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HomeMy WebLinkAbout0036 FERNBROOK LANE 6600 K JP. i f ACR E I� Ili 4' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION: Map Parcel Permit# 3 7 Health Division Date Issued �+ Conservation Division - Fee Tax Collector . Treasurer Planning Dept. ' Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address gg 7310 c Y1�o Cb \L .RYk f Village Owner Q W e h \G ec n A! Address Telephone 71 1 a(9 a Permit Request r%Z6 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation AM) Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑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 —t�mberof Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes O No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:0 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 q No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name d`n(ACN4, 1,C\t C�fbt Telephone Number Address License# C.e vk : 'mA Home Improvement Contractor# fo y9 G 0 &�6 3 • Worker's Compensation# 11 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 110 SIGNATURE DATE i 'OL^ s'Oa FOR OFFICIAL USE ONLY PERMIT,NO. �• G+.. < < DATE ISSUED MAP/PARCEL NO. s p, ADDRESS < VILLAGE OWNER `= DATE OF INSPECTION: ,. .e ♦ A r; FOUNDATION r _ ti FRAME t INSULATION i > FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL1 GAS: ROUGH FINAL FINAL BUILDING ' DATE CLOSED OUT ASSOCIATION PLAN NO. f : . The Town of Barnstable MAS& �m Regulatory Services �Eo +a Thomas F. Geiler,Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: "'C© Estimated Cost 4,0 .Q a Address of Work: 3 t6 Owner's Name: B��'h k\er n A Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law []Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit 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 c.142A. SIGNED UNDER PENALTIFS OF PERJURY I hereby apply for a permit as the agent of the own ev A Date Contractor Rame Registration No. OR Date Owner's Name q:fbmis:Affidav The Commonwealth of Massachusetts S ' Department of Industrial Accidents = exceatifirest/gatieos _ - - 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: w.A ry, ec�o5� location: -5 5 city ce ht y1\A phone# 0 (0 a) b ❑ I am a homeowner performing all work myself. G- am a sole netor and have no one working in anv cavacitv ❑ I am an employer providing workers' compensation for my;employees:working on this job. .................. ................. ....................................... insarancwro.,, ... ... :: :{:{;:<:: ..... of cv#....: ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: ::.. name.. .:::.:.. 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'r:�::? �:.' +:ii:::v'•ii:�'�:.:::�i:i..%}::j{:?y}^;:;.;.;.;%•:.;i;�i:??!:v:i:6:i:y};{{?L{x?x{{y.':;:::;;:•r}i:};}{. .............................v.::�:::::::::::::.�:::•::•:::•:::::•:::::::::•:::::•::•::::::•:::v.�::::: rr:m:.v:.w::::.::}:•}:::?•}::....::.v:n}}}:•}:ji:^iii:•iivfi{::}':�:v' ...M}\{•Y.{•:i;.;.}:.w::w:;ri:}}iii':•}:}}?ii::isiih.::::i:{:�:i};.};?.}}Yti:'.'i:{:{^:•}:4Y:{4}i}::•}:'v}}:J:i•}}:i{::::i:•i:-iiYjiiiii}ii:i: :i:<�iiiiiiii:::�}::i::.ii: :?:yj :}:4::%::jy:}.iyj.ii'fiiii:i:iri.{;inY.:::ti:!':{^i'^Yvvi': T:?•:!.. ...............:..... ................................................ ... .......rv} •{vv con..,4 ... �.:........ r:.}:::nv:::::.., v:}}}i}}}}}:•v..,. rvi,.•r. v:rrv.,v::.v{ ...........v.v ..x:v:r:•vn4:i•}:•}v v:J:4y:::::{::.}"{..... ..vw..v::.v.::::. . .. ................................................:::::::.vnv.�:.v....w::t......�....0.�A<{..:.v{v:::::•k.:•i::{4'J.............. ... {...::;.::.::.....i:•.{.....v....v.........r.?•.{.....::.::•h nv.x.....�:,.Kwi:w:3ii>}:�ti:;.i:j:.. ttsnrut�ca O� /. ::::;?:<::: t ataQ ;. a di{ress: ? >Se :x..+::.fi.i '+:' i2 ......................................... .... ....................................... .............................................,. '' .....:..:�•:con... ....................... ... ..................... ................................ � :.:::...:;.n::::•:n•::?::..x•:L.;}iv..x>.::i:+::ii::}iR:s';:i::::ff::}?:i:$:::pit:;ii:�:i:::':i'.}}:•}}`•i:•:{<.:.;�. Faihue W secm coverage as required under Section 25A of MGL 152 can Ind to the imposition ed tai®ai pedtles of a fine up to s1,500.o0 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I uudustmd that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage veiifleation. I do hereby certify th Pains pen ofPeJWy that tht information provided above is truce and coned Signature Date 1 a-S'd Print nam Ae-nisi Phone# o fficial use only do not write in this area to be completed by city or town official r town• pemitilleeme# rIBuilding Department ❑Licensing Board eckif immediate response is required ❑Sdectrnan's OPIIce❑Health Departmentct person: phone#; - ❑Other��� uey„ed 9rosJJa► Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",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 ari individual;partnership, association, corporation or other legal entity,or any