Loading...
HomeMy WebLinkAbout0141 SPRING STREET ACTIVE T ef1�6/P - - alovis:.:is :aNnoi y'� ' �.�.. _���. .�� .�ram- _ �-�. _ � _ L � � � .�.._..�___--- I,-_. A •�.., � � J l �_.__...._.. _�_y�._ _,_._ ___ _ rk.��_ _�.__ __ __ _ �.` � � � � L-e i t � 1 � i s "� � � . � ,, ,� ti ; .. _ _� __ _ �_g_,� r.._ ..R, ` _�.,.___ _ w_.w _.._ __ ...�_ �._�_ _ ._ ___ __. � _ ___ .`� • � + .. A TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma Parcel GAL Application P Health Division 'Date Issueda Conservation Division Application F Planning Dept. Permit Fee Date Definitive.Plan Approved by Planning Board Historic - OKH —Preservation /Hyannis Project Street AddressZr Village l` '�7 -✓�S Owner :�J�jx> FAO" Address Ao E r�Y Telephone Permit Request 4.4 1 -"5 wow t GJ6„��inUa»► �= K r�d�cAy. /2e/47 a., id sa[1W"&t --� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total,new-" Zoning District Flood Plain Groundwater Overlay g µ Project Valuation Construction Type ` Lot Size O Grandfathered: ❑Yes ❑ No If yes, attach supporting decumdntation. Dwelling Type: Single Family 2r Two Family ❑ Multi-Family (# units) Age of Existing Structure / �'' Historic House: Li Yes MNo On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full urc-rawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: __3 existing _new Total Room Count (not including baths): existing 6 new First Floor Room Count Heat Type and Fuel: ❑ Gas Yclrll ❑ Electric ❑Other Central Air: ❑Yes U No Fireplaces: Existing New Existing wood/coal stove: 0 Yes 2 No 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name /' v�/chtze,� �wy�1L Telephone Number Address 5`� �'�U" � - License# 6=5 7b=35 3 Ci-VTX"L 41L, A* 0-L 3CI L Home Improvement Contractor# i 32 6 Worker's Compensation # I/14-- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �' r FOR OFFICIAL USE ONLY APPLICATION# k DATE ISSUED_ ' MAP,/PARCEL NO:_, ADDRESS VILLAGE r OWNER z�rr DATE OF INSPECTION: FOUNDATION FRAME INSULATION.`! FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL t r GAS: g ,x,x=. . ROUGH '= - s., . FINAL ,.. -INAL BUILDING L DATE CLOSED OUT ASSOCIATION PLAN NO. '� r h , The Commonwealth of Massachusetts r ^; I Department of Industrial Accidents 1 i. Office ofInvestigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Les?ibly gr�- ` Name (Business/Organization/Individual): r Al Cc Address: >tttl0L & Clty/StatelZtp: Phone #. d-- Are you an employer? Check the appropriate box:. Type of project(required): I.❑ Iamaem emp loyer with 4. ❑ I am a general contractor and I P Y 6. ❑New construction nployees (full and/or part-time).* have hired the sub-contractors 2. f am a so le.prop rietor or partner- listed on the attached sheet. # ❑ Remodeling ship and have no.employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp, insurance. 9. ❑ Building addition [No workers' comp, insurance 5, ❑ We are a corporation and its officers have exercised their 10.0Electrical repairs or additions required,] 3.❑ I am a homeowner doing all work right of exemption per MGL 1 LEJ Plumbing repairs or additions myself.[No workers' comp. c. 152, §1(4), and we have no. 12.❑ Roof repairs insurance required.j t employees. [No workers' comp. insurance required.] ]3.❑ Other *Any applicant that checks box#I 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. 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$I,S00.00 and/or one-year imprisonment, as well as civil penalties in the form of STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. !do hereby certify under the p ins a enalties of perjury that the information provided above is true and correct. Signature Date: ®�®/ Phone# 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): ].Board of Health 2. Building Department 3, City/Town Clerk 4. Electrical Inspector 5, Plumbing Inspector 6 OOther Information and Instructions 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-contractor(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 . 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 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. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 I 1 THE To�ti Town of Barn-stable ` Regulatory Services Thomas F. Geiler,.Director L Building Division Tom Perry,Building Commissioner 200 Main Strcet, Hyannis,MA 02601 www.town.b arnatab f e.ma.us Office: 508-862-4038 Fax: 508-790-623 Property Owner Must Complete and Sign This-Section If Using A Builder as Owner of the sub'ect ro ' J P P riY. hereby authorize 6_i: V_!i 3-u �C" to act on my behalf, in all matters,relative to work authorized by this building permit application for. 1 �`- - (Address/of Job) /+e f - t ' Signature Owner Date' Print Khne If Property Owner is applying for permit please complete the Homeowners License Exemption Form on -tie reverse side. ✓,ie �anvrrca�zu�eaLC�i a�✓Z�aae�uaella , •f Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 4 Registration:, --132564 Type: Office of Consumer Affairs and Business Regulation Expiration:_- 2/27/2013 Individual 10 Park Plaza-Suite 5170 =` Boston,MA 02116 F. MICHAEL DWYER =: 1 F. MICHAEL DWYER 772 MAIN ST. OSTERVILLE, MA 02655,=`.'