HomeMy WebLinkAbout0053 SPRUCE STREETr,��3 S�eur� s�-
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Town of Barnstable *Permit# g'3 91 72,'
Expires 6 months from issue date
Regulatory Services Fee ���-�—C?°
Thomas F.Geiler,Director
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street, Y H annis'MA 02601
www.townbarnstable.ma.us
Office: 508-862-4038 FtN 90-6230
EXPRESS PERMIT APPLICATION - RESIDENT Y
Not Valid without Red X-Press Imprint
MMap/parcel Number
sZ 3 ,
Property Address G 5'F `C
Ukesidential Value of Work O OC) Minimum fee of$25.00 for work under$6000.00
/Owner's Name&Address �� A)
3 spe U c e STD, l /�✓UNC� , I (�Z�o/
Contractor's Name jI h Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
I am the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
[� Re-side
Replacement Windows. U-Value + 3 (maximum.44)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Ownermust sign Property Owner Letter of Permission.
Home Improvement Contractors License is required.
l 1 r
SIGNATURE: A,&L -
Q:Forms:expmtrg
Revise071405
The Commonwealth of Massachuse#s
. Department of hidat tiW Accidents
Office of Investigations
600 Washington Street '
Boston,MA 01111'
www.mass.gov/dia
kern' Compensation Insurance Affidavit: Buulders/Conti'actorslElectridaiis(Plu oberl
NVor Please Print Lesdb
scant Information ,
OrpmizationRadividnan:
�Tame(Bu�� . .
Address:
lZi Nam`.S %04e#:;
CitylState • p::.r � . .
sire you an employer? Check the.appropriate boa:. ;Type of project(required):'
❑ Z aIoyer with hired
4. ❑ I am a general contractor and I :_6, (]New construction•
employees(fa andlor part time).* 'e hired the snb-contractors ?. Q Remodeling
rietor or Partner- listed'on the attached sheet.$
.[] I=.a sole prop These sub-contractors have 8• •❑ Ddmolitiou
ship and have no employees. •
working for me in any'capadty, workers' comp.insurance. 9. ❑ Building addition
[No workers comp.insurance 5. ❑ We are a corporation and its 1Q.❑Bitcticalrepairs or.addidoas
officers have ekercised their airs or additions
required.] right of exemption per MGL _ll.Q Plumbing rep
I am a homeowner doi. g all.work . c, 152,t 1(4),and we have vQ. 12.❑ Roof repairs
�l myself: o workers camp. �.
ei'nployees. [No work 13',❑ Other
insurance regafred-1 t ' camp.insurance requu'ed]
alsq fill out the
Anyapplicant that chocks box#1 must section-below showing their workers'c=3Pcn3atioa-policy information:
Homaowaers who submit this of davit indicating they arc doing all work end then hire outside ontaigcantm arcs must submit anew affidavitOY:
Contractara that check his boa,must attached sa additional sheet showing the nano of tha cub-contractors cad thair wcrk�ss sow ga3r
f am an employer that is providing workers,compensation insurance for my employees.'Below is the policy and jab site
Information.
[nnrance•Company Name:
Policy#or Self-ins Lic.#: Expiration Date:•
ddrtss: City/State/Zip: -
Job Site A
Attach a copy of the workers' compensation policy declaration page(showing the policy number and•expiration date).
Fame to,se=e coverage as required under Section 25A of MGL c. 152 cari lead to the imposition of ciiminalpcna7t RDRILm of a
rme up to$1,50Q,.0�andlor one-year$upnsomnent:as
edthat a well as.�of this statementmay oe forwarded to the 00ffic of d aline
of up to$250.00 a day against the violator. e advls cagy
Investigations of the DIA for insurance coverage verification. ——
I do hereby by certi der the pains and penalt<es of perjury that the information provided above is true and correct.Date:'
Si atare:
phone#:
Official use only. Do not write in this area,to be completed by city,or fawn offcciat
City or Town: PermhUcense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.0ty/Town Clerk 4.Electrical Inspector S.Plumbing Inspector
6,Other
Phone
.Contact Person'. #:
ion a ld InstrUktims ..•r• r
Inform�t . .
ensation fo their employees.
ter 152 i hires all employers to provide workers' comp r contract of hire,
Massa,hinds General Laws chap arson is the service of another under any
Pursuant to this statate, an employee is defined as"..,every p
express or implied,oral or written."
'� : ' 1}ip,•;as ciatiouporation or other legal e�titY,or nay two or more
An empjOyer is defined a�•;:14 W4)IaIa to er or the
f N �
engaged is a joint enterprise,and incba4 the legal representatives of a deceased cmp y ,
of the foregoingassociation or other legal entity,employing en3&Yees- HOTWer. e
receiver or trustee of as individual,P� p� an#of the
eceiv of a dwelling house having not more than three apartru zts and who resides 1herem,Or the,orcnp
ownprollin house of another who employs persons to do maintenance,construction or repair wo&'on such dwelling house
dw genantthereto.shallnotbecause of such employmentbe deemedto be® employer." .
cr oa The grounds or bu:Uding?pp
rdGL chapter 152,§25C(6)`also states that:.q.ery.'state,or locallicensing agency, shall w�rtbhold the issuance or '.
a license or permit to operate a business or to construct buildings in'thek°mmonwealth for arty
renewal of not produced acceptable evidence of compliance with the insurance coverage required."_
apphcantwho'hag
Additionally,MGL chaP�152,§ZSC('�states"Neither fl�.e commoIIwealthnoz any of its-political subdivisions shall '
contract for the performance of public work unttl acbeptablc[evidence of comPAMce with ttre insurance
enter into Ray have been presented to the contracting authority.
