HomeMy WebLinkAbout0024 LARCH LANE U o
Town of Barnstable *Permit# 70�
Expires 6 months from issue date
Regulatory Services Fee 1_�5
Thomas F.Geiler,Director CQ
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
-www.town,barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERIVIIT APPLICATION - RESI]DENTL4L-ONLY
Not Valid without Red X-Press Imprint
q
Map/parcel Number ;! g 6 0 (5 6 d l `s
Property Address oS L1 Lk paj , cea_-,.A;
[Residential Value of Work (0 l 5 Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address U✓�NL��C:r► Q-(.L,¢__U
Contractor's Named aA, -� Telephone Number
Home Improvement Contractor License#(if applicable) _ Z oC -S SGD
Construction Supervisor's License#(if applicable) C �O
[,jWorkman's Compensation Insurance
P
Checl one: ,
❑ I am a sole proprietor
❑ I am the Homeowner N O V 0 5 2007
04 have Worker's Compensation Insurance
"STABLE"
- '
Insurance Company Name
Workman's Comp.Policy# 7 5 O L 3,5 c5
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
3-Re-roof(stripping old shingles) .All construction debris will be taken to �w��Q cJ C
❑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
rThe Commomvealth o Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information ,( Please Print Legibly
Name (Business/Organization/Individual): Fk -SEE-
Address: 'PO 2,nX / Q y__5
City/State/Zip: C d-L U-1 -� PH- Qom 3.�Phone #:
Are you an employer?Check the appropriate box: Type of project(required):
1.01 am a employer with_� 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors .6. ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 1❑ Remodeling
ship and have no employees These sub-contractors have g• ❑ Demolition
workingfor me in an capacity. employees and have workers'
Y P tY• 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.:
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.XRoof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13.❑ Other
comp. insurance required.]
*Any applicant that checks box#1 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.
lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. lll �J '
Insurance Company Name: n 7?'rn-T y
Policy#or Self-ins. Lic.#: DES S n L S S50� _ Expiration Date: o�2
Job Site Address: o� 1 �cEIL" �G�-�e.. City/State/Zip: d d(�er
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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form 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 DIA for insurance coverage verification.
I do hereby certi er the ains and lties of perjury that the information provided above is true and correct
Si mature: 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):
1. Board of health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
CERTAINTEED Warranties the shingles and labor 100% through the Sure Start
Warranty duration.
CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the
Sure Start Warranty depending on the shingle that was purchased.
Any deviation or alteration from above specification will be executed upon written
orders and will become an extra charge over and above the estimate. All agreements
contingent upon strikes, accidents or delays are beyond our control. Owner should
carry fire, tornado and other necessary insurance upon the above work. We, if not
accepted within thirty days may withdraw this proposal.
FRASER CONSTRUCTION: Carries Workman's Compensation and Public Liability
Insurance on the above work, certificate available upon request.
DATE OF ACCEPTANCE:
Homeowner Fraser C nstruction
r i
13oard of
One Ashbjrto.0 place
g Regulta" Stazidards
®st®n4 ���a�busett ®�
1� 1301
FRASER C®N Registration:
EAN ��SE}���1lCTION Co. Type: p�3s i
p/q-P.O. ®x�1®845 Egoirafion:- 3/23/2D0.9 T1 127920
C®T UI-r, U 02635
DP&CA, dy fiOAr}05/08-PC84B0
- - UAdate Address and return larIL
lopFd® ®f l�uildirig P"gulati®ns and
- -- Address evv4 1 reas®aa for changes
ib1E Imp EMefVT C®� tsadards %Immt C� ]Lost Card
Regi tBoe�: ACTOR LiCM80 or reggs��
on
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DEAN FRASER C](0�
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COTUIT,MA 02985
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Nov, 5. 2007 3: 21 PM No, 5200 P. 1
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PRODUCER .::�1,f>Y>rzsx:< r'.<,v•x�11.i:.6 i x: S`;%i>a: 10�15-07 Si THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
