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HomeMy WebLinkAbout0106 MARINER CIRCLE IKE t Town of Barnstable *Peru# Expires 6 months rom issue te� °TA Regulatory Services Fee _ anxtvsrnat.E, = PERThomas F.Geiler,Director 9�A iT Building Division TED MA , ��� 2008 Tom Perry,CBO, Building Commissioner - ► T 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red XPress Imprint Map/parcel Number 6 CAS-z— Property Address10 IN U Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Fz �---Fe Contractor's Name_T�2 / f�vl/!�/ Telephone.Number Home rovement Contractor License#(if applicable) Home Compensation Insurance Check one: ❑ I am a sole proprietor ❑ m the Homeowner I have Worker's Compensation Insurance Insurance Company Name ' Workman's Comp.Policy# 6 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re- of(not stripping. Going over existing layers of roof) e-side El 'JReplacement Windows/doors/sliders.U-Value . (maximum/ "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:\WPFILES\FORMS\building perm/f.,m,\\jEXPRESS.doc Revise020108 l Mullen Building &Remodeling Estimate P.O.Box 1274 Marston Mills, MA 02648 Date Estimate# 3/25/2008 182 Name/Address Valerie Falese 106 Mariners Cir Cotuit,MA 02635 Description Cost Siding 8,300.00 -Remove old shingles -Install Tyvek House Wrap -Install+/- 15 Square of new'Grade A R&R White Cedar shingles -Remove and reinstall brackets for flower boxes *Price includes all permit fees,disposal fees,material,and labor* PLEASE NOTE This is an estimate only and not,a guarantee of total job cost. JTotil $8,300.00 ALL MATERIAL IS GUARANTEED TO BE AS SPECIFIED,AND THE ABOVE WORK WILL BE COMPLETED IN A SUBSTANTIAL WORKMAN LIKE Signature MANNER ��ie -�omvnw�xcuec�� o���aaaac�auaelta Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR D 4' Registration 138368 fzpiraUon 3/27/2009 Tr# 123181 : Type DBAI MULLEN BUILDING&REMODEL'ING ` i�OUGLAS MULLEN 1,y NOBBY LN. mE$T YARMOUTH MA 02673 Admmistratm License or re before the QX gistration valid for Board' IPiration d pne ..Q 'd�ngRe ate. If fog d e�url use only Ashburt: gulatiohs a to: 13osto on.Place Rrn nd Stan r G� q,Ma.02108 1301 ds y` r Y Not va1- •: - = ,fit signature:,, •. , i 1 The Commonwealth of Massachusetts. Department of Industrial Accidents . 'Office ofInvestigations , m a 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name(Business/Organization/Individual): P0(/(fin /w Address: 7Z City/State/Zip: Phone.#: 7 7_ Are yo an employer? Check the appropriate box: Type of project(required): 1.EI 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...❑Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition workingfor me in an capacity. employees and have workers' Y P t3'• 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.❑Roof 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. $Contractors 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. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: / O Job Site Address:-1D 6 �N ' S / I City/State/Zip: 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 befforwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify der the pa ndoenalties of perjury that the information provided above is t e and orrect Simafore: Date: Z D _ Phone#: J �����37- 3 2 t/� 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their.employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment'be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed 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 legibly. The Department hai'provided a space at the bottom of the affidavit for you to f ll out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in"the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in _(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation 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 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia Girt I TE STATE INSURANCE COMPANY 70285-0000 WC 638-88-43 1 r1 02 ----------=-------------------------------- Y 3-66-1 1 o7-OO • -.- . - • PENNSYLVAN 1 A DOUG MULLEN /�� Member Companies of PO BOX 1274 MARSTOWS MILLS, MA 02648-0000 14 American.International Group EXECUTIVE OFFICES: 70 PINE STREET, NEW YORK, N.Y. 10270 SEE NAME AND ADDRESS SCHEDULE - WC990610 I.D# MA UI '•• OCEANSIDE INSURANCE AGENCY INC WORKERS COMPENSATION AND EMPLOYERS 52 WEST MAIN ST LIABILITY POLICY INFORMATION PAGE HYANN I S, MA 02601-0o00 INSURED IS PREVIOUS POLICY NUMBER INDIVIDUAL RENEWAL 008855933 OTHER WORKPLACES NOT SHOWN ABOVE:SEE NAME AND ADDRESS SCHEDULE - wc9go6lo ITEM 2 POLICY PERIOD 12:01 A.M.standard time at the insured's mailing address FROM 1 1/21/07 TO 1 1/21/o8 . ITEM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of.the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ SOO,000 .policy limit Bodily injury by.Disease $ 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT - WC200306A ITEM 4 The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. ' Estimated Total Rate Per Estimated Remuneration Premium Classifications Code Number R ❑ ❑ $100 OF Re- M Annual D 3 Yeah X Annual 3 Year muneration SEE EXTENSION OF INFORMATION PAGE - WC7754 TAXES/ASSESSMENTS/SURCHARGES $150 EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) $3 