two or more of the foregoing engaged in,a jomt�enterprise,-and including the legal representatives of a deceased,employer, or the receiver or trustee of an individual,partnership,,assc) ation`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 section 25 also states that every state or local licensing agencyshall 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,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 r, Please fill in the workers' compensation affidavit campletely,by checking the box that applies to your situation and K... .:'; �PPlymg company names,address and phone numbers along with a certificate of insurance as all affidavits may be omitted to the Department of Industrial Accidents for capon of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be retumed 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'compensafuih policy,please call the Department at the number listed below. City or Towns 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 pemiit/Iicense number which will be used as a reference number. The affidavits may be=1uziied to the Department by mad or FAX unless other arramgemeats have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a can. The Depart<neat's address,,teleplione.amd iaxmrmber. � The Commonwealth Of Massachusetts - Department of Industrial Accidents Me of Inve31102110133 _ 600 Washington street Boston,Ma. 02111 fax#: (617) 727-7749 rT, phone#: (617) 7274900 eat, 406, 409 or 375 e. dw .s. HOME IMPROVEMENT CONTRACTOR Registration: 126480 Expiration: 06/08/2002 Type: Individual MARK HERBST" MARK HERBST 35 PEEP TOAD RD.. ADMINISTRATOR CENTERUILLE MA 02632 Jo.onsn"- BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISORNumber. CS. 048546Birthdate:'.0112711953 Expires:01/272002 Tr.no: 20i34 Restricted To:. 00 MARK D HERBST � 35 PEET TOAD RD E' CENTERVILLE, MA 02632 Administrator ill i s � w TOWN OF BARNSTA'BLE Permit No. ------2565_8 » _---.- Buildb* Inspector cash l n a ---------- " —— - ♦Qb 16 , OCCUPANCY PERMIT Bond Issued to Bayside Building Co. Address Lot 14, ;-)36 Fernbrook Lane, Centerville Wiring Inspector � �_ �" Inspection date Plumbing Inspecto� �( zlz� ,.e�'/,.u+ -- Inspection date Gas Inspector + Inspection date v f- A XEngineering Department2 Inspection date/ fo j`y Board of Health �;° �E Z C Inspection date THIS PERMIT WILLf NOT BEJ VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Buildinb Inspector FROM y TOWN OF BARNSTABLE Mr. Francis Lahte-ine Y BUILDING. DEPARTM64T 'own Gd+erk , 4 V, 4 , , , ._ R, 367 MAIN ,STREET HYANNIS, MA 02M Phone: 775-1120 SUBJECT: FOLD HERE - DATE - . ram. WES.SAGE Work has 4beeq ��amPigtgd ����� hP�rm t � 2�5�5� �(;Bays�de: .Buil�di:ng Ae - SIGNED'` / DATE a . v— G :i REPLY na7•reMt - RECIPIENT:RETAIN WHITE COPY,RETURN PINK COPY - _ - - - PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW COPY ONLY.SEND,WHITE AND PINK COPIES WITH.CARBON INTACT. , , l W 1 \ i of AN"40s 0 F" HAS A. BMTEA i No.24048 G 16TC 4/ � CEQTtFIEO PLOT PL.4,.hj L O CA T 10 f� Frt/> � CAL rJD�.Tto SNO%AjQ �t_Ah! R�FERENGE GGJZTiv= THAT TI-1� Fes . N�Q.rDhl GgNIPLVS W ITN Tt4G SID'E.Ll► & j" o T /17L A1JD ,SET$�G�C �EQUtREEuTS bF THE ks t40-7 L G, c . 14g72 LOCATsst> 'Tti-lE i=L D !L'l►J E3AXTCtZ 1� t�YE' I�G. pAT� tp 1� 3 REGISfC--(ZCD 1�►10 5uev�YoctS 05TElZV%LL� o Ma.SS. WoT BASES v►�-{ A�.! . 1iJS�UN�EIJT. 'SuQV��{ � Tt�l� 0��5�=rS Sl�oeaJl...D aPP�I e.n.ti,T' ,C3,E'/.�it/�.4G�� i,lr,1_ E3 G` u 5 t o To D e:.T C P tiI N t^ Ln T (,l iJ t= S • Assessors map and lot number ...... ;_............... 7 O�THE Sewage Permit number ....................................................... SYSTEM T B d g • -SEPTIC_� �,q ��� r TA 1�6r� IN COMPLI C i BaaasTaBLE,NAM i Hou3e number .........................:;.............................................. �.�.. �S s 1111�T' TITLE 5 2639. O� e t* k `A.V' 'I"NTAL CODE s.y TOWN OF- BA1 ;. 4� r IM BUILDING INSPECTOR APPLICATION FOR PERMIT TO .,� TYPE OF CONSTRUCTION ......... �ems ........ ... ........................................................ i # ............. 16� �. I..19. y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies'for a permit according to the following information: Location ........ .. .. ...... .. ..:....:.... . ....... ...... .. .:"...................................................1.7......... .... . ..... .. ProposedUse ......RP /..cC�. C e.......................................................................................... Zoning District ............ .`............................................Fire District ..........0 ....5.t Name of Owner ....... Sr.�e.......A/..... `.c....Address ......... .................. ...................................... Name of Builder ............... .^-�........:...............:.............Address ......... .d:~r:'�............................................................ Name of Architect .......Address..... ..........�..d... .�.............. Number of Rooms ...........:..C.......................... .......Foundation R—` ..'tico2-�(" Exterior ........i ................Roofing ..........