HomeMy WebLinkAbout0055 SPRUCE STREET �� �
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION '
7310 Z 33
Map Parcel r Permit# ���
Health Division le Lwtq Date Issued
Conservatio ' ' ion Tf Fee, �e
Tax Collector oP,&I- SEPTICLSYSTENI PAUST BE
,� _ 'INSTALLED INC OMPLIANCE .
Treasu s WITH TITLE'S
Planning Dept. ENVIRONMENTAL CODE• � }
TOWN REGULATION
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address SIS' S r(4 e e-, �y- -
Village ,[�`�O�An i•5
Owner S(�—�Y1 n L, /loc✓a G k Address SQM e,
,Telephone •725- 17 �0
Permit RequestPei-)CX i r zi re dam o at, 4o 16"se kc a 12 �� 12 `
e i'A r 1"n 40 G VA�l�ec�., /oo% pie�� �� /(� � /6 OG
Q" is l_3 ` Gid cl - P/P:,�S ~J�lO�e, (/2ie t. �-1 /h5 �01 ti®Al
Square feet: 1 st floor:existing proposed 2nd floor: existing - proposed ' Totu +
Estimated Project Cost 3S h o Zoning District Flood Plain Groundwater Overlay
Construction Type Oo
Lot Size Grandfathered: ❑Yes O No If yes,attach supporting documentation.
Dwelling Type: Single Family Two Family O Multi-Family(#units)
-Age of Existing Structure Historic House: ❑Yew�s' )(No On Old King's Highway: ❑Yes ' %No
Basement Type: .OrFull ❑Crawl ❑Walkout ',Other 'ry CIQ4,
Basement Finished Area(sq.ft.) f Basement.Unfinished Area(sq.ft)
Number of Baths: Full:existing new 49— Half:existing new
Number of Bedrooms: existing new C
^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/coal stove: ❑Yes . 0 No
Detached garage:O existing ❑new size Pool:0 existing,, ❑new-size Barn:O existing ❑new size
Attached garage:0 existing ❑new size Shed:❑existing ❑new size Other: T
Zoning Board of Appeals Authorization ❑ Appeal# 'Recorded❑
Commercial ❑Yes ❑No If yes,site plan review#
Current Use Proposed Use
•
'BUILDER INFORMATION
Name u 'Q� Yes t ra libh Serve'cLe5 Telephone Number J Og -;?9D " /l�?
Address /lO Bree A iv, `License# : C 5 0 7 0d2,�y
Home Improvement Contractor#
MA 00 601 Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE s DATE �1 a ��9 � 3 -5 17
FOR OFFICIAL USE ONLY
> •r e
PERMIT NO. — r 1,121
7 be
DATE ISSUED
MAP/PARCEL NO. __ d -•
ADDRESS % .VILLAGE' }
QWNER
DATE OF INSPECTION:
FOUNDATION' s 5 • a - '
FRAME ____��►� S�1 �J/ �h 1 - :' 1 _
INSULATION
FIREPLACE
ELECTRICAL: ROUGH' FINAL
i PLUMBING: ROUGH :— FINAL'
GAS: ��, ROUGH. ril e'+ FINAL
FINAL BUILDING•
i
r OUT .,DATE C LOSED x f
ASSOCIATION PLAN NO.
�e a
• WALLS&MURALS
GLASS WINDOWS
"+^? Custom Hand Painted Signage
and Wash-Off Window Painting
5 ;5 SPRUCE STREET,HYANNIS,MA 02601 V
508-775-6716 • FAX 508-790-4547
suzannenowak@mac.com
1/1
Building Division
367 Main Street,Hyannis MA 02601
MCC: 508-862-4038 " Ralph Crossen
ax: 508-790-6230 BuiIding'Commissio-_
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
f
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
improvement,removal,demolition,or construction of an addition to any pre-cdsting 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. u
i
Type of Work: _f'�r� �es r6o Estimated Cast_ -3S; oaO
Address of Work:
Owner's Name: r,, z IR h n L � �c�C
Date of Application:_ .3
I hereby certify that:
Registration is not required for the following reason(s):
QWork excluded by law
C]Job Under$1,000
aBuiiding not owner-occupied
[30wner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMMOVEMENT 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.
S 3 Ze. SPnl'Le'S i.;23 0 :3
Date 7 Contractor Name Regisn don No.
OR
Date. Owner's Name
q:forms:Affidav
The.Commonwealth of Massachusetts
_l _-- -_�. Department of Industrial Accidents'
Office alfn�estigatians
600 Wash ingivn Street
F7 Boston,Mass. 02111 ,
— Workers Combensation4 Insurance Affidavit
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IN
cant:rril`ar'urattt7rr�✓�//%%��/�/%✓ ..
name:
location:
city yhone#
❑ I am a homeowner performing all work myself.
❑ I a sole roprietor and have no one workin in any ca acity ,
I am an employer providing workers' compensation for my employees working on this job..
comnnvname W 1Q en ! e ora ►on SCE/f/I CeS Jr-hC
• .
:.. .....:.. .
address l i'D e r ee�s 1 D t' A ::.
city: phone#: 790 ' 1 I R 7
insurance rn. !' �lrl olicv#
❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who
have
the follo«ing workers' compensation polices:, ,•
company name:
address:
city: hone#t
a -
olicv#
insurance rn. 'r /0"
0/m/m/m//m/m/isi,�iiaiaaaiaiaiiiiaiaia�aiioia�iiaiariiaii�oiiiiaoai//iiaaaaiaiai�iiiia��ii�i� /i /i //�////%/%///,�
cam an,,name:
address:
hone#:
city ».
...
ojiO
Insurance co.
f Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a One up to S1,500.00 and/or
one Years P
'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a One of 3100.00 a day against me. I understand that a
copy of this statement maybe forwarded to the OIIlce of Investigations of the DL1 for coverage verification.
I do hereby certify under the ains'anJ penalties of, ,727
the information provided above is true and correct
Signature S- Date _
-290
Print name ! en 7 S ll )►'Ll s h t' //C� Phone f!
ofpcial use oniv do not write in this area to be completed by city or town oMc al
city or town: permitNcense N "• ❑Building Department
❑Licensing Board
❑check if immediate response is required ❑Selectmen's OMCe
❑Health Department
contact person: phone 0; ❑Other
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448 HILL AE51
TG-cca�n�o WI-C MA 0
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COtSTRUt `ON UP PV�ON`LICEiV�F� �
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+� NOD, MA 02645
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The Town of Barnstable
• BA NSTABM •
Department-of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
SHED REGISTRATION
55 t
Location of she (address) village
Property owner's name Telephone number
to )( 310 - Z 33
Size of Shed Map/Parcel#
Of
Signnaa re Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction?
Conservation Commission(signature required) 3
THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN
Q-forms-shedreg
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