HomeMy WebLinkAbout0296 STRAWBERRY HILL ROAD �a4 s��=,�ra � �
f1KEr Town. of Barnstable *Permit
Expires 6 months froin issue dale
anmsres[> ' Regulatory Services fee
mass.�
1639, Thomas F. Geiler, Director
1��Alfoy� Building Division
Tom Perry, CBO, Building Commissioner ®bC /12710�
200 Main Street, Hyannis, MA 0260.1
www.town.barnstable.ma.us
Officer 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
7 Not Valid without Red X-Press Imprint
Map/parcel Number N� 2Z
Property Address �kq1&ry l d V.L__c 0.
esidential Value of Work � Minimum fee of$25.00 for work under$6000.00
a
Owner's Name&Address CU� w z
lNa
Contractor's Name C6kL V�L �Uv l Telephone Number I
1 �
Home Improvement Contractor License #(if applicable) ` J v V_Dopec PF MIT
Construction Supervisor's License#(if applicable) f1 It 2 n NMI
❑Workman's Compensation Insurance QWN QF BARNSTABLE
Chec ne:
.Dam a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Com an Name C 0C�
P Y
Workman's Comp. Policy# o do® V
Copy of Insurance Compliance Certificate Lst be on filer
Permit Request heck box)
Re-roof(stripping old shingles) All construction debris will be taken to
❑ Re-roof(not stripping. Going over existing layers of roofl `
❑ Re-side
Replacement Windows. U-Value (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 m gn Property Ow etter of Permission.
Home Improv ent Co r e& Construct Supervisors License is required.
SIGNATURE:
Q:\W PFILES\FORMS\Express\EXPRESSPERM IT.DOC
Revise06O4O9
4/ 1
---s
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
s�•'y www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers
Applicant Information Please Print Le�ibl
Name(Business/Organization/Ind'vidual): C� l�l
r\
Address:
City/State/Zip: Phone.#:
Are_- n employer? Check the appropriate box: Type of project(required):
1: a Imp loyerwith 4. ❑ I am a general contractor and I G. ❑New construction
employees(full and/or pin.el.* have hired the stab-contractors
2. I am a sole proprietor or par trier listed on the attached sheet. T. ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
workingfor me in an capacity, employees and have workers'
Y P n'� $ 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 anew affidavit indicating such.
tContractors 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 or my employees. Below is the policy and job site
information. / ` q
Insurance Company Name: 'h
Policy#or Self-ins. Lic. #: 0 ooq(qu Expiration Date- C7
Job Site Address: C� City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure fo secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine tip 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 ins tion.
I do hereby certify,2under�epsand penaltie ury that the information pra.vided a ve is true and correct
Signature: Date:
Phone#:
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 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
e�
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
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, 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 shall 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«uth 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-contractor(s)name(s),-address(es)and.phone number(s) along with their certificate(s) 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. lr 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 maybe 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 btirn leaves etc.)said person is NOT required to complete this affidavit.
;'he 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:
The Commonwealth of Massachusetts
Department of Industrial'Accidents
Office of Ynvestigatians
600 Washington Street
Boston, MA 02111
Tel. #617-7227-4900 ext 406 or 1-877-MASSAFE
Fax# 617-727-7749
Revised 11-22-06 www;mass.gov/dia
PROPOSAL
pox
1042
CCf 18 36 t 6 ,, ''Page No. of Pages
DESCRIPTION OF JOB
- ARCHITECT DAT OF PLANS
j" �=
PROPOSAL SUBMITTED TO:
JOB
M A R &N 9AiA V✓V 5��`I .
ADDRESS
1 b �JE �Yil, .1t PG, '{"f L 1�.1�♦ 3` CITY STATE ZIP
CE K7 E—k V I !-LE MBE 02. 3Z
_1Q !!''���(( /a�,/^ //� / •^ PHONE DATE
WE HEREBY SUBMIT SPECIFICATIONS AND ESTIMATES FOR: ( -
l rq V
t I•�_ j v V
We hereby propose to furnish material and labor, complete in accordance with above specifications, for the
00
sum of dollars (S
with payment to be made as follows:
All material is guaranteed to be as specified.All work is to be completed in a workmanlike
manner according to standard practices. Any alteration or deviation from specifications Authorized
involving extra costs will:be executed upon written orders, and will become an.extra Signature
charge over and above the estimate. All agreements contingent upon strikes, accidents
or ,delays beyond our Control. Owner to carry fire, tornado and other necessary Note: This proposal may be withdrawn by us.if not accepted
insurance.Our workers are fully covered by Worker's Compensation Insurance. within days.