WISE & QUINN INS AGCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
449 PLEASANT ST HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
BROCKTON COMP
Ma o230 i COMPANIES AFFORDING. RDING CQVERAQE
24
COMPANY
lN6UREO A H TF b U ER TE IN R
COMPANY E MP y
FRASER CONSTRUCTION LLC B
PO BOX 1845
COTUIT MA 02935 COMPANY
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COMPANY
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THIS IS TO CERTIFY THAT THE POLICIES of INSURANCE LISTED BELOW (s
w,..1.2ff."....?�..'k<N
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION A OF ANY CONTRACT BEEN ISSUED OOR OTHER THE RDOCUED M ENT WfrHE FOR THE POLICY PERIOD
RESP CT TO.WHICH THIS a w
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE T5RMs,
CO EXCLUSIONS AND CONOITION8 OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN RI EDUCED BY PAID CLAIMS.9 TYPE OF INSURANCE 'L7TI PORICYNUMBER POLICYEFFECTIYE POUCYE](PIRATION
GENERAL LIABILITY DATE(MW0D1Yh DATE(MNIWD�vv) LIMITS
COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE S
1 CLAIMS MADE PRObUCTS•COMP/Oa AGO. $
OCCUR,
OWNER'S&CONTRACTOtirS PRoT, PERSONAL&ADV.INJURY
EACH OCCURRENCE $
FIRE DAMAGE(Any one flra) 6
AUTOMouLF UAD[1TY MED,EXPENSE(Any one person) $
ANY AUTO COMBINED SINGLE
ALL OWNED AUTOS -
LIMB 6
SCHEDULED AUTOS BODILY INJURY
HIRED AUTOS (Per Person)
NON-OWNED AUTOS BODILY INJURY
(PerAaoldenq $
GARAQE LABILITY PROPERTY DAMAGE i I
I
ANY AUTO AUTO ONLY•EA ACCIDENT s .
OTHER THAN AUTO ONLY;
EACH AOCIDENT g
EXCE68["JUTY AGGREGATE i
UMBRELLA FORM EACH OCCURRENCE g
OTHER THAN UMBRELLA FORM AGGREGATE E
.A WORKER'S COMPENSATION AND
EMPLOVER'SLIABIUTY (6$60U6-08501-35-5-07 STATUTORY
THE PR I 09-26-07 09•-2fi=05 RY umITB PROPRIETOR/
PARiuERLEXECUTIY= INOL EACH ACCI
DENT
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OFFICERS ARE X EXOL DISEASE—POLICY UM(T - E
OTHER DISEASE—EACH EMPLOYEE E
0
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DESCRIPTION OF OPERATIONS/1LOCATIONSNEHICtg6/REgTRIaTIONS/6PEC11414 ITEMS
THIS REPLACES ANV PRIOR CERTIFICATE 'ISSUED TO THE: CERTIFICATE HOLDER AFFECTING WORKERS COMP COV
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" $HOLED ANY OP THE ABOVE DE6CRiBED POLICIES BE.CANCELLED BEFORE
. EI�IRATION DATE THEREOF, THE ►SSUINQ COMPANY WILL ENOF.AYOR TO WAIL
FRASER ENTERPRISES LLC 10 DAYS WRITTEN NOTICRTOTHECEpTo-1CATEMOLaERNAMEDTOMAI
PO BOX 1845 LEFT, BUT FAILURE TO AOAIL SUCH NOTICE SHALL IMPOSE NO oBLQATION OR
THE
COTUIT MA 02635n I ��OFANY Ic1ND UPON THE COMPANY/IT@AGENTS OR REPREGENTA7"S,
AUTHORIZED REPREeENTA
—Assessor's map and lot number .......... ...................... �cFTHETc
Sewage brmit. number ...............................................:.....:
ro
Z 33JSH9TADLE, i
House number ....... .a? !......�...... .. '`....:.......................' ro Asa
p 1639. \0�
0 MO a'
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO �-°e/ � ..1.�1`��................................... ..�... /• .... ............... ..... ............................
' � f�........��,� z_.
TYPE OF CONSTRUCTION ...................................4.Z�...... �..... ....................................:.................................
.......................... ./ .. ......,� ..
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit accordi
ng to the following information:
Location ......... ... .. -?`/1't't�::.'.! ......: ........ � � .......... �'�..
ProposedUse .............. Y.t' l r.................................................................................................................................
ZoningDistrict ................... � ..R::.....:..................................Fire District .............. .................................................
Name of Owner ...........................Address ..-.................. ...,.............
...! ...,.�//.. ..�.:..%`�......
Name of Builder C/�L SQ1L�F�.f. . � �G:......... —Address ...............................1. ... ............................�...........
Name of Architect l.V..:1 ..7;.......r..... f?�5./.Gy.........Address ...f� ........ e.. `2GL!;iGT... ......................
a/Ck' -
Number of Rooms ...:....... .. ..Foundation .:.. .�....... ...���'.!0....�.�............:�...........
