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HomeMy WebLinkAbout0068 PRUDENCE LANE `� `� � ` _� I l i es ' TOWRT'OF BAftN9TABLE Permit'No r Bwlc>zng Inspector ' ,Cash • eun `. OCCUPANCY PERMITS Bond ``Nol building nor structure-shall.be erected, and.no-,land,.building or structure,shall•be " R� used for'a new, different,,ehanged, or-enlarged use_'�,WAoik a Building ,Permit theiefor ,- - first having.been obtained from the.Building Inspector. No'building shall be occupied until a`.-. F. certificate'of occupancy hWbeen-`issued by the Building Inspector issued:to Al CI.1C3-@1209 4T7. _ -Address r €9 Fi ..Prudg'mce 1af L Cob A 3. `���� „ Wiring Inspector: r � y'"""-•-•r� �' ; Inspection.date Plumbing:Ihspector �"' � �. Inspection date Gas Inspector ,`'{;yrr�':` ,A _ a�fv'_� i� t 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. J t r Building Inspector ?�{ Assessor's map and lot number ............................................ SEPTIC F THE tp�1 SYSTEM � s .. Sewage Permit number ... G ..//, .:.......................... INSTALLED I ••••• N COMP , Z SAR33TAXE, i House number ...:% ...................................................... �' ENYIRONl1ATAL 6 ' "639 ° TOWN CODE �aY,. NS TOWN OF BAR TAKU`u `Tt°"S BUILDING IN'-S?EC'TOR %�i/ � /' t/ T �, / /�r APPLICATION FOR PERMIT TO ........:4�?.........;�s.L.���.... �� TYPE OF CONSTRUCTION .1 ...BelbWv.....................................................:............................................ ....7...........19.,VtQ TO THE INSPECTOR OF BUILDINGS: 1 The undersigned hereby applies for a permit according to the following information: j Location .. o.�..... .. � ....d`�J�/U ........ �: /W/? ©/...� .. ............. Proposed Use .... / .........�//�/Y/� .�✓............. ........................................................................................... ZoningDistrict .. ... !...............................................................Fire District U'sev.1................................................................ Name of Owner ......0—. ..A Address Name of Builder W.4v% ... .Address ✓4/�fld!.. U,1 j..... .. ✓ fir.................... .Nome of Architect r .........................................Address ............................................:....................................... Number of Rooms f/r�......6`o. .. �� �U� /U�' % ........ ........... ........................... .Foundation .......n... .... ...... �.... ..�..........:... Exlerior .......................Roofing ................... Floors ..WAI,� 6t .Interior .....!.�........... .............................................................. .......................................................................... Heating fO ..., .T .....W?A`.. .......... -':.�k.\�J........Plumbing ..��........................:....................:.....-................... � Fireplace .. ` ...Approximate Cost ....... ....................................................®®® J Definitive Plan Approved by Planning Board ------------------_--__- � .U..��......� ------�9-------. Area ............. �=> Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH All I hereby agree to conform to all the Rules and Regulations of the Town of Barnstab rd' above construction. Namur .. ............. . . .... , ...................... CIRIELLO, AL JR. & ANNA MAE 22112 °*No ................. Permit for ... ......... Singj!�...:�AMj 1 y..pW.e ...................... ..... ......... Location ..Lo.t...#.8.7....6.8....Pr.U.dP-n.Ce..Lane rt cu cotuit . ............................................................................... Owner ...Al......&.-Anna...Mae...Q1 ..... . .. .......... ........ Type of Construction EK.E.0e............................. 7- ................................................................................ 1.. L .01 Plot ............................. Lot ....................i........... s. April Permit Granted ............................14 . ..........19 80 Date of Inspection ............................ 19 Date Completed .. ....190 U Z PERMIT REFUSED M 0 ........v......>............................... ....... 19 0 0 tip 0 j, yS q M ............ ..............................;;.................... sb .......................................... . ......... ...........................J.