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HomeMy WebLinkAbout0052 PATRIOT WAY o � , c c f Town of Barnstable Permit i� -�—Voc y� Regulatory Services Fee a XAM m Thomas F.Geiier,Director Building Division Tom Peirry,CBO, Building Comucissioner 2001VIain Street,Hyannis,MA.02601 www.town batnstable.maus Office: 508-8624-038 Fax:508-790-6230 EXPRESS P ERNVUT APPLICATION - RESI D ENILAL ONLY Not Valid%n&ow.Red X-Presslmpnnt Map/parcel Number I� 43 Property Address ``�_Residential Value of:Work ^%numIm fee of$5,00 for work under$6000-00 Owner's Name&,A.d&ess 1 �� Contractor's Name Y C ¢ %. ab Home Improvement Contractor License#(if applicable) t c� J 3 _ Construction Supervi.ser's License#Cif applicable) � ✓�Worlanan's CompensationImmuance ,IqN 2 4?�13 Check one: �+ ❑ I am a sole proprietor 9 I am the Homeowner en ^, I have Worker's Compensation Insurance ��eigl�°�►ST Insurance Company Name IVa_ rorlcti Un;aY-' ire. n, :SumnCe I-j Workman's Comp.Policy N ,90�0 f Copy of Insurance Compliance Certificate must accompany each permit � i Permit Request(check box) e-roof(stripping old shingles) All contraction debris will be taken.to y ❑Re ioof(not snipping- Going over existing layers of roof) - ❑ Re-side #of doors ❑ Replacement Windows/doors(sliders.U-Value (ma i=m .44)#of windows *'Whsre regai=&, Issuance of this permit does not=cmpt compliance wish ocher Town depammem regulations,i.e.Ei m4q,Conservation,etc. *—Note: Property Owner must sign]Property Owner Letter of permission, A copy the rovement Contractors License&Construction Supervisors License is - SEC�74 QC9JTlT FS\FORMS*aildingpeatfonnsNM2RESS.doc Revised 090805 r The C0m6WFzWed&of+�i'srs3WkUsetts Dgpmt nmt OfINdustria AccidenXs wwe afDzvaSvgaeam Bastort,MA 62DI I WOrkere Compensabou hM3X=IM 1SLgov/dia Iica➢rt afcrma accon A a��derslCottmd0rSfinecirician5lt'Jnm8bez5 N me tBzLsiness/� }'lease PriutL soa!lsaivia�i}: • raSE.Y �c n s-�r't��••�-t Q '�.L� address: Citylate%Zip: r3r-f- A .A•r�e�eu sa erQ 1 rr? hcrtte#; s�3— 5�28 o7s2`��? p oy CSetli the 2pproprilte� I. I our&employer with 5 4 lam a„emeral c�and Type of]Pry(r' 'd): } emPIoyees(fall mdforpart--lame)� have ls�i the mb- gmd I � �N�cAns�cction 2•{ 1 am asoleprvpdit.m partner- 2istedan the attached sheet 7.. 0 Remode1bg i ship audhavezoanplayees Thmmb-coutractorsbave working fvrzrtr is arty raP S emplrsyem andbave workers'' $ Demolition NO workers'comp insmarsce � � kmrauce t 9, g Building addidon dre10, - 1 r� &j 5. 'We are a corporatioa and its 10.D Blecfricel repairs or additions 3. 1 am a homeownerdobg all W mk - offices baave exercised ter myself.JNo wo&-ra'comp. tight of exemption per MtZ I LEI 21 mabi grepaim or addit iol, I iasnr tcere uu�d j T c 152,§I(4),aad wel><iveno ME]Foofrepzus � eMI[No workers' • I3.L]Other gyp_insurance requ!m .] "�'aPP�t&atc�ccks�ax�lmmw:alm�lloutrkeser4onbe8ces ` ' �F.oraeowneawhosabmittkisa�idav�tmdi� �8�'�4� au��' oa f �ac&��tt�azc�ek'mis6oaGm�catatra g�S�dOimgsIIwankaadrheal�iieo�dcsoatractaismastsabmutazxwa�ttd3v�rui . I ett�d�zdd�ppats6�t$aa+�g7hcnameaf't&esnT�m gsawk. eraploy..es Ifihes�tb-eanrQc&�rslaaveemp7aY�'s,'�e9'mmssrpsaviderheirwadcas'eoom ali �racmrsaadsdtew3etTieroraaifuoseenlifieshave a�rz sarployer Otis prarir iig sverke�s'cnrttpez affen bnw'imce or t M mWkflY0• 8e1v�is the f infornsatmrt ,pol6cy and job site - ih=mce Company Name: - O17A/ U ►ram 'l�vr- Policy#or Self-l&Iie—#: W - kecpiratioaDate: Job Site Arddfrrpesg�v- Attaeh a coN ofthe wodie&Campensarm PONZY Taxation gage(slwwia ffia Faa"inre to secure ca red g Po c9 Uumber grid npira- )•verage as used tmder•Sec#ioa25 ofMGI c fms im to$I,s00.00 and/or one-year h4pr isorrcamt as w n 152 can leadto the in as positim of edrbal penalties of a CM_ _ ofap to�250 00 a day agaiastlhs vioiatox. lie advtseclthat a copy aftiaisemeut ofa 5I OP WORK ORDER and a f&te Iuvestigadocs ofthe DIA iht insurance coverage nesa anon. be forsru$ed to the Office of I da hereby cer' 'u d perraf&eR of perprry char the' orareox ° f p vvzded4bQve is true aadcon» ___ �'aduseonZy. .