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Home My WebLink About0014 PERIWINKLE DRIVE �y �eriwir� k( e "�r, — -- - - - ---- - ,t+� . Town f o Barnstable Perm. Expires 6 months from iss e Regulatory Services Fee • .w�rtsrutu. N"XL 9. Thomas F.Geiler,Director Building Division n / Tom Perry,CBO, Building Commissioner C— 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-8624038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number r�)0(7 Property Address Pe-f l ` VE 01 o n e.S ❑Residential Value of Work � /`Y/ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Ze:c r✓�/ SL4--)a n Contractor's Name Sprinkle Home Improvement Telephone Number 508 775-1778 Home Improvement Contractor License#(if applicable) 103757 Construction Supervisor's License#(if applicable) ,� c" PE RI��IT R]Workman's Compensation Insurance Check one: 0 C T 2 7 2011 . ❑ I am a sole proprietor ❑ 1 am the Homeowner TOWN OF BARNSTAgl I have Worker's Compensation Insurance Insurance Company NameAs_nCia(Pd Ind Ii.,;trie5 of MA . Workman's Comp.Policy#,AWC; 7004943012011 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) ❑ Re-side #of doors _ �eeplacement Windows/doors/sliders. U-Value (maximum.35)#of windows '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 Permission. A copy of a Improvement Contractors License&Construction Supervisors License is qu d. SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Mass. 02111 www massgov/dia Workers' Compensation Insurance davit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/orpnizatiowinwvidaal): Sprinkle Home Improvement Address: 199 Barnstable Road City/StateJZip:Hyannis, MA 02601 Phone#: 508 775-1778 Are you an employer?Check the appropriate box: Type of project(required): 1. CK I am an employer with 9 4. 0 1 am a general contractor and I 6. 0 New constriction employees(full and/or part time).' have hired the sub-contractors 7. 0 Remodeling 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 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] 5.0 We are a corporation and its 10. ❑Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11. 0 Plumbing repairs or additions myself [No workers'comp. right of exemption perm MGL innuance Wired]t c. 152,§ 1(4),and we have no 12. 0 Roof repairs employees.[no workers' 13. Other comp.insurance required.] *Any applicant that cheeks box 01 mart also M oat the section below showing their worker'Compensation Polley iaformatlon. tHomwwnen who submit this atlidavlt indkating they are doing all work and then hire outside Contractors mart submit a new atilidavit indicating such. tContacton that Check this box must attach an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. U the sub-coutracton have empbvees,tluy mud Provide their workers'coma Policy number. I ant an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. Insurance Company Name:Associated Industries of MA Policy#or self-ins.Lic.#: AWC 7004943012011 Expiration Date: 01-01-2012 Job Site Address: N P f i U)i A 1C1 e, City/StateJZip: v 4'.s MA o a(fo I 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 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 $250.00 a day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herb ly under the pains and aloes of perjury that the information provided above is true and correct. Sirmfure: Date: Print Name: Brad Sprinkle phone#: 508 775-1778 Ext.10 Offw l 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 Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact person: Phone#: r CERTIFICATE OF LIABILITY INSURANCE DATE1" 24/2010Y) ``'THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AMID CONFERS NO RIGHTS UPON THE CERTIFICATE BOLDER. 