HomeMy WebLinkAbout0014 NELBERTH TERRACE L-BE
Ewr UA
Town of Barnstable *Permit#,x(l ZQ ,s-�,f
Expires 6 montlis from issue date
X-PLEBS PERMIT Regulatory Services Fee fo23 CS(�
Thomas F.Geiler,Director
JUN - 7 2007 Building Division
TOWN OF BARNSTABLE 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 PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number 3 o)5 g O -
Property Address LA' \:)ecA _�_C aQcc- A k S
[Residential Value of Work 30,6U) Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address C— '
1y MQ, <)a(401
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
I am the Homeowner
❑ I have Worker's Compensation Insurance
�J
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
Re-roof(stripping old shingles) All construction debris will be taken to
Re-roof(not stripping. Going over existing layers of roof)
[Z Re-side
❑ Replacement Windows/doors/sliders. U-Value (maximum.44)
-Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the me Improvement Contractors License is required.
SIGNATURE:
Q:Forms:expmtrg
Revise061306
The Commonwealth of Massachusetts
Department of Industrial Accidents
a Office of Investigations
600 Washington Street
e` Boston,MA 02111
SVe, www.mass.gov/dia
Workers" Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information ii Please Print Legibly
Name(Business/Organization/Individual): .
Address: W 6��P Ab Le_y ca C e—
City/State/Zip: ��`S l 6 Oa QPOI Phone.#: 5 b9 ' 1�l 53 Q�
Are you an employer? eck the appropriate bog: Type of project(required):.
1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction .
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g. Demolition
workingfor me in an capacity. employees and have workers'
Y P tY� 9. �Building addition
[No workers' comp.insurance comp.insurance.$
required.] 5. We are a corporation and its 10.❑Electrical repairs or additions
3X 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 repairs
insurance.required.]t c. 152, §1(4),and we have no
employees. [No workers' .13.❑ Other
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:
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 maybe forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certiff under the pains enalties of perjury that the information provided above is true and correct
N . Date: L - ? ' 0�
Sienature: Q
Phone#• 5 0 9 - 1_ S- 3 -I 0
Official use only. Do not write in this area,to be completed by city or town of icial
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#:
Information and Ins' tructions y�
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute, 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, §25C(6)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,MGL chapter 152, §25C(7)states`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 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contiactor(s)name(s), address(es)and phone number(s)along with their certificate(s) of
insurance. Limited Liability Companies"(LLC) or Limited Liability Partnerships(LLP)with no employees other than the
members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees, a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
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. In addition, an applicant
L
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Sile Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your 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
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. 4 617-727-4900 ext 406 or 1-877-MASSAFE
Revised 11-22-06 Fax 4 617-727-7749
www.rnass.gov/dia
Town of Barnstable
Regulatory Services
a BARNSTABLE, Thomas F.Geiler,Director
9 MASS.
019. ♦0 A Building Division
TED MA'1
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
----------------- -
HOMEOWNER LICENSE EXEMPTION
/ /j Please Print
ATE: �p � � � v� _
JOB LOCATION:
number street i lage
"HOMEOWNER": Clo l n--, Per(cA hS 5 0 S • -?l S- -3 96(
name home phone# work phone#
NT MAILING ADDRESS:
6ac0G(
ity town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to
be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be
responsible for all such work performed under the building permit (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
rt applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection proc res and requirements and that he/she will comply with said procedures and
requir ents.�Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control..
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:forms:homeexempt
S f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel Application# �0��b ���
Health Division.
Conservation Division Permit#
Tax Collector Date Issued ck 0`7
Treasurer Application Fee (J
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board (�
Historic-OKH Preservation/Hyannis
Project Street Address '1 el e A-) CAC e-
Village LL (X1'1 \ S
Owner Cf G I fi 1 Fel r r-I (lS Address i� �Qs1�h Trf(a�2 Q61�
Telephone .]0S - 71715 - 39 DI ff
Permit Request Ize-6Qc.� �' � -�Z a.J C�rnr��`�-1-5 i(1 SG\fie (7'ell Ln ,c
D � ''ii `` ff
� l��SP 2 �-F�acJ�Q� �r -�\�P� (�zr�lS
Square feet: 1 st floor:existingaL'b� proposed 2nd floor:existing 156b proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation H),MOP't)— Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structures Historic House: ❑Yes 4No On Old King's Highway: ❑Yes NNo
Basement Type: Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Q COO
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 MNo
Detached garage:0 existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size=
Attached garage:�existing '❑new size Shed:❑existing ❑new size Other. f
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
"ter
Commercial ❑Yes �No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
,f �/
Name Eking- PoC F�MIS Telephone Number
Address I )eAelh 1eXGCA Ce_ License#
' I Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO MS jh_nCl
SIGNATURE \ DATE - -o-�
FOR OFFICIAL USE ONLY -
PERMIT NO. .�
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER-
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
r
DATE CLOSED OUT `
ASSOCIATION PLAN NO.
