Loading...
HomeMy WebLinkAbout0050 GOAT FIELD LANE �a �G�2t�u/a' ail. i -�\ J P� a--zo -13 Town-of Barnstable *Permit# Expires 6 months ftniss�u_date Regulatory.Services Fee t snxrteresr�, t . ® 16391. Thomas F.Geiler,Director X-Pi ESS. PERMIT Building'Division Tom Perry,CBO, Building Commissioner AUG 13 2013 200 Main Street,Hyannis,-MA.02601 www.town.bamstable.ma.us Office: 508-862-4038 T W A B► ASTABLE EXPRESS PERMIT APPLICATION :- RESIDENTIAL ONLY. Not Valid without Red X-Press Imprint Map/parcel Number d 97 Property Address �2�d. �{nQ, t'TYam i5Q Residential Value of Work + 6 J Minimum fee of$35.00 for work under$6000.00 .. Owner's Name&Address R1 f e nnc, Sprink e .ome.mprovemen µ Contractor's Name 199 Barnstable Road, Hyannis MA-02601 Telephone,Number 508 775-1778 Ext. 10 Home Improvement Contractor License`#(if applicable) 103757 - Construction Supervisor's License# tf a hcable CS-006643 P C. pP ) nworkman's'Compensation Insurance ' Check one: - ❑ I am a sole proprietor° ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance:Company Name. A.I.M Mutual Insurance Co. Workman'.s Comp.Policy'#- 7004943012013 Copy of.Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Yarmouth Transfer Station ❑ 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). ❑ Re-side ; . #of doors , Replacement indow doors hders.U-Value _(maximum.35)#of windows__ Smoke%Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. .Separate Electrical&Fire Permits required. •Whete.required: Issuance of this permit does not exempt compliance with other town department'regulations,i.e.Historic,Conservation,etc. ***Note:: :Property O r must sign Property'Owner Letter of Permission. ` e AS Home Improvement Contractors License&Construction Supervisors.License is SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\Win wffemporary Internet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doc Revised 053012 -The Common wealth of Massachusetts UIPof Industrial Accidents Office of Investigations . 600 Washington Street Boston, MA 02111 f, www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumberi Applicant Information 'Please Print Leeibly Name (Business/organization/Individual): Sprinkle Home Improvement ' 199 Barnstable Road ' Address: - City/State/Zip: Hyannis, MA 02601 Phone #: 508 775-1778 Ext.10 Are you an employer?Check the appropriate box: Type of project(requtred): 1.[XI am a employer with 10-12 4. ❑ .l am a general contractor.and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- : -listed on the attached sheet. 7. ❑ Remodeling -' ship and have no employees - These sub-contractors have g. ❑:Demolition workingfor me in an capacity. employees and have workers' y P h'• 9. ❑ Building addition •J [No workers' comp. insurance comp. insurance.* required.] 5..❑ We are a corporation and its 10.❑ Electrical repairs or:additions officers have exercised their -l l. Plumbing repairs or additions 3.❑ I am a homeowner doing all work ❑ myself. [No workers' comp. right of exemption per MGL 12,.M Roof repairs insurance required.]t' ' c. 152, §l(4),and we have no employees.[No workers' 13.❑ Other ' -comp. insurance required.] "Any applicant that checks box#I 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 sub-contractors and state whcther 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 for my employees. Below is the policy and job site information. Insurance Company Name: AI:M Mutual lnsurance'Co 7004943012013 1/01/2014 Policy#or Self-ins. Lic.#: Expiration Date: _ , Job Site Address oaj ��e� l�l� City/State/Zip: Ay_�f Attach a copy of the workers' compensation policy declaration page(showing the poliCyr 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 may be forwarded to the Office of Investigations of the DIA for insu a coverage verification. 