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HomeMy WebLinkAbout0046 MASHPEE ROAD . , 1 i oFsMWE� Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fees , anaxsrnsL.e, MASS, Thomas F. Geiler,Director . T . i63q. �0 ArFp .1a - Building Division +, MAYf Tom Perry,CBO,,Building Commissioner 71010 n 200 Main Street,Hyannis,MA 02601. ` OWN OF BARNSTABLE www.town:bamstabl e.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 QD 7dJ Property Address (� {'YIIL 7=` Y P. (�Residential Value of Work /<, 'Q�pj:;)�> Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address (//162� Contractor's Name \� �_ �J /� U� .,Telephone Number Home Improvement Contractor License#(if applicable) t Construction Supervisor's License#(if applicable) M16orkman'.s Compensation Insurance L Check_one: ❑ I am a sole proprietor ❑ I am the Homeowner n—fhave Worker's Compensation Insurance Insurance Company Name / J-P77 7.5 , Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit: 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) x ❑ Re-side ' #of doors_ Replacement Windows/doors/sliders.U-Value (maximum.44)#of<windows ✓/; *Where required: Issuance of this permit does not exempt compliance with.other town department-regulations;i.e.Historic,Conservation,etc. ***Note: Pr ty Owner must gn Property.Owner Letter of Permission. opy of the Ho provement Contractors License&Construction Supervisors License is equired. SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\Windows\Temp Internet Files\Content.Outlook\4STGU5QO\FXPRESS.doc Revised 090809 • 1ARNSTABIX "'A9 1 639. Town of Barnstable 14� Fop Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, ewe lfSa-i&% , as Owner of the subject property hereby authorize �Rf elk to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\4STGU5QO\EXPRESS.doc Revised 090809 s 20-eammonweam 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: Registr00,9Y\104804 Board of Building Regulations and Standards EitpiU15/2010 Tr# 270833 One Ashburton Place Rm 1301 ' ``r Boston Ma.02108 F� e }?ilvte Corporation � l4 1�j LAGADlNOS BUr' I &,QG' ,INC Nicholas La actin 1'3 Thankful Lane Cotuit,MA 02635 '�'"'" Administrator Not valid witho signature Massachusetts- Department of Public SafetIV Board of Building Regulations and Standards Construction SupervisoV- License License: CS 12653 Restricted to 00 i. NICHOLAS A LAGAOINOS 13 THANKFUL'I.ANE C_ COTUIT,'0`2635::: Expiration: 7/16/2011 Commissioner`. Tr#: 19456 v 02/01/2010 MON 14: 09 FAX 508 420 5406 Leonard Insurance Agency 0001/001 ' ACORD CERTIFICATE OF LIABILITY INSURANCE 0 iO j20' PRODUCER S08.428.6921 FAX 508.420.5406 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Leonard Insurance Agency Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 7 Wianno Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P 0 Box 494 Osterville, MA 0265S INSURERS AFFORDING COVERAGE NAIL# INSURED Lagadinos Building & Design, Inc. - INSURER lc National Grange Mutual Ins Co. 14788 13 Thankful Lane INSURERB.- AIG XSB009 Cotuit, MA 0263S INSURERC: INSURI R D: INSURER E: COVERAGES 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,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. II T R D' TY OF INSURANCE POLICY NUMBER � POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY MSB87460 01/01/2010 01/01/2011 EACH OCCURRENCE $ 1,00 000 X COMMERCViL GENERAL LIABILITY DAMAGE TO RENTED PREM1145A IF:, $ SOO O00 CLAIMS MADE ❑X OCCUR NED EXP(Anyone person) $ 10,00 A PERSONAL&ADV INJURY S 11 000,00 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICYF—j PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO - (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per Pion) HIRED AUTOS BODILY INJURY $ NON OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO FA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY FACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ +. WORKERS COMPENSATION AND WC004--30-3313 01/02/2010 01/02/2011 WCSTATU- OTH- EMPLOYERS'LIABILITY B ANY PROPRIETORIPARTNERIEXECUTIVE E.L EACH ACCIDENT $ 500,000 OFFeFICERIMEMBE.R EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ S00,000 describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ SOD,OO OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN N0710E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Town Of Barnstable BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 200 Main Street OF ANY IOND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Hyannis, MA 02601 AlTHORIZEDREPRESENTATIVE FRobin Carpenter/LEORC1 4uu ACORD 25(2001/08) ©ACORD CORPORATION 1988 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street FW ,t Boston, AM 02111 www.massgov/dia, Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/OrganizationWividual): Address: % 17h�h4�L�i>` L i9i91: City/State/Zip:_ '07_6 3; 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 I employees(full and/or part-time).* have hired the sub-contractors 6• ❑ New construction 2.❑ 1 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 addidon [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no l 2.