Loading...
HomeMy WebLinkAbout1094 MAIN ST./RTE 6A(W.BARN.) /a 9- y �11� /7p i ' 1 NO. 52 i3 ORA a �V14E Town of Barnstable _-�., �_ _ �. . _ �_ ___��.___ _ _ Building Post This Card So That it is Visible From the Street Approved Plans Must be Retained on Job and this Card Must be Kept y j BAR,\STABLE. . A`�$ Posted Until Final Inspection Has Been Made. f Permit �t :Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-20-1709 Applicant Name: shelley thompson Approvals Date Issued: 07/21/2020 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 01/21/2021 Foundation: Location: 1094 MAIN ST./RTE 6A(W.BARN.),WEST Map/Lot: 178-012 Zoning District: WBVBD Sheathing: Owner on Record: THOMPSON,SHELLEY M Contractor Name:' Framing: 1 Address: 1094 ROUTE 6A Contractor License: ` 2 West Barnstable, MA 02668 Est. Project Cost: $ 10,000.00 Chimney: Description: Renovate solarium with enclosed porch. Permit Fee: $ 101.00 � - Insulation: Fee Paid:; S 101.00 Project Review Req: l Date: 7/21/2020 Final: Plumbing/Gas 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. i Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: /` Service: 1.Foundation or Footing 2.Sheathing Inspection ; F Rough: 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 Final: 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. Work shall not proceed until the Inspector has approved the various stages of construction. Health lipso7fstt acting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: <• Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Z • s�`� oFt�ra,, Town of Barnstable rr t 7 OExpires 6 month ro is ate. Regulatory Services Fee • anxxsrABLE, v� 1639. `�$ Thomas F. Geiler,Director ArED MP'I A Building Division .Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.to wn.b ams tab 1 e.m a.u s Office: 508-862-4038 Fax: 508-790-6230 r EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint l Map/parcel Number 7(�' 0 ( c)— Property Address ` esidential Value of Work 'O —�•---)O Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 'I L f lzi Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) X-PRESS PERMIT ❑Workman,'s Compensation Insurance OCT 2 3 2009 Check one: ❑ I am a sole proprietor 'TOWN OF BARNSTABLE I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# , Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) -roof(stripping old shingles) All construction debris will be taken to ❑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 veer in Property Owner Letter of Permission: mprovement Contractors License&Construction Supervisors License is r SIGNATURE: Q:\WPFILES\FORMS\building permit forms RESS.doc Revised 090809 r y . 1 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations '_ 600 Washington Street t '1 Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): A O Address:� Coe City/State/Zip: �✓. Phone #: - —3(0R.—/ P Are you an employer? Check the appropr ate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I empoyees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction l 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. employees and have workers' Y P h'• 9. ❑ Building addition [No workers' comp. insurance comp. insurance.l required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.Rq-I am a homeowner doing all work officers have exercised their I LE]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. tContractors 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 any employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to 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 certi and ain nalties ofperjury that Ihe'information provided above is trice and correct. Signature: Date: Phone#: 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#: i 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,constriction 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 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-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 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 Fax # 617-127-7749 Revised 4-24-07 www.tnass.gov/dia i Town of Barnstable o Regulatory Services • tinxrtsnAat.e. ; Thomas F. Geller,Director Muss. 1639. Building Division PTEo Tom Perry,Building Commissioner 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: 10B LOCATION: /1 7 zeAc (�n 4:: d jjf,�I_t num er street village "HOMEOWNER": L �" C aD_F_-2!