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HomeMy WebLinkAbout1160 PHINNEY'S LANE (14) // �. //�� ��i�� � ���� �� Town of Barnstable *PerYni ' Building Department `6 ftm t MA"Aan Florence,CBO Esc s 1MAW6 ` Building Commissioner Q200 Main Street,Hyannis,MA 02601 NOV 15 201� wwwv.town.bamstabie.ma.us Office: 508-86MIN Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number,�q h— � Property Address 'i'l(JO -i k4gKb-A LAJU k C. ��In6AVI tlU 02-io'3 2- [Residential Value of Work$ 3 e Lori©•O-D Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name oC M UA I 1 Telephone Number_ Home Improvement Contractor License#(if applicable) Email: �.II lM� 2 S RJ UhGt,cow-1 Construction Supervisor's License#(if applicable)�5 _ 10 3 U 1I _ E orkman's Compensation Insurance (j h a one: �'I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name � •1 K Workman's Comp.Policy# V 'K G I oy bo (to o i Copy of Insurance Compliance Cerdflcate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stopping old shingles) All construction debris will be taken to amn 01 H`7 I S PosA� ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ �R side 0,1 eplacement Windows/doors/sliders.U-Valued; (maximum.32)#of windows #of doors: "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 the Home Improvement Contractors License&Construction Supervisors License is . required. ����7 SIGNATURE. C:\Users\decolliklAppData\Loca]]Microsoft\Windows\lNetCaehe\Content.Outlook\9NNOKXYW\MIDENTILONLYEXPRESS.doc 09/26/17 The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers TO BE FILED WITH THE PERMITTING AUTHORITY Applicant Information Please Print Le gib Name(Business/Organization/Individual): PABLO C.MARTINEZ Address: 49 SMITH STREET City/State/Zip: HYANNIS,MA 02601 Phone#: (508)274.3983 Are you an employer?Check the appropriate box: Type of Project(required): 1. ❑ I am an employer with employees(full and/or part-time)` 7. ❑ New Construction 2. 0 I am a sole proprietor or partnership and have no employees working for me in any capacity. 8. ❑ Remodeling (No workers'comp.insurance required.) 9. ❑ Demolition 3. ❑ I am a homeowner doing all work.myself,(No workers'comp.insurance required.)t 10. ❑ Building Addition 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property.I will 11. ❑ Electrical repairs or additions ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 12. ❑ Plumbing repairs or additions 5. ❑ I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. ❑ Roof repairs These sub-contractors have employees and have workers'comp,insurance.$ 14. ® Other WINDOW REPLACEMENT 6. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c.152, §1(4),and we have no employees.(No workers'comp.insurance required.) *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. [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 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 for my employees. Below is the policy and job site information. Insurance Company Name:A.I.M. Policy#or Self-ins.Lic.#:VWC10060160852018 Expiration Date:08/3012019 Job Site Address:1160 PHINNEYS LANE 4C City/State/Zip:CENTERVILLE,MA 02632 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby under the penalties i f perjury tha the information provided above is true and correct. Signature: P Date: l l/04/2018 Phone#:(508)274.3983 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#: �'� n' �0. -.y... y. r :tip n• ....i �:"� .a .