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HomeMy WebLinkAbout0009 MAY LANE � n Barnstable *.Permit# 0 /2 00 Town of.Barns Expires 6 months from issue date Regulatory Services Fee ' 1 Thomas F.Geiler,Director cf Building Division UL Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Fax: 508-790-6230 ice: 508-862-4038 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without TdX-Press Imprint A trcel Number ® � ��• t �vl �� - ty Address sidential Value of Work C 0 Minimum fee of$25.00 for work under$6000.00 is Name&Address Telephone Number<� .. xw — l�� L�-� actor's Name_ e Improvement Contractor License#(if applicable)- !J -- '----- - �UT'S-L'fCETIS��`('1'f-appiltidblEj -PRESS PERMIT Torkman's Compensation Insurance Check one: MAR 2 7 2007 ❑ I am a sole proprietor ❑ 1 am the Homeowner TOWN OF BARNSTABLE al have Worker's Compensation Insurance trance Company Name rlanan's Comp.Policy# ;�-2- .r.w ,y of Insurance Compliance Certificate must be on file. — mit Request(check box) -j 5 ne-roof(stripping old shingles) All construction debris will be taken to �-Q � � .A- ,'`.- �.t existing layers of roof) ❑Re-roof(not stripping• Going over g Y ❑ Re-side Replacement Windows/doors/sliders. U-Value maximum.44) e of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. *Where required: lssuanc ***Note: LA perty Owner must sign Property Owner Letter of Permission. meIm r nt ontractors License is required. opy of the Ho p IGNATURE!' 4 Z:Fonns:expmtrg tevise061306 f The Commonwealth-of Massachusetts Department of Industrial Accidents i Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pluinbers ulicant Information Please Print Lee bly me(Business/Organizatiowlndividual): .dress: .y/State/Zip: SOO'"A A4Lo-�u Phone#: 50q 60� 4.b L-1 0 (�ou an employer?Check the appropriate box: Type of project(required): I am a employer with. Z.- 4. '❑ I am.a general contractor and I 6: r New construction employees(full and/or part time)* have hired the'sub-contractors. I am a sole proprietor or partner- listed on the attached sheet.t ? [❑Remodeling ship and have no employees These sub-contractors have 8 ❑Demolition working for me in any capacity. workers'comp.insurance. 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 am a homeowner doing all work right of exemption per MGL I LE]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' 13.0 Other comp.insurance required] applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. eowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. actors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy h6imation. an employer that is providing workers compensation insurance for my employees. Below.is the policy and job site oration. ance Company Name: Lt y#or Self-ins.Lic.#: Z'v l S 3" '5 Expiration Date: JE 171%.101 ite Address: City/State/Zip: :h a copy of the workers'compensation policy declaration page(showing the policy number and expiration'date). re to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ip 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 to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of tigations of the DIA for insurance coverage verification.. iereby cce�er}}tify under the pains andpenaKes ofperjury,that the information provided above is true and correct Lture: Date: AM3 ''facial use only. Do not write in this area,to be completed by city or town official ity or Town: Permit/License# suing Authority(circle one): Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector.5.Plumbing Inspector Other i - Liberty mutt�l v xd�>� �1 t l J� 9 I��Box 7202 MUtumd Portsmouth,.NH 03802-7202 Telephone(800)653- __— .31-5693 January 9,2007 TOWN OF BARNSTABLE ATTN.