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HomeMy WebLinkAbout0426 GREAT MARSH ROAD kx_ , Town of Barnstable *Permit# Regulatory Services Erpirees 6 ma t sfro sue date T Y 1 V Z E AR9SfABLE. i #ASS. i619. � Thomas F. Geiler, Director Building Division c&�&/LS 2 Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 www,town.barnstable.ma.us Offrc e: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number / � Alf Property Address �� f 'A Residential Value of Work �/ ��� Q a jj Minimum fee of$35.00 for work under$6060.00 Owner's Name & Address ? f /1-► Contractor's Narne _S If/ CIPre.—_ 1I Tel `� 77S Telephone Number — Home Improvement Contractor License#(if applicable) /6 0. Q2 Construction Supervisor's License# (if applicable)CE / 6J 3 G �4Workman's Compensation Insurance Check one: �� ❑ I am a sole proprietor JUN 21 2U12 ❑ I am the Homeowner AL I have Worker's Compensation Insurance L Insurance Company Name / ®•f% r C(J�C� L Y" TOWN OF BARNS TABL Workman's Comp. Policy# k ff 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 el< 3 ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side #of doors Replacement Windows/doors/sliders. U-Value (maximum.35)#of windows *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 requ'. ed. SIGNATURE: - QAWPFILESIFORMSIbuilding permit forms\EXPRESS.doc Revised 072110 The +Canirtionweal'th oft' assachusetts -- Department of'Industrial Accidents J. Office of Investigations 600 Washington Street Boston, JV4 02111 y wfv.mass govIdia Yorke -s' Compensation Insurance Affida-vit: BuildershContr,,ictors/E.lectric .ins/Plumbers Applicant Information Please Feint Legiblti' Name(Business'Orgauization!tudividual): 4. (DnP* 11P�_ Address: city/State/Zip: "C'M/C All 2�Phone#: ✓tea /��- r Are you an employer?Check the appropriate box.. Type of project(required). l�K I am a employer with 4. 7 I am a general contractor and I employees(full and/ar part-time).* have hired the sub-contractors . 6 ❑New.constnTctiom 2,❑ I am a sole propne-lor orpartnes- listed on the attached sheet- '7. 0.Remodeling shipand have no employees es These sub-contractors have ' p' � $- []:Demolition working far me in any capacity. employees and have.workers' [No workers' comp.insurance, comp-insurance:Y 9• [:]Building addition required-] 5. ❑ We,are.a corporation and.its 1t1.❑Electrical repairs or additions officers have exercised their 3.❑ :I am a.homebvvmer doing all work. � 11.0 Plumbing repairs or additions (myself. [No workers'comp. right of exemption per MGI t 12.�Rbaf repairs ins-urance required.]r c. 152, §1(4)„and we have no employees.[No workers' 13 © Other f z i�i comp.:insurancae required.] *Any applicant that cliecks'box C must also fill out the section below showing their ww1cus'corupevsatica:policy informeatian- t Homeowners who submit this affidavit indicating they are doing all work anfd then hire outside contractors must submit anew affidavit indicating such- h am actors that check this boot must attached an additional sheet showiug.the:nsme of the sub-coutractars sad state whether or not those entities have employees. Ifthe sub-c.ontractorstace empla)ws,they:nmstprovide their workers'comp.policy number. I ant an employ-or that is proi�Ong it y employ,eas. Below is tho patiry rind job site inforNrfidoit Insurance Company Name: Z l','�7 Policy#or Self-ins.Lic. piratio-n.Date: Job Site Address: ` Co �R Pik S'7 City/State�Zip: Attach a copy of the workers'compensa Lion policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of l+r1GL