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HomeMy WebLinkAbout0065 PINE GROVE AVENUE ��._..__ ,� h� \ 2 r � Town of Barnstable *Permit`y#x®f 30 �o Expires 6 mont o issue Regulatory Services Fee - s�vsr,�si.E. 1659� & Thomas F.Geiler,Director ArED tAA� 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 Property. � � �I VU� ���� 4� P ETICe-sidential Value of WorkcQ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 1� 7 C`�'r�C A Contractor's Name I-O f—�-4— c, Telephone Number Home Improvement Contractor License#(if applicable) 7 7r q G? Co�orhman's n S pervisor's License.#(if applicable) n - Compensation Insurance Cher F�eg 15 LI-1 am a sole proprietor Z013 ❑ lam the Homeowner TQpVN ElI have Worker's Compensation Insurance QF S N Insurance Company Name 14�S 6'`� /d—e1d" �' P(V ^ ��L� Workman's Comp.Policy# LA-1C,C_ —<70 t l a- 46'2 O l =L © ( '� 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 ❑ Replacement Windows/doors/sliders.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. *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. SIGNATURE: Q:\WPFIL.ES\FORMS\building permit fomms\MRESS.doc up.,;cAa nsint,) `Q r . The Commonwealth of Massachusetis Department o, 1ndusitial Accidence Office-oInvestigations .V4 600 Washington Street Bosun, 4#2111 . w►cnv xma s&gvv1dia Workers' Compensatian Iusux-Auce Affidavit: Blinders/Contractors/EIec#iicianstPhtmbers Applicant Information pp Please Mut L*embIy Nahne ti4nilvidnal): i"�-� — . C� c Address: City/Sfiate/Zip:C tr 4—t-,,'U i V-� VAQ- Phone#: Are you an employer?Check the appropriate bow Type of pra]ett(required): 1-❑ I am a employer with 4 ❑ I am a general contractor and employees(fall a�sdr` p #ime)- * have bired the sub-eonhwfors 6- ❑New ccrosfrucfion _7- am a sole proprietor or partner- listed on the attached sheet ?- ❑Remodeling I ship.and hatre no employees Tie sthb eontrac#ars have $- ❑Dem lifion warring for one in any capacity. employees and have wcakess' g-" ❑Building addition JN-a workers'camp.+surance comp-insurance-1 .] ' 5. ❑ We are a corporation.and its 10-❑Electrical repairs or additions required 3_❑ I am a homemmer doing all work officees have exercised dwir 1 LE]Plumbing repairs or additions Myself [No workaas'camp right of exemption per MGL 12.❑I6of repairs insurance required.]T c-152,§1(4),and we have no employees_[No workers' 13-❑tither comp-insurance requim Aj *Any appEcamt thm checks box#1 must also f alow The secuanbelaw showing thew workers'camapemsatiaapalicp infarma lab 1 Hommowners who submit this aTu12vA md1C2fng&ey art doing all woofs agd rben hitE outside caattacuors must submit anew afdavit mdicstiag such- Ttracmrs that check this burs must attached an additiawl sheet showing the name of the and stare whether or not'&ose undoes haee emp3eyees. Ifthe mdh-coatmaom have employees,they--st.pmvide their Wwrkers'comp.policy number. jam an emplol+sr tiiat is prvvirlirtg workm,compmrrsativn in=rauce for rrryr employees. Below is the poWq-and jab site inform adom. Instuance Cozmpany Name: ASS, Policy or e1€ins.Lic.#: LAJ,-C-�U ( ( �'7® l o i Fxpimtion.Date: 1 I Job Site Ad&ew:6 S— ez-�t,--e— t Citylstate/Zip: Curs Pt vt i � lN�r v a•6 1 Attach a:copy of the workers'cemp;nsaflon policy declaration page(showing the policy munber and expimfion date). f Failure to secure coverage as required undue Section 25A of MGL cc 152 can lead to the imposition of criminal penal ies of a Fine up to$1,500-00 andior one-gear imprisonment,as well as civil penalties in the foam of a STOP MORE+.ORDER and a line of cep to$250.O0 a day against the violatcr. Be advised that a.copy of this staiemest may be forwarded to the Office of Im+estigatiofls of the DIA for insurance covMsage veriFicaticn- do hereby cetW.fy under ikepains andpmaNes rrfyerj!L7 ffW t1Tie inforar�diem provided ahavw is true amd cnrr>act Siahtte` ©,,fc&d im only. Do not write in this area,to be c&mrplete+d bs dV ar MR,offic aL City cr Town: Pern itUcense At Leaning Authority(circle fine): , 1.Board of Health 2.Building DepaErtutent 3.Cityfruwn Cleric d.Electrical lnsperter 5.P"hi g Inspector b.other Phone 6a tet lemon: #: rV own of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-4035 Fax: 508-790-6230 Property Owner Trust Complete and Sign This Section if Usinea A Builder I. I j (�--Cwna o6 ,as Owxier of the subject property hereby authorize 9—ObC-F--' to act on my behalf, in all matters relative to work authorized by this building permit application for: (ire o€Joh ®i Signature of Owner Date Print Name QTomwexpmsrg Revise071405 Office of Consumer Affairs&B smess Regulation License or registration valid for individul use only IMPROVEMENT CONTRACTOR before the expiration date. If found return to: HOME IMPROV Registration: ;EMENT Type: Office of Consumer Affairs and Business Regulation 13<.1„1/1.5/,20 DBA Expiration: 10 Park Plaza-Suite 5170 -/15/ 0 Boston,MA 02116 RO 'RT BROWN;:CU&TOM BUILD..ING REMODELING ry `l ROBERT BROWt�" , 563 OLD STRAWBERRYHILLI2Dr CENTERVILLE, MA 02F32:-,�-'5=- Undersecretary Not valid without signature IVlassachu;setts- Dcpartmcnt.Ul'Public Safety Board of Building Rcoulations and Standard. Construction Supervisor Specialty License License: CS SL 100878 j Restricted.to: RF,WS '` !.Y ROBERT BROWN ' 563 OLD STRAWBERRY HILL R i CENTERVILLE,.MA 02632 ! J Expiration: 10/10/2013 Commissioner Tr#: 5228 z Town of Barnstable st+e Regulatory.Services oF ram, �� f• Thomas F. Geiler,Director Building Division * BARNSTABLE, '" MASS.