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HomeMy WebLinkAbout0520 MARINER CIRCLE f, i i f� j Town of Barnstable ' Permit# 0 � Expires 6 ntattiis front issue date SARNSTABLE. Regulatory SerVICeS Fee 4 � 1 1 18 MABS Thomas F. Geiler, Director �p t6 1m lfoYa Building Division . DV Tom Perry, CBO, Building Commissioner V 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number O:;:z y Property Address 5 �� �� /�'/h'rC C /✓� , C ❑ Residential Value of Work /3 i�� Minimum fee of$25.00 for work under$6000.00 Owner's Name& Address Contractor's Name 5 eey C-ez-t Telephone Number 77/ Home Improvement Contractor License#(if applicable) j l 2-0 ( 8 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: LI am a sole proprietor ®® I am the Homeowner - RESS PERMIT ❑ I have Worker's Compensation Insurance ,JUL 2 7 2009 Insurance Company Name -TOWN OF BARNSTA►BLE Workman's Comp._Policy# 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-roof(not stripping. Going over existing layers of roof) Re-side &"Replacement Windows. 'U-Value:' 30 (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. Ho e I provement Contractors License& Construct Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\ .press\EXPRESSPERMIT.DOC Revise060409 Snow Construction TRIM COVERAGE SPECIALISTS * VINYL SIDING COMBINATION WINDOWS &DOORS a REPLACEMENT WINDOWS a SEAMLESS GUTTER SYSTEMS Licensed Massachusetts Contractor 8 Homeport Drive Lic. #007855 Hyannis,Mace.02601 Member of the Better Business Bureau Telephone 771-9366 Date • 17-RR .797.. .... Purchaser's Name �/7 l ,` l oje Dhllwo' TeL No. -'5� 81d 7 Address PURCHASE AGREEMENT - - CONTRACT AGREEMENT I/We, the owner(s) of the premises mentioned below, hereby contract with and authorize you as contractor, to furnish all necessary materials, labor and workmanship, to install, construct and place the improvements according to the following specifications, terms and conditions, on premises below described: Owner's name Tel. No. Job address City State REPAIR WORK: No repair work shall be done, except as herein specified and expressly agreed to in writing by the Contractor. t�yiy� SPECIFICATIONS GC/ i--- C leis Alp i' ._ ty vz,,A- Ne 1 e `cep cz -e- /3�,ervly v L �.��/��SSd ay r�i�_�� i�i.�„� �. � �-� •�-ram-- ��-����� �,��-�� �; ,�%��l�o✓� T,rPI�m �f./�1�� --P �"%rt�%�i11 `�:�f3if.�G�ii�-F' �L r� �1�-�1.�.� i��� ��-�. C`�'�.��2 ✓��%r/�i�: ,e�'/S� t-�'�3�J�'►%ni�c ,�v .,vim��.��n ����/�' Ire, h!' i f�i -e, , t Materials and labor to cost$/Mu Down Payment Balance of$2Y,52 DUE UPON COMPLETION. Contractor will do all of said work in a workmanlike manner: f 7` Owner agrees that in event of cancellation of this contract before work is stari Owner shall pay to Contractor on demand. Twenty-five per cent of the contract price as liquidated damages for the breach. No work to be done on this property other than that specified in this contract without'additional charges. All verbal or written agreements not mentioned on the face of this contract are void, and no salesman has any authority to change, alter or add to this contract in any particular. This contract contains the entire contract between the parties. A copy of this contract is hereby acknowledged to be received. his contract is subject to strikes, accidents, or other delays beyond our control IN WITNES WHEREOF the parties have hereunto signed their names thi day of 20 V J Signed epresentative O ner V Accepted: SNOW CONSTRUCTION CO. Signed Owner By Rnaineas certificate filed under Mass.General Laws wish Town Clerk of Yarmouth _-_ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 :�•y� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 5 40LZ,,. CGd S� Address: l�fo�-2 /�a✓�T �l� City/State/Zip: S s,1k oa6a/ Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or parlrier listed on the attached sheet. T. ❑Remodeling ship and have no employees These sub-contractors have g, "❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance.$ 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. XContractors 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: Job Site Address: 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 be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do hereby ce ify under the pains andpenalties ofperjury that the information provided above is true and correct Si ature: /P Date: O Phone#• -7 7/ 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 S.