize
1c � :__.� � L`-^ to act on mybeha�f;
�.tters relative to work authorized by this building permit application for;
in
(Address of Job _. .
Q' �S
Signature at
of Owner
Print I*Tame
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~ 1 B Tr.no: 11237
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S 1F'ARMOUTti, MA 066'
Coar missi oner
,PaIrcel Detail Pagel of 3
Y, ?H ti
Logged In As: Parcel Detail Monday, Novemb
Parcel Lookup
Parcel Info �
Developer
Parcel ID 307-007 Lot!LOT 6
Location 140 MURRAY WAY _ � -� Pri Frontage '100
Sec Road ! �- Sec
Frontage Village;HYANNIS T �� Fire District HYANNIS
Sewer Acct Road Index 1050
VIC _
.Interactive ,
Map
Ly
- Owner Info
Owner jDURYEA, WALTER R&JANE C Co-Owner
Streetl F40 MURRAY WAY Street2
City HYANNIS �� State MA zip 10260� 1T� country F-
- Land Info
Acres 10.22 use jSingle Fam MDL-01 zoning RB Nghbd 0105
TopographyjLevel I Road 'Unpaved
Utilities Public Water,Gas,Septic Location
- Construction Info
Building 1 of 1
Year ` .�___.f�.,�. Roof Ext -
1960 Gable/Hipood Shingle
Built ------- --- - Struct -- - Wall .- --
Effect Roof li AC
Area1009 cover1Asph/F GIs/Cmp— Type None
Bed
style Cottage wall IIn t D wall Rooms 2 Bedrooms
Int'"'......_-"_�-�-�---.,-__" Bath
Model Residential �� Floor{Carpet Rooms 1 Full
Grade Average Mlnus Heat;Hot Air Total 14 Rooms
-- -- - Type Rooms '- -
http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=24550 11/19/2007
Parcel Detail Page 2 of 3
BMT[453]
' 7A
E 4IU.K96
74
ir, s
F
Stories t1 Story Heat Gas Found Conc. Block o
Fuel ation sns
1G: 5
Permit History
Issue Date Purpose Permit# Amount Insp Date Comrr
4/21/2005 Wood Deck 83539 $5,000 10/5/2005 12:00:00 AM
Visit History
Date Who Purpose
10/5/2005 12:00:00 AM Martin Flynn Mea./List Bldg Permit Only
2/3/2003 12:00:00 AM Paul Talbot Meas/Est
11/8/2002 12:00:00 AM Paul Talbot Meas%Listed
3/13/2002 12:00:00 AM Paul Talbot Meas/Listed
6/15/1988 12:00:00 AM ML
Sales History
Line Sale Date Owner Book/Page Sale P
1 7/10/2002 DURYEA, WALTER R&JANE C 15351/296
2 3/26/2002 BAIRD, EILEEN S & LEACH, J 14971/236
3 SLADE, HELEN 2579/54
Assessment History
Save# Year Building Value XF Value OB Value Land Value Total Parc(
1 2007 $92,700 $0 $0 $142,600
2 2006 $79,500 $0 $0 $142,300
3 2005 $76,500 $0 $0 ' $108,300
4 2004 $61,500 $0 $0 $76,500
5 2003 $51,600 $0 $0 $28,800
6 2002 $51,600 $0 $0 $28,800
7 2001 $51,600 $0 $0 $28,800
8 2000 $50,800 $0 $0 $24,400
9 1999 $50,800 $0 $0 $24,400
10 1998 $50,800 $0 $0 $24,400
11 1997 $43,600 $0 $0 $21,300
http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=24550 11/19/2007
Parcel Detail Page 3 of 3
12 1996 $43,600 $0 $0 $21,300
13 1995 $43,600 $0 $0 $21,300
14 1994 $44,200 $0 $0 $24,700
15 1993 $44,200 $0 $0 $24,700
16 1992 $50,200 $0 $0 $27,400
17 1991 $55,500 $0 $G $39,600
18 1990 $55,500 $0 $0 $39,600
19 1989 $55,500 $0 . $0 $39,600
20 1988 $36,900 $0 $0 $24,500
21 1987 $36,900 $0 $0 $24,500
22 1986 $36,900 $0 $0 $24,500
Photos
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http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=24550 11/19/2007
w� f
of r Town of Barnstable *Permit#7
Expires 6 inondhs from issue date
Regulatory Services Fee `J
w
MAM Thomas F.Geller,Director
�:F Building Division .