�� • � �. _:.6 n Now ., } rK_ m aau0issiwuao0 1,090 VW SINNVAH / rr 1S H1lWS Sip z3NIlaVW 3018Vd 6L0Z/LI,/WsaalCer i aoslAa1� 14?: isuo0 spiepuelS pue suoiteln6ab Buipling ao paeo8 aansuaal 1 I euolssa 1oa d 10 uoIsIA1a s;;asnyaesseW;o 411eamuotuuoo j .J`ie C�oazrr2oietar.2��o�✓(/�a�4:ccc/�SeCG1 .,,. 1 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only ?s TOW individual before the expiration date. If found return to: ReaistrationExpiration Office of Consumer Affairs and Business Regulation =1428.01 05/19/2020 ? One Ashburton Place-Suite 1301 a i - PABLO MART.jNEZ — Boston,MA 02108 D/B/A CUERVO!Bt 1 D -,REMODELING I PABLO C.MARTIN 49 SMITH ST HYANNIS,MA 02601 Underse-cret4try F101 valid 1hout signature K,-�rbor ace ox 46 Centerville MA 02632 November 13, 2018 Dear Sirs, We,the Board of Directors,Arbor Terrace Condominiums, 1160 Phinney's Lane, Hyannis,MA,hereby acknowledge that we have given approval to Lisa Frangione to have Cuevro Construction Company, owner Pablo Martinez, install four windows of the same style as already exist on the front of the condominium. S' rely yours, George H. Bartlett Property Manager For the Trustees Engineering Dept. (3rd floor) Map Parcel � Pgr it# 17 ;wS House#a .4�l zW62(p1 Date Issued G Board of Health,(3rd floor)(8:15'- 9:30/1:00-4:30) ,y"� �%3'S�5-� eelc,Ego02�- Conservation Office(4th floor)(8:30-9:30/1:00 2:00) �� � 21sf INSTALLED 6N CCMPLW'itd7 Pl)g"' st floor/School Admin.:Bldg.) YM Dpproved by Planning Board 19 EUVIRON� E AND T®mod R �� 039. TOWN OF BARNSTABLE Building Permit Application Pdress oV °.r Owner e Address ZZ 6 C> t Telephone . Permit Request Z First Floor square feet Second Floor square feet 'Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Ll 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 No. of 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 ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None 1 ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use -Proposed Use Builder Information Name "-/ Telephone Number 77/' Address 2 o License# Home Improvement Contractor# l/Z d L/ d 6 Z Worker's Compensation# 6t--)Z IV b d 2 ZZ- O J NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE _ �.� DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) 3 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED _ R F MAP/PARCEL NO. ADDRESS. VILLAGE OWNER ; ! � e • ,, _ , r DATE OF INSPECTION: s ! FOUNDATION — f FRAME • — R INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL a PLUMBINGii tt�-,JR�OUGH FINALi.A „* GAS: : UGH FINAL c ` FINAL AMRk DATE CLOSLD;Q s ASSOCIATION PLAN.NO. s + a - 77,E , 75.P ! STANDARD LEGEND � . �`? note:not all symbols will appear on a map 0.46� \ , /` , GOLF COURSE FAIRWAY >\ \..,/ ?, ,r - ,.: .;., i` _ _ DECIDUOUS TREES , / / 8� 8 #1167 �`' —: - - /.: '�, 7�3,5 ( ., EDGE OF BRUSH , �, `. \•`e, •._�'•, /' iw \ / -- 71CJ=3 'U ORCHARD OR NURSERY •` l CONIFEROUS TREES L • "\ % / — — . MARSH AREA % l' 2 ,1 75.5 ' '�'� EDGE OF WATER DIRT ROAD 7,93 DRIVEWAYS PARKING LOT 1.20 AC 6 9.PJ �' �PAVEO ROAD 7�Z�jyF Dlrcxfs PI70.5 J / �� PATH/TRAIL PROPERTY LINES `'G✓ \\ `� fJ f EAGE "\; \/ 3HOUSE LOT NUM ER 7\ 70. ' HOUSE NUMBER �j -,,.._� -<•_ / ,j \/ 2 FOOT CONTOUR LINE . �... ... A •,,,; „.,\ 'r, � v� '..,: - —!. 