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HomeMy WebLinkAbout0572 CEDAR STREET IIII c�RECYCIEp�,p2� UPC 12543 No. 53LOR Qpsr•coNS° HASTINGS, MN - - - e _/ i; z !. i S ��. t o i. t l= 't i 7 ., ti 1 !'"�;.: �i3. �' f� �� .. Town of Barnstable Building - ? t Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept 163 Posted Until Final Inspection Has Been Made. Permit i639. �� Permit 111 1. Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-3147 Applicant Name: Michael Brooke Approvals Date Issued: 10/24/2019 Current Use: single family home Structure Permit Type: Building-Family Apartment with Construction Expiration Date: 04/24/2020 Foundation: Location: S72 CEDAR STREET,WEST BARNSTABLE Map/Lot: 109-047 Zoning District: RF Sheathing: Owner on Record: STRATTON,WINSTON L Contractor Name: MICHAEL BROOKE Framing: 1 Address: 572 CEDAR STREET Contractor License: 089455 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $25,000.00 Chimney: Description: The installation of a kitchen in the first.floor of the building to allow Permit Fee: $202.50 elderly homeowner single floor living amenities. Mr. Stratton Insulation: Fee Paid:; $ 202.50 (homeowner) has discussed feasibility onsite with Building Final: Department and has been told that two upstairs bedrooms must be Date: 10/24/2019 conjoined with a framed opening in order to comply with health n department. We will execute this work as well. Family Apt. b 9— Plumbing/Gas ✓ W/Construction. ` Rough Plumbing: Main House:Caitlin Stratton,daughter ------ \Building Official Final Plumbing: Family Apartment:Winston L.Stratton,owner f i Rough Gas: Project Review Req: SMOKE UPGRADE REQUIRED Three Bedroom Single Family Home I I ( Final Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after'issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Electrical All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Service: 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. I Rough: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Final: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Low Voltage Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Health 6.Insulation Final: 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Fire Department 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). �X go rzz—�� L--/) s {iJ j'rz�-r�iJ p 1-- (�-9�" S ��itit`U V p RATT� T- PRA, i T F7' NSTRUCTION CO CO NSTRU`TION CO. G&REMODELING CONTRACTORS BUILDING&RENIC'+ DELING CONTRACTORS M.i1CHAEL BROOKE PAT 'RICK COFFEY . 21.1369 mikeondarkstar@aol.com c 508.280.4688 a 508.420.9333 153Lovells Lane/Box 731 a 508.420.9333 patrick@prott.construction f 508.420.9733 Marston Mills MA 02648 f 508.420.9733 153 Lovell's Lane/Box 731 Marstons Mills,MA 02648 d •� a ,TOWIN OF 109�7 7, , ? I "`'; D: 2 6 �el-9 �9 7 s Town of Barnstable RECEIPT $" 200 Main Street, Hyannis MA 02601 508-862-4038 039. p Application for Building Permit Application No: TB-19-3147 Date Recieved: 9/24/2019 Job Location: 572 CEDAR STREET,WEST BARNSTABLE Permit For: Building' - Alteration INTERIOR Work Only- Residential Contractor's Name: MICHAEL BROOKE State Lic. No: 089455 Address: , , Applicant Phone: (617) 721-1369 (Home)Owner's Name: STRATTON, WINSTON L Phone: (508)237-0403 (Home)Owner's Address: 572 CEDAR STREET, WEST BARNSTABLE, MA 02668 Work Description:- The installation of a kitchen in the first floor of the building to allow elderly homeowner single floor living amenities. Mr. Stratton (homeowner) has discussed feasibility onsite with Building Department and has been told that two upstairs bedrooms must be conjoined with a framed opening in order to comply with health department. We will execute this work as well. \ /\ `= 0 Total Value Of Work To Be Performed: $25,000.00a v Structure Size: 0.00 0.00 OOU Width Depth Total;�Lrea to IM I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or oc her worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). 1 .- I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued, it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Michael Brooke 9/24/2019 (617)721-1369 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees LProjectCost : $25,000.00 Date Paid Amount Paid Check#or CC# Pay Type ee: $177.50 9/24/2019 $127.50 XXXX-XXXX-)C M- Credit Card 0229 ee Paid: $177.50 9/24/2019 $50.00 X)M-XXXX-XXXX- Credit Card 0229 - THIS IS zNOT:A-PERMIT i i I i i I i i i o 0 i i F � , oq xx Q�6a i i i f Note:This drawing is an artistic ZO 20 Designed:7/23n019 interpretation of the general r�cxNotooiu Printed:7/23/2019 appearance ofthe design.It is i not meant to be an exact rendition. 572cedar.kit All Drawing 0:1 L I� V 1 IL I ylb �Q A f C e t c-ve_ ' YON Note:This drawing is an artistic 20 yF' Designed:7/23/2019 Interpretation of the general recMNoto' Printed:7/23/2019 appearance of the design.It is not meant to be an exact rendition. 572cedar.idt All Drawing k;k f Town of Barnstable, MA Page 1 of 2 Town of Barnstable, MA Tuesday, October 1, 2019 Chapter 240. Zoning Article V. Accessory Uses § 240-47.1 . Family apartments. [Added 11-18-2004 by Order No. 2005-026; amended 10-7-2010 by Order No. 2011-010; 3-1-2018 by Order No. 2018-053] The intent of this section is to allow within all residential zoning districts one temporary family apartment occupied only by the property owner or a member(s) of the property owner's family as accessory to a single-family residence to provide families the ability to live together as a family unit, but not to allow for a separate dwelling for rental purposes to non- family members. A family apartment may be permitted, provided that there is compliance with all the criteria, conditions and procedural requirements herein. A. As of right. A family apartment shall be allowed as of right, provided that it complies with Subsection C below and satisfies the following criteria: (1) The apartment unit shall not exceed 50% of the square footage of the existing single-family dwelling and shall be limited to no more than two bedrooms. (2) Occupancy of the apartment shall not exceed two family members; occupancy limitations shall not apply to children ages 18 and under. (3) The family apartment shall be located within a single-family dwelling or connected to the single-family dwelling in such a manner as to allow for internal access between the units. The apartment must comply with all applicable zoning requirements for the zoning district in which it is located. B. By special permit. The Zoning Board of Appeals may allow by special permit, subject to the provisions of§ 240-125C herein, the following waivers from the requirements of Subsection A above: (1) A family apartment unit