❑ Roof repairs insurance required.]t employees. [No workers' comp'.insurance required.] 13•[S Other Ull�I !>rJVL) *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 subcontractors and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: I I }P—'77 S Policy#or Self-ins.Lic. #: /,f)(;" 03() i - Expiration Date: I Z Job Site Address:___q•(Q City/State/Zip:_�(� T' 1 13 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 maybe forwarded to the Office of Investigations of the DIA for insurance verage verification. I do hereby ce i u der the ins d penalties of p ry that the information provided above is true and correct: Si ature• Date: Phone#: 2L,AZ 0 FF use only. Do not write in this area,to be completed by city or town official Town: Permit/License# Authority(circle one): of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector Person: Phone#: MINE 1w f FEE--. TOWN OF BARNSTABLE, MASS. , �b� s 19 O N. tm 0•5 THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TO (� Off'; O O a- (PROPERTY OWNER) (ADDRESS) �I be N - ob N a TO .............._............................................................................................_.._......_............................................................................................................................. (BUILD) (ALTER) (REPAIR) O O (TYPE OF BUILDING) (APPROXIMATE SIZE) M �� op LOCATION .............._._......._............................_................................................_..... ..........................................................................».............................. _�__�� (STREET AND NUMBER) (VILLAGE) NAME OF BUILDER OR CONTRACTOR .........____....__...._..........................__...._.._..._....._. ....__......_......_....___....._._ A d O.0 APPROXIMATE COST 4) c 1 HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN at OF BARNSTABLE, REGARDING THE ABOVE CONSTRUCTION. o al 0 0 a U^+ A EI (gyp (OWNER) (CONTRACTOR) �a0 0 00 _...._.._...._........_......._.....__...._.._...__..........._.__................................................................................. BUILDING INSPECTOR Subject to Approval of Board of Health. 1 1 17 - �, /.-/77 cl G� . a t THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) Im ^�c� C DATA *TM`> TOWN OF BARNSTABLE _-----------_ �, •e Permit No. _______________... »n.0 Building Inspector a A rua Cash ------------- 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 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. ..........................................I..........1 19......_ ..................................................................._............_.........._..__._.._ ._ Building Inspector i n -- Assessor's .map:. and lot .number ..........�......._....1.6r- 3........ .':'J'�f r // • �- 4 Sewage Permit number' ...... ............................ $j/B�8/ iVIT11 ARTICOLE' �} '"" F oar T o L-T. 'f �OfTHEr e 040 JAWN . OF ` BA.RN9V-% X J BAHBSTABLE, 9- & BUI.LDIHG' INSPECTOR ' p0 i639. 0 MAt a' APPLICATION FOR PERMIT TO .. . ahV4........Q!At.....FA!kh4......40")%k:....... ... N TYPE OF CONSTRUCTION ................... eUt_ .....l —'t^►!`1 ............,:...................:......................... ........................ ...............19....'.r.. TO THE INSPECTOR OF-BUILDINGS: The undersigned hereby applies for a permit according to the followirig information: n t `y�4 QoA�i...... "Tvr 1 (OFF ntTv. T P-DA Location ..................� ati:ti.... ..... .......... t.. ..A.......... .. .... ........ ............................................ .................................... ProposedUse ............bN! .........��A :�. ........��S ..................................................................................................... Zoning District ...... ...............................Fire District .....!�Zomm!...k...................................................... . ut-S `5 +�[ �. S"r c Sri° 7 Spli2�� IN�To A55. Name of Owner ...�. ..J`�................:.....�l:J....�.�..................Address ...........�........�..................:.�.....}....�.�............!`�.r. Name of Builder ... 4.....VWNI _Ak.�.L`..................Address ... !. :c:G..4.X..1�,?��.... � is IRT.. ......... Name of Architect ........5A.At............................................Address ...........:G- A.M.k........................................................... Number of Rooms .........4,..JQ1PAA&...................................Foundation ..... !�Pnt.cAkin;........................... vJ Exterior ...... Sl ...... � �...fl A.VWo®....Roofng ...... � ...................................... ! 14 `A... ................ ........ Q .................................... a T c,> Floors �....:�............ ... � rt�T�� Interior ELT Heating : ���� I'� ...........Plumbing ....... A!!� .1.: �. �j �. �p 00 .... Fireplace .........P�.�-....(F?�IC�C�.......................................Approximate Cost .......�::). fi3......r:.................................... Definitive Plan Approved by Planning Board ----- L_______________19 _. Area. .. . ................. . . ................. Diagram of Lot and Building with Dimensions Fee ................