HomeMy WebLinkAbout0178 CAP'N SAMADRUS ROAD a
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912 0/050V�
Town of Barnstable *Permit# $
••. `�� "'�p� Z-V& :6 months from lstue date
l : Regul ry ato Services Fee • � . go
NAM
Thomas F.Gellert Director
Building Division
Tom Perry, Building Commissioner
200 Main Street,.Hyannis,MA-02601 X-PRESS PERMIT .
Office: 508-862-403 8
Fax; 508-790-6230 S E P 2 0 200�
EXPRESS PERAM APPLICATION - RESIDEM2A&QNLY �v
Not validwWwut1tei(X-Presshnprint .. BAR�1S�"�gLE
Mapfparcel Number .... .
Property Address cfttt
i
0 Residential Value of Work W I D 0 D' Minimum fee of•$25.00 for work under$6000.00
owner's Name-&Address C�V�iV1Pt0� � 1� w
�. 3
Contractor's_I�Jame F1�1 L Pilo y .alv ��o °T PO ID c
D --
Home..Imp=vement Contractor License#;(if applicable)
Construction. ervisor's License:#(if-;Lpplipabl. 07 lA
❑Workmaes Compensation Insurance
Check one; •.
0 I am a sole proprietor
❑ I am the Homeowner
® I have Worker's Compensation Insurance
Insurance Company Name t4 t p/\ J L, ,t`�-�J�A C CC'
Workmaa's Comp.Policy# (00 P SXM SV U,Oa1511'
Copy of Insurance Compliance Certificate must be on.Me.
I
Permit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
® Re-side
Replacement Windows. U-Value %%'3t (maximum.44)-
*Where required, Issuance of this permit does not exempt compliance with other town departrneat regulations,i.e.Historic,Conservation,etc. .
Property Owner must sign Property Owner Letter of Permission.
Home Improvement Contractors License is required. ,
Signature
QForms:expmhg
Revise063004
of Town of Barnstable
_ Regulatory Services
�B Thomas F.Geiler,Director
Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-623 0
Property Owner Must
Complete and Sign This Section
If Using A Builder
I, as Owner of the subject property
hereby authorize 7-0H 4 &J E,��A% to act on my behalf
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Signature of Owner Date
Print Name
Q:FORM&O WNMERMIS SION
jo/W -e` ,
Board of Building Regula ions and Standards
One Ashburton Place - Room 1301
Boston. Ma=-sus, etts 02108
Home Improveme ractor Registration
Registration: 132195
Type: Individual
z W Expiration: 12/5/2006
JOHN R. LAVERTY
JOHN LAVERTY d
P.O. BOX 200
W. HYANNISPORT, MA 02672 4
Update Address and return card.Mark reason for change.
DPS-CA1 0 50M-04/04-G1o1216 E] Address [:] Renewal E] Employment Q Lost Card
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
ap 7L Parcel Permit#
ealth Division Date Issued W
Conservation Division FeePO
Tax Collector' L �,4
__Areasurer
Planning Dept. '
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address /7z e 70 �a al& C
Village
Owner �_/,�g,c/ Address _ZZZ4 > ry
Telephone pp,�
Permit Request mil,//�i i� CJsc. �, .-���g 412,C S
Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new
oa
Estimated Project Cost S�Fod Zoning District Flood Plain Groundwater Overlay
Construction Type
Lot Size Grandfathered: O Yes 0 No If yes, attach supporting documentation.
Dwelling Type: Single Family a- Two Family 0 Multi-Family(#units)
Age of Existing Structure Historic House: O Yes 0 No On Old King's Highway: O Yes ❑No
Basement Type: ❑Full 0 Crawl ❑Walkout O Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half:existing new
Number of Bedrooms: existing new
Total Room Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric 0 Other
Central Air: ❑Yes 0 No Fireplaces: Existing New Existing wood/coal stove: Q Yes 0 No
Detached garage:O existing O new size Pool:O existing O new size Barn:O existing ❑new size
Attached garage:O existing ❑new size Shed:❑existing 0 new size Other:
Zoning Board of Appeals Authorization O Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name�cyL � ��_ Telephone Number 7aS - —7 z/
Address License#
Home Improvement Contractor# 9 ,1q
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO g i•% �/<i
SIGNATURE Di DATE
FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.
f
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION i
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
z ,
GAS: ROUGH FINAL
FINAL BUILDING, ;
DATE CLOSED OUT
ASSOCIATION PLAN NO.
The Town of Barnstable
RAMS a L& •
' Department of Health Safety and Environmental Services
'�Eo t ut A Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508=790-6230 Building Commissioner
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW.
SUPPLEMENT TO PERMIT APPLICATION
i
i
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.
