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0249 COTUIT BAY DRIVE
o��� ��'� �r aa�s . /'ec-ros IJ C 01ft^c rtEW- 1 �!t sc .Z"s su�s- Ran 10 cv�Lit•����-tJ �" Su�exz oPEru t�iu� 6/E-1�t R�C�v�ttutr�• t C'i9GGt—�J I^/tb f{ocCSE — /Vo AVS& e �NFQnnc� Cyr IgRG C#rv�-- &sir oxi �fz ��m� �' z� • o s act u�u Ar �r 1r N 6f��T,y .�i � �n � �u"V- f -C6mmonwealth of Massachusetts Sheet Metal Permit Map Parcel _ Date: Permit# Estimated Job Cost: $ Z d v Permit Fee;:$ Plans Submitted: YES NO Plans Reviewed: YES NO Business License# �D / Applicant License# m Business Information: L Property Owner/,Job.,Location.IInformation: Name: I`-. Name: 01 Cracker Street: P/` 2&4l Street: City/Town: l� City/Town: C� Telephone: S`i� / ` Telephone: e��� L! 7011 L� Photo I.D.required/Copy of Photo.I.D. attached.: YES NO staff Initial i Xtq unrestricted.license J-2/M.-2-restricted.to dwelliags.3-storie8 or less and commercial up to 10',000 sq. ft./.2-stories or less Residential:'l-2 family Multi-family Condo/Townhouses. . Other. Commercial: Office Retail Industrial 'Educational Fire Dept. Approval Institutional_ Other Square Footage:'under 10,000.sq..ft over 10,000 sq. ft. Number of Stories: Sheet metal work.'to be completed: New Work: V--,, Renovation: HVAC Metal Watershed Roofing. Kitchen Exhaust System ` Metal Chimney/vents Air Balancing I Provide detailed description.of work to be done: l� A//f 0, 11 ew UH S co v �� i .INSURANCE COVERAGE: I have a current liabilitv.insurance policy or its.equivalent which meets-the requirements of M.G:L.Ch.112 Yes ., No ❑ If you have checked XQ,11ndicite the type of coverage.-by checking the appropriate box,below: i A (lability Insurance policy ❑ Other type of indemnity ❑ Bond ❑ I OWNER'S INSURANCE WAIVERA am:aware that the licensee does.not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my:signature onthis•permli application-.waives this requirement. Check One Only Owner. ❑ Agent ❑ Signature of Owner or.Owner's Agent I ' By checking this.bo I herebycertify that all of the details and Information l have submitted(or entered)regarding this application are true.and accurate to the best o my knowledge and.thafail sheet metal work acid Installations.performed under the permit issued for this.application will be In compliance with all pertinent provisloh of the Massachusetts Building Code and Chapter 112 of the General Laws.. e / Duct inspection required prior to insulatiori installation:YES NO- Pro gjress.Inspections Date Comments Final Inspection Date Comments Type of ense: 3y aster Fide ❑Master-Restricted 'Ity/Town OJoumeyperson. 'Signature of Li nsee 'ecmit.# D❑Joumeyperson-Restricted L'I ZnseNumber:. =ee$ Check at wvvw.mass.govldal nspector Signature of Permit Approval' 2Tre Ga mmonyveakh afMassachuseM Dep=h ent of huhvstrigJ AcciJmYs ' - - t`3�zce o��ixttigotio�rs' 600 Wkshington&*-eet Boston,M1 02 rvn'ty.massgadiea Warleers' Comperlsafiunlnsumuce davit:Buildeirs contra:ctorslElechician&Mumbers Applicant Laftzrmatim Please Print, l�I amf�( f onllnrtividi4- Legibly� . Aaaress- at3,/st't,/z�P: Cc,hC S-t eZS'3 Areyg�t an employer?Check th appropriatebu= Type of project r rLt7,= C/�J,, '�_ I sin a. contractor aad I { L I am a employer vritbt ❑ al 6_ ❑N n,r,�t„r�t; employees(full andlorpart-ime�* havehtlie©�s,.�-f,�r,t•r�-tots. oa 2_❑ I am a sole proprietor or partner- listed on the attached sh$et:' 7_ deding shift anti hate na employees These employees amb-c d h2c ors have g_ ❑Demolition wo6 ng forme is any capacityi comp-ices and have workers' 9 ❑Building addition [go wot3rets' comp_isivrrar,re comp_,,,�,,.�,�I �u� 5-❑ We area corporation and its 10-0 Electrical repairs or additions �.❑ I am a homea-iAmer doing all wardc officers have eaerrised(heir Ii�_❑Plumbing repairs or additions . rnys>✓I€ [No workers'�P right ofes mptiangerlS+fCI 1�❑pnafrepaas. immnzncerequire&]I. r 152,§1(4� and v,ahime,no employees-[Nawadrers' 1-3-El t]ther camp-i asarmce required-I "flay mFh tit checks box#1 must also fill out the sectionbeIow d=wing 6ieitwo&ee coape�hoa pp�F mfi to $omPdWnEt5,7rhD submit this ate i cs�ag they aLe doing ai'I Tra¢IC a'ad then h]1E tie coulracrors nmsi 5,764'F7L a tFPAi 9�d3i7I mdvcHtnng sncT,- ' tCantncmrs first check this box mmrt stt-ched sa additinosI sheet sh whq the nsme of the s0b-omift3chrs andstab-whether-cantthose Mdfies have tmipivyees. Ifthe soh-contce sIh3ve employees,they must provide their wurkess'comp.polity number I am arz empiryer thatispralridiag ivorl ers'congrrsalb.n anrrtrarcce for my employee BeTvty is Ste po i:Y arcd j.ob sits iaj°ormmiia� ' Insurance CompanyName: ` l / ✓ n 5y r Ci h� P G Policy of self iris Lim LVO/ 7/ l/Z' E pirationDate: Job Sif-Address: �G� !� Citp'StatelZip: L. z � A-Rath a copry of the workers'compensation policy declaration page(showing the policy number.artil expiration date). Failure to secme•coverage as requirednucla Section.SA o€MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or o=-yearimprivamment as well as civil penalties io.ihe fiosm of a STOP WORD ORDER-and a fine ofup to$250-00 a day again e violafir_ $e advised that a copy of this stat�n�t maybe forwarded to the Office of iuve*ffations of iffic DIA a coverage vmificatiozL I44 hereby term fp i ns itd penalties ofperjurp thatfhe irefar+ritriiQn praladad move" Inca correct Signature: Date: / Phone 9: ©ffuzal use arty. Da not write in this area,to be campTeted by Gity or room offreiaL City or Towa: PermitMic e rLse# 1ssuin Authority(circle one): 1.Baard of Health 2.$uffdiag Department I Cit_WI aura Clerk 4.Electrical Ynsper-tor S.Plumbing T,r,;pertor 6.Other Contact Person: Phone#: 6 i V Information an.d Instructions Massachusetts General 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 individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives 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 shall 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 shaII withhold the issuance or 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, MGL chapter 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 evidence of compliance with the insurance requirements of this chapter have been presented to the contracting anthority:' Applicants Please fill our the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their certificates)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(L LP)with no employees other than the' members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Depatment 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 Departrient of Industrial Accidents_ Should you have any questions regarding the law or if you are required to obtain a-?rorkers' compensation policy,please call the Department at the number listed below. Self insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The 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 Ell in the perni t/licease number which wr71 be used as a reference number. In addition,an applicant that must submit multiple permit/license applita]ions in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as.proof.that.a valid affidavit is on file for future permits or licenses_ Anew affidavit must be filled.out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial ventare (i_e,a dog license or permit to bum leaves etc.)said person is NOT required to complete this afdda-,it The Office.of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Departraent's address,telephone and fax number: Tha COrrrmarLwealth of Massachusctis Deparllneat of 1ndustrjal Accjde nt office ce of luve'stigatFaus 600 Washington Strcel $ostozi=IAA G2111 Tel.9 61 7 727-49-QU Qxt 4Q6 or 1-&�MASSAFE Revised 4-24-07 Fix P 617-727-7-149 www.aasRgavfdia PROFESSOVAL s L1C . �.