1 O MA MINIMUM PREMIUM $5j00 MA TOTAL ESTIMATED PREMIUM $3.,065 If indicated below• interim adjustments of premium shall be made: Semi-Annually El Quarterly ❑ Monthly DEPOSIT PREMIUM ENDORSEMENTS(FORM NUMBER) SEE ATTACHED FORM SCHEDULE - WC990612 12/29/07 ASSIGNED RISK 66 Issue Date Issuing Office Authorized Represent ive wC 00 00 01 Assessor's office(1st Floor): Assessor's map and lot number tNt To`. Conservation Board of Health(3rd floor): Sewage Permit number t DASI7T�DL i 7 Yyl Engineering Department(3rd floor): 1639. House number �o ixv Definitive Plan Approved by Planning Board tg APPLICATIONS PROCESSED 8:30-9:30 A.M.and.1:00-2:00 P.M.only TOWN * OF BA.RNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO pa/r TYPE OF CONSTRUCTION /✓� G 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following �information: Location ��� / i�✓�'/.r/ [--r am I es 7- 17- Proposed Use f�c�iGa7' o� Zoning District 04-EFire District Name of Owner Address Name of Builder ZeZz!2;: .er1��n- Address 16OC- G��aSDv�rl/ �/J L vfi Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing a ^ Fireplace Approximate Costs/� Area Diagram of Lot and Building with Dimensions Fee 3-29 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding t e cons Ction. Name Construction Supervisor's License FALECE, MRS. No 35165 Permit For Re-ROOF Single Family Dwelling Location 106 Mariner Circle Cotuit r Owner Mrs. Falece Al Type of Construction Frame . . l Plot Lot- Permit rr Granted JuneL 2 6 , j 9� 92 1 Date of Inspection 19 Date Completed 19 F f . t . 1 , Assessor's office(1st Fbor): 4-2 v /�/_ cAL o Assessor's map and lot number n. �`,�,� �TN E Conservation 7— )J 13 SEPTIC SYSTEM MUST EE Board of Health(3rd floor): '-- �t - l �`, INSTALLED lid COMPLIANCE t asai�r�ncc Sewage Permit number Mua Engineering Department(3rd floor): WITH 'QTg'LE$ �o teyq. \od° House number ENVIRONMENTAL CODE AND �o Msr►" Definitive Plan Approved by Planning Board EGULATTON APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-i00 P.M.only TOWN OF BARNS TABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO 114/ryI142L. J6T )1/7 i TYPE OF CONSTRUCTIONi?G3SJ�l��T/� ri�OdJ� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accordingto the following information: ir/!�Z 9, Location !OG 0ejAe e4es 4Y,,- Proposed Use Zoning District_ Fire District Name of Owner Address Name of Builder Address /6�15'/I� i�//✓/C� C,'�ryt�' s Z�� Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost _--341" Area _ v 1/0 Diagram of Lot and Building with Dimensions Fee 0 6 l ?i /7 r 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 a e construction. Name Construction Supervisor's License + FALESE, c`. Nos 36026 Permit For BUILD DECK. Singl e 'Family Dwelling 4 ` Location 1,06 Mariner Circle - - COtu•it c Ow6er Falese Type of Construction :Frame f i f 4; Plot' Lot -' Permit Granted July 15 , 19 93 Date of Inspection - 19 { Date Completed t 19 ? f J'• -� ♦ may` , y f t a Pow yid �'lot IPA T� z ' C/ps�2 iN ces• �R�t.7ae' � •_ d Building. TOWN 0 I Rp SToABLE cash -- --- ----------- ;D Permit No, i, �i STAU"& rua 00 ,ego. ° °" OCCUPANCY PERMIT Bond No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Ox-zei,gr Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department 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. ................................................, 19__. ......................................................................_......._............._M_ Building Inspector r �07- 200a0 lc� , 0 0 4S o 14-o i v PLAN SHOWING f30 FOUNDATION LOCATION C 0 T UI T, MASSACHUSE T T S OWNED BY: Gt--.*�. ii. SCALE / ��= 4U DATE: NORMAN GROSSMAN---- REGISTEREDLAND SURVEYOR 1 HEREBY CERTIFY THAT THIS FOUNDATION IS LOCATED ON TIHE LOT AS SHOWN AND CONFORMS TO THE TOWN .x°.p�t� of r�gss9 OF BARNSTABLE ZONING REGULATIONS REGARDING !' SETBACKS FROM STREET LINES AND LOT LINES . Fv.: N RNtAN q en 12775 Q NORfJAN GROSSMAN R.L.S. DATE j 2 • As sor'`S map and lot number ....... . ...-..�a.P?✓...�� _ ..... F THE t i� 0 Sewage Permit number ......................7.............................. f SEPTi d SYSTEM MU aC House number .......... (o �NSTAL'LED 9Ta LE, • WITH TITLE o wMPL ar aye 1 "^{ TOWN OF BARNS � . v `. BUILDING INSPECTOR PERMIT TO ...................... OR P .............. APPLICATION F . ..................................................................... TYPE OF CONSTRUCTION � .............................. '.......................................... ..............19...7 ' TO THE INSPECTOR OF BUILDINGS: , The undersigned hereby applies fora permit according to the following information: Location A� o /-&-�U✓,-..L� di....../-... .C.1...................... ........................... ............................ ... ProposedUse .......2).., ... - `tG...........................................................................................................:...I......................... /J� U Zoning District .......Ap .............................................................. District ...........1................................................................. Name of Owner ......... ........�........ . ./ � ........................ Name of Builder` .: t° : ).. -1..,�- .��..............Address ................................................................ .............. .Name of Architect ..................................................................Address ..................................................................................... Numberof Rooms ...........6..................................................Foundation .............. ................................................................ Exierior .fir .........`. r............................Roofing ......... ....�.!......e ............................... ........................................ Floors ........................................Interior ............. ..................................................................... Heating �....�-..��!:........�...: � ��...............................Plumbing ......:...... �. .FI................................................... Fireplace ..........C/.e .............................................................Approximate Cost .... (, o e.................................... .. Definitive Plan Approved by Planning Board _ _ ___ � ---------19_7-6. Area ..... ..5... ,. Diagram of Lot and Building with Dimensions FeeQ SLJECT TO AP ROYAL OF BOARD OF HEALTH C)/lJ� JOT, )L . i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .............�........................... � Cedar Acres Realty Trust 22119 Cotuit Permit Granted ....... .lf�----'lV 80 ' Doha of Inspection ....................................lg - ' ' ^ C» Dota Como�ta6 ../����..�'�.����----l9 ' . PERMIT REFUSED . . . - . � lV . ^ . . . ........................................................... mn �� ............j�w:�. ......................................................... ............ °~ to . = . . . . . . ---- ��----------~.--.----... Approve ^ lg `_ ..............................................� ' � -----------------^^----'--^— ' � . . ----_— .......................................................... N Assessor's map and lot number J '�• !� r .1'' /Sewage Permit number ....... :..............-............................... re Z BA"STAI1LE, i House number ...... ........r? V, rasa 4 C i639 M a� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO �� { TYPE OF CONSTRUCTION ::�l�r=�{� . ................... /.` ............19. . t TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..� .....f . ......f...'.:ic'tt.:` :' .. .:lt ......r: .c: ' ........................................:............ ProposedUse ....... ......................1 t'`: ......................................................................................................................................... Zoning District ........... (J. .......`........................................Fire District .............: ...G'..li .............................................. Name of Owner f/ . IC,�';!k>.?...:J�� ......�.:� :.........Address ......... ...... ''..... ..,.. . ........................ ................ . Name of Builder ...:.......... ....Address .Name of Architect ..................................................................Address .................................................................................... • r r Number of Rooms Cry .Foundation .. t '-.'• � Exierior � ..�....... ...........G........C...-•......�.,..1.�... .�.(..........................Roofng ...f...U.. ....................................1 ' t'ltC ...... .................... ell Floors 1(°J.....!..,5)- .. .Interior ......>` 1 � '.f• ..... .. .. .. ......... Heating l r�/ i Plumbing r �.'� ........................................................... .................:................................................................. Fireplace Approximate Cost ..........7(..... ....�C tf . ............................................ Definitive Plan Approved by Planning Board /_i_�y4�3_________19 Area r� if' , . Diagram of Lot and Building with Dimensions Fee ............................... SUBJECT TO APPROVAL OF BOARD OF HEALTH �C)/,)0. I -., q0 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. < Name_ ........................ Cedar Acres Realty Trust! A=23-62 No 2W9.... Permit for ....,one story single family dwelling .. .. . Location ............106 Mariner Circle .................................................... Cotuit ...................................................i .......................... Owner ........,Cedar Acres...�.ealty Trust Type of Construction ............frame .......................... .. . Plot ............................ f Lot ........... 120............ Permit Granted .............Apry1...],5.........19 $0 Date of Inspection ....................................19 Date Completed ............ .........................19 PERMIT/REFUSED ................................ .......................... 19 ................................ ............ ...... .......................... .........................�. ................................................. Approved ................................................ 19 ............................................................................... ...............................................................................