QD
Type of Work: g stimated Cost
Address of Work:
Owner's Name: V1�4. 9 A
Date of Application:
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 forQa permit as the agent of the own-efrr:/\J �p
{i' it 19,9 ILL
Date c Contractor Name Registration No.
OR.
Date Owner's Name
q:forms:Affidav
The Commonwealth of Massachusetts
-r:. Department of Industrial Accidents
Office Ol/t>reSMSMOQS
_ — 600 Washington Street
Boston,Mass 02111
workers' Com ensation Insurance Affidavit
name:
location:
city AM phone# Jae 700 V
❑�am a homeowner performing all work myself.,
Er l am a sole Proprietor and have no one working in anv capacitv
''/////////%/%%/%�//////%%///%/!O%/%//%/'��//%%%%//////////////O////////%///// %%///%O//% /'//////%////%/%//////%/////D////%0O///O%%//%%///%////////%///O//O/%///�D///D////%//////%%%
I am an employer providing workers' compensation for my employees.working.on this job.:::::. ::.:.:::: ::::::::::::::::::::::: :: ::
com anv T1am ` ;
add
cites
o
'ins urn n ce co." ^.::::: licv
ME
❑ .I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who
have
the following rs' compensation e..n..s..a.tion poce
.. .......... ....... ........ . .........................v:::::::..:.h�...::::.::::..
x.
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m an
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.........................................................................r.::::.:..::::::::::::::::.::::::::.......
a dare
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...................................... ...................................................................: Kv.�:::::::. ......k........::::•:;•,`.::: :kkk::..
NWANAVA
or
Failure to secure coverage as required under seed on 25A of MGL 152 csa lead to the imposition of criminal penalties of a Bne ail to 51,500.00 that
a
one years'Imprisonment as wen as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Once of Investigations of the DIA for coverage verification
I do hereby certify under the pains and penalties of perjury that the information provided above is&w and correct
.Signature
Date //�� 127
Print name Phone# .mod 7 7,f— 7do
Jill: 0
official use only do not write in this area to be completed by city or town ofiidal
city or town: permitilicense# ❑Building Department
❑Licensing Board
MEN
❑check if immediate response is required ❑Selectmen's Office
❑Health Department
contact person: phone#; ❑emu
Oemed 9/95 PIA)
a
!y A4
.,� ��NONE IAPROVENENi CON1RpCi0R ��`"j
:r F Regtstrattoe '
4 xptrattoa- 09/21/2001
s:. x
t rTyDeQBA
SNON SCHOFIEIDf
ADMIp-ro- -31 HAPNISgs w HIRE AVE
�.
�x f `-HYpNNIS . �'
TOWN OF BARNSTABLE BUILDING PERMIT.APPLICATION
Map _d 3 Parcel D 'SJ;',;*X. 1i7 WhIS��4yo, plication # g0 1�2�
Health Division 2008 JUL 2$ AM 9PPP Issued �
Conservation Division Application Fee 5000
Planning Dept. - t-, RFee 0D
U1�1lSlal�i'
Date Definitive Plan Approved by Planning Board
Historic - OKH Preservation / Hyannis �(
Project Street Address ?� Cif'✓ �' d�I s9!> /Lvs
Village r i
Owner Address
Telephone
Permit Request /z e~V f 6- 7-cee�Y 7` /�� T�� /ZL'Lo C";
411_ r
Square feet: 1 st floor: existing ro osed 2nd floor: existing
q 9—proposed g proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family.. ❑ Two Family ❑ Multi-Family(# units)
1
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
Number 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
Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_
Attached garage: ❑existing O new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use ' - - _Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name 1&>Oe�q f- 6aaa L Telephone Number
Address Z6 7 License
Home Improvement Contractor#
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE�t`Z G�y"`��-0 DATE
l; FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED 1
MAP/PARCEL NO.
'_ADDRESS VILLAGE
OWNER
r
_ DATE OF INSPECTION: `
FOUNDATION
k FRAME
INSULATION
FIREPLACE
'ELECTRICAL: ROUGH FINAL 3
-PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
S{ FINAL BUILDINGS
DATE CLOSED OUT
�-
ASS
OCIATION PLAN NO. j
I ,per The Commonwealth of Massachusetts
\ Department of Industrial Accidents
rA Office of Investigations
600 WashfAgton Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Buqders/Contractors(EIectricians/P.lumbers
A_ licant Information Please Print Legibly
NaIIle (Business/Orization/Individual): /�Lc'/�/ZB c,/ C�e' GGF9/L�
Address: All"� 2-6
City/State/Zip;�G1f ��`' Phone.#: g —
Type of p
Are you an employer? Check the appropriate box: r oject(required):
1.❑ I am a employer with 4. I am a general contractor and I 6. ❑New construction
loyecs(full and/or part-time).* have hired the s'ub-contractors
listed on the atfached sheet 7. �miodeling
2 a'solc proprietor or partner- Theseu-b-
gcontractors have Demolition
ship and have no employees 8. ❑
working and have workers'
ng for me in any capacity. 9. ❑Building addition
inarrranGe t
[No workers' comp.•innrrancc comp.
