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HomeMy WebLinkAbout0091 NICKERSON DRIVE �i 73d , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 'Map Parcel 3 Permit# � Health Division �' �,� Date Issued Conservation Division Fee j Tax Collect SEPTIC SYSTEM MUST BE Treasurer ' INSTALLED IN COMPLIANCE WITH TITLE 5 Planning Dept. ENVIRONMENTS Date Definitive Plan Approved by Planning Board A 7�1�, Historic tiOKH Preservation/Hyannis /mil Project Street Address a� Village C. -{ Owner 00 1., 4 a Address �11 Telephone Oei — S Permit Request -Y/e-1. Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Costa 160 J*oo Zoning District Flood Plain Groundwater Overlay Construction Type U-o OJ Lot Size f a Oy Grandfathered: ❑Yes U 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 ❑No Basement Type: ❑Full ❑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 new First Floor Room Count k Heat Type and Fuel: O Gas O Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No 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 Name 0tr 1. �, Jo-� Telephone Number 3 y Address, Q59 Q, nQr ��a- - License# u mot•is Home Improvement Contractor# / D�i Worker's Compensation# ' �17 0301 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE t"� i` r DATE 42- 65 Rom. FOR OFFICIAL USE ONLY _ MIT NO. ATE ISSUED 71 MAP/PARCEL NO. _ ADDRESS VILLAGE OWNE DATE OF INSPECTI( : ' r FOUNDATION FRAME s INSULATION FIREPLACE -- " ELECTRICAL: RdU C FINAL ` PLUMBING: ROLJG FINAL GAS: ROM FINAL - FINAL BUILDING '-� ' _� �Ll DATE CLOSED OUT } ASSOCIATION PLAN NO. i PrP Town of Barnstable *Permit#- 1�C5 �,P p Expires 6 months from issue date '+ saxrtsrnst,e, ` Regulatory Services Fee S v t ; ,0a Thomas F.Geiler,Director �prFG��A• Building Division Tom Perry, Building Commissioner VE 1T 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 MAR 3 12003 Fax: 508-790-6230 EXPRESS PERAUT APPLICATION - RESIDENTU&NMINARNSTABLE Not Valid without Red X-Press Imprint Map/parcel Number Q 16 OI9 3 Proper Address T /�,�P, �'( -NJ C) . Residential Value of Work_ 3 000 V Owner's Name&Address V 1 ® P,- gclq Xt � I le Lek- SDI 29 rG jUt� Contractor's NameALs P.iv"Z�L Telephone Number C l-7'7 ( — Home Improvement Contractor License#(if applicable) 19 Construction Supervisor's License#(if applicable) f Z lO (0 ❑Workman's Compensation Insurance Check one: E-1 am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name \Ax 114 _Q P 04 1 7- Y Workman's Comp.Policy# Permit Request(check box) { .� [�e-roof(stripping old shingles) All construction debris will be taken to To wti /41 440 I't ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (ma_ximum.44) ❑ Other(specify) *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. Signature )�%A� Q:Forms:expmtrg Revised121901 �� °FTHE row Town of Barnstable Regulatory Services BARNSrABLE, =MM Thomas F.Geiler,Director 9 16319. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must.Complete and Sign This Section If Using A Builder , as Owner of the subject property hereby authorize�, J&,( ►Zp�, 1 ('odv�'��� cT(o�, to act on my behalf, in all matters relative to work authorized bydh s building permit application for(address of job) 9 tit G..r r.t o--t/ A7 Signature of Owner Date Print Name oFt Town of Barnstable *Permit# (i b sj,!,A,8USQe date BAMSTABLFn : Regulatory Services _ M"S& m 2903 Thomas F.G.eiler,Director bo Building Division Tom Perry, Building Commissioner - S30�d 200 Main Street, Hyannis,MA 02601 Office: 508-86274038 Fax: 508-790-6230 EXPRESS PERNHT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number a I a Property Address [ 'residential Value of Work fro b , Owner's Name&Address U_t k a M �4 L' s LLe Contractor's Name !�Q �✓� 1 Telephone Number 1 7 cc Home Improvement Contractor License#(if applicable) // / IrY Construction Supervisor's License#(if applicable)_h 7 2 (� ❑Workman's Compensation Insurance Check one: W?T—am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's 'Compensation Insurance Insurance Company Name Lv 4n 1'1.