c. 152 can lead to the imposition of criminal penalties of a fine up to$1.,500.00 and/or one-year imprisonment,as well as civil penalties in the foam of a 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 D.IA for insurance coverage verification. I do ltemby crartify under€he prrizts artrl pertafties of peduty that the inforinationproiided a&ire is true a►td correct Siena Date: Phone FCit nirl use only. Da nat:"rite fat this area,to be completed bye city'or tomeofciaiy or Town: Permit/Licemse# uing Authority(circle one): , 1.Board of Health 3.Building Department 3. City/Tovim Clerk 4,Electrical Inspector 5:Plumbing Inspector 6,Other Contact Person: Phone#. 6 of t►�r� + HARNSPABLE, "SS Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder F 1 I, let, , as Owner of the subject property hereby authorize -�TP�4 �i�f�.l`/ to act on my behalf, in all matters relative to work authorized by this building permit application for: 19 (Address of Job) l Signature of Owrier Date ����,y rLc,r71 • Print Name If Property owner is applying for permit, please complete the Homeowners License Exemption Form on the reverse side. r QAWPFILESTORMSIbuilding permit forms\EXPRESS.doC Revised 072110 P�otHET Town of Barnstable Regulatory Services M Y 9 113L'°`�(ASSS. Thomas F. Geiler, Director 679'�► N Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 518-862-4038 Fax: 508-790-6230 -------------------___________ HOMEOWNER LICENSE EXEMPTION Please Print DATE: .10B LOCATION: number street village "HOMEOWNER" name u home phone N work phone tl CURRENT MAILNG ADDRESS: city/town state zip code The current exemption for"homeowners"was extended'to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor, DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-yearperiod shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit (Section 109,1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. , The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval o•f Building Official I Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. 0 HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing ofconstruction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In.his case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 072110 �.L ll-1,l 13;J. }L 1. t�i3•i ii°i 1.."" '� 'liJt.'F: �.sr.r';V,1 iz�. �. ... ..... CERTIFICATE OF LIABILITY INSURANCE `H15 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFEERS NO RIGHTS UPON THE CERTIFICATE HOLDER.TH15 CERT(FIICAT•C ACES NOT AFFIRMATWEL'Y OR.NEGAMELY AMEND, EXTEND OR ALTER TNF cOVERAGE ARFC R011-D RY TtlC POLICIES BELOW. THiS CERTIFICATE or INSURANCE DOES NOT CONSTITUTE A C014MACT BETWEEN THE I$tL6NG INSURER{S}, AUTHORIZED RIZI412£;SENTATIV 'OR i RfJt Ut`> ?c,AND THE CERTIFICATE if(n.bF-R- IMPORYTANT: IS the crr^tirmate holder is an AD.Dri-IONAL IhSUgSD,the policy{Iesr}rnuct by endorsed. If S118tir3GATION iS WAIVED,subject to tilt;felon s find conditions of tilt priiity,uettain polici&%alto};Tequile on endmirtmant. A statEn-At on thift 6att.ificate doea not confer rights to the certifte'zte hoider in lieu of such s<ndomement tz}. P110pucr€i KERRY It`+181-JRANCEAGENCY INC EASTHA,M COMMON RTE",6 r rr. Arr?mot t NORTH EA,'N-FIAM,MvIfX 02651 fA stmEr7(5}AFFORDING C0ytRAgrr. "c e Ir tla(flF lfliktf�t7 t(uUsfgaLlSdttJctotd ao-r:3tucco �.. CRESWELL CONSTRUE TION GCS [NO 105 INN STREET �sCrastic: Oi N'rFRViI_LE MA, Q?