• LICENSE NUMBEq• ! ! I ,w>'�` w�. � EXPIRATION pAT • .z'.k �Yrk' E SERIAL N(JA'jLl g u�e-•-"_-set�sccv�d_sc�_r_���em-•--.. —_ -- '�'+:'•,�%-ro �,%r' O A? Ity i c4 a�mnti�• .r 3M�a e n� {1f4F� •=r�nit � '`,;_ A ��C�.i�tp.Div) r'� �/tit! �/��•�P��lt'�11i'._:gt�,r fir ;,,; r A YYYI CERTIFICATE OF LIABILITY INSURANCEF9/17/D17/201 IDD/Y4 4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. 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. i 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). PRODUCER CONTACT Crystal Isbister C.L. HOLLIS INSURANCE PHONE (508)295-9500 FAX -9B98 A/C Not: (508)295 140 Marion Rd E*MILESS:crystal@insurehollis.com ADD INSURERS AFFORDING COVERAGE NAIC# Wareham MA 02571 INSURER A:TranB ortation Insurance CO 20494 INSURED INSURERB:Contlnental Casual Co (cna) 20443 JAMES DIEDE DRT HEATING & AIR CONDITIONING DBA INSURERC:Twin City Fire Insurance Co 29459 PO BOX 666 INSURER0: INSURER E BUZZARDS BAY MA 02532 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1491501862 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. INSR LTR TYPE OF INSURANCE ADD POLICY NUMBER MMIDDIYYYYY EFF MMIDONYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence S 300,000 A CLAIMS-MADE Fx-]OCCUR 4017719112 /12/2014 /12/2015 MED EXP(Any one person) S 10,000 PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER* PRODUCTS-COMP/OP AGG S 2,000,000 X POLICY PRO- LOC S 7EC F AUTOMOBILE LIABILITY (COMBIINetDSINGLELIMIT E accident) S 11000,000 B X ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED 4016640007 /4/2014 /4/2015 BODILY INJURY(Per accident) S AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE S AUTOS fPer accident Uninsured motorist BI split lima S 100,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE S DEO I I RETENTION$ S C WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y I N DRY LIM ANY PROPRIETORIPARTNEWEXECU "' E.L.EACH ACCIDENT $ 500,000 ❑OFFICERIMEMBER EXCLUDED? N/A (Mandatory In NH) 8WECTK6573 9/13/2014 9/13/2015 E.L.DISEASE-EA EMPLOYEE S 500,000 It yes,describe under DESCRIPTION OF OPERATIONS belov., E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101.Additional Remarks Schedule,If more spaco is required) CERTIFICATE HOLDER CANCELLATION I I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005)01 The ACORD name and logo are registered marks of ACORD Town of Barnstable Regulatory Services Thomas F.Geller,Director BuRding Divigion Tom Ferry,BWM4 C:ommissinner 200 Main Street.Hyannis,MA 0260, wWw.town-barnstable.mans Office; 508-862-4038 Fam 508-790-6230 Property Owner Must Conaplete and Siam This Section If Using A•Builder l'ev�16��1G�t .G•e �411 as Ownet of the sab'ectl pro PAY• hereb7 authorizeQes �'%t"c 'e }� L ���j�' to art on m7 behalf, in an maths relative to work authorized b7 this budding permit ' (16 (Address of job) **Pool fences and alarms ate the responsibility of the applicant. Pools are not-to be filled-before fence is'installed and pools are not to be utilized until�Il final inspections are performed acid accepted. Signature of Owner a of Applicant Print Name Print Name ZIZ/f- Date Q-TORN :owr sorPoois TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map S Parcel 63 a Application #a 01 S ® !S O� Health Division Date Issued qllsdlJ Conservation Division Application Fee ` Planning Dept. Permit Fee',�& 50 Date Definitive,Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Y1 PAe Village+ Owner 16_s e C �-` ��'� �� Jam_ Address ,. G c� 3� L. wQp(^ -Je�(1 � p j3t/?CfIPPJ� aeoy Telephone S-6' — L f Permit Request a wA e-r�&-cr t,< 0-1. i..w .s.S .J oo 6W r,Sf [c F,�k J'C. \A C U\_: rA . Square feet: 1 st floor: existingjproposed 2nd floor: existing, C, proposed Total new FC Zoning District fleg! Flood Plain b B Groundwater Overlay Project Valuation 63 Construction Type �_�s� 3�`"�`z Lot Size - ��G t r�,� Grandfathered: - ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family, Two Family ❑ Multi-Family (# units) Age of Existing Structure I ( Historic House: ❑Yes No On Old King's Highway: ❑Yes No Basement Type: 1--'Full ❑ Crawl ❑.Walkout ❑ Other Basement Finished\Area (sq.ft.)- 6�0 Basement Unfinished Area (sq.ft) T Number of Baths: Full: existing new Half: existing N., riew _ Number of Bedrooms: existing _new47 sad Total Room Count (not including baths): existing _new First Floor Room Count - Heat Type and Fuel: X 'IGas ❑ Oil ❑ Electric ❑ Other -� Central Air: j�Yes ❑ No Fireplaces: Existing New Existing wood/coal st ve: C 'e No Detached garage: ❑existing ❑ new size_Po : 0 existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: existing ❑ new size Z 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 ���� -tt S' i-e t'.4< Telephone Number Address 72 R '`.e ,c P4 Ae R aA License # S' -- a 6_r 9 0 S- < r y i l I r yvt g v o2 �c rj Home Improvement Contractor# 1 , G 3 o Email Worker's Compensation # W C C-S7oo ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE a FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE OWNER DATE OF INSPECTION: JJ � FOUNDATION CO sS g.S )=am6co- > FRAME INSULATION ' FIREPLACE ` ELECTRICAL: ROUGH FINAL � PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT - ASSOCIATION PLAN NO. The Corrmzonwealih ofHassar-husetts Deparbnent oflndush-hdAccidenis Ojjzce of Irrvestigrztzons 600 Washhwon Street .Boston,MA 02111 www.mass govldia Workers' Compensation Insurance AffdaviL BOders/Contractors/Electriciam/Plmm.bers Applicant Information Please Print Legibly Name(Busmcss/organizaii=b ivy): f i - 6 D Pia c I n r3yyl c n n r P Address:3 a Zr' 4 y- t'4-•-l-cG'k 12 v A-a City/StaWZip: 0S c i I le ' o d 4 r Phone#: 50 - 7 3 7 �2 Are you an employer?Check the appropriate bow Type of project(required): 1.0 I am a employer with__ 4- ❑I am a general contractor and I 6 employees(full and/or part time). * have hired the sub-contractors ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. emodeling ship and have no employees These sub-contmctors have g M Demolition working for mein any capacity. employees and have workers' [No workers'comp.iamna � tn comp.insurance 9. ❑Building addition required.] 5. ❑ We are a corporation and its I O.❑Electrical repairs or additions 3.❑ I am a homeowner do' all work officers have exercised their 11. Plumb� ❑ mg repairs or additions I myself [No workers'comp. right of exemption per MGL insurance required-1 t a 152, §1(4),and we have no 12.❑Roof repair; employees. [No workers' 13.❑OfEer comp.insurance required_] *Any applicant that chocks box#1 must also fill ou±thc section below showing their workers'compensation policy iuformzlion- t Mmeowncrs who submit Ibis affidavit indicating they axe doing all work and then hire outside contractors—, submit anew aadavit indicating mch- lConhacta s that cbcck this box must attached an additional sheet showing the ns c of the sab-contrrclnrs and statc whctha or not tbosc Cztities have employees. If the sub-mntraemrs have employees,they must provide their workers'comp.policy nnmber, I am an employer that is providing workers'corrpetsadon insurance for my etnplayeEs. Below is the porxy and job site informadom Insurance Company Name: SS 6[i re�.�� Civ��O e Ff�i-S (h S u r 4v,ir Policy#or Self-ins.Lic. v I Ll Expiration Date: 6 C- /1G /5— Job Site Address: 4 r6oy W;ter City/Stat 14: (1o4b T V,*. Attach a copy of the workers' compensation policy declaration page(showkg the policy number and expiration date). Failure to secure coverage as required.under Section 25A of MGL e• 152 can Iead to the imposition of criminal penalties of a fine up to$1,50.0.00 and/or one-year imprisonment;as well as civil penalties in the form of a STOP WORK ORDER and a rime of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insm-ance coverage ver fication_ I do hereby c under the pains wtd penalfies Ofperjray that the hzfornation provided above is true and correct S Date: G.j� Zo I Phone#- 087cial use only. Do not write in this area,to be completed by city or town ooYciaL City or Town: Perm%License# Issuing Authority e one t Authoc' (circle . --.. ... . .... . ...._.. .... . �.... )�.._.. .._....