��✓A workman's Comp.Policy# - Permit Request(check box) J ER-roof(stripping old shingles) All construction debris will be taken to 'T 6 w,✓ La d fi' t ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) *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. Signature Q:Forms:expmtrg Revisedl21901 go'ard of Building Regulations and Standards, HOME INj�ROVcMENT CONt� ACTOR � \ •Regis# ron 1859 : rpua#rqn 1f`�'h2103 MICHAEL RENZI.GC, LP MICHAEL RENZI � J/ 387 PHINNEY'S LN bENTERVILLE,MA 02632 :. Ad ids � I•' u �6ce U�anvit2Qozcu� a��/e�a���`4 J �I I3'QAYRD O BUI'LDLNG REGUlu1AT�©N3 I� Licensee COIJSTRUCl�ION S1PER+VISOR 14 jj I, I Nam-Ue7� ©5$266 I . ;; j BiCt Z�a4e 6Oi��53 ! -38 ,�N Tr.no: 13512 3 MIGHAEL 387 PHI'NNEYS LN' C,�WTERVILLE, MA 0�2�2="-'� _ Admirtistra�o� . V ; MANUe.L GARCtP COr CF*ROM F49!3. or S 500C NICKERSON �_ ?oadw �r t•` we.oe 0 N. D IVF-N W FORMERLY ABBIE �• NtCKER30N MERIEL e1 ELLIS All; O y HEIRS o� IS0 _.; l 1=� z O O o• a•s. 2 � ;cp� ku C E �. .,. _ � O 1 P1 h S.t7. 4q'3o'-W ITS Sal • GD rwaD�� t NLl•h 9'.io•C�., p i Z ` n / 1 �o OY � U Ii � v � 0 01 N Z 1 O . Z I f DEPARTi4FNT Of PUP- _IC '_(IF"-rY ME lf+ i t,'I,li jt't+l I i't 12./?0t?0- IJ HOME IMPROVEMENT CONTRACTORS 'REGISTRATION ' Board of Building Regulations and Standards „ One Ashburton Place - Room 1301 Boston, Mabsachusetts 02108. HOME IMPROVEMENT CONTRACTOR Registration 109374 Expiratjon- 09/11/00 TYPe" PR7 VATS"CORPORATION P,INE 'HARBOR :BUILDING CO ., JAMES D. MCGRATH 259 ®UEENANNE RD i HARWICH MA 02645 „ t ,• - c �: Suggested Affidavit for Home`Improvement Contractor Permit Application For ornce Use only :_ NAME OF CITY/TOWN Permit No _. v Uo4 ' AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGLc.142Arequires that the"reconstruction aheration.trnovation,teoair modernvation conversion,inoravetnent removal demolition or construction of an addition to an_v,Dre-cxistuir cwnm-occuyied building containint a'icast one but not more than four--g—- . or to structures which are adjacent to such midence or bulldine"be done by registered contractors,with certain etceptions,along with other requirements. Type of Work:-C_0n5i 1)Cf761) Wit" Pin T 13&7fn J) Est_ Cost Address of Work V ► V �C �� .6 a(�3 S� v. Owner Name'✓ ��1� W /� P Date of Permit Application: I.hereby certify that. Registration is not required for the following reason(s): r - _Work excluded b{ law - A p ¢ ; �• Job under S1,000 Buddin&:not owncr-occupied Owner putting own permit 'r _Other (specify) Notice is herebv given that . 4 ' 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. a Signed under" penalties of perjury. I hereby apply for a permit'as age t �t r: , �� a TJ Date Contractor Na" a Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of,the above property,' Date Owner Name Suggested Affidavit for Home Improvement Contractor Permit Application For Office Use Only NAME OF CITY/TOWN,, Permit No- Date AFFIDAVIT Home Improvement Contractor Law-H Supplement to Permit Application . MGL c.142A requires that the"reconstrutxion.alteration.renovation,repair,modernization,cortvaaion,inprovement removal demolition Or construction of an addition to amr rue edsung own occuoied building containing z�bast one but not more than fourdwelling units or to structures which are adiacent to such residence or building"be done by registered contractors,with certain exceptions,along with other requirements. Type of Work:_L.J;Ji IS d on Pr Ji fi &4,n �CCCC�Cttllll Est_ Cost 6d ` j I Address of Work v/ IQ - Od &3 S Owner Name'✓ lam✓ Date of Permit Application: C ne I hereby certify that: " Registration is not required for the following reason(s): Work excluded by law G . Job under S1.00f) - Building not owner-occupied - - -Owner pulling