_;_::".> Undersecretary No/t valid withouLelgna re 1lassachusetts - Department of Pub h lic S,lfe . Board of.Builtling a . ., Re and Standards Construction Supervisor License License: CS 76393 S Restricted to: 00 F MICHAEL DWYER _ 55 SACHEM DR CEN T ERVILLE; MA 02632 Expiration: 6/13/2011 ('unuuissi"nei• Tr#: 17156 • . s t s,,` jALLee ��v,H'r v anti �.O t. ( y Ov - .� ,t' L L.IV, p e ���- Assessor's map and lot number ...... ......e per.... Sewage Permit number 4................. I....:......... .��t`�� yof7NETo�° TOWN OF BARNSTABLE i • i 33AWSTULE, i 039. BUILDING INSPECTOR 0 M a• APPLICATION FOR PERMIT TO .......4.0.0.......... .�� 1......GO.M......................................................................... TYPEOF CONSTRUCTION ............F.A of f................................................................................................................ ........... . T..... .0.............19...7�y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location14 j.....�,P61 A.6.....��.T........... NIV ��................................................................................................. I �t((� ProposedUse .............-........................................................................................::tt..//........................................,......................... Zoning District ...... '� Fire District ... .1. .��.. .�. ..........................................y...�1........................................................ Nameof Owner ..... . EIZ...................Address . ......r T,....................................................../v I Name of Builder PUti,1'Z0 .fOh/�—�- Address I� i t�....................... ................................ �v�a'LD.......00-M �� r. Name of Architect ...................... ..............4:.,.,................Address .................................................................................... Number of Rooms a Foundations �G K /J I� " <" '7s^i L ................................................................ .......................r................................... . ........... Exterior .....�A fVA4,4 S ...Roofing .......)H�►�G,LF Floors �...................... Interior .............................t ................ Heating ...........:............................_..........................................Plumbing .....?............................................................................ Fireplace NU ...............................................Approximate Cost Z �G' . Lru Definitive Plan Approved by Planning Board ________________________________19________ . Area Diagram of Lot and Building with Dimensions �� Fee ;�.- -- SUBJECT TO APPROVAL OF BOARD OF HEALTH' -� A6 Ot,61?) 1 $� E-- -- to � �� , .ram i\���'`�1� ��\�\-� __ ''- F • > j - IC] T 1�C��44 qu. ! w Go �.o of ------------- c, �1 (� 6h, Sl • �97 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. f Name ...... .................................................. �Leidner, Ronald 17399 add to single No ................. Permit for ...........................:........ ...........family._dwellin . . . g.................................... . ....... . . .... Location .... Spring Street ...................Hyanni . ........s ............................................. Owner Ronald Leidner Type of Construction frame .......................................... ................................................................................ Plot ........................ Lot ................................ Permit Granted October 29........19 74 ................. + Date of Inspection ....................................19 Date Completed ................19 PERMIT REFUSED �. ................................................................ 19 ............................................................................... ............................................................................... ............................................................................... ............................................................................... Approved ..........................................:..... 19 ......................................:........................................ ............................................................................... THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I A- C&' L M / SAT . -" --t.ur'"—,. --=...�.�r.d-.•;•..�s+.»a' n .,�,r�.., r=;..-+••>•`--.,-..e,.:a7-»:.:3.fwc....w:w�-`"�w'tv+ 'ac o N TOWN OF., $ RNSTABLE, 1VlASS 76 c-m THIS IS TO CERTIFY ,THAT'A 'PERMIT IS HEREBY GRANTED"TO oNEA ICE tat��bEs'� .... ..... (PROPERTY OWNER( -._ (ADDRESS) of Add W 9�r c ` kk 1u I 4E 'C� , 4 �',a (BUILD)•.: :. ,rtALTERI.,... ....,' IREPAI RI �_._ ¢.. (TYPE OF BUILDING) IA PPROXIM ATE BIZEIF # s o, rA LOCATIONS.. �y .. ... ,_ ... ISTR6ET AND NUMBERI - (VILLAGE) f� ...... ..... ....... ......... ... ....... I m NAMEOF BUILDER OR CONTRACTOR'—'_.- ' +� APPROXIMATE COST mM e �d '•as ' . ,., ' TOWN� I HEREBYAGREE TO CONF E RULES AND REGULATIONS OF'THE OF ,BARNSTABLE _REGARDING 'TH ONSTRUCTION _ (OWNER) `•••ICO NT RA CTO RI 1:. 