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HomeMy WebLinkAbout0025 LIGHTHOUSE LANE�T a Town of Barnstable *Permit 0070575� Expires 6 months from issue date Regulatory Services Feed_ Thomas F.Geiler,Director Building Division 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 Not Valid without Red X-Press Imprint Map/parcel Number 0(0 _,C)0 5 Property Address �S LI G H Q HOW C LAN 6 [Residential Value of Work �3(90® Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address F�1(?—a L1 A ?641c_ t;2 S L.I G NjWL)USE` LdUIF H'fi 144S A14 02. 6 0 Contractor's Name TRO M A S Telephone Number 7 74 —0 3 fo "604 Home Improvement Contractor License#(if applicable) !�"a 3 Construction Supervisor's License#(if applicable) CS ®96 00 ❑Workman's Compensation Insurance X-PRESSPERMIT 0 k one: am a sole proprietor S E P 13 2007 ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF BARNSTABL.E Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ZRe-roof(stripping old shingles) All construction debris will be taken to -O 6 !Dill'?P ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value maxl=� 14Q[S '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 Pe1'irlt M *** 1. ssnF 1 copy of the H me rovement Contractors License is required. iFln ; SIGNATURE: '2. Ot, Q:Fonm:expmtrg Revise061306 -s The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 , www.mass.gov/dia Workers" Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):. . 4W- 4 -Address: l(o& I Qzr-y t'tN& L,4,t< City/State/Zip: X/r v Phone.#: , 1 •- 77 S- 13 0 g— 3-7 4- 93G-&0e1 r 0 Are you an employer? Check the appropriate box: 4 I am a general contractor and I 'Type of project(required):. . 1.❑ I am a employer with g 6. ❑New construction . employees(full and/or part-time).'" have hired the sub-contractors 2.®'I am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ' ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 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 ahomeowner 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 a new affidavit indicating iuch. tContractors that check this box must attached an additional sheet sbowing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must providb their workers'comp.policynumber. , lam an employer that isproyiding workers'compensation insurance for my employees Below isihepolicy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 imprisomment, 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 Investi.eations of the DIA for insurance coverage verification. I do hereby ce under the pain • nd pe hies of perjury that the information provided above is true and correct: Sienature: 0& Date: 7'' 0 7 Phone#: ��0 �� c� Z 74—ja(n (Co+5 Official use only. Do not write in this area,tb he 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 CIerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person, Phone#: °f1HE r ti Town of Barnstable. Regulatory Services EARNSUBLE, +` MASS. Thomas F.Geiler,Director �'AIfD MA'S A,� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 "w.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder I R[e�,� U La It ,as Owner of the subject property hereby authorize 'I 14O f 4 S A , L D oU 6 to act on my behalf, in all matters relative to.work authorized by this building permit application for: . J S L14 H T-H ovs R 10-. P YA'VNr s oz-(0 1 (Address of Job) d7 Signature of Owner Da e Print Name Q TOMM S:OwNERPERMIS S ION • i Boat n`3yandf ! HOME IMPROVEMENT CONTRACTOR i Registration, 142393 Expiration�4/._1/2008 Typ� ndividual THOMAS A LONG THOMAS LONG 166 KNOTTY PINEtCgN � CENTERVILLE, MA 0263? .% Deputy Administrator ` _ Assessor's 'map and lot 'number ...............:�....................�... O:,Y. /QG!f 7/45 717`Y. SYSM T-BE `— IINSTALLED IN COMPLIANCE Sewbge ,Permit number C..:.. i WITH ARTICLE-II STATE SANITARY CODE AND TOWN TOWN OF B AR N S llyx r ° } i 89HHSTADLE. 1639. �•� RU0 w IG,�' LDLIHIKSPECT0R ar a ..+ �, , �J V r r <; APPLICATION'FORS PERMIT TO .........................t /((lY'� ....... ...................................... TYPE OF CONSTRUCTION ....`. 7".:` ........... ...................... ................... ................ T TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for c�permit according to the following information: Location / ) .................... :. `t... ..�1..1.........f 's tS�2�....f -r... ' ... . ... ................................................. . Proposed Use ......... 2 ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ..................................... ....................Address ........ .........�.. ... .�5�..... . Name of Builder ..........................................f.......................Address . . .................................................................................... Name of Architect ..................................................................Address .................................. Number of Rooms ..................I...............................................Foundation . �. �` 6.'ei!'c 1--r. d. .P........................... ........................ Exterior ....:......... fir..............................................Roofing ........... Floors . ?..K!I:f.. .............................................Interior 2 1'aC ►1 1 �C i !"- .........................�77 1" Plumbing l `� iY1 Heating ................... ............... ..... ........ ........... ........................... c. ,.may Fireplace ..........:..... .^......................................................Approximate Cost .............." v;,!.. ...