I he commonwealth of massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, ALL 02111
www.mass.gov/dia '
Workers' Compensation Ihsurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print LeQM
i P
Name (Business/Organization/Individual): . [ *
Address: l`� hFLL 11�&nfi/a D&P•A c�
City/State/Zip: Phone.#:
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 sib-contractors 6. New construction .
2.7 I am a•sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling
These sub-contractors have g, Demolition
ship and hive no employees 1 0
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.] 5. 'We are a corporation and its
officers have exercised their
3. I am ahomeowner doing all work 11.0 Plumbing repairs or additions
myself. o workers' co right of exemption per MGL
Y � mp• - 12.❑Roof repairs
c. 152, 1(4),and we have no y I
insurance required.)t § 13:EZ Otheq� \AL e,cl -
employees. [No workers'
comp,insurance required.] W1,hACW5 $ aclot
*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.
tCantracton that check this box must attached an additional sheet showing the name of the sub-contractors and state whether ornot those entities have
employees: If the sub-contractors have employees,they must provide their workers'comp.polidy 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:
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 , 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 maybe forwarded to the Office of
Investigations of the DIA.for insurance coverage verification.
I-do 4certinder the picins d penalties of perjury that the information provided above is true and.correct,i Date:
Phone#:
Official use only,. Do not write in this area, fo be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one): �I
�1.Board of Realth 2,Building Department 3. City/Town CIerk. 4.Electrical Inspector 5.Plumbing Inspector '
6. Other
Contact Person: Phone#:
Information and Instruction ,
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of anther 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
=ej�or trusteof an e• individual,partnership. association or other legal entity, employing employees. However the
owner of a dwellfng•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, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewaj 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,MGL chapter 152,-§25C(7)states"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 out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if
necessary,supply sub-contractor(s)name(s),address(u)and phone number(s) along with their certificate(s)of
insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other.than the
members orpartaers, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Bp advised that this affidavit 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.licens'e is being requested,not the Department of
Industrial Accidents,• Should you have any questions regarding the law.of-if you are required to obtain a workers.'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate-Ent.
City or Town Officials.
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. In addition, an applicant
that must submit multiple permit(license applications in any given year,need only submit one affidavit indicating current
policy'information(if necessary)and under"Job Site Address"the applicant should write"all•locations'in (city-or
town)."A copy'of the affidavit that has.been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial ventuie
(i.e.a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would hke to thank you in advance for your.cooperation and should you have any questions
P •�-
lease do not hesitate to give us a call.
The Depatment's address,telephone-and fax number;
o Eom onwe th of Massacbuntts
Depaf=1=t ofkdustal.A.oczdonts
Office of Inves ga-dons
600'Washingtoai Street
Boston,ILIA 0.2111
Tel, #617-727-4904 ext 406 ar 1-M-MASSAFB
Fax#617-727-7749°
Revised 11-22-06
wwwmass.gov/dia
t THE r Town of Barnstable
Regulatory Services
� MASSS. A Thomas F.Geiler,Director
�p 0 ft. ��
lEo 9. a Building Division
Tom Perry,Building Commissioner
200 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 than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.
Type of Work ,,�
YP : d AriVGEstnnat�d Cost _
Address of Work:_1� �}P.1�jCj(+Y 1 r , e 9 nnn_\5 mn Cam?l00
Owner's Name:
Date of Application: �_ v-�—071
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
❑Job Under$1,000
❑Building not owner-occupied
`SOwner 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:
Date Contractor Name Registration No.
