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HomeMy WebLinkAbout0096 SIXTH AVENUE (HYANNIS) �'jp Sixes Ava, 1 VE Town of Barnstable *Permit �� f Building Department Services Expires6motzths •''� Brian Florence,CBO 1 �,..� ° Building Commissioner ,�d M Main Street,Hyannis,MA 02601 www.town.barnstable.ma us Office: o 62%112 3 �� Fax: 508-790-6230 EXPRESS PE rRM"PLICATION - RESIDENTIAL ONLY' Not Valid without Red X-Press Imprint Map/parcel Number ,1 1/S Property Address - � 74 e4 Residential Value of Work$ 0 0c, Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) /j�)' Construction Supervisor's License#(if applicable)_Q O ❑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# Xk�C- _;-00- .�-40009 O/ Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) � Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to n ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ® Re-side Replacement Windows/doors/sliders.U-Value g'J O (maximum.32)#of windows _ #of doors: _ '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 Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: or Q:IWPHLESTORMSIbuilding permit forms\EXPRESS.doc 08/16/17 v l - Massachusetts Department of Public Safety t Board of Building Regulations and Standards Y License: CS-004276 € Construction Supervisor ARTHUR L DOLGOFF 19 MCCORMICK DR WEST BARNSTABLE MA 02668 Expiration: 1211112017 Commissioner Lie W.CV?,cueaNz'o�C��aaaac�c�eC� Office of Consumer Affairs&Business Regulation I License or registration valid R OME IMPROVEMENT CONTRACTOR before the expiration date. If: egistration: ::104499 Type: ! Office of Consumer-Affairs an :Expiration:__-_;711412.01.6, . Private Corporal i 10 Park Plaza-Suite 5170 e Boston,MA 02116 ART DOLGOFF BUILDINGI,REMODELING INC Arthur Dolgoff ' 19 McCormick Dr. W. Barnstable,MA 02668` - '' Undersecretary. Not valid without sig r Office of Consumer Affairs & Business Regulation - Mass.Gov Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) x ti Consumer Affairs and Business Regulation r " Home Consumer Rights and Resources Home Improvement Contracting HIC Registration Complaints s Registration# 104499 Home Improvement Contractor Registrant ART DOLGOFF BUILDING& REMODELING INC . Registration Home Page Name ARTHUR DOLGOFF .Address 19 MCCORMICK DR City, State Zip WEST BARNSTABLE, MA 02668 Expiration Date 12/15/2018 Complaints Details' No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Back To Search ©2012 Commonwealth of Massachusetts. Mass.Gov®is a registered service mark of the Commonwealth of Massachusetts. a i https:Hservices.oca.state.ma.us/hic/licdetails.aspx?txtSearchLN=104499 10/12/2017 a .77m Coanmomveaith of Max sachusetts D,eparhment af1'ardushid Accidents Off we 007vesfigations 600 Washington Stmet Boston,MA 0211 wrtnumasmgov/dia Workers' CampensafsanInsurance Affidavit Buitders/ContractcirsMecth bans/Plumbers Applicant Information Please Print f 'bIv Na=(BusiIIessnz niifion&&i�- t,, /Jo/c vt'=f if%i�✓� 12rs G Ad&ess: J //G Caill9/11 A-011, I0-1 Cityfstatefzig: Are you an employer?Check the appropriate box: Type of project(required): I-❑ I am a employer wffi 4. ❑I am a general contractor and I 6. ❑New cti(m employees(full an&or part-time)'s have hired the sub-cont€ackms 2.,R I am a sole proprietor orpartuer- listed oathe attached sheet 7. Remodeling ship and have no.employees These sub-contractors have 8..❑Demolition wod-Ing for roe in any capacity. employs and have wodaxs' 9. ❑Building ad'ditica [No w.mkers'camp.insurance coop. I . required-] I ❑ We are a corporation and its 10-❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 L❑Plumbing repairs or addition mystelf[No workers'gyp- tiht of exemption per IMGL 12.❑Roofrepairs insurance required-]F c.152,§1(4�andwe have no• employees.[No workers' 13.El Other cam.insurance segued-] 'ArryWHcsz1datcbedshoaftlnmsi also fill out thesectioa below shovdnttieuaorkerecomp-sad pokyiaCvnmatica: Homeowners who submit&is affidn t indEcatiag t5ey amdaing alf wa l aud&mhke outd&contmctois— submit anew dica -affida¢it in suclL ZCd ' c' that cbecic this boa must attad and sa zr1&drm sheet sbowh g the:name of�sub-c�sctn¢s and s-tete whethm or not those eatitkshne employees.Ifthe.sub-c tactoxshm employees,they amstgivuide their worker'comp.parley number- I am are employer flint is pratffing workers'compensidia a insurance for uzy eitrpFapees Below is Cite paEcy madiah rite information. Insurance Company Name: Policy 44 or Self-ins.l ic. Expira&nDate: Job Site Address: City/State/22p: Attach a copy of the~corkers'compensationpolicp declaration page(sh wing 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 petralg s of a fine up to$1,5OD-OD and/or one-year imprisonment.as welt as civil penakies.in the form of a STOP WORK ORDER and a fine of up to$250-01 a day against the violator- Be advised thaf a copy of this statement maybe forwarded to the Office of Investigations of the DIA,for insurance coveragt;Torerificaicm Ida herAy cerfFfy under the pains and pmtafties ofperjury fhatf ie informadmi-pro iiW abMw is bare mid correct Si�atttre: ]date- Phone O,{jiciaL errs anFy. I7a not rcrrte in ttQi+s srett,€�r be armpfeted by taty tarfuntt a�aciat City or Tawa: Per mtEkense 4 Dining Authority(tdrele one): 1.Board of Health 2.Building Department 3.CitylTown Clerk 4.Flectrical inspector S.Plumbing Inspector 6.Other s Contact Person: Phone#: laformation and Instructions Massachmeft Geheaal Laws Chapter 152 requires all employers to provide workers'compensation for their employees. Parsrlanttn this stataiE,an elrrployw is defined as.'