� Tom Perry,Building Commissioner m ArfoeA� 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax�SQ$-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: Nallic: Qy'-� Address: (Ps Village: Name of business:_V�V sa S i t� _-- vleC t�1 C�ZI[�----- ----------- _-- ___ -- r 'Type of lusiness: r1'e_C_' c CGA Map/Lot: INTENT: It is the intent of this section to allow the residents of the`ToVvn of Barnstable to operate a home occupation cNitltin single Family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,proVriclecl that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no Visual alteration to the premises which vv�ould suggest anything other than it residential use;uo increase in traffic above.normal residential vollinles; and no increase in air or groundwater pollution. After registration mith the Building Inspector,a customary home occupation shall be permitted as of right subject to tale Following Conditions: • The actiVgity is carried on by the penrlauenf resident of a single family residential dwelling unit, located within that dwelling unit: • Such use occupies no more than 400 square feet of space. • There are no external adterations to the dwelling which are not customary 111 residential buildings,and there is no outside eVidence of such use. • No traffic miIt be generated in excess of normal residential volumes. • The use does not.involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or oilier objectionable effects. There is no storage or use of toxic or hazardous materials,Or flammable or explosive materials, in excess of normal household.quantities. • Any need for parkinggenerlted by such use shall be'lnet on the same lot containing the Customary Honle r Occupation,and not avitllill the required front yard. • There is llo exterior storage or display of materials or equipment. • There are no commercial vellicles related to the Customary Home Occupation,other than one vale or one dick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet ill length and not to . exceed 4 tires,parked on the sauce lot containing the Customary Home Occupaticnl. • No sigh shall be displayed indicating the Customaly Home Occupation. • If the.Customary Home Occupation is listed or advertised.as a business;the street address shall not be included. • _ No person shall be enlployed ill the Customary Home Occupation Who is'not a penlla icnt resident of tlac dwelling unit I, the undersigned, have read and agree mth the above restrictions for nay home occupation I ana registering. Applicant: , Date: 3 10 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for years). A business certificate ONLY REGISTERS YOUR NAME in town you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office 1a` F (which Main Street, Hyannis, MA 02601 (Town Hall) L., 367 ,A DATE: 3 (0 APPLICANT'S Fill in please: � k 'la! YOUR NAME/S: � Oi �q��� �� � � ���` BUSINESS Pa YOUR HOME ADDRESS C5 ,�z ��;4�Irr M M/� O Z4v N" T x H�` TELEPHONE # �; Home Telephone Number j c3$ 3(ct{ o 39 NAME`OF CORPORATION: .NAME OF.NEW.BUSINESS IS:THIS A HOME OCCUPATION? YES" NO TYPE OF BUSINESS ADDRESS OF BUSINESS �5 sI' t GS.ZCcCj MAP/PARCEL NUMBER:r (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations o f the of Barnstd'ble. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (cor eroof Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has n informe any permit requirements that pertain to this type of business. MUST COMPLY WITH HOME OCCUPATION Authorized ignature RULES AND REGULATIONS. COMMENTS: o LA l-. TI O NS. FAILURE T ��OM O . PLY 2. BOARD OF HEALTH This individual has bee i ormed of t rmit re frements that pertain to this type of business. A Authorized Signatur - - COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has een informed ofthe li using requirements that pertain to this type of business. " Authorized Signature** COMMENTS: ly Assessor's map and lot number ..79a.........0.3/......' CF THE T� Sewage Permit number i 33AHd9TAELL House number ........(. `?........... .!1.................................. 90 Yaea I psi�639. ` TOWN OF BARNSTABLE BUILDING - INSPECTOR APPLICATION FOR PERMIT TO., 1 J. .fl.`.......S.e..U4......fl 14 C,.{!L. .J.V1 ....q Cl.��a.::r... .............. C TYPE OF CONSTRUCTION ...........r Aw�..�. ...... ...................................................................................... tJ ...19i 5 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: f /n1 Location ...... .t�r..... ...�6Z<Q.....1J.2 G�/�.... (/t ............./.... ..:............................................................................................. ProposedUse .1 Va. ..... D ', '. . ................................................................... Zoning District :....... ... .........................Fire, District AVI .(.�. 4 Name of Owner ... �- ,!►. .�......I...!..5.�. .......................Address .. .. ..!: ....GI�I/i/e......'.1.