°.................................... Definitive Plan Approved by Planning Board ________________________________19________. Area .......... 4.!...:' ............ am Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH � e iz 1 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ........................ Peak, Howard, III No ..,, 17210 permit for .te aid to single .................................. family dwelling ............................................................................... +Lighthouse Lane Locatio ...... '' Hjlannis......... Howard Peak, III Owner .................................................................. T Type of-,Construction ............frame................... ; .� .. ... ... .. ... .... .... Plot ... .................... Lot ................/............. r ,L ti Z _Permit Granted J'Al,y....1.5.......719 74 Date of inspection ,�.'f.....?� ... ,9 Date. CoImpleted 7 y 9,4,0 .j19 b PERMIT REFUSED . .......................................................... .... 19 .i 01 ely ............................................................. �r 14 .............................................................. CZ ............ ................................................... _ I 910 Approved ' ..rt .................................................................. i � fi s............................................................ ' "�Y , 711-1. Assessor's map and lot number .......................................... 4 Sewage Permit numb er THE TOWN OF BARNSTABLE 139BISTAXLE, 101 7 MAM ,639-D1 BUILDING INSPECTOR M . APPLICATION FOR PERMIT TO ....... ...................................................................... ................. .............................. TYPE OF CONSTRUCTION ........ ............................................................................................ .................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 017'? Location .................. ................................................................................................................. L ProposedUse ......... ..... ...................................................................................... ZoningDistrict ........................................................................Fire District .....................................................!........................ Name of Owner .....Z�Z...Adclress ........ ................................... Nameof Builder ....................................................................Address .................................................................................... Name of Architect .......Address ...................................................................................... .. ..............1L. -7— Number of Rooms . ...............................................Foundation ........... r 95,L.......c!",(-i,-e f —c— ........................................ Exterior .............. ................................................Roofing ..................... Floors ..............7��..klx ........ .....................................................Interior .................... . 4 — Heating .......... ................ .. ./......7�q/I'.I...., ................Plumbing .............. ........ V........................... Fireplace ..............................Approximate Cost ............... 7................................................... Definitive Plan Approved by Planning Board --------------------------------19-------- - Area ......... ............ Diagram of Lot and Building with Dimensions Fee ........ .................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH � ifl I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name'. ......................... Peak, Howard, III ��(� ' oZ No .....1721© Permit for a'dd` to s ngle ...... .... ....... f ami lydwe 11 ing.................. Location Li ,hthouse Lane ........................Hyannis....................................... Owner ............Howard.Peak.t..IIL.................. Type of.Construction ........f rame .................................. ................................................................................ Plot ............................ Lot ................................ Permit Granted ...........J.uly..15.............19 74 ' Datetof Inspection ....................................19 h Date4 Completed ......................................19 PERMIT REFUSED ........................................................ .... 19 ............................................................................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... P TdK, .IL• 308+20 TOWN 'OF BARNSTABLE, MASS. l 3u ; 15 7& .. .19 �4 1 +Id+ l THIS IS TO CERTIFY THAT PERMIT IS HEREBY GRANTED' TO o Howard F, P"k III Nymnis kD. ^� ......_.. ........................ ......... ..�...... . _.......__ .._M_ ...._ ._ . .. ,.:,_ _....._,.. O `fit (PROPERTY OWNER) (ADDRESS) ` � TO ..AdB. X � > A� y t. (BUILD) ALTOR) (REPAIR) A4d 168 aq >tt. _....._._...._ l fAtai�Y - 1�1� riQ ..__.w _............... _.._ (TYPE OF BUIL'DINGI - IAPPRO%IMATE SIZBI t �' 1 Lighthouse lard �tyatu�� o LOCATION( .......�...__..._. _-____ _._..._-„........._.._......_ ...._. _.___- ____-_ _ (STREET AND'NUMB ) IVILLAOEI it � NAME,OF BUILDER OR CONT �G1 OR tAyIR!!!Y f r,5 3A' APPROXIMATE COST PAN :' ti I HEREBY A5 'EE TO CONFORM TO ALL THE RULES AND REGULATIONS' OF THE TOWN OF BARNSTABLE; REGARDING 'THE ABOVE CONSTRUCTION. ........................... v, W t (OWNER) - (CONTRACTOR) AO •�N1 y BUILDING' INSPECTOR �, Sabjeel to Approval,of Board of Health. f ,� � � � .� . � -� -7