greater than 50% of the square footage of the dwelling. (2) A family apartment unit with more than two bedrooms. (3) Occupancy of a family apartment unit by greater than two adult family members. (4) A family apartment unit within a detached structure, with a finding that the single- family nature of the property and of the accessory nature of the detached structure are preserved. C. Conditions and procedural requirements. Prior to the creation of a family apartment, the owner of the property shall make application for a building permit with the Building https:Hecode360.com/print/BA2043?guid=6559607&children=true 10/1/2019 Town of Barnstable, MA Page 2 of 2 Commissioner providing any and all information deemed necessary to assure compliance with this section, including, but not limited to, scaled plans of any proposed remodeling or addition to accommodate the apartment, signed and recorded affidavits reciting the names and family relationship among the parties, and a signed family apartment accessory use restriction document. (1) Certificate of occupancy. Prior to occupancy of the family apartment, a certificate of occupancy shall be obtained from the Building Commissioner. No certificate of occupancy shall be issued until the Building Commissioner has made a final inspection of the apartment unit and the single-family dwelling for regulatory compliance and a copy of the family apartment accessory use restriction document recorded at the Barnstable Registry of Deeds is submitted to the Building Division. (2) Annual affidavit. Annually thereafter, a family apartment affidavit, reciting the names and family relationship among the parties and attesting that there shall be no rental of the principal dwelling or family apartment unit to any non-family members, shall be signed and submitted to the Building Division. (3) At no time shall the single-family dwelling or the family apartment be sublet or subleased by either the owner or family member(s). The single-family dwelling and family apartment shall only be occupied by those persons listed on the recorded affidavit, which affidavit shall be amended when a change in the family member occupying either unit occurs. (4) When the family apartment is vacated, or upon noncompliance with any condition or representation made, including but not limited to occupancy or ownership, the use as an apartment shall be terminated. All necessary permit(s) must be obtained to remove either the cooking or bathing facilities (tub or shower) from the family apartment, and the water and gas service of the utilities removed, capped and placed behind a finished wall surface; or a building permit must be obtained to incorporate the floor plan of the apartment unit back into the principal structure. https:Hecode360.com/print/BA2043?guid=6559607&children=true 10/1/2019 The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations ' 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): G b Address: 3 L 6"eA ate_ City/State/Zip: S�b S &A S Phone#: 150 g Lf� Are you an employer?Check the appropriate box: Type of project(required): 1. I 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. 1 am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp.insurance.t 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 11. 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 employees. [No workers' 13. Other 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: CC,. c Policy#or Self-ins.Lie.#: lJJ C,!''( L; �eZ� a �► Exp' ation Date: oZb Job Site Address: �j CcSQc SV I ik�. 13czi ip; 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 certify under the pains and penalties of perjt ry that the information provided above is true and correct. Signature: � Date: S gyp' i Phone#: 4 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department. ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval 5 • Section 13—Owner's Authorization S�Mpt � , as Owner of the subject property hereby authorize ,f-a,yV_ C flu� ,,c��,n U��c�n e e l��act on my behalf, in all matters relative to work authorized by this building perrmt application for: 57 a S ,A (Address of job) Signature of Owned - ^ L date W 1 V%s�-o yti Print Name Last updated:11/15/2018 8/13/2019 Proof of Coverages Search Labor and Workforce Developme,n,TM. ;,... iO Date Last Updated: 8/13/2019 ' Navigation Links Workers' Compensation Proof of Coverage - Employer Details POC Disclaimer New POC Search Search Name: PRATT CONSTRUCTION _. Employer: PRATT CONSTRUCTION CO INC Address: 153 LOVELLS LANE UNIT D City/Town: MARSTONS MILLS,MA 02648 W IaCe.:Fiiaud"." > Back To Results Page 1 of 10 Policye, D of f Y erm ACADIA INS CO jLISt . r WCA52525895113 290 DONALD J LYNCH BLVD 06/1512019 06/15/2020 — - MARLBOROUGH,MA 01752 ' ► ACADIA CO WCA52525I395112 290:DONfALD J LYNCH BLVD 06115/201,8 06/15/2U19 , Education Links MARLBORQUGH;'N1A.01752. ACADIA INS CO , Who Needs WC Insurance? WCA52525895111 290 DONALD J LYNCH BLVD 06/15/2017 06/15/2018 MARLBOROUGH, MA 01752 Employer's Guide to WC ACADIA INS CO WCA52525895110 290 DONALD J.LYNCH BLVD 06/15/2016 06/15/2017 Employer's FAQs About WC MP�RLBOROUGH;MA-Q1752 LIBERTY MUTUAL FIRE INS CO Injured Worker's Guide to WC WC231S373220015 150 LIBERTY WAY PO BOX 9090 06/15/2015 06/15/2016 DOVER, NH 03821 Injured Worker's FAQs About LIBERTY MUTUAL FIRE INS CO WC WG231$37322Q014 150 LIBERTY 1WVAY Pb BOX 9090 06/15/2014 0$/1512015 D.OVER; 03821; :.. Related Links LIBERTY MUTUAL FIRE INS CO WC231S373220013 150 LIBERTY WAY PO BOX 9090 06/15/2013 06/15/2014 Experience Rating History DOVER,NH 03821 LIBERTY MUTUAL FIRE INS C0 Connecticut POC Search W0231S3�3220012 150 LIBERTY WAY RO.BOX 9000 06115/20a2 .06/15/201$ DOVER;,N 71.-04 1 . " New Hampshire Workers Comp WC131S373290011 LIBERTY MUTUAL INS CO 06/15/2011 06/15/2012 --147.202.209.36/Details.aspx 112 1 -_� ►�V JauolsslwwoO I C4�is�§1C.3 , ctJV ; . i r Z99Z0• VAII3- llA2131N30 y " 1 '13381S 3NId WC r t3H0011813VF431W i !Z0Z1VWL0:S8nd , 9SV680-SO , Josln �t� } fsuoO : spiepuelS pue suo11eln6atl 6ulplm8 10 pjeo8 ainsuaall Ieu0lssaJ9Jd 10 uoIsIA10 tl suasngaessew jo tilleamuowwo0 �" l �. w, - _ .�__.t,� ---�.�.�._... --.�-.-. •'a �l`,a"lf.•.��-.—.... .... .. .... •,tea ':x=�-- ..� .*"J�*^f�w. lei Office of Consumer Aff2irs and Business Regulation:." 1 One Ashburton,'Face - Suite 1301 Boston, Mas�Achusetts 02108 Home Improvemohif :ontractor Registration • M Type: fndja MICHAEL C3ROOKE viM�x �` W Registration: 170 i,;� . ^� Expiration: 11Ir ! t�1.9. 301 PINE&7 CENTERViLLE, MA 02632 iCA 1 O Y Update Addre�s'ar. 20t�05l17 �J��• yry� /�� Q �� _ �-��•" may.,...�. T ✓/eri V�O�✓[[%(2<a.4.G(j j'.l4MfG3 _'-. - •----.