-- -.. ........ ..._ _. _. -. 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 Moyer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives 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 that three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair wok on such dwelling house or on the grounds or building appurtenant thereto shall 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 construct buildings in the commonwealth for any applicant Who has not produced acceptable evidence of compliance with the insurance,coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract forthe performance ofpublic woik until acceptable evidence of compliancewith the insurancd. requirements of this chapter have been presented to the contracting aurthority" Applicants i Please fill out the worker' compensation affidavit completely,by checicag the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships (LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required_ Be advised that this affidayit 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The 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 perm icense number which will be used as a reference number. In addition, an applicant that must submit multiple permitllicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should writ-"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i-e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Coma cmv,tealth of Massachusetts Department of hidustial Accidents Office of kvestigatiwa.Ei 6�4'(A�ashingtan S`t�t Boston,MA 02111 Tel.9 617'27-49QO ext 406 Q.r 1--977-MASSAFE Fax 9 617-727-7749 Revised 4-24-07 w-m=_goof dia � E rti Town of Barnstable Regulatory Services �xivscwsis. $ Richard V.Scali,Director �A i63¢ �e T 61 & Building Division Tom Perry,Building Commissioner _._. _... . __._._.......... 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder QV)dy'lf/ ,as Owner of the subject property hereby authorize �' �,� J-4- S 3 Z-, .r I to act on my behalf, in all matters relative to work authorized bythis building permit application for. (Address of Job) ''''Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. 4a=qerC)wner ignature of Applicant Print N e Print Name Date Q:FORMS:O WNERPEP MISSIONP00LS Town of Barnstable Regulatory Services �oF crte re Richard V.Scali,Director Building Division +B Tom Perry,Building Commissioner MA.sa 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: i city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings 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 two-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'.bomeownee'assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. _ � it The undersigned"homeownee'certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and 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.State 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 of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,RuIes &ReguIations for Licensing Construction Supervisors,Section 2.1S) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor..The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fuIIy aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS_doc Revised 061313 V/te -omr�na�zcaea�a�V[�lnssa�u�e(,Ca , Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: istration: `170270 Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Expiration::` 1a4t2Q15 Corporation. _=_= Boston,MA 02116 TRIS DEVELOPMENTGORP:r'-~; SCOTT SHIELDS 72 BRIAR PATCH OSTERVILLE,MA 02655 Undersecretary No a d without signature Massachusetts -Department of Public Safety Board of Building Regulations ulations and Standards Construction Supervisor License: CS-065898 SCOTT S SIDELDSr 72 BRIAR PATCH RD OSTERVII.D1 W* 02655 Expiration Commissioner 07/10/2015 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE Associated Employers Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803-0970 (800)876-2765 NCCI NO 40959. POLICY NO. I WCC-500-5007148-2014A PRIOR NO. I WCC-500-5007148-2013A ITEM 1. The Insured: TRI-S Development Corp DBA: Mailing address: 72 Briar Patch Road FEIN:**-***8313 Osterville, MA 02655 Legal Entity Type: Corporation Other workplaces not shown above: 2. The policy period is from 05/01/2014 to 05/01/2015 12:01 a.m.standard time at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers'Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ 500,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 500,006 each employee C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 A D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Code Estimated Per$100 Estimated No. Total Annual Of Annual Remuneration Remuneration Premium INTRA 404881 INTER SEE CLASS CODE SCHEDU E . , •�' GENERAL NOTES: COTUIT :{ I. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL ` BOARD OF HEALTH AND THE DESIGN ENGINEER. 2� r 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS �pV•(E O OF THE STATE ENVIRONMENTAL CODE. TITLE V, AND ANY APPUCA13LE O LOCAL RULES AND REGULATIONS. p 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR Q N 1 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. Q LOCUS 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING + \ FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN j n0 O ENGINEER BEFORE CONSTRUCTION CONTINUES. Q 0 `SAj, 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. O�O� O� 04 �8• LOT 69 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF O 0) G A THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 00 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 9� 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. �0 O,p S.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A CONDITION AGREED UPON BETWEEN OWNER AND 'CONTRACTOR. 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO STARTING WORK. LOCUS MAP \�_// G 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND REMOVED PER TITLE 5. � W•\ EXIST. LEACH REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5. LOCUS INFORMATION _ 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION PLAN REF: 292/26 ' w CEDAR FLOOR -- �% 42 O 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY TITLE REF: 8272/247 EL— _4�0 h AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY PARCEL ID: MAP 56 PAR. 32 13. NO PRIVATE WELLS WITHIN 150 FT. OF PROPOSED LEACHING ZONING: "RF" ^7��� n TO 2�A 14. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPEC. ) FLOOD ZONE: "C' o #249 ^7 In !r� �� 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW COMMUNITY PANEL 25 0001-001 8-D DATED:07/02/92 Mi j ,�D FOR THE USE OF A GARBAGE GRINDER O i %j;%' '' / ; ' y 16. NO WETLANDS WITHIN 150 FT. OF PROPOSED LEACHING SEPTIC SYSTEM EXIST. 1,000G - ;' ;' ; ;' REPAIR PLAN �' ;' i' S1 LOCATED AT: 249 COTUIT BAY DRIVE CION , ; i;% 5�0' z8 COTUIT, MA. i PREPARED FOR k O - '' WILLIAM E. & CAROL A. BEGGS �2 -" , JUNE 17, 2014 �' 5N TH-1 OF WOODED' `L$ ;�vP No. 1140 LOT 70 SCALE: 1"=30• MEYER & SONS INC. AREA=45,306f S.F. LOT 71 LEGEND P.O. BOX 981 ;'' �•�0�1 PROPOSED CONTOUR E. SANDWICH, MA 02537 ® PROPOSED SPOT GRADE PH. (508)360-3311 98 =— EXISTING CONTOUR fox (774)413-9468 + 96.52 EXISTING SPOT GRADE meyerandsonsinc@gmail.com —W— EXISTING WATER SERVICE Town of Barnstable Regulatory Services Richard V.Scali,Interim Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERNIIT# V/ FEE: $ 01 SHED REGISTRATION RESIDENTIAL ONLY01 O 200 square feet or less \; ZZ Location of shed(address) Village w w Cc id\ .fog' • Z Z �• �.5�/ / Property owner's na a Telephone number x/O OS`G - 0 -1 Size of Shed Map/Parcel# Signature Date Hyannis Main Street Waterfront Historic District? /l( o Old King's Highway Historic District Commission jurisdiction? 