10 FOOT CONTOUR LINE �• 6 / . E x�. SPOT ELEVATION 75.2 ;� 73 1 \/ ;` \/6 STONE WAIT 69.1 /-1 FENCE ../ �\ ` ^ r� ...� .-` RETAINING WALL `f I /\ .5 ,. RAIL ROAD TRACKS / (' ~`' r7E, TELEPHONE POLE / \ \•..\` HOW � -\%/ I +y � .\'� \/6 7.IU`.. STONE JETTY .,t.r 0 /\ YJ �-y (�L� .. SWIMMING POOL '�• / ... ;/ `�, 3.3 PORCH DECK 4N b •.� '�`� \'w..., r •.:. ... ,. „'� _._ �t. � C'7^ BUILDINGS/STRUCTURES 4 \766 / 7@ �' t �� DOCK/PIER/JETTY ASSESSOR'S MAP BOUNDARY / 0.30 AC E / �,,• �.}.- .,,J ; A' O #1 7 0.32 a� � "( I.O.B.GEOGRAPHIC INFORMATION SYSTEMS UNIT ..JJ . , 86 9 f.... 0.3 A I i„ w _.E _... 0.30 AC — 1 i 1.1 $j / #21 7 o E50 100 t '\ �� 1 E� 1� � SCAT feet 0. 41 A #340.29 AC : W E a 0.28 AC / i \ 0.29 AC 91 8 110- 3 A.37-k, #33 \ j 1. YFG[I TION,TOPOGRAPHY AND PLAN METRIC DATA INTERPRETED FROM 1989 AERIAL DVERFlIGN1$,PNOIDDAAPNY AI I'-R00' �;0.30 AC 36 AC ,..,, ... C T _; \•i 1 MAPPED AT I-too',PARCEL DATA DIGITIZED FROM I•m IOEY r C'�`� "\ .. .. \t ,� ENGINEERING ASSESSORS MAP519X9 J I #58 I i. 0`32 AC I N I✓L � L X Pr joh0 17 gC V-\j � Jt�t i f CF THE lQ� : . The Town of Barnstable KM 11639. `0�' Department of Health Safety and Environmental Services ArFp�x+" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only 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. e,e-� Ote-a k Dot,'T Type of Work: /0,r' &x/0 _.¢sr1 Est.Cost Address of Work: Owner's Name Date of Permit Application: %Q /a, 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 PENALTIES OF PERJURY I hereby apply for a permit as the�age of the owner: /h L,2-I AJO f 112(2 ZIq bat6 Contractor Name Registration No. OR Date Owner's Name The Commonwealth of Massachusetts `•�ri� _ -j; �- Department of Industrial Accidents . r - Office 01IMSMOSAOns 600 lVdAington Street Boston. Alas. 02111 ` Workers' Compensation Insurance Affidavit 'i �-.. 'x••�'-."�'�'�"""'�"�••'^T•"' .. ... L .•t�wWaa�a�t+�a�^-�.M>.9iMe>+>^+f ,ysY .c+.+....^y.�... � - Appltcant information: ._- . _ _ � Please PRINT le;ibl�•s„y- __.-..._ .._.... ._ name: location: city phone# 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity `��-+s':`'� Z•1 •Ter's .75ti7r.•"4ptppkvR '=''T.e�n►..�L..,x.+N t9!'Rpq••. .^ram +,wg(t' xt:..!vTw+a. ;'r!.±a�y�rr:+>r +tr.•.:r,4� ...,i- _ _ :.oi's:.: i'i�: lt::�` -"`• . "ri' 3 [..:.a.r.�e.._...�..�_..._...r 1 am an employer providing workers' compensation for my employees working on this.job. company name: address: city: phone#• insur. ce co. policy# ....aM'a`M'�,tRRV'k)M'Tt�.y _....:..-..N... .Mi'.i.l.+!lr.:.wtr .w..aa •. I am a sole proprietor, tractoor homeowner(circle one)and have hired the contractors listed below who have the following wor-ers' compensation polic company name• 57 address Aza�� c�2-d� o #• insurance co. Policy# 4O q 9-? �.. :a t-.' ....;, ilP:Fi+« .... ?t`at*.`=-�r^r t'['1'C.Y'+YZS'?;yG. .+.�_s^'mte�r.T++iyY..^^1��7`•f�,�r�a-R¢!:�^�?, x_, `t�'. x:,r mar sy.; +._'-^'_?� company name: address: city phone#• insurance urance co. policy# . ;Attachadditionalsheetifnecessa�� f '°'''i'' .* r _ -_ ��• - .F• is _ 4 ' "x""" '"`" .__. ....r-_.r._._...�..r�.�1Yr:•iL.i� -y:iiiifyb'�aTS•�' � ��' - - �ei�10xG JY•'�i/R�f Failure to secure coverage as required under Section 25A of NIGL 1.52 can lead to the imposition of criminal penalties of a�fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereAr certifj under t/re pains and unities of perjurt•that the information provided above is true and correct. / Si;nature -----Date,���/ Print name Phone# . 