OR
Date Owner's Name
Q:forms:homeaffidav
�oF IHE Tp��
Town of Barnstable
Regulatory Services
SAnNS'fABLE, Thomas F.Geiler�Director
+ •
y MASS.
039• ,e A. Building Division
lFD MP't
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us.
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
l Please Print
DATE:
JOB LOCATION: (`1 Over �—�'E \ I U t1'U Cl��)�S
number street j village
"HOMEOWNER': l_�UI�4L ' 2er _i s .SOBS -115 . 3gbl
name 1 home phone# work phone#
CURRENT MAILING ADDRESS: Ly `�(�( 2-ccace—
V�6�5 M61 OCDC)
ci /own state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to
be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit. (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance-with the State.Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
re uir ments.
gnature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet of larger Adll be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1 Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner_shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction-Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly .
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
` To ensure that the homeowner is fully aware of his/her responsibilities,many communities require;as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:forrns:homeexempt
DG'M e- Fe.�-�iQ5
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�€ Andersen Windows -Window Schedule Report
rsen:
Project Name: PERKINS -r
Quote#: 013853 Print Date. 02/14/2007 Quote Date: 02/14/2007 iQ Version: ig7.0 Page I Of I
Dealer: Customer: MICHAEL BERNSTEIN
216 Thornton Dr. Billing
Hyannis,MA Address:
508-862-6200 Phone: Fax:
Sales Rep: CLAY GILMORE Contact:
Unit Size Rough Opening
Code
esc.ri tion O� Location Width
Height67 2 Width
3/4� H 6g$t
0001 FWG12068-4,SLRS
0002 ASW 3'0"x 3'9 1/16"x 2'0 3/4"x TO"R, F 1 3'0„ 3'9 1/16" SO 1/2" 3'9 11/16"
0003 ASW 3'0"x 3'9 1/16"x 2'0 3/4"x T 0"R, F 3 0
3'9 1/16" 3'0 1/2"
0004 ASW 3'0"x 4'0". x 310 1/16"x TO"R, F IL 3'0" 4'0" 3'0 1/2" 4'0 5/8"'
0005 FWG10068-4, SLRS _ 1 9191. 67 1/2 9'9 3/4" 6 8"
0006 FWG5068, SR 4'11 1/4" 6'7 1/2" 5'0" 6'8"
0007 FWG2968,S 2'8" 6'7 1/2" 2'8 3/4" 6 8"
0008 Not Applicable, Not Applicable
Project Comments:
WEEKS LEADTIME W/EXCEPTIONS
ONCE ORDERED-NO CHANGES
ITEMS ARE SPECIAL ORDERED& NON-RETURNABLE
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,FTME TOWN OF BARNSTABLE Permit No. ...28938......
' BUILDING DEPARTMENT
{ H°MASK I TOWN OFFICE BUILDING Cash
b
HYANNIS,MASS.02601 Bond ......x.......
CERTIFICATE OF USE AND OCCUPANCY
Issued to Harold Perkins
Address 14 Nelberth Terrace, Hyannis.
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL-NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
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• J
( Building Inspector
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�'�y�••: TOWN OF BARNSTABLE
BUILDING DEPARTMENT
»iST 1 TOWN OFFICE BUILDING
rua
HYANNIS, MASS. 02601
MEMO TO: Town Clerk
FROM: Building Department, r. '�
DATE:
An Occupancy Permit has o been issued for the building authorized by
BuildingPermit #....„ `'} „„........................................................................................................_..„...„......„........................
issued to Ze4-'rD.l „.,1,. C{ 5...„.....„ „� r 1 1... .„. !"! „ �. ......
-
Please release the performance bond.
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M n d" DON
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PINK- DEPT. FILE COPY/WHITE-FIELD COPY/YELLOW.-APPLICANT COPY z O
TOWN OF BARNSTABLE, MASSACHUSETTS �'L�� Q a
�;, _090 PERMIT
VALIDATION
t
C/ DATE_ Jl+ c I7
' 19 85 PERMIT NO.APPLICANT roa. n Cons tr. CO. ADDRESS_ 9) CzoJV. jil T>r n �nr� 6 � t�y�. 7. r
1ahs e / C n7•
(NO.) (STREET) �.. �
7-� (CONTR'S LICENSE)
PERMIT TO BU11Q �ti'ai11nq 2 Single 1'C1 !T,7 NUMBER OF
(__) STORY ��TZ1.-i:l• DWELLING UNITS
(TYPE OF IMPROVEMENT) NO.
