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HomeMy WebLinkAbout0008 SIMMONS POND CIRCLE 8 ti nnnr►o r�S"-,Aon d C i V-, C TOWN OF BAR,IVTLi`BLE Permit No. 2 240__ a�M.M Building Inspector.J."IL - Cash :- �0"pT•`6 OCCUPANCY • PERMIT , Bond ____x_ Y Issued to jar iT -ei��S''' " Address .- Tnt- 1.3. 5�.nlmont 'w Pond ii,-cl:P Wiring Inspector Inspection dater= j r Plumbing Inspector,!, f __._Inspection date- Inspection �. r. �%•°.+G.as 1. r"s. _.e:a - Gas Inspector /" f w J date f. s1 i Engineering Department - --rr�sy+✓ ° Inspection dater ww _ if' i..4 4„,., • r-�fads i r Board of Health ' Inspection date -` 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 TIlk-MASSACHUSETTS STATE BUILDING CODE. _ ...... ......... ......... .......... ............. . W.. Building Inspector c FROM _ . TOWN OF BARNSTAB E BUILDING DEPARTMENT Mr. Francis Lahtene FAIN STREET~` HYANNIS, MA 0 Town Clerk Phone: m-lM SUBJECT: ti4 FOLD MERE - - DATE - I September 4:f."1984 ,� - MESS-AGE.- Work has hem completed under Pexnni.t #26240 (Larry, Niaku].as. Please Tease Bend + .. SIGNED _ DATE REPLY i - - - •- SIGNED Ne7-RMI RECIPIENT: RETAIN WHITE COPY,.RETURN PINK COPY M PRINTED IN U.S.A. SENDER:SNAP OUT-YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. Assessor's map and lot number �y� :....P�l,� �PTI � 11s t �?;y'i l:: INSTALLED IN COIVF f,.IA ' Q•:°f 7 E Sewage Permit number .........................:.. .VuS, .... WITH TITLE 5 ENVIRONMENTAL CC7': Z EAUSTAXL E, House number .........................................r. .ire.................... 1639- TOWN er ^ r " a AB rFOMAYa' TOWN OF BARNSTABLE ra, �. BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...:.... !..c.......... � .... ............. ......... TYPE'OF~:'CONSTRUCTION ................�:� JCIX.......... .......................................................................... ............:...................................19........ TO THE INSPECTOR/OF",.BUILDINGS: The undersigned hereby,.Papplies for a permit according to the folloV-Lqg information: Location .......... /: ,...13................. A. ProposedUse ....... '�.. . . .. ................................................................................................. ............................. Zoning District ........ ..:. ....�............................................Fire Distract ..........�!....1�................................................. Name of Owner ....... ��".`.`::�:..,<.�/r�:,/� i.......Address ..........�.�..�....... ..�!1r�........ ..........(.. Nameof Builder ....................................................................Address .................................................................................... Name of Architect .Address Number of Rooms ..................... .........................:.............Foundation ................. ... ......................... �G�.. �. ...Roofing �� .ram Exterior ..................... .... .... x.................................... ..:. Floors t°. ........Interior .Te.G/ .................... ........ . ..................................................... Heating ................... ........, ............`...........Plumbing .............. :..../..r�.G. ......: .................................. Fireplace ......... .. ....................A Approximate Cost .................. ...........................................Q �I P �... .... pp . ........ Definitive Plan Approved by Planning Board _____ 1 _6__________19 S_L. Area ......../�?/ .........�. %lc Diagram of Lot and Building with Dimensions Fee 71741. SUBJECT TO APPROVAL OF BOARD OF HEALTH f f 0) 9 :"7Q ? ?4Y �. 72e 7/ p � - r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....... ... ....... ................ Construction Supervisor's License �� NICKULAS, LARRY W26240 11-2 -S ry o ................. Permit for ...... �S ............ Single Family Dw ling ................ ................................................./.. I Location ..Lot .................. ..........................!............ <f AY Hyannis 7A S11q1,4bk-,1.r1,.. ............................................................. .. ... Owne ....b��,�Ey Nickulas r .................................................. Frame Type of Construction ........................................... /< .................................................................................. Plot" ....... Lot ................................ or Permit Granted .....Ap-r-i-1...4........ 9 84 -Date.of,Inspection ....................... ............19 Date Coplet4;d 9rr(L 4e Of All r' I T l RRR Xo 4Q i6.o s o y o p /y! o 23 `.. Op r; . j r CERTIFIED N of C LOT' PLAN ,� � n4® s r� o ��.r � `pry LoT . 