Loading...
HomeMy WebLinkAbout0399 NOTTINGHAM DRIVE t . ._ �� . .� _ .F,, ,; ., : - , � -. �i �. ,�l� -m ., ,� :. , , .. ,. �. � ,,.. .. ;, o, o ., q Proposed Use BUILDER INFORMATION u , Name L., ' / Telephone Number � Address DO � 1 V�h; to License# (JDSZ 7 U4C4"Ylll �I Home Improvement Contractor# Worker's Compensation# 31 S--7(C(GW C J ALL CONSTRUCTI N DEBRIS RESU ING FROM THI ROJECT WILL BE TAKEN TO SIGNATURE DATE" � — TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma p 1� 1 Parcel v Application# Health Division Conservation Division Permit# Tax Collector = Date Issued b /(o l 6 Treasurer �; r Application.Fee Planning Dept. {: Permit Fee "b b© Date Definitive Plan Approved by Planning Board _ ®r— Ir.411pb Historic-OKH Preservation/Hyannis Project Street Address n(0 T'T i w t 6`L-�/+vd Village Owner C t(F-STEA 60aa/s k r Address 311 AJO7T['>u Ci yo-�c TelephoneS-v S Permit Reques(I _'51 jVEJZ_ iZF e1kUAW4 l e- QiA1C10tJ5 Square feet: 1s7 or:existing proposed- 2nd floor:existing proposed Total new- Zoning District Flood Plain Groundwater Overlay .Project Valuation 10 6'&0 Construction Type _�! Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure ?/� Historic House: ❑Yes $,No On Old King's Highway: ❑Yes �lo &Basement Type: 'Full l9'Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) �`�� Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing (C new First Floor.Room Count Heat Type and Fuel: 9Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes VNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0 Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:)(existing ❑new size Shed:❑existing' ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# -Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# , Current Use Proposed Use BUILDER INFORMATION Na e Ik EwJ,�l 74 fay.k T iNL. _'Qq C� Telephone Number Sob -S(o'),— spa Addre 'To Lice e# Home provement Contractor# Oil � ° Worker's ompensation# ALL CONSTR TION BRIS RESULTING ROM THI PROJECT WILL BE EN TO SIGNATURE DATE 06 z' i FOR OFFICIAL USE ONLY e PERMIT NO. DATE ISSUED MAP/PARCEL NO. ' ADDRESS — "'VILLAGE ' OWNER — T - DATE OF INSPECTION: FOUNDATION fi FRAME "- okt 10 2-71b INSULATION �C) C113�� AAA— Y FIREPLACE ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING 6C DATE CLOSED OUT ASSOCIATION PLAN NO,. s s Town of Barnstable Regulatory Services 1AaNSTAKS, ' Thomas F.Geiler,Director 9 'MA33. 039. g� Buildin Division'"lEc r�•Y°, Tom.Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing 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 vr=other requirements. Type of Work: Z CAotfA Estimated Cost /O,Ck:;yn Address of Work: ;��of IV nl 4 6�i4rit/I )A' Owner's Name: C Pt_57-t,/ C_v,6CA-1 SL,( 1 Date of Application: I hereby certify that: Registration is hot required for the following reason(s): r7Work excluded by law ❑Job Under S 1,000 Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER P S OF PERJURY I hereby apply for a permit as the age n o e own . Date Contractor Signature Registration No. OR Date Owner's Signature Q:wpfiles.forms:homeaffidav Rev: 060606 Department of Industrial Accidents ' Office.of Investigations- ' 600 Washington Street Boston,MA 02111 . ^' www mas&gov/dia Workers' Compensation Insurance Aff.1davit: Builders/Contractors/Electricia /Plumbers kpplicant Information / Please Print Legibly Name (Business/Orpnizationandividual)' ///�Q✓ j l 11 F 4ddress: •10 I,. UU k City/State/Zip: Phone#: Lre you an employer? Check the-'appropriate 6'x::.. Type of project(required): ❑ I am a employer with' 4. am a general contractor and I 6 New construction (full'and/or part time).* have hired the sub-contractors ❑ I am a sole proprietor or partner- listed'on the attached sheet. $ 7• remodeling ship and have no employees These sub-contractors have 8. [] Demolition working for me in any capacity. workers' comp. insurance: g ,❑ Building addition [No workers' comp. insurance 5• ❑ We,area corporation and its equi 10. Electrical r airs or.additions • rred:}— --- �—��c�--hav�o�rc-used thg' �❑ I am a homeowner doing all work right of exemption per MGL 11.0 .Plumbing repairs or additions myself [No workers' comp.' c. 152, §1(4), and we have no 12-0 Roof repairs insurance required.) t employees. [No workers' comp.insurance required.] 13•❑ Other oy applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: omeowners who submitthis affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such mtractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers,comp policy informaation. . :m an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site Formation. ,urance•Company Name: L l 11,5zr1 mi MVTuA ham_#or Self-ins.Lie.