�t..................... Apgrbfed ...7 ................................ ...... 19 . • ............................................................................... > .............................. ........................... .................... i i � o �I L� !`r► � t... W J � LOCATI oI-A SCAL C ��� �o SAT i= d`a ao CGIZTII=�{ Ts4AT TNT 5"c>,. w lzIs cZa►,Jca Wr--ZG014 COAAPLYS WIT" THE -SlVzSt. (WC-- i � Awt> SE rSACK QC-QUIIZEAAE:WT,; OFTNF 1� b -rowQ of LAQr--� DATE Q iCcy uY1= I�•1G_ B,G,XTc-.cZ e, 9ZeGIS'cs:tZG1:> LA.WD 5u2vEYolzs TNIS CLAW IS WOT E44SEV Aal 05TE2vILLE o ArCass. � lt.ly'f�tJMt�t.1;' SUQvc { ¢ T.�L- 0��"S�rS SI.1o"vw APPLLGAI�IT `! / ti1C.l"' �1r USC:O 1c� DG'TC c��I��•!C LOTl_I►.1i=S y�/t!.,,,. GQe�TT M r - Town of Barnstable *Permitjonoo Q. Expires 6 months from issue date Regulatory Services Fee MASS. azy.6�eg Thomas F.Geller,Director sb Building Division �y Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY i Not Valid without RedX-Press Imprint Map/parcel Number Property Address Residential Value of Work 52U�' oaf ( Minimum.fee of$35.00 for work under $6000.00 Owner's Name&AddressA Contractor's Name c J Telephone Number r���S . Home Improvement Contractor License#(if applicable) j 2 3`f 1 Construction Supervisor's License#(if applicable) [ Gf ❑Workman's Compensation Insurance wt �: MI Check one: X b ES ❑ I am a sole proprietor ❑ I am the Homeowner Q C T 07 2011 "I have Worker's Compensation Insurance TOWN OF Insurance Company Name l/US`.�( �_ E9ST 'B LE Workman's Comp.Policy# t�yU Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) - ❑i Re-side ti'( L I:tj- C[�) S ,,� #of doors E Replacement Windows/doors/sliders.U-Value -30 (maximum.35)#of windows "Where required: Issuance of this permit does not exempt compliance with other own d artment regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is re uired. SIGNATURE: C:\Users\decolU\AppD cal\M erosof4\WindowsUemporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 i ! r • s • BARN3rABLE. ,, p, Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division G Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I v�.o� Y ��� �" P,as Owner of the subject property hereby authorize v0 /�� l �'t� to act on my behalf, in all matters relative to'work authorized by this building permit application for:{ (Address of Job) gnature 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\decoM\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc ° Revised 072110 ./J The.Corm►eonsreafth ofMlissadjusetts Department of Industrial Acc"id wh Office of lnvestiguliotts 600 Winhington Street Boston,MA 02111 wwn+n1ass:gov1dia Workers' Compensation Insurance Affidavit BuilderslContractorsM.ectricians/Ptumbers Applicant Information ': C f/y�C_ } d2.(!Y\C Please Print Legibly Name.(3usinessionpivation1idividualj:V 1 U�l�y . . S'(1C- ("AJ Address: �2 �— � \11C City/State/Zip: &At4�WtCk Phone-#: � Are you an employer?Check the appropriate boa:, 4. I am a general contractor and T Type of project(required)::' 1�I am a employer with � g C New construction etarployees(full andior pert-tame).' have wed the subcontractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7odeling shipand have no employees These sub-contractors hay{e. y 8_ Demolition working for in any capacity. employees and have workers' 9. �-Building addition. [No workers'comp.'insurance comp.insurance. required.] 5. ❑ i1Te are a corporation and its 14:0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their i.l.❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs, insurance required.]l c,1.52,§1(4),and we have no' employees_[No workers' 13_11 Other comp.insurance required-] •Any applicant that checks box#1 tonn also fill out the Section below showing their woakets'compensation policy infort�tion 1 Homeowims.wito'submit this affidavit indicating they are doing all work and then hire outside coutractors.mast submit a new affidavit indicating such. iContractors that check this boa mast attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have• employees. If the sub{ontractots have employees,they M-M prinade their workers'comp.policy number. I ain an employer that is providing rtrorkers'coiuipeitsation inmira►ice for tin,e"niplayem Beloit,is the policy'and job site inforination `�" ,�' c Insurance Company Name: vAN A—b c�-N—SOV Policy#or Self-ins.Lic.