-SALLY 230 MAIN ST HYANNIS,-MA 02601- RE: Certificate of Workers Compensation Insurance Insared: OLIVER KELLY 9 PEREGRINE LATE . S YARMOUTH,MA 02664 Policy Number. WC2-31 S-338804-026 •Effective: 12.282006 Expiration: 12f282007 Coverage afforded under Workers Compensation Law of the following slate(s): Mq Employers Liability. Bodily Injury By Accident: $ 100,000 Each Accident Bodily Injury by Diseasz: S 10000 Each Person Bodily Injury by Disease: $ 50.0,000 Policy Limits As of this date,the above-referenced policyholder is insured by Liberty Mutual Fire Insurance Co under the policy listed above. The insurance afforded by the listed po4cyis subject to all the terms,exclusions and conditions,and is not altered by a"requirement,term or condition of any or other documents with respect to which this certificate maybe issued. This certificate is issued as a matter of information only and confers no right upon you,the certificate holder. This certificate is not an insurance policy and does not amend,extend,or aher the covei av afforded by the policy listed above. If this policy is cancelled before the stated expiration date,Liberty Mutual will endeavor to notify you of such cancellation. AUTHORIZED REPRESENTATIVE UdBERTYMUTUALINSURANcE GR07P Ibis Cer6LcaleisexecutedbrL]BERTYIVnJTI-ALINS[RAMEGROIIPasmspeeissuenwsusonceasisaffowedby hose Companies. cc: Insured: Producer of Record: OLIVER KELLY SANDPIPER INSURANCE AGENCY INC 9 PEREGRINE LANE I ENTERPRISE RD S YARMOLTH.MA 02664 HYAIv-NIS,AA 02601 L'S/H107 II Al Boar o Building Replaflons and tan ards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration " Registration: 128957 a Type: Individual Expiration: 6/14/2007 Oliver.Kellyy Oliver Kelly �� t 9 Peregrine lane . S. Yarmouth, MA 02664 Update Address and return card.Mark reason for change. Address E3 Renewal ❑ Employment [],Lost Card- OPS-CA1 A SOM-"04-0101216 Town of Barnstable Regulatory Services t i * BARNSTABLE. 9 MASS. g Thomas F.Geiler,Director 1639. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder L , as Owner of the subject property 7 P PnY hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. �- ( dress offob) 4natureAf er I Date 0(4 P-u PAQL) I Print Name Q:FORMS:O WNERPERMISSION i I: 61 z - Z-7 .ZV ----------------------- 136 'i it ! [3r4X rEJi c Ca,2 T/.�=/EO 7-/.cY 7;41A7- T�/�� fI�.�1T/cN/ .GaG.4T/O.t/ /72-t- L.L z I. SNOWit,r,yE.eEO.(/CONI,�,G YS J�//T/�• SCA L G- '' � ! I � Tom:' BA XT,E,P_ �s�D 70 /c,�iV7' ;- ° Assessor's map and lot number ... ........................................ q SYSTEM MUST BE cFt"ETo WST.ALLED IN COMPLIANC �Q� Sewage Permit number ... °... .�5..... .,.d?..................... F d . WITH TITLE 5 Z BA"STABU, i w MVIRONMENTAL CODE A�-_0 M�a House number ......................:............�-�.............................. 9 'OWN REGULATIONS °°�oMpY'Ar, A P P R O V ET WN OF BAR.NSTABLE Ba stab Conservation fission 7 LDateILDING INSPECTOR Si pad APPLICATION ION .FOR PERMIT TO ...... .. ........)... ... ���....... ..................................................... TYPE OF CONSTRUCTION ....� 1C30�..�.....2 ........ ...eZ�. ............` ......... ..- .. ............................19 . . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..E. )f�Z � --I— �N. ..�...T.................... ................................... Proposed Use ...... a `i... ................................................. .............................: . . ....................... .. �'.\ Zoning District .............. ............................. ...................Fire District ............... c..... .......�!.................. ...... �- Name of Owner `........... -........................Address IW—St..... .. .'{'f?r ......�'.�ih''�.`...................... Name of Builder � � .�-I&C�t!�r..................... d!4. 2. .[. ...........0.............. Name of Architect ...................�---... ......................................Address .................. —.....................................0.................... Number of Rooms ..... .. ......................Foundation .. ! :.` ................................ Exterior1�.. ."... .................................................Roofing ..........A5. .11A... . ............................................... Floors ...... Interior ..... ... ....... ........ ............................................ ............ ......... .. ok Heating ..W.•v" ��...� ` Plumbing �" '....... ......................... ........... C�i 1 '.................................. �.