�Z O 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 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"homeowner"assumes responsibility for compliance with the State Building Code and other i applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum ins ection procedures and requirements and that he/she will comply with said procedures and requ' Signatur f omeo er 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, 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 hdshe 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:\WPFILF-S\FORMS\bomeexempLDOC r SHE Tp� Town of Barnstable yT Regulatory Services a^xr'AE& Thomas F. Geiler,Director 039.�fo 39i 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 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner Date Print Name If Propedy Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMISSION r Town of Barnstable *Permit# �67 Expires 6 monlhs from issue dale Regulatory Services Fee + BARNSPABLE, , v Mom' Thomas F. Geiler, Director • fD MA'S A (� PR 3 p 2�0, Building Division 0rl 09109 Tom Perry,CBO, Building Commissioner �F BA 200 Main Street, Hyannis, MA 02601 I_ `®�� www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address esidential Value of Work. /MQ) , J—=3 Minimum fee of$25.00 for work under$6000.00 Owner's Name& Address orv. bra/n s A 1 T &7A oa Co v Contractor's Name Telephone Number I Ionic Improvement Contractor License# (if applicable) Construction Supervisor's License# (if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance insurance Company Name Workman's Comp. Policy # Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) Re-side eplacement Window, doors s 'ders. U-Value (maximum .44) *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 cop he Home Im rovement Contractors License is required. SIGNATURE: i t:`\A ITILI:S\I AMS\huilding pe mit lorms\EXPRESS.doc Revised 100608 ,.� 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: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizationflndividual): Address Cs City/State/Zip: .S 7 �e. Phone.#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with . ' 4. 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. .[*Remodeling ship and have no employees These sub-contractors have 8. '❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• $ 9. ❑Building addition [No workers,comp.insurance comp.insurance. 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 subrmt a new affidavit indicating such :Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have amployees,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: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to 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 c fy u e penalties of perjury that the information provided above is true and correct Si e: Date: _ Phone Official use only. Do not write in this area,to be completed by city or town offtclaL 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#: r 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 toregomg-engaged m alom en rpns—` eEn =inlu-d-mg the leg` represen rtive3-ufwdetzased.tW!i .eL,-uL-the receiver or tfwtee 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 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-contiactor(s)name(s),address(es)andphone 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 