S. [] We are a corporation and its 10_❑Electrical repairs or additions
rtqu a h]omeowner doing all work
3. I am a h officers have exercised their 11.[]Plumbing repairs or additions
❑ ,
myself [No workers' comp. right of exemption per MGL 12 ❑goof repairs
insurance,requued_]t c. 152, §1(4), and we haul no insurance, Other '
employees. [No workers'
comp.insurance required.]
*Any applicant thal cheeks box#1 mart also fill out the section below sbowing their workcrc'eornpmsation policy information
t Homeowners who rubmit this affidavit indicating they arn doing all work and than hire outside cantractom must rubmit a new affidavit indicating such.
lcantraetors that ebecic this box must attached an additional rbect rbowing the name of the sub-Cantractors and static whctha or not tbosd entities have
crnployees. if the sub-contractors have ernployccr,they must prvvidb their wDTkcm,comp.policy nranbar.
lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Jncirranco Company Name:
Policy#or Self-ins. Lic. #: ExpizationDate:
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 securc coverage as requircd.under Section 25A of MGL c. 152 can lead to the imposition of criminal pcnaltics of a
fine,tip to $1,500.00 and/or one-year imprisonIn ut, 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 statLmerit may be forwarded to'the Office of
JnVC5tjRatiGUS of the DIA for inn rancc coverage verification.
I do hereby certify under the pains-and penalties of perjury that the information provided above is true and correct
' Si stoic:
Date: 7— z 7_ c-> 1
Phone# O� (, Z 2--7
Official use only. Do not write in this area, tb be completed by city or town officlaL
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2.Building Department 3.City/Toytm Clerk 4.Electrical Inspector 5. Plumbing Inspector
6. Other
Phone
Contact Person: #:
Massachusetts Gcneral Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire,
express or implied, oral or written"
An employer is defined as"an iudividual,partnership, association, corporation or other legal entity, or any two or more
of the foregoing_engaged in a joint enterprise, and including the legal represcntativcs of a deceased employer, or the
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 shaU not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6) also states that"every state or Iocal licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construpt buildings in the commonwealth for any
applicant who has not produced-acceptable evidence of compliance with the insurance coverage required."
AdditionaDY,MGL ohapter 152, §25C(7) states 'Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for,the performance of public work until acceptable cvidcacc of compliance aZth the insruauce
requirements of this chapter have been presented to the contracting authority.'
Applicants
please fill out the workers' compensation affidavit completely,by chccking the boxes that apply to your situation and, if
accessary, supply,sub-cuatractor(s)name(s), addrrss(cs) and phone number(s) along with their cerfificatz(s)of
bsurance. Limited Liab>7ity Companies'(LLC) or Limited Liability Partnerships(LLP)with no-employees other than the
mambers or pa.rtncirs, are not required to carry workers' compensation insurance. If an L.LC or LLP does have
:mployees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
ALcci&aft for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should
)e returned to the city or town that the application for the prra it or license is being requested,not tho Department of
n&vstri al Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
:ompcnsation policy,please call the Department at the number listed below. Self-insured companies should enter their
;clf-banU-anGo license number on the appropriate line.
:ity or Towp Officials
'lease be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
,f thr affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant
'lease be sure to all in the permit(license number which will be used as a reference number. In•addition, an applicant
Rant must submit multiple permit/license applications in any given year,need only submit cup affidavit indicating current
olicy information(if necessary) and under"Job Site Address" the applicant should write"all locations in - (city or
f )wn)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
pplicant as proof that a valid affidavit is on 51e for fire permits or licenses. A new affidavit must be 51lcd out each
ear.Where a home owner or citizen is obtainer a license or permit not related fo any business or con=cr6al venture
_c. a dog license or permit to burn lcavcs etc.) said perso. is NOT required to complete this affidavit
he Office of Investigations would]ilm to thank you in advance for your cooperation and should you have any questions,
(case do not hesitate to give us a call
ie Department's address, tcicphone•and fax number.
The;Cammonwealth of Massachusetts
Dq)artmDnt of IDAustrial A ocidents
Office of Investigatians
600 washington street
Boston, MA 02111
TeI• # 617-727-49-00 ext 4.06 ar 1-877-1\-- ASSAFE
Fax# 617-727-.7749
:d 11-22-06
www.mas,3.gov/dia
i
�oFm�r Town of Barnstable
. do
Regulatory Services
v Ate$ Thomas F. Geiler, Director.