�_.. __ —._ - •_- �YYro—.-:� ' Office of Consumer Affairs&,Business Regulation Jf HOME IMPROVEMENT CONTRACTOR Regf-;.Totion•valid for individual use only ' 4PE.IndMdual befo'�3 the expiration.date. If found return to: � lfatio isn.- Expiration 011fbof Consumer Affairs and Business Regulation t1/21/2019 10 P;?k Plaza-Suite 6170 MA 02116 MICHAEL BROOKED _ ...,ns.�t-- .If MICHAEL BROOKEi 301 PINE ST ,TV, CENTERVILLE,'MA v undersecretary j Not valid without signature • � E � Town of Barnstable Building Department Brian Florence,CBO BA MMAM Building Commissioner prEv59. � � 200 Main Street,Hyannis, MA 02601 Office: 508-862-403 8 B k 32361 P 9 81 C 4 9 2 4 S Fax: 508-790-6230 10-07-2419 & 03 = 285a AGREEMENT FOR FAMILY APARTMENT I Winston Stratton, the undersigned, being the owner of property situated at 572 Cedar Street, W. Barnstable, MA, holding title under a deed recorded with the Barnstable County Registry of Deeds in Book 31372, Page 213, being shown on Assessors' Map 109 as Parcel 047, hereby agree, certify, warrant and represent to the Town of Barnstable that the accessory attached apartment, which contains living quarters, is intended for use as a family apartment, for year-round occupancy. This unit shall be used for a "Family Apartment" (as defined in Zoning Ordinances)which would xNuir" compliance with the Family Apartment Rules and Regulations. The family apartment unit must 1 T4 ccupied ay by the property owner or a member(s) of the property owner's family as accessory to an owner-occ�- ed single.-,family% residence. D ca Occupant Main Residence: Caitlin Stratton Relationship to Owner: daughter w cs® Resident of Family Apartment: Winston Stratton Relationship to Owner: owner This unit shall not be rented as an apartment or as a single room,or in any fashion,which rental would be a violation of the Town of Barnstable's rules, regulations, and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants are to be recorded with the building department. This agreement shall be updated whenever a change occurs or every calendar year. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this day of 20_ TOWN OF BARNSTABLE: OWNER: By: C� Winston Stratton Brian Florence,PBO BARNSTABLEIMTRY OF DEEDS Building Comml ssioner John F. Meade, Register THE COMMONWEALTH OF MASSAC14USETT BARNSTABLE COUNTY, SS Date /D /7 Then personally appeared the above-named (ov r.N v tS At-A /7o••_, and made oath as to the truth of the foregoing instrume`t `'•; _ 0. Car;; �SciDICTIS • `wlyi � or tnission} spires: .3ENEDICTIS .N;0T—.041& 13LIC 1i� 'Y� ^''e _l' :?. •i. PUBLIC a Q..,.••,•.. / Xachusetts .'� ,;:;< o "f a .,i.A Massachusetts M, L'onu+bs'•^'Expires o i.;� ;,J• 1I A, .7unisslon Expires I1� f�ri�:� %024 4�}'o':i�'�v. `;�;•' , ,i, 7, 2024 Town .of Barnstable Building Department t F Brian Florence,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office:508-862-4038 Fax: 508-790.6230 Family Apartment Supplemental Form Owner must complete and sign Address of Property rJ' p� Cf Check one: Apartment is located within the single family home Apartment is located in a detached accessory structure Zoning Board decision number Check one: I am the owner and I will occupy the dwelling. The apartment will be occupied by person or persons related to me by blood or marriage. As defined by§240-128 {20) Family member(s)name (s) I am the owner and I will occupy the apartment and the single family welling will be occupied by a person or persons related to me by blood or marriage. t Family member(s) name(s) Name Signaturennk\A VU-t=Date Q:wp/forms/FAMILYAPTSUPPLIWNTALFORMt-DOC �r � v Vil cam. j A , c1 71 ne 4 y S I f' Uj N 'i I Q N f I W _ d j • r F1 AIL. 'l -LLERARJ SM KE DAETECTORS REVIEWED BAR TABLE BI'fILDING DEPT. DATE.FIRE DEPARTMENDATTE r, r ' s 1 BOTH SIGNATURES ARE' REQUIRED FOR P��,n`•���-� �_(•N I' I��� �� � I ERMl7TlNG L.1 Vj . • .4 LLB�"C �1. (�'�� sa ALA PM row Yr. I _ I is a 1 �a r i r -77 t . . U. 77777 �. ie ti ,r f _ l . 2 r. �., VO . •: `:> a 4 6 �!+ .� i �+J.Z1 .�. �. ... �� _ �� ., i ... ... . _ .�. �_•: � _ t f � ���� `:.'` `�. . � � . . . . .. � �`: .: ::: ... .. . . � � ,f� � . . . .. .. r.----.. _ � � _ _ . ... .. : . .. .. �:';. :`:, :. ..-� y �� i ::: � � .. . .: � � :�� �� . _ .� �, � � � . e 3 �. S t..' i t . f --p_�.: ' . 1 Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fag: 508-398-0399 ✓�N.. ��Fpr 5/31/19 TORN 1�20>g OF84RNsT Brian Florence CBO Ae�E Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permit,19-1046 s Dear Mr. Florence: This affidavit is to certify that all work completed for 572 Cedar Street,West Barnstable has- been inspected by a third party Certified Building Performance Institute (BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCloskey Town of Barnstable _ Building • eeswsr,�eu ' Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept M �' Posted Until Final Inspection Has Been Made. .esv. Where a Certificat Permit . � e of,Occupancy is'Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-1046 Applicant Name: William McCluskey Approvals Date Issued: 04/02/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 10/02/2019 Foundation: Location: 572 CEDAR STREET,WEST BARNSTABLE Map/Lot: 109-047 Zoning District: RF Sheathing: Owner on Record: STRATTON,WINSTON L Contractor Name: WILLIAM J MCCLUSKEY Framing: 1 Address: 572 CEDAR STREET I Contractor License: CSSL-102776 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $3,800.00 Chimney: Description: Add R-10 rigid insulation, R-19 fiberglass,and R-42 cellulose to the Permit Fee: $85.00 attic.Air seal the attic plane with expanding foam. General , Insulation: Fee Paid: $85.00 weatherization. Final: Date: 4/2/2019 Project Review Req: ; Plumbing/Gas i Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after'issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for.public inspection for the entire duration of the Final Gas: work until the completion of the same. f ,_ .. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT S` i - • OF1ME Tom, Town of Barnstable Building Department Brian Florence,CBO MA MASS. • Building Commissioner 039. `0$ e, 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 8k 32361 P981 -11F49245 Fax: 508-790-6230 10-07-2019 a ' 03228s, AGREEMENT FOR FAMILY APARTMENT I Winston Stratton, the undersigned, being the owner of property situated at 572 Cedar Street, W. Barnstable, MA, holding title under a deed recorded with the Barnstable County Registry of Deeds in Book 31372, Page 213, being shown on Assessors' Map 109 as Parcel 047, hereby agree, certify, warrant and represent to the Town of Barnstable that the accessory attached apartment, which contains living quarters, is intended for use as a family apartment, for year-round occupancy. This unit shall be used for a "Family Apartment" (as defined in Zoning Ordinances) which would xquire8 compliance with the Family Apartment Rules and Regulations. The family apartment unit must'66 tccupied poly by j the property owner or a member(s) of the property owner's family as accessory to an owner-occupied single-�fafmily.a residence. „ o Occupant Main Residence: Caitlin Stratton MJ Relationship to Owner: daughter W � Resident of Family Apartment: Winston Stratton s n Relationship to Owner: owner This unit shall not be rented as an apartment or as a single room, or in any fashion,which rental would be a violation of the Town of Barnstable's rules, regulations, and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants are to be recorded with the building department. This agreement shall be updated whenever a change occurs or every calendar year. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this day of 20_ TOWN OF BARNSTABLE: OWNER: By: /) Winston Stratton 101 Brian Florence,PBO UARNSTAKEIMTRY OF DEEDS Building ConIssioner John F. Meade, Register THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY,SS Date /,0 ZT ; s Then personally appeared the above-named (owpet'),,"„ riff v TN k /2ue..o and made oath as to the truth of the foregoing instrument, �prr i '0 s,n CA; _h B FxiDICTIS w �?�'Cornmisston>tacpires: %gin, :'ENEDIMS t� Oi.^a &'BLIC PUBLIC a C: ,,...,,.. 17 a xachusetts �,. fJ a b. �, r.:,r Massachusetts M; 'Lb�l�mr�vl�'•"Exptres o' i!;� J•'1��� �;nnii5sion Expires I7Uri•�:L9 %024 .�a ar�';��'r•va ��.' .F ri! •7, 2024 TOWN OF BARNSTABLE Permit No. 2 2 7 2 t �. Building Inspector cash1639. OCCUPANCY PERMIT Bona _ :401111:1 "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 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." Issued to Winston L. Stratton Address :1. Yarwouth Lot 136A 572 Cedar Street .q- Barnstable Wiring Inspector lI , f� Inspection date Plumbing Inspector �4 Inspection date Gas Inspector Inspection date Engineering Department Inspection date 'r� THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOW -' REQUIREMENTS. s J�1i4%r�1 19 fil / /�i�f' r�.i47/!r !n_�� Building Inspector - A �o S 1T F CA X VJ J 43 T e ij S1 ltl�Tr.)J o L er 3 `-R Ce�pA�t 5�. I'^.A�v�Ce,J C A A► J STA r3 Le:, SM A . JL 4, C � _ Lit. S )re . 10VA N1o►.226575 p So �v<w ) o MrclLtta►/S� Q �sicA3 S 1�J 6l FA")ty . r-)w rL L, u.4 w /3 43 0 6t�3 Al o G A NS oI C Ch s c%S,� OP► — / to X3 —.33a G:P D 33o G•6'. �. -S � 4 ��' GA,LT. OoO G A,L. 14AlK 1 �156°oS�AI �� Oe5ii;j63y- ksW �� �,a. k) a.pp,,, S� o��CPLvs LA, rrny 11ssoc . L" I v V AtipT N / t. oso 3A 4-4' �y OS p 8 3 45 9C 1. 0 3 10 AG26 o ` ' /48 40 60 7 7 9 3 ,ec °6 Y" ��y�4�9 5 aG •c •89 Ac O s s h 0 7s so : ^ca •e I AC_ 1. 04^.c ¢ O -78 9 b0 ac 6p a 1 Ar_ '� o b Z Pi 7¢ v �9 � i o • 84 .►c �6 73 8 3 AC_ 'S L� Al ,BA �6 `�`O y_ 8 1 AC, S - 7Z ` 63 -J U N .r AC /' p8 '70o��� dK a s Assessor's offioe Ost floor): Assessor's map and lot number ...../� .- �� . ��� *NE T �` Board of Health Ord floor):. _ �e, SEhTIC SYSTEM c o" Sewage Permit number ........................................................ f INSTALLED Engineering Department Ord floor): WITH TITLE 5. ; . -m..a9..House number ............................ �.... .....".. �— &VIRONMEHTAL C® APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN REGaUl��P� TOWN OF . BARNSTABLE BUILDING INSPECTOR APPLICATION'FOR PERMIT TO ......V1/�G� TYPE OF CONSTRLI&ION ............:.�9 ....... .... �� auk ................................ ...............7 .....__19........ ' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location........ �7 ?�2...G /Z.....v` .......t!1�r` T../r�i� /UsTi � . ... i ... L? ...�.................... ProposedUse ....... / o . C.....................".."............................................................................................................ Zoning District ...... .....................................................Fire District ... . ! .................. Name of Owner lN.�/VSTl..dv " L' ".vi �?'�/V .................Address ..................................................................... Name of Builder ... ... .....,....:. .. .................:.........................Address 4�G ... ...J�T...... Name of Architect ... +L. .....7&f/". .......Address ..��'.. ..'. IJSC..FS/.....�—....1/......9 •,. /„O(v Number of Rooms ...<....:... wC.��/r %k ......Foundation :.. BU �� ....e.: b . Exterior ... W .......................... ..G= ..... ...Roofing .. /.................................................................. Floors ...0VQ.✓.................. ...[......j�!�.���....................Interior .................................................................................... — Heating ` ......... ©"!VL` Plumbing .......... (� � Ad /, ......."................................. Fireplace .............1..v..... �� .Appro imate Cost .... ,�� (?........ . . . ..... Definitive'Plan Approved by Planning Board ___ ______________ _____/19________ . Area S Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I ' OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ! .G..Oroll /�r�� `� Construction Supervisor's License ........�.q..... .. C, STRATTON,' WINSTON L. Permit for .,Build. Frame. G.rage .. . .... . . ...... ..... Accessory to-Dwell:............... ...... Dwelling....................... Location ....572 Cedar Street ............................................................ ...... ..........West...Bar..n..s.......tab..l.e............................ ...... . Owner.. ........W.i.n.s.t o n...L......S.t.ra.t.t.o.n.................... . . . ...... Type of Construction ......Frame......................... ......................................................... ...................... Plot ............................ Lot ................................. July 11, 86 Permit. Granted ........................................19 Date of inspection ....................................19 A Date Completed ..................19 Assessor's offioe (1st floor): Assessor's map and lot number .��. �� P��TN¢TO f Board of Health Ord floor): Sewage Permit number ............... 1 IIAMSTABLE � Engineering Department (3rd floor): 90o re 9•3 House number ...........................�:.. .. ..... ......�.�.`....... '°�'c rAY a' APPLICATIONS PROCESSED 8:30-9:30 'A.M. ands 1 00-2:00 P.M. only AzT-OXN OF BARNSTABLE BUILDING INSPECTOR APPLICATION—FOR PERMIT TOU�G� TYPE OF CONSTRUCTION ....................:.......:.............. !l�.C�CJ T/..!�?!U/� ?:. �.��fG........19..--.... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: /A Location .......-.67..72....G 1Aol-' ....v` '.......�i L` r.../r�/9 5 /��JG�`,,.../!!/�...0[-COIO .................... ProposedUse .......(...a�`r' / "(`..................................................................................................................................... P � Zoning District ...../\.:. ..........................................................Fire District ...CN .� !P�/J`��� Nome of Owner �/ �/1/STp� G ' � ... ...Address S7 ..G��i�/Z .S... Name of .Builder ..�,27Q/V..... ..................Address �G ...Ik � ...ST-....... 1i�. Name of Architect G G...... `CGf//Vsc`1/f/L�........Address ./7.d................................. Sri; Number of Rooms ... '...! wC....... ...`..Foundation ....�ovn `.y,... Exterior ....... ....LUG!'//�....5� ...... W �./�O/ 92/ .. � ��..GE .o.Roofing i _ ' Floors AS/ ......L L 17 ! .....:' Interior .................................................................................... Heating �/�..� .................................................Plumbing ..........a✓.1/..q& Fireplace // �............................... .A Approximate Cost .. .7 �� 0 n p ............/V d A1..... pp /�Fes-Tt Definitive Plan Approved by Planning Board ---- (J-----__-A-��/ .... �?....5.�........ r ------19-------- • Area _ Diagram of Lot and Building with Dimensions , Fee ..................... .................... w SUBJECT TO APPROVAL OF BOARD OF HEALTH i y I �V C 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 STl�/G, '41 Construction`Supervisor's License ..... ��� STRATTON, WINSTON L. A=109 047 29638 No ................. Permit for ... ....... ......Accessory.sor ...t.o..Dwe.11.iP-9...................... ...... . . . ....I. . .. ...... .... . Location .....572 Cedar..Stree��.............. ................... ........... ............ West BarRs.tA1�1P............. ..................................... .............. ,Owner .........Winston ...... ................ Type of Construction ........ram....................... ....................................................................... Plot ............................ Lot ................................ Permit Granted .......j!4Y..11x.................19 86 Date of Inspection .....................................19 Date Completed ......................................19 00f4p 11,187 Application to ,y Lr� °'s� t Old King's Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, iri triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ❑ Addition ❑ Alteration Indicate type of building: ❑ House 21 Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR"PRINT LEGIBLY DATE ADDRESS OF PROPOSED WORK ASSESSORS MAP NO. D 6 S/7 w• d�1zv�sr�L� /lil oZ��� ' OWNER ASSESSORS LOT NO. HOME ADDRESS yT7x �tiO AC cSJr G(/ ��5� TEL. NO. �(0i2_3771 . �lrQ Quv6� FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). M Ly7;tZZ ,n/z-i a5M-0 C6v'0102 X'_y: Zl . Aio10 - 7 /17iQ �66� ,�F�?ryr�lzb �iA�'d�y /o zVdk�s� C✓�1i� Gl/ �I.P�.�i l.�/1liQ lL � c7�Of�/1/ �S7�f�.f�6y1�S o.(� ,$'S/ c�� b'r GV. A�•v-r>` � AGENT OR CONTRACTOR /4jIAIkz-A,, 4- 4�72 ,PVyAi TEL. NO. 3 —377/ ADD R ESS eX1L'o►/5,�Z,5_ol - DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8,other side), including materials to be used, if specifications do not accompany plans. In the case of signs,give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). -9­';'"l/W'�s� 1'-e is Signed - owner- ontractor-Agent Space below line for Committee use. f6 OKMH HI .DISf. BARNSTABLE The Certificate is hereby ate G �� Time , +L B y JUN 6 1086 Approved IMPORTANT: -.If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ max, OLh KING 'S HIGHWAY REGIONAL HISTORIC DISTRICT BARNSTABLE HISTORIC DISTRICT COMMITTEE 367 MAIN STREETt HYANNIS , MA 02601 FORM : "A—I " SPEC SHEET FOUNDATION TYPE : SIDING TYPE :- >z231 A 00 { CHIMNEY TYPE: �©/�/� COLOR: ROOF MATERIAL: Gf�/�2 COLOR: PITCH : WINDOWS: SIZE: TRIM COLOR: DOORS : COLOR: SHUTTERS: AZ pA/LE GUTTERS: /l/ 0A16 DECK : GARAGE DOORS : COLOR: TWO COPIES OF THIS FORM IS REQUIRED. FILL OUT COMPLETELY REGARDING MATERIALS, MEASUREMENTS AND COLORS . LANDSCAPE PLANS-PLAT PLANS-ELEVATION PLANS. 4 � r �0%j P moc Yr - Assessor's map and lot_;num�er ...... 7S:,Ar:.......... SEP�1 i t P..,f....i.:''E THE SYSTEM Mtlifi Sewage Permits tkmbe\ ;g/...........QrlTt....h ,? /o/y�BD INWALLEO IN CAM _ .._ - 1MTH TtTU 9 _ Z BABH9T ABLE , i House number ............:::J..°,1......._:................................. �NVI��f� filTAL Ct� RAs TO :'', ;'A d?!J+QiTIOiV O MPY i' T _'N OF BARNSTAB' F BUILDING INSPE" R APPLICATION FOR PERMIT TO ........., + N..�r,:.+ . i /5'!'11 L?.. .'r'�.wk` TYPE OF CONSTRUCTION .... . . O¢z?... }:r..........?`;}. . . ...................e.......................................... A' __ i. ... ..: .4. ...............................19.... TO THE INSPECTOR-OF BIAILgINGS: i., ----•_ _�_;Jw . .:� , The undersigned hereby applies for a permit according°t o•the "following.information: 1 Location .... �.4'r:: S° -... 9 .... �7./�,� .`JT. tGl/t ..... ..A �`�.1. ;/ ...( ..... ..tea................ 4'r.'.. Proposed Use_� l+i/ �i ,V�?....................... �: '�:.:.:.......Jy_. .._.: f"> , �' 1 � )....2............ .�....... Zonin •District ':?4.:.�:.:�.�. .. ................ Fire Dist[ict _g ;,..,- -v+.: ,:� . .......r............:.::-::,............................ . .............. T!K :.rSTI2!>1it/... ` + ��d.. ! tJool� Jlz'• Gv% i4iP/1�6Gdf ./ iQQ�lv23 Narr :,a�.0f✓vner" ; u f. ;,.;3:Zt;J?�C1efr�ess " .., :. .• .r:. . �• Nome.�q uiId TEr ` !¢ ^!!S"? :....Ac ress. ING � U7�: T... //1/QtI1/G1 / / OoZ, 7 Name d€' Architect .: .. .. ........:...... �..- a,... E�ddreSs: QX,. ....... 4U. r. ........ .j......... ................. Number of Rooms .....:�t/��`7✓..`'.,.......:` ,,',. ..5 .."Fo�Jnd tion J�au.2E ,`....................................................... {.., r; Exierior .................. J� t/ C .............................. Floors lit/lTjE....................................... `.`..,. • .�fnterior & G �'A�?p Gt/ .t$ i?!l.. ./�Lv! . Heating ......:..........Plumbing `./�UG� fq1P2VS Fireplace .....l.� U �� L./L� /.€�G�C C�...........Approximate Cost ..47FILI.............................................. .. ... .. ......... .... ......................... 7 J.o... Definitive Plan Approved by Planning Board ___________7 -__ • 19.;_t �.� Area / . .Q.i�.......... 77 Diagram of Lot and Building with Dimensions FeeC./v.l-..... SUBJECT, Tfr)-APPR•OVAJ ,QFBOA�D OF HEALTH 1 1 /W i�? I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name 1,4�....