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HomeMy WebLinkAbout0166 FIVE CORNERS ROAD �l � a �v e rr���s��, .. � y ,� e ., � � � � .. . .: ,' �„ ',... r o. , �.. ., 7 .. u :. y '� .. n �' � .' ,� -, � -�.. +. o -. .. .. . ,. 3 . i .. .. � it ', .. '. k.. - ..: f, .. a, .: .. n - �a - .. ., ,. t _ ` � .. ` .v F � r .. - u .. .. _a � � - i _ .._ � ., - � 4 � s � ': .. � _ n y .� .,'_ � e � ':. ., � o << 4 .i � o ,:' .. .; ..c� .4 ,.. a Assessor's map and lot num ..... �P.4..:.., 77 a / _ 9 ITIC-SYSTEM MUST, BE Se:� age.<Permit num-ber ` v..��f ........ PLIR VCE.( L ��� ARTICLE II STATE , i Y C, 1 ;3 yo*THE Toy TOWN. OF BAR5� -F® N •� t i BABF9TADLE, � r'Y //� i ` ¢ 8 MASL 439• �0r BUILDING ' INSPECTOR �.. mayy� � x t 41 PLICATION FOR PERMIT tO .:: .......... ......:.. .................. ,• r _ TYPE OF CONSTRUCTION ......... ... ...... .!l4A.e .................................................................... z- ...............zz)..':'. ......19.2.? TO THE-INSPECTOR OF BUILDINGS:. The undersigne herebypplies for a permit ac ing to the f 'I ing information: i1 Location ..... . .Q .... ............ ..... ........ ® ..................... G �G .... ... ... ... .. ProposedUse .................. .0 GC 1 . ........... .......................................... .............................................. Zoning District .................................................. Fire District Name of Ownerl .... .^ 44�-�r.. .Address .. .z-............ .! ' Nameof Builder ........................................:......... .....Address ..:....:....................:........................................................ Nameof Architect ..................................................................Address ........................................:........................................... o� Number of Rooms ..................... ........:.. .:Foundation/� Exierior � �. e . ......... ....... .Roofin ...A .................................. . . . ... . . . Floors '........... ..�.rl... �...... �.�.............................................Interior ...........Heatin .......gct Fb dl/ ......................Plumbing ....... ........... .............. Fireplace ...............:............. ..:.................................................Approximate Cost .....`'9..�.............. .......................... .. . e Definitive Plan Approved by Planning Board ___ ___________________________19________. Area ...... ....... Diagram of Lot and Building with Dimensions Fee ........30,.................O ............... SUBJECT TO APPROVAL OF BOARD OF HEALTH a v; I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above :construction. Name J. F. Breen Co. , Inc. � ' ' . . . ~ �� l9��7 one No -----.. Permit for --.—...s....����---- \ . . ' single fa�o1 dv�^11 in� - —.----.--.—.—.--..,---_..--.~^—. ` � 1 Location K M_..Five..Cormmmrm..Road __.. ` � ' - lle --.~--~----~--^,.---.-.-----.— Owner .......J.�—P.�.B���m..Co°.k..In.c........... ' Tvoa`of Construction --. ---..--.--. ' ' ' ~ , ........................- ..................................... ----.. P #7Plot —.�_-----_. Lot ----------.. October 77 Parm� Granted �.._.—.]9 Dotaof |n &/Y.22**� ----]9 ^ Dote Complete ��-----.—lq ' ' - ` - PERMIT REFUSED . --.-----.—...,...._.—.----.. lQ ` .` , - -; _ ' ` .� ---_---' ?'~^^^^'�^^---_^ --_---'' '._'..........~.--.—.--..--..--.—...— . —'--'—'~'`^r—^—^-^"^'-^``--^^^^—'--^^/ .—.-~.—.--`�--_—~—.......��..~. ' ' --.,.— ' ^ ` ~ ` .,-----------^—''... lA Approved ' ' ' ----^-----'-----'~--~—^''---^^'' � --------.--..---.,..~-.........—.` ' 4 . . Assessor's map and lot number .............::...:....:...:..... ...... 'ri' ! �` SewagePermit number ............ ........................................... THE Tp�y •) TOWN OF BARNSTABLE 7 Z BASH9TGBLS, t639.j am BUILDING INSPECTOR pow APPLICATION FOR PERMIT TO .........:/. '^. -�::.........fir..r.a`.:...a'. ....... ....:.Le t:'.:c ........... TYPE OF CONSTRUCTION ` !/...� a ' ' .1�...:.:.:�..r.........19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........'................. ........... �...........................................I......... ......... ProposedUse .................... .......... /... .................................................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ...............`......................................................Address ... .::. .....1. .............:.: ..:j!^c.. [ :'........... ... ' Nameof Builder ...... `..........................................................Address ...........r........................................................................ Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .......................?..........................................Foundation41 .L. t Exterior :. ...Roofing .......�:... ... ..... ................................... 1^ Interior 1 .✓A tJ Floors .................................................... ..................................................................................... .................. Heating ..................................................................................Plumbing .....................:-............C............................................. Fireplace .........................................Approximate Cost......................................... .................................................................... Definitive Plan Approved by Planning Board -----------_-------------------19________, Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........ 