Building Division
Tom Perry, Build ing.Commissionet
200 Main Street, Hyannis, MA 02601
www_town.barnstable_ma.us
Office: 508-862-403 8 Fax: 508-790-623 0
Property Owner Must
Complete and Sign This'Section
If Using A Builder
as Owner of the subject property
hereby authorize �T�� G� - �no C Gi9 � to act on my behalf,
in all matters relative to work authorized by this building permit application for.
(Address of Job)
-7121 OB
Siwtare of Owner Date
PA;t Name
If Property Owner is applying for permit please complete the Homeowners License
Exemption Form on th'e reverse side.
Town of ]Barnstable
Regulatory Services
Thomas F. Geiler,Director
sAtzNSTwsr
M"— Building Division
Tom Perry,Building Conunissioner
200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us
Tice: 508-862-4038 Fax: 568-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE_
JOB LOCATION:
number Street village
"HOMEOWNER": work phone#
name home phone# -.
CURRENT MAILING ADDRESS-
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellin.jzs of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s) who owns a parcel of land on'which he/she resides or intends to reside, on which there is, or is intended to-
be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a fivo-year period shall not be considered a homeowner. Such
"homeowner" shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be
responsible for all such work performed under the building permit. (Section 109.1.1)
The undersigned"homeowner" assumes responsibility for compliance with the State Building Code and other
applicable codes, bylaws,rules and regulations.
Th'e undersigned "homeowner"certifies that he/she understands the-Town of Barnstable Building Department
irements and that be/sbe will comply with'said procedures and
m;n;mum inspection procedures and requ
requirements.
Signature of Homeowner
Approval of Building Official
Note: •Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
;torte Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
ervisors);provided that if the homeowner engages a person(s)for hire to do such
f this section (Section 109.1.1-Licensing of construction Sup
Mork,that such Homeowner shall act as supervisor."
use this exemption aim unaware that they arc assuming the responsibilities of a supa-vi
Many homeowners whosor(sec Appendix Q,
u)cs&Regulations for Licensing Construction Supervisors,Scction 2.15) This lack of awareness often results in serious problems,particularly
hcn the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would With a licensed
u re pervisor. The homeowner acting as Supervisor is ultimately responsible. ommunities require,as part of the permit application,
To ensure that the homeowner is fully awa of his/her responsibilities,many c
at the homeowner certify that hrJshc understands the i ersponsibilitics of a Supervisor. On the last page of this issue is a form currently used by
Ycral towns. You may care t amend and adopt such a form/certification for use in your community.
RAMSBEAM V2 . 0 - Gravity Beam Design
I Licensed to: Dan Braman, P.E.
Jo15: 178 Captain Samadrus Road, Steel Code: AISC 9th Ed.
SPAN INFORMATION:
Beam Size (User Selected) = W8X15 Fy = 36. 0 ksi
Total Beam Length (ft) = 15. 00
Top Flange Braced By Decking
LOADS: Self Weight = 0 . 015 k/ft
Line Loads (k/ft) :
Distl Dist2 DL1 DL2 Pre DL1 Pre DL2 LL1 LL2
0. 00 15. 00 0. 165 0 . 165 0 . 000 0 . 000 0 . 440 0 . 440
SHEAR: Max V (kips) = 4 . 65 fv (ksi) = 2 . 34 Fv = 14 . 40
MOMENTS:
Span Cond Moment @ Lb Cb Tension Flange Comp Flange
kip-ft ft ft fb Fb fb Fb
Center Max + 17 . 4 7 . 5 0. 0 1 . 00 17 . 74 24 . 00 17 . 74 24 . 00
Controlling 17 . 4 7 . 5 0 . 0 1 . 00 17 . 74 24 . 00 --- ---
REACTIONS (kips) : Left Right
DL reaction 1. 35 1. 35
Max + LL reaction 3. 30 3 . 30
Max + total reaction 4 . 65 4 . 65
DEFLECTIONS:
Dead load (in) at 7 . 50 ft = -0 . 147 L/D = 1221
Live load (in) at 7 . 50 ft = -0 . 360 L/D = 500
Total load (in) at 7 . 50 ft = -0 . 507 L/D = 355
I
j Page 1 of 1
I Mckechnie, Robert
From: Allen, Jennifer(DPS) [Jennifer.Allen@state.ma.us]
Sent: Friday, August 08, 2008 2:22 PM
To: Mckechnie, Robert
Subject: HIC LIC
HOWARD WOOLLARD
HIC 106615 EXPIRE 7/24/2010
8/8/2008
YOUR L,0030
)-'OUR FAX NO.