cant'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. j 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 permittlicense 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 appicant 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 maybe 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 venture (i.e.a dog license of 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington street Boston,MA 02111 W. #617-727-4900 ext-406 or 1-877-MASSAFE Revised 11-22-06 Fax# 617-727-7749 www.mass.gov/dia THE Town of Barnstable 41 Regulatory Services switu�tsrwsrE. Thomas F.Geiler,Director s¢. .0� Building Division jFD NtA�fi Tom Perry,Building Commissioner . .200-Maiii street;Hyannis;MA-'026,D1 _........ ... . .. _.._. .. .. --._...... . www.town.barnst-able-ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 3 t O //J // 1 JOB LOCATION: / ,` —J ��' va�--�o number / street "HOMEOWNER': / name home phone# work phone# CURRENT MATTING ADDRESS: cityhown 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. DEFWMON 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 subunit 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 unde 'geed."homeowner"c rns ertifies that.he/she umderstwds the Tpwn of Batable.Building Department minim ection procedures and requirements and that he/she will comply with said procedures and r e Signa ' omeowner 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 pernrit is requb-cd 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 ad 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 hirrs 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=sponsrble. To ensure that the bomeowner is fully aware of his/her respannWities,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 can t amend and adopt sucb a form/certificatian.for use in your community. Q:forms:homccxempt To�,ti Town of Barnstable Regulatory Services 9 MAB& Thomas F.Geiler,Director 16 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 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMISSION 05/04/2007 12:06 18662530538 STEVE BARNATT PAGE 03/04 kflr 7.77.1"'HV1H 1a:ob •)LIVJ 'il'9L: �... . DP 1D SL DATE IMl"rd"'M ACORD. CERTIFICATE OF LIABILITY INSURANCE � _1 01 a., O9 Pnoou�FR —. pas CERTIK1CA7616 I mo,m A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THF-CERTIFiCAT7: R lanaRx I>nisWrat>zcla 8as s�b�V HOLDER.THIS CERTIFICATE DOES NOT AMENO,EXTEND OR Rop snaky gton S tea v ALTER THE COVERAGE AFFORDED BY THE POLICIES DELOW. Waithavan M 02719 NAIC4 pbone. 508-•994-1616 8aa:509.93�6--1919 INSVRERSAF'FORDINGCOVE'R11GE ,mbal" Protectsat+ ins 1 1?fl00 PMURED - INSURPR 0; We ARP 1N WER C: 18to 3Ce�atOeraien, Inc.St ,NsuaERD so. Aomni.9 M 02660 INSUREflr. COVERA(s1E(,Er 3 THE PO j09t.9 OF ONSUNINCE LISTED BUOW HA11L'BF EN 19r;kfED TDTHE niSugEO NOIIAEb nBovE FOR THE I'O 'NIOV PERIOD WDIfr-MAY RCT SUED OMrprtar, ANY MUMEMENT.T[RM 0R CONl7yMN OF ANY COe✓'►R'M�T OR OTIreR OOULAQNT WLTH R@DPECT To'A"CN THIS Ct!RTIFlCATr_MAY BL 19SUEO OR MAY I'MrP.W.THE IWOURANCE AFFORDED OY THE EAtIC,11,F CIESCNMED""Lim IS SUBJMT TO ALL THE TGRW.CXCLUSIONv AtuO CONDITIONS DF SUCn POLICItS.AOAReGATG L)WM SHOViM IIAv MAvE BrFN ROW=BY PAIOCeANS, LTR TV",OPINSURA1 e0tlCTNU14 R OATr t-t-mYr VATL}INwt1flT uLIfTS .- ecroGRALUAml.rry GACNOCCLNIRFNCE s1.000,000� A X COMW..RCIALClNF,RALVABILlry 11500038749 12/21/09 12l21/09 woo mmooro s50,000 NIEO!xv lnrgarM P"wIU GLAWS MhDr. OCCUR ... AFR60NAL S AOV MI.RRtT S2,000,000 �— — - GEWMALAGGREGATt S2 000,000 �--- I-rMUCTS.COW10P Ac0 E 9=UDED I T,LEMI.AGGRERAW..LIMIT APPI.IPS PER "- �Poutr jE a LOC AUTOMOBIL F LIAW1. Y I COMNED SMOLE LIMIT lEe necylrMq 3 ANT AUTO r AU OWNED AUTOS 0001I.V INJURY (Pet pM gM SCNEDVIF.DAUTOS -" HORED AUTOS BODILY 1"„Am' i NONAIWO.O AUTOS •---� !' IP�(c0 FFVYU AMAGe e RARAOE IJnB1LrtY r AUTO ora,T•M ACCIDENT to ANY AUTO OTHER THAN nCC E AUTp004r AGG S 1 LDCCS';'SAVAMl'I.LA LIn MAY I PnCM OCCURRLtdCE S OCCUR CLAIM i 1AAOE I AQ(;R6HRTTi 4- C I OEOUCTI9LE 5 wor4cm CONMSATION AND II X TORV L 1. B E7Relq'YF.R9'UA lLm 1 V! 6410161001 12/29/08 L2/28/09 tL.EACHACCIOW a100 000 ANY PROP11fE70}UPARTNERrE><ECUTNE E.L.or.EASE-EAe^CIM 9 100 r 000 oar•ICERmI�eea Excl.wem uyy��pp d!Mnleeolu!