_.every person in the service of anothw u adr r any confract of wire, express or implied,oral or wrften" An e T&Yer is defined as an individual,parinmMbip,associ do corporation or other legal entity,or any two or more of the foregoing engaged in a Joint entez-pise,and including the legal hpuese tafives of a deceased a MPIoyer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees- HowevCr the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dw Hi g house of anof her who employs persons t D do maintenmim,constriction or repair work on such dwelling house or o2:L the grounds or buadmg appzatenantffiereto shallnotbecanse of such employment be deemed to be an employer." MOL cbapter 152,§25C(6)also states chat'every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a basintess or to construct buildings not the commonwealth for any applicant who has not produced acceptable evidence of compliance with the nhsur ance.covexage required." Additionally.MCrL chapter 152,§25C(7)stains'Neither the commonwealth nor any ofids political subdivisions shall enter into any contract for the performance ofpnblic workunirq acceptable evidence of compIiancewith the insur"ancce._ requirements of tlh chapter.have been presented in the co—f�anthoiity." Applicants Please fill out the worlcras'compensation affidavit completely,by c hmlang the boxes that apply to your situation and,if necessary,sapply sob--contractor(s)name(s), address(es)and phone Tn— ex(s)along with their cmtda-cate(s)of ms<rrauce. Limited Liability Companies(LLC)or Limited l iabi-ity Partne rsbrps(LLP)with no employees other.than.the members or partners,are not regaked to cry work='compensation insurance- If an LLC or LLP does have empIoyc es,a policy is requi rrZ Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and data the affidavit- The affidavit should be retuned to the city or town that the application for the permit or license is being requesbA not the Department of La-dastzial Accidents- Should.you have any questions regardmg the law or ifyou are regmred to obtam a workers' compensation policy,please call the DepartmeeA at the number listed below. Self-ms<n-ed companies should Cnfrr their self-in soxan ce license number on the appropriate line. City or Town Officials T . Please:be sore 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 co act You regarding tine appitcanf Pleas a be sine to fill in the pen nit icense number which will be used as a reference number. In addition,an applicant that must sabuit nhuhiple permitllicense.applications in any given year,need only submit one affidavit indicatsng c�ent policy in�rmation(if necessary)and under"lob Site Address"the applicant should write"all locations in (may or town)-""A copy of the-affidavit that has been officially stamped or marked by the city or trova may be provided to the " applicant as proof that a valid affidavit is on file for fu m 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 bo any bucm�s or commercial veotze (i_e. a dog license or pem it to bum leaves etc.)said person is NOT rvlakcd to complete this affidavit The Of ice of Investigations would Em to thank you in advance for your cooperation and should you have any questions, please do nothesNte to give us a call- The Department's address,Wephone and fax m nber: -Iu3 i CO aWealtie of I chnsa s ', Depaz�m cif 11ad AccZe lft OEM=of Dive&tintio--� FQ4�ashn�tQn�` Fax#>t 6 17 727 774 Revised 4-24-07 Balri@stWe ' uui�lld g Department S!Oviees. • Bran Fiarence,CBO a�diag�offi�issaoaer 200.Maiu:Straet, iysnms,IvA fl2601. �vw:#own.banou table ms.us. Office:;508-862-4038 Fax, 50&790-623Q h' e erty owner Mint Complete and Sign T'hxs Section �f Using A�wlder y, eta "'� ,as C}wner of the subject property hereby authorize •' �� to acx oa nap bebal io aIl;matters relative to authorized by this bdug permit application for: Address of �'�Pool'fences and:alarrns ate the responsibility of the applrcaat Pools are not to:be filled ox ut lszed before fence is ins. Cll and n final inspections are perforraaed and accepted. ,l Signature of Applicaat L G�� Prlat Ni4Psxnt`Naxne c < �7 Date QF ORW�.0,WN R1'n MsslUNpoors: ae 5-- y— � Assessor's map and lot number .... .Y.,ar". 5'". ,1.4 �oFTHE tOr Sgwage Permit number ..:..CfQ WZ9. i � SS ®"C TEM MUSTIN COANVA House number ABB9TADLE, "A"ENVIROWM TITLE 5 0o 1639. 0� ENTAL CODE AN 0 MAI TOWN OF .BARNSTABItJETIONS G% INSPECTOR BUILDIN 4 APPLICATION FOR PERMIT TO .., !��. d .............................................................:......................................:.. TYPE OF CONSTRUCTION .....WKcSP.....,�51?19 ...... ............ .............. ...........................:.......... Mt�l ..°2.9......................19k: TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �f n J Location .. 7t.......... .1.�1.......�Td. ........... ........................................................................... ... ProposedUse ��y��........ Gb!rl............................ .................................................................... ............................... .....Fire District f N�Zoning District .��I........................................................ . ..........1.../.........r.�../...................................... Name of Owner ....... ...............Address ... .. J/!.!�� i� (l /Ccd..:...te /�t!Pc�cS '�/1� . Name of Builder ?....�-.:. �Le �l !n 5..........Address .I��4 S l"G� �' _D...... .... ............................................................................ _Name of Architect NO'JC Address .� v Cyr ..................................... ..........................� ...................................................... Cane A"cf Number of Roams ....::............�...............................................Foundation �,;. . ............ Exierior ..........................................................Roofing ...... >l ! AL ....................................................... Floors (2(* E�......:..........................................Interior ...........9J� ...:...................................................... ............. ........... Heatingg `................ e..........................................................Plumbin ..........4!vC.......................................................... Fireplace (VOnTC" Approximate Cost �......................................................... .. �.a.................... ....l....................... Definitive Plan Approved by Planning Board --------------------_-----------19:_______- Area ..Is �J............................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO.APPROVAL OF BOARD OF HEALTH da I k `�� I hereby-.agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. C�. D �--- Name .. ..................................................... FRIEDMAN, HARROLD No ... Permit for ...hdditi.Qn........... Add to Frame Dwelling ............................................................................... Location ........471 ..6..........................th Avenue......................... West Hyannisport ................................................................................ Owner ....Harrold. . . ...F-r.ie-dma.n�....... .. ....... .. . .. .. .. .... ....... ... Type of Construction ....................Frame........................ ................................................................................ Plot ............................ Lot ................................ Permit Granted ......'....,May..'. 9.1....19.8-09 .......19 If PP!�......... Date of Inspection 02 Date Completed .................Z10 ---f.....19 PERMIT REFUSED fn N t.- ....... 19 . ..... .Co ......................... ....................... ................................................ ..................................... CN) Approved ................................................. 19 ............................................................................... ................... .......... ................................................ Assessor's map and lot number .... ...... � :.r'e:...... oFTNEto Sewage Permit number .....�!,V 33AHB9T11DLE, i House number ..... r MJ18a j }............................................................ CD t639. 9� MPy a\ TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...................................................................................................:.. TYPE OF CONSTRUCTION .....AX!7 .2 ;F c�731�t :............................................ .......... ......::..�......................19 ..... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a' permit according to the following information: Location ......... ...... ll .............. �.....t .`1 :+r. ... .'. ��:!: ........................:........:... ProposedUse ........ ...........................................P.......................................................................................... Zoning District .�r'.7.Fa..............................................................Fire District ..:. ....: t2!...'.................................................... Name of Owner �.�k'� .f?!:. .......t C ?!!1. ...............Address .. f✓�i.{ rl�, I�;,; i` „J<L1..:...! 'r:�..:` (-/-.:»r`s L V' y Name of Builder! !4;,A..S...........Address :. ...................................... .......................�. -Name of Architect ��IJ ...................................Address 'u c................. ........r.. .................................................................................... Numberof Rooms ................. ...............................................Foundation .............................................................................. Exterior ............ ..........................................................Roofing ..............,./A............................................................... Floors ('r�.�C'62f�+T_ ..........Interior ........:..!.�? r?.�....................................... Heating -L Plumbing N ............................................... .............. .............................................................. Fireplace .................A?�.F.....................................................Approximate Cost ...:� ?•,Cc?c ............................................... ii -------19--------. Area 1 ' �...:i Definitive Plan Approved by Planning Board ________________________ ....,,:;.� n c9 Diagram of Lot and Building with Dimensions Fee _�- .....:....................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH u a I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. S 1;.,.,.,1,:,,.ac ma's .. Name .......... ... . ............................................ FRIEDMAN, , H0RPj,0LD A=2585 No .22.TZ7... Permit for ,Addition ......... ................ Add to Frame Dwelling ............................................................................... q(0 Location ....4--t-r 6th Avenue ............................................................ West H t .................................I ..................... Owner ...Harrold Friedman ............................................................... Type of Construction ...Zr AM.9.......................... ...........................................I................................... Plot ............................ 0 t ................................. / Permit Granted 144Y...2.9.,..................19 80 Date of Inspectio*/*....................................19 Date Cornpleteld ......................................19 PERMIT REFUSED ..../. . .. 9 ................ ... ........... ..... / -21k19' ............... .. .. ............. ........................................ ................................ ............................................... .................... ...................................................... ................ ... ........................................................ Approved ............................................... 19 ............................................................................... ...............................................................................