� ..... Zd,.,.e STRATTON, WINSTON L. One 1/2 Story a Permit for .................................... S.i X1.g.Le...Family..Dve'UiAg............. Location Lot 36A 572 Cedar Street ............................................................... West Barnstable ............................................................................... Owner ...Winston L. Stratton .............................................................. Type of Construction ...Frame ..................................... ................................................. .............................. Plot ............................ Lot ................................ Permit Granted December 3.......1980 CIA Date a Inspection .............. ......195-( .......... Date Completed ............ .......I PERMIT REFUSED GA ...... ............................................. 19 ....................................................................... en ................................................................ ................................................................ CID ..................................................................... Approved................................................. 19 ............................................................................... ............... .............................................................. 7 Assessor's map and lot number ..:.. ...r:...�... �..:..::........... �pF TH E TOO Sewage Permit number �.....:? . .. .............. Z 33MOSTAMLE, i House number ................. :''..^:::......................................... r NAB& O�,o,1639- 90 CFO MAX a\ TOWN OF BARNSTABLE i Q. . BUILDING INSPECTOR APPLICATION FOR PERMIT TO :! .:.. :..: ...::.,..... ...:i .:............................................... TYPE OF CONSTRUCTION ....... ..' .... .�.... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................................................. ........................................................ ::..:...:............................................... j I Proposed Use � � � � ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner » rs o Address � � Name of Builder ........:....� d .........................Address .................................. ......`. ......... ...... .................................................. Name of Architect ::: .... :..........................Address ...y:::. u Number of Rooms ............. ..:.................................................Foundation ... ' :.....,:....:........... :.......:..::............................... Exterior ..::'. ..... Roofing ..f....... ......... ......... ............................ ......... ......... ...................... ..................... Floors ° Interior .......':.................. . ,,..................................................... ............ .............................................. Heating ..........: .. Plumbing _ ...- ............................ .....:................................................................. ....:...........................:...................... 4. Fireplace ............Approximate Cost.......N.� ..: :.. . :... ....... .... ........: ............................................... Definitive Plan Approved by Planning Board ------------__----------------19_._____. Area '` Diagram of Lot and Building with Dimensions Fee „ SUBJECT TO APPROVAL OF BOARD OF HEALTH _ A I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name-::.::�����is�° � .y> STRATTON, WINSTON =109--47?9--47 .P!�e 1/2 Story No ... Permit for A......................... Sin le Famil......Y ?:�!�!Iing ................... Location Lot....3AA...5.7.2....Cedar...S t.r.e e.t ....... .. .... .. .... .. ...............West Barnstak� Z .......................... .. .................... Owner ...Winston L. Stratton ............................................................... Type of Construction Frame ........................................ ............... ................................................................ Plot ............................ Lot . ...................... December 3 80 Permit Granted ........ 19 Date of Inspection 19 Date Completed ........................7 ......................................19 PERMIT REFUSED ......... . .... .. .. ........... 19 -Y� euw ....................... ............................. /......... ................................................... . ........... ... . ....... ..... .............. ....................—.4.............. ..r...................................... Approved ................................................ 19 ....................... ....................................................... ............................................................................... oFt►+F ram, Town of Barnstable *Permit# p� Erpires 6 months froin issue date -Regulatory Services Fee su:rrsrnst.e, 9e M^39. Thomas F. Geiler, Director Tjo ib �� lE0 MA't A Building Division. Tom Perry, CBO, Building Commissioner a.11 200 Main Street, Hyannis, MA 02601 _ www.town.barnstable.ma.LIS ' U "201 Office: 508-862-4038 T.QO�pj, Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENT A O1V�LYNS!al_i~ Not Valid without Red X-Press Imprint Map/parcel Number Property Address , 72 00x4I 5ITee—T— k.1: &r1USF6L � residential Value of Work 8 2-0o, Minimum fee of$35.00 for work under$6000.00 Owner's Name & Address CI���► �-Ot� � ���� Contractor's Name QJ"n �Q ;�J Telephone Number 6Q8.7`246-6866 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 1. 101072- ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner FVhave Worker's Compensation Insurance Insurance Company Name &_rrj1' kkf Workman's Comp. Policy# Copy of Insurance Compliance.Certificate mus.t accompany each permit. Permit Request(check box) P"Re-roof( tripping old shingles) A onstruction debris will be taken to `'use ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of t e Home Improvement Contractors License& Construction Supervisors License is re fired: SIGNATURE: - Q:\WPFILES\FORMS\bui mg permit Forms XPRESS.doc t The Commonwealth of Massachusetts r i Department of Industrial Accidents r Office of Investigations 600 Washington Street i Boston, MA 02111 I �t www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information yt Please Print Legibly Name (Business/Organization/Individual): l,Ce ( DD Address: City/State/Zip: ��Y m�( -�, ,� . Phone #: JV6'—14&-6 glVo AVreyu an employer?Checke appropriate box: Type of project(required): lam a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hued the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their ]0.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#I 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: bona t ga— !T K Policy#or Self-ins. Lic..