6' U If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature'is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 4 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,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 . Q-forms-shedreg REV:110413 I i 69 'tK x LOT 70 71 do Al 9 �- 330. 00 COTU IT DAY DRIVE MORTGAGE LOAN INSPECTION ML14350 SAGAMORE SURVEY ASSOCIATES SCALE: 1 IN.= 60 FT. - - � P.O. BOX 28 DATE: NOVEMBER 2016 SAGAMORE BEACH, MA. 02562 ,o��"✓ (508) 888 8667 c T pox: ' y I CERTIFY TO CHARLES GIFFORD AND JULIA GIFFORD �' THAT THE LOCATION OF THE BUILDING SHOWN HEREON CONFORMS Ardo.34314 1 fy TO THE ZONING OF THE TOWN OF BARNSTABLE y� <Ss�o I CERTIFY THAT LOCUS DOES NOT LIE WITHIN THE FLOOD HAZARD - o S�_ ZONE AS DELINIATED ON MAP 0018C COMMUNITY NO. 250001 PLAN REFERENCE: BARNSTABLE REGISTRY OF DEEDS REGISTRY OWNER: BOOK/PAGE: PLAN BOOK 292, PAGE 26 LOT NO.: 70 PLAN BY: GARCIA, HANACK AND RICHARD BUYER: DATED: JANUARY 3, 1975 THIS INSPECTION :NOT MADE FROM AN INSTRUMENT, SURVEY AND IS NOT TO BE USED FOR FENCES, HEDGES OR TO ESTABLISH LOT LINES. '-FOR USE OF:, BANK ONLY. aD1:5—dv a a of Town o 'Barnstable : *Permit#. Expires 6 months from issue die �s Regulatory.Services - . Fee. ��?? -0 + BAELMABLE 1639. Richard V.Scali,.-Director ArED �a Building Division X-PRESS.pE Tom Perry,CBO,Building.Commissioner �Z 200 Main Street,Hyannis,MA 02601 JAN. 1 3. 2015 www.town.bamstable.ma.us TQwN.:®F B Office: 508-862-403 8 A R �89 f623 Q EXPRESS PERMIT APPLICATION ' - RESIDENTLA L ONLY Not VaUd without Red X-Press Imprint Map/parcel Number O 5 Property Address oZ Lk q C-07%-X-\T '� ." dIL� \`�. �. ❑Residential. Value of Work$ c,(i u Minimum fee of$35:00 for work under$6000.00 Owner's Name&Address 38 r-\ AV�,nac 0a75;21 Contractor's Name 9 C a A �h f I .S Telephone Number S e, Ir." 737` oa 2 C o2 Home Improvement Contractor License#(if applicable)_ Ca a-7 C! Email: Construction Supervisor's License#(if applicable)(3 Q 6, �' ',QWorkman's Compensation Insurance Check one: ❑ I am.a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name A -PC-, C a,. P (G,/ •c 5 1 Y\ Vt A;A C L Workman's Comp.Policy# W c S y U 7 '1 `l f 2 c i y ,A,- 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 Replacement Windows/doors/sliders.U-Value ,. 3 j (maximum.35)#of windows` 6 #of doors:_f ❑ 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: QMPFILESTORUMb.ilding, permit torms\02RESS.doc ^ Revised 061313 The Commonwealth of Massachusetts Department of IndustrialAccidents Office of.Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Elei tricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):jet- S i---Aev e i s#"A s vA A ( Z,` P � Address: 6`"i r t u 62 G3 ) Phone jCit /State/ZiP - � - 73 c a Are you an employer?Check the appropriate box: Type of project(required): 1. am a employer with_ 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. .❑New construction- 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. Remodeling These sub-contractors have. ' ship and have no employees. 8. [ Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurancecomp.insurance.1 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a:homeowner doing all work officers have exercised their 'I LEI Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no 13.❑Other 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. t 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: ASS 0 c-'itk a J2 P'C S u ! ABC e (yw� tin ii Policy#or Self-ins.Lic.#:ty L( --.3 v 6- 5002 l`1 8 ` 2 c i 4N Expiration Date: Job Site Address: N cj. c;ru) k . •4 t, D-6 y� City/State/Zip:_Cv-j u r 4- r t n Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year 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. Be advised that a copy of this statement may.be forwarded to the Office of Investigations of the DIA for insurance.coverage verification. I do hereby cer�ffy under the pains and enalties,,ofperjury that the information provided above is true and correct Sigpature:/V J 13 s c-e 11l Date: %+ Phone#: .-l) F Official use only. Do not write in this area,to be completed by city or town official _..... .. -- --.:ri..o...r... _...__..._..._........_....- ...._...__....._._._._.:-._...._...._..._.___..... _ _..-..._...:.. __...-..._._...._._.. .- - _. ....__ Ci 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#: Information .and Instructions Massachusetts General 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 individual,partnership,association,corporation or other legal,entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives 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 -to do maintenance,construction or repair work on such dwelling house dwelling house of another who employs persons .. or on the grounds or building appurtenant thereto shall not because of such employment'be deemed to bean employer." MGL chapter 152- §25C(6)also states that."every state or local licensing agency shall withhold the issuance or 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,MGL chapter 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 evidence of compliance with the insurance requirements of this chapter.have been presented to the contracting authority." Applicants Please fill out. the workers'compensation affidavit completely,by checking the boxes that apply to your situation.and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance..Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees.other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or.LLP does have. employees,a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their self-insurance license number on the appropriate.line. City.or Town Officials Please be sure that the affidavit is complete and printed legibly. The 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 permifiUcense number which will be used as a reference number. In addition,an applicant.. that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"aIII ocations.in (city'or town)."A copy of the affidavit that has been officially stamped or marked by the city.or m r town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or.permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. . The Office of Investigations would hRe to thank you in advance for your cooperation and should you have'any questions, please do not.hesitate to give us a call.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 Tel..#617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 . Revised 4-24-07 www.mass.govfdia t BARMABLE ` MASS $ Town of Barnstable . Regulatory Services Richard Scali,Director Building Division Thomas"Perry,CBO Building Commissioner 200 Main Street, Hyannis,"MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property .hereby authorize r C"3 S Y ..I to act on my behalf, m all matters relative to work authorized by this building permit application for: (Address o Job) ' 3 volt? S: ature of-Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFMES\FORMS\building permit forms\smokecarbondetectors.doc Revised 050412 1'own of Barnstable Regulatory Services otr h Richard V.Scali, Director sr Building"Division R�RxarAATF_ : Tom Perry,Building Commissioner Hams. 200.Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: . JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town ..state zip code'. The current exemption for"homeowners"was extended to include owner-occupied dwellings 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 Persons)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 two-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: . The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and"that he/she will comply with said procedures and requirements. Signature of Homeowner. Approval of Building Off cial Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State"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 of.this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed. persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner:acting as Supervisor is ultimately responsible.,. To ensure that the homeowner is fully aware of his/her responsibilities,many communities"require,. as part.of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several.towns. You may care t amend and adopt such a form/certification for use in your community. http://issgl2/intranet/plopdata/ParcelDetail.aspx?ID=3w �( it L�t bBig —_ ,p Fife--Edit View , Favorites• .Tools' Help Favorites I €P Parcel Lookup - Parcel Detail - Page Safety Tools C�- E l I f I ' Sales HistDate Price ory Sale Sale Owner BooklPage :) 1 12/16/201 4 BEGGS, WILLIAM E JR TR 28574/282 $0 2 42/28/2014 ;BEGGS(WILLIAM E 128008/114 � $0 BEGGS WILLIAM E & j II 3 10/15/1992 CAROL A 8272/247 $1 it 4 19/30/1991 BEGGS, _ 7698/17 $6�30'2 I i CAROL/K'I.LM U RRAY, M I BEGGS, WILLIAM E & 0 ii CAROL :< BUTLER WALTER H 6 12/16/2014 I28574/283 . $310,OQ0 j .'VICTORIA j 7 2/28/2014 BEGGS, WILLIAM E & 28008/117 $10 WILLIAM E JR TRS i j Assessment History �— �Done— — -- ----— _ --- --_ ------------------- ---- — — ---- C��__,_-�Local Intranet--��_� !Start ,p. ( A Main S stem... Appliica�tion E Parcel,Detail y 1 . Y 3 iJ� - Y L ' ' - I.` M Computer M Netwrork Pla... »�— :34 PM 4 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE Associated Employers Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803-0970 (800)876-2765 NCCI NO 40959 POLICY NO. I WCC-500-5007148-2014A PRIOR NO. I WCC-500-5007148-2013A ITEM 1. The Insured: TRI-S Development Corp DBA: Mailing address: 72 Briar Patch Road FEIN:""*8313 Osterville, MA 02655 Legal Entity Type: Corporation Other workplaces not shown above: 2. The policy period is from 05/01/2014 to 05/01/2015 12:01 a.m.standard time at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers'Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ 500,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 500,006 each employee C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 A D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Code Estimated Per$100 Estimated No. Total Annual Of Annual Remuneration Remuneration Premium INTRA 404881 INTER SEE CLASS CODE SCHEDU E ze .anv,no,zurea e o aaac zuae Office of Consumer Affairs&Business Regulation License or registration valid for individul use only - OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egiistration: ;'1j70270 Type: Office of Consumer Affairs and Business Regulation _1 10 Park Plaza-Suite 5170 Expiration:_ -.l-4/,2g,-1& Corporation Boston MA 02116 TRI-S DEVELOPMENT=CQRP:T e✓ _ _ SCOTT SHIELDS 72 BRIAR PATCH ROAD;` OSTERVILLE,MA 02655 Undersecretary Ncrt<add without signature ------------- Massachusetts -Department of Public Safety s, Board of BuildingRegulations and St g Standards ards Construction Supervisor lkl 7. f License: CS-065898 ' a. SCOTT S SHIELD 72 BRIAR PATCH OSTERVHJ MA- C, :e Y �C, Expiration '3 Commissioner 07/10/2015 1 Viea stable Building '�. ._ ....�... .� Town o Barnstable� .k- � � ���.. . ...�.. uaxsree� ; ;Post'This Card So That rt is Visible From.the Street-Approved Plans Must be`Retained on Job and this Card Mush be Kept 6'¢ €" Posted Untilfina) Inspection Has Been Made.- Permit Mld° Where a Certificateof Occc .upancyis Required,such Building shall Not be Occupied until a Final.lrisp' ion has been made: _� .. _ _ n� ____ Permit No. B-18-2342 Applicant Name: WILLIAM A CARTER JR Approvals Date Issued: 05/21/2018 Current Use: Structure Permit Type: Building-Deck Expiration Date: 11/21/2018 Foundation: Location: 249 COTUIT BAY DRIVE,COTUIT Map/Lot. 056-032 Zoning District: RF Sheathing: Owner on Record: GIFFORD,JULIA A&CHARLES C III TRS Contractor Name: ,WILLIAM A CARTER JR Framing: 1 Address: 249 COTUIT BAY DRIVE Contractor License: CS-072350 2 COTUIT, MA 02635 Est. Project Cost: $5,400.00 Chimney: Description: Add 5 feet to existing deck,construct new 10x15 deck on the side of i Permit Fee: $110.00 existing deck. i Insulation: 1 Fee Paid:, $ 110.00 Project Review Req: ENSURE CABLE RAIL DOES NOT ALLOW PASSAGE OFFOUR ,.� Date. , 5/21/2018 Final: INCH SPHERE. _=w Plumbing/Gas Rough Plumbing: - \Building Official t Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afterssuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for'public inspection for the entire duration of the work until the completion of the same. _ /` Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing i -- 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 1t �1 1 m, a i :% I • i L. r ` r C"ll ti w m f�- `Y' I > rn — � .' r t .I I I _ C 71 r a Commonwealth of Massachusetts {•fit Division of Professional Licensure V Board of Building Regulations and Standards Constr, i'�i-O§bptrvisor CS-072356 �9 F I E::pires: 12/0612019 WILLIAM A CARTER JR�� 3 RACCOON LJ �!! % FORESTDALE A 026%e , �0�. Commissioner 4 Commonwealth of Massachusetts 1`"t Division of Professional Licensure V Board of Building Regulations and Standards Constr4ja r bpgrvisor CS-072356 JL�Pires: 12/06/2019 WILLIAM A CARTEOR 3 RACCOON L FORESTDALE KA 026: y �� Commissioner Construction Supervisor ]nn ` Unrestricted_ ` roup which contain less than 35,000 cubic feet(991 cubis of any use c meters) space. Failure to possess a current edition of the MassaState BuildingCode is cause for revocation of thiFor information about this license Call(617)727-3200 or visit wwry,rrtaugov/ Office of Consumer Affairs &Business Regulation-Mass.Gov Page 2 of 2 Click on the registration number to view complaint history. You can also view arbitration and Guaranty Fund history. The list is current as of Monday,April 30, 2018. Search Results RegistrantName RESPONSIBLE REGISTRATION' ADDRESS ! EXPIRATION STATU I INDIVIDUAL NUMBER _L_ i DATE _ 'William m Carter --- !CARTER,WILLIAM— 143264! I3 Raccoon Lane 104/29/2020�^ Current l ;Forestdale,MA 02644 Site Policies Contact Us © 2012 Commonwealth of Massachusetts. Mass.Gov® is a registered service mark of the Commonwealth of Massachusetts. https:Hservices.oca.state.ma.us/hic/licenseelist.aspx 5/1/2018 _ .. . _ ... ...... . ... .. .. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Binders/Contractors/Electricians/PIumbers Applicant Information Please Print Legibly Name(Business/0rganization/IndMdvaI)• IA li I 11 Address: �3 Rmccoci! 6^- City/State/Zip: rt•e 5- dJ -Z (/� Phone#: "77l/'99 tl—69 Q Ci Are you an employer?Check the appropriate box Type of projeef(required): 1.❑ I am a employee with 4. 0 I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet 7. 0 Remodeling hip and have no employees These sub-contractors have g. Demolition working for mein any capacity. employees and have workers' 9. Building addition [No workers'comp.insurance comp.insurance# required..] 5. 0 We are a corporation and its 10.0 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 per MGL 12.0 goof repair t c. 152, §1(4),and we have no insurance 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. 1 t 14omeowners 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 sbect showing the name of the sub-coatractors and state vYhether or not those entities have .employ= 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 pokey and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/state/gip: 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 e. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year fmprisomneni as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerliijy under the pains and penalties of perjury that the information provided abov /is true and correct. Si e: Date: Phone#: 77 '99 Y 2 E only. Do not write in this area,to be completed by city or town official n: PermitXicense# hority(circle one): Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector. rson: Phone#' 5/1/2018 AsBuilt http://issgl2/intranet/propdata/prebuilt.aspx?mappar=056032&seq=3 2/2 :.