Exterior C�k�.�../ �............. ..............Roofing ................... .. .:�................................:..................
...........................:... f
Floors :f�?L 1/,(449G/�..... Interior .....................a!�. ................ ....................................
Heating ....................... ......... .......Plumbing .......... ...... ............G .....1'T{.......
Fireplace ...................... ., 1'S...............................................Approximate Cost ...........�.V.4 .........................................
Definitive Plan Approved by Planning Board -------_ -�t___�_-------19 _ _. Area ...........................................
{ �
Diagram of Lot and Building with Dimensions Fee `
SUBJECT TO APPROVAL OF BOARD OF HEALTH
1
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. /
i* A �tNa e .....�. . ... ....77 .. . .� ....
Construction Supervisor's License .:`...Cf. C!..J ..........
T
S L S TRUST A=189-4J069 . D/J-
No ..292,22,,,, Permit fob'....1 Z „Story
Single Family Dwelli g
....................................................... ......... .............
Location Lot #15, 24 La c Lane
................... .............
Centerville
' Owner S L S Trust
............ ......................................................
Type of Construction' .......Fram
....a .e.............................
. ................................................................................
Plot ............................ Lot ................................
Permit Granted April 18, 19 86
Date of Inspection .:.,.................................19
Date Completed .....19
SYSTEM MUgg
E
Assessrwr's map and lot number .`'l�l/�.. .............. ........ SEPTIC cf THE TO
4Q� SS �- I¢ISTALLED IN COMPLIANCE
r Sewage Permit number ......................... .......................:..:..
WITH TITLE 5
House number ....... oz!. .................... ENVIRONMENTAL CODE
AND : H6839TADLE, i
... TN REGULATIONS '°oo� 6 9
nW Ar-
'.- Fi � 0 MPY
TOWN • OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO• ................... . .. ,1...............................................
TYPE OF CONSTRUCTION ............... ............. oU.._ ....,f: �� :.........................................................
....... : . ...........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies forrya permit according to the following information: ,%�
Location ..........-77.1� .,T .!!�::��'1........: .................. � � C........../:..1..��.................................
ProposedUse ............. .!./ ............................ ........................................................................I.........................
Zoning District �. Fire District
........... ......................................... ............... �..... /........................................ . .....
Name of Owner .....:...L`.... fLr4 1. ................................Address ..13I 0 -�./� . .!••3 .., 7/��/./ 9! .. a......
C( fr
Name of Builder�/ L S�Z�(ley,'�.. . �,.............Address .... ..................... ...................................................
Name of Architect ..1/7.C....... /../.���.:.......Address //- p ........................
Number of Rooms .Foundation ........ .. yl ��rt/�P. ...� `f�....:.....
Exierior ......... ......�-L, L ,f.................................Roofing ...................0 .!.:T' ..................................................
. J
f .interior .. ` � �r� ..!/ .................................. ........ .......2.....................
Floors ........................ .Urr�/
Heating ..................................................Plumbing .............
Fireplace .......................... ...�.r�..............................................Approximate Cost
r�Definitive Plan Approved by Planning Board-�- ---19 _. Area D.
Diagram of Lot and Building with Dimensions Fee SO f ....... �...................
...................
SUBJECT TO APPROVAL OF BOARD OF HEALTHis Y�• `�
(t�
Iti 1XY
A o
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 )tio/Supervisor's
`i: i ...... ...
Constr License ...... ......
r •,S L § Trust
No 29222 Permit f6r.....1 STORY -Single y.DW..e.7.7 zng.................... -
Location ...... 2.4...Larcli...Laae........
Centerv'
.......... .....................xa J.�.............. . ... ........
Owner '.......S.. ...5.....T U 5.1;....................:...........
Type of Construction .Frame.............................. -
Plot ............................ Lot ................................ y '
Permit Granted ...... Pr21.........18.....................19 86
` Date of Inspection ..................
Date Completed ..4S*.'�'. z . .R ......19.
,F - T
Cr
Z ,
1 ,.
'r
ofTNE>o TOWN OF BARNSTABLE Permit No. . ?9 ?.2
BUILDING DEPARTMENT
TOWN OFFICE BUILDING Cash
°�teuv HYANNIS,MASS.02601 Bond ....x
CERTIFICATE OF USE AND OCCUPANCY
Issued to S L S Trust
Address Lot #15. 24 Larch T,An4
Centerville. 1�asa��h�a�ett�
USE GROUP FIRE GRADING OCCUPANCY LOAD
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.