#: Expiration Date: Job Site Address: it 2 Clew- 5 City/State/Zip: 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 certij nder t p 'ns and penalties of perjury that the information provided above is true and correct. Signature: Date: Za �6 Phone#: (7 -7 6 6 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town:. Permit/License#. Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: 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 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, 625C(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 permit/license 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"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 burn 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 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 Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia �1ze Vonrinra�uoea��a�✓�aaaac�i/ueek2 Office of Consumer Affairs&Business Regulation _= HOME IMPROVEMENT CONTRACTOR Registration*."'- 164213 Expiration:�`•9/23/2011: Tr# 289048 Type: Private Corporation FALCONE ROOFING.CO INC. JOHN FALCONE 126 LONG PONU.RD. PLYMOUTH,MA 02360 Undersecretary llassachusetts- Departrnent of Puhlic Safety 9 Board of Building-, Rc�-ulations and Standards Construction Supervisr_•a S ecia?tJ License License: CS SL 101072 Restricted to: RF,WS JOHN FALCONE 4 . 6 LAUREN ROAD . PLYMOUTH, MA 02360 2Y� Expiration: 7/19/2012 ('nnmisirncr Tr-": 101072 a ,t ti i . g License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 No valid with ut signature r ` mLCONT- 126 Long Pond Rd Unit 7.Plymouth,MA.02360 Phone:(508)746-6866/Fax:(508)746-1411 www.falconeroofingco.com HIC#: 148025 FID#:26-3337202 CONTRACT 1. Parties.The parties to this Contract are Falcone Roofing Co.,Inc. 126 Long Pond Road,Unit 7,Plymouth,MA 02360("CONTRACTOR")and Winston Stratton("CUSTOMER"). 2. Location.The address where the work described herein shall be performed is:572 Cedar St W. Barnstabe, MA. 3. Description of Work.As described in detail on Proposal attached hereto. 4. Start and Completion Dates.The Contractor shall begin work 30days of receiving signed contract and expects such work to be substantially completed 30 days from start date.The Contractor shall not be held liable for delays not within the Contractor's control,such as delays caused by weather,government officials, unavailability of materials;acts of God,or other unforeseen circumstances above and beyond the Contractor's control.In such cases,the completion date shall be extended as reasonably necessary in order to permit the Contractor to complete the work described herein.No work shall begin until this Contract is signed and a copy delivered to the homeowner. ..5. Contract Price.The total cost for all labor and materials per attached Proposal, shall be$ 6. Payment Schedule.The payment schedule shall be as indicated on attached Proposal. Any deposit required to be paid in advance of the start of the work shall not exceed one-third of the total contract price,or the actual cost of any material or equipment of a special order or custom made nature which must be ordered in advance of the start of work to assure that the project will proceed on schedule.No final payment will be demanded until the contract is completed to the satisfaction of the parties.However,in the event the contractor deems himself to be insecure,i.e.,that the homeowner is not able to make payment for work performed or to be performed,the contractor may require,as a prerequisite to continuing said work,that the balance of the funds due under the contract,which are in possession of the homeowner,shall be placed in a joint escrow account requiring the signatures of both the contractor and homeowner for withdrawal. 7. Amendments/Change Orders.This Agreement shall only be amended by an agreement in writing and executed by the parties hereto.Any"change order"to the work specified to be performed hereunder shall be made in writing and executed by the parties hereto.Any additional cost as a result of such change order must be paid by customer before contractor performs any work as specified in the change order. S. Permits.It shall be the obligation of the Contractor to obtain all necessary permits.Homeowners who obtain their own permits are excluded from the guaranty fund provisions of M.G.L.c. 142A. The permits necessary to perform this Contract are:BuildingPermit ermit 9. Registration.All contractors and subcontractors in the Commonwealth of Massachusetts must be registered with the Board of Building Regulations and Standards.Any inquiries about a contractor or subcontractor I, relating to a registration must be directed to: i Registration Division,Program Coordinator One Ashburton Place,Room 1301 Boston,MA 02108 Tel.(617)727-3200 ext.25239 10. Right of Cancellation. If this Agreement is consummated at a place other than at the contractor's address herein,then the customer may cancel this transaction,without any penalty or obligation,within three business days from the above date. To cancel this transaction,mail or deliver a signed copy of this cancellation notice to Falcone Roofing Co.,Inc.126 Long Pond Road,Unit 7,Plymouth,MA 02360 not later than midnight on: (third business day after the signing of this Contract). I hereby cancel this transaction. Customer Date: 11. Warranty.Contractor guarantees all work for one year from completion of the contract. 12. Arbitration.The contractor and the homeowner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contract,the contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided in M.G.L. c. 142A.This only applies to disputes initiated by the contractor. FALCONE ROOFING CO.,INC.BY: John Falcone _.a� N-115P �_6 CUSTOMER (Note:If agreed upon,this provision must be signed separately) 13. Executed in Duplicate.This Agreement has been executed in duplicate and each party acknowledges receiving one original. NOTHING IN THIS CONTRACT SHALL BE INTERPRETED TO LIMIT THE HOMEONWER'S RIGHTS UNDER M.G.L.C. 142A AND/OR 780 CMR. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. J ClU S OMER ' Signed this day of Q�� / ,201L. FALCONE ROOFING CO.,-INC.BY: John Falcone i A LC 126 Long Pond Rd Unit 7 Plymouth MA.02360(508)746-6866/Fax:(508)746-1411 www.falconeroofingco.com CBS Publications Winston Stratton December 13,2010 572 Cedar Street W. Barnstable, MA. 02668 508-362-3771 win@cbspublications.com AUTHORIZED FACTORY TRAINED INSTALLERS. CERTIFIED GAF MASTER ELITE ROOFING CONTRACTOR. CERTIFIED INSTALLERS OF CARLISLE,GENFLEX AND FIRESTONE RUBBER,TPO&PVC SYSTEMS. 