N.
Acceptance of Proposal - The above prices, specifications and condi-
tions are satisfactory and are hereby accepted. You are authorized to do
the work as specified. Payment will be made as outlined above. Signature ------— ---
-,Date of Acceptance: i ' t' ' Signature __
J
1
Alkiss!"!
iss z11t1s tts- DeIrt hunt of Public Sit
7! ultns "I&Standalyds
Board of Buildin�� Rc'
Construction Supervisorpecialty license
. .
License: CS SL 99382
Restricted to: RF,WS
HECTOR SANCHEZ
286 STRAWBERRY HILL ROAD
CENTERVILLE, MA 02632
Expiration: 911412011
T r#: 99382
Board of Building Regulations and Standards
= HOME IMPROVEMENT CONTRACTOR D
Registration,, 145356
_ 1t
t Ex piratib7 1 12/2011 Tr# 283768 ?
e 0. alY TYpe OBA i
4r EMMANUEL CONSTRUCTIONS
II HECTOR SANCHEZ` �f
i' e86 STRAWBERRY H�LLRD
l'i CtNTERVILLE,MA"02632 Administrator +
License or registration
on date. If found return to:
before the ezpirat
Board of Building Regulations and Standards
One Ashburton Place Rm 1301
Boston,Ma.02108
----- —o witho Lure
r
Assessor's map and lot number 7,2.2
......... .... ..... TM E
ypF
TOE
Sewage Permit number. .................. .......................................
EARN STALLE.,
House number ........................................................................ MUM
00 039,
a MAI
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ........1��............C,ever 7......................................................
TYPEOF CONSTRUCTION ..................................................................................................... ...........................
....... . ............2......................I 9J�,
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ....2-9.A....... ............ ............................................
... .. ... ............
ProposedUse ....... .................................................................................................................................................... ......... ...
ZoningDistrict ........................................................................Fire District ...............................................................................
A, e- 00
Name of Owner . ...........C,..................0.,3................................Address ................................ jl
.....................................
S7 Re(
Name of Builder AleR.��..... ...... ........Address
........................ .
.................. ...................
Nameof Architect ...................................................................Address ................................................................ ....................
Numberof Rooms ...................................................................Foundation ...............................................................................
Exterior .......... .................... ....................................................Roofing ....................................................................................
Floors ......................................................................................Interior .....................................................................................
Heating ..................................................................................Plumbing ..................................................
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
bt z- /c/
A
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name .......... .... ..... ............../.................
. . ............... ..............
--------------------------
. .
R0SENE]I, DR. \/ICT0Il
No Permit for
�.D ANAQn'.....TY}.. i ..F.AMi1I^Y...nnmErI,
i Location .3.9S....St ]�..B�II.. oad
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i
..�----{��P±����j`ll��_.__________ ^
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�Jvvnar —..D�:.. ..]��p.e a er----.
Type of Construction FXaMe---------..
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----.----------------~----- ! ~
.
Plot �� /----_---- ----------..
' |
Permit Gnonh*6 ....Jq�n3�}/...Ox---,lg 81
Date of Inspection ------------lA
. �
��~� ,
Dote Completed --.~.=���./�-----l9
PERMIT REFUSED
----.-----------.�----. l� �..
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Assessor's map and lot number / '
gyp%TH E T� 1
Sewage Permit number ........................................................
Z 339HBSTADLE, i
House number Sop ,"6& 0�
...................................................
�0
�F0 MAY Or
TOWN OF BARNSTABLE
BUILDING INSPECTOR
r .
APPLICATION FOR PERMIT TO ..KC-A)ry"` A' `'C 1,)t o" e" 7... .......................................... ......................................................