><T 171.DIC,EASE•POMYLIAM $500 000 SPEGIAI.PRQVISIDNS Oeleur ---_ pTML'R DE3CR1rTTON OR OPERA710fe9/LOCATIONS f VEMtCL�r SxCier9e0>+s gppEo ENO .rEIMENT I SPECai PRovf<aONs �..CERTffIGA1E HOLDER CANCELLATION s►IDe11,D aNY o6 THE A8011fi DESCRIBED POLJdkS[LE CANC[lLIaO BEFORE THE E7IPIRATIO OATbTII +Eot.THE+ssUlNseNSURERNeI.IPIIBBAVORTOMAIL 2O VA"WRITTEm NOTICE TO THIRiCERT=ATC HOLOER"AMM DTD TNP LP.FT.BUT PArLU$IE TO COSO SHOW WPM NO OM16AR10N OR UAOWY OF Aw 9wo UPON TXP.QISURER.ITS AGENT(,OIL Wift ,� . --. rLQPRr+sErlTnTnfEs. A ATRR Town of Barnstable Regulatory Services - aAsxAM e. Thomas F.Geiler,Director 1 rA Building Division Co SY Elbert Ulshoeffer,Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508=862-4038 Fax: 508-790-6230 SHED REGISTRATION 120 square feet or less Location of shed(address) Village Property owner's name Telephone number S ` y- Ga' f)lw LT� Size of Shed Map arcel,# Signature.,. Date l Hyannis Main Street Waterfront Historic District? / Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) 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 PLOP PLAN a• Q-forms-shedreg Application to pp 2 O 01 t-:8�2' ' ®rb Ring'sS 3bigbWap Regional 30i.5toric -MIigtrict Committee. �t In the Town of Barnstable ;BHi�l �t',SLE. 1,1%�� . CERTIFICATE OF APPROPRIATENIF-96Vf 0 Ail 33 Application is hereby made, with four complete sets, 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 ❑ Addition ❑ Alteration Indicate type of building: ❑ House ❑ Garage- ❑ Commercial 11F Other X&LOQ 2. Exterior Painting: . ❑ 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign . ❑ Repainting Existing Sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other TYPE OR PRINT LEGIBLY: DATE_iSS;;14)/ ADDRESS OF PROPOSED WORK /0y`1 �C 6, lid _ L-✓LSi�6's .r'/. ASSESSOR'S MAP NO. /7,l OWNER cS'yiSEit/ w dUEcG f�F.2rn£�e.fiyz�cJ ASSESSOR'S LOT NO. O/'o2 HOME ADDRESS TELEPHONE NO. 3Go?-//7F' FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) AGENT OR CONTRACTOR e X0� TELEPHONE NO. 77/-57 Od 7 ADDRESS DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. Y I X /o� �i4,el7F.ilI S�lEO Signed ��(�nm ]� Owner-Contractor-Agent A 1`.'JIJI"< For Committee Use Only U liuV`L& This Certificate is hereby. Date D Approved/ enied AUG 15 2001 Co *ttee Members' Siiggnna- T WN OF BARNSTABL LD KING'S HIGHWAY ' 20p1. , V82 Town of Barnstable •' Old King's Highway Historic District Committee SPEC SHEET FOUNDATION SIDING TYPE �/�!Q COLOR CHIMNEY TYPE COLOR ROOF MATERIAL COLOR PITCH WINDOWS COLOR SIZE TRIM COLOR DOORS COLORS SHUTTERS COLORS GUTTERS COLORS DECKS MATERIALS i GARAGE DOORS COLORS SKYLIGHTS SIZE COLORS COLORS SIGNS 1 D uG 2�01 A . � Pi ,�� N pF NSTABLE BAR Y i� ;.►� :�r Jr� TOW HIGH FENCE F - COLOR S H NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SPECSHT Revised 11/98 - /i I4 Alp L PINE ARBOR OOD � RODUCTS ' %' 4� Quality Outdoor Wood Products 11 optional'cupola iS fir Z Y { F_ Salt Box Design MAY UAW 8'x10' $ 1210 8'x 12' $1380 10'x10' $1550 10'x 12' $1620 10'x 16' $2340 ' x t 12'x 14' $2420 i plus tax Even Pitch Design I Built on your property. 6'x 8' $ 960 Storage Sheds 8'x 8' $ 1040 e " Have Many Uses... 8'x 10' $1280 8'x 12' $1480 • Riding Mowers 10'x 10' $ 1650 •Workshop 10'x 12' $1720 10'x 14' $2140 •Garden Tools 10'x 16' $2440 • Garden Tractors 12'x 12' $2200 12'x 14' $2620 0 , 1 • Outdoor Furniture 12'x 16' $2980R8 • Motorcycles plus tax 4 011P •Pool Supplies Built on your property. �-a r:3 % � 259 Queen Anne RoaiDDD ��, 3� a (tW 11 ) i Harwich, MA 02645 OOD PROD�}G M)V- & i , MA 2 1 508-430-2800 - -�00 Fax: 508-430-1115 1-800-368-SHED (7433) TO\NN o �07 The Outdoor Storage Specialist pLD yjt4us Hl Licensed • Registered • Insured www.pineharbor.com 2 00 Nt4.q r ,u y�Ca4 � ! rS �,.