NO. OTHER FAQ S I i"I 1 LE START T i IIE- USAGE MP blof.,IE GE'S, RESULT
01 7035756997 May. 27 --1!:02AM 0,1 0 1 RCI,I 0 OK,
02 flay. 213 10:57AM 0 2 314 cl OK
03 <FAX # NOT AVA 1 L. > flay. 29 02:07PM 03'09 RCU a OK
04 Rigi-.,tFax N1-2 May. *30 11:50AP 1 02?Sc:
R.,--V 03 CK
05 50e47779SO Jun. 02 09:47QII 01'0.2' SND 01 OK
06 <FAX # NOT AUA IL. -> T ci I
.)Un. 03 0 '37 Fill W-0'45 F,`C�-! 0 1<
07 <FAX # NOT AVAIL. > Jun. CIS 07:29PIll 00'56 R'-I..,' 01,1
03 <FAX tf NOT AVA I L. > Jun. 11 (:J t3:-3 9A M 00'41 RCI,: 01 OK
09 15082,326075 Jun. 122 01:57PH 0*-7'09 PC.; 0;4 OK
10 150377531.84 JU1,11 12 02:07PM 02'55 (St-!D 0111 oil
11 NOT AQAIL. '> Jun. 23 01:2"Pri 47 in i OKI
12 5083622667 Jun. 26 08: 00'4i R.ri) (3 1 ok.,
13 16.106319040 ju 1. 06 08*59AM 130,55 SI--ID C3 I OK
14 16102762023 Ju 1, 08 03:59AII 01.'351 S-411D 01 Ok
15 508 4:30 9979 Jul. 09 03:33PMI O'J'29 F,'--'-V 03 Ov
16 <FAX ti NOT AVAIL. > Ju 1. 09 03-49FII 00 57 k.CtJ 01 011\1
I7
1 <FAX 9 NOT AVA I L. . Ju 1. 10 W:26PPI C.10 44 R00 01 311,
18 15039951674 Ju 1, 161 12:20PI1 00' 13 00 PRESSED THE STOP KEY
19 V-5*0889516 74 Ju 1. 10 12-22PH 03'46 IS,i I I D 0_: 0K.
20 <FAX # NOT AVAIL. > Ju 1. 10 121 40P!'I 00 ,46 Rc , 01 OK
21 <FAX # NOT AUA I L. Jul ul. 11 10:41AM 19 12 RI-V 02 ok
22 508 430 9979 Ju 1. 15 12:-19P[1 03'45 RCQ 10 OK
23 <FAX tl 140T Ali A I L. > Jul. 21 08:46AM 00'4e RCQ 01 01\1
24 2032276992 Jul. 21. C'123:"I'AM 03'00 PC,,, El 5 OK
-,a, ')>,' # rar A001L. > 22 1' : 1-AM CIO'42 PCQ of OK
— <FF jLI 1. a 3. 0
26 5083622667 jut. 24 10:400,"1 00'42 RCU 01 OK
2-11 V -3uI. 2,1 11:20AM 00' 0 Ra 01. O K
=e <FAX # NOT AVA I L.. > Jul. 31 09:34AII 00'47 RCU 01 OK
29 Me"N # NOT AVAIL.. > Aug. 06 OLE):I 51AM 01'09 Rrij 01 OK
30 IG171-:2271754 Aug. 02 09:03RII 0!'23 D OK'
FOR FAX ADVANTAGE ASSISTANCE, PLEASE CALL 1-800--I-IELP-FAX(435-7329).
INSTRUCTIONS FOR RENEWAL APPLICATION
ITEM
1. Name:The name must be the name in which you door plan to do business.It cannot be a different name than used for previous registration.
5. Applicant type:If applicant is not a corporation and at least the surname of the principal or one of the partners is not included in the company name(dba
name),a copy of the"fictitious name"certificate filed with the city of town clerk must be included with the application.
6. Applicant partnerships and corporations must show a Federal ID number.Applicant individuals should show a Federal ID number if they have
employees in addition to the owner.
7. Number of employees:For the purposes of this application and 780CMR R6,the number of employees shall include all construction related employees
who worked 20 or more hours on the payroll in the weekly pay period prior to the filing of this renewal form.
9. Responsible individual:If the name in Question 1 is other than an individual,(i.e.,a corporation,partnership,etc.)the name of the individual person
responsible for the home improvement contracting work of the entity must be entered here.If the person so named holds a construction supervisor license
and owns 10%or more of the applicant entity,the applicant entity is exempt form the registration fee.Enter license and ownership data in Question 11 and
12 and check"Yes"in Question 13.