--. Fireplace ..... � .... ..................................................Approximate. Cost ......�.��.�.�-�............................ ........... Definitive Plan Approved by Planning Board ---19 7-7__. Area .......,/ 1..................... Diagram of Lot and Building with Dimensions —�� - Fee 1)z) SUBJECT TO APPROVAL OF BOARD OF HEALTH "\ 1 IL OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the T)6Wjn of Barnstable regarding the above construction. Name ...... 044-3q Construction Supervisor's License ............................... .... I:AQUETT, CARL � r- do ....30837: Permit fir ... . ... ..tort'............ Build..........DI.;. c ....................... r ......................... Location ..Lot # 4 9 Mai Lane C`@ni ery lie . ..,. ...... .............................. a Owner .......Carl: Pac�u tte ..... ,-.,.... . ..................... Type of Construction Fra r � s ....................................... ..... .r. ............................. i Plot ............................ Lot ................................ Permit Granted .......J.1 .nQ...9..R...............19 87 1 Date of Inspection ............ .....................19 Date Comple ed ...,.. ./� ................. 1 _ /i 7t v -1 a z 4 BUILDING ;=,PERiV11T TOWN OF BARNSTABLE, MASSACHUSETTS DATE iu1:e 9 19 87 PERMIT APPLICANT_Bl�ksly build4rs ADDRESS 014144 7r� (NO.) (S BEET) (CONTR'S LICENSE) PERMIT TO ( , u STORY NUMBER OF o DWELLING UNITS 1 (• IM N (PR.POSE AE)' _ AT.(LOCATION) _- 19O/� T t r 1 ZONING DISTRICT_ f r, 6N0.) r(STREEc E1TF.E--tb� dz�E� .. c� �- BETWEEN AND ( -(CROSS STREET) .. (CROSS STREET) .. LOT SUBDIVISION LOT BLOCK SIZE, BUILDING IS TO BE IT. WIDE BY FT, LONG BY FT. IN HEIGHT AND SHALL CONFORM IN.CONSTRUCTION TO PE. - 'USE GROUP BASEMENT WALLS OR FOUNDATION . - (TYPE) REMARKS SYL P #87 195 BOND AREA OR PERMIT VOLUME 7.004 Bq ft ESTIMATED COST �- 110,000 FEE �. 80•50 (CUBIC/SQUARE FEET) - OWNER (:ar1 Paquette A BUILDING DEPT. + / ADDRESS 17Q Rainhrirl g�+ Rnar�' West ii�'rtfnrri, ('T BY s ' -`,."�;""`� E`WT'V`�"'`%'Ol3-'L't`C'-VCYJRr(5:"'r'Yi'E YSS-'tYaP7C`E"oF'—rrr,�"'r rrt-rvrr'Y"i`i'O�-s iVY7Y' rz`L"'rtr'ttS'C-Yr-ri~--ar'P�trtxrrcr-i�-rt'trNrYrtc-C.ivrrtii'i ,vrv�..-=. OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE .REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH 3. FINAL INSPECTION BEFOREE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 U 1"f l L"k 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 1 OTHER I e WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT 'W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN B� TOR HASAPPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED 'WITHIN Sl' MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN INSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION, 4 �TME TOWN OF BARNSTABLE - 3 0837 Permit No. ........... .... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash '�°'fcrin► HYANNIS,MASS.02601 Bond /X CERTIFICATE OF USE AND OCCUPANCY Issued to CARL PAQUETT , Address lot #24 9 i4ay Lane, Centerville 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. 19................. / Building Inspector 77 °•. ' TOWN OF BARNSTABLE BUILDING DEPARTMENT _ ram""o- TOWN OFFICE BUILDING ua t639. �� HYANNIS, MASS. 02601 �`0■AV M. MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by 4 BuildingPermit #........... o .. ./ .............................................................................................................................................._. issued to C.....1�3��1.c- ..................................... .......� Please release the performance bond. 4r,84 h)S-1 (off L Lcr k SF c-0 SF l 2 8 12 I S,oco SF -7o t Sri q�`'s F r1 N - G / �� � `/ /oa•G /vTC. &.U. A/ k/4,: /G E- / ' \ ` _ _. yr.� �. � �A _ i �,�. u�. ! T?w�:L.�.��1(, D ;�✓t�(J�i(c�K G�(A tJ 6.tz'� - cz nwL UJ P4o7 R-A N en-y- %�• 13 ,JIL-f12Q - • 147 L� c . )) F - �3y F' q I Y 7 -- ���JJJ 4:j ,4IW 2'>6; zlilti t= `3 — T XB ',r�C';,�1 fJs,�Cv ��< :,,�• c ' .. ���'� --- _ --- X�,�i�;:J._=mac ; ! 3�''/ c' ' ©. s'/�7 = ,L1 r/�� ". 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