�. .�................................�� _ Application Number........... . . . _ MA88. Permit Fee........:..:...........................Over Fce.................:...... TotalFee Paid.................................................................... . TOWN OF BARNSTABLE Permit Approval 1Y.. .....................oa.. u...l...... BUILDING PERART Map.......05: . ...........parceL.....03. ........................ APPLICATION eMATL, — Section I — Owner's Information and Project.Location Project Address GJ-;,,t 3L4 Ck— Village CoTv Owners Na a G&,A e s + awe ( r' b ccl c o Q Own Ls Legal Address City C) State Zip 635 o :r- ifi Owner CeIl1# !E0j?4a/-31-RV E-mail 4 Section 2—Use of Structure Use Grroup ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet �. Single/Two Family Dwelling Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure . ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alan Rebuild Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify i Section 4 -Work Description n Pc6 ,, 16�,15 ' 0le c n T aet ands 2/V2019 Application Number.................................................... 'Section 5—Detail Cost of Proposed Construction Square Footage of Project ZO Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design v Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing Gas Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply Public ❑ Private Sewage Disposal ❑ Municipal On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last=dated:2/9/2019 .v � ApplicationNumber........................................... Section 9-.Construction Supervisor Name IiU� I I sa^ rc,A,�''�� Telephone Number -771') - 09 9 q Address City State Zap 026 V Y License Number Q a 3 S 0 License Type A r r, Expiration Date 12_ Z06- / Contractors Email -�e�r�e�s1/� VPn�(o,AF� Cell# -77V 9 9Y-0�Z y9 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CUR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CUR and the Town of Barnstable.Attach a copy of your license. Signature Date 5 l Section.10—Home Improvement Contractor Name �/j�;"�(;�,,,. �- Telephone Number - 77Y. 629 Address R6nCC.A Grp City -�,fes �It state A4 . zip 07�1iei Registration Number/�/3,���/ Expiration Date I understand my responsrbrlitties under the rules and regulations for Home Improvement Contractors in accordance with 780 CUR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and — documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.LC... Signature 1�� Date / Section 11—Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CUR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature //� Date S / /r Print Name Telephone Number -7 71/ ��Y—n2qq E-mail permit to: ('c� ��e s 2� yu c 120✓� ,4-C* .....i.. A.1mnnto Section 12-Department Sign-Offs Health Department ❑ Zoning Board CifrNuhvd) ❑ Historic District ❑ Site Plan Review Cif required) ❑ Fire Department ❑ Conservation For commercial work,please take your plans directly to the fire deparbnent for approval Section 13-Owner's Authorization I, Ckc,,Aes G;a," Q , as Owner of the-subject property hereby authorize C-,�-f-t�- to act on my behalf, in all matters relative to work authorized by this building permit application for: �y C (Address of job) SipatYe of Owner date Char-les r,'AIJ Print Name Last=dates 2/92018 FROM TOWN OF BARNSTABLE Mr. Fra,c� Lahbeiuie BUILDING DEPARTMENT Zbwn Clerk "r""�.•.�`-"----367 MAIN STREET HYANNIS, MA 026M 4 fib -�°>M - •^ Phone: 776-1120 A. SUBJECT: FOLD HERE , DATE Jmme 1, 1984 MESSAGE �1 +M.q h•4.saV1.l w+n•N.;;.rw 'iss•r�•a.! Work hea-been,=rpleted==br ermit.t23315� i11 am E „�eg9s).. P1eaa release Bond.. - was•rr u+�aV.x.rK':r.s.Y s�vrss..�rs.a+4^ETpryrl^tST ri•T'i�Hirv�'► SIGNED P"f ,DATE REPLY SIGNED N87•RMI, , • RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITWCARBON INTACT. 3, 3 „�•""'. TOWN OF BARNSTABLE Permit No. _-_--- - t s,esir.n Building' Inspector Cash _-- ;OCCUPANCY PERMIT Bond �X No building nor structure shall be erected, and no land, building.or structure shall be used for a new,,different, changed, or enlarged use without a Building. Permit therefor f first having been obtained from the Building,Inspector. No building shall,be,occupied until'a' certificate of occupancy has been issued by the Building Inspector." - �`//F�f� `f �i,T.liam E. B"dgrc- SaY 695,, Qster4;�:lle % ~• Issued to Address Lot j7G �49'�Cotii ,t Bay.'-Drive- Cotuit - Wiring Inspector fL� Inspection date s / Plumbing Inspector,+'s ` r���c-�" - Yf:+�. A Inspection-date / Gas Inspector �f/ �.�L ff /�' , Inspection date f� - Engineering Department' t .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. _................_..._, 19 . ....... ..............................__......_..._...--. Building,Inspector i Assessor's map and lot number ....... . R ' CF IN E TO Sewage Permit number ................................ ' SEPTIC SYSTEM M : House number 3 / LE, . NL INSTALLED IN COM 1639- m t ••;+ , .� WITH TITLE 5 �`�oMav ale TOWN OF BARNSTIABIt"E � 4 BUILDING .I-NSPECTOR APPLICATION FOR PERMIT TO L ��.I.. . ... �............ ...... ... . ... .... TYPE OF CONSTRUCTION ................. i.Y..G.7.L..........T... .......... '! .t................................... ....... .�.. ..... ......... .,9.., 7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location1.'��.�.......... ...Q.........� v ................. .... '. .. ........:................................................... ProposedUse .L-4....�/.e/� v ....................................:............................................................................ Zoning District ................. ... . ...........................Fire District .0 ................................................ o Name of Owner ..�f..\ �CRY?:�.. ..!...�?.. ..... ....��......Address ...?��?`tC �� �. hV..� �. ............... Name of Builder `SJ•;S' ........Add'ress ......................:.............................................. Name of Architect 0 n.. ..�9.�:�Acldress �c.�`�,C,7, � .. ..x.!�6,3 N O` oo) Number of Rooms .. ..........................................................Foundation, .. ..... \ ... . .... c E'xierior-...........:..........�t..... ..�. \��' �5.:'........Roofing ..�.G.�.. �?.�..�....... , ............................................ ` . 1.... Floors r . `�. 1 Interior hv ....... ...\ ,`. ... .: ,.............�f . ................ Heating ... .`. ..!C:.�.:C,�:. .... .. ...............................Plumb.ing ...........A...!L! ...................................... 4 \� � 3 _ Fireplace .......\........................................................................:Approximate Cost ............... .......... ................:.. ................. . c. Definitive Plan Approved by Planning Board --------------------------------19_______. Area 0991 ............................ Diagram of Lot..and Building with Dimensions Fee ...��.�5-0-a................ SUBJECT TO APPROVAL 'OF BOARD,OF HEALTH �, 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the abov construction. ° Name-:f'--- ...................................4.... .. BEGGS, WILLIAM E. A. No ... Permit for One 1/ Stork 2 .Sin.gle...F.amily....Dwe.1.1i q.............. Location ..Lot,,,#,7�.. 249 Cot it Bay.. Dr. ..... ..................... Owner ..,, illiam, E. Begg Type of Construction. ....Frame......................... ` ................................................................................ Plot ............................ Lot ................................ a Permit Granted ....Jal....24..'