1 do hereby ce tl aims and penalties.of perjury that the information provided above is true and correct. Si nature: Date: 1 3 '[ Phone#: 508 775-1778:Ext. -0. Official use only. Do not write in this area,to be completed by city or town official City or Town:' Permit/Liceise# " ' 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#: 1 Unrestricted Buildings of anv use group which contain less than 35,000 cubic feet (991in3)of AAassachusers, • Cepartrnent of Puolrc Safety enclosed space P Boas or 3uiid rn� Ra i,iatrons ano atan 9 tiaras 9 0,n.rru.•ttr1n 4upcn r.,�r ?C8n5G. CS-M643 ' + BRAD K SPRINKL-E 190 LOTHROPS LANE �° Failure to possess a current edition of the Massachusetts W BARNSTABLE MA State Building Code is cause for revocation of this license. For OPS Licensing information visit: wwa,.Mass.Gov/OPS fern fsstonec ._ 10/08/2013 a '! '�1�• r- •c ? Office of Consumer Affairs&Busipess Regulation License or registratio0 valid for individul use only =HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: . x registration: 103757 Type: Office of Consumer Affairs and Business Regulation Expiration: 7/9/2014 Private Corporatior. 10 Park Plaza-Suite 5170 %�- Boston,MA 02116 SPRINKLE HOME IMPROVEMENT,INC. , Brad Sprinkle , 199 Barnstable Rd. _� t Hyannis,MA 02601 Undersecretary Not valid�signature - i r t c i i y /'1 SPRIN-1 OP ID:DS CERTIFICATE OF LIABILITY INSURANCE 1 DATE12/21112 12121/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER Phone:608-776-6060 CONTACT Bryden&Sullivan Ins Agency PHONE FAx 88 Falmouth Road Fax:508-790-1414 Ara Nc Ext: fi ac No Hyannis,MA 02601 E-MAIL ' Kelley A.Sullivan ADDRESS: INSURE S AFFORDING COVERAGE NAIC A INSURER A:Associated Industries of MA INSURED Sprinkle Home Improvement Inc. - - INSURER e: 199 Barnstable Rd Hyannis,MA 02601 INSURER C A. INSURER D 'INSURER Ea - INSURER F: - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO,CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I EXP LTR TYPE OF INSURANCE POLICY NUMBER MION1uDD� POLICY MIDD YY LIMITS LTR ' GENERAL UABILnY EACH OCCURRENCE $ k DAMAGE TO COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EX (Any one person) $" PERSONAL&ADV INJURY. $ GENERAL AGGREGATE' $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ POLICY PRO- LOC a' $ AUTOMOBILE LIABILITY. COMBINED SINGLE LIMIT , Ea accident ANY AUTO s BODILY INJURY(Per person) ;$y ALL OWNED SCHEDULED ! BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE NON-OWNED .I '- Per aCCltlent - $ .HIREDAUTOS AUTOS - { UMBRELLA LIAB OCCUR tt { EACH OCCURRENCE $' n EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION - IN STATU-y OTH- AND EMPLOYERS'LIABILITY F Y I ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y� N./A WC7004943012013 - 01/01/13 01/01/14 E.L.EACH ACCIDENT $' . 500,00 OFFICERIMEMBER EXCLUDE l7! (Mandatory In NH) s E.L.DISEASE-EA EMPLOYE $ 500,00 . If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 500,00 g 3 DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It more space Is required) - CERTIFICATE HOLDER CANCELLATION N. SPRNKHO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE; THE "EXPIRATION DATE THEREOF, NOTICE WILL- BE•: DELIVERED IN Sprinkle Home Improvement,Inc ACCORDANCE WITH THE POLICY PROVISIONS. { Margo Mack 199 Barnstable Rd. AUTHORIZED REPRESENTATIVE ,.. Hyannis,MA 02601 Kelley A.Sullivan ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD A Town of Barnstable Regulatory Services Thomas F.Geller,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us 0ifice: 508-862-4038 Fax: 508-790-6230 r Property Owner Must I Complete and-Sign This Section If Using A Builder I brenriA Lovil , as Owner of the subject property hereby authorize Sprinkle Home Improvement to act on my behalf, m all matters relative to work authorized by this building permit application for: F-i e, (Address of job) I l � ICJ Signature of Owner Date I 0. �d 'Print Name, If Property Owner is applying for permit,please complete the.Homeowners License