1� �� a RDI9ER f. .ELD.R.ED I N { SCALE, ��; I ya " D A T E Ir G �' 4 U !�E N EE ! Q_ I a _ i CERTIFY THAT THE F N T! � �_ N R N �:1N CLIENT a� �.� `- --" SHOWN ON THIS PLAN 19 LOCATED WiG i TlREQ REGISTERED J00 M0.` : ON THE GROUND AS INDICATED AND CIVFI. LAND. CONFORMS TO THE ZONING LAWS ENl9INEtER SURVEYOR hR NYC OF. 13ARNSTANL MfiL�,tl . 712 MAIN STREET CKsyl Ii:Y A N t✓ I a M A 5 ; DATE 17F0. 1 A!1(1J 8t1�tVE'faN . . '9:. i� Town of Barnstable *Permit# . 6b �-( 85� Expires 6 months from issue date Regulatory Services Feet y( I 6� Thomas F.Geiler,Director Building Division Tom Perry,CEO, 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 Q Not Valid without Red X-Press Imprint Map/parcel Number U Property Address © .S-/!! l m clA- /��'�J %J��e���'��st//y' d 1►' f� c. �v Residential Value of Work T O `0•7. Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address - / Z o e� � � j?cam u /il'i� Contractor's Name/?a�G,7, / At l'T t e!'/ r I/��i'C�f�� fephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) -PRESS PERMIT ❑Workman's Compensation Insurance Check one: AUG - 6 2007 ❑ I am a sole proprietor ❑ I am the Homeowner TOWN OF BARNSTABLE I.have Worker's Compensation Insurance 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) Re-side ❑ Replacement Windows/doors/sliders. U-Value um. *Where required: issuance of this permit does not exempt compliance with other town department regulations,i.e.Hist r'it;Conservation,etc. ***Note: 4Perty Owner t sign Prope ty Owner Lett4 bf-er siof the Ho �r vem t Contractors License is required. l� 013 V j 0 Z SIGNATURE: Q:Forms:expmtrg Revise061306 ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' d 600 Washington Street T Boston,MA 02111 www.mass.gov/dia Workers" Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Ledbly e (Business/Organizatior,/In 'v'dual): t7� i -� % SAT Address: �eA<J City/State/Zip: (f-eyl,kx7✓���. Phone.#: » Are y employer? Check the appropriate box: 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 stab-contractors 2.El 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 comp.insurance. . [No workers'comp.insurance required.] 5. We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumbing repairs or additions '3.❑ I am a homeowner doing all work ❑ g P myselL [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no 1 13.❑ Other employees. [No workers' comp.insurance required.] , C S A,i le *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who subriit 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 foorrmy employees Below is.the policy and job site information. z Insurance Company Name: l �f' C.rn's Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: Se ilnrr,,,., �i�` �� l City/State/Zip:G` D 4-0/ 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$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance covera e verification. I do hereby certi and r th pain •an4pena t' s ofperjury that the information provided/above is true and correct Signafore: Date: Phone#: 5aff / Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: �i ti°Fz►,E, 'down of Barnstable. Regulatory Services '�$ . ThhomasF.Geiler,Director Buildina Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,NIA 02601 "w.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder A . <' ;/ ,as Owner of the subject property ..I'J� .?.Vtr o,.) herebyaut.4orz C ® Ce to act.on my behalf, in all matters relative to work authorized bythis building permit application for; (Address of Job) } Signature of er Difte Print Name QTORMS:OWNERPERMIS S ION Liberty Mutual Group Liberty PO Box 7202 Mutual. Portsmouth,NH 03802-7202 -. Telephone(800) 653-7893 Fax (603)431-5693 October 4. 2006 V�r 1� THE HOUSE COMPANY - z .s,,E., t:. q� PO BOX 1166 w.. .>.. , BARNSTABLE, MA 02360- RE: Certificate of Workers Compensation Insurance Insured: ROBERT MITCHELL DBA PROFESSIONAL BUILDING AND REMODELING 452 STRAWBERRY HILL RD Policy Number: WC2-31 S-323994-016 Effective: 9/21/2006 Expiration: 9/21/2007 Coyerage.afforded under Workers Compensation Law of the following state(s): MA Elnpovers Liability-. Bodily l.njury By Accident: $ 100.000 Each Accident `, Bodily Injury by Disease: $ 100.000 Each Person . Bodily Injury by Disease: $ 500.000 Policy Limits As of this date, the above-referenced policyholder is insured by Liberty Mutual Fire Insurance Co under the policy listed above. The insurance afforded by the listed policy is subject to all the terms; esclusions 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. Thic r r!i' c• is issued err f i c . .._ �_C. .