=egniremeuts of-ibis chap .
Applicants lion and,if
ensatiou affidavit•completely,by checking the boxes that apply t°your situa
please fill out the workers' cow addresses)and phone numbers) alongwith then certificates)of
necessary,supply sub-contractors)name(s), yyith no employees other thanthe
insurance. LimitedLiability Companies(LLC)orUmitedLiability►Partnuallips'(LLP)
or LLP does have
members or p artaers; are notrequired ti9 carry worikers Ld vi� . ed to the Department of Industrial
employees,a,policy is required. Be advised tha ,.. .
The affidavit should
Accidents for coufimation of insurance coverage,. 'Also be'sureto sign and date at 3davit:
request
not tha:Dcparfineiit of
the ' ' er town that ft application for the permit•or keensa u being req ,.4 : - _
be returned to crtY eStio� a ardinge law or if you are required
n Fg
Industrial Accidents, SfOk
Should you have any q awes should eater their
lease calltheDeparbmentattheaumber listed beloyvti Self-insured comp . , ,
compema p tion acy,p
• .
number on Ili appropriate line•
self-insurance license run r
City or Town OfIldals
tedle `bl TheDepartmenthasprovidedaspaceatthebottom
please be sine that the affidavit is complete and prin gl Y• applicant
of the affidavit for you to IM out in the event the Office of Inbesti at as as reference vegjoj�hzs to tnnmb er regarding In addictru tion,an applicant
Please be sure to fill thepea�it/hccnse number which wfil
that must submitmalfiple peimit/license applications in any given Year,need only submit one affidavit indicating current
oli information(if necessary)and under"Job Site Address"'tor s`Ppked t sthe or to n locations be provided to the or
p "A copy of the'dr,davit that has been officially stamp ed or mar by Y
t im) .or'liceflses. Anew affidavitm stbe filled out.caoh
vrt is•on•filo far;fature permrt,s ,
applicant as proof that•a valid a�da •
year where ahome owner or citizen is obtaining alicense orperm notielattt &ate this affidavit
or c r ercial venture
Y t to burn leaves etc.)said �s NOT required nap
(ie,a dog licenje orper�
The you in advance for your oogperation and should you have any que
pffice of investigations wautd like to thankstions,
please do nothesitate to giveus
a call ,
TheDeparent's address,telephone and.faxmmaber:
The Commonwealth of Massachusetts .
Department of IndustrialAccidmts ..
.Office of Itivesigatio�ns
.. .. .. , .. 3• ,� •a r •• 600'y�asshington Street . • .. . ,
V
'Boston,MA 02.111�
`Tel.#617-7-27-4900 ext 406 or-1-877 MASSAFE
7 ax#617-727r774
„_�__� r ��115 �rayay.maSS.gOVIola '
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Y r
oFINE r Town of Barnstable *Permit#
Expires 6 monrHs from issue date
N BAMS ABM ' Regulatory Services Fee ?�
v� HAM
`0$ Thomas F.Geller,Director
pTfOMA�� Building Division X-PRESS PERMIT
Peter F.DiMMatteo, Building Commissioner
367 Main Street, Hyannis,MA 02601 w S E P 12 200.1
Office: 508-862-4038 �r
Fax: 508-790-6230 TOWN OF BARNSTABLE
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press imprint
Mapiparcel Number
Property Address �� 10rL1 C e_ Sf ie e
Residential Value of Work
Owner's Name&Address �al
Contractor's Name zr lli�'r� �O��T2UC�0''� Telephone Number
Home Improvement Contractor License#(if applicable)
r
rr Construction Supervisor's License#(if applicable)
r'
❑Worlanan's Compensation Insurance "
} Check one:
❑ I am a sole proprietor
I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name "� {�A
Workman's Comp.Policy# W 009/W 0,
Permit Request(check box)
❑ Re-roof(stripping old shingles)
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows. U-Value ( •44)
Other(specify) eiii6flo G
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc:
Signature
Q:Forms:expmtrg:rev-070601
Assessor's map and lot numbers ....................l......... THE
_ QypF Tp�♦
Sewge Permit number
Z BARNSTADLE. i
House number ...............................ti ...�;........................ 9�o M�,ems i69 \0� t
TOWN OF BARNSTABLE
BUILDING INSPECTOR
-52 APPLICATION FOR PERMIT TO ....... 4l1F ..... ay� !�?.5........C.®4 ............................ ...............