4 # �oficial use only do not write in this area to be completed by city or town official city or town: permit license# riBuilding Department Licensing Board 0 check if immediate response is required C3Sclectmen's Office oliealth Department ' contact person: phone#; nOther 0. (rased sr15 P1A) Information and Instructions rvlassachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compens�ltion for their employees. As quoted loom the "law", an e►►►pinree is defined as every person in the service of another uiicler any contract of hire, express or implied, oral or written. An en►plurer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of r �r • including le-al representatives of a c •m lover or the the foregoing engaged in a joint enterprise, and p deceased c p , 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. chapter "2 s 2 also states that every state or local licensing agency shall withhold the issuance or MGL 1 to 1�_ section _5 a g b • 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. 77 ;. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits 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. Citv or Towns Please be sure that the affidavit is complete and printed legibly. Tile 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. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, pi.ease do not hesitate to give us a call. , r+a�ev-e...» - ,r....a.-r-r.s ,....s.�s:-Zc.,- ��^'.!+ stm?�T•,no� rt:;,v� :fin!!..-s ?ne+..r.--^^ n+..a�z;?wr..rxx' -^=•.r+v+o+aww....ra•..• .s, The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 ,� . (, 'i 2 AI� - - .i - _ � �� � � �. coo c�ia � 2 � �, - "i.. .. . v. H � NF, ` r- rl G � �P 2 �_ p ..' E� 5i '. �Hq O H - "� � t lt�' �� �Y's. CG W�O i I� Rl r �-'. O 19 Q Es`.Z�"'��.� BEM�A� � � P.t � � r-s ps 1 H �\ �. :tll"' �.� - _ nor. � � t� .�c B L+] y v � i- �• ��k -p ti'1 -.ram-�------` ...�.eg:.:::?,7a.�"4^',s�`�'-� _ '� fi. •. �. ... � - ..-. y I -. _.. � . _ Engineering'Dept.;(3rd floor) Map � Parcel _ _Permit- It ©�M House# Date Issued le 'y Board of Health(3rd floor)(8:15 -9:30/1:00-4:30)0 - - � =}/ Fee e&4 Conservation Office.(4th floor)(8:30-9:30/1:00-2:00) P 13 SEPTIC °�� � u� �E Planning Dept.(1st floor/School Admin. Bldg.) IN Definitive Plan Approved'by Planning Board 19 PE AND ��� ONS TOWN OF AARNSTABLE TOWN n Building Permit Application I-,roject 2Street Address 60 � f, J � Village iU l 3 Owner j!�F7/ -- Address Telephone Permit Request L4-cz - L— &+r,J f First Floor square feet Second Floor square fee Construction Type Estimated Project Cost $ y 69— Zoning.District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑N 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 No. of 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 ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑N Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use -- Builder Information Name bJ1Ct,1+A^- Telephone Number Address 2 , License# os -5 ( 0 L` ✓�/ -`'� 2� Z Home Improvement Contractor# L 1 Z.O L( 9 Worker's Compensation# W Z�-� D2 � NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL A� PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PRAT Cr WILL BE TAKEN TO r SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)