HomeMy WebLinkAbout0213 OCEAN STREET (5) Ste'
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map a2 Co Parcel o� Permit#
Health Division 5��a b to� 3 Date Issued .l 13�
Conservation Division Application Fee _
`Tax Collector /D'3of o3 (a� Permit Fe 0 VP
Treasurer
Plannin De t. tMCC�MTOBT'�ASEW1,
9 P CTION PERMIT FROM T'iE
Date Definitive Plan Approved by Planning Board NM ENGMMM� oNPBIORTo
Historic-OKH Preservation/Hyannis
Project Street Address ti 09 OCU _ CaAll7— 1
Village P'I�z
Owner _� We(�L t EnA7�A Address 1,0 aCOr-- 4W, -R 47, Atv-)f5 ,(,,V
Telephone f - Ob oL Ii 0 2
Permit Request 1-® CoN,*zb 2 L cE�_- ApAts A td-�1-' Q-< -- A-PP1`t ivmop,
Nt� 112 em&r� i� J-Z 2 yam -�J P, t v N co Ff'
Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type
Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) "i.
Age of Existing Structure BUD� Historic House: ❑Yes U-PGo On Old King's Highway: ❑Yes ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) �"01- Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new D 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 U11 lectric ❑Other
Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 2rNo
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes,site plan review#
-Current Use _ _ Proposed Use
BUILDER INFORMATION [r
Name �� c�2. 2� Telephone Number 'Vl-
Address ` ��n �� S� ��. �� /dti�'License# 7
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO \J t 0, PJ OnpP �
SIGNATURE 4"� DATE
FOR OFFICIAL USE ONLY -
1 PERMIT NO-
DATE
r ,
ISSUED
r �
(t i
MAP/PARCEL NO. 1
ti
ADDRESS, VILLAGE
OWNER
r
DATE OF INSPECTION: -
� r �j
FOUNDATION •�
.� FRAME .(5 r IYI /
INSULATION
r
FIREPLACE
ELECTRICAL: ROUGH FINAL '?
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING ' ri /✓ G 0 c � '
Y
DATE CLOSED OUT
ASSOCIATION•PLAN NO.
5
i
AlI IT i
COMMERCIAL BUILDING PERMIT FEES
APPLICATION FEE
New Buildings,Additions $100.00
Alterations/Renovations $50.00 SQ o
Building Permit Amendment $50.00
FEE VALUE WORKSHEET
NEW BUILDINGS
square feet x$140.00/sq.foot= x.0061=
� r
ALTERATIONS/RENOVATIONS OF EXISTING SPACE
square feet X$96/sq.foot= /3, 3 3. 6 o X.0061— 3
STORAGE BUILDINGS ONLY
square feet X$32.00/sq.foot= X.0061
Commprojcost
1
_ The Commonwealth of Massachusetts
' Department of Industrial Accidents
-= - office aflosestlgativos
600 Washington Street
Boston,Mass. 02111
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name (N a,l�lGce. � t�y Q�
location.
city SCL,t t,.1 Z\ (��` (�rJy4lb� phone# LUL724
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❑ I am a homeowner performing all work myself~
I am a sole rietor and have no one worku in capacity
I am an em 1 er rovidin workers' compensation for my employees working on this job. 2•„�.>..,,X•>.•,.�:::.<..
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wnrancexo..;:;;:$::.ta.>x:.:•h;hn},,f,.Y.};.$};4X.}:{v::ixr}}... ..:..n.....::::... .. •:}:. .,:n•...n.,.:........, ..
Faitme to secure coverage as required under Section i5A otMGL 152 can lead to the imposition of ertnninal penalties of a tine to 51,500.00 and/or
one years'imprlsonmmt s'weIl dull penalties in the form of a STOP WORK ORDER.and a fine of S100.00 a day against me: I understand that a
copy of this statementany be forwarded to the Oiflce of Investigailons of the DIA for coverage veriQcatton.