-632- WAURpn COVERAGES OEI."17FtCATE"NUNtctL=R g,2 0 r REVISION NUMBER:'I"His Is to 1I•s i.F�OJC'jrc 'Cip IN 51.if�ia.V�to LISTED BELOW s 1AVE 13r-NI i,—6 TO Fi v4suRrD"XIIE D!'ebV z OR THE POLICY PERIOD INDICATED, NOivirtH.S--10,10R r.ANtN PrQuiREmENT,1' FI1+.OR CONDITtON OF ANY EFoi`I RAMOR{)THFq 00'CUtv1Ev--WITId RE-:,-5 SECT-I'0 U'HIC•1 T1,1,1 ( C: ?"fIFGRT! AY E!E I �aUEr C1iz PLAY f'e inINI TIit t ivLIR 1'1c_?.rCCRJE)IJY T63C IaLLICi S Ia 43GfrrtECs IS AiSJSC-T T'.J' ALL 11.E "'-l2Nl=, t E`tG USioirgs,xqu c ctNt Irian."OF SUCH 7t ft;ICE.LIMITS:SHOWN MA 0 AVL O'CEN REDUCE DSY PAID CLAWS. ------------- PUt.d,,Y 'XS7.. c a tarn t�Atstuty a ciaac t rry rfsis€ :taimo Yvxva;t arg{e F uxrrs } t3� h Sac{ tl�rU# l GU rUf Pt C tx EF Pti LfA .n. PREMISES'I#tTF7rCt� t R P PREMISES'tEo CI:1riA MArt V"F3 G„?tu�'i1 nci�n rre3ttsrr �R I 1 n_�t�ewrtf e cr cn."c---!€3 IG'EMIACGREGAML;WTAPPLIF:,'PFk7 r. ^I.rr Yr. C 1s1t.n t i _ CU Pilll'451' '3z31tr• URLtra.ffY, - i p,. .t l �y(�"I': I,Lt ;:?, ._._..... 11 [ ��..a�8�l ii Afl't Am I 0.01'O LLt'UF-y , 11TtL9 s @ 1tv, IJR {€er M.�tR tvxs A {Iku1"O3SaQGli F"3uPCit1'f Ar+rirf'` _ h#�iG rt niIT09. ._,_..3 at111 r.s, { I ,•{ aM i p{� is, tlrit2ktEh�A r.rAA om OR k!F� pp ,. UVRE.",LlArr�"� LhlAbid«:it.C'!;;( - i nP.Gr�CCxrs'a", :o I n ertrrgt,s � (( A WORKERS WMPr^NST JON t O� nNu eau r vwtrt5 unett f R pp. I RIP rr�r-t r:::�. r. c enc r rscar srr f}iUt!(I &a44S dPE RtRfyeU11laav �J WA t.,urxfaMrq in t.Ytl i i � E•,% QtN`R`3t` r#EP•r1'l.t?YCt= 5 .._,��.i � n t res it eper3n3 t yam t {- E,,-01,z 6aje-POLZYc4 rr �aflJt7�G �H3i:tzJo'R6n_r.UFLNxL'-itATi{iMS.fY.pCA1't4rt3aifll klL3t,C6 tarsragpt:trRO tqt Atfalitlomllitwitkolrbn6tkrlo>rfwoe,3p.rwin vnuleaoj - - Worlw! compar•;snllon Irlftumnct nnver-O90 opplie3 Only iu Ulf wwpom cornpannot on Imto of the nirr;ta of MA, SHOULD ANY C7t"YH rAMVE DEqCRISED POLICIrS 13r:CANGGLt,CD BEFORE T0VVN OF BARN THE LXPURA110N9 D;Trz Tx ter-, �JOTICC VOLL lad OCLIVEED IN BUILDING DIVISION ncrca��srrcEavt f�rfrEa�O t�Ynrotltssurts. ATTN THOMAS PERRY 200 MAID!STREF-7' Alai-AM7srrr3crHssFsarr�tni HYAANN'jS mA c2-651 Jtlif Eltirld l e ID 1988-2014 ACORD CORPC1I ATIt�N. All rights rese"d, ACORD 25{2{f1flt0 r} The ACCORD name and logo fire regiwtured marks of A(=D Di, Ch[t.+... L. ^nac�.+, FnL' r <.+t-. r.l..:.gT..;viov,.;t .a-tvh, :-w»4:Lt...�•r,"3• .. i f71R112112 02:46 PM Page 1 r ./ Bprd:ot Bitd'oug Gtegalatians and Standards- K HOME fM ROVEMENTCAh1TRACTOR Reglstratl© 160627 Expu4tI6 4j6/2010 ' TO 272337, qd STERHEN CREt " { STEPREN ORESjWELL�E 1.95 pINE ST' � ; , " CEN•ERVILLE MA 02632t�� * E!"i.t�s;tchucCti�:-"im�t of puhiiL�S:s3�tr�a'�r B RC ulations and Stunt�a�tic;,:='i. oard;r�f Btsilel in��; r 6 k Ctisttucton Supervisor,.License; License: PS, 76536 1 q STEPHEN W CRESWELL - xa ' 195 PINE STREET' }�r CENTERVILLE,MA'02632: . .� ' 't"��mrnE�i.+aur _ � `'Tr�• 20265 �i�` F- t O We of o€i�ul)i,et 1TF��)tS. li��l :l. Uisii�e�s R-cy�ul� on 4 r ;, ���=• I3r,si€�s),,�1�z:,�aclz�asvi:ts 02 t :(Ci Home 1111prove31ei (,;oq tor RegIstratican. ettsfration:- 160627 Type: incclliv citt�i E`X..ir atio(?; rSi {ti7 jre, 20716 STEPHEN \N1. CRESWELL. STEPHEN EPHEN CRESWELL 195 PINE ST CENTERVILLE, MA 02632 a.. Clpd.,it:Addreti5 and ;elan�t crud.Al',trk' rca un €or Address lleiww d Employment -._€ €ost Caf d 0rfl 01'Co nsurotrn�fGurs&ilR eAntiss Reg Hlat;C+n license or re!,isU a uM10-��4ihd fe:>irtdis't��ul usr grdv 5 04 HOME IMP ROV€A"EtvT CONTRACTOR before the.expiration date. If found returti to: Registration: 60o27 Type: Office of Cousuiver A Hairs situ't3tunae� .Re��ais�t_inn � w Expiration $8,12012 Individual €01"aii.l lazy 5atte5€.7I) L _ = i3ostan,.)AA 02lk6 STEPHEN CRESVVEE t 19a PHNE,Sl CE\TFRVI[_LE, 1r102S32 1Jnt4�.ast1 raarc Not,v;did witttottl s'ignnt;tre 0 „• TOWN OF BARNSTABLE Permit No. _ <_�-__ ` Building Inspector UUIr n Cash --------—------A-- +,69� " OCCUPANCY PERMIT Bond � issued to Barnstable Holding Co. Address Lot 9, 426 .Great Marsh Road, Centerville Wiring Inspector - Inspection date Plumbing Inspector' ^ Inspection date Gas Inspector —�� Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Building Inspector .i �� :_ ., i.,_:w . :;,.