1.......................-.............................. J. P. Breen Co. , Inc. A=168;8` (not plotted) 19687 lone story No ...... .....4wermit for .................................... single family dwelling ............................................................................... 1W...Location Five Corners Road ..... ............................................ ........... Centerville Owner J. P. Breen Co., Inc. .................................................................. Type of Construct* R ........frame ....... ..... Plot ...................... L't .. �.. t .ber 24 77 Permit Grante .......................................19 Date of Inspection ....................................19 Date Completed ...,.H......:..........................19 PERMIT REFUSED ......................................... ................ 19 i ........... .. . ............. ............... .. ........ . . r�......... t ............ .... ....../...f. :. ......................... Approved ................................................ 19 ............................................................................... ............................................................................... Assessor's map and lot number �' r4� /�� /v- THE TQ Sewage Permit number ...�r�;.. SAHBSTME, i House number .Z„r rasa YPY.. tr\0� TOWN - OF BARNSTABLE BUILDING INSPECTOR 4. APPLICATION FOR PERMIT TO � �'�'� �' . ................................................ TYPE OF CONSTRUCTION .......... ......... ...:........,..... .............................................................. TO THE INSPECTOR OF BUILDINGS: The undersigned —hereby !applies for a permit according to the following information: Location ... . ...�?., �.... �/ '.��.... .�a; .... ,p ... ........................ . .......... ProposedUse ...... . , ......... ............... .... ....... .. ............................................................... Zoning District ................. t✓� .... ... ..........................Fire District ............. .. ................ .................................. Name of Owner !���'"�...:� ..... '��..:�-°Address ........................ Name of Builder' r.�?�!1r' �.. .. ....&TV.%.x1. ..Address � � . � —'�',�.� k Name of Architect ...�rffY A .......................................:Address ...:ft?�� ...:. Number of Rooms ..... `* '°:.........................................Foundation. Exterior 6:pAt4)..............Roofing . ', Floors ...... ..........................................................Interior � �-����r"T Heating .. �� ¢ ;d �r` .......................................Plumbing .... .... *' :'.:.... ...... Fireplace f qq � Approximate Cost ... ................................. ................. . .......... .. ..... ..... Definitive Plan Approved by Planning Board ------_----_______-----------19____:__. Area .......................................... Diagram of Lot and Building with. Dimensions Fee ........... SUBJECT TO APPROVAL OF BOARD OF HEALTH Li �✓�i w. I �4 f 7,10 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 � ..... ....... ............: ........ FREEMAN, BRADFORD /63 A=-3=k2=3-6 No 24231 permit for ADDITION Single Family Dwelling , ............................................................................... Location ...... Five Corners Road Centerville Owner ..Bradford. . . . ...Free...man........................... .... .. .... .. .. ...... ..... Type of Construction ....Frame ............. .... ................................. i Plot ............................ Lot ........... ................... t 1 21 82 Permit Granted ....t ..y............ .........19 Date of Inspection ......:........... ....:.......19 Date Completed ... .................... ... ........19 6 /av PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 09/22/06 TIME: 08:12 -----------------TOTALS----------------- PERMIT $ PAID 26.65 AMT TENDERED: 26.65 AMT APPLIED: 26.65 CHANGE: .00 APPLICATION NUMBER: 2GO63406 PAYMENT METH: CHECK PAYMENT REF: 231 Town of Barnstable *Permit# 6 m Expires 6 months from issue date Regulatory Services Fee d6- 6 S X-PRESS PERMIT Thomas F.Geiler,Director ��-n, _/� SEP 2.2 2006 Building Division. Tom Perry,CBO, Building Commissioner TOWN OF BARNSTABLE 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY c Not Valid without Red X-Press Imprint Map/parcel Number ® 1 Property Address /Z� `/ye! anl&� �L! ����1,4 z 0'.2-�3 2— [Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name �& Telephone Number HomeyImprovement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor Ep am the Homeowner �. ❑ I have Worker's Compensation Insurance Insurance Company Name 4� Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Pemvt Request(check box) E6741le-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 (maximum.44) *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 is required. SIGNATURE: Q:Forms:expmtrg Revise061306 Department of Industrial Accidents Office-of Investigations ' d 600 Washington Street Boston, MA 02111 - '�M Sve J� www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plum-begs- applicant Information y - Please Print Legibly ,lame (Business/Organizationllndividual): address: Aa1/! ,-ity/State/Zip: P ���� ; /VX- e;0?-Phone#: re you an employer?,Check the appropriate,box Y Type of project.