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601 RESS PERMIT
Office: 508-862-4038 • �, P Ilee A�`
Fax: 508-790-6230 UG 10 g 2003 ,
EXPRESS PERMIT APPLICATION - RESIDENTIAL
Not vaUd ft1jourRedx-pdms1mprinr OWN OF BARtqSTABLE
Map/parcel Number
Property Address
Residential Value of Work
Owner's Name&Address
5
Tele hone Number
Cont<�actor s Name
�1 P
Home Improvement Contractor License#(if applicable)__A TJ ��
Construction Supervisor's License#(if applicable}
41 ❑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#
Pen-nit Request(check box)
(�Re-roof(shipping old shingles)
❑Re-roof(not stripping. Going over `existing layers of roof)
❑ Re-side
[] Replacement Windows. U Value (maximium.44)
❑.Other(specify)
Where required.,Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
Signature
QTorms:expmtrg r
Liberty Mutual Group
PO Box 8094
Liberty Wausau,WI 54402-8094
Mutual,
Telephone(800)653=7893
1�'i , Fax(715)843-2650
December 11,2002 `
TOWN OF BARNSTABLE
BLDG DEPT
367 MAIN ST
HYANNIS,MA 02601-
t
RE: Certificate of Workers Compensation Insurance
Insured: NICKERSON HOME IMPROVEMENT INC
PO BOX 2476
ORLEANS,MA 02653
Policy Number: WCl-31S-318102-022 Effective: 11/6/2002 Expiration: 11/6/2003
Coverage afforded under Workers Compensation Law of the following state(s): MA
Employers LiabiliM
Bodily Injury By Accident: $ .1,000,000 Each Accident
Bodily Injury by Disease: $ 1,000,000 Each Person
Bodily Injury by Disease: $ 1,000,000 Policy Limits
` As of this date,the above-referenced policyholder is insured by Liberty Mutual Insurance Company under the
policy listed above.
The insurance afforded by the listed policy is subject to all the terms,exclusions and conditions,and is not
altered by any requirement,term or condition of any or other documents with respect to which this certificate
may be issued.
This certificate is issued as a matter of information only and confers no right upon you,the certificate holder.
This certificate is not an insurance policy and does not amend,extend,or alter the coverage afforded by the
policy listed above.
If this policy is cancelled before the stated expiration date,Liberty Mutual will endeavor to notify you of such
cancellation.
AUTHORIZED REPRESENTATIVE
LIBERTY MUTUAL INSURANCE GROUP
` This.Certificate is exem ted by LIBERTY MIMAL INSURANCE GROUP as respects such imIIm1Gt,as is afforded by those cotnpmties.
cc-Insured: Producer of Record:
i
NICKERSON HOME IMPROVEMENT INC PIKE INSURANCE AGENCY INC
PO BOX 2476 PO BOX 1658
ORLEANS,MA 02653• ORLEANS,MA r02653
17110/=
05/26/2003 21:36 915087906230
Town of Barnstable
4 Regulatory Services
Thomas F.Geller,Director
6)4 Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-8624038 Fax: 508-790-6230
r
Property Owner Must {
Complete and Sign This Section
If Using A Builder
I, W aA-tQ r l Y ,as owner of the subject property
hereby authorize UCl(lf Cn &QU MDO (YU-6-f. to act on my'behalf,
in all matters relative to work authorized by this building permit application for:
a MOr �u �nniS
(ACI&C93 of ob)
i!(Izz
Signature of Owner Date
Print Name
fr• „� .yr „a .. _ S'..- .s.. - .,. _ ,. .. .. .-.
WORMS-.0VINERFU ssroN
�,, 6aI7A."11 lllQPCLCl/L a`���f�aaa cfu�6elta
t' �rf' Board of Building Regulations and Standards License or registration valid for individul use only
before the expiration date. If found return to:
HOME IMPROVEMENT CONTRACTOR Board of Building Regulations and Standards
Registration: 133851 Ashburton Place Rm 1301
e9 One
Expiration: 8117103 Boston,Ma.02108
Type: DBA
NICKERSON HOME IMPROVEME .
URK NICKERSON
286 SOUTH ORLEANS RD.
ORLEANS,MA 02653 Administrator Not valid without signature