12. Corporations or partnerships must include official document which lists the required information,such as pertinent sections of the Articles of
Incorporation,current Annual Report,registration as a foreign corporation as filed with the MA.Secretary of State,or a copy of the current partnership
agreement in lieu of listing the required information on names of partners,trustees,officers,directors and major owners.Organizations other than
corporations must submit copies of any business certificates filed in cities or towns pursuant to MGL Chapter 110,Section 5.(Also known as the DBA or
"fictitious name"law).
13. If applicant or responsible individual is a licensed construction supervisor under MGL C.143,S.94(i)or a registered motor vehicle repair shop operator
and is claiming exemption form the renewal fee,check yes on Question 11 and include a copy of the current license/registration certificate with this
application.(See instructions for-Question 9 above)
14. Enclose a certified check or money order for the registration fee(if the applicant is not exempt)and a separate certified check or money
order for the Guaranty Fund(if necessary,see below).Make checks and money orders payable to the Commonwealth of Massachusetts.
Mail completed application form,required documentation and certified check(s)or money order(s)to:
BBRS-Home Improvement Program
One Ashburton Place,Room 1301
Boston,MA 02108
tRt� Applications are not processed on a walk-in basis. Please allow up to 30 days for processing. •••• .
Registration Fee: $100(Renewable every two years)
Note#1 Individual Licensed Construction Supervisors in good standing under Chapter 143,Section 94,who register as an individual or as indicated in instructions to
.Question 9 above and individual motor repair shops registered in accordance with Chapter 100A,Section 2,are exempt from the registration fee only
Guaranty Fund Contributions: (see instructions below for computation of contribution for renewals)
Zero to three employees ................................... $100.00.
4 to 10 employees ............................................... $200.00
11 to 30 employees ............................................. $300.00
More than 30 employees ................................... $500.00
Note#2 If the number of employees has increased so that the fine has gone into another of the categories listed above,you must submit the additional amount of the
contribution. Examples: (1)Your firm has increased the number of construction related employees from 2 to 5.You must now make an additional contribution of$100. (2)
Your firm has increased the number of construction related employees from 3 employees to 11 employees.You must submit$200 to the Guaranty Fund.(3)Your firm has
decreased the number of construction related employees from 5 to 2 employees.You do not need to submit any money.This office will keep your employees listed as 5.If you
increase the number or employees in the future to the four to ten category,you will not have to submit an additional payment.
Rev.4-08
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A
Howard W. Woollard
8-8-08
To Whom It May Concern,
Enclosed please find my renewal application as the one I mailed appears
to be lost. If you find this all to be correct,please respond by return fax
that this is acceptable and I will await the hard copy in the mail.
Thank you for your help in this matter.
Howard W.Woollard
Fax# 508-362-2300 Cell# 508-221-7101
P.O. Box 263
Bamstable, MA 02630
(508) 362-2300
r THE COMMONWEALTH OF MASSACHUSETTS present Registration No: Ode / S
Board of Building Regulations and Standards
Home Improvement Contractor Registration Program
Effective Date:
One Ashburton Place,Room 1301
Boston,MA 02108
Expiration Date:
Application for Renewal of Registration as a Home Improvement
Contractor or Subcontractor•MGL Chapter 142A,780 CMR R6 Date Entered:
(PLEASE READ BOTH SIDES CAREFULLY)
1. BUSINESS / t'�,NAME: W 440 CO - C— 0e>
Print the name in which the applicant is conducting business (SEE BACK OF FORM)
2. Mailing Address: ��y� Z ( ) -
3. Cit
y: ����Yf�� « State: �1f— Zip: p 2-6 o Area Code Telephone Number
4. Street Address(if different): L_"S,
(Print street and Number,a P.O.Box is not acceptable for address)City State Zip
5. Applicant type: 'Individual _DBA _Partnership Trust _Private Corporation Public Corporation
_Limited Liability Partnership _Limited Liability Corporation
Please Check One (See instructions on back regarding enclosing a city or town registration under DBA or"0dftious name"law-MGL c 110,§5 8 8)
�
� (see back) 7. Number of Employees d
(See back of Form)
8. Have you registered previously under this law?
If so,under what? Registration No:
9. Individual responsible for Home Improvement Contracts:
(See back of form) Last First MI
10. Title of individual responsible for Home Improvement Contracts:
11. Does the applicant or responsible individual hold any other construction related state,city,town licenses or registrations? Yes No
Type of License or registration Issued By License or registration# Expiration Date Name of License Holder
/5--r 3 /O ?o y � '�� W
12. List all partners,trustees,officers,directors and major owners(10%or greater of ownership)of an applicant partnership or corporation below. Use
additional paper if necessary. See instructions below Check here if you wish to receive an application for additional ID cards for key persons.
