HomeMy WebLinkAbout0096 RIPPLE COVE ROAD �6 Y�j ;ppit- �o' ✓e�i A
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` TOWN OF BARNSTABLE BUILDING,PERMIT APPLICATIONZ�d
1
Map 345 Parcel It �7 Permit# 7SaO -
Health Division 5 XF-0917 1113!b Date Issued Lf C_3 a'''
-Conservation Division ii '"r Application Fee
Tax Collector Permit Fee'O' .
TreasurerhPISCA?�1TMUST =
. OBTAINA�E9VEF
CONNECTION PERMIT FROM THE
Planning Dept. '_ "t ;�, ""ENGINF,ERINGDIVISIONPRIORTG `
r - ,
CONSTRUCTION.o . .:..
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address 9(D an I P Coe_ 2�0
Village A n 15 `
Owner Address [9q 1..AK1E 54o21 2aA}9 wl)
'%k1gti+C--J MA
Telephone
1
Permit Request 047761d- r_11Al .'Q �,I(t re-Z ow�6" - oao1Pa+ .
i L s fe c-4 an ct ►2 e 12 e o ' cps
SL 0 KR—. /7 rc AWir k0/Age!?AeA,9& 1�rd,-7—
r
Square feet: 1st floor: existing proposed ° - 2nd floo . existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
roject Valuations Iaovo° ` Construction Type
Lot Size k Grandfathered: ❑Yes ❑ No If es attach supporting..� y documentation.
Dwelling Type: Single Family a Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic_House: ❑Yes ❑ No On Old King's Highway: pYes ❑No
Basement Type: ❑Full . O Crawl ❑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. ❑Other
Central Air: ❑Yes ❑No Fireplaces: Existing New, Existing wood/eoal stove: QI YesP ❑No
Detached garage:O existing ❑new. size Pool: ❑existing ❑new size Barn:U,e isting Q new size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: 4
Cn
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ ,
Commercial ❑Yes ❑No If yes,site plan review# Pro -
Current Use '�� — _ _ Y<. - s po ed Use
y y BUILDER INFORMATION
Fl Name° �Qn; ° 9 h. Ae-tc ` " Telephone Number 5106 tf 3 t9$
' , _ License# 8�9 -Address ` p � � `S
9�-iAr2iy aCH o'Vi Daly`}` Home Improvement Contractor# i D 65',23_
g Worker's Compensation# _
ALL CONSTRUCTION DEBRIS.RESULTING FROM THIS PROJECT WILL BE TAKEN TO es tej C h Ids1
SIGNATURE DATE
FOR OFFICIAL USE ONLY
y .
.iPERMIT NO.
DATE ISSUED
MAP/PARCEL NO. r
ADDRESS � VILLAGE
OWNER
DATE OF INSPECTION: y ..
FOUNDATION
FRAME 6 FK� CI � .�J � cC/�/0 � r
INSULATION -611V-S C' 0 k g o
v
FIREPLACE *`
ELECTRICAL: ROUGH FINAL . _
PLUMBING: ROUGH FINAL -
GAS: ROUGH FINAL
FINAL BUILDING
DATE'CLOSED OUT
ASSOCIATION PLAN NO.
a
t
�OF'11HE t° � Town of Barnstable
Regulatory Services
BAMffrABLB. ` Thomas F.Geiler,Director
Building Division
M
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Permit no.
Date
AFFIDAVIT
HOME EvIPROVEMENT 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: 4+ t t o F — Estimated Cost i a 000'
Address of.Work: ct(o (2 y n l P COJe
Owner's Name: t S e L 1 y V en i
Date of Application: Mou
4 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
❑Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME EVIPROVEMENT 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:
d.o03 Tctn OLS �Ae-cis®nl 10�sa3
h
Date Contractor Name Registration No.
OR
Date Owner's Name
d
Q16 ms:homeaffidav
The Commonwealth of Massachusetts
- Department of Industrial Accidents
— Office 811oYe50atfew
t 600 Washington Street
Boston,Mass. 02111
Compensation Insuranc����riffa/�%
name: ran
location •oft?3 0114 EN ST
city AiUwt C c4 MA 0"`U — phone# 5b 8— 430—12 8 a
❑�am a homeowner performing all work myself.
L� i am a sole r etor and have no one I fla z m ca achy
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❑ I am a sole proprietor,general contractor, or homeowner(circle one) and have hired the contractors listed below who
have
the followingworkers' compensation polices;
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Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of crirnirnal penalties of a fine up to$1,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of S100.00 a day against me: I 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 andpenalties of perjury that the information provided above is true and correct
signature ��� n Hate ;�V J Igo c� 3 . .10o 3
i,
Print name _Phone#
551555555
official use only do not write in this area to be completed by city or town official s
city or town: peradt/license# ❑Building De partment
❑Licensing Board
r ❑check if immediate response is requited ❑Selectmen's Office
❑Health Department
contactperson: phone#; _ ❑Other•_
HERS
UrAged 9195 PIA)
i r
Y.
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 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
construction or repair work on such dwelling house or on the grounds or
another who employs persons to do maintenance, constru ep �
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,neitherthe
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 and
supplying company names,address and phone numbers along with a certificate-of insurance as all affidavits maybe
` for confirmation of insurance coverage. Also be sure to sign and
submitted to the Department of Industrial Accidents
�p a affidavit should be returned to the city or town that the application for the permit or license is
a affidavit. Th
„ date the � »
Accidents. Should you have any questions regarding the `law or if you
not the Department of Industrial Y.