�., .�;.; `..� r''`�i 7 �Y .,��s •kiS.n`a.'.r''�:i. "`."o-={.�. .1.�.�4 ry ,,D _-. �'r...S:,..t�:a��.' `�:,wc .r��«. k TOWN OF BARNSTABLE BUILDING DEPARTMENT i ssaa�r TOWN OFFICE BUILDING riva 039. `� HYANNIS, MASS. 02601 - - ' MEMO TO: Town Clerk FROM: Building Department DATE; d 1An Occupancy Permit has' been issued for .the`building authorized by BuildingPermit ......... ......... .................._...................».......... . ._... ..... issued to .............. •9�s� . Q� Please release the performance bond. Assessor's map and, lot number .......,l. d.'... .19 ......... 7I�;SYSTEMMUST �E THE p f t ;NSI iLLED p�® PLI14 G�,p1 Sewage Permit number . .............. Iv TITLE L »,- BARNSTAD E,ONMENTAL CCD'E .. ............................... ......number .................... r ...� i rasa f TOvvpi iy�j �; (� �C3 9�0 i679. �00� M a• TOWN OF- 1BARNSTABLE BUILDING,- INSPECTOR APPLICATION FOR PERMIT TO ...f..✓..4 ,... :............................. .. TYPE OF CONSTRUCTION ...... f! ................. r� ..4�C�✓� v ......... 5'..............19 .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a ermit accordi to the following information: Location ....... ....... .... . ..... .......: /.. �....... ProposedUse ... ................................................................................ Zoning District . Fire is t:�.... ................................ /. . Name of Owner ...... �✓. ��(!�/. ..................... r ss • LlJD s �/,/ //J✓9G/:........ '�-- itiC ................. ....` ......../......... `l Name of Builder s .. .. ..Address ./pA..: ..... . ..! /.. �.... . .`��l' Name of Architect .... . ./ ,e✓/!.. �.tL IJ!f..G.�. Address ..... UGGti / ./ ..... .... ................ ....................................... Number of Rooms ........... ................................................... /.10 &ie.4.......e#On4,. .�............... . .... .......... Exierior_.. .... �c...... .....� .......Roofin /Z C.,J. ae_ xoi,ye ew e".4,e j'o1i�,4- � 1 � Floors ..................�...................................................................Interior ....... ...............�!'��......G�fT�G.��............ Heating ..... .G , ........................................................Plumbing ... . ..... :.......... . .................. Fireplace ...(../.Loev.4.........................................................Approximate Cost ........... n ......................... Definitive Plan Approved by Planning Board -----------_______-----------19________ . Area ...l..Os b...:..................... . Diagram of Lot and Building with Dimensions Fee � ! '/ 't 1 ' SUBJECT TO APPROVAL OF BOARD OF HEALTH P I hereby agree to conform to all the Rules and Regulations he Town of Barn le regarding the above construction. Name . ...� '.!".m'. ............................. BA} 3STABLE HOLDING CO. .... �.............. No ...27628„. Permit for .$�A Single,:an-d. ..]�w��r i,xl�. _ . ........ _ Location .. t..9.......426..Great..Marsh.