Exemption Form on the reverse side.l , C:\UsmWecollikI\AppData\iocal\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.dm Revised 0721!10 i i i TOWN OF BARNSTABLE Permit No. 2621a Building Inspector aye Cash ------------ - °�''tcup'v�� OCCUPANCY PERMIT Bond �--------__ Issued to Bayside Building o. , Inc. Address lot #5 50 Goat�ield Lane. West Hvannisnont Wiring Inspector � Inspection date Plumbing Inspect Inspection Inspection date l Gas Inspector � � � Inspection date .2 - v Engineering Department Inspection date�p Board of Health 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 1 wi.N,li l: ... 199 � f r' '?',.,..L!Q t... _./ ................................................. ........ . Building Inspector - FROM TOWN OF BARN-STABLE BUILDING DEPARTMENT Mr. Francis lahteine 367 MAIN STREET k#YANNIS, MA -02801 Tbwn Clerk Phone 775-1120 SUBJECT: . c FOLD HERE... DATE June 15, 1984 M E S S A G E Work has 'been cmPleted under permit Vs 26241, 2627 and,'2fi278 - �' c.fP by 9R flw.ar f}i . !+•.4 _ g� !' �� {Baysidee dug Co. release Bonds. .. • SIGNED e - :_ 'DATE " v R.E P L._1 j. ,. _ .. rlGNED - ' Ne7.RMi 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. e i3 c/��ssor map and lot number ... yS...... ? SEPTIC. ....... . . .... THE _ / f c ANSTALL Sewage Permit number .....�•.........��.y 7..... WITH TITLEre�Q y� ENVIRONMENTAL COO aBasTABLE, 6 � MABa House number ............................................ 'ti TOWN REGUPATIO) 90 ' - O 1679• 9 TOWN OF BARNSTABLE BUILDING I P CT °—` APPLICATION FOR PERMIT TO a.n... ... ..Q........ . �4J c TYPE OF CONSTRUCTION �� Q .t .. .:.`.....4� ....................................... .......... ..........C�l ....................... 2 . w ...`... ...........19.f �z _ Con TO TW@NSPECTOR OF BUILDINGS: The undersigned h eb applies for a permit ac rding to he'following �inf.ortion: Location ... fl ............ .... ........................................................... ProposedUse L.(.... <.... �". ......... ... ...................... .......................... .................................. Zoning District ... .. .......... ... . ........ ....... ..............:...Fire District . . ... �!� ...... . . ... 1 Name of Owner ... '........Address .. ... Name of Builder ..C, /V �! ........................................Address .....c.�... .. :............................................... Name of Architect .. /....�...�....... .. ........................Address �.:1U �,? A4, Number of Rooms ...... ............................................:.Foundation S/....... . ... �U' '........................ Exterior .............LiS.I .. a L'•-..............Roofing ........� ........................ , Floors ......��........ .. . ... ...... . ...4....... "..............Interior ... ... ........ ... .�-h. Heating . ...................................Plumbing ......... h ...t .........w.... 0/1 Fireplace ... ......Approximate. Cost ... . ........... ....•, f Definitive Plan Approved by Planning Board ___________________19_'21 Area �1 i�l Diagram of Lot and Building with Dimensions Fee ......... .. ... ....... .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ti c d . OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the n of Barnst I r gar in the above . construction. v� � Name .................... .... ...:., .......... .......................... ... Construction Supervisor's License T� BAYSIDE BUILDING CO. , INC. No x.2627.6.... Permit for ................ Single Family ...................... Location ....Lot..5 5 0..Goat.f.i.eld...Lane......... ......... . . ...... ........ West . sport .................... .... ........................................... Owner ......Bayside Building Co. , Inc. ..........Bay side ...... Frame Type of Construction .......................................... . ................................................................................. Plot ............................ Lot ................................. April 34 Permit Granted ...... .. . -10....................14 • Date of Inspection ........ .19 Date "Completed ... .......... .19 j" 9 Assessor's map and lot number �/ `� ... �7 a k'' ���� %r='�l_ �s'.................H ............... �THE Sewage Permit number ................................. ................. u Z 11ARNST1\DLE, i House number ........................ ?..... .......................... .....:.... 900,0,M639 9� No a� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ���`��--w �� TYPE OF CONSTRUCTION .....1.cJQ d d.. ���� r ......:.`.......................... ............................................... r` ....,1..�..;/,,!.,•l•.................19,/ f TO THEJNSPECTOR OF BUILDINGS: The undersigned hereby,,�Pplies for �a /permit, accdd�in�g�to the following information: Location ...�. . .� "fs { rCl. /.. ''V;( /C�N �� / t�..��!,.. �..f � ........................................... ProposedUse ,.•...�� .. ./'./.. ....................•............................................................................................... Zoning District ...A6 .�.. � ..................,...................Fire District .. xil /1/✓1��?... ............................................ Name of Owner .../ � �.( Q..�!iif ✓y.'h" ...............AddressJ .../J•,,,.Ii,/. �.......:��:. ,..: ✓ Name of Builder ..c.•,>./�!✓1" ..................................................Address ....... ' 7. .......................................................... jj Name of Architect ....�,�....��� �. Z..:........................Address t � "�r�' /�...0<-< Number of Rooms ....... ......................................................Foundation .../. /�f���- 1.../_?,!144,�,....�; f �k-� - g ,.?� ........................ Exterior ...... �� ✓��- 'L- .............Roofin Floors ...... !'`... ..............Interior ........ ../.!� _:. !. .` ......;> .�.!. S�.i� ... �,... _ Heating r X.&V:7:.C<�:. ..`................:................Plumbing it t� :/..d .��t ''�..�� Fireplace ............... ... ,y�......................................................Approximate. Cost ...(.r?.> Cr�J,L/,........................................ Definitive Plan Approved by Planning Board &- ;010j----__________19 Area .......................................... ' Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH E X�- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the To n of Barnstable regardiin`ng7the above construction. `� / Name ...........�.V��/ ..�.. C.......................................1 ... l � Construction Supervisor's License J BAYSIDE BUILDING CO., INC. A=248-275 No s26276 Permit for ..... Story .................... .DwelLi.ng....................... Location ......................... ??A s )Q 1......:.................... Owner .Bayside„Bu ld1A9.Co.;,Inc,.,,,,,,,,,, Type of Construction V ............................... ................................................................................ Plot ............................ Lot ........................... Permit Granted ... Pr'1 100 19 84 Date of Inspection ....................................19 Date Completed ......................................19 d I ,I i tr i - r � I✓ ` a 4 E r f r titi ! Fb Oa It Nz NZI u C ( 0 , ° ,r CERTIFIED PLOT PLAN 1 7 li "5 l+ �a�_�; /DG t N Wr_ CONSTRUCTION. ONLY 'I u� .r h TtI OF ' FOUNDATION ;IS ..:_.. FEE V1 ' � N IN t i . SLOW- POINT OF ADJACENT 'YSGs R€�A D ' ) +t s 1 7't ✓ 3 S 1 1 4'�rs �aR , f SCALES DATES 7 = �O 4/, N®! EF /N�r' l► ys`rt Jrayi✓JRTiO sy n t ,F{: --I ..CERTIFY THAT THE — _ . ,..� CLIEN K E818T`EREO REOI.STERED SHOWN ON THIS PLAN 18 `LOCAT J06 N0. 3 o bZ� ON:::THE,G'ROUND AS INDICATED :AND CIVIL'. LAND ; "" CON'RORM3 TO THE ZONINB LAWS '.ENGINFER 8URVEY. DR.By A... _. iw �- WA —Y RN'STAB E, MA88. `.7i2' MAI STREET �h HYANhIIS MASS ra .; BHEE '_.,_.0 --.- REO. LAND BURVEYOR `