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
has to contact you regarding the applicant. Please
the Office of InvestigationsY _
for ou to fill out in the event _ .,, _ _
affidavit y
be sure to fill in the Permit tense number which will be used as a reference number. The affidavits may be retarhR 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.
'tom Departrneat's address,telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
0mce of Inuesugauans
600 Washington Street
Boston, Ma. 02111
fax#: (617) 727-7749
phone #: (617) 727-4900 ext. 406, 409 or 375
RESIDENTIAL BUILDING PERMIT FEES '
APPLICATION FEE
New Buildings,Additions $50.00 s,:a O
Alterations/Renovations $25.00 — --
Building Permit Amendment $25.00
FEE VALUE WORKSHEET
NEW LIVING SPACE
square feet x S96/sq.foot= x.0031=
plus from below(if applicable)
ALTERATIONS/RENOVATIONS OF EXISTING SPACE
square feet x$64/sq.foot=
o ® x.0031= ?• a o
plus from below(if applicable)
ACCESSORY STRUCTURE>120 sq.f� ,
>120 sf-500 sf $35.00
>500 sf-750 sf 50.00
>750 sf- 1000 sf 75.00
>1000 sf-1500 sf 100.00
>1500 sf-Sarre as new building permit: x.0031=
square feet x$96/sq.foot=
STAND ALONE PERMITS ,
Open Porch x$30.00=
(number)
Deck __x$30.00=
(der)
Fireplace/Chimney _x$25.0- =
(number)
Inground Swimming Pool $60.00 .
Above Ground Swimming Pool $25.00
RelocatiowMoving $150.00
(plus above if applicable) Permit Fee
projcost
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PROP.
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JOB# 03-296
PLO T PLAN
FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT ONLY PREPARED FOR:
LOCATION : 96 RIPPLE COVE ROAD
HYANNIS, MASS. R. & E. NUGENT
SCALE : 1" = 20' DATE OCTOBER 16, 2003 (REF. IAN JACKSON, BUILDER)
REFERENCE L.C.P. 7615E SH. 2
ASSESS. MAP 325 PCL 117
I HEREBY CERTIFY THAT THE STRUCTURE
SHOWN ON THIS PLAN IS LOCATED ON THE
GROUND AS SHOWN HEREON.
,�P��H Of hlgss
off. 508-362-4541 dpy� ARNE 9�yG
fax 508-362-9880 H.
down cape engineering, inc. c OJALA zi
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CIVIL ENGINEERS
LAND SURVEYORS 0 1l(04,77 �i� E � •+
LA
939 main st yarmouth, ma 02675 DATE REG. LAND SURVEYOR
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EXHIBIT B
CONSTRUCTION PAYMENT SCHEDULE
50%deposit upon signing of this agreement and final payment when work is completed.
This Agreement entered into as of the day and year 20o
ACKNOWLEDGE:
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Owner
Ian B Jackson, Contractor
OFSNE rqy, Town of Barnstable *Permit#
Expires 6 months from issue date
N
IAMSTA33M = Regulatory Services Fee or-6-r.
v� 16 9 � Thomas F.Geiler,Director
p'ED"A0`� Building Division X-PRESS PERMIT
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601 NOV 3 2003
Office: 508-862-4038
Fax: 508-790-6230 TOWN OF BARNSTABLE
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red%Press Imprint
Map/parcel Number .:3 a S 117
//�� �/
Property Address R R 00% (.o ve 2d �k.ann.t
[Residential Value of Work A :9 0 ent
Owner's Name&Address evssew_ 6, Q yc one
19 a L A-KE, S t{oel Qo 44S 12Wul R9_t QkFegj (YI A Qa t 3 S- 6 3(,q
Contractor's Name 1:74n 3 Telephone Number S -.43o- 1'i Ga
Home Improvement Contractor License#(if applicable) 1 O 6 Sa3
Construction Supervisor's License#(if applicable)_ O 50 'A 19
❑Workman's Compensation Insurance
Check one:
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❑ I am a sole proprietor
❑ am the Homeowner
CD
( I have Worker's Compensation Insurance i .
Insurance Company Name 12-Au e-krA s Trn W44gric.e
Workman's Comp.Policy# K 0(.'6—-1 aD Sc q y I 8- 03
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Permit Request(check box)
5!rRe-roof(stripping old shingles) All construction debris will be taken to t>V W,0S,4.,._ (l -J1.u,)
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows. 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.
Home Improvement Contractors License is required.
Signature \
Q:Forms:expmtrg
Revise053003 '
..............
7k
ti License tF BU"ING REGULgnONS
y 4�1NSTRUt;TION SUPERI[IBQR
�1 Numbers 050829
Btrthdate �07/t3/�g�
T Expires 07/{f
k 3/2Upq Tr.no: 537
Restricted Op
LAN B JACK$QN ,j
MAIN$T
N`HARWICFi, MA 02645'
Administrator
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T.��a„�.w�uuea�� o�'✓Llcreoac�ruae
Sa> ri:of if,ilding kcsul'!Ws x yuc++ ards
1_6i 523
,2al2OD4
.IACSON CONS'^l,C. OFI
273 MAIN S`i'REET
HARWICH,11iA02645 M.adm+nt'a ttor-
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EXHIBIT B
CONSTRUCTION PAYMENT SCHEDULE
50 % deposit upon signing of this agreement and final payment when work is completed.
This Agreement entered into as of the day and year r M. ZOC�
ACKNOWLEDGE:
Owner
Ian B Jackson, Contractor