� /-�-� Y.................................................... Floors ............. ` �- - ...:. ....V.�. ` ....1.......................Interior .......�Y'/.y�S U. ...... 0� _4 ........................... Heating .............tr:.... ,1.1T1......1 .................................Plumbin .......6U..C.......:6d1p.6�.:, Fireplace k �CK....... � Approximate. Cost Definitive Plan Approved by Planning Board --------------------------------19________. Area /... . ...... /yf /: Diagram of Lot and Building with Dimensions Fee .../....� a SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. !L ... ....................................... Name .... ................. Construction Supervisor's License .................................... f BAYSIDE BUILDING CO. , INC. r i�No 2565 :.... Permit for ..l z Story............. . ......Single„Fami ............... Location .I0t;...4.4.........3.6..Fe.ruhriaok...Lane f .................. .....................:........... Owners.......$aY.e de..j3iai.].diug. ..Co......Inc. } Type of Construction ......Zrame....................... !4 f -- -- • _ _. _ r � .'... ............................................................ , [ Plot ........................ Lot ................................ r• Permit-Granted -.......October 17, . r•lq 83 Date"of Ins ec1aaPS:�??", . ....../ZP....19 P3 Date�Completed ..... ., . ................19(f`� �, + '-•� ' .. -. � , .sue - Assessor's map and lot number ..................... .. TO ... .................... THE f . -Sewage Permit number ................................... ... .... 33AWSTABLE, Hause number. ............. ................................. MABS. ......... 1639. Ufa mix TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO . .......... .................................... .......................... .................. ............ TYPE OF CONSTRUCTION ..... 21 ....................................... 1")t-1 .............................................................................. f 10T .....................;...........................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... ............I—'. .. .... ..... ... ................. ............ ......... ...... . .... ... Proposed Use ...... ...................................... ............................ ..........I........................................................................... • Zoning District .... .............................. Fire District ........................... ............................................................................ Name of Owner ....... ......../"/P4 (...:Address ..........:........................................................................... Name of Builder ....................................."`:a.........:................Address Address ......... ..... ............................................ . Name of Architect ....................... .........................Address .................................................................................... .......... . .. Number of Rooms ..................................................................Foundation ......................................�,, ......................................... �tx k......... '... Exterior ............. ........... .................. .................Roofing,"�a�..:' ............. . ............................................Interior 1 4., Floors ................ ................................................... ... ........ ...... ...... ...Heating .................Plumbing ....... ............. ... .....�/...... .......... ....................... I.............. ............................................ Fireplace .... ........ ....... .........I........................ ....Approximate Cost ............1....................................................... Definitive Plan Approved by Planning Board --------------------------------19---------- Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH f N\ OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS J hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. /X A Name ...... ......... ........................................... Construction Supervisor's License A .. ............................ 1 BAYSIDE BUILDING CO. , INC. A=208-85 2�0� ► o�7 '-G� � � No ...25 6-5.... Permit for ..Z...Story............... ......Single„Family...Dwelling............... Location IA(?.t...1. �,. �„Fernbrook Lane Cevxl P"x.Yi.ue.................................... Owner Bayside....Building. . . ...Co....,....Inc. . .. .... .. .... ....... ..... . . .... . Type of Construction Frame ............................................................................... Plot ............................ Lot ................................ r Permit Granted .QQ.t.dPar...1.7.............19 83 Date of Inspection ....................................19 Date Completed ......................................19 UU �76G C