� ..atC l.,1�„Ecd as a iLatw� G,�ini0rlliativli Ulllj"2tnd CGllfl%rS I10 rlght`Llpofl y0n,�rne CerthllCaLC 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; LI131::RTY\MTUAL.INSURANCE GROUP This Ceniliwte is C:eecured by 1-I:11ER1Y NIUM.0 INSURANCE GROUP as respects such insurance Ls is afforded by those companies. cc: Insured: Producer of Record: ROBERT MITCH-ELL DBA PROFESSIONAL BUILDING FREDERICKS INSURANCE AGENCY INC AND REMODELING P 0 BOX 427 452 STRAWBERRY HILL RD , OSTERVILLE. MA 02655 CENTERVILLE, MA 02632 1 o/d/2oo6 .�a. - Jlze -�o�,�n�a��ueczltlz �✓�aooacic } t BOARD OF BUILDING REGULATIONS t t : License: CONSTRUCTION SUPERVISOR Number;;CS 050051 Birthdate 03/08/1946 T k Expires 03/08/2008 Tr.no: 16219 , Restricted 00 " i a ROBERT E MITCHELL 452 STRAWBERRY HILL RID r pCENTERVILLE, MA 02637 C I i Commissioner Board of Building Regulatio s and Standards II HOME IMPROVEMENT CONTRACTOR { Registration,,110069 I Elug xpiration .I"/2008 I~ t Type Individual ROBERT MITCHELL is ROBERT MITCHELL ;' 452 Strawberry Hill Road^' Centerville, MA 02632 ti�•�- .:` L Deputy Administrator 'C r s r t r ,�� ':�;�5 � , ✓l�TDO'YI7//YLO92lI�6CLGLf2 O�i///LCLQQCZCfLIId BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number CS 050051 I Bict f6 03/08/1946 s e Expires 03/08/. Tr.no: 16219 i 1 Restricted r00-� � �' ROBE RT E MITCHELL ' ! I 452 STRAWBERRY HILL RD j aCENTERVILLE, MA 02632 .Commissioner Board o f B il�d RRem gu a s an Standards lug HOME IMPROVEMENT CONTRACTOR Registration: 110069 Expiration 10/6/2008 TYPe .N iv dual ROBERTMITCHELL # E n 7 ' lip ROBERT MITCHELL r j 452 Strawberry Hill Road �' Centerville, MA Deputy Administrator Assessor's map and lot number7NE �oF tO� Sewage Permit number 7 / f Q Z EARBSTADLE, i NAB& House number ............................................ a C..................... 9p� i639. ♦� sir ''rEo war a` TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... �;.:: ri Z.�?... �'`.00".`.':�:'.... ': :.e-1 ...... :..... ..... .... TYPE OF CONSTRUCTION ` `=`=-s ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......... �. ... .,�}................. ...,:..:: c^� . ................. ............................ /%�;f, ✓(' ra'J ��a ""• nY7 Proposed Use .........K.:........r.............. ........................................................................................................... Zoning District ......... .:a'F.:.�...........................................Fire District ......... .................................................. _ Name of Owner 8-r 1. f rc yet f ........Address .......... i' z/ ... :*...... l,. Nameof Builder ....................................................................Address ...............:.................................................................... Name of Architect ! ....................Address _ .............................................. .................................................................................... Number of Rooms ......................................Foundation Exterior ........................................Roofing .................. r ............ ................... .� ....................................... Floors ' ...........................Interior ..............:.... ..... .r............. .................................... r j � . r Heating . g ,� 1.. .... .... f ........ ................................. Fireplace . .......................................................Approximate Cost �. 6 .... o.....C..s..c...�.Definitive Plan Approved by Planning Board _____ ✓ ------------19_r------ Area ........z / �-.-'.........s..'ii f Diagram of Lot and Building with Dimensions Fee f..................................... i `I SUBJECT TO APPROVAL OF BOARD OF HEALTH Zen f 7Y 7 " � , f I d 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS _ I hereby agree to conform to all the Rules and Regulations of.the Town of Barnstable regarding the above construction. Name ............... ......�........�...:.......,.:........... .................... Construction Supervisor's License .... � ....................... NICKULAS, LARRY No ,26240. Permit for l Z...Stor�'............. Single Family Dwelling Strnhlpn rond Location Lot 13, *<. ................. ............................................. Larr Nickulas Owner .............X.................................................. Type of Construction .....Frame f ................................................ ............................ Plot ............................ Lot ................................ j f Permit Granted .Agri1,..4A..................19 84 r Date of Inspection ....................................19 Date Completed ......................................19