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 endorsement(s). PRODUM - - CONTACT Bryden & Sullivan Ins Agency PHONE ,( Inc (A/c. N.. Z.W: (A/C. No): E-IwIL 88 Falmouth Road AWRZSO PROOOCw Hyannis, MA 02601 COAL IDe• INBURED(S) AFTORDINO COV&Rh= RUC e INSURED INsumm A: A.I.M. Mutual Insurance Cc Sprinkle Home Improvement Inc INSURER B: 199 Barnstable Road INSUEDI C: Hyannis, MA 02601 rNSURM D: INSURER S: INSURER r: 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. yam` POLICY NUMBER POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE oaUm/mr) (rum/rrrYP GENERAL LIABILITY EACM OCCURANCE e EICOMKeRCIAL GENERAL LIABILITY DAIYOR To RCUM1:1 7 PAncuOlEa.uoour,.no.) 11LAIMa MADE DUCCUR NED AJ� ((Any.a.P.[.anl❑ e ❑ PERSONAL i ADV INJURY e GEN,L AGGREGATE LIMIT APPLIES ER: maN:RAL AaaRZOATS e ❑POLICY nPROJECT MLOC PRODUCTA -COI®/OP AGO D e AUTOMOBILE LIABILITY - COMBINSD SiNOts L=T aANY AUTO (u a=idant) e . ALL OWNED AUTOS BODILY INJURY (P.r P.—) e SCHEDULED AUTOS ' BODILY INJVRY(P..aaa14-0 e ❑HIRED AUTOS PROPERTY DAbu= (P-a 4-0 e ONON-OWNED AUTOS e - e UMBRELLA LIAR OCCUR EACN OCCURRENCE e ❑.CESS LIMB ❑ CLAIMS MADE AOOREOATE 0 DEDUCTIBLE e RETENTION S e WORKERS COMPENSATION. orH- AND EMPLOYEES LIABILITY ran uNlra ER THE PROPRIETOR/PARTNERS/ E.L. EACH ACCIDENT a 500,000 A EXECUTIVE OFFICERS ARE - ® incl ❑ excl 7004943012011 E.L. DIBEAAE -POLIcY LIMIT a 500,000 O1/01/2011 O1/O1/2012 E.L. DISEASE -EA XKPWYEE a 500,000 COIADOITA7 DESCIRMON or aivATIwu OR LOCATIONS: WORKERS' COMPENSATION COVERAGE APPLIES TO MASSACHUSETTS EMPLOYEES P CERTIFICATE HOLDER _ CANCELLATION PROOF OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. - AUTHORISED ASPRSSEYPATIK - r Town of Barnstable i Regulatory Services ELMINS71 _ � $, Thomas F.Geiler,Director o � Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.b arnstab le.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, Zq r r y L-1 G h 4e, ,as Owner of the subject property hereby authorize-({0RZ,�vk c�= � �1C /'yI/°�o�Ex�� to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) igna of Owner Date Print Marne If Property Owner is applying for permit please complete the Homeowvners License Exemption Dorm on the reverse side. Q:F0RMS:DWNERPERM1SS10N ' ~ �! �A Ku:lrtl +,t Iltlililln� l:, tsl sstns , 'lilt! `i,tri{l.ut) 1lftit•eo ('unsunurAf`ltairs.\ B siness{2c ulathon ' Construction 5tioerviso T °.tC UI')s HOME IMPROVEMENT CONTRACTOR -1i, Registration: 103757 Type: L"`'"": CS 6643 Expiration: 7/9/2012 Private Corporatic SPRINKLE HOME IMPROVEMENT, INC. BRAD K SPRINKLE ' 190 LOTHROPS LANE ) t Brad Sprinkle W BARNSTABLE; MA 02668 199 Barnstable Rd. _ Hyannis• MA 02601 1 ndcrsccrrtar� 6004 I.icen e tu' registration valid for individul use onP Failure to possess a current edition of the before the expiration date. If found return to: Massachusetts State Building;Code Office of C•onsunmr Affairs and Business Regulation is cause for revocation of this licence 11) Park Plaza-.Suite 5170 Boston,NIA 02110 Referto: WWW.Mass.Goc/UPS Not N slid without sign:lure Assessor's map and lot number ...!.(...... • y�i TM E T��♦ , Sewage Permit number /,�?!�.c i ?t..�es.....: .1h�:.S�rl�c, d�' �+► 33AMSSTa LE i House number ............................................1.1t � ......................, p/may t63q. �o MPY a' TOWN OF BARN STABLE ,,,,,,,., (,, /V° ! 1 e C cbn„v e�cTr'1� a M BUILDING INSPECTOR APPLICATION FOR PERMIT TO .�t..�t � '` � .......... ;7..xv... .................... . ............ .... ......... ..... ....... TYPE OF CONSTRUCTION / .D.x) '�'?' '� ....... /'`' ' G' ..........19 � -- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies four -a-permit according to the following information: y� Location ............................ .i< ........... ` !.�...�. y .t..!..� -... .�/.