�Jar�ot»�irelnxliisareu,tofeco�lered,�iyc�3'Qrzoxmo�ui¢L � City or,I owe¢: I.'er'nrztPUeemse# I-Idng AAtlftor ly(circle one): 1 - 3.Board oFfiealtla Z.,I�dinaT}epartraeaf 3.�fylYows E:Ietic �d,EAda�brirs➢ IF S.0rher ](aspeetor S.E'Irnssbing Inspector Con actpenma: Phone#: I 1 FIZASCON-01 MOSU CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 1 0/512 01 2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ,THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR P90DUC5R,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must he endorsed. if SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(S). PRODUCER CONTACT (508)676-0309 NAME: Suzette Mon'Iz VivAirport Insurance Agency,Inc. PnR 375 Airport Road rc°.N.w:508-676-0309 is c,No;508-324-9147 375 AIL Fall River,MA 02720 ADDRESS:SMoniz ViveiroslnSUranCexorn INSURERS)AFFORDING COVERAGE NA]C INSURERA:National Union Fire Insurance Company INSURED Fraser Construction LLC < INSURER S: P.O.BOX 1845 INSURERC: Cotuit; MA 02635- INSURERD: INSURER E INSURER F- COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE AD POLICY F POLCY EXP R WVD POLICY NUMBER NMIDO Molic LIMrrS GENERAL LIABILnY EACH OCCURRENCE S COMMEP.CIAL GENERAL LIABILITY _0AMAZE­TO_FERTS37-PREMISESoccurrence) 5 CLAIMS-MADE OCCUR MED EXP(Any one person) S _ PERSONAL&ADV INJURY S GENERALAGGREGATE S GENL AGGREGATE LI MITAPPLIES PER PRODUCTS-COMPIOPAGG S POLICY 7 5R� 7 LOC S AUTOMOBILE LIABILITY COMBINEI GLELIMIT - Fa accidentDS $ ANY AUTO _ + BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) S HIREDAUTOS AUUTOBWNED PROPERTY DAMAGE S er accident S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE I AGGREGATE S DEO I RETENTION S S WORKERS COMPENSATION TlCRYTLIM O R AND EMPLOYERS'LIABIL1Ty YIN X - A ANY PROPRIETOR/PARTNERIEXECUTIVE WCOOSS30601 - 9126/2012 9/26/20t3 E.L.EACH ACCIDENT 5 500 OFFICER;MEMBER EXCLUDED' MIA - - ,DUO (Mandatory In NH) { EL DISEASE-FA EMPLOYE S 500,000 If yes•desenbe under JE DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S SO0,000 t DESCRIP'nONOFOPERA-nomsILOCATIONSIVEHICLES(Attach ACORD1M,AdcWonal Remarks Schedufe,ifmorespace-.repaired) , CERTIFICATE HOLDER ' CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 5EF0RE Fraser Construction LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 31 l3oVVCloin Rd ACCORDANCE WITH THE POLICY PROVISIONS. Mashpee,MA 02649- ` AUTHORIZED REPRESENTATIVE ©1988 2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and 1090 are registered marks of ACORD Office of Consumer Affairs and VUSeless Regulation 10 Park Plaza- Suite 5170 Boston,Massachusetts 02116 Home Improvement'Ooz ''ctor Reg suction Registration: 112536 Type: DBA Expiration: 3123/2013 Tr# 209= FRASER CONSTRUCTION CO. DEAN ERASER P.O. BOX 1845 COTUIT, MA 02635 Update Address and return card.Mark reason for ehange. Address E] Renewal Employmeut l]]Cost Card DPS-CAi e'a 50M-04lO4-G10i25S Officc ofL4a ca""��r"�f'i'`sus�c inesssa OA License or registrationvalid for indi[vidul use only � HOME IMPROVEMENT CONTRACTOR + before the expiration date If found return to:- Registration: 112"T Type• ' Ofi?ce of Consumer A#fsirs and Business Regulation, 10 Park Plaza-Suite 5170 Expiration: 3f23 D13 D6A Boston,MA 02116 R CONS7f UCTION.C4. ' DEAN FRASER 104 TWINN VIEW LANE EFAEMOl1TH.klrsA0�53r; 'Undersecretary Notvaii wit utsi re.' - ------------- iyls�ssitCkiiigetti-ilepfty-tment or Pubiic'Sai>t'y Board of-Building" Regulations and Standards Gt�nsiruttibn Supervisor License -L•lcensei•CS 97668 DEAW.�I ,09R LAST l;ALbVI=fA � — Expiration: U17/2013 t:ommissin�tar Tr#: 16602 12/19/2012 14:51 5126716408 SHERRY BIEHLER PAGE 04 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. F'RASER CONSTRIICT ON, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE- --� OL ,r4i 1 Homeowner Fraser Construction, LLC For um Date Received Date Started: Dote Completed .lob estimate:'.D=n/11 Vke # of squares: Bdled Material ordered Extras ,PWd - Available Discounts M1 R 4 EVE r° The Town of Barnstable Department of Health, Safety and Environmental Services MAM Building Division ergo MAC a � 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration J-,5 4 Date: 2 tt-,Q,1 19267 Name: Phone#: /✓!t3'G+ /Oc..g. (oy!