own permit y L -Other (specify) 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 c142A . Signed under penalties of perjury: - . a 1 hereby apply for a perniii as ace t n r. , /. ;I . -1. . ", - - g roc _ S 7� Date _ . tractor Nal'pp.e t5, Registration No. I Notwithstanding the above notice, I hereby apply fora permit as"the'owncr of the above'<property. Date Owner ;Fame �ry THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) A UGMIL DATA COUSTI IUCZT.ION S'UPERVISoft' -FGRR4 PLEASE PRINT. JO$ LOCd"%TI ON PROPERTY OWNER• CONSTRUCTION SJPr,nz'ISvR = Y1 L_C:.iISr- 14U_2'�E PHONE SEC) y � y �G rmoo h rf v �. y _as e . #. r 4ICENSED DESIGN" .( IF ANY) . Res-oons_.:: I ?i-7 o e=c^ 1 , ca=se halve_ 2 . i^ e �3Cn^SZ E' .ic>> to sf3 '1T r :__s,cP.s=_^-� e �o� a 'wO-z c wn- ho _s =s- �le �c� see-rc -c ssDe 1 �s�hc a sr�F11 �e tea. r ,o _ z.s core c' the Be_1C_rc CCGe tne, �,T - :C_c� _ s _ y_ a+* ' The 1 1 Cense hc,-r" s-a i 1 r,c =-le ie^^_^S�_ . 0 ��cn a C rp- t0 C he ,, i.. C � I^G*•G= ri0_cer �c nc-,� - l.,e �e�-_ 7: nQ ° f'�. -G.'.. _ l..:e ce .,i 15 . 4 Y��r '�.-'.Ce^_"S e.a '•�L o s..c1 1 W-.1 _U1?EJ .� l 0�...�'F 2 2. L5 , a_ c . G-' 0-ems: sec _ons- o- t e'seC r a1e= a-c -�­_Culazions ant; G _ CC ES as cae_^_C'�C'r Ci1C11 be , 5::.^.IEC� G- 4:r ?1cerse .ov tie - r i �� j c_-�C ce _.- o�1ca�_ors shal cO r��� .^. tie r_�.*;e ca snc_ e_ r_=C cue •r.`e_" ¢`, ccr-s= _ - �.- V— ."�;.1V/ {, LC= G ; �_:?:rcS ray`_ S a. S aC: sUc-e^! _ `-G- sa_C 0er 3CP.S tie "WC ' ..1e^_.c:-_ cC,_E F _ G .S.iLcc SGr _ 1 ; ce--=_e -der j �. - ' have read and r���o�s - urce_ es arc 1 -dons =cc _eery-=C c^-'s--z'-'cw_on six e* re=` rs W_.__i Scc_ n `J'_ \ .G .lLa I a -nu IdI.:C-coCe . I nncerS aT.c _ a ccr__�r-lcr1Onrceo,�,,_es GnQ --ec- = r - ca_, , e^ -.O by - , A . k' - ..r . , rt 1 i . � ... ,Y ;. • � ` � • c t � � F ' - 1 � b i 4 _ � � t y .. 1 . � . s, � - 1 � •_s--P~ 7 r - t� t g' � i j. �� .. � � � � .1 � � � . - .� � � _+,� { � 1 � ;to �� � �� � 5 i � t ' x /+ 5 � Y' x • ' - .. � 1 � 1 i f .. 1 . . t ' 1 ` .. • i III � / _ � � 1 .• . - 1 _ � *, 1 .� � � � ,t i� � ', f •' •+ �t Y . '' k�� .. .. a t� ' � �� , 1 � 9 1 ,t � � ,} 1 _ � - _ .. s� � , _ .- i • � � 1 o 1 1 .. � - - _ ,i r- t.. .. ` fi' � r T A. .... _ ` OWNER: Map Lot ' DATE: The Commonwealth of Massachstsevs Department of Industrifat Accidents — 01h'reol/a .�oloas 609 Washington street � �:• - Boston,Mass: 02111 Workers'Compensation Insurance Affidavit �c cites phin,a 'Tad o1 did S C) 1 am a homeowner performing all work thyself. C] I am a sole proprietor and have no one working in any capacity Cl I am an ern ployer,providing workers' compensation for my ernployecs working on this i b,D8/{ A ♦ 3 G C � Ptic of addreaa- k7oa ' I h.insurance ca. ' \ n e 1. tnoficy d [j I am a sole proprietor,general,contractor,or homeowner(circk one)and have hired the contractors listed below who ha the roilowinc, workers" compensation polices: SS29�l1 nn mc- phone N: iAlurance co R 1lLc�,# company nmc- iddresss: r r £ r city: a ._ phone M. iII.5ltr�nce co policy tt Fadurc to secure coverage as requited under Seetion ZSA ofNIGL 15:an lead to tba imposition of criminal penalties nr._f -tT1oS1.i00,Qoaad/o� unc years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine ofS100.00 a day against me. 1 understand that a copy of this statement be forwarded to the Office of Investigations of the DIA for coverage verification. Jo hereby certifyu d ,t p d ucs ojpetjury that the injormiaion provided above is true and corrnae r Signaiurc � Date o camp j- � �r� �n • Print name j S Phoac official use only do not wrier in this area to be completed by city or town official utv or town: - ocrmit/licensc>r t'l8uildine Denarrment , f o L j f . Sovo 7'o?F�s o �on►ENs�oNra�_ N��� AME C&Ja LOU vr t� � �wta� SFfawu, Li 14` TvP PzAT� i - I , I i e - f -. 1 Cc� ✓ — iX Alki1us CD CD CD ► /� I , 1