-Road .................. ..................................... Owner ....Barnst�1(a..H0.1dir19..Co............... Type of Construction .......Frame........................ z Plot ........................ Lot ................................ Permit Granted ......March................21..,................19 85 _ Date of Inspect' .... .. ... .Ll'9 S'�S Date Com et�d . . � :. ......... ..19�� ' PERMIT REFUSED ................................................................ 19 ............................................................................... 4 ...................................................................�..... .... /` ............................................................................... Approved l ....... . ..........:......................................................... THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I M A�C(, F DATA Assessor's map and lot number ............................................ *THEr��o Sewage Permit number ........................................................ d Z BA"STABLE, i House number ........................................................................ G M6 9 ,sue \0 �E0 No a. TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPEOF CONSTRUCTION ..................................................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....................................................................................................................................................................................... ProposedUse ............................................................................................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Nameof Owner ......................................................................Address .................................................................................... Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exlerior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. 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 .................................................................................. BARNSTABLE HOLDING CO. A-196l2-19 x= !9o-,?/9 No ..27628.... Permit for ..one Storx Single Family Dwelling................. Location Lot 9, 426 Great Marsh Road Centerville ............................................................................... Owner ......Barnstable Hldig Co. ' ......................................Type of Construction ............ ........................ ................................................................................ Plot ............................ Lot ................................ Mar Permit Granted ......... �..21:...........19 85 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 Approved ................................................ 19 ............................................................................... ............................................................................... j` f y 03 • / :�, . `*-•lac �, . M r so 8, o s,s312 3 � •�� � 1n ME/1cE2 , la .r. I "J 7a { 7"Tm ry m: wI Z. /�9at KL ZoN,CQ RFe l� p s sv wE pu oho , .z r— 'g, --N w� CERTIFIED PLOT PLAN Av OF p�4 T 9 _ 2CA A�'c ROBS tl° G� � /�/ 7 2 NEW,E ` CONSTRUCTION ONLY l � B r; FTOP QF F®U N1a. I WDATIOW IS FEET E�" `` '`�� `� IN q 4G, �r � AS. VE x La>t1Rl.'' POINT OF: ADJACENT-. �'_ �,. < ,. . c, z 4• xz t SCALE, / i yo' DATEt .3,M, CLIENTS o,Nra 1 CERTIFY THAT THE F EQOST N0:0� RE®ISTERED �� SNO%VN ON THIS PLAN IS LOCATED . 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