TYPEOF CONSTRUCTION .....................................................................................................................................
'�Gt 1 3
c...... 1........ .:..................
. 19. .....
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location Z V-, y> YV c,v ,� *r e/ .. 'f �'f`� ( Nz 1c , �,'✓/C
................................................. ......... � '...........�.......................................................... ............................ ...
f
Proposed Use .' t� . �t ` .... .
............................................................................................................................................................................
ZoningDistrict ........................................................................Fire District ...............................................................................
Name of Owner t�}:.... '..' ' .....! "�'. ."`.. .`"...............Address ..1'?�...? :i�.:`:.:.rlvc�. ....:'.J' ...... {..r c?.. ^......
Name of Builder `,"c' a L�1�e� eta I_ 1 ? 1�.'��lt � ........ � .r'/... �`�
..............................Address
Nameof Architect ..................................................................Address ....................................................................................
Numberof Rooms ..................................................................Foundation ..............................................................................
Exierior ....................................................................................Roofing ............. ......................................................................
Floors ......................................................................................Interior ............. ......................................................................
Heating ..................................................................................Plumbing ............................................ ....................................
Fireplace ................................................:.................................Approximate Cost %f _� f�'.?0 r
?�:... . ....... . .........................................
Definitive Plan Approved by Planning Board ________________________________19________. Area ..........................................
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH (� /
ci� f �/ b,..� ('• t !^ may f.�i / / ' - t � l t - •'� t � / j � !�/ �!,;, ��-- - �
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ... .................................'� ' s rl........... ........:................
ROSENER, DR. VICTOR - 22
No Permit for ...REPAIR FIRE DA'![AGE
.................
............ ingle„Family... well.ing.........
Location ..2.96....$txawb.eKrY...Hill...ROad
.................Ge1lterville.................................
Owner Dr. Victor Rosener
..................................................................
Type of Construction Frame
............................
................................................................................
Plot ......................... .. Lot ................................
Permit Granted ..January 8, 19 81
Date of Inspection ....................................19
Date Completed ......................................19
PERMIT REFUSED
........................................ .................... 19
f
...................................... .......................................
.................../..........................................
. !: ...................................
Approved ............... 19
...............................................................................
�TM�T 019986
TOWN OF BARNSTABLE Permit No. ----------—------------
_____
Building Inspector
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."
17 Hadrada Lane Centerville, MA
Issued to D*M.L• Truot Address
lot #1 304 Strawberry Hill Road, Centerville
f -
Wiring Inspector Inspection date 4?1421jl ��
Plumbing Inspector J�4 � Inspection date
Gras Inspector , Inspection date
Engineering Department f �� ,� 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.
Building Inspector
! -;�.Pr•� .� tom!-r - L{�E. tG� �a�_ ��� - - s"�y�'�.'°`�*'� � ``
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AsseWor's map and lot number .......�. ... . .. ... . ... . ��tl`� s��;.
w1y INSTA LED H,
�'O�b�r�l_If i� i
�o-: 4 4 / z _ 7 a �
WITH r: 11 STATE
SgvageN-Permit number ........................................................... ..
:ANfTA' y CODE AND TOWN _
REGULA"f
of:THEro TOWN OF ,BARl S'�ABLE
1 BAHB;STAIIL&; i Gt �•
,5 E `•
11,11LDIN:G ° INSPECTOR.
ti APPLICATION FOR PERMIT TO ., :! / .. ...... ..°!: ...................................................................................
;
Tik OF CONSTRUCTION .... ��, . .. . . ....................... ....:.......................................
441
......................... 19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies fo-r- a permit according to the following information:
Location .` .6. ..... ........�. �+s�c! "`�' .... . ` .— ..... �� ..........................
ProposedUse ..... : ... ............ ........................................................................................
ZoningDistrict .... ........................................................Fire District ........ r.....................................................
Name of Owner ... . ...
�, .~............Address ...... � .. .. .. .. .... e.
..�:...... ...........
Name of Builder eti
......................��...........................................Address ........................................................................:...........