TYPE OF CONSTRUCTION ...w 7e-n f/a..e41,6.. �/. .....� .............................................
......................... .
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location �S'....� �rucei"+.-�.T. `.��!?.!�p. .......................................................................................
.............. ......................,7 ...........
ProposedUse .... �c�ca�sne!?.I.!f ......po-.............................................................................................................................
ZoningDistrict ........................................................................Fire District ...............................................................................
/ ojo q! �....a.: r......... ..
Name of Owner�e�o..........�!�....�r..<�l....��,�dt.�....Address ...:�3..� �',� �.�s2ltte...S.................
f
Name of Builder O4X C010)(..f�ftMc rA�.l1.►3 - ..Address ..�.. 9���t... 7 / !il�JrJi,f
Nameof Architect ..................................................................Address ....................................................................................
Numberof Rooms ..................................................................Foundation ..............................................................................
Exierior ....................................................................................Roofing ....................................................................................
Floors .........................................Interior .....................................................................................
Heating ..................................................................................Plumbing ..................................................................................
Fireplace ..................................................................................Approximate Cost .... .0s................................
Definitive Plan Approved by Planning Board -------------------------- / x
r
------1 9--------. Area . ... .....o ti..... ...................
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL C)F BOARD OF HEALTH
t t
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 <... r�.. .........................
Construction Supervisor's License 00.1(�`I .. ...............
ST COEUR, PETER B. A=310-232
53
No 264 Permit for Pool...
�...........
.........................
Location ..... Z.ZPX-UC:e..Stxee-t.....................
............i.......HYMMis............................................
Owner .....FeteX..B.,.StXceur....:7..................
Type of Construction ..Fran-L..............................
................................................................................
Plot ............................ Lot .................................
Permit Granted ..... ....................19 84
Date of lnspection"....................................19
Date Completed ......................................19
Assessors map and lot number` ...... ..... . of T E rot
Sewage-,Permit number
t ? MAWSTADLE, i,House number_ ................ .. .. ....��?' ....... e' too i63 e0�
a
9.
TOWN OF • BARNSTABLE
'BUILDING INSPECTOR
APPLICATION FOR PERMIT TO . �IfC,G ... .....�.IlJ�e'2��?. (. :�.... S;
`. TYPE OF CONSTRUCTION • ... 1.: '�` J /1 �0.. L..... i�L.f' ................................
............. r ...:.. ,9
TO THE INSPECTOR OF BUILDINGS: ,• y
The undersigned hereby applies for a permit according to -the following information:
Location ...... S........................................:.:.......:........:................:.........
Proposed Use ...... g!r_1?1H?1 '......rG' . ....................:... ....................... . ......
}
Zoning District ................:...............:.....................................:Fire District ............................................
Name of Owner i �:.../ %t^!?r...�.:.: 3t... 6? :LdI . .Add4ress :.. 3..5: �"t/GG' �. 27....: j! ...............
Name of Builder 4- ...roik.?1(...eetftOdd li'lrJta�..Adclress S............................
Name of Architect ....:...............................................................Address
Numberof Rooms ..........:.......................................................Foundation :.............................................................................
.............Roofing ........................
Floors Interior
Heating Plumbing .......
Fireplace ..................................................... .........................Approximate. Cost .1 .�+� °a`....:............... `
:. ` ...........
Definitive Plan Approved by Planning Board ________________________________19_______. Area .../................ ..................
Diagram of Lot,and Building with Dimensions Fee
SUBJECT TO APPROVAL F BOARD ,OF HEALTH"
OCCUPANCY PERMITS REQUIRED FOR NEW.DWELLINGS ' r
I hereby agree to conform to all the .Rules and Regulations of the Town of Barnstable regarding,the above
construction. '
Name 6KI4rf::.. ...G............................ ...
Construction. Supervisor's License .06 .k.S'3.....'.........
30
ST COEUR, PETER B.
No 26453.... Permit for ... ^'........... ..Pool
€; Accessory to Dwelling
Location ....53 S?ruce Street........................
Hyannis......................
Owner ..................................................................eter, . t. Coeur
-Type of Construction Frame
........... .........
Plot ............... lot hJ
Permit Granted ..:-May..lg...........'......19 gq
,
Date of Inspectiori f •1940
'
Date Completed C +
,r �r .•� ,.,_. ''- �� }! Jam'
Al
�. o- �M1s
Town of Barnstable
��oFt"E'Owtio� Regulatory Services
Thomas F.Geiler,Director
' '"R" ' Building Division
9 SS'MASS. 0a
•
1 39. Tom Perry Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
COMPLAINVINQUIRY REPORT
Date: Rec'd by:
Complaint Name: Map/Parcel
Location
Address• :�3 C
Originator Name: �h6.2 06
Street: ! .
Village: State: Zip: >
T-:
Cn
Telephone:
Complaint Description: V ` �,,fr
FOR OFFICE USE ONLY
Inspector's Action/Comments Date: _ ��a Inspector: � �
Additional Info.Attached
Q:forms:complaint