Last First Ml Title In Applicant Business %Owner Address
13. Is the applicant claiming exemption from the registration fee?(See the instructions on the back) ---Ye—s _No
14. Registration fee enclosed:$ (see note#1,on back) Guaranty Fund fee enclosed:$ (see note#2,on back)
If necessary,include two separate certified checks or money orders-one marked"Registration Fee";one marked"Guaranty Fund". See instructions
on back for amount of fees.Make all certified checks or money orders payable to"Commonwealth of Massachusetts". NO PERSONAL OR
BUSINESS CHECKS WILL BE ACCEPTED UNLESS THEY ARE CERTIFIED.
Pursuant to Massachusetts General Laws Chapter 62C§49A,1 certify under the penalties of perjury that I,to my best knowledge and belief
have fill d H state tax returns and paid all state taxes required under law.
S ature of applicant or applicant's representative Title held with applicant Date
A false answer to any question in this application constitutes grounds for suspension or revocation of the applicant's registration.
Rev.4-08
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Board of Building Regulatio s and Standards
Construction Supervisor License
License: CS 15834
EXpiration:'10/30/2009 Try 8333
Resfristion: do
HOWARD W WOOLLARD
PO BOX 263/3219 MAW ST
BARNSTABLE,MA 02630 Commissioner
Board of Building Regulations and.Standards
.4.Ol41E.IMPROVEMENT CONTRACTOR
'Reg-stratiun: 106615..
Expiration: 7[24/2008_
--:':Type:_Individual
HO WARD W W:)OLLARD
r?bvi�rd.411a'i "d -
2.3r-Ci N?E4%STREET.._ t��1�, L
..:: . ._......r,,..,;,-.,,�.._; 207 cpulyel;dryitias'trator
HOME IMPROVEMENT CONTRACTOR
Registration: 106615
Expiration: 72412010 Trf1 0
Individual
HOWARD W.WOOLi}1RD
Howard Woollard
236 CENTER STREET :_'Y Administrator
YARMOUTHPORT,MA 02`675 `
Town of Barnstable
FINE
Regulatory Services
BAMSMIM Thomas F.Geller,Director
9� MASS.
, ,ei' Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
PERNHT# S I rI y FEE: $
SHED REGISTRATION
120 square feet or less
GAlO/AI ti VWA ID aQ S AAA ()2b 31
Location of shed(address) Village
A Arm R,00 (sop) 9(2 F - y99 7
Property owner's name Telephone number
/0 Y 12 43o"— O�Z
Size of Shed Map/Parcel#
40 3�0 r-
Signs Date
Hyannis Main Street Waterfront Historic District? KO
Old King's Highway Historic District-Commission jurisdiction?
Conservation Commission(signature is required) Nn _J.
PLEASE NOTE: IF YOU ARE WITS1 THE JURISDICTION OF ANY OF THE ABOVE
COMNIISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
THIS FORM MUST BE ACCOMPANIED BY A
PLOT PLAN .
MARA A A
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MAP 038 � AA
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`�,�•�'�>.e TOWN OF BARNSTABLE permit No. __`6516
- —
` Building Inspector
su»r.m i Cash ------------__---• -•_
may NAA
OCCUPANCY PERMIT Bond
Issued to Janx--s C. Bar P-r Address
4n 77 1'70 Dn-%.a OrN+.1.i 4-
Wiring Inspector L/� �/; L j v Inspection'date,G/�r�
Plumbing Inspector, -1.x.�, w�J Inspection date
Gas.Inspector ,�i l� Inspection date
-,Engineering Department `" /J,9w1 5V/51v�,,.'/.,,,e�x/-,/- Inspection date A-) A
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.
................
la.
Building Inspector
FROM
TOWN OF BARNSTABLE
'Mr. Francis hTQ- 7—*l ,wm'P - BUILDING DEPARTMENT
miss•r+.ao mvtrMgws yt�v.•S'v't�wo
Tam
Clerk 367 MAIN STREET HYANNIS, MA OM
.•VaN•:P+R«.iMo Phom "n&112Q
L 'A
SUBJECT:
FOLD HERE r
DATE
October 19, 1984 . �.�.�.. .a...M E S S A G Ew
Work has been leted der'-Permit #26516 jggTt C. Bar r,.
«eara>•�#cs•sss..e. �N-.twsa.n'+�-•,..,a••=.
MtsssQts .
Please release Bc nd.
'Q'Y`AW'Ni+[rti+..i1'�4•M1T.Y�T!^I'�a1B R.Pp Mlri.�'aY$'IISN?PN N�n'K'!C
• r r ^ 1
SIGNED /
+, cd LI
.. DATE - • j/' y � �./ /�
REPLY
SIGNED
.. .ram ..