Nameof Architect ..................................................................Address ...................................................................................:
Numberof Rooms ..............-7.................................................Foundation . ..........:..... ............................................
Exterior ........... :..�.i.�...�...�\.f. .........................Roofing ...... . .. ..........:.........................,..............
Floors Interior
Heating .....................................................Plumbing ...... .4�..................................................................
Fireplace ..................................Approximate Coat ......r '"...
............................. ............................................
Definitive Plan Approved by Planning Board --------------------------------19 7-_16 Area .....�.. . - ................
Diagram of Lot and Building with Dimensions / Da,
..... ..........................
.
SUBJECT TO APPROVAL OF BOARD OF HEALTH o •
Return to: �f
Paul Leonard 1 C a I
_ _Box .Ayanntg, MA
r ' Z 02601
Bank Check $800.00
Cash 12.00
Total 812.00
'A40 7"
- - - - - C 3
9b C�, F,e✓rcc
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. p,vt
Nameiij ................................................................. ...�M
D.M.L. Trust 4
l
%Nc�j�. ...............19986 Permit for ....................................o ne story
single family dwelling
.............................................. ................................
Location ...........3.04 ttaw.b I erry...Hill. ...Roa.d.
.. ........ . ........ ...... . ...... .
Centerville
...............................................................................
D.M.L. Trust
Owner ..................................................................
Type of Construction frame
..........................................
. ................................................................................
Plot ............................ Lot ....... ....................
February 27
Permit Granted .........................................19 78
Date of Inspection .. . ...... .......................19
Date Completed ...I. ..............ig
V
/�
PERMIT REFUSED
................................................................ 19
................................................................................
...............................................................................
...............................................................................
rs
...............................................................................
Approved ................................................ 19
.. ...............................................................................
................... ................................................... .......
It_ `'. - )
t F s:
• Assessor's map and lot number ..............
Sewage Permit number ................:..........................................
%THErO�♦ TOWN OF BARNSTABLE
P
1
Z BAIMSTADLE,
M639.
am ,e�� =' BUILDING INSPECTOR
aY a' _
APPLICATIONFOR PERMIT TO i 1>/...........................................................................................................
TYPE OF CONSTRUCTION .......�. r:.'''' �'" `` -� - �`
..........'.. 19.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
.30
Location ......................................................................................."'....................................................................................
ProposedUse .......`.....................'................`..............*............. .......................................................................I.........................
ZoningDistrict .........................r...................................Fire District ..............................................................................
Nameof Owner ..Ifs!i... .... ......................................' ...Address ......�.`}...........................................................................
t
Nameof Builder ....................................................................Address .....................................................................................
"s iti
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms �'�.............................................Foundation ..J `^`..`.. �"'
Exterior ......................I1........ ......! . ....................................Roofing .... ..:'`J ... ..... ....................................................
/. S ! f
Floors Interior ....' ..
...............:..........:......................................................... .......... .......................................................................
.:A `
Heating '' ..............:..............................................Plumbing ............ ........:..........................................,................
t y ......Approximate Cost
Fireplace .....:..:........ .................................................
................................
Definitive Plan Approved by Planning Board ________________________________19__-_L'% Area ...................... ".............,..
Diagram of Lot and Building with Dimensions Fee .. ................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
Return to:
Paul Laonard
_ Box 1232, I.1yat1iiis,
02601
Bank Check $800.00
Cash 12.00
Total 812..00
r
lot
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
r �
Name ...... � .�...... ..... .. ..`...:..................................I
D.M.L. Trust A=247-222
a ,
19986 one story
No ................. Permit for ....................................
t single family dwelling
Location2q(:".: Strawberry Hill Road
' Centerville
...............................................................................
D.M.L. Trust
Owner ..................................................................
Type of Construction ., frame
.....
Plot ............................ Lot `.....................
Fe�ruary 27 78
Permit Granted ........ ...............................19
Date of Inspection ....................................19
t
Date Completed .. :..................................19
i
PERMIT REFUSED
� t
.... ............ 19
P
} ....... ................ . ...............................
.� ...... . .... r........................
Approved ................................................ 19
...............................................................................