�:.... C��wL`'t5...... ProposedUse ...........................Y ?.. ..........t, - :...... ..:................. ............................................................. Zoning District ...................Fire District ............... � a............. ,. ................... s' �..s...... Name of Owner ......... 452 � '.!q h :�-.C-A��ddress ...... . . .::. l c ... �', ... Nameof Builder' ......................... -�r .......................Address ...........:........................................................................ Name of Architect .....Address ............ f Number of Rooms ................... .........................................Foundation .........f '=7.C!r�.r ,, .. � .�.�'......... Exterior ...................C /t........ Roofing ................ .. ............... Floors ...............Interior ...............:......., .lt. ...`i..:..::................... Heating j ....?�.....� :-''............Plumbing .................. ... ......�..�r �r `'1............ .................•.•••:...1.•*•.•••••••••.•• R �� o Fireplace ..................................................................................Approximaat�e Cost ...................-.�.. ......... ............................... Definitive Plan Approved by Planning Board ____SI/I� 19(�__� Areas')... ......: ...... � --------- --------- Diagram of Lot and. Building with Dimensions fee .....: .�!. 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 egarding the/d L construction. Name ......... !.1.. ........................................................ GREENBRIER CORP. �A=30 —�5 No 2.4332 permit for ...1?. Sto.. Single Family Dw ,lli g Location ..,,Lot #6, 14 Pe inkle Drive Hyannis ............................................................................... Owner Gr.eenbrier. . . . ....Co.rp.. ......................... .... .. .... .. .... .... ..... . Type of Construction ..........Fra...m.e .... ........................ ............................................................................... Plot ............................ Lot ................................ August 30, 82 Permit Granted ...............................19 Date of Inspection ...................................19 Date Completed ......... ............................19 HtO> 0 • o x esSor's map and lot number .,...... .... 4! � � �i �°ST6Ui :�1# fS"I' 33 4 'STALLED IN CONI LIAR TO�f • THE Sewage Permit numberfr/t?�.r. �4. -tea, ,.,,. TITLE 5 ENVIRONMENTAL CODE E l' 9TULE, House number ..........:................................ ......� � .....'....... ... ... TOWN IECall ATI6i19 '°0 039a�0� TOW Ivvug&o]Fb AP . F.w STABLE ��,,' Ne 0CCtooRNc7 BAi�NSTABLE C2. L � �a � &ar,t ?� O PL'2i9rron, • COMMISSION COMMISSIO TawN ra-wr-2 BUILDING INSPECTOR , APPLICATION.FOR PERMIT TO ... D . ,............' ....................... ll .............f.- TYPE OF CONSTRUCTION........... ........:.:........:..... . .............. . .......................... cG Ali .19�. ...... . . ......... �..... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: .. ... / Location ... .................. .... .1�............ :�:`.....�: `... J,,. .. . �... y ...... ProposedUse ........................ . {.".Zjr/l..T'.. ... .�� ...... ............................... .............................................. Zoning District ............................... � ,!.• . ..................... .....Fire District .... � . Name of Owner ...... .. "..L:.. l :. � ddress ......... . .Q. . .�t!0:...C....: ............ Nameof Builder' ......................... ti!.-t............. .......Address .................. ..:........................................................... Nameof Architect ............................................................::....Address .........:............:..:.......................................................... Number of Rooms f I, ...................4•�..... ...........Foundation .......:. Q Exterior ...................C ... . . ....... ..0 .. .............Roofing S } ...................................... Floors ( ........ .....................................Interior ..........Y. .. G. ........................ Heating .......................A/,.._ � . . 0............Plumbing ...................................................... ... ..C�. ,.......... Fireplace ................................—._...................................Approximate Cost ............� ........................ Definitive Plan Approved by Planning Board S �7___-----------19- Area .....ZA.—>....S4................ Diagram of Lot and Building with Dimensions Fee .............................................. SUBJECT TO APPROVAL ,OF BOARD OF HEALTH w 'OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnsto a egardin the a construction. ` Name ............:d.. ...................................................... GREENBRIER CORP 24332 �. 12 Story ............... Pr`mit for .................................... Single Family Dwelling Location Lot #6, 14 Periwinkle Drive j Hyannis ....................................................... ................ Greenbrier Corp. Owner _ Type of Construction Frame ( + r` Plot ... ..... ...... Loth.......................... - f ' Permit,Granted . :Au .us;t 30,.. ....19 82 ` 'Date of Inspection ..' .... .............19 Date Complete (.. Z.d. .....19 o {3.►.I,CL'' �18.07 Top.Pr- y LoT 5 �a 0 o s� PIP or 4 f x, Ly F A �lb ' C+��L.D c� 740 ISTS SURV � &TE::_roP m F Fcxj,tA . EiE�l�lztou _ 15:4-7 < � •� , ' G Pr'v ?VI ELEv/\`f-)C>J IS RASE IS'.'Ola u,S:G.S. -A'Lif`A: fo,<Doc7 _.:i= DA7R1M Pc.C'_ MOwjAhEKFi Qs CM 25 ( EL- ZR.aoJ lqo wl dry qcD F rT -ESt :. n/� -- I co SIDa � 12CA SE'rBr�cL Lf c-P_ TO Tc"' OF B P_o 2S A BL-F= CGS iSE�IA`flala C r�l�^ro�s OaDc-k :,nF callornoNs F1ua ►J PLOT PLAN D4T✓D JuNE .3 , 198 Cry ALL CnmSTPJC-f)0J w,Jlll-1r 7)4E. 100-YEAS FLncab PLAKIE Mu T P� "FLoob PPc:loF-E D„ PEP �TA17 E IN Du1LDir,1G cofJE 0E:C -s;=er-Ic�Q -748.0 (CT=vrS�� 8 .2s s2 SC ALE= I Sa' DATE: LDREDGE ENGINEERING CO.1N I CERTIFY THAT THE EGISTERE REOISTERE CLIE %NTa� SHOWN ON THIS PLAN IS LOCATED D D alos3 7771 CIVIL I LAN® , JOB NO., ......_,_ ON THE GROUND AS INDICATED AND ENGINEER SURVEYOR DR. CONFORMS TO THE ZONING LAWS, t OF �2i_isT-A , E , M SS. 712 duo Daly ST. CH.®Y� , . .HYANNIS .Mass. 8•►'L�l: SHEET!OF DATE ARE . LAND SURVEYOR TOWN OF BARNSTABLE Permit No. ______?l_: ` ^____..___ Building Inspector cash •"'~ OCCUPANCY PERMIT Bond ___________ ___�_Z��3 Issued to Greenbrier Corp. Address Byrn 510, Ce'iit;er-vilie Ioc #61 14 Periwinkle Drive, Hyannis Wiring Inspector (f" ( � J � Inspection-date Plumbing Inspector d f V Inspection date Gas Inspector �f Inspection date VEngineering Department , . , ��! _� 1 Inspection date vBoard 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 MASSACI USETTS STATE BUILDING CODE. . .... j............. 19A_ �.�.� . �,� /....�...... . .. ..��...._..................._ ._ 1 Building Inspector' rem y 0� i B6Bl9TABLB,,i MABB. � soo i639 p MAY k� anssa, ./�aaaa�auaeff 02601 COMMISSIONERS: (617) 775-1120 Ext. 123 KEVIN O'NEIL, CHAIRMAN JOSEPH J. CAMPO. P.E. JOHN J. ROSARIO, VICE CHAIRMAN SUPERINTENDENT THOMAS J. MULLEN MILNER D. MELODY PHILIP C. MCCART.IN January 21, 1983 A Cmmnwealth M6rtgage Cm pant Braintree, Mass Gentlemen: Please be advised that the Town of Barnstable has activated the Sea Street Sewer within its mi icipal sewer system on January 19, 1983. The Sea Street Sewer serves the Greenbrier at Hyannis sub- division through South Gate Drive, Periwinkle Drive and Daria Drive all of which. are gravity fed to a lift station at Periwinkle Drive. All dwellings except that structure erected upon Lot 30 is connected to the activated sewer system. Sincerely, JOSEPH j, vk�MO, P.E. f Superintendent JJC/bw i •