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH E_ jia ,� stP�►a loos � 1` d 1 t 3i r - _ I t 40 is � 1 t • 1 of 1 1 71 2®A L a t I hereby agree to conform. to all the Rules and Regulations of the Town of Barnstable regarding the above construction. • 4 Name ...X .................... ............ ... . .... 13:498 one story, No ­­*­­­* Permit for .................................... single family dwelling ................................................................................ Location Oq_/�7 Mashpee Road ................................................................ Cotuit ............................................................................... Owners JamesJames J. Connell r Au Z' z Type of Construction ....frame........................... C' TN 0 ........................................................ .4 ILPlot ............................ Lot .......................... .Z1 In 4 1,P.erm it'Granted ........December... 9 74 Z) bate of Inspection 19W Date ComIpleteI i 9'�/........ ..... I -9 4% t gz IT ri PERMIT REFUSED A 0 W .....................V..... 19 ;Y-: C, o 441' .................................................. IS 41 10 F C— . .. ......................................................................... �c 04 < C .................................................................... IT ..........................,................................................ V Approved ................................................ 19 ..................... ......................................................... ............ Assessor's map and lot number ...........�.c;r...... 2C 1;tt o".... ...... Sewage Permit number .......................... .................. ...... 0,*THE TOWN OF BARNSTABLE t BARNSTABLE, mum 1639- BUILDING INSPECTOR. MAID, APPLICATION FOR PERMIT TO ....*...�P! h........6.N t ........ ....... ........... TYPE OF CONSTRUCTION ................. ................................................................................. ........... ...3a....................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 4DA4-r0,1- ............( Location ............... ......&�...... F:4.7........................... .... Proposed Use ............b.A� .4............. ......... . .. .......................Ii ...........................................................................I......................... Zoning District ........ ... ...... ..................................Fire District ..... ................................................... Name of Owner ....SD�fA t� ....-S....I ....... ..............Address ..... ....... .. . ...... ............ ...... ........ .. .. ..... .. .. .......... Name of Builder ... ...... ..................Address ... ........Q.o ............ ... ... .... . . .. .. ... AName of Architect ....... A At............................................Address ....................... .......................................................... Number of Rooms ........ ....................................Foundation ......pe)0 P-k h 0-0 fq 0-p-0�k ............................ .................................. Exterior ......9QP W%k....... qOPP ,....Roofing ...... ....................................... 4- ....................Interior5�t e--F g,- Floors ....ql��47....17.... .............. ......... ...........................45............................................ 7 a t - .......... 1PILmbing ...... L.(WAS.. .-u...rP..t..P.—.-....1UA .. Heating ...................... ............................ .Fireplace ......... .......................................Approximate Cost .......... ................................. Definitive Plan Approved by Planning Board --------19 Area .... �./................... Diagram of Lot and Building with Dimensions Fee ........ ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH ooO 6Ak- 51,rfc- Ib SO' ,1 S9 :5-S" 60 ) 2 41, t- QCA I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �.. Name .... . . ................................................................ Connell, James J. 7 z 1 498� one story, No ...:............. Permit for .................................... single family dwelling ............................................................................... Mashpee Road Location ................................................................ Cotiuit ............................................................................... Owner James J. Connell .................................................................. Type of Construction .........frame ................................. ................................................................................ Plot ............................ Lot ................................ December 23 74 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... .............................................................I................. Approved ................................................ 19 ...............................................................................