(required) ❑ 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 sub-contractors 7. Remodelin ❑ I am a sole proprietor or partner- listed on the attached sheet t ❑ _. $ ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. workers' comp. insurance. ❑ g Y P. Y 9. Building addition- [No workers' comp. insurance - 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] _i 1 am a homeowner doing all work :- right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. ` c..152;§1(4), and we have no - 12.❑Roof repairs insurance required.] t employees. [No workers' 13.[:1 Other comp. insurance required.] :y applicant that checks box#1 must also fill out the-section below showing their workers'compensation policy information: 'z :)meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such - ntractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. - w an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site -x i7rmation. urance Company Name: icy#or Self-ins.Lic. #: Expiration Date: _ Site Address: City/State/Zip; :ach a copy of the workers' compensation,-,policy declaration.page(showing the policy number and expiration date) =• lure to secure.coverage as required under Section25A of.MGL c._152.can.lead to the.imposition of criminal penalties'of a - e up to$1,500,.00 and/or one-year>imprisonrnent, as well:as civil-penalties in the form of a STOP WORK ORDLR and'a fine y ap to$250.00 a day against the.violator.' Be advised.that a.copy of this statement may-be forwarded to the Office of estigations of the DIA for insurance coverage verification.' - - 9.hereby certify under the pal and enalties of perjury that the information provided-above is true and correct -; ature: LIy Dater fz >ne#: 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): I.Board of Health 2.Building Department 3.City/Town.Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions [assachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.- - arsuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, cpress or implied,oral or written." -_ - n employer is defined as`.`an individual,partnership, association, corporation or other legal entity,or any twq or-more f the foregoing_engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the -ceiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the;- wner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the,. er who- to do maintenance, construction or repair work on_s welling house of anoth uch dwelling house r on the grounds or building appurtenant thereto.shall not because of such employmentbe deemed to be an_employer." _ 6 also states that"every state or local-licensing agency shall.withhold the issuance or, QGL chapter 152, §25CO 'enewal'of a licenseor permit to operate a business or to construct buildings in the commonwealth for any. Lpplicant who has-not acceptable evidence of compliance with the insurance coverage required." _ MGL chapter 152;.§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall additionally, . le evidence of compliance with the insurance. ,nter into any contract for the performance of public work until acceptab equirements of this chapter have been presented to the contracting authority. kpplicants workers ?lea fill out the ' compensation affidavit completely,by checking the boxes that apply to your situation and,if lease i s ary fill supply sub-contractors)narne(s), address(es)and phone number(s)along with their certificate(s) of. nsurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than.the nemliers or partners; are not required to carry workers' compensation insurance. If an LLC or LLP does have -mployees,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 (ndustrial Accidents: Should you have any questions regarding the law or if you are required to obtain a workers' ber listed below. Self-insured companies should enter their compensation policy,please call the Department at the num - self-insurance license number on the appropriateline. 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 ouain the event the Office o Pl f Investigations has to contact you regarding the applicant ll ease be sure to fill in the permiVlicense number which will be used as a reference number. In addition,an applicant that must submit multiple pennittlicense applications in any given year,need only submit one affidavit indicating current policy infoub ation(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 maybe provided to the applicant as proof that a valid affidavit is 0n.file for future 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 bum leaves etc.)said person is NOT required to-complete this affidavit The Office of Investigations would lice 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 ;wised 5-26-05 www.mass.gov/dia own 0 77 plan,, �.v� �l�j C e N s 7-R v c- T'� O�/ /O�. 1 J i �Yo ov�iRlC�C► ��.:�.as�/ ANAs, y S / S 0 � 'O- .�'4-• ���•a���aa. Ar►r•� ," Yes .3 �00 116Q 4077 '7-- 1 O v W 4 cd t � t t'sr , »C /7, . 3 k`;4� !9, 1'� a � 8f791 u,7 �h �,Y P T I C. �`3 �"E„f 45/ Al �a N s -,�l.v� l v A1 w - , "L_6'ypd ©. c,4 p, f' w */, ! SrIQ»eR has a01 �Cr rota \o / - /o csC) e r a. t V/ f�*W,, ° r /YO _lrai-ld'cc G�,roi�'►4M1� � e/� 32tr GCc 4�421eI� /.s w 1,4,r /oo ' ol ve4c/7 , �1 l t � ,DOS° PLAN of LAND ceY76 IV, v IN �j,6 OF I$ / OWNED BY I CERTIFY THAT THIS PLAN SHOWS ,or�,� ��N oFMAJ�cy� t/O •��� ha �t:'t=� /`l NK THE ACTUAL LOCATION OF THE o co E Y y FRANK FRANK G(}NE1Y 5 TRE'd;OAI ST. STRUCTURE ON THE LAND AND V, No. 6232 0 coNEFtrV. HYANNIS. MAS.�+. =1 fSTEf+ THAT IT CONFORMS WITH THE � � � No. 6573 0 � � G ��• ,o '•Q� !� 4�� REc�sTetzeo�Raeaw +s u►No cuwvrow / BY-LAWS OF THE TOWN 1/ 1 �'^� su �y ���� KS+.AL�a SCALE 1 IN -Za FT. /0//¢177