#: JAJ ;'a S f Expiration-Date: - 3 Site Address:_ wed ✓6j City/State/Zip:_1��G•n'•t tach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). lure to,secure coverage as required under Section 25A of MGL c. 152 cari lead�to the imposition of criminal penalties,of a e up to$1,500,.00 and/or one-year imprisonment, as well as civil penalties m the#form of a STOP'WORK ORDER and a fine up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of restigations of the DIA for insurance coverage verification o her e pains and pealties of perjury that the information provided above is true and correct: mature: Dat: ' )ne Official use only. Do not write in.this area,to be completed by city.or town off c4L City or Town: / Permit/License# Issuing Authority(circle one): ' I.Board of Health 2.Building Department 3.City/Town Clerk 4.El 6. Other ectrical Inspector 5.Plumbing Inspector Contact Person: Phone#: 77 Information and Instructions lassachusetts General La apter 152 requires all employers to provide workers' compensation for their employees. ursuant to this statute;an a ployee is defined as"...every person in the service of another under any contract of hire, xpress or implied,oral or tten" m employer is defined a$:"an dividual,:partnership,:association,corporation or other legal emtity,_or any two or more f the foregoing-engaged in a j t enterprise, and including the legal representatives of a deceased employer,or the eceiver or trustee of an individ partnership, association or other legal entity,employing employees. Howev..er the wner of a dwelling house havin not more than three apartments and who resides therein, or.the occupant of the weIling house of another who e loys persons to do maintenance, construction or repair woik•on such dwelling house it on the grounds or building app ant thereto shall not because of such employment be deemed to be an employer." vIGL chapter 152, §25C(6)also scat that"every state or local licensing agency sh withhold the issuance or enewal of a license or.permit to op rate a business or to construct buildings h a commonwealth for any ipplicant who has not produced ace table evidence-of compliance with the ins rance coverage required." Additionally,MGL chapter 152, §25C states"Neither the commonwealth nor of its-political subdivisions shall ;rater into any contract for the perfomian a ofpublic work until acceptable.'evid ce.of compliance with the insurance 11 uuements of this chapter have been pr ' ented to the contracting authority. 4pPlicants Please fill ou thwe-works'coon letel by the the boxes that f. apply to your situation and,i accessary,supply sub-contractors)name(s), ess(es) and phone n er(s)along with their certificate(s) of insurance. Limited Liability Companies (LLC)o Limited Liabfiity P ersh. s(LLP)with no employees other than the members or partners; are not required to carry wo ers' compe, do insurance. If an LLC or LLP does have a policy is required. Be advised that affidavit may submitted to the Department of'Industrial employees. P cY , Accidents for confirmation of insurance coverage. so be sure sign and date the affidavit. The affidavit should to the city or town that the application be returned for a permit r license is being requested, not the Deparf neirt of Industrial,accidents. Should you have any questions're ding a law or if you are required to obtain a workers' compensation policy,please call the Department at the e ' ted below.. Self-insured companies should enter their... self-insurance license number on the appropriate line. City or Town Officials . _Please be sure that the affidavit is complete and printed le ly. a Department has provided a space at the bottom of the affidavit for yor u toil ou ffi�e?e�%ent the Owe o esw 'Ois-as to een*2et�oa�eg g the-appliEaat—-:- - Please be sure to fill in the permiVlicense number which be us as a reference number. In addition, an applicant that moist submit multiple permit/license applications in y given y ,need only submit one affidavit indicating current policy information(if necessary)and wader"Job Site dress"'th'e app 'cant should write"all locations in (city or toyvn)."A copy-of the:affidavit that has been officially 'tamped or mark. by the city or town maybe provided to the applicant as proofthat•a valid affidavit is on•file for. a pernuts.or'lio es..Anew affidavit must be filled out each year.Where a homeowner or citizen is obtaining a li erase or permit not fe ted to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said on is NOT required complete this affidavit The Office.of Investigations would like to thank you advance for your coop lion 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 . DepFtam=t of Industrial.Acddents . ..Office of jEavestigatioxis , 600'Washin on Sheet St . 4 Boston,MA 02111. 'Tel. #617-7-27-4900 ext 406 or'1-877-MASSAFE Fax#617-7274749 . evised 5-26.05 wwwmass.gov/dia I -- 05/03/21)06 14 :02 FAX 5084201837 - FREDERICKS INSURANCE C�j002/0G3 LMU �/UIZUUb "L : IU YAUr: 0UL/UU'L LMU Liberty Mutual Gtvttp Liberty PU Box 7202 MutuA Portsmouth,NH 03802-7202 Telephone(1 00) 653 7593 Fax(60.4) 431-5693 May 3, 2006 TOWN OF BARNSTABLE 200 M./UN ST HYANNIS, MA 02601• RE: Certificate of Workers Compensation Insurance Insitre4- MAKKW(X)D CORPORATION 110 BREEDS HILL RD UNIT 10 HYANNIS, MA 02601 PolicyNumbQ: WC2-31S 319674.036 Effective: 211 2006 Expiration: 2/1 .'2007 Coverage afforded under Workers Compensation Law of the following state(s): MA Lmployers Liability Bodily Injury By Accident: $ 100,000 Each Accident: BoQv Injury by Disease: $ 100,000 Each Pm.t)v Bodily Injury by Disease: S 500,000 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 policy is subject to