� •'t"t',Ot ��\R,e�4L _ r 4'�• y� . i 5 `�; t t*s'r�^ t'�p rl >�y 7 1 " � '�t,��•c�-fit r a , J ��:���r r'4ir,.n {d�•u ,.5- rqt ��.Y^' �'I t y'�" ?» +S"+'r' � 7 '. CO A h T Cj•R!TI FY 7 o97' 7-f-11 I C PRXP,,9k?ED W CONF"O r I 0 R9r&%ULA r1o"Is OF THI l I p DEEDS OF TR-Ja Comm l I lU MfiS.SF)CHUSETT-S � I' P �RT� • R��c NJ ! r t 1 � z • �,a. r. $ . y. TOWN OF BARNSTABLE ! , �� OLD KIN G'S HIGHWAY W S U8D1 V/ 5. ) 0Al f�� —,IVO �.oN4CfZ or IN crrsT L A DDDOVED O F L ANb � Q �l! W E.S T lq 0 J �. swJ��� To BE CONVEYED 7"o 0 0 - •��� � 3 � ! LAND. SHok/N /N PLA I , r l,•�y3"98 '©5"� ZONE R- F 0 10A0JO40X0 1 V /sy s1-a to d6p - O 3 7-/q TE I G A �PUBLIC� The Town of Barnstable �/' dp tME rb,,_ Permit# �o l r 34 Massachusetts •_ Date /0 3 b-7 e�ea KAM • SOLID FUEL STOVE PERMIT - s� .� �o2�wr1 o ze Fee This constitutes an official stove permit after inspection and approval by the building inspector. ✓ Owner �/ / °�'I .S Q n elephone no. — Address of Property O � ,� Village ��— cation and Stove Type / /Zv Date: Oliolf7 Building Inspector The solid fuel burning stove at the above location passed: failed: inspection. The Town of Barnstable �/ lJ4o B Massachusetts Permit# . ereStB. : Date 6 ,3 9 KAM SOLID FUEL STOVE PERMIT � Fee 41-75—a--Y This constitutes an official stove permit after inspection and approval by the building inspector. �IZLe�Z ✓ 'Owner /�Y/ :g-110S -1 eT lephone no. Address of Prope Village ocation and Stove T . �% /�� Usr! Type Date: o io f 7 Building Inspector The solid fuel burning stove at the above location passed: failed: inspection. `4 [ ] [R178 012 . ] LOC] 1094 ROUTE 6-A CTY] 05 TDS] 500 WB KEY] 104675 i ----MAILING ADDRESS------- PCA] 1091 PCS] 00 YR] 00 PARENT] 0 SCHERMERHORN, NELL S MAP] AREA188AB JV] MTG12010 C/O CONNORS SP1] SP21 SP31 1094 RTE- 6A UT11 UT21 2 . 01 SQ FT] 1060 W BARNSTABLE MA 02668 AYB] 1855 EYB] 1975 OBS] CONST] 0000 LAND 48100 IMP 89100 OTHER 200 ----LEGAL DESCRIPTION---- TRUE MKT 137400 REA CLASSIFIED #LAND 1 48, 100 ASD LND 48100 ASD IMP 89100 ASD OTH 200 #BLDG(S) -CARD-1 1 52, 500 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 100 TAX EXEMPT #BLDG (S) -CARD-2 1 36, 600 RESIDENT' L 137400 137400 137400 #OTHER FEATURE 1 100 OPEN SPACE #PL 1094 OFF RTE 6A W BARN COMMERCIAL #RR 1387 0094 INDUSTRIAL EXEMPTIONS SALE100/00 PRICE] ORB13037/186 AFD] LAST ACTIVITY] 12/07/90 PCR] Y R178 012 . A P P R A I S A L D A T A KEY 104675 SCHERMERHORN, NELL S LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=VBB 48, 100 200 89, 100 2 A-COST 137, 400 B-MKT 126, 500 BY 00/ BY /00 C-INCOME PCA=1091 PCS=00 SIZE= 1060 JUST-VAL 137, 400 LEV=500 CONST-C 0 ----COMPARISON TO CONTROL AREA 88AB -- --MAY NOT BE COMPARABLE-- NEIGHBORHOOD 88AB WEST BARNSTABLE PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 481001 LAND-MEAN +0 1374001 97303 IMPROVED-MEAN -80-. 250-. ] FRONT-FT 11 100 DEPTH/ACRES TABLE 02 1000-01 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP]ADJS/SB/FEAT STR] STRUCTURE ARR] AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] i R178 012 . P E R M I T [PMT] ACTION [R] CARD [000] KEY 104675 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT The Town of Barnstable Q1p ME Permit# 2-C l 34 Massachusetts p Date BARMABL& Q 3 KAS& SOLID FUEL STOVE PERMIT019. n MIS A`� Fee This constitutes an official stove permit after inspection and approval by the building inspector. f Owner !i' � °t�'1 -1 eT le hone no. — • r! P Address of Property V �7 �P�7 Village ocation and Stove Type I Date: Building Inspector The solid fuel burning stove at the above location passed: failed: inspection.