31899 Cedar Roo In regards to the above referenced project Falcone Roofing proposes to remove and replace existing roof for the sum listed below: :: 1). Front only with 18"-#1 3/8 3) Front and rear with Red butt Red Cedar-$5,400.00 Cedar-$14,400.00 2) Front with Cedar/rear.with 4) Rear only with Red cedar- .:30yr:IKQ Cambridge Arch $9,000.00 • Remove existing roofing down to deck and dispose of debris in dumpster provided by Falcone Roofing,house and grounds shall be protected by tarps during demolition.Clean grounds of loose nail by using magnetic rake. • Re-nail all loose roof decking. • Provide and install GAF ICE AND WATER SHIELD to all eves,valleys,rakes, step flashing and skylights. • Provide and Install GAF Deck Armor under lament on entire roof deck. • Provide and Install drip edge on all eaves. • Provide and install cedar-breather on entire roof deck I • Provide and install CEDAR 18"PERFECTION Certi Sawn SHAKES 3/8" butt, 5" to the weather on entire roof deck,fastened.using 1 14"stainless steel ring nails. . • Provide:and Install GAF Ridge vent at entire ridge. . . • •Provide and.install Ix5 red cedar ridge boards at entire ridge capped with 4"copper cap 0 Provide and Install new red cedar shingles on all hips. • Provide a 10 yr workmanship warranty. * Upon acceptance of this proposal payment shall be as follows: $500.00 deposit mailed with signed contract, 113 at start, with balance due upon completion. ACCEPTANCE OF PROPOSAL (Signature) Print name Contractor John Falcone FALCONE ROOFING CO.,INC.IS FULLY INSURED WITH LIABILITY AND WORKERS COMP INSURANCE. Thank You Falcone Roofing Company Inc. Proposal will be honored for 30 days Jan-12-I1 11ATam From- S 1Y�d 47 T-126 P.001/002 F-339 F ERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE FICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED E POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN SUING 1NSURER 8 AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate holder is an ADDITIONAL INSURED,the policy(iss)must be endorsed. If SUBROGATION Aotatomont this certificate does not confer rights to the certificate holder in lieu of such endorsement PRODUCER Court Street Insurance Agcy Inc 120 Court St Plymouth MA 02300 COMPANIES AFFORDING INSURANCE INSURED COMPA14YA GRANITE STATE INSURANCE COMPANY Falcone Raoting Co Inc 120 Lang Pond Rd#7 Plymouth,MA 0230MODO THIS IS TO CERrIFYTHAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING ANY FW-GUIREMENT.TERM oRCGNDrTION OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED THE POLICIES DESCRIBED HERON 18 SUBJECT TO ALLTHE TERMS,MCCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED Or PAID CLAIMS. W L1R WIFEGFINwomee PCRIOfNO►OlElt POLIOVIFFIaMPATL POIICYQWWRLTIONDATE /{ RI�RSCOMPENSATION D EMPLOYERS'LYwILITY LIMITS E PROPRIETORr ARTNERMECUTIVE FFICEHSARE I FICL 0 ENCL 0 L 126I S23 1 7/12/2010 711219011 TATVMRY LwnS ER ' oters�ApPllwloMA OP�o+�vNy. ACS ACCIDENT S 'lOO.OD MEASE POLIO UM(T S 500.09 i—EABE-EACK EMPLOYEE S SOD 0 DE8CRIPTICN OF OPEfiA't'IONaNEHICLE'S18PECtAL ilIEM6 CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE OESCRIBEDPOLIC[EBBE CANCELLED BEFORE THE p MQf EW(RATIONOATSTHEREOF.NOnCEW&LeEDELnERWINA000RDANCE Z4Q MAIN ST WWETHEPOLICYPROVISIONS. HTANNla,mAvAvOi pvI nvrOaeu nt!PRl.3tNlA'1`Nt'_ epv '4 RD CERTIFICATE OF LIABILITY INSURANCE °^TE(M�° PRODUCER (508) 7q�-75TO Ol/10/2011 Court Street Insurance Agency Inc OF ON YCAND ICONFERSISNO RIGH S UPONR HE IER'TI�FICAOTE 120 Court Street HOLDER. HIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER HE COVERAGE AFFORDED BY THE POLICIES BELOW. Pl outh MA 02360- INSURED INSURERS AFFORDING COVERAGE NAIC 0 Falcone Roofing Co. mac, INSURF1tA:PENN AMERICA INSURANCE CO 126 bong Pond Rd Unit . INsuRER e: INSURER C: Pl outh MA 02360- INSURER D: COVERAGES INSURER E: EE E 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 S. TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM FNSR WERE LTR INSRD TYPE OF INSURANCE POLICYEFFECTTVE POLICY E(PIRATION A POLICY NUMBER MIp OATEMID GENERAL LIABILITYLIABILITYDATE(M (M D LIMITS X COMMERCIAL GENERAL LIABILITY / / EACH OCCURRENCE g 1,000,000 �EDEXES F�a�nee 5 :]CLAIMS MADE �X OCCUR 8AC6865826 03/24/2010 03/24/20I7 MED EXP(An 50,000 one Person) 8 51000 PERSONALBADV INJURY o 1,000,000 GEWL AGGREGATE LIMIT APPLIES PER: / / / / GENERALAGGREGATE 5 2,000,000 POLICY PRO- JECT IOC PRODUCTS-COMPIOPAGG g 1,000,000 AUTOMOBtLELIABILITY / / /• ANYAUTO / COMBINED SINGLE LIMIT ALL OWNED AUTOS Me accident) $/ / / / SCHEDULED AUTOS BODILY INJURY HIRED AUTOS (Per Person) s / / / / NON-OWNED AUTOS BODILY INJURY (Per accident) s PROPERTY DAMAGE �ATIAGE IJABILITY (Per accidem) g ANY AUTO / / / / AUTO ONLY-EA ACCIDENT g OTHER THAN EA ACC g EXCFSSIUMBRELLALIABILITIY AUTO ONLY:/ / AGG 8 OCCUR CLAIMS MADE / / EACH OCCURRENCE $ AGGREGATE g DEDUCTIBLE RETENTION 5 g WOILKficate to follow g EMPLOYERS LIABILITY ERS COMPENSATION AND Certi / Ok ANY PROPRIETORIPARTNERAD(ECUTIVE OFFICERIMEMBEREXCLUOED7 Fa EACHACCIDENT g It SPEC AL PRO under / / / / EL.DISEASE-EA EMPLOYEE s SPECIAL PROVISIONS below - i OTHER E.L.DISEASE-POLICY LIMIT s DESCRIPTION OFOPERATTONS(U=,(ONSIVEHICLESIEXCLUSIONSADDED BY ENDORSEMENTlSPEC(ALPROVISION9 CERTIFICATE HOLDER _ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR To MAIL TOWN OF HARNSTAWZ 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT 200 MIN STREET FAILURE TO SO SHALL IMPOSE NO OBL R LIABILITY OF ANY RIND UPON THE INSURE6 TS AGENTS OR RE PRESET tSRQED HYANNIS lei 02601 REPRE4ENTA ACORD 25(2001108) q,,rINS025(a1oBy.D5 ®ACORD-CORP TiON1988 ELECTRONIC LASM OR INC--(S00)3 .GU5 Page 1 of 2 Regulatory Serviccs Fee 9�e" Thomas.F Geiler,DL'eztor, �Prfo►�.{'" Building Division Peter F.Di5iatteo, Building Commissioner 367.Main Stites, Hyamms,MA 02601w Office: 508-862-.L'338 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - �SIDENTTAL ONLY Nor Valid widoutAaX-FF=Imprurt .Map:parcel Number Property Address — Value of Wark rl Residential 0 wn,er's:v'ame --kddress n' Contract or Tame � � Telephone Number r51f�3�''�3�G Home improvement Contractor License#(if applicable) f a Construction Supervisor's License=(if applicable) r ❑Work=n's Compensation Insurance Check one: Q I aai a sole propnewr ❑ I am the Homeo,%= 9-1 have Worker's.Co=ensation Insurance Insuce Company l t� ran Worlanaa's Comp.Police';4 CPU r-� 571-1 "2 Permit Request(check box) .[Z�Re-roof(stripping old shingles) X-PRESS PER , Q Re•roof(not stripping. Going over existing layt:'s of roof) MAR .1 2 2002 Q Re-side TOWN OF BARNSTA E ❑ Replacement Windows. U Value (m=j==•44) ❑ Other(specifti) .Wh=required: issuaace of this pamit does not e=Mt compliance wnh other town drat t regulations-i.e.Historic.Conser+ation.e:c. 47 Sitntature Q:Fom %ornns—av,41i0601