# �Z �^� Expiration Date: �JJ Job Site Address:�Q Cif„StatelZip CCU 1'UL`�' . 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 o€theDIA.for insurance coverage.verifxcation. I do hereby,cnYV1r the pains art tiles of perjwry that face information provided above is try /a/red correct Signature: Date: G 1 Phone#: :! ! 6 �6 5 Official use only: Do not write in-this area;to he coinpleted by city,or town offl laL City or Town: PermitfLiceuse# 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# Workers' Compensation and Employer's Liability Policv GUARDAmGUARD Insurance Company - A Stock Company INSURANCE Policy Number MCWC239396 R U P Renewal of MCWC130137 NCCI No.[21873] Policy Information Page [1] Named Insured and Mailing Address Agency MCDERMOTT CONSTRUCTION INC PAYCHEX INSURANCE AGENCY 52 Easterly Drive 150 Sawgrass Drive East Sandwich, MA 02537 Rochester, NY 14620 Agency Code: NYPAYC10 Federal Employer's ID 13-4227616 Insured is Corporation [2] Policy Period From September 30, 2011 to September 30, 2012, 12:01 AM, standard time at the insured's mailing address. [3] Coverage A. Workers' Compensation Insurance - Part One of this policy applies to the Workers' Compensation Law of the following states: Massachusetts B. Employer's Liability Insurance - Part Two of this policy applies to work in each of the states listed in item [3]A. The limits of our liability under Part Two are: Bodily Injury by Accident - each accident $100,000 Bodily Injury by Disease - each employee $100,000 Bodily Injury by Disease - policy limit $500,000 , C. Other States Insurance - Part Three of this policy applies to all states, except any state listed in item [3]A. and the states of North Dakota, Ohio, Washington, and Wyoming. D. This policy includes these endorsements and schedules: See Extension of Information Page - Schedule of Forms [4] Premium The Premium Basis and, therefore, the premium will be determined by our Manual of Rules, Classifications, Rates, and Rating Plans. All required information is subject to verification and change by audit. (Continued on another page) Total Estimated Policy Premium Total Surcharges/Assessments Total Estimated Cost $ INTERNAL USE XX I MGA :MCWC239396 Page - 1 - Information Page Date :08/31/2011 WC 000001A MANOTE 16 South River Street• P.O. Box A-H•Wilkes-Barre, PA 18703-0020•www.guard.com Nl tssachusetts- DCI);Ia*tnfient of 1 liblic Ss€f'ctN Beard-eff Building R c;ailaticrras j,"d St.awlards ; f Consteuctior? Supervisor License License: CS 51991 JON P MCDERMOTT 52 EASTERLY'DRIVE " E SANDWICH;;MA 02537 Expiration: 9/28/2012 C.'I n lissioner TO: 4366 Office of Consumer Affai &Bdsinessss Re ulation License or registration valid for indrvtdul�use only i@ HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration 1;,12398 Type: Office of Consumer Affairs and Business Regulation C Expiration 3/25/2013 Individual 10 Park Plaza-Suite 5170 ew J Boston,MA 02116 O P MCDERMOTT_ _,.�r ,,.:. .. , . JON MCDERMOTT } f 52 EASTERLY DR 0 7U � � ES ANDWICH,MA 02537 �� f✓ Undersecretary ``Not valid without signature Assessor's map and lot number .................................... cF THE ro Sewage Permit number ......... .............................. /� Z BABBSTODLE, i House number .... .............................................................. ro M A86 p 1639. \0� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TOC }. *......" >:11'{° f...:�:�':/71t....:'..y!�:JJ� i.:�ff! .�..� TYPE OF CONSTRUCTION TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......(�......... '...'7................ . !{!' ....�'l�r=i.Ur.......... . ?'? �r•T_..........fluf...�..................l..i .............:p ..1............... Proposed Use ...... '!�:.( i. ........f 1�iJi�.k: '..............) !� /! : : fi ................................................................................ Zoning District ::lJ...............................................................Fire District ..f..,- -ia. ........................................................... Name of Owner ! ...