all the terms, exclusions and conditions,and is not altered by any texptirement, term or condition of any or other documents with respect to which this certificate maybe,issued. Ibis certificate is issued as a matter of information only and coaRrs no right upon you, the certificate holder. Ibis certificate-is not an insurance policy and does not amend,extend, or altt7 the coverage afforded bythe policy listed above. lftWs policy is cancelled befcrc for stated expiration date, Liberty Mutual will.mdcavor to notify you of such cancellation. _ AtTrHOR=RrTRF9EPTTA:1.1 VT LIBERTYMUl'IJALINSURANCF C*RCILW I'tll9 c'eru%iJLce is eAmuwd byLIEFRTY ML;'fUAL INSTMANCL GROUP ax rcsRcb sllchlpbyc�nce az is affix lyd b}chose mnapankx, cc: Insured: Producer of Record: MAkKWOOD CORPORATION 17REDElUCJCS INSURANCE AGENCY INC 110 BREEDS HILL RD LTNTIT 10 P O BOX 427 IIYANNLS,MA 02601 OSTERVILLIs,MA 02655 5i3R006 { BOARD OF BUILDING REGULATIONS I' " #' J License: CONSTRUCTION SUPERVISOR 005867 Number CS k Birthdate 1111211953 s y Tr: 111121 no.`6847 0 ' 2O Expires + ReWlcted OQ i TIMOTHY PEARSO(J f ' p0 BOX 519 CENTERVILLE IMA OZ632=^ Commi§sioner t S 1 Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:, Registration:'\_100871— Board of Building Regulations and Standards Expiration ...6W24/2008 One Ashburton Place Rm 1301 E Type t;:Private Corporation Boston,Ma.02108 r x. ,MARKWOOD CORP t '; TIMOTHY PEARSON` I• v 110 BREED'S HILL ROAD U'NI.TI10 - HYANNIS,MA 02601 - Deputy Administrator Not valid without signature pFZNE Tp� Town of Barnstable Regulatory Services • BARNSTABLE. 9 MAss g Thomas F.Geiler,Director i639• ♦e '°rEo►�►►+' Building Division Tom Perry, 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 as Owner of the subject,pro erty hereby authorize `GGG� / � Ti— � —to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) l✓ lr / , Signature of Owner Date Print Name QTORMS:OWNERPERMISSION '"� 'l a r J� I I i` t vt ;C-A kr( {ors GoN C-A t. Assessor's map and 4lot number .............�............................ M SST BU v� INSTALLED IN COMPLIANCE Sewage Permit number ..........�. / WITH ARTICLE 11 STATE SA141TARY CODE AND 1'OiiifRl "Tl QyofTNEt T WN OF BAR.NSTA IE fps O� r Z SAB 3TADLE, i p� "6 9• BUILDING INSPECTOR 'EO MPY a' r APPLICATION FOR PERMIT TO build one family dwelling .... ..... ..... TYPE OF CONSTRUCTION wood frame p . .....A..r i 1......16..................19.... 4 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........lot 62 Notting.ham Drive, Centerville, Ma. ................... .................................................................................................................... ProposedUse .........residential. ... ....... .............................................................................................................................................. Zoning District R.D. 1 Fire District Centerville—Osterville District ....................... .............................................................................. Name of Owner Normest Homes Inc. ....Address Nottingham Drive Name of Builder Same .......................Address Same Nameof Architect .none..........................................:...........Address .................................................................................... Number of Rooms Foundation full 10" concrete 6..................... ..... ......................................................... s halt Exterior siding, g a p Floors ........................ Interior .........dr wl ......................................................... Heatingwad?!?-. 1r........................................Plumbing ......2...fu11 baths .. ............................................................. Fireplace ....................yS.S......................................................Approximate Cost 24.1.000.00 Definitive Plan Approved by Planning Board -----------_------_-----------19________. Area ...................... ................... Diagram of Lot and Building with Dimensions Fee ...................... . .................... SUBJECT TO APPROVAL OF BOARD OF HEALTH �3 IC 1 IL 45 49 4 f 65g z I hereby agree to conform to all the Rules and Regulations of the Tow f Barnstable ega ing the above construction. Name , l S n.�C ................... Normest Homes, Inc. ' No ...1M.. Permit for ......one story single familx dwell Loca i ll t7Sn y..1...... ..Notti.ngham Drive................. Centerville Owner Normest Homes, Inc. 0................................................ Type of Construction frame ................................................................................ Plot ............................ Lot ................................ April 18 Permit Granted19 74 Date of Inspection ............:.......................19 Date Completed ... ,/ .,1...�..... 7. . PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ......................................................................... ............................................................................... Approved ................................................ 19 t- .............................................................................