'x O o 1 BUILDING INSPECTOR �pl Subled.ao,Approvi', of-Board of,Health T q , r a 4 4 4 TOV.TT OF BARNSTABLE BULK RATE COUNCIL ON AGING U.S. POSTAGE PAID 198 SOUTH STREET NON-PROFIT ORG, HYANNIS, MA 02601 PERMIT NO. 2 t 1 gag - � �. r y III a ' , ,�. ,; Assessor's map and lot number T."TIC S OTFN"j V"T5T BE Sewage Permit number ................ ....... ......... .. /` ✓I _ L D TOWN �Q�oFTHEro��, TOWN OF BARNST BLE S • i BAHHSTLBLE, i 1p q .•�0 BUILDING INSPECTOR ` r APPLICATIONFOR PERMIT TO .........�.U......... 4'f� �©a �....................... ............................................................................. TYPEOF CONSTRUCTION ............ �� ................................................................................................................ IL d. ' T.... Q.............19...�..7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit` according to thefollowing information: Location ...NJ......1.Pgl.i�4 1.......5-r'..........11 Y�'A/.I4�1..�1................................................................................................. ProposedUse ....... ...................................................................................... Fire District .. ...... ,✓ f ` ZoningDistrict .....�..t ............................................ 1�............................................................ Name of Owner Ili©N/-�.© LG IPIUClZ �4� ...``�1,�IhlCn 5T, (� �!�q-�vjv1S ......................................................................Address ....i ... ,............. ...... Name of Builder 13���� � �- �r�� t, << ...............................�' -................Address ................................................................�.................. �'t /1l�II Ll-�1D/✓ Nameof Architect ..............................................fi"�...............Address ...................................................................:................ Number of Rooms �- ��° a"� Cor✓c-fL��L' ......... .N................................................Foundation ...�:..(?:C K...... ......... ............................... .. ff .� .Roofing ff/uG► Exterior ..... ..RJ.�.. 4 5............................................... g .......f... ....... .................................................... Floors U �� Interior ........../..,•q-'U //U ........................................................................ Heating ................A( 0 N ...............................................Plumbing ............... .c).�6..................:................................ Fireplace /V� N Approximate Cost 2.0 0 .......................................................... ...................... .......................................... Definitive Plan Approved by Planning Board ________________________________19-_______. Area / .` y ............. Diagram of Lot and Building with Dimensions � ' Fee ..... ....................................... SUBJECT TO APPROVA OAF BOARD OF HEALTH I 5 IN(OAIC 0-001? l�l � f^--- I o '---� o ' � Ti �" Jp t�l�U � S(• I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........;....... . ........... �' �................... � Laldner^ Ronald � � . No _..l.7399.. Permit for _..add..to_oio8.le.. family dwelling ^ --------------------------' z ^ _. � 141 Street - Location ---.._������-----------' - - ~ ' ^��"""^n -.--- --. ------.----------- Ronald �el6oer C�vvnar'�---....................................................... �r��o Typo of-Construction . ---�.�. -------` _-------------------------. 21! Plot ' ` �� --------'' ----------'' Permit G,onua� --..�o���e�'3�_--.lg 7� Dote of - Date Completed 1»�/y �� ��� � lq ' ^—r'��` ----- ' � ������ ������� - -----_---.----------- lA ' ^^ . �� ~~~ - 7 ' | ^��-------------.-----------. '.----.--------------------- � ) , --------.--..----.---..-----,. . '-.--~---.-.--.-----...-..--..~-. � ' ^ iApproved ................................................ lQ ~ ~ ' ' -------.-------.~...-,---.--- �~-------`--------------.---.. ' - ` - FTHE, Town of BarILStable *Permit# e4 S O aY,y Espires 6 months from issue date y o U' �7 v7 (! ,,,�,� Regulatory Services Fee 9� M"S& $ Thomas F.Geiler,Director .es19P. 10rEo tom•+` Building Division Elbert C Ulshoeffer,Jr. Building Commissiot*IPRES 367 Main Street, Hyannis,MA 02601w OC1 Q ZQO1 Office: 508-862-4038 STABS-F Fax: 508-790-6230 IT APPLICATION OF BARN EXPRESS PERM Not Valid without Red X:Press Imprint Map/parcel Number Z a Property Address S 21 V ED Residential OR ❑Commercial Value of Work 3 O C Owner's Name&Address K-00 Y,C SOcc/l_s� Contractor's Name �-2Gt� �RS'e-^ Telephone Number Home Improvement Contractor License#(if applicable) �✓�s3 Construction Supervisor's License#(if applicable) [gWorkman's Compensation Insurance tc Check one: ❑ I am a sole proprietor a ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# J W C v1 y O O 05 Permit Request(check box) (� Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows. U-Valtie - (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations.i.e.Historic.Conservation.etc. Signature expmg