� ......l; .l........... Name of Builder, ..........................Address. . .......... ............... Name of Architect ..C/.ue..... !?1. ... .... K..a-,4:�. .J.Address ................. Number of Rooms ....)........................................... undatici—n Fo Exlerior .... ... i.�t. lx.1 G. .............................................................Roofing ....J....�.��. �.'•. ..:................................. ............. ,.. Floors PM,J1. .PJ... ....�r4�oQ.91 Interior �VI -I" C��C .:p ........................................... ...t. .....�:.. ..... ............................... ff , Heating .. 2�!.5.........:.?i:f....(. (A.� .. ...........................Plumbing .......r 1,. . : .......................................................... Fireplace ...��.�� .. ...... ........................Approximate Cost ...... .. .U. ................ .... ............. ' • � Definitive Pla,n Approved by Planning Board ________________________________19________. Area ... czlD......................... 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 regarding the above construction. Name ... y Construction .Supervisor's License ... ....... .. .... .......... FISH, STEPHEN J. A=290-03 A=2 90-93 1291 No ... Permit for ....Add 2n lFloor .................. .............. lj ..............Single...Fam.i.ly Dwell.i. . ............... Location ......6.5...Pine...S.........t............................ ....................4yiKIRRis............................................ .......Stephen J, Fish Owner .............................................. Type'of Construction EK4WP...................... ................................................................................ (Plot ............................ Lot ... Permit-Granted ..........Se.......ptember...17,. - ............. ...... ..19 85 Date of Inspection ....................................19 Date Completed ......................................19 9® C&12 r4o' b I notJ 111 187 �y Assessor's map and lot number ..� ........-`..0.3/.....�' CF TH E t0 re4iQ� yw Sewage Permit' number�9�... . .. .. .��� p Z 33AHB9TADLE, i House .number ......... ....:: .!1............................ .::.. MA86 9Gp 1639- \e� ' p MPv a' TOWN _ OF BARNSTABLE BUILDING - INSPECTOR APPLICATION FOR PERMIT TO i 1"t.s'X11� .............. TYPEOF CONSTRUCTION. ....... . .1........................................................................... ....... ............. .... .. �...t... ...........19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......CF.� p'.K.....1�.12.(l/:�...�V................�• .... ..:............................................................................................. 0 ProposedUse ....P ................................................... ................................................................. Zoning District 6 ...........................................Fire District .... .... ...1/A/I.S.. ................................................. Name of Owner ... . ...�: ......1 Name of Builder .� .........................Address . . ...:.tc. .............. ............... Name of Architect ..C11! Q ... .Q�'1. .... ...111!?'!1K..V.`!4 4/.`. .Address ......... .... ":If��(/.�C'A................................ Number of Rooms .... .........................................................Foundation ...((S�OCS.....................................:.................... Exterior ..G... lA .� . ............................................................Roofing .... ............................... J P .................Interior t 6�4. .. � Floors �'0�� O . J Gl/PP¢1.......................... . ............................................................. Heating ..1/.� S [" 1�� ...........................Plumbing .......j.. .(� ''1......... ...... . .... .. . ......................................................... Fireplace ...lvcr_)l�................................................................Approximate. Cost ...... Of,Q..U.U........................ .......... ......... s��I Definitive Plan Approved by Planning Board ________________________________19________. Area............................. I Diagram of Lot and Building with Dimensions Fee 6la'3� ..... ................... . .. SUBJECT TO APPROVAL OF BOARD OF HEALTH i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. .... Construction Supervisor's License ... ........ .. ..... ........... 1, FISH, STEPHEN J. 28436 ADD 2ND FLOOR No ................. Permit for AD.............................. ' '� Sin le Family D.welling. . ................... 8z........................ ........ . .... ' ``. ..6.5 Location ...Pine. ...Grove. ...Avenue. + j . . ...... . ........ . .... ........................... _ r "v ..................HXannis.................................................... 4 ' Stephen J. Fish€ "`> Owner ................................................................... E 't . Type of Construction .............Frame................... S ..................... ........................................................ S �+•9 Plot ....................... Lot• ................................ .Y ' Permit'l Granted SeP.t 17 85 . .............. .19 ` y- ••t Date of Inspection q`.�y. '��.......19E + ' Date Completed t - `J ti ..