� /1/y�nliJ•`S�Y17 .OHO/ Address: A,2 Type of Business: D44, =A iaz-4,rw,-Az� Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or.,.odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: Date: —XAA. Jj* Homeoc.doc egs Q 'SEPf"fG TAt.e. �. S ' P -e2 12;0� EDAD RtCHARpv A. F', UAXTER ts7 ERw E?T{,-.{�:.1� [ 4 C a'T' i ✓14-.�� +C4. 0 — - { C -.trTtt= `1 7!4AT 'r PF_ F-C.�V1J�• �itlr�t�4.J �-�:S't= U{� G+;J:ti^,i�:.� (i, L,�,7�-:':� •Z-4.1t ;tt�'t��t,+�: �`�`'�•~ `��'t"�!�ACI:: "._'`..,;�~t.;i:"'�_,L�S==t,.;`T'�, C�,� •�-�.tEr;; �j -ry �1 " Oki tt; r��- �QC%�.}'jT"Q} Pat) h�. Iq 1. �A6aa, 12 Nt.! i _ t.nF�P_k r c.►�t Zi' F— t r. �-r t,r_ �.� _11 'rt> t .�- �F-E,_t,.:.�, � �.1:� �..- '�' t �-� � � � v �►C.LPa*1 1):7,L /7-7� Assessors map and, lot number . .. t .. . ......� �., ♦ f _7 ' ;. Se`wage,Permit number ..................................:.................,..:.. I TOWN OF BARNSTABLE . . t "6 9•a�e� RtU ILD.I NG I NSP.ECTO R .�"� NST L. E Mkt $E �a war `� ", i 'WIT IN`CAMP W AR�'ICL L[,A' al i r•4 F. 4 S,gNrT. F tl ST/}T. // _ l y T®co AND TOyy APPLICATION.FOIR PERMIT TO ......�.��,//.Z!............ ............................................ ........ TYPE OF CONSTRUCTION ......: .�`/s" l> ... . ,t �.rr!&.C .. .............................. c, c �......... 7................19 a TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �'..,:� ..........rr.:v..si�.....1!e..,'A !........a>fQ,a��! e�tJ� ............ :w'.cs�-��f< ,................................ 47 Proposed Use .......... ��a1�:.1. ....1'�a�rr�.Syr.... . S.c. � �.. . ............................................................................. '.. Zoning District ....... .!4.�..............Q.......,.............................Fire District ....t��a�l.�.ru>�/. .''....5 ,��a!d./� �........ 4 ` Name of Owner /' -,rN��.. ���:-�5..�.� ......Address ......elac,. ., . .:dJe, l.. ..................................... Nameof Builder ............. /-94.o� ..---.............................. ................................:...............................,................... .............................Address Name of Architect .............. .�: ......................................;...................................... Number of Rooms .......... ""ra4,.).1.. Foundation ..... .��..1�r..?�.i ..a� .. Exterior ........ .e........�.f.�sfjC6.fi' ..................................Roofing ... � r� .... : .aS .!.............................. � s Floors .......... .r .2 G+ .......:............................Interior ........... .:!�.............. ..N .../s��'.C.1..' ....................... Heating .... x�4.....�.......�C!l(�4�s.:^ml.....�s.''.............Plumbing ......04A67....... Wit./ .. .................:..................... -- � _ - lno Fireplace ...................��f�>.. ,,,_..i..............................:.........Approximate Cost ...... ..A ......... ' Definitive Plan Approved by Planning Board --------------------------------19--------. Area .........-'�••.......®0 f Diagram of Lot and Building with' Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH /C I Ill/loll I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. IZA� .. Name ..L .. . .��/1 �. a' ...... f 1 " R. Arthur Williams, Inc. ' 1-8771 1 1/2 story, No .. ............ Permit for .................................... single faihily .dwelling , Location ............ ...................................... ... > :..Centerville..................:............. Owner .R. Arthur Williams, Inc. ' ...................................................... - frame Type of 'Construction 4'' j .......................................................................... -Plot ............................ Lot ...... .................... , ? ! Permit Granted .. October 27 , ;A 76 ' t t Date of Inspection ... . 19 iDate Completed ... /............. l9 iI PERMIT REFUSED �` I .......................................... 19 .............................................................................. ........................,.`........... c. Approved ........................... ..... 19 ...................` ................. �i