I N87-RM1 • • - • RECIPIENTS 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.
I
• i
IT
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o.�.�sE'Ts syow�✓s�,�v�� .voT a� A 4/cA,417
/y"o i�4 3f- V7 Y13
Assessor's map and lot number ............................................ T
Q�c%THE
44 7'1 SEP il IC SYSTERh
off'6
S w 4- INSTALLED IN CO
e � age Pe'r'mit number ........................ .... ..................
WITNTITLE TkATINST&BLE,
C
House number. ............... ......1178..... L6..................... ENVIRONMENTAL 39--
TOWN REGULATI
TOWN OF BARNSTABLE
BVILDI G , INSPECTOR
-44
APPLICATION FOR PERMIT TO ..... . ...........................................
TYPE OF CONSTRUCTION ................... .... .. ........................................................
........ ....A.....w V.../.0................19.
.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ... ......... ................................................
ProposedUse .................. audoc. �1.........................................................................................................................
Zoning District ........................................................................Fire District ..............................&07Z//7-
................................................
Name of Owner ....Address v
Nameof Builder je%5..... Address ....................................................................................
Nameof Architect ..................................................................Address .....................................................................................
Numberof Rooms ................1!!!.�.............................................Foundation ......cc, ..........................................
Exierior ......... .......................................................Roofing .................................................................
Floors ......... . . ..................................................Plumbing
.........................................................Interior ..... )121W441,
.............
Heating ........0/ .........;.........................................Plumbing ............... .................. ...........
Fireplace ........... ..........................................................Approximate. Cost ......... .............. .................. .............1:....
Definitive Plan Approved by Planning Board ----------------------------- Area
Diagram of Lot and Building with Dimensions Fee ...... ........;Lj..........
Z7
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 . .. . .... .... .. ........ .................................
Construction Supervisor's License V..(q
P,ARGER, JAMES C.
26516
No .... ...... Permit for ...kL��99�y...............
.........Single Family Dwelli]�(j......................
11...........................................
Locot'ooin ..Lot..2.7........1.7.8-Capt....Sa.....madrus.............-Rd.
C
................... otuit............................................................
Owner ....`.James .............................
... ..... .... ..
Type of Construction ......)FK4M. ........................
................................................................................
Plot ............................ Lot ................................
Permit Granted .........May...3.1...................1984
L
Date of Inspection
Date Completed ......A07eP7.CL............19
qz
Assessor's map and lot number ......... ......... .........
E
Sewa•e�erm t number /L...7 c,/.......(................................... b�Q�pUTH .rO�y� I,
' .........................•� B STODLE •
f AHH •
A 9NA
House number .................::.....�................ ... G� 039
e �
o uar a�
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO Z/V . ..................
TYPE OF CONSTRUCTION. ......................... ............................. ................................................
h �... 1......{....�`. .................19.f�.�
�..
�I -
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ... �.............................�/..........�:!!;�f�F?.,... �....v�...........:.'..........nz�.�................................................
Proposed Use ............
...... 1.. . .��c.>.G.............................................................................................I.........................
O /7
Zoning District .................�.................................................Fire District ..... .. ........................
Name of Owner ....!-�!4. �5....(,..: r� ��. .....Address
Name of Builder .5,,�f} /e,.5.... .....! �1 1� 2......Address ......................................
i
Nameof Architect ..................................................................Address .....................................................................
Number of Rooms ..............�..............................................Foundation .....�iil�;/J�,��'................................
Exterior ......... ..................................................Roofing ....A'154 '1......................................................................
Floors ( / Interiors ...:.........:.....
.;,,..,...��. ................................... ��. ;. ........ ..............................
Heating .... .L1e� ..................................... . ..................Plumbing ............. .�� .i d !CJ...... .... .......................
a
Fireplace Approximate Cost �.�
............. ......................................................... r.....Q..........
'',Definitive Plan Approved by Planning Board ________________________________19________. Area ........................
` Diagram of Lot and Building with Dimensions Fee .. j
...........: .............
J 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 ,.,f` � ;..—��,,,, � ............................
Construction Supervisor's License %..® 3. ..... '..
' I
BAICER, JAMS C. A=38-47
No .26116.... Permit for ...11-2..Story...............
........Sj
-Xlgle-.FGU11UY..Welling......................
Location ....1.,Qt-.2.7......1.7.9....capt.,..s -Rd
.................cot.uit.................................................
Owner ....James C. Barger
.............................................................
Type of Construction ..FKMM.............................
................................................................................
Plot ............................ Lot ................................
Permit Granted .....May..31.f....................19 84
Date of Inspection ....................................19
Date Completed ......................................19