I do hereby_certify under the p and penalties of pedury that the information provided above is tnm-cud correct
signature Date l0/0�Pont name -
Ew/�//C f�lo%. Phone#
�
omcial we only do not write in this area to be completed by city or town official
city or town: perudttlicense# ❑Building Department
❑Licensing Board
❑checkifimmediate response is required ❑Selectmen's Office
_ ❑Health Department
contact person: phone#; ❑Other
O vited 9195 PJA)
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
li ied, oral or written.
of hire, express or�P .
partnership, association, corporation or other legal entity, or any two or more of
An'employer is defined as an individual,>j p, ,. �
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or
trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a
dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of
another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or
building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or'renewal
of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the
commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until
acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting
authority.
;s. Applicants
lately,by checking the box that applies to your situation and
Please fill in the workers' compensation affidavit comp
supplying company names,address and phone numbers along with a certificate-of insurance as all affidavits may be
Al 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
e not the ' astment of Industrial Accidents. Should you have any questions regarding the"law"or if you
being requested, eP
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/Iicense number which will be used as a reference number. The affidavits may be mtarhR to
the Department b mail or FAX unless other arrangements have been made.
. eP Y
u have an questions.
for you cooperation and should o y gu
The Office of Investigations would Like to thank you m advancey p Y .
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 InifesilgauOns
600 Washington Street
Boston,Ma. 02111
fax#: (617) 727-7749
phone#: (617) 727-4900 ext. 406, 409 or 375 .
alp
BOARD OF BUILD
License ING MGULAT►ONS
Nu
NSTRUCTION SUPERVISOR
►�ber'�
_ 072568
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Tr.nG: 4577 If
WALLA-GE A
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13 LENT
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SANDWI"C-- MA "0 ( ,
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Administrator
10/30/2003 11:34 5087786448 HYANNIS FIRE PAGE 01
HYAIMS FIRE DEPARTMENT
Y 95 HIGH.SCHOOL RD. EXT.HYANNIS, MA.02601
«' IC RI
HAROLD S. BRUNELLE, CHIEF
ME wf, P"VEN Y ION BUREAU
BUSINESS PHONE:(508)775.1300 FACSIMILE PHONE:(508)778-6440
I,T.IDO>•I.ALD IL CASE,,jJR-,CFI LT.ERIC F.IIU LJM,CFI
FI>RIE ",WV1?N7I0N OFFICER FIRE PF EVEN'nOr 1 OFFICER
BUILDING' CODE COMPLIANCE FORM
THIS FIRE PREVENTION EIUREAU.HAS REVIEWED THE PLANS DAXgD
FOR THE PROPERTY LO TED AT � iJ01PJ
ALSO KNOWN AS:......._T
THE CHART BELOW INDICATES THE STATUS OF OUR REVIEW:
T'YPZ;t F.CIDM$'x hil1CIO N.b UMEN ;:: 9WA RECEIVED REVIEWED COMPLIES
I' 1 ARR TIyE RlpF-OR7.
2:FIDE;E.IGH`fI1V !R I✓ E A 5.5 ,'
3-HYDF iANI`LOCATION/11VATCf 3 SUPPLY
.4.SPR1:AIKLFR SYST S.,.:
57SPRjNKLEfl CQNTRUL. EIVT
Eel,
9TAdrII�PIPIr VALV.E;4C��aA)IQ.NS `
EIR DEPI4RTA1dENT -ONNEC`,l N.
9-FIF1.E PROTECTIY,.slGN, NG SYST:
10-F.P.S.S. & ANNUNCIATOR`LOCATION
11-SMOKE CONTROL/EXHAUST
12-SMOKE CONTROL EQUIP. LOCATION
13-LIFE SAFETY SYSTEM FEATURES'.
FIRE EX3INGUISHI1Nd SYSTEMS
15W F.E:S,CONTAOL EQUIP LOCATION
1B*rIFIE..PROTECTION RdPM .:
17-FIRE'RROTkCTION EQUIP 91GNA6E
I8-ALARM TRANSMISSION METHOD J __..._.._.....
19 SEOUENCt=0 4P RATION REPORT
•I
20 ACCEPTANCE.TESTIN.G CRITP-RIA
WI*a VE: .HE DOC EN B OMPL E AND COMPLIANT FOR THE ISSUANCE OF A BUIL G
PERMIT: � d
WE HAVE COMPLETED THE ACCEPTANCE TESTING FOR THE OCCUPANCY PERMIT AND BELIEVE THAT
WITHIN THE SCOPE OF THE BUILDING PERMIT,THE ABOVE ISSUES APE IN COMPLIANCE.
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