1
�:.. �'�
.........:...�... 19................. .................... ...... ...........
B- ingInspector
B
f�
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
i 3eanrAsc t TOWN OFFICE BUILDING
7 MYL
g i6J9• � HYANNIS, MASS. 02601
1
I MEMO TO: Town Clerk
FROM: Building Department
DATE: g►_� �_�/
An Occupancy Permit has been issued+ for the building authorized by
BuildingPermit 1....� _ ..._......
$ ...... 6.. ........................................... _.... .._
issuedto ..... h J..._ ........... .............................................................................. ....w.........._........._.__..
Please release the performance bond.
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINAL (S)
I M A�C(, I
DATA
:. �..tt'�'•gF .i...� •,�?:.-t..,� ::,s, Y �sa ,�",r,'"�s,Yl^v�. .-,• •�':r. -' .:..., j:.;�+ze �.� "H�Y� vir„ >+
TOWN OF BARNSTABLE, MASSACHUSETTSPERMIT
JOB WEATHER CARD'
i DATE It;)rll•. La 19 eh �I�f�� . 2 9
APPI-11, i.CScl—SolAowr
ADDRESS 1 l.L 1'PERMIT,
IN0.) (STREET) (CONTR'S LICENSE)
PERMIT TO iiU�..Ld •l1WN_llli?)� (�T STORY :':1; ` "' �`:' `{dam -i; NUMBER OF
DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) LOt Y�.5 .))4 :.,.':'..ii. ,,::11. I. :'::Gt?r'+li.11t ZONING lt,
DISTRICT
I (N0.) (STREET)
t•. BETWEEN AND
j (CROSS STREET) (CROSS STREET)
LOT
i SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN WEIGHT AND SHALL CONFORM IN CONSTRUCTION
i
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
j - - - (TYPE)
REMARKS:
i
i
VOLUME it U sq. � FEE
�. '.i{•°�
µ
(CUBIC/SQUARE FEET) ESTIMATED COST $
PERMIT
i L S ,1ru:it
OWNER
ADDRESS y ' BUILDING DEPT. e s Iqi•
By1
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR
PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP-
PROVrD BY TH_ JURISDICTION. STREET ON ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED
FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN
ALL CONSTRUCTION WORKS ELECTRICAL, PLUMBING AND
t:FOUNDATIONS OR FOOTINGS.
MADE.. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHAN CAL INSTALLATIONS.
I 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL "MEMBERSIREADY TO LATH). s
S. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE.
OCCUPANCY. "
POST THIS CARD SO IT IS VISIBLE FROM STREET
.'4
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
64
3 HEATING INSPECTING APPROVALS R ION IN C N APPROVALS
vl ��� N RIOF STABLE
ENGINEENG DIVISFOIN
OTHER 2 -- _.
2
� fir,,
WWCRK'S,,AL-r"NCT PROCEED UNTIL THE %i;DIAIT
ERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD F:NSPECTOR AAS APPROVED THE VARIOUSQRK IS NOT STARTED WITHIN SIX-MONTHS OF DATE THE 4!STAGES OF-CONSTRUCTION. CAN BE ARRAN ED FOR BY TELEPHONE
IC ICCIICn •C UnTen wsn OR WRITTEN NOTIFICA-FJAu. r�i•
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CERTIFIED PLOT PLAN
L 0 C.A T 1 O N 4=4E'Aeo7--.t:/e-
F 0 R: L��EG- ScGGot�,S E!/EGao�-lE.�rT'Gorjo
SCALE:
DATE.
/�` /9 8
,16
REFERENCE BE/A./G� G� _S Al Ov U
��C�/sT.zy c� •��c.JS iv D A E
I CERTIFY TO THE BEST OF MY KNOW DG EG. LAND SUR EYOR
AND BELIEF FROM INFORMAT ( ON AC 1 R D�
THAT THE -/ SHOWN ON THIS PLAN
IS LOCATED ON THE GROUND AS SHOWN HEREON.
OF
g JOSEM G�
M. -+
. J• M . MONAHAN.. JR . & ASSOCIATES vMONAHAKJFt
No. 13M
PROFESSIONAL LAND SURVEYORS & ENGINEERS Nf11STa��yoQ
T-OWN.E PLAZA - 90.0 ROUTE (-34..- S-OUTH D.ENNi--S� MASS. O suV0
I