(PROPOSED USE)
AT (LOCATION) 14 N=�=-''tn T'e=ace, HS/anni$ ZONING
I�ETIE�EIN0.) (STREET) DISTRICT
BETWEE
(CROSS STREET) AND
' � (CROSS ST RE ETI
SUBDIVISIV„ LOT LOT
BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY
FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP
BASEMENT WALLS OR FOUNDATION
REMARKS: 1:,;:.0 1u.i: 5a-'';ar
(TYPE)
AREA OR
VOLUME +• T}
` 1 D n 1�• PERMIT
(CUBIC/SQUARE FEET)
ESTIMATED COST $ f 0 FEE 1 -'�• -
OWNER -",-YI:.'I 1-';::^�+-.L'•Ir
ADDRESS �dtiUS \r' %
- - --- BUILDING DEPT. /
BY
MINIMUM OF THREE CALL -" J
INSPECTIONS REQUIRED FOR APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
ELECTRICAL, PLUMBING D
2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MEMBERS!READY TO LATH).
3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE.OCCUPANCY. ,
POST THIS CARD S® IT IS VISIBLE FROM STREET
1 BUILDING INSPECTION APPROVALS PLUMBMG INSPECTION APPROVALS
ELECTRICAL INSPECTION APPROVALS
'
1
2
2 2
�,Iv
9 !0t� �/ 1 �H�E�A,TI�N�G 1 SPE TING ArPP ROVAL'S REFRIGERATION INSP TION APPROVALS
6 lu A.e�J€�_ =
0-'q P _/1
2 SOAR® OF HEALTH
_ s
"ISF- s OR-q NGT ?PoccE� uNT,L THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION NS PECT I0N5 INDICATED o11 THIS CAR[*
NSFE^�F -{Ac tPPROVED 7HE VARIOUS r..
TAGES OF CONSTRUC"!!ors WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPHONE
PERMIT IS ISSUED AS NOTED ABOVE, OR WRITTEN NOTIFICATION.
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Ttrti2.n G Y'4 .�3 Ay s�/vrt C 'eo-04 o� C.
tZ• a 9. o z n/. G,v. o o FRANK
WHITING ti
0o No. 29869 ,a0'^Fs '-rOISTER�� �` P�0!T
TL A N
SQQ' �
THE STRUCTURES. SHOWN WERE
LOCATED ON THE GROUND IN
ON /V;"g/ z 3 04,p
MA Ss.:,
THIS SKETCH IS FOR PLO T PL AN
PURPOSES ONLY AND SHOULD .7Zun/cn /o , Zo
41
NOT BE USED FOR ANY
OTHER PU POSE .
R
CAPE COD
SURVEY
ROFESS/ONAL LAND SURVEYOR CONSULTANTS
3261 MAIN ST.iROUTE 6A
PROJECTNO o3 - iz GG -� BARNSTABLE VILLAGE, MA 02630
fF;17l
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Assessor's map and lot number . .i..............
/ M a - NM
Q
Sewage Permit number ..�/�/8 ...�..... .........................
Z B E
House number ABMAO& •
............. . .... .....:.............................:.......... ! MA86
..
pp i b 3 q. `00
MA
TOWN- , 'OF BARNSTABLE
BUILDING I KS P E C T 0 R
APPLICATION FOR PERMIT TO ::..014 D.........QX.C_....�'1.�1A1.1..Y....... .......................
TYPE OF. CONSTRUCTION ..........V.1/..4..Q.d>.......FIn-,AJ.'.CS,:..................................................................................
.........1.9..............19.1 1
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ............ ........... .......................:
.... tZ.l.1�AT�R...... c.9. 4.4.L.hf.��...........................Proposed Use ................................ .
Zoning District ..............: ..................................................Fire District ! /r'�/!/
Name of Owner .I..l.! R..ot_ ...........POKKJ.4.5...............Address ........... t�...................lfl IqN.��J..S.....