................19 81 Date of Inspection ............................. Date Completed .......E7.............. .19 jot r 44 PERMIT REFUSED .................. ....................................... 19 ............. .•_F- ....................................................... - ............... ...._. ...................................................... Approved : : ............................................ 19 ............................................................................... ...................... ............................................................ iJ ,y i I k 11' 4 (IV �� 34 •� 9 do") ��• AAeA FT tJl)c i 51-I 44- oa z, C-0 BAXTE 24 fug O� VYT a y �� ds. ,• q�X Heap \ .. a tip,•+ r7 AREA i 'ZO FT WIVE a i-e •1 BRXT No.24 -Sg cE• :. 1 0%2 SI�.iG LE .FQM��.�! • Z• �ROo�K - . VJ,T iA GA 5446 Wow . Ito t Z +50�� .P.R SePn C. T AU4W. 330 X 2o0 790. I U;fs ISoo OP.-L T^NV, ' v%SPo,SAL. PCT VIM 100o gkc 3� 5toIJ1r, i A AA r 6oTTOAA Ages'113 ,�F�SC�PC> -�O �kT[111�" �A� -' i l 3 x I•o;� 1 13 6aPD i . • .;, ., c i w 1 ... . . . Tora� ��s�cN .. .. . �... - :•, �TU1.1� ' PE?rc oLxr IoeJ -?,Q•TL'- t"�W Z #Aj oZ LFf{: �..: QAXTt:RNa 2409 �♦ ' i in Fw * Io J 4401-&-j 1.1 --1i C,rA7 �8' FL• 97 aR 777�7J1C� � ter.►v 4 '• _... - -- !' .ice •� , . • wu• 90 S�BSO►l. ¢ we DKT ta�c lr,Lt.. �,� •f' - - 2Box. 99.G S�PT�G 1 T=='' TAu►t , taco 4-W wv. WE PIT 540 CE2 T I I=I Ca R.o-t ?L_.a A►T•lo►.1 CUT cJ 117 : tL•7B IZ:� {Jo SCa►uGr�• Gl�L6 �11— � �AT� `i JI� 'f.� I N o W I�T 2 . M a r r PL-A.wt tZFF�t r,.lc I C¢2Ti FN{ T"AT rv4t-- I b V�1D�Ti O lJ S"owaJ ►-�E2E.o�.i GoMP�Ys w�TH T4aG. ;Iper`.1�m. ° � 1-D"r �O AND SfaT814GK QGQJ�QL�.M6�•►T; OF T41ERC t . tt�wM O;IF �A�>J STA L.�, r� • D1L 2q2 r�O - 2 C� bATE:.1 I I"11$ ! d A XTe a E; U`•(E %64C•. %Z&C 15T6. ZZM'C� LAbJD 4)ZvC1pZr. B ; TKI4 PL&W It JOT BASED 014' AU 1144TWMEMY oSTE:iZVI# � iAA cep. TbIG oFFswr; 'wwt.b� uoT $G ulpeJp To 7�ETCt[ tIUt �.cT t.tuEFF*. it APF%-%C. W r WILLIarM 13��GGS FtHEt Town of Barnstable Building Department-200 Main Street 'renMn�' Hyannis, MA 02601 ........ Tel. (508) 862-4038 ` Certificate Of Occupancy Permit Number: B-2015-01508 CO Issue Date: 12/9/2016 Parcel ID: 056-032 Zoning Classification: RIF Location: 249 COTUIT BAY DRIVE, Proposed Use: 1010 COTUIT Gen Contractor: NELSON, WILLIAM H., JR. Permit Type: Residential - Comments: Building Official Date: e� • _ ' TOWN OF BARNSTABLE Building TH E tp Pe • "°� 201501508 * BARNSTABLE, Issue Date: 04/15/15 P e r m i t MASS. �A i639• `0� Applicant: SHIELDS,SCOTT Permit Number: B 20150762 rF0 MA'I A Proposed Use: SINGLE FAMILY HOME Expiration Date: 10/13/15 Location 249 COTUIT BAY DRIVE Zoning District RF Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 056032 Permit Fee$ 331.50 Contractor SHIELDS,SCOTT . Village COTUIT App Fee$ 50.00 License Num 65898 Est Construction Cost$ 65,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND ADD FRONT FOYER,RENOVATE INTERIOR KITCHENS,BATHS, EX WIC CARD MUST BE KEPT POSTED UNTIL FINAL AND DOORS,NEW DECK REPLACEMENT INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: BEGGS,WILLIAM E&CAROL A BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 21 BUCKSKIN PATH INSPECTION HAS BEEN MADE. PLYMOUTH,MA 02360 Application Entered by: JL Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER VORAPJLY 0 CROACHMENTS ON PUBLIC PROPERTY,NO SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEMAND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDMSION RESTRICTIONS. , MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). Mqu �- BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 6')/C F��7 1 'G'✓6' �/�3� ��' ( 2 X ©'� 2Fo 3 1 Heating In pection r als Engineering Dept Fire Dept 2 Board of Health �� �«157 ©�, z � ✓sue;, t cty st Milli1 r C�n t--4 ern OPOO, 71, t ; � f � r 5 1�{ 6. 1 Ak CT cc U s { D 6?�6 C"© 7-Ce1 T- �,7y �,e� C 0 3/ ����� IN 65�WI ti-i c"ll #� w " 4. Ot Masi _ � d M u rl-j i _ k El AW Ask- All, 1110111 1 t 1� LLJ CD CC: � - - - - ��a- - ��'- iJ .J jl i�.f-.i� _ J_].lam I a�G �o7u�T �� ��r�c', �'7" d� a/ �� /.�SiGt> ��C rnc� ©P�c/ Sc,��9c� Lij C) -3 C, C3 . PI-1, Cr Lr% 01: �r .,�, �yC� L'� �u r r- .�-� .�/��U� Cr B 3�oZ t 1'�' /�3SlL�-� �_ ` a. �. i i `. �. .. -- '� �::: c- _ t-- '�_: r. •'� :fir. •r r d� IL r aV'6 Co ray T ,C9'.�y �u�, (27- Cl I Mckechnie, Robert From: Barrows, Debi Sent: Friday, March 21, 2014 9:30 AM . To: Mckechnie, Robert Subject: FW: Vacant Property question -----Original Message----- From: McKean, Thomas Sent: Friday, March 21, 2014 9:24 AM To: Barrows, Debi Cc: HeathDeptMailbox Subject: FW: Vacant Property question -----Original Message----- From: McKean, Thomas On Behalf Of Health Sent: Friday, March 21, 2014 9:23 AM To: 'Jen' Subject: RE: Vacant Property question Good Morning, I forwarded your inquiry to the Building Division. As you may be aware, the Town recently adopted a vacant property Ordinance which requires an owner of a vacant property to register with the Building Division. Here is a link to the Town Ordinance: http://ecode360.com/search/BA2043?query=vacant#BA2043?query=vacant&_suid= 139540781227109981475787339176. In the meantime, a health inspector will be dispatched to that location to look at the debris in the yard and to inform the property owner regarding any necessary clean-up. Sincerely, Thomas McKean -----Original Message----- From: Jen [mailto:jsto671@gmail.com] Sent: Friday, March 21, 2014 8 :47 AM To: Health Subject: Vacant Property question Good morning Not sure if this is an item for your dept. . . . .we have a home in our neighborhood that seems to be vacant for a couple of weeks now. There were renters who seemed to have moved out. Beyond the obvious debris left behind in the yard, the back slider door to what looks like the basement has been left wide open, which is concerning to the abutting properties. Not sure who owns the property but the address is 249 Cotuit Bay Drive Cotuit-dPlease let me know if I should be contacting a different dept. Thank you, Jen Stoner 508-737-6994 Sent from my iPad 1 Assessor's map and lot numberC.2 ....... ,. S G" �FTNETO 'Sewage iPermit number ` /�390 — e�P� 0 ..�............................................ � Z BAS LE, House number MAGIL .� .................... i OD 1639• 0� 'E0 YPY a� TOWN OF BARNSTAB=LE BUILDING INSPECTOR APPLICATION` FOR PERMIT TO ......1 ..... ....ZALk—L...... TYPE OF CONSTRUCTION � 1�\!t /. r �- ��.................................................... ... _ ... ........................................................ ........ ... .............19....(f.,.•� . r' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: .Location ..1-.��'.....-. 0........1;LP ..."..�......��`.y.......�.r.�.V..�............................................................... .,.. ProposedUse ...........................::. ... ........................................................................................................ Zon'ing District .................... ... .........Fire District Name of Owner ��� \�\1C'). � C@� ��X �Q Yam........................... - Address ........................................:. ............. 1 �. Name of :Builder .5....... ........�. ......... . c� xI ..Address .................................................................................... Name-of Architect " �1.. Qh�? Number -of Rooms .........................................................foundationC 'n .13`�.. Exterior ..... C_ a .l �\\1t�;.1 5...........Roofing �, Q�c* ," ,....... v.......... ... Floors ......... n .......... ..............Interior _ ................................... I. , , . : Heating .�..`. ..k'1..L�.. ......:.......:......... ........:.....::.Plumbing ....... ........ Fireplace ...... ..0 ...................................................'