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 g g 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,artnershi , 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 Iocal licensing agency shaI 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-conti-actor(s)name(s),-address(es)and phone number(s) along with their certificates)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 has provided a space at the bottom of the affidavit for you to fill 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 fo any business or commercial venture (i.e. a dog license or permit to brim leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations wo»id 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: ,- r ' The Commonwealth of Massachusetts Department of lndustri,al Accidents t Office of luvestigations 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 (. Board'of Building Regulatio sand Standards ow HOME-IMPROVEMENT-CONTRACTOR ' C . .Registraton 112818 1 Expiration 4/27/2011 Tr# 282626 ' Type DB-TV ON A' { SNOW CONSTRUiC,TION }s JOHN LOPEZ s 8 HOMEPORT DR ; HYANNIS,MA 02601 "- '., Administrator- Board + Y ✓1LC�-�0,'YIYplO)LG%6Q.G/./L"a� Board of-Building RegulatioiSs and Standards ConstructiortSupervisor License # Licnse CS 7855 I g ,j Expiration a� !28/2010 Tt# 22485 .,yam ,��µ� � Restriction 004 I 1 ( 3 JOHN R LOPEZ k 8 HOMEPORT DRIVE; } NYANNIS,MA 02601� L } mission E Com er r e e q J it License or registration valid for individul use only before the expiration date. If found return to: Ij Board of Building Regulations and Standards I One Ashburton Place Rm 1301 IBoston,Ma.02108. j I, Not valid witho signature,, segibr s map and lot number ......... .... ....... THE ..-:..,o�.. _. .. . .... . Z TICSYSTEM INSTALLS MUST ®E Sewage Permit number N D IN COMPIIANC S BAEaSTOBLE, . C�.-.S.3. ...� 3- SY T MU � 8 S EM f Y House number ....?0"-�.�:D..:................... ........................... WIT}I T�T�� 9 MU& • �EN�/lRO�! � CD 1639 I�lENTIb CODE AND °wara� TOWN OF BARDS',. ��AR :3° ;"NS BULPIHG I:HSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION .....INJ --� .. �... .... ..... ... .. ... ............. ...................................... • 'L• "f .. ...................19.d'rJ � yI TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies ,forya permit according to the following information: Location .. .... ..�........./.�:(. ....C44�....f. ... . j. .: .................................................. ProposedUse ........... ..................... ................................... ....................................................................................... Zoning District ................ .............................................:...Fire District �G� Name of Owner ..../.... .. ................Address ............... 1.a'. ..................... Name of Builder .. .. . ...........:.J..........Address Nameof Architect .........:.........................................................Address ...................................................................... Number of Rooms ...................1..."...........................................Foundation .. G � 'u%�%�........... ...................................................... Exterior .�N� . .......... ..... ....................Roofing .... .................j4Y4 ............................. Floors �� i�/ ......................................Interior ...... �.I. ... ....... .. .........................:......................... . ..... .... (J Heating :: ..G!`'.:........ `/.. ;� .....................Plumbing ....:....7" ............................................................ Fireplace ...........:............ .....................................................Approximate Cost Definitive Plan Approved by Planning Board ___ __ z2____19.7Q. Area. ....... /.../ � ....5. ...:....... V. /� Diagram of Lot and Building with Dimensions Fee c �r . SUBJECT TO APPROVAL OF BOARD OF HEALTH 3(0 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. , Name .... . ............ ............................... - .L if THEO CONSTRUCTIO N No ...225.85.. Permit for ...qne...�t9A�Y......... Single Family...Dy.el.l.iag............... ..................................... .. .. .... .. .. Location •.Lot.....#.76...5..2.0....M...q7.i4.e ...cir.c cotuit ............................................................................... Owner Theo Construction............... ........................................ .... Type' of Construction ...ZIZAMe.....:�.................... . ................................................................................ Plot ....... /Lot .,I............... ............ Permit Granted ....!?c...t...obe........r.....1.6... . .......19 80 Date of Inspection ......................... :.:19 Date Completed ................ 19&/ 1-n PERMIT REFUSED . ........ .. ....... �19 . . ..................................... ............i............................ .................. ......... ........ ........................................................... .. ............................................................. ............... ............................................................. APpovecl ................................................ 19 ............ ....... ......................................................... ............... ........................................................ r -,Assessor's map and lot number ......:.............. ......... / . ypi THE Sewage Permit number S c :t g Q y Z 33AWST"LE, i House number ...............?0..................................................... ro MABa 1639, TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ................ ...................................................................................... TYPE OF CONSTRUCTION ..... .1/ fl Est."lam- �;.................................................... ................................................... C.� .....................................19.�' J TO THE INSPECTOR OF BUILDINGS: The undersigned hereby ap/plies for1a permit according to the following information: J Location ..!��.......... ... � J�7 ........./, ��^i;C.. ;?t..... :�: .... ......(A ..: `�.��. ' ................................... ProposedUse ...... /�G;`�� it. ...... ...............................,...................... '........................................................ V ZoningDistrict ..............Fire District ��............... .................................... .............................................. Name of Owner %a � -f- " ...........Address / +��� /„ Name of Builder - /. !�;r.;�}... ): :✓r'r �il.........Address ............. 1�....... ... ............................................... ..... ................................... Name of Architect _ ..................................................................Address ......................................................:-.--.-:-.---::.:............ Number of Rooms ..................�/............:.........................:....Foundation ...r....c.................sl,.Gl�P p. Exierior .<% `� (,�,!�ll.}•C: 1 �'� . .......................Roofing � :.............................. f � J C �"-t/ L.T......�J Floors .... ..............................Interior flil,�t: f l —Hating. :..... —:f .`...&,'-l....... ` `;-"?!r, 7 ....................Plumbing ......... ................................................................. ... ._.... ........ Fireplace ........................//........... ........................................Approximate Cost ........ ;. 77? ...................................�...... / " Definitive Plan Approved by Planning Board _____- lc-{`�___� ____19_�7h. Area ,f . .V.......... Diagram of Lot and Building with Dimensions S� Fee ........... ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH LS`�7 fti1 t_j t. i 5, l I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name _/.r,(; r Aa,..././�.v.................... /THEO CONSTRUCTION No .22.5.8.5.... Permit for ...QM.Q...t5t;Q.K-V......... .......5 ill.g ale...zamily...Dwelling.............. Location ..Lo.t...#.7.J5....52.0...Mariner...Circle .................co.tult.............................................. Owner Theo Constr tion ...................................... . ............................ .. Type of Construction ... rame.......................... .......... ................................................................................ Plot .................... .:.....Lot ................................ Permit Granted ........Octobe .. .. .6.,...lg 8 0 .... ... Date of Inspection ................../..............19 Date Completed ......................................19 ..........................PERM. ..REFUSED ........ .. .. ...................... 19 ............................ . .......................................... ............................. ..... .. . ...... ...... ... . ................ ........ ........ .......................... ......................... ................................................ Approved ....... ................ ............... 19 ..................... ... ... ............... ............................... `��,,�"'•:.e TOWN OF BARNSTABLE Permit No. _22585 Building Inspector Cash ----__-_-- �YL OCCUPANCY PERMIT Bond No building nor structure shall be erected, and noo, 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 Theo Construction Address South Yarmouth Lot-. A76 920 Mar.i npr_ .ri rclp Cntiiit d Wiring Inspector !• `f, --- Inspection date Plumbing �Inspector �1 _ _ Inspection date Gas Inspectors ` y Inspection datef .Engineering Department f?!t �A Inspection date „ _1,�9/y! t1 f 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. . � � � Building/Inspector r u 7 ' N X'w 174) • }, fir, - 03 �, „ z , { 4 ♦ �. ,Q w FOU IDot '101 L C . 1, N : Zz G0 'f T ;M,,-A-S ,goS G.H . o OWNED BY -rwEo• L .oll,2XIzoC.,rl+C►d� r�. tJCE S'GALE �'� .rJGa�..i VIT•G �i.��. :. f IY'ORMANLCiROSSMAN- - RE0ISTE`RED CiAAfO SURVEYOR, �►' - QO�Ix `£sa I ,HEREBY. GERTIFY TNAr THtS• FOUNDATION dS- ,OCATFO k p ONTHE LOT- AS .001NN ,AND CONFORMS FO THE TOWN y� y OF'BARN'STABLE ZONING REGULAt,IONS REGARDING ''" ; NORMAN QROSSMpN SETBACKS FROM' STREET. LINE'S AND: LOTm LINESf. ;`� a• 2775 D NORM#N GROSSMAW R.L. S.