Name of Builder CRPt A! ....CjQA(5 1 ..C..4...r.........Address ...4�?.� ... 3. d, Oz.J a...(5.,,..C�/�l; ue
Name of Architect ......Assoc......tN.0 ......Address ..�.�..4.!e.G.f,s- ......�..r.....1�.�.L-.m TH.
,
i
Number of Rooms 4= i C f�.° {............... .........................................Foundation .. .�?.�t�....?s........ .f�1.�.�-.:....................;.....:.......
f
Exterior .... .... ..6.......... ................Roofiing .......K . .
Floors .....0.A.K........... .....0.o'9. . ' .........................Interior ..........,/...2........ .� Ll ..... ®�14....................
II Heati M. ........................................................ ..Plumbing .. . '/.2.._`" - .5.........:.....................`..:.'. -
Fireplace ..... `.. ..............................................................Approximate. Cost ..11®,.1�,. l?1,'..F!A? '...................... . .....
��7GDefinitive Plan Approved by Planning Board ________________________________19________ . Area ......Q......`.. J��......:..
Diagram of Lot and Building with Dimensions Fee ............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
J, �v `
o ��Sv
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS s
I hereby agree to conform to all the Rules and Regulations of 4TofBarns ble regarding the above
construction.
Name .. ...... ........ i .....
Construction Supervisor's License 7.4...........
,,,,,PERKINS, HAROLD
"No ...28038... Permit for ...��..5 �...............
... S ngle._Family Dwelling..........................
Location .....14,Nelber. th Terrace. .................
.. ................... .......... ,• • R
.............Y.annis............................................. '
Owner ...Harold Perkins................................
n
Type,of Construction :..Frame
- -�
Plot ...................... Lot ................................
R � 1
June 17 85
Per Granted ................................._......19
D c
ata Inspection ............................:.......19 '
Gab
/� { C/
Dat ,. ompleted ....�!../�L+ .... ` .........195(0 ,
o�
V a +
Assessor's map and lot number . .......... :�a'
GL-
Q
t Sewage Permit number 6.(,7. '...�I� � ........................
�_ Z BARASTADLE, i
House number ........... / /.......................................... 90o rb s 0a
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ... 1!l .7......... ... .j4'i t.l '1...... .......................
TYPE OF CONSTRUCTION .........Ift�c� 7...... `RAl'Ic". ................................................................................
( .......... .`.................19.95-
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the' `following information:
Location `........��..... ...�� + .... ' .................... .....Iq
...... ....................................................................
ProposedUse ..... A(ax.z`..... .............................................................................................................
I
Zoning District ................!.J.` '...............................................Fire District .................;: ......................................
Name of Owner A.as.P4.)� .....Pt<!.A.5................Address �i k�Rra,t.�..........................
Name of Builder R®Niat�l....��5?.!�{:47"� ® Address �� l..119YSK...�
Name of Architect ...... {? ..:....j.N..X:,.....Address .: .. '. .f '. ......�).Te.....
Number of Rooms .........................................Foundation Gv!:q<
Exlerior fi'2 X1„. Roofing �-t�,,T" �'1 6t7-D 1?................
Floors ....� ....... I< .................. ��4.6. fg-.71:7�.........................Interior .........�!:. .......tea. " 0.-:..11..... a fC....................
�- t � 5
r
rieating �..............................................................Plumbing ............................ .....................................................
/ y
Fireplace ..... \.. --.....................................................................Approximate. Cost .. Gn Dt�D r
Definitive Plan Approved by Planning Board -----------_-------------------19________. Area ..........................................
Diagram of Lot and Building with Dimensions Fee .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
4
f
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstdble regarding the above
construction.
Name ..... . .. � ..... � . , .....4�,. _ ................. .... ...
Construction Supervisor's License Pgoo..11.74...........
J PERKINS? HARQLD A=325-090
No 2gNa..... Permit for .....'Ttao Story..,.,....,
........... Family Dwelling
Location ...14„Nelberth Terrace
........:....................................
....................HY.ai?r? s...........................................
Owner. .......Harold..Perkins......... ...... ....................................
Type of Construction ...Frame
...............................................................................
Plot ............................ Lot ................................
Permit Granted .................1...7 ne ....................19 85
Date of Inspection ....................................19
Date Completed 19
F