�,�.'•.,: t::..::�:� . .......`--I!c/ l;i f •Y,.Ac1dress j �/�;.1�:.:..5i.:..... //.: !.. `. :..................... ,Name of Builder I��E .t, `:_.\j e�ri..� ........................Address g �' ..`! ••I;t/ T lvf1;,'1i115�...... .. ............................................ .... .�. ........ ................. ......... .Name of Architect ..................................................................Address .................................................................................... Number of Rooms f ........Foundation /C a.......................... f1)I.i?;�l ..�•j .... r ,G /tl�l Y...... '�k � r ...Roofing .....1 :���, 1 Exterior ......................:'-�:............. .................................. ........................................................................ Floors .�- Interior .......:,++ff�>rX� ...............................i ......................................... ......................................................................... 1 Heating �'. :-� 4- 1!f1 i' t=,�a ".,�r � Plumbing ...�. .............................................................. ................................................. ' ' J 3 Fireplace .. ..:........................................................................Approximate Cost ........ .LJ..� ......................................... Definitive Plan Approved by Planning Board -------------------_-----------19________, Area : .................................. Diagram of Lot and Building with Dimensions Fee . SUBJECT TO APPROVAL OF BOARD OF HEALTH w I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable-regarding-the above construction. / �. i�%z ,, CIRIELLO, AL 7JR , & ANNA,MAE No ...221.12. Permit for ....011e...S.to-r-y......... Single Family Dwelling............ ..........:...................................................... Location Lot #87 68 Prudence Lane ................................................................ Cotuit ..................................................................:............ Owner ....Al , & Anna Mae Ciriello .............................................................. Type of Construction .......................................... ................................................................................ Plot ............................ Lot ................................ ti Permit Granted ........April...1.4.........19 80 Cr Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED 13 ................................................................ 19 ............................................ .................... st ............. ... ... . ............................................. rj ................................................................................ ............................................................................... Approved ........................ ....................... 19 ............................................................................... ............................................................................... oF�ME T Town of Barnstable ,P` o Regulatory Services _ Thomas Y.Geiler,Dk'ector Building Division • �`�E°���1 Tom Pe .rry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 .PERMIT FEE: $ ►� O SHED REGISTRATION 120 square feet or less cow vocation of shed(address) Village 'roperty owner's name V Telephone number V'V\ pLD POS ize of Shed Map/Parcel.# /o ®6—CA gnature Date rannis Main Street Waterfront Historic District? t d Ring's Highway Historic District Commission jurisdiction? nservation Commission(signature required) 9 f �'�, " PLEASE NOTE: IF YOU ARE WITHIN THE AMSDICTION OF ANY OF THE ABOVE CONMSSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE, PLEASE SEE THE APPROPRIATE COXVISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED By A PLOT PLAN p t � w OCAW00 i f C-SZTI.r-IF,-I PUb ice.-4,1-.1 . 4 LoCATt ot-4 L�. [ t1 I,T c rz•r t Y T"AT T,44 ma t-lo r►.� :Q •t_c L.lSZMa 4 e-OAAPLYSt►- A-34 > SETeALtG FGQUttZEMaWTS dF 't'►� - Tj la 4 A7M ��� �` �` n ��''E'�,E w Y' Sv Qv�� ¢~cs�� :t���5 ITS � t.•�c.��.r�-"'�" "'.' - - ---: .�. .�e...� ...,t.:;a.•a,a:...r�..f.�... 1,.Cs'[" i l-i1ae-•f�' '- �,^.� '.•.. K .� 1':i.-: �'