.............Approximate Cost ... . . .:U ....................................... Definitive Plan Approved by Planning Board ---------------____-----------19_______. Area ........................... 'Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH /2 I hereby agree to conform to all`,the Ruletstprid Regulations of the Town of Barnstable regarding the above Construction. ' 't Name .................. ' BEGGS, WILLIAM E� (�A-L-56-32 � -3;L 23315 One 1/2 Story No ................. Permit for .................................... Single„Family.,.PKqjj.ing............. . ............... ..... ..... Location ...Lot...R.7.0...2.49...C.Qtuit...aay...Drive ..................catui.t.............................................. Owner ..... .................... Type of Construction ..Fxame........................... .................................................... ........................... Plot ............................. Lot ................................ Permit Granted .JAlo 29 .X.V... .... .... .............19 81 Date of Inspection ....................................19 Date Completed ................... .................19 PERMIT REFUSED ................................................................ 1-9 ................ .. ............ .............. ................. ....... .................. ................................ ............................................... ................................................................................. Approved .................................... 19 ............... ............................................................... .................... .......................................................... *ii�:-.s`�^'`i"-..- x.�:y,.A��' - � �. .:i,"x ..-o � :';Jkw Y G of 'c AN � Z..:... �.4'.:V...�! ...a ,. _a .•':.at a.:,,.::. .,.Li,.;-...:., ,a+,r:..�..,. s.h.-�.. �..^.� :"-,t a i..:. 1... .... C�; r Assessor's map and lot number Sewage Permit number ............ ✓ / I"Er° TOWN OF BARNSTABLE. 5 1 Z B,$$9TAIILE, 1639• BUILDING INSPECTOR \00 APPLICATION FOR PERMIT TO ................ ..... .................................................. c TYPE OF CONSTRUCTION .............................................................i ...... TO-THE INSPECTOR. OF BUILDINGS: _ The, undersigned hereby applies for a permit according to the following information: Location . ..7#9 ..........?�!? .........�.� ........ .......!.!l'7'�°�`/ <' Proposed,.Use ...... .. .. ................ ................................................. Zoning Districts xv Fire District ... .......................................................................... . i Name of Owner , TnPufr.Address ......+fr; Name of Builder ffi,'V......i.O W?S.....1 K,G,'..................Address / a! l `�"'� l!t ' '�'°....... Name of Architect ........................................Address """ 7 Numberof Rooms ..............` + .................._.............................Foundation 4!:-;*-�:.-�':. :.................................................... Exterior .... ...Roofing .. �a '!!! .....: /rs, `..i f , Floors .at rT .......................Interior .17 ,!'✓"............. Heating .........................Plumbing ................... `... -r Fireplace r? -- /'�c ....................................................Approximate Cost ... �e?Gf. ............................................... Defrinitive Plan Approved by Planning Board ------------------ .SzB'`....... --- -- 9 Area Diagram of Lot and Building with Dimensions ` t g g Fee ........:.................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH � t r i • �1 r + + I • hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............................................................. Gotuit-Weston Realty Trust A=56-28 18832 one story,. u7 No ................. Permit for..................................... single family dwelling ............................................................................... Location 252—clotu i.t..B.a.y..Drive. . .................. ............ ...... . .. .. . .. .... . .... Cotuit . .......................................................... Cotuit=Weston Realty Trust Owner .......................................... ..................... f-ame Type of Construction .......................................... ...............0 ................................. ....... ... ....... #93 Plot ............................ Lo .. ..... ............... ....... Permit Granted ..... ....November. . . ...24......19 76 ...... . .... Date of Inspection ......... 19 Date Complet6d ............. ..................19 PERMIT EFVSED .................................. ........ 19 ................................. . ...... ....... ................ 0 ............... . .. .. ........ .... ...... . ........ .............. ..................... . ........................................ .................. .... ... .... .......... Approve cI—.-r.-------7'0 ................... ....... 19 ..................... .................... .................................... ................................................ ......................... C NOTES: I•a PA 1,)CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS I &DIMENSIONS IN THE FIELD 2.)CONTRACTOR TO VERIFY ALL INTERIOR 8 EXTERIOR MATERIALS, DETAILS,&FINISHES IN THE FIELD WITH OWNER 3.) ROUGH OPENING HEAD HEIGHT OF WINDOWS AT SMOKE DETECTORS VIEWED DN. PUA OR C LLCOFIRST FLOOR CONSTO BE RUCTION CONFORM ABOVE 4.) ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTS STATE BUILDING CODE,8TH EDITION AMENDEMENT d IRC2009 .) 110 MPHWIND ZONE 6 ODWALL S _ _ Y .) ALL SHEETS OF PLYWOOD WALL SHEATHING TO BE INSTALLED VERTICALLY, OR HORIZONTALLY W/BLOCKING AT EDGES,3'EDGE/12'FIELD NAILING ., A _ BUII D!,11G i' .1. SATE ;• 7.) SEE CERTIFIED PLOT PLANP LOAD LAN DEVELOPED BYFOR ALL B - PROPOSED 6 EXISTING DETAILS 0 9.) FOLLOW ALL MANUFACTURER'S SPECIFICATIONS FOR INSTALLATION OF �r Id 6 ALL SIMPSON COMPONENTS FIRE DcPHP T Nc^eT DATE A _ NEW DECK 10.)ALL CONCRETE USED FOR FOUNDATION WALLS,FOOTINGS d SLABS 1 BOTH SICI''4",^;E-: `t '-UL,IiY L.P 1•) [ol, r�RM�rnHc Tx TO BE 3000 PSI ,. 21 YIYR1.OWPICTUR lr-0' 11.)VERIFY ALL PLUMBING 6 ELECTRICAL DETAILS W/OWNERS ON THE SITE coreo.w twc TEMPERED a•-T- I1•a DURING FRAMING CONSTRUCTION 2�0 12.)TIMBER FRAMING TO BE SPRUCE/PINE/FIR NO.2 GRADE a§. wr[DowsuT eP - I3.)FOLLOW ALL REQUIREMENTS OF THE 110 MPH CHECKLIST SUPPLIED ___ ______ ______ __ \ 14.)THIS SITE IS IN THE 110 MPH WIND BORNE DEBRIS AREA,EXPOSURE'B' 8 WITHIN ONE MILE OF NANTUCKET SOUND PER STATE OF -FF Y IMwEvosT eRER 000OP MASSACHUSETTS WIND SPEED MAPS I I I I IP 15,)GLAZING PROTECTION PER 780 CMR 5301.2.12 TO BE IMPACT GLAZING OR TOCAT10N I coNr.2.2aaHu6FI PLYWOOD PANELSVERIFY ALL WIND BORNE DEBRIS PROTECTION REQUIREMENTS REMOD. I I I I I I C OS. W/OWNERS PRIOR TO START OFCONSTRUCTION I I I I III KITCHEN I I (1 I 1 31 I 1O`1Y 16.)FOLLOW ALL REQUIREMENTS OF THE IECC2012 RESIDENTIAL ENERGY I 11 - 9 TROE MFARN N.ECWU fB EDAOMLY N I1I _ I III R EMON.bI RIIlMbl i rIIII .am-=I III t RIFY KITCHEN I III II D I EFFICIEN"CY'IR REQUIREMENTS S[dR,.V ERIFY ALL DETAILS.<WITH�T .HE..INS U R�ODLATION Yo UT n DINNER) ING INSTALLERICONTRACTOR.11 MA N NaALL FIRE RATED BEDRO M mvsuM eoaD w 1 ES.POSTTO FAMILY W.W RU.WALLS4CMWW 17.)ALL HEADERS TO BE 3.2 K 8's UNLESS OTHERWISE NOTED RCWN. ROOM L.oto TO FR XwSw IECC2012 RESIDENTIAL ENERGY EFFICIENCY DETAILS REMII0EKISTBAM CLIMATE ZONE SA(USE EITHER VREBCRIPTVE VALUES OR RESCEC CALCULATION&REDLCEWM),L,• aw.P-TO LVE/.M OR(.11 Rl- TRLE1021 MIMESCPTNENSULAT10NaFENESTRATIONREOUREMENTS, lVp MSEECO J L___J L___ NMI'VERATED W- Ir DOOR REMOD.pu� CONT.>F..HEADER •.a`•, I 1 I a I FOtONO I I ON REMI)WEXIST. 10'aSTDH 2O.nDM ao-_srN1 GARAGE Y_L . 1 WNOOW WNDQY NOI[wY 1.M IUESARE MN DWMStUiACTORSARE YAMYUYS. 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